Wounded Healer

New Mexico Pretty

2010-09-24T11:23:00.000-07:00

I wish I had one of those features like the voice over on the TV show Glee so that I could quickly recap from the last posting to the current one. I am busy or lazy or both and find it hard to keep this up to date. It's a good sign that my life is now full of fun, activities, and yes, work, that I don't often stop to record my day, my week or even my month.

So imagine, a real quick summary goes like this...my Mom came to visit for a recheck at Duke; her vision is now 20/63 in the "blind eye." She had another Avastin injection. Follow up again in 1 month. My sister blew out her back-really, her disc ruptured, and she had surgery this week. Nurse Dad was there for a week, followed by Nurse Mom, who is there now. Handy when your parents can go from patient to medical care provider so adeptly. Work has been busy-crazy busy. I saw more than 100% of my expected patient load for July, August and September. That's a lot of charts, exams, notes, and labs to handle.
And, we took a week of vacation to New Mexico over Labor Day.

We met Holly's parents in Taos at a house her Mom had rented for the week (Pepe's Place). It was just north of town with a spectacular view of Wheeler Peak, the highest spot in NM at 13,161 ft. A beautiful mountain range stretched out behind the house with gorgeous views of pink and purple light as the sun went down each night. The light in NM really is spectacular- as wonderful as everyone says it is. I can see why Georgia O'Keefe fell in love with it. The light changes everyday, and the views of the sky and mountains are stunning. Taos is a terrific town and reminds me a lot of Asheville and Arcata. The downtown is small and walkable, with plenty of art galleries, boutique shops, and eateries. Wisely, they have relegated the chain stores to the highway on the southern edge of town. The mix of tourists, gringos, native americans, and hispanics makes for a pretty interesting culture too. We met two women who were hiking Williams Lake the same day we were, who said that they enjoy splitting their time between Ft Myers, Florida in the winter and Taos in the summer. I can see why. Summer is sunny and warm with cool nights. Winter, apparently is long but also sunny; they'll have snow by the end of this month at some of the higher elevations. Thus the abundance of Subarus everywhere.

Here's a partial list of things we did:

a trip to Santa Fe to see the Abstract exhibit at the Georgia O'Keefe museum

a hike to Williams Lake with another hour of hiking up the bushwack trail towards Wheeler peak

a hike up Gold Hill Mtn (12711 ft); it was 38 F when we started that hike

running through our Upper Colonias neighborhood each morning with the mountain vistas filling our eyeballs

Holly and her Dad went horseback riding with a real, live, honest to goodness cowboy in Arroyo Seco

I ate honest to goodness pinon caramel ice cream in Arroyo Seco (easier on the body in so many ways)

toured the downtown Plaza, where the historic center of town is now the de facto tourist crawl

ate lunch at a picnic area overlooking the Rio Grande

So that you can see what I mean about the light, I've included some photos from the trip.

Sadness Revisited

2010-08-18T14:39:00.000-07:00

The last two days I have encountered worrisome laboratory findings waiting for me when I logged onto my computer in the morning. Yesterday, there were abnormalities in the bloodwork of one of my prenatal patients. After discussing her case with the OB specialist affiliated with our clinic, I had to send her straight to the hospital for a potential induction of labor even though her baby is only 33 weeks along. One of the sweetest parts of providing prenatal care is how one patient gets wheeled into the labor room but two, hopefully healthy, individuals emerge. However, one of the scariest parts is that both individuals are in danger when crises occur with the pregnancy or delivery. Hopefully, this time all will turn out well for both mom & baby.

Today, I pulled up the labs from my patients yesterday on my way into our weekly staff meeting. At the top, was the blood panel I'd ordered on a 7 yr old boy with a nosebleed. Mom mentioned that he seemed to bruise easily, more easily than his older brothers, so I'd ordered the blood counts to reassure both of us. Unfortunately, this little boy's labs were severely abnormal with low values of infection fighting cells, red blood cells and platelets (they help the blood to clot). As a first year intern, right out of medical school, I'd seen numerous cases of abnormal blood counts like these in children before they were diagnosed with leukemia. We seemed to have at least one case of new leukemia each week, as doctors from rural and far away areas sent their sick patients to be evaluated and treated by the Pediatricians specializing in childhood blood cancers. I felt a sinking feeling in my stomach as I realized all that this patient and his mother had ahead of them. Though I had only seen the boy once, the previous day, I had to call his mom and deliver the bad news. And I had to send them immediately to UNC to be evaluated by the pediatric specialists in hematology/oncology. I tried to remain calm and reassuring on the phone even though I felt a dumptruck load of sadness raining down on me. By the time our staff meeting started, tears were rolling down my face. My colleagues were comforting, of course, but I couldn't hold back the tears. I suddenly felt so overwhelmed with pain and darkness for them, for their impending suffering. Childhood blood cancers are (now) 95% cured. But that road, well known to me from my own leukemia 2 yrs ago, is a tough one. Needless to say, I was never able to recover fully from the difficult start to my day-alternating between feeling so, so sad for them and reliving how hard all of that was for me.

Even now, hours later, I am still resonating in the sadness of what is to come for them. Though I feel especially lucky to have survived my own "major death scare," I feel uncertain and vulnerable. That is the hardest part of "sitting with it" . Tomorrow will be a bit better I do feel certain of that.

Flustrated

2010-08-12T07:49:00.000-07:00

I try to let my patients tell me how they are feeling or describe whatever symptoms brought them to see me. Every once in a while, I hear a really good word that isn't, in fact, a word. When I was working in the rural countryside outside of Asheville, my patients often told me that they were "flustrated" by this or that. As I write it now, my computer's spellcheck is underlining it in red to let me know that it's not a real word. Well, let me say that it may not BE a real word but it IS a real feeling. I suspect the word originated when someone combined the words "frustrated" and "flustered," probably in some agitated state of mind.

Yesterday, my patients flustrated me (there goes that red underlining again). I had the middle aged, heavy woman who argued with me when I said I wouldn't write her out on disability from her Walmart greeter job. There was the young diabetic man with foot pain and whopping high sugar levels who doesn't take his insulin (which would lessen the nerve damage and subsequent foot discomfort). There was the 5 yr old just discharged from the Psych hospital, who screamed at his momma the whole time he was in the clinic. Regardless of what you personally believe about the value of psychiatry, some people really do need the help & expertise they provide. Suffice to say, he is one of them. Then there was the new patient who needed forms completed to renew her driver's license. After many roundabout questions, I finally learned that she needed to have an eye specialist evaluation and a psychiatry follow up for her schizophrenia. Whew! Am I helping these people at all? Some days I wonder if all of those years spent studying biochemistry and physiology should have been replaced by psychology and social work. I was completely undone by the end of the day, flustrated for sure.

Holly asked me what I planned to do for myself this morning before I head to the clinic. I decided to go to the Sportsplex and swim laps. I haven't been a swimmer in over 20 yrs-honestly. I used to swim quite a bit during college and graduate school. But I haven't been in a pool in decades (it's more scary to write that I haven't done something in DECADES than to actually do it. But there you go in middle age). I really had a great time. It took about 10 minutes to feel comfortable and get some semblance of form back. Then I swam for 50 minutes, which seemed long enough for a good workout and to chew up some of the anxiety and frustration from yesterday.

My mom left this morning, after staying with us for the past week. She was here to get a second opinion and another surgery on her eye at Duke. She'll be back in another month for her next evaluation. Hopefully she'll regain some sight in that eye. I'll say more about that later.

Grateful to be here. Thank you Holly for all of your help with my Mom's visit.

We watched Cherry Blossoms, a German movie, recently. Very lovely and bittersweet. I recommend it. Also saw an older movie, Diva, which was excellent as well.
Photo: My Mom and me at the beach house a few weeks ago (on my birthday).

Why I Left

2010-07-25T13:49:00.000-07:00

On Palm Sunday, 3/28/2010, my stepfather died of brain cancer. The week before, my friend's mother died of complications associated with lymphoma and heart failure. The following week, our buddy Jo died of pancreatic cancer. It was just too much illness and death from cancer to leave my coping mechanisms untouched. I felt myself getting pulled further and further under water with each of their last days. I wanted to feel lucky to be alive, to have emerged from my own two bouts of cancer, but I couldn't muster it. My mood slipped lower and lower, sinking me into a panicky, worried state. Several days later, I attended a medical conference on the H1N1 or swine flu. The researcher presented information on the number of cases recorded in the state with information on the number of deaths from the virus. Three people died in the Duke Bone Marrow unit where I received my Leukemia treatment from June until November of 2006. That just hit too close to home. Had it been different timing, it could have been me dying of the flu when my immune system was obliterated by my chemo. Had it been different timing, it could have been me who was treated with Tamiflu, only to discover that my virus was resistant. Had it been different timing, it could have been me they intubated when my lungs stopped exchanging oxygen. No, it wasn't me, but I became more anxious and unhinged anyway.

Then I had my own health scare when one of my cell counts fell a bit below normal during one of my routine blood draws. It sent me over the edge. I couldn't concentrate at work or at home. I couldn't relax without worrying that the numbers were evidence that my leukemia was coming back. I fretted through 3 weeks of sadness and a whole new round of "what ifs?" Then I had my blood drawn again. My counts were back to normal. It was just a hiccup. I'd love to say that I found a way to control my emotions and all of the negative thoughts, the worries, but I didn't. My counts just came back to normal, and my mood improved. Hallelujah!

That's where I went for a while.

Happy Birthday to me...48th today.

Losing My Way

2010-07-24T14:30:00.000-07:00

Last Friday I got a message on my cell phone from a police officer who asked me to call her about a subpoena. I guessed that one of my patients had stolen or forged a prescription. The policewoman informed me that I was being subpoena'd by an attorney in Asheville who needed me to testify in the criminal case of a former patient. The attorney had actually called me two weeks prior to ASK me if I'd be a witness for his client, someone who had been accused in a sex abuse case. The attorney hoped to refute the sex abuse allegations with my testimony verifying that his blood pressure medications made him sexually impotent. I refused to testify in his case, so he had me subpoena'd to compel me to testify. Usually I would be only irritated by such a maneuver. But I really lost my way on this one. My family has had plans to vacation at the beach with my newly widowed mother for months. Each year, my mother rents a wonderful place at the beach during the week of my birthday. This year, after all of the stress associated with my stepfather's diagnosis and subsequent death from brain cancer, we have been particularly looking forward to our week at the beach. I explained to the lawyer that I had a week of vacation with my family planned for the week of his trial. He explained that the court proceedings in this criminal case in Superior Court would take precedent over my vacation. (As my friend who is a lawyer explained-"the court doesn't care if you have vacation since your testimony may decide whether someone goes to jail ..."). I have to say, I came undone by this whole episode, which seemed like such an unfair travesty. I did not want to testify for this creep, and I resented the jerk of a lawyer for serving me with a subpoena that would potentially wreck my vacation unless he found another MD from my former clinic to testify.

I am ashamed to say that I focused entirely too much on the potential loss of my vacation with this inconvenient timing. I was in an "ill mood" as my grandmother used to call it, for most of the weekend and the early part of the workweek. I found it hard to focus on anything other than my anger. I kept telling myself that I needed to relax and let it go. I was letting it control me. And then I realized this whole episode for me was about control. Apparently, I have to keep learning this same lesson over and over again.

When I had cancer the first time, I realized that we are all going along, living our lives, just under the illusion that we are in control. I got through that tough, tough 6 mos of treatment, happy to emerge from the other side no worse for the experience. I went back to work, my hair grew back, and I moved on. When I got cancer the second time, as a result of the chemo and radiation used to treat the 1st cancer, I got that slap in the face again. It's as if the universe was saying (again), "You are not in control." Oh man, how many times am I going to learn and relearn and relearn this one? I mean encore un fois over again...
Sooooo, here I was realizing, encore un fois, that I am not in control. If the Superior Court of Buncombe County tries to subpoena me to testify in this case, who I am I to say that I won't be there-vacation or no. When I finally came to that realization, and let it go, my moodiness lifted. I felt so much happier. I wasn't ill or angry or resentful anymore. The next morning, I telephoned the lawyer and surprisingly was told that I didn't have to appear. He'd found another MD to testify in my stead.

What's the life lesson here? I lost my way because I thought I could control something that I couldn't. We all delude ourselves like this each and every day. Maybe it helps us somewhat. It can be paralyzing to think that whatever you do or plan can be readily undone by the universe. Here's what I took from it: I spent so much time being angry and upset, fretting about what would happen if I "lost" my vacation, that I lost 4 or 5 days to that funk. I'll never get that time back. And unlike most people, I actually am aware that our time here is precious. I squandered some of mine on something that didn't matter, really. Thankfully, when I let it go, I got good news, and I am now writing this from the beach. Hopefully, I'll be smarter next time.

Forever and a Day

2010-04-27T07:42:00.000-07:00

I have been reluctant to write for quite some time, trying to deal with all of the life events of friends and family. On Palm Sunday about 9am, my mother became a widow. Brian's death did not come as a surprise, of course, since he had been diagnosed with an aggressive brain cancer in September of 2009. But he seemed to do well with the surgery, chemo and radiation, and was at least, holding his own until the cancer returned around Christmastime. He never really recovered from the second major surgery- marked by one mishap after another-a head bleed, leakage of spinal fluid from his ear, delirium, a stroke that left him with poor strength on his right side, and then countless hours of rehab, followed by a restless course at home with hospice care. The end is never easy, and his wasn't either as my mom and his son, Vernon, struggled with him until his placement in the hospice facility in Mt. Pleasant. Even the last little bit dragged on more than usual, until Palm Sunday when he passed away just before 9 am.

We had a church memorial for him that Wednesday followed by the scattering of his ashes off the dock at their house. The service was terrific with Father Charlie, their former minister, doing the eulogy. Charlie had know Brian and my mother for a long time, and he really conveyed that familiarity in his remarks. The memorial included a full church service, something that I think Brian would have really liked. The scattering of the ashes involved just family-all of us huddled together on the dock, at extremely low tide, watching his dust scatter in the wind and water. Amazing that such a big guy is reduced to not much more than a gallon sized bag of ashes and bits of bone after cremation. I scooped a big handful of the gray dust and bone shards to feel him between my fingers for the last time- a welcome relief after all of the words and feelings that had been swirling about all day. The wind took some of the dust into that shallow water and mud and blew some of it onto my pants leg and the dock surface. It felt so good to have a bit of bone in my handful and get to feel something solid. But that is just the way we are, isn't it, holding onto solid forms for as long as we can. I was so glad that we could scatter Brian's ashes exactly where he wanted to be-the very place he most loved in the world. It makes me tear up even now to think about how sweet that was. How it made me feel part of something bigger than myself, than any of us. What a delight to share all of that community and fellowship in Brian's honor. I know that I was not the saddest person there that day, but I had my own special reasons for being sad and touched and fortunate to be there as a LIVING being, given all I have been through with my own cancers. It makes me all the more grateful and pleased to be here.

Happy St. Patrick's Day

2010-03-17T02:00:00.000-07:00

I'm pretty sure my Irish ancestors somewhere would be proud of the 10K run we did as a benefit in Asheville this past w-e. Lots of people were dressed up, in lots of green, for the Shamrock run, which proved to be a challenging 6 miler up and over quite a few hills in our area of town. It threatened to rain but held off, giving us a beautiful day to enjoy the views from Sunset Mtn Rd toward downtown and the mtn range west of town. As one woman said to me as we were finally, finally crested the top of the biggest hill, "Well we worked for that view." Yes, we did. Holly and I rewarded ourselves on the way home with some delicious treats from the Sisters McMullen bakery which has just relocated (again) to another spot on Merrimon Ave-our part of town. We knew them when they still made doughnuts (now left to Dunkin D, just not enough profit in those...) and were located just around the corner from us. Now they specialize in cakes and more traditional bakery treats. Just fine by me, as they're all good and yummy.

Wear green today, pick up a shamrock, and spread some good luck today. Happy St Patrick's Day!

A Gaelic Blessing

2010-03-17T01:53:00.000-07:00

Deep peace of the running wave to you,
Deep peace of the flowing air to you,
Deep peace of the quiet earth to you,
Deep peace of the shining stars to you,
Deep peace of the gentle night to you,

Moon and stars pour their healing light on you,
Deep peace of Christ, the light of the world.
(from a stone inscription at the Bald Head Island, NC chapel)

A Wonderful Day So Far

2010-03-09T07:38:00.000-08:00

I have been remiss in catching up here lately. As I have said before, I feel a bit sheepish about continuing to post my writing here, now being so far from all of the original reasons to start this thing in the first place. While I will never forget that time of uncertainty and worry over my (then new) diagnosis of leukemia, I have moved on. Sure I get a monthly reminder of all of that seriousness when I have my blood counts done, but the steady, normal counts quickly push away any worries I might have. I would never say that all of this happened for a reason (unless you count weak DNA repair systems) or that I am better off because of it, but I can take pleasure, still, in the simplest things. As my girlfriend was leaving for work this morning, she wished me a good morning. I work the late clinic on Monday nights, a hellishly long 12 hour day that I never look forward to-e.g. I saw 36 patients yesterday. However, my recompense is Tuesday mornings to myself, with only half a work day. So I was sitting on the edge of the bed looking at the trees just starting to bud, with daffodils I had planted blooming at their bases, while a myriad of birds sampled our feeders. I was sipping a delicious cup of French Roast coffee and thinking about my run to Ayr Mount, my usual run destination on Tuesdays and Thursdays. As Holly wished me a good morning, I replied that it had already been wonderful so far. Can you imagine how terrific it feels to sit in a warm, sunny spot where you can watch birds, flowers, trees, and drink coffee in a leisurely fashion? Can you imagine getting to do that every week-not having to set an alarm clock or rush out the door to meet your first patient of the day? Honestly, it has been a wonderful day so far...

This past w-e, Holly and I rode the ferry to Bald Head Island to join our friends Marty and Debbie at their new beach house just south of Wilmington. They have a big old place hidden amongst the moss covered oaks that they share with 12 other couples, each of whom gets the house for a week per season (13 couples x 4 weeks/couple =52 weeks). This is the spring week for Marty and Deb, who so graciously allowed 8 of us to join them. We had a terrific w-e there too, running the trails along the beach, visiting the Nature conservancy and Old Baldy lighthouse, enjoying seafood and other meals together (thanks Deb for that fabulous fried shrimp dinner-my favorite!), and watching a few basketball games as a group. As there starts to be some cross pollination between our friends in Asheville and our friends in Durham, Susan and Donna were along for the w-e too. Marty and Deb joined us in Asheville at Thanksgiving last year, and invited Susan and Donna to meet them at the new beach house sometime. So it was really a delight to have so many of our friends from both communities with us to enjoy that special place. I can't wait to see Susan's pictures of the island, being the photojournalist that she is. I'll make do here with a few photos from my little camera, just to commemorate the trip.

Almost March

2010-02-23T07:37:00.001-08:00

I realized yesterday that March is next Monday. Perhaps this does not come as a surprise to anyone else, but it did to me. I was doing the yearly physical exam on one of my female patients, going over the preventive things we need to address for her health. I made the comment that when she turns 40, I want to order her mammogram. She pointed out that her 40th birthday is March 1st, this upcoming Monday. Wow! Already! Great news. Somehow, I've been mired in February and winter in my mind-
seems like f-o-r-e-v-e-r.

After my run this morning I was filling the bird feeders, cleaning up the trees that had been blown over by all of the recent snow, and trimming some of the dead stalks from my perennials. Upon closer inspection, I noticed that the perennials are gearing up with new green shoots and leaves. I hadn't noticed any of that from my bedroom window, but at ground level, it is quite obvious. Fabulous to see spring just around the corner.

I spent this past w-e in Charleston with my Mom. She had fallen on her face last week, just one more thing for her to deal with during this difficult time. My stepdad hasn't been doing very well in the Rehab facility where they moved him after his latest brain surgery. However, things progressed some this w-e for both of them. My Mom's face is getting better slowly with less swelling and bruising everyday. She can drive again and even walked with me Sunday for exercise (getting her Teresa points as she calls it). And, we were able to get Brian up to sit outside, visit with their dog Dixie, converse with visitors, eat on his own, and walk (assisted) to the bathroom and shower. I am hoping that he has turned the corner and will be able to do more and more as he regains his strength. I know that eventually his brain tumor will come back-it's an aggressive bastard-but my hope is that he can go home before any of that happens.

I was struck by how odd it feels to help dress and bathe and walk with Brian. I had my own hospital days not so long ago with lukewarm showers and hospital food and interminable hours in my own little room. I was weak too, especially after that 7 day course of continuous chemo to get into remission from the leukemia. I too, could barely walk on my own, fatigued even by the act of eating. Amazing to think that without those tough times, I wouldn't be here. Boy am I glad I persevered through that and more to be here today to run through Ayr Mount park as I did this morning, to get to see all of the woodpeckers at my feeders as I write this, and to notice all of the green shoots coming up where I trimmed away the old dead stuff. That, to me, is the perfect morning, as we barrel towards March now.

Fat Tuesday

2010-02-16T07:45:00.000-08:00

We attended the Mardi Gras parade held in downtown Asheville this past Sunday before we left for Hillsborough. There was a lot of standing around waiting at the street corner for the fun to start, and many conversations among the spectators about where the route would go. It was not a big deal parade like the one at Christmas, but it was spirited nonetheless. I do think there were more people who turned out to catch a glimpse of the "freaks" and the costumes than there were paraders, but that's okay. Susan took this photo of the dancing girls leading it on. Early February is a little cold for those outfits, but they sure got into the music.

Happy Mardi Gras!

Half the Sorrow, Twice the Joy

2010-02-15T02:25:00.000-08:00

This is a bit belated being that yesterday was Valentine's Day. I was more than a little distracted by my Mom's accident and all of the attendant worries and concerns that brought up for me-not just about today and this episode but also for the future. When something like this happens, you realize that a 5 hr drive is not close enough to take care of someone from afar. But you cobble together some plan and hope it works. As my boss says about staying home with her sick kids when her Nanny is sick, " I am only 1 deep," meaning that she is the back up. I think one of my biggest worries for both of my parents is that they will find themselves alone dealing with all of the vagaries that older age throws at you. I read something in a novel recently that I think is quite true-marriage was described as offering half the sorrow and twice the joy. What a sweet way to boil it down. I would add that a committed relationship offers the same thing-I have been lucky enough to have that. My Valentine has shouldered much adversity with me these past few, challenging years. I am so very grateful for that.

Thanks to my gal for halving my sorrow and doubling my joy!

Tag, You're It

2010-02-14T17:07:00.000-08:00

It is always amazing to me how differently people handle tough medical issues-not only their own health crises but also those of their loved ones. Being pretty solidly in middle age now, like most of my friends, my time has come too. My stepdad's recent diagnosis has certainly affected my sisters and me, but more from the standpoint of trying to support my Mom. We have been visiting him to help her-translating medical events, driving to the hospital, and trying to disentangle his online banking system for her. Many of my good pals have recently made emergency trips home due to medical issues with one or more of their parents. Well, it's my turn now. Earlier today I got a call from my sister saying that my Mom tripped on a speed bump in a parking lot and fell flat on her face (my nephew Ethan calls that a face plant). Apparently she landed on her nose, cut her face requiring stitches, and injured her knee. Hmmm, it's one thing to do a face plant when you're 8 and sledding down a snowy hill; it's another when you're 68, distracted by your husband's brain cancer and fall on the asphalt. That stuff hurts. All I could think of when my sister called me with the news was "tag you're it." My turn to share in the unexpected health woes of my parents.

You might think I'd be pretty good at it with all of my medical experience. Suffice to say that when it's your parent, you're just the child like everyone else. We are really lucky that my sister was already there visiting with her kids. And we're lucky because one of her oldest friends can be with her this week until I can get there this w-e. I hope that she rests some and lets herself heal. It's been a rough last 6 mos since Brian's diagnosis.
February is often a tough month-it's the longest, short month. Seems like ours is going to be filled with doctors and hospitals and trips to Charleston.

This year we are getting lots of fun snow the mountains, and I really enjoy that. This is a shot of Beaver Lake which is one of my favorite runs near our house.

Happy 70th Pop

2010-02-08T08:02:00.000-08:00

As I was running in the woods yesterday, enjoying the serenity of being alone on my favorite mountain, I remembered a card I had made for my Dad when he was in Vietnam. I was in my horse phase and drew him a horse's head with the caption

2 good
2 be
4gotten.

I thought it was a nice sentiment that I still want to convey all these years later. Today my Dad is 70 yrs old, a far cry from the 26 yr old he was when I made the card. Pop (that is what I used to write in my letters then), I hope that you have a really great day and a fabulous year ahead. Happy Birthday!

Snow Days

2010-02-02T07:20:00.000-08:00

In the Triangle, we are still digging out from the latest snowstorm. All of the schools were canceled yesterday, and my clinic was closed as well. The secondary roads were and still are pretty much a mess. I went running yesterday morning, dodging cars as we vied for clean asphalt at the edge of the roadways. We had the same beautiful white stuff in Asheville over the w-e, but they did an excellent job of salting the roads BEFORE the snow hit this time (they learned from their mistakes with the recent December storm). In Asheville, we played in the snow and did 2 hikes around town to look at all the trees and houses and mountains with their 8 inch blanket. It was really spectacular when the blue sky rolled in on Sunday before we left to drive back. The interstates were clear, but our neighborhood was pretty icy and still is. I think they are holding the speed skating trials on our loop road here later today-tee hee. Actually, it isn't that bad if you drive slowly. It has been really cool to see so much snow again after our trip to NH to cross country ski. It sort of reminds me of living in New England.

I used the snow day yesterday to check out the new Orange County library. At the end of December, the fine old building near our house closed, and they relocated it to the new official looking county building on Margaret Lane, near the Weaver St Market. I have to say, I will miss our little hillsborough library with its quaint old building and everything/everyone all jammed in together. The new building looks so institutional, and the inside looks, well it could be anywhere. I am sure it is much nicer for the kids to have their own reading room and for the librarians to have their own desks/reference areas, but I will miss the character of the old place. It really did have character, and I am not just saying that because it represents a change. Oh well, all things change... and then you have the iPAD.

Okay, one thing that doesn't change is how much fun I am having on my runs lately - enjoying the invigorating winter air and the long range views one gets this time of year. I hope that all of my pals can get outside to enjoy that fresh sunshine and wiggle their joints a bit.

Waking Up

2010-01-26T08:00:00.000-08:00

Holly and I went to Charleston SC last w-e to be with my Mom and visit my stepdad who is still in the hospital. He was moved from the Neuro ICU but remained delirious the entire time that we were there. It has been weighing heavily on us as I knew it would if/when he got worse. Well, we are there. He just hasn't bounced back from his most recent surgery, though my Mom said that he woke up yesterday-could eat, talk, recognize folks, and even stand for a bit. Hard, hard to watch such a big man be dwarfed by this illness and his hospital bed. I guess we all look small when we are sick, can't eat, and just lie in those hospital beds under florescent lights. I hope that he continues to make rapid progress from here and enjoys some more good times before whatever is around the next corner. I'll apologize right here for all of the bruises Brian probably has from me rubbing his sternum this w-e as I tried to get him to wake up and talk to us.

Our trip to NH to cross country ski seems so long ago now (the hospital will do that to you). I did want to show off the kittygirl we brought back. The B&B had all kinds of stuffed bears, cats, and moose situated on the beds for guests to enjoy. We "adopted" this one since it reminded us of our cat, Gracie, with that same beautiful, calico, queenie personality. Here she is hanging out on the couch.

NH Peaks

2010-01-19T16:28:00.000-08:00

We love to cross country ski whenever we can take time off to travel and find a snowy locale. It sounds simple enough, but finding snow, even in New England, has been tricky the past few years. We keep trying to get to Bend, Oregon where everyone raves about the snow as well as the town. But Oregon is a far piece from NC, and we just don't seem to be able to make it happen. This year I wanted to xc ski over the MLK holiday and came across the website for Jackson NH, a whole town devoted to cross country skiing. They have a touring association in town as well as a very helpful website. We stayed at an Inn I found on their website (the Inn at Ellis River). The Innkeepers served a terrific breakfast and were just nice, nice people.

We spent the 1st day skiing at Bretton Woods,west of Mt Washington-enjoying our granola bars and peanuts right alongside all of those hearty New Englanders with their pb&j sandwiches. I'm pretty sure we could cure the obesity epidemic if we could get more people out skiing with all of those frugal Yankees who show up in their old tights, wool sweaters, bike gear, and boots from the 70's-whether they fit or not. I have never seen so many members of the same family tackle a sport at once, then sit down to granola, sandwiches and a thermos of coffee only to march back out to do it all again. It's pretty cool really. I, of course, was happy just to get my heart rate up, see so many peaks covered with snow, and give my slider-glider muscles a real workout.

We skied the Great Glen trails just east of Mt. Washington on the 2nd day. Their beginner trails were a little more advanced beginner for us as we tried to remember the intricacies of slowing down and turning all at the same time. It's tough when your last lesson was 3 years ago, but it did come back. Fortunately we got some spectacular views of the Presidential mountain range in the morning because the clouds moved in later in the afternoon obscuring the peaks altogether. Neither our car nor our bodies climbed Mt Washington, but I'd love to go back for that someday. One interesting variation on the famous "This car climbed Mt Washington" bumper sticker was a car with one that read "The owner of this car RAN Mt Washington." Now that is one tough feat-almost 5000 ft of up in just under 8 miles. Can you imagine? I'd love to do that race someday...

Exeter Reunion

2010-01-19T14:48:00.000-08:00

Holly and I made good use of the MLK holiday to escape up north for a bit of cross country skiing. We flew into Boston and drove north to the White Mtns in New Hampshire. On the way, we visited Exeter, the boarding school I attended for 3 years of high school. We traipsed around campus from my old dorm to the field house and on to the main part of campus. I can't remember the last time I was there for a visit, probably ten yrs ago or more. The science center, where I took many classes and taught as an intern after college, has relocated across the street to an even larger facility. Other than that, things were pretty much the same. We even managed to find my old soccer team photo in the field house.

I added a few photos here, just for old times sake.

Not So Great This Time

2010-01-15T01:17:00.000-08:00

I find that if it takes me a while to get back to writing here, either I have been too busy (good times rolling) or I am dealing with something. This time, it's the latter. My Stepdad had to have more brain surgery this week, and I have been very distracted with hopes and worries for him and my Mom. We learned at Christmas that his tumor had recurred-it just kept marching through his head despite 6 weeks of chemo & radiation after surgery. He went in for more surgery Wednesday, getting 5 1/2 hours of Dr. Frankel's time and expertise in the Operating Room. Unfortunately, he developed a bleed Thursday afternoon and needed more surgery to stop the bleeding. Now they have him in the ICU, in a coma, to keep him calm and sedated. Of course, I have been worried for him and for my Mom who has had to wait patiently through each of these surgeries. Obviously, none of us can predict or control the future. But I am hoping and praying for the best outcome with no suffering.

Here's a photo of the old bald guy at Christmas, doing his Soduko.

New Year's Day Good Luck Pig

2010-01-01T04:18:00.000-08:00

Supposedly there is a custom with the chinese of giving little pig ornaments as good luck. I used to buy lots of them and give them to friends as gifts, but I can never find them anymore at the toy stores. So this is my rendition of the Good Luck pig for all of you. Luella's BBQ here in Asheville put a lit up pig on their rooftop for the holidays, adorned with a santa cap and lights. I've been meaning to photograph it since I first noticed the little guy (seems a bit much to call this photography but whatever...). This being New Year's Day, and being up to see the sunrise, and to welcome in the year my own way, here it is.

We had a fun New Year's Eve with dinner at the new, cool, cheap eat called Chai Pani that serves street Indian food (okra fries, I'm not kidding) followed by a yummy desert of s'mores and coffee at Cafe Posana just as the city's fireworks were going off one street over, and then the Swayback sisters' concert in Black Mountain at the new acoustic music club White Horse Black Mountain. Made it home in time to wish each other a Happy New Year on our own.

Today we are doing the traditional New Year's Day hike with friends (one year I swear Susan took us to Penn to start the hike, but I believe we're only going to Brevard and the Pisgah Area this time, tee hee) followed by a lasagne potluck at Jan's house. Great way to start the year off right, and we still have 2 more days to enjoy being off.

So whatever you wish for in 2010, here's your Good Luck Pig.

My Treat & Delight

2009-12-30T05:42:00.000-08:00

I cannot believe that tomorrow is the last day of 2009. I am sure that this does not come as a surprise nor am I likely to be alone in this one. This time last year, I was anxiously awaiting Jan 2nd when I wound finally get to return to work after being out for 7 mos with my leukemia treatment. To say that I was anxious really, really does not do it justice. I was as scared to return to work and treat patients as I had ever been-even when I was just starting out. It is amazing how much this line of work requires concentration and a good memory as well as well, there is no way to say it modestly, intelligence. I felt that 7 mos at home had left me dull and unprepared. Luckily that first week back, my boss let me work part-time to get me back up to speed (call it work hardening)and my patients were those easy walk-in types with colds, flus, and diabetes follow ups. I rememeber how tired I was at the end of the day and would just fall into bed exhausted. I am sure that I was suffering from some lingering effects of the chemo too, but my brain took the longest to bounce back. Some days I am not sure that will ever be the same because my memory is not as sharp as it once was. My other menopausal friends tell me they are the same so maybe we are all in this boat together-chemo or no.
Today is actually my last workday of 2009 so the next time I come back into work, it will be my 1 year anniversary of being back. Unless you have experienced that for yourself, you cannot imagine what a treat and delight it is to be here now. And I mean that in all sense of the word. I love that I am still here to enjoy my work, my colleagues, my co-workers. I love that I know how to enjoy today w/o worry about tomorrow or yesterday (buddhists call it being in the present). I love that my precious girlfriend, family, and friends have seen me through so much. My resolution for the New Year is to write more, think more, and keep on keeping on. Sounds delightful, doesn't it?

Merry Christmas

2009-12-25T17:04:00.000-08:00

My family has been visiting for Christmas from the far flung reaches of SC and Ga. As there was a good bit of snow leftover from last w-e's snowstorm, those southern kids were happy. I took them sledding near UNCA. I kept checking periodically to see if they were ready to go stop and head back to the house. Despite the cold and the wind they kept at it for a long time. But once Ethan did a face plant, as he put it, and Emma's fingers were icy from being cold and wet, they called it quits. We had a great time and I'm really glad they still had snow to experience on this trip. When you live in the deep south as they all do, you can remember almost every snow you experience as a child, and it's special. In fact, it was one of the reasons we hosted Christmas for everyone this year. And we were lucky enough to have snow for them to enjoy. Unfortunately, rain moved in last night, and it was cold, windy and raw. Not such great weather for sledding. Oh well.

I know that this will come as a bit of a surprise, but he kids wanted to open their presents on Christmas eve. Whole parts of the living room had been given over to gifts piled high. The tree, our measly little artificial number, could barely contain our gifts much less all the ones from grandparents, aunts, and uncles for the little ones. Suffice to say that it looked like a tornado had torn through a toy store after they were finished unwrapping all of those gifts last night. The Asheville house is pretty small by today's standards, but it seems really small with 13 people, 4 dogs and mounds of Christmas presents.

I was able to snap this photo of Santa last night as one of the mini but mighty rein-dachsunds arrived at our house

Have a Merry Christmas!!!

Mama's 95th Birthday

2009-12-22T07:03:00.000-08:00

My family congregated in Charleston SC this past w-e to celebrate my grandmother's 95th birthday. We met most of Charleston at the Elks Lodge for the big birthday bash. There was music, food, and lots of pictures. Most of my cousins are on Facebook and there is even a Fralix family account where everyone seems to post old pictures from our younger days. I suspect quite a few of the photos from the party are already posted there. I include a picture or two here because well, I'm not on Facebook. I have trouble enough just keeping this blog current, or current enough.

It was great to see my Mama and behold that whole room filled with people, all of whom are directly or indirectly related to her. Pretty cool as well to imagine all the impact she has made and the legacy she leaves by pondering all the people there.

I had hoped to drive to Asheville on Saturday, but the snowy weather keep me in Charleston for an extra day. I did make it there Sunday just in time to attend the Swannanoa Solstice concert with Donna and Susan. That was really a feast for the eyes and ears with various acoustic instruments played, a show with panoramic photos of the mtns in winter splendor, and even a group that performed Scottish step dancing. It was quite a Christmas treat-thank you both for giving us that. Fabulous!

Well, as it is now December 22nd, we are past the shortest day of the year and can celebrate the light returning again. I so look forward to this time of year because I love the light so much. I have a touch of that seasonal affective disorder so my mood is brighter when we have more daylight. I can get more done and enjoy those few extra minutes of light with a longer run or piddling outside. Only 6 more months to June and the longest day of the year. But we have winter and spring to go through first.
Merry Christmas and enjoy the light!

Running with the Girls

2009-12-22T06:49:00.000-08:00

There is a terrific organization called Girls on the Run that holds a 5K race every December in Asheville to raise money for their scholarship fund. GOTR teaches girls to be active and healthy through running and jogging, just my kind of fun in other words. A few Saturdays ago my friend Donna Z and I ran their 5K which was held on the UNC Asheville campus. There were loads of girls (and boys for that matter, and parents of course) congregated by school to attend the event. We ran 3 loops around the main campus, one of the flatter runs I've ever done in Asheville. Donna, who has been toying with the idea of running again after many years off, joined me for the fun. Everyone got a #1 race bib and "earned" a ribbon for finishing the run. I like that they have made it less competitive and more about showing up and participating. It was a cold raw day, about 24 F, and I give many thanks and kudos to Donna for joining in on the fun in that weather. That's a tough draw for your first running event.

Happy Birthday & Congratulations!

2009-12-09T03:40:00.000-08:00

Today is my stepfather's 70th birthday. It is also the last day of his chemo and radiation for a brain tumour. I don't know which is a bigger thing to celebrate, but then he certainly doesn't have to choose. I am relieved and proud of how well he has done. It is never fun to hear that you have cancer-much less that you have to have surgery, chemo and radiation. But he has handled it so well. I wish that I had a current picture to post here, but this one is from the morning he went in for surgery.

I extend a big hug of support and relief to my Mom, too, who has had to worry right along with him.

Congratulations to you both! Happy 70th Birthday VBJ!

The Nice Volunteer Lady

2009-12-08T11:13:00.000-08:00

I am writing early on the last day of our Monterey trip. All of the people attending Holly’s conference had the afternoon off to explore the area or whatever yesterday afternoon. I had a coffee in one of the local cafes and asked what we should do that is nearby. The barista recommended a hike in Point Lobos State Reserve which we had actually passed on our way to Big Sur. It was gorgeous-lots of hikes along the headlands with views of birds, seals, otters, and sea lions. There was even a nice volunteer lady at the info station (and I say nice because it was one cold and raw and windy day to be sitting out just waiting for 2 little tourists from NC who don’t know the 1st thing about those pinnipeds). Anyway it seemed that each turn was more spectacular than the last especially as the sun made its arc over the sky illuminating different parts of the rocks, bluffs, cypress, and coves. We saw several places with protected inlets where the water was a true emerald color. There were birds galore. The nice volunteer lady said that she had seen 2 whales earlier in the day, but not knowing what to look for, I can only say that I saw alot of surf. Maybe one of those spurts was a whale spout. Who knows? Could be.

We also tried to cram in another trip to a bird sanctuary called the Elkhorn Slough before Holly had to be back for a big reception, but a guy was just closing the gate for the day when we arrived. It was about 30 mins north of Monterery and tucked away down a bunch of rural roads. I wasn’t disappointed though because we got to see a lot of rural farmland-many farmstands advertising avocados 5 for $1, artichokes 3 for $1, broccoli 2 for $1, well you get the idea. It was pretty, rich land that must grow alot of what we eat back east too. In fact, we passed a big Dole plant sitting next to one of the farms. Cool views even though we missed the slough.

The nice volunteer lady at the info station had a green State Park service jacket and official, green ranger pants. I knew that she was a volunteer rather than a paid ranger because she had a big patch on her sleeve that said “volunteer” (I’m smart and observant that way, tee hee). The State Parks out here are really suffering with the California budget cuts. So it was really nice of her to spend her time sitting out in the cold, as I said, to help us learn more about the features of her park. It got me thinking about the research I read recently about how doing kind things for others helps people who have serious medical conditions. One article I saw in the NY Times was about a woman who had been diagnosed with MS in her 30’s and wasn't doing well either physically or emotionally. One of her doctors told her to try doing things for others to take her mind off her condition. She decided to give 29 gifts to others, one a day for a month-sometimes actual gifts, sometimes gifts of kindness or helpfulness. She felt it improved her MS symptoms so she wrote a book about it (called something obvious like "29 gifts".) There are scientists actually doing research on why that helps. Personally I think it takes your mind off your own problems, forces you to concentrate on the needs of someone else, and diminishes whatever difficult symptoms you’re experiencing. Having a bad day or just feeling crabby? Do something nice for someone else. There is always someone worse off to help and they’ll appreciate it.

Along that same vein, I remember when I was being treated last year for my leukemia and couldn’t work. I was very sad about that. I had worked through my breast cancer treatment, just taking off the days I was sick from the chemo wallops. The leukemia kept my cell counts so low that I couldn’t be around the general public much less the going to the doctor public. It made me feel quite useless. I was kind of crabby and listless at one point early on in my treatment and couldn’t figure out why. Then I saw a young woman being treated for her scleroderma, a condition that causes the skin, fingers, and connective tissue to stiffen. I first saw her in the hospital on one of my admissions then again in the clinic. I spoke to her and her family, which just lit me up inside. I felt for just a moment like I was back in my clinic talking to a patient and her family. That helped me understand all of that irritableness I had been feeling. I wasn’t doing anything for anyone else. I just had to live with that for a while. I am very happy now to be back at work, to be helping other people. And if you come to me with the blues, I’m gonna write you a prescription for 29 gifts-to give others.

More of Monterey

2009-12-07T11:32:00.000-08:00

Holly scooted out to her meeting early this morning and I went for a long jog on the road we had driven yesterday to head south to Big Sur. We had found a back way from Cannery Row up a long steep hill to Hwy 68 that leads past the tiny town of Pacific Grove on to Hwy 1, the Oceanview Hwy that heads to Carmel and then to Big Sur. This morning, I made essentially a big loop with the trail from Old Monterey, the historic district where we are staying, then on to Cannery Row, left up the big steep hill with incredible views (My Mom once commented that I always manage to find a big hill or mtn to live on. Its the views, Mom. I also manage to run them when I can-tourist or no). I ran along Hwy 68 around the old Presidio base for several miles, amongst the tall Eucalyptus and Redwood trees, and back to Monterey via Hwy 1. It took me an hour and 54 mins, the longest run I've done since the Asheville Half-marathon in September. I pulled my hamstring in that one and had to take 6 weeks completely off from running. What a bummer that was! This getting old stuff is tricky. Healing just isn't as fast as it once was. Oh well, I am better now and had a terrific run in a terrific town up a terrific hill. What a sweet and fortunate life I have!

Monterey

2009-12-07T11:23:00.000-08:00

I am writing this from our hotel room in Monterey California. Holly is attending a meeting here for her association, the American Society of Clinical Veterinary Pathologists. That’s a mouthful for sure, but they use their abbreviation mostly, ASCVP, which makes it a bit more manageable. We flew out early Friday morning dodging the snowstorm in Houston (yes that Houston) where we changed planes, bound for California. Though I usually think of California as warm and sunny, even Monterey which is about 2 hours south of San Francisco, is cool and cloudy this time of year. We are staying in an upscale hotel near Fisherman’s Wharf and the marina, so the views are great, cool and cloudy or no.

This morning we took advantage of Holly’s break from the meeting to drive 30 miles south on Hwy 1 to Big Sur. I’d read about a fun place to eat called the Big Sur bakery, but they were closed for winter break. Not to be daunted, we grabbed a few Big Sur bars from the deli next door and headed to Andrew Molerno State park and the Venta Wildlife Society center. They are doing work with California condors, which have become nearly extinct. The hike along the coastal trail was spectacular with lots of hawks, falcons, and many little birds (sadly no condors observed by us anyway). The trail meandered by the river and up the bluff for a terrific view of the coastline. The sun even came out during the hike back to the car, so we were able to enjoy all the beautiful things we’d seen on the way out, not only from a different perspective but with better light. We commented on how the California coast is so different from the beaches we know and love in North and South Carolina. Here the sand is nothing more than a small strip - strewn with old logs, kelp, and rocks- while the NC beaches are wide, sandy and full of shells. The NC dunes may be 10 ft high, but here in California, the bluffs extend up hundreds of feet. Both coasts are beautiful, just different.

Last night we tried a sampler of the microbrews here at the hotel pub. They were okay, nothing too stellar. At this point, we are hopheads, and spoiled ones at that. Asheville has so many fine breweries, and we’ve grown accustomed to those bitter beers as one of my pals put it. It was fun, though, to try out what they have locally; you never know when you’ll find something new you really enjoy.

I read a great book on the flight out here. We often listen to public radio on our journeys to and from Asheville. Last Sunday, we were listening to a program about religion and heard an interview with the Rev. Kate Braestrup who is a chaplain for the Maine Warden and Game service. She goes out with them on missing person cases or when a body has been discovered. Her job is to be there for the families and to counsel the Game Wardens if necessary. She sounded like the wisest counselor I’d ever heard, and I decided to check out her memoir “Here if you need me.” Not only is she a wise counselor and Reverend, but she writes well too. It turns out that she was a writer before becoming a Unitarian minister in her second career. If you’re looking for a peaceful, uplifting, hope inspiring book check it out. Our little Hillsborough library had it, and Amazon sells it too, of course. Now I’ve moved on to the new one by the author of “The Time Traveler’s Wife.” It’s a good one too, but I haven’t finished it yet ( “Her Fearful Symmetry” by Audrey Niffenegger.)

Again, our little Hillsborough library astounds me. I just finished perusing the list of 100 Notable books from the NY Times Book review and ordered several of them from the online library catalog. In 2 days, my books were waiting for me just a half-mile from the house. Amazing! Call me a Luddite, but there is no technology better or more satisfying that the public library. While I enjoy reading some of the NY Times online, I much prefer the paper version. Call me old school, but I enjoy holding a real book in my hands. I hope that I am dead and gone long before books appear solely in electronic form. And I hope that our little Hillsborough library (shall I abbreviate it OLHL from now on?) keeps on ordering all of those fantastic books. OLHL is moving, though, to a bigger space downtown next to the new Weaver St Market and big parking garage. I’ll have a bit of a longer walk for my books, ~ 1 mile from the house instead of half a mile, but the new space is going to be much larger. Eventually, there will be a walking trail, too, that goes right along the river past the library, Weaver St Market, and out to Occoneechee Mtn. That will be really cool.

We Ate with Thanks & Gratitude

2009-12-07T11:14:00.000-08:00

WE GAVE THANKS
I never got the chance to write about Thanksgiving after the holiday. It was full of fun and food and fellowship, just as I knew it would be. We did take a short hike on the Mountains-to-Sea trail before dinner Thursday. Little mini but mighty (Riley the amazing, hiking dachshund) led the way from Craven Gap - where Town Mountain Rd meets up with the Blue Ridge Parkway- some 4 miles further south. We had a bit of a snafu or situation as some would call it, when Miriam and Alex got separated from the main group and ended up heading down from the ridge on a different trail. With cell phones and Marty hoofing it to get back to them, we were all reunited safely.

Dinner was quite a feast as you can see from my plate here in one of the photos. Holly did a fabulous job of cooking the turkey, which was very delicious. Everything was yummy in fact. Glad we did the hike before the meal because there would not have been a big hike after that big, filling meal.

Friday morning early, early, crazy early, Alex and Debbie went out for a little Black Friday shopping. Alex wanted to go to Wal-mart, of all places, to buy a Gameboy she saw on sale. Best I could tell, Debbie was just along for the fun, though she did come home with some prizes too. They struck paydirt in Weaverville, where the lines weren’t as long as those in Asheville. And I think, they managed to buy everything they set out to find on sale. I was skeptical they would really go at “O Dark Hundred,” as we say in my family, but they did, later relating all the fun they had. I will say that they got some great deals for their sacrificed sleep.
Maybe that needs to be part of the tradition from now on. Someone has to get up really early and brave the lines to snag an excellent deal. I'll add that one to the list.

The Week for Giving Thanks

2009-11-24T07:31:00.000-08:00

Just as I like to make a big deal about birthdays, I really like to make a big to do about Thanksgiving. I think it is the perfect holiday. It's all about being thankful, enjoying people, and sharing good food and times with folks you care about. It's not about gifts or opening presents. This year we are celebrating in Asheville with a big potluck dinner Thursday evening. We expect to have 13 people including a few from the Triangle who took us up on our offer to visit for the holiday. In addition to the traditional turkey, we plan to have sweet potato casserole, dressing, mashed potatoes, salad, homemade bread, brussel sprouts, gravy, pumpkin pie, pecan pie, cranberry torte, fudge and maybe a few things I haven't thought of yet. Our buddy Jo has even decided to hang around and join in rather than make the drive to Columbia.

This past weekend, we attended the Holiday parade in downtown Asheville. They always hold the parade the Saturday before Thanksgiving-an odd time to have the Christmas parade but there you go. I caught the unicycle team and the llama golf caddy service on film. It's Asheville afterall. Why be normal???

I'll include some photos of the Thanksgiving Day food & fun once I have them. I'm salivating just thinking about all it now. I will miss seeing the rest of my family who are gathering in Charleston this year to eat at my Dad's. Bet they are having a real spread too.
Enjoy your Thanksgiving and don't forget to reflect on all the good things in your life.

Love at First Sight

2009-11-15T17:09:00.000-08:00

Lately the skies around Asheville have been truly spectacular. The weather cools off overnight allowing a gentle fog to settle around town while the cooler, crisp air of the ridges remains higher up. The sunrise scatters through the fog about 6:50am with the most beautiful rosy glow near our house. Fortunately I woke up at the fist hint of light this weekend and ran out to our deck to get these photos. It is one of the best times of the day, as well as a really lovely time of year. One of my favorite things is to sit on the couch in our living room and watch the light change while I drink my coffee. With the leaves off the trees, the views of downtown, the skyline, and the ridges both east and west of town are gorgeous.

Ferdinand

2009-11-15T17:00:00.000-08:00

We have been thinking lately that the market for new Priuses would get tight when the price of gasoline increases again. Holly's Prius, which we drive on all of our trips back and forth to Asheville as well as other long trips, now has 95,000 miles on it. Of course, it hasn't given us a lick of trouble. But we decided to go check out the new improved 2010 Prius, which is now rated at 51 mpg. So Saturday we bought a second one from the Toyota dealer in Asheville. We've named them Ferdinand (the new grey one) and Isabel (the old red one). Here's Holly beside her new toy.

Why It's Fun to Learn...and Teach

2009-11-15T16:41:00.000-08:00

While Holly was toiling away Friday in the Asheville home office, I attended an educational conference held by my old residency program MAHEC. This one covered the latest greatest informational on the flu as well as other Infectious Disease topics. It was so current that one of the speakers said that her slides for the flu data were being updated daily as the number of cases continues to increase here in NC as well as the other parts of the country.

I wanted to attend this conference because MAHEC does such a good job with educational programs. Also, it being my old training program, I knew that I would see some folks from my time working in Asheville. I threw in my camera just in case I ran into the former director of my residency program. I have been thinking of him a lot recently. We have a few new providers in the Drew clinic, just hired straight from their residencies or Nurse Practitioner programs. As such, I have been doing more teaching than usual. It's been really fun to re-visit with them how to do a shoulder injection for rotator cuff syndrome or to help a young doc identify a mysterious rash. My residency director was an incredible teacher and mentor-funny, smart, patient, and extremely knowledgeable. So I had been thinking about all the things he taught me that I am now passing along to them. Luckily, he did attend the conference so I was able thank him directly and get this photo. In addition to being a great mentor and teacher, he is a terrific person. That's why I am so happy standing beside him.

2009-11-11T09:22:00.000-08:00

This past w-e Holly and I ran in the Superhero 5K run held in downtown Asheville. Our pals turned up to volunteer as race marshalls and/or to photograph us and the crowd. This one was especially interesting since everyone was encouraged to dress up as their favorite Superhero. There were lots of costumes-Flash, Superman, Souperman, Batman, Robin, etc. We didn't have Superhero costumes so we went as ourselves with little bandannas wrapped around our necks. Ellen and Susan captured us trolling along enjoying the view of all the other Superheros in the race. This one was sponsored by our favorite pizza and beer place so we were treated to, yep you guessed it, pizza and beer after the run. It was a lot of fun.

I had planned to write November 8th to commemorate my last doses of chemo on that date last year. But we got busy having fun and I never took the time to sit and write. Wow what a difference a year makes! Out having fun instead of recovering from chemo. Anyway, I am 1 year out and it sure is terrific. Again, thanks to everyone who has been enormously supportive during all of this.

Yippee!

2009-11-06T23:56:00.000-08:00

Thursday afternoon I was scheduled for my regular 3 mos recheck with Dr Long and Tanya in the bone marrow clinic. Usually I get my blood drawn, followed by a physical exam with Dr Long and/or Tanya, and finally a bone marrow biopsy. The aspirate and marrow they collect from my hip is sent off for special leukemia studies to look for any signs of recurrence. At my visit in late July, Dr Long decided that I could skip the bone marrow biopsy since my blood counts were so normal. But he told me that I'd have to get one at my next visit. So all week, I'd been dreading the visit. The biopsies are painful since the numbing medicine they use only dulls the pain at the skin and muscle overlying the biopsy site. The part where they drill into the hip bone and beyond into the marrow is quite painful. They drill a second hole to suck out liquid marrow for the aspirate sample and that produces an intense pain that radiates across the whole pelvis. That part isn't dumbed by the Lidocaine either.

My first bone marrow biopsy was actually at UNC where I was diagnosed with the leukemia in late May 2008 after my white blood cell counts started dropping followed by my red blood cells and then my platelets. That very first biopsy was angst ridden- what with the waiting for news of what this was. I knew that it was something bad because in addition to the low numbers of cells, the cells had begun to appear atypical, a sure sign of malignancy. But the actual biopsy procedure was not uncomfortable because they used what is called conscious sedation. They placed an IV in my arm, monitored my breathing and blood pressure, while they gave me IV morphine and ativan. It's kind of a "La La Land " where you know what is happening, but there is no pain or anxiety. I got spoiled a bit by that first biopsy because it was so easy. Well the actual procedure was easy anyway. My hip was sore and bruised and tender for the next several days, but Motrin handled that easily.

So the dread started seeping back in Monday, Tuesday, Wednesday this week as I thought about having another biopsy Thursday afternoon. My appointment was scheduled for 3pm at Duke, and Sallie, my boss, let me rearrange my hours to be there without missing work time. I worked the morning clinic and through lunch until 1:30pm. There is nothing like hearing 19 other peoples' health issues to take your mind off your own impending date with a big needle. And it worked to keep me busy and focused before I had to leave for my appointment. Then Dr Long decided that my blood counts looked great. Not only did I not need the biopsy, but he was cutting me loose to follow up whenever I wanted as long as my monthly blood test remains normal. All that worry and dread for nothing. I was so very relieved not to have the biopsy and even more relieved to get on to a more minimal follow up routine. Though it might not be needed, I did tell him that I want to be seen again in 6 mos. Call it post cancer wariness. I don't want to be too far removed from the clinic in case I need them.

We piled into the car as usual Thursday afternoon and headed for the mtns after my appointment. The mountain views are finally clear & sunny here. We are still seeing a little leaf foliage though it is definitely post peak. I love this time of year because the Asheville house starts to have a splendid view of downtown as well as the mountains both east and west of town. The sun comes up just over the east mountains, shining into our eyes with its low winter arc. We have to close the curtains for the first hour or two until it gets higher in the sky with less of a slanting path through the bedroom windows. If it's sunny, there is often a beautiful rosy glow to both the sunrise and the sunset. It's one of the reasons I like this house, though it is modest and boring in the way that raised ranches are. We keep feeding the birds, both in the front and the back of the house, and they keep coming for us. The woodpeckers are looking brilliant this time of year.

So Yippee for me!!!

People Who Share Their Bounty

2009-11-03T14:57:00.000-08:00

Once in a while, I am truly astounded by the generosity of people. In addition to all of the intimate information that they share about themselves, I sometimes receive gifts from my patients. This week one of my patients brought me some canned goods from her garden. The jars included pear conserve, grape jam, homemade spaghetti sauce, heirloom tomatoes preserved with herbs and vinegar, and cooked wild pears. We had been talking about how nice it is to grow a bit of your own food, how it tastes better than anything you can buy at the store, when she announced that she was going to bring me some treats from her garden. I had forgotten about it for several days until she returned to the clinic toting a large basket full of goodies, some of which are shown here. Most of you know that I take care of many people without health insurance, and like this woman, they tend to work in low paying jobs. I was struck with gratitude at this woman's generosity and couldn't help but give her a big hug of thanks for all she'd done. How nice of her to take the trouble to do all of that and to drop by to give it all to me. And what a delicious surprise too; those heirloom tomatoes are swimming in the best garlic sauce I've ever tasted!

My other delight this morning was getting to meet Anna Elizabeth- all of 4 days old today. My work pal Sarah went into labor Thursday night and delivered her on Halloween eve about midday. Anna got to experience her first Halloween in Chapel Hill -from the inside of the UNC hospital, a much safer place than trolling down Franklin Street in costume. Mom and baby are doing great, and it was terrific to see them today before I had to leave for work. I had trouble tearing myself away from holding her to drive to the clinic. I can only imagine how it will feel for Sarah when she returns to work 3 mos from now.

Thanks to everyone who has shared a little piece of themselves with me this year. It doesn't go unnoticed or unappreciated.

How Does He Do It?

2009-11-01T14:47:00.000-08:00

I looked outside my bedroom window Thursday morning as I was drinking coffee and thinking about the day ahead. I spied this guy in his usual corner of my garden showing off the last of his tomatoes. I don't know how he does it, but he manages to leapfrog me every year-if I put in 3 tomato plants, he has to plant 4. If mine stop producing in October, his go clear into November. Fortunately he is kind and shares them with me. Tee hee, as Susan says.

Well it is October no more, since I'm writing this on the evening of November 1st. We have set our clocks back, and I'm already missing the daylight. The weekend weather in Asheville was unseasonably warm and rainy. At one point, I was pretty sure I'd been transported to Seattle or some other Pacific Northwest clime. Today, finally, it was a respectable 45F with at least some patches of blue sky for a few minutes. That sunshine was a welcome sight. I used it to do a terrific 8 mile run around Beaver Lake (my first in over 7 weeks after my hamstring pull) and to clean up the garden a bit. I only had time to transplant a few perennials & trim some wild grapevines before heading back to Hillsborough. There is always next weekend to tackle the next two or three jobs that need to be done.

I'll be seeing my bone marrow doc and his PA later this week. I have an appointment with Dr Long and Tanya this Thursday afternoon, my usual 3 month follow up. Since they skipped the bone marrow biopsy when I saw them in July, I suspect that I won't be so lucky this time. I am hoping that all will be well with my blood counts, and maybe, just maybe, I can defer this biopsy too.

I have another big anniversary coming up this week. My last hospitalization for chemo last year was November 4-8th. I had 2 treatments each day on the 4th, 6th, and 8th. You can bet Holly and I will be celebrating how far we've come. As I always say, Yippee!!!

Supporters

2009-10-25T14:01:00.000-07:00

I got a comment to one of my posts from someone who calls himself Hopeful Husband. His wife had breast cancer about 18 mos ago and was subsequently diagnosed with secondary leukemia like I was. He apparently ran across my blog while looking for info or maybe just doodling with AML sights on the internet. Her doctors are advocating a bone marrow transplant after her initial chemo to induce remission, which of course my doctors did originally too. I don't know where you both are in the process, but I wanted to take this opportunity to wish you luck with all of the day to day decisions and issues that come up (you've already been through chemo and surgery so you know a thing or two thousand about what I mean).

Good luck to you and to my Stepdad and Mom who start their next phase tomorrow too.

Finding a Way

2009-10-25T13:21:00.000-07:00

I wrote a blog post a while ago called "Other People's Cancer" because we had two people close to us who had recently been diagnosed with cancer. I wrote about how the news of other peoples' cancers causes me to relive some of my own past health struggles. Since I wrote that, my stepdad was diagnosed with brain cancer and had surgery to remove his tumor. Next week he begins his own course of radiation and chemo, while Holly's brother-in-law finishes his. I know intellectually that there is no more cancer now than when I was in my twenties; it just seems like it. Just another consequence of aging I guess. I don't mean to focus so much time and energy and words on the topic, but it just keeps popping up. I promise that when it stops appearing and re-appearing, I'll stop writing about it so much. Until then, to those finishing and starting their treatment course, good luck!

Remember, energy begets energy. Do anything to move-get off the couch and go for a walk or if you're too weak for that, just walk around the yard. Be outside and feel the breeze on your face. Anything to enjoy being alive and feel less like a patient.

Holly and I attended my work banquet this weekend in Chapel Hill. How nice to see so many of my fine co-workers all dressed up, enjoying themselves at the dinner. Nice too of Piedmont to stage such a terrific event even in this time of tough finances. I promise to see a few extra patients everyday over the next year to help pay for it-well worth it!

Lighting Up the Night

2009-10-23T15:09:00.000-07:00

Last night we attended the Leukemia and Lymphoma Society "Light the Night" fundraiser in Durham. Marty, Deb, and Alex join us there with several friends adding donations to our team to benefit all of the good work that is done by the society for research and patient advocacy. Last year I was out of the hospital on the night they held the event, but my cell counts were too low to out and about with the public. It felt good to be able to join in this year, walking with a lit balloon-mine white since I am a survivor, while Holly and Alex had red ones as supporters. The event was much more somber than the Breast Cancer events I've attended. For one, it was notable how few white survivor balloons there were compared to red supporter balloons. Fortunately there are fewer blood cancers diagnosed each year, but the survival rates are much lower than for breast cancer. It certainly hit home seeing the paucity of white balloons compared to red ones at this event. I could go on and on about how lucky it made me feel. I could extoll my appreciation to everyone who supported me last night & the last year whether you were there or not. And I could assure all of you that I am happy for every additional day I get to be here. One survivor who had the same cancer I had last year spoke to the gathering just before we left for the 2 mile walk around Durham. He said that he didn't feel much like a hero which someone had called him. But then he realized that he was "Here -Oh," and that seemed to fit. Well thankfully I am "Here- Oh" too.

What 50 Looks Like

2009-10-21T06:26:00.000-07:00

Today is Holly's 50th birthday. While I was able to avail myself of the 3:30am hotflashes to say happy birthday, I had to wait until 7am to properly sing her the Happy Birthday song which is customary in my family. She was good natured too about the big tube of "Oil of Old Age" which I gave her. Tonight we'll go to the local hangout to celebrate a bit. We haven't done nearly enough of that- what with the cruise trip to Scandinavia, the cabin weekend with friends at the Va Creeper trail, and of course that happy birthday wish at 3:30am. Tee hee. Anyway, I feel incredibly lucky and blessed to be here now and celebrating my girlfriend's 50th. In some ways, it feels like I am celebrating my 50th birthday too. After my struggles and health challenges of the past few years, I feel older than 47. So 50 seems as good as any age to pick, and it's a fun one to commemorate. Thankfully I'm here and healthy and happy and able to be part of so many fun events.

More Happy Birthdays

2009-10-13T07:41:00.000-07:00

On this delightfully sunny October 13th, I'd like to wish my sisters Beth and Becky a warm Happy Birthday! They are turning 45 yrs old today. Now all three of us are deeply ensconced in our mid 40's (well I'm 47 which feels a lot closer to 50 than 40, but you get the idea). I hope that they have plans to to do something fun and exciting today to celebrate.

The Asheville gang plus Miriam and Alex from Durham celebrated Holly's 50th in the Virginia mountains this past w-e. We rented a big cabin that used to be the one room school house for the Whitetop Va community, where we stayed to take advantage of the Virginia Creeper bike Trail and hiking in nearby Grayson Highlands State Park. The family who owns the house turned it into a family cabin with gas logs, a big open kitchen, sleeping porch and loft in addition to actual bedrooms downstairs. We were a little cramped all eleven of us stuffed in there together, but this is the gang that goes camping, hiking, and canoeing all the time so intimacy just means having your own bathroom. We had a fabulous time with everyone arriving Friday evening just as the weather turned from blue skies to drizzle. We enjoyed a big potluck dinner with lasagne and eggplant parmesan followed by Susan's famous pound cake for dessert. She made a new one, tweaked a bit with the addition of cream cheese. It was the best I'd ever eaten and her other ones are pretty fantatstic. Ellen celebrates her birthday Sunday Oct 18th, so we got to fete her Friday night, and sang to Holly Saturday night. Seven years ago, Ellen rented the very same cabin for our group on her 40th birthday, so it was really fun to go back to the same spot. They even had a candle still decorating the house that she had left there 7 yrs ago. We had to get all nostalgic about that when we realized it.

By the way, while I'm thinking of it, nostalgia really is under rated. I think it's one of the reasons we go to these places with our group. We have so many terrific memories of old trips in the area, of staying the last time at this same cabin, of all the cold bike rides from Whitetop to Damascus when it's freezing even in July. This time did not disappoint either as we had a cool drizzle most of the day. But hey, we didn't let a little thing like light rain keep us from having a blast. The colors were at their peak, the bikes were all functional, and we even figured out how to shuttle then back to Whitetop without much ado. Everyone was such a good sport about the trip, all aspects. We enjoyed great food, funny stories, a beautiful mountain view, the bike ride, an entertainment show complete with dancers, and plenty of fun. I am thankful everyone was able to go to celebrate Holly's 50th and Ellen's 47th. More fun and funny memories for later (not everyone is brave enough to fashion a rain poncho from a plastic bedsheet, but we have just the gal for that too!)

Here are some photos from the trip.

More Yellow Ahead

2009-10-01T12:36:00.000-07:00

Today being October 1st, it reminds me to take time to notice the leaves. We've been very busy at the clinic lately, what with H1N1 infections and now giving flu shots and all the kids getting every stray cough, cold and crud that floats their way. It's easy, I think, for everyone to get caught up in what is happening at work this time of year. The kids are back at school meaning that they, too, are going full throttle with homework, tests, report cards soon and, of course, fall sports (a little soccer anyone?). But this is the most gorgeous time of the year, and I entreat all of you to stop once in a while to catch your breath, take a walk (now that it is no longer hot & humid, you can't use the weather as your excuse), and notice the leaves. We'll have plenty more yellow ahead, but now is the time to pay attention. Sure, it will get better and better-brighter and more vibrant as the days get cooler and shorter-but today is exquisite too.

I found myself driving around Charleston with my Mom earlier in the week explaining some of the gifts that having cancer has given me. I was down in my old hometown to be with my Mom while my stepdad had exploratory brain surgery. Unfortunately, we didn't get good news-he, too, has cancer. We're still waiting on the official biopsy results to know more about the type of chemo and radiation he'll have depending on the tumor type etc. I told my Mom that I like to think about each day and remember where I was last year and what I was doing (usually either in the hospital having chemo, or recuperating from chemo, or getting ready to have more chemo). Then I like to celebrate that I'm not doing any of that now by contemplating exactly what do I want to do TODAY, October 1st, just in case next October 1st is different from today. I know it might sound silly, but the perspective is really helpful. It is really freeing to consider what I want to enjoy today just in case next October 1st isn't so fun. So here's what I did today that I really enjoyed-woke up at 5am, snuggled until I was sure I couldn't get back to sleep, drank coffee while watching the daylight creep into my bedroom, had a terrific row while listening to REM, drank coffee containing chocolate syrup and whipped cream while visiting with Holly once she woke up, wrote postcards to 3 loved ones with cancer, wrote a Thank You card to my friend's mother who prays for me at a pilgrim site in France (I swear I am not making this up), treated a few sick people and told a few that they weren't as sick as they thought, enjoyed a fabulous walk at lunchtime up and down the street behind my workplace, ate a peanutbutter sandwich dribbled with extra peanuts, treated a few more sick people, then came home to start this blog entry. Holly and I will go hit the local sandwich place for dinner when she gets home in a few minutes.

So you pick the thing or things you want to do today that you just might not be lucky enough to do next October 1st.

Photo-my Mom and Brian just before we left for his surgery. I should have taken an "after" photo since he was up showered, shaved, and ready to go just a mere 24 hrs later.

Hugely Grateful

2009-09-24T01:44:00.000-07:00

Hugely Grateful-that is what one of my patients told me yesterday when she came for her usual check up on diabetes and high blood pressure. Her husband of 47 yrs died of a ruptured bowel in late January, and she had not been in to see us since. She said that they had been together "since the 10th grade" and that she was "hugely grateful" to have had so much time with a great man (she is now 66). I was struck by her words because I too am hugely grateful. Hugely grateful to have been able to attend the Brewgrass Festival in Asheville last w-e, when I couldn't last year due to my treatment. Hugely grateful that I have so many great people to enjoy both at work and outside of work. Hugely grateful that my girlfriend is game to run 13.1 miles with me to celebrate life. Hugely grateful that my best pals are willing to hang out all day listening to bluegrass music while we eat pretzels and sample craftbrewed beer. Hugely grateful that my family is ever ready to call, visit, and drop their daily lives to be with me when I am sick. So today, after hearing my patient's story, I just want to reiterate how hugely grateful I am to be here enjoying the heck out of everything I get to do-each day, a gift to share with people who are terrific. You know who you are!

Okay, on a different note, we did finally get to the Brewgrass festival this year. We had tickets to attend last year. But that w-e, I was busy recovering from one of my chemo treatments, and we couldn't travel. Susan and Donna sold our tickets to someone else and attended on their own. This time, we got to go too. Donna made us pretzel necklaces to chomp on during the day, and naturally,I ate all of mine (see photo). We loved hearing the Dehlia Low band, and the others were great too. One band from Knoxville, Tenn was terrific. We arrived good and early to get our chairs set up close to the stage, which was great, because later in the day, that field was full and I mean full, full of people. We sampled lots and lots of craft beers which was really fun. I didn't enjoy the taste of them all (pumpkin beer-why combine the two???), but it sure was fun trying new ones. I got a temporary tattoo from the "Tattoo Man" so now I am tickled like my little kid patients who get them from us at the clinic. Mine says "Rogue Nation" with a big fist. I got one for later that says "Big Boss" so watch out for that one. Fun and silly.

We are staying in Hillsborough this upcoming w-e since it's my turn to work the Saturday clinic. We plan to reconnect over dinner with some friends who live here. And I'll have a chance to work in the garden here, getting the space ready for my fall plants and bulbs. Later I'll leave for Charleston to be with my Mom, whose husband is having surgery on Monday. Hoping all of that goes smoothly.

Happy Birthday Momacita!

2009-09-14T10:38:00.000-07:00

Today is a very special day-my Mom's birthday. I had to call (as she always does) and sing her happy birthday early this morning. I just love that we celebrate birthdays as a special day in my family. Of course it's all I've ever known. But I simply can't imagine being in one of those families that treats birthdays like any other day (you guys know who you are). I try to be open minded and tolerant of differences, but with this one, we are right and they are wrong. So a big warm, happy birthday wish to my Mom on her special day.

Saturday morning Holly and I ran the Asheville half marathon over hill and dell, past Beaver Lake and up Lookout Rd. It was a challenging 13.1 mile course, to say the least, and we were happy to finish in about 2hrs and 9 mins. Actually, we ran the course a bit faster, but we stopped to visit with our support crew (Donna, Susan, Jan and Ellen, see photo) at our house which happened to be near mile marker 10. The new course is a good bit hillier, and it gave us a great excuse to pause before heading back to the race. They were sweet to come out and cheer us on, and the eclairs from the Creme bakery afterwards were pretty nice too.

Lovely, Just Lovely!

2009-09-07T10:22:00.000-07:00

Holly and I are home again, safe and sound in our little Hillsborough home after a week in Scandinavia and England. We had a terrific time-blessed with fabulous, sunny weather and only one choppy,rainy day at sea. Friday night we caught the direct flight from RDU to Heathrow airport in London. That got us into London around 7am their time, where we took a National Express bus directly to the Southampton Cruise terminal some 1 and 1/2 hrs away. Neither of us slept much on the overnight flight so the bus ride allowed us a short nap before boarding the ship. Our cabin was terrific with big sliding glass door, balcony, and deck on the starboard side of the ship. That turned out to be the better side of the ship as we got to see the dixieland jazz band play at the gangway as we sailed away. It also afforded us a marvelous view of the Oslo fjord both coming and going on our last port of call at the end of the trip.

Our first stop was in Zeebrugge, the port for Bruges, Belgium. We took the local train to Bruges about 8 miles away-through the beautiful countryside of Flanders-an area of important battles during WWI. It was green, lush farmland. The Bruges train station was a short walk to the old part of the city, a medieval village that has preserved much of its character and history. I got a picture of the bike lockup area outside of the train station because I have never seen so many bikes. It was just the first of many such bike parking areas in these European cities that tax cars at 180% (yes, you read right. We couldn't believe it either, but a car, even a small car costs the equivalent of $40,000 to encourage biking, trains, buses, etc).
Anyway, we literally ate our way around the Bruges walking tour I'd downloaded from the internet. In short, we had waffles, chocolate, beer, mussels, and frites (fries). We bought some great Belgian beer to take back to the ship since they only had can British beer-not our favorite. Beer must be heavily subsidized in Belgium as a bottle costs little more than 1 euro in the grocery store (well they are brewed by monks...). We bought a selection of different ones and enjoyed them one at a time each night before dinner. Unfortunately we didn't have time for a brewery tour at one of the monasteries-next time.

Our second stop was in Copenhagen Denmark. The walking tour started right near the boat dock with the Little Mermaid statue and continued along the shore to the Royal Palace, the city hall and then to the central shopping district. We had packed some delicious sandwiches for lunch from the hard rolls, smoked salmon, and cheeses from the ship buffet. But we still ate our way around the city, stopping for chocolate and pastries at the golden pretzels (that's how they advertise their bakeries). I wish we had had time to take the countryside bike tour with Mike at one of the local bicycle shops. Bikes are huge in Copenhagen-everyone has one-those cool commuter types with good fenders, baskets for hauling goods and, of course, bells on the handlebars to warn pedestrians. They cost the equivalent of $1,000 for the basic model-a lot cheaper than a $40,000 car at least. The bikes have there own lane in the streets, and watch out if you're a pedestrian, because they do have the right of way. We saw every kind of person biking, and I mean even women dressed in chic outfits with fancy shoes. Everyone bikes and you can get everywhere on bike. People were especially friendly and happy, it seemed to us, in Copenhagen; it's high on our list to see again. Maybe a bike trip next time.

Next we cruised an hour or so North to the small town of Helsingborg Sweden. It was the least impressive of the ports we saw. But we had a great walk through town and up past the fortress to a preserved farmstead from the 1800's. That was pretty cool-to see what an old town square was like complete with shops, barns, animals, windmill, and gardens. I looked, but I couldn't find Pippi Longstocking. She was in the bookstores though. Tee hee.

Our last port of call was Oslo Norway. We cruised up the Oslo fjord just as it was getting light; we really enjoyed seeing that entrance into town. It was the prettiest of the places we docked being at the marina for ferries and other boats. We bought one of the Dagskot cards to get the tram, or streetcar, out to Frogner park with all the famous Gustav Vigeland sculptures. We managed to get there early before all the tourists arrived. It's a city park with many paths for walking or jogging and some 200 sculptures. I took lots and lots of photos as the guy made sculptures of all kinds of human figures expressing various emotions. At one point, we were walking along the jogging path and noticed a big monument that looked remarkably like Lincoln. When we got closer, we realized that it was Lincoln-our Lincoln seated on a big slab of marble. The monument said it had been given to the people of Oslo from the state of North Dakota in 1914-Go Figure. Must have been alot of people from Norway in ND in 1914, who knew?
Oslo was full of interesting museums, including the Nobel Peace Museum, right near the docks. Again, there were tons of bikers just like the other cities, but everyone rode mountain bikes instead of those city commuter bikes. And man, talk about an expensive city. The cheapest mountain bike was Kroner 14,999 which is the equivalent of $3,000. A typical sandwich at a shop was Kr80, about $16 each. A beer was Kr49, about $10. It turns out they are the richest country in Europe due to their oil (3rd behind Saudi Arabia and Russia), fishing, and timber. But $3000 for a mtn bike, really that is alot. Makes my little Bella seem like a bargain (and she is).

We had a beautiful trip back out the Oslo fjord on the way back to Southampton England. Once we got to the North Sea, we hit bad weather with galeforce winds and rain. The Captain slowed the boat to a crawl, and we landed in port later than planned. Many people missed their connections to buses, trains and planes, including us. Fortunately, we were able to go online in the Ship's internet cafe and rebook a later bus back to London. We missed the chance to go into London and sightsee, but that was okay. We had a nice dinner of fish and chips and Fuller's ESB in the Three Magpies pub near our airport hotel. All in all, we only had 1 day of bad weather (out of 8), and it was a day at sea anyway, so who cares? As the Brits say, Lovely trip, just lovely!

Bon Voyage

2009-08-28T06:28:00.000-07:00

Well later today Holly and I take off for our grand tour of Europe. We are taking this trip to celebrate her upcoming 50th birthday. In my family, birthdays are a big deal, and a fantastic trip for turning 50 yrs old seemed in order. She has been to Europe, and we've even been to Italy/London together. So I wanted to plan a trip somewhere that she had not been previously. Scandinavia seemed just perfect. We fly out of RDU later tonight, straight through to London. Then we shuttle down to the coast to board our cruiseship. The actual cruise leaves Saturday afternoon and heads on to Brugge,Belgium, then Copenhagen,Denmark then to Helsingbor, Sweden, then to Oslo, Norway and back again to London-all in one short week. We've never been on a cruise together but this seemed an easy way to sample some ports, unpack only once and require less time/planning than most Europe trips. I know that we will have fun, but I've been pretty nervous and excited about everything working out well. I know that we'll have a spendid time.
Hopefully you'll have a splendid time during the next week too and enjoy your Labor Day!

Bon voyage!

Summer Fading Fast

2009-08-24T09:49:00.000-07:00

Holly and I have been enjoying the w-e in Asheville. It's been mild and breezy-that kind of late summer weather that is so gorgeous in the mtns. Friday evening we had dinner with friends, enjoying their house which is nestled among the hardwoods, rhododendrons and mtn laurels. What a beautiful spot to enjoy a delicious dinner with such terrific hosts.

Saturday morning we did another section of that challenging half-marathon course which we will run Sept 12th in Asheville. The course begins downtown near the historic Grove Arcade and winds its way through town to a beautiful neighborhood near the Grove Park Inn (i.e. it's some up), the Kimberly area, over to the golf course (again, it's up), around Beaver Lake, then down to the River (what goes down must come up), turning on to a winding road that passes our house (that one is really up, up, up), around the university and down a long street heading back toward town to complete the 13.1 mile route. This Saturday we ran a little over an hour and a half. We have been reading in the local newspaper about all the people training for the half-marathon who have already completed the course for their training. I like a little more excitement and mystery in my life. If I'd already completed the whole thing, I wouldn't feel the need to do it on Sept 12th. I mean, the purpose of the thing is to see if you can do it. It's a kind of health celebration for me-to prove that I can run that far after all of that horrible chemo last year. I need and want the mystery of wondering how I will feel running that far. As far as I am concerned, all of those other people can train by doing the entire course if it makes them feel better. Me, I'll stick with a little uncertainty on this one.

Saturday afternoon we attended the Beer & Baseball event held downtown at the stadium. It was a showcase for about 30 microbreweries with several bands playing on the actual field (there wasn't a bit of baseball, go figure). Anyway, we got turned on to a new artist named Kellin Watson, a bluesy rock singer who did a terrific hourlong set. Really cool to catch some new live music and enjoy some great fresh beer. My two favorites were the ESB from Sweetwater Brewing Co and the new offering from the Hebrew brewery. However, there were lots of other great styles to try. Water was a very popular beverage too as it was fairly sunny and warm early in the day.

Sunday we ate brunch with our friends Susan and Donna before they had to head off to work. Great to catch up with them over eggs and bacon. I got to show off Bella, my new mtn bike. Susan tried it out briefly. I think she liked it, especially having that extra shock in the back. Afterwards, Holly and I rode the mtn bikes in Bent Creek, and we did one of those routes with the big hill climb (59 mins of continuous up but who's counting...) followed by the big whirlygig down, down, down (Green Lick, it's called). Wow what a blast on my new bike. I love that Bella girl. It really does make a difference in the amount of jostling and jerking when you ride over rocks or roots. And there were just a few of those.

We saw the "Julie & Julia" movie Sunday evening. What a treat! I love seeing Meryl Streep in anything, and getting to see her play Julia Child is incredible. She does such a good job laughing in that sing song way that Julia did, lumbering around in all of those old outfits, and wrestling with all that poultry. She made the movie so fun to watch. Just don't go hungry, or you'll be starving by the end. Even I am tempted to cook beef bourgandy after seeing it in the film, and I don't even eat beef.

Next Friday, Holly and I leave for a trip to Scandinavia to celebrate her 50th birthday (which is actually in October). In her honor, I wrote a message in stone (well sort of...) The pink bit is an orchid bloom.

Meet Bella

2009-08-18T16:51:00.000-07:00

Things have been more than a little hectic the past few weeks. I am extremely busy at work with more than my share of patients, their phone calls, refill requests, and the mounds of paperwork every primary care doctor has to wade through. Actually, work has been pretty stressful lately with more than a few patients now homeless and unable to afford their medicines due to the economy, another few with new diagnoses of cancer, and many more with complaints of depression and/or anxiety due to work or family issues. Some of the time, it is all I can do to keep from drowning myself in the 20-30 stories I hear each day, but then I remember to breathe, relax my shoulders, take a walk at lunch, and enjoy some delightful patient or co-worker.

Though we schedule our w-e's in Asheville to the max, I finally found time to buy that full suspension mtn bike I have been talking about for over a year. I named it "Bella" which means beauty- so attached is the photo of Bella AsBike. Tee-hee as Susan would say. For those of you who care, it's a Trek Fuel EX 8 Woman's Specific Design, and the technology with that rear shock certainly does make a difference. Now I can bound up the hills faster, higher, easier and all that. I am very happy with my purchase as is Holly who was already way past my long wait to (finally) buy something so nice for myself.

Our Buddy Jo's birthday is coming up Sat Aug 22th. Happy Birthday Georgia Girl.

No Needle Until November

2009-08-04T14:52:00.000-07:00

I was scheduled to have my next bone marrow biopsy and general check up yesterday at Duke. My blood counts looked so good that Dr Long gave me a reprieve from the bone marrow biopsy they had planned. I have been getting them every 3 mos since I finished my chemotherapy last November. My white cells are behaving themselves as are my other blood components.

My only problem has been soreness in my right hip near the spot of my past biopsies. We think that I have a little scar tissue aggravating the nerves in that area. I took an X ray to make sure everything is okay, but I haven't heard back yet. I was certainly relieved to get away yesterday without another big needle stick in my rump. Thank you Dr Long.

Holly and I were on vacation in SC last week with my family. My Mom rents a large beach house right on the front beach at Folly near the park area (i.e. fewer homes and lots more wildlife). We had a great time enjoying the sun, the relatively mild temps (upper 80's mostly), and hanging out with family. I got to see both of my sisters, their kids, both of my parents and their spouses as well as my Mama. I think I'm the only one who looks older. Everyone else has managed to age in reverse except for the kids.

Our first day there was my birthday (July 25th), and Mom cooked my favorite - fried shrimp. For dessert, we had a 4 layer chocolate cake that she adorned with 47 candles. We ate famously well during the week-what with Mom cooking all the time, one night out at my Dad's, a dinner downtown at a ritzy restaurant, and plenty of Bessinger's barbeque to fill in the gaps.

Emma and Ethan sure earned their water wings. Emma jumped at least a million breaking waves until she learned to go with them and bodysurf. Ethan may still be submerged peering through his scuba mask. He collected a veritable treasure trove of ocean goodies including starfish, all manner of shells, eggcases, and seaweed. I suspect he'll announce the opening of his ocean exhibit later this month. Next year we'll be lucky if we see him at all. He'll probably have a boat or surfboard by then and merely playing in the surf won't do.

Here is a photo from the birthday-a gorgeous cake not yet decorated with all 47 candles.

What You Can Learn from a 12 yr old

2009-07-24T13:26:00.000-07:00

Last weekend Holly's nephews Christopher and Thomas visited us from Kansas City. They flew into Charlotte, where Holly met them and drove up to Asheville for the long w-e. I feel pretty confident in saying that I haven't spent that much time with 2 adolescent boys since, well, I was an adolescent myself. And suffice to say that much has changed in that time period (cellphones, computers, and technology in general) while other things are still the same (girls, braces, and pizza). I don't think we were as fun for the boys as they were to us. For example, Thomas taught us how to send and receive text messages (I swear I am not making this up). Amazingly, he displayed a comfort and ease with everything we threw at him while managing to straddle the boy's world of computer games and 1 # jaw breakers. He was completely comfortable kayaking in the river, paddling on the French Broad rapids in a ducky, and hiking with 2 middle aged women. Apparently we have a black widow spider that lives on our hillside which he found while playing outside (who knew?). Christopher treated Holly to a flute concert (both boys brought their instruments to practice dutifully as their mother requested) and was more talkative than when he visited 2 yrs ago. I am not sure we were very helpful regarding his question about how to attract the interest of girls. Still I was a bit amazed by their knowledge-the weed overtaking my garden is called carpetweed, black widow spiders have one of the strongest webs of any spiders, and origami cranes make good thank you notes. They were really a delight to have visit.

Tomorrow Holly and I leave for Folly Beach to spend a week in SC with my family. It is also my birthday-I'll be 47. What a treat to see another birthday even healthy again. I purposely put off my next bone marrow biopsy until AFTER this trip just in case I get bad news. I didn't want anything to interfere with our vacation week. This way, we can behave like anyone else on vacation-carefree and easy.

Our Buddy Jo

2009-07-16T01:53:00.000-07:00

Though it's been almost 2 w-e's now, I wanted to post one of the photos from our trip over to see "our buddy Jo." I cannot take credit for the moniker there, however, as that is often the subject line that Susan uses when she sends out email updates on Jo. The photo here is from our visit to see Jo shortly after Susan baked her a big pound cake that we accompanied to her condo. As always, Jo looked happy and at peace, like the remarkable woman she is.

Last weekend, Dennis and John, our friends from DC, were visiting us. They both retired from government service in October and just moved to a new home in Fort Lauderdale. I hadn't seen them in about 4 yrs, so it was good to catch up and reconnect. We were the last stop on a grand one month tour of friends and acquaintances all up and down the Eastern seaboard from Savannah to Maine and back again. They pulled up Friday in their big Texas truck, as I like to call it, loaded with a month's worth of clothes stuffed behind the seats and bikes in the truckbed. One of the highlights while they were here was our trip out to Saxapahaw, a small rural community, really a crossroads, located on the Haw River to hear music. The area has a community park just across from the river where they have free music every Sat night as well as a farmer's market, Hula hoops for sale and use during the music, and of course, bbq (this is NC afterall). My boss had told me about the fun as she went with her husband and 2 young kids some weeks ago. We took our blankets and picnic to find a place among the families with kids and babies and all of the tie dye. There was a lawn facing the stage for enjoying the music (a great bluegrass band) as well as a slip and slide for the kids and a whole hill of people doing the hula hoop thing. I mean women, children and even guys not too scared to look silly, using a wide variety of hula hoops, which if you haven't looked lately have become more upscale with different sizes, bright colors and even come adorned with fancy ribbons. We had a great time just hanging out for a few hours doing the small town thing with music on the lawn. Very fun.

It's getting to be vacation time. Our friends Miriam and Alex are off in the Pacific Northwest visiting a montage of sights from Vancouver to Seattle and the Olympic peninsula. Laurie is off on a big Alaska hiking adventure, and soon we will be off to Folly Beach for a week. I have been busy at work and weighed down a bit by the serious health problems of my patients. Many of them are stressed to the max (and won't have anything like a vacation) since they have lost their jobs in this economy and are barely making it both financially and emotionally. I can help with some with their medical problems, but I don't see any easy solutions for the rest until the job situation gets better for everyone. It makes me feel mighty fortunate to have a good job and even better to have good job skills and a good career that will always reward me, both emotionally and financially. If all you know how to do is to make Gold Toe socks, like so many of my patients, then you are in big trouble.

I don't want to end on a sour note. I feel really fortunate for all that I have, and most especially, for all of the people who add meaning and love to my life.

July 8, 2008

2009-07-08T08:27:00.000-07:00

I have promised myself not to dwell on the past, especially all the difficult or bad things that happened last year. Usually I am so busy enjoying my life now that I rarely even take the time to write here anymore. Sometimes it feels silly to broadcast my comings and goings, especially as my weekdays have become dominated by work while my weekends consist of the commuting flow to and from Asheville.

I don't ever forget all of the love and support I received during difficult circumstances. So let me take this opportunity to thank my partner for helping me through the roughest day last yr which was July 8th, 2008. I had finished my 7 days of continuous chemo in June only to develop one infection and then another. My fever hit 104.2F as I was diagnosed with pneumonia. I felt horrible that night and begged Holly to stay with me in the hospital that night. I truly felt it could be my last day as awful as I felt. I barely had a cough or shortness of breath but my body hurt and wrenched from the high fever and chills. But my doctors found a good combination of antibiotics and anti-fungal medicines which cured everything.

And the most amazing thing is that today, a year later, I am cured, feeling wonderful. I did a 4 mile run this morning, enjoying the gorgeous roses blooming all over Hillsborough, followed by push ups, sit ups, and stretches. Before work, I sipped coffee with chocolate sauce and whipped cream (I call that my dessert cup) while I watched the birds at the feeders outside my bedroom window. If you need more than that to be happy, you've never faced serious illness or death. Several times a week I give thanks for all I have, grateful to be here now. Just call me lucky...

Other People's Cancer

2009-06-25T17:46:00.000-07:00

I have been reeling a bit recently as we learned that 2 people close to us have cancer. I am just now celebrating my 1 year anniversary in remission, a time of sweet celebration for me. But it is tempered a bit by all of the other emotions that come up with such a major death scare - the hard times in treatment, how things could have turned out differently, and how even something as innocent my monthly blood test is a reminder that despite all my current good health and energy, things could change at the drop of a hat. I don't intend to stay in this mode for long-remembering the bad/scary moments -but I am worried doubly for my pals with their new diagnoses of cancer. I hate that anyone has to go through this too and feel all of the uncertainty, worry, and grief that accompanies cancer. I can only hope that my pals get all the support and love they need to deal with this.

Our friends Rebecca and Sara were with us last weekend in Asheville. We took advantage of the great weather to see the magical display of rhododendron and flame azalea at Roan Mtn. I've included a few of those photos here.

Just a Regular Old Update

2009-06-16T15:07:00.000-07:00

I realize that I have been slow in getting back to the blog lately-mostly because I am doing well, and we are very busy. We have been getting back to Asheville most w-e's except when we are headed to the beach with friends, or to Charleston with Holly's Dad, or to Kansas for her niece's wedding. Asheville has finally gotten its share of wet weather after 2 yrs of drought, and our garden is thirstily drinking it up. I have spent a great deal of time recently mowing, mulching, separating and generally tending to all of the plants there. The plants have really spread out, and the garden is all a mish-mash of spent peonies, irises, bee balm, phlox and other varieties. I am still trying to tame all of the weeds that got a head start last year when I wasn't able to play in the dirt due to my cancer treatment. I spent most of Monday getting some order to the bigger area of the hillside, prying out miniature tree stalks, native grape vine gone wild, and just plain old grass. It was quite satisfying to get a bit more order going there, even if there is still much to do.

The garden here in Hillsborough seems so orderly by comparison but that's only because it is young still and hasn't taken off yet. There are more trees along the fence here (on purpose to act as a plant barrier) and fewer perennials, giving it more daylight and mulch between plants. I have just harvested my second crop of romaine lettuce for a dinner we are having tonight with friends. I love being able to say "I grew that." I have also planted broccoli (hope I'll know when it's ready), herbs, tomatoes, peppers, eggplant, and berries.

I have been meaning to relay a story about our latest visit to hear music at the French Broad brewery a few w-e's ago. We had gone to see the Leigh Glass band with some of our pals, who also like bluesy, folksy rock. I was sitting at one of the tables when this guy comes up and offers to buy me a beer. He tells me that Leigh Glass, the woman singer and front musician for the band, wanted to buy me a beer. I deferred telling him that she didn't have to do that but thank you. Then a song or two later she announced that sometimes she googles the band's name to assess the presence and impact of their bookings. She said that one day she came across this blog from someone doing her own healing and wanted to thank me for being there with my pals. She'd been having a bad day, wondering if what she does is worthwhile. It was uplifting for her to see that she IS making a difference. I was very touched by her gesture; she certainly didn't have to acknowledge my struggles in such a kind, encouraging way. Leigh if you're reading this, thank you. And keep on playing-you are making a difference.

What a Difference a Year Makes

2009-06-05T01:51:00.000-07:00

June 4th last year was my last day of work before going out for 7 months. I had just gotten my official diagnosis of AML from the hematology-oncology specialist at UNC. On June 4th, I gathered together a circle of my coworkers and announced that I would be leaving to have cancer treatment. At that point, I thought that I would be admitted to UNC for chemo and then a bone marrow transplant. I also thought that I'd be out of work only 3 mos, expecting to return by September. Well there were lots of zigs and zags after that, but, now, a year later, I am back at the Charles Drew Center taking care of others. I am healthy; my cancer is in remission and I didn't have to have a bone marrow transplant with its attendant problems and complications. I cannot do justice to the feelings I've had in the last few days, as I've relived the events of my diagnosis last year-the fear I had then, of the unknown ahead, and the extreme gratitude I feel now for my extra year, jammed pack with fun and the love of friends and family. Every day that I can be of help and significance is a good day.
Every day that I get to run or walk outside, either alone or with others, is a good day.

While we were in Kansas last week, I saw a cool magazine article in the Atlantic Monthly. There is an ongoing study of happiness and life events in a cohort of Harvard men. The researchers have been interviewing the men since college, and they are getting to be elders at this point (both the researchers and the study participants). They have found that the one best predictor of happiness is good relationships-not money or prestige or job success. Just plain old relationships. It's amazing that all the trappings and things and money can't make one happy; yet so many people work so hard for those things. When you wake up one day and hear that you have cancer, you realize that you might not live to a ripe old age. Money and things don't seem very important but relationships do. I think they have it right, those researchers.

Today I feel fortunate and happy to have so many people who made a difference for me in the last year. If you're reading this, thank you.

2009-05-29T02:23:00.000-07:00

I keep falling behind on my blogwork as I get more and more into work at the clinic, gardening at both houses, and our full social calendar with friends. It takes a lot of work (and sometimes planning/organization) to juggle two households, two sets of friends, a 3 hour commute back and forth each week, and a job. Lately, we have been doing a lot of additional travel as well, with trips to Charleston, Sunset Beach, with this w-e to Kansas. There are so many comings and goings that I keep getting confused exactly which w-e’s are Asheville ones and which involve travel to another area. It’s a great problem to have, and one that I could only dream about last year during my cancer treatment. I don’t take it all for granted. A few rogue leukemia cells, and I’d be back in my Duke blue chair in the bone marrow clinic getting platelets and blood, only dreaming about going somewhere for pleasure travel.

I have been thinking about travel a lot lately because this week is the 1 yr anniversary (if you want to call it that) of my leukemia diagnosis. While that is not exactly something to celebrate, I am looking forward to June 20th which will be 1 yr in remission from AML. Last year, I was hospitalized from June 13th-20th for 7 days of intensive, continuous chemo. At the end of that treatment, I was in remission. I plan to celebrate June 20th because it commemorates a year of life I wouldn’t have had without all of that tough treatment. I owe an enormous debt of gratitude to many people for helping me through all of that. My pal Peggy, the potter out in California, has been making mugs for me to give as cups of gratitude. I just got a shipment of them, and they are gorgeous. I am hoping that everyone who gets one realizes how much I appreciate their efforts to help me get well. And I hope that they can symbolize for me, and for them, how precious life is. Yeah, and here is a beautiful handmade piece of sky and mountains to remind you (the mugs are porcelain with a beautiful blue and green glaze that looks to me like the sky and mtns).

Today's photos are from our hike last week in the Max Patch area of the Appalachian Trail-our Ansel Adams, and cucumber vine.

Having a Time of It

2009-05-18T16:26:00.000-07:00

We spent the w-e enjoying a beach house duplex at Sunset Beach. Though it is part of the NC shore (just barely though since you can see N. Myrtle Beach from some spots of the beach), it has the wide, gently sloped white sands of the SC beaches I grew up with. The water was a bit too cold for me to swim, though some of the hardier souls in our group took advantage of the warm sunny days to do some boogie boarding. Holly and I made do with beach runs and fried seafood and kayaking in the sound. We saw many good birds including one large bald eagle perched high in a tree on the other side the sound as well as numerous oyster catchers swooping around the waters edge. Our group of ten managed to eat, swim, play bocce ball, bird watch, kayak and cook together. Sharon reserved an upstairs/downstairs duplex, and we had plenty of bathrooms and queen beds to go around. We ended up with 2 kitchens, too, of course, which really simplified mealtimes, especially the evening we all cooked together (gaucamole and chips then grilled red snapper, boiled shrimp, grilled veggies, broiled asparagus, followed by ice cream and fresh strawberries). Though it kept threatening to rain and thunderstorm at various times during the w-e, the bad weather held off until Sunday night. It was still pretty windy this morning, but the worst of the rain had past. Before we left, I got in a good run, enjoying the beach almost to myself. It was an excellent day to watch the storm clouds roil by and to feel the pull of the tide on the sand beneath my feet. Others were out vetting their new raincoats and other waterproof gear, while I enjoyed the contrast of the post run warmth and the cold pelting raindrops. It was something else.

Though several folks made comments about our antiquated whitewater boats, which we took to kayak in the sound, we had a perfectly good time getting in and out of the marsh creeks and alleyways made by the reeds. Neither of us paddle enough to justify spending money on new boats expressly for sea kayaking or more accurately marsh kayaking. (The boats we have are free- a price I like alot, as my father likes to say...) Here are some photos from that trip. Top-me, Middle-Holly, Bottom-Holly with single, Laurie & Julia with their canoe

Yet Another Reprieve

2009-05-11T17:13:00.000-07:00

I had my yearly mammogram this morning, and I am happy to report that everything is clear there too. Last week it was the bone marrow biopsy results, and this week the mammogram. Duke just replaced their mammography machines with a new state-of-the-art digital machine. Unfortunately, at this point, they only have one of them. Everyone who used to get their scans in the three different rooms must now funnel through the one machine. The scan itself is quicker and has higher resolution. However, because there is currently only one of them, all of us waiting for the radiologist to interpret our images waited with the ladies yet to have their mammograms. I sensed that things were pretty tense as soon as I stepped into the room to wait on my turn. First, there was only one free chair for me to sit in, the rest were filled with other women waiting to go back to have their mammogram or to receive their results. One lady got called back to the radiologist's area for a "consultation." She ended up having additional views taken, followed by an Ultrasound. Suffice to say that she did not get good news today. It cast a pall over the whole room. I wanted to tell her that I'd been there, done that, but I kept quiet. It was unnerving enough for the poor lady to get bad news surrounded by a whole room full of strangers. Of course, they didn't actually tell her the news in front of us all, but we were all sitting there waiting to be told that we could get dressed now and everything is okay and here is your copy of the radiologist's note, blah, blah, blah. She didn't get any of that; she got extra scans, an Ultrasound and questions from the tech about how to contact her doctor. So we all knew without officially knowing anything specific. She left with that blank, shocked look on her face that I know only too well.

When I got back to the big Snappy machine, I just let my tech move me all kinds of different ways - pushing me here and there under the plexiglass ledge and bending my face out of the way of the beam. She kept commenting on how good a patient I was, and how she hoped that she wasn't hurting me, especially when she had to get the machine really tight into my chest wall where my old scar is located. I told her that my goal is to be flexible like Gumby; she seemed to appreciate that. "But you are so good; usually they are complaining when I press this hard." I explained that after the bone marrow biopsies, this was nothing. "Well I hope that you don't ever have to have another one of those," she said. Yeah, well that isn't likely, I thought, but I kept it to myself. I got good news today, which is more than I can say for that other poor lady. I'll be thinking about her this week, and all she has to take in.

On a different note, we did have our fete for Ellen on Sunday. Here she is in her celebratory yellow shirt at her graduation party.

Peonies for Mom

2009-05-10T03:55:00.000-07:00

Today is Mother's Day and I am up early enjoying the birds singing and the big bushy peonies blooming in my Asheville garden. I'll do a run later this morning before the gang comes over for Ellen's brunch. We are honoring our pal Ellen because this w-e, she is graduating with her BSN in Nursing. Tough as it was, she worked full time as an RN at our hospital here AND went to school for the advanced degree. I think we'll get to see a little more of her now. So we are having a big celebratory brunch for her on this beautiful Mother's Day.

My mom, Sara, is in Atlanta to celebrate the college graduation of my niece, Sara, from the University of Georgia, which incidently my mother graduated from as well (a branch of the UGA system in Columbus). My mom also went to college in her 40's and worked hard to attain that precious diploma. She and I were in college at the same time, so I know a thing or two about how hard that must have been to achieve. But my mother is one of the strongest people I know, and when she sets her mind on something, watch out! She always told us " where there's a will, there's a way" and she made that happen. I am so fortunate to have some of her determination and will in me.

I think I also inherited my love of plants from her; so Mom, here are some beautiful peonies I photographed just for you this morning. If I could bring you one so that you could smell its sweet aroma and see all the delicate layers to the blossoms, I would. I love you very much. Happy Mother's Day, your Tree

Date Night

2009-05-08T00:53:00.001-07:00

Holly and I had a date last night and went to the locavore restaurant Watt's Grocery which is located in an older neighborhood in Durham about 1 mile from the University. We had an excellent meal with a roasted beet salad and an entree portion of their flounder cakes on a bed of creole style black eyed peas. We had a similar dish in Charleston last w-e at the Fat Hen, also a locavore place, that served us shrimp and crab on a bed of black eyed peas. Last night we talked about the fact that until we got together, Holly had not eaten black eyed peas. Amazing! I ate them lots growing up, and they always make me think of my grandmother (not my Mama who is my Dad's mom and always cooked an okra soup/stew/gumbo). It tickles me that this dish we used to have because it's thrifty has become one of those fancy sustainable foods. Of course it always has been a sustainable food and a delicious one at that. I usually fix it with rice and saute in some onion, garlic, and a little cumin. It goes great with greens like kale or collards. Add a little corn bread or a biscuit and Ruby (my grandmother) would be proud.

After our dinner, we drove to the Duke gardens to see the flowers. It was filled with families enjoying the sun after 2 days of rain. The big blossoms of digitalis, peonies, and allium didn't hurt either. The gardens are tiered, if you've never seen them, sloping down to a koi pond with water lilies. When I had my breast cancer chemo (every other friday for 12 weeks), we used to sit in the gardens on the other side of the koi pond and take in the flowers while we ate lunch. It felt odd to be back in that same place and just be able to enjoy the sight of it all-no need to steel myself for upcoming needle sticks, nausea, and feeling sick. Holly asked me if it feels weird to be back there where we spent so much time associated with my treatments. It does feel a little weird because it reminds me of all we had to go through so close by in the medical center. But I have lots of other happy memories of the place too-memories from my undergrad years of running through the trails, memories of walking there during med school when I had a short break, and even fond memories of Jason and LeAnn's wedding with the whole Riley clan taking over the lawn. I owe alot to those gardens with their soothing paths and varied plantings. And the best thing of all is that I don't take it for granted. I got another clean bill of health this week, and I'm almost a year out from my leukemia diagnosis. Very delighted by that.

Photos: Duke gardens on May 7, 2009 and Quigley sleeping under her mink with my socks and underwear to feel close, I guess

Another 3 Mos Reprieve

2009-05-04T16:29:00.000-07:00

Holly and I just returned from a w-e in Charleston SC showing her Dad, the history buff, around the old revolutionary and civil war sites. He made a list of the things he wanted to see and managed to get to many of them. It's pretty cool to see your old hometown through someone else's eyes and enjoy the wealth of history and sightseeing that comes with being a visitor. Holly rented a condo in a great central location West of the Ashley River, which was convenient to all the different spots we visited. The condo complex was located on a piece of land that used to be my Mom's old housing project. She lived there when she was in high school and used to take me to stay with my grandmother who continued to live there after I was born. I have seen photos of the housing complex in the early 1960's and believe me, the condos are much more upscale. Oddly enough, we were also just around the corner from the house where we lived the first time Dad served in Vietnam. Each morning, Holly and I ran along a greenway trail that crossed the street near the old house. In addition, my aunt Mary Alice and her family lived just across the street in a similar house. I took some photos of the two old homes to commemorate where I played outside with friends and skated at Christmas in my Indian outfit. Somewhere I have photos in my army fatigues posing on the front lawn with Beth and Becky in their matching twin dresses. You'd never guess at all the history in those homes if you drove by, barely registering the low, simple ranches with their dirt driveways and chain link fences.

When we returned from Charleston today, there was a phone message from Tanya ("this is Tanya from Duke") about my most recent bone marrow biopsy. The results were all normal fortunately. Lest you think it's easy to wait a week each time for those results, let me disabuse you of that notion. Something about having cancer and treatment and cancer and treatment and now big needle pokes every 3 months that reminds me of where I've been and where I could end up again. I don't know if I'll ever get more relaxed about the whole biopsy process. I mean, really, what greater reminder can you have that you have/had a life threatening illness than the death scare that just can't be swept cleanly away. I do manage to put it all out of my mind once the soreness from the big needle receeds (and the news is good, obviously). I'll be there in a week or so, when my biggest preoccupation again will be work, until the next time (cancer, what cancer?). I hate to belabor the point, but I just don't think anyone who hasn't been through it can imagine how nerve wracking and potentially upsetting it is to wait on those results. Thank goodness I have another clean bill of health, and I can move on again for the next 3 months.

Today's photos: the West Oak Forest homes looking nicer than I remember them from 1968

Lucky Enough!

2009-04-27T16:57:00.000-07:00

We had a terrific but short w-e in Asheville. We met Miriam and Alex for dinner downtown Friday night since they were in town for a conference. We met up at our favorite Indian place, Mela, on Lexington Ave, where the curried prawn dish and chicken kebobs were just excellent.

Sat Holly and I did our Beaver lake run, drenched in sweat from the unusually warm April weather. We had planned to spread the wood chips/mulch that the tree guys had left us last week, but it was too warm after we finished all the mowing and other yardwork that needed to be done. Fortunately, the Asheville house only needs to be mowed every 2 weeks, and we can usually get to it easily in 45 mins or so. But neither of us is used to the heat yet, and we had made plans to meet up with friends for a chicken liver potluck at 5pm. We had concoted this elaborate schedule of meet ups and carpooling so that we could get 9 different people to Donna W's house w/o overloading her small driveway. Part of the goal was to save gas and see Jo's new condo, which turned out to be quite an open, sun-bathed place facing the mtns. It made me think of that T shirt I've seen a time or two in Asheville that says, "If you're lucky enough to live in the mtns, you're lucky enough." Jo is lucky for sure with that great view and light filled space right down from the VA hospital and I-40. She moved out of her Black Mtn, perched on the edge of the cliff, cabin and now lives where she can actually negotiate the roads if we have bad weather. Good move.

And yes, we really did go to a party where the main dish was fried chicken livers, Maggi, who is from Mississippi, and Donna W, who is from Arkansas, made them as well as Johnny cakes. Brought me back to childhood for sure. I don't like chicken livers, fried or otherwise, but I did try them again just to make sure. I liked the quiche alot, and the famous salad with homemade dressing that Donna Z was kind enough to make for me. Donna W let me have some of her sweet bubba plant (it suckers..), and we viewed the photos from their recent trip to the Swamp-lest anyone think that all we do is eat. It is almost true, of course, but we do try to canoe or hike or camp while we're out enjoying the food together.

Sunday Holly and I got that big mulch pile of wood chips spread in front of the driveway. Holly found a deal on small azaleas so we planted those near the rock wall. Voila, a new garden and less grass to mow.

Today (Monday) was one of those procedure days for me. This afternoon, I had my quarterly bone marrow biopsy & blood tests with Tanya and Dr Long at the bone marrow transplant clinic. I'll know those results in a few days, though my blood counts were fine. First thing in the morning, I had a colonoscopy and fortunately that came back normal too. We had returned from Asheville early on Sunday because I had to drink that liquid prep that cleans out your bowels. Happy to have all of that unpleasantness over for another 10 yrs. Yuck!

At the clinic today, everyone kept asking me how it is to be back at work. Well let me tell you, it is so nice to be back at work and to be preoccupied (or occupied) with the flow of the day and other people's problems. I feel like my cancer time was a kind of retirement preview. I got to experiment with my time to see what I'd enjoy doing but also got to return to all of the meaningful and rewarding aspects of my work. Unlike most people, I know how special it is to wake up and enjoy all the spring trees in bloom, how fortunate I am to work with good colleagues, and how unusual it is to have not one but two great communities of friends with whom to share good food & laughter. To that end, I've had my retirement "lite" but I'm thrilled to be able to work at something equally fun. We should all be so lucky!

Photos: the chicken liver dinner at Donna & Maggi's house

Tree's T3 Trek

2009-04-21T14:27:00.000-07:00

We had a magnificent time during our celebratory hike over the w-e. Friday the gang from the Triangle started arriving just as Holly and I settled into the house after our own 3 hour drive. Laurie and Julia arrived with their dog Ely after hiking part of the Mtn to Sea trail in Asheville earlier in the day. Marty, who came alone on this trip, arrived courtesy of Sandy and Amy and their panopoly of high tech gear & clothes for the hike. Everyone got fast to work unloading coolers and boxes of hiking stuff. We ate lots of yummy cheese that Marty had gotten from Trader Joe's while Julia and Laurie grilled delicious salmon (actually caught in Alaska by Laurie's twin sister I think). We had plenty of good eats to use as carbo loading as everyone pitched in with salad, Guglhupf rolls, cookies and homemade beer.

The hike went off without a hitch. First, we actually did get up early enough to have doughnuts & coffee (thanks Holly!) before we left at 8am for the Parkway where we met up with Susan, Ellen, Jan, Patti and Ann. We shuttled 7 folks (& Ely) up in my Volvo and the other group did their shuttle separately. We had cars stashed at the halfway point for those who wanted to hike a shorter piece or in case someone turned an ankle. The weather was about 43F at the start but hit the upper 70's with lots of blue skies and sunshine by lunchtime. It could not have been better weather, really. We all ate lunch together, and seven of us continued on to the end of our route at Sleepy Gap. Sandy's feet were a bit tender by the end, but all in all, we fared quite well. I didn't hear anyone complain much, especially once we got the pizza pie and potluck dinner going later that night. A few friends joined in who hadn't been able to hike with us and that was very special too. Again everyone pitched in and made it a delicious banquet. We had appetizers, pizza pie, various salads, chicken enchiladas, cookies, 3 cakes, and ice cream. And we had a selection of microbrews from a couple of the local breweries too.

It really was fun to have so many friends doing a physical feat to fete my good health & recovery. We had a great time and the event went off flawlessly. I have to thank everyone for pitching in with ideas, planning, food, flexibility, and enthusiasm.

Sunday the gang from the Triangle packed up and hauled out of town. We had a low key day and went to the Sourwood Inn for dinner since Kacia Duncan, the chef, was making her fabulous Country Captain dish. I know that we did alot of physical activity over the w-e, but we did alot of eating too. Fortunately, I had a great 2 hour run on Monday hitting the long course I usually run and the mtn across the way as well.

Holly and I are planning to run a half-marathon to celebrate again just the two of us. I usually do the Sunset Stampede, a 10 mile run up Sunset mtn in Asheville, but we'll be in Kansas for her niece's wedding this year. We are trying to decide on a course that will allow us to see a fun place and have a terrific run. We'll find something-maybe Chicago with 19,999 other silly fools.

Photos-with my new smaller, sleeker Canon camera: (a) the twelve folks at the start of the hike, (b) the seven of us with enough time to go the whole distance, (c) me at the Sourwood Inn dining room about to mange on (d) Country Captain made lovingly by chef Kacia Duncan

Tree's Terrific Treadmill to Trail Trek

2009-04-16T17:58:00.000-07:00

Way back when I was still getting over the last few slugs of poison, err I mean chemo, our pal Julia had the idea to plan an event that we could use to celebrate being healthy and one that we could use to challenge ourselves. We decided to do a hike along the Shut In Ridge Trail which is a beautiful hike that parallels the Blue Ridge Parkway from the French Broad River in Asheville south to Mt Pisgah some 17 miles away. It was originally a trail that Vanderbilt used to get from his enormous estate to a hunting cabin he owned near the summit of the mtn (truth be told, he owned all of that land). I chose the route because I had done the 17 mile race that is held on the mtn each November and knew that it would be a tough but doable kedge.

Now that the w-e for the event is finally here, Holly and I have been frantically emailing people back and forth about start times and car shuttles. We have run almost the entire route to scout out overlooks and parking spots and get a feel for the trail. But we haven't done the whole thing in one fell swoop yet; that will be this w-e, with friends from the Triangle & Asheville joining us for the event and/or the potluck afterwards. I had so, so much support during the whole cancer ordeal; now they are getting up early and risking tenderfeet to help me celebrate being back to health again. I'll be smiling with gratitude all the way.

Here is Holly's email announcement about the Trek:

> Hi everyone,
>
> April is around the corner and we're gearing up to have a beautiful hike in the mountains soon. We'd love you to join us. You can choose to hike anywhere from 0 to 17 miles. We're planning on a 12mile hike ourselves, but we can carpool to accommodate various pick up spots for shorter distances depending on interest.
>
> We're planning to leave our house at 7am on Saturday (Sunday will be the rain date). Bring water and lunch and appropriate wear for the weather (check www.wlos.com if you want local forecasts). It's usually a bit cooler and windier on the ridge.
>
> We'll host supper at our house at 7pm on Saturday. We'll provide pizza. Please bring a beverage, dessert or salad if you'd like to contribute something. We'll probably pick up a couple of growlers of local brew.

I expect that we will be tired and hungry by the end. But it sure beats chemo.

Photos: from last w-e's trip with Susan and Donna to Greenville SC to tour the Thomas Creek brewery, the Art Museum and the goats at the Carl Sandburg place

thanks to you & no thanks to you

2009-04-02T14:32:00.000-07:00

We are getting a nice gentle rain here in Hillsborough so Holly and I have decided to stay in the Triangle area this weekend and work on the yard. We have woefully little grass after the big drought of the past 2 years, so this is an opportunity to reseed and fertilize. Also, we are planning to head out to one of the big landscape places for bushes, shrubs and trees to pick out some items for the open space behind the Hillsborough house. For the longest time, we had a big open lot behind us and only 3 or 4 other houses in the neighborhood. Now that space is partially occupied by a jungle gym for the kids and well, let's just say we aren't alone anymore either. About half of the lots have houses and there are many more families now. We want to enjoy our screened porch and backyard with a little privacy. Thus the trip to load up on bushes and trees. The sooner we get those carbon containing organic pieces in the ground, the sooner we'll have a screen of sorts.

As I've said before, I've managed to slip back into my old life again, especially at work. Primary care medicine has a way of taking over and before you know it, you're worrying about other people's lumps and bumps instead of your own. I have begun to notice a bit more chaos and urgency in the lives of my patients as they lose their jobs or have to pawn things to get much needed medical tests or dental work done. No sooner do I pat myself on the back for a job well done with one patient that I have to live with the frustration of not helping another. Yesterday I saw a woman back who I had diagnosed with a big stomach wall hernia that bulged and pouched every time she sat up. She seemed reassured several weeks ago when I sent her on to the surgeon to have it repaired. He had faxed me a form to complete giving her "medical clearance" for the surgery since she has diabetes and a few other medical issues. (Surgeons who are quite capable of deciding for themselves if they should operate have gotten into the habit of asking the medical doctor to "clear" the patient for surgery and anesthesia to limit their own liability if something happens during the procedure. I hate that they don't think for themselves and instead rely on our evaluation, though they don't pay us for it). Anyway, I had ordered a heart stress test on her, and it came back abnormal with areas of her heart not getting enough circulation. I referred her on to a cardiologist who will have to do a catheterization and likely stent one or more of her arteries. When she came back to see me yesterday, her comment was "I don't know when I'll be getting this original thing fixed but thanks to you, I have to get my heart situated first." I felt good, I have to say, because there are 900, 000 some odd heart attacks each year, and maybe she would have been 900,001.

On the other hand, I had this guy as my last patient who has HIV and gets his care from the UNC infectious disease clinic. He came in because we were the ones to pick up his HIV back in May of 2005, and he feels puny from his HIV medicines. He was upset because he is losing weight, the HIV meds make him feel bad, and other meds they gave him didn't heal his mouth ulcers or shingles when he got those. I tried to explain that his immune system is poor, but he just didn't get it (it is called human immunodeficiency virus afterall). This is a tough discussion even in english and doing it with my so-so spanish is near impossible. Round and round we went, him expressing his desire to be treated by us and me explaining that he needs the specialty care at UNC. Finally he gave up and took my prescription for weight gain. But I felt like he could just as easily have walked out muttering under his breath, "and no thanks to you." Well it gave the day that you win one, you lose one kind of feel. I think you can imagine it.

Today's photo: my desk area at the Drew clinic where I work

One last Weekend in March

2009-03-30T18:15:00.000-07:00

Holly and I enjoyed the last w-e of March in Asheville, doing some gardening in the rain, some running on the trail, and visiting with old and new friends. Friday we arrived around 7pm just in time to enjoy dinner with the rest of the world at the Asheville Pizza Co. They were all there to see Benjamin Button for $3. We were there to unwind from the drive and grab an easy dinner. Saturday it rained most of the day, so we caught up on basketball. We met up with Donna Z at the French Broad brewery to listen to music as one of our new favorite bands was playing. The Leigh Glass Band does mostly blues and americana music with a twist. We heard her at the French Broad on Valentine's Day, and she was a hoot. Fun to share her and the band over a Rye Hopper. Sunday we headed back out to the Blue Ridge Parkway to run the trail near Mt Pisgah, where we will launch the big trail trek on April 18th to celebrate good health. We ran about 80 minutes this time and covered the steepest, most difficult section of the trail. It promises to be a hilly Trek even though we are doing the trail to take advantage of the general downward slope. Late afternoon on Sunday we headed out to the Sourwood Inn off the Parkway to take advantage of their local special with rooms half off. Kacia, the chef, cooked for us and one other (local) couple who were also there for the special.

They were a young married couple who work in the music business. He owns a music marketing company (Ani Difranco, Catie Curtis, etc), and she is a disc jockey and music writer. They told us they too had had a commuter relationship early on (Boston-him, Aville-her) until he decided to move down and start his own company in NC. Like so many others, they are making it work though they have both worked remotely now and in the past. She told us the funniest story about doing the DJ thing for a radio station in Wilmington while she jiggled her son on her knee hoping he wouldn't make too much noise for her microphone. On his part, he told us about a woman who owned a clothing store in the same building as his office and how he accidentally learned that she actually does sound for Hollywood movies when she borrowed a fancy sound cable from him once. Amazing what people in Asheville are really doing while we watch basketball or plant camelias and rhododendrons.

I had my monthly blood work this past week and everything was great!

Photos: Holly with the Pisgah mtns in the background. Our weeping cherry tree and Susan's Aunt Janice redbud tree in the background.

A Week Away

2009-03-23T01:30:00.000-07:00

I had one day this week in the clinic and then I spent Wed, Thur, and Fri at a medical education meeting in Chapel Hill. My pal Shannon who worked with me at the Buncombe Co Health Dept several years ago came down from Asheville to attend the meeting too. It was great to have her in our home and to attend the meeting with her. She is so funny and irreverent with her comments about getting rid of her "crackberry" since she was constantly checking email or calling people in every spare moment. I still smile thinking of her telling me about it. Crazy girl. I thought the meeting was a little weak compared to years past, but maybe I am a bit jaded and expect to be dazzled, entertained. and astounded by the learning from "on high" (mostly UNC Internal Medicine Faculty). I do so much reading now that I expect more meaty educational sessions than I did previously.

I did finish a terrific book this week by my guy Abraham Verghese, the Infectious Disease doctor who is also an author. This one was " Cutting for Stone" a story about 3 doctors in Ethiopia and how they got to be the parents of twin boys who grow up to be surgeons with their own interesting histories and stories. That author is so bright and resourceful with medical info that he fashioned bits and pieces of medical lore and cases into a fascinating book about love amongst friends, colleagues, and family. I'm on to "The Marcy Papers" about one women's grief at losing her mother to cancer. It was really well reviewed in the NY Times so I had the Hillsborough library order it for me. They had not even heard of it but ordered it for the system on my recommendation. Wish I could earmark ALL of my taxes to go to them. They really add a lot to my life, always having exactly the book I am looking for or willing to order it for me like this one.

We have had a terrific w-e in Asheville with pizza and microbrew beer at our favorite place around the corner on friday, a run in the woods and NCAA basketball on saturday, and brunch with friends on sunday. We are trying to cover all of the route of the celebratory hike we are doing April 18th here. So each w-e we try to cover a portion of it by foot, scouting out spots for parking cars to access the route along the Parkway. The entire trail is almost 18 miles, and we plan to do most of it that Saturday if the weather cooperates. It's our celebration for my good health and an attempt to push ourselves to do something physically challenging. I have been toying with the idea of running another marathon this year. Holly doesn't want to do a race that long, so we may just find a shorter run we can do together. A half-marathon somewhere we've never been together would be fun too (e.g Chicago). Anyway, I hope many friends will join us on April 18th for hike along the Shut-In trail and a potluck afterwards.

Today's photo: a group of pelicans flying over Emerald Isle.

A Rare Site Indeed

2009-03-16T09:44:00.000-07:00

We spent the w-e in Emerald Isle watching basketball with a gang of friends, most of whom were disappointed when UNC lost in the semi-final round of the ACC men's basketball tournament on Saturday. Pam and Cindy have a wonderful house they remodeled so that they can live at the beach full-time and work from home. Though they aren't on the beach front, they can see the ocean from their deck and several of the big windows on the front of the house. We kept watching a group of cedar waxwings that were quite taken with their juniper trees and a powerline nearby. I managed to get a photo of the flock in one of their calm moments, all perched on the pole and powerline in an orderly row watching the ocean. It struck me today how rare it is to see the cedar waxwings so close to people and the ocean. Then it hit me that they had settled upon an ideal spot to share with friends with whom they could fly, hang out, eat, and enjoy the scenery. We enjoyed that rare sight/site too.

Beach bound for the ACC Tournament

2009-03-12T18:31:00.000-07:00

Holly and I have just finished watching NC State, her alma mater for Vet School, lose to Maryland in the first round of the ACC men's basketball tournament. Sadly, they are probably done for the year as their record has been only so-so. Tomorrow after I get off work, we'll drive down to Emerald Isle where our friends are hosting a w-e of fun, fellowship and basketball. Tomorrow there are 4 games with both UNC and Duke playing in the afternoon or evening. Now that NC State is out of the running, Holly will pull for UNC, and I will be left the sole, lonely Duke fan FOR THE ENTIRE WEEKEND. It's a tough job, and I'll need the proper balance of humility and school spirit to pull things off in that den of Carolina blue. Wish me (and my team) luck.

I was really happy seeing my patients yesterday in the clinic. Things have been going smoothly now that I seem to have all of my wits about me again. I mean that my memory is back to normal, and the last remnants of my chemo brain seem to have cleared. It is much easier to move through my day if I can remember the encyclopedia's worth of knowledge that I acquired over the last 10 yrs or so (okay it isn't really that much, but I have to at least know where to look to find the info if I can't remember it all). I was pretty worried in November and December about how spotty my memory was. I had some real word and fact retrieval issues. I didn't want to hurt anyone with my feeble chemo brain and I know from experience that one of the worst things is not knowing what you don't know. But the rashes and lab tests and treatment protocols are all streaming back into place just as I'd hoped, and I feel safe again.

I had an interesting encounter yesterday with a 50 yr old hispanic woman who I was seeing for her yearly physical exam. We were going over Lillian's social history-issues like do you smoke, drink alcohol, work, have a partner or husband etc...
She told me that she was now divorced (for 2 yrs) which made her initially very depressed and sad. (I couldn't help remembering Liz Gilbert's analogy in "Eat, Pray, Love" about divorce being like a car accident everyday for 2 years straight..) Anyway, Lilliana now has a new partner. She had this big, sly smile as she relayed this news in spanish and added that he is much younger than she is. When I asked how old he is, she grinned and told me that he is only 28 yo, younger even than the oldest of her 4 boys. She said that he makes her happy, takes care of her, and showers her with attention. Well who wouldn't like that??? I asked her if she is working, and she told me that she now works in an Italian restaurant in Fuquay-Varina. My spanish is not so great so I was sure I had misunderstood her since Fuquay is south of Raleigh-Durham and pretty far from Burlington where our clinic is located. I asked for clarification, and sure enough, I understood right. She is now living in Angier, at least an hour from our clinic in Burlington. She had tried getting her care at another office closer to where she now works and lives, but hadn't liked the experience. "You are my doctor so I am here again. It's only an hour," she said. What a compliment. I kept thinking about that and how fun it was to see her delighted by her younger man. You go girl. If men can do it, why can't we?

Photo: me at the Sourwood Inn on a recent trip to our favorite B and B in Asheville.

Swamp Chicks

2009-03-09T11:16:00.000-07:00

Today a group of my pals from Asheville are headed down south to spend 3 or 4 days in the Okefenokee Swamp. I've never been, but I have the T shirt, as they say. Actually, I don't have the T shirt, but my good friend Susan, the photographer, has given me a number of her cards and reprinted pictures from past trips. I really wanted to go this time, but I just couldn't see asking for the time off after recently starting back to work after my cancer. Though it feels like I've been back for a while now, it's really only been a little over 2 months. I'll be thinking of them this week though as they paddle around, taking in the mossy environs. Hope to get another good picture or card out of it at least.

I was going through my Duke Medical School alumni magazine last week, and I noted their article on liquid tumors. That is what they call leukemia, lymphoma and multiple myeloma since they are all tumors of blood products and/or the immune system. The article was talking about all of the headway that is being made in these cancers, especially now that more immune system research is paying dividends and stem cell transplants are more common. A few of my doctors commented on their research and work with patients, which is always good to see.

At the back of the magazine, they have a section that announces new faculty members, profiling them with a photo and their educational background. I noticed that one of the guys from my gross anatomy dissection group was just hired by the surgery department. Eric took a detour from our class to get a PhD in genetics and then finished medical school in 2003. After that, he did the interminable Duke surgery residency and just got his first non-training job. He and I started medical school in 1993 so getting your first real job in 2009 is quite a long time to delay gratification, if you know what I mean (only in medicine can you train and train and train like this). I had to smile a little when I read about his appointment to the surgery department because he was rather squeemish about cutting our cadaver when we were in class together. At one point, we had to do a "Bobbitt" cut of the penis, named after the woman who cut off the penis of her husband way back. He couldn't watch while I did the maneuver and seemed pretty queasy about dissecting the organ after I had removed it from the cadaver. Imagine my surprise to see him smiling up at me from the magazine, having completed his surgery residency & training. It just goes to show you, you never know about people. We can all be whatever we want. It's a good thing too.

Today's photo: an interesting sculpture in the Wedge brewery taproom on a recent visit with Susan and Donna.

Spring Arrested

2009-03-06T12:03:00.000-08:00

I just got back from our great little library in town (Hillsborough), having returned the Abraham Verghese book I finished earlier today. "The Tennis Partner" is the author's story of his friendship with an Australian born tennis player turned medical student who studied Internal Medicine under his tutelage at Texas Tech. I'd read the positive review of the book when it came out and recently noted a review of his new novel in the NY Times, which made me want to order both of the books. "The Tennis Partner" had a very poignant ending when his friend, the medical student relapsed back into his cocaine addiction after working so hard in AA and in school to (re)set his life under Abraham and others. I couldn't even imagine trying to do medical school with a drug addiction problem; just managing the school part was stressful enough.

I'm still on the reading kick I started months ago during my leukemia treatment, though lately I've been particularly interested in books by doctors. I've adjusted my lunch schedule at work so that I have a little time to read each day, and I can often sneak in some more reading while Holly is driving to or from Asheville. It's been a real joy to keep up the reading, and I find the books by doctors to be more helpful to me now than in the past. I've always enjoyed thinking about the social side of medicine-how it is different from any other job in its explicit openness. I read recently that there is an impending shortage of primary care doctors, especially those willing to see medicare patients or the elderly. It makes me wonder who is going to take care of all of us baby boomers when we get to be that age. Hopefully there will still be people training who enjoy medicine.

One of my colleagues and I were talking earlier this week about how to deal with a patient we have both seen who refuses to have his foot amputated despite a huge non-healing ulcer and bone infection that is not responding to antibiotics. He has been told that it won't heal without amputation and that eventually he might die of a bloodstream infection. Yet he declines anything except antibiotics which are, at best, a band-aid solution for now. My colleague is much more proactive than I am, trying everything to exhort the guy to have the surgery. My style is to tell him what can happen and let him decide. I can't imagine what it would be like to hear that you have to lose your foot to save your life, especially when you're hobbling along and making do as it is. But she and I debated the right way to handle these kinds of patient cases, not sure what is really best. How hard do you push or threaten or scare the patient versus letting them decide the course on their own? I don't know that there is a correct answer; I suspect we all adopt a style that meshes with our own values and what we can live with. It's challenging though.

Last night we had dinner with friends, and one of the other women there had not heard about my leukemia and 7 mos of treatment until last night. She lives in the Triangle area, but we don't see each other often. I summarized that whole experience in about ten sentences from diagnosis to treatment course to my thrill at being back at work now. I haven't had to do that this illness so it felt awkward to summarize all of that as if I were talking about another person in passing. But those ten sentences were 7 mos of my life-major death scare followed by hard scrabble effort. Thank goodness for repression and optimism; they helped me alot.

Today's photo: saw this guy on one of my long runs in Asheville; had to catch him before he ran off. Spring was arrested by the colder weather we had earlier this week. Now the forsythia can keep budding with the 70 F we have today.

Our March Snow

2009-03-02T09:06:00.000-08:00

We are still in Asheville celebrating the snow. Miriam and Alex were here for most of the w-e too, but they left Sunday midday after Alex realized that she was coming down with a cold. It had been raining or rainy all w-e, but that didn't stop us from enjoying Brushfire Stankgrass at the Pisgah Brewery on Friday night as well as the Mast General Store, Salsas and the Hot Springs Hot Tubs on Saturday. It was a bit more drizzly on Sunday though, and it began changing into sleet and then snow around noon. It was so beautiful here all day yesterday, even though it was cloudy and gray most of the day. Despite the clouds, 4" of snow has a way of brightening things up-all clean, and white and pristine looking. Today it is clear and cold with blue skies to offset our white topped hills. It was 19 degrees and windy when I did my run around Beaver Lake (me and the guy with the Salukis) this morning. I almost fell a couple of times in the icy patches, but it was terrific to get out and play in the snow. I have been wanting to go somewhere to cross country ski before it gets too warm, but I'm not sure we will make it to Vermont or Colorado anytime soon. So I was imagining that I was skiing since the exercise, movement, and views are very similar. It sure was pretty going up and down Lookout Mtn (and up and down it again after running around Beaver Lake). I took a couple of pictures to include here.

Later we'll pack up our things, Quigley and the kitties and head back down the mountain to the Triangle. Holly's company announced a 10am start today, so I suspect we'll encounter snow or ice there as well. Next w-e is the start of daylight savings time so this is out last w-e here before we have more daylight evening time. Nice to get one real snow if this turns out to be the last one.

I had the cutest little boy in my clinic earlier this week, being seen for a cold and sore throat. He was about 5 yrs old, hispanic, with that short buzz cut that really accentuates their thick, black hair. He conversed with me easily in both english and spanish, hopping up on the exam table, saying "Ahhh," and breathing deeply when I told him what to do for me. After we were finished and I was telling his Mom what to do for his cold, he officiously pulled out his wallet, one of those hand tooled leather ones with lacing around the edges, and removed a crisp dollar bill to hand to me. I had to chuckle as I told him that he didn't pay me but instead the women at the front window. I told him that I only do the doctor part and someone else takes the money. That seemed to satisfy him, and he carefully placed his dollar bill back into his wallet. I felt honored, actually, that he wanted to pay me. I remember how precious a dollar is at his age.

Today's photos: Miriam and Alex plus one of the house in the snow.

Busy week

2009-02-26T16:22:00.000-08:00

We continue to move along at work on the computerized medical record or EMR as we call it. This was supposed to be the first week of using it exclusively, without all of the paper processes. But one of our Medical Assistants just returned from her maternity leave. She hasn't had any EMR training until now, so we elected to stay at 60-70% EMR until we could get her up to speed. I've been doing all of my pts "electronic" for the past 2 weeks, so it is starting to get easier for me. I think it's really funny to come out of my little hallway to the main, open area of the nurses station and see all of the Medical Assistants and Nurses with their heads down, fingers pecking away at their respective keyboards, as they type in all of the information that previously got recorded in pen. Call me a Luddite, but I'm going to miss all of the inscrutable handwriting that dotted our charts previously. I consider myself somewhat of an expert on bad handwriting, my own being pretty poor at times when I am in a hurry (One of my mentors told me that my handwriting only looked illegible at first glance and that once you really tried to read it, it was actually pretty clear as opposed to those folks with handwriting that looks neat at first glance, only to be undecipherable upon further inspection. Ever wonder why our handwriting is so bad? I did. But one day I counted the number of times I had to write or sign my name; I stopped counting when I got to 300, but I digress). Just out of curiosity, I am doing a desk audit every week now to see when my supervisor's desk is clear of paper charts. She is one of those people with stacks and piles all over her desk. I know that once those are gone, we will be fully electronic.

I have been thinking about my Aunt Mary Alice who would have celebrated her birthday this week, her 60th I think. She died several years ago from alcohol abuse, accelerating her own drinking after Uncle Tommy died of alcoholic pancreatitis just weeks before his retirement from the Postal Service. Aunt Mary Alice was my Godmother, favorite aunt, and a role model with her secretary to Vice President career path despite never going to college. When I was really young, maybe 6 yrs old or so, she took me to work with her, which I thought was the most fun in the world-playing with the telephones, sitting at a desk, and getting to write on official paper with company pens (surely bad handwriting then too). It seemed so adult and real world, which I just loved. But we also went to the fair and roller skating and camping-all things I adored as a kid. And I often got to do them without my twin sisters, just me and Aunt Mary Alice and Uncle Tommy escaping together. I was so heartened when she stayed sober for several months after my Uncle Tommy died, but eventually, she relapsed-drinking more and more and more until she just died one day. I checked her name on Google today to see if there was any mention of her, the way one might look for info on an old classmate or friend. She wasn't there. She is still with me though; I just wish she were still with us.

Today's photo: Lenten Roses in my garden in Asheville

The Attitudes

2009-02-21T10:49:00.000-08:00

Holly and I are in Asheville for the w-e, and we are allowing ourselves a rare afternoon to just hang out at the house and do nothing. Well we aren't really doing nothing since I'm writing a bit, and she is looking at old photos, but you get the idea. We did our run around Beaver Lake this morning, going backwards since Holly was bored of doing it the same way every w-e. It always amazes me how different a route can look when you do it backwards. You see such different views of everything-the houses from another angle, different mtns in your view, and the downhills suddenly up instead.

Work has been going really well the past few weeks. I am happy to report that our transition to the Electronic or Computerized Medical Record is speeding right along. The people I work with are so terrific, and they have fully embraced this transition, though it was difficult at first. We are over the hump now and are all just waiting for the last remnants of the paper processes to be gone. Marnivia, our EMR trainer, continues to be helpful and positive; again, I lament the day she leaves to go help our next clinic with the system. Hopefully we have her for another week or two, not that we are using her much these days. But when you need her, you really need her, and it's a relief to see her sitting at her cart in the hallway. Sometimes I like to just peer around the corner, down the hall to see her sitting there at her cart, even when I don't need her help. It just makes me feel better. She had a birthday this week, and we didn't even know about it until later. I left her a bag of chocolates and a card on her cart to surprise her the next morning. It was the least we could do.

I've had a couple of interesting patient encounters this week. I was doing a physical exam on one of my female patients, a 49 yr old black woman who I've seen several times over the past 2 years for her blood pressure and smoking. As I was examining her, she was telling me about her hot flashes and trouble sleeping. I commented that she is probably going through menopause. "I know I am, " she said "because I have The Attitudes." Now if ever there was a phrase that better defines a condition, I don't know what it would be. She gave me such a chuckle with that one, and I asked if I could use her phrase. I know exactly what she means, and I suspect every woman who has been through menopause does too (and maybe some people living through menopause as a bystander.) I mean if ever there was a time when you feel defensive and offensive at the same time, it's menopause. There ought to be a sign for menopausal woman; it would say "Watch out! I have THE ATTITUDES."

I also got reconnected with one of my longtime patients who had been seeing one of our other doctors while I was out. Though he is my age, he looks much older because of his medical problems. Ivan has end stage COPD/emphesema, so he wears a nasal cannula or plastic tube to supply extra oxygen for his breathing. I'd read his chart the day before I saw him and was sad to see that his condition had detiorated considerably during my 7 month absence. He's had 3 hospitalizations just in the last 2 months for confusion and low oxygen levels since his lungs can't clear infection well. When we saw each other yesterday, I think we were both relieved to see each other back. He gave me a big hug and told me that he had missed me. I hugged back and assured him that I was glad to be back and glad that we were both still around to see each other. I commented on how much weight he had lost and how much softer his voice was now. He said it had always been this way, but I know that he has weakened in the intervening months. He told me that the other doctors had tried to "mess with his medicines" and that he was glad to have me back since I "know everything about him." Honestly, I didn't make one adjustment to his medicine regimen yesterday, but I did refer him to exercise therapy to strengthen his leg muscles. It will makes his body better able to extract and use oxygen, a precious commodity in his chronically ill state. It is difficult to express how much joy he gave me-something about being happy to see me, something about being happy that he is still around, that I can do something, anything to make his life a little better. When I feel like that, I am so appreciative that I got to do this for a living. And I feel like I should be paying him for the visit, not vice versa. It's the best.

Today's photo is some turkey tail fungus on a log from one of our recent hikes.

Attraversiamo

2009-02-18T17:49:00.000-08:00

I finished a couple of books this past week. One was the interesting memoir of her year in Italy, India, and Indonesia by Elizabeth Gilbert. That one is called "Eat, Pray, Love" and it's been (rightly so) on the NY Times bestseller list for a while now. I wrote about it here briefly while I was reading the Italy section at the beginning of the book. Apparently it is being made into a movie with Julia Roberts, which I can so easily see with the quips, humor and winsome stories she packs in that little volume. One of my favorite parts is how she just loved learning Italian-you know, it's not a language anyone really needs to know unless you just want to. She loves the way it sounds, its beauty mimicking the beautiful countryside, people and food. She gets enamored of the word "attraversiamo" which means "let's cross over." She likes it so much that she is always saying it and pulling her walking companion from one side of the street to the other. It's a metaphor, too, for all of the transitions she undergoes that year, the real point of the book, after surviving a terrible divorce. I like the word too because it seems so hopeful -all about moving forward. I'm doing that too, settling into work again and home routines. My repeat blood work today was beautiful so I can stop thinking about that for another month. Attraversiamo.

Today's photo is from the Black Mtn/Montreat hike we did up Graybeard trail.

iTouch

2009-02-14T09:07:00.000-08:00

On this holiday to love, I know not one, but two people who are getting married today. One is my coworker (in her 20's) getting married in the little church where she grew up, all out in the country near one of our health centers, as a matter of fact. The other is the mother (in her 70's) of a friend who is marrying a gentleman (in his 80's) she met when she moved to Asheville to live in one of our retirement communities. I just think it is so romantical (not a word but it should be) and sweet to pick Valentine's Day as your wedding day. And I think it is wonderful that people in their 20's can say they want to be with someone FOREVER and that people in their 70's and 80's still believe in love enough to commit to each other in a ceremonial way. You go guys!

I am just starting to get patients back in my clinic who never knew I was gone. Most of them are seen infrequently, for example, only for their yearly physical and pap smear, or to get their year's supply of allergy medicine. This week I saw a really nice lady who teaches French at Elon College. After I had finished her exam, she commented that my hair is much shorter than last year when I did her exam. “You look like a different person,” she said. “I almost didn’t recognize you.” I told her that I am a different person, almost, and then explained what had happened with me since she saw me last year. She expressed relief to hear that I am doing well and that I could come back to work. I sure do enjoy being back again, where I was last year- in some ways the same, in some ways different. Gosh I've been through alot to arrive back where I was, and the hair is only the tip of the iceberg as far as that is concerned.

My sweetie got me an Apple iTouch for a Valentine's gift, as you can see from the photo. Such a nice, fun new toy from a truly sweet partner.

Mighty but Mini

2009-02-10T17:03:00.000-08:00

The last several days have been warm here in the Triangle as well as in Asheville. We arrived to snow still in our backyard for the w-e on Friday, but it melted quickly with the 60 degree days we enjoyed Saturday though Monday. We made good use of the warm weather, running around Beaver Lake on Saturday and then walking around downtown with everyone else heading outside to enjoy the sunny day. We ate dinner at the Laughing Seed restaurant which is just about the best vegetarian place I've ever encountered. Everyone else was eating outside at the Mellow Mushroom (a pizza place) which is always full of tourists and towns people who want to sit on their patio when it is warm and sunny like it was this past weekend (despite it being February). We even saw a bit of live music at the French Broad Brewery, but the guy playing wasn't as good as our usual group Brushfire Stankgrass, which plays a mix of acoustic rock and bluegrass. Still it is always fun to catch a live show. The warm days in February and March really make it worth living in the South. Try finding that in Vermont or New Hampshire which are mired in snow and gray skies all of winter and into Spring too.

Sunday we did some hiking in the Black Mtn/Montreat area with Susan, Jan, and their respective dogs. We must have been a funny looking group with Lucy the big, fluffy shephard type dog and Riley, the mighty but mini black and tan dachshund. The trail heads up, up, up as they do over there in the Greybeard area, then flattens out a bit along the old Trestle road and then heads steeply down. Susan sent me an email today asking if we were sore and telling us that her triceps were the most sore. That's what you get for using those fancy hiking poles to help you down the hill. You should have taken your chances and hoped that your downhill muscles would hold you like the rest of us (tee-hee). We did something like 1000 ft of down in only 0.87 mile so you can imagine the steepness of that. I'm just crazy enough about hills to wonder what it would be like to go up it next time. I'm always up for a challenge (no pun intended, really). I'll throw in the photo some nice college gal took of us at the top (though mighty but mini is cut off in the photo, sorry Riley).

I'm reading a terrific book Susan suggested, that has been on the NY Times bestseller list recently. It's "Eat, Pray, Love" by Elizabeth Gilbert. She writes about her year traveling to Italy (to eat, what else), India (to pray) and yes you guessed it to Indonesia (to love)-all after suffering through a horrendous divorce which she doesn't really detail except to say that it felt like a car accident EVERYDAY for 2 years. I'm thinking my sister needs to read it too. The author is funny and insightful and not preachy though she really does find God with a capital G. You'll have to read it for yourself, and enjoy it too. I've laughed outloud in many places, always a good recommendation for a book.

Feb 7, 3 years Cancer Free from Breast Cancer

2009-02-07T10:18:00.000-08:00

Today is an anniversary of sorts for me. Three years ago today I had a lumpectomy to remove a 2.1 cm mass in my right breast. Gosh was I a groggy, nervous mess. I had never been sick or had any kind of medical procedure prior to that, and even though I have alot of familiarity with medical issues, I didn't know what to expect. Fortunately, my mom and two sisters came to be with me (they had all had surgeries before of one type or another) and Holly stayed with me in the waiting room, then the pre-op and post-op holding areas. I had the kind of surgery where they inject a little dye right into the breast mass to see which lymph nodes are closest to the cancer. They biopsied those when they took out the whole tumor. Fortunately for me, I had no cancer present in my lymph nodes, and they were able to get all of the tumor with the lumpectomy. Later that same day, they sent me home with percocet for pain, which I promptly threw up and then threw away since the pain was better than the stomach upset from that drug. I don't know how people get addicted to that medicine but they do; it induces horrible nausea and vomiting for me. Anyway, I am happy to be far, far away from all of that breast cancer stuff-the difficult chemo that would follow, the surgical site that pulled apart and had to be packed by one of my colleagues who had been a wound nurse in her previous job, and the daily radiation that started my day for 7 and 1/2 weeks.

Today is also the anniversary for two of my friends who are together. Happy anniversary to you two as well. Hope you are celebrating and basking in this glorious day too. I'm really happy to be here seeing the birds at the feeders, running around Beaver Lake while the Audubon folks gawk at the geese, and soaking in my big porcelain bathtub to rest my sore muscles.

Today's photo: a wire dachshund that my pal Donna W gave me at Christmas; she has a little black and tan too.

2009-02-06T10:44:00.000-08:00

Every Tuesday I try to peruse the NY Times for the articles in their Health & Science section. Many of the articles are written by prominent doctors or leaders in healthcare and the late, breaking medical news is always helpful too. There are columns about wellness, prevention, and nutrition as well as difficult cases written by MD's or personal experiences of the healthcare system written by patients. Lately I’ve been reading a very interesting series by a journalist who is being treated for prostate cancer. He writes openly about his experiences as a patient, and it is very revealing to read about cancer from a man’s perspective. He has had surgery as well as chemo, hormone therapy, and radiation, so he knows a thing or two about long treatment and side effects. He writes openly about how the hormone shots have killed his libido and how the surgery left him (sometimes) incontinent and (sometimes) unable to have sex (add hot flashes to that and I’d swear he was in menopause). Soon he will have his first real follow up blood test, the PSA, to see if his cancer is in remission.

He has written recently about all the doubt he feels, especially his doubt about the future and whether he will remain cancer free. Hopefully he'll get good news and then his cancer will take up less and less space in his life like mine has as it gets further from the last treatment. I spent a lot of time around men with prostate cancer when I was having radiation for my breast cancer in 2006. We were all sitting in the same hallway at the Radiation Oncology clinic waiting to receive our daily radiation treatments. One thing I noticed about the men is how little they interacted with each other. They were always talkative with me and any of the other women being treated (there was a elderly woman getting her colon cancer treated at the same time) but almost never with each other. It was like they were too embarassed to share all that they were going through with each other. I wondered then, and I wonder now, how much harder it must be to go it alone as they seemed to do. Me, I was happy to share my experience with anyone who asked, even the lady at Lowe’s who commented on my bald head (“yup, I have breast cancer and I’ll be done with treatment in July. Thanks for your concern…”) Once, I even had the conversation with a woman at one of the rest stops on I-40 who noticed my bald head and asked if I had breast cancer (“No, this time it’s leukemia but I’m doing well…) What’s my point? Don’t suffer in silence. Share your struggles with those who ask in concern. As a doctor, I am amazed how often people just want me to listen to them and validate what they are going through. I'm paid to listen, and I still get a kick out of that.

Later today we will drive up the mtn to Asheville for the w-e. Hopefully we'll get to see some pals and hike like we did last w-e. Today's photo is from the hike we did last week with Susan and Donna in the Pisgah area, the Slate Rock trail.

Marnivia and her Cart

2009-02-02T11:15:00.000-08:00

They sent us this heavenly woman named Marnivia to help us learn to use the new computerized medical record we are adopting in our office. When I first came back to work in January, they had me meet with her several times to catch up on the training sessions I had missed. She has the perfect temperament for this kind of work. Marnivia is consistently upbeat, positive, and optimistic. She always has a big smile on her face which is a plus when you're teaching a bunch of clueless doctors how to do something new. In addition, she is non-threatening and approachable despite the simplest question. She has really been a help to me as I’ve tried to catch up to everyone else already using the computer system.

Now that our center has moved from the training phase to the implementation phase (called a Go Live), we are actually using the new system to document our patient visits, to order labs, and to write prescriptions (yeah, we are now part of the 21st century just like the Jiffy Lube down the street). As you can imagine, things don't always go so smoothly. Fortunately, Marnivia is still hanging out in the clinic everyday to help us troubleshoot. She grabbed a rolling cart that we use for unloading supplies and parked it directly in front of the nurses area along one of the walls. It is also near our patient rooms, so we can dash out to ask her help if we get stuck, which happened ALOT the first day that we started using the system in the clinic. Not everyone would be willing to work everyday on a rolling supply cart, but Marnivia is that helpful, practical type. She even has a card laminated with her kids' photos that she brings everyday to place on the cart near her laptop. There are no cubicle or pod walls for hanging photos in her makeshift "office" but hey, she's not letting that stop her. I'm already lamenting the day she'll leave us to help the next clinic, lucky guys.

I do think that our first week of the Go Live has gone remarkably well. Imagine trying to use a computer for EVERYTHING you ever did on paper, and you about have the size and dimension of the task. One of the doctors joked that she had bumbled through a visit and felt the need to assure her patient that yes, she did actually know how to be a doctor. Funny how that feels like the "easy" part now. Well I thought we did pretty well in our first week, and soon it will all be the easy part.

Today’s photo: Marnivia at her cart in the center hall helping me with the computer.

Don't Overdo It

2009-01-29T14:52:00.000-08:00

I came down with a scratchy throat and cold symptoms earlier this week, and it's progressed to the point where I am very congested. My voice is noticeably different than usual, and I now have a raspy cough as well. It's my first virus since I finished the leukemia treatment, so I've been curious how my body would handle it. Did my immune system come roaring back after all of that chemo? I've been achey and tired most of this week, but I've finally turned the corner. One of my coworkers overheard my cough and hoarseness this afternoon and told me not to overdo it. She said it in a really concerned tone which struck me as very kind. It was the way she said it and the whole unspoken meaning behind my being sick. I do really love the people I work with; they are kind and caring and demonstrative that way. It makes me feel that I belong there. I missed that when I wasn't working- so glad to have it back.

Tanya emailed my bone marrow biopsy results. They are normal. Yeah, I won't have another date with her big needle/drill until April 20th.

The daylight is just now escaping into the clouds, and it's after 6pm. Soon the days will be noticeably longer, and we'll all feel like doing things after work again. I hate driving home in the dark in the middle of winter. Fortunately, most days, like today, I can get out at lunchtime and take a walk for an hour or so. It was sunny and bright and clear today. A very good day to take my cold virus out for some sunshine and exercise.

I have been thinking about my old unit 9200 in the hospital today because a coworker's daughter is up there being treated. She is having harsh chemo alternating with rest days until they do her bone marrow transplant later in the week. I really wanted to go by and see her to cheer her up, but this cold precludes that. I am thinking of her often though and sending good vibes and healing energy. I know the nurses up there will treat her well.

Today's photo: Art at Peggy and Naomi's house. You could furnish and decorate several houses with all the stylish stuff they have just in their yard.

Today was the day that the new computer system clicked for me, and it's suddenly become much easier to navigate. I think we will like being part of the 21st century.

GFW

2009-01-26T12:31:00.000-08:00

Holly spent the last 3 days in Kansas attending her parents' 50th wedding anniversary celebration. I had the weekend to my self-a girlfriend free weekend (GFW) as we call it. I had planned to drive to Asheville by myself either Friday or Saturday but my bone marrow biopsy Friday afternoon made me pretty sore. Tanya had to drill two holes in my rump this time since she couldn't get enough liquidy marrow for the slides and tubes from the first hole she drilled. I finally took the bandage off today, and it was a bloody mess. No wonder I'd been hurting there all w-e. I didn't think 3 hours in the car there and back to Asheville was the way to go.

I am reading a great book about breast cancer that I found in our little library. It's called " Five lessons I didn't learn from breast cancer and one big one I did" by Shelley Lewis. She was working for the Air America radio program when she was diagnosed. The book is her (funny) take on how breast cancer didn't teach her anything phenomenal or philosophical except that you get cancer, you do what you have to do, and you move on. None of that spiritual awakening stuff for her. I have to say, she has some of the pink ribbon stuff dead on. I did experience a twinge or two when she wrote about deciding which chemo regimen to pursue by electing the one less likely to cause a secondary leukemia. I don't remember being given a choice. Maybe I could go back and have a redo on that one. I wish. As she put it, leukemia seems like a step up in the cancer seriousness scale. I'm with ya babe. It sure felt that way to me too. That whole 7 + 3 treatment I took with continuous chemo for a week WAS the pits. Glad that is only a distant memory.

On to another subject. I saw one of my sweet older patients last week. Lora is a 90 yo black woman who lives in one of the local rest homes but manages pretty well for herself. Her mind is intact, and other than some high blood pressure and arthritis, she does great. She and I had talked previously about her sharecropper days when she picked tobacco and watched children while she was in the fields. She would set aside a place for the kids to play and pour kerosene in a big circle on the grass around them. The kerosene would keep the fireants and other bugs away from the kids while they played. After every row of working the tobacco, she'd head back and check on the kids. She used to collect $1 per child per day for babysitting them. It supplemented her income and allowed the parents to work. Talk about affordable daycare. I can't tell you how happy I was to see her and have her remember me too. We don't have any long term relationship or anything; we just really like each other. She calls me "mam" which just seems plain wrong, but I know it's a term of respect. I call her "mam" too because I brought up right, thanks to my parents and grandparents. Are people in the South still teaching their children to do that?

Photo: Holly and I at the top of the Lover's Leap hike in Hot Springs

My Stand-In, a Measly Poinsettia

2009-01-24T10:15:00.000-08:00

Well this was the end of my third week back at work, and finally, things are beginning to make sense again. I can flow through my day without wrecking my schedule because I have to look something up in a textbook or find supplies in our cavernous clinic. I've done about every procedure I usually do, including cutting open skin abscesses to drain them of pus as well as inserting IUD's for birth control. The computer work is getting easier too after numerous training sessions. We are starting with a few "electronic" patients each day over the next week to slowly build up to using the computer system with every patient within a month or two. That seems doable.

The scrabble for office space is working itself out now too. Bernie, the ER doc who has been filling in for me, is leaving to work at another site. Helen, the nurse midwife who was stationed at my old desk, has now vacated to Bernie's space. We moved bulletin boards, computers and bookcases on Thursday to re-situate ourselves. I now have my old desk back, complete with all the motley snack bars and peanut packages I'd previously hidden in my drawers. I am back to gazing out the window when I type at my computer and get a daily dose of sunshine just working at my desk.

My new officemate Helen, the nurse midwife, is one of those "neat and tidy" types. She confessed that she wanted to throw away the sickly poinsettia that I'd inadvertently left in my office window. The thing looks bad-very little foliage as compared to its big pot still wrapped in red foil from Christmas a year ago. The leaves still present are tiny, and only a few turned red again this season, which I missed in my June 4th (2008) to January 5th (2009) cancer hiatus. Helen said that as much as she wanted to throw the sick thing away, she hesitated because everyone in the office took such care of the plant in my absence-watering it, pruning it, loving it through a hard year. It was the stand in for me, symbolically, and they couldn't let it go. Well I am really grateful that they cared enough to check on my plant and wait for my return. And I'm really grateful that Helen didn't throw it out or keep my desk space. I am getting rid of the snackbars and peanut packs though, since they are pretty old by now.

Friday I discovered a great way to enjoy my 25 minute drive to work. Some people sing in the shower; I sing in the car. My friend Donna Z made a terrific Christmas CD with lots of different songs. Although the season is over, the music on that CD is stellar, and it makes a great accompaniment to my drive. Try it yourself, singing to Josh Groban or the singer of your preference, and you'll be smiling from ear to ear by the time you get to work.

I had my follow up with Tanya at the clinic yesterday. My blood counts are good. My rump is a little sore today from the needles and bone marrow biopsy but not bad. I'll get those results later next week. My next appointment is April 20th for another bone marrow biopsy (every 3 months).

Today's photo is from my neighbors snowman earlier in the week.

The Work Has Just Begun

2009-01-20T14:02:00.000-08:00

Were you there? Despite a plentiful snow here in the Triangle, our clinic did open today (Tuesday) on a 2 hr delay. I made it to work with time to spare and turned on the lights, computers, etc while others arrived for work in the snow. Most of the morning, I listened to NPR radio while the downtown mall in DC was the site of the inauguration festivities. I tried several options for streaming the video of the swearing in ceremony and finally discovered that the NY Times website had the best signal.

Imagine my great surprise and delight when I actually got to see both Joe Biden and Barack Obama give their oaths. I especially enjoyed the moment at the end when a stately gray haired, white man wiped tears from his eyes after the prayer by Dr. Lowery to end the ceremony. Is this a great country, or what? I am so grateful that I got to see it, hear it, and experience it with snow out my window as I write this. I almost feel as though I were there in person.

Ready for Change in 2009

2009-01-20T03:27:00.000-08:00

I've been so excited about the change we are about to witness later today, waiting for this day a long time, eight years to be exact. It snowed here overnight, and my clinic won't open until 10am. So I have a little more time to sip coffee and let it all sink in before heading off to work. Several of my coworkers will be at the inauguration, with kids and grandkids to celebrate Obama's start with millions of others on the Mall. I wish I could have joined them. Historic doesn't even begin to describe it-transformative and more.

I too am hoping for better luck in 2009 - good check ups (I have one with a bone marrow biopsy this Friday) and lots of energy. The beginning of the year has been great, getting back to work, getting a daily routine going again (I just finished my row workout), and returning to Asheville on the w-e's. We are finding our pattern again, and it sure is nice to see all of our old friends in the mtns more regularly again.

Today's photos are from the hike up Lover's Leap outside of Hot Springs, where we did the soak in the outdoor hot tubs on Saturday.

The Spirituality of Everyday Things

2009-01-19T09:43:00.000-08:00

We had a splendid w-e in Asheville enjoying the mountains and all that Asheville has to offer this time of year. Saturday morning we did a run around Beaver Lake though it was quite cold and windy. I thought we did a good job considering that it was only 14 degrees and we faced a headwind at times. It was a gray day until later in the afternoon. We joined our friends Susan and Donna that afternoon for a hike at Lover’s Leap in Hot Springs followed by a soak in the tubs at the little resort there. It had been a long time since I’d been there (at least 7 months), and in the interim, they added a long white house for the check in desk and rooms for the massages. Before there was a dinky old building for the check in and trailers for the massage rooms. Now they have bottled water, a waiting area, and gear for sale. It’s almost even upscale.

I was struck by the loveliness of it all as we soaked in our little tub (#8) overlooking Spring Creek. We had the 5pm-6pm time slot so we were there while the sun went down. It was cold and still windy but the warm water was more than enough to keep us toasty. I just really enjoyed that view of the trees on the creek bank, getting blacker and blacker as the daylight disappeared. It made me very emotional to be there again-thinking about all of those hard days with chemo treatments for 2 hours in the morning and night-all necessary so that I could enjoy that hour of peaceful calm on the river bank. It made all of that tough stuff I put up with for 7 months worth it.

After our soak, the plan had been for the four of us to eat dinner at the Bridge Street cafe there in Hot Springs. They have great wood fired pizzas that we had all been looking forward to enjoying. But for some reason, they were closed, and we had to drive all the way back to Asheville for dinner. After a misstart at one restaurant that allows smoking, we ended up at another for sandwiches and sweet potato fries. What a great invention, sweet potato fries I mean.

Sunday morning we enjoyed coffee in bed while looking out towards Sunset Mtn. The woodpecker came to the suet feeder while the finches, chickadees, and sparrows enjoyed the food at the other feeders. Quigley nestled into the covers with us, and Gracie sat on the bed getting her pets. I felt like I was enjoying a holiday w-e at a cabin what with the old pine wood walls in the bedroom. I was struck by how lucky I am to have the Asheville house for w-e trips. It is so cozy and quaint. Again, I just really felt fortunate to be here, to still be here, to enjoy all the cool things about my life and all the special people I know. I am struck sometimes by the spirituality of everyday things-how truly fortunate we are to have so much, and so many people who love & cherish us.

Today's photo is some iceplant we saw when we were at the Wildlife Refuge outside of Arcata, Calif.

FogHead

2009-01-15T14:35:00.000-08:00

Now that it is Thursday, I am barreling down to the end of my 2nd workweek. I had Monday off since that is my new schedule. I'll work tomorrow seeing patients until 1pm, and then we will head to Asheville for the w-e. Mostly I have gotten used to working again, but I am still adjusting to having to be "on" all day. While I was out for my cancer treatment, I read the newspaper (both the local paper and the NY Times), sat on the couch reading the latest bestseller, or played on the computer. I didn't accomplish much in the way of real work-my daily tasks limited to doctor's appointments & laundry. Now that I am back at work, I feel behind so much of the time because I am having to relearn all of the systems for seeing patients while I also train for the Computerized Health Record that we are implementing. The computer system is large, complex, and not necessarily intuitive. I feel fogheaded most days when I get home because I am struggling to remember (A) how to treat a patient for his or her particular medical problem after being out for 7 months and (B) how to use the new computer system to document what I've examined & done for the patient. Much of the time on my drive home, I realize that I am in my head, trying to distill everything I've learned into helpful routines. I am really fond of routines, both in my personal and professional life. I joke with my friends that I am like Rainman, the character Dustin Hoffman played in the movie with Tom Cruise. He had some intellectual giftedness but would fall apart if anything was out of order from his usual experience. I'm probably not as bad as that, but I do crave routine. I find them comforting and efficient. Right now I am fogheaded because I have no usual order. Everything is new after 7 months of being out of work. Also, I don't have an office space, computer, or desk of my own yet. There are three of us sharing two desks until one of the providers goes to work at one of the other clinics. So I am uprooted and fogheaded. It only adds to the discombobulation.

I am desperately trying to pay close attention to everything I do during my day to find all the helpful shortcuts. I am getting up to row or run before work, but I don't have that as smooth as I'd like yet either. I am getting my workout done, but I still feel rushed. Some of that may be because I didn't have to move so quickly from one task to another during the last 7 months, and it feels rushed to do so now. Also, I need more sleep than I did a year ago, before all of this cancer treatment, and I am trying to sleep as long as I can before my workout. I like to walk at lunch if I can; it gets me outside at least for part of the day. I haven't been able to do that consistently yet which is adding to my foghead and my sense of being behind. I know that it will all get easier and that, in reality, it's only been 9 workdays. However, I'll be happy when everything flows again, and I can come home to a clear mind.

A Bright and Sunny Winter Day in Asheville

2009-01-12T11:14:00.001-08:00

Holly and I are still in Asheville (Monday) getting used to our new schedule. I went back to work this week, about 20 hours, which felt great. We left Hillsborough on Friday afternoon and headed for the mountains, our first Asheville trip for the new year. It's been a cold, gray w-e until today; it is finally sunny with clear blue skies. We are trying to get used to our new commuting schedule since I now work Tues-Fridays. Holly is going to work from the mountains on Mondays, and we'll head back to the Triangle late on Monday afternoons. Today, I've had the day free to go running around Beaver Lake and to do some errands around town. I just took some of that big carrot cake I bought previously from the Bone Marrow clinic, over to Susan and Donna's house. Luckily I got to visit with them a bit before they head off to work.

The Christmas season is now officially over for us. This morning, I took down the tree and Christmas lights, packing everything away until next season. I am sad to see all of those colorful decorations & lights go back into their boxes until later this year. I couldn't bear to take down the wreath on the front door so I am leaving that up until Spring. Why not be festive, at least at the front door?

I read a review recently of a book written by a woman about her experience with her Mother's cancer. The reviewer had some similar life experiences and had written a blog about her feelings, though she admitted that she hates the word "blog". She prefers to think of her blog entries as "little boats" that she launches with her feelings. I, too, have felt funny about the word blog, mostly because I don't want to be the kind of person who thinks that what I write is important. It started in June after my leukemia diagnosis with news & updates for my family, friends, and co-workers. But I have come to enjoy the process of recording my impressions of things. I plan to continue that as long as I have time & enjoy it. I don't expect anyone to read it now that the acute scare of my cancer is past. If anyone does read it, I hope you find it helpful & pleasant too.

Today's photo is from a hike we did along the Elk River just south of Arcata in N. California. The trees were covered in moss and even had ferns growing out of the branches.

Bone Marrow Biopsy Reprieve Until Jan 23rd

2009-01-08T11:49:00.000-08:00

Yesterday I got an email from Tanya at Duke (that is exactly how she introduces herself everytime she calls to leave me a message) asking to reschedule my appointment from Monday the 12th to another day. We settled on Friday Jan 23rd instead. Apparently they are over scheduled on this upcoming Monday. Sure, I'm happy to put off my date with the wide bore needle until later. I'm helpful and giving that way.

One of my coworkers is about to have alot of contact herself with the Bone Marrow Transplant program at Duke. Her daughter has lymphoma and has failed her initial chemo regimen. She is going to have a different treatment-very high dose-to blast the lymphoma, and the transplant will replenish her bone marrow after the new chemo. They are just beginning the process now and have many questions about the timing of everything and how things work. I remember being in that place with a million questions and all the uncertainty about how you'll handle the treatment. It is very tough facing those unknowns, even small things like whether the nurses will let you have someone stay overnight with you. I remember how the loss of control is magnified by each little question and detail that you can't pin down. I finally had to give up and told myself that it was not on my time, as my friend Susan pointed out so eloquently. The bone marrow folks will treat them well over there, and the nurses on 9200 where she will take her chemo are terrific. It will all get easier once things get going, and it becomes more clear what is ahead.

Work has been going really well this week. I feel good being there. So many people have welcomed me back with hugs and encouraging words. We really have a great group, and I look forward to spending more time there next week. I'll be ready to work my usual hours by then. I've been able to exercise in the mornings before I head to work, and I haven't been as tired as I thought I'd be. My goal was to get used to a set schedule again and manage to wake up early enough to exercise before work. Next week I hope to walk at lunchtime if the weather is amenable. Maybe one or more of the new providers will want to walk with me. They seem like cool people. I look forward to getting to know them better as we work together more closely.

Today's photo is the coastal view from the top of Trinidad head.

Levitating on Oxygen and Purpose

2009-01-06T16:38:00.000-08:00

My friend Shannon in Asheville left me a message on the blog last week with a comment about my hemoglobin level of 14. She said that I must be levitating on all of the oxygen that I am now getting with so many new red blood cells. I really liked her comment and thought it was an apt description of all the great pumping ability I have now that my cell counts are normal. Gloriously normal is how think of them. I'm sure it will wear off eventually, but I feel quite energetic with all of these great new red blood cells at my beck and call. So yes I am levitating.

And today I got to work in my clinic for the first time in 7 months. That makes me levitate with purpose. Several times today I found myself just grinning from ear to ear either because a coworker had welcomed me back or a patient agreed to take my advice. I didn't do anything profound today, diabetes checks and pap smears aren't like that, but it was fun and good to be helpful. There are new people in the clinic to make things lively and interesting. I'll be getting used to the pace of going all day and learning the new computerized medical record as I go. Sweet.

Today's photo is from our hike up Trinidad head at the beach. There is a small lighthouse near this cross which acknowledges those who have died at sea.

A New Start for 2009

2009-01-05T16:45:00.000-08:00

Holly and I just returned from our trip out of town for Christmas and New Year's. I am so thankful that we got to travel, on a jet plane no less, to see family and friends before I restart my job tomorrow. My last day of work was June 4th, 2008 which seems an eternity ago now. It's been a difficult journey for sure, but one we have survived with humor, support, and love from so many people. I am especially glad that we got to see Holly's family on this trip since they have missed her (and me) while we went through all of this tethered to treatment here in NC. Now that we can move on to the next phase whatever that might be, I feel relieved. And grateful-so grateful that I went out and bought myself a new pair of running shoes today. Gotta celebrate that lifeforce.

Tomorrow I actually start back to work at my clinic. I'll be more part-time than usual this week so that I can build back up to my usual 4 workdays per week. I feel energetic even though we got in from California late last night, and I'm still on West Coast time. We had a terrific vacation seeing our friends Peggy and Naomi in Arcata (Northern Calif) after the Christmas celebrations in Kansas. We saw many new birds on our runs through the Arcata marsh and got to hike in the ever primordial Redwoods, always a treat. Ruby, their dog joined in on many of our jaunts. She is really a cool dog-calm, loving & gentle with the sweetest eyes. I included a picture of us heading up Hwy 101 to hike. Ruby is sitting on Peggy's lap while Naomi drives. Later in the day, we caught the most beautiful sunset over the beach near Trinidad.

On the health front, my next appointment is Monday Jan 12th for another bone marrow biopsy. Tomorrow will take care of itself, as they say.

New Numbers in Arcata

2008-12-29T17:44:00.000-08:00

My doctor wrote a script so that I could get my labs done while we are in here Arcata, California visiting our pals Naomi and Peggy. We were hiking around the Arcata marsh watching the panopoly of birds when I realized that I had a message from Tanya at Duke. Peggy had taken me to the local hospital this morning to have my blood drawn. Tanya wanted me to have another blood count done this week, just to track the white cell count. Thankfully my numbers are continuing higher still-my white count is now up to 4.9 with 2200 neutrophils, my hemoglobin is up to 14.0, and my platelets are 217,000. Everything has improved from 2 weeks ago when my counts took a brief nosedive. Tanya thinks my bone marrow needed more time to recover after that last chemo treatment and the stress of recovery.

Regardless, it's nice to have all the numbers behaving themselves. And I'm free to run longer distances again. Watch out!

Merry Christmas

2008-12-24T19:06:00.000-08:00

We've dropped off the kitties and Quigley at Carver St Animal Hopsital in anticipation of our trip out tomorrow. We enjoyed the dinner here last night with 11 other friends for Christmas Eve, Eve. We had a terrific time; so glad everyone could make time to come and share their friendship.

Today we've been doing odds and ends, last minute details before our 9 day trip to Kansas and California. We opened our gifts tonight and ate delicious leftovers from last night's feast. We also shared stories of childhood Christmas's past-the year of my sister's Gemeinehart flute, Holly's guitar and bow and arrow set, etc.

Everyone have a Merry Christmas and Happy New Year. Thank you for remembering us with all of your cards, well wishes, and gifts. Though it has been a trying year in many respects, I feel incredibly lucky to have so many caring people in my life.

Photos: Christmas Eve, Eve dinner; Christmas sweater, Spread the Joy

Better Numbers

2008-12-23T08:17:00.000-08:00

I had my labs redrawn yesterday at the bone marrow clinic. They are improved from last thursday, and my doctor thinks the "blip" is just my bone marrow resetting itself. He did have me back off some on my running since exercise can drop your white blood cell count. Who knew? I've never had a doctor tell me to exercise less. That's a first.

Anyway, we do get to leave Dec 25th on our trip. (Leaving on a jet plane...) The numbers were white cells 2.5 with 30% neutrophils, hemoglobin 13.0, and platelets 158,000. Everything is normal except the white cell count. At least my neutrophils have come up out of the dangerous range and are above 500. Just to be safe, we've decided to cancel the side trip from California to Oregon. I don't want to tempt fate and get into any health issues out on the cross country ski trail.

When I was checking into the lab yesterday, Kristen, the young girl with the fancy shoes, was checking out. She did not seem happy, and they made her another appointment for Dec 29th. Apparently something is going on with her labs too, and she got bad news. I know how she feels. We almost had to cancel our whole trip to Kansas and California, the first after 7 months of chemo and blood transfusions and pneumonia medications. Christmas is no time to hear you have to be galavanting back and forth to the clinic for anything, even if you are wearing fancy red leather pointy toed shoes. She had a transplant for aplastic anemia when her bone marrow just stopped working. The last time I saw her, she was so happy, sitting in the blue recliner next to me, waiting to drive home several hours away after her transplant and other treatments ("I've been here 43 days," she said to me). This bone marrow stuff is hard. There's the hard of I have a life threatening illness; there's the hard of chemo and other treatments, and there's the hard of whatever else the bone marrow just decides to do like quit making blood cells or reject the transplant or make a new cancer. Well that's just the life we're going to have, one that lacks even the illusion of control. I'm still trying to get used to it.

Photo:My nephew Ethan with Lacy the Rein Dog

Old South, New South

2008-12-22T16:52:00.000-08:00

I went back to the clinic this afternoon when we got back from our weekend trip. My white cell count was low on Thursday, and Tanya wanted me to come back today to have them rechecked. I'll hear about my numbers tomorrow and hope they are better. I want us to be able to go on our 10 day trip on Christmas (to Kansas and then on to California). Even more, I don't want to have anything wrong with my bone marrow. I am hoping the dip in the counts was just a "blip" as Tanya said. It's very nerve wracking having to wait for the news. I have had to get used to this kind of thing, but it never gets any easier. My mind goes through all the possible explanations-everything from a temporary dip in the counts to a relapse of my leukemia. That would be the worst outcome, of course. However, I had a bone marrow biopsy only 6 weeks ago, and it was normal. I suspect that if my counts stay down, they will want to do another bone marrow biopsy sooner rather than later. My next one was supposed to be January 12th. I'll be very disappointed if we don't get to go on our trip. We finally get to travel after 7 months, I book us flights to Kansas and California, and then this comes up. Hopefully all will be better tomorrow.

We drove to Georgia for the weekend to visit my sisters. One lives in Atlanta and the other one lives about 2 hours further south in Columbus. Becky had to work unexpectedly so we went by her house in Atlanta on our way home Sunday. I finally got to see Haley, Becky's new dog, and the house she is now renting. It's a cool bungalow with old pine flooring. Very nice and near her work and lots of other fun city stuff.

Saturday morning Beth, Henry, Holly and I drove over to Ft Benning so that we could show Holly the post. Henry is a Ranger in the Army, but he and Beth live off post in their own house about 20 mins from Fort Benning. We drove all over my old biking and running routes and saw our old housing. Some of it seems a bit run down after all of these years. But then that was more than 30 yrs ago. Wow, it really has been a long time!

Saturday night we attended Emma's dance recital along with about 150 other families. They held it in one of the local HS auditoriums-that's how many people attended. There were wee little girls (2-4 yr olds) up to HS students, who did an elaborate Hairspray number. It was all quite fun, and Emma seemed happy to be part of it. I took a photo of her with her roses after the performance. I'm not sure why dance is so big in the south, but it is very popular. It's a little like soccer with all the practices and recitals and even competitions sometimes. Ethan thought something was wrong with Emma's face when she was in costume. She pointed out that she had on makeup. Oh to suffer the comments of a bigger brother.

Sunday we attended Ethan's hockey game. Part of the New South experience after our Old South one the night before with the dance recital. He was tough and focused and even scored 1 goal and 1 assist. I'm biased, of course, but I thought he did well. He is quite an athlete and knows no fear. Hockey is great for him.

We are having friends to a potluck here tomorrow for Christmas Eve Eve. That will be lots of fun with 13 of us getting together. Holly is doing a turkey; I've made sweet potato casserole and pound cake. I bought a carrot cake from one of the nurses at the bone marrow clinic when they did the bake sale to benefit the Leukemia and Lymphoma society. Everyone else is bringing a dish to share. Should be fun and yummy.
Photos: Old South and New South Fun

Low Counts Again, Darn It!

2008-12-19T07:38:00.000-08:00

We are on our way to Ga to visit with my sisters for a few days. Before we left Hillsborough, I had my blood counts drawn yesterday at the Bone Marrow Clinic. It's been about 6 weeks since my last chemo treatment and 2 weeks since my last lab tests. They were beautiful the last time -so beautiful that they pulled the catheter in my chest and told me that I could eat anything I want, get a flu shot, etc.

But I just got a call from Tanya, the Physician Assistant for Dr Long, telling me that my counts are low again. My white cell count is only 1500 with the absolute neutrophil count at 400. A count lower than 500 is dangerous since these are the cells that fight infection. My hemoglobin and platelets are low too at 11.3 and 128,000 respectively. So it's back to food precautions again-no salad, only cooked vegetables, no playing in the dirt, back to avoiding those with a fever or illness, and off to the hospital for IV antibiotics if I run a fever. Oh bother!

Tanya told me to go on GA trip, but I have to be back in the clinic Monday to have my blood drawn again. She is hoping that the counts will be up by then, and this is just some blip. Only 2 weeks ago my neutrophil count was 2200-more than 5 times what it is now. Darn.
Despite the lab numbers, I feel great. I just finished a 7 mile run around the lake here and included 2 steep hills on my route. Hmmmm, wonder what is going on now???

Good Advice

2008-12-18T06:02:00.000-08:00

After writing that I am still having hot flashes & can't sleep if I don't take the meds my doctor gave me, I got a very helpful email from my old friend Karen N, who is also a doctor. We were interns together at UVA in 1996-1997 and shared many a night on call together during our training. You develop a special relationship when you've seen each other bone tired from trying to keep up with all the work on the floor. We shared a call room often and helped each other answer the nurses questions when they paged us frequently. In her email, Karen reminded me that I need my sleep to heal, to fight infection, to resume work with energy, and to maintain my immune system. She made me see that this thing I have of toughing it out w/o sleep medicine is just plain stupid. Thanks for that. It takes a hard headed, no nonsense doctor to get through to this hard-headed, no nonsense doc what is right. Truth is I am not that far out from my last treatment, only 6 weeks, and my body still has work to do. I keep forgetting that. I keep forgetting how much sleep is part of good health. I owe Karen a big thanks for reminding me of all that and giving me "permission" to keep taking those little pills that let me sleep, even if I don't want to need that. Get over it already.

Little Things I'm Getting Used to

2008-12-16T13:54:00.000-08:00

Now that I don't have to go to the hospital or clinic on a daily basis, I am not sure how much writing I intend to do here in the blog. It's been a great way to keep my family and friends abreast of my daily events, but I don't have much to report these days now that my treatments are completed. Your comments and emails have been very helpful and uplifting, especially when I had to stay here to avoid infection or take chemo for 5 days in the hospital. Soon my life will be getting back to normal and I won't have much out of the ordinary to report.

Recently, I received my job paperwork from Piedmont making January 5th my official restart date. That was the last piece to complete before heading back to work at the Drew Community Health Center, where I worked previously. I was always a little nervous about the whole job situation. In June, I took Family Medical Leave which guaranteed my job for 12 weeks. That put me to September when I had to resign my position. I still had 2 more chemo treatments to go, the economy was tanking, and I worried about whether my non-profit, indigent care clinic would even have a place for me in 2009. I really didn't want to have to find a new job, interview and explain this baby bird hair. I know that primary care doctors are hard to come by, but they might be hesitant to hire someone who has had not one but two cancers, finishing treatment only a month earlier.
But I don't have to worry about any of that. Piedmont is taking me back, at my former center. The staff there is terrific, and I have a lovely supervisor and colleagues. I'll try to shake out all of the cobwebs for them before I get back there on January 5th.

There are some things I am still getting used to with my health and body. They include this baby bird hair, that seems to curl and frizz in its grayness. I'm still waiting on my MaMa hair. Maybe it will be brown & thick again eventually and maybe it won't. My eyesight is worse again-the readers are now 1.75, and I seem to need some distance correction too. Gotta get that checked in a few months once the chemo effects are completely out of my system-they say I should wait 6 months. I'm still having chemo-induced hot flashes at night. I tried to sleep w/o medication last night, but I was up at least 6-7 times between 10pm and 2:30am. Thankfully I have more of the sleeping pills they gave me, but who likes to take those? And like every other woman in menopause, I forget words just moments before I have to use them. I can't wait to see how bad it is when I'm speaking spanish all day because even the english is halting at times. I thought it was my own special chemo brain thing, but Gail says she has it too. Whew, I'll rest easier.

Photo: Me in the Asheville garden this past w-e

Rein Goat

2008-12-15T11:22:00.000-08:00

Holly and I spent the w-e in Asheville, and she got this picture of the Rein Goat who was at one of the holiday farmer's markets. Both Asheville and Hillsborough do a terrific job of showcasing local farmers as well as handmade goods and local shops, especially this time of year. We have felt more than a little worry for our local shop owners, hoping all the businesses that we enjoy weather the current economic downturn. There are lots of places we like but don't frequent much. Hope they hang on too, places like breakfast spots and tailgate markets. Holly bought delicious pumpkin ginger cupcakes just to support the folks at the tailgate market on Saturday (duty calls). We watched the fireworks from our deck later, though the picture doesn't quite capture it.

Over the w-e, I received a package from work with my paperwork to restart my job. That feels like a long time coming. I've been trying to do all of the last minute things I can before I am back to work and busy with a real schedule again. Today I've been cleaning up my desk, my files, and all of the bins and baskets I have everywhere to dump stuff like loose papers, cards I need to write, etc. I live in two places, really, with some stuff at the Asheville house and some stuff here in Hillsborough. I have a large boat and tote bag from LL Bean that I use to haul stuff back and forth, always dropping things in the bag during the week as I realize I'll need them at the other house. You have to stay organized to do this back and forth thing. When I notice the bins and shelves are overloaded with papers or books stuffed everywhere, I know it's time to clean up, reorganize and file things away. Today was that day.

I wish I had taken before and after pictures of the Asheville garden this w-e. We did so much getting it trimmed back and cleaned up. I'm happy that we got ALL of it done, even the gutters and grapevines. We worked hard. Our reward was pizza, beer and a Netflix movie. We're easy to please.