Thursday, December 31, 2009

Health update ....

I am grateful to at least have some clarity around one of my health concerns. I met with my surgeon yesterday afternoon to discuss the results of the pathology report from the removal of the lump in my breast. Her nurse had called me last week to let me know that "no invasive carcinoma was identified." My diagnosis was the same as what I had back in May when they removed the first lump - "atypical ductal hyperplasia" ... essentially cells that are pre-cancer and are showing signs of going haywire! My surgeon was a little more concerned this time, however, and wanted to confirm with the pathologist if we had now crossed over the line to cancer with atypia/pre cancer cells showing up twice in the same site. Essentially I am again in that very gray area ...she said some pathologists may say it's cancer, however, she trusts these pathologists and according to them there wasn't sufficient evidence yet. Their report reads "the changes are quantitatively insufficient for but borderline on low grade ductal carcinoma in situ..." This go around, I also have two versus one site where atypical cells have been found. The options given were the same as what I was given back in May: 1) close surveillance, 2) hormone therapy/tamoxifen or 3) double mastectomy. The risks associated with option 2 (with not great odds of a positive benefit) are too great so option 2 is not even an option. My surgeon understands that and supports it. At this point, I have chosen to remain on option 1 - "close surveillance". In addition I will be seeing an oncologist for a second opinion and to discuss alternative options. I will also be seeing a holistic doctor (in addition to my acupuncturist).

My partner asked my surgeon if atypical cells always form lumps and if that's why I had another lump ... she said no. Unfortunately she said there is no way to know where these atypical cells are and they can be seen only at a microscopic level. I have truly been blessed to have had these lumps appear and to notice them because most often atypical cells go unnoticed until it's too late and they cross that frightening line over to cancer. I know the truth is that i'm in that very gray area ... an area where my surgeon says some may consider it low grade DCIS. I guess i'm not ready to choose option 3 (double mastetcomy) unless I know for sure that I have cancer. I have, and I will continue, to do everything I can to take care of myself and create an internal environment (through acupuncture, meditation, nutrition, etc.) where cancer cells will not have an opportunity to grow or thrive. I will continue to be proactive about my health in pursuing alternative treatments.

My second health concern -- my digestive issues -- is not so clear cut. Yesterday I woke up with stomach pains. My body continues to not be able to digest fats. Most of the time I don't have pain but maybe 1-2 times a week they hit me and literally suck the life and energy out of me. My blood work for the pancreatic enzymes came back. Lipase levels dropped from 79 to 58 (the "normal" range being 0 - 59). Amylase levels were in the normal range but on the high end of the spectrum. I have an appt to see my gastroenterologist on Jan. 14th. On the phone he had indicated a possible next step would be an endoscopic ultrasound of the pancreas. Part of me says, I can live with these symptoms .... the other part of me knows better. I hear a voice inside of me, and I think it's my Papa talking to me, "Marilou, listen to your body ... don't ignore the signs. Don't wait till it's too late." Maybe if Papa had listened to the early symptoms he would still be alive? I made a chart of my weight loss. I didn't realize that I was still losing weight. Since August, 2008 I have lost 35 pounds. In the past 7 months I have lost 8 pounds. My acupuncturist tells me that 8 pounds is a lot ... that's 7% of my body weight.

Over the holidays, my partner and I took a picture of ourselves .... it's a great photo of us but I remember looking at my face and saying to my partner, "I have bags under my eyes. I look gaunt." My partner said to me, "you've had bags under your eyes for about 8 months now," and as if she could read my mind she said, "but you still look great!" In my mind, I was thinking I look sick. In my mind I was thinking, I look so tired. Truth is, I am fatigued a lot. I have come to adapt my life to what my body is physically capable of ... i guess that's not so bad as I'm listening to my body.

As 2009 comes to a close, I reflect on all that this year has brought to me. Yes, I have had health challenges .... but more than anything, I am grateful ... truly grateful for my life. I am ready for 2010 and whatever that may entail ... I have always found comfort in the 23rd Psalm and will continue to believe in God and in some higher power/being to watch over me:

The Lord is my Shepherd; I shall not want.
He maketh me to lie down in green pastures:
He leadeth me beside the still waters.
He restoreth my soul:
He leadeth me in the paths of righteousness for His name' sake.

Yea, though I walk through the valley of the shadow of death,
I will fear no evil: For thou art with me;
Thy rod and thy staff, they comfort me.
Thou preparest a table before me in the presence of mine enemies;
Thou annointest my head with oil; My cup runneth over.

Surely goodness and mercy shall follow me all the days of my life,
and I will dwell in the House of the Lord forever.

Friday, December 25, 2009

Merry Christmas

Last year on Christmas day my partner and I were in Marco island, enjoying the sounds of the waves crashing against the shore, hearing the seagulls singing, and watching pelicans dive for fish. My mornings began with a nice long run on the beach. This year we are staying home in St. Paul. This year I guess I won't catch the exuberant joy of little boys racing towards a flock of seagulls wearing a Santa hat. This year we will be homebound as we wait for the second round of snow to arrive ... 15 - 20 inches is what forecasters are saying. A white Christmas in St. Paul. Missy and Mister were out in the backyard loving the snow and tearing around playing chase. Ahnung stood on the sidelines, not so sure about all this snow. She had to live in it a little over a year ago and I think she's decided that she would much rather hang out in the warm house and on the couch -- well, can you blame her?? I have always said, she is the wise one :)

This year we stayed home for a couple reasons ... one being so I could take care of some health issues. I am recovering well from surgery. The nurse called on Wednesday to let me know the preliminary results of the pathology report. The great news is that there is no cancer. The not so good news is that, like the report back in May after my first surgery, there is evidence of atypical (pre-cancer) cells again. The nurse did not go into any details and told me that my surgeon would review the entire report in detail with me during my post-op visit (which will be this coming Wednesday). I am extremely grateful for that report. Like last time, I've been very fortunate that we have removed these lumps and pre-cancer cells at a very early stage. My acupuncturist always tells me that my squeaky clean, healthy living and listening to my body is enabling me to notice things so many others wouldn't notice. So next week I meet with my surgeon about my pathology report. I also hope to get results of the blood work done to check for pancreatic enzyme levels of lipase and amylase. Next week I will hopefully know if more procedures will need to be done to address my digestive issues.

I wish everyone a very Merry Christmas and a peaceful holiday season.

Monday, December 21, 2009

Faith ... returning home

After a long absence, and to be quite honest, a defiance for organized religion, I found myself with my partner at St. Joan of Arc's 5 pm mass on Saturday evening. The only time I have gone to mass in the past 5+ years was to accompany my mom when I was visiting her in the Philippines. Since early adulthood I have struggled with organized religion .... being sexually abused by a trusted family friend and a deacon of the Catholic church tainted my view of the Catholic church. It has been a life long struggle to make sense of what happened to me as a young girl. Yet something inside of me has been calling me to return to church, return to a faith I hold so deep in my heart. For decades my connection to some higher being (I've been afraid to call this higher being God) has been private. I have found comfort in the Buddhist practice of meditation and in the acceptance and celebration of all sentient beings. The truth is I do believe in God. The abuse that happened to me as a young girl has nothing to do with God but everything to do with human failings and shortcomings. For months something in my gut has been calling to me ... yes, I honor and value my quiet morning times and my meditation. Yet, something ... something inside of me has been calling me to find a community and a place where I can pray.

This past Saturday, my partner and I went to the 5 pm mass at St. Joan of Arc's in Minneapolis. I have gone to their Sunday services years ago and always enjoyed it. It was held in a gymnasium because of the large number of people and was a liberal, accepting church ... a church that always felt so alive and full of joy. This time, however, I wanted a more quiet and reflective mass. Saturday masses at St. Joan are in their chapel. As we walked in to the chapel the air was filled with the beautiful sounds of a woman's voice as she rehearsed a Christmas version of "Auld Lang Syne". As Fr. Jim began mass I felt chills run through my body. I wasn't coming to mass because I was "supposed to". I wasn't coming because my mom told me I had to. I wasn't coming because it was the "right thing to do." I was coming to church because I wanted to and because "my gut" (which I believe is God and the natural wisdom we all have inside of us if we take time to listen) was calling me to. Fr. Jim's homily was about "wonderment". For Advent, the theme has been Wonderment. He asked us to take time to reflect on a moment growing up when we felt pure wonderment. For him, it was his third birthday as he was standing next to his birthday cake attired in his new cowboy outfit and a smile that stretched from one end of the earth to the other. For me, I think back on the photo of Papa carrying me. He then went on to share how he recently spent time with a couple whom he has know for 12 years - a couple where he presided at their marriage 12 years ago. The woman now has some health issues and is most likely facing the last year of her life. As I deal with my own health issues I could feel the tears inside of me well up ... as tears start rolling down my cheeks i feel my partner's hand reach for my hand. No matter what lies ahead of me, no matter what my journey is, I am not alone. As Christmas carols are being sung and the chapel is filled with music, and as we hold hands to say The Lord's Prayer, I feel an incredible sense of community, of love and of healing.

As I prepare to head into surgery this afternoon to remove a lump in my breast, I place my trust in God for whatever journey I am meant to travel. Yesterday, December 20th was the 41st anniversary of when Papa died. Christmas has always been hard for me as it reminds me of a loss so deep. This year I will celebrate Christmas ... for me, I will celebrate the birth of Jesus Christ and Papa's life. For me, I will also honor all sentient beings and all religions and faiths ... for me, as St. Joan of Arc's motto is "We welcome you wherever you are in your journey."

Wednesday, December 16, 2009

It's okay to be scared

I'm up bright and early this morning. I was exhausted last night and went to bed at 8 pm. Fatigue often gets the better of me, or so it seems .... it's been that way for many months now. Yesterday my gastroenterologist called with the results of blood work and labs taken. It's always nerve wracking when your doctor calls you and he (or she) isn't returning your call. You know it's not good news. He tells me my lipase levels are elevated (lipase is an enzyme that the pancreas produces). He says it's moderately elevated. He wants me to proceed with the small intestine x-ray (which is scheduled this morning) after which he will want blood work done and a test done specifically for lipase and amylase. He doesn't think i have pancreatitis as I don't have the severe abdominal pain. After he sees where my lipase and amylase levels are, and if nothing shows up on the small intestine x-ray, he indicated that the next step would most likely be an endoscopic ultrasound of the pancreas. He also is going to take a look at the PET/CT scan that was done back in July. It appears we are heading down the path of screening for pancreatic cancer. Yes, it's scary. I know something is wrong and my body is screaming "pay attention!" As I prepare for my second lumpectomy of the year, I am aware that I will know soon whether the cells in my breast have progressed from pre-cancer to cancer. Somehow, I'm more prepared for that emotionally ... maybe because i've convinced myself that we will catch it in the very early stages even if it is cancer and it will be okay. The possibility of pancreatic cancer ... that's a whole another story. Even though my weight loss has slowed down, it still continues. In a year I have lost almost 35 pounds. My body continues to not be able to digest fats. There is so much I want to do. I have immersed myself in the animal welfare community with dreams and hopes that give me the energy I need .... yet, there are moments when my body feels weak and tired, and I know I must slow down, take a deep breath, and be okay with simply resting and taking care of myself.

Yesterday, I broke down and cried in the arms of my partner. I've been trying so hard not to feel the emotions. Finally, I admitted I am scared. I am truly scared and I am tired of feeling fatigued. I am tired of not feeling 100%. I admitted I have been coasting along doing everything I can to not feel the pain and the fear ... instinctively, i've kicked into survival mode. Shortly after I broke down, I got the call from my doctor about the abnormal lipase levels. As difficult as it was, it was also a relief. After coasting along it was time to land and root myself on our beautiful earth and to accept my feelings ... all of them. There's a road ahead of us as I work with my doctors to find some answers ... but i'm not alone.

I am grateful for my partner who has been standing by my side through all of this. I am grateful that feelings and emotions don't scare her. I am grateful that no matter what, I know that I will have her walking with me on this journey ... and I know that right by her will be our dogs Ahnung, Missy and Mister and our kitty Henry :) I also know that from up above Papa is watching over me. I also turn my worries and my fear over to God as I pray this morning for the strength and the courage to handle whatever journey I must make.

And when I need to smile or need a big bear hug ... I also know I can always count on my girl Ahnung :) She's got lumps on her ear that we are also trying to figure out what's causing it ... we'll walk this journey together, all of us together, no matter what!

Monday, December 14, 2009

The heart breaking side of animal rescue

My friend Laura just returned from a trip up north from Red Lake Rosie's Rescue. She shares on her blog the harsh realities of the bitter winters and how a puppy in the middle of the night strayed away from his litter mates, and almost freezes to death - his still frozen body found at dawn.

It's been a year since my last trip to Red Lake Rosie's. Memories come flooding back of last winter when I first met Ahnung. My first trip was in October with Laura. I returned in November to bring Ahnung back to the cities. By then winter had already arrived with frigid temperatures. The Red Lake Rosie's shelter was overflowing and Ahnung had been moved from a kennel she had in October with her puppies to an igloo and hanging out with the big dog clan. Ahnung and I took a trip to Red Lake Rosie's last December to spend a week up north with Karen and to help her with chores. On my trip last December a blizzard hit, and we got over a foot of snow. Surrenders of dogs and cats continue, chores continue, fighting to keep the dogs and puppies warm continue ... Laura accurately describes what a trip up north in the middle of the harsh winters is like ...

"Winter has come to Red Lake Rosie's. And it has arrived with a vengeance. Temperatures fell to 13 below zero. Chores are done mostly in the dark wearing so many layers it is hard to even move. Water freezes in the dog pails in no time. Short haired dogs shiver to keep their body temps up. They walk on three legs because the snow stings their paws. Calls come in daily telling of more dear ones left at the dump, thrown away like last night's pizza boxes. Kennels are full to overflowing with dogs and puppies fighting to stay alive through the frigid night.

One pup, Clarence, almost did not make it. He strayed away from his littermates during the night and old man winter grabbed him. His still cold body was found at dawn and was rushed to the warmth of the cat house where he was given warm water to get his blood circulating again. Somehow that little guy fought back with all he had left and is now on a slow recovery back to health. That was my first eye opening glimpse into what winter is like on the rez. And it broke my heart. My tears frozen to my cheek. But there is no time for sorrow or pity. Emotions are pushed aside because there is so much work to be done in order to save the rest
." [For her full blog posting visit Rescue Buddy Boarding].

Last December I experienced the brutal winter along with Ahnung. Last December, Ahnung was one of the lucky few who no longer had to sleep outside in the frigid cold, huddled up in an igloo next to a fellow homeless dog. We helped Karen with chores during the day ... we were lucky because when we got cold we had a place to warm up and find refuge. At night, we slept in the warmth of the cat house, curled up under blankets. Meanwhile, many others shivered through the night in their outdoor kennels despite all of Karen's efforts to protect them from the unforgiving cold and wind with tarps and blankets. One night while we were there we heard noise outside in the shelter ... Karen couldn't sleep because she was worried about the puppies. At 2 in the morning, windchills in minus 30s, she was transferring one puppy after another to a small kennel where they could huddle up and have more protection from the frigid cold.

Tugged by my heart to do something immediately, I am asking myself to slow down and think --- be strategic, be purposeful and figure out what's the most effective way we can help Karen at Red Lake Rosie's Rescue. I have the utmost respect for Karen and the work she does. I will also be forever grateful for all the animals she has rescued and especially for Ahnung.

Laura in her blog posting is right .... while I sit here in front of my laptop, my pups (Ahnung, Missy and Mister) by my side on their dog beds ... we are warm. Ahnung can sleep soundly without her body jerking her awake from shivering uncontrollably. For a woman who has dedicated her life to eliminating the suffering of animals, it's now our turn, as a community to come together to help Karen continue the absolutely incredible work she is doing.

We will do just that. Somehow. Some way.

Sunday, December 6, 2009

Life Lessons from our four legged friends

Today, I find myself grateful for our three big black dogs: Ahnung, Missy and Mister.

All three dogs have their own special gifts, personalities and quirks that yes, can drive us crazy!

Ahnung is the wise one with the gift of healing.

Missy is the attention-giver and reminds me to slow down so I can give her belly rubs and she can give me kisses.

Mister .... oh, Mister reminds me to laugh and to not take life too seriously!! :)

Listen to your gut -- to your inner voice and the wisdom inside of you.

Slow down. Take time to notice and pay attention to the beauty that is around you every moment.

Laugh. Play. And when things don't work out the way you hope it would, just shrug it off, or, as Mister would say, "Mom, let's go for a run!"

Thank you Ahnung, Missy and Mister ..... for the daily reminders.

Thursday, December 3, 2009

Cancer reflections

Cancer is a word that brings lot of emotions with it .... it has been called the "silent killer" and touches the lives of millions of people in one way or another. The origin of the word cancer is credited to the Greek physician Hippocrates (460-370 B.C.), considered the "Father of Medicine." Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors. He noticed that blood vessels around a malignant tumor looked like the claws of crab. The Roman physician, Celsus (28-50 B.C.), later translated the Greek term into cancer, the Latin word for crab. When I think of crabs, I think of crabs being able move and flow with the natural cadence of the moon, water, and land. A crab is protected by a rigid carapace, but to grow she must risk molting her armor, becoming soft and vulnerable. In so many levels, the crab is speaking to me.

[Photo of crab from Flickr]

In May of this year I had surgery to remove a lump in my breast. About a year ago, out of nowhere, I had a dream that I had cancer in my left breast. I woke up the next morning wondering why I had that dream. I was feeling healthy and strong. In many ways, my dreams are my guides..... not one to do self-exams, my dream prompted me to begin. I noticed a small bead-like lump which led me to my primary doctor and eventually to my surgeon (the same surgeon who removed half my thyroid many years ago). Both doctors did not have any concerns about the bead-like lump -- "fatty tissue." My surgeon, however, discovered another area that was of concern to her, an "area of asymmetric thickening." One, to be honest, I would never have even noticed. It still amazes me how she was able to notice it, but i guess that's why she's the M.D. and the surgeon! She said to monitor it closely and to check back with her in 6 weeks. I got busy and it was six months later and the passing of my dear friend Elaine to breast cancer (Elaine, i still miss you dearly), that prompted me to check ... by then the lump was very noticeable. I returned to my surgeon who immediately scheduled me for surgery. A 3.5 x 2.9 x 1.2 cm lump was removed. Upon returning to see my surgeon to discuss the results of the pathology report I learn that I officially have "atypical ductal hyperplasia" -- essentially cells have started going haywire and beginning to act like cancer cells. Of concern to her was a note in the pathology report "the changes are insufficient quantitatively to diagnose ductal carcinoma in-situ" ... to be honest, i'm not exactly sure what all that means. What I got out of my meeting was that although my official diagnose was atypical ductal hyperplasia that the pathologists weren't willing to completely rule out cancer. I chose the path of "close surveillance" versus hormone therapy or a double mastectomy.

Now six months later I prepare for my second lumpectomy of the year. The date has been set for the 21st. A new lump has grown in the same area. This mass appears to have grown with even more of a vengeance. Based on the results of the pathology report and what they find I realize that new decisions may have to be made. Trying to catch the cancer early is critical to a positive prognosis. The fortuitous dream I had a year ago about having cancer in my left breast led me down a path to hopefully catch the cancer early. I have always believed my Papa is watching me and protecting me from up in heaven. I think he sent me a message a year ago through my dreams. Thank you Papa for watching over me.

This time last year my partner and I were also preparing for our trip down to Marco Island for a week of warm weather ... this year we will remain in Minnesota. I still remember what an incredible time we had last year .... on Christmas morning while walking on the beach we saw several people wearing Santa hats ... this young boy was ecstatic and every time i look at the photo I took last year I savor the joy that this young boy has for the moment.

I wish I could walk along the beach this winter. I wish I could listen to waves rushing up onto the shorelines. I wish I could hear the seagulls and watch the pelicans dive for food in the ocean. I wish I could toss shells back into the ocean.

This year we won't make it to Marco Island ... at least not physically. This year, my partner and I will journey there in our mind and in our heart. Next year, God-willing, I will be strong again physically with more clarity around health issues. My surgery will be in a few weeks ... every morning when I meditate I ask for the strength and the courage to handle whatever comes my way. I never ask for a certain outcome. So as my second surgery of the year approaches, and I wait for the results of the pathology report ... I pray for the strength and courage to handle whatever comes my way. I pray to be more like a crab ... flowing with nature's cadence and shedding my armor.