Don't Overdo It

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

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

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

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

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

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

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

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

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

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

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.