Day 292 - what I saw this morning

This has nothing to do with leukemia and, fortunately for a cute young woman named Maja, nothing to do with goodbyes either, but is an interesting story. This was not my favorite morning. I had therapy and got on the expressway in the wrong direction (on autopilot I was going to work) and took a few miles to figure it out so I had to turn around and then I didn't have time to buy coffee or put gas in the car so I was running super late and you can imagine how happy I was. Then, the insurance people called to tell me that actually there still is some problem with *their* records which they cannot fix until the ambulance company sends them a copy of the bill because and then she started speaking in a lost language of the people of farthest Siberia. She was very nice and assured me that they wouldn't take me to collections for what is essentially their bookkeeping error and I was in the midst of saying "thank you" when I witnessed an accident.
What happened is I was on 101 headed west and there was a slow moving car in the right lane followed by an oil/gas truck. Not one of the residential ones that deliver oil to people's houses, but one that delivers gas to gas stations. So, a big one. There were four cars ahead of me and the first one was going just marginally faster than the truck so it was taking f-o-r-e-v-e-r to pass the slow going car just ahead of the truck. I thought I did not want to be stuck behind the truck if it pulled into the left lane so I pulled up to close the gap between me and the car ahead of me. The car ahead of me was about even with the back of the truck and all of them were kind of packed in in the way drivers get when someone is going slowly in the fast lane. The truck put on its turn signal and no one made a move to let the truck in. It turned its turn signal off and a few seconds passed, then it turned it back on. I said to myself "Trouble" and pulled back a few car lengths. When no one slowed down to let it in, it started to drift over into the line of cars next to it. It appeared as though it was trying to put its nose into the space ahead of the SUV it ultimately hit. Then it drifted back to the left, then it came over for real and hit the side of an SUV. We were all going around 65-70. It just hit her car and realized what happened and then pulled back into the right lane. I stopped. The truck stopped. "I didn't see you!" he said. The person he hit was a 25 or so year old woman. I gave her my cell phone number, checked that she was ok and headed off to work (now even later). I am hoping she calls me because this is a driver who should not be on the road IMHO and I hope there is a police report. Even if her SUV was not there, there was not enough space for him to be in the left lane between the other cars that were there. And, if you cannot see an SUV, something is wrong with your looking apparatus. Just saying.
It's a good thing I am interested in things because I cannot drive to work evidently without something interesting happening. I had to hang up on the insurance woman, "O, my God, gotta go, it's an accident!" so I still don't know what I am supposed to do to correct their accounting error. I keep thinking about how easily it could have had a horrible ending for that young woman who seemed only a little bit older than my own daughter.
So, let's look at a happy picture, OK?

The daffodils in my front yard with Ellie's cast iron garden fairy.

About the insurance thing, I keep thinking that this is the only problem I have had in over $200,000 worth of treatment. I cannot believe how lucky I am. Better believe I am deeply grateful. I am also thankful that I did not witness a fireball on the expressway this morning. As for hopes, I hope that driver uses this near miss as an opportunity to change his behavior so he doesn't cause a real disaster in the future. For you, safe travels even if it's just a little ways.

Day 291 - nothing but normal

Ellie was stalling at bedtime tonight by trying to engage Terry and me in talking about my hair. I realized it was the third conversation I had had today about my hair. Losing my hair did not turn out to be a terrible experience for me probably because I knew from the beginning it was going to happen and probably especially since I got it cut fairly short just before I went into the hospital for my month long stay so that I didn't lose my hair to the leukemia. I think taking control of that was really helpful and meaningful for me. I wonder if there are ways people can take control of other physical parts of the cancer experience. I'm actually sort of surprised that getting your hair cut short before you start chemo that will make your hair fall out is not standard advice.  I know people often cut their hair after it starts to fall out, but doing it when there was nothing amiss made me feel like I was a little bit in charge. The idea of sitting around and waiting for two feet of hair to fall out in clumps is not very appealing to me. Suggestions for patients if I get to see them early enough in the palliative care clinic.

It is funny though, how often people mention my hair, usually to tell me it looks nice short (thank you; I agree!) I'm not sure if it's because they want to talk about the cancer experience some and can't think of another easy way to start. Or maybe people just like my hair shorter. I will have to try experimenting with other ways to answer that make it clear we can talk about stuff deeper than my hair. What might such an answer be? Thank you; I'm keeping it short to help me remember the cancer experience? Not sure.

I am grateful to have growing hair. I am hopeful we all have lots of haircuts in our futures.

Day 290 - deposed

I told our nurse practitioner student today that I feel something interesting is always happening in my life. Today was no exception; I did my deposition. I had never been deposed before and that was interesting. The county prosecutor and the public defender and the court stenographer (who recorded everything and will transcribe it probably from the comfort of her own home--nary a stenograph in sight) were there with me. The public defender asked me a whole bunch of questions, many of which were highly predictable, some of which were not. The situation is that I examined a patient after she was assaulted and the person who did it has been found and is on trial for it. My piece is really straight forward; is this your note? when did you see the patient? what did she tell you? then what? etc. Some of it was somewhat surprising to me, but probably shouldn't have been: what did you mean by [body part]? (he brought pictures from the internet and asked me if the circle was on the [body part]) He asked a lot of questions about could I tell how/when the wounds had been made? (nope, not my field of expertise) It was nerve wracking to not be able to figure out where he was going all the time. I also wished my note had been better, but there is nothing for that at this point. Now, I've had that experience and am hopeful that I never have to be deposed on my own behalf. Once we had a patient involved in a lawsuit at the Hospice House. I was not there the day they came with their stenographers and team of lawyers to depose him. He died soon after, but it had been an important life goal for him to do the deposition. It must have been exhausting.

Can you see the little bit of purple in the lower left above the grass stem? That is a pansy that made it through the winter under all the snow for an early start. We really got our money's worth out of that plant; this is its third year back. Pansies are *supposed* to be perennial.

I am thankful for being so naive about the legal system and hopeful that I can remain so. For you, I wish the same.

Day 289 - it's a big circle

Now that it's getting around to nine months since I was diagnosed, I am starting to do things that I associate with my diagnosis. I remember when I was being induced (that is doctor talk for the month long admission that started the treatment off), I was being a tester for the ABIM board exam. They asked again this year and I said 'yes.' I remember the doctors (especially the residents) thinking it was funny that I was doing that test last year while I was getting chemo. I must admit I thought it was pretty funny too. I did a couple of the questions tonight and it was very odd because I remember clearly the last time I did those questions was in room thirteen (113,  think). As I reflected on that, I realized that everyone is a year further along in their lives. My cute little intern who saw me as her first patient of her first day in residency is almost a second year. My fabulous third years who were so kind and knowlegeable are almost graduated. I feel sort of like when you see your friend's kids that you haven't seen in years and you expect them to still be little.
I am getting close to the time I have to really panic about boards, too. I could have taken them last year, but really did not have the heart, stomach or bone marrow to do the necessary studying. I can't leave it to the last year possible because if I fail, I can't work. I guess I better get planning how I'm going to study; I have to pass the test by the end of 2015.

Here is a picture of the windows weaving hanging next to a painting Ellie did a while ago. I am very pleased with how it came out. I don't know if you can tell, but the colors going up and down are crossed against the same colors going left to right so that the top row is blue and the left most column is blue, the next column is white, then blue-green, then pink, etc. The diagonal from the topleft to the bottomright is the "pure" colors where both the warp and weft are the same. I really love it. I hope you like it too. My loom is back together, but I have done zip zero weaving in weeks.

I am thankful for the chance to do another year's worth of everything. I am hopeful for lots more years and the same for you.

Day 288 - run, view art and identify your infection

I checked at about 1:30 and happiness! my culture was back--sensitive to methicillin, but not to other pcn's and sensitive to every other antibiotic. The small print at the bottom said it should be sensitive to pcn+beta lactamases (i.e., the augmentin I got earlier this month), but perhaps not and perhaps that is why it didn't vanish with the disgusting sputum I was coughing up when I took the augmentin. I suspect it is time for another round of antibiotics, but fortunately since there are so many other alternatives, not vanco. You may recall that vancomycin seemed to cause fevers before. It was never 100% clear that it was the vanco (although the 1West nurses and I were completely convinced) and it is not 100% clear that my immune system now that it is not leukemia/neutropenia disregulated would respond in the same way, but if it's all the same to everyone, I'd like to hold off on finding out.

Here are the last of my New Orleans pictures. The New Orleans Museum of Art is really a fabulous museum. They're open late on Friday night, had a pianist and a singer, sold drinks in the lobby and had a fair number of people there. You can get right up close to the works, there were no crowds by the art (there were by the piano) and they had a lot of really great stuff including this Modigliano that I took for Terry who really likes him and the de Largilliere below that I just loved. I had never heard of him before, but something about the self-portrait really speaks to me.

I didn't see a security guard in the museum the whole time we were there.

I love how informal this guy looks and feel like he is about to start saying something to me about the canvas behind him that he is gesturing to.

Watch this space for upcoming shocking pictures of the flowers that are starting to grow in my front yard!
My other happiness for today is that I managed to get myself out on the shoulder of the road for 5K today. My speed is about the same as pre-leukemia even though I had to walk a couple times because I got tuckered out. I think this means that overall I might have somehow sped up! Perhaps those blasts were weighing me down.
I am so thankful that I can run. I am hopeful for more running soon. I am hopeful for you to be able to engage in your favorite outdoor activities too.

News unrelated to Agnes

Three times since New Year's I have gotten mild cellulitis of the nasal tip, just to the left of the tip of my right nostril. Not a huge patch, but it doesn't take a very large patch of bright red or even pink in that location before one feels quite noticeable. It goes away with some combination of neosporin and on its own. It recurs each time I get a runny nose, most recently this week. Three's the charm so I called my doctor's office to ask what they thought I should do. (Look how good I'm being! I *called*; I *asked*; I didn't just do what I thought I should.) They agreed with what I thought and asked me to stop by and swab my nose. This morning, it was growing staph aureus, sensitivities pending. Drat. Hoping for M*S*SA. I'll let you know.

I am thankful that I have not had any worse problems with resistant organisms. Given that my ANC was 200 when I was diagnosed and I was hanging around in a hospital, that is a huge piece of good fortune. I am hopeful for antibiotic sensitivity and that my port wound continues to heal nicely. I hope for you that you can avoid resistant organisms effectively.

Day 287 - return of the basset

I think I might be getting old because I am having a harder time sleeping in even when I am tired. I just automatically wake at 0600 or so without an alarm and can't seem to get back to sleep. I have heard this complaint from many an elderly woman. I don't mind because one of my favorite things to do is lie in bed and stretch a bit then roll from left to right to left and think about stuff and yawn and I could do that easily for a couple of hours if the house is quiet. I think I may really have fallen asleep, but who knows? I didn't feel asleep.
I was halfway up a narrow steep flight of stairs. They were dusty and at the top was a little landing where the stairs turned around and a huge round window with sun pouring through. I don't know why, but I was really afraid to go up the stairs. I could hear the sound of a dog's nails scrabbling around on the floor above me.
"Agnes? Is that you?"
No answer.
I lifted one foot to the next riser and shifted my weight up. Other foot. I felt each step in exquisite detail, the way my shoe felt when it hit the stair, my thigh muscles contracting to lift up my weight. Even though I thought Agnes was up there, I was terrified. I don't know why. I could feel my heart pounding in my chest and my neck. When I got to the top, it wasn't a landing but steps that curved around and the ceiling was really low and I had to lean way over. There was a very dusty, dark room at the top and Agnes was there!
"Agnes, I'm so happy to see you! Why didn't you say you were here?"
"That wouldn't have been honoring your fear."
At the time she said it, I knew just what she meant. Now, I have no idea.
I sat on the floor and scratched behind her ear; it was so incredibly soft and then I pulled her into my lap. She scrambled out and sat facing me. I couldn't figure out why she did that.
"Agnes, tell me what's going on!"
"I'm a dog," she said, "I can't talk."

So, what, I wonder, exactly am I supposed to make of this? I am doing some new (and, yes, kind of scary) stuff in a couple domains in my life that I don't really want to talk more about. I'm sure that brought her out. Was I supposed to find her visit encouraging? I wish I understood more what "honoring your fear" might mean.  I found it more helpful when Agnes provided me with more direct advice, but it was nice to see her. I had wondered a little bit if she would make a repeat visit and certainly when.
And, really, isn't that maddening? "I can't talk." Yeah, and I can't type. Geez.