Thank you AITC!!!!!

I saved the best for last.  My family and I would like to give a huge giant THANK YOU to the Arlington Infant Toddler Center community.  Our son Connor has attended this amazing daycare since he was six months old.  Starting with the first emergency in July, AITC families have shown us enormous generosity - rides and babysitting and sleepovers for Connor, so many many wonderful meals for our family, moral support and impromptu therapy sessions.  These families basically jumped in and said "don't worry about it" - literally any of it.  It is a debt we will never be able to repay.  I know I would not be doing as well as I am without their positive energy and loving assistance.  

Thank you AITC families, so much, for taking care of us.  It means more than you know.

http://www.arlingtoninfanttoddlercenter.com

Go take a walk!

Today was a milestone... I took a walk!!  It was short, and slow, but it didn't hurt like I thought it would.  Big, big win.  Having had all this pain, I am constantly in fear of having more, and the anticipation is often the worst part.  Pain is still there, hanging out trying to sell me something, but I'm learning to mentally just say no.

A couple other things I learned from my walk:

1.  Speed is NOT IMPORTANT. 

I have always walked fast.  Always.  I am the annoyed person trying to get around the tourists on Newbury Street or Atlantic Avenue.  Walking slow is just so inefficient for a fast walker.  But now that I can barely stand up I would like to apologize to everyone whose leisurely stroll I scoffed at, all those who walk slowly because that's as fast as they can go, who are injured or afraid of falling or who have pain.  I see a slower, gentler walking future for myself.

2.  I can STILL WALK.

Some people can't walk - never could, or lost the ability due to illness or injury.  I still can.  Sure, it hurts a bit now, but I can do it.  I apologize to my kids for having them get things for me, or not helping them look for a toy, or whatever, because I was tired or too comfy with Sunday morning coffee to be bothered.   What I wouldn't give to pick up my son's toys right now.  I'll still need help for a while, but will never not get up and walk to do whatever it is because I'm grateful I still can.

So all y'all who can, go take a walk and appreciate the amazing ability to do so.

Progress, revisited

I posted too soon yesterday... big overnight excitement.  Annoyance is a better word I guess.

First the night nurse had to change one of my dressings.  She did this around 11pm.  It isn't usually any big deal, but I was asleep, and upon waking up, on verge of needing pain meds again, so it wasn't the happiest thing.  But it went fine.

She also had to get blood for labs.  The port that didn't work for this was again not working, even though the needles were changed.  They could get fluid in but not out.  She tried for a long time, then had another nurse try (unsuccessfully), then paged the IV nurse.  Two showed up and were also unsuccessful, so they had to change the needle again (at 1am).  Turns out some blood had clotted in a "safety valve" piece of the mechanism and that basically renders it useless for draws.

Once the new one was in they checked and could successfully draw fluids so they left.  The nurse came back and COULD NOT DRAW ANYTHING.  Got more tips and tricks over phone from IV nurse but nothing worked.  This was upsetting - I had just seen fluid in the tube... why was this not working??

Well, the end of the story is phlebotomy came up around 2am to again do it the old-fashioned way.  Today the IV nurse came up to check what I had, but hasn't been back.  I hope new needles - and not a new port - are all that are in my future.

The Amazing Presto

By the way, this guy is my hero:

http://theamazingpresto.blogspot.com/

Preston is the son of a childhood friend who is winning his fight.  If he can do it, I can too.

Please check out the latest post in that blog for a link to donate to pediatric cancer research.

Progress, I think?

Long day.  Busy day.  

5am: nurse takes blood for labs as usual but has trouble getting it via my port.  This is a shame as it's one of the silver linings of having one that you don't get constantly poked with needles.  She has someone come to draw it.  At 5am.  Not gently.  I hate needles.

8am: see all the docs on rounds, the weekend crew.  Nothing new here.

9am: got new needles in my port.  This has to be done once a week.  This is a weird sensation and this time I was not numb at all.  All things considered, not a big deal.  I told this nurse about the inability to draw blood earlier and she was quite unhappy; she said it meant they didn't want to try hard enough to get it (there are various tips and tricks).  When she left she was on a mission to re-educate some folks.

10am: all dressings changed at once.  First time I glanced at my belly... a glance was all I could handle.

11am: time to move! The great Journey to the Reclining Chair commences.  15 minutes later I completed the arduous, 2-foot quest from mountainous bed to valley chair, with the help of two nurses.

12noon: food.  Earlier in the day I was put back a regular diet (from clear liquids) and so tried to eat regular food.  Felt kind of feverish so didn't get much down. Baby steps.

1:30ish: visit from parents, who are here helping with the kiddos (thanks Mom & Dad!).  Continue feeling feverish and starting to get nervous about it.  Also feeling nauseous but can't tell if it's from food or morphine.

2:30pm: decide I've had enough time in the chair.  I ping the nurse to ask about meds and making the journey back.  

3:15pm: for whatever reason it takes a while to wrangle a nurse this time around.  Thankfully by now the nausea has passed but feverish symptoms remain.  It takes 3 nurses to help me back into bed.  When I get settled I mention the fever.  Turns out I have no temperature.  I have MENOPAUSE.  Right.  I forgot they just took all that stuff out of me.

(The plan for this here is gyn oncology wants to wait for pathology to come back before deciding how to approach hormone replacement and/or treat these other symptoms.)

4pm: take a great big nap.

6pm: wake up from a dream when I laugh in the dream and it jostles my tummy and it hurts.  Coincidentally, the nurse is there to tell me the pain management team wants to switch me to oral medication instead, so I don't have to worry about hitting the button all the time, or getting nauseous.  It will also last longer and eliminate the need for many of the tubes and wires.  Win all around.  New meds taken and tubes and wires removed.

7:30pm: watched the end of The Lord of the Rings: Return of the King.  I wonder, do hobbits get cancer?

8pm to now: ate dinner, chatted with superman hubby, getting ready for sleep.

Here's to less pain and longer journeys on foot going forward.  Next I think I will attempt Mountainous Bed to Ancient Elvish Doorframe.

Taking things out, putting things in

Another day, another emergency surgery!  Though this time I knew most of what was to happen.  It just wasn't exactly what happened.

First, because of all the antibiotics and liquids in my system (no solids allowed), I had all kinds of liquid coming straight back out.  This is the BEST part of having an ostomy: if you let things go too far too fast, the whole system breaks down.  So that happened, twice, and one of those times was while they were waiting to take me to pre-op.  (TMI for sure, but if you've gotten this far in the blog, you probably expect it.  My advice is to expect it.)

Second, while attempting to deal with the second instance of the first thing as quickly as possible, I suddenly become nauseated.  No time for anyone to do anything.  With tubes everywhere and no place to move them.  Awesome!

Third, I could use some pain meds.  I know, I'm about to be knocked out cold - but at that moment there was no way I was getting out of the bathroom without pain and nausea relief.  The nurse definitely concurred, and I got the zofran and morphine right then.  Those typically work quite fast and I was up and out five minutes later.  I apologize to whichever hospital employee had the pleasure of cleaning up after me.

Finally I made it to pre-op.  Procedures are detailed, risks are explained, consent forms are signed.  When an operating room is available, away I go.  All my new surgical team friends are there.  I'm scared out of my mind but these people have told me the whole time, "We'll get you through this."  Next thing I know I'm asleep.

The gastrointestinal surgeon did come out to tell Ryan it went well but they weren't done yet.  I found out today it was a much more complex case than originally envisioned.  Three different surgical teams were involved - 1) gastrointestinal for the colorectal mass, 2) gyn oncology for the ovary, and 3) one more team from urology that had to put in ureteral catheters so they would be easily identifiable during the surgery (the ureters can be hard to see, especially in an abdomen that's already messed up, and you don't want to accidentally cut one).

They expected this surgery to take three hours; it took seven.  Apparently the abcessed infection was the length of the mass, and the ovary was basically dying from the inside out and leaking infection everywhere.  The uterus was clearly affected and there were even possibly spots on the pelvic walls (could not confirm).  They did take out the mass, associated colon/rectal tissue, both ovaries, and the uterus.  They also reversed the existing ostomy and gave me a new, smaller one on the other side.  Unfortunately they could not reconnect the colon tissue that remained, and since I am expected to have some kind of radiation therapy at some point, the scar tissue would make it very difficult to attempt later.  I'm officially an ostomate. 

They've continued the IV antibiotics for now, and I have a pump for some self-serve morphine, and fluids.  Had a brief affair with Dilaudin but it made me hallucinate really weird things (green grass field full of running Snoopy dogs, older ladies having tea at the end of my bed, answering questions by imaginary people who disappear when I blink or open my eyes, that sort of thing).  I know it sounds kind of fun... but it's not.

I'm covered in bandages.  Everything is sore.  My nurse made me get up and sit in a chair for lunch - I know it's good for me but I just wasn't up for it.  I didn't get up until day 2 with the last surgery and that was far simpler than this one.  This was less than 24 hours!

Chemotherapy will still happen next to kill any disease that might remain, probably followed by radiation, and then, hopefully, I'm all done with this cancer thing.  It's crazy how much has happened in the last five weeks, but still such a long, long way to go.

EVERYONE NEEDS HEALTH INSURANCE

It's 2:39am and I could be homeless, sleeping on the street somewhere, with the same original problems - severe abdominal pain, abnormal bowel function, no fever- and it's very likely no one would bat an eye.  Maybe I do work, 12 hrs/wk at McDonald's.  Maybe I don't smell so good as I've been wearing the the same clothes for a while, can't do laundry so easily.  But let's say someone does notice the situation (at work, say) and calls an ambulance.  Maybe I get to an ER and they do the same tests and find the same cancer, they even offer the emergency surgery.

I'm homeless.  I have a job that pays very little with no to little hospital insurance.  So let's assume I can't afford the operation at all.  What do I do?  Writhe in agony until something ruptures and kills me?  Black market opiates in huge quantities?  Get the surgery but selling everything I have?  Begging family and friends knowing I can never ever pay them back?

In the future I'll post costs to date of all this insanity.  It's fascinating and quite educational. My anesthesia cost almost as much as the surgery did.

And I could have a great job that still has lousy insurance.  Same situation.  Maybe I end up declaring bankruptcy just to  recover, just to attempt to start over.

And if I have no insurance?  I'm not familiar but I believe there may be places that will treat anyone regardless of ability to pay.  But still I still have to pay the BILL.  Do you know the size of such bills??  My anesthesia cost near as much as the surgery. In the near future I'll have a running tally of all our costs, to amuse and delight.

This is just what I'm thinking about trying to get to sleep my first night after the "cancer" surgery.  I work for an awesome company, NEPC, LLC - http://www.nepc.com - and won't end up paying a dime out-of-pocket except for copays. THAT is amazing and should commended.  And they are great people besides.  Thank you, NEPC. 

Now I will try to sleep again.  More on today, tomorrow.  I'll be here.

Edit: not to mention, in this situation, how would you afford the necessary prescriptions once you were no longer an emergency?  So many plans don't have decent prescription coverage, if they have any at all.  Very little of this is cheap.  It just blows my mind.

To Surgery

The universe is out of options.  Surgery it is.  Tomorrow morning.   

Removing both ovaries and uterus (though the latter is not a priority) and the colorectal mass and some nearby lymph nodes. Will attempt to reconnect colon but if that adds a great deal of time or anything else isn't going well, will skip that part for now.

It is a longer and more risky surgery but seems no other choice.  You also can't just up and have colorectal surgery.  Now I get to drink a bunch of Miralax in the next 5 hours and I forget what else... need another blood transfusion.  It's déjà vi all over agaiin.

And bonus I just spiked another 103 fever!

Well, if I don't send another update, catch you on the flip side, cancer-free?

To surgery or not to surgery

So far everyone's hope was this infection nastiness would be obliterated by aggressive antibiotics and the pain and fevers would go away.  I could still start chemo soon thereafter.  Sadly I started the day with another high fever.  Now everyone is leaning towards surgery to remove the source of the infection all together, and follow up with chemo to make sure it's all gone.

But no one has been by to say that definitively yet.  Surgery means a long recovery, a delay in chemo.  It also means I'm immediately menopausal.  I don't know what else they could do.  But I wish they'd hurry up and say it.

Passing the time...

This is a typical day:

1. Wake up from one or another machine beeping, ping the nurse to make it stop.

2. Nurse takes care of it. Since you're up she also takes vital signs.

3. Small fever, noted. Back to sleep.

4. Fever getting hotter, very sleepy, can't remember if I already pinged nurse, pinged again.

5. Nurse provides Tylenol and ice packs in strategic locations.

6. In 1-2 hours when temperature starts coming down, try to reorient myself to whatever the heck is going on, by going right back to sleep.

Rinse, repeat.

Baggage

The end is nigh?

That's too dramatic... still... the original plan was for some rounds of chemo to shrink the tumors and then surgically ressect them.  It seems that surgery first may be back on the table.

Yesterday I had an ultrasound to get more info on the ovary - was it torqued, current size, etc.  At the same time I was switched to a morphine drip (1mg/hr).  There was some mixup or delay with the pharmacy so I couldn't get the drip right away.   But the nurse was able to get me a 6mg dose while we waited.

That should have been more than enough but it took FOREVER to get the imaging done.  By then I was in need of more. The radiologist graciously agreed to get my nurse down to give me more, so they could continue imaging (and pushing and prodding and poking). She continued anyway while we waited... I've had plenty of ultrasounds before and unless there is a known issue (hello!) they are never painful. This was painful.

I got the drip and restarted antibiotics

 as soon as I was back in my room.  And then... we waited!!

This morning my oncologist says his suspicion is an infectious mass within the ovarian mass.  That mass also looks like it may be starting to "adhere and communicate" with the colorectal mass.  This is all hard to tease out from one image, so today he's getting the whole team communicating and reviewing all images to date to assess and confirm or revise treatment.  New treatment could be to remove it all before chemotgerapy.

Waiting for again pros, cons, more info.  No tests today at least.

Hurry up and wait

Somehow the universe was not content to let me just start fighting the actual cancer.  That would be too easy.  Instead I had to wake up early in the morning (again) with some kind of belly pain (again) and, for good measure, a fever of 102.5.  I just had the portacath placed so infection was a concern, but the belly pain was new and different (again).  

The on-call oncologist advised we go right to the Brigham ER to get a scan.  Another weekend, another trip to the ER, complete with toddler.  I was in a room in fairly short order.  My portacath was so new the nurses didn't want to access it, so I got an old-fashioned IV.  Morphine was provided.  While waiting to get the scan, more blood needed to be drawn, and the nurse gave me a second old-fashioned IV, in anticipation of me needing antibiotics - twice the IVs is twice the infection-fighting fun!

It took a while to get the scan, and then a while longer for the result, but antibiotics was indeed the next step.  The scan showed an inflammation of my colon (colitis) but no blockage.  It was expected that a course of a few antibiotics would take care of it.

Everything changes when you're an oncology patient.  You get a fever, you're admitted.  You cough, admitted.  You sneeze, admitted.  They told us before I had the scan that I would be admitted, but it took all day to get a room.  I was put in the oncology ward.  The oncology nurses did the more reasonable thing and confirmed my port could be accessed; my old-fashioned IVs were removed.  I was on three different IV antibiotics.  We were basically waiting and seeing.

That was yesterday.  I continued to spike fevers that day and overnight.  Today we were hopeful the antibiotics were doing their job as I hadn't had a fever all day... until late afternoon when it spiked again.  The doctors suspected the mass on my ovary might be abcessed but after an exam and review of the scan again, that was ruled out.  Turns out my red blood count has been dropping too, so there could be bleeding in that mass - if so however the doctors said they are usually self-contained and stop on their own.  

Lucky me now gets to have a blood transfusion tonight as well as blood cultures (from my port and the old-fashioned way, to rule out the port as the source of bacteria) and an ultrasound tomorrow to more closely examine the ovarian mass.  I basically can't leave until they know what's going on - though not sure I could anyway as the belly pain continues, and morphine does do the trick.  

I also can't start chemo until whatever this is is resolved.  I'm not excited that I haven't even started treatment and I'm already exhausted.  I hope I have the chance to get this before it gets me.

Putting things in, taking things out

On Friday I had a portacath placed to facilitate chemo delivery.  A portacath is basically a fancy IV that sits under the skin and allows for direct access to a larger vein. I was very nervous about getting one but have to say I'm very glad to have it - no more needle sticks in my arms!  They also give you conscious sedation.  I was hoping to not be aware of anything, but I guess I didn't take to the sedation as well as I'd hoped... I did eventually doze off, but all the nurses were, um, impressed with the amount of medication I ended up having... I guess I was squirming way too much, aware or not.

Immediately before that procedure we met with a gynecologic oncologist.  She was fairly sure that the colon cancer had spread to the ovary.  (Can I get a "stage IV?")  It would be very unlikely for me to have two primary cancers at different sites, at roughly the same time, especially when it is not uncommon for something in the colon to directly transfer to the ovary.  She said the ovaries are often "sanctuary sites" for stuff and things happening in the lower abdomen.

Her recommendation then is to remove both ovaries when the tumor is removed. And, as managing hormones with a uterus but no ovaries can have its own complications, she would think about removing my uterus as well.  

Better safe than sorry.  And even though this totally sucks, how fortunate that I got to have my two beautiful babies before any of this happened.  I feel for the women who wanted that option and did not get it, whether due to cancer or something else.  You are all far stronger than I am.

Bridge Free!

It turns out that having an ostomy is weirder than you could imagine.  Mine is saving me from incredible pain and other complications, allowing for very necessary treatment, and (bonus) should only be temporary.  Amazing, this thing they can do... but still, not the most convenient thing in the world.  I've learned that sometimes when they do this, especially with a loop procedure like I had, they place a flat X-shaped piece of plastic underneath the loop and extending to either side, secured to the abdomen with a stitch at each end point.  This "bridge" helps with healing and is typically removed after about 10 days.

I got a bridge, and this made it even less convenient and a bit more uncomfortable than it would have been otherwise.  Plastic digging into your skin is not cool.  Plus, a lot of nurses are unfamiliar with the bridge phenomenon and don't have a lot of tips for care and maintenance while it's in place.  At my surgical follow up last week - 15 days post-op -  I was expecting it to be removed, but my surgeon said, "One more week."

It was a long week - but today I had my last follow up (23 days post-op!!) and finally had the bridge removed.  My surgeon said I'd notice the difference immediately; literally, as soon as I sit up, he says.  I'm so happy he was right.  Bridge free!

Vacation

Somehow we got lucky and the reservation we made in Ogunquit, ME way back in March was for the exact right time.  A week earlier or later and we wouldn't have been able to go.  So go we did!  My little guy was so sad to leave - next year, we're going to stay a lot longer.

Everyone is Awesome

I was remiss with my first post to not call out the incredible and overwhelming support of pretty much every single person I know since this adventure began -- family, friends, colleagues past and present, neighbors, our daycare community -- I am shocked and awed by the outpouring of well wishes, positive thoughts and prayers, gifts of food and necessities, and offers of assistance in all ways imaginable.  We are humbled and more grateful than words could ever express.

Most of all, thank you to my amazing husband Ryan, my superman, my rock, my everything.  I could not do this without you.  I love you.

And it begins...

Today is Saturday, the day before my vacation, the ides of August, and day 21 of my new and improved normal.  I do not blog - clearly, since I still use two spaces after a period when I type, and this I understand to be a cardinal sin of writing in the digital age.  Nonetheless I have things to share and news to convey and too many people to whom to convey it.  So, here we go.

Day 21 is actually too late in the story.  For those just tuning in, I'll give you the whole rundown.

A little more than five months ago I thought I had a stomach bug.  Symptoms progressed such that I ended up in urgent care on a Saturday morning in early March.  However by the time I saw a doctor, everything was almost back to normal - no more awful cramps, no running to the bathroom every hour, no fever.  Various poking and prodding revealed no tenderness or other cause for concern.  Tests of bodily fluids were normal.  All was well and good.

The only thing that did not return to normal was my daily constitutional, if you will.  Now, sometimes this happens to people.  I was not overly concerned; this was mostly just annoying.  I waited two months before I went to my primary care doctor.  Coincidentally, on the day of my appointment, my right knee had become quite swollen (for no good reason - painless, temporary swelling has happened to this knee for years).  My doctor was very concerned about my knee and not so much about my gastrointestinal distress.

That landed me with a rheumatologist a couple of weeks later.  Coincidentally, on the day of that appointment, my knee was not swollen at all.  A half dozen canceled appointments and three weeks later I finally managed to see him when there was enough fluid present for him to take a sample.  (That's a lot of fun, by the way, a big old needle in the knee.)  All this told us was the problem was inflammation and not infection.  With that out of the way he encouraged me to (finally) see a gastroenterologist, as the original problem continued to persist.  It was never unmanageable, and aside from a stray contraction-like cramp now and again, not painful.  Nothing about my day-to-day changed because of it.  It was just weird.

A month later I'm at that appointment, and again nothing is overly concerning, and again poking and prodding and all kinds of tests don't tell us anything special.  Next up: colonoscopy.  I scheduled this for Thursday, July 30th.  I was good and followed the rules.  The preceding Saturday, I went shopping for low fiber foods, lots of liquids, and the laxative prep, and tacked the list of what I could and couldn't have for the next five days to the fridge.  All set.

Sunday morning around 4am my belly woke me up.  All of a sudden this was not manageable and very painful, waves and waves of cramps all across my abdomen.  I woke up my husband, Ryan, and told  him something was wrong.  He was barely awake and asked if I needed to go to the emergency room but I wasn't sure.  I called urgent care instead.  My pain wasn't localized and I had no fever, just the agonizing cramps that made it impossible to get comfortable.  The woman I spoke with didn't seem impressed, though said I was entitled to see someone, but as the office didn't open for appointments until the afternoon I felt she just wanted me off the phone.  Eventually I took some Tylenol, and then I got a fever, and I called back.  This time I was told to go to the emergency room - someone would want to evaluate me with tools they didn't have at the regular office.

We went to Mount Auburn Hospital.  All day the cramps had been a little off and on, coming in waves that were very painful, but then would subside for a time.  When we got there they had subsided a little and I started to second guess the decision.  The fever was gone now.  When I got into the ER they gave me an IV, scheduled a CT scan of my abdomen, a chest x-ray, a pelvic exam... and all I could think was, this is overkill.  I drank the purple liquid contrast for the scan and had the other procedures, and within two hours was in for the scan.

Not too long afterwards the ER doctor came in and closed the curtain (all the way this time).  She wanted to talk to me about the results of the scan.  It revealed a mass that looked to be circling my large intestine; it was blocking anything from getting out.  Whatever had been getting out the last four and a half months was only what could leak around the mass.  I hadn't had fevers all those months so infection was not likely.  What was likely was cancer.  She said she was sorry and held my hand, told me they would admit me, and there would be others to talk to me soon about next steps.

Ryan had taken our 3-year-old Connor to get dinner before I went for the scan and I had to text him that the results weren't good and I was being admitted.  An admitting physician came and talked with me before they moved me; she was also sorry.  The ER nurse who got all my things and IV ready to move was sorry but said, "Don't put the cart before the horse."  I cried a little but I wasn't really absorbing the situation in any meaningful way.

The next 18 hours were a painful morphine haze of more tests and surreal conversations.  Now I really had to have that colonoscopy and had to attempt to down 4 liters of prep that same night.  I tried but nothing was moving... I was bloated and distended and miserable.  The first attempt at the procedure the following morning was not successful; a sigmoidoscopy later in the afternoon was and samples were taken for pathology. Scans had also shown spots on my liver and an enlarged ovary, and more diagnostics were scheduled, but I was still in a lot of pain.  Surgery was scheduled for the next morning to (at a minimum) relieve the pain and work around the blockage - a temporary diverting transverse loop colostomy.

I'd say that was one of the longest nights of my life, waiting for that surgery.  I had more morphine every hour but nothing helped when the cramp waves came.  They took me to pre-op mid-morning and I was in post-op by early afternoon.  The procedure was successful and I woke up, having just had emergency abdominal surgery, comfortable.

I also had a new egress that I'd need to learn to deal with, eventually.  I was scheduled for another CT scan, an MRI, blood work... but we just needed the pathology, which normally takes five days.  They got the samples on Monday - if we were lucky we would have results by Friday.  Now it was Tuesday.  So, we waited.  I made friends with the nurses.  I had wonderful friends and colleagues visit.  I had so many flowers they filled the window ledge.  Ryan and I watched a lot of Law & Order (it's always on).  On Friday, I was told I could go home.

A couple hours before we left, the oncologist came to visit.  She had just been in a conference with the surgical team and others, reviewing the preliminary pathology report.  She confirmed for us that the mass was in fact cancer.  She said there would be conversations about treatment and such but first I should go home and recover from the surgery.  I still was not absorbing this information.

We came home.  I recovered.  I saw more friends.  I worked from home.  I even went out to eat!

We saw that oncologist again, and then got a second opinion from Dana-Farber and switched my care there, on the spot - if you've been lucky enough to never have had a reason to go there, please know that if you ever have a reason, you won't want to be anywhere else.  I have a gastrointestinal oncologist, a colon and rectal surgeon, and a gynecologic oncologist (they could not safely rule out the spread of the cancer as the cause of my ovary's abnormal size and shape; the needle biopsy required was too risky should it result in a rupture and spread cancer cells all over my abdomen).  All of them have said this is treatable and curable and they will get me through it.  I have my last surgical follow up at Mount Auburn next Thursday; I get a portacath next Friday; I start chemotherapy on Monday, August 24th.

I have still not fully absorbed the situation.  I cry now and then, suddenly and unexpectedly and usually when I'm alone, and I'm not sure what about.  I'm too young, too healthy.  It's unfair and scary and wicked inconvenient.  It's an unreasonable burden for my husband and kids.  I had no say in the matter and I still have to deal with it.  Of course that's what I will do - deal with it.  I'm adaptable and strong enough and confident in the tidal wave of support that is behind me.  And so we'll get on with the business of getting better.

Today, though, is the day before I go on vacation.  I need to pack.