Thursday, April 2, 2015

Our cancer journey

I haven't blogged about this yet, because I think it's all been too raw for me to sit down and actually process what's going on in words. 

I'll never forget the phone call I got from my mom, just ten days before Christmas. She was going back to her doctor to find out if a biopsy she'd had done on her breast was clear or not. Of course I was worried, but it was a worry that I was trying to shove back to the back of my brain. She'd had a questionable lump once before, about twenty years ago. And she had a lumpectomy to take the whole thing, but it ended up being fine. No cancer. So I kept telling myself that this would be the same thing. She called my cell phone and said that she had just left the doctor, and the news wasn't good. It was cancer. And there were also some lumps under her arm that the doctor spotted and was also concerned about. It was a pretty quick phone call because we were both too choked up to talk. The kids were home and I didn't want them to see me upset, so I walked to the side of the house where we have some chairs and just sat there crying for a few minutes. I tried to rally for the kids, but I was devastated. Not my mom. My mom is full of life and kind and generous and giving and just about the best person I know. She's nowhere near the age that shows on her drivers license. She's swimming laps with the kids, riding bikes with them, coming to each and every one of Owen's hockey games, even if it's a 6:15am start in San Jose (45 minutes away). She picks up the kids from school at least once a week to take them for frozen yogurt and often has them each invite a friend or even two if it means making sure they aren't leaving someone out. We spend holidays together, random summer days floating in her pool, weekends in Carmel with her and my dad. She eats healthy and always has. She spends more time working in her yard than anyone ever should because she loves it and takes pride in having such a beautiful yard. She came to stay with me for two weeks after I had Owen because I needed my mom there to help me figure out how to be a mom to a brand new baby. She took care of a fifteen month old Owen when I had Emily until I learned how to juggle having two babies at once. She's often texting me, "That new movie came out this weekend. See if each of the kids wants to invite a friend and I can pick them up and take them out to lunch and then to the movie."  

So how can she have cancer? How is this happening? I think we all went through the motions of Christmas just trying to figure out how to soak it in. Of course I was looking at breast cancer websites and trying to figure out her prognosis. But we still didn't know much about her cancer at that point.  I remember being in my bedroom on Christmas Eve, wrapping presents for the kids, and I just stopped and sat down on the floor next to my bed. Eric walked in and found me sitting there crying. He put his arms around me and told me that everything was going to be okay. "But how do you know that?" I asked him. As I cried I said to him, "I feel like I'm walking around in a nightmare that I can't wake up from." And that's really how I felt. Scared to death and trying to figure out how to wake up from the nightmare. 

We had to leave the day after Christmas for a hockey tournament for Owen. It was the absolute last thing I wanted to do at that point in time. I didn't not want to get in the car and drive five hours away from my parents with this going on. But I also knew that nothing makes my mom happier than seeing Owen play hockey and how much he loves it, and I knew that if we canceled the trip she would be upset. I knew there would be much socializing on the trip and I just was not feeling up for it. I wanted to crawl into my bed and just cry and sleep. But I couldn't. And I didn't. Instead we celebrated Christmas as normally as possible. Went to my parents for Christmas dinner like we always do and had a nice, if somewhat subdued Christmas. We played around with my selfie stick and some presents that the kids were excited to get, and tried to make things as normal as possible, but we still felt the dark and heavy word "cancer" hanging over us. (At this point the kids did not know yet. I didn't see any reason to tell them until absolutely necessary.)


The next morning we woke up and started packing for our drive, and the next five days or so were consumed by hockey. Everyone was very understanding of what I was going through and couldn't have been more supportive.  Unfortunately, while we were gone my mom got pneumonia. The next day, my aunt passed away (my mom's sister), but my mom was too sick to travel to Maryland for the funeral. I knew that had to have been hard for her. Another devastating thing was that my parents' dog of sixteen years was dying. It was time to release him from his misery, and so just three days before my mom's surgery to remove the cancer my dad had to take Andy to be put to sleep. It was a very dark time for all of us. 

Friends were trying to help, but I know no one really knew what to do. I had responses ranging from super supportive and checking in with me daily, to people going completely dark on me, to others saying they didn't know what to say or what to talk about. I tried so hard to make it clear that this was all new to me as well. People said that they didn't want to talk about their own lives because their own situations seemed so trivial compared to what I was going through. But I tried to explain that no matter how trivial something was next to the big bad word "cancer," it was still their reality and I still wanted to hear about it. I told them, "I want you to ask about my mom. I don't want you to feel weird asking about her. And I'll never get tired of talking about it. But I also want to hear about things going on with you. I want to hear about your issues with your car, or your problem finding the right outfit for a special event. I want to talk about trivial things like the Real Housewives and The Bachelor. Basically nothing is off limits. But talk to me. Don't leave me. Don't disappear on me. Because that is the one thing that I can't take right now. I need my friends. But don't feel weird with me. Just be my friends like you always have."  And for the most part I think that worked. I still had some friends kind of slip away into the distance (and I have friends from all walks of life, from the gym, to the school, to my neighborhood, to hockey moms, etc. So if you are reading this, don't panic and think I'm talking about you, because it's very likely that I am not.)

New Years came and went, quietly, then Owen's birthday. We met my parents for lunch on Owen's birthday because we had a Sharks game to go to that night. 





And three days later was my mom's surgery to remove the cancer. My parents had already met the surgeon several times while I had been gone for Owen's tournament and really liked him. I met my parents at the hospital that morning at 7am. I left the kids home with Eric and asked him to take them to school. By then we had explained that Grandma was having an operation. The kids asked where, Eric said "On her chest." And the questions stopped. It was actually funny. Fine with me. Let it sink in and we'll take it from there when necessary. Next time I think I hear them listening in on a phone call I'm just gonna say, "Oh yes, and the growth on my butt is getting worse." Then I know they'll stop listening and mind their own business. Anyway, the nurse who helped my mom that morning could not have been better. So nice, so caring and warm. Very talkative We were nervous, and we needed someone like that. She had a southern accent and she told us about her "mama" who had also fought and beat breast cancer. And she told my mom that she would beat it too. I know the three of us were terrified, but we are a pretty stoic family. We don't go around showing a ton of emotion all the time -it's just not who we are together. On my own, I'm a freaking ball of emotion at all times. I cry at Kleenex commercials, I cry when I see a dead squirrel on the road, I cry when I hear a kid crying in the grocery store. But as a family unit, we still take our cues from the families of the 50's. Even still.....there were moments where it was impossible to hide our terror. It wasn't even fear. It was terror. Step one, take her back and inject some sort of dye into her body to help guide the doctor when cutting out the cancer. They came to get her and told us that it was going to be a good hour before she was returned from radiology. The radiologist and nurse suggested (and so did my mom) that my dad and I go grab something to eat. We told my mom that we'd be back, and shakily made our way to the cafeteria of the hospital. But we were also very close to a shopping center with a lot of other choices, so we decided to go to Panera Bread, not even a mile away. We had met at the hospital, so as we walked out to the parking lot, I saw my dad's gorgeous Maserati sitting in the parking lot. My dad said to me, "Since you know where the Panera is, why don't you drive?" Staring at that beautiful car that comes with the price tag that could buy you a house in most Midwest states, I stuttered, "Oh...no. I don't think so. I'm really not comfortable.... what if I crash?......" Then I saw my dad look at me with a furrowed brow and then glance over at my Acura sitting right across from us, and I shook my head, suddenly realizing, "Duh! He meant my car!"  Wake up, blondie! "Oh!" I said. "Of course! Yes, I'll drive! Let's go!" I grabbed my keys from within the depths of my purse and unlocked the doors, feeling so embarrassed by my stupid blunder. Looking back, I think it's hilarious, but at the time I just felt stupid.

So off to Panera we went, where we ate a shaky breakfast. Eric met us there, and then followed us to the hospital. We waited for my mom to come back from radiology and she did, just moments after we got back to her little pre-op room. My dad choked up when he thanked the nurse for being so nice to us, and I had to look away so I didn't start to cry. My mom came back and we made some small talk while we waited for her notoriously late surgeon to show. Once they got word that he was there, the tech came for her. As they wheeled her away, we each hugged her with tears in our eyes. Hating to see us so scared and emotional, she said, "Oh, go have a party! This will all be over when I'm done." If only. But we laughed and watched them wheel her away. We'd been told that it was going to take hours and there was no reason for us to sit there waiting. I live about two miles from the hospital and my parents only about three miles away from the hospital. I went home to take a quick shower and my dad went home to make a few phone calls, and we agreed to meet back around noon. Once I showered I didn't know what to do with myself, so I went back to the waiting room and worked on addressing my New Years cards. My dad returned soon after, and called back to the pre-op area to check for updates, but they didn't have any yet. We waited for awhile longer, my dad made a phone call to his credit card company to tell them that they only credited them $30.00 when he actually had sent $3,000, and at the table across from me, I listened to a lady call one place after the next trying to find the best price for an ink cartridge for her printer. I watched the group of turkeys congregating outside the window and scared them off when I got my phone out to try to get their picture, and finally the surgeon walked out. He shook our hands and told us that everything looked great. He felt confident that he got the cancer out with clear margins, and that he did take a couple of nodes, but not because they were cancerous, but because they were attached to tissue that he'd had to remove and if he'd left them they'd sort of just been left to hang there and it was easier to remove them. He said that the nodes they had tested turned out to be clear, and that the tumor would be sent to the "tumor board" and they would determine the best course of treatment. Most likely chemo and some radiation just to be safe, but over all, the prognosis was good. 

We went back to see my mom and she was doing remarkably well. They called in a few prescriptions for her, and since Safeway is notorious for not having things ready, I called the pharmacy from the hospital to let them know that my parents were on their way straight from the hospital and to please have the stuff ready. We helped my mom into the car and off they went for her to rest and recover. I went home that night feeling exhausted, but also relieved. For the first time since that awful phone call I felt a sense of peace. We faced what had been thrown at us, and she was going to be just fine. Some sucky chemo, some radiation, and all of that just to be safe, but all in all, clear nodes and the cancer was gone.  I posted this picture on Instagram that night. 


In the days following the surgery, my mom even expressed that same sense of relief. About a week or so after the surgery, she met with her oncologist, and she called me with an update. The margins looked clear, which meant that the surgeon had cut an ample amount of area surrounding the cancer to hopefully catch any sneaky cancer cells that were trying to spread. The cancer hadn't metastasized to any other areas and she was in good shape. But there was one more little piece of info for us that at the time seemed innocent enough. The type of cancer she had turned out to be pretty rare. It was called triple negative metaplastic carcinoma. Hmm....okay. Weird. I thought cancer was cancer. Didn't know that there were so many subtypes, but whatever. They got it out and she was good to go as far as I was concerned. 

Of course that night I started doing some Googling and my feelings of relief and peace quickly disappeared and were replaced with pure terror as I read things like, 

From the Johns Hopkins website - Triple negative breast cancer is estrogen-negative, progesterone-negative and HER2-negative. Approximately 10 to 20 percent of all breast cancers are triple negative. People who are younger, African American, Hispanic, or who carry the BRCA1 gene mutation, which is a genetic marker that indicates high risk for developing breast cancer, are more likely to have triple negative breast cancer.
Triple negative breast cancer does not respond to hormonal therapy or other therapies that target HER-2. It is very understandable to feel concerned about treating this kind of cancer effectively to prevent it from returning. Researchers are currently investigating new medications and therapies to help treat this type of cancer.

Well that didn't sound so good.  


From BreastCancer.org -  About 10-20% of breast cancers are found to be triple-negative. For doctors and researchers, there is intense interest in finding new medications that can treat this kind of breast cancer. Early studies are trying to find out whether certain medications can interfere with the processes that cause triple-negative breast cancer to grow.

Tends to be more aggressive than other types of breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment.

Five-year survival rates also tend to be lower for triple-negative breast cancer. A 2007 study of more than 50,000 women with all stages of breast cancer found that 77% of women with triple-negative breast cancer survived at least 5 years, versus 93% of women with other types of breast cancer. Another study of more than 1,600 women published in 2007 found that women with triple-negative breast cancer had a higher risk of death within 5 years of diagnosis, but not after that time period.

Tends to be higher grade than other types of breast cancer. The higher the grade, the less the cancer cells resemble normal, healthy breast cells in their appearance and growth patterns. On a scale of 1 to 3, triple-negative breast cancer often is grade 3.

My mom's was grade 3. On a scale of 1 to 3, hers was a 3. The worst.

It can feel upsetting and even scary to find out that you have a form of breast cancer that (1) is often more aggressive than other types and (2) isn’t a good candidate for treatments such as hormonal therapy and Herceptin. But triple-negative breast cancer can be treated with chemotherapy and radiation therapy, and new treatments — such as PARP inhibitors — are showing promise. Researchers are paying a great deal of attention to triple-negative breast cancer and working to find new and better ways to treat it. “This is an exceptionally hot area of research in the breast cancer field,” says George Sledge, M.D., medical oncologist and Breastcancer.org Professional Advisory Board member. “There is immense interest among drug developers, pharmaceutical companies, and breast cancer laboratory researchers in finding targeted therapies for these patients."

 

I don't want to hear about intense interest in finding new medications that can treat this type of breast cancer. I wanted to hear about medications that are known to successfully treat this type of cancer.  Let me tell you this. When you or someone you love is diagnosed with cancer, or any scary and often deadly disease, Google can be both your best friend and your worst enemy. And I'm a Googler. It's what I do. I Google. About fifteen times a day. Sitting at the bagel shop in the morning with my friend and she says that her hands look like a crack whore. Really? Let me Google images of a crack whore's hands and then look at hers. Um, not really. Just get yourself a manicure and some lotion and you're good to go. Listening to Barry Manilow while putting on my makeup and wondering if he's gay, despite singing about Mandy. Maybe "Mandy" was really "Manly."  Well...let's ask Google. Hey Google, is Barry Manilow really gay? Turns out, in case you were curious, the official word is that he is not gay. But we all know that he is. As long as he's happy, I really don't care. So once I figured out the triple-negative aspect of it, I tried to think of it as the cancer cells each having little antennae attached to them in the form of hormone receptors. And if you have hormone receptors on your cancer cells, it opens you up to any number of hormone based medications that can help to blast away the cells. But if you don't, well....it's not as easy. It means chemo. Not meds. Not the end of the world. No one likes hearing rare. And no one likes hearing that there are still major studies going on to figure out how to treat something you have. But still doable. 

But what was the metaplastic carcinoma part of it? Time for more Googling. And what I read scared the holy fuck out of me. There are no other words. 

From Johns Hopkins  - Metaplastic breast cancer is a rare form of breast cancer, accounting for fewer than 1% of all breast cancers.  It differs from the more common kinds of breast cancer in both its makeup and in the way it behaves. 
Like invasive ductal cancer, metaplastic breast cancer begins in the milk duct of the breast before spreading to the tissue around the duct.  What makes a metaplastic tumor different is the kinds of cells that make up the tumor.
When the cells of an invasive ductal tumor are examined under a microscope, they appear abnormal, but still look like ductal cells.  Metaplastic tumors may contain some of these breast cells, too, but they also contain cells that look like the soft tissue and connective tissue in the breast.  It is thought that the ductal cells have undergone a change in form (metaplasia) to become completely different cells, though it is not known exactly how or why this occurs.

From MetaplasticBC.com  -Metaplastic BC tumors are larger at presentation and grow at a 
rapid rate.

In the two weeks between the biopsy of my mom's tumor and the surgery to remove the cancer, her tumor had almost doubled in size. I'd call that pretty dang aggressive and fast growing. Even the surgeon was baffled by the growth.

I continued to Google. I stayed awake nights until my eyes were practically bleeding. And everything I learned was bad. Bad. Bad. Bad. I know some people get mad at the term "bad cancer." All cancer is bad. I get it. But this cancer is horrific. It's mean. It's nasty. It's aggressive. And even if you do get rid of it, it absolutely loves to return. But next time in your lungs, or your liver, or your bones. Triple negative metaplastic carcinoma does not want to take no for an answer. It wants to find a nice comfortable place to live in and do maximum damage. And it was living in my mom. I was now in a position where I had to share this information with my parents without scaring the ever loving crap out of them. How to calmly and lovingly tell them, "This is some bad stuff. Bad, bad stuff." Meanwhile, they were learning some of this on their own. They are no dummies. They had been warned by the surgeon though not to do too much Googling because there is a lot of misinformation out there. And I get it. Because he's right. But there's a hell of a lot of really, really good information out there. You just have to take the time to study and scour until you figure out what's real and what isn't.

I began to try to plant some seeds. First and foremost. Find out if my mom's current oncologist had ever successfully treated this rare and extremely aggressive type of cancer. If the answer is no, it's time for a new oncologist and stat.  Unfortunately this diagnosis took us by surprise, so the oncologist was just the name of someone my mom's primary doctor put her in touch with. Well, my mom tried to find out if her oncologist had ever treated triple negative metaplastic cancer. But she wasn't getting her calls returned. Bad sign. It took more than three or four phone calls to even find out what type of chemo this doctor planned to use on my mom. And even that phone call was not returned by the doctor - it was just info passed on by someone in her office. I continued to research and I began to become a complete basket case. But one thing I didn't understand was this. Why go through the absolute hell of chemo if the surgeon felt confident that he got all of the cancer out? Does my mom have cancer, or did she have cancer, but now it's gone?  Meanwhile people are making comments like, "Oh cancer. Another one. Wow, it's practically like the common cold. Everyone gets breast cancer nowadays. Your mom will be fine." And while I didn't appreciate someone making light of CANCER, I did get what they were trying to say. They were trying to comfort me by telling me that it was so common and so easy to treat and before we knew it my mom would be as good as new. Everyone had a story about a sister/cousin/aunt/grandma/friend who had breast cancer and never skipped a beat. And I know that every single one of these people was coming from a place of love and a place of support. But at the same time I wanted to jump up and down and scream, "But not this cancer! Not this one! And you don't understand! This one is different. It's nastier. It's meaner, it's more aggressive and it's more deadly!!" But instead I smiled and thanked them for the support and kept my feelings to myself. 

Time seemed to slow down. I continued to read. And then I found a group on Facebook. It was called, "Metaplastic Breast Cancer and Research and Information." It's a private group and you have to request to join. You can bet that I immediately clicked "Join" and then sent the moderator of the group a note telling her who I was and why I wanted to join. She accepted my request and to me, that was a huge turning point in this battle. Here was a group of women who had the same rare cancer as my mom! 433 members! From all over the world. Not all were triple negative, but they were all metaplastic. I introduced myself and was immediately welcomed with open arms. The "about us" section said: 

 This page is for you if:

- you are someone living with MpBC, or are supporting someone going through this disease, and wish to learn more about this type of cancer
- you are a researcher or medical professional interested in the study of MpBC, and wish to share your findings with others, and advance this field of research.
- you are a medical professional currently supporting a patient with MpBC
- you want to make a change and can help financially to support the research of MpBC
- you simply want to learn more about this type breast cancer


Yes, yes, yes! Me! I want to learn more. I am supporting someone going through this disease! So I started sharing my mom's story. And I started searching other message boards at cancer.org and other places. And what I was seeing so often were cases of people who had been diagnosed and treated for metaplastic breast cancer, who were treated as if their cancer was of the "regular" variety and here they are again weeks, months, years later with the nasty motherfucker back inside their bodies.  I continued to read story after story and one thing quickly became very clear to me. My mom needed treatment by the best. I didn't care if it meant traveling to the ends of the earth. She needed someone to treat her as if she had a ticking time bomb inside her body (which she did), and someone who knew how to diffuse the bomb and get it out. And no offense to the oncologist she was seeing, but it couldn't be any old doctor. It had to be someone who knew their stuff. I continued to learn, learn, learn. And what I found was that there was a doctor at MD Anderson Cancer Center in Houston, Texas named Dr. Stacy Moulder, and she knew her shiznit. She knows this cancer, and she treats it, and many of the women on this board were literally living in Texas while being treated by her. THIS was who my mom needed to see. This was recommended to me over and over by the women on the board. "Tell your mom to go see Dr. Moulder." "Take your mom to MD Anderson." "Please look up the info for Dr. Stacy Moulder at MD Anderson. That is who your mom needs to see." But I kept thinking to myself that we live in a pretty metropolitan area. We have UCSF, we have Stanford. Surely there are doctors there who can treat my mom. But Dr. Moulder's name kept coming up over and over again. After only a day or so of being a member of this group a very nice girl named Ashley offered to talk to me on the phone. She had supported her mom through a very similar story and ended up taking her to see Dr. Moulder as well. She answered as many questions as she could, but by then I was like a dog with a bone. We were going to see Dr. Moulder. We had to. Now, how to broach the subject with my parents. 

I spoke a little with both of them while trying to keep things from sounding too dire. And again, I don't want to try to make it sound like it was all me. They were researching on their own and trying to learn things too. As were my sister and brothers. The surgeon wanted to install a port to make the administration of the chemo a bit easier as my mom has really ridiculous veins that roll away in panic as soon as they see a needle coming. I inherited those from her - thanks a lot, Mom! ;-)  So my mom and dad met with Dr. Gottleib and they told him about the group that I found. Dr. Gottleib basically blew me off and said something to the effect of, "Impossible. This cancer is too rare.  There are probably only a couple hundred people in the entire world walking around with this type of cancer and a lot of people confuse the words metaplastic with metastatic. That's what she's found. A group of people who have metastatic cancer. Most oncologists will go their entire career without ever seeing a case of triple negative metaplastic carcinoma." Hmph. No disrespect doc, but dude underestimates my Google skills. I'm not confused in the least. And these women do have triple negative metaplastic carcinoma. Boom. I explained to my mom that I did know what I was talking about, and she said, "I know, Mickie. I just didn't know how to politely tell the man that operated on me, and was about to operate on me again that you really did know your stuff." Fair enough. I understood that. 

At that point, the plan was to have the surgery to install the port in her chest, and then begin chemo with Joe Schmoe over in Pleasanton who had yet to return any of my mom's phone calls. So I got the contact number for Dr. Moulder in Texas and I called her patient representative. Who had attitude from the minute she answered her phone. I gritted my teeth and smiled through the conversation though and asked how to get the ball rolling on an appointment. First thing she wanted to know was if my mom knew that I was calling. I said not yet, but that I'd tell her right away. She took some info, including my mom's phone number and said that she would  have to speak to her, and if she called her as soon as we hung up, was my mom going to take her call. I asked her to give me five minutes to warn my mom about the phone call and that she would take her call. Great. Nothing like pressure. So we hung up and I called my mom, who was at the bird seed store with my dad because it was senior discount day and my mom takes very good care of the many, many birds in her yard. (And the squirrels, much to her chagrin.) I stuttered and hemmed and hawed and finally told her that I was sorry, but some woman was going to be calling her because there was a doctor I wanted her to see in Texas. My mom was very understanding and said that she'd speak to her when she called. The great thing was that my mom, and really my dad too, were very open to any info that I was finding and giving to them. I remember one night sitting in my dad's office with him while my mom was in the kitchen with the kids and my sister who was visiting at the time. I looked at my dad and said, "Dad.....I've been doing a lot of research, and this is bad. It's really, really bad." We both started to cry, but sucked it in as much as we could and he said, "I know." So I told him that I was learning as much as I could and he was completely open to that. My dad was a high-ranking, well respected, very powerful executive in his working days, and seeing his eyes fill with tears just literally brings me to my knees.

So after my mom gave the mean lady at MD Anderson her initial info, I spoke to them a little more about what I'd learned. I was pleasantly surprised when they were both on board immediately. Coincidentally there had been a program on "60 Minutes" just days before about MD Anderson and unfortunately it wasn't super flattering. While it touted them as the best cancer hospital in the US, if not the world, it also talked about price gouging. My dad doesn't stand for that. He's not cheap, but he drives a hard bargain. He's the guy that neighbors call when they're going to the car dealership to buy a new car because Burr Schinner is going to get them a better deal than they ever knew possible. He's going to get the car for thousands less than sticker price, and the sales guy is going to throw in floor mats and free detailing for a year before it's over with. And he will walk away in a heartbeat knowing that if they won't do it, someone else down the street will. So to have a report of price gouging air on TV just at the same time that I'm trying to convince them to go to that particular hospital made me nervous. I said to him, "I don't know how much this consult will cost." Before the words were even out my mouth, my dad said, "I don't care. I don't care how much it costs." He was just as scared as I was. 

Ultimately the goal was to go to MD Anderson, meet Dr. Moulder, get a treatment plan in place that she drew up, and find a doctor locally to carry out the treatment. That was the ideal situation. My mom wasn't thrilled with the idea of moving to Texas for six months. But she would have done it if that's what it took. It took what felt like forever, but was probably realistically ten days to finally hear back from Dr. Moulder's office. In the meantime, through the wonderful Facebook group, I was put in touch with a woman from the group who lived in San Francisco and had been treated successfully by an oncologist in San Francisco that she absolutely loved. We spoke on the phone and she told me all about him. She had also consulted with Dr. Moulder in Houston. 

While I knew that the cancer had been removed, what I was trying to avoid was having my mom be one of those stories where she had it removed, was treated by Dr. A or Dr. B, then had a recurrence almost immediately because Dr. A didn't know the nature of the beast we were dealing with. Taking a, "let's try this" type of approach was unacceptable. So my mom called this oncologist in San Francisco, and while none of us were thrilled with the idea of weekly trips into San Francisco for treatment, if it meant she was getting the right treatment, it was a small price to pay. She got scheduled for a week later. We felt like the clock was ticking and everything was taking forever to happen. Meanwhile life goes on and you begin to live a new normal. Cancer was the new normal for us. It wasn't easy, and there were days where I'd burst into tears at a stoplight for no reason and then five minutes later meet friends for lunch and slap on a smile and talk about the latest news or entertainment gossip. I felt the need to try not to make waves in my friendships. I don't like to lean on people and I tried so hard to just be normal, smiling Mickie. And sometimes I was. But sometimes I wanted to scream like Nancy Kerrigan, "Why!!?!? Whyyyyyyy?!" But adults don't do that, so I tried not to. I did have one minor nervous breakdown in the neurologist's office when there was a misunderstanding about the type of appointment I had booked as I was waiting for Aetna to approve Botox for my migraines, but otherwise I thought I'd been holding up semi-okay. And really, the doctor was an ass, and walking into the room carrying his laptop, telling me, "I don't have time to see you today, next time do what everyone else does and make an appointment before you just show up and mess up my schedule, but you're here now, so what do you want?"  wasn't really the way you'd want to be greeted, ever. So when I started crying and gave him the upset wife treatment as I stood up and said, "Well, sorry to be a bother! Don't let me interrupt your busy schedule!" as I started to storm out of the room was sort of called for. I don't think he expected that, and he eventually insisted that I stay, and the major crisis was averted, aside from my embarrassment each and every time I return to the asshole's office. (But he holds the keys to the Botox, so mama will keep going back.) And by the way, I had made an appointment, it was actually a mistake on the part of the girl who took my phone call when I had called to make the appointment. 

Anyway, the day finally arrived to go see the doctor in San Francisco. We drove to his office, three balls of tightly wound emotion and nerves and found a parking spot on the street and took the elevator up. He reserves Mondays for new patients, so it was very quiet in there. The office is on the top floor of a building that overlooks the San Francisco Bay, the Bay Bridge, and the Ferry Building. It's spectacular, and it's huge. This was a picture I posted on Instagram that night. 

  
We were led into the doctor's office and sat down in chairs to wait for him. The doctor also paints and we noticed paintings with his signature throughout the office as well. It's an integrative oncology center, meaning he does it all right there. He has a nutritionist, a therapist, he administers the chemo, he treats patients, and more - all right in one place. He's a little guy, dressed in cords and a button down and very unassuming looking. We had already sent my mom's medical records so he had them ready. The girl I had spoken to told me that Dr. Smith used to be with UCSF, and he had found that his patients that seemed to thrive the most were the ones who were also seeing a nutritionist, having massages, possibly accupuncture, maybe using herbs, etc., and he wanted to integrate that into his practice, but because it didn't fit within the parameters of a teaching hospital, he didn't have that freedom there, so he broke out on his own and created this wonderful space. Here are a few pics from his website.  (That's him hugging and kissing his patient. Because that's the kind of man he is.)




The doctor came in, introduced himself and got right down to business. He was warm, and calming and literally everything we needed him to be. He clearly knew his stuff, and he clearly knew how to deal with triple negative metaplastic breast cancer. (Such a mouthful, I know.) We told him about the upcoming appointment with MD Anderson, and he fully supported it. He also told us about another "thing" that he likes to do with this type of cancer. It's an expensive test and insurance companies hate it because it's new and cutting edge and they don't like to pay for it, but in cases like this he felt that it was invaluable. MD Anderson had already sent for my mom's tumor that was sitting in a jar or something in the hospital in San Ramon, but it hadn't left yet. Dr. Smith just wanted a piece of it before they sent it off. He was going to send it to a place called Caris Labs. They were going to take my mom's tumor and cut it into about 80 tiny pieces, and then they were going to take all the different possible chemo drugs and test the reaction of the tumor against the drugs. By doing this, they can immediately tell which chemo drug my mom's tumor freaked out over. Sounded like a no brainer to all of us. Yes, please, get your piece of that tumor before it goes off to Houston. Send it off to Caris. Let's cover all bases. There was a surreal moment when I looked at my mom and dad sitting there, and this man that we had just met talking about how to get my mom's tumor from point A to point B and how to best attack it and find it's Achille's Heel. So weird.  He fully supported my mom's trip to Houston to speak to Dr. Moulder, and basically said, "Okay. You guys go to Houston. I'll send my piece of the tumor to Caris. We'll get the results from all of that and reconvene back here in about two weeks. Sound good?" And it did sound good. He gave all three of us warm hugs as we left and I think we all exhaled as we walked out of his office. 

Three days later it was time to fly to Houston. And no matter how many times I begged to go along, my parents insisted that I had already done so much and they could handle this. The control freak that I am, it was hard for me to hear that, but I wanted to respect their wishes. Some people said, "Just show up at the airport." And believe me, there was a part of me that wanted to do that, but at the same time I didn't want to take completely over. They are still my parents, and I didn't want to disrespect them. I helped them book their flights and made their hotel reservation for them, but the rest was up to them. One thing Dr. Smith had warned my parents about was that as great as MD Anderson was, you would feel like just a number there. He told them that they would probably have to tell fifteen different people my mom's name, and what they were there for, and as long as they knew that going into it, it was still well worth the trip there for the knowledge Dr. Moulder has on metaplastic breast cancer. 

So they flew to Houston and life continued here. Laundry, bills, taking care of our own dogs, rats, kids,  and a revolving door of friends' dogs here and there. I had to say no to some, which I felt bad about, but things were just too up in the air some of the time.  I had quit my job teaching classes at ClubSport because I wanted as much free time as possible to help my mom and dad through this journey, and as much as I missed my people there, it was a relief not to have to plan choreography and worry about finding subs. Dr. Moulder met with my parents and gave them her plan, which was a combination of two different types of chemo. AC -which is Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide). Four rounds of that, given every three weeks to let her body heal in between treatments because they are pretty nasty chemo drugs. After four treatments of that, she wanted her to switch to 8 rounds of Taxotere. Then 8 weeks of radiation done daily.

We took that info back to Dr. Smith and he agreed that it sounded like the same exact plan he would like to follow. But we were still waiting for the results from the Caris Labs. At that appointment he also more clearly explained just what metaplastic meant in easier to understand terms. He said to imagine a cancer cell as a cat. When you look at a cat, you can tell just by looking at it if it's a regular pet cat, a baby kitten, a tiger, a lion, a leopard, a mountain lion or a cheetah. And let's say your cancer looks like a leopard. You said, "Okay, leopard cancer cell equals  insert chemo drug here." Or, "Oh, you have lion cells. So we use this other drug." But metaplastic cancer has maybe the body of a lion, the claws of a kitten, the stripes of a leopard, the spots of a cheetah, and the mane of a lion. Well shit, how do we treat that?" And that's what makes it so hard to figure out. This type of cancer didn't even have a name until 2001. That's how new and rare it is. He also explained that he has an entire pantry of cancer drugs that he can use, but that some of them leave lasting damage. He said that he wasn't going to use anything on my mom that he wouldn't be comfortable using on his own wife. This man is a godsend to us. I can't imagine where we would be right now if we hadn't found him. I really, really can't. We waited for that fax to come from Caris to find out how my mom's tumor reacted to the AC and Taxotere, but as long those drugs did a good job of destroying it, that was going to be the plan. By then, my mom had had the surgery to install her port, so he checked that while we waited for the fax and all looked good. Her incision from the surgery to remove the cancer was infected, but she was already taking antibiotics for that. Finally the fax came in, and the verdict was AC and Taxotere after all. We scheduled her first chemo appointment for the following week and were on our way back home. 

 Unfortunately my mom's first chemo was scheduled for the same day that Eric and the kids and I were scheduled to fly to San Diego for a hockey tournament for Owen. It was also on Eric's birthday. There was no way I was going to walk this path alongside my parents all this way and ditch them for the first chemo. Before I even mentioned it to them, I changed my flight to go the next morning. I would still arrive just in time to take a taxi to the ice rink and make the first game, and I'd be able to go with them to my mom's first treatment. 



We met Dr. Smith before he administered the chemo, and then we moved into the actual chemo room. He explained the entire process, talked about how she would lose her hair on day fourteen specifically, and that he suggested that she just go ahead and shave her head, "then go have a margarita and cry." He explained that he was going to call in three different nausea meds. One for mild, one for medium, and one for severe. He told her that he wanted her to take a severe that night before bed (Zofran), and again the next morning, whether she felt like she needed it or not. After that she could follow her body's lead. Whatever she needed, that's what she needed to take. And because they were all different types of drugs, she could follow a mild with a medium just an hour later if she felt the need. We talked about other side effects to watch for, and off we went. He found her port and got started. My mom insisted that my dad and I go have some lunch, and although we didn't want to leave her, we walked outside and found a restaurant literally right across the street from the office building. We both had the same Thai salad and loved it so much that we go back every time now. 

After that first emotional chemo treatment, I went home and packed for yet another trip that I didn't feel like taking. And I got on a flight the next morning and just felt like I was in a dark place, yet walking around in this bright world that I wasn't ready for yet. Hard to explain. Like I was in a fog. It was a hard re-entry into the real world and my first 24 hours in San Diego were pretty tough ones. But I eventually adjusted and enjoyed the trip as much as possible while knowing what was going on at home. Owen's team did great and it gave me such great pleasure to watch him play. I enjoyed taking Emily shopping at the mall across from the hotel, and we even enjoyed a family day at the San Diego Zoo before flying back home.

So far my mom has had three chemo treatments. And they suck. Sure, she's in a comfortable and warm, inviting room with a fish tank that is the doctor's baby, with pretty paintings on the wall, and comfortable recliners, and that jaw dropping view of the bay and the bridge to look at. But the fact remains that aside from the IV bag of fluids and the IV bag of nausea meds that will hopefully get her through to the next morning without being violently ill, the rest of what is going into her veins is poison. And the second of the two drugs is bright red. As the doctor says when he pushes it into her IV, "This one always gets a lot of attention because it has to be so dramatic." It stains her urine red, and for people who used to wear hard contacts, it even tinted those red, for it changes your tears to pink. Let's poison you just to the brink of "I can't take this for one more second" and then we'll back off and give you three weeks to recover before we do it all over again. Some doctors even wear an actual hazmat type of suit before administering the red one. Some people call it the Red Devil because of it's color and because it's just fucking evil. My mom has lost her hair, but that hasn't stopped her from slapping on a hat and a blanket and sitting in frigid temperatures to watch Owen play hockey. She might be so weak that she can barely stand up from the couch, but that doesn't stop her from dying Easter eggs with my kids. And I can guarantee you that she'll show up at my house on Easter Sunday with the awesome potato salad that only she knows how to make so well. And my dad is by her side every single minute. He won't leave her for even a minute if she's sick. He's cooking every single meal for them, picking up every prescription, checking on her while she's sleeping and answering texts for her when she's too weak to do it herself. If I'm being brutally honest, those 4-5 days after chemo are the shits. They suck. But she pushes through it, because that's what she does. And we support her because that's what we do. 

My sister came out for this last chemo treatment. I can't even imagine how hard this must be for my siblings who are so far away. My job is to be there for every step, but I'm lucky because I can be. They can't. And I know it's so hard for them. My dad and I took her to lunch at our chemo day lunch place. And she ordered the same Thai salad that we did. It was nice to have her there.
One day, once my mom is finished with her chemo, she's going to come with us and eat the Thai salad too. And we will celebrate with cocktails even if it's 11:30 in the morning. And someone else can drive our asses home that day.


Meanwhile I am still active on the Facebook group, and the support I have found there was has been priceless to me. I have been navigating a phase in my life that I had no idea how to handle. It was all new to me, and I was only doing the best I could. Like I said, there were days where I felt okay about everything and where we were, and then there were these moments that came at me out of nowhere when I would just break down. I'd be brushing my teeth and suddenly I'd cry so hard that I'd gag. Then five minutes later I'd paste a smile on my face and tuck the kids into bed. Was that the right thing to do? I don't know. I just did what I had to do to survive and disrupt the rest of the people in my life in the smallest way possible. I'm sure I made mistakes, and I'm sure I still will. When your husband wants to take you on a date to take your mind off things, but all you want to do is sit in your room and watch Housewives, do you get dressed and go out to make him happy, or do you tell him no? I don't know. So I got dressed and went. When your friend tells you that she doesn't know what to say to you anymore, should you let her off the hook and tell her that she doesn't need to bother with you anymore because it's too hard for her and you don't want to stress her out? Or do you beg her to stick around because you need her? I don't know the answer to that. And then I'd log on to the Facebook group and see the soul crushing announcement that one of the women from the group had passed away. And I'd want to curl up into a ball and howl. But life goes on for the rest of us. So into the shower I'd go and then I'd drive to Lafayette to get my eyelashes done where I'd listen to the lash girl tell me all about the crush she has on her personal trainer. Some days I don't even remember what I did the day before. Some moments I remember with excruciating pain. But I'm doing the best I can and I'm trying to be strong. For everyone. For myself. For my kids. For my mom. For my husband. And my dad. For my sister. And my brothers. And for my sisters on the Facebook group who need support navigating the shitty world that is triple negative metaplastic breast cancer. It's all I can do. Just keep moving. Just keep smiling. And cry when I need to. And I hope that's okay with all of you. Because it's the best I can do right now. Courage isn't always something that looks like a lion. Sometimes courage is just putting one foot in front of the other. And when you fail at even that, you just try again the next day.
But I will survive this. My dad will survive this. But most of all, MY MOM WILL SURVIVE THIS!!!!! And I will be standing by her side every minute of the way. 

Monday, November 17, 2014

Perspective

This morning I woke up with two kids who weren't feeling well. Last night Emily was complaining of a headache and a sore throat, and she just wasn't herself. I kept finding her lying on the floor in various parts of the house. (Usually next to one of the dogs, but still, unusual for her.) Owen didn't really want much in the way of dinner last night, and both kids just seemed somewhat rundown. Then last night Owen came into our room at 2am and said that he'd been awake with a stomachache since midnight. Neither kid was feeling well this morning and I was trying to decide how much of it was that they were just worn out from a busy weekend or if they really were sick enough to stay home from school. I ended up letting them both stay home, even though Eric was sure that I was being a pushover. The best way to gauge Owen for how well he is feeling is to threaten that he can't go to hockey practice, because he won't miss hockey practice for anything. So I told him that if he stayed home from school, he couldn't go to hockey tonight, and he was fine with that. So that at least tells me that he's being honest about not feeling well. 

With two kids sick at home, it was a lazy morning for all of us. They were lying down watching a movie and I was putzing around the house, working on laundry and playing around on my computer. Just before lunchtime I decided it was time to get my butt in gear and run to the grocery store to grab some soup for them and stuff to make dinner tonight. I didn't wash my hair yesterday because we were recovering from two late nights in a row and Owen had a fairly early hockey game in San Jose yesterday morning. So many of my friends keep trying to tell me how great dry shampoo is for long hair, and that I shouldn't be washing my hair every day because it's not good for it, but I've always been a wash everyday type of girl. My hair is blonde, so when it gets a little dirty, it's easy to see it. I've tried a couple of dry shampoos, but I hated the feel of them. I had also heard that baby powder works well for blonde hair, and I thought I recalled seeing a container of it in my bathroom cabinet, so in honor of a quick trip to the grocery store, I decided to try the baby powder. I went into the bathroom and leaned my head over the sink and tried to sprinkle the baby powder on my scalp along my part. But I didn't shake the container first, which was a rookie move, I'm sure. A stupid mistake, definitely. So a clump of baby powder that had been stuck at the bottom of the container came dislodged and plopped down to the opening, thus dumping a huge gust of baby powder all over my head, face, shoulders, neck, bathroom counter and floor. I was so frustrated. It took what felt like forever to brush all of the powder off myself and through my hair, and to also clean up the big mess it made. I finally got myself ready to leave for the grocery store, where no doubt someone was going to either think I had a white powdery drug problem or a powdered donut problem (and it's the latter, in case you didn't know), and I told the kids where I was going and that I'd be back really quickly. (They are just now getting old enough that I'll leave them for short periods of time just to run to the store.) I came downstairs to leave and was perplexed when I didn't see my car keys hanging on the hook in the kitchen. But then I remembered that my keys were in my purse. And my purse was in my car. Which was in the driveway. And locked. Seriously? 

I had taken my keys with me yesterday to Owen's hockey game, and when we got home I was so worn out from the busy weekend that I just left my purse out there (not smart to do, I know). Then Eric locked the car and it was all but forgotten. And when he left for work this morning, he took his keyring, which has the spare key to my car on it. Which meant no trip to Safeway for me. Between the sick kids, the baby powder incident and the keys being locked inside my car, I felt like I was qualifying for someone having pretty bad day. 

I went back inside after checking to make sure that my car was indeed locked, which it was, and I told the kids that the trip to Safeway was off and that I'd find something for them in the kitchen. I found two cans of soup pushed way back in the back of the cabinet so I made those. As I did this I was also unloading the dishwasher and cleaning up in the kitchen while smelling of baby powder and kind of lamenting my bad luck.  The kids were still lying down upstairs and I was playing a new Lorde song over and over on repeat as I worked in the kitchen. As the music played I heard a fire engine siren passing by on the street that is behind my house. Normally when my kids are at school and I hear sirens, I immediately check the Pulse Point app on my phone to see where they are going. Call it paranoia, call it being over-protective, but there's a sense of comfort in looking at that app and seeing that they are going to a fire across town instead of a medical emergency at the school. But since my kids were upstairs I didn't pay it much mind. Until I heard the siren stop and the back up beeping noise a fire truck makes when it backs up. We live on a hill up above the freeway and directly behind us is an overpass that crosses above the freeway below. Occasionally there will be an accident back there, so it's nothing shocking to hear the sirens stop, but when I opened the back door and ran up to the back of my yard to look out, I was shocked at what I saw. 

It took me a minute to see because the fire truck was pulled across the intersection blocking my view. All I could see were several police cars, an ambulance and a few bystanders' cars that had been abandoned and people standing in the street. I couldn't figure out where the accident was because none of the cars looked like they'd crashed. Then the fire truck pulled forward, and there, standing in the very middle of the overpass, on the outside side of the guardrail, facing away from the street was a man who was clearly ready to jump down onto the freeway below. He had positioned himself so that he would have been jumping into the traffic that had just exited from underneath the overpass, so they wouldn't have had any warning before hitting him. I could not believe my eyes. 

As I stood there watching I realized that if my kids came downstairs and saw me standing there, they'd come out and ask what was going on, and I did not want to have to explain that to them. A couple years ago a local teen girl jumped off the Golden Gate Bridge and died and the whole town wrapped ribbons around the trees and organized a candlelight vigil for the family of the girl and I had such a hard time answering the questions that brought up. At that point I don't even think my kids knew that killing yourself was even a thing. (If that makes sense.) And I didn't really want them knowing that it was a thing. But kids at school talk and some kids have older siblings and not everything is easy to keep quiet, so I did have to answer some questions about it and I did not want to be doing that again anytime soon. So because I didn't want them being exposed to this, I ran inside and upstairs to my room. I told them that their soup was ready and I went into my bedroom and locked the door. As I ran to the window I texted Eric, then called him, but he was in a meeting, so he declined my call and texted me back asking if it was urgent. I was really freaking out so I posted on Facebook something like, "OMG, there is a man on the freeway overpass behind my house threatening to jump!" It was a knee jerk reaction, but I felt like I wanted to do something, I just didn't know what I could do. Clearly he was in the hands of professionals at that point and all I could do was watch and pray. There were two regular "citizens" talking to the man, and then several police officers slowly approached him. He had his back to me, but he looked to be somewhere between 20-40 just based on his physical appearance. He was holding on to the guardrail with one hand and gesturing with the other hand as they tried to talk him down. At one point he had something in his hand. It looked like it was possibly a phone. He waved it around a little bit as he continued to gesture. Then he stopped interacting with them and turned back to look at the freeway below. When I first saw the situation there were still cars zooming below him, but by this time, the traffic had been stopped. 

I called my mom and talked to her as this was going on because even though it wasn't about me, it was really freaking me out. It was like something out of a movie. The group of people continued talking to the man as everyone else just stood off in the background. This went on for a good 5-7 minutes, and then all at once three police officers tackled him and pulled him back over the railing and to safety. I was shocked at that, but also so relieved. They had the man on the ground on the sidewalk for several minutes, and then eventually strapped him into a stretcher and moved him into the back of an ambulance. After another fifteen minutes or so, the whole area was clear, like nothing ever happened. I was still reeling though. I went downstairs to check on the kids who were eating their soup in front of the tv and totally clueless about what had just been going on outside. 

There had been several comments on my Facebook post, but I started to feel bad about it because I didn't want it to sound like I was excited about it or sensationalizing it, so I deleted it. I had been in such shock when I posted it, it could have been interpreted as if I was excited about the possible drama unfolding behind my house. Which wasn't the case at all. Actually quite the opposite; it was really traumatizing to me. I know it wasn't about me, but seeing something like that isn't easy. 

I went back to my dishes with a completely different outlook on my day. Yes I had a baby powder explosion and I can guarantee you that at some point tonight my husband is going to come up and hug me and go, "Um, why do you smell like a baby diaper?" And yes, my keys were (and still are) locked in my car, which kept me home from getting groceries for my family, and yes, my kids are mildly sick today with sore throats and upset tummies. But. Perspective is a beautiful thing. Whatever silly little things I was going through his morning were nothing to that man who felt like he had no other option but to end his life.  I hope that man can find the help that he needs and that he never finds himself in that position again. I can tell you that every time I drive over that overpass from this point on I am going to think of that man, and that moment that I saw him standing there, and I'm going to feel grateful for everything I have in my life.

Thursday, January 9, 2014

Dead rats and hermaphrodites.

How was your day?

My day went something like this....

I woke up this morning with a pounding migraine. It's okay - I get them. I give myself Imitrex injections for the headaches and during certain times of the month I get them almost daily. The streak usually lasts 5-6 days, but I'm mostly able to keep the migraines at bay using the Imitrex shots. The problem is that the shots are very expensive, and my insurance is stingy and I always run out of coverage on them before the end of the year. I have fought them and fought them and I've had my doctor fight them as well, to no avail. Sometimes it will take 2-3 shots to get rid of a single migraine, and I can't afford to spend $215 for two shots, so I did what anyone else would do. I had Eric go to his doctor and tell them that he was suffering from migraines, and that he'd been given Imitrex shots before and they'd worked for him. Booyah! Plenty more shots to get me through the end of the year. Take that, AETNA! (PS- He does get the very rare migraine, too, so it wasn't a total lie.)

Anyway, I woke up with a pounding headache this morning, but I had to go teach my step class. The same step class that I convince myself to quit every Tuesday and Thursday morning on my way to the gym. I don't know what this stage fright thing is, but I wish it would go away. I keep thinking that I will eventually get used to it, but it's now been almost three years and every Monday and Wednesday night my nerves kick in, and from about 5:00 on, I can't relax. I stress that I'll oversleep and somehow not make it to my class. I have nightmares that I can't manage to get to the gym in time, or that I forgot my shoes or my music. I dream that I can't get the stereo equipment to work right, or that I can't find the gym. I wake up in the morning with a feeling of dread that I'm going to mess up, or I'm going to feel sick in the middle of class, or that some other horrible unthought of thing will happen. I worry that people walking past the class on their way to other classes or to the equipment will look in the windows, see me teaching and think, "Well if the instructor looks like that, why should I bother?" I figured I just needed time to adjust and that I'd eventually get over it, but so far it hasn't happened.

So this means that typically I don't sleep very well before I teach. I have what I call stress dreams and I toss and turn a lot. However, despite my fears that it won't, my alarm always does go off (I set two of them.), I wake up, get dressed, brush my teeth, wash my face, finish helping the kids with whatever they need and drive off to the gym. By the time I've pulled into the parking lot, I've composed my letter of resignation in my head. I tell myself what a load off it will be to not have to teach anymore. Then I park in the employee lot, punch in the code to get into the gate, and go in the back door by the tennis courts. I grab a towel and some water on my walk to the studio, wave hello to the ladies who always get there early enough to sit and chat at the tables by the climbing wall, and I enter the cold studio. I turn on the lights, turn on the stereo, check the headset microphone and make sure it has fresh batteries, set up my step, plop my choreography notes down on the floor in front of me, and review my notes until people start to trickle in. I like to get there at least fifteen minutes early so I have plenty of time to troubleshoot any stereo or microphone problems. Once those things are set I'll chat with the people who have grown from acquaintances into friends.  

Then I start the class, and all those feelings of dread and stress melt away. I'm in my element up there. I know what the heck I'm doing, and I'm confident in it. I enjoy leading the class and I know the members enjoy it. So after class I gather my stuff and walk to my car thinking, "What the heck is wrong with me? I'd never want to quit doing this." And this is the cycle that repeats twice a week. Poor Eric is so patient with me. He hears the same things over and over again, but he never gets frustrated. He just listens and tries to be understanding even though I am clearly a basket case

So I woke up with a bad migraine today. I also knew that today was the day that I was going to have to put our beloved rat, Javier to sleep. About six months ago he started making wheezing noises so I took him to the vet and they prescribed antibiotics. His breathing was very labored, like he'd always just finished running a marathon. We tried multiple treatments for him, and some of them seemed to have a temporary effect, but after a couple of weeks he'd be back where we started. The vet had suspected a respiratory issue, but the medications should have helped him if that's what it was. A couple months later I went out to the rat rescue organization where we adopt most of our rats to get our two new boys neutered. I took Javier along with us so the rat expert could take a look at him. I respect veterinarians for everything they do and the knowledge that they have, but a lot of them aren't familiar enough with rats to really know the ins and outs of treating them. That's why this organization is so valuable. They really know rats. So I took Javier with me and the lady from the rescue agreed that Javi was very sick. She suggested a three part treatment to see if it would help him. She said that he probably felt like he was having an asthma attack all the time. But despite the labored breathing, he was still his happy self, so I wanted to keep trying treatments on him because I felt like his quality of life was still good, and we loved him so much.  Unfortunately none of the treatments worked and his health continued to decline. Especially over the past two months. He began to pee every time we'd get him out of his cage, which he never used to do. I think even the smallest movements stressed his little heart and lungs. And he began to get skinnier and skinnier. He was also puffing up his fur all the time, which is a sign of pain. I knew that his days were numbered and I couldn't stand to watch him sit in his cage struggling to breathe and getting thinner and thinner. That's the hardest thing about being a pet owner - when do you know that it's time to say goodbye? Being the one to make that decision is really hard. To say that you are the one who should decide when to end a life. It's tough.

So that was what I had going for me when I woke up this morning. I don't normally like to have a migraine shot so close to working out, but I knew it would be really hard to teach my class with a pounding headache, so I went ahead and stopped in the bathroom to inject myself before I left the house. I grabbed my gym bag and sat quietly in the car on the way to the gym, hoping the shot would kick in. By the time I got there, at least the headache was gone, but my heart was still heavy about Javier. Class went well, and since I had actually remembered to pack my bag last night I was able to spend some time in the steam room (my favorite!) before taking a shower and getting ready there.  

Yesterday when I emailed the girl from the rat rescue organization I asked her if she could help me with euthanizing poor Javier. Unfortunately since I've been through this before with the rats, I know that the vets at the office we use aren't consistent with how they choose to euthanize a rat. The method varies depending on who I get. I've done my research on this and there is really only one humane way to euthanize a rodent. The best way to go is to give them something to sedate them, and then give them a shot in the heart to stop their heart. Only once have I had the vet allow me to hold the rat while it has passed away. The other ones have made me leave him with them and they take them in the back and put them in a tank where they breathe in a gas that eventually makes them die. I know that my rats would be scared if they were just dumped into a glass tank and left to pass away on their own. I don't want that to be the last thing they experience. I want the option to hold them and comfort them as they're passing. I knew there were home methods to use, but I didn't have what I needed at home to do them, so I hoped she could offer some assistance. 

She emailed me back right away and said that she was so sorry about Javier and that she could help me. She told me that I could go over there right then, but she lives a good 35 minutes away and it was late, so I asked if she was available today. It turns out that she works right near my house, so she said that she would come over once I got home from the gym. I had no idea what she would be bringing with her, but knowing how much she loves rats and all she does to find homes for them, I knew it would be humane and the right thing to do. I knew that I was just putting off the inevitable, but I still dawdled at the gym. I took extra time in the steam room. I filled my water cup up like three times, then I took my time walking to my car. On the way home I realized that I needed to go to the bank, so I did that too. 

Finally I was home and I went upstairs to check on Javier. He was sitting in his cage huffing and puffing and wheezing. In the past when we've had to do this, I've given the kids a chance to say goodbye. That is absolutely heartbreaking - to see them holding the rat on their lap, petting them and talking to them, thanking them for being such good pets and friends and telling them how much they'll miss them. Then I'm the one to pull the rat out of their hands and walk out the door - it's excruciating. It really is. The kids were already having a hard time with getting back into the swing of school after being gone for winter break, so the last thing I wanted to do was tell them right before school that Javier would be gone when they got home. I decided that I'd just tell them that he passed while they were at school. I know some people don't agree with lying to your kids. About anything. I'm not one of those people. If there's a white lie that I need to tell to protect them, I'll do it. Don't get me wrong, I don't go around lying to them all the time, but for something like this, I wouldn't think twice.

So I picked up Javier from his cage and held him in my lap, petting him as I called Dr. Kevorkian to come do her thing. She told me that she'd be there in five minutes. I got all nervous that she'd come in and check out my rats and scold me for something. She takes her rats very seriously. I had recently moved their cage off the desk in our spare room and put them on a chair so that Emily could use the desk to rainbow loom. The chair was in front of the window and I immediately worried that she'd come in and tell me that they should never be around drafts. Then I hid the bag of Petco brand pet food because I know how anti Petco she is. She hates the way they treat small animals and doesn't like people to shop there. It was crazy how nervous I was to please her. She's probably in her twenties and just a very serious person. Here I am, forty-two years old, running around my house with my dying rat in my arms, hiding bags of pet food and moving their cage in case she comes up there. I also closed Emily's bedroom door because it was messy and I didn't want her to judge. Even I can see the humor in that. 

Anyway, she arrived and was very nice and respectfully somber as she carried her little bag inside with her. My dogs were acting like idiots as usual, and Rudy shoved his nose right into her crotch as I led her into the kitchen. (Thanks a lot Rudy.) She asked where I wanted her to set up and I said the kitchen table would be fine. I already had a towel with me since Javier would randomly pee when being held. She took him from me to just check him out first. She showed me how blue his little feet and hands were (yes, I call them hands), which meant that he wasn't getting enough oxygen. The puffy fur and bony body were also signs that it was time. This is when I get all emotional and need that reassurance from someone else that I'm making the right decision. I looked at her with tears in my eyes and said, "My husband asked me to make sure that you thought it was really time. It's time, isn't it?" She stroked his fur and said, "Yes. We've tried the meds and those blue feet are sure signs. I mean he could go on for a while like this, but he's suffering. I would do the same thing if he were mine." 

I nodded and took a deep breath and said, "Okay." She opened her little case and said, "By the way, what I'm doing is very illegal, so please don't sue me and take my house." I shook my head and assured her that I'd never do that, and that I just appreciated the opportunity to be able to have Javier be comfortable in his own environment and with me. Plus this way I also didn't have to go through the whole Kramer vs. Kramer scenario of ripping him out of my howling kids' arms to take him to the vet. She took a small drinking glass out of her bag, along with some cotton pads. Then she took a brown bottle of some sort of liquid medication type stuff. She explained the gist of what we were going to do. She said that the liquid was anesthesia, and that basically we were just going to overdose him on the anesthesia. That he would go to sleep and just never wake up. She said that at the vet, a lot of times they'll use this to sedate the rat, then give them an injection into the heart just to be sure. But that if we kept him under it long enough, it would be enough to send him off in the most peaceful way possible. 

She opened the bottle of anesthesia and soaked two cotton pads with it. She then put those in the bottom of the glass. She turned the glass on its side and explained that we needed to put Javier's nose into the opening of the glass so that he would breathe the fumes. She said that rats don't like breathing the gas, so sometimes they will struggle a little. I helped her hold his struggling little body up to the mouth of the glass, but he wasn't having it. He fought us and pushed away with his little hands. While I wanted him to be comfortable by being with me, and in his own environment, I wasn't counting on this. He would never, ever bite, and of course, even in his fear he didn't try to bite us. He just pushed away and wiggled around to try to stay away from the gas. The stuff had a strong odor and he probably didn't like it. Eventually we were able to get his head in there and then he started gasping.  Well that just about did me in. His little mouth was open and he was gasping for air. I hadn't cried up until that point, but I started crying pretty hard. It was kind of surreal. Here I was, sitting in my kitchen with a virtual stranger who was helping me illegally euthanize my pet rat, crying like a baby. If someone had come to me five years ago and described that scene to me I'd have told them they were crazy! Javier made one final gasp and then the anesthesia seemed to take hold and he settled down. I was able to pet him and talk to him as he relaxed and stopped squirming. She said to me, "This would probably be a good time to say your goodbye." I looked at her and said okay, but I thought to myself, it's not like I'm going to bend down and give him a little speech right here in front of her. So I just kept soothing him and telling him that he was a good boy until he lost consciousness. Eventually his breathing slowed more and more until he finally took his last breath. Once that happened I settled him on his side and she told me to leave him in that position with his face in the glass for as long as possible. Since she doesn't have access to that final shot to give him, if he didn't inhale enough anesthesia, there was a tiny, tiny chance that he could wake up. But this lady knows her stuff. She's taken in hundreds of rats from shelters and who knows where, and she's had to handle dying rats numerous times, so I knew it wouldn't happen. She re-packed her bag, I gave her some money to donate to the organization, and thanked her again before she left. I sat and cried for a few minutes, then I covered him with the towel and tried to move on with my day. 

By this time it was just after noon and I had two hours to figure out how to break the news to my kids. I decided to busy myself around the house. I took the rest of the decorations off the Christmas tree and packed them up. Then I took the tree out to the garage, then pulled some dead plants out of the flower bed in the front yard. I vacuumed the house and did a few loads of laundry and finally it was time to go pick up the kids from school. I wanted them to think that he'd passed away naturally, so I got rid of the cotton balls and glass, and I wrapped Javier in a towel and put him in the closet. Then I searched for a box to put him in to bury him. A shoebox would be too big, and the ground is hard right now, so to dig a hole big enough for a shoe box would be hard, so I was trying to find a smaller box. I looked all over the place and couldn't find anything that would work. As I walked through the kitchen I opened the cabinet to put something away and noticed that there was a new bottle of Absolut vodka in there. It came in a box. The tall, narrow box was perfect for Javier. I took the box down and set it on the kitchen table before leaving for the school. 

Owen was going to his friend's house after school to practice his Blues Brothers routine for the talent show, so I just had Emily and the two other kids that I drive carpool for. I dropped both of them off and walked into the house with Emily. Normally she runs straight up to the rats to talk to them and pet them before washing her hands, having a snack and starting her homework. We all love our rats, but Emily loves them like no one else. At any given time in the day she's walking around with a rat in her arms. She plays with them, she sings to them, and she just really, really loves them. So I was seriously dreading telling her. She told me that she was really hungry and started looking for a snack. She saw that I had bought ramen noodles at the store and asked if she could have some. I said that would be fine. She likes to make them, so I helped her get the pot and fill it with water. As we waited for the water to boil, I said, "I have some bad news." She said, "Is it Javi?" I said yes. I told her that he'd passed away. She started to cry and I hugged her and just let her cry. I told her that he must have passed away while I was at the gym. We talked about him for a few minutes and I told her that he was in a better place where he could jump around and take as many deep breaths as he wanted without a struggle. Emily agreed and we finished making the noodles. She was sad, but she seemed to handle the news better than I thought she would. She asked where he was and I told her that I had him wrapped in a towel. I told her that we could bury him that night. I asked her where she wanted to bury him and she said behind the fence where we buried her parakeet over the summer. 

Since it was Tuesday, that meant hockey practice for Owen. It also meant that I was going to get together with my friend Alicia for our regular Tuesday night ritual of watching the Real Housewives. We save Sunday night's Atlanta Housewives and Monday night's Beverly Hills Housewives episodes and watch them on the DVR together on Tuesday night. We alternate whose house we watch at and the visitor usually picks up salads for us to eat while we watch. It was my turn to go to Alicia's, which meant that Emily would have to go to hockey practice with Eric and Owen. I figured getting out of the house would do Emily good anyway. Eric stopped at home to grab Owen's hockey stuff and Emily, then went to pick up Owen at his friend's house. I left it up to Eric to break the news about Javier to Owen. He told him on the way to hockey. Owen also seemed to handle it okay. Later Emily told me that she feels like it's just a little easier to know that he just passed away on his own. This reinforces my decision to handle it the way that I did. 

Normally Alicia and I grab salads from somewhere, but I texted her and said, "I know we've both had stressful days, so I'm going to get us sushi instead! I need to drown my sorrows in good food!" (She's got a lot going on at work - like 3 people in a row either quit or got fired, so she's handling way more work than normal.) She texted back and told me what she wanted, and I headed out to pick up our food. Once I got to her house, she sent her son into his room to entertain himself so we could start our shows in the living room. (Her husband doesn't get home from work until around 7:30 or so.) There's something so great about being in the comfort of a good friend where I felt like I could just exhale and unwind. We sat on the floor and ate our sushi while we caught up on our days. I teared up a little when I told her the details about Javier and she told me about the stuff going on at her job. I mentioned that I'd had a migraine this morning and that I needed to find a neurologist who used Botox to treat migraines. (It's something I've been meaning to do for a couple years now.) I told her I would just start calling neurologists in the area and ask the receptionist if they prescribe Botox as a migraine treatment. 

Once we got our chit chatting out of the way, we settled in to stuff our faces while watching Housewives. I think we were both slap happy from stress, and under normal circumstances we have a tendency to crack each other up a lot and laugh a lot, but because we'd both been so tightly wound, I feel like we were laughing more than usual. It takes us like two hours to get through a one hour episode because we have to pause it so often to dish on what we're seeing and laugh at stuff. Several times I cracked up so hard that I almost peed my pants. This isn't unusual for me, unfortunately. So just to be safe I got up and went to the bathroom about halfway through the episode of Beverly Hills. I came back and resumed my spot on the floor in front of the couch and we started watching again. About ten minutes later, Jamie Lee Curtis appeared on the show. She was helping Kyle with a fashion show. Alicia and I made eye contact and started to snicker. For no reason - that's the best thing - sometimes there doesn't have to be any reason. We just find things funny. We probably sound like immature fourteen year olds to anyone eavesdropping, but I don't care. We have fun, and laughing is good for the heart, the mind and the soul. After we snickered at the TV, I sighed and said, "Oh Jamie Lee...." Then Alicia said, "She's a hermaphrodite." I nodded and said, "Yes. I know!" For whatever reason, this sent us both into hysterics. And I started to pee. So I started to flap my arms at her to tell her to shut the hell up and stop laughing because the more she laughed the more I laughed, and the more I laughed the more I peed. But you know how it is - we were laughing at something so stupid, then we were laughing at the fact that I was wetting my pants. On her floor. In my jeans. I had made it to my hands and knees by then, and I kept squealing, "Stop! Stop!!! STOP LAUGHING!" Her husband, who was in the kitchen at that point, and very familiar with my "problem" called out, "Do you need a towel?" I yelled back, "Yesssss!!" By then the floodgates had opened and there was no turning back. When I get to that point all I can do is let go. I soaked my underwear, my jeans, my socks, and even the bottom part of my sweater. And, of course, her rug. Once the laughter wore off and reality set in, we stared at each other in horror. "What do you need?" she asked. I answered, "I don't know! Pants! Clothes! Towels! Oh my gosh! This is horrible!" Alicia is smaller than me, so she started to politely stutter, "Um, I don't know if I'll have pants...." She trailed off. I finished for her. "To fit me. I know! So get something from Bill! I have to take everything off!" I waddled into the bathroom with my legs far apart, doing the walk of shame known only to me and every other three year old being potty trained. Once in the quiet of the bathroom I assessed the situation. It wasn't good. My jeans were completely drenched. By the time I took off every piece of clothing that had come into contact with my urine, I was down to my bra and a tank top. I waited in the cold bathroom (they never use that bathroom so the heat vents are closed and they keep the door closed) for Alicia to find something for me to wear. I heard her hissing at her husband, "Bill! Help me find some sweats for her!" Poor Bill. I cleaned myself up in the meantime, horrified at what had just happened. She finally knocked on the door. She said, "Here are some pants. Try them out. And here's a sweatshirt, too. I looked at the pants. They were both nylon sweat type pants. You know - the kind they use to make windbreakers. They have zero stretch in them. Bill is a pretty small guy. He's not any taller than me and like most men, he has nothing going on in the way of thighs or a butt. Any extra weight he carries is in his belly, where the beer goes. I looked at both pairs of pants. They were men's mediums. I held them up and shrugged. What choice did I have? I put them on and while they were fine at the waist, they were squeezing my butt, crotch and thighs like nothing else. Could I get any lower? I'm in my friend's bathroom, with a pile of my own clothes sopping wet on the floor, wearing her husbands pants that are too small for me! I threw on the sweatshirt, washed my hands and walked back into the living room. "Are those okay?" she asked. "Yes, they're fine," I lied. I then got down to the business of cleaning her area rug. Luckily it's brownish/tan so she couldn't really see how much of a spot I left. I cleaned it all up, put my wet clothing in a grocery bag, like they do to the kids in preschool, and went to settle back on the couch. We still had part of Housewives to watch, and all of Vanderpump Rules! 

As I sat down Alicia said, "How did that happen? I thought you just went to the bathroom like ten minutes ago?" I said, "I did. This is what happens! I can completely empty my bladder and fifteen minutes later have that happen! I really, really need to get that surgery to fix this ridiculousness! I need to make an appointment. This stuff can't go on!" She said, "Yeah, because what if we were out somewhere? Are you going to wet your pants at the Eagles concert when we go?" I looked at her like she was crazy and said, "Of course not! There will be music playing! We won't really be talking, so there won't be that much laughing! If I wet my pants it will definitely be at dinner before. And in that case, I guess I'll just keep a change of clothes in the car. But seriously, this is a major problem. I've just been putting off going to the doctor because I don't want to deal with surgery!" Alicia agreed that surgery wasn't a fun thing to think about, and we resumed our show. 

As we watched I struggled on their couch to get comfortable in those tight pants. I lay on my side lengthways along the couch. I kept tugging at them. "These pants!" I gasped. Then I tried a different position, but no matter what my thighs and butt were protesting and trying to burst free. I finally got myself fairly settled and tried to focus on the show. I texted Eric. 

ME: OMG,  I just peed my pants bad!!!!!! Soaked my jeans and underwear and sweater and socks. And I'm shoved into a pair of Bill's size medium nylon sweat pants!!

ERIC: What else is new? 
ERIC: Send me a pic.

ME: OMG No!
ME: I'm wearing them home so you'll see.
ME: If you need to bury Javi, he is under the staircase
ME: In a towel
ME: I feel like these pants are 2T!
ME: Have you buried the rat yet?

ERIC: Yes. After dinner.

Alicia and I resumed watching. We got some more laughs out of the ridiculous people on Vanderpump Rules, when suddenly this commercial comes on the TV. We both thought it was a joke. It had to be. Like one of the fake commercials SNL makes. Watch it - 



Okay, seriously? As the commercial started Alicia and I stopped talking and just watched. It had to be a spoof....but wait. No. This is a real thing. Now don't think I'm insensitive - but come on. That is one of the weirdest ads I've ever seen! I gasped. "I think I have this!" Alicia laughed and said, "No you have urinary incontinence." I said, "Yes, but I have this too! I laugh uncontrollably!" We continued talking about how strange the commercial was and even called her husband in to watch it. Before we started it we said, "Tell us if you think this is a real commercial or a fake one." He thought it was a farce too, until he saw the phone number, etc. It was just so weird. And that's about all I can say about that. 

After Vanderpump Rules was over I gathered up all my stuff and bid my friend adieu. I said to Alicia, "Tell Bill thanks for the clothes. Considering the state I was in when I put them on, he probably never wants to see them again. But I'll still wash them and give them back." She laughed and said, "No problem. I'm just glad you have something to drive home in." I said, "Yeah, no joke. If I had to drive home in just what's dry, I'd have been in my tank top and shoes. Imagine me getting pulled over wearing that. How would I explain my way out of that ticket?" I thanked her for her hospitality and said, "Now if you'll excuse me I have to go home and look up all the medical treatments I need. Botox for migraines, bladder surgery for the wetting problem, and possible medication for PDA. We chuckled and I hit the road. 

When I got home, the kids were asleep and Eric was in our room playing his PlayStation. I modeled my tight pants for him and then ran to the closet to get something more comfortable. As I peeled off the pants like you peel the skin off a grape I called out to him. Did you bury the rat? How'd it go?" He told me that they did bury him, and that it was sad, but the kids were doing okay. I said that I was glad and got my nice, comfortable pajamas on. 

And then I crawled into my bed and reviewed my day in my head. Migraine. Euthanizing a pet rat in my own home. Burying him in an emtpy vodka box. Wetting my pants in front of my friend and her husband. Borrowing her husband's size 2T pants to wear home. I'd say that today was a day that I won't soon forget. 

How'd you say your day was again?


Rest in peace, little Javier. We will miss you. 
PS - I know that Jamie Lee Curtis is really not a hermaphrodite.

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