Let go ... needing to trust and surrender

Today began with some great news from work ... profit sharing, merit increase and bonus distribution ... and my new work iPhone had arrived to replace my blackberry. I was off to a great start and was hoping it would continue in that vein. I was of course anxious to hear about the results of the MRI from yesterday. Now in some ways I wish I hadn't gotten the call. As I was driving into the office I got a call from the hospital. The nurse called to tell me that there were two lesions in my MRI that were of concern. I asked if they were in the same area as the lesion I had last summer. She said, "no, these are new lesions" and the radiologist wanted me to come in for an ultrasound as soon as I was able. She said my surgeon would be calling me to discuss more of the specifics.

So late this afternoon my surgeon calls. She tells me that she was very discouraged when she read and saw the report. I've been seeing this same surgeon for almost 10 years now and just love her. I've had 4 surgeries with her. The first was to remove half my thyroid back in 2001 and in the past year and a half i've had 3 separate lumpectomies where she removed lumps in my breast. She's walked this journey with me for 18+ months. This was the first time I noticed some real concern in her voice and in her tone. She tells me that there are actually more than 2 areas of concern. The area that was of concern last summer has resolved. That was also the same area where Mayo did an MRI-guided biopsy and the lesion turned out to be benign. Then in October I had a couple areas removed from my left breast where there was significant abnormality in every pathology slide. She removed a large chunk from what she calls the 12 o'clock position. It's the same area where she's removed lumps for my past 3 surgeries. The MRI from yesterday shows a 1.5 cm lesion in the 12 o'clock position which indicates to her that this is new growth from last October. This is a fairly large lesion. There is also a lesion she says in the 6 o'clock position on my left breast and now a new lesion in my right breast around the lymph node. She says, the results of my MRI are 'busy'. There's a lot of activity going on. She repeats again that she's very concerned.

I go in for an ultrasound early Thursday morning. If they're able to see the lesion/tumor with the ultrasound they will go ahead and biopsy the areas. In the past, ultrasounds have normally never revealed anything for me. Same goes for mammograms. I see my surgeon next Wednesday to go over in more detail the results of the MRI and to discuss options and next steps as I will have more test results by then. There's a part of me that just feels like i'm in a daze. One moment I feel strong and positive and feel like I can handle whatever is thrown my way. Other times I simply just want to break down and cry. I am tired of these health issues. In the end I know I will be okay, no matter what. I have enjoyed the time i've had of feeling good and feeling healthy. If the ultrasound isn't able to detect the lesions i'm back to the gray area i've been in for such a long time .. on the other hand the ultrasound and possible biopsy could reveal a definitive case of cancer, and if it is what kind is it and what stage?

So at this moment I find myself praying for courage and for the strength to simply trust, surrender and let go. I'm heading out of town on Friday to attend a workshop "Transforming your Life" in Virginia. How timely for me to be going to this workshop. My hope is that I will be in a safe place to do some deep healing ... and while doing so I will be surrounded by a loving community where it will be safe to cry and to feel and to create space for whatever emotions surface without passing judgment.

When I get scared I always imagine myself being carried and protected by my Papa. I return to the photo of him carrying me when I was a little girl, and not long before he died. I imagine him holding me when I'm scared and I imagine him whispering to me, "it will be okay. I am right here with you." And I know he sent me angels ... when I hold onto Ahnung I can feel his energy and presence so strongly. She is truly my north star and I will hold on tightly to her as I step into what will be weeks of uncertainty around my health.

Surrendering .. letting go

There have been many moments over the past week or so where I have felt like I had reached the end of my rope .... clinging on so tightly it was like I could no longer hang on. Then this image of one set of footprints in the sand came into my heart. I needed to surrender ... to let go ... and to fall into the arms and the love of God and of my family and friends and my furry 4-legged angels.

I've struggled with significant health issues over the past year and this past week received more bad news. I'm working on reframing "bad" to simply, more news ... not good and not bad. I am working on truly letting go and surrendering myself into the arms of God. Today, I feel moved to share the Footprints in the Sand poem:

****************

Last night I had a dream. I dreamed I was walking along the beach with the Lord. Across the sky flashed scenes from my life. For each scene, I noticed two sets of footprints in the sand: one belonged to me, the other to the Lord. 

After the last scene of my life flashed before me, I looked back at the footprints in the sand. I noticed that at many times along the path of my life, especially at the very lowest and saddest times, there was only one set of footprints.

This really troubled me, so I asked the Lord about it.  “Lord, you said once I decided to follow you, You’d walk with me all the way. But I noticed that during the saddest and most troublesome times of my life, there was only one set of footprints. I don’t understand why, when I needed You the most, You would leave me.”

The Lord replied, “My son, my precious child, I love you and I would never leave you. During your times of suffering, when you could see only one set of footprints, it was then that I carried you.”

Multiple Truths

Yesterday I spoke to my surgeon and got the results of the pathology report from my surgery on Monday. It took longer for me to get the results this go around than in 12/09 ... I come to learn from my surgeon it's because 5 pathologists reviewed by slides and there wasn't complete agreement. My surgeon tells me that 4 pathologists say that it is borderline DCIS/atypical ductal hyperplasia and one says it's definitely DCIS. Every slide she said showed abnormal cells and that I have every form/type of atypia with the exception of lobular. We discussed the report in-depth and also what the options were as far as next steps. Her opinion and also the opinion of the pathologists was that it's no longer okay to simply go with close surveillance.... so for me, as I reflect on what my options are and what western medicine tells me are my options, I realize my gut doesn't feel right about any of them, at least not at this moment. There is no doubt I have the best western medicine team of doctors and support ... I also have the best support from an alternative healing perspective, and believe there is even more I have not considered or explored ... I am also learning that I know my body and to trust my gut. A month ago, when my doctor was telling me I could wait a few months on this growing lump I felt in my breast and that it didn't feel concerning, I knew there was something going in my body and it needed to removed. I chose to listen to my gut and for that I am grateful.

My surgeon tells me that the atypical cells and cancer cells aren't forming lumps. They are spread throughout my breasts. My gut tells me there's something happening at a cellular level in my body ... some changes and transformation ... not just in my breast and in my pancreas but throughout my body. I don't know what it is and it's not good or bad ... I can just 'feel' something. For now, I know that I am not ready to make any major decisions and I need to sit with all of this and allow time and space for the wisdom of my body and my spirit to guide me.

There is this great story (and there are many versions out there) ... the following is the Jainism version of the story "Elephant and the Blind Men" ... a beautiful reminder to me that there are many Truths. I need to open my mind and my heart to the many possibilities and paths that are before me.

ELEPHANT AND THE BLIND MEN

Once upon a time, there lived six blind men in a village. One day the villagers told them, "Hey, there is an elephant in the village today."

They had no idea what an elephant is. They decided, "Even though we would not be able to see it, let us go and feel it anyway." All of them went where the elephant was. Everyone of them touched the elephant.

"Hey, the elephant is a pillar," said the first man who touched his leg.

"Oh, no! it is like a rope," said the second man who touched the tail.

"Oh, no! it is like a thick branch of a tree," said the third man who touched the trunk of the elephant.

"It is like a big hand fan" said the fourth man who touched the ear of the elephant.

"It is like a huge wall," said the fifth man who touched the belly of the elephant.

"It is like a solid pipe," Said the sixth man who touched the tusk of the elephant.

They began to argue about the elephant and everyone of them insisted that he was right. It looked like they were getting agitated. A wise man was passing by and he saw this. He stopped and asked them, "What is the matter?" They said, "We cannot agree to what the elephant is like." Each one of them told what he thought the elephant was like. The wise man calmly explained to them, "All of you are right. The reason every one of you is telling it differently because each one of you touched the different part of the elephant. So, actually the elephant has all those features what you all said."

"Oh!" everyone said. There was no more fight. They felt happy that they were all right.

Pray Health

Every night before I fall asleep I check the lump(s) in my breast. Maybe, just maybe, they have miraculously gone away like the mysterious lumps that appeared on Ahnung's ears earlier this year that there was no explanation for ... but every night now instead of it disappearing they seem to be screaming louder to me. They are getting larger and they feel like they are spreading. Or is it just my imagination, my fear? My appointment with my surgeon is on Wednesday morning. Seems like a long time away.

I am doing my best not to succumb to fear and to terror? I've had unexplainable growths/nodules in my body, like a huge nodule in one of thyroid lobes. Over ten years ago my surgeon removed a massive nodule that was causing my body to feel like it was in constant panic mode, with a resting heart rate that was so high I was put on heart medication to slow it down. They weren't able to perform a needle biopsy on my thyroid in fear that I would go into cardiac arrest so instead I went through surgery to have the entire growth removed. The pathology report came back "benign" but again, there was no explanation for what caused the growth. Today I am fortunate that the other half of my thyroid has kicked in to carry the load of my now missing left thyroid lobe ...

So is this growth in my breast the same thing? I woke up at 3 this morning and had trouble falling back to sleep. Something about these lumps feel different than the two lumps I had removed in 2009. And being analytical in nature, and learning from my previous jobs that "the past is predictive of the future" I find myself thinking ... the first lump removed had 1 site of atypical (pre-cancer) sells; the second lump removed had 2 sites of atypia and was now borderline cancer. And here I am less than a year later with another lump and this one feels like it has doubled in size over the past month and feels like it is spreading with what feels like a secondary growth shooting off the first area. So I worry. And my head spins around and around and around at 3 am in the morning.

I am working to return to some level of calm and peace. In the book "Secrets of the Lost Mode of Prayer" by Gregg Braden he shares the story of how there was an extreme drought in the high deserts of New Mexico and how his friend invited him to an ancient stone circle to "pray rain." He talks about the difference between praying for rain and praying rain. "He began by describing how the elders of his village had shared the secrets of prayer with him when he was a young boy. The key, he said, is that when we ask for something to happen, we give power to what we do not have. Prayers for healing empower the sickness. Prayers for rain empower the drought. Continuing to ask for these things only gives more power to the things that we would like to change.

So instead of praying for rain, in the case of the story Gregg shares ... his native friend says, "... I begin to have the feeling of what rain feels like. I felt the feeling of rain on my body, and what it feels like to stand with my naked feet in the mud of our village plaza because there has so much rain. I smelled the smells of rain on the earthen walls in our village, and felt what it feels like to walk through fields of corn chest high because there has been so much rain."

So this morning, instead of praying for health, I pray Health. I envision my body and all the miraculous cells in my body being vibrant, healthy and alive.

Stand Up 2 Cancer

I was traveling this week for work. I spent the week in Los Angeles. On Thursday a request came to my inbox for pet partner teams to visit the Riverside Clinic Cancer Center here in Minneapolis and spend time with cancer patients undergoing chemo treatment. I've been wanting for my dog Ahnung (a therapy dog) and I to do just that! If you set the intention out there it's amazing what happens. My dog and I were "called" to volunteer in hospice. Now something has been "calling" me to volunteer with cancer patients.

Then on my last night in Los Angeles as I kept hearing about the Stand Up 2 Cancer campaign I was gently nudged to check on the lump in my left breast. It's been a little over 3 weeks now since my MRI guided biopsy where I developed a hematoma that prevented the surgeon at Mayo to check on the lump in my breast. I was told it will be about 3 weeks for the swelling to go down after which I need to check on the lump and see if it has changed or grown. Thursday night I checked -- the swelling from the blood clot had gone done but much to my dismay the lump has grown. It almost feels like it's starting to have a life of it's own. I know I need to call my surgeon up and to let her know. I know that this probably means another surgery. I know this means more waiting. I had two surgeries in 2009 to remove two lumps. So called "blessings",  or as my doctors have said, I am lucky that lumps have formed around these atypical cells. I believe it's God telling me, "Pay Attention" ... "Notice" ... "Listen."

How do I practice staying in the moment when my mind wants to shoot forward, to race again and play out all the various scenarios? How do I find peace in the midst of the unknown? How do I not let fear consume me?

This coming Wednesday I also meet with my GI doctor. It's my 6 month follow-up to check on the status of my pancreas. The good thing is that i've been feeling great physically. The enzymes I've been taking have done wonders. No more weight loss, no more fatigue. Heck, I'm training for a half marathon! Will the comprehensive blood panel that he will request come back showing that everything is good? Two things my doctor has mentioned and why he wants to monitor me closely: diabetes and pancreatic cancer. He seems more concerned of the possibility of it leading to diabetes but did share with me that a possible cause, albeit less common cause, of pancreatic insufficiency is pancreatic cancer.

Next week ... actually 9/14 it will be exactly one year since my body started screaming loudly to me that there was a problem. I had just arrived in New York City for work and checked into my hotel. That evening I discovered my body no longer knew how to digest fats. It was the beginning of symptoms I could no longer ignore or disregard. Interestingly, 9/14 is also my father's birthday. My GI doctor struggled to find the cause of my symptoms. I had lost 35 pounds in a year and was experience debilitating fatigue. He called me an enigma ... then on January 3, 2010 my father appeared in my dream for the first time ever. In that dream he told me 3 things of which I only remember two of them: 1) that there was some bacteria that was growing and spreading through my body, and 2) that I had pancreatic cancer. I wasn't afraid in my dream. I remember feeling joy because my father had come to visit me. In late February, after a bunch more tests and procedures, my doctor finally diagnosed me with pancreatic insufficiency with unknown etiology. A portion of my pancreas had shut down and stopped producing the essential enzyme, lipase, which digests fats. It was worrisome and puzzling to him that they couldn't figure out why. He prescribed a pancreatic enzyme and it wasn't long before the fatigue started to lift, the weight loss stopped and my body could once again digest fats. From my perspective, I was simply grateful. I continue to be grateful that I no longer have debilitating fatigue. I am grateful that I am feeling healthy.

Cancer continues to afflict so many of us and so many of our loved ones. I am grateful for the Stand Up 2 Cancer campaign to create awareness and to generate funding for collaborative cancer research.

Today I dedicate my prayers to everyone who has been touched by cancer, which is probably all of us. May we find peace, strength and courage in whatever path our life's journey takes us.

The dolphins call

Yesterday I spent the day meeting with doctors ... my surgeon and then driving down to Mayo Clinic to meet with Dr. Ghosh of the Breast Center. I was so grateful to have my partner with me for the entire day and to be by my side as we met with my doctors. I brought with me a CD containing all the actual images from previous MRIs, mammograms and ultrasounds. In addition I had copies of the pathology reports from my two surgical biopsies. The latest report showing that I was now borderline DCIS.

My first visit was with my surgeon. I just love and trust. She has always been thorough and taken whatever time is needed to answer questions I have .... for what was supposed to be a quick 6 month re-check she spent 45 minutes with us. In the end she felt like it was reasonable to follow the recommendation of the doctors who read my MRI and following ultrasound: to do a 6 month MRI follow-up. I shared with her a new lump I was feeling again in my left breast but wasn't sure anymore if it was a new lump or just scar tissue from my previous surgeries. She felt like it was more scar tissue. I was relieved.

Next stop Mayo Clinic for a second opinion. I was so impressed by my experience at Mayo. It was my first trip there. I met with Dr. Ghosh. As she walked into the room she looked directly into my eyes and extending her hand to introduce herself. I could feel warmth and compassion radiate from her. She spent a over an hour and a half with us! It was obvious she had reviewed the written reports and then she asked me to share my story and what has happened thus far ... she listened attentively, taking notes. A team of specialists was reviewing my MRI, mammogram and ultrasound. She also wanted the slides from my previous surgeries so that the Mayo pathologists could review them. I never imagined they could do that. She shared how critical it was for them to be able to take a look at them ... all the while never disregarding any of my current doctors and health care providers. She called and put a rush for my slides to be delivered from Fairview Ridges to Mayo Clinic. Her pathologists will either confirm my previous diagnoses of atypia/borderline DCIS or they will indicate DCIS. She went over all the various options for "screening" and "risk reduction"if it remained atypia (which she said I am doing all the right things!). She said close surveillance was a very reasonable choice with atypia. If however the pathologists come back and say it is DCIS/early stage cancer then she said she would not be comfortable with surveillance and that we need to be more proactive ... she went into what some of that might entail of which meeting with a team at Mayo that includes a surgeon and oncologist would be a first step. Dr. Ghosh did notice the "lump" I had been feeling and said that it was of some concern to her. But she's got a plan for that too!!

I asked her if I continue close surveillance is breast cancer slow growing. She said it depends on the type of breast cancer. I guess I wanted to know if I could jump from atypia to invasive cancer and skip DCIS. I guess the answer is yes although most go through DCIS. She stressed the importance of the Mayo pathologists re-reading my slides.

So for right now we wait for her to call. She assured us it wouldn't be long and she would call me immediately. Of course, we told her we are leaving on Saturday morning for the Bahamas and won't be reachable for 8 days!! My partner and I are heading to Bimini, Bahamas to go swim with the dolphins .... wild, free dolphins!! We are going through WildQuest. It's been my dream to swim with dolphins ... and with all my health issues this past year with my breast and my pancreas I decided it was time to PLAY!! So on Saturday we leave St. Paul and along with leaving St. Paul I will leave all connection to electronic devices and the internet .... when I think about this trip and I think about being in the ocean with the dolphins and spending time with Mary ... it's like I was given the biggest dose of some magical medicine! I probably won't know get the call from Dr. Ghosh before I leave, at least regarding the re-reading of my slides and what the Mayo pathologists say ... she told me she will call immediately but to go enjoy my time in the Bahamas with the dolphins.

The dolphins are calling us and we are going!! Bimini here we come!!

Cancer

Cancer touches the lives of millions of people every year. It touched my life again in these past couple days as our family here in the States got word that my uncle passed away in the Philippines. By the time his cancer was discovered it had spread throughout his body.

On September 14, 2006 I heard the words come out of my vet's mouth as he palpated my dog Shen's abdomen area, "You need to take her to the Univ of Minnesota right away for an ultrasound. I think she may have cancer." Hours later, we got confirmation that Shen had tumors in her spleen - cancer. The next day I opted for surgery, only to find out after two blood tranfusions, that her cancer had spread throughout her body. She was dying and there was nothing I could do for her but to hold her in my arms and to let her go.

And nine months later, Shen's beloved brother Shadow, who was devastated after his sister died, also got cancer - intestinal cancer. They told us at the U that anything we did for Shadow would be palliative. I opted to enjoy the remaining weeks I had with him as best I could. And so we did. We had two beautiful weeks as I did everything I could to keep him comfortable. We slept huddled together on the couch downstairs as I whispered to him each night "I love you Shadow boy ... please just let me know when it's time to let you go." We had good days and not so good days. On good days he was out swimming in the lakes. On the not so good days I held him and covered him with all my love as he heaved and his body gradually started to shut down. Till early one morning on July 2, 2007 he burrowed himself in a hole he dug by a stone where the ashes of Shen had been sprinkled ... he looked at me and I knew it was time. I thanked him for the gift he gave to me of being able to say goodbye and the gift of creating precious memories I will also hold in my heart. Later that morning sweet Shadow joined Shen.

Then in April, 2009 my dear friend Elaine died from breast cancer 17 months after her initial diagnosis. I met Elaine in a writing class in the summer of 2006.  A beautiful woman, inside and out. She was an artist and a poet and a woman whose love, radiance and energy was contagious. It's rare to meet a person who lives and breathes love, pure love. Elaine was, and is, love. I was away on a business trip in San Diego the morning she passed away ... my heart still aches to this day that I wasn't able to say goodbye to her. She must know my heart aches because she has blessed me with the gift of visiting me in my dreams 3 times and letting me know she is okay, that we're okay, and that she knows I love her.

As I deal with my own health issues and the words of "you have breast cancer" looming over my own head ... I remember Elaine and how she walked her journey, with courage, grace, acceptance and a will to keep living and loving no matter what. On Wednesday I see my surgeon to review the results of the latest MRI scan showing a new growth. I am also driving down to the Mayo Clinic to meet with a doctor at the breast research center to get a second opinion.

And then on Saturday, my partner and I head off to the Bahamas to swim with wild, free dolphins!! A dream come true. Whatever I am told on Wednesday will come with me to the Bahamas and I will look to the dolphins to guide me ....

A Lesson

~ by Judy Roehm

[From the book The Cancer Poetry Project. Judy was inspired to write about her long time partner Becky after she addressed an American Cancer Society rally in Lansing, MI in May, 1993. Becky had been diagnosed with cancer the year before at the age of 40. She died in 1995. "Seeing how the experience of facing death transformed her, how she lived every day of her life, taught me a lot about courage", Roehm says. Two years later she lost her brother to pancreatic cancer and in 1998 she was diagnosed with advanced ovarian cancer].

At a breast cancer rally she rises

above sixteen positive lymph nodes

to tell the world that cancer is a wakeup call

that resonates to the cell level.

It is a lesson taught to trembling hands

that squeeze from today a second cup of coffee

on a sunny deck with someone you love.

It is a slap that sends you flying from Michigan

to Cozumel because cancer teaches that snorkeling

coral reefs pays greater dividends than a savings account

and mowing summer grass can be postponed

for bike rides past wild flowers and country streams,

and vacuuming the carpet and washing the windows

are low priority items when a friend drops by to visit.

Cancer is not a gift but a lesson

full of seeing now and loving presently.

Cancer touches so many of our lives and in the process transforms us and those around us. I pray for the same courage, strength and grace that my dear friend Elaine had ... and for wise way that my beloved animals Shen and Shadow approached the end of their journey ... I love how animals don't fear death. They live in the present and they live every moment.

Namaste Elaine.

Namaste Shen.

Namaste Shadow.

Making room ...

On Friday I went in for a breast MRI. I had hoped I would get a clear scan and that the 2 lumpectomies I've had in the past year would have removed any potential cancer or recurrence.... early Monday morning I received a call. MRI indicates a new tumor has grown in the same area of the previous lumps. Now the journey to check on whether it is or isn't cancer begins. On Friday I go in for an ultrasound and possible biopsy. Shortly after that I follow up with my surgeon. I can feel a new lump in the same area as the other two.

In the past mammograms and ultrasounds have all been negative, showing nothing. I am grateful for my surgeon who noticed a suspicious lump and insisted on removing the entire lump and surrounding tissue. Only by looking down to the cellular level were they able to find that my cells had started changing and going awry and becoming more like cancer cells. But the lumps were removed before crossing that line of cancer .... this last go around, I was still lucky ... closer to the line (borderline DCIS) but nonetheless, still on the other side.

So this go around ... will I be as "lucky?"

I've been struggling in my mind to make room for whatever is to become ... and I was reminded of this beautiful poem by Rumi, The Guest House. It will become a part of my daily meditation and prayer.

The Guest House

This being human is a guest house.

Every morning has a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they're a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still, treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice,

meet them at the door laughing,

and invite them in.

Be grateful for whoever comes,

because each has been sent

as a guide from beyond.

~ Rumi

It feels like my "house" is being re-arranged right now .... for many different reasons. I have a new guest knocking on my door right now. At times I want to slam the door shut on this guest. One way or another these guests will make themselves at home .... it's up to me to welcome them in so we can find a place for them  and so we can live in harmony. 

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.

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!

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.