"Other Findings"

Yesterday I had my followup appointment with my surgeon. It's been two weeks since my surgical biopsy. I was told the mass removed was not malignant ... however, there were "other findings" my doctor wanted to discuss with me. I get a crash course on how normal cells progress to cancer cells. Normal cells are uniform. Some of these uniform cells start to multiply (hyperplasia) --> cells begin to lose uniformity and take on different shapes and sizes as well as multiply and form along the lining of the duct (ayptical hyperplasia) --> they continue to multiply/progress but remain with the membrane (ductal carcinoma in situ ... this is considered cancer) --> abnormal/cancer cells break through the membrane (invasive cancer).

Yesterday I learned my cells had progressed to atypical hyperplasia. And of the grade of atypical hyperplasia it was the most severe. Essentially, I am in that very gray area. Not quite cancer but I guess bordering it. Atypical hyperplasia is considered a precancerous condition - not cancer, but a forerunner to cancer. My doctor read something on the pathology report to me (of course, it was like speaking another language to me!) ... it was concerning to her especially on top of the fact I was already high risk. The pathologists found atypical cells in one duct but was not convinced it was localized to one duct based on the way my cells appeared. I believe that's the gray area i'm in ...

So the options given to me were: a) "surveillance" -- essentially closely monitor and come back in 6 months for an MRI. At that point I would probably have additional tests and probably an additional biopsy. She said "if we're lucky, you're MRI comes out squeaky clean. I would plan for more tests though," b) hormone/drug treatment - take tamoxifen for 5 years. Side effects include blood clots, other types of cancer, plus many other non-desirable effects, c) double mastectomy!


With a smile on my face, I tell my doctor, "I'm not so sure i'm liking all my options. Don't you have something somewhere between option A and option B??" Given my choices, I pick "surveillance." She assures me that the rate of growth is slow and that 6 months is a safe time period. She tells me that the results of the MRI will tell them so much more.

My doctor tells me "You've known you were high risk for breast cancer with my mom having had both breast and colon cancer. These results confirm you are high risk." She also tells me that ayptical hyperplasia does not always progress to cancer. She also tells me if it does progress to cancer and we catch it early the prognosis is very good.

Over the course of the afternoon I realize I have a choice on how to approach the next 6 months. My doctor will contact me in 5 months to schedule the MRI. Until then, I will do everything I can to take care of myself. I can choose not to let this consume me with worry. There's something scary about knowing that there are cells inside of me that have started going haywire. The knee jerk reaction is to fight and resist all that I have no control over. The buddhist teachings I have come to embrace, tell me to welcome and accept all parts of myself, even the cells breaking out of the norm. They are doing it for a reason. This is my "wake up call" ... it's time for me to notice, slow down, pause and listen.

Homeless man and his dog

I have seen this photo of this homeless man and his dog floating around the internet. This photo was taken by Kristen Bole and has touched the hearts of so many. She has captured in an image what touched me in a very deep way a few years ago. It prompted me to write my first essay, three summers ago, about a homeless man and his black dog as I was sitting at a Starbucks on Nicollet Avenue in downtown Minneapolis - an essay I have been asked to consider trying to get published. Maybe some day i'll be brave enough to try submitting it for publication.

I'm in San Francisco this weekend for work. Last night after getting a quick run in I decided to walk a couple blocks to Westfield Center on Market Street to grab some dinner - the food court there, I discovered earlier in the day, was filled with lots of ethnic and healthy, organic meal options. A few yards away from the corner of Market Street and 4th leaning against the wall for the entrance to the BART train station, was a young man who looked like the man in this photo. He was wearing an army green jacket, probably in his late twenties, dirty brown hair down to his shoulders, and facial hair. Next to him, sitting on top of a ragged black suitcase sat his dog, a tan and white pitbull wearing an army green dog sweater. The man's head was down. I could feel his exhaustion. He was holding a cardboard sign that read "Hungry and broke. Please help." His dog sat patiently and loyally by his side. No leash. The only leash connecting the two was one of companionship and friendship.

I kept walking past them yet the image of the young man and his pit bull would not leave my heart. After getting Vietnamese takeout at Westfield center I took the same route back to the hotel in hopes I would see them again. It was a chilly evening in San Francisco with temperatures in the low 50s. Market street was hustling with people - locals and tourists. Music filled the air. People were celebrating and exploring yet all I could do was think and fixate about this homeless man and his loyal pitbull. I approached him and handed him some change .. a $5 bill (I now wish I had given him more). As I gave him the $5 bill he said "God bless you". I acknowledged him with a nod and as I did, his dog came up to me as if to say "hi and thank you." "Beautiful dog", I said, as I petted the gentle pit bull who gave me a kiss on my hand. The young man nodded back in acknowledgement. No doubt, he was proud of his companion.

I received a gift last night from this homeless man and his dog. Oftentimes, the greatest gifts we receive are from strangers.

There is a non-profit organization, Feeding Pets of the Homeless based out of Carson City, Nevada. Their mission is "Through Feeding Pets of the Homeless, we will do our part to help reduce hunger in pets that belong to the homeless and the less fortunate and provide medical care for those pets in communities across the country. We believe in the healing power of companion pets and of the human/animal bond which is very important to life."

I couldn't agree more. I also know, there is more for me to do.

Beauty and grace in the simple things ...

It's easy for me to lose my way. I've been through what feels like a roller coaster regarding my health. I still don't feel like I have complete closure. I at least know it's nothing critical (or at least I hope so) since my doctor has said she will discuss the "other findings" at our follow up appointment. I see her on Wednesday. It will be good to know what the "other findings" are.

This morning as I sat quietly in my hotel room here in San Francisco I thought of Ahnung and how she was, and still is, my north star. I traveled a lot as a kid. I travel a fair amount now in my job. My passion is the animal rescue work I do -- but that is all volunteer work. My paying job takes me around the country visiting professors and students at universities, giving presentations, teaching workshops and attending conferences and tradeshows. There have been times where I have woken up not knowing what state (mentally or physically) where I am at. There have been times I have gone out to the parking lot and not remembered what kind of rental car I had. This weekend I'm in a city by the bay -- yes, a beautiful city and even though i'm here for work I feel I should be celebrating. Yet I would rather be home in St. Paul with my partner, Ahnung, Missy, Mister and Henry. I would rather be home enjoying our brand new sod in the back yard, helping plant and catching a game of scrabble and drinking iced tea with my partner.

Ahnung ... my north star, reminds me of the beauty and grace in the simple things. For me, they are at home.

Gratitude ...

I have many reasons to be grateful this morning. Most importantly, the results of the pathology report from my biopsy this past Tuesday have come back with no malignancy found on the mass they removed. I haven't spoken directly with my surgeon yet -- just her assistant who didn't want me to go into the weekend worrying! There are "other findings" my doctor wants to discuss with me. I got the sense of "don't worry, but we have to monitor you closely." My guess (speculation on my part till i have the discussion with my doctor which will hopefully be on Monday) is that is has to do with additional tests they ran to see if I had pre-cancer cells. Even if that has come back with a "yes", i'm okay with it. For now ... i'm in the clear and for that I am beyond grateful.

I am reminded this morning of how much I have learned from the animals who have touched my life through the animal rescue work I am doing. Porter (pictured here) was one of many dogs who came into Pet Haven's foster program. He waits patiently, with hope, for the treat he anticipates will come if he sits quietly. Moments later, hope transforms to gratitude.

Dogs live in the present moment. Dogs love, live and play. Every day I am blessed to know that the work we are doing at Pet Haven, and now with the newly formed animal welfare coalition, Minnesota Partnership for Animal Welfare (MnPAW) is not only helping companion animals -- more importantly, are the lessons I am learning. To be honest, one of my fears surrounding the prognosis and outcome of my surgery was that I would be told I had cancer and i would have limited time. In my head I kept saying, "but i've got too much work left to do. We've just gotten the coalition (MnPAW) up and running and have so much more work to do, we've got to ... and so on, and so on!" As the lights went out in the operating room, I surrendered to whatever outcome was meant to be. I think of our dogs ... of Ahnung, Missy and Mister. They don't worry about tomorrow. They simply are. On days when inner peace seems out of reach, I simply stop and notice Ahnung (who is the most peaceful of the lot!) ... most often I catch her sleeping - often she's snoring. Who would've thought that the steady rhythm of her snores would bring me comfort.

Today, even though I know there are no guarantees of how much time we have left, I am grateful for the outcome of the tests. My partner took me to the India Arie concert the night after my surgery. What an incredible, beautiful and spiritual experience that was ... and as she sang "God is real .... earth, air, water, fire -- that's how I know God is real" ... i knew at the moment there was no question in my mind how real God is to me. In surrendering I find peace. I feel the presence of a being much greater than me in all the simple yet magnificent, miraculous occurrences that take place all around me.

This morning, I am off to a Pet Haven dog adoption event to take photos of dogs in our foster program. This simple task reminds me of the presence of God and a responsibility I have to live my life guided by love, compassion, truth, understanding and forgiveness.

A new day ...

My memories of yesterday are somewhat foggy ... after my surgery my partner says I was pretty "loopy" :) Then again, I was probably loopy before the anesthetic swam through my veins and made me "feel good." What I do remember was a feeling of anticipation, some anxiety. What I do remember were those feelings being immersed in the comfort and love of my partner and the caring, positive energy of the nurses, doctors and staff at Fairview Ridges hospital in Burnsville. Small things make me smile. I remember this cool new gown they had me put on ... it had purple paws on it and a magical way of keeping me warm. I even got to keep the Bair Paws socks -- little did they know that deep purple is my favorite color, and combined with paws, it was enough to make me smile. My partner kept telling me to stop playing with my gown which would puff up every time I turned the heat up ... a blast of warm air would fill the gown. Simple joys. I remember how I would entertain myself as a 4 year old in the corner of my dad's hospital room. My dad died at the young age of 39, only 5 short months after my mom learned he was sick. My mom has had breast and colon cancer. My doctor has indicated I have all the factors that make me high risk for breast cancer. These thoughts have been in my mind as I have muddled through this period of uncertainty ... trying to find comfort. Yesterday, for some reason, I found comfort.

The nurses and doctors were friendly, personable and caring. My nurse Brenda even came back to my room to give my partner a heated blanket because she was cold. I was toasty warm in my Bair Paws gown. She wanted my partner to be comfortable too. The anesthesiologist walked in my room wearing a surgical gown ... with great energy and a smile, he introduced himself, "I'm Jim and i'll be your anesthesiologist who will be with you and Dr. Guttormson in surgery. Lisa will be assisting me." He cracked jokes and engaged in conversation with us. He helped make us both feel at ease. My partner looked away as he stuck me with a needle. "Uncooperative veins" is what I had and he apologized as he pulled the one needle out after an unsuccessful attempt. I had bubbles in my vein which sometimes make it difficult for the fluid to move through. For some reason I thought I would be conscious, just numb, for the surgery. He said I would be "sedated" and conscious enough to do my own breathing but assured me I would not remember anything. With a smile, he said, I will make you "feel good." I told him, poke me as many times as you need to so i'll feel good!

I remember being wheeled into surgery as Lisa, his assistant, whispered some comforting and assuring words. I remember bright lights and Lisa saying "this will help you relax" as she put something over my nose. Lights out. Next thing I remember I'm waking up in recovery to soft, calm voices. I vaguely remember my doctor/surgeon coming by ... I think it's music playing as she says the mass she removed looked "normal" and she would be surprised if it's cancer. We'll know for sure by Thursday or Friday. About eight years ago she took out half my thyroid, an overactive nodule. No cancer. Eight years later i'm doing great with just half my thyroid and continued trust and respect for my doctor.

I have slept a lot since yesterday. I arrived back home to beautiful flowers from my dear friend Dana of Chuck & Don's; and hours later to Bread & Chocolate cookies and a touching card from the Pet Haven board of directors and my friends at Pet Haven. I am blessed and I am more than grateful for my life today. I feel myself surrounded by love and support. I am hopeful the results of the pathology report will indicate no cancer. I am prepared this morning, however, for whatever is to come.

Funny isn't it ... how peace and serenity come from the simple act of surrendering and acceptance.

In search of peace

Tomorrow I go in for surgery to remove a mass that has been growing inside of me. In a few days I will know. I confess I am struggling right now ... part of my spirit is thrashing inside with all this uncertainty; the other part, struggling to find peace ... yes, to find the peace of wild things ...

The Peace of Wild Things
by Wendell Berry

When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children's lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.

Embracing Uncertainty ..

The passing of my dear friend Elaine awoke me on so many levels. 17 months ago her journey began as she innocently discovered a lump in her breast. 8 months ago I too discovered a lump. Shortly before that I had a dream that I had cancer in my left breast. Some crazy dream I thought. Or was it a premonition? Yet something told me to get it checked out. Tests all came back negative. The original lump I went in for was not the lump my surgeon was concerned about -- there was a different one. To be honest, I couldn't even tell it was there. Thank God for having a great doctor (she was my surgeon many years ago who removed half my thyroid). On my last visit with her almost 7 months ago she said ... "monitor the lump, and if it gets any larger in six weeks come back in and we should consider a biopsy." Six weeks turned into six months as my life got busy and I convinced myself there was nothing to worry about. The fast track came to a screeching halt the day I got word Elaine was back in the hospital. One week later she was gone. A reminder to me of how brief life is. A reminder to me to also check the lump I had conveniently blocked from my mind. Six months later the lump/mass I couldn't find has become prominent. Yesterday I met with my doctor. The option to wait and not do anything is no longer an option. There is obvious concern. It's amazing how quickly things happen when doctors say the word -- tomorrow I go in for a diagnostic mammogram/ultrasound with a possible biopsy. If nothing appears on the mammogram/ultrasound she wants to proceed with a surgical biopsy next week. Either way, by the end of next week I will know if the tumor is malignant or benign.

So what do I do with this period of uncertainty? What do I do with worry and fear that have come flooding into my heart and the heart of my partner? Last night was a sleepless night ... for me, for my partner. She was worrying about me; i was worrying about me; and i was worrying about her worrying about me :)

As I meditated this morning after journaling and looking out my window to our back yard, I realized I have a choice. Elaine had a choice. She chose to embrace life. I have a choice now, and as I journey through turbulent waters this next week, I choose to embrace uncertainty. I choose to be grateful for all I have today. I choose to welcome whatever comes.

I also choose to fill my heart and my spirit with positive, healing energy and thoughts. I also choose to share this process with you, and on my blog, because I believe we are all connected and there is something transforming and healing when one is a part of a loving community. I am blessed to be a part of such a loving community. In this week of uncertainty, I ask for your positive thoughts, and I ask for you to pause for a moment from the craziness of your own life, and to savor life in the moment, because YES! it is beautiful.

Namaste.

Celebrating life

Spring is here. Yesterday my partner and I attended the memorial service for our dear friend Elaine. Six months ago I sat in the pew of the Unitarian church in White Bear to honor and celebrate the marriage of Elaine to her partner, Susan. Yesterday we sat in the pew, only this time, to honor her life. Both days were perfect - the sun shining brightly and birds bursting in song as we enter the chapel. Stories and tears filled the spaces and music filled the air. Elaine was not only an incredible artist and painter, she was an incredible poet and writer. The minister shared her words throughout the service --- Elaine's writings from her last year. What was apparent was she celebrated life. She loved life. And despite the cancer that was ravaging her body, she told her loved ones that this past year has been "a good year."

Elaine was not afraid to love. She was not afraid to risk everything to live life fully. She embraced life and savored the many moments that so many of us miss because we are rushing through life. She wrote in her journal about the joy she felt from conversations with strangers, in the simple things, and when she wrote about nature, her words gave life ... a true poet with a gift of enticing you with her words to step into the page of her writing and experience the moment, wholly and with intention. To risk. To love. To live life and celebrate life.

Spring has arrived Elaine. We feel your presence. We always will. Your spirit will continue to live on forever in the hearts of so many you have touched. We love you.