Wednesday, March 7, 2018

" been beat up, and battered around,...handle me with care; overexposed, commercialized; i've been uptight and made a mess, but i'll clean it up myself, i guess. oh the sweet smell of success, handle me with care. " handle me with care by the traveling wilburys

i just read an amazing article posted by the group, choose hope. the title of the article is " for patients fighting cancer, PTSD, is one more battle." the article went on to say that " new research shows that at least 20% of patients develop PTSD within six months of a cancer diagnosis. this is a rate similar to that of combat veterans."

wow! i personally think, and i do not have any concrete research to back this up, that the percentage is much higher than this. i feel this way, not only because i myself  have been struggling with PTSD, but several other  cancer patients that i know have had similar problems with PTSD. what we desperately need is a holistic treatment for cancer. we have great surgeons, oncologists, radiologists, and other health care professionals in this country.  but we are lacking in mental health services for cancer patients. in canada, there is a more holistic approach to cancer treatment. almost every cancer patient has the option to see a therapist who is trained to deal with PTSD. the article in choose hope said that while this service is  available, not every cancer patient in canada chose to accept it. even when holistic care is offered, there is still a stigma associated with needing care for mental health issues.

the above mentioned article, listed several examples of cancer patients with PTSD who have benefited from various treatments for anxiety and depression. one patient is a thyroid cancer patient, who has been dealing with the effects from having her thyroid removed due to cancer, for most of her adult life. so many things tag along with the big C. not only PTSD, but weight gain or loss, being on medications- sometimes for life- and dealing with the side effects of the very medications that keep us alive and functioning, just to mention a few cancer hanger-ons.

for me, the big deal is A N X I E T Y. i am not a depressed person, but boy, oh, boy, am i an anxious one. testing anxiety, and the fear of recurrence are forever in the rear view mirror of my life. unless it is a testing day, i can pretty much control my anxiety during the daylight hours. but come evening and bedtime- well, it is another story. i worry about my family should something happen to me, although i know that they would be fine. and every lump, bump, nauseous feeling or fever takes on tremendous proportions during the night hours. i bet at this point, you are marking me off your " would like to have a pj party at her house" list. i am certainly not perfect, but i am trying to feel more at ease. i know basically what to do to feel better. i am involved with crafts ( beeswax candle making to be exact), i am walking some ( exercise is so good for mental health as well as fitness), and i am on the waiting list for a Tai Chi class. i have been wanting to take Tai Chi for some time, but had been unable to find a class. this one, the one i am on the waiting list for, is offered at our local senior center. yes, i swallowed my pride, age is just a number-ha, and called the center. seems like there are lots of enlightened seniors that have beat me to the punch. but i am on the waiting list, as i said.

one of the other ways to treat PTSD is talk therapy. this has been the hardest subject to broach for me. i know it is not shameful to need some mental health counseling, but i have not been able to make myself do it. there i said it. ( or i wrote it) . out loud. talk therapy is said to be as effective as medication, when it comes to treating depression and anxiety. perhaps i can make some progress on this in the near future. i said i was not perfect. remember?

so, we cancer patients have been beat up and battered around. we really do need to be handled with some care. we are facing so much more than just surgery, chemo, and radiation. it is our life at stake here, and we need not only to take the best care of ourselves that  we can, but we need for our families and friends to understand what we are going through and be supportive. think of humpty dumpty. when he fell off that wall, he had many pieces that needed to be put back in place. i know that he did not get reassembled, so to speak, but i do believe that with the right holistic care, cancer patients can put back most of the pieces.

Tuesday, February 27, 2018

"every day is a winding road, i get a little bit closer. every day is a faded sign, i get a little bit closer to feeling fine." every day is a winding road, by Sheryl Crow

today was my six months check up for breast cancer. in may, i will officially be  a three year breast cancer survivor, and an eight year thyroid cancer survivor. my surgery dates were only 3 days, and five years, apart. may, as a month, has not been so good to me. it is quite the coincidence, really.

so, as usual, as my husband and i got closer to the oncology center, i tried to divert him into the far right lane, instead of the left one. the right lane leads to the interstate, and eventually( 3 or 4 hours later ) to the beach. the left lane leads to the oncology center. it is a long standing joke between my husband and me. well, an  almost  three year one. the very first time that i went  to the center  for my  first chemotherapy treatment, my husband almost fell for my attempts to run away to the beach. i will have to say that going there for my first treatment was one of the most terrifying experiences in my life- so far, anyway. the fear of the unknown, and the fact that i was aware that the first dose of chemotherapy is the strongest. it is the largest dose that they can give you,basically, that will save your life without killing you. your immune system is strongest before your first dose, of course. but no one is quite sure how anyone is going to react to the chemotherapy. my oncologist did reduce my dose slightly as we went along, and i knew what side effects that i would experience. that made the experience a little less terrifying.

oddly enough, and i am not the only person to experience this, i get nauseous when we pull into the parking lot. i had a lot of trouble with nausea and vomiting with my chemotherapy, and that all comes back to me, i suppose. another thing that bothers me, and this is sort of strange, is the smell of the hand sanitizer soap that the center uses. it is a violent reaction for me. i smell it when we come in the door, and of course i have to wash my hands a couple of times ( small bladder) before i get to leave the center. i am nauseous for  the rest of the day, and even though i shower when we get back home, i can smell that darned soap for a day or two.

also today, i saw a woman that reminded me of myself during my treatment. she was very pleasant (put on a happy face for family and friends) and she told the receptionist that she preferred wearing head scarves instead of wigs. that was me, as well. i learned to tie head scarves from watching a you- tube video, and got rather good at it. i did have some pre-tied scarves, but i much preferred tying my own. i wanted to go up to her and give her a hug, and ask her how she was really doing. but since  i did not want to scare the poor woman,  i just smiled at her.

so the bottom line is that i had a good check up. i did not get all of my blood work results today, but i am not expecting any problems. they will mail me a copy of everything in a few days. i keep a record of all of my tests, procedures, etc, in a three ring note book. that is about the best piece of advice that i can give anyone facing serious health issues. be informed, and know what has happened, and is happening to you. i have amazing doctors, but i am not their only patient. occasionally, test results have been lost, but i have had my own copy and that has actually come in very handy on more than one occasion.

my husband told me today that i will now  be " back to normal"( i should say my new normal ) for about the next five and one half months. then, the test anxiety, nausea, and moodiness will return. that said, i am getting a little stronger, a little tougher when test time rolls around. i guess i do get a little bit closer to feeling fine.

Thursday, February 15, 2018

the long and winding road, or AKA, the results blog...

i had my big 6 months thyroid cancer check up on february 7th, with my endocrinologist in raleigh. i had the blood work done at a lab in boone,  the week before that. it was not quite the check up i was expecting, because either my physician had forgotten to check the box to test for thyroglobulin, or the lab forgot to do it, or did not see it on the sheet,- who knows. to refresh, thyroglobulin ( his friends know him as TG), is a protein  only secreted by the cells in the thyroid gland. no other type of cell can make this. so if you have had thyroid cancer, and your thyroid gland has been totally removed and sent to wherever they send those things to, theoretically you should not have measurable TG ( we are friends now) in your body. UNLESS, some thyroid cancer cells managed to  escape the jedi fighter, AKA, radioactive iodine, or RAI-131 as his friends call him. these thyroid cancer cells can set up shop elsewhere in the body- being especially fond of the lungs and bones, bless their hearts.

for the first three or so  years after my surgery and RAI-131 treatment for thyroid cancer, i had measurable TG. i also had anti-thyroglobulin antibodies ( AKA, TgAb). not to get too technical, but those people with the TgAb, are most likely to have an auto immune type of thyroid disease. having TgAb is not a bad thing ( they are not harmful to your body ), but unfortunately it makes the test for TG very unreliable. it was a gamble. do i really have elevated  TG or is the TgAb just making it appear so? no way to tell, folks. since i had two types of thyroid cancer, papillary, and an aggressive form called follicular variant, my endocrinologist decided to err on the side of caution. she kept my thyroid medication on the high side( low TSH, and  higher range T4)  so that hopefully there would not be any  stimulation of  any TG that may or may not be present. my lungs and bones appreciate my endocrinologist's efforts.

now to the important stuff. i received my test results today from the TG test that i had to have done in my endocrinologists office. yes, two rounds of blood work this time. i do not have TgAb, and my TG is low. not quite undetectable or zero, but low. that means that i am still on the every six month plan. i will be an eight year survivor in may. i really do not like using the term " survivor". one could make the case that no one really beats thyroid cancer. life long monitoring, testing, medication adjustments to get the TSH, T4 , T3, etc. correct enough so that a person feels well, but also at correct values to keep recurrences down is the norm. but despite that, i feel that this is good news and i am pleased with my overall results.

on february 26, i will have my big six months breast cancer check up. i am so looking forward to march this year...

Sunday, January 21, 2018

the importance of our pets- especially when one is dealing with cancer or any other chronic health condition

what i have to say in this blog is not ground breaking news. there have been many studies about the efficacy of service animals for those of us  who are dealing with PTSD, epilepsy, cancer, or other chronic health conditions. in certain instances, of course, professionally trained service animals are necessary. but i think that our family pets can play a huge role in helping those of us who struggle with anxiety, depression, or other problems that are  associated with the trauma brought on by certain health conditions.

i will use myself ( again) as an example. when i was having chemotherapy i had terrible nausea and vomiting that was not controlled by any medication that i was given. and believe me, i have tried all of the anti-emetics on the market. i have mentioned that listening to classical music, especially rhapsody in blue by george gershwin, helped take my mind off of the nausea to some extent. what also helped me was the love and affection that i received from my cat and dogs. my cat was especially helpful. for whatever reason, and you can read many theories on this, my cat always  knew when i was sick. she would lie on the bed with me, and snuggle up to my leg or hip. she was not one of those " in your face type of  cats", but her presence and gentle purring were very comforting to me. petting a cat or dog is supposed to decrease your blood pressure, i have read.i am not sure of the validity of that statement, but i do know that when i petted my cat, she would give me little cat kisses with her rough little tongue. having her with me, especially when my husband was at work and i was alone, was very comforting. not sure if my blood pressure went down any, but having her there was very soothing to me.

my dog- a german shepherd- has also been so important to my mental health. again, during my chemotherapy, he stayed extra close to me. when i was able to get up and about, we would take short walks together and he seemed to know that he had to be by my side and be on  his best behavior. i named my dog "shadow" and that is exactly what he has been, and still is. our dogs sleep inside our house  at night. i can walk into the kitchen, thinking that shadow is sound asleep, and if i look over at him he has one eye open- following my every move. there is nothing quite as good as a big ole dog hug. he used to be able to sit in my lap, and sometimes he forgets why he can not ( he weighs 120 pounds). but hugging and petting him helps me as much as it helps him, i think.

another thing about a pet is that they never ask questions, such as" why aren't you feeling well? why are you sad? why are you anxious? why are you in bed? why are you bald?" they also do not care if you are in your PJ's and a robe, you are beautiful to them.  pets are truly living in the " no judgment zone" and they give you their full and complete affection. our pets seem to instinctively know when we  are sad and need a hug, a kiss, or an affectionate rub on our leg. also, i was happy to have my dogs and cat to take care of. just the simple act of feeding them made me feel good. so many people were taking care of me- it was good to have someone else to care for.

having a pet or pets is a lot of responsibility. i guess that it is not for everyone, or perhaps is not practical for some people to have a pet. but i can honestly say that i am so thankful for my pets. they have shown and continue to show me so much love and affection. they help me with my anxiety ( testing anxiety , fear of a possible  recurrence,etc) and for that i am very grateful. there are many " non drug" treatments for certain health disorders. one of the best ones comes with four legs and a big heart. 

Monday, January 8, 2018

" say, here i am, on a road again, there i am, up on the stage,..there i go, turn the page...and you don't feel much like riding, you just wish the trip was through." lyrics from "turn the page" by bob seger

yes, i have used these lyrics before. but it is almost testing time again for me, and these lyrics just suit my situation so well. i have blood work due in a couple of weeks, and a visit with my endocrinologist for evaluation of my thyroid cancer. i also have an appointment with the oncologist, for the breast cancer,  and more blood work sometime this month or next. the problem i have with my oncologist's office is that they never tell me exactly when my appointments will be. the office just mails out my appointments, already scheduled, and i have to juggle them around events that i may already  have planned. maybe even fun stuff that i have to reschedule. sometimes if i call my oncologist, the office will tell me when my appointments are, providing i do not call too soon. i think that i will call tomorrow and try to extract that information from the receptionist. i did bring her a box of candy one time...

the subject of this blog, and i know that it might have been  unclear at first, is testing anxiety or "scan anxiety" like it is sometimes called. i have not yet learned, and i wonder if i ever will, how to deal with this. on the one hand, i appreciate the care that my doctors provide to me. i know that my chances of survival are better the earlier a recurrence is diagnosed. i also realize that by having had two primary cancers, my chances of a recurrence are somewhat higher. i can manage to enjoy my life pretty successfully until it is time for testing. i will admit that i do panic somewhat when i have a stomach virus, upper respiratory virus, or other acute illness. one of my first thoughts, and i am admitting it here in this blog, as i usually try to keep these thoughts  to myself ( i hate for my family and friends to think i am neurotic, ok, well, too neurotic) is to wonder if my cancer is back somewhere else in my body.

a few days before my testing, i get testy. i get  short tempered and very anxious. what will i do if it the cancer returns? what do i tell my family and friends? how will they handle the news? and so forth. and physically my body reacts in a negative way,too. my blood pressure increases, my sleep is off, and as i said, i get anxious. i have tried to do self care or holistic care to try to manage my test anxiety. this is not an easy task for me. i will give you a little background. when i was pregnant with my first child, my husband and i attended lamaze classes. we did the " woo-hoo" breathing, but along with this, we did relaxation exercises. our instructor told me that  i was the " least relaxed" person that she had in the class. i have not made much progress since then, and it has been about 30 years. i have been working on breathing exercises and meditation. since i know how to breathe, this has not been too hard. however,  so far, meditation has not been successful for me.

i have really enjoyed my candle making and a few other crafts that i have become involved with. i feel very fortunate to have the opportunity and time to invest in my hobbies. this is a joy for me, but when testing time comes around, even these activities do not trump ( sorry to use that word)  my anxiety. i read in a blog that another cancer patient struggles with testing anxiety, and i am sure that many other  cancer patients do as well . in  the most recent blog that i read about testing anxiety, the patient had conflicting feelings in the " in between times" as well. not only did this person have the testing anxiety for a few weeks leading up to the tests, but they worried about issues that face us when we are not being tested. the patient felt like an " all clear" scan and blood work were just temporary reprieves from the worry that comes in 3, 6 or 12 months, whenever the next testing is due.

it was good for me to read this blog from another cancer patient. i used to think that something was wrong with me when after good results, i did not feel like celebrating over much, or shouting my results from the rafters. the testing and scan anxiety ebbs and flows. that is what constitutes my daily living now. i try to make the best of things, here comes pollyanna, but i still have to deal with the testing anxiety and the "what ifs" in my life now. i hate to use this over-used term, but this is my " new normal" life now. i am trying to be happy and make the best of things. but here i go, on a road again.

Wednesday, January 3, 2018

i am a pollyanna kind of person, but even i have those times when i feel like throwing rocks at the moon...

i have never been into making new year's resolutions. i have thought about my " goals for the new year" on occasion, but nothing so formal as a resolutions list. this year i have unfortunately had some flashbacks to my surgeries from two years ago. why now? i am not sure. i suppose at first, i was just happy to be alive with a fairly good prognosis. there was so much to think about, that i sometimes did not think about certain things at all. not that i did not have my moments, you might say. one of the first things that i did when i got home from the hospital, was to round up all of my pretty lace bras and throw them in the trash. i was angry and sad that these did not fit any more, and frankly i did not want to ever see them  again. i also went through my closet and tried on a few tops, sweaters and blouses. i gave a huge part of them away- to my family members or to  the salvation army. when i tried certain clothes on it was so strange to discover that the clothes that fit so well just a little while ago, now did not fit well at all.  it was  like i was wearing someone else's clothes. in some ways, i guess that i was.

for the last couple of days, feelings of loss, sadness, and the details of the  surgeries that i had, have come to my mind unsolicited. i am not what i would call a "crier", but tears have also found me, and at the oddest and most inconvenient times. i have tried to tell myself that these feelings are O.K., but i do feel guilty about having them. one thing that i have always told myself, is that there are lots and lots of people who have health issues that are worse than mine. being in health care, i saw people  with severe health conditions who handled them with dignity and grace. i have really tried to do that myself. as i said in my title, i have always been a pollyanna type of person. when i was a little girl and would get sick, i told my dad " don't worry, i will feel better tomorrow." my dad always liked this, and he would remind me, when i got older,  what i had said as a small child.

we are all different, and we all handle health issues differently. it is not a contest to win or lose. what really bothers me, might not bother someone else and vice  versa. i think that it is time for me to throw some rocks at the moon. i know, of course, i am not going to hit the moon, but it might just make me feel a little bit better. away with you, pollyanna, at least for a little while. for now, i am gathering up a few stones.

Saturday, December 23, 2017

" oh, i get by with a little help from my friends, gonna try with a little help from my friends.." to paraphrase the beatles song, " with a little help from my friends"

i read an article the other day in a popular thyroid blog about identifying those people who have helped you, as a thyroid patient, deal with health issues and challenges over the years. most of you who are following my blog know that i am a thyroid cancer survivor AND a breast cancer survivor. as i have said before,this blog is a kind of  "2fer" you might say. i have given this a lot of thought, and would like to acknowledge my own support staff. the author coined a particular phrase for these people, which i am not going to use. instead, i will just refer to my support staff as " my people". this is an old, southern mountain phrase, usually referencing folks that one is related to. but in my case, i consider  these wonderful people to be  my family, even if we are not related.

so here is my eclectic list of people who have helped me survive and thrive after having had  cancer twice. most are living, some are not ( i did say eclectic), but i owe a debit of gratitude to each and every one of " my people". without your love , support, knowledge, and care i would not be here today- that i am sure of.

1) my husband, jeffrey smith. he is without a doubt my number one fan. he has taken care of me during my worst moments, told me i was beautiful when i was as bald as a bowling ball, and still  picks me up when i fall. he has had to deal with the "dark side" of cancer- when i was not smiling with a pretty head scarf and make-up on. it was also helpful that he is a pharmacist,too, and was working at the time of my illnesses. he filled my prescriptions and brought them home to me . what service! i know that some people can not handle the pressure and challenges that come along with a close family member having cancer . he was, and still is, there for me every single day. i can not thank you enough, sweetie.

2) my children. they are grown with families of their own, but they will always be my children. my daughter, shelley , lives fairly far away, but she still calls every day to check on how i am doing. after my thyroid cancer diagnosis, she compiled a mixed CD for me. " songs to get better by", you might say. it contained songs like " i will survive", " i won't back down", " touch of grey", just to mention a few. also, she is a teacher, and her students all made handmade get well cards for me. that touched my heart as well as my tear ducts. i still have all of the cards, and always will.
my son, dylan , and his family, live close by. on several occasions, he drove  over to check on me- especially when i was having trouble after chemotherapy and jeff was working late. he has a young family of his own, but he would always make some time for me. his daughter was born a month after i finished chemotherapy, which was such a gift to me. his son, who was in daycare at the time i was having chemotherapy, and his fellow friends in daycare made cards as well. the children, thanks to juju and paw paw, called me one day to sing " you are my sunshine" as well as other sweet songs. my tear ducts got quite  a workout that day as well.

3) my endocrinologist, Dr.  Shawnee Weir, of raleigh endocrine associates in raleigh, north carolina. she has been my doctor for years. previously,  i had such a difficult time getting someone to realize that i had a thyroid disorder and actually try to help me! my blood work looked normal, but i certainly did not feel normal. she believed me when i told her how badly i felt. she is a physician who goes by how the patient is feeling and not just by the blood work. it was a hallelujah moment when i found her~ she actually did my biopsy and diagnosed my thyroid cancer. i still see her every six months of course, for follow up blood work and testing. i credit her with saving my life- seriously.

4) Dr. Kenneth Parish , my general surgeon, and Dr.Steven  Siciliano, my plastic surgeon. both of these doctors practice in Hickory, N.C.  and  are another "2fer" you might say. they like to work together. some people wonder why i did not go to a bigger hospital in a larger city for my bilateral mastectomies and reconstruction. honestly, i do not think that i could have had better doctors for this, and it was fortunate that they are close to where i live. that made it easier for me as well as my family. Dr. Parish has officially released me, but i still see Dr. Siciliano.( my husband says it is because of my white chocolate chip and macadamia cookies that i bring to him when i have a check up).  i was on a six month schedule, but i have graduated to yearly check ups now.

5) Dr. Richard Orlowski, an oncologist and hematologist, who works with Carolina Oncology, in Hickory, N.C. again, i do not think that i could have had a better oncologist- even in a larger medical center. he listened to my concerns, discussed chemotherapy treatments before i had them, and did his best to prescribe anti-emetic drugs for me - even though nothing controlled the nausea and vomiting that i had. i still see him every six months for blood work and check ups. he has prescribed the drug called anastrozole - a type of chemotherapy that helps prevent breast cancer recurrence. i have every confidence in his treatment choices for me.

6) Dr. Chandra Baker, radiologist, practicing in Hickory, N.C. i think of  this doctor as  my angel doctor.  she also saved my life, this time from the breast cancer. i had had two different radiologists look at my x-rays and remark that there was an  area that looked " suspicious". that was as  far as they went- they were not worried about it, i guessed, so i should not worry, right? WRONG. Dr. Baker took one look at the x-ray, on the day that  i was supposed to be having a lumpectomy, and said, " that area looks suspicious! with your permission, i would like to cancel your lumpectomy today "( the OR was calling, multiple times, to try to get me up there- the medical support staff as well as  the surgeon were past ready for me). she wanted to do  a stereotactic core  biopsy. her exact words were : " i treat my patients like family and i have to be able to sleep at night". i had just met this doctor. she usually practiced at the other hospital in town. she was filling in for someone that day at the hospital where i was to have my surgery. long story short- i trusted her, she did the stereotactic biopsy, and found another area of cancer that would not have been removed with the lumpectomy. this doctor is my hero, and i think of her often. we need more doctors like her.

7) george gershwin, composer extraordinaire.  bear with me- it gets a little weird here. during my chemotherapy, there were nights when my husband had to work late and i was by myself. as i mentioned, i had the absolute worst nausea and vomiting and none of the drugs ( and my doctor tried every one available) helped. what did help to some degree, was to listen to gershwin's "rhapsody  in blue" as well as some of his other works. i would lie on the bed, try to remain calm, and let myself ride along with the music when the waves of nausea hit. i know that he certainly did not write this beautiful music for me, but i love his music  for the comfort and calm that it brought to me.

8) beth stout- sister and friend. my sister helped me out as much as she could. when i was going through chemotherapy and my husband had to work, she would come and sit with me. she carried on the traditions of our dad, which was the power of a good cold wash cloth. as i pretty much just laid there on the bed, trying not to be sick, she kept up her end of the conversation, and then some! i really appreciate all of her care, love and concern for me during this time. i owe her a debt that can not be repaid.

9) numerous friends- too many to name, but i will mention a few. amy- my breast cancer buddy, karon- another breast cancer buddy, and becky- a thyroid cancer buddy. no one, not even family members, understand how it is to have cancer  or" get it", like another cancer patient. these ladies were and still are supportive and loving friends of mine.

10) last, but not least, is mary shomon, author and patient advocate. we have not always shared the exact same opinions on thyroid treatment issues, but mary was so kind to mention my blog on her website. from that moment on, i was connected with other thyroid cancer patients. i live out in the " boonies" and support groups in my area  are pretty non-existent. having people read, what started out, as a thyroid cancer blog, share stories and offer support was very important to me. i have tried my best to help others- to pay it forward, you might say.

well, those are " my people" who have helped me survive and thrive during my adventures with  thyroid and breast cancer. in my opinion,  it is a good idea for others to make a list like this, i think. for me, i knew the names of the  people in my life who had helped and continue to help  me, in countless ways. but actually writing their names down reminded me that i have had and continue to have  great support. i am not alone on my journey, and for that, i am grateful.

Thursday, November 30, 2017

thyroid cancer is not the " good cancer" and here are some reasons why...

if you have been diagnosed with thyroid cancer, you have probably heard people say, " oh, you have the good cancer!". this response, though well meaning i think, is still one of my pet peeves. first of all, there is no " good cancer". cancer by definition is not a good thing. any type of cancer is serious business, and should not be taken lightly.

i received my thyroid cancer diagnosis in 2010. i had papillary with follicular variant, stage three. after having my thyroid and two parathyroids( also cancerous) removed, i received the I-131 treatment because  even the best surgeon can not get all of the thyroid cancer cells. think of them as little storm troopers who escape from the mother ship and make their way to other parts of the body. one way we know that they are present is by doing blood tests for thyroglobulin and thyroglobulin antibodies. only thyroid cells make thyroglobulin, so if you destroy the mother ship, and you have measurable thyroglobulin in your blood stream, that means that you have the rogue cells, or thyroid cancer cells elsewhere in your body.

for three years after my surgery and treatment for thyroid cancer, i had measurable thyroglobulin and thyroglobulin antibodies. there are a couple of ways to deal with this. some people, depending on how high the level of thyroglobulin is, have to receive another dose of the I-131. unfortunately, this does not always work in all cases . the I-131 is supposed to destroy the rogue cancer cells. one way to explain it, is that thyroglobulin cells love iodine. if you " feed" them the radioactive kind it is supposed to destroy them. another way to deal with the presence of measurable thyroglobulin is to keep the TSH very low- close to zero. what TSH (thyroid stimulating hormone) does is to stimulate thyroid cells into action. this is fine if you do not have cancer. but if you are stimulating CANCER thyroid cells into action, well, it is obviously  not a good thing.

as i said, after three years my thyroglobulin went down to an "acceptable" level and my antibodies were no longer present. my last blood work revealed that my thyroglobulin was less than 1. the range that this lab uses is " less than 1 is acceptable, 1 or greater is positive for thyroglobulin.". so, my level is low, but not zero. what the heck have those rogue thyroid cancer cells been  doing in my body for the past seven years? my doctor keeps my TSH near zero so that they do not spring into action, so to speak, but that still gives me pause. i continue to  get blood work and ultrasounds every six months. once you have had thyroid cancer, you basically have testing for life. there is no " five years and you are done" to this type of cancer. for those of you who have been thinking that thyroid cancer is the good cancer, are you beginning to see how this is not the case?

if thyroid cancer is able to spread to other body locations, it is most often to the lungs and bones. it can go anywhere, but those are two primary locations. when i had breast cancer in 2015, one of the first questions i asked my doctor after the surgery was " were there thyroid cancer cells present in my breast tissue?". i am happy to say that  there were not. 30% of thyroid cancer patients will have another primary cancer in the body, and i fell into that category. the best thing that you can do in this situation, is to make sure that you have your mammograms, colonoscopies, and other tests on a regular basis. early detection is key- as with any cancer.

thyroid cancer affects all age groups, male and female, though there is a higher incidence in females. there are several types of thyroid cancer, and a person can have more than one type, as i did. this is hardly a good cancer to have. life long testing, the possibility  of recurrence, or an increased chance of   developing a second primary cancer are all part of having thyroid cancer. as with most any other disease, a person never really understands until it happens to them. i like to be connected with other thyroid cancer patients. no one understands our situation and daily challenges like another thyroid cancer patient.  no, this is not the good cancer at all...

Tuesday, November 28, 2017

" I've looked at life from both sides now, from win and lose and still somehow, it's life's illusions i recall, i really don't know life, at all. " both sides now, by joni mitchell

it all started with a doctor's visit. one that i wish i had never made, but at the same time,  eternally grateful that i did. this is the way that it has been for me since i received my two cancer diagnoses. i possess two faces of cancer. there is the one that i present to the world- upbeat, optimistic, totally in control of my situation. and then there is the other one, and it is not very pretty. i struggle with PTSD, anxiety, and a general feeling that i am not in control of anything in my life. feeling out of control has probably been the hardest thing for me. i like things organized, well planned out, and safe. cancer makes your life anything but those things. in my work, i was used to being in control- making difficult decisions on a daily basis. i was responsible for not only what i did, but what my support staff did as well. i had the lives of my patients in my hands, and while it could be  daunting on occasion,  over time  i developed a sense of confidence in what i was doing.

cancer has a way of stripping away  all sense of control that you thought  you had. where i was once the one making the decisions about someone's health, i was now sitting back and becoming the patient. i was listening to the recommendations of several doctors concerning my health. and they were not just any decisions, they were life or death ones. of course i did my research on what surgeries, treatments,etc. that would be best for me, but when it came down to it, i had to depend on health professionals to make the calls. i am very fortunate to have had very good medical care. i realize that unfortunately not everyone has this opportunity, and i am grateful that i did. i also have a wonderful support system in place. my family and friends have given me so much encouragement and care, and i am extremely grateful for that, as well.

i am learning that it is o.k. to have conflicting feelings when it comes to having cancer. maintaining a positive attitude certainly helps me as well as those around me. but it is important that i address the dark side, if you will, of a cancer diagnosis. loss of control, overwhelming feelings of loss- not just physical loss, but loss of the way my life was before i had cancer, always loom in the background. while i am fairly sick of the term " my new normal", nethertheless, it is a true statement. i do have a new life now, in many ways. i retired a few years earlier than i had expected to. i found that while i could do my job as i had before, it just took too much energy. i had trouble recovering from a day of work- i was exhausted after a 8 to 10 hour day and it took me two to three days to recover. i do miss my work, and the people that i worked with and for. i was angry about this for a while. again, it was a loss of control issue. my careful life  planning had just gone down the drain.

i am a " i will do it myself" kind of person. it was difficult for me to accept help from others. not that i did not appreciate kind offers, i just was used to being more self sufficient, and it was, and still is, difficult for me to admit that i need help sometimes. one terrible example of the dangers of always  doing things yourself, was when i made my first trip alone to the grocery. ( here is another awful grocery experience). my husband was working that day, and i was determined to go out myself and get our groceries. that would have been fine, but instead of waiting on my husband to carry our groceries inside, or maybe being patient and making 100 trips carrying the grocery  bags inside, i carried them, even the heavy items, in just a few trips. i felt my stitches give way on one side before i got inside the door. i knew that i was in trouble, but i  could do nothing about it at this point. long story short, i ended up with an extra surgery and a round of antibiotics  to repair the damage. this ended up delaying my last surgery for reconstruction, and my surgeon said that i was very lucky things were not worse.

i have had to make a major life adjustment ( i will refrain from using "new normal"). i have discovered the joys, albeit different than my previous work , in making candles and other crafts. i am enjoying time with my husband. we have both, in the past, worked long hours, holidays, weekends,etc. so this is a treat to get to spend more time together. i am so happy to get to see my grandchildren more often. i like to be able to help out with childcare or just visit, more often. this is definitely a silver lining in my dark cloud. while my anxiety is still there,  i am managing those dark feelings a little better now. as i said earlier, i am trying to maintain a positive attitude. but i am also dealing with a dark side,too. i suppose the trick is to not to let the dark outweigh the light, so to speak. 

Sunday, November 19, 2017

it is the season to be thankful and non judgmental. in fact, these two things are always in season.

i have learned many things from having had cancer. for me, the most important  lesson is to be thankful, always, for my  family and friends and all of the good things- even small things, in my life. i try to practice gratitude every day, and i think that it is important to others as well as hopefully making me a better person. one thing that i learned first hand, that i had  never previously  given enough thought to, was what it is like to be judged by  or discriminated against based on my appearance. 

the first time this happened to me, was right after my surgery for thyroid cancer. yes, i looked like the bride of frankenstein, but i was certainly in for a shock when my husband and i stopped at a rest area on our way home a couple of days after my surgery. my surgeon, and the hospital where i had my surgery, are four hours away, so needless to say, we had to make a couple of stops. as i made my way up the sidewalk to the  rest area , a little girl took one look at me and ran! and a week or two later, i was in the grocery store for my first excursion out since my surgery. not only did two little children almost cry when they saw me, but their mother put her arms around them to " protect them." i waited quite a while after that to venture out again. i love children, and am not used to making them cry simply by getting a look at me. 

the next occasion i faced discrimination, was during my chemotherapy for my breast cancer. i had lost all of my hair, and was wearing a black head scarf. ( i thought it was pretty- silly me). this man, also in the grocery- this seems to be a dangerous place for me to go- grabbed his children and moved to the other line. the look that he gave to me was one of disgust, and frankly, hatred. i was shocked! i realized that either he thought cancer is contagious, or he thought that i was of the Muslim faith. i had not thought about it, but in addition to my black head scarf,  i had a black shirt, black pants and a black coat on. i could see where he might think that i was  Muslim. now, i have worked with several pharmacists who are Muslims, and i have always  considered them friends as well as colleagues. i am a person who believes that there are " many paths to heaven." i do not think that it is "my  way or the highway" as some people unfortunately believe.

at this time of year, we all gather together in a mostly all inclusive holiday to celebrate with our family and friends. we think of all of the things that we are thankful for. perhaps it would be good to realize that we are all different, yet all  the same. we have different religions, customs, and ways of dressing. what unifies us is the fact that most of us love our families and friends, and just want to live in a place that is safe and makes us happy. because of my experience at the grocery, when i see someone wearing a hijab , i make a point of making eye contact and saying hello. i will admit that this happens more often when i am in raleigh visiting my daughter and her family. she lives in a more culturally diverse community. but i love where i live- it is my home, and i would like to think that most people who live here can offer civility and kindness towards others who are not carbon copies of themselves. 

i have lived a life with a certain amount of  privilege. working with the public can be stressful, and people seem to be more " vocal" with their concerns these days. yet, i have been afforded a certain amount of respect because of the work that i did. i have now  learned what it is like to be stared at, avoided at all costs, and shunned due to my appearance. these experiences have been a "learning moment" for me, i think. so before we eat that thanksgiving turkey at my house this year, i will be recounting all that i am thankful for as well as hoping that all those that are different, yet the same, will be able to do the same. 

Thursday, November 9, 2017

as the saying goes, " the proof is in the pudding", or in my case, it is under my shirt

yesterday i had an appointment with the  plastic surgeon that did my breast cancer reconstruction. i was under the impression that he would release me, as my general surgeon had done  when i saw him last month. my plastic surgeon used to have a small practice with  a very friendly, homey type atmosphere. whenever i had an appointment i would bring some cookies that i had made for the plastic surgeon and his staff. i found out that he liked my macadamia nut/white chocolate chunk cookies the best, so for the past several times i have seen him, those are the ones that i made and took to his office. my doctor has since moved into a larger practice, with several other practitioners. it is a nice practice, but not quite as friendly as the old place used to be. still, i made the cookies and gave them to the doctor and his nurse- the only people that i knew in this new practice. as i said, i thought that this was going to be my last appointment with the plastic surgeon. as it turned out, i have to see him again in a year, which is not too bad. i do not have to get tests, blood work,etc, when i go see really no stress anxiety associated with these visits.  basically, the doctor just wants to check with me to make sure that i am not having any problems.

my doctor was very pleased with my areola/nipple tattoos. he had been encouraging me to get them for the past year and a half. i was only too happy to relate to him how much they had changed my life in a very positive way. instead of seeing just the two large scars on my chest, i now see something that looks closer to what i used to look like. he was so impressed with the appearance of my tattoos, that he asked my permission to take photographs. you can not tell that it is me, by the way, as the photos are only of my chest area.

so i got dressed and was checking out when a new staff member approached me. she told me that her sister had also had  bilateral mastectomies, and had been debating about getting the tattoos. her sister had seen the program about 3D areola/nipple tattoos on the today show. she wanted to go to vinnie myers ( the person in the today show segment, and the person who did my tattoos). the staff member said "  i would like to ask you something unusual  and feel free to say no if it would make you feel uncomfortable." what she asked me was would i consider showing her sister ( turns out she worked in this office,too) my tattoos? without even thinking about it too much, i said " why, sure!".after i checked out, i was to meet the staff member and her sister in the room where my photos were taken.

i followed her to the room, and her sister was already there waiting. we said a quick hello, and then i unbuttoned my shirt and showed her my chest. now, i am not in the habit of flashing people. in fact, only a very few  people ( mostly doctors) have seen my beautiful tattoos, but this felt like the right thing to do. i talked to her and told her how much getting those tattoos  had helped me . having that procedure has been a huge part of my healing process. i happened to have one of vinnie's cards in my purse. i gave the business card  to her and after we talked for a little while longer, i told her to go ahead and call for  her appointment. i could tell that she just needed a little nudge in the right direction. the proof is in the pudding, or in my case, under my shirt. every woman is different, though. what is right for me, may not be right for someone else. but i feel that i helped someone out and it felt good. as i walked by the receptionist's desk, several of the staff stopped what they were doing and  smiled at me. one woman waved and another gave me the thumbs up. perhaps it was not such a strange thing for me to do after all.

i also realized that i never made cookies for my general surgeon. coincidence? i think not.

Tuesday, October 24, 2017

"rocks and waters,etc, are words of God, and so are men. we all flow from one fountain Soul. all are expressions of one Love. " quote by john muir

having had cancer twice, i have often wondered " why me?". not why did i get cancer twice, but why did i survive when others i have known have not?  i suppose that you could call this survivors guilt. i have read a little about this lately, and i really did not think about it that much until recently. having a serious disease, like cancer, is somewhat like peeling an onion. the first layers are the early days- diagnosis, treatment, aftercare. i call them  the mechanical part of the process. while this part does require some thought and study, it seems to occupy a different part of  one's  brain. one can make these decisions rather unemotionally or rationally, without a great deal of self reflection.

the next part of "peeling the onion" is realizing that in having had this disease, one's  life has changed forever. there is no going back to what was a more innocent and carefree time. of course, i did not realize this until later on. some of the things that i dealt with before cancer seemed so important, so earth shattering, but in comparison to cancer, they were pretty inconsequential.

after a period of self reflection, and trying to answer the question of "where do i go from here?" i came  to the heart of the "onion". why did i survive? not that i am complaining in any way, but so many others- wonderful, kind, productive, intelligent, important, young,etc, people have not survived cancer. i do not think that anyone can really answer this question. i am very grateful for still being here. i am grateful for the time that i get to spend with my family and friends.

nature is very important to me. i seek solace in being outside. the mountains where i live are as important to me as the air that i breathe. i especially like the part of the above quote from john muir, -"we all flow from one fountain Soul". i believe that everything in this world is connected. i was fortunate enough to be able to see the orionid  meteor shower last week. i awoke at 5am and decided to go stand on our front steps to see if i could spot  any meteors. i really did not expect to be that lucky , but i was fortunate to see about a dozen or so.the orinoid meteor shower is caused by the earth passing through  little bits of debris from  halley's comet. i remember seeing halley's comet back in the 1980's. my husband and i took our daughter, who was only a baby, up to the parkway to get a better view. i see this as a connection between the major event of over 30 years ago, one that i will never forget, and the smaller celestial event that  i witnessed last week.

for whatever reason, i am still here. nothing in life  is certain, but i am thankful, if puzzled, as to "why me." i almost feel like i should accomplish great things now, but i can not imagine what that would be. i am, as i feel a lot of cancer patients are, more aware of my life. i am grateful and will try to make the best of my time here on this wonderful and beautiful earth.

Sunday, October 15, 2017

"so comes snow after fire. and even dragons have their endings." from the hobbit by j.r.r. tolkein

do dragons really have their endings? this quote from the hobbit has been my mantra during the past two years as a breast cancer survivor. ( since this is breast cancer awareness month, i will focus on this rather than my thyroid cancer.) i have talked about my body being on auto pilot during the diagnosis, testing, surgeries, and chemotherapy that i have  had to endure. really, now comes the challenging part. how to deal with the side effects of the treatment phase along with the anxiety that is partially caused by the  every six month testing.

i have tried to be honest about the PTSD, especially the anxiety, that i am having to deal with. along with this, i have had severe muscle and joint pain from the chemotherapy drug that i will have to take for another two and one-half years. there have been other side effects from this drug- an estrogen blocking drug- that i will not expound upon. my physician assures me that taking this drug  is a necessary part of the treatment for breast cancer. being a pharmacist, i am  familiar with the side effects- of course it is very different when you are the patient. it is a struggle sometimes figuring out ways to deal with the numerous side effects left over from the chemotherapy as well. "chemo brain" is very real, folks. i have definitely noticed a difference in my ability to remember names, certain places, and probably the most disconcerting thing is to be in the middle of a sentence and forget a simple word. sometimes i wonder if this is what some people who have had a stroke feel like.

so, this firestorm of events happened to me. i have had to deal with several  side effects that i thought i would never have to deal with. i have had to be creative in facing many challenges. as i see it though, every dark cloud has a silver lining, so to speak. i have been able to retire from work  a couple of years earlier than i had previously planned on. i  decided to enjoy my life and do some things that i have always wanted to do. actually, i am pretty proud of myself for putting myself out there- making new friends, doing my crafts, spending more time with my grandchildren and my children. sometimes i think that i am being selfish. it has been almost 10 months since i retired, and basically, i have just been taking care of myself and trying to get better. i would like to be able to do some public service, and i hope to at some point. fatigue is a big issue for me now  as well. i went back to work ( after 8 months medical leave) a few weeks after my last surgery for breast reconstruction. i found that while i could do my job competently, it took every bit of energy that i had to do it. i went home and felt like a wet noodle. for every day i worked, it took at least two days to recover. i also find that  now, just a day outing with friends, or an all day grocery,etc. shopping day wears me out. that tells me that i am not quite up to myself as yet. of course that brings me to the subject of that somewhat overused, but very true, phrase " your new normal".

yes, i have a new normal now. i have side effects that i have to manage. i have made a concerted effort to have a better diet, and to get more rest. those are two simple, but huge things when it comes to improving one's physical and mental health. i am working on getting more exercise. one thing that i have been doing more of is expressing gratitude. i am truly grateful for my family, friends, and for every good thing that comes my way. even the simplest things in life can bring joy and gratitude. i think that by having this mind set, i am showing appreciation for my world and changing my attitude to a more positive one. honestly, if you think happy, you can be happy. i promise that i am not going all "Pollyanna" on you, but the mind is like a computer- it can be reprogrammed.

so some snow came after my firestorm. what keeps me going, my mantra, is that " even dragons have their endings." i am hoping one day that will be the case for me.

Tuesday, October 3, 2017

"living for tomorrow, only takes away today. can we be happy like children, they're not afraid to lose their way; and if they walk in the wrong direction, they will never go astray;...cause when i sing with a heart of a lion, nothing can stand in my way. ... it takes my fears away." lyrics from heart of a lion, by alex boye

first of all i would like to thank my son dylan,  for introducing me to the music of alex boye. if you have never listened to his song " lemonade" you should. it was my theme song during my treatment for breast cancer. i still listen to the song fairly often, and i always get teary eyed when i come to the part in the song when he sings " you were saved for a reason". i will admit that i write this blog partly as therapy for myself. but a major motivating factor in writing about my treatment, my travails, experiences,etc. is to hopefully help others.

in my last blog, i talked about PTSD and other issues that we cancer patients deal with after our diagnosis and treatment phases are completed. there is that " i want to be happy" issue that we all deal with. cancer took my joy, and i want it back, to paraphrase lucinda williams. happiness does not just drop from the sky, unfortunately; we have to actively seek happiness. one thing that came with my cancer diagnosis, was a deeper  appreciation of my family and friends. i received a lot of love and support from a lot of people. i am eternally grateful for this. even considering this, sometimes happiness is like an elusive bird in the sky. sometimes i can spot it in the sky flying high above me, and sometimes, just sometimes, the bird will come sit on my shoulder.

last night, for instance, that  bird of happiness was sitting on my shoulder. my husband and i attended my grandson's soccer game. my grandson is 5 years old. watching a bunch of 4 and 5 year olds play soccer is just  plain  joyful. sure, they stick to the soccer ball like velcro, but there is lots of bouncing, gymnastics( 3 or 4 players inevitably end up in the soccer net whenever someone scores), hand holding, hugging, shoe tying, laughing, playing outside of the lines, just to name a few things that happen during a game. i am happy to say that everyone, no matter what side you are pulling for, claps for the player(s) when a goal is miraculously made. no one keeps score, at least not officially, and both team members  feel like winners.

what made me the happiest last night, though, was when my grandson, without being prompted by his parents or coach, saw a little boy from the other team standing alone on the field. he went over to him, put his arm around his shoulders, gave him a big hug, and walked off the field with him. the kindness of children always amazes me. they help each other up when someone falls, no matter if they happen to be  their teammate or someone from the other team.

so everyone came away a winner last night. the children were happy, and the parents and grandparents enjoyed a game that while was not played exactly by the rules, was joyful. i am trying to catch that elusive bird of happiness. it takes some practice. it takes having the heart of a lion- not being afraid to go after it. living every day to the fullest and being present in the moment-  because tomorrow is never promised.

Friday, September 15, 2017

" i don't want you anymore, 'cause you took my took my joy, i want it back. you took my joy, i want it back." joy, by lucinda williams

i realized the other day, that i have been dancing with the "big C" for the past seven years now. the first time i got a cancer diagnosis ( it was thyroid cancer)  i was at work. my doctor called me ( she could not reach me at home) to give me the news. needless to say, i was pretty upset and had to go home. then i had three skin cancers thrown into the mix- they were not serious, but disconcerting nevertheless. the third time, and i sincerely hope the last time i hear those horrible words, i had left work, thinking that i would return after i had a 3D mammogram. i had been called back, after an initial mammogram a couple of times  before because i had dense breast tissue. i was not worried at the time, but did worry when the radiologist ordered an ultrasound. i called work and told them that i would be back- but a little bit later than i had thought.

time seemed to stand still . the technician came into the room where i was waiting and told me that the radiologist wanted to speak with me in his office. my heart almost stopped; this was new territory for me. this radiology center gives a long stemmed rose to all female patients having mammograms or ultrasounds. i remember taking the rose that the technician offered me after i was dressed. i remember walking into the radiologist's office. it was dark, and he had a picture of  my left breast up on his computer screen. i laid the rose down on his desk and looked at the monster inside of me. i am not an expert at reading ultrasounds or xrays, but even i knew that what i was looking at was not normal. the radiologist let me come to my own conclusions. he said that we would not know for sure until after i had had the needle biopsy, but the doctor, nurse and i all knew within a reasonable doubt, what the outcome of that would be.

i called work and told them that i would not be coming back in that day. i drove home on auto-pilot, and i am not sure where the rose ended up. that was the beginning of  almost a year of more biopsies, surgeries, chemotherapy and reconstruction. most of the time i was present in body, but my mind was elsewhere. some place safe. my husband was with me for all the other tests, treatments,etc. so i was fortunate that he was my eyes and ears during this time. it is the most surreal feeling to be told the unimaginable. i made treatment decisions, informed ones, but my body was on auto pilot. i just needed to get through the medical part- survive the surgeries and chemotherapy- and then i would deal with the emotional part.

i had always thought that only victims of war get PTSD. i was wrong. it was after the worst physical pain that i began to suffer in other ways. panic attacks, sleep disorders, coming to terms with the fact that i might not survive the cancers, worry for my family, just to name a few things that i was obsessing  about now . my brain had left that safe place and now i was having to deal with all of the other issues that i had pushed aside. i felt guilty for feeling these things. after all, i had wonderful support from my family and friends. i was able to write about what was happening to me in this blog- which has been my lifeline. why then should i be feeling all of these negative emotions?

a few months ago, i happened to read an article about cancer patients and PTSD. a light bulb came on. i realized that i needed some major life changes if i was going to get better. i have  already made some positive changes in my life, but i need to make some more. i retired from work- about two years earlier than i had first planned. i loved my work- i like to help people and i love to do medication counseling. but the store where i work is a high volume, stress filled environment. i know that stress alone did not cause my cancer, but stress probably weakened my body's immune system and that was certainly not helpful.

another thing that i  have done is to get involved with doing some crafts that i had always wanted to do. i am making soap, candles and stained glass pieces. i also read that doing crafts, learning to play a musical instrument- anything that is a newly learned activity, is helpful in dealing with the symptoms of PTSD. my husband and i have spent the majority of our lives working and taking care of our family. working long hours, 13 hour days to be precise, as well as weekends and holidays left  little time for anything else. i am happy to say that now  my husband and i are cultivating friendships. it is wonderful to be able to spend time with friends- both old and new. we actually have time to do things with our friends. and of course, two of my grandchildren live close by, so we are so happy to help out when their parents need us. actually, it is a pleasure to be with our grandchildren, and my husband and i love being able to say " yes we can" instead of " no, sorry, we have to work."

i have read that exercise is also good for PTSD. i have a bad knee and have not been able to go go zumba for a couple of years. i can not find a tai chi class near me, but i have purchased a video and hopefully doing that, and walking, will become a healthy habit for me. i am also working on my diet- not just to lose a little weight, but just to incorporate healthier foods into my diet. sounds like i am making new years resolutions here, but i am just trying to come up with a plan that works for me. counseling is also another great option. i have considered this, but have not made any immediate plans to do this- yet.

cancer took my joy. it has impacted my life for the past seven years. some people do not understand that just because the  medical treatments are over, that it is over and done for cancer patients. i think this is when the hard part comes. how to deal with test anxiety, worry over the smallest symptoms- is the cancer back? and of course, worry that the cancer will come back with a vengeance and the impact that it will have on your life and the lives of your family and friends- the people who love you.

i am working hard to recapture my joy. i am trying to deal with PTSD, as well as side effects  of the chemotherapy medication that i take every day, and will have to take for the next 3 years or so. i am also coping with the side effects from the surgeries and chemotherapy that i had 2 years ago.  i am not quite to my happy place yet, but i sure am trying. the "big C" took my joy, but i am working to get it back.