No cute cat pictures today-Stream of consciousness

June 4, 2012 //

Well, back to work today after the weekend. I had a full schedule. I’ve also had to let more folks know about my health status as it is wreaking havoc with my work schedule. I see about 150 patients a year. I primarily do testing these days and a little counseling. This allows me to come home earlier in the day since kids I counsel need to come during the after school hours whereas I only need to see a kid a couple of times for testing so it is easier for them to miss some school. I have 16 assessments scheduled between now and the end of the summer. I would have more but I stopped scheduling people once I diagnosed. I usually have about a 6-10 week wait for an initial appointment but now I have a voice mail that says that there is at least a 4 month wait for an initial appointment. That’s cut down on the phone messages considerably as has telling my main referral sources that I have a four month wait. There are some folks who still want to see me because I was strongly recommended. While it is mostly flattering, I do feel a little bit of pressure to live up to “the hype,” especially given the wait. “You mean, I waited 4 months for this?” Okay, this doesn’t keep me up at nights but I do think about it a little.

Anyway, between the 16 kids I am assessing, the 8 ongoing counseling kids, and the parents of kids I’ve seen in the past that will contact me over the summer to reconnect, I’ll probably end up needing to discuss my health with about 30 families. A couple of the kids I see already have moms with serious medical conditions. I’m not sure how mine will fit into the mix. Sometimes, things I think will bother kids don’t and other times I am surprised by something I thought wasn’t a big deal, which throws a kid for a loop. In any event, counseling can be a very special relationship. I will try my best so that kids and parents don’t feel like they need to worry about me but there are limits to what I can do. I will focus on being as upbeat and optimistic as I can be. I am also hopeful that parents will model a positive attitude. I know that health issues scare a lot of people and sometimes people who are scared unintentionally spread their fear like a contagion. So far, most families have responded in very positive and hopeful ways. I’ve gotten a couple of responses that have raised my eyebrows. Fortunately, I feel pretty solid emotionally so I felt bemusement rather than distress.

On another note, I find myself waking up each morning thinking “I have cancer” not exactly in a distressed way (though these are not pleasant thoughts) but similar to the way I’ve experienced other changes in my status such as the first few weeks of being married (“I’m a wife”) or of being a mom (“I’m a parent”). I’ll keep the marriage and the kid but I hope to soon be able to get rid of the cancer.

Categories Feelings

As you can see, our cat is taking the news of my cancer particularly hard.

June 3, 2012 //

Categories Uncategorized

Protected: Dress Shopping with Zoey

June 2, 2012 //

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Categories Not Cancer-the other part of my life, Parenting

Probabilities

June 2, 2012 //

As a psychologist, especially one who was a researcher for many years, I know a lot about probability. The efficacy of our treatments are assessed using probabilities. For example, in a study assessing the efficacy of a treatment for depression, the question for the treatment group would be, “How probable is it that improvements in the group that got the depression treatment were due to chance rather than from the treatment itself?” If the probability is low, less than 5%, it is taken as positive support for the treatment. I am oversimplifying here so that you don’t pass out with boredom before I get to my point.

In my clinical work, I work to select strategies that maximize the probability that a child will be helped. There are no absolutes. We can’t control other people, we can just look for the avenues where we have the best chance of influence and focus our efforts there. I also can make predictions about long-term outcomes for kids with particular issues but I can’t tell parents absolutely what the future reality will be. For example, I can tell a parent if he/she has ADHD, there’s nearly a 50% chance that any child he/she will have will also have ADHD. I can also tell them that if a child has ADHD, there’s about a 66% chance that he/she will have some other diagnosable condition. I can tell a parent of a child whom I’ve diagnosed with ADHD what the best practices are for treatment, for example that stimulant medication has an 80% efficacy rate. (I know that ADHD meds make a lot of people uncomfortable but if you wouldn’t mind, please don’t use my blog as a forum for expressing your views on this subject.) I can give a list of possibilities and sometimes I can even make pretty good predictions based on information I already have about the child but I can’t know for sure. In talking to parents about these numbers, I have to balance a tight rope of providing them with enough information so that they can make informed decisions, convey the information in a way that will encourage relatively quick action, but not scare them silly. This is a different balance for each parent, which can make it difficult if I am talking to two parents who have very different coping styles. It also depends on the child’s particular situation. Some situations are more dire and urgent than others. Oops, I’m blathering on and on again. Back to the main point.

So I know a lot about numbers, predicting, identifying risk and protective factors, treatment effects, etc. I also know that the numbers can be extremely useful but there is a balance between keeping myself knowledgeable and borrowing trouble. I will be getting my genetics testing results back in a couple of weeks. I know that my chances of having any of the genes is low based on probabilities for the general population as well as those based on my family history. I know the probability is low but I can’t tell you the exact number. And I’m not going to look it up in my notes from the genetics counselor. I have learned the hard way in my life that worrying about something I can’t do anything about is a recipe for crazy. When the time is right to get lots of information, you know I’m going to get lots and make the best decision I can based on the information that is available. So until I know what the findings of the test are and can develop a plan for dealing with it, I’m going to fight the urge to spin my wheels on the Internet or keep myself up at night worrying. Obviously, this will be harder as I get closer to the two week mark, but I’m going to do my best.

Wish me luck in keeping this balance between information-collection and sanity preservation.

Categories Facts, Feelings

Protected: Awww and Aaaah

June 2, 2012 //

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Categories Feelings

Absurd exercise in self examination

June 1, 2012 //

So my phone alarm went off this morning as it does every month to remind me to do something very important. Is it to pay the mortgage or the rent on my office? No silly, it’s to remind me that it was time for my monthly breast self-exam. When the alarm went off, I laughed a little. What was I going to find that three mammograms, two ultrasounds, a biopsy, and an MRI would have missed? Then I thought, “What the heck? I’ll just do it and keep up the habit. Plus, lefty has not gotten nearly the attention that righty has gotten.” So I did my exam and not surprisingly I felt nothing, even in the area that has a known tumor.

So ladies, you will soon tire of hearing me say this if you haven’t already, be sure to get regular mammograms. Yes, they are awkward, yes, they hurt, yes, you may feel that you are the star of some really weird fetish film. Plus, almost all of us have given birth by the time we start mammograms. That’s a lifetime of awkward physical exams for each kid. Finally, for the 12% of you that will some day get breast cancer, all that boob squishing will likely save your life.

Yes, I know I turning into a zealot. I’m going to dye my hair pink, wear only pink clothing, and get a pink ribbon tattooed on my right forearm. Feel free to dodge my calls if this happens but don’t forget to get your mammograms.

Categories Facts, Feelings

Lots of kindness

May 31, 2012 //

Although my husband may disagree in matters related to my attitude toward his contributions to housekeeping, I am a pretty positive person. I believe in the inherent value of people even if they do “bad things” or worse, even if they annoy me. Even with my above average rosy view of humanity, I am absolutely blown away by the kindness I have received regarding my cancer. There is at least one person praying for me (a chaplain at St. James’ Cathedral) who has never met me. My friends and relatives have been beyond kind and helpful. The various technicians and nurses at Swedish and their partner health care offices tend to my comfort, ask me for the names of my doctors, and tell me that I have an “excellent team” caring for me.

I sure don’t like being seriously ill but this is pretty sweet. No wonder Huck Finn (or was it Tom Sawyer) faked his own death so he could hear all of the nice things that people said about them. No wonder people have trouble with malingering or Munchausen’s by proxy. All of this attention could be addictive to some people.

But no worries. As much as I am touched by the kindness around me I look forward to the day it will not have to be so obvious and necessary. I look forward to being taken for granted. (Okay, that last bit is dishonest. I hate being taken for granted! Ah, the song of a mom of a teenager.) Let’s just say, I look forward to the day when I am not taking up so much space in the worry parts of people’s brains.

In the meantime, keep the prayers and positive vibes coming. I’ll send mine your way, too.

Categories Feelings

No facts, just me talking

May 31, 2012 //

I may actually have a week without any appointments or test results. What will I do with myself? I guess I can just peer back into my memory banks to 8 days ago and remind myself of what I did with my time. I can deal with that.

Okay, actually that’s a bit of a dream. I’m still working on cancer stuff. I’m trying to guess how much I can work this summer, whether I need to cancel folks I already have scheduled, and what to tell people in my practice. Fortunately, I have just a handful of long-term therapy clients since I mostly do testing and booster sessions for old clients.

Looking on the bright side, I’d have to take care of planning my workload and dealing with my clients whether I had medical appointments or not so it’s nice to have a few days breather. Plus, my right arm, which was poked three times in the span of 5 days is happy to have a little rest from blood draws, etc.

Categories Feelings

Unexpected lack of news

May 30, 2012 //

I had a meeting with a genetics counselor today. I had mistakenly thought that the purpose of the testing was to go over the results of my genetic testing. However, I apparently have not yet done this testing. I wonder what last Friday’s blood draw was for? I know it was explained to me. I must have gotten confused. Anyway, the purpose of the meeting was to go over my family history and discuss the pros and cons of doing the genetic testing. I decided to go ahead with the testing, had my blood drawn again, and will hear back in a couple of weeks. (There is only one place in the country that does these tests and it is in Salt Lake.)

Categories Facts

25 Feet up a Fir Tree

May 29, 2012 //

So I told Zoey about my cancer last Friday. She had a pretty hard weekend. She was really anxious, moody, and complained of “not feeling well,” especially when we wanted to go some where or do something rather than watch tv. My parents had a dinner party yesterday. She was complaining a little about going. Zoey doesn’t always really “listen” to what I say so even though I told her who was going to the dinner, it didn’t really register that her beloved cousins would not be at the dinner until about 20 minutes before it was time to leave. She was disappointed, but did not balk at going. Then we got into the car and I accidentally slammed her fingers in the car door! She ran out from the car and into the house. Many 13 year-old type declarations were made about how she was declining her invitation to the dinner party. However, we have a policy in these incidences of not allowing her to stay home by herself. She took issue with family policy as only a gifted 13 year-old Zoey can, by running out the door and climbing the Douglas Fir in the back yard. My father-in-law happened to be in the front yard and holding her coat. When he saw her run out the door he said, “Wherever you’re going, you’re going to need this coat.” So she put it on while on her way to the tree.

Our Douglas Fir was planted when the house was built in 1958. It’s TALL. She goes there for fun or when she needs time away. When I was a teen, I did the same thing. I went to nature when I was upset, though we had woods not just one tree. Anyway, I wanted a couple of minutes before walking to the tree and looking up. She had climbed 25-30 feet up that tree. (I was silently relieved that she was able to scale that tree after having accidentally slammed her fingers in my door.) I said, “It’s not too late to change your mind.” Then I went back inside. I came out after another 5 minutes and said, “You are up pretty high. You’re a really good tree climber.” She said, “Is it too late to go?” I replied, “No, come on down.”

We ended up having a really good time at my mom and dad’s. I was proud of Zoey for turning a bad situation around so fast. It’s got to be awfully upsetting to have a mom with cancer when you are trying to be a fearless master of the world.