Friday, August 26, 2016

5084 Calories

Friday, August 26, 2016

Rudeness is the weak man's imitation of strength.
 – Eric Hoffer --

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I figure I've got to lose weight, because I have to fight the nicotine gain, and since since my ovaries aren't pumping out estrogen, most of that is coming from the fat.  Less fat, less estrogen; less estrogen, less potential tumor growth.

I started counting calories today.  By the time I'd finished supper, I had a total of about 900, maybe a little less, including the creamer in my coffee, and a one ounce bittersweet baking chocolate treat.  Today is a "no meat" day, I do that about two or three days a week, so that makes it easier to count. 

Then Daughter brought over an ear of sweet corn (fresh, boiled, no salt or butter).  I love her corn.  She always does them just right, sweet and tender.

I ate it.  Then I tried to find out how many calories to add to the total.

Some websites say 59 for a "small ear".  Some say 59 for a "regular ear".  Other sites say 135.  All the others are somewhere between.  89 seems to be popular.  Very few get into specifics like weight.  All I can say about this ear is that it was 7" long and had about 17 rows of kernels.

Maddening!  Whose numbers do I believe?  Whatever.  I think no matter what number I use I'll probably still be below the target 1100 for the day.

It's a sad truth that if I stick to canned and packaged foods, it's easier to count calories.  Something wrong with that.
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5083 Still no idea what's going on

Friday, August 26, 2016

"Those who can make you believe absurdities,can make you commit atrocities" 
– Voltaire AKA Fran├žois-Marie Arouet --

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Last week I saw the medical oncologist, but didn't learn a whole lot, except that we don't know much of anything until we get the Oncotype DX results.  I mentioned that I had no idea when the radiation was supposed to start, so he set up an appointment for me with the radiation oncologist, whom I saw yesterday.  Again, I didn't learn a whole lot.  One important thing is that they will do my radiation prone, the "drop the breast through the hole" position, so there is almost no chance of messing with heart and lungs.
 
I was under the impression that the radiation would be definite, and before any other treatments, but again, they're waiting for the Oncotype DX results.

If I need chemo, this group likes to do it before radiation.  We won't know whether chemo is advised until ... guess what.  And that might be another week.  Or two.  Or more.
So, chemo if required (and if I decide to accept it - I may not), then radiation, then the hormone stuff.   (Calling it hormone treatment is a misnomer, because they wouldn't actually be giving me hormones.  It's an estrogen blocker, blocks the receptors on cells.  Big deal.  It's still treating hormones as far as I'm concerned.  Menopause is a hormone issue, right?  With menopause you stop producing so much, and with the blocker you can't use what little you've got left.  Same kind of thing.  So there!)

So here I sit.  I can't make any plans for the next many many months because I don't know what will be happening when.
The medical oncologist  said that the estrogen blocker he'd want to use is called Femara (Letrozole).  So I did some research.  Apparently there are three blockers out there, and this is the one with the mildest side effects.  

Oh.  My.  God!

If this is the mildest, I'd hate to even contemplate the others.  Want to scare yourself?  Check out the user reviews on
 http://www.rxlist.com/script/main/rxlist_view_comments.asp?drug=femara&questionid=fdb4363_pem or 
http://www.webmd.com/drugs/drugreview-4363-Femara+Oral.aspx?drugid=4363&drugname=Femara+Oral.  
Side effects include severe bone pain, joint pain, weight gain, insomnia, spontaneous bone fractures, headaches, ... to list a few.  

Yeah, some people it will affect more than others, so I sorted the reviews to see the positive ones.  They listed joint pain, bone pain, headache ....
Oh dear. If this is on top of my fibro, oh dear. On the other hand, it's possible it's no more pain that I usually experience, just in different places. These women might think it's so awful because they so seldom experience random pain, so maybe I'm conditioned to pain enough to just pass it off.


But really, I'd rather not have to find out.

The worst part is that you will be on this poison for YEARS!


You know all those women who go off to Europe or Mexico, or to fringe nutritionists, to get alternative treatments?  Now I know why.  Sometimes the price of continuing to breathe just is just too high.

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Philosophical musings:

My theory is that everyone "has cancer" multiple times in their lives.  A cell somewhere goes rogue and doesn't behave as it should.  But the immune system recognizes it as "not mine" and kills it and its progeny very quickly, and you never knew it was there.  Only when the immune system does not recognize that there's something wrong, when the rogue cells somehow escape detection, does the person "Have Cancer".

Right now we attempt to excise and kill off rogue cells with poisons.  It's all we've got.  But in doing so, we also damage the immune system.  That seems counter intuitive.

It seems to me that we should perhaps be looking closely at what allows the rogues to escape detection, and attack that.  Looking at how to energize and direct the immune system.  (That's the clinical trial Jay was enrolled in, and it was sort of crudely working when he died, but it was so experimental that he wasn't allowed to enroll until he was so damaged by all his earlier treatments that his organs simply gave up.  He couldn't survive long enough to see success.)

So it bothers me a little bit that all the treatments planned for me are concentrating on the precise characteristics of THIS tumor.  It has been excised, wide excision with clean margins, and there has been no signs of metastasis.   Maybe we should ask why the immune system didn't detect it, and fix that?  Why do we assume that a recurrence would be the same tumor (progeny, escaped cells), and not a brand new tumor with different characteristics?  If this tumor is estrogen positive, then it makes sense for an estrogen blocker to prevent the growth of "children" of this tumor (although from what they're saying, there shouldn't be any), but why do we assume all future tumors would follow the same rules?  If they're thinking I could throw another tumor in this or the other breast, maybe we should look at why tumors got started in the first place, and why the immune system missed it, and attack that issue instead?

I'm just wondering.
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Sunday, August 21, 2016

Saturday, August 20, 2016

5081 Lots of little stuff

 Saturday, August 20, 2016

"The big thieves hang the little ones."
-- Czech Proverb -- 

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The breast.  I had hoped that after the surgery and lab reports I'd have a better idea of what's going to happen.

Nope.

I got a tiny bit of additional info, and it's not the best.  The stage is still good, at T2aN0M0, and it's stage 2a instead of 1 only because it's .2 cm too large in one of three measurements to qualify for T1, and there's a lot of other good indicators.  So that's good.  However, there's a bunch of stuff they look at after it's removed to judge the grade of the tumor - how active it is, how "deformed" the cells are and so on, and I score 8 out of 8.  It's a very nasty tumor, high grade, as high as they get.  Not so good - or so I thought.

So, last week I had my first visit with the oncologist.  The first thing he said was, "Congratulations!   You are now cancer-free!"  

I gave him a look that said, "Yeah, sure, so why am I sitting here?  Let's not play that game, ok?"

I found out nothing useful.  I had assumed that cells would be sent out immediately after the surgery for an Oncotype DX test.  They check the genetic makeup of the cells and it gives all kinds of information, like the likelihood of recurrence, susceptibility to various treatments, and so on.  In fact, most oncologists no longer base treatment on the stage and grade any more.  Oncotype DX, although expensive and not covered by some insurance, is now considered the standard of care.

Anyway, it was NOT ordered automatically, and he had just received my files, and just ordered it (duh?) so it will be another week or two or three before we get the results and I find out whether I'll need hormonal therapy and/or chemotherapy.  In the meantime, I do still have to have radiation (Grrrr! Because I had the lumpectomy instead of the mastectomy I wanted.)

No one has contacted me yet about starting the radiation.  And I'm still having some kind of nasty reaction to the blue dye.  I don't know if that will delay stuff or not.

Sigh.

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How to thread a needle.  Someone will say they can't thread needles, and then you see them hold the needle in front of them, squint, and try to push the thread into the eye.  Yeah.  That doesn't work.  It especially doesn't work if you wet the thread.  Here's a hint I've never seen anywhere before, but it always works.  

First, make sure the end is cut super bluntly, no trailing fuzz.  Now note the way the thread is twisted.  Put the end of the thread between the sides of your thumb and index finger, and roll it slightly, a tiny bit, in the direction that will tighten the twist.  Then pull the thread down until you can just barely see the tip between the thumb and finger.  Take the needle and slip the eye over the tip of the thread, holding the thread tightly and pushing the needle down between the thumb and finger.  Roll the thumb and finger a tiny bit up, so it's past the needle, but still gripping the tip of the thread.  Pull the needle down more, and you should find it on the thread.

Might take a little practice, but once you get it, it works first time every time.

My eyes are so bad right now (I'm about three years overdue for a prescription upgrade) that I can't even manage the huge eye on the sewing machine needle any more.  So I just remove the needle, thread it using the above method, and then put it back in the machine. 

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Want to have a little fun?  Look up the word "trumpery" in the dictionary.  It'll probably be definition #2.

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Donald Trump has been talking about an ideological test of "American values" for visa applicants (he doesn't seen to understand that there are different types of visas, oh well), to verify that they agree with things like religious freedom, gender equality, gay rights, and so on.  

I'm frustrated because I can't find exactly what values Mr. Trump is interested in testing.  Most pundits seem to think it's stuff like the short list above, but that can't be it, because those are all "disgusting liberal" values.  If we can't allow people into this country who would fail a test like that, then most of the population of the southern states and almost all of his supporters should be deported.

It's been Republicans who have fought and legislated against all those "values" over the past few years.  So it's gotta be other stuff, but what?





Comments from Trump supporters on this video insist that it's fake, that the interviewed people must be actors.  Uh, no, I've talked with a few Trump folks, and this is exactly what you get.  From the article linked below, "...current Republican congressional Rep. Jody Hice said that a woman should run for political office only if her husband consents to it since husbands have “authority” over their wives. Before you dismiss Hice’s views as being an exception, he easily won his election in 2014 and was vocally supported by well known conservative Erick Erickson."

This article is interesting, but I can't figure out how to link only the pertinent article, so ya gotta look fast, because it might scroll off the page:  http://www.thedailybeast.com/articles/2016/08/15/trump-s-ideological-vetting-plan-would-banish-most-republicans.html

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This is super cute. I guess I didn't realize tortoises could have so much personality and would stand up for their rights. "MY ball!!"

Monday, August 01, 2016

5080 My clueless insurance

Monday, August 1, 2016

I mentioned that my medical insurance folks try to be very helpful, but next to nobody accepts my insurance.  They often send me emails or call me to urge annual checkups and mammograms and the like, and even offer incentives - like after I saw the doctor last month, I discovered a $25 gift certificate in my Amazon account, from them, for having a checkup. 

So, anyway, after the past two months of medical excitement, last week something rather weird happened.  I had just left the surgeon after the followup visit, was in a store looking for something to drink and munch on, and my phone rang.  It was deep in my purse and I had to dig it out, and I assumed it was Daughter calling for a report, so I answered it without looking. 

It was my insurance company.

The very young-sounding lady on the phone had called to urge me to get my annual checkup and mammogram, and embarked on an obviously scripted explanation of why it was so important. 

I exploded.  I'm afraid I was not very gracious.  Probably a lot of released tension.  I interrupted her and informed her that I'd had a diagnostic mammogram and ultrasound six weeks ago, had been diagnosed with breast cancer, had a slew of pre-op testing, had surgery just the week before, and had left my surgeon's office minutes ago, and I'm shocked that she didn't already know that!

This was off script, and the poor girl didn't know how to handle it.

Maybe I should feel bad, but I don't.
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Wednesday, July 27, 2016

5079 Photos!

Wednesday, July 27, 2016

I forget where I got this: "If the Islamists laid down their arms, there would be peace in the Middle East. If Israel laid down its arms, soon there would be no Jews, Christians, or any other 'infidels' left alive in the world."

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Daughter stopped by for the report.  She took some photos.  Here they are.

The red line high up on the breast is my reaction to the tape.  I always turn red along the edges of that thin transparent tape they use.
The blue spot is from where they injected the dye into the tumor to track the location of the "first-in-line" (sentinel) lymph nodes.  That spot isn't supposed to be there.  It surprised the surgeon.  It won't wash off.  It may end up as a permanent tattoo.  
The yellow is bruising.  The bruising above my hand looks worse in this photo than in real life.
Some of the fullness is swelling, but actually, not much.



A better view of the incision.  See how well the little old lady heals?  This is one week after surgery.




Sigh.  Can you see why I want a major reduction?  Nobody needs to carry that around.  By the way, I'm not lifting them here - that's their normal droop.


I rather like the way my hair looks.
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5078 Hands are not visible if they're black?

Wednesday, July 27, 2016

Ain't no fun when the rabbit got the gun.

--I can find many uses of this, but I can't find the original source. Of course, no contemporary usage credits it, like it's supposed to be original to them? Nah. The earlier usage seems to apply simply to tables turning, to the oppressed rising up, like in country songs about battered wives. But my research also took me to some of the dark scary parts of the internet. The past few years it seems to be used most by people talking about an armed revolt against the government.

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By the way, I strongly suspect that the reason the surgeon didn't want to do the mastectomy was that she had no faith in my ability to heal well from such drastic assault.  I think I proved her wrong.  Piss me off!

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Police shootings in the news.  This is one that happened some time ago, but hasn't been in the news much, but I think it's one of the most egregious, most appalling.

Take a look at this photo:


The man lying on the ground is a health care worker.  The guy sitting is his charge, a kid or young man (age not given, but often described as a boy) with severe autism.  They are near a health facility.  The kid is holding a toy truck.  Someone called the police and said the kid was waving a gun.  The police arrived and got all excited. The caregiver lay down with his arms in the air as the photo shows and attempted to explain to the police that the kid did not have a gun, it was a toy truck.  He tried over and over.  The kid of course ignored all instructions to throw away the "gun".  So a police "sharpshooter" (quotes because he was incompetent) fired three shots, hitting the caregiver in the leg with one shot.

The police then handcuffed the caregiver's arms behind his back, and let him lay there for something like 20 minutes.

Now, here's where it gets even weirder.  The caregiver was lying down with his hands in the air the whole time.  I guess when the cops realized they'd screwed up royally, they claimed that they were shooting at the kid, who had ignored their orders and therefore deserved shooting (he's autistic, remember? and the caregiver had told them that)  and completely missed the (white) kid and "accidentally" hit the (black) caregiver.  Yeah, uh huh, so, um, why the handcuffs?  When you found out the kid had, in fact, a truck, why leave the handcuffs on and why no medical assistance for the caregiver?

As was pointed out in the Trevor Noah video, what is a black man supposed to do to avoid getting shot?  He can't walk toward the police.  Hands up or not.  He can't walk away from the police.  He can't stand still.  He can't lie down with his hands in the air.  He can't lie on his stomach, because then his hands aren't "visible".  What can a black man do to avoid getting shot?  Apparently, nothing.

As you know, I dated a black man for a long time.  He was respectable, intelligent, well spoken, law-biding, strong, and protective. But I'd seen him on a few occasions very nervous around police.  He knew there was no valid reason for them to target him, but he also knew that he had no power to stop very bad things from happening if we'd come up against the wrong ones.


Skip ahead to about 1:22 in the video:

 Here's the story from Snopes: 
http://www.snopes.com/2016/07/22/north-miami-police-shooting/
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5077 Lab report

Wednesday, July 27, 2016

"Education is what survives when what has been learned has been forgotten."
-- B. F. Skinner --

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Saw the surgeon today.  Got the bandages off.  Got the lab report.  

I am healing beautifully.  Well, not beautifully, it's pretty ugly, but you know what I mean.  I can now wear a regular bra and do whatever I want.

The lab says the edges of the excised lump are perfectly clear, not only clear around what she removed (and she did go wide, as I had requested) but clear right up to (and including!) the centimeter around the tumor itself.  Two of the closest lymph nodes (what they call the "sentinel node" and one past that one) were removed and examined, and they are also perfectly clear.  Even though the earlier core biopsy said it was dividing rapidly, the size of the tumor was about the same as determined by the MRI of a few weeks ago.  

That was my biggest worry, and one of the factors in my decision to go ahead with the lumpectomy rather than searching for a surgeon who would agree to a mastectomy - I felt pressured by time.  My #1 priority was to get the tumor out of there before it decided to expand territory, travel, and set up shop elsewhere, and given the difficulty finding another surgeon who would accept my rotten insurance, I didn't feel I had the luxury of time.  Now I do.   We can clean this up later at our leisure.

So, altogether a very good report. 

Next I see an oncologist, and find out what the recommendations are for follow-on treatment.  I'm hoping that radiation will not be required (it probably will be recommended, but I can hope not), and hormone treatment rather than chemo (that's a probability).

Note.  This is important to know!  When there are multiple treatment possibilities, like mastectomy versus lumpectomy with radiation, you, the patient, have every right to choose which to have, which to reject.  No one can force you to accept any particular treatment, even if one is more highly recommended than another, as long as either is medically approved.  As long as the risks and benefits of one over the other are explained to you, you have every right to accept or reject those risks.  It's your body, and you can determine the course of treatment.  Your doctors also have the right to refuse to do one or the other if in their opinion it is not the best treatment for you.  In my case, my surgeon refused to do a mastectomy, but I also had the right to reject lumpectomy/radiation.  All I had to do was find a surgeon willing to do what I wanted (which, with my insurance would have cost time).  In fact, even with this surgeon, if I had flatly refused to even consider radiation, she would have done the mastectomy.  She did tell me that.

So, why didn't I just flatly refuse radiation in order to force her to do what I wanted?  Because I learned a long time ago that you don't piss off your waitress until after your food has arrived.
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Sunday, July 24, 2016

5076 Moving along

Sunday, July 24, 2016

"Writing gives you the illusion of control, and then you realize
it's just an illusion, that people are going to bring their own stuff into it."
-- David Sedaris --

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The last three weeks have been very busy.  There was a lot of testing, of course, that kept me moving.  When this all first came up, I started out so very positive, and then things got more and more frustrating, and I got more and more angry.   I believe that one's attitude has a lot to do with medical outcomes, so being put under unnecessary stress made me even angrier, like a snowball effect.  

One thing is my insurance.  They've tried to be very helpful, but ... it turns out nobody much accepts this insurance.  When I called around to schedule the chest xray, for example, I discovered that my local hospital doesn't take my insurance!  Same when I was trying to find a surgeon for a second opinion.  My PCP recommends that as soon as possible, I should dump these guys and go back to just plain Medicare.  Medicare works everywhere.

Another frustration was that no one seems willing to accept that I want both breasts removed, and I DO NOT want reconstruction!  I get looks of disbelief, like an incredulous "You know that means you'll be just flat?"  Uh, yeah.  That's what I want.  The surgeon said she would not do a mastectomy, just a lumpectomy, and her reason was that because I have a long history as a smoker, there's an increased chance that "the flap" would not have enough blood supply, and the flap skin would die, so she doesn't want to make a flap.

Well, I did the research.  First off, the incidence of flap necrosis is in fact doubled for smokers, but as is often the case, a very small incidence doubled is STILL a very small incidence! People tend to forget that.  Secondly, the research indicates that the difficulty with the flap occurs ONLY when the skin is draped over a filler/mold/expander used when reconstruction is planned, because the flap is thin injured skin draped over non-living non-organic material, so the skin must be able to support itself throughout healing.  If you are not planning reconstruction, the skin is laid nice and flat over living tissue, into which it happily grows and shares blood with.  None of the research indicates a common flap problem when no reconstruction is planned.  But, this is the reason she gives for insisting on lumpectomy.

Why do they refuse to believe I want NO RECONSTRUCTION!  Are my breasts so magnificent they can't imagine my ditching them?

(You know, I'm almost believing that, because almost everyone was amenable to complete removal until they saw them in all their glory.  Then suddenly they were against anything more than lumpectomy.)

So, I had the lumpectomy last Wednesday, July 20.  Daughter took me in early morning (arrived at 7:40).  Things did not happen quickly after that.  There was a lot of waiting, with, of course, no food or water since midnight.  I finally got into the OR at 2 pm-ish.  That was kind of funny.  They had taken my glasses, so I couldn't see anything, but there were 10 or 12 people in the OR, mostly women, and it sounded like a party going on.   They have tumor conferences on Thursday, the interesting case of the week, and it turned that the prior Thursday was me.  Every doctor and technician I had seen since then knew all about me.  It felt weird.

We finally got out of there around 5 pm, I think.

I'm all bandaged and taped up, and probably swollen, so I have no idea what it looks like.  The right one is definitely smaller now than the healthy left, but not by as much as I had hoped.  Imagine a volcano shape.  Now blow off the top of the volcano, leaving the base intact.  That's what I seem to have.

They gave me a prescription for Percocet, which I haven't filled.  They chewed up my upper lip and the right side of my jaw inside, so I briefly needed pain killers for that.  But not for the breast.  No pain whatsoever from the breast or from the two lymph nodes removed high on the side of the breast.  Nothing but itching.

The surgery was Wednesday.  Wednesday evening blood showed in the gauze through the transparent bandages.  Thursday morning the red was replaced by pale yellow.  By Thursday evening there was nothing there.  The gauze actually looks almost clean, which is weird.  Thursday morning the itching started.  That's supposed to be good.  There's some slight tenderness off to the side, pretty much where the lump was.  And that's it.

The lump and lymph nodes went off to the lab.  I'll find out what the lab says when I see the surgeon in a few days.  According to my research, something like 30% of lumpectomies show "dirty" edges, and you need a second surgery to get to clean edges.  That's a part they never tell you.  I told her if she was going to insist on lumpectomy, she should "go deep, go wide, take a lot more than you think you need, I don't want to see dirty edges, and remember cosmetic result is not a consideration", so we'll see.  I will be absolutely pissed if we have to go back in there.  Um, considering I wanted a mastectomy.  Once and done.

Also in a few days I'll find out what kind of follow-on treatment I need.
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Friday, July 01, 2016

5075 Surgery tentatively scheduled.

Friday, July 1, 2016

Short story - She lies. He lies. They lay.

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I spend a good portion of yesterday and today on the phone.  Dr. Kohli, the surgeon, wants a nephrologist (kidney) consultation as part of the presurgical testing.  She wants to ensure that they don't kill my kidneys with whatever else they have to give me. 

We're having trouble finding one known to her and my PCP who will also take my insurance, and is fairly close to Monmouth Medical Center (where the Breast Center is).  Found one today, have an appointment with her July 14.  The surgery is scheduled for July 21.  Three weeks out.  I wish it were sooner.

I have to get a referral to the nephrologist from my PCP, so I called him today to ask for that.  The poor guy.  He's been getting scan and lab reports, but still feels out of the loop and isn't sure why we need the nephrology consult, so I have an appointment with him on Tuesday to fill him in on what's been going on.

I'm feeling a bit frustrated.  I don't like delays.  This thing is fairly small, in a good location, and so far the lymph nodes "look good".  But it's growing fast.  It's aggressive.  I don't want it to suddenly decide to become an empire, with colonies elsewhere.

As far as the kidney is concerned, it's only the left that we have to worry about (I guess).  I can live with one kidney, and even if the worst happens, there's dialysis, whatever.  I'd really rather take care of the thing that we KNOW will kill me and not delay working on that because of  worry about the possibility of something that might kill me.

But, I seem to be the only person worried about delay, so, maybe I should relax.
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Wednesday, June 29, 2016

5074 Changing plans

Wednesday, June 29, 2016

"It is dangerous to be right when the government is wrong."
-- Voltaire --

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Well, I said I would be willing to change plans after taking into consideration what the surgeon had to say.  And yeah, plans have changed.

I spent about an hour and a half with her.  She was open to double mastectomy ... um... but not right now.

It's a little complicated.  I'll explain.  And this explains why she cancelled today's surgery (or handed it off, I don't know) and moved my appointment from Friday to today.

I smoke.  Not a lot, but enough.  Where this causes a problem is in the blood supply to the skin that will cover the area.  I've got one count against me because of the size, a second count because of my age, and the third is the smoking, which constricts blood vessels, so there's a danger of the skin actually dying, and then we're talking necrosis and grafts and a royal mess.  

If I quit smoking right now, after about (I forget how many) weeks, (in a minute you'll understand why the time span doesn't matter anyway) my odds of no problems after the mastectomy go way up.  So, ok.  Cold turkey tonight.

The problem is that I don't have that much time.  We have to move on this fast.

I had noticed that every time someone scanned or prodded this thing, the size estimate went up.  I kinda figured that was because everyone was looking at or estimating something different.  Well, no.  It IS getting bigger.  Fast.

It's now at 2.1 cm by 2.2 cm by 2.2 cm.  On the 16th it was 1.5 ish.

I saw the lab results from the biopsy today.  Most stuff looks pretty good, but there's one bad number, and that makes all the difference.   Not in prognosis - that still seems pretty good - but it means we don't have time to waste.

Biopsy lab results: 
Grade 2 (of 0 to 4), in the absence of a lymph node biopsy, but the nodes "look good".
It is estrogen sensitive, 60%.  That's good for treatment effectiveness.
Slight progesterone , at 1%.
Her2/neu is negative, which is very good news.
Ki-67 is 40%, which is very bad.

Ki-67 is an indicator as to the aggressiveness, rate of growth.
Under 10% is almost like the tumor is resting.
10-20% is borderline.
Over 20% is high, fast and aggressive.
I'm at 40%.
That means that 40% of the cells are currently in the process of dividing.
Do you know what exponential growth is?

So, there's no time to wait for anything other than pre-surgical testing. 
She wants to do a lumpectomy and sentinel node biopsy ASAP.
I had told her about my negative feels about lumpectomies, so I asked her to "go wide and deep, way beyond what looks like the margins, as much as you can take without creating secondary problems.  Remember, appearance is not a consideration."  She laughed, and agreed.  Go wide and deep.

And then, after we have the malignancy in control (after radiation and chemo, and how much of what kinds depends on what they find), after I've healed from all that, THEN we can do the double mastectomy if I still want it. (And I'm pretty sure I will.)

I swear I heard her say the lumpectomy will not require a hospital stay.  In and out in one day.  Interesting.

Now I quit smoking, and wait for calls scheduling all the pre-surgical testing.

Garbage collection is tomorrow, luckily, so I can clear out all the ashtrays and whatever tonight.  (One ashtray on the front porch, one on the back patio, one in the van.  I don't smoke in the house.)  That's a quick cut.  And I have all the milk, eggs, and bread I'll need for a long while, so I won't have to go to the deli and be tempted.

You know, I'm still not worried about the tumor.  The quitting smoking, yes, but not the tumor.  I'm surprisingly relaxed.  Or at least I am now.  I might not be so relaxed after four days cold turkey.

Hmmmm.  

Rocky, any hints to make it easier?
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Tuesday, June 28, 2016

5073 Costs of medical care

Tuesday, June 28, 2016

"Love is an irresistible desire to be irresistibly desired."
-- Robert Frost --

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I read a NY Times article this morning about the high cost of maternity care and delivery in the US.  When Daughter was born 41 years ago, the bill wasn't so terribly high, but I do remember that when I requested an itemized bill, the hospital objected at first, then finally gave in, and I was shocked to find that we were charged for things that we never got.  I'd had no medication whatsoever, not even aspirin, and yet we (well, the insurance co.) were billed for all kinds of stuff.  I noticed, for example, that we were billed some ridiculous amount for Daughter's blood typing, so I called the hospital and asked what her blood type was.  They hemmed and hawed, and finally admitted it had never been done.  Buncha stuff like that.

I informed the insurance company of all the bogus charges.  I don't know what happened after that.  It was like they had a standard list of usual procedures, and just charged for all of it, whether we got it or not.  

So, I wondered what the breast business might end up costing.  My insurance dealy has me pay 20% for just about everything up to a certain out-of-pocket limit, so I figured out what this has likely cost so far - just through the diagnostic part.
So far, I've had
- a diagnostic mammogram (how is that different from the standard mammo, BTW?)
- ultrasound
- ultrasound-guided core needle biopsy
- fine needle aspiration of a cyst
- MRI of breasts
- associated lab work and technical stuff for the above.

So far, I've paid a bit over $500 to the breast center.  If that's 20%, then so far it has cost over $2,500, and we haven't even got to the fancy parts yet.  I don't know if I should expect a separate bill from radiologists, but according to everyone I've spoken to so far, no, they are employees of the center, so do not bill separately.  The only ones who bill separately are apparently the anesthesiologists. (Incidentally, I did the math wrong first time through, and came up with $10,000 instead of $2,500.  Oops.  Not so terrible after all....)

Jay's brain cancer was intense, a lot of stuff done, many MRIs, three craniotomies, five different chemotherapies, immune system therapy, several weeks of daily radiation, steriotactic radiosurgery, many stays in hospitals and specialized care centers, many specialists, many expensive maintenance drugs, and yet between late 1998 and the end of 2001 the grand total was less than $300,000.

Wow.  I think costs have increased a bit ....  especially distressing given that insurance now covers a lot less of the total.
.  

Monday, June 27, 2016

5072 Some exciting news

Monday, June 27, 2016

I am fully aware of all the things I don't know,
and those things seem more important than the things I do know.
-- Silk --

------------------------------------------------------------------------------------------------------

I had an MRI of the breasts today.  They were able to use my hand to infuse the contrast, so that was no problem at all.  The setup was kind of funny - I lay face-down on the table, with my breasts hanging through two holes in the surface.  I was quite comfortable.  I am seldom able to lie on my stomach, and I liked it.

Before we got started, I told the technician about my wonky left kidney, so we have to be cognizant that anything that goes into the lower chamber (my left kidney has two unconnected chambers and two ureters, and the lower one is blocked by a stone) may not be flushed out for a long time, so I would prefer not to use anything that might damage a kidney.  So he went off and talked to some doctor, and came back and did two things.

1.) They switched to another contrast that is gentle on kidneys, "It's the one we use for people with renal failure".  He told me the name, but of course I've forgotten it.  I asked him if it was as effective, does it give the same results, and he said yes, that the scans are exactly the same.  So I blinked twice, and asked "Then why don't you use that one all the time for everyone?"  He looked like I'd just voted for his favorite candidate, and said "Yeah.  That would make sense.  [shrug]  I don't know."

2.)  They took some blood, and ran it straight to the lab for renal function testing, and came back in minutes with the news that TA RAH my kidneys are not just working fine, they're working exceedingly well!  He told me what they tested for, what the ranges were, and what my numbers were, and of course I've forgotten (I didn't have a pen or paper in there to write anything down), but translating to a scale of 1 to 10 where 1 is a healthy teenager and 10 is you'll be dead next week, I came in like 1.2.    What the...?!?!?!

Remember that kidney doctor who tortured me through 2011 and 2012?  The one who, when I asked why we were doing the same (often painful) tests over and over when the results were always the same, answered "Because it's progressing" and wouldn't say anything more?  Who scared me to death because kidney failure is relentlessly progressive, kidneys once damaged never heal but turn into a chain of dominoes?  Yeah, him?  Before I just didn't like him.  Now I'm furious with him.

I fired him because I had no trust or faith in him, and I figured if I was headed for dialysis anyway, I'd rather skip all this useless testing between now and then, since nothing was going to stop or slow it, so I may as well sit back comfortably in the meantime. 

Apparently it's not progressing.  And I guess all the things I've been doing to protect my kidneys, like restricting foods and supplements high in minerals and salts and drinking lots of water throughout the day, have been working. 

Maybe now I can even have a banana occasionally.  I miss bananas. 
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5071 Losing it

Monday, June 27, 2016

"God created Man in his own image and Man, being a generous sort, returned the favor."
-- Mark Twain --

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In a comment on an earlier post, I wrote, in regard to mastectomy: "Daughter told me that losing them entirely will break my grandbaby's heart. "Huh?" Daughter doesn't even fill an A cup, and Nugget (5 years old) finds snuggling into Gramma's soft chest pillows very comforting."

That brought an old memory vividly to mind.

My grandmother was, no other way to say it, fat.  She was almost perfectly round from her shoulders to her knees, with big doughy arms.  She was no more than 4' 7" tall.

I forget how old I was at the time, still a child, anyway (but maybe into middle school?) when we went to visit her again.  We'd been living pretty far from Scranton and I hadn't seen her since the previous summer. 

She was skinny!  She was all flat all over!  There was nothing left of her! 

Mom said Gramma had been diagnosed with diabetes, so she had to lose weight, but that didn't mean anything to me.

I completely freaked.  It took me a very long time to come to terms with that.  I kept wailing, "Grammas are SUPPOSED to be fat!"

See, the way I saw it then, other fat people might take more than their share, but when a Gramma was fat, that meant she had more to give.  I was afraid Gramma couldn't love me so much anymore.

You know, I wonder if that has anything to do with the fact that I've gained a good 30 pounds since Nugget was born, and it hasn't bothered me at all?  Now I'm a Gramma.  Grammas are SUPPOSED to be fat!
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Saturday, June 25, 2016

5070 Mammo, pictures!

Saturday, June 25, 2016

“The flag is a symbol, and I leave symbols to the symbol-minded."
-- George Carlin --

-------------------------------------------------------------

It took me literally hours today to figure out how to read the mammogram disk from last Thursday, then to find out which of the fifty or more folders and files on the disk had the actual mammo pictures, and then how to copy/print/snapshot them.  Finally had to take a screen capture (another hour trying various methods to accomplish that).  So, anyhow, here they are.  (Just the one orientation - there were several.)  

This is the left, the "healthy" one.  I kinda wonder about that denser part in the middle....


This is the right, the "bad" one.  It's pretty easy to pick out the tumor.  This is a little deceptive as to location.  It's actually in the lower outer quadrant.   They had me twisted funny.
 
The hollowness just behind the nipple is a cyst.  They drained it and checked the fluid, and it's of no further interest.

You notice all the "processes going on" around the tumor?  That makes the lump feel much larger than it is (it feels about ping pong ball sized, although the actual tumor is about the width of my thumbnail) and that's the reason lumpectomy will not be acceptable to me.  I don't like the looks of that at all.

On to the next steps.
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Friday, June 24, 2016

5069 More appointments, minor rants

Friday, June 24, 2016

Attention to detail: An apostrophe is the difference between a company that knows its shit
and a company that knows it’s shit. 

-------------------------------------------------------------------------

My MRI is scheduled for Monday.  That's going to be both without and with contrast.  I'm not looking forward to the contrast (see my previous experience at http://thesilkentouch.blogspot.com/2011/05/3246-friday-thirteenth-has-vampires.html), but if they don't insist that I be dehydrated, it might be ok.  Might.

The surgeon appointment is Wednesday.  Apparently my biopsy results are interesting, because she requested that my appointment be moved up from Friday.  Interesting.  I have to be there about 8 am, to see her before she goes into surgery. 

On the subject of double mastectomy, I've been thinking about what the radiologists said about surgeons being reluctant to remove healthy tissue. 

Bull poopy. 

They were perfectly happy to remove tonsils, even when they didn't know what they were good for.  Same with the appendix.  I don't know if it's still true, but when I lived in St. Louis, it was a state law that if the abdomen was opened for any reason, the perfectly healthy appendix  had to be removed.  Again, no one was sure what the appendix did.  Also, all non-Jewish baby boys were to be circumcised, by state law.  I especially remember that one because I caused a furor with the hospital when Daughter was born (1975), when I said that if she was a boy and was circumcised without our permission, I was going to sue for mutilation. 

And of course there's plastic surgeons.  They are more than willing to remove half your nose for no reason, or masses of useless fat anywhere. 

I consider my breasts to be masses of useless fat that cause more current problems (back strain) and possible future problems (5 times more likely to have future tumor in the other breast) than they are worth (having no worth).  So what's the problem?

------------------------------------------

Missouri scared me.  There was the appendix thing, and the circumcision thing, and all this didn't come from doctors, it was the state legislature that made those decisions.  Then, the legislature decided that if someone was discovered unconscious and taken to the ER, and their blood pressure was below a certain level, internal bleeding was to be assumed, (regardless of medical history or nature of injury), and the chest and abdomen were to be opened forthwith!  (And of course I guess the appendix would be removed.)

What scared the heck out of me is that, at that time, my normal regular BP was below that cutoff.  For more than a year I wore a medical bracelet with my normal BP noted on it, just in case I ever fainted from the heat or something.

Finally, there was Roe v Wade.  The Missouri legislature freaked, and in their infinite wisdom, said, "Ok.  You can have an abortion if you want.  But you ain't gonna like it!", and passed (either proposed or passed, I'm not sure, although I believe it passed with almost no discussion) a law that said all abortions in Missouri for any reason would be by hysterotomy only.  That was the first time I'd ever heard that word.  It means "caesarean section".  Missouri's doctors finally had enough, I guess, and rose up screaming. 

-------------------------------------------------

I found this in reference to Britain's vote to leave the EU:
But this was not democracy in action. This was fascism in action. People voted because they were ignorant, and they were ignorant because the fascists are terribly, terribly good at propaganda. The people were manipulated.

What's amusing was that when I first read it, I thought it was referring to the Republican primaries.
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Thursday, June 23, 2016

5068 Anniversaries!

Thursday, June 23, 2016

Checking the calendar to note future appointments (MRI next Monday, surgeon Friday of next week) I noticed two anniversaries.

1.  Happy belated birthday Becs!  (it was Monday.)  I hope you treated yourself to Indian food and a kutri.

2.  Yesterday was the 12th anniversary of this blog/diary.  Over the years it has been very useful, to go back and find when things happened, and so on.  I don't intend to quit.


5067 News from my corner

Thursday, June 23, 2016

Ye shall know the truth, and the truth will make you mad.
-- Aldous Huxley --

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Most people will interpret "mad" in the green quote above as "angry", but given the source, it's more likely "insane". 

---------------------------------

When you think of Antarctica, and the research station at McMurdo, what do you "see"?  Probably a small cluster of connected space-lab-looking canisters, and a land covered in ice and snow, miles thick.  Right?  

Well, it's nothing like my mental image.  Something I read sent me off to look at pictures.  McMurdo Station looks like any small town in the US, and as for all that snow and ice, check out McMurdo Dry Valley.  It's like that all year, not just summer.

 Amazing.  So very different from what I imagined.

---------------------------------

I've been among the missing lately as far as blogging goes, mainly because there's nothing much happening, and politics is disgusting (to use one candidate's favorite word).  Favorite joke right now - "Orange is the new Black."

I think things are going to heat up pretty soon, though.  I've been visiting the Jacqueline M. Wilentz Comprehensive Breast Center at the Monmouth Medical Center in Long Branch, NJ.  I'm impressed and happy with my impression so far.  It's the first in the region to be designated a Certified Quality Breast Center of Excellence, the highest recognition attainable from the National Quality Measures for Breast Centers and is also a recipient of the Women’s Choice Award as one of America’s best breast centers.

I had a diagnostic mammogram and ultrasound Thursday of last week, and an ultrasound-guided core needle biopsy last Tuesday. The lab results from the biopsy came back today, the radiologist called me this morning.  I have a 1.5 cm invasive ductal carcinoma in the lower outer/right quadrant of the right breast. I didn't ask for details as to grade and so on in the phone call.  It really doesn't matter right now, and I'll get all that info when I see a printout.  My lymph nodes seem to be fine, but we haven't checked them yet other than by ultrasound.

I'm very relaxed about this whole thing.  I don't have that feeling of doom about it, and neither does Daughter.  In fact, when I first felt the lump (about six or eight weeks ago, yeah, it took me four weeks to finally admit that I had to make an appointment with a doctor, I hate doctors that much, but I lucked out there, the PCP assigned by my insurance company, although Egyptian, is very nice and really talks to me without condescension).  Anyway, my first thought, and I'm serious about this, was, "Oh, wow, maybe I can spin this into a double mastectomy."

I have to talk to a surgeon next.  I chose a woman from India who has been at Monmouth for five years, has fellowships at Mount Sinai and Beth Israel.  Have to make an appointment with her.  My PCP recommended a male surgeon at Monmouth, but he's going on vacation on Monday and won't be back until August.  Actually, I'm a bit relieved.  I'd rather a female, and this woman was recommended by the radiologists (male and female) who did the biopsy.  So, we'll see.

[Flash - just got a call from Monmouth - tentative appointment with surgeon Friday 7/1, secretary is going to try to rearrange her schedule to get me in sooner, schedule MRI before that.]

My reasons for wanting double mastectomy (no reconstruction):
  1. My first bra, at age 12, was a B-cup, and they grew quickly.  They've been DD since my 30's.  For men and women alike they've been my defining characteristic all my life, ahead of any of my other skills, talents, or abilities.  
  2. Men of slight acquaintance walk up behind me, reach around, and grab them, so often that I have developed an automatic back-elbow-jab response.  They always look embarrassed and say, "I just wanted to know if they were real..."  Yes, they all say the same thing.  I don't want or need this.  I want people to see ME when they look at me.
  3. I am now 4'8.5" tall, with DD boobs.  I have a fragile back.  These things hang off the front and pull.  They're too heavy.  I walk around the house cupping them in my hands to lift the weight and center it more over my spine, and it feels so much better.  With them gone I'd almost feel like I could fly.  I need double, because one gone would unbalance me even more.
  4. Once you have a tumor in one breast, you have five times the chance of another in the other.  
  5. Face it - they have no use whatsoever once you're past childbearing age.  If I need something to make clothes hang right, a nice light padded bra would do just fine.

One of the technicians at the breast center warned me not to get my hopes up, because surgeons are highly reluctant to remove healthy tissue.  That's one reason I'm fine with switching from one of the male surgeons recommended by my PCP to a female.  I'm hoping she might be more understanding, (men get emotional about breasts), easier to convince, and able to convince my insurance --- but if the insurance refuses to pay for the other breast, I will.

So, further developments as they occur.

Please don't leave mushy comments.  I'm not a hugger, and really, I'm fine with this.  It's just news from my corner.


Sunday, June 12, 2016

5066 Circles

Sunday, June 12, 2016

"Accomplishing the impossible means only that the boss
will add it to your regular duties."
-- Doug Larson --

-----------------------------------------------------------------------------

You know, I'm tired of people sneering that "Adults should not drink milk."  "Humans are the only animals who drink milk past infancy."  Not true.  Farm cats regularly line up when cows are hand-milked.  Many cats and dogs love milk.  Why?  Because it's high in protein and fat.  The same reason humans find it beneficial.  Other animals will relish it when they can get it, especially in the form of cheese.  

They just mostly can't get it.

--------------------------------

Tinfoil hat time.  It's no secret that Americans in general seem to be getting more and more incapable of rational thought / critical thinking, and they seem a lot more poorly educated than previous generations of the same social class.  (Not to mention the rest of the world.)

I don't think that's an accident.  

Stupid people are a lot easier to herd than intelligent people.  All you have to do is feed them a load of garbage, tell them what they should fear, and then convince them that you are the only one who can save them from these fears.  If you've done your job well, they won't be capable of figuring things out for themselves and they'll believe you and follow you.  

It shows up not just in politics.  How many of those stupid made-up memes on Facebook are taken as fact by people who have no idea how to check the facts?  It's not an accident that the fastest-spreading and most believed ones are those that feed into people's carefully cultivated fears and prejudices.   They don't WANT to have them disproven.   They will close their ears and eyes to science, logic, and evidence.

I don't understand.

An example - I've been trying to understand how anyone can believe that contrails are actually "chemtrails" meant by some nebulous group (usually the government) to poison us.  You can give them all the science, all the data, and they won't listen.  You can point out that if someone is actually doing what they think, those people are also poisoning themselves and their own children, and still no lightbulbs go on.

With the ability to search the internet, you'd think people would be able to check facts.  But A.) they're too lazy to do it, and B.) when they do, they can't tell the difference between valid sources, screaming idiots, and bogus "news sources".  So they just indiscriminately choose whatever source agrees with their prejudices, no matter where or who it comes from. 

Watch the movie "Idiocracy".  Do you see a parallel with the Trump candidacy?

It's getting darker and darker out there, and that scares me.

  ------------------------------------------

In earlier centuries, people were poisoned by lead.  In makeup.  In paint.  Artists were especially susceptible, like Van Gogh and James McNeill Whistler.  The lead tended to affect certain segments of the population.  More recently, lead was in gasoline, the solder in food cans, water pipes, house paint, toothpaste tubes, and pesticides.  Lead wasn't banned in paints in the US until 1978.    


According to a footnote in a book I'm currently reading, "although lead has been removed from most consumer products, it continues to build up in the atmosphere because of industrial applications.  The average person of today has about 625 times more lead in his system than someone of fifty years ago."** (Note, sources differ, see my footnote below.)

Anyway, in earlier centuries, only some people got lead overdoses.  Now, everybody has very high lead levels.  I wonder if that contributes to the general mental nightfall.

It's getting darker and darker out there.

 ----------------------------------

I came across an interesting discussion of why the Japanese have so much difficulty with English, both in learning vocabulary and pronunciation.  In English, we have letters that represent individual sounds.  Given a written English word and the sounds of the letters, you can figure out (or approximate) how to pronounce that word.  Given a spoken word, you can phonetically figure out how to (approximately) spell it.  

In Japanese katakana (in simplest terms) it's even easier to figure out the pronunciation of a Japanese word, and how to spell it, but the problem is that there is no correspondence between the Roman alphabet and katakana.  Katakana has five vowels and (I think) one consonant, and all of the remaining symbols represent syllables.  For example, there is no katakana symbol for the sound of the letter "P" all by itself.  The closest symbol is for a syllable like "pu".  So katakana pronunciation guides for English words will have the learner pronouncing the final letter of the word "stop" as "pu".  "Stopu".  There's a good video on the topic at https://www.youtube.com/watch?v=fherVzjq20w

===========================================================================

**Said book has an extensive bibliograpny, but no connection between the bibliography and the text (phooey!), so I have no idea where the author got that from.  I did search a bit and found the "625 times more lead" in this book:  https://books.google.com/books?id=agaOKrvAoeAC&pg=PA615&lpg=PA615&dq=lead+625+times+more&source=bl&ots=qAsmsKyldi&sig=i6nAxEEIyFEwlgmJla7vpJdArIM&hl=en&sa=X&ved=0ahUKEwj5raDptqPNAhWJWj4KHQriBBYQ6AEIJTAB#v=onepage&q=lead%20625%20times%20more&f=false
but it's significant that this reference says we have less lead since unleaded gasoline, but "625 times more" than a hundred years ago.

Saturday, May 28, 2016

5065 Not done yet

Saturday, May 28, 2016

"Egotism is the anesthetic that dulls the pain of stupidity."
– Frank Leahy –

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Strange thing I noticed -- Trump's current wife has Ted Cruz's eyes.

------------------------------------------

I can't figure out why Ex#2 is getting heart valve replacement surgery.  Or maybe repair.  I don't know.  

It's not like it will improve his quality of life any more than just keeping him on oxygen would.  At this point, he has no quality of life.  

I guess I'm still hearing the doctors refuse certain treatments for Jay on the grounds that it "wouldn't improve his quality of life."  Actually, physical therapy for example would have improved what life he had left immensely, and he had a lot more life left than anyone ever expected him to have, but they just didn't expect him to live much longer.  

Those words still ring in my mind.

So how is surgery for Ex#2 justified?  Who makes those decisions?  It doesn't make any sense.  With everything else that's fallen apart, why fix the valve?  Is the only criteria just a matter of getting it approved by insurance?  I wanna know what insurance he has!
.

5064 Pressure

Saturday, May 28, 2016

Where hangs the smoke of hate burns a fiercer fire called fear. 
– old Russian proverb --

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From the Rhinebeck Community Forum, regarding the Memorial Day parade:

The parade will proceed south on Mulberry Street, turn west onto East Market Street and stop at Village and Town Halls for simultaneous flag raisins and a wreath laying ceremony

So many questions.  Does no one proofread anymore?  Raisins?  And it's one parade.  The village and town halls are almost a quarter mile apart, so I wonder how that "simultaneous" works. 

---------------------------------------

I'm in procrastinate mode again.  Everything is tomorrow, tomorrow, tomorrow.  

Daughter's father, EX#2, is in the hospital again, has been there for quite a while.  What I get from Daughter tends to be very garbled, so I'm not entirely sure what's going on.  He's in some kind of rehab facility and is supposed to have some kind of heart valve replacement surgery soon, actually I was under the impression that was supposed to be some time early in this past week, but Daughter has said nothing more, and I don't like to ask because she acts like I'm harassing her when I do ask, so.... 

What made me think it was to be early this past week is that she and the Nugget went to visit him about 8 days ago, because she thought it was important that she see him before the surgery.  The rehab is in Camden, which is a day-trip, but when they move him for the surgery he will be much further south and visiting is a much harder trip, especially with the Nugget.  

I've had to walk on eggshells lately with her because she's very tense for a long time about this week.  They all left this morning for a week-long visit with Hercules' mother, who is currently living in, uh, Arizona?  New Mexico?  Wherever she is, it's way out in the middle of nowhere, something to do with a reservation school or something.  I don't know.  I don't ask.   

I do know that the MIL is nuts.  Oh, not that kind - well, that kind too, but she's fine if she takes her medications - I mean she has some weird ideas and is frequently, in fact usually, completely unreasonable.  There's the orbs thing, and the astrology, and the way she "wouldn't let" Hercules and Daughter name the baby what they wanted to name her, loudly rejecting name after name as being "bad omens".  "Wouldn't let" is in quotes, because of course they could have chosen any name they wanted, but if they did, she'd have made their lives hell.  I am mostly pretty easygoing, but after one hour in her presence I quite literally want to strangle her.

Poor Hercules.  He drew some bad straws in parents.  His father actually told him that Daughter was a gold-digger, that she would eventually leave him and take all his money.  Not suggested, TOLD him.  When Daughter told me that, I said that she should casually drop into conversation sometime how much she stands to eventually inherit from me.  She won't need any of whatever pittance he leaves Hercules.  Anyway, he gives Daughter a hard time.  Nothing she says or does is acceptable. 

The FIL has an odd arrangement.  His second wife, Hercules' stepmother, is an identical twin, and her twin sister lives with them.  The women have the same hairstyle, dress alike, the three go everywhere together, do everything together, at least as far as I know, but of course I know next to nothing.  I don't know what their domestic arrangement is, but it does leave one wondering.  You'd think a guy who has so much money that he's worried about gold-diggers would say, "Hey, let's install your sister in her own apartment."  But, like I said, I know nothing.  I seldom gossip, but I don't feel in the least guilty about this instance.

-------------------------------

Almost forgot.  Back when Daughter and Nugget visited Ex#2 a week ago, he was sitting in a wheelchair, and the urine bag was on the side.  Daughter moved the wheelchair, and the bag somehow came disconnected, and urine spilled all over the floor.  She attempted to clean it up using paper towels or something, and then the nurse came in, and told her that she shouldn't have touched it because Ex#2 has a UTI, and it's a MRSA infection.  

Daughter was freaked enough that she called me from the road on her way home, wondering what kind of danger she and the Nugget might be in, and what she should do.

I didn't say it to her, but I figure she should have asked at the hospital.  I'm surprised that if it was very infectious that they would allow the Nugget in the room.  Of course, on the other hand, it was supposed to be confined in the bag.  I told her to call her doctor or pediatrician the next day.  I haven't heard anything since.

To add to the stress, her cat Titus has had some kind of mouth problem since kittenhood (he's 9 this year) and it finally seems to be causing him problems eating, so Daughter ... well, long story short, several thousand dollars in surgery needed.  

-----------------------------------

Well, I may regret this post.  Daughter is extremely defensive of her "boundaries", and I'm sure she'd figure I overstepped here.  But damn it, it affects my life, too.  I have issues of my own that I have been unable to bring up for the past few weeks because I didn't want to add to Daughter's problems.  So I have a right to complain about things that are attacking her, at least.
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