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 him.so 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 joy..you 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.

Wednesday, September 6, 2017

" how does it feel? how does it feel? to be on your own, with no direction home, like a complete unknown, like a rolling stone. " like a rolling stone, by bob dylan

oddly, or not so oddly, enough this blog is going to discuss salivary gland dysfunction- including salivary stones that can occur after treatment with radioactive iodine in patients who have had thyroid cancer. i am afraid that i know quite a bit about this subject from first hand experience. i had my I-131 ( radioactive iodine) in 2010. it was a large dose- 155 milicuries. in about a year after my I-131 dose, despite faithfully  following instructions that i was given ( drink lots of water, suck on sour candy, drink sour lemonade, to name a few) i developed salivary stones. how does it feel? well, bob, not very good. my first time experiencing salivary stones was when i was at work ( of course). my technicians and cashiers noticed that my jaw was swelling, looked  red and was  hot to the touch. they asked me what was wrong. i had no idea. i was praying that it was a dental issue ( also a side effect of the I-131) so i made an appointment with my dentist. he said no dental problems, but he felt that it was salivary stones in my parotid salivary glands and referred me to an ENT for a diagnosis. the ENT agreed with my dentist, and so it began.

here is the short version of what happens with I-131 ingestion. the I-131 is meant to kill any rogue thyroid cancer cells still present in the neck area. what it also does is hone in on the salivary glands where it is concentrated and secreted into the saliva. this appears to be dose related. NOW, not when i received my I-131 dose, the recommended max dose is generally 100 milicuries. the trigger dose for salivary gland issues, at least in a couple of articles that i have read, appears to be about 150 milicuries and above. other fun side effects from the I-131 include: dry mouth, taste alterations, increase in dental cavities, facial nerve involvement, yeast infections of the mouth, inflamed and sore mouth- to the extent of interfering with eating, and neoplasia( abnormal growth- a tumor, but not always cancerous). interestingly enough, there is now a drug, not available when i took the I-131, called ethyol ( amifostine) which is sometimes used to protect the salivary glands and kidneys. i am not familiar with this drug. i think it is given IV, but if someone reading this blog is about to get some I-131, it would behoove you to ask your doctor about this, and ask if you would be a candidate to receive this new drug.

so salivary stones and salivary pain and swelling may be due to thickened saliva and/or scarring of the salivary glands due to inflammation caused by the I-131. you might be asking yourself about now if i am having regrets about getting the I-131. and the answer is no. my thyroid cancer was aggressive ( papillary with follicular variant ) , stage 3. for a person who has a lower stage, less aggressive thyroid cancer, it would seem prudent to talk to the doctor about a lower dose of the I-131, if needed. some patients choose not to take the I-131, and that is an individual decision. my doctor and i felt that the benefits outweighed the risks of the I-131. i urge people to research and read all the material available  on the I-131, consult with your doctor, and then make the best decision for you.

so, what does one do who has salivary issues or salivary stones? an office visit with  a good ENT is a pretty smart starting point. i will use myself as an example when i am talking about treatment. we are all different, though, so what works for me, might not for someone else. also, i will mention here that there is laser treatment to unblock salivary glands. this is available, for the time being, only in larger cities. i am sure there are risks involved with this, as with any procedure, and i do not know the pain involved, the risks  or cost of this procedure. frankly, it could be more painful for your wallet, if you know what i mean.

what my ENT recommended to me was as follows: gentle massage, heat on the area, sour lemonade or sour candy, lots and lots and lots of water, and if needed, ibuprofen for pain and inflammation. over the years, i have noticed that certain foods tend to cause a "salivary gland flare" for me. these would be chocolate ( !) and highly sugared foods. there are others, but these are things that i have to be careful with. i can have SOME of them, but if i consume too much, i will usually have pain and inflammation in my salivary glands. prevention seems to work best for me. i also have problems if i do not drink enough water. i have purchased a few 24 oz water bottles, and i try to keep up with my water intake. this also helps with dry mouth. there are commercially available products that you can buy for dry mouth, but drinking lots of water seems to work best for me.

i hope that i have answered a few questions about salivary gland pain, swelling and stone formation. it can occur days to years after a single dose of the I-131, or not at all. it seems to occur in those patients who have  received a larger dose of the I-131. in the majority of cases, the salivary glands will heal on their own, requiring no further treatment. in others, me for example, it may be an ongoing problem. knowing how to deal with the symptoms, and even better,  preventing  a "flare" ( my word for this) seem to work best for me.what prompted my blog on this subject was the fact that i went months and months without a flare, and then had one a few weeks ago. also, a good friend of mine is dealing with this issue. if someone has further questions, i will be glad to address them if i can. but i do recommend that you see an ENT to get a definitive diagnosis as a starting point. see there, we are not on our own, and we have some direction home.  

Monday, September 4, 2017

" you certainly usually find something if you look, but it is not always quite the something you were after. " a quote from the hobbit, by j.r.r. tolkein

generally i love the month of august. i get to celebrate my birthday near the end of august, and i am still enough of a child to delight in the celebration of my birth. this year however, while i enjoyed my birthday very much- thanks to my family, especially my grandchildren, all three of my six month cancer check ups became due in the month of august.

at the first of august, i had my thyroid cancer checkup- ultrasound and blood work. everything was fine here- just some adjustment to my thyroid medication dose, which is always a slippery slope, as every thyroid patient, cancer or not, well knows.

towards the end of the month, i had my breast cancer check up- blood work and office visit. you may be wondering at this point if i have any blood left. my endocrinologist ordered 5 tubes taken, while my oncologist only needed two tubes. that left a little left over for me. my tests all came back fine, i suppose. my oncologist was on vacation, and i saw a nurse practitioner. not that i have anything against nurse practitioners, but this one was grumpy and needed a nap i think. i will be seeing my oncologist in february- along with everyone else now, i guess.

my third" six monther" ( i made up a  new word, spell check hates this) was with the dermatologist. i do not consider myself a skin cancer survivor, but i have had one basal cell removed from my face, and two squamous cell carcinomas removed from my leg, so i guess that technically i am a skin cancer survivor,too. not to insult skin cancer survivors- far from it.  basal cell generally does not cause too many problems, but squamous cell can be very aggressive, and people can die from this if it is not diagnosed early enough. i have mentioned the importance of wearing sunscreen in one of my earlier blogs. of course, the skin cancers most of us adults are seeing now were caused by the sun exposure that we received when we were children. you know, back in the day, when we put baby oil on our skin and baked our poor bodies in the sun for a few hours or so. of course, in my case, i did not tan- just freckle and burn. also, one of my college  roommates' dad was a plastic surgeon. my roommate told me that some of his best customers were those people who had had too much sun exposure. in fact, her family never went to the beach on vacation- they always went to the mountains. my roommate had very white skin when it was not fashionable. since i generally  learn by example, i stopped torturing my skin and tried not to get sunburned- at least not as much.

still, i was very surprised when my dermatologist had to take a biopsy of (what he thinks is ) another skin cancer on my face. of all of my six monthers i was not expecting to be concerned with my dermatology check up. i am not supposed to get the results for about two weeks. if it is not skin cancer, then i am done and no worries. if it is, then i am in for another mohs procedure on my face. hopefully that will be all that i will have to have done. i have had the mohs procedure for the basal cell on my face, so i know what to expect with that. not fun, but as my dermatologist told me: " well, what do you expect? you are a redhead in the south!"

i have one of those small circular band aids on my face, and apply some antibiotic ointment daily. i did not think that my grandchildren would notice it, but even my nearly two year old granddaughter said. " mimi, what happened to you?!!" i told her that i just had a boo-boo on my face. she was o.k. with that, but i had to go into further details with my grandsons. i could have said, well if you pick a fight with a dermatologist, you will not be the one to win, but i did not want to scare them. after all, they are" nearly redheads" in the south,too.

so now, somehow, i have all of my six monthers on the same schedule! i am not sure if that is a good thing, or a bad thing. i guess it is good that i can get them all over with and have a six month break. hopefully soon, they will all graduate to one yearers. sorry, spell check.


Tuesday, August 22, 2017

" i see trees of green, red roses too, i see them bloom for me and you, and i think to myself, what a wonderful world. i see skies of blue and clouds of white, the bright blessed day, the dark sacred night and i think to myself, what a wonderful world....i see friends shaking hands, saying " how do you do?", they're really saying, " i love you". what a wonderful world, by louis armstrong

a very dear friend of mine passed away today. she was not a "blood relative", but we always said that we were family- sort of sisters in friendship, you might say. i am going to miss her terribly- she had a very good heart. when i was undergoing chemotherapy in 2015, she called me almost every day to see how i was doing. some of my friends did not call to check on me. i suppose that they did not know what to say, and in the past i may have been guilty of this as well. but my faithful friend never let me down. my sweet friend had been in declining health for a few years now, and had had a few very close calls, but she always managed to battle back- until today.

i have been trying to make sense of this loss today. what have i learned? what would my friend like to say to me if she were here? i think perhaps she would say, " bea, make the most of each and every precious day that you have on this earth." i have had a couple of close calls myself in the past seven years. each time, i reminded myself to be present in life- to tell people how much i love them, to enjoy the small and wonderful things around me. today, my husband and i took care of our five year old grandson, as we will be doing again  tomorrow. his parents are teachers, and had to go back to work. i am so thankful that we can help our family out, and we certainly enjoy each and every minute we get to spend with any of our grandchildren.

my five year old grandson said the most amazing thing to me  today. it was raining, and i said, " oh, i am so sorry that it is raining!". he said, " mimi ( that is my REAL name, by the way), i love the rain!" i said, why do you love the rain? i thought that he would say he loved jumping in mud puddles, perhaps getting to be inside to watch a movie or something like that. what he said was this: " mimi, i love the rain because it is a way that God talks to us. He talks to us with  the sunshine, too." i hardly knew what to say to that. i am not one  to force my religion on anyone else. i am not one of those " my way or the highway " kind of people. i believe that God hears a prayer said in nature, just as clearly as he hears one that is said in a house of wood and stone. the wisdom of children is powerful, true and not to be ignored. i told my grandson that i agreed wholeheartedly with him.

with this loss, i am also reminded of that statement that keeps popping up on social media. it goes something like " eat the cake, buy the dress, take the trip, etc." why is it so hard for us adults (meanwhile children have things pretty much figured out, in my opinion) to enjoy life and be kind to others? if there is something our hearts desire, we should do it now. we may never get that chance again- nothing is guaranteed in this life.

if you happen to be a cancer survivor - be it thyroid, breast or any other- i hope that you can appreciate all of the beauty in this world. there is kindness in spite of some madness that has been happening. enjoy your life and be grateful for every wonderful thing that comes your way. i am sure that my good friend would remind me of this fact as well.

Sunday, August 6, 2017

" looking back on when i was a little nappy headed girl, then my only worry was for Christmas, what would be my toy. even though we sometimes did not get very much, we were happy with the joy the day would bring....i wish those days could come back once more, why did those days ever have to go, i wish those days could come back once more, why did those days ever have to go, cause i love them so." i wish ( somewhat altered) lyrics by stevie wonder

i posted my blood work, ultrasound and appointment results on facebook, but i realized that not everyone who reads my blog is my facebook " friend". so for those of you who already know how it went, sorry to repeat this subject. i got a good check up basically. the most important thing, was that my thyroglobulin was less than 0.1 and  my anti- thyroglobulin antibodies were less than one. these two numbers were elevated for three years after my surgery and radioactive ( I-131) iodine treatment. those were a tough, worrisome three years. luckily, my endocrinologist did not panic, and we just kept my TSH very low, or suppressed, near zero, and waited it out. my doctor was considering another round of the I-131 just before my thyroid cancer indicators( above mentioned blood work) returned to the cancer free zone.

as far as my other blood work went, my TSH was good - 0.006- a little low, hahahaha. but that is the way that my endocrinologist wants it- i will explain why later in this blog. my doctor scared me a little during my office visit  when she first started talking to me. she said, " how are you feeling? are you having any heart palpitations, chest pain, shakiness, etc?" i said no, i was still feeling a little tired in the afternoons, but that was all. a few months  ago, my endocrinologist changed my medication. i went from the synthetic levoxyl and an occasional cytomel tablet in the afternoon, to a naturally derived medication. i know several people who do wonderfully on a naturally derived thyroid medication. in fact, a person in my family, who is hypothyroid, but who has not  had thyroid cancer, is taking this and has the best blood work numbers they have ever had. and best of all, this person feels better than they did when they were on the synthetic medication.  i really, really, really wanted this naturally derived medication to work for me, but it did not. i was extremely tired, depressed, cried a lot,etc - i knew that something was up. and i had to admit, it had to be the fact that  my thyroid medication was not working for me.

 so my doctor switched me back to the levoxyl/ cytomel combo.she called in a higher dose than i had been on previously. i thought that maybe she was trying to jump start my system so to speak.  i had been taking the higher dose of  levoxyl for about a month before my appointment. the reason why she was so concerned about how i was feeling was that my T4 had gone out of sight! the so called normal range, according to this lab- and labs have slightly different ranges- is 0.82-1.77. my value was 2.63 which puts me WAY into the hyperthyroid range. previously,  the highest my T4 has ever gotten to had been 2.1. my endocrinologist freaked out then, so you can image her concern this time.

my t3 was wonderful- 4.1 ( the range is 2.0-4.4). this is the " energy" part of a thyroid medication. i have previously not been able to hit 3.0 mark. but of course, this value  will go down again as i can not continue to have such a high T4. just a side note for those of you who may not be aware of this- synthetic thyroid medications ( levoxyl, synthroid, levothyroxine,etc) are just made up of T4. they  depend on the body to convert the T4 to T3 which mainly supplies the energy to the body. naturally derived hormone drugs ( nature-throid, armor thyroid, etc) contain naturally derived T4 AND T3. this is helpful if there is a problem on a cellular level- if your body, for whatever reason, has trouble converting T4 into the T3 that you need for your body to function properly. it seems to me that the naturally derived thyroid hormone would be the best choice, IF IT WORKS FOR YOU. but unfortunately, it did not work for me. as i have always said, this is not a one size fits all kind of thing. what is a wonderful choice for someone else, may be a terrible choice for you.

my endocrinologist lowered my dose of levoxyl( T4) , and added an afternoon cytomel( T3) if i need it. i really was not happy with this, but i understand that i can not have a T4 that is that high. having a T4 that is too high can cause heart arrhythmia's, chest pain, nervousness, osteoporosis, just to mention a few goodies. it is frustrating to me how complicated thyroid hormone dosing can be. most people, not thyroid patients for the most part, do not realize how difficult it is to get a thyroid dose, or dosage form, that is going to make the patient feel good and be able to function at a somewhat normal level. it is a trial and mostly error experience, at least for me. my endocrinologist has scheduled blood work for me again in three months to see how i am doing. which brings me to the topic of my next appointment...

i was really hoping that i could "graduate" to once a year tests, blood work and ultrasounds. my endocrinologist told me that because i had an area of " very aggressive thyroid cancer" i would need to stay on the every six months visits for a while longer. also, she wants to keep my TSH suppressed for the foreseeable future.  ( i said earlier that i would explain this). keeping the TSH at essentially zero is supposed to keep any thyroid cancer cells that are roaming around in the body from becoming active storm troopers. i was very O.K. with my doctor wanting to keep my TSH at zero. being a two time cancer survivor, i am nervous about there being a possible third time.

sometimes i think about my life before thyroid cancer or breast cancer. i try not to rehash the past, but i do sometimes long for it. i wish that i had never had cancer, to be honest. i have learned a lot from having cancer, though. i have discovered that i am stronger than i thought. i have found out how to be my own best patient advocate. i have really learned what things, and what people, are important in my life. i have learned that if i want to do something, i need to do it now, as the future is not guaranteed.  i have learned not to take anything for granted. and, probably the best thing that i have learned is to be grateful for everything good thing that comes my way.

Thursday, July 27, 2017

" here i am, on the road again. there i am, up on the stage. here i go, playing star again, there i go, turn the page." turn the page, by bob seger and the silver bullet band

it is that time again for me. i had my blood work done this week, and next week i will see my endocrinologist for a neck ultrasound, office visit and discussion of my blood work results. i used to have to drive down to raleigh to have my blood work done, then drive back the next week for my visit. since my physician likes lab corp( that is where her office sends the tests anyway) , she said if i could find an office up here, i  would not have to drive down to raleigh for the blood work. lucky for me, there is a lab corp office in boone. even luckier for me, there is an angel who works there. i am what the med techs call a "difficult stick". five times is my limit, as far as being stuck and not hitting gold. after that, i turn a whiter shade of pale, and start to break out in a cold sweat.

the "angel" med tech who works at the lab corp in boone, uses a butterfly needle. if you get blood drawn as often as i do, you will need to be familiar with a butterfly needle. these are much less painful for the patient and work better for those of us who have veins that like to make trouble. previously, when i had blood work done by less talented med techs, and after all those unsuccessful sticks, they would notice the back of my hands. and the med techs would literally salivate. i have " man veins" in the back of my hands. it is from opening about a million child proof bottles during my 40 years of pharmacy practice. but, as some of you might unfortunately know, hand sticks hurt- a lot.

getting back to the above mentioned angel med tech. she got out her butterfly needle, asked if i preferred one arm over the other ( i do- i can not have blood drawn or blood pressure taken in  the arm that i have lymphedema in) and then applied the tourniquet. then she did something that i have had only one other person do- she closed her eyes. she closed her eyes and gently searched my arm for that illusive vein. it only took a few seconds, and then she found it. i barely felt the needle and my vein held out for the FIVE tubes of blood that my doctor had requested for the blood tests.

you might be thinking at this point that having a relatively pain free and successful blood draw is a minor thing. well, i have to have blood work done several times a year. i am having testing anxiety already- it happens a week or so before my tests and office visits. not having to worry about passing out when they are drawing my blood is one less thing to be anxious about. i thanked this med tech- this is the third time that she has drawn blood from me and every time has been successful. the med tech probably does not know how much i appreciate her talent, and i do believe it is a talent.

one thing that i learned when i was having all of my tests and surgeries for both of my  cancers is that people who work in health care- from the people who clean your hospital room up to your  physicians can make your experience either a positive or negative one. small kindnesses are huge and make all the difference. being a patient instead of a health care provider gave me a new perspective on how to treat my patients. it is not enough to just do your job- and by that i mean the mechanics of your job. it does not cost anything to go the extra mile for someone. be kind, reassure someone who is anxious, take a little extra time to counsel or talk to someone who might need it. i always tried to do this when i was working, but i tried a little bit harder after my experiences on the other side of the counter.

so here i go again. i wish that i could control my test anxiety a little bit better. hopefully things will go well next week, my test results will be good, and i can relax until the end of september. that is when i go to my oncologist for my six months breast cancer blood work and tests. and so it goes.

Sunday, July 23, 2017

"...and the seasons, they go round and round, and the painted ponies go up and down, we're captive in the carousel of time. we can't return, we can only look behind from where we came, and go round and round in the circle game." the circle game, by joni mitchell

i was watching the cbs special this morning on cancer- which was very good, by the way. of course, cancer is such a big complicated issue, that it would be impossible to cover every type of cancer, potential problems associated with a particular cancer , treatments ,etc. but i will have to admit, the producers of this program did a pretty  good job. two predominate themes in this program, at least in my opinion, were the future of more effective treatments  and the  prevention of cancer.( i will lump those into one theme ). the other theme, as i saw it, was reminiscing , or looking back at choices made by cancer patients and the ramifications of their  choices.

in treating cancer, there is no one size fits all, unfortunately. there may be recommended guidelines for treatment in certain types of cancer, but there are treatment options and choices that every cancer patient has to make. it is really a gamble. what if the treatment causes problems on down the line? heart issues and possibly other cancers just to name a few . is the risk worth the gain in other words. when i was practicing pharmacy, i felt that the most important part of my job was to counsel patients on the side effects/ interactions of their medications. i felt that once the patient was aware of possible side effects, they could  weigh the risks versus the benefits of a particular medication. in most cases, i felt that the benefits would outweigh the risks, or side effects, but i always made it clear that this was the patient's decision. i told them to be their own best patient advocate. get the good advice from their physician and pharmacist, and then make a decision that was right for them.

i had to take my own advice and be my own best patient advocate for both of my cancers. choosing a physician, hospital, treatment plan,etc. were tough decisions that i had to make myself. that is not to say that i did not listen to my doctors, family and friends before making those decisions. but i am the one who ultimately has to live with those decisions. that brings us to the carousel part of this blog. having cancer has made me feel helpless at times. i do feel like i am on a carousel going up one day- feeling good about the choices that i have made, but then going down the next- doubting my decisions.

on the cbs program, there was a segment on " going flat" for breast cancer patients. that is a decision that i labored over. my surgeon and plastic surgeon were horrified that i was even considering not having reconstruction. my feelings on this were, well, i am losing both my breasts and even though my plastic surgeon is amazing, there is no substitute for a real breast. and i will not lie to you- reconstruction is painful. the process began when i was on the table having my mastectomies, continued during the time that i was having chemotherapy, and did not wrap up until six months later- with a final surgery to receive my permanent implants. there has been off and on pain in my reconstructed breasts, but it has not been unbearable. i think the one unexpected thing that sealed the deal for me, that finally made me realize that i had made the correct decision for me, was the 3D areola and nipple tattoos. when i look in the mirror now, i do not see two huge scars stretching over my chest, i see a semblance of normal. it is the new me 2.0. not necessarily the best me, but a more acceptable me to my eyes.

i will tell you one funny thing that was said  about reconstructed breasts. the plastic surgeon that cbs interviewed for the cancer program said, " well, i tell my patients that if they sleep on their stomachs, it will be uncomfortable. it will be like lying on a frisbee." hahaha... she is correct on this. i am a back sleeper totally, now.

so, as a cancer patient i go round and round on the carousel. i am up some days, and some days i am down. i look back at the decisions that i have made about my treatment and hope for the best outcome. i am not a warrior. i am not out to beat cancer ( remember, in my last blog i said that cancer beat the stuffing out of me). but i am a decision maker, a planner, and i try to stay positive and enjoy my life. really, that is all that any of us- cancer patient or not- can do.

Wednesday, July 19, 2017

" at first i was afraid, i was petrified...i will survive. as long as i know how to love, i know i'll stay alive... i've got all my life to live, and i've got all my love to give. and i'll survive, i will survive." i will survive by gloria gaynor

i started this blog back in april, 2010, when i was first diagnosed with thyroid cancer. it has served several purposes, i think. writing about my experiences has been therapeutic for me. it has helped me work through my feelings about having cancer in a positive way. also, it has always been my sincere wish that my blog posts will let people know that they are not alone in this cancer journey. for me, not knowing what might happen- and that includes medical as well as emotional issues, is the worst thing. if i can help someone who is afraid of the cancer road ahead of them cope a little bit better by knowing how things were for me, well, then i am  happy. i feel like i have accomplished something, albeit small.

one of my most treasured possessions is a book of my blogs, starting from may 8th, 2010 ( my first blog post )  through december 6th, 2010. my daughter had the book made  as a Christmas present for me. she put a picture of a beautiful butterfly on the front cover, a picture of our home on the back, and an inscription inside the front cover that still brings tears to my eyes when  i read it. it says, just a minute while i get a kleenex, " for mom, who has dealt with her thyroid cancer with humor, grace, and self-reflection. i love you!" i certainly hope that i have done a good job with that. adding a second cancer, breast cancer, in 2015, changed the tone of my blog a bit. while i still try to add humor whenever i can, i think my blog is now more reflective.

the way that i usually write my blogs is that a song pops into my head that i can not get rid of. from those lyrics, i start to think about what i would like to write about. occasionally, the subject matter comes first and then i match it up with song lyrics, but usually the music comes first. music has always been an important part of my life. it affects  my mood in a positive way and makes dealing with difficult issues, such as treatments, surgeries, outcomes,etc, easier for me . being outside in nature runs a pretty close second to music , though. i think that it is important that everyone decide for themselves what are  the best coping strategies - be it music, being out in nature, writing about cancer experiences,etc.and try to incorporate those things into your life as much as you possibly can. music, nature, and writing make me have a happier life. it might be bingo and margaritas for someone else, but whatever it is, my best advice is to go with it.

i recently read about an extremely talented mathematician, from iran, who recently passed away from breast cancer. her name was maryam mirzakhani, and  she was the first woman to win the math world's nobel prize ( it is called the fields medal ) for the first time. one of her co-workers said this:" a genius? yes. but also a daughter, a mother, and a wife." this made me think about the quality verses the quantity of life. certainly, i want to live as long as possible, but the quality of a well lived  life is immeasurably important. only a small percentage of us will be able to do things that are globally important and meaningful. the rest of us should do what we can on a " regional level" you might say to improve the lives of others. i feel that our actions do not have to be on a grand scale. what if all of us did just a few positive things? that certainly  could change the world for the better. or at least in our little part of the world.

it is important to survive. we should all do the best that we can, and all that we can,  to take care of ourselves. but i think that it is more important to actually live a good life .  none of us knows how much time we have here on earth. we can not control the quantity of time that we have, whether  we have a serious disease such as cancer or not . what we all can control, though,  is the quality of our life. help someone, love someone.