As I’ve written about previously, when I was a college student, I worked as a research assistant for an orthopedic surgeon who was completing a research fellowship at the University of Washington working in the biomechanics lab at Harborview Medical Center. He was doing a study on the use of an oscilloscope in assessing fracture healing in tibiae. He had a device that made a little thump on the skin over the tibia, thereby making it vibrate. A couple of readings were taken and recorded.
I have always maintained that it is not fair to expect smart people to automatically have professional skills with which they’ve had little or no training. So, I am not putting down the medical profession when I note that an M.D. is not a research degree and it was very clear that this very skilled and compassionate physician, did not always know what he was doing from a research methods standpoint.

One day, he and I were taking readings. There were some he didn’t like. He said, “Those a spurious.” And then he deleted them. I was shocked and said, “You can’t do that!” He repeated his rationale and looked mighty nonplussed for someone who had just DESTROYED DATA. It is true that most things in life are not normally distributed and even when they are, there will be outliers. But outliers count. They can’t just be dismissed. They are still part of the sample, the sample that is designed to represent a larger group.

A lot of the time we spend on defining what is normal, what is average. A average, or mean, is a measure of central tendency. It measures the middle. But sometimes the mean does not reflect the middle. Take home prices. Have you ever noticed that people talk about median, not mean, home prices? That’s because wealthy people tend to live in much more expensive homes, with prices outlying the general distribution. These outliers, or extreme scores, are described to exert too much leverage on the mean. Let’s say that all of the houses in your neighborhood are worth $200,000-$300,000 except for one, which is worth $2 million. The mean is going to end up being higher than the price of all but one of the homes and is going to be substantially lower than the highest one. The mean is not very meaningful so a median, the actual middle point of the distribution is used instead. Now the outlier house is not meaningless. There’s some meaning around someone having a lot more than everyone else. That says something. And the majority of the house prices mean something, too. One cannot get a complete picture without looking at both the norm and the exceptions.

If you are still with me on this statistics post, you know that I’m going to apply this to something else. You would be right. There is a lot of discussion in the breast cancer community about what words, experiences, and group best represent us. Sometimes we are talking about educating and changing our culture. We talk about the implications of words for funding, physician/patient relationships, and societal support for individuals with breast cancer. These conversations are very important.

Then there are the times we apply the mean to ourselves as individuals. Sometimes that fits and sometimes it doesn’t. Sometimes we apply our individual experiences to the group. Sometimes that fits and sometimes it doesn’t. Sometimes we want to be the average. Sometimes we want to be the outlier. I had a kind of breast cancer that has a good prognosis based on the type, stage, estimated aggressiveness, and the results of genetic testing. I am hoping very much to be an average breast cancer patient. I don’t want to be an outlier. My friends with metastatic cancer most commonly want to be outliers. They want to live longer and with a higher quality of life than the typical patient.

Some of the more controversial writings and interviews on breast cancer have occurred when an outlier case is treated as the typical case. Melissa Etheridge comes to mind. She is entitled to her own individual opinion about what caused her cancer and what will keep her healthy. She has freedom of speech, even as a famous person, and I have the freedom to think that she is living her life on a foundation of likely erroneous beliefs. But it is her life. Good journalism is supposed to present a story in context. When an individual expresses an outlier belief about the prevention and treatment of a deadly disease, there is a responsibility to present other view points, in particular, to interview an expert in the field. That provides context and a representative story.

Stories about individuals are often more interesting because they are less abstract. They seem so much more real than statistics. But as real as individual anecdotes are they often do not represent the group.

Breast cancer is not always interesting. Some of us are suffering in a way that is not good for print or t.v. Not all of us feel like “survivors” or “warriors” or “fierce”. Some of us do, some of us do not. Some of us believe in the power of prayer, the power of positive thinking, and some do not. For some, mastectomy feels like an amputation, for others not. We all deal with this disease in our own way. We feel losses in our own way.

It is unrealistic to expect all cancer patients to understand the complexities of these diseases, to cope with them, and also to EDUCATE the public. Some people are able to do this, but others are not. Some people argue that public figures have a responsibility to the public to educate because they are influential. This assumes that they have the skills necessary to educate. It is, however, realistic to expect people whose profession it is to provide health information to do so, and the blur between news and entertainment as well as news and disease commercialization, troubles me greatly.

We may be the mean. We may be outliers.

Every one of us is real.

We are all part of the group.

 

I am taking a six month class in skills designed, basically, to help me keep my emotional shit together. Unsurprisingly, the first unit is on mindfulness. I got into the class thinking, “Mindfulness, I’ve been doing this for over two years. This will be easy peasy lemon squeezy.”

I am here to tell you that week two has not lived up to it lemon squeezy potential. I have a lot of practice in observing without judgment. I also have a lot of experience describing my feeling states and being somewhat non judgmental about that.

Apparently, there’s other stuff. One of those things is doing things effectively. This has to do with thinking about my goals, at least that’s what I understand so far.

The instructor explained the whole thing. Meanwhile, I can tell you using my describing skills that I felt confused followed by elucidated followed by the realization that I was elucidated and not just confused, but in a different way. Then I think I got it but we will see on Wednesday when I check in about my homework.

And you know that I practiced on hubby. I can go through an interaction with my husband thinking, “Hm, that hurt my feelings and I don’t think John meant to do that. But wow, I am hurt and angry.”

That sounds good, doesn’t it?

Except that often what comes out of my mouth is, “Why did you say that?”

I am here to tell you that asking someone “Why did you say that” or “Why did you do that” when you are hurt, angry, or scared, will get you no where good, fast.

And yet I find myself saying this over and over. It is utterly not in keeping with my goals to be a peaceful loving wife who communicates well with John, whom I love dearly.

Another thing I might do is say nothing and think to myself, “This is not a big deal. Don’t start a fight.”

But in that case I did not accomplish my goal of communicating a hurt that was important to me and I risk getting resentful about it.

So I tried something new. John did something I didn’t like. And I said, “Honey, I am not trying to punish you or fight with you. But I am feeling anxious and angry about x and wondering if we might talk about it?”

It was not the easiest conversation but it was much easier and it was not a fight. But then I got very hurt and angry about something else. In time, he apologized for what he said and sincerely, but I found that I was still hurt and angry. I couldn’t let it drop. But it took me awhile to understand why I couldn’t let it drop. He had said something that might not upset someone else but because of who I am and what is important to me, it hurt. I was still upset because what he’d said had surprised me and I wanted to know that he understood why it was upsetting. I wanted reassurance that he still knew me and what is important to me. I said, “I’m sorry, I am still really hurt about this. I am sorry that I can’t let it drop. I need you to say, x, y, and z.” And then he said those things and he said them sincerely. We had been stuck in one of the arguments that go around and around. And then I felt so much better.  We had a very nice evening after what had been a tense couple of days.

The best thing about this class? I got confused because I encountered some new ideas and skills. That means there are more tools out there for me to learn. This is very reassuring to me.

I like my hair. It is long, with soft curls, and dyed an appealing shade of reddish brown. I am in the last year of my 40’s and my hair is longer than it has ever been in my life. Even including the time in the 70’s, when I wore my long hair tied back with one of those over-sized yarn pony tail holders. Back then, I used to run around barefoot and spent a good deal of time climbing trees. For many years, my feet were very calloused and my hair consisted of a neighborhood of knots and tangles. I just used to brush the top layer of hair to provide a presentable appearance. Every once in a while, I would have to sit in a chair while my mom painstakingly separated the tangles and the knots. Ow! Ow! Ow!

By the time I was 12 or 13, I was convinced that I had “bad hair”. In the 8th grade, I got a stylish feather cut. I used a curling iron religiously. I kept that cut for a number of years. It looked pretty good. By college, I shortened my hair even more and by the time I was 20, I had a pixie cut, which I loved. I kept my hair short for many years, no longer than a bob. By the end of college, I stopped using a curling iron.

I was still convinced that if I were to wear my hair long, it would be ugly, the way I remembered it being as a young adolescent. Then I got pregnant. I was 31 years old and my hair was growing very fast. I decided that it was time to see what hair longer than a pixie cut would look like.

After a few years, I discovered that my long hair was pretty. Also, I discovered that it was much curlier than it had been when I was younger. I didn’t have bad hair, after all. When my hair went gray, I decided to color treat it. Curly hair tends to be dry. Color dries it out more, especially the do-it-yourself stuff. I realized that if I were to keep my hair long, it would need professional help. I get my hair colored, cut, and deep conditioned every seven weeks.

When I was diagnosed with breast cancer 2 1/2 years ago, I started growing my hair even longer because I could and I wasn’t sure how much longer I would have long hair. I figured that if I had chemo and lost it all, I would never grow it back to long again. It would take years and years and at that point, not be “age appropriate”.

When chemotherapy was not recommended for me, I kept it growing. I have not stopped letting my hair grow except for a light trim, since my diagnosis. When straight, my hair now falls to the middle of my back. For the record, I believe that it has officially entered the realm of “not age appropriate”. I find that for the record, I don’t give a rat’s ass. I like my hair. It may not be with me in the future but now it’s here. It’s mine and I like it.

There are a lot of breast cancer writings about hair, what it means to a woman, and what it means when it is lost. A bald head is a dramatic difference in a person’s appearance. But hair carries so much significance, even if still remaining on one’s head.

How important is it to have good hair?

When my daughter asks my husband, “Dad, how does my hair look,” he sometimes replies, “It looks good but it would look better if you brushed it.” At this point, my daughter and I give each other knowing glances. She has curly hair, too. Brushing or combing curly hair while it’s dry breaks up the curl and to most eyes, does not look attractive. The only time I brush my hair when it is dry is to remove the tangles prior to straightening it with a flat iron. The last time I did this was a couple of months ago. My hair looked crazy and I thought it might make for a funny Facebook selfie, a kind of public service announcement explaining why curly hair is not dry brushed.

Curly tops: Don't try this at home.

Curly tops: Don’t try this at home.

How important is hair to people?

You would not believe the amount of advice this photo elicited about how to better care for my hair. It was pretty funny. But then I realized that the people commenting had seen MANY photos of me and my hair. It had never looked like this. Perhaps I am exaggerating, but it made me wonder if the sight of a woman with “bad hair” was so surprising that people forgot how I normally look and jumped straight into an urgent mode to save me from my split ends. Suggestions of coconut oil, olive oil, etc.

Hair is really important to a lot of women. I don’t want to lose mine, I know that for sure. Maybe it SHOULDN’T be that important. But it is. And one of the lessons I am learning in my life is that lots of things “should be” a certain way but they are not. We can only work with the way things are.

So please, please, please when one of your loved ones or even yourself loses hair as a result of chemo and is feeling sad about it, think twice before saying, “This shouldn’t bother you.”

If it bothers you, it bothers you. If it doesn’t, it doesn’t. What should be is not relevant to this particular situation.

My husband recently complimented me by noting that in a crisis, I am good at quickly figuring out what needs to be done, assembling resources, and doing it. This is true, in a number of respects, and I am grateful to have the skill and drive to carry it off.

There are some aspects of my life when this is hard and unfortunately, it is related to my physical health. I have a difficult time maintaining a healthy diet and exercise routine. I had coincidentally rejoined Weightwatchers a few weeks before my cancer diagnosis and had already started losing weight. I added walking at least 5 times a week a few months later, and I’ve been walking nearly every day for over two years. Since I started logging my miles on 12/2/12, I’ve walked close to 2000 miles.

I started tracking my miles as a way to help maintain my exercise program. That, combined with my renewed interest in nature photography, has helped me maintain the habit. Admittedly, I am having a little trouble transitioning to the damp part of the year but I’ve gotten out in some rather cold weather and enjoyed the sights and sounds of the outdoors. I know that I am getting my groove back.

My diet is another matter, altogether. I don’t eat a lot of sweets except around the holidays. And my gluten allergy means that I can’t eat most prepared foods anyway. However, I have been eating a lot of fruit, A LOT, and probably too much. I know that sounds silly but it has a lot of sugar in it. Finally, I know that my portion sizes are too big. I have gained nearly 20 pounds over my goal.

This all started when I decided to stop tracking what I ate every day. I stopped following Weight Watchers, basically. I was in a groove. I was ten pounds below my goal weight and walking a lot. I was really fit. I don’t know why I let myself do this. THIS IS HOW I’VE REGAINED WEIGHT EVERY TIME!

I keep restarting Weight Watchers for a couple of days but I have not yet gotten it to stick. Really, I am hoping that by writing this, I will get myself back into the long game, especially since we are in the holiday season.

I usually don’t end my blog posts with questions, but I have some. How do you help keep yourself motivated to maintain a healthy lifestyle?

One of my sister-in-law’s hosts Easter each year. She is a competent cook. She is also able to have people in her kitchen while she cooks. I could say that one reason for this is that she has a large kitchen with places for people to sit at a table, out of the way. I could also note that most of the things she makes are not hot and can be made ahead of time and taken out of the refrigerator. I could also point to the fact that she does not make something that requires the making of gravy. But the fact of the matter is that she is able to concentrate on entertaining people and making food all at the same time.

I am not like this. I can talk to people up until about the last 30 min before Thanksgiving dinner is done. Thanksgiving is the holiday that I host. I have done it for all years except one for the past 10 years. Before the last 30 minutes, I feel relaxed and confident. My apron is typically still clean. I am able to avoid burning myself on the oven’s heating element.

And then half of the food is ready and the other half of the food needs to be finished. The turkey is cooked and needs to be lifted out of the pan to rest on a carving plate. Meanwhile, I place the roasting pan on two burners, pour in alcohol to deglaze it, scraping the fond from the bottom of the pan. I add flour (now a gluten-free blend) and turkey fat and stir constantly. It always gums up immediately and the first worry is that the gravy will turn out clumpy. And it will if I don’t keep my head in the game. I add poultry stock, bit by bit, until I start to see a beautiful brown glistening sauce develop. Then I keep adding stock while I am plating vegetables, side dishes, and heating things up at the last minute. I have to work quickly so that the turkey does not rest too long and become cold. When the time comes, I call my husband to the kitchen to carve the turkey while I finish the last 500 details.

If you are a guest and you ask me what you can do to help, I will ask you to please sit down and enjoy yourself. If you ask me during the last 30 minutes, I insist that you sit down and enjoy yourself. My husband and my mom have both gotten into the habit of running interference for me and helping shoo people out of the kitchen. Even if I am not in the last push of frenzy, my kitchen is small and not a good place for people to hang out to visit with one another. My mother knows this because people congregate in her kitchen when she is cooking, standing in front of the stove or the sink, not realizing that they are setting off her rhythm. My husband shoos people out because he has empathy for me and knows how my brain works.

I love to cook but I am a person who cooks in deep thought. I have a hard time socializing and cooking at the same time. Both socializing and cooking are high interest for me and I have a hard time focusing on anything else when I am deeply engaged in one of these activities. So doing both of them is really really hard. As for those that want to come in to help, unless they know exactly what to do and how to do it, delegating is a chore for me. A chef is a boss of a kitchen and has training to do this. I don’t. I am a home cook with a small kitchen. I have a schedule and a list in my head. I am working at full capacity and the wheels are already in motion. This is also why, if you come to my house with a dish that needs tending to or oven space, I will use my powers of reasoning to tell myself that you have probably not considered that all of the burners and all of the oven space have already been accounted for. I will smile tightly and problem-solve. I may think of the time that friends had a potluck and a mutual friend showed up with a grocery bag full of unwashed vegetables and raw tofu and exclaimed, “Look, I brought stir fry!” That story always makes me smile.

I live my life at a certain pace. I try to live a lifestyle that is not only manageable, but healthy. Sometimes I even think I know what I am doing. I feel relaxed and can coordinate the different spheres of my life. And then there are the times when everything happens at once. I need to be in multiple places to do multiple things, all at once. And the consequences for failure are far worse than lumpy gravy.

I am working my best to be the kind of parent my child needs. So is my husband and so is my child. It seems that we get to the frenzy frequently and often without notice. This is the way our lives have been for the past 4 years. Cancer happened in those years, too. The normal real life bumps and reorganizations have occurred, as well. Last week, I learned that my colleagues and I need to find new professional office space. We’ve been in the same place for 10 years. I don’t like moving. It’s a lot of work. We are working to find the least disruptive and expensive solution to the problem.

During these times when I am racing in my life, I find it harder to talk about the details of my life. Not so much because it is emotionally hard but because my brain is working at capacity. I am finding myself in that mode lately. It is easier for me to organize my thoughts in writing than in conversation but even writing has been hard to organize in the past couple of weeks.

I recently wrote that I was looking forward to this week because I would be able to concentrate on cooking an spending time with my family. And I have done just that. Although I awoke this morning fairly pooped out from entertaining, I think it says something that I am finding writing to be easy again.

Simply live.

I am trying.

I love making fruit pies. Actually, I love eating pies. And the quality of the crust is crucial. The wheat allergy thing has put a crimp in my pie dough making ways. Not only can I no longer eat it but I can tell that it is affecting the quality of the wheat flour pies I make for my family. Pastry making is not as forgiving as other kinds of cooking. The moisture content of flour can vary, the amount of humidity in the kitchen varies, and there are always little variations in measuring, depending on settling. I’ve relied on the “feel” of the dough while I am handling it as well as the texture of the dough when I cut into the pie after I slice it. This is helpful but not the same kind of feedback I get when I actually eat the pie. And don’t get me started on the moisture content of the fruit filling and what it does to the crust! I have also been working with gluten free pie crust recipes.

Here’s the thing, gluten does wonderful things to pie dough. Even so, I don’t like most wheat flour pie dough recipes! I also don’t like most of the crusts on the pies I eat. I had settled on a recipe a number of years ago and it had been a solid winner. Working with gluten free dough was almost like learning from square one. First, the dough is really brittle. It breaks easily. It has almost no elasticity. My first attempts were rather sad looking. Now if they had TASTED good, that would have been okay. But the first doughs cooked up like brick. Okay, I am not being entirely accurate.  Actually, they tasted like bricks with delicious fruit topping.

Last October,  I thought I was getting close. This week I did some more tinkering and I am happy to say that I liked the pie! You might think that I’ve put an awful lot of work and emotional energy into this. You’re probably right. It’s a little win to offset the inconvenience of my gluten free lifestyle. I have come to the conclusion in the last couple of months that the only way to manage the skin problems caused by my wheat allergy, is to avoid eating any food that I have not prepared myself. Think about what this means. Not fun. But here you go, the much promised pie dough recipe!!!

2 ¼ cups Namaste Perfect Flour Blend 2 tablespoons sugar 2 teaspoons xanthan gum ½ tsp salt 1/8 tsp baking soda 2 tablespoons butter ½ cup canola oil 2 teaspoons baking powder ½ cup milk 1 tsp white vinegar

Directions

1.    Mix 1 cup of the flour blend with ½ cup canola oil. Combine with a fork until well blended.

2.    Heat butter in small saucepan on low until it’s nicely browned. (You can tell because it changes to a brown color and gives off an amazingly yummy fragrance).

3.    Add the browned butter to the flour/oil mixture and combine. Put the bowl containing this mixture into the freezer for 20-30 minutes.

4.    Combine the remaining 1 ¼ cup of flour with the sugar, xanthan gum, salt, baking soda, and baking powder. Add it to the semi-frozen mixture and cut it with a pastry blender until it is the consistency of coarsely ground cornmeal mixed with some bigger lumps, up to the size of a small pea.

5.    Add the vinegar and milk about 1/8th of a cup at a time. Use the fork to help distribute it evenly but do not stir!!!! Once all the milk is in the bowl and the combination is evenly moist, more or less, form it into a ball with your hands. The dough might seem too wet. Be patient because once the xanthan gum does its magic, the dough will turn to a nice consistency. (This, by the way, is how I dried out the first dough but thinking that it was too moist and adding an extra cup of flour blend.)

6.    Divide the ball into two parts. Roll each part between two sheets of waxed paper and use for one double crust or two single crust pies.

Note: I made a lattice crust this time but it broke a lot while I was making it. It is much easier to roll out a single crust for the top.

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On this day in 1954, my parents got married. Congratulations, Mom and Dad!

My mom recently suggested that my blogging so frequently about how stressful my life is, might be adding to the stress in my life.

So, Mom and Dad, for your anniversary, I will be a font of positive communication until tomorrow, at which time, we will be back to our regularly scheduled program of life, with its ups and downs. And I will be writing about both.

I also promise to post photos of pies on Facebook. That always makes everyone happy, including me.

Seriously, I love you, Mom and Dad! Happy Anniversary!

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This is a re-post from 9/20/13, which I wrote (and sang) as a gift for my mom’s birthday. Mom has been fretting about me a bit because I’ve been writing about worry and stress. She is asking me what she can do to help. I am reposting this 1) to remind her that I know that I am resilient even if my life is complicated at this time and 2) to remind her that she has already and continues to do so much for me, just by being herself.

 

Martha MacKenzie is my wonderful mom. And today is her birthday. In addition to being a mother of six and a wife for nearly 59 years, my mom is a singer. She has a glorious voice. Mom has almost no formal vocal training but comes from a family of musicians, especially singers. Her singing style can best be described as sacred classical. In other words, she is a church singer. Mom has been singing in church choir since she was six years old. Her oldest sister, Gloria, sang for KIRO radio’s Uncle Frank’s Kiddie’s Hour for a number of years, until she was about 12. Mom and her middle sister auditioned for and were accepted into the children’s choir for an opera production in Seattle, starring Metropolitan Opera’s Rise Stevens. Mom still remembers what she was asked to sing for the audition.

Mom  was SMART and graduated from high school at age 16, after which she took a music performance class, along with her older sister, Barbara at Seattle University. We have recordings from those times of my mom’s clear soprano and my aunt’s animated mezzo-soprano singing songs from 1950’s musicals. Shortly after, Barbara moved to New York City to try to make it on Broadway. She was an amazing performer but like many talented performers did not make it in the Big Apple. During the Koren war, Mom was in a singing trio with Barbara and their cousin, Betty. They wore glamorous dresses and pulled off those unbelievably dark lip stick shades that were popular in the early 50’s, while performing for the USO.

Mom continued to sing in church choirs all of this time through marriage, rearing six children, and throughout my father’s post-retirement years. She is a member of the St. James’ Cathedral Choir in Seattle. It is a wonderful choir, which has toured Europe singing at noted cathedrals such as Notre Dame in France. They also sang at the Vatican and had an audience with Pope Benedict. My mom likes to tell us how she was trying to hike up the waistband of her support hose just as Pope Benedict walked by.

Wow, Elizabeth your mom sounds great. And you’ve talked about being a musician in your youth. You must have sung. You must have sung for your mother.

Well, it’s complicated. I was in band but did belong to the choir during 7th grade. Our claim to fame was performing, “The Sound of Music” during a middle school JAZZ competition. And no, it wasn’t a jazzy rendition of the song. I don’t know what that teacher was thinking. Then I stopped singing except for a few months during college when my mom convinced me to come to St. James to rehearse for a special community choir mass. (Regular choir members must audition. Soloists are professional opera singers.) I remember singing “A Mighty Fortress” and learning a piece based on Psalm 84 (“Yeah the sparrow hath found a house…”). I learned how to articulate words differently for singing than for speaking. It was a lot of work but was really fun.

So I did a little singing in groups. But NEVER alone in front of people. (Okay, one time five years ago I sang “Goody Goody” for my neighbors Jim and Deana. I’m not sure why I did it.) Not even for my mom except for a few bars of something and even then that was when I was much older, like 35 years old. People, singing in front of people is even more mortifying to me than wearing a swim suit in public! Zoe is the only one I have ever sung to and I sang to her a lot when she was little. I would sing with her now except that she only likes to sing alone. (Annoying teen.)

My mom used to sneak next to the bathroom door to try to hear me sing in the shower. (Watch the comments section, she will deny it!) If we were in church together and standing next to each other, she would sing really quietly so that she could listen to ME. I knew that it was really important to my mom to hear me sing but it was so hard for me to do this and I’m not sure why. She wanted to know if I had “a voice”. I performed frequently as a flutist, despite my nerves, and even performed in two master classes. (A master class is when some well-known musician comes to town and students are selected to get a lesson by that person in front of an audience of a bunch of students and music teachers. I did it twice as a college student.)

My singing anxiety does not just apply to my mom. Objectively, I have a pleasant, untrained alto voice with limited range. I think I could have been an excellent singer if I had trained to do so as I had with the flute. Perhaps the difficulties started as a combination of my perfectionism and the fact that my mom’s eagerness stressed me out a bit. And then as irrational anxieties do, it gathered its own steam from my continued avoidance, and took on a life of its own.

Last July, I wrote about the co-existence of grief and joy as being part of resilience in the post, How Can I Keep from Singing? The post title is the name of one of my favorite Christian hymns. I included the lyrics in the post followed by a little message to my mom asking her to record the hymn so I could post it on this blog. She offered me the deal that she would record it if I sang WITH her. I replied to her comments with a “definite maybe” type reply. I don’t think she ever saw that reply because she hasn’t mentioned the topic even once in the last almost two months. Or perhaps she has been playing it REALLY COOL.

I subsequently decided that I wanted to record the song both for my mom and for myself, to face my fear of public singing. Unlike going on loop de loop roller coasters, I actually enjoy singing quite a bit. It’s the only kind of music I still make. My original vision was for my mom, Zoe, and I to sing one verse apiece and the last verse together. However, Zoe was not at all interested in participating at the time I asked. My mom kept going camping with my dad all summer. I ended up not talking to her about it.

I decided to go solo and a cappella. Actually, a cappella is my favorite for this hymn. Plus, I don’t play piano and ukulele accompaniment by Zoe would probably not sound right.To me, the hymn sounds a little Irish. However, it is American and although there is a somewhat complicated history behind it, the authorship for the music is attributed to a Baptist minister, Robert Wadsworth Lowry. There are a number of different versions of the lyrics. I chose the one that was closest to the one I’ve sung in church many times as a member of the congregation.

I started practicing the song on and off about three weeks ago. Then I had to figure out how to audio record myself. (No way would I have a videotape made. This audio recording is a big enough step as it is.) I finally decided, as time was passing quickly, that I just needed to get it done. So I downloaded a free recording app onto my smartphone and started recording myself. I spent enough time on it to give myself a few tries but not so many as to activate my perfectionism.

Happy Birthday, Mom! Here is a song for you. I am posting it on my blog as my kind of “performance” so you can have a cyber stage mother experience.

How Can I Keep from Singing?

My life goes on in endless song
above earth’s lamentations,
I hear the real, though far-off hymn
that hails a new creation.

Through all the tumult and the strife
I hear it’s music ringing,
It sounds an echo in my soul.
How can I keep from singing?

Oh though the tempest loudly roars,
I hear the truth, it liveth.
Oh though the darkness ’round me close,
songs in the night it giveth.

No storm can shake my inmost calm,
while to that rock I’m clinging.
Since love is lord of heaven and earth
how can I keep from singing?

When tyrants tremble sick with fear
and hear their death knell ringing,
when friends rejoice both far and near
how can I keep from singing?

No storm can shake my inmost calm,
while to that rock I’m clinging.
Since love is lord of heaven and earth
how can I keep from singing?

Next Monday is my 49th birthday. My husband asked me what I wanted. I told him, “I don’t want anything. I just want to have dinner with you or something.”

I didn’t really have the emotional energy to think about what I wanted. It’s been a stressful few weeks with lots of worries on top of my normal worries. Sometimes, I worry that I think too much. I think about cancer every day. I think about my husband and daughter every day. I think about the obligations I have to my family, my friends, my job, and to myself. When I am really stressed, as I am at this moment, I worry that I am burdening my friends and family by asking for support, even the support of knowing what I am going through so I don’t have to do it by myself. I am worrying about this right now by sharing this with you. But I also know that when I feel most alone and burdened is the time I need to call on my resources and this means friends.

My friend, Nancy, sent me an email with a parenting resource. Actually, the email was to a bunch of people. Nancy is a dear and she always prefaces any email with, “I hope you are well.” I replied just to her. “I am hanging in there. Things are not going well but I hope you and your family are well.”

I’d never done that before. I got a phone call from her within the hour. I felt a great deal better after we talked. I am very lucky to have such wonderful support in my life.

I’ve been wishing very much to go on a vacation. Then I realize that I’ve just had two vacations, which were wonderful. What I really want is to be away from the stress of the current complications of my life.

Yesterday, I thought to myself, “For my birthday, I want a simple life.”

Immediately, I reflected that this was a fantasy. There are people who have simpler lives than mine, but their lives are complicated. More importantly, I can’t be anyone else, anyway. My life is complicated.

I also started thinking about the fact that I am ending another decade of my life, my forties. I thought, “Wow, a lot has gone on during my 40’s.” But then I started thinking about all of the other decades in my life. Just thinking about all of the changes that occurred for me just as a natural part of growing up during the first two decades made my head spin. A lot happens between the time we are born and the time we hit 20 years old. Holy Cow!

But I still want a vacation and I want a simple life.

And then it dawned on me. Although I am working on Monday, my birthday, I will not go into the office for the rest of the week. I host Thanksgiving every year and to do so, I need cooking time. So I’ve made a habit of only seeing patients on the Monday of Thanksgiving week.

My job after Monday will be to cook and spend time with my family. My husband is taking off the entire week.

I think I will get my birthday wish for a few days and this makes me very happy.

As I parked my car at my cancer center last Friday, I thought to myself, ‘This is my last “double-stick Friday”!’ Friday is not a day I see patients so it is the day I typically choose to be a patient. The first stick is a blood draw, which marks the beginning of every medical oncology appointment. Two vials of blood are drawn. Most of the phlebotomists are amazingly adept, which is very important when working with cancer patients, who have veins that are no stranger to the needle. My blood is always drawn on my left arm because I had lymph node removal on my right side. Prior to cancer, I’d had one I.V. placement when giving birth to my daughter 16 years ago and blood draws on a very infrequent basis for some of my annual physicals. Since cancer, my left arm and left hand have been poked and prodded many times a year for blood draws and surgeries. I didn’t even have I.V. chemo and I can tell the difference.

My name was called by an unfamiliar phlebotomist. But they have all been good so I didn’t worry. Then I noticed that it was taking her a very long time to find a vein. I have what they call “difficult” veins. This is why I often get the I.V. line placed in the back of my hand, which by the way, which is kind of ouchie. I could also tell that she was getting nervous. I close my eyes during blood draws because it helps me relax and also because I like to give people privacy to do their job without my staring at their work. I kept feeling the tap tap tapping of her index finger on the inside of my arm and some whispered nervousness. She stuck the needle and then the draw was taking a really long time. Usually, the phlebotomist lets me relax my fist once the needle has been placed. But she didn’t. She kept apologizing and then finally gave up. It wasn’t an adequate blood draw. Then she peered at my arm again, anxiously fretting as she did so. I kept saying, “Don’t worry about it. It’s okay.” She found a vein on the outside of my forearm. This was a new sticking spot.

Again, more time passed than usual. I didn’t mind the extra needle sticking as much as her distress and repeated apologies. Finally, the vials were filled. She fretted over the bruise she knew would be left and in attempt to prevent it, wrapped my arm tightly with medical tape.

I walked upstairs for my oncology appointment with two bandages on my left arm. It would be “triple-stick Friday”. The last stick would be a Lupron shot into my left hip. I have been getting Lupron shots every three months for over two years. Their function is to disrupt the signal from my pituitary gland to my ovaries, which respond by producing progesterone and estrogen. This is a non-surgical way of “shutting down the ovaries” and putting a woman into a near instant and possibly reversible menopause.

And yes, over two years ago, I entered menopause. At the time, Lupron was more commonly used to treat prostate cancer. There was a photo of a smiling middle aged man on the package that held the pre-filled syringe. This struck a few of us in the breast cancer community as funny. The man on the package looked far too happy with his cancer status and the fact that his testes were going to be “shut down” by Lupron.

In three months, the Lupron will wear off and I will wait and see what kind of change ensues. I asked my oncologist what I might expect to happen. It was quickly clear to me as she explained the possible factors (my natural menopause time and the fact that both Lupron and tamoxifen, which I am still taking can cause irreversible menopause) that this was a hard outcome to predict. I said, “Ah, there are many factors involved and they are all DYNAMIC.” Then I covered my eyes and pantomimed throwing a dart. Dr. Rinn replied, “You got it, it’s like throwing a dart at a moving car.”

Like throwing a dart at a moving car.

A great deal of life is like this. My health, parenting a teen.

Mindfulness is like throwing a dart at a moving car with my eyes open.

Wide open.

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