Fleas and Lice

My goodness. I just cannot believe how long this took to hear anything.

Biopsy was 2 weeks ago. Total disaster. I was in LOTS of pain and awful nausea. Scheduling nurse and I had talked 3 different times about taking my MJ vapors, so I wouldn’t vomit. She said she would make a note of it. Next time, when I brought it up because I remembered the ‘circus’ when having a CT scan.

Once there, however and barely registered, I was taken to the Financial Office to ‘see if they can help me.’ Well, NOT on that day! Just before a procedure.

Again, this ‘nurse’ came up to me as I was waiting on the Gurney to admonish me about ‘smoking’. GOSH! NOT again. I just moaned, cried and rocked with pain. I ‘think’ they finally gave me something for nausea. Speaking of nausea: This last bout of ‘bowel problems’ has been responsible for me losing 35 lbs in 5 weeks. This had me so very worried and concerned. I finally put the symptoms in search engine and there was a NEW word. (New for me.) ‘CACHEXIA’. This is the terrible ‘wasting disease’ caused by cancer. Cancer cells feed and suck the protein out of the healthy cells. NO MATTER HOW MUCH YOU WOULD EAT, even if you could, it would not matter. You starve to death. Being so passionate about food and a decent cook, I thought this would be the most cruel end. Many a night I cried with terror of this death and no one told me different. This was an older dated research and I’ve not had time to find more. BUT, other than some Opiates which they say may or may not be effective, what I did see was that this ONE medication for this ‘condition’ has shown good promises: “CANNABIS”. At that time (2006) it was only legal in Europe. Well, was I happy to see that. I’m already on my way. Then, after a break through 2 weeks ago, when I finally had some peace and less pain with bowels. Three days ago, I strted eating ‘NORMAL’ (organic) food. Just small plate but ‘plate’ never the less. My weight had spiraled down to 155 lbs. I’ve gained 5lbs since. I cannot convey the PURE JOY of feeling ‘Hunger’. I’ve also learned, that I have to have 3 different forms of MJ.

First: ‘Tears of Phoenix’ cannabis oil for cancer. One grain of rice-size about 5 times a day. Ingested with applesauce, 1 mini, tiny piece of ‘European butter’ (fat content is higher.) I found the perfect way to get it down without ‘gagging’. I cut off a slice of lemon, suck on it, throw down the ‘cannabis’ and suck on lemon again. THAT way, no taste of MJ.

I’ve also learned, that when you are so very sick, you cannot eat from a plate or ‘chunky food.’ I was still drinking this powerful bone-meat-veggie-broth. In the middle of the painful night, to soothe my poor abdomen, I would get my beanie bag heated and then 1/2 cup of thus HOT broth.

When Cameron was here and we sat down to eat and I couldn’t, he looked at me with such naked fear and tears brimming, that it broke my heart that I can’t do better. But then, if it had been this disease, nothing matters.  I took a photo of my ‘first food’ and posted it on FB. 🙂

Meanwhile, I have also had an appointmenbt with my ‘regular’ doc whom I beseeched to help me get better with the ‘other stuff’. Also asked him, if he would ‘monitor’ me and note changes and improvements.

I guess, we are still doing the CA 125 even though the Diagnosis is in question. When I learned, that even though the Liver has lesions, it is not cancerous. Once I had shared this, I received many ‘congratulatory’ mails and phone calls.

This does NOT mean, I don’t have cancer anymore but only that not now, on the liver. Everythinbg else was still there, last CT scan. The one with the MOST worrying feature, is the tumor on the aorta. No help for that. This is why the Cannabis has to work because THAT could be my death sentence.

I had asked a friend from the medical field to look at a few things. He graciously did so. Since I don’t have a ‘workable’ diagnosis, I asked what it could be? He answered:’ Lice and Fleas!’

WHAT!?  “Some people have a definite cancer (lice) and some people have a definite cancer ( fleas) and some people have LICE AND FLEAS!”  Best medical explanation I ever had. Thanks.

Had to get another batch of cannabis. This one seems to be much improved and so am I. When you consider, that ALL I am taking for the remaining bowel problem, is ONLY 1/2 of an Ibuprofen and ‘maybe’ 1/4 of a Tramadol, then be assured that’s my entire PHARMA. Less and less pharma pills.

Still envisioning going to Germany and Austria. I guess I will know more after next week’s test.

At the hospitas, later, I vomited all over the place. Horrible experience. I made some decisions. I will have all my tests done here, at home. That will reduce the ‘Misery time’ of about 3-4 hours or more. I live only a few blocks from our Hospital. (They are NOT as rude, either.)

I am supposed to have another Biopsy. (Will call my surgeon and ask if he does this as well.) Not sure if I shoud have before or After the trip. (I will interject that if the ONLY option they will offer me is chemo, I probably won’t take it. My bowels and blood clots would not withstand a new toxic assault.

The other day, I felt soo good, I put some ‘Strauss’ on and  I cleaned my fridge, kitchen, changed guestroom, made Pear Strudel, cleaned my bathroom and THEN….. then I danced a waltz. Alone in my kitchen, the pale sun shinig in and tears running down my face for the JOY of just doing this simple, little thing.

“Chemo never felt this good.’  Cannabis can do a lot but it cannot sew. Healing (sewing) damage. Researching new concepts and treatments.

Lost a few ‘friends’. One, because I take Marijuana. (Gateway to Hell) hahaha. The other one, because I won’t play the Political-Hate game. I JUST do NOT care right now. I am trying to save my life and ignorant opinions do not interest me.

Sure wish I could see my grandkids. It’s been over 2 years with Kaleb and 3 years for Brianna. (Dylan is working, still and busy in the high country.)

 

Camino Not Chemo

This took much longer to do than anticipated. Every turn and test was either lost or Doctor was out of town and left us hanging without results. 

Meanwhile, I had received a new batch of cannabis/hash oil. Three vials to see which one I would respond best to. I took the first syringe and tolerated it well. I noticed that small improvements happened. A wart on my index finger disappeared. Blood clots gone. Whatever type of horrible, painful bowel obstruction that was, it’s nearly gone. Thanks to cannabis. It’s all I take.

Second syringe hash oil was still alright and I started feeling hungry. Great feeling. By now, I have lost nearly 30 lbs. A great downward, scary spiral. Just the mere ‘thought’ of food made me ill.  However, I know what happens once you can’t eat. So, I would cook these great, tasty bone broths and I would sip out of a cup. The heat of the broth felt so nourishing, especially in the middle of the night.

Now, it was time for the third syringe with cannabis. I took the first ‘grain of rice size’ and felt just a momentary ‘burning’ but then it was O.K.  When I woke up around midnight with the same rollercoaster spasms, I took the prepared hash oil, which I had near my bed. Barely had landed in my stomach, when immediately I became so very nauseous and the feeling of hell fire burning me alive in my stomach!! I vomited all over myself, the bed and was so sick I thought I may have to go to the Emergency room. By the time I changed my bed, got into a bath (warm, not hot!) and went back to bed, I was totally exhausted, shaking and crying.

I was very upset with this batch. THEY FORGOT TO BURN THE ALCOHOL OFF!! That is nearly 95% PROOF that hit my stomach full force AND without food.

Lost so much valuable time just trying to figure out what type of strain and oil to use. How much of it to use? With food? or not? No one to ask all these questions. What if people cannot take 1 gramm per day? Will it still perform? Meanwhile we had the new CT scan. Finally had it interpreted. I may have had a ‘mis-diagnosis’. I may NOT have Ovarian cancer, which was treated with a non-working chemo for nearly 1 year. But, instead I have lung and liver cancer. (Oh, still the tumor on the aorta too. It’s been there so long, I tend to forget.) 

At least I can eat. I am starting to ‘think’ about food again. I wonder what people do, that don’t cook ? Or know what to eat? Had friends over yesterday and cooked ‘crackling pork roast, potatoe balls, Sauerkraut and mixed salads. I ate 1 potato ball with sauce. MMM. I guess comfort foods it is.

The CA 125 (which stands for ‘ovarian’ may not be the proper test anymore either. Right back to where I was, nearly 4 years ago. After diagnosis, going to Europe. I still have my frequent flyer mile ticket and am planning going this spring. As I said to my oncologist ‘come hell or high water.’ Want to celebrate my 70th birthday with whatever family I have left, and old school friends.

When I had my INR finger stick to determine how well my blood was running (clots) my local doc was soo amazed how quickly this had healed. I had questioned the nurse to take less of the Warfarin but she argued and insisted. So, for another week I took the strong dose only to measure 8.6 which is WAY too fast.

I am losing energy. This is getting so very long. Friends are still close and caring. Some of my family, not so much. Hurts but ‘it is, what it is’.

So, for now I feel so very much improved and the thought of even having to go onto an ‘Oral chemo’ just really has me in a ‘flight mode’. 

Cameron still having to do all the hard stuff. I can’t even begin to imagine, how it would be or where I’d be, if he were not helping me. So, this ‘crap shoot’ keeps going and we’ll see what comes next.

 

24 Hours in the life of….

Aside

As days passed in a haze of pain and misery, not knowing why I was hurting so bad.. and why the Vapors were not working. Coupled with such debilitating nausea and loss of appetite that I rapidly lost 22 lbs before one month was out. I was trying desperately to slow, halt this slide toward starvation…As a total Foodie and passionate cook, not being able to cook/eat was so sad. Cameron came to help out and take me to the store. It had been days since I’d been out. But only a few minutes in the Grocery store I had to leave very nauseous. Sight and smell of food was ‘disgusting’ to me. I asked to hurry home.

Weak and sick, so sick. So much in pain. PLEASE-DEAR-GOD-MAKE-IT-STOP-PLEASE-PLEASE-PLEASE…..crying and snot running down the same time. That’s all I have against the pain. If I take morphine, constipation so severe, same pain.

I had been off the cannabis for 3 days and decided to restart with the original  ‘rice size’. I swear, that only 3+ hours later , pain subsided and I could ‘go’. But, at night, still between the hours of 1-4 A.M I was in Painhell!! I noticed, that this pain was like a ‘rollercoaster’ peaks and valleys. I thought: this is NOT the cancer, this is the COLON trying to PUSH and if it is blocked, then the matter pushes against your stomach, which immediately makes you sicker than a dog! Being nauseous from NOT eating is different. Learn to listen to your body. The cycle continues IF there’s no relief. In the pain category,

I would judge this way: 1. Kidney stones, 2.Bowel obstruction, 3. Childbirth. (I’ve had all 3.)  Bowel and Birth pain is about the same with ONE HUGE difference: After labor pains you get a lovely, little baby and then it’s over.  With bowel obstruction, all you may end up with is a bag that doesn’t match anything you have.

As lay helplessly weeping and hiccupping, Cameron came to sit with me, talk and hug me.

Then I learned these small but oh so important improvements.

First: I manage the pain throughout with smaller portion but more times. Right now, I take this times 4, so it covers me DURING the spasm time. Then, I take some ‘vapors’ against the NAUSEA. I’ve cooked a strong beef-bone stock and this is what I divided into 2 batches. I take 1/2 cup of hot stock and the warmth that I feel going down, is priceless. The instant relief one gets is miraculous. So. Now I could start to eat. (Cameron did not inherit any cooking genes.) When I woke in the morning without ANY pain nor NAUSEA, I sank to my knees, just overwhelmed with blessed, heavenly relief.

BRAEKFAST: 1/2 cup stock. 1/8th Melon, a few vapor puffs, wait 10 min then 1/2 sandwich.  ( A few vapor puffs, wait, then LUNCH: 1/8 of Melon, 1/2 bowl of Spaghetti with only a little garlic taste and butter, plus 1 German Hamburger. Later: Tea with 1/2 slice bread.

DINNER: Left over Spaghetti, same way with 1 more hamburger.

I have learned to PUREE my food so it will NOT become a harsh mass. BE kind to your colon and learn to eat ‘different’. Your brain only knows ‘what was’. That’s why we want to ‘sit down with the family and eat a nice dinner.’ Well, of course you can sit down with them BUT you cannot EAT like them. We now have a new way of eating. Small portions, pureed so I can have (organic) meat-protein as I’m not allowed much Vitamin K. (Blood clots from chemo). When my friend Silke took me to CT scan and then out to Lunch, I’d asked to have this great soup ‘pureed’ and they are more than glad to do this.

To fight cancer successfully, you should really RESEARCH well. Go to: www.phoenixtears.ca learn how to make it. http://phoenixtears.ca/videolibrary  THIS IS NOT IN A DISPENSARY. You have to find someone to make it. IF it is NOT high in THC content and it’s not been decarboxylated FULLY— then it is NOT Rick Simpson’s oil (RSO). Suggested is 95-98% of INDICA strain .( SATIVA is what is used more for brain matters such as Epilepsy, Alzheimers.)

The latest link is from a Swiss clinic, which reports marvelous successes. When you click on link, there are little Flags which depict language uses.

http://www.qcmaf.eu/our-swiss-clinic-opens-on-the-28th-october

Friends have asked, how much do you take? Well, it is different for everybody. That’s why you start so small. But, rule of thumb: If you ‘poop’ like an elephant, it’s too much, if it’s like a Hummingbird, not enough. (That’s one of the ‘side effects. Great, huh? FOR US it is. I have managed to get it nearly right after 3 mos of hit and miss.

Still waiting on CT scan results. SOO many desperate phone calls and messages. SOOO many people in PAIN. SOOO many ignorant people.  Be at least open minded. Research. You may just save your or your child’s life. There has been an Exodus to Colorado by parents who bring their very sick children to have this PLANT medicine. NO one should be denied to help themselves and their child.  I had to make a decision, when Chemo was in-effective, I remembered this quote: When you are on the edge of a cliff and there’s no way out, you better grow wings OR take a LEAP of faith. This is what I did.

 

48 harrowing hours

I am astounded that I am still here. I am not exaggerating. The whole past months I was continuing with cannabis, I was in so much pain that I was just an exhausted, weeping mess. Every night, between 1:00 and 4:00 A.M I woke up with great abdominal pain. I would try to take 1/2 Ibuprofen, with a half of Tramadol. Might as well spit into the wind. I would put heating on it, I would fix tea, etc. I twist and turn and I could not sleep. Could not figure out why MJ was not helping much.

The next thing that happened was as I was on the couch and my abdomen was extented and I had ‘gained’ 17 lbs starting chemo. I kept telling the nurse, I don’t know why I gain  as I can hardly eat and have to have Marijuana vapors just to get a few bites in. Well, December 29th, the day when this ‘hard knot seemed to ‘snap, break, sharp pull, etc. I nearly blacked out with pain. Some time after I had the urge to use the bathroom. Seemed like an elephant got there first.  I had lost 16 lbs in 2 days. I am holding my ‘old’ weight even though appetite is still a problem.

The way  I am dealing with food is different now. It occured to me that we always expect to sit down and eat our plate. When you’re nauseous that way too much food to look at. So, I wouldn’t eat. BUT you HAVE to eat. Then I had the idea to minimize. I am using my small, tiny prep bowls and would put 3 grapes in one, 2 apple slices in the next, banana, etc. In between, I would use my MJ vapors to produce appetite long enough so I can eat a few bites but I ate throughout the day. I’ve become addicted to Wendy’s Chili. When I can’t cook, that’s is great to have.

The other worrisome change that happened was my mental agility. I felt as if there was a  steel band around my head. Pressure. I would talk to my friends and after every 5 seconds I would ask, ‘what was I talking about? Where am I going with this? It made my friends pay excellent attention as they had to remember.  NAUSEA. NAUSEA. That was my companion all day. I just did not know why. Then came: Depression, anxiety, paranoia, nausea, loss of appetite,  I was getting scared as I felt I am falling into an unknown hole. But by being unable to eat, I was nauseous because I had no food. Terrible catch 22. Since I was already up, I researched Rick Simpson again. I had always used the You Tube video info. I knew that one cannot overdose on Marijuana. You may get really sick, they said, like bad drunk but you will not die as one  would with alcohol. I am the living proof.

There were the ‘Side Effects listed, if you take too much stuff. I had overdosed regularily for 2 months. All of the symptoms that are listed  further up are the ones. My goodness. Trying so hard to save my life- may kill me! But from chemicals NOT MJ. I stopped right away to hydrate and try and flush it out. But I was so nauseous. VERY surprising, I had absolutely no withdrawal or anything like one would with some REAL BAD drug. Not addictive UNLESS you decide. When I’m well, then I’m done stuff!

Doctor exams, all well. They said not to try to diagnose myself. I said, well, I’m sorry but I had NOT HAD the best of luck with proper diagnoses. Besides, that’s what we do. When things are not really helping, you just want to do it to get it done. Just want the pain to stop. Just that tiny bit of ‘mental problem’ the weeping, etc. is so very painful (even if it is not you) that ‘anything’ would do to ram it in there to STOP.

My blood pressure , three hours later when I saw doc, was still 190/95. She said, she could not believe that I did not have a stroke. Also, the horrible, horrid abdomina pain was an “bowel obstruction’, which is fairly common with chemo. (Also, chemo injures the colon. A woman from my support group, died because most of her colon had become thin as paper and then broke when fecal matter moved through. Because I had been regular I did not know.

CA 125 cancer marker numbers were UP but not much. Doc said, what with all that trauma of colon and nausea and a new Lab may be responsible. I am NOT starting another chemo. My colon is trying to repair itself. I did say again, that I did NOT think that this was the ‘Cancer’ . Maintaining that 1/2 of an Ibuprofen would not help managing cancer. Besides, it would also be painful during other hours. (Oh, excuse me. I just ‘diagnosed’ again.  :-)I think it’s healthy LOGIC. I’ll just keep it to myself. Tuesday CT scan to see ‘inside’. At the cancer center I was so manic and wired, that I had to ‘suck’ on my vapors to get rid of feeling. The problem was, that there was too much SATIVA in it. This works on your mental receptors. That’s why they are using it on Alzheimer patients now. INDICA is the one for cancer and many other illnesses. It is usually mixed because Indica seeds are very hard to come by and GOVERNMENT does NOT allow the cultivation. So, we have a ‘lower’ quality. I suppose, Gov wants to make money too.

A friends’ 95 year old mother is on this for Alzheimer’s and doing pretty well. (She still has Alzheimers but not so severe and has bright times.

While I was gone, my sweet friend cleaned the whole house! Vacuumed. Had taken the morning off to give me this gift. THIS IS WHAT WE NEED. Someone to help. When I walked in, I cried. She also came after work to stay with me until my other friends came. They had gone out for their anniversary dinner. (My friend texted if it was possible t come, not knowing. ) I will cook you a 5* menu when I’m better to make it up. Love you guys.

Also had to get back on Warfarin because ‘those numbers’ were too low. 

Trying to get cannabis after my son left for a little time off, turned out to be a very stressful circus. It has become harder and harder for me to get this ‘paste’ down, even with aplesauce. My gag reflex is the best working thing in my body.  I was anxiously awaiting my appointment for blood work to see new results. Also had appointment with my ‘old’ Oncology surgeon who gave a big hug and smile. I had wanted a CT scan to see if the tumors had less or more activity. I mean, I had 2 hours between appointments and I didn’t want to make an extra trip.  Not till Tues.

The night before my appointments, I was not feeling well. But, as usual since there is nothing  else I can do, I used my homespun tricks. Finally, I got up at 1:28 A.M to take a hot bath with epsom salt, which always helps. I ran the water into the tub, added salt and could hardly wait to go into that wonderful warmth. I figured since I’m already here, I might as well shave my legs, now that’s it’s growing agin. Suddenly I was overcome with a nausea so severe that I thought this is BAD..black spots in front of my eyes and I could hardly breath. I propelled myself out over the rim of that high, old tub, as I was afraid of ‘blacking out’ and drowning. There I was. The skin of my whole body was Lobster red. Never experienced anything like it. I looked over to the tub and all I said was, ‘well, that won’t do.’ I crawled to the bedroom because I was shaking uncontrollably and felt like fainting. I need  HELP I thought. I called my good friend Bonnie. There are REALLY friends you can call at that time. She drove right over. She stayed with me until my other friend Berle, came to take me to Grand Junction. As we were sitting there, talking, I remembered suddenly a sentence in a conversation that I had with a nurse friend, right after the blood clot incident. I was telling her about my tub/salt preference. She looked at me funny and said: YOU CAN’T TAKE A HOT BATH WHEN YOU ARE ON CUMADIN! WARFARIN!! I had a severe reaction and nearly had a stroke. That’s what that bright lobster red was. I had taken the pill the evening before.

Some people received wealth, Beauty, talent at the time of their births. I? I received 9 Lives. THANK GOD!

This is for my support group “TEAL Warriors:

Dear friends. I’m using this way to answer requested info.

Marijuana is the plant.  Cannabis as a product, divided into INDICA and SATIVA  (many otherstrains and combinationa.) ONE product dowes not work on everything. It’s like cooking. Let’s sa, recipe calls for Parsley and Dill , they go well together but if you add some curry that’s not good. The right strain for the ‘right’ illness. You need the TEARS of PHOENIX model, not just ‘some oil. I can’t afford Rick Simpson’s oil as it is %4000.00 for 3 mos. Still WAY cheaper than chemo but WE have to pay this. I needed an EXTRA $1200 per month to buy my cannbis. My son thinks, that these prices were before it became legal in a few states.

My son gave me the Link to a Foundation to help financing the treatment. I can’t access the link right now but I will later.

You remember how you start? a small rice-grain size with European butter to take it. The higher fat content will intensify the healing properties. What cannabis does, is to instruct the cancer cells to committ suicide without harming surrounding cells. This could have been the reason that my first month on it, the numbers were lower.

Tears of Phoenix is NOT like cooking OIL. It’s a dark, dense PASTE. You take it x3 a day. Also supplement with Tinctures, Vapors and WEW. (What ever works.)

Victoria, and all of you precious friends try to get this. I cannot promise ‘it’ will do exactly the same with you guys. Everyone is different. The break through from blocked bowels was the prolonged (2.5 mos) use of cannabis. The properties of the LEAF PLANT had worked it’s way through, THANK GOD. After that, the terrible pain was gone, the nausea dissipated. Oh MAN, I can take a deep breath without thinking I’m throwing up. Just the next day, I’ve eaten more than the other 3 days combined.

Research : Rick Simpson but this time NOT on You Tube. There’s a new web site full of GREAT info, testimonials. Go to www.marijuanadoctor.com  If you need more info, CALL> xxxooo

CANNABIS vs CANCER

At first, I wanted to wait until I had results from CA 125 blood test. But, meanwhile, things change and my memory is not the best these days. In 2 weeks, I will start my 3rd month on cannabis oil ONLY. People have asked me why I would not take anything else with it. Like, chemo or pills. How would we know WHAT had worked? I need to know that it was the cannabis. It’s vitally important to many people who are waiting to ‘see’ how things turn out with me. Of course, many cancers are different and this treatment is too new but we do know, it works! 

I don’t understand it. Someone has cancer. They do all the conventional treatments. Then, one day, while they are settling into their chemo line and sit there, while Toxins run into the body and they’re trying so very hard to use gentler Visualization of this ‘liquid’; why they would NOT run out and get something far less damaging. I thought, once they see that it works and cancer numbers are coming down, that this would convince them. Well. Knock me down with a feather!! That did not happen. I suppose people will do what they KNOW. No matter that it fries their intestines, damages veines, loss of hair, appetite, sick, sick, sick till the cows come home. And you want to use it again? How many people know that Chemo comes from Mustard gas??

Well, then comes the day that they tell you, you have become “Chemo resistant’. When you have no choice, then you eat dirt if it helps!! Wouldn’t you think that in over 50 years of cancer reserarch and the BILLIONS of dollars for research, they’ve not come up with something better and more humane. Already in 1989 the Cancer Industry made more than 100 MILLION per year from cancer, in the US alone. What does that tell you? Huge business.

Christmas was a quiet affair and sad. Grandkids are too far away, and so is family. No tree this year. No money for frills. It all goes to ‘Cannabis.’ This ‘new’ batch though was MUCH more pleasant to ingest and it only takes applesauce to get it down. The taste for that split second in my mouth, gags me. I would never make a ‘Druggie’.

Here is a BIG shout out of THANKS to the group: German Girls Living In America.’ It is due to their compassionate collection and donations, that have made this possible. Ihr Lieben. I cannot thank you enough. Also, your never wavering Belief and support means the world to me. Other friends have made generous christmas checks and so I could have another month.

Cameron is in New York. A well deserved Respit. I’ll try not to bother him while he is there. (Hope you have LOTS of good times, son.)

To get a refill on cannabis, I called the producer of this oil. (Usually, Cameron does this for me as it takes over an hour to get it to Montrose.) This turned into a circus of frantic messaging. But, finally that nice guy got a ride and DROVE all the way to bring me my medicine. At $550.00 this makes it very expensive and NO Ins pays for this. (NOT even Affordable Care  Act. 🙂 This last about 2 weeks.

I’ve read that to be better equipped to fight cancer, one needs to be ‘comfortable’ with death. Accept it. Only then can you move on. (Seems paradox but, if that’s what it takes?)

So. I’ve written and determine what is to happen with my (meager, few) possessions. I’ve decided, that this spring I will go to the gorgeous Black Canyon, find me a pretty spot and when the time comes, put the Ashes there. Take a photo of the area and breathtaking surrounding of the canyon and its Billion year old rocks. But, of course this little excercise is not what is meant. Taking stock, asking and giving Forgiveness.

In pondering this one, it surprised me how many people are holding on to ‘Stuff’. Someone very dear to me, brought up an incident which happened over 25 years ago! It was nothing earthshattering but obviously bothered enough for so many years. Need to forgive. The heart is big and elastic. It will adapt to any size. Just not too small.

I’ve been doing pretty well for most part. Twice, there was an episode and always at night, that the pain was so excrutiating that I layed on the floor, in fetal position, just howling. I put my feather comforter over my head, so the neighbors wouldn’t hear. But, there was nothing else I could do. This took about 2 VERY long hours before it abated.

I have had big problems with loss of appetite. (One of the 4 symptoms of ovarian cancer.) I look at food and I’m hungry but then it nauseates me. No matter what it is. THIS is what is soo debilitating for cancer patients. They starve to death.  If I did NOT have my MJ Vapors to produce appetite, I could not eat at all. This way, I can eat small amounts and get appetite.  Even though, I’ve lost 15 lbs so far. Cannot and am NOT allowed Dairy as it produces painful inflammation. (Eggs are not dairy.)

Yes, I have Morphine, Tramadol, Oxycodon, etc. I cannot take ANY of it. The side effects are too severe. All I have, is my little 600 mg Ibuprofen. I don’t ‘like’ it either. It damages your liver and I already have a ‘cancer leasion’ there. But, what to do? At some point I said, ‘Dear God. I’m not doing this anymore. I can’t stand it anymore. It’s been (nearly) FOUR years with this bout. I just want the pain to stop! Yes. Cannabis helps and I do take it when I go to bed. But then, it wears off and by the time I get more in, I’m already in pain. (GOSH. This is sooo BORING to talk about. I’m sick of it myself. 🙂

Wishing all of you the VERY best of 2014. Make it YOUR year. Change your lifestyle. Walk a little more. Be kind. Be tolerant. Thank you for sticking with me through this journey.

             HAPPY NEW YEAR.

Look Ma! .. No net!

So. How does this saga continue? On Oct. 14 th with Cameron in tow as well as Adam, who was visiting, I showed up at the Cancer Center. I visited Sue first.

Sue has had ovarian cancer over 3 years ago and dealing with a recurrence right now. It is really upsetting and worrisome that NOTHING was detected. She had her bloodwork and tests, she had her CT scan and all showed ‘clear’. She had complained about pain but also ‘diagnosed’ herself… thus saving docs the trouble and cost of medical school. She kept telling her oncologist that she may have ‘appendicitis.’!!!! I believe that ANY time a cancer patient complains of a long lasting pain, you don’t send her home. They all trusted these tests. And then, she had emergency surgery and it was finally noticed that she has new tumors. So. Now a much worse scenario. But she’s fighting the fight. As one motto says in our group: Fight like a girl”. Big shout-out to Gerald, her husband, who is such a tremendous help with everything.

We’ve lost 3 of our ‘Teal Warrior’s. Wow. So young. There’s Sonya, not quite 48 years  who did not get to see her grandchild being born. Not even the measly-amount of 3-6 mos ‘given time’, was upheld. We are all reeling. Of course, the unspoken fear is, that ‘YOU’ are next. We’re all moving in a little closer to each other, as if for protection. Who will the Boney guy pick next? You all duck!!

Here I am, after a whole month being absent from the ward and visiting Sue, I went to Doc’s office. Cameron was there. First thing: Scan shows no new growths. No significant changes. I asked her if she thought I could stay off chemo for another 6-8 weeks and give this Tears of Phoenix’ a chance. If we start chemo and, at the same time, take this, I won’t ever know if it really worked. Since the last 2 chemo’s did not work anyway, I’m not losing a lot.

It does feel odd. No chemo. No radiation. No magic pill. Only a tiny, dark powerhouse. I spread that grain of rice-size cannabis on my cracker and the taste of it, errupts in dramatic shakes all over me. I do not like this at all. Yuck. I have now sheduled my ‘waking errands and chores’ before I take anything because I am totally useless, once I have it.

It’s a good thing, one can’t overdose. I thought I was ready to doulbe my dose. It had been 10 days, although when I have an appointment or some things to drive to, I won’t take anything because I cannot function. After about 35 min there was this pressure around my forehead and my surroundings were compromised. Like swimming through Molasses. I tried to get up but couldn’t. It took all I had to GET up! When I finally managed to be upright, I bounced off the wall like the bumper-game machine. That night was really horrible. Dreams and images, torn and loud.. …but I noticed that was me coughing my lungs out. Terrible cold to boot.

My grandson, nearly 19 years old, is here to help me. All the way from Alabama. They move 10 years ago but he’s till our Colorado boy. Have not seen him in a long time and I sure hope he can withstand my present life. We had the ‘booze-drug’ talk and a few others. Done. He has worked in the yard, cutting down some of those silly trees that have thousands of seed pods to procreate and they’re such a nuisance.

What if ‘Tears’ of Phoenix’ does not work? Well, there are a few chemo’s left (that may not work either.) Meanwhile I now have problems walking with these compromised legs. Still taking Werferin but can’t go far. Maybe around the block. I really have to increase my distances. I am just tired.

I borrowed Pumpkin. My best Poodle buddy. He snugggles up and stays close and is totally devoted. I wish he could fetch and carry. But, I have to get up and go for a walk with him. (NO! Please. No dogs for a gift.) I have Cassie next door, whom I love and visit. There’s Bruno, another fun dog and Pumpkin. Those are enough.

 

 

 

Chemo Limbo and Tears of Phoenix

There is always something else to rattle my brain and make me shake all the way to my “argyle socks’, if I had any. I’ve had another CA 125 (the cancer marker blood test) after my second ‘Doxil’ chemo to find out how it is working. Well, the Hawaiian Punch carried NO punch. My numbers went up a few points. In itself not a drastic change were it not in the middle of CHEMO treatment!! Now what? I can’t quite understand it. This had never occurred to me that chemo may not work. Doc is not giving me another chemo until we find out why this one has not worked.  She will say:’ Cancer cells got smarter’.

What is our option now? Atom bomb? Next step is CT scan. Is there, perhaps a new tumor? Is this the preventing factor that cancer cells don’t die? In a few days, this question will be answered. Wait for blood test, wait for phone call, wait for news, wait for next step. Wait for CT scan. Wait….

I had researched the ‘Tears of Phoenix’ quite a bit a few years ago but

THC and CBD mixture the size of a grain of rice

THC and CBD mixture the size of a grain of rice

could not find anything on where they make them, who makes them, what it is exactly. Meanwhile, there is a LOT of information on You Tube. The founder’s name is Rick Simpson. He had to leave the country, years ago because the Fed’s were after him. This goes with all the horrid meds are allowed but let someone invent something cheaper that actually helps, well there’s hell to pay. Of course, Medicare (Nor any other ‘care’) will  pay for this. So it was out of my budget zone.

Then, something absolutely wonderful happened. A Facebook friend told me that she and a few of her friends were talking about my situation. The exorbitant cost of being sick. She asked if I had a Pay Pal account because her friend would create a “Widget’ for me. (A ‘what’s -it??) Never heard of it. But soon, there was this Widget on our Camino page (under ‘Read our Story’) as well as on the group page.

Pretty soon, I heard the ‘ding-ding’ of e-mail alerts on my I-phone. I looked and saw names I did not recognize, sending money. More names, some I did recognize from my German Group. ‘German Girls Living In America.’ Had not known much about the other group called ‘Laester Schwester’. Seems they are at odd with another. BUT, for my sake, this time, there was only the desire to help, putting aside their differences. (Unlike the Government, this seems to work.) So, with utmost gratitude and waves of overwhelming feelings of so much kindness and sharing of even a few dollars, had me crying. Their generosity now allowed me to purchase the very concentrated Hash oil to ingest. For the amazing hash properties to go in and tell this ‘smart-ass’ cancer cells to commit suicide.

I really, really want to thank all involved of helping me so I could buy this stuff. I was a little apprehensive. Here I am again, taking and trying more ‘stuff’. Going on some Internet info and FAITH that this will not only work but better and cheaper than chemo!! –which does not work.

Help Inge get treatment that works.  You can do so here (ignore the ad on top) where it says “Pitchin“:

I take this on a cracker, with just a little butter. The size not much larger than a half a grain of rice, and take it 3x per day. The tiny Powerhouse looks like a ‘ mouse-turd.’

So. I had my first cracker with the oil on it. My son took me out for breakfast. Not knowing what to expect, I thought oh, this is not so bad. Other than a little off center, I didn’t feel anything. Luckily not, till I got home. Then had to sit on the couch. Fog descended, things seem to move much slower. I felt like I was talking very slow myself. My son, meaning this in a good sense gave me a double dose for lunch… just before he left to drive to a wedding. Well, I sat there much later, still. I thought, ‘good Lord, I sure hope somebody comes and feeds me’. Couldn’t get off the couch. Fell asleep in the middle of one of my favorite programs. I’m thinking, the world needs more of this. They won’t argue, fight, kill each other. My foot started to feel much better but I’m not sure if this is a coincidence or some ‘early healing.’  I can’t believe that this tiny, eensy =weensy bit has that much POW.

So. After 4 days, we double the dose. I hope I have enough time taking this hash oil, before someone decides to throw chemo after it. I want to see how it helps but if I do get another chemo, I won’t know for sure whether the cell death is due to chemo or hash oil. But then again, if chemo does not work…again… except make me miserable and sick, I may ask for more ‘non-chemo’ time to allow hash oil to work. I guess, it depends on the CT scan results.

Meanwhile A BIG, HUGE Thank you to my German ‘Girls.’  Ich druecke euch alle in tiefer Dankbarkeit, das ihr mir diese Lebenschchance ermoeglicht. 

 

Door Number 1-2 or 3?

A few years ago, there was a T.V show with that title. Contestants would go through a series of differnt question they had to answer correctly and then they got the choice of the 3-curtained doors. Two had nice and sometimes valuable prizes, one of them a ‘boobie’ prize. A bale of hay, or a pile bricks.

I feel like I got one of those doors.

Two weeks ago, I had a CT scan to determine how well (or not) chemo therapy was doing and, what change, if any, about the ‘tumor.’ As many scans as I have had, this result was very much anticipated.

Lab person was going to use my port to access veine for dye. Not sure what happened but the pain and burning sensation was so severe, that I yelled and came off that chair. Startled, nurse pulled it out quickly. To allow her to do this again took great effort.

My friends and I went to have lunch down town and theybought  bought this delicious Gelato for me to minimize ordeal.

After I got home, I waited for the call which would give me results. There was Tuesday evening, Wednesday, Thursday. Nothing. Friday I called Oncologist’s office only to find out she had left.

Then, I called local doc. I knew they also would get a copy. Left message. Then I went grocery shopping. Walking is still an effort. Although swelling has receded, there are places which are painful and I have to wear compression hose, which go up to the thigh. After walking some, they roll over and then there’s a big, red indentation and I constantly have to pull it up. Annoying. I need one of those stocking holders. As I drove home, my cell phone rang and it was the nurse from local doc. She said, they were looking at scan and that blood clot had not dissipated. Was still there and in precarious place. I needed to go to Hospital as soon as I could and have another Ultra sound. I was really confused why they would see the ‘clot’? She said, that scan reaches a larger area.

So. Went to hospital and got scan. Waited till they send it to doc before I was allowed to leave. He did tell me that tumor had receded. But not how much, or anything else, since this was not his expertise. Waiting some more.

Tuesday, chemo day and appointment with Oncologist. So. This is the good news. Tumor has shrunk from 5 cm to 2.2. Doing the happy dance for that. Now I am hoping, that these 2.2 cm will be gone in another 2 month. Then she says, that blood clot did not originate in the leg but in the abdomen. It was very unsusual that the clot would travel DOWN instead of UP. Which would’ve been very dangerous. I totally believe, that I had my little miracle. My blood tests, which I have to have prior to each chemo is ‘perfect’.  (I asked what I was doing there if everything is so perfect!!)

The down side is, that the chemo is destroying my veines. There’s the catch. I can’t stop chemo now but for the veine, it’s a horrid thing. Which door to choose??

After so many rounds, the effects from the chemo are felt more and more . Most of the time I am very fatigued and can’t catch up with house and yard work. For 2-3 days, bones hurt and I am freezing form the inside out. Depression is marching in as though it belonged. Watching a commercial the other day, I started crying although there was nothing about it to cause this. At the store, suddenly there are tears. My nose is dripping constantly, until we figured out it’s because I have no ‘nose hair’. No eye brows, lashes … nose hair. Now that it is getting warmer, the pretty wig feels like a fur cap. My memory is becoming faulty and this what we call ‘chemo brain’.

Bills are piling up and that one night stay at the Hospital cost a whopping $6800.00 and of this $1,133.00 which I have to pay fully. I am feeling overwhelmed. It shows that one cannot be allowed to get sick in the ‘Golden U.S.A.’ I’ve not opened the bills from St. Mary’s.

I have had wonderful and caring support. Some from people I have never met. (I received a $25.00 donation from a ‘Stranger’. I was so very touched.) I get uplifting and caring posts nearly every day from a new and precious friend ‘Michele M.”  Two days ago, I had a particular hard time, when a beautiful sun flower appeared on my Facebook wall. This helped more than any pill I could have taken.

I also got to drive to Telluride to visit my son. A dear friend drove as she was certain, this may be too much for me, to start. (She was right). A most beautiful, perfect day and drive. His new apartment is gorgeous and roomy. I had prepared lunch to take up. (Hungarian Gulash, Spaetzle, cucumber-tomatoe salad and fresh strawberries for dessert. We drove to the end of town to see the many waterfalls. Azure sky and awesome surrounding. Good to breath and be out of this house. It was slow going as the altitude was making walking more labored but I did walk from mid town to the apartment. Small victories.

In a few days, it’ll be my birthday. I am totally grateful that I get to be here and celebrate, although this will be the first time in many years, that I won’t (can’t) host a party.

I still try to reconcile the actual number of my years with my internal years. Where have the last 20 years gone??

 

Too close for comfort.

If this were not my life, I would believe someone made it up! What more can possibly happen?

It’s nearly two weeks ago, now, that when I went for chemo, we noticed my right leg being really swollen. All the way up to the groin and down to the toes. Immediately an Ultra Sound was ordered and performed to check on blood clots. I could hear the return ‘swooshing’ of the blood. NO obstruction, they said.

By the time I got home, it was worse and I was in a LOT of pain and could hardly lift that leg. I called twice on that Thursday, needing help and asking what to do?

They said, it was ‘probably’ lymphatic blockage and I needed to go have it ‘drained.’First, there was this thorough process of marking and measuring certain points, up and down the leg. By the time it reached the groin, we had 68cm. (Used to be almost my waist size.)

The massage felt rather pleasant and I was happy that finally something that didn’t hurt. Came home and was miserable.

I cannot move. Cannot walk. Two steps and I’m done for. The skin is so very tight that I’m afraid it may just crack open. I was to have another massage on Friday. Cameron took me there. When the Therapist saw the leg, which now sported a huge, red-hot area of 20″ inches, she became very concerned. Thought it might be cellulitis. (I thought that meant ‘fat-handles’.) Absolutely no massage. I was so worried and requested that this leg should be seen  by a doctor. Easter was coming up and people go out of town and help may be scarce.

She called over to the E.R and then wheeled me over. They inserted an IV. (They did not access the port as that may bring a different problem.) My ‘old’ doc came and I sure was glad to see him. He just knows my whole history. They decided I should be admitted and stay for observation overnight. They were not sure whether this red area was an infection. The Ultra Sound showed at least 3 blood clots. What? Where do they come from? Well, that’s the $64,000 dollar question. Could be from chemo. Could be from the port. Could be from not being able to move a lot. Could be that when I stopped the Ibuprofen, the blood thickened? Well, just a guess. I feel ‘betrayed’. I was soo good to my body the last few years and this is how it pays me back? Childish outcry.

I felt so removed from reality. This is now my LIFE!! A leg that is the size of small tree.  Luckily, cellulitis was ruled out. (Staff and hopsital were great.)

A friend, who is a retired nurse had agreed to stay with me, so I could have help. That fell through. Cameron had already left for Telluride. He has to find a new apartment since winter season is over. We were supposed to fly to New York for a dear friends’ wedding. Certainly I can’t go.

As I layed there, leg way up and in white TED hose, totally feeling sorry for myself, the thought came to me HOW VERY LUCKY I WAS! Yes.  In all of that, I was so very close to disaster. IF she would have massaged the leg, the blood clots could’ve been set loose and traveled to lungs, heart, brain. BOOM!

Had I ignored all the little signs, at that point and went to Germany, this could have turned into a full blown disaster. So, even in all of that, I was protected. Now, all I want, is to just walk again. Do all of the mundane chores. I would LOVE to clean the toilet.

Friends have been a big, big help. Sending food and coming by. But, there are many hours in the day to fill. I have never been so ‘still’ in all of my life. Whole different reality. Having a problem adjusting to these blows, one after another. Back on pain pills. Of course, there’s MJ. My good buddy. Have very little appetite but this could be because I am not busy enough.

I had to give myself shots. Twice a day, in the abdomen.  There were 8 shots in all. That cost? $611.00.  There’s nothing generic or anything else. Either that or you could die! Also taking Warfarin to help thin the blood. It did come up from 1.1 to 2.8.

I think, somewhere along the lines, I lost a portion of my positivity and good humor. I am cranky and whiney. I am in pain and general discomfort. Now, I have to deal with constipation from the darn pain med. (I don’t know me like that either!!)

No breaks to catch…

I was finally on board with bald and cold head and all inclusions thereof. I was being strong and gracious (except a tiny fraction here and there).

Back in December, on one of my visits to Cameron in Telluride, I had noticed that my upper thighs seems to be really heavy. I thought, this was because I had not been able to excercise since the last two surgeries. I blamed the high altitude and steep incline to his apartment. When I was back home, it disappeared only to repeat this on my next visit.

I had mentioned it to Cameron because this puzzled me but did not give it more thought.

I was starting to feel better. The different pains in my abdomen were GONE. I thought ‘O.K. that’s one good point for chemo.’ Still awful stuff but hey, no pain. I could finally stop the 600 mg Ibuprofen. Felt great about that as at that point ALL I was taking was my daily Thyroid pill. No other meds.

After a couple of days, the pain in my thighs returned. Funny that. I walked a few steps, had to stop and rest before I was able to walk another few steps. What the heck?? I thought, it would ‘go away’. I thought, this is only temporary. No such luck. I could not walk much farther than half a block.

Now this really scared me. I had walked 500 miles only 18 mos ago and now couldn’t even walk around the block? I was stunned. What to do? What IS this new calamity? If I can’t walk, they may as well shoot me. No matter about the ‘hair’, no matter even about chemo. THIS was a real big, black shaky fear. My mind could not even go there. Ever since I was a child, I hardly ever ‘walked’ I ran, skipped, jogged. As an adult my strides were always longer and faster than the person next to me. (Except my son, who is always ahead. )

I could not think straight. My mind was crowded with terror. I remembered Doc’s urgent words when he had called me that Sunday. ‘ The tumor is pressing on the Aorta and can restrict blood flow to your legs. Once the damage is done, it cannot be reversed. You must have chemo and it must be soon’.

Was this that point of no return? Is this going to be my life? Had I brought this on by my own ‘stubborness’ NOT to have chemo sooner? Am I to blame for this? ‘Oh GOD. OH GOD.’

I had foot therapy and could barely do the exercises prior to being hooked to the machine.

Last week, I had had enough and called Oncologists office in Grand Junction. No live person to talk to, so I left a message. Nurse called back and I explained this in very careful words. I had told her that this was NOT due to chemo since I had this before I started. She passed the message to the oncologist and then called me back. Onc said ‘this is probably neuropathy, caused by chemo’. I frowned on that because it was opposite of what I told them. I had also asked to have a CT scan to see what the tumor was doing and if chemo was helping with anything. Too soon for CT scan, they said. Chemo had not had time to really work but we will do a CA 125 this Tuesday.

I could not find anything online that would give me an answer or, even a starting point. My legs hurt and I took a bath in Epsom salt. My veines were more pronounced and there were ‘blotches’ on my upper thighs. I think I need oxygen to my legs, is what I thought before I absolutely broke down and horrible keening bounced off the bathroom walls. I screamed and cried and thought I would lose it completely. Only a few times in my entire life had I felt like this.

So far down in despair. NO one near, no one here. Very alone and felt abandoned. ‘Always have to go through the hard stuff by myself’ , is what I thought at that point. Of course, that’s not really so. But then, I also have chemo brain and along with it, comes its faithful friend ‘depression’.  There is absolutely no way to cut this tumor off and out. There is no way I can have radiation. There is NOTHING anyone can do. The perfect Storm.

I won’t be able to travel. I won’t be able to go walking, hiking in Austria when this cancer part over. I may never be able to leave this house. Those were my darkest and blackest thoughts. It seemed unbearable and I wished I would just die.

I also took a break from Facebook. Couldn’t deal with people’s petty, little problems. Talking about if they couldn’t find the perfect, water proof mascara, that this would RUIN their day. That was the last straw. I know that this is not their fault. They just do their lives. But, when one battles on so many fronts, this was just too much.

Other people just stay away. Don’t even visit or call. I am ‘pruning’ my frienship tree as well.

I sat on the couch, took some ‘puff’s of my vapor marijuana’ so I could just calm down. Had a fitful night.

I had an appointment with my Foot Therapist early in the morning. I ranted and complained about not knowing what ‘this’ was and what to do? Where to go?

He looked at me thoughtfully and said, ‘I think, I know what it is you have. Give me a few minutes to research’.

He came back with some medical research. ‘Here, he said, this is what you probably have.

ATYPICAL INTERMITTENT CLAUDICATION.

What? What? What the hell is that??

‘Claudication or limping . The Term is associated with the Roman Emperor Claudius, who was notably lame. As a medical term it refers to a cramplike pain in one or both legs, which developes on walking and may eventually cause a limp.

The usual cause of claudication is typically that theyhave to stop walking a set distance because of pain in the calves. After a short rest, they may be able to walk another few steps. This is called Intermittent Claudication.

A rarer cause is spinal stenosis (narrowing of the canal  carrying the spinal cord, causing pressure on the nerve roots that pass into either leg.

My cause is different, that’s why it’s ‘atypical’ but the end effect is the same. With me, it’s the tumor that’s pressing on the aorta and restricting the bloo flow.

Oh, my goodness. That’s IT, I said. I was so relieved that ‘it’ had a name and a starting point for me to research and get help. He gave me some pills “Argenine Plus’, which is a cardiovascular aid. I looked at that little, brown bottle as if it were Manna itself.

I took 2 Pills that Friday without noticing anything but then, it was to soon.

Meanwhile, my best and childhood friend had flown in and what a rock she is. We met in Kindergarten, in Germany 60+ years ago and went through all the trials and tribulations good, bad and horrid times. No matter what, she’s always there. I was soo glad to see her.

Saturday morning we got ready to do some shopping and I stopped at the bank to get a few dollars. I came back out and as I approached the car, suddenly I noticed I was ‘running’!! My usual fast stride. Ohh, I cried out loud, ‘did you see me? Did you see me running?’ Tears yet again. Joyous ones. Once, the pills wear off, then it’s the same but in between, I can almost walk normal. So. I am hoping that with the next 2-3 chemo’s that sucker in there, is GONE!!

Then, finally the book which my son had ‘ghost written’ came out. That was a proud moment. ‘The Cat Whisperer’, by Mieshelle Nagelschneider My ex-daughter in law. A beautiful and great expert on cat behavior.

Next book?  “Camino not Chemo.”  Maybe not that title but our adventures. Cameron will unveil the new working title soon.

Tomorrow is chemo day. Friends are coming with me. My relief and new hope were so enormous, that I planned and had a wonderful Lunch for friends and my son on Sunday.

The worst nightmare in recent history is receding. THANK GOD!

Goldilocks no more.

As the days were bumping along and I was just about to catch my emotional equilibrium, there came the next surprise, courtesy of chemo.

Went to take shower and got my stuff ready and shampooed my hair, when I felt something weird and unsusual in my hand, as I wiped the soap out of my eys and looked, there it was. A whole big fist full of hair.

Now, of course I knew this was going to happen and I had told Cameron, that I would definitely lose my hair ( I remember saying that this would happen in 3 weeks and 20 minutes) but he had said, ‘you don’t know that. Maybe it’s different this time.’ Cancer people cling to every little lie. So. No matter what you tell yourself and how strong one deals with this, when hair loss happens, many say, it’s the toughest part of chemo. It’s tied in with the little girl brushing her dolls hair, her friends hair, the dog’s hair. It’s having good and bad hair days, when just a few strands look out of place. It can ruin the first good moments in the morning, when after gel and curls and spray, the outcome is not what people expect. So very much is tied up in hair, or the lack of it. The feminin thing. Guys always look good bald. Hair is overrated.

 And so, I stood there with water running furiously, and sobbed. I felt very vulnerable, exposed and naked. Eye lashes will follow and brows as well. Well meaning people say, oh, it’ll grow back’ and they have so many new things now’.  Others, who had cancer previously would say, Just embrace your baldness’. But, we must be allowed to moarn. It’s not business as usual. There’s no strength that lasts 24/7. No matter how old you get, you want your mother at this point. A pain that runs that deep that it goes all the way back to childhood and needing that comfort. (Besides, I already embraced it once, with grace.)

I had asked my Ovarian Cancer Support Group, what it was that they wished people would NOT say to them. Here, some of the comments. When you want pople to hear you and not for them to keep saying how strong you are. When people dismiss their feelings  because they don’t like having to comfort. When they say, ohh, you look so good. Which is quite suspect because, how on earth did I look before this? They are also annoyed because they do not want to talk about cancer all the time. Or, that someone elses’ grandmother’s brother’s cousin had this cancer. They don’t want to hear every cancer story in the universe. Meanwhile we do stay strong because there’s not much else to be. Once in a while, you just want someone to take your hand and tell you, ‘it’ll be alright’.

Thank you, Sue for your warmth and wonderful comforting e-mail.

When I had sufficiently gathered myself, I thought I would like to walk to the Post Office. Had to return the wig, that my daughter chose because it was too narrow, too tight and the color did nothing for my face.

I was about a block and half, when the pain in my upper thighs was so severe and felt like they weigh 50 lbs each, that they just went out from under me and here I sat on the street. Forget the hair. THIS was serious. If I can’t walk, then we have a huge problem. Since it was right by my Beauty shop, I was helped and sat on their chair to collect myself but then it was just too much and a torrent of tears came unbidden.

I remember when I had the frog ‘Timothy’ in my throat while walking the camino at certain times. Here he was back. I just could not talk. My Beautician offered to do my mailing for me as well as re-do my wig from last time. I also found a few scarves/turbans. They sure got expensive. Up to $30.00 each. Everyone cashing in on cancer.

My neighbors saw me come back and came to check on me, since they had not seen me. No word was needed, they just enveloped me in a big hug and told me how much they cared.

My good friend Peggie came by to cheer me up and took me to a new wig shop. I didn’t even know we had one right on Main Street. I’d tried a few on and chose a blond one, that they all really liked on me. ( My daughter said, do NOT get blond.’ Sorry, Sweetie. There just isn’t anything else that looks decent.)

My friend Silke came to take me to foot therapy. This is called ‘Sympathetic Therapy’. I like that name and it really helps with neuropathy.

Yesterday, a gray and dismal day but here again, my friends show up. Peggie took me for a walk while we had ten minutes of sun and then, my favorite Mike came with wife Jodi and son. They brought chicken and we spend a few very nice hours. Thank you. This means a LOT.

I am alright now. Got over the hair-thing. Come Monday, I’ll call my Oncologist to find out what this weirdness is in my legs.

Then, I’ll find out how many chemo’s she thinks I should have.

 

Port and Chemo

February 22nd was a cold and snowy day. My friend Lynne came to pick me up and drove to Grand Junction. I was extremely anxious. The whole idea about insertion of Port and then Chemo, was a hrash tig to swallow. During the ride I made liberal use of my MJ.

The day before my little buddy and Annika came to visit. Their mom had just told them about my situation. When I opened the door, I saw the solemn faces and the minute they came in, started to cry. I asked what was the matter and he said;” I am so sad’. I patted the couch beside me and told him to come sit. I actually put him on my lap and held him as he cried and being scared for me. I told him, that even though this was not what I had wanted or planned on, it would be alright. That I would do all I could to get well and he could help me.

I saw Annika sitting there, crying as well and I told her how I remembered the last time, when she was only 3 years old. She had asked me, if she could see my bald head. I said, sure and took my wig off. Ever so tenderly she touched my head and petted softly, saying “awww.’ Brought tears. She said, she remembers it too.

Blood pressure was still 159! I asked Nurse, who approached with IV, if she was any good with inserting the same. She said, ‘yes’. Well, she lied. It took her several tries and finally called someone else.

As we were waiting to be wheeled into OR, there came the ominous ‘Code Blue’ over speakers. Not something you want to hear before going in.

The surgeon came to talk with me and to explain procedure. Tears came unbidden and this  Doctor said to me:’ We don’t force anyone to do this. If you don’t want to continue, then we’ll call Dr. M and tell her you want to stop.” Well, being chided was not what I would expect. Do they not teach compassion 101 anymore? But, I can imagine if you put people through like cattle, there’s not much left. I told him, that I’d only had 3 days to get used to this whole thing. It was also, the inevetability of it. That nothing would stop this now. That after 3 years of out running chemo, there it was.

The Twilight sleep was very nice. I did feel gentle pulling on my upper chest but no pain. Afterwards, I was starved and we went to lunch.

Next anticipation was the dreaded chemo. Cameron came Monday afternoon to take me next morning to GJ. I woke early, as usual and when I looked out the window, fat, thick snowflakes and everything white. Geez. What else? We had a white-out as well but got there very punctual.

One of my support group ladies had told me to have a cream (Lidocaine) prescribed, which goes on top of the port, so that way I would not even feel the ‘Poke’. Anything I can have and take and do to minimize the trauma, I will. (Got me a MJ refill and I used that a lot as well.)

Nurses in the chemo ward, were not sure about this protocol but I told them since it is NOT smoke, I would use it. The ward itself could use some nice paint and some greenery. Some pictures and ‘warmth’. Very generic and blah. Had some very nice and compassionate Volunteers. Ready to give you anything you’d want. Among a few documents I received a beautiful quilt. Sewn by Lutheran church ladies. I must send them a nice card. I was very touched.

Then it was time for all the ‘liquids’ to be hung. Saline, Carboplatin, Toxil.  I worked very hard not to resist. For that chemo to come in and do it’s job. My Onc promised I would not get sick. She said, ‘I know you’ll be pleased how easy this will be, this time.” I assured her that I really wanted to believe.

We came home right after chemo. In the back of my mind, I was wondering if I can really go past the nausea which was soo very debilitating, the last time. I had prescriptions for anti nausea but 20 pills are $91.00 so I’d left them there. Cameron said, no, I’ll get them for you, in case you need them. Plus he bought all supersize Miralax and Softeners, etc. (That has been more miserable than anything else. To be in that situation again, after I’d just got everything to work normal.)

This morning, now 2 days after chemo, just a tiny bit nauseous but immediately took a pill.

Now, waiting for Tuesday and round two.

I do want to say a few words about the great social media, when it’s used to the good. I have so many, many people, most whom I’ve never met and don’t know personally, wishing me well, cheering me on and supportive with words and deeds.

Now, that the decision has been made, I’ll try not to whine or become a Prima Donna!

My daughter picked out two very nice wigs and I shall order those.

GOTCHA!!

After that little pondering session in my last post, I was still clueless about what might come, running over me like a dump truck.

I was waiting for the doctor to call with results but figured what with the weekend and then a holiday, it might be Tuesday before I would know.

Sunday, early afternoon, I was watching this great show on T.V. when the phone rang. Unsuspecting of anything, only mildly curious who it might be (I canceled caller ID since it’s over $10.00 a mos.), I heard a long-forgotten voice of my former local doctor. He asked pleasantly how I was doing. He’d given up Private Practise to work at the hospital, so I didn’t even know he was still involved but then, he been still listed as my Primary Physician and he got the results. He always works on weekends at the office, clearing things up.

He told me, he as looking at the result and it was NOT good. At this point, my breathing became shallow. He continued to say that the tumor had increased and pressing on that veine and it would cut off my blood supply to legs. Worse, the return of said blood supply would be near impossible and legs would fill with fluidds and that would be disastrous. My CA 125 blood test had risen to 159. Nearly 2.5 times higher than previous. Alright! He now had not only my attention, he had me scared to death. All I could think of was:  I already booked a flight to Seattle and then a flight (with frequent flyer miles) to Germany.

He said I could not go because this tumor was creating big problems and I had new ‘spots’ on my lung and liver. He urged me to have chemo. He said that I would be fine, that a lot was different than last time. That I was in good shape and that my Immune system was great and I could live ‘forever’. (Now there’s a lie 🙂 I said I didn’t want to live forever but a little longer.

When we hung up, I was shaking and my brain was truly fuzzy. I nearly hyperventilated with fear of CHEMO! I called my son who told me he would come.

I cancelled my flights, barely being able to talk. I thought I was in a real dangerous place and my system kicked in with that ‘flight for life’ response. Only, I wanted to run away. (Yea. And then what??)

Cameron arrived and then called Oncologist’s answering service for her to give us a call back.

I called my family and told them I could not come after all. Set off this upsetting motion.

Mom listens to her oncologist, Dr. Melancon

Mom listens to her oncologist, Dr. Melancon

Then everything went very fast. Hardly time to think. Met with the Oncologist Tuesday, early morning. When she came in, the first thing she said, was “Who scared you to death?”

Although things do need to be dealt with, she was NOT as dire as my local doctor made things out to be. I was really angry that I fell for this, in the end. He’s been trying to scare me into chemo for nearly 3 years and now, that’s where we are. But, for these reasons. The tumor on that vein does need to go. We can’t do any other localized treatment because there are a few spots and they need to be gotten at once. I do not want to have to worry about this on and on and on. She promised that this would be ‘gentler’. Funny, that. To use in the same sentence as ‘chemo’. We will do a lower dose of carboplatin and Toxil, same stuff I had last time. Once a week but for longer. I ‘may’ have constipation or diarrhea. I may be nauseated, I may get neuropathy (very painful) but all in all I will be fine! (In what way has chemo changed?? Sounds like the same horrible side effects I had!) Except this timeI have marijuana for the nausea. A few, little pills she had called in are $91.00. Pot is cheaper, better with no side effects. It is a NATURAL plant.

I had finally got the Diverticulosis under control where everything worked well. But, I do have pains in my lower back now, where tumor sits. So, I am now symptomatic. This bitter cup does not pass me by. I can’t be ignoring things just because I want it to be different. Could I have waited another few months? Possibly but then, perhaps would have had more unpleasantness to deal with.

Friends are gathering with their love and support, like a beautiful coat. My son will be

Carrie and Mom reunite for another camino, or path

Carrie and Mom reunite for another camino, or path

here this time to help as well.

But look, I say. How many things I have done those last 3 years, while running away from chemo? Germany, Holland Venice. The following year, Camino de Santiago. Wow! Would have never done this except for cancer. Cameron says, there will be another camino now. The North Route. It’s just as long, perhaps even a little longer. But, I don’t have to do the whole thing.

I am calmer now that the decision is made. At the same time, I started to juice Marijuana leaves. Went to Dispensary and got me some fresh leaves. I washed them and juiced them with a little apple juice to sweeten the bitter taste. Only a couple of ounces. I would have needed 40 days for this treatment. There are lots of great testimonials about this.

I made a wholesome Lentil stew with Kale leaves. Then drank my juice. It was pleasant. The name not so much. This strain is called “Agent Orange’. Good thing I am not superstitious.

So family and friends, we have started a new journey. A detour I had not planned and am so reluctant to go. But, I can’t fight the chemo otherwise it’ll be that much harder to tolerate. Friday morning I will go to the hospital to have to port placed (in my chest.) They put you into a Twilight sleep, as they do with Colonoscopies. Tuesday then, is my first chemo.’

( It occurred to me, that maybe I need to change blog name? camino not chemo only fitted for 3 years.. Now, that I have to have it, what name can I choose?)

Green light for Green Juice

The last few weeks have been mostly uneventful. (Aside from whining silently as everyone, including myself is getting tired of the ‘same ol’ thing.’

There were also some pleasant days. When Rebecca and her friend came to visit. When we celebrated my son’s birthday. When I received a gorgeous bouquet of flowers from my friend Peggie. When friends just dropped by…. because. And, when my granddaughter send loving messages on FB.

Then came the appointment at the Cancer Center. CT scan and CA 125, last Wednesday. I am just a little anxious as I had not had a CT scan in 7 month. Strange pains in the back, in the abdomen. But, I don’t think it would help to get appointment with doc. What would they say? Unless we could look inside, they wouldn’t know. I don’t want drugs, so, I use my stand by heating pad. (I already burned up one and my Beanie bag as well.)

Still wake up, each night out of sound sleep, due to harsh, abdominal pain. I wanted to get off the Ibuprofen but can’t quite manage without any pain med.

Meanwhile, some other exciting things have happen. I was invited to fly to Seattle to help an aquaintance manage his health problems/ weight loss, etc. They are very interested how to do this Lifstyle ‘diet’ I’ve been on. Although I have been somewhat lax with it, due to Diverticulosis. So, soon I’ll be doing just that. It will help me to restart too.

I thought, I would wait until I had the results of theses tests to decide whether I could go to Germany. I have some frequent flyer miles and wanted to know the value. I called UA and got ahold of a very nice, young man who checked and worked on a good deal. He then told me, I had enough miles for a Round trip. I was ecstatic and told him to go ahead and book. Especially, when he told me that the miles would expire in March. Lucky call. So. I decided I would go, no matter what the results were. If they were not good, I’d go because I wouldn’t know when I could go again. If they are good, I’d go anyway. So, I’m going. Running away again.

I am also lucky to have good friends and neighbors who help with house and plants and stuff.

While I am researching all the time for new options or treatments, I came across the newest Marijuana treatment. To juice the leaves. Each day drink some juice. It is purported that this would kill the cancer cells without harming healthy cells. Shrink and or destroy tumors. NO side effects. (Unlike chemo!!) One could also use the fresh leaves in a salad. One does NOT have to smoke it. Many, new options. There are many testimonials reporting this awesome success.

I’ve read in the newspaper that a lady, who is suffering from debilitating Fibromyalgia, tried marijuana pills. It stated, that she was (as are many) reluctant to try this because of the ‘stigma’ but has not had any uniterrupted sleep in years and the pain was getting worse. Well, she came back to the Dispensary the next day, in tears and ever so grateful as she had had her FIRST good night’s sleep.

It’s really unfortunate that Medicare would pay for devastating chemo, approximately $5000.00 EACH to the tune of $30,0000 for the course of treatment but not for marijuana juice that’s much cheaper and harmless.

I am starting next week. Another adventurous decision and becoming my own ‘Guinea Pig’. It sure appeals to me a LOT more than the thought of chemo and /or radiation which would destroy my colon among other vital things.  I am optimistic that it will help. I definitely will let you know. We will have plenty of P.E.T scans and CT scans and blood test to compare.

Any feed back?

Tomorrow…

It’s getting very close and I’m getting very antsy. Hospital called yesterday with pre-op instructions. NO food/drink after midnight, tonight. I’m already worried about food or, the absence of it.

I’ve requested that they add anti-nausea meds into IV so I won’t get so sick upon waking. (I also worry about waking, or not waking.) I remember, some time ago when I saw a medical show where the patient was given anesthesia and they started to cut him open and all the while he was wide awake, felt everything but couldn’t move. I really know that this is silly and I don’t know why my mind conjurs up these oddities.

Friends have been steadily visiting and asking how they could help best. It’s great to have this circle of friends embracing me with a big hug. They will clean house while I’m in the hospital, also shampoo carpet and work in the yard, trimming tree limbs and bushes. (That alone is worth going to the hospital.) Others will prepare soup.

Last night, when I woke with pain and took meds, I was so hoping that this was the very last time I’d feel it. That, in a few days, other than the soreness of the incision, I’m done. My son Cameron is offering for me to come to San Francisco after I’m healed as a Reward. I  am so excited. Also, making plans to go to Austria. It may be cutting it a little short with time. May have to postpone it until spring.

Professor Koebe wrote a nice note to wish me well. Still laments the fact that he can’t personally do this surgery. I am definitely going to go to Wuerzburg to see him again and Marion, his secretary.

My daughter called the other day and we had a nice, long talk. I know that her not being able to come is tough on her as well. Grandkids sending notes of love and support.

So. I’ll meet you all here, in a few days. Gung-ho and ready to roll.

I will put myself into the hands of our Lord.

Full circle and Dr. Two

I drove to Grand Junction myself, the other day for my appointment with Oncologist/GYN/Surgeon. (I had been there just two days prior for a CT scan. )This was, after all, ‘number Two’. This was the one, I had meant to see when Dr. Giggles insisted that I go to Denver, ‘because Dr. D. was ‘number one’.

We all know how that worked out and ended. Wasn’t too impressed by number ‘one’.

So, I was a bit curious how I would find this good doctor? Would she be brusk? Unfriendly? Arrogant? I sat in the treatment room and nurse did the vitals. Bloodpressure up a but it seems to match the surroundings.

After that, I sat there and waited. Nothing so boring as to sit and wait. Not even a magazine in there. My cell phone didn’t work in that little room. I took my checkbook out and tallied the sums. Not very exciting nor fun. Noticed how much I spend on medical bills and holistic stuff. I just heaved a sigh and put it behind me. Light knock on the door and in came Dr. ‘Two”. Nice smile, handshake. Then we discussed the lengthy tirade of my futile visits so far.

She examined me, then told me that she could not tell the source of the pain. There are many choices. But the CT scan was alright. No changes. No new growths, or movement from the old one. THAT is good news.

Here are my options: Try to manage pain ( not an option because it’s not managed.) Or: have a laparoscopy, go in, look and see’ then discuss further steps. (WHAT??? Go in twice? No. No.) third: Make a larger cut, so she can get her hand in (too much information!) to feel around. She said, they really can’t ‘see’ much therefor have to also ‘feel’. She wants to remove the cluster of small lymphnodes. They are no problem at the present but could be. Then, take out that piece they placed there over 10 years ago, for the adhesions to grow onto. (Should have been taken out and exchanged for a newer one, years ago. Maybe that’s the culprit??)

She will then place a new material in the abdominal cavity, the material being  similar to ‘Saran Wrap’ so adhesions can’t form. We will NOT touch the ‘errant lymphnode’ which is too overgrown with veines and blood tissue.

Surgery would take under two hours and I’d have to stay there 2-3 days.

So. Our number TWO doctor has no such hesitations to help me, as did doctor number One in Denver, or my GYN here, or, even worse Dr. Giggles with his arsenal of chemo.

I like her and I absolutely trust her to do her best for me. Finally. Someone to help alleviate this horrid pain. She asked me to think about it and then let her know. I was already pretty sure when I left, that I would do this surgery. She also assured me that we’re not doing chemo until ‘absolutely’ necessary. That was balm to my fearful soul.

I met with Carrie and Laurel, Gracie and a couple of their friends for lunch. Fun to have young, vibrant people around.

When I came home, I called Cameron to discuss these new options. He said they sounded good to him, too. He offered to come out again as well but I can’t ask so much for just a few days. Besides, sometimes we need a woman to do ‘womanly’ things.

Friday morning, I called Angela, her nurse and said I’m ready to set the date for ‘redecoration of the pelvis.’ She laughed and we settled on the 24th, July.

Now, that this is settled, once I have passed the unpleasantness of waking up right after, which is always so bad as the pain hits severely before they can give you anything. I remember this from every other surgery I’ve had but yet, this is not enough to deterr me.

Now, I’m setting up the friend rotation schedule, for after when I’m released. I so wish my daugher could’ve come to help me physically (she helps with the writing of my story with her brother)  but with the children and no money for the trip, it’s not possible. Cameron can’t come this time as he has to move. But, I think it’ll only be for a couple of days. Friends have offered right away to stay the night. Even from far away, like Boulder, my friend Rebecca has offered. Many, many well wishers and so much kindness.

Of course, sneaking into my brain are the thoughts that I usually have before any surgery. That very thought that woke me, early this morning before even the birds were up. I sure hope I will wake up. What if I don’t?? Well, I wouldn’t know about it but the (even remote) possibility makes me sad with missing my children, grand kids and friends already. And then, there’s my little buddy.

I better push all that out of the way and concentrate instead on my trip this fall. I’ve seen some pictures of ‘Meteora’ and ‘Valley of the fog’, in Greece. I really, really would like to go there. But, I speak no Greek, ‘that’s Greek to me,’ ha (even less than Spanish!) So. I better stick with Austria. Just the thought that I could plan and actually go gives me new vigor. A very nice Facebook friend, from Austria, who’s a singer- (You Tube-Peter Martell) wrote the nicest comment. He told me that when he recorded ‘Amazing Grace’ he was thingking of me and praying that I’d find relief soon and asked the Lord to listen. Touched me to tears. Also said, when I come to Austria, he and his lady friend would sure show me around and help me find reasonably priced rooms.

It seems a long time now, since I’ve started this ‘cancer-health-journey, to now. I told my friends how grateful I am for their loving, never wavering support. For listening to my woes and tirades. For coming and helping, no matter how big or little the problem. In this, especially my ‘favorite Mike’. My son, who took a big chunk out of his life and time, to come and help me find treatment. My friends, Monika and Inge, who always take me for tests. Others who bring food, laughter warmth. Strangers, who, after reading the blog have called or written e-mails with suggestions and links to doctors and or Naturopathics. Others, who have become new friends and presented me with a Pedicure. Others again, bring vegetables, soup, cage free eggs etc. Or, bring the dogs when I had a particular low day, to cheer me up.

(I’d written an e-mail to recommended Naturopathic doctor in New York but have never received an answer). Never again heard from that woman Dr. in Boulder. That 15 min phone call cost me $75.00.

So. Next week, I will pack my bag. (They have T.V. computers in the room). I can wear my own PJ’s. Hopefully, this will be my last surgery. I sure would like to have a few years without pain or some other health problem. As long as the cancer behaves, I’m good to go. I  will write after surgery, as soon as I’m able.

Thank you all. Hugs all around.

Oh, I want to mention that it rained yesterday. A true ‘Gully-washer’. Everything looks brigher, greener and grass is finally green and not brown. Birds are singing and the scent of fresh washed air is coming in through the open windows, carried by a light breeze. Great Sunday morning. Thank you GOD.

 

Venus in Transit

It seems that a lot of time has passed since my last entry. Actually, not really. If I start to recount the past days and describe these painful bouts, I will get very bored with myself. I can’t believe that there’s nothing else to talk about than constant pain. But, it is my life right now. Just trying to work the meds to where I can ‘outsmart’ it, is a full time job.

Yesterday morning I managed a 40 minute walk. (Last year, I managed 8-10 hours). I miss, really miss this good feeling and energy I’ve had. I have very poor appetite!! I feel like I’m slipping and can’t get a good hand-hold.

I spend a lot of time in my back yard. Now, that the Medicine Wheel Garden is finished and so lovely, it gives me such pleasure.

This past week, there was all the attention on Venus’ transit. I had brought free newspaper home and started reading. Good things are going to happen to me, I’d read in my horoscope. Venus is in MY sign. It’s always nice to read something nice. I was really very pleasantly surprised when this ‘love’ promise actually started to become reality.

I had befriended a young lady over FB and would share comments, pictures, with Lori A.H. She had sent me a message asking if she could meet me. After a little scheduling back and forth, she came Thursday. With a potted plant in hand and big, lovely smile.

We got along like ‘a house on fire’. She was so complimentary and credited me with lots of wisdom. The time was too short before she had to leave but, there will be other times, I am sure.

Then, Saturday I received a letter from Amber. She is the daughter of an old acquaintance  who’s life I had saved about 28 years ago, when his two gas tanks caught on fire under his pick up. Lonely, empty stretch of highway, on a Sunday afternoon in January and the Superbowl on, no one else traveling.

Her dad and a few family members and Amber were coming through Montrose and wanted to visit. I put up all six people, fed them and next day they left. That was 2 years ago.

She had just found my address. The letter is filled with Thank-you’s. She states that even though the time was so short, I made a profound difference in her life. In part, she writes: Thank you again. You are a special person who really makes a difference. Please know how truly amazing and inspirational you are. Thank you a million times over!

I was totally and wonderfully surprised. To think, whatever I had said and done in these few hours, made such a difference in this young Woman’s life. (I think she is 29).

So, how very accurate this Venus Transition was in my life as well. I felt warm and appreciated, even 2 years later or maybe, because it was 2 years later and she still remembered. So, I am glad that I was kind and hospitable. I have no clue what in particular I’d said. This letter and Lori’s  and Julie’s visit really made my day(s). It buoyed my stale energy. Another new friend (met her through the blog) invited me to have a pedicure, next week.  It’s raining Love and Kindness. Venus in Transit.

Oh. With all of that, I nearly forgot the awful day I’ve had.  For days I smelled something musty. I kept saying to Julie,’ I smell something wet’. She couldn’t really smell anything so I let it go another day. Then, Thursday morning when she left, I thought to check the cellar. I went downstairs, turned on the light, openend the door And … WATER. Lots of it. All over. Immediately I called ‘my favorite Mike’. He came at once and at least shut off the water. All hot water. Hundreds of Gallons. Water heater valve had broken and so it kept running over. He called the Plumber. Luckily, the warranty was still in place. I was overwhelmed with all these tasks plus hurting like the dickens. I called my friend Bonnie, at work, trying not to cry and asked her to come help me for a bit. Which she did. She handled the Insurance company and just to have someone here, had me much calmer. Is it the meds? Is it my age? I seem to have a harder time dealing with sudden mishaps, or changes.

Meanwhile I had yet another appointment with Dr. Michael. He has performed several colonoscopies and my lung surgery, last year. It’s actually on the same date this July 5th, that I will have a colonoscopy. I am sure, my colon is fine. But, ‘just in case’ as the last one was 6 years ago.

Another doc, more tests and CA 125

I can’t believe how unraveled my whole life is becoming. More questions than answers piling up. I have faithfully taken those Chinese Herbs. (They look like little BB’s.) I’m sure that some of the debris from the kidneys got out. It gave me temporary relief and I thought, I nailed it. Until the pain came back with a vengeance. It feels like some little gerbil is biting its way through the abdomen. Really. Although not much faith, I called my OBGYN for an appointment. This was de ja vue of 11 years ago, when I came to his office, crying in pain.

Well, we now know how that ended. This time, I already know that I have cancer, so I just needed help with this pain. He was not encouraging. Would not advice laparoscopy because they may encounter something much worse, i.e. cancer stuff and won’t be able to deal with that kind of surgery. He suggested a colonoscopy. Wow-yay! But, since I’ve not had one in 6 years I said O.K. I am not, at all looking forward to that procedure.

I remembered that I had some dealings with pain two years ago, which had me visit the Emergency room. I got my diary and went back and sure enough I’m describing the very same symptoms, place and severity. They hooked me up to Morphine and I remember saying , ‘Thank GOD for drugs’ as it flowed through the veines and I could feel the relief at once. No diagnosis though. As I was still losing weight at that time, it seemed to disappear after awhile. I wonder, if these is the same scar tissue that I’ve had so much problems with, over the years. I’ve had 2 surgeries to alleviate that pain but it always returns-worse. Research shows, that it’s a chronic disease. To think, I may have to live like this, is not an option. I wouldn’t care if I got ‘just’ another 10 years out of it, I’d go for it.

I will have to call my Oncologist and see what she says. We know, this has nothing to do with the cancer, although my Doc, here, always seems to want to place it there. I’ve had my CA 125 blood test (cancer marker) the other day and doc called me yesterday to give me the result. It went up. He said to start thinking about oral chemo. He thinks this is the cancer pushing on something or has grown to where it gets in the way. I am going to be contrary again, and say no, these are adhesions. My oncologist says: This is not the cancer. Radiologist and her went over that CT scan with a fine tooth-comb and nothing has changed. (Except numbers are a bit up. But we won’t worry until numbers go up 35-45 points.) They went up only 6 points.

I was not surprised as my Immune system is fighting this inflammation and taking these meds will always change numbers. I can feel myself slipping. I wonder where all this great energy went? I am uninspired about cooking. I feel no great need to eat. (That worries me a bit). I am not motivated because I am in pain so much that nothing else seems to matter. I just want to reach in there and rip it out. I tell myself to ‘buck up’, to get over it, to stop being a wimp’. But time is starting to wear me down. I can’t concentrate on helping myself against the cancer, as I have to get my energies toward this  issue now. If it isn’t one damn thing, it’s another. I am starting to feel overwhelmed, again. Since I have not been able to walk much, I’ve gained weight. That has to go so now I am back on track. But, my friends are not making it easy. They invite me, either out or to their home and surprise me with wonderful food, but not the kind I’m allowed. Then they say, oh, go ahead, it won’t hurt you this once! Yes, it does. And it’s not just once. I’m struggeling with low appetite and so they want to tempt me, so I’ll eat. Loving gestures but I need to get back into my lifestyle.

My friend Julie called and she will come on June 2nd to  help me for a week. Help clean, cook and go walking with me. I wish my family lived closer.

My BFF Irene, send a birthday card with money and although I told her NOT to, she ignored me and did anyway. I’ll use it to have acupuncture since that is helping a lot. (And, maybe a pedicure because my feet hurt.) All these extra treatments and herbs and supplements are costing a mint. Not something that Medicare pays but yet vital to me, in fighting this fight.

I still try to envision my trip to Austria, this fall. I can’t seem to see myself there, yet.

I’ve been walking again because I can’t just sit here. I need to move. I’m taking Ibuprofen before I start and hope I can finish.

Tomorrow is my 68th birthday. I look at that number and it looks so strange. I don’t feel ‘that old’. On the other hand, two years ago when I didn’t know where this journey would take me and the ‘C’ loomed huge and scary, I am sure glad to see 68. If I just get to feel better, I don’t want anything else. Ever. I don’t care about a new house, or furniture or keeping up with certain people. I don’t care about sleek cars and who’s got more. I just want to feel  better. In that is a richness beyond compare.

I am trying to get my ‘umph’ back.

 

Constantly Questioning What We Think We Know

Over the last week, Mom and I convinced ourselves of certain things about our interaction

Mom Checks Email and Facebook in Bilbao

with Dr. Chutzpah, and I summarized that thinking in the post Paging Dr. Chutzpah.  However, the doctor, who I’ll now call Dr. Denver, phoned us back today and answered several of my questions.  In the process, I realized that some of her earlier explanations had been merely unclear or confusing, and some of the conclusions Mom and I had drawn needed to be revised.

I toyed with the idea of leaving the original up to dramatize how information gets distorted by our thinking, and our thinking by our emotions, but I felt the disadvantages of being incorrect and unfair to an unnamed person trumped the advantages (the interest of generations of historians).  So the post as written yesterday has been amended, and I’ll add the new information below.

First, we had not been made adequately aware that Dr. Denver’s decisions had come on the heels of consultations with a team of about a dozen experts in different fields in what I gather is a routine multi-disciplinary meeting to discuss difficult patient cases.  I view the results of that kind of discussion more favorably.  While the groupthink phenomenon is always a danger, and I have no way of knowing if other doctors at the meeting stood to profit from any decision for chemotherapy, the presence of numerous people from different fields does present less opportunity for a decision motivated even unconsciously by profit.

Second, while Mom and I both understood the doctor’s comments of last week as meaning that Mom’s mucinous tumor was as unlikely to respond to chemotherapy as most mucinous cancer cells, Dr. Denver appeared (now I must qualify everything, even though I took contemporaneous notes) to say that, because the tumor is a recurrence of her original ovarian cancer, it would likely respond as well to chemotherapy as that first cancer did.

Below are my notes from the recent conversation, expanded from memory and edited for clarity.

What is the primary cancer? 

I noted that a pathologist said a few months ago that the spot on her lung – removed last summer before the Camino — was lung cancer.  And that another doctor had deemed that nonsense, saying it had to be ovarian cancer.  Dr. Denver said the pathologist had noted in his report that the spot “looked different from her original cancer,” and added, “if they say it’s lung cancer, they’re definitive.”  The pathologists at her own hospital, in any event, had concurred that the lung spot was a separate cancer, lung cancer.

So what kind of cancer is in this largest tumor?  Ovarian?

“I have no doubt,” Dr. Denver said, emphatically.  The lung lesion had been quite small, while the cancerous lymph node in question is not in a place where lung cancer spreads to, but it is where ovarian spreads to.

Pelvic Spots

Proton therapy is based on high-tech particle acceleration, which, like pelvic spots, reminds me of the Sun

I said that we had contacted a proton therapy center in New Jersey last week and were told today that their radiation oncologist saw other areas of concern in the pelvis and sigmoid colon.  He said this meant the cancer was metastatic, or had spread, proton therapy would not be appropriate.  (However, I could not get, or did not understand, an explanation for why removal would not be better than nothing).

There is something in the pelvis, Dr. Denver said, but that’s “relatively easy to resect,” which is Medical Latin for to remove.

Are these stable unchanged nodules something of concern?

Dr. Denver said something about Mom’s “trend over the years” that I did not capture, and went on to say that Mom’s cancer was behaving more in “a low-grade, indolent fashion.  If this was a high-grade cancer, she likely would have died of it by now.  In that sense she’s fortunate.  But where it’s decided to cause trouble is in a spot that’s impossible to get out without significant risk of just bleeding to death.”

Those other two sites, the doctor said, are another reason Mom “should get systemic therapy” to see if it “shrinks down.”  (I now see ambiguity in that “it”  — to see if what shrinks down?  The cancer generally, or the difficult lymph node?  Once again, I see a real benefit in a super-clear written explanation by the doctors.)

Oh – by “systemic” she means chemotherapy.

How did you know the lymph cancer was mucinous?  

She didn’t have the reports in front of her (note to doc:  buy a tablet), she said, but said mucinous was the histology of her ovarian cancer.  “These tumors aren’t known for being chemo-responsive tumors,” she said.  I believe she said the histology doesn’t change.

So, I said, are you saying that because Mom’s cancer, 11 years ago, was mucinous, and the histology doesn’t change, that this cancer must also be mucinous?  I believe she said yes, but she was on to a discussion that to my lay mind seemed unrelated, and hard to follow.

She said that chemo 11 years ago should have been done after Mom had had “everything visible cut out?”  I asked what she meant by “everything visible” (after all, Mom’s heart and other organs were “visible,” so surely she meant something more specific).  By “everything,” did she mean everything that looked problematic? That was my understanding.  I said that the original surgeon had spotted the lymph, but had left it there because he deemed it inoperable.  This is Mom’s memory, and she believes it’s in her diary, but one of her local doctors said the spotting of the lymph wasn’t in the surgical notes).

Dr. Denver pointed out that she couldn’t know what the doctor may have been referring to.

Should We Get Surgery to Remove as Much as Possible?

If we left some of the tumor behind, Dr. Denver said, “we’re not accomplishing much.  It will be all scarred in, it will grow back, and any attempt to resect will be even harder.”  As I did many times on the call, I restated this to her in different words to ensure I had understood it.  She went on:  “When you operate and disturb the natural tissue plain, you create more scarring.  If you have to go back in there again, it’s worse.”

“So you’re saying,” I said, “that if you go right up to the border of where you can cut safely, then when you are done that border will become scar tissue that’s harder to operate on in the future?  And that you’ll have scar tissue immediately adjacent to the aortic veins?”

“That’s right,” she said.

I asked about something called Insulin Potentiation Therapy, a form of chemo that uses a far smaller quantity of chemotherapeutic chemicals.  It’s also called “soft chemo”.

Insulin Potentiation Therapy

During my research, I had liked the idea of IPT (as Mom did), as it’s also called, but was not impressed with the dearth of science.  The idea:

It consists of giving a patient a dose of insulin followed by a tiny dose of chemotherapy.

Cancer cells have 15 times more insulin receptors than normal cells. The insulin dose helps to target chemotherapy into cancer cells because they have so many more insulin receptors. So small doses of chemotherapy can be used that cause little harm to normal cells. With Stage 1 or 2 cancer, IPT is, I read, about 80% successful, mixed results for more serious cancers.

I contacted a company called EuroMed and a doctor there got back to me this morning.  Ovarian cancer is very sensitive to IPT, he said – it’s the most sensitive of all cancers to chemo, but difficult to keep in remission.  It can get aggressive and resistant to treatment.  Almost every patient on IPT will go into remission, he said.  They frequently take patients in Stage IV, already sent to hospice care by their oncologists, who are now surviving five to seven years later.

The most important element for a patient’s prognosis is the clinical picture, he said.  He said it was very good that Mom felt well.  If she feels well with no symptoms, he said, she’ll do better with IPT.  “The way out [of cancer] is through a strong immune system, and that’s the key difference between IPT,” which aims to preserve the immune system, and conventional chemotherapy, which many say destroys it.

After Mom went into remission, he said, she would have her blood drawn monthly and be brought back for another “zap” in the case of “a flare”.  She’d be given unspecified oral supplements along the way.

Science, Alternative Therapies, and Follow-the-Money

What about scientific studies?  I’d been unable to find any original studies on the web, and only scant reference to any studies.  I heard from the EuroMed doctor a variation of the argument I see a lot these days when people discuss alternative therapies.  The arguments sometimes carry a conspiracy flavor that I find distasteful even if I can imagine them, in this case, being true.  They go like this:

IPT [or insert other potential cure] is opposed by big pharmaceutical companies (who are now people for purposes of lobbying, per the Supreme Court’s decision in Citizens United).  There is no money to be made in therapies that aren’t conducive to being patented.  If something can’t be patented (e.g., a plant essence), it can’t be sold at a high profit margin because others can sell it too, at low prices.  In the case of IPT, it’s not an entirely different therapy, but the small amount of chemicals used means little profit for pharmaceutical companies.

So big pharma, which allegedly (I have not confirmed this myself) funds the research hospitals that do all the studies, will not fund studies to prove the efficacy of competing, unprotectable technologies.  Doing studies properly costs a lot of money.  IPT [or other potential cure] providers lack the funding to do such studies themselves, and get no cooperation from university hospitals.  And doctors like the one from EuroMed, who do IPT, are oriented toward clinical work, not research, in their limited time.

In any event, the doctor asked for her biopsy report; her recent bloodwork (her CA-125 is currently a very low 52); and a recent scan.

Dr. Denver on IPT and Chemotherapy

I had just gotten the words “Insulin Potentiation Therapy” out of my mouth when Dr. Denver said, “Chemotherapy.  Anything else is just investigational.  She can do that, but it’s way outside the norm for what we would do for a recurrence of this cancer.”

When would IPT be appropriate? I asked.

“I don’t know what it is,” she said.  “It’s not something that would be used for ovarian recurrence.”

It’s clearly an alternative therapy, I allowed.  That she hadn’t even heard of it proved that much.  It was her job, of course, to focus on therapies with some research behind them.

“You’ve got to assume she will respond to chemo,” the doctor said.  She also said, of Mom, “She’s got multi-focal disease and is not a candidate for surgery”:  the systemic assault of chemotherapy was the solution to such a case.

Biopsy

What about doing the surgery in part to get out some of the tumor for a biopsy?

Surgery for the purpose of getting a tissue sample would be too invasive, she said.

But would you test a sample if you had one?

Sure, she said, for a chemotherapy-sensitivity assay.  There are a variety of them in use; some are good and some are not.  The University of Colorado Medical Center uses one called CARIS.

But you need a core biopsy, she said.  A certain amount of tissue.  And she was doubtful you could do that safely.  She concluded:  “I wouldn’t operate on her because it’s too much risk and there’s not an adequately identifiable benefit.”  This is the kind of language I look for.  It suggests she’s weighing both costs and benefits, and comparing them to one another.

She asked an oncologist in Grand Junction to contact us.  We’re going to set up an appointment with the Huntsman Cancer Institute at the University of Utah.

Paging Dr. Chutzpah

I came to Colorado near the end of February because my mother’s Denver surgeon had

What I brought from Oregon

What I brought from Oregon

said, unequivocally, that surgery on the last of Mom’s tumors would take place “at the end of February or in early March.”  Once I was already in Colorado, the doctor, whom Mom had told I would be flying in for the scheduled surgery, told us removal of the entire tumor would be risky, and was not viable.

Still, I’m glad I am here now to sort out this curious breed of people they call doctors, and to help Mom reason her way through important medical decisions.  I am finding that being a patient-advocate means being a very patient advocate.  Here I am, calling the proton therapy center in Loma Linda, California:

Me:  What do you mean you can’t take people with Stage IV cancer?  Why not?

Bureaucrat (not her actual name or title):  We only do the proton therapy on Stage I and II.

Me:  She’s not symptomatic.  Another proton therapy center thought that made a difference.  No?

Burcrat:  We only do I and II.

Me:  So is there some distinction, as regards proton therapy, that makes Stage I and II different from Stage IV without symptoms?  Or could it be a distinction without a difference?

Burcrat:  Stage IV is the stage we don’t do proton therapy on.

Me (trying another tack):  Can you tell me why that is?

Burcrat:  That’s our policy.

Kafka Was Lucky

The works of Kafka became famous for situations that make more sense than talking to someone who doesn’t know why her organization does what it does.  If only the woman had uttered one of my favorite lines from The Trial, in which two mysterious men materialize in Joseph K.’s apartment and are unresponsive to his queries, the day would have been at least aesthetically perfect.  In The Trial, Joseph K. eventually tries to leave his apartment, but the men tell him:  “You can’t go out, you are arrested.”

“So it seems,” K. replies. “But for what?”

“We are not authorized to tell you that,” he is told.  “Go to your room and wait there. Proceedings have been instituted against you, and you will be informed of everything in due course.”  And then the hilarious line:  “I am exceeding my instructions in speaking freely to you like this.”

K. tells himself this must all be a practical joke, or at least a mistake, for he lives in “a country with a legal constitution.”  But no.  K. is now in the surreal, irrational world that would come to be called Kafkaesque.

And I am in the world of American medicine, the bloated, inefficient thing we find ourselves stuck with in 2012.  I’m an advocate for my mother in a different kind of trial.  And one of the lesser trials is of our patience.

Witness our experience with the Denver-based gynecological surgeon and oncologist we met above.  We’ve taken to calling her Dr. Chutzpah.

Dr. Chutzpah:  Part I

Nearly two years ago, Dr. Chutzpah told my mother that she, Dr. Chutzpah, would not perform surgery on the tumor now in question unless my mother underwent chemotherapy afterward.  (Yes, afterward.  As if she could legally bind my mother’s post-surgery conduct).  My mother told the doctor that she couldn’t go through another round of chemotherapy.  The doctor said she would not operate without chemotherapy.

Last Monday, Dr. Chutzpah told us that the tumor is now too wound up with veins from the aorta to allow for a safe operation.  She also said that Mom has a mucinous tumor, and that such tumors are usually not responsive to chemotherapy.

Dr. Chutzpah to a White Paging Telephone, Please

So Mom and I unpacked that as best we could.

In order to perform critical surgery, two years ago, that could have prevented the further growth of the tumor, had she required a likely waste of time, my mother’s scarce money, your taxpayer money (Medicare), and, not least, a great deal of statistically unnecessary suffering?

So what should we do now? we asked, two years later.

Dr. Chutzpah suggested that Mom should go through chemotherapy, just in case it worked.

Mom and I were perplexed.  Hadn’t she just said this tumor was unlikely to respond to chemotherapy?

Dr. Chutzpah: Part II

In mid-January, Dr. Chutzpah told Mom to get another $8000 PET scan.  Mom had just had a PET scan in mid-November.

Dr. Chutzpah then had Mom and her friends drive over the Continental Divide, in January, to Denver, for a pre-op procedure – and then sent her home, saying the hospital in Grand Junction had failed to send the critically necessary PET scan.  Once Mom had arrived back home $400 lighter, Dr. Chutzpah’s office located the PET scan.  It had been in her office all along.

But then Dr. Chutzpah said the $8000 PET scan that she had ordered, and which was necessary to the $400, two-day trip to Denver, didn’t show the right information.  She called it “blurry”.  Then Dr. Chutzpah did an interesting thing.  She told my mother to get a CAT scan.

Now, you would think that if a PET scan had been the best choice all along, Dr. Chutzpah would have ordered another one.  Or, if PET scans had a tendency to be “blurry” or to be unlikely to show the object in question, Dr. Chutzpah would have known that and ordered the CAT scan the first time around.

So far, two PET scans and a CAT scan in 60 days.  Who absorbs this cost?  We do.

In any event, Mom, her immune system struggling with the fearful thoughts this confusing process was causing her, immediately went to St. Mary’s Hospital in Grand Junction and underwent a $4000 CAT scan (thank you, readers!).  The hospital again sent the doctor the CD.  Then we heard nothing for several weeks.  How to explain the time-sensitivity that says a November PET scan may not be current enough — but surgery can wait for several weeks after the third scan?  Maybe there is an explanation, but if Mom was given one, she didn’t realize it.

Mom’s nerves were fraying.  She wasn’t sleeping well.

Finally, Dr. Chutzpah left a message last Saturday saying she’d call Mom on Sunday.  On the appointed day, Mom chained herself to her phone and did not go out all day.  There was no call.

Late on Monday, Dr. Chutzpah reached Mom, said she’d called both of us earlier in the day (a curious fib in the age of missed-call lists), and said she hadn’t called on Sunday because, she said, “I thought you might be in church.”

When Mom (who does not go to church) got off the phone, she was incredulous.  “Did she think I’d be in church all day?”

This, too, affected Mom’s sense of trust, and well-being.

Dr. Chutzpah:  Part III — Primum non nocere, or First, do no harm

I watch these things with the eye of a consultant, a coach, a businessperson.  (And a comic, sadly).  I have been passionate about best practices and efficient systems since before I knew their names.  I’ve devised the best ways of doing things, used them, recommended them, helped others build them for my entire career.  And I too am incredulous — at the avoidable waste, inefficiency, and poor service I see in medicine.

Dr. Chutzpah, for example, does not have in place the fundamental operating policies a competently-run business has in place to make a real effort to respect clients’ time, money, and emotional energy (which is, or may as well be, the immune system).  Leaving aside the possibly wasteful scans, here are just a few policies Dr. Chutzpah could implement as easily as creating checklists for them:

  • Waste no patient money, I.  Establish a procedure to ensure that a patient does not even cross town, much less the state, unless the doctor possesses all the tools and information the appointment requires, including a PET scan.
  • Waste no patient money, II. Establish a procedure to ensure that a patient does not expend the time and money to come to an appointment unless all tools are in working order, such as clear PET scans.
  • Take responsibility. If doctor’s office does cause a patient to foreseeably waste time and money, the patient’s overall bill should be reduced to compensate for the increased expense caused by office’s negligence.
  • Pay attention to foreseeable consequences. If you know that a patient is making plans based on what you say, pay attention to what you say.  For example, if you haven’t yet reviewed the CAT scan that would alone tell you if surgery was or was not possible, do not set a date for surgery that others will rely on at their expense.
  • Do not substitute authority for evidence. When you do recommend courses of action, explain why.  Cite a scientific basis for a recommendation.  For example, if chemotherapy doesn’t “usually” work for a particular situation, give the patient, at a minimum, statistics for your interpretation of “usually.”  Better yet, provide the actual studies you are referring to.  Otherwise we have to wonder how cutting-edge your knowledge is, how good your memory, and how well you interpret data.  And because you’re a human being and I’ve read the research on medical errors when doctors don’t implement good systems, I don’t want to rely on you alone.
  • Have the courage to talk about ideas you disfavor. Please address those actions you do not recommend, even if you think they are absurdly alternative.  Because we are going to find out about them, and we will want to know the scientific bases for your dismissal of them.  We’re probably going to ask you anyway; why not be thorough and streamline things in advance?  (Another doctor inspired this addition:  When you are asked about alternative therapies, discuss them rationally and unemotionally, rather than with anger and contempt.  The latter is about your ego.  The former is about your patient).
  • Better yet, write it all down.  It is madness to expect a terrified person to hold in her head everything you tell her, or to take flawless notes.  The mind screams:  What are you thinking?

Dr. Chutzpah’s Last Ride?

Because no doctor had clearly laid out the options for my mother, nor written anything down for her, we were left with a raft of questions.  I called Dr. Chutzpah’s office and left a voice mail saying we had questions.  I asked for her email address.  I said that we would not rent, sell, or barter the email address, but if the doctor was concerned about getting inundated with emails, I could put the questions on a web page and they could view them there.

I mean, right?

Dr. Chutzpah’s nurse called, several days later, to say that I should leave the questions on their answering machine.  Twice she stressed that I should not be worried about leaving “a long message”.  In fact, I was quite brief.  I read off these questions:

  1. What is the primary cancer here?  We have heard ovarian and lung.
  2. How was the stage defined?  What does it mean to be in Stage IV without symptoms?  Is such a Stage IV not qualitatively or quantitatively different from more symptomatic Stage IVs?
  3. Is this tumor metastatic (spreading) from the primary?
  4. Why was chemo required 2 years ago when she’s saying now that Mom’s type of cancer typically doesn’t respond to chemo?
  5. Why not do a chemo compatibility test?
  6. What are your thoughts on partial removal of the tumor first?
  7. Can a biopsy be done without surgery, or in this case is a biopsy about the same procedure as surgery?  If the latter, does it not make sense to do the surgery in order to learn what kind of mass it is?

The next day, the nurse called us back.

“Dr. Chutzpah,” she said, “said that if you have so many questions you will need to make an appointment to see her.”

No, Seriously

“I’m disappointed to hear that,” I told the nurse, “because I think we shouldn’t have that many questions.  Their answers should have been included in a well-thought-out presentation.  And if there’s not going to be any medical exam, it doesn’t make any sense to travel all that way for a conversation that can be done by phone.  Does it?”

Eliminating the only remaining reasonable objection, I added, “We’d be happy to pay her for her time on the phone, but it makes no sense to drive four or more hours to Denver when there won’t even be a physical examination.”

“I will communicate your views to Dr. Chutzpah,” the nurse said.