"none of us knows when we are going to die"

On April 25th, Alaina Giordano lost custody of her children. A North Carolina judge ruled that her two kids need to move to Chicago to live with Giordano's ex-husband. She based this decision, in large part, on the fact that Giordano has Stage 4 breast cancer.

Visit msnbc.com for breaking news, world news, and news about the economy

I can't be articulate about this story, except to say that I work very hard to make sure that my kids will be all right- no matter what happens. I wish I could protect them and all those who love me from the realities of cancer. But do I think that cancer makes me a less fit parent?

Not on your life.

Want to read more?

I first read about this on BlogHer, where Jenna argued very articulately that anyone who has ever been ill or ever might be should care about this story and the frightening precedent it has set.

My friend Judy (from Mothers With Cancer) wrote a beautiful response called "We Are All Terminal." 

You can read Alaina's own words on her blog, Beauty in Truth.

I couldn't find a single post or comment by anyone who agreed with the judge's ruling.

For that, I'm grateful.

selfish (dear loved one)

I'm sorry that my fear becomes yours.

I regret that you get pulled into my panic.

I feel ill when my every cough, ache or bump twists your insides the way it does mine.

I would prefer to protect you.

I want to watch you smile, hear your laugh, feel your heart thump with joy when you pull me to your chest.

I don't want to make you scared, or sad or worried.

But I can't wish you weren't ever scared or sad or worried.

Because I need to share.

Because I need not to feel alone.

Because I need you.

beautiful eyes

That's what struck me when I met Sarah in person: she had the most beautiful deep brown eyes I had ever seen, with a lovely smile to match.

It was February 2010 and we were both in attendance at the Annual Conference for Young Women Affected by Breast Cancer. We had met online through our online community, Mothers With Cancer.

A short time after we met, Sarah found out that her breast cancer had become metastatic and she began treatment anew. A few weeks ago, she learned that the cancer had spread to her brain and she started radiation treatment. A couple of days ago, she was admitted to hospital with breathing issues. Last night, she passed away.

I won't claim to have known beautiful Sarah better than I did. But I did consider her my friend. And I will miss her.

Here are some things I knew about this remarkable woman:

She loved her three daughters very much and she was incredibly proud of them.

She was happily married.

She was a talented photographer.

She loved animals, especially dogs and horses.

She had an appreciation for good coffee.

She left this world way too soon.

Sarah, you will truly be missed. My heart goes out to your family and to all who loved you.

You can read more about Sarah at her blog, Spruce Hill. Tributes have also been posted by Jenny (cross-posted to Mothers With Cancer), Susan, Nicole, Ree and Mary Beth.

Note: Blogger was down for about 20 hours and when it came back up, this post was gone (as were the comments from my previous post). If you are seeing this twice in a row on the blog, it will be because Blogger has returned it to me.

i can relate to this...

...and so can, I would wager, anyone who has been harassed by  condescended to infantilized by dealt with an insurance company on health related matters.

Especially if you have been on long-term disability for any length of time, you can expect regular correspondence. Blogger Katherine describes this experience:

"But as sure as the swallows return to Capistrano, every March CIGNA sends me information on its Cancer Support program. Last year’s began “Good health is a gift.” This year’s reads like a grade school report:


Dear KATHERINE O’BRIEN:


The American Cancer Society estimates that two men and one in three women will face cancer in their lifetime. Although these are scary statistics, CIGNA HealthCare wants you to know we’re here to help…"

Most of us just sigh, groan, maybe yell a little and then toss the letters into the recycling bin (unless it is one of the letters making demands to send information we have alread sent them SEVERAL TIMES. Then we scream a little louder, call the company, get transferred to voice mail, leave a message and then never hear back, send the info as requested and then get ANOTHER LETTER requesting the SAME INFORMATION and scream some more. Or maybe that's just me.). After years of this kind of correspondence, Katherine decided to write back (CIGNA is her insurance company):

"Dear DOUG:


Thank you for your letter of March 2010! I couldn’t agree more that good health is a gift! I was blown away that you want to help me make the most of it.


It was gratifying to know that “as health care claims are submitted to us, we review them and identify steps you might take to help improve your health.” Gosh. I feel a little guilty. I mean, you are poring over my health claims and I am doing bupkis for you. Maybe I could clean out the coffee room fridge in Bloomfield some time? Police the parking lot? Just let me know.


As you might have gleaned from your research, I have metastatic breast cancer. My doctor says that in 2010, there’s no cure for metastatic breast cancer. Of course that’s what she said in 2009. So I do intend to doublecheck in 2011. I will keep you posted...


...I think it is important to take care of me, too. I see Dr. Gaynor once a month. It might be hard to see her more regularly than that. Unless she wants to join my mahjong group. I will make inquiries."

You can read the rest of the letter and Katherine's post about it on her blog, ihatebreastcancer. Thanks to Anna Rachnel (ccchronicles) of The Cancer Culture Chronicles for telling us about Katherine's letter via Twitter.

my kids are alright

I had a dream a few nights ago.

My kids were in a giant flash mob, dancing their hearts out, surrounded by dozens of other kids and adults. They were exuberant and focused, their movements fluid and in synch with those around them. My heart swelled with pride and joy.

I learned that the flash mob had been created to drum up excitement over an upcoming performance. In a couple of hours, my kids would go on stage and perform. I could tell they were ready.

Then I was handed a note. My own performance was scheduled for right after theirs. I was wholly unprepared. I hadn't even looked at my script. I was rushing off to find it when my alarm went off.

Sacha was in a play very recently. And they did organize a flash mob a week before the performance, as a form of advertisement. And Sacha performed beautifully. My heart did swell with pride.

In part, my subconscious might have been remembering the play but I choose to believe that I was also sending myself a message.

Life with metastatic breast cancer is filled with uncertainty. But no matter what happens, my kids will be fine. They are smart, talented, resourceful and resillient. They have friends and family who love them. My kids will be alright.

i'll take it.

No nausea.

No bad taste in my mouth.

No rage or sadness.

No aches and pains.

I'm just very, very tired.

I'm not complaining.

what if nothing changes?

Today is a treatment day.

For the first time ever, I will have Herceptin on its own (if you don't count the Demerol and Gravol I get to keep the shakes and fevers at bay).

Some people have almost no side effects with Herceptin. Some feel like they have the flu.

Will the fact that my body has such a strong response to Herceptin mean that I feel more of its side effects?

The break from chemotherapy is meant to help me heal and rebuild - physically and emotionally.

The break from chemo is also a risk.

Here's hoping it all works out for the best.

mixed. but good. i think.

And I'm not talking about the weather, which while it has been mixed, has been pretty consistently bad for the last twenty four hours. We had a big dump of snow (the photo above was taken from my front door), followed by freezing rain, which will be followed by ordinary rain.

Good thing I just bought rain boots.

My GP called me last week to let me know the results of my endoscopy (I won't get in to see the gastroenterologist until March 21st). All my results were negative - no celiac, no bacterial infection, no cancer. It's all good.

Then I talked to my oncologist on Friday. We discussed my scope results and my digestive symptoms (diarrhea, heartburn, abdominal pain). He expressed surprised that I was still feeling lousy on Friday after a Tuesday treatment. I told him that my recovery time had gone from four to six days and that last round, I'd felt sick for a week (this ended up being the case this time, too).

Then my oncologist said, "It's time to take a break."

I was floored.

I had been hoping to hear these words for months (years even) but when I finally did, I definitely had a mixed reaction. I'm being taken off the chemotherapy not because I've been in remission for a while (although I have) but because the chemo has started to take too big a toll on my body.

As Dr. G. said, "You can't stay on vinorelbine forever."

I'm going to continue with the Herceptin but take a break from the chemo for at least three months. Herceptin is also known to induce flu-like symptoms but I don't think it has the lasting toxicity of chemotherapy drugs. I'm likely to bounce back more quickly after treatments.

So we'll see what happens. There are no guarantees of anything and no promises. Every change involves risk.

But the next few months will be devoted to healing.

Cross-posted to Mothers With Cancer.

scoped

I once had a colleague who was a former Fleet Street journalist. I can't remember his name but I do remember a story he told over a particularly boozy dinner.

"The worst kinds of press releases," he said, "keep all the best bits for the end. That's just not how it should be done. It's like reading a news story that says 'A crowd gathered at Buckingham Palace today. There were also fire engines and ambulances. The corgies were brought out to safety. The Palace burned to the ground. The Queen is dead."

As I went on to work in communications, I kept that anecdote in mind and tried to make sure that the most important facts were kept in the lead of my news releases.

But this is not a news release and I can tell my story in way that pleases me.

I had an endoscopy yesterday.

I wasn't terribly worried when the secretary at reception couldn't find any record of me. I credit the Ativan for that. You still feel the anxiety but it's further away. Almost like it's someone else's anxiety.

She must have found me in the end, because I was called into the endoscopy unit, given an id bracelet and told to change into a robe.

The endoscopy unit at the Civic Hospital could use a facelift. The paint was peeling off the walls in the waiting room and the beds in the prep and recovery area are separated by curtains. My neighbour and I learned a lot about each others' medical histories and bowel movements.

Every nurse I spoke to was very taken aback that I should have metastatic breast cancer at my age.

Every one of the nurses was really kind.

The nurse who took my history and prepped me for the anesthetic noted my "crappy veins" but she got the vein accessed in one poke, so major kudos to her.

My bed was eventually wheeled into the room where the procedure would be done. At this point, I met Dr. A. for the first time. There was another doctor with him who introduced himself so quickly that I didn't catch his name. This second doctor, who I assume was a resident (why don't they introduce themselves as such? Residents always say, "I work with Dr. So and So." They never say "I am learning from Dr. So and So. Do they think the patients can't be trusted with this information? This really bugs me because I can always tell they are residents and I would be much more forgiving if they were honest with me) began to very rapidly list off all the horrendous risks of the procedure and then handed me a waver to sign. 

It's a good thing that I had done tons of my own research (and that I had taken the Ativan) because I might have demanded that they wheel me out of there.

Dr. A. asked me if I had signed the waiver and if I had any questions. I said, "I just want to get this over with."

I mentioned my strong gag reflex to Dr. Resident. He instructed the nurse (pompously? Am I being biased?) to give me some extra shots of the anesthetic spray for my throat (I had the distinct impression that the nurse was going to do this anyway but perhaps I am biased). Then they hooked me up to the drip, placed a plastic frame with a hole in it in my mouth and shoved a tube down my throat.

I then proceeded to gag, choke and gasp for breath. Tears streamed down my face. 

I'll never forget the nurse who gently held my head and spoke comfortingly to me.

It's amazing how big the endoscopy tube looked to me. There's no way it could have  been that big in real life.

I heard Dr. A. say something about how studies had shown that the gag reflex was greatly diminished when Fentanyl is administered.

I heard Dr. Resident sound surprised.

A nurse administered Fentanyl via my IV. And then I was really, really stoned (I just read that Fentanyl is 100 times more potent than morphine and I had a cocktail with other sedatives).

Not sure if I passed out or not but I was pretty woozy. I know they called T. to come and get me. And I know that one of the nurses suggested I try and get dressed.

I sat up and nearly puked. The nurse got me to lie back down again.

Lather, rinse and repeat a few times.

One of the nurses gave me some apple juice, which helped.

I asked what drugs I had been given. A nurse looked that up and said with surprise that I had been given a drug in the Valium family and Fentanyl. She said, "No wonder you're so wasted."

I heard someone mention Gravol (known as Dramamine in the US). I now understand why they give it to me each time they give me Demerol at the cancer centre. They gave me a barf bag.

I texted T. to see why he still hadn't arrived. He texted back that he was in the waiting room. I told him to come get me. He said that the secretary wouldn't let him past the waiting room.

If he wasn't allowed past the waiting room and I wasn't allowed to leave without him (nor could I walk on my own), we were kind of stuck.

One of the nurses went to get him.

Before I left, Dr. A. came to talk to me. He said that I am to come to his office in around four weeks, at which time I will get my results. He also told me that there were no visible tumours (see what I mean about burying the good stuff under a whole pile of details?).

I went home and slept for 6 and a half hours. It would have been longer if T. hadn't come into the room to check on me. I was pretty dopey all evening (giving all my online Scrabble opponents an unfair advantage) and hit the hay before 10.

My throat hurts today and I'm still kind of tired but I did get out for a run (it's 10C here today that's 50F), so I guess I'm recovering pretty well.

In a months time, I'll find out if the biopsies revealed any pre-cancerous cells. Or if I have celiac disease. And Dr. A. promised that if they don't find anyting, he's going to want to do a colonoscopy.

What fun.

feeling better

Because I've been able to go out for walks and for runs with the dog.

Because I had a really nice weekend and a very nice Valentine's Day (especially for someone who doesn't really celebrate it).

Because I have so many wonderful people in my life.

Because some of my symptoms have improved considerably (and they most definitely did not improve at all before I was diagnosed with the recurrence of cancer).

Because I have survived experiences that have been far more physically traumatic (like giving birth. Twice) than an endoscopy could possibly be.

I am feeling better today.

when Google is not your friend

So I've been having some (ahem) gastrointestinal issues for a while. Last spring, I was diagnosed with GERD. Things got better after I made some amendments to my diet and started taking meds (so much better that I got lazy about the diet and just took the meds). But now the issues are back in spades, along with abdominal discomfort and a feeling I can only discribe as "weasels chewing on my innards."

A couple of weeks ago, I went to see my GP who doubled my dose of the meds, ordered some blood tests and other (ahem) samples and put in a referral to a gastroenterologist. She told me that it would likely be a six month wait.

I had chemo on Tuesday, February 1st, which means I should have been feeling more or less like myself on the week end. I did not. By Saturday, I was still achy, weak, nauseated and the stomach weasels were out in full force. On Sunday, I felt no better.

On Monday, I went back to my doctor. 

She examined me and, to my enormous relief, reassured me that my liver is where it should be (not swollen and tender like it was when I was diagnosed with liver metastasis. She also said that I should  take comfort from the fact that my blood counts, taken less than a week before had shown all my liver functions to be perfectly normal.

We discussed the possibility of me having contracted a parasite or a virus (I certainly know enough people who've been ill, including my two kids. My suppressed immune system - from the chemo - makes me susceptible to every passing illness) or that anxiety could be playing a role in my physical condition.

My doc is a great advocate, though, and she picked up the phone while I was still with her and left a message for the gastroenterologist, asking if I could be seen more quickly.

I left her office feeling almost euphoric, with all health related anxiety pushed to the back of my mind (there was enough other anxiety to take up all the space in the forefront).

Then yesterday, I got a call from my doc's office, telling me that I have an appointment with the gastroenterologist - and an endoscopy - scheduled for February 17. That's really soon.

I've heard that endoscopies can be really traumatic experiences, so I Googled "endoscopy" just to reassure myself (seriously, that's what I told myself).

Well, not only do I not feel reassured (they shove a camera down your throat to look at your innards! I have a very strong gag reflex) but I am now freaking out about the test and about exactly what it is they might find down there. It could be nothing. Could be something relatively benign. Or it could be...well I'm trying not to think about it.

I haven't been for a run in more than a week because of chemo and the (ahem) gastrointestinal issues. But I think I might risk it.

welcome to my life

Earlier this week, my friend K. sent me an article from the New York Times that was the best piece of journalistic writing on metastatic breast cancer I've ever read. And I've read a lot on this subject.

I cried when I read it (but as I told K., in a good way) because it resonated so deeply with me, juxtaposing the facts and the experiences of women living with cancer that can never be considered cured. I started to highlight the best bits to share with you here but ended up cutting and pasting more than two thirds of the article.

I've decided that it's best not violate copyright or my own ethics and just post the link and ask you to please go read this article:

A Pink Ribbon Race, Years Long.

this is kind of nice

TopOnlineColleges.com as included Not Just About Cancer in their list of "15 Inspiring Breast Cancer Blogs."

Get inspired by this breast cancer survivor, who turned her unfortunate situation into a book about defying the odds and beating cancer.

Pretty cool, no? It's nice to know that someone's reading and finding resonance in my words. As for the "beating cancer" part - I know it lurks there somewhere and that we who have gone to Stage 4 are never, ever out of the woods but I do like to think I'm beating it.

mind body spirit

Thanks to Andrea for the photo.

I just spent an inspiring (and I don't use that word lightly) week end at Body, Mind, Spirit, 2010: National Conference for Young Women Living with Breast Cancer.

My best parts:

A Friday afternoon workshop: "Take charge of Your Treatment for Women with Metastatic Breast Cancer" with Dr. Maureen Trudeau. Engaging, accessible, interesting, informative and hopeful.

A Saturday afternoon workshop: "Intimacy after Cancer: Rekindling the Flame" with Dr. Sally Kydd. Amusing, motivating, reassuring, helpful and just plain fun.

A Sunday morning workshop: "Living with Metastatic Breast Cancer. Support that Works" with Dr. Tzeporah Cohen. Emotional,moving, cathartic, uniting, strengthening.

Speakers who resonated: Deborah Dubenofsky (Ontario Region Board Chair, Canadian Breast Cancer Foundation) and Carol Ann Cole.

My takeaway message (from Dr. Natasha Zajmalowski, Dr. Rob Rutledge, Dr. Roanne Segal and others)-

When it comes to breast cancer recurrence, it appears that insulin is the root of all evil. Lowering insulin levels improves the odds for a long and healthy life. How to do this:

1. Get at least thirty-five minutes of moderate exercise every day. Hooray! Something I'm already doing right!

2. Maintain a healthy body weight. This has provided the kick in the pants to re-commit to dropping 44lbs by my 44th birthday. Weighing too little isn't good either but that's never been my problem.

3. Eliminate or reduce alcohol and sugar. The insulin explanation is the first one I've understood and accepted re the link between these yummy things and cancer recurrence. To be truthful, not being an "all or nothing" kind of person, I don't see myself promising to never consume booze or sweets again. I can't even say that I haven't partaken since the conference, this being the season of Hallowe'en and pumpkin ale. I can say that I will make a greater effort to hold out for the good stuff and not give in to cravings.

I'm happy to say that although this message was consistent, the speakers seemed to be devoid of judgment. No one was blaming the victim or telling cancer patients that they brought the cancer on themselves.

I still feel that there are greater environmental and medical issues that need to be addressed. But there are just so few things we can control as cancer patients that I appreciate straightforward advice and simple things I can do to increase my odds of being around to see my children grow up.

Thank you so much to the staff (especially Jenn McNeill of the CBCN) and volunteers (especially Andrew, a volunteer from Humber college who helped with my books, kept me company and was enormously supportive during and after my book signing) at the Canadian Breast Cancer Network and the Canadian Breast Cancer Foundation for helping me to promote Not Done Yet, and especially for organizing an amazing conference.

Can we do it again next year, please?

chronically whiny

I always think it's going to be different.

I say to myself, "This round of treatment, I will exercise and write and continue with my daily routine and see if that makes me feel better."

And thent, in the days that follow each dose of vinorelbine and Herceptin, I stay in bed too sick to do anything and lacking the self-discipline (motivation?) to try getting exercise, writing or going about my daily routine.

I don't even bother to eat well (although the soup I made the night before chemo was delicious and easy to heat up, so I did eat lots of that) or even do the easy things that might help (I was on the phone with my writing buddy and she asked if I'd been drinking hot water with lemon and ginger. Easy to prepare and she swears by it, yet I had completely forgotten).

I don't even drink enough water.

I just wait until the weekend when I know I'll feel better (unless I get sick, as I did yesterday and had to miss dinner with friends and my beloved book club).

I'm fed up.

Fed up with losing a week out of every month.

Fed up with having to constantly worry about my energy levels and not overdoing.

Fed up with not  having answers and having to worry.

Sometimes I amuse myself (and no one else) by announcing, "I'm done. That's it!"

But I don't really mean it. 

I know where I'd be if it weren't for all the chemo and the Herceptin. And I know that it's worth it.

And who knows? Maybe next time will be different.

a light has gone out

I just learned the very sad news that Christine Lynds passed away last Friday.

Chris was a strong, smart woman, who inspired and gave hope to so many people who's lived had been affected by cancer. We shared an oncologist and I appreciated her outlook towards living with advanced breast cancer.

I was also more than a little in awe of her. She was active and fit and a true community activist. The first time I met Christine in person, she had brought a posse of women who'd lived through breast cancer to my book launch. The second time I met her, she came to collect a prosthetic breast that I no longer wore so that it could find a new home with a friend of hers. We sat and drank coffee on my couch and talked about our boys and our dogs.

I know that she loved to organize people and projects and that she had many loyal friends to whom she was very committed. And I know that there are legions of people by whom she will be sorely missed.

Christine's blog was called "The Edge of Light." The world is a little darker without her in it.

my fundraising pitch: run for the cure

Dear Friends and Family,

This year, I am running/walking in the Run for the Cure in support of the Canadian Breast Cancer Foundation and I'm writing to ask if you'd be willing to make a donation.

As you know, this is an issue that is very personal for me. In November 2006, when I was told that my breast cancer had spread to my liver, I knew no one who had survived this kind of diagnosis. Even my oncologist reluctantly told me that I had “years not decades” to live.

But my response to treatment was immediate and dramatic – by June 2007, there was no longer any sign of cancer in my body. As I write this, I am still in remission. I'm also still in treatment, as we don't know enough about what happens when metastatic breast cancer disappears to make an informed decision about stopping.

There is no question in my mind that I am alive today because of the kind of cutting edge research that is funded by the Run for the Cure and the Canadian Breast Cancer Foundation (CBCF).

In November 2007, I attended a conference that was funded my the CBCF for younger women affected by breast cancer. In one of the plenary sessions, I stood up and asked how many women attending the conference were also living with metastasis.

There were dozens of us. For the very first time I internalized the idea that having stage four breast cancer need not be a death sentence. It's not an overstatement to say that moment changed my life.

I support the Run for the Cure because I don't want any woman with breast cancer to feel alone.

I support the Run so that more of us with stage four can go into remission and even walk away from treatment with confidence.

I support the Run so that no woman need ever fear breast cancer again.

And I'm running with Team No Pink for Profit because I hate the corporatization of breast cancer. Our team name makes me feel a little bit subversive. I'm so proud to be the captain of this team comprised more than 30 women and we're the top fundraisers for our region. It gives me great pleasure to see our team name scrolling on the front page of the regional web site.

Can you help by making a donation? Any amount would be appreciated.

You can click on this link to learn more about me and make a donation: http://www.runforthecure.com/site/TR/RunfortheCure/Ontario?px=1268119&pg=personal&fr_id=1101

Thanks so much!

Laurie

43 things (part four)

32. I can organize ideas, a campaign or a project but I can't organize my house or even a room to save my life.

33. If I become interested in something, it can easily turn into an obsession. At least for a little while.

34. I'm trying to ride my bike as much as possible. I think I'm becoming addicted (see above).

35. I'm always a little surprised to discover that someone likes me.

36. I didn't think Facebook birthday wishes were a big deal until it was my birthday. I loved getting messages from all over the world and from people from all parts of my life.

37. I have already passed my minimum goal of raising $150 for the Run for the Cure. I dream of wildly exceeding that.

38. Two of my favourite childhood memories are of a family cross-country ski trip and going sailing on my uncle's boat. I don't particularly want to do these things now but I felt happy doing them then.

39. I like the idea of creating fun memories for my kids. I wonder if they will hold close the memories of our trips to Florida and our week end at Blue Skies when they are adults.

40. When I was six years old, a man in a raincoat flashed me. I was passing through the parking lot of the Catholic Church, on my way to school.

41. When I'm depressed, I feel invisible.

42. I'm making good progress in my quest to lose 44lbs before I turn 44 (on August 4th, 2011). I lost three pounds in the first week. I know it's going to slow down from here on in but I'm feeling encouraged. And determined. And you're going to be reading a lot about it here and on Twitter/Facebook because I want to stay accountable.

43. I think it's really cool that I'm planning for a year from now.

44 (bonus thing). I really do think that the red Smarties taste best.

well, hello there

Yikes!

It's been a while, hasn't it?

I seem to have lost my blogging mojo. I remember a while back when Average Jane wrote that her blogging had been derailed (my word, not hers) by Twitter and Facebook. I get that now.

Whenever I have a quick observation or a link to share, I can gratify myself instantly with Twitter (I'm lauriek, by the way). And while each tweet does go to Facebook and the sidebar of Not Just About Cancer (on the right - see it there?), it hasn't done much for my blogging.

I don't want to give up the blog though, so I'll try and re-commit to posting regularly (how's that for hedging my bets?).

On the cancer front, there is a little news. I loved having a break in April. That month also brought another clean CT scan. My oncologist continues to be happy with how things are going (or not going, really).

We talked a bit more with about the weirdness of being in ongoing treatment (with side effects that are cumulative, both physically and emotionally). He talked frankly (one of the things that I love about him) about how, in my case, he really has no idea what to do.

We don't know what would happen if I were to take a longer break from treatment or stop it altogether.

"You're a riddle, wrapped in a mystery, inside an enigma," he said, quoting Churchill.

He said that, theoretically, we could start our own clinical trial, where half the women stop treatment for three months and half continue as I've been doing.

"But then what do you say to the women in the first group, if the cancer comes back? 'Oops?' 'Im sorry?' " (I'm convinced that the man lies awake at night wondering about these things. His compassion is another thing I love about him).

He has a way of putting things into perspective for me.

I had planned on asking for another break in six months but he surprised me by suggesting I take a break in August (hooray!)

He also said that, some time in the future, he's not sure exactly when, he's going to feel ready for me to take a longer break. Meanwhile, I'll have fewer appointments with him and, unless I'm worried about something, I can call them in (another hooray!).

I am very pleased about all of this but I admit to also feeling a little blue. I'm still dealing with some of the "grey area" fallout. It's really hard to articulate (and I feel guilty for even complaining. Guilt would be a good subject for a whole other post).

Life is a funny thing. And it's really hard to plan even five years ahead, because you never know what's going to happen. I'm trying right now to return my focus to living in the moment, accepting what is and reminding myself to notice the good things.

haven't done this in a while

Haven't blown my own horn in at least a few weeks.

Alysa, who I met last year when she ran a wonderful workshop on writing your way through breast cancer (at the Living Beyond Breast Cancer conference for women living with metastatic breast cancer). I introduced myself and gave her my book.

Yesterday, Alysa emailed me to say that she'd written a review of my book for oncolink and that she thought it would make me smile.

It did.