Saturday, October 31, 2009

Indian Summer

This time of year tears my heart out and rips it into tiny shreds. My emotions run all over, and always did, even before throwing cancer into the mix. I can't understand the people who say they love fall best of all. I'll give you that there's lots to love about the colors, the certain angle of the light as it glows from beneath the leaves in the late afternoon. The mushrooms growing up through the leaf mulch. For plain ole' riotous beauty, there's a lot to be said for the colors of fire, and dramatic presentation. But there's that undertone of sadness, of remorse and regret. There's the memory of all we didn't do over the summer, the tomatoes we left to rot, the late crops we didn't plant, the perennials that didn't get separated. And then the trees themselves, who after carrying a pure persona of LIFE!!!! has now tucked in and will show to the world the expression of death. For six months the sky will be cloudy and gray, the sun will only manifest itself as a strange glow moving across the sky, and no moon, no stars, either. Just that odd orange glow to the northeast- the high pressure sodium night lights of Cleveland.

Yesterday I got a visit from a couple of women from my church. I tell them that they have designated themselves "church ladies" because this was the second week in a row they had gone out to visit "the sick." We sat outdoors on the deck in 70 degrees weather, it was quite breezy, there was a cacophony of wind chimes in the background, so much that it was difficult to carry on a conversation. But absolutely delightful weather! It makes me glad I didn't check the forecast. It rained overnight and while I wrote this entry, but now that I'm back to edit, the sun has come out!

I ordered a bunch of tree seedlings from the Arbor Day Foundation this spring, and we planted them right away, just as you're supposed to...but we still had a high failure rate. On of the big disappointments was American Beech. Beech is a slow, slow grower that you'll only find large samples of in old forests. When Greg moved with his family to this property in the early 60's, there were many beautiful, huge beeches. The portion of the acreage that the old house was on had never been clear cut for farming, so the trees were huge! Old, old oaks and beeches, with some maple in it was the primary forest. The building lot Greg's dad gave us is on the opposite end, and has partly overgrown farmland, and partly second growth forest, which is mostly ash and maple. We're very close to the old section back in the woods. We are trying to help the forest along with seedlings, and also by protecting the trees from deer damage. American Beech is a gorgeous tree, great to climb (yeah, I know, but one must consider these things for future generations), and it's a food tree in desperate circumstances. We've been looking at all the garden and tree centers with no luck.

Earlier this week Greg and Molly vanished just before dark. When I tried to be a little irritated with them, he told me he had found two more little seedlings on our land, plus a whole bunch - at least thirty - across the property line into the railroad right of way. We'll get those moved in the next week or so. I want to plant several up near the street, a few in the back yard on each side, and spread the others throughout the woods. I don't know how they'll grow without sunshine, since they're "old growth" they started first, on bare soil, but the seedlings that have taken root in subsequent years are growing in full shade. I imagine they're adaptable. I'm happy to invite them to live in our yard. I think we are doing OK at practicing out tree stewardship.


Here's something quick, easy, and hearty for the upcoming fall chill.

Spaghetti Carbonara

Cook 12 oz to a lb. of spaghetti, linguine, or fettucine, while you're making the sauce. Use that big pot with the pasta insert that you bought for the boiled chicken.

In a separate big wide pan or a wok, saute about a half pound of bacon, rough chopped. When it's about half way done, add four or so chopped cloves of garlic. Let them cook as the bacon finishes, but don't let the garlic get too brown or it will be bitter.

Now, pour off about half of the bacon grease, but save it in case you need to add some back. In the pan with the bacon and garlic, add about a cup and a half of half and half (nonfat is ok) and 2/3 cup or so of grated parmesan cheese. Put back onto lowest heat.

In a separate bowl, beat two or three eggs, and add, a little at a time, about a half cup of the pasta water that the pasta should be draining over by now, cause it's done, you cooked it until it was barely done, right?

Stir the egg-pasta water mixture into the rest of the sauce, then put the wet noodles into the pan, too, and stir while you heat it all up to finish cooking the noodles and smooth out the sauce. A good handful of chopped Italian parsley and a lot of fresh ground black pepper goes in now, use tongs to serve.

READ THIS PART!!!!!

I know people who skim over directions and don't come away with an understanding of why it's important that things be done in a certain sequence. So I want to talk about the pasta and the eggs.

First, always salt the pasta water. You can never do a good job of salting pasta except by cooking it in salted water. Second, I know that a lot of people pour oil into the pasta water to keep the noodles from sticking together. That's counter intuitive. It's the starch from the noodles that sticks to itself as it absorbs liquid that makes food like gravy, or pudding, or risotto, or pasta sauce, creamy, smooth, and delicious, with that great mouth feel. You know when you eat spaghetti and it tastes really delicious, but something is not quite there? It's probably the mouth feel, and the sauce is sliding off the pasta because it's oily. I always save some pasta cooking water to mix with the sauce.

EGGS. Eggs are protein and they cook and turn rubbery at low temperatures. You prevent this in sauces by tempering them, and to do this, you beat in some warm liquid to the eggs a little at a time. Then you can bring up the temperature gradually and you will have a lovely, creamy sauce.

This is one of those recipes that depends a lot on technique, not so much on ingredients. The way you treat the eggs will make or break the sauce. Pay attention.

Cancer update first

You know how it is when you're a young healthy person and it seems like every old person you come into contact with feels a need to torture you with and update on his hemorrhoids, or arthritis, or ingrown toenail? I mean, who cares? I'm boring myself silly.

But I do know that there are those who care and really want to hear the detail, and I've made a bit of a promise to keep distant family updated, too. So I will separate the clinical updates and you can skip over them or not. Really, it doesn't hurt my feelings if you don't want to know about this part.

Last week was my "off" week for Xeloda so I scheduled to go in on Thursday for bloodwork and a visit with the Nurse practitioner, Machelle, since the oncologist was out of town at a conference. My breathing issues have actually been getting worse, as has my chronic pain around my ribcage. So, even though the bloodwork cleared me for starting a new Xeloda cycle, Machelle wanted me to confer with the radiation oncologist Dr. Mackliss, about the superior vena cava syndrome. Maybe you remember that I had treatment to these blocked veins in August by angioplasty, but the relief - what little there was - only lasted a couple of days. The plan back in August was for me to consult with the vascular surgeon AND Dr. Mackliss before deciding on treatment, but Dr. Macliss was on vacation. When I mentioned to Machelle on Thursday that i never had had a radiation consult about it, she wanted to get one in between cycles. So, quick scheduled a CT scan within the hour, and a followup with Dr. Mackliss and Dr. Moore (radiation and medical and radiation oncologists) on Tuesday. Confused yet????

So, my appt. on Tuesday happened to have me see Dr. Moore (she's the team captain, as it were) before Dr. Mackliss. Dr. Moore, never to be confused with PollyAnna, is concerned that this means the cancer has become chemo-resistant. So, no more Xeloda. At least one bright lining. I expected this would happen, but hope for not so soon. She sent me off to see Dr. Mackliss and hear if he thinks there's a benefit to radiating the enlarged hilar nodes that are associated with the SVC syndrome. Dr. Mackliss was behind schedule, and uncharacteristically brief. 50-50 chances of some benefit, but also 5-10 chance it could harm healthy lung tissues (and there's not very much of that left). Greg and I couldn't make that decision on the spot, but he's out of town next week at a conference. He said he would schedule a simulation appointment and I could keep it or not. This was on Tuesday. On Wednesday I emailed Dr. Moore asking for her advice (forgot that this was her day off), but by seven pm I hadn't heard anything. Greg and I decided to forego the radiation and go straight to strong chemo, one more time...... and blow off the appointment. Within twenty minutes I got an email, she recommends radiation, thinks it has a better chance for quick relief for the SVC and breathing issues. So, back on. I will start daily radiation on Nov. 3, for ten days. Then a week break to heal (Yeah, not much!) then on to chemo avastin and abraxane. The hope is that my vein will open, my head will drain, and I won't have a chipmunk face, or, as I was comparing Baby Sidney and me, using Nathan description the day Justin was born, "fluffy cheeks." I do have me some fluffy cheeks.

So that's it. Don't ask me again because I'm bored to tears.

Friday, October 23, 2009

Keeping Time

I remember being a girl and going to summer camp for the first time, for a week. I was probably nine or so. The anticipation was unbelievable! Of course I had to get all new clothes (why??) so there was the shopping weeks in advance. Then I packed my suitcase, at least two weeks ahead. Then I unpacked and repacked it several times. Now, I know that I was obsessive, because my sons never behaved like this before going to Boy Scout Camp - just the opposite, we'd be flying around town the day before - getting last minute necessities. But those three weeks as a child waiting for camp went so slowly, I thought the time would never come.

When you are a child, there are so many momentous events, that in your mind they become a placeholder that you mark time by. Trivial things are paced by the more life-changing, like, "I got that new skirt before I went to see Romeo and Juliet."

Later, there were the children's births and family events that hold a place in time in my mind, that other events are relative to. We moved to the mountains six months after Tristan was born. Nathan got bitten by Rupert soon after we moved to Winston-Salem. Matthew lost his pinky just before we went to Nag's Head, in seventh grade, the last year we lived on Bridle Path. Justin was a toddler when my father died, and eleven,, I believe, when my mother died. When there's a death in the family it is a dramatic marker because it changes the dynamics, as well as the routines and traditions of the family.

I wonder how it is for people who don't have children to mark their places in time, to grab their attention away from the mundane. Do couples go from weekend to weekend, eating at restaurants, buying a new car, painting the kitchen? To say, years later, um, yeah I think that was in 2001, remember, dear, we put new carpet down. Instead of saying, 2001, remember, that was the year we took state in football, remember how the weather was so crappy we always took huge sheets of plastic to cover up with? Remember how they had to keep sweeping the snow off the field?

There were years in there, where the kids were growing, and we weren't all that happy about the direction our lives were going, and it seemed that time passed slowly and without events of note. No plans, no long term goals, just go to work, get a check, pay the bills, hope there's enough left for groceries - for four starving boys.

We built this house with our sons in 1995, and right now I'm looking at two gorgeous maple trees, I'd guess thirty feet tall, that we planted soon after we moved in. I wanted to be sure that there were young trees growing up around the house to take the place of the older ones, when they die. They may have a long time left, but when they do, we won't be left with a treeless lawn. Our neighbors, who moved a few years after us, haven't planted any young native trees, and they've lost many trees due to careless construction. The nature of their yard has changed from a woodland, to an open lot with a few trees and ornamentals. Each year goes by and I wonder why they aren't doing something to maintain the population of the native forest trees. Procrastination.

Time still passes, no matter how we ignore it. On Monday of this week Greg mowed the grass around the house so the leaves would be easier to get up; today the leaves are almost all on the ground. And I've not walked in the woods for weeks.

I like to think of my time as open ended, though it takes conscious thought sometimes. I catch myself thinking of the future in terms of "this will probably be our last trip to Maine," or "I probably won't see the fall leaves again." But what I want to think is about all these trees we have planted, this year lots of nut trees, and a few years ago a small orchard. Two years ago when I found out I was metastatic, I asked for a ginkgo and the boys got a big one. They are extremely long lived and hardy. I don't want to get into the trap of not planting and building for the future because I won't be here for them, but to remember that others will. We have to live on the earth as though it has a future beyond ours, and our stewardship is meant to benefit the generations yet to come.






The best cream of broccoli soup.

You'll need

A big bunch of fresh broccoli
an onion, rough chopped
A clove of garlic, rough chopped
about a quart of Half and Half, fat free, regular, or a combination

In a three quart pot, put a couple of inches or water on to boil. Throw in the chopped onion, and the garlic. Chop the dried up ends of the stalks off and throw them away, then cut the rest of the stalk into chunks (half inch to an inch) and throw them into the pot with the onions. Put the lid on and turn down to a fast simmer, for about ten - twelve minutes. Next chop the tops or just divide the stalks, and thrown them in. Add salt and pepper. Let this cook until it's well done, about ten minutes.

Now scoop out the veggies into a bowl. This is a good time to boil off some of the water left in the pot if you think you have too much. About an inch should be right. Puree the veggies in a blender or food processor in batches, adding some of the liquid from the pot, then put them back into the pot. Add the half and half to the consistency you like. Check for salt and pepper, heat it up, and serve. It's good with a little fresh parmesan on top, but not necessary. This is great diet food if you use all fat free half and half, because it's tasty and quite filling.

Friday, October 16, 2009

Laughter

Last night we babysat for Nathan & Katie's three kids. It felt normal, and good, though I was exhausted at the end of the evening. Sidney was born in early June, just as my cancer had decided to blossom in several locations, and over the summer I had a lot of treatment, brain radiation, bone metastasis pain, angioplasty, lung fluid drained, just seemed like everything hit me at once like a ton of bricks and I was overwhelmed. My back pain is bad enough that I couldn't hold Sidney, then I lost my right lung when it didn't re-inflate after surgery. I'm a mess, really. But last night the kids got dropped off while their parents went out to eat and we had fun.

Sidney was actually awake for quite a while and I talked to her and gave her a bottle and she had a poop explosion out the back of her diaper so I got to change all her clothes, too. I'm almost embarrassed to say what a feeling of accomplishment I had that I could do this all by myself, that's how weak I've been.

Grayson is not quite two, but he's a sweetheart rough-houser. And he loves his Pa-pa (Greg) like you wouldn't believe. He and Greg built a fire in the woodstove, and Grayson kept going down in the sunroom to check on it. He loves his racecars, and over the years of garage sales I've got a collection of matchbox cars that he heads straight for. Nathan is Papa (say poppa) and Greg (grandpa) is PaPa, with equal stress on both syllables. But to keep the sound different, Grayson tucks his chin down and lowers his voice to say PaPa.

Annabelle is three, four in February. She's a woman in charge, make no mistake! She insisted on having a bath before getting her pajamas on, and of course Grayson wanted to get in, too. So I settled on the toilet seat with a glass of Gentleman Jack and they had a blast making tea, drinking coffee, making potions, giving shots, squirting each other. When they started taking turns pouring water over each other's head and giggling, Greg had to come and see what was going on. We all had a good belly laugh and it felt so good. It was a grand time until Grayson pooped in the water and we had to re-lather them and switch to the shower. Greg held the hand shower down low for them and Grayson just squirmed and writhed in ecstasy.

I've been down in the dumps, I admit it, even though I'm quite a jokester it's hard to laugh through discomfort. The month of clouds and rain we've had doesn't help, either. Those kids were a good dose of medicine. Laughter increases endorphins, which are a mood enhancer and pain reliever. There's laughter therapy that you can pay for, where you force a belly laugh without the involvement of humor. Look it up on YouTube, there's a yogi that'll show you how it's done. Somehow, I just can't get into that, even though "they say" that the physical benefits are the same as for real laughter. My kids are worried about me, and it's turning them serious when they're around. I don't know how to take my kids being serious. Enough of this! Time to laugh!



HOW TO COOK A CHICKEN

One of the handiest things to have as a base ingredient is a boiled chicken, and the broth from the pot. Everybody needs to know how to do this, because it's simple, and as long as you plan for the steps, it's easy.

Whole chickens are cheap by the pound. So buy yourself a fryer, and reach in and pull out the paper wrapped giblets. Open it up and take out the neck and gizzard for the pot, (not the liver) or if you don't want to mess with it, I'll forgive you if you throw it away. But you know I would never do that, even if I just fried it all up for the dog.

You'll need a big, deep, pot, and if you don't have one yet, you need to get one. I have an eight quart pot with an insert that I use for pasta and for things like boiling a chicken, because I can lift out all the goodness and leave the liquid in the pot without needing to strain it. If you don't have an insert just use a big pot, but think about getting one because you're going to be boiling a lot of chickens and it's really a timesaver.

Into the pot, add about three inches of water, a quartered onion or two, a couple stalks of celery cut into big chunks, and a couple of carrots, also in big chunks. If you have herbs in the garden, good ones are thyme, rosemary (not too much), sage, and parsley. Oh, parsley, sage, rosemary, and thyme, Simon and Garfunkel must have been cooking a chicken! Put them in the pot with the chicken, whole, and about a tablespoon of salt and a big grind of pepper. Bring to a boil, turn down to low, and let it simmer on the lowest heat you can manage, with the lid on, for 45 minutes or so. Then, turn off the heat and let the chicken cool in the liquid for at least two hours.

You can see that this is a proposition that is great for a couple of days, even though the time involved is minimal.

When the broth is room temperature, you need to pull the chicken out, and the other solid stuff. This is where the insert comes in handy. Get a pie plate or something similar to put the chicken on. The veggies have given up their goodness, they go into the compost. The broth now needs to be chilled overnight or for several hours so it can be defatted. If you don't have room in the refrigerator for the pot, the best container is a plastic pitcher - probably a gallon size. Let it chill, the fat will solidify on top, and you just lift if off with a spoon. You'll probably need to strain the broth before you use it - use your own judgment. You can also freeze it. I use quart freezer bags, I stand them in a big measuring cup to fill them, and just put them carefully in the freezer. When they're frozen, use a magic marker to label with name and date.

Now, back to the day before, and the chicken. The chicken is on the pie plate, smelling heavenly. You'll need a bowl for bones and skin, and another for the meat. Just use your hands, it pulls right away from the bones and you can scrape all that good meat away from the ribs. Your dog will be at your feet. That's all there is to it! And what can you do next????

Chicken enchiladas
Chicken soup
Casseroles
Chicken salad
Sandwiches
Chicken and dumplings
Chicken and gravy over biscuits. Yum.
OK, I'll admit I don't know all the things you can do, because we almost always make enchiladas or chicken salad.

When I have fresh made chicken stock, I'll make risotto lots of times. This week I made chicken noodle soup with the chicken and the stock. It's been that sort of fall weather.

Wednesday, October 14, 2009

Water

Since we moved to this house we built in 1995, I have had a sort of obsession with draining the standing water. Finally last year, we bought a little red tractor with backhoe and front end loader, and got to work on it. Last year we dug a trench to take the water from the rain gutters to the pond that we built, and dug an overflow that carries it away to the river. It made a huge difference in the mosquito population this summer, and I'm really glad we did it, but wish we had bought that tractor years ago.

This summer I've been sick a lot of the time, but we have managed to dig across the front to collect the snow melt that makes such a longstanding mess in the wintertime. It still needs grading, but it will carry water. That was a big item on my "bucket list." I'm so looking forward to NOT having a pond in the front yard.

Coming to Cleveland to live in 1989 was a geographical shock for me, because I couldn't grasp the flatness of this little area just on the edge of the Great Plain. Seriously, on the East Side of Cleveland, it's hilly and stretches toward the eastern mountains. But you get on the Ohio Turnpike and drive twenty miles west and you won't see a hill for - I don't know how far, farther than I've been. And when it rains, the water just sits in puddles mostly, because the clay soil won't let it perk through and there's no downhill.

I always compare it with the terrain of the mountains of Grayson County, Virginia, where a part of my heart will always be. There was water everywhere, bubbling right out of the earth, clean and pure. And never standing still, or breeding mosquitoes. Water knew what to do there, tumble down the mountain over rocks, to settle in a rich bottom where it caught the silt that made the soil so deep in those bottomland fields.

When we built our house in the mountains we captured a spring that we piped over to a reservoir, then pumped up to the house for our water supply. We weren't lucky enough to have a spring up the hill behind the house, which would have enabled us to have gravity feed, depending on the pressure created as the water flowed downhill into the house.

Right beside the driveway coming up to the house was a little tiny spring that ran down and connected with the other stream from up the hill, that was the overflow from the house water supply. One fine summer day the boys and I (Tristan, Matthew, and Nathan) were playing in it, and decided to do some excavating. So we dug into the dirt crevice where the water was trickling from, all the way back until we found the rock with cracks the water flowed through. We cleaned out the dirt and made a stone basin. And then, I remembered we had a bit of a bag of concrete left over from something. So, we mixed it up in a bucket, and with our hands and kitchen spoons, we made a dam, and so, a little pond with a tiny waterfall. That was a good time! The boys were very young, maybe four, six, and eight, because Justin wasn't born yet.

I can only imagine the projects I might have done if I had had my Little Red Tractor back then! Oh, what digging I could have done! We did without so many material things, and I'm happy about the choices we made, but I sure wish we'd had a little (red, preferably) tractor.

Tuesday, October 13, 2009

What a couple of days! Gamma and Gramma

I had mentioned that I would be having Gamma Knife for another (third) brain metastasis on Monday. No big deal, screw the metal frame in my head, send me off for hig resolution MRI and CT scans, and then the team makes a treatment plan (programs the computer to carry out the treatment), then go lie on the table and let it do its thinkg while I listen to music. OK, so when they had been working on the treatment plan for two hours we got called back, where the neurosurgeon said they discovered "quite a lot of new disease"- four additional tumors that would be added to treatment today, plus several more shadows that we would take a look at in six weeks. He also said those dreaded words, "It may be time to consider whole brain radiation." That's what I have been putting off till it's absolutely necessary,but I thought I would have more time. Side effects are deep fatigues that lasts for many months, loss of hair permanently over all the scalp, loss of memory and cognitive deficits. Plus, it's done with that god-awful hard mesh mask that I wore for IMRT just two months ago when I had the pituitary tumor.

I'm on chemo now, and we'd have to stop chemo to do WBR, I believe. I can't imagine more fatigue piled on top of the chemo fatigue I'm suffering from now, but I hear that's what you get. And then there's the darned inconvenience of the whole think = getting to the Clinic every day, either getting a ride or parking two blocks away, or paying nine dollars for valet parkint for a fifteen finute treatment. Well, we've got some of the best minds in the world working on me, so while I will express my preferences and concerns, I'm not going to try to outguess them. We really do have world class care at the Cleveland Clinic. I have been considering hiring someone to help me keep up with the housecleaning, and maybe it's the right time to do that. Greg says he can do it, but I have his time prioritized pretty well with projects, not scrubbing toilets. Iknow how his time is best used.



But let's go back a day or two in time. Larisa was past her due date on Thursday, I believe, so every day we were waiting for a call. We knew it was a girl, their third, and the sixth granddaughter (two grandsons). By Sunday, the 11th, I was hoping they could hold out till Greg's birthday on the 12th, since I wasn't doing anything fun for him - just brain surgery. But, we got the news by text message that she went in to the hospital at around noon, then no updates until we got another text at 6:50. Her name is Brynne Rene (Named after me with an updated twist), and she was 7# 10 ounces. A gorgeous, sturdy girl that looks to be all muscle. Must be from going running with her mother so often. Welcome to the world, Brynne, and welcome to the family. You will have high expectations placed on you, because it is how we honor you. And you will be showered with love,

Monday, October 5, 2009

Full Moon

Finally we have clear skies, and a full moon. I had gone to bed, utterly exhausted, at about nine o'clock, too tired to go out for a look at the moon. From the bedroom window it was behind the big maple. Then, when it rose high enough, I woke with a start like someone had switched on the light, and as I lay motionless, I was wide awake.

We measure time by the moons, whether consciously, by watching the phases change, or unconsciously, by marking time in months on the calendar. But I always note the moon when the sky is clear, and in Cleveland, where it is so often overcast, I'll find myself lost in time sometimes for weeks when it's cloudy and overcast and I don't know what phase the moon is in.

I remember as a girl, always a light sleeper, waking up in the night and slipping outside in the moonlight. It's a magical world, the light is bright enough to do anything you want, there's nobody else out, and it's so quiet. I would go to bed early, as usual, and three or four hours later, wide awake. We lived in a small town and sometimes I'd go out walking. Never would I see another soul, except for the police cruiser once in a while, and it was easy enough to duck behind a tree to avoid being seen. I think the insomnia runs in the family, because I heard my Daddy get up in the night many times. Once when I was a teenager I went outside and he was there already, looking at the moon. We just stood there in the quiet for a little while, then both turned to go inside and back to bed.

Whenever it works out, I plan a beach vacation for the week when the moon is waxing gibbous. It's a delight to watch the moon grow into full as it rises a little earlier and a little rounder over the ocean every night. And when we lived in the mountains, we had a double sliding door on the east wall. I remember so clearly the shape of the horizon as the moon would rise behind it.

Soon, maybe even next month, when the full moon comes, there will be snow on the ground. Then, it really is almost a bright as daylight. That's when we have to make sure Molly is closed in the bedroom with us, because when the deer come and gather in the yard, she can see them through glass doors on three sides of the house, and like a good watchdog, she will let us know. Greg yells at her, but she's just doing her job. December, January, February, and March we will likely be snow covered, and as I think ahead to those full winter moons I wonder what they will bring - to the country, to the world, to my family, to me... Next March I may be wide awake on the night of the full moon, looking back to the fall, wondering why I did this or didn't do that. I hope I still am well enough to get up in the night and write about it.



Today we worked out on the ditch, and even though I had the easy part, sitting on the tractor or looking through the transit, I overdid it, and was too tired to make dinner. So bless Greg's heart, he pulled together a great Mexican burrito buffet - always a winner.

I had cooked a whole bunch of chicken thighs earlier in the week, so he started by cutting off the meat from several, and warming it in a pan. He cooked some jasmine rice while I was in the shower and when I came out the aroma filled the kitchen and I realized I hadn't eaten since my breakfast bagel. So, here's what he put out for make 'em yourself burritos.

Chicken
Grated cheese
Rice
Black beans
guacamole - we had the ripe avocado so he made it fresh
salsa
sour cream
lettuce from the garden (the late planting from August)
chopped red onions
flour tortillas
We often put out chopped black olives, sometimes tomatoes if they're in season.

What a good meal this makes out of leftover chicken and odds and ends. It's one of those desperation (don't want to cook, don't want takeout) meals for us, and it's great when there's a crowd of hungry Funk family around, too.

Saturday, October 3, 2009

Time for a cancer update

If you're interested in reading about the cancer, this is it. If not, pass it by, this is ALL CANCER INFO day.

I promised I would use this blog to update about the progress of the cancer and treatments, and which is currently winning. Here's what's new.
On Tuesday I had a brain MRI to follow up on the IMRT therapy that I had on the pituitary tumor in August. Seems like yesterday, but I think it was August. When I went in to see the rad onc we were talking about other symptoms in general as a lead up and I mentioned the superior vena cava syndrome that I had angioplasty for, in August, but had not had the radiation consult because the Dr. was on vacation. Dr. Suh seemed confused, as I was, why only angioplasty was done to clear scar tissue from the veins, when there is obviously pressure on it from enlarged mediastinal lymph nodes. He examined me quite thoroughly for SVC syndrome, noted my puffy face and eyes, as well as the proliferation of new veins across my right upper chest and arm. He asked if my shortness of breath had improved since the angioplasty treatment. Am I reading too much here to think that it should have? Dr. Google said it would.... I have scheduled a follow up with the vascular surgeon next week, and Dr. Suh wants me to call afterwards, and says he will also talk to Dr. Moore, my medical oncologist. Since I'm doing chemo, I don't know if focused radiation to the offending mediastinal nodes is still an option. I also wonder if it means that the chemo is not working, if the nodes are still swollen. I HATE feeling like I'm the go-between for all these specialists who don't really want to talk to one another. And each one wants to treat me with his own tools. Remember the saying "to a man with a hammer, every problem is a nail"? I wish they would all confer at the same time, preferably with me in the room! I know it's not going to happen, of course, and I guess this sort of tunnel vision is the price we pay for specialized medicine. It makes you wonder if it's always better.

Anyway, sort of casually at the end of that conversation, he said, " that spot we've been watching has grown so we need to get you scheduled for gamma knife." This is a tiny spot that showed up in May but too small to define, then had not changed in August, when the pituitary tumor was noted, so thought not to be cancer after all. Well, now it has grown, definitely a tumor. Still quite small, three mm or so, but needs to be zapped. After having the sequence of IMRT in August on brain tumor #2, I find myself being thankful that this one is in a location it can be treated by gamma knife. Sure it's a pain, and the metal frame screwed to the head not so cool, but it's done in one day. I'll take it. I am also immensely grateful that these are still appearing one at a time so whole brain radiation is not yet necessary.

Just to make this a full cancer update, the right lung does not show any signs that it might decide one day to reinflate. One of those odd occurrances, I guess. No one has seen this before, but my thinking is that it's because the diaphragm on the right was already dead and can't pull down to open the lung. The breathing I was doing on that side was totally with chest muscles, not diaphragm. I don't know enough about the anatomy but for some reason now that the pleura is attached to the lung, the chest muscles don't have any control. Had I known this would happen, I would have opted for a permanent pleurex catheter (chest tube) that could be drained when fluid built up. This is way worse than being filled with fluid.

Oh, yeah, I also saw a shrink that deals with oncology depression only. (Talk about a specialist) I had asked the dr. about an anti-depressant because the tears come too easily, and once the conversation turns to my cancer, they flow and I blubber. End of conversation. It's embarrassing, mostly - I'm not a pretty crier. And it only lasts for a minute. It's not like I'm clinically depressed, just sad to be dying of cancer and I cry about it in short bursts. So we went through a long question - answer series and she gave me an older drug, Celexa, to try. When I went online to ask Dr. Google, who referred me to Dr. Wiki, I found out that this drug was also use to reduce the pathological crying sometimes seen in stroke victims. I thought, yeah, sometimes that's what it feels like. But then I saw the common name given to that syndrome and nearly peed my pants - "emotional incontinence." Yeah, that about sums it up.