Tuesday, July 30, 2013

Tuesdays with Naqvi --Herceptin #14

Patience

It can feel so overwhelming to still have so many more weeks of treatment, so much more prep work to do before surgery, and a long recovery after surgery is completed. Even though I have crossed over some major hurdles in the path, I have a long distance still to go. Somedays, it seems that all I can do is wait, or make it just to the next week because thinking past that can be discouraging.

I came across a quote that reminded me to shift my attitude about my current place in this journey.
"Patience is not the ability to wait, but the ability to keep a good attitude while waiting."
--Joyce Meyer
There is no question that there is a great deal of waiting in this overall process. It is a long, exhausting path. Some sections of the trip have a few more checkpoints and mile markers, making it feel like I am getting places more quickly. Others seem to go on forever, with no end in sight. True patience is not just waiting around for the next thing to come along, but being positive and happy, whatever the scenery, whether moving forward or seeming to stand still. So, I am trying to be more patient by having a better attitude.

Thinking about waiting reminded me of a section from Dr. Seuss' Oh, the Places You'll Go.


You can get so confused
that you'll start in to race
down long wiggled roads at a break-necking pace
and grind on for miles across weirdish wild space,
headed, I fear, toward a most useless place.
The Waiting Place...

...for people just waiting.
Waiting for a train to go
or a bus to come, or a plane to go
or the mail to come, or the rain to go
or the phone to ring, or the snow to snow
or waiting around for a Yes or a No
or waiting for their hair to grow.
Everyone is just waiting.

Waiting for the fish to bite
or waiting for wind to fly a kite
or waiting around for Friday night
or waiting, perhaps, for their Uncle Jake
or a pot to boil, or a Better Break
or a string of pearls, or a pair of pants
or a wig with curls, or Another Chance.
Everyone is just waiting.


It's true that everyone is waiting for something, but waiting can be easier with a little patience and positivity. Instead of "just waiting," there is always something to do. While I wait each week for another treatment in what seems like a never-ending countdown, I need to work on my attitude. I have much to be grateful for and non-cancer-related goals to reach. Negativity and "just waiting" get me nowhere. Some people live by constantly making goals, seeking to improve. Others sit back and wait for someone else to get the job done. Those who are highly motivated don't stay in the useless "Waiting Place" for very long because they are not discouraged by hurdles but see them as blessings in disguise, opportunities for learning. I want to be someone who waits with patience but is motivated to move forward. I want to be like the people Dr. Seuss described:


NO!
That's not for you!

Somehow you'll escape
all that waiting and staying.
You'll find the bright places
where Boom Bands are playing.

With banner flip-flapping,
once more you'll ride high!
Ready for anything under the sky.
Ready because you're that kind of a guy! {or gal.}

In the past, I was not always a patient person. This experience is helping me work on that. I have also had to learn that true faith is not just believing in God or believing that he can and will heal me. It's also believing that he might not heal me, if that is His will and in His plan, AND believing that either outcome will be okay in the grand scheme of things. Once I accepted that, I've been able to see so many miracles, blessings for my faith. Patience seems to be learned in a similar pattern. When you decide to have a positive attitude in "the waiting place," the reward for that patience is that your time waiting doesn't feel like "just waiting." That's when you start living and truly going places.



Thursday, July 18, 2013

Plastics

I met my plastic surgeon yesterday.

His office is in the Med Center, but since I was having Herceptin #13 yesterday, he came to Katy to meet me.

I liked him immediately, especially because I was the silent witness to a greeting he had with a former patient who also happened to be in the waiting room.  The minute he walked in the front door, she jumped up to greet and hug him, and at first I thought they were just old friends.  Then, he said, "I hardly even recognized you!  You look SO good!!"  She talked about it being two years since surgery and that she was doing fabulously.  "No wonder you didn't recognize me.  I looked so much different back then, and my hair has come back."  He just said how happy she looked and how great she looked.  It was a warm first impression.

Shortly after that, a nurse called me back to the conference room, and Dr. Boutros came in.  He introduced himself, and asked me to tell him about myself.  "I'm 33.  I'm the mother of 3 boys.  I'm an Aggie."  He stopped me.  "I'm an Aggie!!!  Did you know that already?"  {I didn't, but it pretty much sealed the deal.  I knew I liked him!}  We then went on to share stories of Aggie football games, how he lucked into some great season tickets on the 50 yard line, thanks to an older woman and her broken hip and bad health, but they'd only last 2 more seasons unless he wanted to give a "donation" of $250,000.  He asked where I was from, how I ended up in Houston, and then the conversation moved to cancer.  I told him it came out of nowhere.  "Do you have a family history?"  No.  "Do you smoke?"  Never.  "Interesting.  What has been the hardest part of the journey?"  I explained that the hardest thing has been all of the unknowns and extra challenges that have creeped in during the process.  The surprises have been difficult.  He then went on to cement my like for him by explaining how challenges can often be blessings, that most of his patients now have such a love for life and such a happy outlook, now that cancer is all in hindsight.  He talked about how he hasn't had to overcome anything so challenging in his life, so he doesn't even fully understand it, but he can see the changes in his patients, and it's inspiring.  He then talked about how his office and Dr. Pollack's are both very faith-based.  He believes that God {or whatever you believe in} has a way of using challenges to build you up and make you stronger.  You just have to have the faith to see the miracles.  I got a little teary because didn't I JUST blog about that?  It was another tender mercy.

Then we discussed the issue at hand--surgery.  He asked what I knew about breast reconstruction.  "Only what Dr. Pollack told me yesterday.  Before that, just what friends have talked about with their own breast augmentations."  "Good," he replied.  "You don't have too many preconceived notions."  He talked about how the procedure is done.  It's called DIEP flap surgery.  There is an incision made in the abdomen from hip to hip.  That tissue is used to reconstruct breasts.  The old way to do this type of surgery was to use some of the entire ab muscles to rebuild the breasts, but this resulted in the loss of core strength.  Now, they leave the ab muscles intact, but use the blood vessels to reconnect and reconstruct.  Plus, most patients, especially those who have had children, don't mind having extra tissue removed from their abdomen.  It's not a true "tummy tuck," because there is no liposuction, but it's a small silver lining in the whole thing.  He explained that Dr. Pollack only refers him patients who she thinks are good candidates for this procedure because it's intricate, lengthy, and state-of-the-art.  "If you just want a mastectomy or an augmentation, there's lots of doctors who can do it.  If you want a good reconstruction, it takes a little more experience and skill.  This is my specialty.  I've done a lot of them, and I'm very good at what I do."

The pros of the procedure are the natural look and feel.  "They will last forever, will always look good, and will grow with you.  They'll look good at 40.  They'll look good at 60.  They'll look good at 90--well, as good as they can look!"  I asked about implants and why I was told they would only last 10-15 years when I've had friends who've had their breasts done who haven't been told that.  "Good question! In a regular breast augmentation, the implant is placed behind tissue or muscle.  Even someone with small breasts has a few inches of tissue."  He then got out a Kleenex and placed it over his fist.  "With a mastectomy, all that remains of your breast is skin.  It's a thin layer, and trying to put implants behind that doesn't look natural at all.  They won't look full.  They won't last.  And, scar tissue will build up between the implant and the skin because it's the cement that puts us back together as we heal.  Without any other tissue to hold onto, scar tissue will just build up.  I've seen patients who have so much scar tissue that they get to a point where it's difficult to lift their arm at the shoulder.  With reconstruction, it's natural tissue and they last forever.

"Can I take a look at what we're working with?"  We went into the exam room.  "Oh, you're a GREAT candidate for this surgery!" he said, tugging at all my extra abdominal skin.  "I can tell you carried your babies really low and they really stretched you out.  That's great because I have LOTS of tissue to work with.  You are going to be so happy.  In fact, you'll probably tell me to make them smaller when we come back for touch-ups!"

I like the doctor.  I am confident in his abilities.  I think the pros of reconstruction FAR outweigh the cons.  We are going ahead with this plan.

I'm so grateful to have more information.  I basically know what to expect for the rest of the journey.  I'll have a hard recovery process and MANY more weeks of Herceptin, but it's nice to have the fog removed off the path.  I can see where I'm going.     

Wednesday, July 17, 2013

Tuesdays with Naqvi--The Last Ultrasound and The Surgeries

I had my final ultrasound in this process last week, with the follow up and results yesterday. The miracle of Dr. Naqvi not being able to feel the tumor in an exam was confirmed: no definable mass or lesion with discernable margins could be identified by the ultrasound! My tumor at the first mammogram/ultrasound was 4 1/2 to 5 cm in diameter, large enough to require a mastectomy. After one hell of a chemotherapy experience, it is no longer able to be measured with an ultrasound! There is only a slight change in my axillary lymph nodes, but the cancer cells there weren't originally discovered until after body scan and a second biopsy. I'd say the chemo did its job. How assuring it is to have visual proof of another miracle in my life!

Now that chemo is over, it's time to move on to surgery.

I discussed my options with both my oncologist and my surgeon yesterday, and feel like I have some answers and definitely a plethora of information to think on.

Dr. Naqvi was reluctant to give me her surgical recommendation yesterday; she deals on a cellular and chemical level, and wanted to know the pathology of my tissue before moving forward with her best opinion. She explained that because my initial mammogram and ultrasound showed so many calcifications that are still there, it's hard to know if those areas are precancerous and could later transform into cancer without looking at the pathology of that tissue. Some patients elect a mastectomy, to be done and over with the whole thing, but I could have a lumpectomy to remove the entire area of the original mass, plus extra tissue for study. After the pathology reports came back, we would know the results of my calcifications and have more of an idea of my percent of recurrence. It might be that my entire breast tissue was precancerous, and I would need to move forward with a mastectomy anyway. Or, the results might show that all those calcifications just represent my normal tissue, are benign, and the lumpectomy plus radiation would suffice. If radiation was my choice, one week after surgery, I would start that 6-week process, 5 days a week! I was shocked at the commitment required for that treatment plan and that her desire to have surgery just to discover the pathology of my tissue could end up proving that the other surgery was necessary, anyway. I needed the advice of a surgeon.

Dr. Pollack hasn't seen me for 6 months. I'm on the other side of the big chemo hill, and am ready to move to the next big step. I've also gained 15 pounds since I was last in her office. The nurse said that was normal, and they actually preferred their patients gain weight on chemo than lose it. Go, me! I still had so many surgical questions to ask, so when Dr. Pollack asked what surgery I would like, I told her to explain it all to me as if I knew nothing--the pros and cons of both options, her recommendation, etc.

She started off by telling me that based on my age and the type of cancer, she would recommend a bilateral mastectomy and reconstruction. I have a lot of life left to live, and a lot of time for cancer to come back. With the mastectomy, they are able to remove 97-98% of the breast tissue, which means there is a 97-98% chance that cancer won't return. Plus, I won't need mammograms! Those are some amazing pros! I would have immediate reconstruction, one long surgery, in which they keep most of my breast skin and reconstruct breasts from abdominal tissue. So, I get a boob job and tummy tuck in one! The plastic surgeon takes tissue from my gut and then reattaches the tissue on a micro level, connecting blood vessels. This type of reconstruction looks natural, is my own natural tissue, and lasts forever. In the exam, Dr. Pollack took a look my midsection, seeing a good portion of those extra 15 pounds and said, "yeah, he'll have a lot of tissue to make some nice, big boobies for you!" And that explains one reason they like patients to gain weight during chemo: there's more tissue for the harvest! Who knew I'd be able to find a silver lining in my muffin top? After I heal up, there would be some touch up work and the reconstruction of my nipples, including tattoos. And, here I thought I'd never be inked! The hard part of this procedure is the length of surgery, the 4-5 day hospital stay to drain the sites and watch for complications, and the lengthy 6-8 week post-op recovery time, in which I will have pain, a difficult time being able to get up and stand up straight, or lift anything over 5 pounds. This is NOT a disease for mothers of young children!

My other option is a lumpectomy and radiation. The pros to this were, in her opinion, basically just easier surgery and recovery. The cons of radiation seemed to outweigh the pros. First, my breast tissue would shrink even more, causing me to probably need a reduction on the other breast so it would even out. Also, radiation can cause skin color changes, skin toughening, and scar tissue. Plus, if I chose this treatment and cancer came back, I would require a bilateral mastectomy anyway, and then they would be working with scarred and radiation-damaged skin, instead of healthy tissue. Dr. Pollack was, not surprisingly, anti-radiation and pro-surgery. She is a surgeon, after all! After this meeting I felt like there was really no question as to the best option for me. I just needed to meet with the plastic surgeon to ask a few more questions.



Tuesday, July 16, 2013

Tuesdays with Naqvi--The Miracle

I've often heard that "faith precedes the miracle."  Now I can be one to share a personal story of that truth. 

From the beginning of this journey, I started with a study of faith.  I've worked at trying to see the silver linings in all the added challenges that have accompanied this already difficult experience.  It hasn't always been easy to not have all the answers and to take small steps forward without having the control over my life that I like to have, but I've come to understand how that control is often just an illusion if we think all the power lies in our own hands.  Through it all, my study of faith has turned into a change of mind and heart into being more faithful. 

And then came the miracle. 

Last week I had a follow-up appointment with Dr. Naqvi because she wasn't able to meet with me during my chemotherapy.  I asked some questions about the timeline for the remainder of my treatment and counseled with her about being able to travel to see my family and attend a wedding in Stephen's family, even though the setback in my last chemo put us a week behind schedule.  Amazingly, she felt that I would be okay to travel and gave me the green light for the trip, with precautions.  That was miracle one.

Since I was already in the office, Dr. Naqvi was interested in the progress chemo had made on my tumor, so she wanted to do a breast exam.  The minute the exam started, she just kept repeating, "Oh. My. God!  Oh.  My. God!...."  I figured that meant that she was extremely happy and that the tumor was tiny.  I asked, "It's good, right?"  Her response:  "I can't even feel a tumor anymore.  It's a miracle!"

Miracles happen.  They happen everyday.  I'm learning that the miracles in our lives do come after the trials of our faith, and maybe that faith turns our hearts and minds in order to see those miracles more clearly and have the ability to more easily recognize the source.  

    

Tuesday, July 9, 2013

Tuesdays with Naqvi--The Last Red Devil

This has been a rough, hard, unexpected year. There have been ups and downs, too many unknowns, and many depressing, discouraging, difficult days. However, through the challenging times, we have been blessed--blessed with help with the boys, blessed with meals, blessed with an outpouring of love, and blessed with growth and eyes to see the silver linings in the storm.

People are constantly telling me things like, "Every time I think I have it hard, you come to mind, and I realize how easy I have it." or "This in NO WAY compares to what you're going through, but..." I always smile when I hear these phrases of comparison because who is to say that one trial is SO much more difficult than another? Everything depends upon perspective. If I am ever complaining or feeling sorry for myself, I hear a story that puts everything back in place. I was at my doctor, waiting for my immunity booster shot, which makes me achy and pretty sick. Another patient explained that she was allergic to that shot, so she had to come down to the hospital 5 out of 7 days a week to get a daily shot to keep her numbers up. I was immediately grateful for the one powerful, yet effective shot, even with its negative side effects. Even when I think my experiences with cancer can't possibly get worse, I'm quickly reminded that they can, or I hear an experience from someone else that instantly makes me grateful for my unique experiences and trials in all of this.

After my recent difficulties with becoming so sick, having no energy, and being forced to push back chemo for a week, I was up all night, thinking about perspective. Two people could experience the same challenge and have completely different ways of coping, different stories to tell, and could have completely different outcomes after the difficulties pass. Often, the way we look at trying times can affect our entire experience. Changing our perspective can change our motivation, our reactions, and often our evaluation of an experience.


We have a limited ability to see, and often our perspective can be easily skewed to trick our minds into thinking we see something that isn't there. From far away, mountains look like rolling hills, roads become more narrow, tall trees seem chopped down to our size, and railroads seem to converge.

From high above, entire cities become mapped out like squares on a game board. In the dark, every day objects can seem terrifying. When face-to-face with a road block, it fills our entire field of view, making it appear to be the only object in the world. We have to learn how to train our mortal eyes to shift from getting discouraged and bogged down in our skewed perspective of our earthly experiences into the faith of an eternal perspective.

I believe in eternity. I believe we existed and lived as our spirits before being born. I believe we chose to come to this earth to be tested and tried and to gain physical bodies and experience the love of family relationships. I believe that after our earthly test is completed, we will go on after death, able to take our knowledge, our experiences, and our relationships with us. The faith in this plan of our Father in Heaven, with the ultimate goal of eternal life, is the foundation of an eternal perspective. If we keep the end goal in mind, our trials in this stage seem small in comparison.

I've heard all about having an eternal perspective pretty much my entire life. In fact, I think it's one of my Dad's favorite topics. Learning to look on things of an eternal nature helps focus our perspective of worldly challenges and even blessings. Brigham Young once said that he would wish to bless people to have “eyes with which to see things as they are.” (Journal of Discourses, 3:221) This implies that our mortal eyes cannot always view the day-to-day with the proper perspective. Our vision is vastly limited in comparison to the eternal nature and eternal vision of God. Isaiah 55: 8-9 tells us, "For my thoughts are not your thoughts, neither are your ways my ways, saith the Lord. For as the heavens are higher than the earth, so are my ways higher than your ways and my thoughts than your thoughts." Our Father in Heaven is eternal in nature and can see the past, present, and future. We can only see the here and now, often coming face-to-face with some stumbling block in our path. We need to train ourselves to focus beyond the boulders in our view, for from a distance they seem as pebbles, or even grains of sand. What seems like a jumbled, confusing, road ahead when in the middle of it can actually be an easy course to navigate if the focus is pressing forward to the end. 



Our motivation to keep moving comes from faith that all our experiences will be for our good and that weak things will be made strong. With that perspective, we can find the strength to press on through the challenges.



I gained experience with shifting perspective during my years of teaching math to 5th and 6th graders. I introduced new subjects to my students in one of the easiest ways on this earth to learn--line upon line, precept upon precept. We started our study of geometry by reviewing points. A point is the foundation upon which geometry is built, the name of any location, an individually defined place in space.


Then, we learned that there are an infinite number of points, all identified by their location.







You can start connecting points to make lines, or line segments.



Then, we learned that those line segments can actually go on infinitely in both directions,




that an infinite amount of lines can be drawn through all of these points, that there are an infinite number of points on each line in between the original points, that all these points and lines are defined in a plane, a flat, 2-dimensional surface.



Then, their minds were blown when they made the connection and shifted their perspectives to see that we actually live in a 3-dimensional world, meaning there are an infinite number of planes defining all angles and directions and that each contain an infinite number of points and lines! The perspective of my students had to quickly shift from one point in one dimension to infinity in all directions and in all planes! That shift can be a bit overwhelming because even though they understood that all these planes and points and lines were constantly overlapping and crossing, there were times when they had to isolate a few points or a few lines in one plane and simply focus on finding a way to solve one problem at a time. They could still have the knowledge of infinity, but the here-and-now perspective was the most practical vision for the question at hand.

I always tried to teach my students ways to apply our learning into their "real world." Unlike that trigonometry teacher who lied through his teeth, you DO use 5th and 6th grade math on a daily basis! We found examples of points, lines, and planes in the world around us. We learned that the shortest distance between 2 points is a straight line and learned to connect lines to make line segments. We talked about how the end points were the start and finish of the line, but adding arrows reminded us that line segments have the ability to go on eternally, that what we see as a beginning and an end might just be one section of a much longer pathway. All of this led us to talking about maps, a logical, real world example of points and lines. The problem with a map is the same problem of taking something in a perfectly controlled environment out into the real world. On a map, there is not always a simple, straight line between 2 points. Sometimes there are many paths that connect one point to another. Sometimes, the most straight path is still under construction. Perhaps there is a detour. The road might twist and turn, circle back on itself, or pass through rough terrain. Topographical maps clearly show when a line--road--passes into another plane, thanks to hills, valleys, mountains, and bodies of water.


The real world is not always as easy as these points and lines seem in theory. There might also be several straight lines to follow that would all connect our points of interest, each with benefits and disadvantages, and we would have to choose a way and hope for the best. Even if the shortest distance between two points is a straight line, we are not always promised that our real world path will be a straight one. We are told the path will be STRAIT and narrow. {Matthew 7:14--Because strait is the gate, and narrow is the way that leadeth unto life, and few there be that find it.} The strait way is narrow and difficult, hard to see beyond, and easy to get lost in. But, the way is there. We are promised it. What seems STRAIT--narrow, difficult, and impossible to traverse in one perspective, actually becomes STRAIGHT--easy, short, and direct in an eternal view.

It's all about perspective because our A to Z beginning and end points go on with an eternal outlook. As you zoom in to the present, there are an infinite number of points on our path, an infinite amount of choices of possible lines on which to travel, an infinite number of stops and bumps in the journey, a never-ending road trip of life where we can't always see clearly which way to turn, or if we shouldn't turn at all. We never know when our transportation will break down, when the road might turn, when another car will impede our progress, when the speed limit will change, when a detour might appear, when a bridge is out ahead, when we need to make an unexpected stop for someone else, and so on. Also, in order to press forward with faith and endure to the end, we have to pass through B, C, D, E, F,...and so on until we reach the end with Z, but, often when we think we are at an end to something, we might be surprised that the journey continues on with AA, BB, CC,....etc. Trying to grasp this eternal concept with our limited, mortal view can be challenging. Perhaps that's why enduring to the end is so difficult--we get in our own way, and we have to learn how to walk more by faith than just by our mortal perspective because we don't know when we will reach the end.  Even after each trial, we often can't see the end of it until it's already over.  We never know if we will be strong enough to endure unless we make it through to the other side. Eternal perspective is what helps us evaluate our strength and our ability to stay on the path even when the way is rocky.  Faith in the eternal nature of God and in following His path, though it lead us through the valley or up a steep mountain, is the only way to find the strait gate.

Eternal perspective seems so simple in theory! But, we live in earthly time, as imperfect beings, in the daily perspective of human reality. We don't have the ability to know when or how the path on the map of life will end. "But of that day and hour knoweth no man, no, not the angels of heaven, but my Father only." {Matthew 24: 36} God is the only one who knows the end from the beginning, so we must learn to have an eternal perspective when it comes to our faith and understanding all the reasons why we are here or why we are enduring certain trials. We have to truly put our lives in God's hands and go forward, motivated by faith. However, the trouble with relying solely on an eternal perspective is that we also need a daily perspective to see the small steps of how to proceed in real time. If we ONLY live by the eternal--which is all just hope and faith--there can be a disconnect from sights to see, points of interest, knowledge to learn, relationships along the way, experiences, goals--all the small steps that connect within the journey to enrich our lives and help us reach to much more. There's a reason maps are made in different scales. It's nice to understand the beginning and end, to have an understanding of the ultimate goal, but if you simply rely on the eternal perspective--the map of the entire world or of the ever expanding universe as a whole--you're going to get lost in the middle of farm road Texas on your way to the big city and really be wishing your perspective was a bit more zoomed in so you could see the points right in front of you.

The trick in perspective goes back to balance. If we understand the eternal, our ultimate goals and purposes for this life, we can more easily grasp that there are reasons for the detours and pot holes in the road, even if we don't ever receive all the answers. The eternal perspective can always be in the back of our minds, whenever we need to refer to the overall plan. We can remain motivated by faith to keep on the path and can learn to react optimistically when troubles, trials, or temptations attempt to move us off course. We also need to use the perspective we gain from living and learning on a daily basis, enjoying the journey, taking in the sights and sounds and being able to focus on the small steps. We need to have an entire set of maps that can help us navigate on any scale, from the hallways of our local school, to the hiking trails in the neighborhood, a simple public transportation line map,



the multiple ways to get around an entire city,

from town to town in a state,



across the country,


around the world,



and even out into the universe. When the confusion and frustration and overwhelming feelings arise because of the troubles, traffic, and trials that can easily halt our progress and skew our perspective, we can always refer back to the master plan, using our "eyes to see" the eternal reasons for such learning experiences. The ability to change the focus of our perspective between the eternal and the day-to-day is what will truly help us to use that faith to find the paths that will help lead us to the strait and narrow way, all while feeling that our earthly difficulties really are bearable. Sometimes all that's needed is a shift in perspective.



























Saturday, July 6, 2013

Tuesday Didn't Happen

The 4th of July fireworks were supposed to be celebrating my freedom from "The Red Devil" round of chemo, but that plan just didn't end up happening this week. I went in on Monday for STAT labs to check my white blood count to see if I was well enough for my last dose of this hard chemo, and my numbers actually went back down. My WBC from Monday was 2.5, too far from the required 4.0. My ANC, which had been at the correct level of 1.0 was back down to 0.2. Those results meant no chemo for me for at least a week. I was pretty frustrated by that, just because I had been counting down the weeks to checking off that last dose, and not only did I not have chemo in the planned timeline, there's no guarantee of when I'll have it again. I cannot have chemo until my numbers go back up to the minimum requirements.

I felt like I did everything my doctor told me to do, and it still wasn't enough. I canceled my trip to the beach--my favorite place--and it didn't get me any closer to my goal. I forced myself to eat, even when I had no appetite. I stayed away from raw fruits and vegetables, even when that was exactly what I was craving most days. I didn't leave the house for days, took my meds, washed my hands frequently, stayed away from people and places with potential germs, slept more than usual, let the laundry and cleaning go, and still got off track.

Already I saw a few reasons why I might have been sick enough to stay behind while my family went to the beach. First it was SO hot over the weekend, which would've been hard on my weakened immune system. Also, everyone got some kind of food poisoning. Nausea and diarrhea for the healthy adults would've probably landed me in the ER. There were also a few run-ins with jelly fish and sting rays, and who knows if my body would've been able to fend off those attacks. It's nice to have a little glimpse of how what might seem like a big negative on the surface could actually be a blessing in disguise.

I was saved from the harshness of the beach vacation by being mostly dead, but now the whole supposed time frame of my treatment is thrown off. I have a very hard time going into the unknown without some grasp on even the illusion of control. I feel like I've already calmed way down and learned so much patience and how to live by faith and not question, but I keep getting tested and pushed to the next level. I've been humbled and have relinquished so much of my control and have learned so much about how to ask for help and let other people be blessed by giving service to me and my family. It's very difficult to not have feelings of frustration or to attempt to understand the lessons I should be learning from these added experiences to this journey. And sometimes, it feels like everything I've learned and all that we've been through still isn't enough. It's never enough because there's always something to learn, always some area in which to grow, and always another step toward perfection to make.

I'm sure there are many reasons why chemo didn't happen this week, some I'll probably never know. Not only does this change push back my chemo and surgery timeline, but it could potentially change plans we've had laid out for months, including another vacation. Perhaps I need to learn to deal with disappointment and be more flexible. Perhaps I need to learn balance between my need to have something to look forward to and my ability to be completely content even with nothing exciting in the near future, or to not be unhappy when plans change.

I have felt weak and sick this week, in addition to being frustrated over all the unknowns of the time frame. Thankfully, I'm starting to feel stronger physically. My friend, Michele, was here this week to force me to eat, to help out with Evan, and to let me rest. Kyle and Ryan got to stay at the beach with our family, which was another blessing. I'm so close to the end of the hard stuff, but still so far away from being through with this trial. Obviously, I still have much to learn, but I'm strong. I continue to not allow this to take me down. I'm still looking for silver linings and ways to be glad. Here's one for today: I'm only one week behind schedule, and my hair is already coming back in strong. I'm going to be fine; I just need my blood to allow me to get back on track, and before I know it, this will all be behind me!