Lyrlem Ipsum

Happy flowers

2011-07-23T16:25:00.000-05:00

Three years ago, I moved my panther lilies. They were one of the many flowers that had come with our house, and had probably been in the same location for decades. Every year, they would lean away from the house until they fell over. Looking for sunlight, I guessed.

So I moved them to the edge of our yard: the neighbor's yard is much sunnier. The new flower location is more along a deer "trail". Now the panther lilies provide more mouthfuls for our local cervine population. The past couple of years, we've been lucky to have one flower escape the mouths of deer. I have wondered if my move was a good choice.

Now, the panther lilies are blooming. And not - as was the case every year near the house - just one flower to one plant. They have two, three, even four flowers on just one plant. These are happy flowers. Sunlight beats deer.

Conversation on charity

2011-05-22T14:56:00.003-05:00

Yesterday in Bible study, we came upon the topic of charity. A lively discussion ensued.

An example of a charitable cause was given; it was disputed that the cause was a charitable activity.

One person claimed that people who give nothing to charity miss the boat on an important moral obligation; another countered that we don't know everything people do with their money or what their reasons are and should not judge.

The tithe of 10% was brought up: this person believes that if we do not give 10% voluntarily, God will take it from us in unexpected ways. (And then the conversation drifted to how active God is in everyday life.)

There were some hard feelings generated during the conversation on charity; the sensitive nature of this topic took me by surprise. It's a topic I find very interesting and hope comes up again, with a caveat: that our group members can contribute to the conversation without generating any of the defensiveness I saw yesterday.

Diplomacy, please hang out with us all.

Cow artwork & family memories

2011-05-14T06:35:00.002-05:00

Fifteen years ago I had my fourteenth birthday. For my birthday, my grandmother sent me a ceramic cow. It was posed sitting on its back legs; from hind end to top of its head the cow was about 8" tall.

Included with the cow was another package. Unwrapping it, I found four wooden eggs. The eggs were painted black and white, and were sized to perfectly fit around the legs of the cow: cow eggs. I was delighted to no end. The cow and her eggs were prominently displayed in my room for many years.

A month ago, I was shopping at Pier One. I found a large mug painted in the white-with-black-spots cow pattern. It had feet, of a sort: painted pink to look like udders. I thought of my grandmother, and the happy exchange we'd had with the cow eggs. I bought the mug, and intended to talk to her about it.

The next week, my mother called. My grandmother had passed away.

I will miss her. I'm sad we won't share any new memories, cow-related or otherwise. I'm happy I have the memories I do. Farewell.

A red fox in my yard

2011-05-08T09:49:00.000-05:00

For the past week, I have seen movement of a small-dog-sized animal. A tail, a quick movement as it ran behind the garage. Racoons are common in my neighborhood, and woodchuck (groundhog) sightings are common in my yard. The flashes of fur seemed a little too orange to be woodchuck or racoon. But what else, I thought, could it be? Surely not a fox.

Well, yes. It surely was. The fox is, right now, asleep about four feet from my living room window. Apparently that pile of leaves makes a nice fox-bed.

It was an exciting sight: I woke my husband up and made him come downstairs. The fox woke up when a bird flew by, looked around, and went right back to sleep.

And I'm not alone: the Illinois Department of Natural Resources has a bulletin from 2004 about foxes in cities. The bulletin says they eat mainly rabbits and mice (and can survive on insects and nuts if needed) and do not attack cats or dogs. Sounds like a useful animal.

Welcome to my yard, fox.

I cut a corm

2011-01-01T10:20:00.002-06:00

Yesterday, I divided my cyclamen plant. I've had it for six years; it was time. Yesterday was a warm day; most of the snow had melted overnight and in the morning. My compost pile was easy to work in, and I dug up a potful of soil. I sat on the porch (no coat! so warm!) with my supplies, and mixed the compost with perlite and coconut fiber.

Time for the cyclamen to come out: I turned the pot upside down and started shaking. Shake, shake. Shake, shake. No movement. I stared at the roots coming out of the bottom of the pot, wondering if they were stuck inside. I was afraid to pull on the plant top: cyclamen stems are fragile. Shake, shake - it was loose!

I eased the rootball out of the pot and started prying it apart. I think I was expecting bulblets that would peel off. What I actually found was a solid mass, about the size and shape of a small donut. What was this? Could it be divided? Off to the internet.

Cyclamens have corms, which can be divided, but not by pulling apart with fingers. They require a sharp knife. So, paring knife fetched from the kitchen. I cut the tuber like a cheese wheel. Each wedge into a pot, add my prepared potting mix. All done - plants back to the kitchen window with a fresh watering, supplies put back away.

And wait. Plants don't always take well to having their roots messed with. Taking a sharp knife to a living thing and cutting it into pieces seems an illogical way to promote its health.

I come downstairs this morning, into the kitchen for breakfast: the windowsill has four perky-looking plants. They seem happy in their new homes. I'm happy I could do that for them.

Now I have four cyclamen plants, only one of which I intend to keep. All with flower buds. Three to give away. So, who needs a new houseplant?

Would you like to restart your computer now? YES!

2010-12-24T10:33:00.000-06:00

Yesterday, I broke my mother-in-law's computer. When turned on, it would show the Dell logo, then a cursor would blink a few times. Then blackness.

An hour later, after much rebooting and Windows startup repair utility failing - twice - I managed a system restore to a point before I broke the computer. And then I spent another hour reassuring my mother-in-law, and fixing the things I had gone over there to fix: installing a new mouse (the LED in her mouse had burned out - who ever heard of that happening?) and removing expired antivirus software.

The cause of the breakdown? When prompted "would you like to restart now?" after installing software for the new mouse, I said "no". And then I uninstalled the expired antivirus software, which also required a restart. Only, after doing those two things with no restart in between, the computer was no longer able to boot.

I have never before broken a computer that severely. It was especially scary because I did it to someone else's machine. Yikes.

Moral of the story: if your computer wants to restart, SAY YES!

Lactose and osmotic pressure

2010-12-05T09:46:00.000-06:00

Since college, I have had some issues with lactose intolerance. My degree of tolerance has seemed to go up and down, which is puzzling and frustrating. After a recent bout, I decided to do some reading on the subject to try to gain more understanding of (and more control over) my situation.

I started with a Google search. After reading several webpages, the information was all starting to sound the same. Until I got to Wikipedia: "lactose... raises the osmotic pressure [in] the colon."

Osmotic pressure? I think I learned about that in ninth grade... I had to click through the wikilink to figure that one out. So, having something that cannot cross a semi-permeable barrier (gas and other by-products made by lactose-eating bacteria cannot cross the intestinal wall) causes water to cross the barrier (making watery, um, colon contents).

It looks like the unchangeable part of lactose intolerance is lactase deficiency: the inability to digest lactose in the small intestine. So the lactose travels down to the large intestine, where it is eaten by bacteria. At that point, the degree of symptoms (or even if there are any symptoms) depends on the behavior of said bacteria: how much gas and "increased osmotic pressure" they produce while eating lactose varies widely from bacteria species to bacteria species.

So I can eat cheesy pizza one week, and have polite bacteria that dispose of the lactose without causing me any trouble. The next week, not-so-polite bacteria cause me to seriously regret that cheesy lentil and leek loaf. How to encourage the polite bacteria to keep up residence? There seems to be a feeling that eating the same amount of lactose every day can help, but nobody really knows. So I haven't actually gained any more control from my reading.

But at least I can laugh while thinking about my situation as a problem with "osmotic pressure." Thanks, Wikipedia.

New line of communication

2010-11-06T14:24:00.002-05:00

At work, I may call a customer without knowing who I need to talk to. Sometimes I have notes from coworkers or predecessors, extension numbers and names that are useful. Sometimes the notes are hopelessly out of date. Sometimes there are no notes. Regardless, after navigating voicemail systems and explaining myself to secretaries, I often meet a person I will work with over and over again. This was the case with customer A.

I have been at my current job for six years. In that time, my contact at customer A has answered his phone once. At first, he would call back to respond to the voice messages I left. A few years ago, he stopped returning my phone calls: instead, a coworker would bring me reply he had faxed over.

Taking this as a hint against voice messages, but not being too fond of faxes, I tried sending him an email. His email address was printing in the header of his fax. It bounced back to me: invalid address.

I sent him a fax with my email address. He replied, from a totally different email that what was printed on the fax. Success! In the time since then, I have come to rely on his quick and helpful replies to my email inquiries.

Last year, a coworker asked me to get some paperwork from customer A. "You're the only one who can get a hold of anybody there," I was told. I'm not sure how I developed this mystique among my coworkers; I was somewhat bemused. I made the contact as requested, and met a new person at customer A, one who handles paperwork.

She now emails me on a regular basis with questions. I get the impression that before acquiring my email address, she suffered these questions in silence. Certainly none of my coworkers seem to have any previous contact from her.

Last month, a person from customer A's accounting department emailed me. I put them in contact with our accounting person. How we could have done business with this company for decades without them knowing our correct accounting contact makes me wonder.

I am somewhat disturbed that so many of my coworkers and so many people at customer A seem unable or unwilling to communicate with each other over the phone. I am happy I have been able to improve the connection between our two companies with electronic communications. The whole experience leaves me with puzzled emotions, but has led me to one firm conclusion: email is a very powerful tool.

Chemo-ically treated hair

2010-10-23T17:11:00.001-05:00

Saturday, I saw my sister-in-law's family. The occasion was their son's fifth birthday.

We exchanged pleasantries with my in-laws. My brother-in-law commented to me, "I didn't know you had curly hair." I gave my standard reply, "It was the drugs they gave me."

It is common knowledge that chemotherapy usually makes one's hair fall out. Its later effects seem to be less commonly known: when hair comes back, it is often a different color and texture.

Pre-chemotherapy, I had dark brown, almost completely straight hair. Now, I have medium brown hair with a pronounced wave.

Having people comment on my new hair texture bothers me. Not that I have any problem with how my hair looks (I actually think I look rather cute with it). But I feel like I'm marked: the chemotherapy changed me in ways that I had no control over. The hair changes seem benign, but what else did the drugs do to my body?

I will try not to dwell on it. I think I will be pretty successful. At least, until the next time someone notices my hair.

They're like potato chips

2010-10-17T17:49:00.000-05:00

One week ago, my partner and I met with a woman who lives nearby. She breeds birds, mostly parrots. We were interested in a hand-fed budgerigar (parakeet) she had for sale.

She gave us the pitch for the local bird club, told us about the need for foster homes for large parrots, and gave us a brief tour of the birds she owns. We handled the bird we were interested in. Before we put him in our carrier, she made sure his wings were safely clipped (we don't want any escapee parrots!) and trimmed his nails.

There was a moment when we were all staring at the bird's little feet kicking in the air near the nail clippers. She looks at us and says, "You know that birds are like potato chips." I must have looked pretty blank. She went on, "You can't stop with just one."

I laughed. This purchase brought our parrots to four; we will always remember two others that have passed away. It is a joy to interact with them, and to watch them interact with each other. I was especially grateful for their presence when I was fighting cancer.

No, I thought, I could not imagine having stopped with just one.

Holy nickname

2010-10-12T12:00:00.002-05:00

Last spring, my bible study group read the Song of the Sea - what the Israelites sang after crossing the parted sea while fleeing the Egyptians. One thing that caught my attention was the nickname "Yah" used in the song. It is, the commentary explained, an abbreviation of the YHWH formal name of God.

It made something click for me in the worship services: Halleluyah. Learning it growing up in a Protestant church, and seeing it used in novels, I had always thought of it as just a word of praise. The past six years of attending worship services that include Hebrew let me realize that Hallelu is a Hebrew word: Let us praise. And "yah" is a nickname for God.

The name YHWH used to be pronounced by the High Priest inside the Temple during the High Holy Day services. Two thousand years ago, the Temple was destroyed and the office of High Priest was discontinued. The prohibition on saying the name outside that specific circumstance is such that the vowels and pronunciation have been lost. The Bible records an instance of the death penalty being imposed for inappropriately speaking the name YHWH (Leviticus 24:10-23).

And yet, there is this nickname. A nickname so pervasive that it is part of the most common praise for the Lord. Halleluyah. Holy nickname.

Cook hopes

2010-10-09T19:23:00.002-05:00

I just ordered three cookbooks from Amazon.

I am in the process of researching slow-cookers. Two of the cookbooks are for the slow-cooker. I hope the information in them will help me decide on a size and give me an idea of which features are most useful.

I am afraid this is overambitious. The past few months, I have only cooked one or two meals a week. (The partner and I eat a lot of frozen meals, and eat out a lot.) While my hours at work have improved from this spring, the stress from work is worse. I often feel so mind-numbed that all I can muster up the motivation for or enjoyment of is flash games on the internet.

I hope things are improving, and planning to spend more time cooking is an expression of that hope. I also hope that a slow-cooker meal, where I could do the prep the night before, would work better with my schedule.

Planning and working toward a better future. That feels good to do.

Making my bed

2010-09-19T16:52:00.000-05:00

Children often argue with their parents about chores. I was no exception. Making my bed was a particular sticking issue. My father kept telling me I would be more comfortable sleeping in a freshly made bed. My own experience proved otherwise - I was perfectly content sleeping in a bed with mussed covers. There had to be more to this bad-making thing. Turns out, most people appreciate the aesthetics of a made bed. It's good for socializing to have visible parts of your house look nice - making the bed is for the community, not the individual.

I've been thinking about that while attending services for Yom Kippur, the Jewish Day of Atonement. The idea behind the holiday is for people to reflect on how they can be better, and lay out an ethical plan for the year. Sounds nice.

But... it doesn't seem to work. People who attend Yom Kippur services (or comparable practices in other religions, such as Catholic confession) don't seem to have any higher standards than people who are religiously apathetic. I don't see any different behavior in myself now compared to my religious-service-free college days.

So, if the purported effect of making us better people doesn't pan out, why do we come to these services? My theory: the same reason we go to weekly services. Not for ourselves, but for the community. Those who pray together stay together and all that.

I like the community at my synagogue. It provides me with study opportunities, opportunities to give back to my local community, and social interaction with a wide cross-section of people. I'm glad we have events such as Yom Kippur that keep us together as a group.

Happy New Year

2010-09-11T10:32:00.000-05:00

I grew up in a town with a much higher Jewish population than my current city. On major Jewish holidays, there were generally multiple people absent from my school classes. Everyone was kinda aware of the holiday season.

Yesterday at work, three coworkers learned for the first time that I am a synagogue member. They kind of stumbled into it asking how my day off was: no clue that Thursday was the start of the Jewish New Year celebration.

At least I didn't go my husband's route, telling them that we all dress up in a giant dragon costume and set off fireworks indoors.

Lack of taste

2010-09-04T08:52:00.002-05:00

Tuesday, I was eating grape tomatoes, picked off my own tomato plant. It is really rewarding to have a successful vegetable after so many disappointing years. And they taste good, too... just as good as the store-bought ones.

I remembered all I'd read about home-grown tomatoes. About the extra flavor that vine-ripening gives, how the more delicate varieties for home gardens taste better than the bred-for-storage-and-mass-transportation commercial brands. People are driven to write songs about this wonderful flavor experienced by the successful tomato gardener. I'm not seeing it in my tomatoes.

Perhaps the brand I chose is the culprit. Or perhaps my gardening: my plant had a rough start and took about 80 days to produce its first fruit: much longer than the rated 60 days. It may not be getting all the sun and fertilizer it needs to reach its full flavor potential.

Then again... the people who rave about homegrown tomatoes also rave against refrigerating tomatoes. Not just the homegrown ones, but any tomato. The cold can break down important flavor compounds. They say. But not for me: I have done experiments, and cannot detect any taste difference between refrigerated and non-refrigerated tomatoes. Maybe it's me.

Last summer, my sister came to visit. Our conversation drifted to her college classes. She talked about her food science class, and shared how it had improved her appreciation of flavor. Not as much as her classmates, though: some of the things they could smell, she could not detect. This struck a chord with me. I cannot count the number of times friends, family, and coworkers have complained of a smell I cannot detect. "It must be genetic," I told her. Our sense of smell is sub-par.

Perhaps my poor sense of smell comes with a poor sense of taste. I think this calls for further research. Today, I'm going to a tomato tasting festival. Will they all taste alike to me? Or will I discover what I've been missing? Let the experiment begin!

Update: OK, so the partner's not up to a 3 hour roadtrip this morning. Maybe next year?

Not good enough to help

2010-08-29T18:29:00.000-05:00

When I was growing up, one of the stories my mother told me was about my grandmother's childhood. When my grandmother tried to fold laundry, she didn't do it right. Her mother told her she couldn't fold laundry, and the mother might as well do it herself. When my grandmother tried to clean her room, she didn't do it right. Her mother told her she couldn't fold laundry, and the mother might as well do it herself.

When my grandmother had children of her own, she was an extremely poor housekeeper. My mother has strong memories of not being able to have friends over because they couldn't stand the dust. My mother also remembers the regret my great-grandmother expresses over her impatience with my grandmother. It was very important to my mother that she walk a middle path: clean enough for company, but standards at a place where my sister and I were capable of meeting them. She did not want to make the mistakes of her mother or grandmother.

Another story my mother told was of trying to get my father to help with household chores. He tried to do the dishes, but he put them away in the wrong place, so my mother might as well do all the dishes herself. He tried to cook dinner, but he didn't have the side dishes ready at the same time as the main dish, so she might as well cook dinner herself.

I think I have avoided that particular mistake of my mother's (I think it's cute when I can't find a dish because my husband found a better place for it). Seeing how hard she tried to avoid it, though, and still fell into that trap, makes me wonder what habits I have that I am too blind to see.

Tomato plant: 1 Gardening advice: 0

2010-06-27T15:04:00.002-05:00

In May, I planted one cherry tomato plant. I tried a new location this year and hoped to get more than a handful of tomatoes. And at first, my plant seemed to really take off.

At the end of May, I went to check on my plant. Most of it was gone: one or two deer mouthfuls, I suspect. All my hopes wavered. The plant did sprout new stems, and I staked them. All I could do was hope for the best.

I was worried, though: my first gardening book, Bountiful Countainers, warns against secondary stems: it says they only make leaves. It recommends pruning away everything but the main stem, where all the fruit would be produced. My main stem was pretty much wiped away. I wondered, had that been my only hope for fruit?

Yesterday, I was ecstatic to find blossom buds on my plant, on all four stems. And so I have learned: there is more than one way to prune a tomato.

Ripening berries

2010-06-15T00:00:00.000-05:00

The mulberries are ripe. We have at least three trees in our yard: no matter where I am doing yardwork, I can stop and snack on a few mulberries.

The gooseberries are ripe. My neighbor helped me cut down a bunch of smallish elm trees last year, and the gooseberries really like the extra sunlight. It looks like I'll get several dozen berries, up from less than five in previous years.

The raspberries are ripe. This is about on-time from our 2006 and 2007 experiences. But it surprised me, because we didn't get berries until July in 2008 and 2009.

I won't do any formal berry harvesting this year because of my work schedule. I will enjoy seeing these reminder of summer every time I walk through my yard.

Facing mortality

2010-06-12T19:53:00.004-05:00

I visited family recently: my mom and grandparents. While I was there, my grandparent's fridge broke. I went to their house to help set up the replacement.

One of my tasks was to transfer all the decorations. I started with the letter magnets - two sets, larger and smaller letters. The sets are decades old, ones that I played with as a child. I put some up randomly, and spelled a few words with others.

Next in the pile was my cousin's artwork: it fit neatly in among the letters and words. There were some magnets with cute sayings that held up the artwork. I was mildly proud of the arrangement I'd made.

Finally, I came to the last item. I examined it, wondering where it would go on the fridge. It was an envelope. I read the letters to myself: EMS DNR inside. "Emergency Medical Service" I puzzled out. And then, "Do Not Resuscitate."

I stood there for a little while, just staring at the packet. My mother came over. She looked at the packet, looked at the fridge, then said, "It doesn't seems like it fits, does it?"

Hearts and stomachs

2010-05-25T10:53:00.003-05:00

This morning, I watched the routine at my mother's house. She went across the alley to check on my grandparents. We listened to the morning news. The dogs were fed, the cats were fed. Her husband left for work - "Don't forget your lunch!" admonished my mother.

Making meals for a loved one seem to me like an excellent way to express one's love. It's convenient - they don't have to meal plan or cook - and often it is healthier than other options. Being cooked for can have a dramatic impact on one's health - my mother's husband lost over fifty pounds the first year they lived together.

I am visiting my mother and grandparents this week. I have been really struck by how much care revolves around food: my mother packs lunch and cooks an evening dinner for her husband every day, and most days cooks a mid-day dinner for her parents. Cooking and other care for her parents is a task she shares with a sister and a brother's girlfriend.

Seeing all this food-caring makes me wishful in two ways. One, I wish I had more time so I could take care of my own partner by cooking healthful meals. Two, I wish my partner would take care of me by planning and cooking our meals. There are obstacles to both wishes. But being reminded of how good cooking can be, perhaps these obstacles can be overcome.

Dirty parrot

2010-04-03T21:00:00.004-05:00

Last night, I was winding down from a long day. I made a cup of tea, and sat down on my couch. As I sipped my tea, my cockatiel got excited. He wavered back and forth on his perch, then climbed down the cage to the couch. Step, step, step, hop! Onto my mug.

He likes tea, but this was more than the usual excitement. This time, he didn't just sip the tea. He got some in his beak, shook his head to throw it around, and then fluffed his feathers up to enjoy the moisture. He looked like he was thinking about jumping into the mug. Our blue-and-white budgie came over and wanted to do the same thing. Poor dirty parrots - I've been working so much I haven't bathed them.

Today, I brought out the casserole dish. I filled it halfway with lukewarm water. The budgie jumped in and splashed around, beating the water until he was at least damp all over. The cockatiel likes to have help from a spray bottle - he gets really soaked. Afterward, they preened. And preened. And preened some more.

Now we have good, clean, happy parrots. It was a fun day.

A mouse did it

2010-03-14T21:10:00.002-05:00

Two weeks ago, the telephone line in our computer room stopped working. My partner and I took a break from internet and phone calls. We read books, we hung out with each other. My workload is still crazy heavy (one week I was there for 80 hours!) which helped keep the phoneline a low priority.

Yesterday, I traced the cord around the room and into a large closet. Way at the back of the closet, where the roof slopes down and you have to stoop, there is a knot in the floorboard. The hole it leaves is mouse-sized. And in front of the hole, the phone line was neatly chewed through.

It was quick work to patch the wires together. But thanks, mouse, for a refreshing break from the always-on connectedness of internet.

Arcing

2010-02-07T07:59:00.004-06:00

Yesterday morning, I was at Bible study. We started the sixteen verses that contain the ten commandments. Most of our discussion centered on Exodus 20:5-6, which follows the commandment against idolotry:

I, the Lord, your God, am a zealous God, Who visits the iniquity of the fathers upon the sons, upon the third and the fourth generation of those who hate Me, and [I] perform loving kindness to thousands [of generations], to those who love Me and to those who keep My commandments.

The idea that innocent children should be punished for the sins of their parents, aside from being repugnant, directly contradicts other text in the Bible (e.g. Deuteronomy 24:16.)

One commentary put an interesting spin on the passage: perhaps it is not a statement of intent to punish. Rather, it could be an observation of the moral interdependence of parents and children. Children who are abused, for example, are at significantly elevated risk of becoming abusers themselves.

We also talked about the ratio of bad effects—three to four generations—to the "thousands of generations" for good effects. Does time really increase the amount of good in the world?

I remembered part of a quote from Martin Luther King, Jr, and looked it up when I got home:

The arc of the moral universe is long but it bends toward justice.

It's a hopeful statement - bending toward justice. I find it kind of inspiring to think of the arc reaching back to Moses and the commandments. May we continue to guide the morals of our society toward justice.

Wanna take a break?

2010-01-30T16:53:00.003-06:00

Yesterday, a supervisor and one of my bosses asked me to join them: they were going for a cigarette break. I wasn't sure how to respond.

I have come to a point in my career where being a non-smoker is a (mild) impediment to further advancement. Not something I had foreseen, and not a welcome development.

On the other hand, I'm well-liked enough to be invited. I think that's a sign I should just keep doing what I'm doing. No tobacco necessary.

Advertisement and body image

2010-01-09T16:28:00.008-06:00

As I mentioned last week, I am spending a lot of time at Pogo. Pogo is an advertising-supported service. This means I have been watching a lot of advertisements.

In these ads, a common product is an expectorant. If you have a cough or sinus pressure, say the ads, take this product: it will get the mucus out. To dramatize the eviction, the ads anthropomorphize the mucus. Green people who live in our lungs or sinus cavities are shown riding motorcycles, swing dancing at clubs, having family reunions, or reading bedtime stories to their children. These green people are bad, imply the ads.

All the green people are obese. All the ill people—"good people" being harmed by the green folk—are skinny models. In addition to the "you don't have to suffer sinus pressure or a lingering cough" message, these ads are sending the message "take our product and you will kill the fat person inside you." It's absurd and disturbing at the same time.

Burnout

2010-01-02T16:07:00.004-06:00

I have been feeling burned out. When at home, I avoid intellectually stimulating activities - I read very little, I don't write (here or on Wikipedia), even knitting sessions have been rare. Most of my free time is spent playing flash games on sites such as pogo.

Pogo offers many multi-player card and board games. While I am overstimulated from work, my introvert nature takes hold: even the minimal contact of playing an internet game is too much for me. Solitaire is more what recharges my batteries.

Yesterday, I stated playing dominoes. With other human beings. A sign of recovery, at least for this introvert.

Blogging: On hold

2009-11-07T20:35:00.006-06:00

I enjoy blogging. Over a year ago, I commented on how I benefit from blogging, and those comments still hold true.

As part of a recent post, I mentioned taking on new responsibilities at work. I'm trying to do a lot of my old job, train for my new responsibilities, cover for coworkers who are taking big chunks of vacation, and in general deal with the personnel shortages of a company that has laid off half its employees. In other words, I'm spending a lot of time at work.

I'm excited about the direction my job is taking. And I feel lucky I'm able to take advantage of this opportunity: even two months ago, I had neither the physical energy nor the mental capacity for anything so demanding. I am very grateful to have recovered so quickly from my cancer treatments.

The demands of work are requiring sacrifices: I exercise less frequently, I haven't picked back up on my organ lessons, I don't cook what or as often as I would like to, and my blog posts are infrequent. I plan to start picking those things back up after the holidays at the end of 2009. Until then, I will blog only once or twice a month. C'est la vie!

I hope everyone has a happy Thanksgiving!

Budgie alarm

2009-10-25T19:26:00.004-05:00

My husband and I have two small parrots. Morning with them on most days are pretty quiet: I go to work before the sun comes up, when our birds are still sleeping or engaging in quiet activity.

On weekends, we normally sleep in. For years, when the sun starts shining into our house, our cockatiel would begin a cheeping. A loud "Cheep!," a short pause, another "Cheep!" and on for some time. Often, he would settle when one of us goes into his room. If not, usually having both of us in the living room would get him to calm down.

Why the insistent calls until we get up? I don't know. But it was neat to see that he felt some connection to us.

About a month ago, my husband's coworker found a parakeet at their wild bird feeder. Wilson is now living with us. When a new pet comes into a household, things change.

Parakeets (also called budgerigars, or budgies) are known for talking to themselves. Whistles, cheeps, crackles, words, and any other sounds they learn to imitate get all jumbled up into a monologue. Our first parakeet does this. But Wilson does it much more. Often, when Wilson starts up, the other budgie joins in.

And that's our new weekend wakeup call: the two budgies talking to themselves. No more insistent cockatiel cheeps. I'm a little sad the birds don't seem to need my husband or I as much in the morning. But I'm glad to wake up to such a happy sound: a budgie alarm.

That's not part of my job!

2009-10-18T20:46:00.005-05:00

Growing up, one of my chores was to do the dishes on certain days of the week. A particular day of dishwashing stands out in my mind: after I had done the dishes—completing this chore the same way I had done for years—my father insisted I wasn't finished. "You haven't wiped down the counter!" Passionate argument ensued, with no resolution.

The next day I went to my mother, full of righteous indignation. After hearing my side of the story she said, "Well, it doesn't seem unreasonable for wiping down the counter to be part of doing the dishes."

I don't remember what was said after that: I was overcome by a feeling of dumbfounded shock. No one had ever asked me to wipe down the counter. I was upset at being scolded over a responsibility I had not agreed to; it had never crossed my mind to consider whether the task was reasonable.

At work, I will soon have some authority (although not supervisory) over a number of other employees. Gaining cooperation can be a tricky task; I have heard many supervisors compare their job to parenting. Perhaps memories such as the dishwashing incident will help my management techniques at work.

I hope I'll do well. I'm excited to have the opportunity to try.

Botanical aid

2009-10-10T08:59:00.003-05:00

I complained this spring about an invasive vine threatening my raspberries. I spent a significant amount of time this summer removing the vine from most of my brambles. I was curious about exactly what it was, and took a flowering sample to my local botanical center.

It took several months, but the diligent research of the master gardener paid off: the vine is an American Hog Peanut. Turns out, it's technically a native plant, not an invasive one.

Native plants support significantly more wildlife than imported species. The wildlife in my yard is one of the things I enjoy most about it. So now I don't feel as negatively toward the vine as I did this spring.

I feel lucky to have access to a botanical center with such a helpful master gardener.

The science of parrots

2009-09-27T13:39:00.005-05:00

Sometimes one idea leads to a different idea, one thought to another. The mind wanders.

One of my recent thought trains started with Wilson, a parakeet. One of my partner's coworkers found him at their wild bird feeder. The coworker managed to catch him (the bird let him get within towel-throwing range), and after contacting the local Parrot Society and avian vet (no lost parakeets reported) Wilson now lives with us.

We have two other small parrots, neither of which has ever expressed interest in the noises of radio or television. Wilson, on the other hand, not only gets makes noise in response to the radio, he actually seems to respond to the songs: he gets louder and softer with the music, and often will squawk preferentially on the beats.

The ability to recognize musical beats and perform an action in time with them (such as a squawk or a head bob) is known as entrainment. It used to be believed that only humans had this ability; in April of this year, evidence was published that this is a trait humans share with parrots.

Which in itself is kindof neat. Even more interestingly, the evidence was parrots entraining to the music preferred by their human owners. Other animals can be influenced by musical sounds; a recent study found that the moods of tamarins, a kind of monkey, was affected by music. But not by human music: only by music specially composed to resemble tamarin calls.

It is surprising that parrots, that are such distant relatives (they're not even mammals!), can relate to human music, while much more similar animals (monkeys) cannot. Perhaps the ability to enjoy music of a different species is tied to the ability to make a wide variety of vocalizations. To my knowledge, certain families of birds (parrots and corvids) are the only animals able to imitate human speech.

The ability to make a variety of complex vocalization may correlate to other traits. It was recently suggested that, for evolutionary reasons, complex and varied songs are strongly associated with avian intelligence.

And so it goes, me listening to Wilson cheep while wondering about what evolutionary pressures were shared between his ancestors and mine. I have a wandering mind.

Red bowl, yellow bowl

2009-09-13T14:27:00.003-05:00

Some of our food bowls are red, and some are yellow. When we originally bought the dishes six years ago, it was half and half. When putting away clean dishes, I liked to stack them in alternating piles: red bowl, yellow bowl, red bowl, yellow bowl.

As time has gone one, some bowls have broken. And some get recruited for long-term use (more than a single meal): storing leftovers in the fridge or holding snack foods. I didn't always have an even number of different colored bowls.

The inconsistent color pattern sometimes really bothered me. I have several times rearranged the piles–putting a different color on the bottom–to make the alternating pattern come out. Last week, in exasperation, I changed to single-color stacks. One stack is only red bowls, one stack is only yellow bowls.

I feel good knowing there is now more order in my house.

Radiation summary

2009-09-13T09:00:00.001-05:00

For lymphomas, two radiation schedules are common. One is 180 centiGray per day to a total dose of 32 Gray. The other is 150 cGy per day to a total dose of 36 Gy. My radiation oncologist chose to give me the 150/day treatment. He believes the lower daily dose has a lower risk of long-term side effects, even though it requires a higher total dose to be effective. There's not enough good data to make a definitive statement on the issue, but his position sounds reasonable.

My area hospital has a proton radiation machine, so that was what I got. It delivered one dose to my front and one to my back to a about 3.5"-wide strip that started just above my collarbone and extended down my chest about 6". Ideally, they would have treated the entire original area of my bulky tumor. However, the radiation oncologist explained that because radiation to large areas of the lungs is a bad idea, they restricted the width to the mediastinum.

They radiation oncologist and his staff explained to me the most common side effects of radiation to this area: painful swallowing (the esophagus is in the radiation field), coughing (some lung is in the field), and skin damage. I think three different people went over each of these side effects. They gave me a prescription for RadiaGel and told me to apply it three times a day, and to let them know right away if it became painful to swallow because they have drugs that can make that less bad. I think someone might have mentioned being tired was also a possible side effect.

I was more mentally prepared for the physical side effects, I think. They never came: applying the gel twice a day kept my skin from doing anything worse than turning very slightly pink; my esophagus sometimes felt warm and sometimes I felt like it was a very good idea to chew thoroughly before swallowing, but I never had any pain; and I never developed a cough. Two to three weeks into my five-week treatment, however, the fatigue came on.

In part, this was feeling tired and completely unmotivated to do anything productive. I also had to cut back the intensity of my exercise videos: aerobic workouts I had done without trouble two weeks before left me panting with a sky-high heartrate. In addition, I developed an aversion to doing anything that required thinking hard: playing piano, knitting, writing... I had been so happy to enjoy these again after chemotherapy, and they were gone once more.

I'm lucky to have not have any major physical symptoms from the radiation. The surprise of acquiring such intense fatigue made it difficult to appreciate at the time, though. It's easier now (a week and a half out of radiation): I'm not feeling completely normal, but I'm very close. Moving in the right direction.

I ate oatmeal today

2009-09-01T22:04:00.008-05:00

Some people say to not eat your favorite foods during chemotherapy: it can cause food aversions. Overall, I was lucky to avoid this side effect... except for one food. Since college, oatmeal has been a breakfast staple for me. But somewhere around chemotherapy number seven or eight, I could no longer even bring myself to touch the stuff.

Today, I ate oatmeal. And it was good. It felt like a victory.

Other marks that chemotherapy made are healing: my hair is 1/2" long; what were bright white lines on all eight fingernails are now indistinct lines on just two nails; the frequent pain in my right shoulder has faded to mild discomfort when laying on that side.

Radiation has taken its toll, too. I'm sleeping more than normal and feel tired all day long; even simple tasks like going to the grocery store seem daunting. My exercise tapes have become difficult like they were during chemotherapy. For a while, it also gave me brain fog (difficulty concentrating, "chemo brain").

Even though I'm still receiving radiation (tomorrow is the last of my five weeks of treatments), my brain seems to have recovered some function: over the weekend I tripled the size of the Wikipedia article on hormonal contraceptives. I didn't really believe the radiation oncologist when he said some side effects go away even while one is still receiving radiation; but apparently he was right. While I've been fortunate to avoid physical side effects (such as painful swallowing), some on the lymphoma boards report that those, too, can go away even during treatment.

Next week is exciting for me for two reasons. It will be my first week free of radiation therapy; I'll be completely finished with cancer treatment. And, I'll be restarting work! After two months on layoff, my boss called and said they're ready for me to come back.

The future is looking bright.

Dead bats and feminism

2009-08-27T18:42:00.006-05:00

My project for today was fixing the ductwork for our bathroom ventilation fan. As I posted last week, our original "good enough" installation resulted in a dead bat inside the fan housing.

I thought I was prepared and had everything in the attic I needed to complete the job. But I kept making minimal progress before having to climb out the access hatch and wander around the house looking for tools. I didn't know where any of the tools were, because I think of them as "my husband's tools," and therefore not my responsibility.

During one of these expeditions, a recruiter calls me. Good, I think, another person helping to end my unemployment. "Well," he says, "the job I'm looking at doesn't accept women."

All tools finally collected, I really get down to work in the attic. And discover that self-tapping sheet metal screws require significant assistance to "self-tap." I kept having to take breaks to pant. I wished a man were there to do that part for me.

Near the end of the project, to let me work at a more comfortable angle, I detached the ductwork from the fan. Inside were four dead bats, furry and dessicated-looking. I pondered them for a while. Slowly, it dawned on me that they would have been unable to escape from the vertical portion. It was too small for them to fly out of. It was too large for them to chimney up, and of course too smooth for their claws to get any purchase. Becoming trapped while exploring the ductwork, they must have died of thirst inside it.

With that grim image in my mind, I descended from the attic once more, taking the duct with the bats down with me. I "buried" them in my compost pile, then finished the work that would save future bats from sharing their fate.

Later, I went to my radiation treatment. The techs asked what I had done that day, and I told them I'd fixed the exhaust ducting for my bathroom fan, and found dead bats during my work. "Wow, you must be really handy!" said one woman. The other woman expressed fear of creatures in her attic and commented, "I think my home inspector took pictures of my attic. That's the closest I'll ever get to going inside it!" My doing home repairs and being unafraid of creatures in the attic was not anything they could relate to.

Maybe they would have responded the same way to a man telling that story. But my own feelings of thinking of our tools as "my husband's" and wishing for a "strong man" during the project make me wonder if their reaction was specific to a woman doing these things. After all, as the recruiter reminded me (he was looking to fill a military position), we still live in a world where our gender determines what society expects us to do.

I guess I'll keep working on my own attitude, and trying to be an example of change. One dead bat at a time.

7 Quick Takes (home improvement edition)

2009-08-21T13:03:00.000-05:00

--- 1 ---

Jen at Conversion Diary generously hosts "7 Quick Takes Friday". This is my second entry; my first "quick takes" post was a lymphoma edition.

--- 2 ---

Last weekend, we investigated the broken exhaust fan in our bathroom. Once we had taken apart the heat lamp assembly, we found a dead bat in the fan housing. After putting everything back together sans bat, the fan works beautifully.

--- 3 ---

Over the past five months, a contractor has been working on remodeling our house. They were here everyday at first, but for the finishing touches sometimes weeks have gone by with nothing more done.

The electricians worked all day Monday. And now the contractor's work is all done! We're doing some more work ourselves, but it's exciting to have passed this major milestone.

--- 4 ---

Another sign of progress in our house is that all our pictures are back up. The construction pounding had literally made them fall off the walls.

--- 5 ---

Through our remodel, I learned something new about contractors: gutter installation is a specialized trade.

As electricians work only with wiring and plumbers only with pipes, gutter installers only work with gutters. I'm not sure if this impresses me with the size of the construction industry (that people can make a living working with such a small building part) or with the importance of gutters. Maybe a little of both.

--- 6 ---

Recently, my husband prepared to replace a broken lamp socket. I asked, "Do you want me to come with you for moral support?"

"Of course," he replied. "Just think of the immoral work I would do without you."

--- 7 ---

Home improvement is a rewarding way to spend one's time. Completed jobs often provide a sense of satisfaction that lasts for months or years. I feel lucky to have a home I can improve; I hope I can continue to work on it for many more years!

Wikipedia, dashes, and me

2009-08-20T07:56:00.006-05:00

Over the past few years, Wikipedians have developed a number of bots and semi-automated processes to fix common errors. I find that I feel like I've been chastised if I make an edit and then a bot immediately comes and cleans up after me; it's become a point of pride with me to try to prevent this.

My efforts to lower the workload of automated computer scripts have given me new habits. One is a compulsion on using hyphens and dashes in certain ways. For example:

I am receiving 36 Gray—at the high end of the recommended range of 32–36 Gy—of proton-beam radiation.

Note the hyphen in the compound adjective, the en dash in the number range, and the unspaced em dash in the parenthetical expression. A year ago, I would have just used a hyphen for everything and never thought twice about it. Now I've memorized the HTML codes for the dashes and it would drive me nuts to type something that used them "incorrectly".

Thanks, Wikipedia. I think.

On holiday dates

2009-08-17T10:00:00.004-05:00

I have long been somewhat cynical about the date to which Christmas has been assigned. After all, no one knows the time of year in which Jesus was born. A date near the winter solstice was chosen, not based on historical accounts, but to aid in the conversion of pagans who also had major festivals at that time.

I suppose I'd made the assumption that since modern Judaism doesn't actively recruit converts, such considerations were not part of the dates of Jewish holidays. Well, except for Hanuka, which as the "Festival of Lights" has rather obvious midwinter symbolism. But, I rationalized, that's a minor holiday: the book of Maccabees with the Hanuka story isn't even part of the Hebrew Bible.

Learning that the High Holy Days—the Jewish New Year and Yom Kippur—were suspiciously similar to certain Babylonian holidays didn't phase me, either. Celebrating the passing of a year and pondering the ways in which we have gone wrong over the past year are not time-dependent activities. They could be just as meaningful on any date; that the date used by the Jews is the same as that used by the Babylonians doesn't affect the significance of the holidays. Similarly, the way that Easter evolved from Passover has never been something I thought negatively about.

But speaking of Passover, the Bible study I attend is currently studying the Exodus text relating to this holiday. Regarding Passover, the commentaries we use say it used to be two or three separate holidays, none of which was related to freedom from slavery. A date near the spring solstice was chosen, not based on historical accounts, but to institutionalize the telling of the Exodus story by setting it near the date of unrelated pagan festivals.

One of the group members protested, "But Passover has to mean more than that." I come to Bible stories with the belief that they have some basis in truth, but that few details are historically factual. Even so, it bothered me to learn that the date so explicitly spelled out in the text (Exodus 12:18 and 13:4) was chosen for reasons completely unrelated to the story.

I'm not sure if my feelings are rational, or if they are caused by an irrational anti-Christmas, "my husband's holidays are better than your holidays" prejudice. (I specify "my husband's holidays" since I have not converted to Judiasm.) I am very glad, however, to have access to a Bible study group that causes me to think about myself and my assumptions in such interesting ways.

History is powerful

2009-08-12T09:38:00.003-05:00

I recently finished Battle Cry of Freedom by James McPherson, a history of the civil war. The narrative began with a highly abbreviated description of the Mexican-American war. A striking similarity to our present time immediately drew me into the story: one political party believed that use of troops had spread American freedom and democracy; the other believed American values would have been better spread by being a good example than by military force. The way differences over the Mexican-American war fed into increasing polarization on other issues also felt eerily familiar.

The political situation of the 1850s soon went well beyond our present-day experience, but it continued to tell a powerful story. The experiences of Americans during those years was vividly brought to life. My school history classes had focused on the outcome of the war; reading Battle Cry of Freedom taught me why it was fought in the first place, from the motivations of the leaders to the soldiers to the women and non-soldiers who supported the cause behind the battle lines.

I had been taught that of course the North won, it had a stronger industrial base. McPherson argues that the two sides were evenly matched. Having read through battle after battle where a chance event caused one side or the other to gain advantage, I'm convinced and awed at how easily the war could have gone the other way. I don't think I've ever before read a book that long (900 pages!), but it was a surprisingly easy read, and I'm glad did.

Look good, feel better?

2009-08-05T15:20:00.003-05:00

I've gone a few weeks now without wearing a scarf. While I'm excited to note that my scalp area has gone from "looks like five o'clock shadow" to "very, very short hair", I'm sure I still present a startling sight to most people.

I appreciate comments along the lines of "you have a nicely-shaped head." Other comments, though also well intended, don't make me feel so good. One person told me, "It's a good thing you look good bald!" As if my right to leave my house without a scarf is dependent on my appearing attractive while scarfless.

In a recent email discussion, I expressed sympathies for a friend with prostate cancer. He was rather retiring about his diagnosis but commented that "observing a roomful of attractive young ladies wearing head scarves and baseball caps" was a "misfortune".

I have been interested recently in the idea that a social system can exist that results in certain outcomes that none of its participants intend. I believe these comments are an example of such a system: the people I quoted above were intending to convey admiration and sympathy. But the language available to them for doing that was limited, and the word choice they made resulted in them reinforcing the social concept that, for women, "value=physical attractiveness".

It's not really what I expected when I went out without a scarf.

Why the plagues?

2009-07-30T06:20:00.007-05:00

My Bible study group recently went through the plague story in Exodus. One theme that kept surfacing was that of attitude toward miracles: the miracles of the plagues are presented as dramatic evidence of God's will. And yet in modern Judaism, as explained by the midrash The Snake Oven, miracles are rejected as evidence of God's will.

In Deuteronomy 30, where Moses is explaining the importance of following God's laws, verse 12 states that a record of these laws "is not found in heaven." The Jewish understanding is that God gave Torah on Mount Sinai, and the post-Sinai interpretation has been entrusted to Jewish scholars: God has agreed to stay out of it.

The Exodus story is so important in Judaism that it has a major holiday devoted to it: Passover. Our study group found the prominence of the plagues in this story to be a stark contrast to the religion's current anti-miracle stance.

The first time this question came up, our rabbi pointed out that the Passover holiday emphasizes the "journey to freedom" aspect of the story, and the plagues get only a minor mention. This consideration lessens the seeming contradiction, but doesn't eliminate it entirely.

Later, we discussed a more interesting possible explanation: in Exodus 10:2, God explains that he causes the plagues so that (as translated by the Jewish Publication Society) the Jewish people will recount the story "in the hearing of your sons and of your sons' sons... in order that you may know that I am the Lord."

At Passover, the Exodus story is recounted in the presence of children. This practice is widespread even among otherwise non-observant Jews: Passover is the most widely celebrated Jewish holiday. The dramatic story of the plagues has motivated generation after generation of parents to tell their children about God's power. If that was their purpose, then the plagues have been wildly successful.

Hickman out!

2009-07-28T16:41:00.004-05:00

At the beginning of January, I had a Hickman line installed. I wrote some about it here. The line exited my skin in the mid-right area of my chest; it ran under my skin up to my collarbone; at my collarbone, it entered my subclavical vein. In the photo at right, the scar where it was pushed into my vein is visible near the strap of my tank top.

This line made my chemotherapy treatment safer and saved me from countless needle sticks. I had it for five and a half months. Today, I had it taken out.

While the line placement was done in a hospital operating room with sedation, the removal was done quickly in the surgeon's office. The procedure started with the surgeon injecting the area with lidocaine. There was a cotton sleeve around the line near where it exited my skin; the surgeon opened up the exit point a little so he could see the sleeve. The cotton caused my body to form scar tissue, which is what has held the line in. (The surgeon said they used to hold these lines in with stitches, but have found the cotton-scar tissue method is much more reliable.) He cut the scar tissue away from the line, and then it just pulled right out.

The surgeon put a couple of loose stitches at the exit point. He said he did not stitch it up nicely because the wound was potentially dirty, not something he wanted to seal up. So I'll have a scar there, much like the scar near my collarbone.

When I had the line placed, I lost a lot of movement in my right arm: it was a month before I regained my full range of motion. The surgeon said I would be sore tomorrow when the lidocaine wore off, but that it would be minor and only last for a few days.

Hickman lines are somewhat uncommon; port-a-caths are the most common type of central access line for cancer patients. When people have their ports removed, they often say they got deported. Unfortunately, there are no such cute sayings regarding Hickman lines. Not to dwell on that, though: I'm so happy to not feel like a cyborg anymore!

Discovering light

2009-07-28T08:29:00.003-05:00

About a year ago, the light in one of our house's closets stopped working. There seemed to be a problem with the socket. We never got around to fixing it, seemingly content with fumbling around in the dark when we needed something out of it.

At the end of last week, electricians came to our house to activate the wiring in our new living room. In what seems unlikely to be coincidence, this closet light now works again.

Upon discovering this, my partner and I gazed into the lit closet. "Hey, we have an iron!" I said. He says, "Are those my tennis shoes? I didn't know I had tennis shoes!"

It's like Christmas in July.

My cancer story

2009-07-22T11:48:00.015-05:00

I was diagnosed with primary mediastinal diffuse large B-cell lymphoma in December 2008. After months of vague symptoms, I developed a horrible dry cough. As part of investigating my cough, my doctor ordered a chest CT scan. The images showed a tumor under my breastbone that was over five inches wide.

After six months of chemotherapy, the last part of my cancer treatment was a decision to add radiation to my treatment plan. I wrote two posts about my radiation experience, one during treatment, and one after I was finished.

I hope my story is helpful to others. If you have any comments or questions, feel free to email me; my address is

Throughout my battle with cancer, I have found a lot of support on the message board community at http://forums.lymphoma.com/. They have a "share your story" thread where I have posted a much more detailed description of my initial symptoms and how I was diagnosed.

Before I knew I had cancer, I wrote several posts where I talked about being tired all the time:

During treatment, I had several CT scans and one PET scan to track my progress:

I also had some thoughts on residual scar tissue.

A couple of posts (although the subject is so important is should really have more than that) on how much the support of others has meant to me:

Posts about the technology used in my treatment:

I also wrote one post about my prognosis.

The bulk of my posts on this topic has been discussions of my side effects:

I have been extremely lucky to have my insurance cover every cost associated with my care, after just one small snag. There are several active members of the lymphoma message boards who do not have insurance, and their situations are just heartbreaking. I hope that soon everyone will be entitled to the same level of care that I have received.

Residual effects

2009-07-22T11:03:00.004-05:00

It will soon be two months since my last dose of chemotherapy. I've had eyebrows for a week now. The hair on my scalp has progressed beyond peach fuzz to actually give a small amount of color (à la "five o'clock shadow"). It's enough I'm trying to get comfortable going out in public without a head covering. I'm not there yet - it still feels like I'm not completely dressed - but practice makes perfect.

My only chemo side effects left seem completely benign: big dark blotches in the center of my big toenails, and white lines on my fingernails. I think the fingernail issue is Muehrcke's lines. At least, I hope so, since I added a picture of my nails to that Wikipedia article.

I also have intermittent pain in my right shoulder and upper chest. This was my first symptom of the tumor, and it never completely resolved. My oncologist said it was probably caused by scar tissue. The latest flare-up has so far lasted almost two weeks, with several days being bad enough I need acetaminophen or ibuprofen to function.

Most days, though, I feel completely normal. Even the hot flashes are close to resolving: the intensity is significantly less, and I'm just have a couple every few days. Hopefully this feeling of normalcy will last a long time.

Radiation

2009-07-21T12:25:00.003-05:00

I'm all done with chemotherapy, to which I responded well. The next question is, should I have radiation? This is a controversial question for the type of cancer I had (primary mediastinal diffuse large B-cell lymphoma). My oncologist recommended getting a second opinion; he sent me to a lymphoma specialist he works with, Dr. Brian Link in Iowa City.

Dr. Link explained that radiation reduces the risk for relapse by 5-10%, a figure that agreed with my own research. The question is, are the risks of radiation worth that benefit? My tumor was under my breastbone. The major risks of radiation in this location are heart disease and, for women, especially young women, breast cancer.

I have no family history of heart disease or of breast cancer; I also have no risk factors for either disease. Dr. Link explains that he worries most about radiation-induced breast cancer in women in their young twenties and in teenagers. Since I am in my late twenties, he's more comfortable with my level of risk. Because my baseline risk for heart disease and breast cancer are relatively low, he believes the benefits of radiation outweigh the increased risks for those conditions.

Dr. Link also told me that he had colleagues - lymphoma specialists at other institutions - that did not believe radiation should be given in cases like mine. The research data is just not there to support a firm opinion in either direction.

With no good data to guide me, though, it seems prudent to follow the advice of my doctors. Today, I met with my radiation oncologist. He was pretty thorough about explaining all the short-term side effects of radiation treatment.

He said many women getting radiation to the chest worry about breast cancer, but this seemed to only be an issue for teenage women. I mentioned the studies I'd seen of women treated 30-40 years ago that experienced significantly higher rates of breast cancer. I'm aware that treatment in the past 8-12 years has used lower doses of radiation applied to smaller areas of the body. But the long-term affects of radiation don't appear for 15-20 years, so there's no data on how effective the newer treatments are at reducing such risks. "Yes," he replied, "there's no data showing current treatments increase the risk for breast cancer."

The radiation oncologist didn't even mention the risk of heart disease. I guess it's a psychological defense mechanism: he doesn't want to believe he's harming his patients. Oh, well. I need him to be good at giving me radiation, not at deciding whether to use it in the first place.

I will have my setup visit Thursday, and then I'll have treatments every day (Monday through Friday) for five weeks. I've enjoyed the past several weeks of no treatment, and it's disappointing to once again have frequent visits to the hospital. Still, I think these weeks will go by quickly.

How complicated is paint?

2009-07-09T11:14:00.003-05:00

Recently, I was talking to my elderly neighbor about painting. He talked about how he used to be a die-hard paintbrush supporter, but eventually got converted to rollers; we discussed how much of an improvement a good paint job can be to a room; the satisfaction that can come from completing a home project such as painting a room.

He also mentioned that when he and his wife (now deceased) painted a room, she put masking tape to protect areas that shouldn't be painted; he applied the paint. He sounded proud about how they had worked as a team, which I thought was nice.

He went on with a story about how she had painted once; she didn't know to thin the paint before applying it, and the whole wall had to be redone. When that happened, he said, he told her to stick to the taping. For the rest of their marriage, she only taped.

These additional details changed my feeling about the arrangement. Confining herself to taping wasn't her choice - she had wanted to paint. She tried one time, messed up, and understandably her confidence in her abilities was undermined. Instead of supporting her by teaching her which paints had to be thinned and how to thin them, he reinforced her belief that she wasn't capable of the task.

I was sad and angry to realize this. I couldn't think of anything appropriate to say to him, though, so I came and wrote about it here.

A busy day

2009-07-06T14:35:00.001-05:00

So far today, I have:

Completed a workout tape
Filled the bed of my truck with pruned elm trees
Cooked a pizza from scratch
Taken my glassware to the recycling facility
Gone to the library
Made 20 edits to Wikipedia articles
Updated my blog (this is my third post today)
Filed for unemployment insurance

Not bad for my first day on layoff. Hopefully keeping busy will prevent me from worrying too much about when (or whether) my company will be able to call me back to work.

Raspberries, yum

2009-07-06T14:34:00.004-05:00

I harvested about a cup of raspberries yesterday. They have been bearing for a little over a week, but we had neglected to harvest any before yesterday. Everyone in my household enjoyed some of the berries I picked, including the parrots. (The cockatiel still has red stains on his beak.)

This harvest is a little later than normal (our raspberries are a June-bearing variety that typically bears in, well, June). But we have had mild temperatures, like last year, and the raspberries are actually fruiting a little earlier than during last year's harvest.

Our raspberry patch in the front yard is going gangbusters: almost all of my cup was taken from there. Our patch in the back, however, has been largely overcome by some kind of invasive ivy. Removing the ivy and keeping it in check looks like a large, labor-intensive project. I hope I'm up to it; losing those raspberry bushes would make me very sad.

Almost there

2009-07-06T13:27:00.005-05:00

Background: my May 7th CT scan showed a residual mass of 4.3cm x 1.4cm.

I had a combination PET/CT scan June 25th. The CT scan showed a residual mass of 3.2cm x 1.2cm.

I believe the chances of relapse are much lower if the residual mass is less than 25% of the diameter of the original tumor. At diagnosis, my mass was 12-13 cm across (my CT report from Dec. 22 said 12, my PET/CT report from Dec. 30 said 13). 25% of 13cm is 3.25cm, so I'm right at that size.

The best news is the PET report: while I have "minimal residual uptake" of the tracer in the site under my breastbone, nowhere did I have high enough metabolic activity to be suspicious for active cancer. I believe this means I am in remission!

Next step: July 15th appointment with a lymphoma specialist. Topic of discussion: whether I should have consolidative radiation.

Patchwork of color

2009-06-28T15:19:00.004-05:00

Most of the rooms in our house are currently off-white. We'd like to repaint them all with somewhat brighter colors; it makes sense to start with our new room.

My husband and I discussed paint chips and agreed on a color. The painters came, and now our new room is the color we agreed on. Neither one of us is completely happy with it.

We don't agree which direction to move, though, so we've bought a couple of samples and are doing test patches.

I think one of these colors will do quite nicely.

EPOCH+R, recovering from round eight

2009-06-25T16:18:00.006-05:00

My platelets were low again the week following my last chemotherapy treatment, but I had no bleeding or bruising: not even the minor issues I had after cycle seven. Also in the first week off the chemo, my hemoglobin dropped to 7.9. Below 8.0 is the normal cut-off for needing a blood transfusion. However, my oncologist had noted in my chart to not transfuse me unless I was symptomatic (which I wasn't), so I got away with no treatment.

Someone from my local blood bank left a message on my answering machine two weeks ago. I had called them and left a voicemail in December, canceling my appointment to donate blood and asking them not to call me: I had lymphoma. It was shortly after I was diagnosed; I was pretty upset. When I returned the call from two weeks ago, I got sent to voicemail. I'm not sure if they were calling to see how I was doing, or to ask me to give blood. Just to cover both bases, I told the voicemail that I was finished with chemotherapy and also that my hemoglobin had recently been 7.9.

The hot flashes had subsided somewhat the first two weeks after cycle eight (still multiple times every day and every night, but less often and less intense). This week, though, they came back at full strength. I've had some minor leg pain (a symptom of neuropathy) a few nights (including last night), but no bone pain, no tongue pain, and no hand-foot syndrome this time. I do have a new pain symptom: since about a week ago, both of my big toenails are tender if the end of my toe is pressed. Each nail also has a big red splotch in the middle of the nail bed. I'm not sure what this is called, but when I asked one of my oncology nurses about it, she said it's a common side effect of chemotherapy.

Recently, I've had trouble trying to sleep for more than a few hours at a time; not every night, but many nights I get to sleep rather easily, only to wake up a two or three hours later. Fall asleep again without a problem, but then wake up again an hour or two later. It's hard to tell how much of this is chemotherapy side effect, and how much is due to my crazy work schedule (three weeks of 3am to 11am, then two weeks of 5am to 1pm, and now they've laid off the night shift entirely so I started 6am to 2pm this week).

My hunger and thirst both came back to normal; I even tried eating some jalapeno potato chips last week, which I hadn't done for several months. It was somewhat painful, though; looks like I need to let my mouth heal for longer before trying more of the spicy foods I used to love.

My pants have been looser (although my weight is still the same); I think I've had water retention for several months that I just recently lost. This week, I'm trying reducing my Metamucil fiber cookies to Monday-Wednesday-Friday. So far, my intestines have not complained. My heartrate has consistently been in the 80s recently, which I find reassuring. I did a workout tape today, a tape that a month ago sent my heart rate up to 200: today it only went up to 170, a much more reasonable range for exercise. Interestingly, I was more out of breath today than I was with the higher heart rate: I'm guessing the faster rate, while hard on my heart, was more effective at delivering oxygen?

I feel like I'm recovering. It feels good.

Cockatiel feng shui

2009-06-20T18:14:00.004-05:00

For several weeks, we've been working on the window in our current living room. This required moving the birdcage next to the bookshelves.

Our cockatiel, who loves small spaces, discovered he could crawl behind a row of books. It was quite neat to watch him scoot into and pop up out of that space. The tap-tapping as he pecked against the bookshelf, the sounds of paper we'd given him being chewed up, and the long strings of happy "awk-awk-awk-awk" were really cute.

However, he was overcome with a fierce need to defend this space from all comers. Since he accessed the bookshelf from the top of his cage, this was also an area he defended. If he was in the cage, we could handle him normally; but on top of the cage, watch out. Whenever we walked near (not even necessarily intending to interact with him), he would jump onto us and bite any exposed skin he could find. Hard.

A few days ago, we finished our work on the window and moved his cage away from the bookshelf. Since then, neither of us has even been threatened with a bite. He spends much less time looking angry (somewhat skinny, crest laid flat) - not just with us, but with the parakeet, too - and more time looking contented (fluffy, crest halfway up). We miss the entertainment of his time behind the books; but he's now picked up an old habit of falling asleep on us. It's a good tradeoff.

It's amazing what a little furniture arrangement can do. Then again, perhaps we shouldn't be surprised that parrots are affected by feng shui. After all, some argue that they invented tai chi.

EPOCH + R, round eight

2009-06-07T07:46:00.003-05:00

Three weeks ago (right when I finished round seven), my company laid off our only night shift inspector. To try to get product ready to ship out on our trucks in the morning, I have been starting work at 3am. I have been leaving work at 11am, which is nice, but makes for a weird sleep schedule (nap when I get home, wake up for the afternoon, then have a short sleep before work). This coming week my boss is having me try a 5am to 1pm shift; it would be nice if that ends up working so I can stop having to wake up at two o'clock in the morning.

At the end of the first break week, my blood tests came back low on platelets. I noticed several times that idle scratching of a scab produced, not a lot of blood, but much more than would have normally seen. My eighth Neupogen shot left me with a bruise, something that had not happened before. It worries me to have my blood cells becoming more affected by the chemotherapy. On the bright side, though, my hemoglobin levels have been hanging in there. Below 12 is anemic; below 8 requires a blood transfusion. The past four cycles, I've squeaked by at 8.3 to 8.4.

I was not hungry or thirsty for most of my first break week. My thirst started working again on Thursday, but the hunger came back more gradually. It wasn't until well into my second break week that I felt I was eating normally again. I must have been making myself eat enough, though, because I did not lose any weight. It's reassuring to be at the same weight I was when I started the chemo.

The break from round seven, for the first time during my treatment, I never felt a need for pain relievers. No nighttime leg cramps, no tongue pain: it was wonderful to be pain-free for so much of the time. That said, I did have some occasional minor irritations. One was similar to lower back pain/cramps I have typically had on the last day of Neupogen shots. This cycle, however, I had cramps along my entire spine (usually when I was leaning forward to look at something) that persisted several days after my last shot. I had been attributing this to the "bone pain" side effect of the Neupogen, but now I think it must be something else.

Also, the palms of my hands and soles of my feet were very sensitive for a couple of days during my second break week (e.g. standing on an uneven surface barefoot was painful). I believe this is called hand-foot syndrome. Having it for a long period of time can cause a person to lose their fingerprints, which apparently upsets U.S. Customs officials. This isn't a risk in my case (since I plan on being done with chemotherapy now), but I thought it was interesting.

My eighth week of chemotherapy was very similar to the past few rounds: sleeping about ten hours a day, toward the end of the week everything started tasting really nasty (on Friday I had the nurses give me IV fluids). The hot flashes have continued. And of course, the torso swelling this weekend that makes it painful to be touched (I think is inflammation caused by withdrawal from the steroids). The lack of hunger and thirst has started, and I know I'll have the low energy/steroid crash in a couple of days. But I'll get through it, and this time, I get to stay feeling normal! Yay for chemotherapy being done!

Rolling out the dough

2009-05-31T16:21:00.003-05:00

When I was in middle and high school, I cooked very little. In college, learning to be responsible for feeding myself was a challenge: grocery shopping, menu planning, the whole works.

Even now, ten years later, I still struggle with some things. Today, I tried a new recipe: spinach calzones. For the first time in my adult life, I used a rolling pin. The first one was rather frustrating: the dough kept sticking to the pin, it was square instead of round, and getting it to the right size took more time than I really wanted to spend on it.

Then a childhood memory came back, of helping my mom roll out dough. I couldn't have been older than ten, but the rhythm has stayed in my brain all these years: roll, roll, flip, roll, roll, flip... my dough wasn't exactly a circle, but it was roundish, it didn't stick to the pin, and things generally seemed to go faster.

Thanks, mom.

Lifetime limits and EPOCH

2009-05-30T06:36:00.006-05:00

One of the drugs in my chemotherapy regimen, doxorubicin, has a lifetime maximum dosage. (This is the H drug in the acronym; its trade name is Adriamycin, and the drug is also known as hydroxydaunorubicin.) According to Wikipedia, this maximum dosage is 550 mg/m². Above that dosage, there is a high risk of permanent heart damage.

I think, after round eight this week, I will have received a cumulative dose of 510 mg/m². I asked one of my oncology nurses how close I was to my lifetime limit; she wasn't sure, and asked the doctor. Apparently the maximum dosage is much higher when the drug is given by continuous infusion: most treatment regimens involve giving doxorubicin over just a few hours (2-4?), while in my regimen I receive it over 96 hours. He didn't give specific numbers, but said I was "far away" from any dangerous amount of doxorubicin.

I did some internet searches and came up with a couple of studies confirming what my oncologist said: one of adults, and one of children.

Hopefully, when my treatment is finished in another month or two, I won't have to deal with cancer anymore. But it's reassuring to know that, if I needed it, this particular drug is still an option for me.

Guided by the sky

2009-05-25T07:08:00.003-05:00

I learned this week that this is the International Year of Astronomy, celebrating the 400th anniversary of Galileo's telescope and of the publication of Johannes Kepler's Astronomia Nova. As part of their observance of the IYA, the editor's column in this week's Science News discusses a claim by Henri Poincaré that astronomy "has given us a soul capable of comprehending nature."

Apparently Poincaré believed that it was success in the science of astronomy that inspired scientific investigation of other topics. "Under heavens always overcast and starless, the Earth itself would have been for us eternally unintelligible," he wrote.

That's an impressive theory. My knowledge of scientific history is insufficient to judge its merits, although the Science News editor is credulous enough to lend some weight to this claim. I would like to think humanity would have muddled into the realm of science even without the help of the night sky. Still, it's intriguing to think about the stars in their courses showing humans that nature obeys strict laws, and that careful observation can discover those laws.

Many religions assume the universe was created for humanity. In discussions of this assumption, it's sometimes asked why, if humans are the point of the universe, so many stars were created. On the face of it, assuming a human-centric Creator, the size of the universe seems incredibly superfluous. But the "stars as a guide to science" theory offers a nice response.

Cool.

Garlic: high hopes

2009-05-22T16:14:00.000-05:00

After a few years of replanting garlic that hadn't grown very well, last fall I bought new stock from a seed catalog. Unfortunately there's no perspective in my picture, but the garlic is mid-thigh on me. I'd forgotten how big garlic gets when you start with big cloves!

My plan is to use Miracle Grow on it once a week until the summer solstice. (Garlic is day-length sensitive and won't grow any once the solstice is past.) With the remodeling and my chemotherapy treatments, the garlic is the only gardening I'm doing this year. I hope those bulbs get as big as their green tops!

Spinach revelation

2009-05-19T16:30:00.001-05:00

I try to cook with spinach regularly: being vegetarian, iron deficiency is an issue for me, and my body seems to absorb iron from spinach better than any other food. I have for years (my entire grocery shopping career) bought frozen spinach as a block.

At my last grocery shopping trip, the store was out of the frozen spinach blocks. Nothing, not even way back on the shelf where only my husband can reach. Searching through the frozen vegetables section, I find frozen spinach in a bag. A bag of frozen spinach? It struck me as so odd. But I got two.

I can't believe I haven't discovered this before: I can use just half the bag without the assistance of a bread knife. I can stir the pieces of spinach into my dish without having to wait for the entire mass to melt. The pieces melt faster than a block does, too! Why would anyone buy a frozen block when bagged pieces are available?

There must be some advantage to the blocks. But as for me, I am a convert to the way of the bag.

Remodeling excitement

2009-05-19T16:25:00.001-05:00

Our new vinyl siding is going up. We liked the color of our house, and matched it as closely to our old siding as we could. It does mean no "new house color" excitement. But it's nice to see the insulation being added to our house, and to know we won't have any future need for paint.

Except for the siding, our porch is finished. We've had years of mild fear that our porch would sink into the ground and take part of the house with it. Now, it's obviously still a construction zone, but we have a structurally sound porch!

I haven't taken any pictures, but the drywall is up in our south living room, too. It not only makes it look more like a room than it did at my last update, it stopped all the off-dusting from the cellulose insulation. Ah, clear air!

I had written in that update that our roof was finished, complete with removal of our badly-damaged gutters. I got ahead of myself, though: the gutters have not yet been replaced. And our basement is suffering. The damp areas in this photograph? This weekend had a half inch of standing water.

It's not dampening our excitement over the progress, though. What an exciting summer.

Not alone

2009-05-17T20:32:00.002-05:00

I have been touched by so many people in the past months. My family has given me exactly what I needed from them: at different times talking, listening, and giving me space. Caring and supportive messages from so many people I've met only over the internet have buoyed me.

Members of a knitting group I attend put together an amazing care package that has been helping to keep me warm, clean, fed, and entertained. My mother put it best when she said it gave an environment surrounded by love.

Members at my synagogue have called and written and offered support. Friends have helped me focus on fun things that have nothing to do with cancer.

I don't think there's any way to repay everything that has been done for me. This is such a short post for such an important topic, but I hope all those who care for me know this: it means the world to me to not be alone.

EPOCH+R, round seven

2009-05-17T17:20:00.004-05:00

Well, first for some backtracking. After cycle five, I had written that my leg cramps had cleared up. I think it was only minutes after posting that I got leg cramps again. Cycle six they came back during the second break week, but instead of diffuse cramp-type pains, my calves just decided they wanted to be shorter. Sitting or standing straight up was fine, but leaning forward to take a step? Ouch. Going downstairs was the worst - I had to keep most of my weight on the handrail for a few days.

The pain from my last round of Neupogen shots was minimal - no need for acetaminophen, even at night. I had none of the pain from breathing or leaning forward, and no esophagus tingling, either. I still had a few days where eating made my upper chest awfully uncomfortable, though. Oddly, some foods went down better than others: Tuesday of my first break week my dinner was no-salt potato chips and ice cream.

In the days after cycle six, the bottom of my tongue ached when I first got up. Thursday of that week it didn't stop. The numbing mouthwash helped a lot with eating: no mouth pain, and it reduced the pain of swallowing (although it wore off after about twenty minutes and sometimes I had to re-dose mid-meal). The tongue pain was not intense when not eating, but it bothered me enough I had to take acetaminophen or ibuprofen to get to sleep - and then I would wake up in the middle of the night and have to take pain meds again. It wasn't until the following Monday that all that cleared up.

My blood counts before cycle seven were still good, but worse than they've been before any other cycle. I guess my bone marrow is getting worn down. Happily, my thirst kept working throughout my break of cycle six and until Thursday of cycle seven. At that point, though, the awful taste in my mouth came back. I had the nurses give me IV fluids Thursday and Friday.

My heartrate stayed high for longer this time around: Thursday morning I checked it at 120. It made up for lost time Friday morning, though: I checked it at 44 beats per minute. I had the buzzing in my ears when I got up at night, like last cycle, and a dizzy spell Friday morning, again like last cycle. Only this time, the dizziness lasted longer and was complete with colored spots completely obscuring my vision. This repeated Saturday morning, with it taking a few hours before I was confident in my ability to stand up and stay that way.

I have slept more this weekend, my first "break" weekend, than in any previous cycle. Not only was there no early am insomnia Saturday - but after napping Friday and sleeping in Saturday, I went to bed at seven Saturday night and took a nap today, too.

I had hot flashes really badly while getting my seventh cycle of chemo. Multiple times every day and every night. I had night sweats when I was first diagnosed and for several cycles into treatment. They were intermittent; not having them often, plus the temperature changes as spring has come, I wasn't sure if the hot flashes were the same thing. But with the sweats, I didn't feel extremely hot. And with the hot flashes, I'm not extremely sweaty. So I think they're different. I have wondered if the hot flashes are related to my menstrual cycles: I have not ovulated since the end of January. I don't know if my fertility will come back post-chemo or not. The partner and I didn't have any plans for children, but the idea of that option being taken away is sad.

For now, though, I'm celebrating the disappearance of constant unbrushed or chalky tastes in my mouth: my husband and I went out to celebrate our sixth wedding anniversary. Yay us!

7 Quick Takes (lymphoma edition)

2009-05-15T00:43:00.002-05:00

--- 1 ---

Jen at Conversion Diary has been generously hosting a "7 Quick Takes Friday" for several months now. As part of downsizing at my employer, my workweek has been reduced to Monday through Thursday, so I find myself with some extra time on my hands. This is my go at seven quick takes.

--- 2 ---

I am addicted to message boards, ever since I discovered the (now-defunct) Estronet community nine years ago. I've moved from board to board as the internet communities and my life has changed. My most recent shift came in December, when I was diagnosed with cancer: I moved from the Long Hair Boards to the no hair boards.

--- 3 ---

In the winter, when I most missed having hair: when lying down on my back, and the back of my head touched a cold pillow. I can't see my head (out of sight, out of mind) and putting on a bandana or scarf has comfortably replaced fixing my hair as part of my daily routine. But that cold touch on the back of my head got me every time.

--- 4 ---

While my head hair fell out after my first chemotherapy cycle, other facial hair waited until the weather got warmer. Now that cold pillows are no longer a concern:

Not having eyelashes makes putting contacts in more of a challenge.
I now need tissue for even the tiniest of sniffles. Not having nosehair, even the smallest amount of mucus runs straight out.

--- 5 ---

My husband baked cookies last week - and almost burned them. They're pretty hard, and he has apologized to me several times. The apologies were unwarranted, though: they turned out to be the perfect cookies for this week. Chemotherapy damages taste buds, and I have an aversion to sweetness. The cookies have had just enough of their sugar denatured that I can actually enjoy them. Anything that tastes good is precious to me right now, so hooray for almost-burnt cookies!

--- 6 ---

Humor has been a big help in keeping my spirits up. Following my first cycle of treatment, I was just feeling blah. My treatment regimen includes a high dose of steroids, and after I stop them I have a several day energy crash. "I don't feel good," I complain to my husband. He looks really concerned. "I've been thinking," he says. "Maybe you don't feel good because you have cancer." I laughed, as much as I could manage with my low energy. After that I felt a little better.

--- 7 ---

I am tired of eating Metamucil's fiber wafers. My daily dose of sugary, cinnamony, crunchy cookie goodness keeps my abdomen from causing me trouble, but it just gets hard to take eating the same thing day after day after day for four months now. I still have another few months of chemotherapy-damaged intestines, though, so Metamucil will get some more of my business.

I hope everyone is having a good Friday!

Beautiful

2009-05-11T15:31:00.002-05:00

I was thrilled when my oncologist called my latest CT report 'beautiful'. He was very happy with how much the mass in my chest has shrunk.

Tumor size March 26, 2009 (measured by Dr. D):
* 6.7cm x 3cm on the axial projection (side to side & front to back)
* 5.3cm coronal measurement (top to bottom)

Tumor size March 26, 2009 (measured by Dr. C):
* 6.6cm x 3.9cm on the axial projection
* No coronal measurement given

Tumor size May 7, 2009 (measured by Dr. C):
* 4.3cm x 1.4cm on the axial projection
* No coronal measurement given

Since the tumor is still responding to the chemotherapy, we're going to do two more cycles, bringing my up to eight cycles total. Eight cycles will be it: one of the chemo drugs has a lifetime maximum dosage which I am close to (going over the lifetime maximum carries a high risk of heart failure). After I finish the chemotherapy, my oncologist said he'd like to send me to a lymphoma specialist to discuss whether or not I should do radiation.

From my own research, there is good evidence that radiation after chemotherapy reduces the risk of a relapse. However, it also carries risks of secondary cancers (because of my age, sex, and the tumor location, breast cancer would be of particular concern) and because my tumor is so close to my heart, heart damage from the radiation would also be a concern. It's not clear which option (rads vs. no rads) has a better risk/benefit analysis.

I know my doctors will make the best decision based on the evidence we have available. Regardless of which treatment plan we decide on, my chance of a cure will be good. And that's about all I can ask for.

A bridge story

2009-05-10T06:28:00.002-05:00

I've had a recent visit from each of my parents. With both of them, we ended up driving past one of the bridges in my town that is closed. I explained that we couldn't cross that bridge because a a train ran into it.

Most people have heard of trucks running into bridges. Which, to some degree, is understandable: drivers not familiar with the routes, or driving a semi taller than they are used to. Stuff happens. But a train? This railroad has gone under that bridge for over 100 years. That a train would have cars tall enough to hit it is kind of mind-boggling. Not to mention annoying, as that was the bridge I most frequently used.

Still, it makes for a good story to tell to visiting relatives.

Double hung

2009-05-03T20:52:00.002-05:00

As part of our remodeling, we've had most of the windows in our house replaced. Our reasons for replacing them were typical and not very interesting: to reduce heat loss and to make cleaning the outside of the windows easier.

What I didn't expect to appreciate with the new windows was their being double-hung. Our old windows, while all completely operable (surprising considering their age), had their top sashes painted shut. With the new ones, the top sashes work.

Since our downstairs rooms are works in progress, we don't sit around in them at all. When we're in those rooms, we're standing. Opening the bottom sash blocks the eye-level view from a standing height. Opening the top sash (newly possibly with the new windows) makes the outside more visible from a standing height. I'm finding it very nice; it's like the icing on the cake of these beautiful days we've been having.

So, hurray for double-hung windows.

Morning birdsong

2009-04-25T09:44:00.000-05:00

This morning I had my usual day 5 of cycle early a.m. insomnia. Laying in bed, deciding whether to get up or not, I heard a whippoorwill. I have never seen or heard one before, but the song was quite distinctive. And according to a short but seemingly well-referenced Wikipedia article, they are nocturnal birds whose range includes my location.

Hearing that song just made my morning.

Human granulocyte colony-stimulating factor

2009-04-25T09:43:00.000-05:00

After my five days of chemotherapy, I get Neupogen (also called G-CSF) to help my bone marrow recover its ability to make neutrophils (bacteria- and fungus-eating white blood cells). White and red blood cells (among others) grow in several steps from stem cells; the chemotherapy does not kill the stem cells or the adult blood cells, but rather the steps in between. Adult blood cells normally die and are then replaced by younger ones; with chemotherapy disrupting the pipeline, though, blood counts drop lower and lower until the stem cells have had enough time to start over from scratch. The day with the lowest counts is called a nadir.

I get the Neupogen (subcutaneous in my abdomen area) every day until after my neutrophil nadir. My ANC (absolute neutrophil count) is always lowest on day 12 of my cycle, which works out to nine shots of Neupogen (cycle days six through fourteen). I suspect I'm actually good to go after eight shots. But confirming that would involve having bloodwork done on a Sunday, which I have not been motivated to pursue.

Last week, I came across this article on the EPOCH-R regimen, which says, "The ANC nadir was invariably observed around day 10–12 of treatment." Now I feel kinda behind the curve: having my nadir on day 12, when others are able to get that over with by day 10.

Neupogen has been on my mind more often lately, as just last cycle I did some of the injections myself. My oncologist's office normally has the nurses give all the shots, so I trekked into the office every day I needed the injections (including two weekends of each cycle). My last two shots of cycle five, though, I asked to take home and give to myself, and I'll do the same for these two weekends of cycle six. It's kinda neat to have a bag labeled "biohazard" in my refrigerator (the shots have to be kept chilled).

The manufacturer's directions for injecting Neupogen warn of hitting a capillary. If this happens, they say to discard that syringe and try again. My oncology nurses don't do this, they haven't had any adverse events from it, and at $350 per syringe I can understand the failure to follow this recommendation. The manufacturer's directions also specify either a 45º or 90º angle for the injection. All but one of my oncology nurses gives it at a 90º angle; after some experience with the 45º method, I found that it was more painful. So my own technique is the same as that of most of my oncology nurses: alcohol swab, straight in 90º, give the injection without checking for blood return.

It's fun to get the hang of this stuff, but I will be so glad when it's all behind me. I hope that time comes soon.

EPOCH+R, round six

2009-04-25T09:42:00.000-05:00

In my second and third cycles, my heart rate would stay around sixty during my five-day chemotherapy infusion, then climb up a little over one hundred for a week, then drop back down to the eighties before my next treatment.

In cycles four, five, and six, my heart rate has been much more variable during chemotherapy (sometimes as low as sixty, still, but other times as high as 120). And in the week after (at least in cycles four and five), I've occasionally found my resting heart rate at 150.

I complained about this to my oncologist, and also let him know that light workout tapes bring my heart rate into the 170-180 range. He said he'd like to see my heart rate stay under 120. If my resting heart rate is elevated, he recommended nothing more strenuous than walking. He also sent me for an ECG and echocardiogram (ultrasound of my heart), both of which were fine.

I'm not thrilled with the high heart rate and my onc's disapproval, but the ECG and echo results are reassuring. Considering how much better I've felt these past few weeks (versus the previous weeks when I skipped exercising), I can't see myself giving up my workout tapes.

My onc did say that dehydration can contribute to an elevated heart rate. I've been having swallowing aversion and resulting low fluid intakes during my first break week; my first break week is also when my heart rate is the highest. Interesting. I don't know if my subconscious decided to run with that suggestion or what, but my fluid intake during treatment this week was 11-12 8-oz glasses a day. It hasn't been that high since my very first cycle; I was surprised at how consistently thirsty I was every day. It seems likely I'll have the swallowing aversion again this coming week; if so, I'm going to ask for IV fluids from my oncology nurses. That would be a simple enough thing to take some strain off my heart.

The increased fluid intake resulted in more nighttime restroom trips; the past few days these have been accompanied by buzzing/ringing in my ears (not the typical single tone of tinnitis, but more like a rainstorm). Friday morning when I first got up for the day, the ear sound was particularly strong, and I actually felt faint, which has not happened at any other time in my treatment.

Back to planning for the near future, I now have a numbing mouth wash to use for tongue pain. It seems likely it will again been severe enough to interfere with talking and eating painful. Apparently this kind of tongue pain is called stomatitis, although most texts discussing stomatitis talk about mouth sores (which I have not had). An article on EPOCH-R says stomatitis was "uncommon", but it happened enough to make their toxicity table, at 12% of cycles. The text of the article says stomatitis typically occurred in later cycles, which has been my experience. The Oncology Nursing Society says stomatitis may correspond with the white cell count nadir (lowest number of white cells), which has also been my experience.

Other things to look forward to this week: general weakness and bone pain. I think the weakness is what is called a "steroid crash". Lymphoma patients getting a more common regimen called R-CHOP get chemotherapy for one or two days, except for the steroids which are given for five days. They typically have lots and lots of energy and sleep very little on the steroid-only days; when they stop the steroids, they crash. I get chemotherapy for all five of my steroid days, so I don't really get the steroid "high". But I think stopping the prednisone still makes my body go, "What? I have to make my own steroids now?" and my increasing weakness these next few days is a "crash".

The bone pain last cycle was not nearly as severe as cycles one and two (before my chemo doses were escalated). But it woke me up for four nights in a row to take more pain meds; in cycles three and four taking 1300mg of acetaminophen before bed lasted me all night long.

Whew. I think I'm written out on chemotherapy for a couple of weeks (this blog has been a helpful therapeutic tool). On to happier things!

We have a roof!

2009-04-20T06:19:00.005-05:00

Well, OK, the roof on our south living room was up two weeks ago. But I just now got around to posting the pictures, so here they are:

In the lower picture, the sunny spot to the left is our new back door (we won't have to go through the kitchen to get to the back yard!). The middle area will house a woodburning stove, and the room to the right is a competitor for world's smallest 3/4 bath.

Our porch rebuild is also still in the framing stage:

And we have a bay window in the kitchen:

I had the azalea (in back of the photo) for not quite three months before I killed it. Let me recommend the cyclamen (the one with flowers) to fellow brown-thumbs, though: it has managed to not only survive my ministrations the past five years, but bloom through them.

Back to the topic of roofs: our contractor has now fixed the damage from a tree falling on our house last summer (broken eaves, mangled gutters, damaged shingles). Since it rained all day yesterday, I was very appreciative of having gutters that worked.

I'm quite happy with how far our contractor has come in the six weeks they've been working. Maybe six more weeks and they'll be done? I guess I'll just have to wait and see!

Meow?

2009-04-11T06:59:00.006-05:00

I think people tend to compare growths in our bodies to spherical objects. A coworker who had a painful fatty deposit in his upper arm described it as golfball-sized. Another coworker whose wife passed from ovarian cancer described the tumor at the time of diagnosis as grapefruit-sized.

My tumor was never really even sort of spherical. I was describing it as pear-shaped after my first meeting with my oncologist, due to it being thinner in front of my heart and thicker to the right of my heart. My father has described it as potato-shaped when giving updates to his relatives.

After my last CT scan, I was describing the current dimensions to the partner. "I had a CAT scan," I said. "Meow meow cat scan?" he asks. "Was it bigger than a mouse?"

That conversation lasted all the way through dinner. We decided that while it was very much shaped like one, it was bigger than a mouse. Still, it is smaller than a hamster.

The kind of cancer I have leaves scar tissue behind; I will always have a residual mass. Now I'm going to go through life with the image of a small rodent having made a home in my chest. Ha. Thanks, husband.

Ballpoint idealism

2009-04-07T16:39:00.003-05:00

In high school I was a cashier at a Dip 'n Dots stand. I never had to bring anything to work except myself; my supplies were at work. Including pens. During my first two summers of college, I got internships. Pens were always around.

The summer after my junior year, my pen ran out of ink, and there weren't any other pens. I started asking the supervisors for a pen, and ended up going around the entire office of four or five engineers. One of them did scrounge up a writing utensil for me, but it really was scrounged - out of the drawer of an abandoned desk or something. Not out of a supply cabinet as I had expected. They all seemed amused that I was asking for a pen, too, and I realized that they brought their own pens to work.

I felt really strongly that my workplace should provide me with writing utensils, and it was a mild shock to realize that not everyone felt that way.

Since graduation, I have continued to use pens provided by my employers. I never had a repeat of that episode at my internship; pens have just been supplied.

This morning, I talked with the accounting assistant about the pens they have now: they skip. (I suspect due to the oil that gets on many of the documents we use.) For years, my company has offered gel pens that do not skip, but we're out. The assistant seemed distraught that the other pens weren't working for me: "But the gel pens are so expensive!"

I knew we were having financial difficulties; I hadn't thought about them as extending to office supplies. I don't want to feel like my need for a pen was the tipping point in our company's decline; her distress was almost enough to make me consider buying my own pens, as do a number of my coworkers.

I don't think I'm ready to give up that ideal. A woman's got to hold on to something during hard times, and apparently for me, that something is a ballpoint pen.

EPOCH+R, round five

2009-04-07T16:08:00.004-05:00

During my second break week of round four, I never felt good as I have in past cycles. This run-down feeling continued into my infusion week for round five, and Monday, Tuesday, and Thursday I just dragged through. Why I felt good Wednesday and Friday I'm not sure.

Our living area was rearranged a few weeks ago due to our remodeling, and my exercise space was one of the victims. During my first three rounds, I did two or three easy workout tapes during each break week. Not exercising during my break in round four is a top suspect for why I haven't felt so hot the past two weeks. I got my husband to rearrange again so that I could get back on the exercise bandwagon. Hopefully this will make the next round easier on me.

My fluid intake has been low again this cycle. I complained of it to the nurses last week, and they started giving me a bag of saline while I waited for them to mix up a refill for my pump. My normal fluid intake is water and a variety of tea flavors (mostly herbal). On these days when my thirst isn't working right, I've found that flavored water, or just adding lemon juice to water, or having coffee instead of tea makes it go down a little easier. Still, it's a struggle to keep my intake at 3-4 8-oz glasses a day. During round four my thirst started working normally on Friday of my first break week. Having to think about fluids so much is tiresome, so I'm looking forward to drinking becoming an automatic habit again.

Keeping on top of nausea medications is important. Like round four, the IV medication they gave me in the afternoon plus a pill in the morning (promethazine) kept my stomach happy during round five. I forgot the morning pill one day though, and besides being uncomfortable at work all day, the IV meds didn't completely take, and I needed a pill that evening.

The Neupogen is making me a little more achy this cycle than last: it's mild, but I needed to take Tylenol to get to sleep last night. The painful swelling from the steroid withdrawal has not been as bad this time; I'm not sure why, but am grateful. The tips of my fingers feel sorta numb off and on, but no tingling and no pain, and the muscle cramps in my legs, feet, and forearms that I had the first three cycles seem to have resolved: I attribute this to my lowered dosage of vincrinstine in rounds four and five.

Currently, my esophagus tingles, my tongue hurts (not to chew or swallow, just a mild ache), and it hurts to take deep breaths. Of these, the esophagus tingling bothers me the most, and makes eating uncomfortable. I've talked to several of the oncology nurses about this (today, and also when the same thing happened last cycle), and they say no one has ever complained to them about esophagus tingling before. Theories include neuropathy (like the tingling in my fingers) and something to do with the vagus nerve (which has some relationship to swallowing... and also to heart rate, which my heart rate is over 100 most of this week). They say as long as it goes away (which it did last cycle) it's not anything to worry about. So now, just to figure out what to have for dinner.

Putting the "DA" in chemo

2009-04-04T04:46:00.003-05:00

As has happened as I complete most of my treatment weeks, I woke up around 3am this morning and could not go back to sleep. Going straight from sleeping 10-11 hours a day to insomnia is always somewhat jarring; fortunately, the insomnia has never persisted beyond this one day.

In the meantime, I've been trying to make the best of it by doing research on the internet. I came across an interesting comment on the regimen I'm getting, which is a "dose-escalated" regimen (DA-EPOCH+R). If my blood counts (white cells, red cells, and platelets) tolerate a dose well, my next cycle I get more of the E,C, and H drugs.

According to this study, clearance of these chemotherapy drugs gets faster with successive cycles, especially in younger patients. Apparently our bodies can learn how to get certain poisons out of our system. Pretty neat. It does mean, though, that when we want poisons in our system (e.g. for cancer treatment) that it makes sense to increase the dosage over time.

So, my insomniac brain just thought I would share.

Making progress

2009-03-30T13:59:00.004-05:00

I met with my oncologist today. My CT scan last Thursday showed improvements:
* The mass on my left adrenal gland is gone
* The pericardial effusion (fluid around my heart) is gone
* The tumor has shrunk some more

The shrinkage was not as much as I had hoped for. The measurements also seem to be dependent on which radiologist looks at them.

Tumor size February 11, 2009 (measured by Dr. O):
* 7.2cm x 3.8cm on the axial projection (side to side & front to back)
* 5 cm coronal measurement (top to bottom)

Tumor size February 11, 2009 (measured by Dr. D):
* 8cm x 4cm on the axial projection
* No coronal measurement given

Tumor size March 26, 2009 (measured by Dr. D):
* 6.7cm x 3cm on the axial projection
* 5.3cm coronal measurement

So just 1cm shrinkage in each axial direction, and no change in the coronal plane. Not nearly as encouraging as my first progress scan.

The type of lymphoma I have often leaves a mass of scar tissue even when all the cancer cells are killed - but 7cm would be a highly unusual amount of scar tissue. I was hoping for enough shrinkage we could possibly say the cancer cells were dead, and I'd only need two more chemo cycles (six total).

But since the tumor is still good-sized, I'll need more treatment after my sixth cycle. We'll do another CT scan: if the tumor has shrunk more, we'll do two more cycles (eight total) and evaluate from there. If it's the same size, we'll talk about other treatment options, probably radiation.

As disappointing as it is to be looking at months more of treatment, I feel so lucky I have a variety of effective treatment options available to me. Just thirty or forty years ago, I would have been dead within a year of diagnosis. So, hooray for effective chemotherapy, and on to cycle five.

Dancing floor

2009-03-27T18:44:00.003-05:00

For nearly three weeks, the door from our dining room has opened onto a three foot drop. Yesterday, the floor of what will be our new living room was installed. Excited that there was something solid outside the dining room door, I opened the door and walked out shortly after getting home. "Congratulations on your new dancing floor," says our carpenter.

EPOCH+R break four: side effect round up

2009-03-22T16:22:00.005-05:00

While my bone marrow tolerated the increased dose in cycle three very well, this doesn't appear true for the further dose increases in cycle four (dose increases were for the E,C, and H drugs). Hemoglobin is a component of red blood cells: levels of less than 12 are considered anemic, less than 8 require a blood transfusion. I've been between 9.5 and 10.5 since my first chemo cycle; on Friday my hemoglobin was 8.4. Neutrophils are a kind of white blood cell needed to fight bacterial infections; absolute neutrophil counts (ANC) below 1000 are considered dangerous. My first cycle, I dropped below 1000, but not in cycles two and three. Friday, though, my ANC was 144. I don't think my oncologist will be increasing my dosage for cycle five.

Despite a reduction in dose of vincristine, the O drug, the tingling/numbness in my fingertips came back the Sunday after my fourth round. It's still here a week later. But, it has not spread any further up my fingers, and they don't hurt nearly as easily.

Also on Sunday, I got a tingling sensation at the very top of my breastbone when I ate. With each swallow, the tingling sensation would spread out to a larger area. Not that the tingling was particularly unpleasant, but for some reason I developed an aversion to swallowing, especially liquids. And the underside of my tongue hurt - the pockets where you stick a thermometer. Chewing was fine, but extending my tongue to clean food from the outside of my teeth was extremely painful (so I've been using my fingers to get food out from in between teeth).

On Wednesday, that area at the top of my breastbone hurt all day, especially when taking deep breaths. Wednesday night, by the time I finished dinner, the tingling had spread to my ears. My aversion to swallowing was strong enough I only managed three or four 8-oz glasses for my fluid intake that day. All these symptoms have gradually improved; by Friday only the tongue pain remained. Today (Sunday) my tongue hurts just a little - I can even use it to get food off my teeth again.

I'm guessing all of this is caused by the same kind of nerve damage that is causing the fingertip issues. When I told a nurse about my breastbone pain, she had one of the doctors come talk to me - his best guess was also neuropathy. I think being so bothered by my issues with swallowing has made me not be bothered by the weird sensations in my fingertips. I'm glad everything seems to be resolving fairly quickly. I hope next cycle isn't any worse.

Biopsy payment

2009-03-22T13:31:00.003-05:00

When my tumor was biopsied in December, my insurance paid for the procedure at my local hospital, but not for the interpretation of slides done at the University of Iowa (which for some reason came as two separate bills). I called my insurance company, and was told the University of Iowa was out of network. That was discouraging.

I asked my oncologist's office about this, and they said, no, that wasn't right, they would resubmit the bills. A few days later, I got a slip from my insurance company that they were going to pay one of the bills. That was a big step in the right direction.

A few weeks went by with no word on the other bill, so Friday I called my insurance company. The agent was very confident that U of I was out of network, and that bill was not going to be paid. I pointed out the other bill (part of the same biopsy interpretation) that they had paid. No, she said, U of I was out of network, and they hadn't paid that. (!)

We went back and forth a few times, she insisting it hadn't been paid, me insisting it had. On March 3rd it was paid, I told her, find an action on that claim on March 3rd. February 18th, March 2nd... then she found March 3rd. There was silence for a minute. I was really afraid she was going to find something to un-pay it.

Then a light bulb must have gone off. "Did you go to the University of Iowa?" No, my biopsy was done at my local hospital. Only the slides were sent to U of I. Well, that was entirely different. Of course they would pay. She apologized for the trouble they had caused me.

Good news, but how bizarre. I would have thought the thousands of dollars in hospital bills would have clued them off that I was in my local hospital that day. Or that the procedures being billed from U of I would have obviously been done on slides, not an actual person. Considering all the money that passes through their system, health insurance does not seem as with-it as one would hope.

Foundation

2009-03-22T13:13:00.004-05:00

The living room at the back of our house was not part of the original, 90-year old house. First, there was a cistern there. Then a back porch half the width of the house. And later, a living room spanning the entire width of the house. Only, the roof was at a much shallower angle than the rest of the house, and leaked. The previous owner (one of the daughters of the family that had the house built) was elderly and just let it leak, so there's a lot of water damage in that room. The previous owner's sister arranged for the house to be re-roofed before we bought it - but it still leaks there.

We have had that room torn off, and are rebuilding it with a flat roof (and the special membranes that involves) rather than attempt fix a shallow sloping roof that hasn't worked in decades. And while we're at it, we're adding an extra 200 square feet. As of Friday, the foundations are done:

The wall running halfway through the center is the foundations of the old room - beyond that is the new space we're adding. Our contractor demolished half of the old wall before realizing they didn't need to do that.

The progress so far has been really exciting. I'm sure the progress this next week will be even more so, as that room starts to take shape.

Demolition

2009-03-15T08:11:00.002-05:00

Monday, a contractor started working on our house. Our south living room has roof/water issues, and while fixing those we're expanding the room. Currently, the south wall of the house is gone, along with the floor of that room.

Our porch has no foundation, and has sunk over the 80-year life of the house. At some point, the sinking porch would pull down on the roof enough to damage the rest of the house. So the front porch is now torn off, in preparation for foundations and a rebuild.

About half of our new windows are installed. I was worried I'd miss the old wood windows with the weights, but I've found myself pretty excited with the new ones.

We wanted to do major work on this house from the time we bought it four years ago. Talking and planning for so long, and now it's actually happening. I'm almost giddy.

EPOCH+R, round four

2009-03-15T07:58:00.003-05:00

My white blood cell count was good enough in round three, my oncologist increased my dosage again. 20% more of the E,C, and H drugs. I slept more than in previous cycles. The IV anti-nausea medication they give me in the afternoon didn't last the full 24 hours; I took a pill once each morning.

For my steroid taper, I'm trying my 20mg dose in the afternoon Saturday, and then the 10mg dose with dinner Sunday. Last cycle, I took both doses in the morning; I'm hoping by pushing out the schedule I'll get the inflammation to subside sooner. While having any kind of taper helps with the level of pain, having it hurt to touch my torso is annoying even at lower pain levels.

I've had some of the icy/tingly sensations in my lips, but not as bad as last cycle. Yesterday, I had ringing/buzzing in my ears for about an hour when I got up in the morning; I had not had that side effect at all in round three. Otherwise - pretty much the same.

A worrystorm

2009-03-15T07:36:00.003-05:00

The Thursday before I started round four of chemo, my fingertips went tingly on me; half-numb, like a dentist's shot wearing off. It hurt to operate the cap on my toothpaste; I ended up washing out the inside of the cap so it went on and off more easily. It hurt to button things; I figured out how to work buttons without using the tips of my fingers. It hurt to open flip-top bottles; I started just unscrewing the lids. All day at work, preparing samples, I started to think I'd really been taking my fingertips too much for granted.

Neuropathy - nerve damage, a common side effect of one of my chemo drugs. It can continue to get worse for months after treatment, affecting the entire hand and foot. Almost all cases are reversible, although it's common for it to take years to heal. I was fairly freaked out. I sent the partner out to the grocery store to by vitamin B6 and B12, which my oncology nurses had recommended if this happened.

It cleared up on Saturday. Sunday and Monday, just my left thumbtip was affected again; all fingers have felt normal since then. That in itself was tremendously reassuring. My doctor reduced the dose of vincristine (oncovin, the O drug) by 25%. I've wondered if I'm now getting less than the optimal cancer-killing dosage, but my worries about nerve damage are basically abated. It feels good not to worry.

Where I get some of my reading off my chest

2009-03-08T11:11:00.003-05:00

Lately I've been doing Google searches on diffuse large B-cell lymphoma. Apparently, this is an active field of study with a number of large trials currently being conducted. It's interesting to read about how, just in the past ten or fifteen years, it was discovered there are at least three sub-types, with my sub-type (primary mediastinal) typically appearing in young women.

When I first started this reading, I thought one of the sub-types was called "bulky". Bulky disease has a poorer prognosis, and I was glad that wasn't the kind I had. Later, I realized that bulky disease is a tumor larger than 10cm. Mine was 13cm: not heartening. Having a pericardial effusion (fluid around the heart) is also associated with a poorer outcome. Shucks.

Still, the primary mediastinal sub-type has a better prognosis than the other sub-types, with most studies 5-10 years ago finding 5-year survival rates of 70-80%. This despite about 75% of patients presenting, like me, with bulky tumors and either pericardial or pleural effusions (fluid around the lungs). And the drug Rituxam has greatly improved the treatment of B-cell cancers: survival rates up 10-20% since it became part of standard treatment. (Unlike normal chemotherapy drugs, which kill rapidly dividing cells, Rituxam kills B-cells.)

With my good response so far, I'm confident I'll have a complete remission with my chemotherapy treatment. Still, it's sobering to know there's a not-insignificant chance of a relapse: if that happened, my chances of surviving 5 years would be less than 50%.

Exactly what my prognosis is I'm not sure. The clinical trials for diffuse large B-cell lymphoma that include Rituxam have not been completed. Even without the precise numbers, though, the general idea is that I have a very good chance of being cured. And a "very good" prognosis sounds good to me.

No-touch light switches

2009-03-08T11:07:00.003-05:00

Yesterday, I walked into a restaurant bathroom. The lights came on.

Motion sensors. It startled me, but was neat.

I was a summer intern Argonne National Laboratory; they had all their lights on motion sensors, and it worked really well. Except that if you were doing something sitting still (such as reading), you had to wave your hand in the air every ten minutes or so (to turn the lights back on). Fun times.

EPOCH + R, round three

2009-02-25T20:14:00.003-06:00

It was with great relief that I went through yesterday and today with very little pain. A little acetaminophen at bedtime has been all I've needed: the extra chemo drugs killed enough of my bone marrow that the bone-marrow-stimulating shots didn't overstimulate me. Yay.

The additional drugs this cycle did upset my stomach a little, mainly when it was empty. Peppermint candy seemed to resolve that problem, a simple enough fix. Not new this cycle, but much worse than previous cycles: I have had a nasty taste in my mouth for almost a week now. Only today is the unpleasantness finally starting to go away. The bad taste doesn't interfere with eating, but it makes drinking unpleasant. The uneasy stomach followed by the taste issues have made my fluid intake this cycle lower than in previous cycles.

I'm also much weaker this week (break week one) than I was last cycle. I haven't felt up to doing exercise tapes yet. Sometimes I'll be doing something while standing up and feel a great need to sit down. Occasional cold/tingly sensations in my lips, upper back and upper arms, and legs started on Saturday.

I will definitely take the stomach and weakness issues over the pain I had last time, though. And some of my side effects have actually improved: the jaw cramps have been much less. The muscle cramps seem to have almost gone away; I only had some achiness in my shins at the end of my treatment week.

I tapered the steroids from the 200mg/day during treatment to 20mg Saturday and 10mg Sunday. This made the withdrawal swelling only mildly painful, but, disappointingly, did not shorten its duration. It still hurt to sit back or be hugged through Tuesday. Last cycle I had taken nothing Saturday, 20mg Sunday, and 10mg Monday: I hurt more over the weekend, but by Monday I had no pain. I may talk to the nurses or my doctor and see if they have suggestions for trying to keep the pain levels low AND shorten the duration in future cycles.

My heart rate was again in the 60s during my treatment week, and by the Monday of my first break week had crept back up over 100. If it follows the pattern of previous cycles, it will now start dropping, and will be about 90 when I start cycle number four. Cycle four will start in a week and a half: I have much less fear of the unknown in this treatment, but more dread for the side effects I have experienced. For now, however - for the next week and a half - I look forward to feeling better every day.

Measurements

2009-02-19T16:28:00.002-06:00

The measurements on my tumor finally came in today.

Tumor size December 22, 2008:
* 12cm x 8.9cm on the axial projection
* 9.8cm coronal measurement

Tumor size February 11, 2009:
* 7.2cm x 3.8cm on the axial projection
* 5 cm coronal measurement

Approximately half the size, woo-hoo!

They also gave me a copy of my PET scan report from December 30. Reading it over, I noticed the phrase "intrapericardial invasion". I had thought the tumor was just compressing my heart; apparently, it has actually penetrated into the sack around my heart (pericardium). That is quite disconcerting.

Seeing the size reduction is overwhelmingly good news, though. Now, just to get rid of those remaining 7cm.

Beginning EPOCH+R round 3

2009-02-16T19:24:00.004-06:00

The CT report said my tumor was "significantly smaller" and that my "pericardial effusion was significantly improved". I hadn't realized I still had fluid around my heart (I had that diagnosed at the end of October), but I guess it makes sense: the tumor is still irritating it.

The radiologist didn't measure the tumor, so I'm not sure how much it has shrunk. The doctor said he's put in a request for the measurements. Tomorrow, when I see the oncology nurses I should be able to get the results from them. (I see them everyday this week for chemo, and then every day after that for shots to help my bone marrow recover.)

Since my white cell counts were so good last cycle, the doctor is increasing the dose of chemo by 20%. I might have more side effects this time. My main hope is that, with an expected lower white cell count this time, the bone pain from the Neupogen won't be so bad. Here's crossing my fingers for no additional side effects but less bone pain.

Break, round two

2009-02-11T19:29:00.005-06:00

I had the same painful inflammation start Saturday morning as with the first break. On Sunday, I talked to the nurse about it when I went to get my Neupogen shot: she thought it was a withdrawal symptom from the steroids. She called my oncologist, and he approved me for 20mg of prednisone Sunday, and 10mg on Monday (my dose Monday through Friday had been 200mg a day).

Tapering off the steroids helped tremendously with the pain. It brought the swelling down on the days I took it, although it ended up lasting longer: I couldn't button my pants until the next weekend. (The first cycle, the swelling had receded to the point where I could button my pants by Thursday.) I didn't mind too much, though: having the pain significantly reduced was wonderful. Monday I only had a little bit of achy from the Neupogen and felt overall pretty good.

The Neupogen shots they give me daily, starting the Saturday after my chemo, stimulate my bone marrow to make white blood cells. The first cycle, that whole first break week was largely a haze of pain and I wasn't sure how much of it was due to the shots. But having Monday be so good pain-wise made the aching and sometimes stabbing pains later in the week obviously due to the Neupogen: Tuesday and Wednesday every large bone in my body hurt so, so bad. Taking the max recommended amount of acetaminophen and ibuprofin (4000mg/day and 800mg/day) only took the edge off. Taking two at a time of Tylenol #3 (which has codeine) relieved the pain for a few hours - but taking large amounts of narcotics is a bad idea while fighting constipation.

I don't think it helped anything that my white cell count was double what it was after my first round of chemo. It's nice that my bone marrow wasn't as damaged by the chemo this time, but, ow. Ow ow ow. One of the nurses said my counts were high enough this time the doctor might reduce the dosage of Neupogen next round. Literally every bone in my body is hoping he agrees to that suggestion.

Other side effects were much more minor. Again, I had jaw cramps Saturday through Thursday, though they seemed less severe this time. The inside of my mouth, which had toughened up during my chemo round (likely due to the steroids), re-sensitized. (Although I found the sensitivity was really not bad if I refrained from trying to eat jalapeno flavored potato chips.) My eczema came back again, although much less severe: the first cycle we had record low temperatures - and dry air - during my break weeks, while now we're having record high temperatures.

My heart rate went back up over 100 the first break week, then this week dropped down into the 90s. I think this may be a reaction to the chemo drugs, or to my anemia, or some combination, and not completely due to the tumor next to my heart. Laying on my right shoulder is also still uncomfortable; that was my very first symptom of this cancer, so it seems reasonable it will be the last thing to clear up.

My energy level has been better these two weeks than it was during my first break, even though I caught a cold and had to make friends with a couple of boxes of Kleenex over the weekend. Feeling so good is very encouraging; still, I'm nervous to see the results of the CAT scan I had today. Hopefully the radiologist report will be ready tomorrow, so I won't have to be in suspense too long.

Physics and religion

2009-02-11T19:04:00.002-06:00

I am such a nerd. At Bible study on Saturday, we talked about some of the mysteries Jewish scholars have struggled with over the years. Such as, how God can be completely unchanging and outside of time, yet interact with humans and make time-bound humans in his image. My answer? It's like the wave-particle duality of light. Physics has proven there are certain ways in which something can have two contradictory characteristics at the same time, so this is really not a mystery at all.

The mystery of when the Sabbath ends - is there a moment when it is both the Sabbath and yet not the Sabbath? Well, quantum physics says no. The revolutionary idea behind quantum physics is that time and space are quantized - divide them small enough, and you get an indivisable unit. There is a quantum of time that is Sabbath, followed by a quantum of time that is not. There is nothing in between, mystery solved.

I also had some idea about relating how humans view God to how we can construct the three-dimensional shadow of a four-dimensional hypercube, but can't actually see the hypercube itself. Disappointingly, I wasn't able to work that into the conversation.

I don't think I actually solved any enduring religious mysteries with modern physics. But it was fun to contemplate the possibilities.

EPOCH + R, round two

2009-01-31T06:01:00.003-06:00

This week was similar to my first round of chemotherapy. It took a few days for the tiredness to really kick in, probably because I started out feeling so much better than going into the first cycle. The thirst wasn't quite so strong (I think I drank about 11 8-oz. glasses of fluids a day, instead of 12). The muscle cramps were less severe, although they were spread out this time in my legs and forearms and the arches of my feet (the first cycle I only had cramping in my inner thighs). No buzzing in my ears at all this time, which was really nice.

My hair has continued to fall out; I sometimes think I look like the character Golem in the Lord of the Rings movies. My eyebrows and eyelashes are so far unaffected, which is a nice bright spot.

My food cravings have been different; for example, the first cycle I wanted hot chocolate every day. This time, I had hot chocolate on two days, but it wasn't as good. This morning, I woke up at 4am and microwaved some frozen minestrone soup, and wondered if I could get the partner to run to the grocery store for some orange juice (which didn't sound good at all during my first round) and grapefruit. Maybe when the store opens.

Starting in the break weeks, I've been having trouble eating salty or spicy foods because the inside of my mouth is tender. I really like spicy foods, and snacky-type foods that don't require preparation tend to be salty, so this has been a difficult adjustment.

I've given blood regularly since I was 18, and my heart rate has always been in the 80s. This week, my resting heart rate dropped to the 60s, which has felt very odd. I'm guessing my heart got a really good aerobic workout pressing against the tumor for so many months, and is now showing off how buff it is.

On Thursday, they told me I was anemic, with a hematocrit level of 29.5 (I think below 30 is anemic for premenopausal women). To give blood, they require a hemotocrit level of 38, which I have struggled to maintain since becoming vegetarian - my normal diet has a low iron content. The chemo drugs damage the intestine lining, so I'm sure reduced absorption is compounding the difficulty my damaged bone marrow has making red blood cells. There are shots they can give to help anemia. But, they do not give the shots if they are treating the cancer with intent to cure. Knowing I'll probably be more tired because of the anemia isn't fun, but it is pleasant to dwell on being cured.

Hobbies

2009-01-25T17:08:00.005-06:00

I read novels voraciously in middle school, mostly science fiction and fantasy. My reading dropped off with the more time demands of high school, then in college I discovered high-speed internet.

Since I've been sick, I've again started getting novels from the library, most recently The Lady by Anne McCaffrey. A few chapters into the book, I developed a nagging suspicion that I had read it before. One of the young characters called a particular scene to my mind: her American cousin lecturing her about how having a menstrual cycle makes a woman fertile, and teaching her what contraception was.

About halfway through the book, this scene did actually happen. I've definitely read the book before, almost certainly in middle school. Yet, through the four-hundred-odd page book, I remembered nothing else from my first read. That one scene apparently made a deep impression. It makes sense, in a way: I grew up to become one of the major contributors to the birth control and menstrual cycle-related articles on Wikipedia.

Not that I've done much with them lately: my edit count has been declining since August (which, maybe not coincidentally, is also when my first symptoms of cancer appeared). I look forward to feeling consistently mentally sharp again, and re-starting work on those articles.

A mixed break (week 2)

2009-01-25T17:00:00.004-06:00

I've felt much more myself this week. Increasing energy levels as the days went on, cooking, some aerobics, knitting some for the first time since before chemotherapy. But, my resting heart rate has been up around 100 again all week. Wednesday, when I woke up with pain in my right shoulder and realized that it also hurt to breathe, I was ready to start chemo round 2 then and there.

My painful symptoms have subsided (I guess whatever was resisting the tumor regrowth got stretched out enough to accommodate it) and I have really enjoyed this weekend. I feel more all over good than I have in months, and I think it will help carry me through the next cycle: treatment starting tomorrow (Monday) through this Friday, then two more break weeks.

Alopecia

2009-01-25T16:39:00.002-06:00

I had gotten the idea that hair loss was going to happen over a few weeks. I didn't think too much of it when I started having more shedding than usual on Friday.

Saturday I felt like I was filling up trash cans with my hair. It's still coming out quite a bit today, but not like yesterday. I'm not sure if I'll be bald in another day or two, or if I'll stall here for another three weeks and then lose the rest of it, or if these hair follicles are going to tough it out for the rest of treatment.

What a change in just two days:

"Break" week one

2009-01-18T07:25:00.005-06:00

The chemotherapy drugs I'm taking are all inflammatory; the steroids are given to help counteract that. The steroids also made my normally dry skin not like moisturizer for a while, and cleared up the eczema patch on my left elbow that I'd had since July. By Wednesday of this week my skin was liking the body butter again, and on Thursday I found a new eczema patch on my right arm.

My last dose of steroids was Friday night, and by Saturday morning I could tell I'd gone off them: I started to swell up and be tender to the touch along the back of my neck and up along the back of my jaw, along the top back part of my shoulders, down both sides of my spine, and down both sides from my armpits to my hips. This continued to get worse most of the weekend, and on Sunday the worst headache I've ever had in my life was added to the mix. Not realizing how bad the pain from the swelling was going to get, I waited way too long to start taking pain relievers.

The inflammation was better on Monday, and had completely cleared up by Wednesday. I'm not sure if it was my body's reaction to the chemo drugs themselves—so it will be just as bad next time—or if it was caused by the amount of dead tumor cells in my chest—which should mean it would be less severe next round. I guess I'll find out soon enough.

Saturday also saw the start of jaw cramps. If I put anything in my mouth - liquid or solid - the back of my jaw would cramp for a few seconds. The second bite or sip would also cause some cramping, but not as bad. By the third bite or sip, I could eat or drink normally. This annoying effect continued through Thursday.

I've been having lower back pain this week, too. Possibly from sitting on the couch with bad posture so much, and losing muscle tone in my back from not exercising for the past few weeks. I've also been getting a shot every day to help my bone marrow recover, and these can cause bone pain. One of the oncology nurses said the shot might also be the reason for the pain in my lower back.

The fatigue has been just as bad as last week, but I haven't had the need to sleep so much. With my extra time (and now that I've regained most of my range of motion in my right shoulder after having a port installed near there) I started doing some of my easiest workout tapes. They seem to have helped reduce my pain levels, and it feels like an accomplishment to be able to get back more of my normal routine.

Friday I had my hair cut into a pixie style. I'm ambivalent about how it looks, but have been really happy with how low-maintenance it is. I used to enjoy taking care of my hair, but the fatigue the past several weeks had turned it into a chore. I also like that my hair now doesn't move around very much: I had some scalp sensitivity during my chemo week, and am expecting that side effect to be worse next time.

This week has not been as much of a break as I was hoping for. Still, I'm encouraged by how few side effects I've had (I never have been nauseous, for example) and it is absolutely fantastic to be able to lie on my right side comfortably - something I hadn't been able to do since the beginning of August. Things are looking good.

Today feels like a heat wave

2009-01-17T17:10:00.004-06:00

Thursday morning, I discovered my truck's battery is not capable of starting the engine when the temperature is -10º.

Friday morning, I was delighted to discover the plug hanging out of my truck's engine was a block heater, that despite having to be sanded before it would fit into the extension cord it did work, and having been plugged in overnight, my truck started even though it was -22º. A coworker commented that it was warmer in Alaska than in our town.

Looking at my local weather report, I see it reached -31ºF last night. (These are all actual temperatures that do not account for wind chill.) The local paper had said the record low—since weather reports started in our area over 100 years ago—was -28º. While it's neat we set a new all-time record, I'm glad I didn't have to go anywhere early this morning.

By the time our Bible study group met at 9:30, it had warmed up above 10º and everyone was delighted at how warm it felt. What perspective.

EPOCH + R, first round

2009-01-10T07:23:00.007-06:00

My pathology report states I have diffuse large B-cell lymphoma. This type of cancer is usually treated with chemotherapy. My particular chemotherapy regimen is known as EPOCH + R, and is given in a three-week cycle: five days of chemotherapy, then two weeks off to let my bone marrow recover.

I started on Monday with the Prednisone, a steroid. 100mg of it, twice a day, through Friday. After my first steroid pills Monday, I went to the oncology office to get my first IV drip of Rituxam. This drug kills B-cells, the kind of cell that mutated to start my cancer. Reactions to this drug are common, and they've found that giving Tylenol and Benedryl right before the Rituxam helps to prevent and mitigate its side effects. Like many people, Benedryl makes me sleepy; the nurse said getting it in an IV drip tends to make this side effect more severe. It took four hours to get the IV drip of Rituxam, and I slept through all of it.

When I was done with the Rituxam, they gave me an anti-nausea drip, then hooked me up to a portable IV bag with a pump. This bag had the E, O, and H drugs of the regimen. I didn't like the carry bag that came with the pump system, so I bought a fanny pack to carry around; I was attached to this IV bag 24 hours a day. I went to the oncology office once a day for another injection of the anti-nausea medication and a new IV bag with the EOH mixture.

On Tuesday, the first side effect I noticed was a puffy face ("moon face") from the steroids. People who see me everyday noticed pretty quickly; those I don't see as often couldn't tell. The inside of my mouth has become slightly more swollen each day; it's annoying but not too bad of a side effect.

The next side effect I noticed was the thirst: for the rest of the week, I drank about 12 8-oz glasses of fluids every day - mostly water. My doctor had talked to me several times about how important it was to drink lots of fluids while on chemotherapy; one of the nurses explained that it's partly to help flush the chemo drugs, but mostly it's the breakdown products of all the dead tumor cells that are so hard on my kidneys. Another drug they have me on is allopurinol to help my kidneys deal with these waste products.

I've been easily tired since the end of October; all the tests/minor surgeries at the end of December and beginning of January exacerbated this. Going straight into the chemotherapy treatments I wasn't surprised that all I did at home was sleep, wake up to eat food my partner made, and go back to sleep. I have been able to continue work full-time, which has really helped me feel more normal through all of this.

Excitingly, on Tuesday my heart rate stayed in the 80s all day long. Since the week before Thanksgiving, my heart rate had been between 100 and 120 beats per minute almost all of the time, presumably due to pressure from the tumor. Even after less than two days of treatment, the cancer was already showing signs of shrinking.

On Wednesday I started to have occasional muscle cramps in my inner thighs; painful but not enough to restrict my movement at all. Muscle cramps are a listed side effect of one of the chemo drugs. My regimen is unusual, and not something my oncology office has a lot of experience with. The cramps combined with my really high thirst level made my doctor want to check my electrolyte levels (sometimes potassium levels get too high due to the dying tumor cells) and my sugar (the steroid I'm on can cause temporary diabetes). My labwork came back fine, though.

Also on Wednesday, I started having a sort of ringing/buzzing sound in my ears for a few hours after I got up in the morning. I had this effect this morning, too; the nurse I talked to about it believes it's a normal side effect. I've had some constipation and gas, especially Thursday and Friday. These are listed side effects, and have been fairly mild.

I've had pain or just uncomfortable sensations laying on my right side since August. I had a cough that started the week before Thanksgiving, which by mid-December became so severe I have been unable to sleep on my back or stomach - even taking codeine pills for the cough. Laying on my stomach also caused my heart to start skipping beats, a very disturbing sensation. Thursday night almost all of these symptoms were gone. Just the discomfort of laying on my right side is remaining, and even that it's difficult to say if it's the tumor, or the port I had placed last week. I am so, so excited to see this much progress in just a few days.

Yesterday after detaching me from the portable pump (yay!) I got a drip of the C drug (this took about an hour). I felt just kinda weird, especially in my chest area, for the rest of the afternoon and evening, and wasn't able to nap like I had been the rest of the week (though I was still feeling tired). I've noticed my waistline getting a little larger thoughout the week - I must have been retaining a lot of water while on the 24-hour pump. Last night I woke up at midnight, one, two, three, and five and produced prodigious amounts of urine every time. After the five am trip, my partner commented that my back didn't feel puffy like it had when we went to bed last night.

I get a break from the chemo for about two weeks now. There are some side effects I've been warned to expect. Being immunocompromised is one; the EOC and H drugs all have a side effect of damaging my bone marrow, where many important immune cells grow. I'll be getting daily shots of a drug to help my bone marrow recover until my lab work comes back to their satisfaction. Nausea is another: the IV anti-nausea drug they've been giving me daily lasts about 24 hours. The C drug I got yesterday can cause this side effect for up to 72 hours, so I'll be carrying my prescription anti-nausea pills around in case I need them.

Knowing my hair will fall out was one of the most difficult side effects for me to come to terms with. This is from the EOC and H drugs; they've already damaged my hair follicles. Hair shafts are lined with little pusher cells that control the rate at which the hair comes out of the skin; it takes two to three weeks for them to push the hair out once the follicle stops growing. The delay in this side effect gives me more time to deal with it, but nothing could make it pleasant.

What a week. And I get to do it all over again a few more times. Amazing modern medicine.

Hickman line

2009-01-10T06:56:00.003-06:00

Last Friday, I had a Hickman line installed. This is a kind of central venous access port: a device running from inside one of the major veins that drains into my heart to the surface of my chest. As long as I have the port, I don't have to get stuck for IVs or blood draws. Putting the chemotherapy drugs into a major vein also helps dilute their corrosive effects more quickly; these drugs can be damaging to the smaller veins IV lines are placed into.

Some types of port (I think called portacath) are completely under the skin. These types do require puncturing the skin, but there's not the risk of missing or damaging the vein there is with a normal needle stick. The under the skin type has the lowest risk of infection and other complications and seems to be preferred. Because of my particular treatment regimen, however, my doctors believed a Hickman line would work better for me. This device has a catheter that comes out of my chest; it splits into two lines ("lumens") that hang down about four inches.

One of the symptoms of the tumor in my chest was that I could only sleep on my left side. I asked the surgeon to place the port so I would still be comfortable sleeping on my left side, and he put it on the right (the line exits my chest at armpit level about 2-3 inches away from my shoulder). The pain afterwards was never bad (I didn't take anything for it). But the location of the discomfort surprised me: I thought it would be restricted to my chest, when actually my shoulder movement has been severely restricted. Even now, a week later, I can just barely raise my right arm to a 90º angle without pain. Had the surgeon placed the port on my left side (he said this was where the normally place it, because the anatomy makes the surgery easier over there), I cannot imagine how I would have be able to sleep. It is an absolutely terrifying thought.

I was not happy with the care instructions from the surgeon or the discharge nurse at the hospital. Fortunately, I met with one of my oncology nurses right after my line placement: she put a Biopatch (a 1" round antimicrobial sponge) around where the line exits my chest, and covered the whole area with an adhesive patch that looks like Saran wrap. Now I don't have to worry about getting the area wet (and so susceptible to infection) when I shower. Another oncology nurse changed my dressing yesterday (a week later).

I finished my first five-day course of chemotherapy yesterday. Despite my fears and complaints regarding the Hickman line, I have been very happy with how it is working. I meet with the surgeon in another ten days to have some stitches removed, and hope to express my gratitude for making this part of my treatment a little easier.

Amazing IV technology

2009-01-03T22:02:00.003-06:00

On Monday, as a nurse removed my IV line, I noticed all she was removing was a plastic tube - no needle. I asked about it, and she raved about the device: the needle has this catheter around it, and after the IV line is placed, the needle is withdrawn and discarded, leaving just the plastic tube in place.

When this woman first started nursing, they had to leave the needles in: this required tying patient's arms to boards to prevent any motion, which would puncture the vein all the way through. Even with the bound arms, they still had many incidents of veins punctured through both sides, with the IV drip going into the arm tissue. I caught on to the nurse's enthusiasm for the catheters very quickly.

On Wednesday I had another line placed, and commented on how neat I thought the catheters were. This nurse was impressed by a different aspect of the devices: their flexibility means they can be pushed further into the vein than needles. Where the needle goes in is a weak spot; the ability to push the IV fluids in further away from that weak spot greatly reduces the risk of blowing the vein.

I'm ambivalent about a lot of plastics; they leach chemicals that we are only now learning contribute to obesity, PCOS and related disorders, and heart disease. But a plastic that offers that much protection to my veins? I'm all for that.

Lifestyle changes

2008-12-27T13:42:00.003-06:00

I'm going to be sick for longer than I thought: last night my doctor called to let me know I have lymphoma. The pear-sized tumor they found is directly under my breastbone; next week I'll have tests to see if the cancer has spread beyond that location.

Today the partner and I went to Target to start preparing for this. For the past week, I've been spending part of most nights on the couch, since it's not always comfortable for me to lay down: we bought memory foam to make the couch more restful. Three days ago, I started having drenching night sweats, waking up with my pajamas so soaked I have to change them: we bought more pajamas for me.

Being surrounded by loving and caring family, friends, and health care providers has helped mitigate my shock and fear at this diagnosis. At this time, that's all I could ask for.

Fiery angel

2008-12-20T18:31:00.003-06:00

Last week in our Bible study group, we started the story of Moses and the burning bush. This is one of the more famous Bible stories; I have heard it many times. However, I had never read the opening lines very closely:

And the angel of God appeared unto him in a flame of fire out of the midst of a bush

An angel is what was in the bush.

Now, I was very into fantasy novels as a teenager. This genre tends to include things like fire elementals, which appear as flame but don't actually set anything on fire unless they choose to. I find it fascinating that the story of the bush so closely parallels our modern idea of a pagan world.

No one else in the group found this interesting. So it seems more likely that I've overloaded on fantasy novels than that this is actually an insightful observation. Still, it has stuck with me; it will definitely make me pay more attention to appearances of angels as we continue our study.