It's time to Vote, but not on a Candidate!

I recently joined the Digial Health group on LinkedIn, led by Paul Sonnier, who has amassed a huge group of followers on Twitter and LinkedIn. I have found it to be one of the best places for bleeding edge health technology news and great discussions! Paul recently posed the question, "What is the biggest human benefit derived from the use of digital health solutions?" There were five categories to choose from: Disease diagnosis, disease prediction (especially genomics), disease management, disease prevention and reduced radiation exposure (imaging). The winner by a fairly wide margin was disease management, which garnered 49% of the votes. Coming in second? Disease prevention with 31% of the vote.

The discussion that accompanied the poll was very rich and worth checking out. My vote was cast for disease prevention. In my mind, if we can finally give individuals the tools to more proactively manage and maintain their health, we won't need to focus so heavily on disease diagnosis. What do you think? Which item would you have chosen?

For an additional reference, check out this blog written by Paul about the results of his poll:

http://popperandco.com/2012/07/poll-results-what-is-the-single-greatest-health-benefit-afforded-by-digital-health-solutions/

Relief

Relief is a common feeling – one can be relieved that they make it to work on time when the traffic is bad, or be relieved when a child arrives home safely 15 minute after curfew. We can get relief from a headache with a Tylenol or Advil, and relief from hunger by eating a meal.

But on Friday of last week, I learned what relief really feels like. It’s an overwhelming feeling that impacts every cell in your body – it’s like the world’s biggest sigh; or the removal of the heaviest load you have ever carried. As it passes over you, it incites you to cry huge tears of joy, and then makes you want to lay down on the floor to be absorbed into the earth. It is a freedom that I have never, not once, in my 51 years on this earth, felt so intensely.

Last Friday morning I had blood work and CTs of the chest, abdomen and pelvis. This was in follow up to scans 8 weeks ago that showed some abnormality in my right lung, which the radiologist and radiation oncologist suspected was the remnants of an infection, but they could not rule out an underlying malignancy. While I had a gut feeling that things were going to be good (because I have felt so good and have been taking pristine care of myself), I had received several “signals” throughout the day that perhaps that would not be the case. And so, as Bill and I sat in the waiting room for the physician to call us back, I could not help but be exceptionally worried, to the point of hands shaking, stomach twisting, room spinning.

But relief was mine when my nurse practitioner came through the waiting room and stopped to tell me on the sly that my physician was going to put me in a room to “tell you the good news, your scans are completely clean.” As the words left her lips, I can’t do justice to describe the intensity of relief I felt. This is a moment that I will hang onto for the rest of my life! It’s the perfect opposite of the moment when I heard the words, “It’s cancer.”

I am not naive enough to believe that this is the end of my journey – in fact, it is the beginning of the hardest part – survivorship. The constant temptation to wonder if something is going on, or if the cancer is back is sometimes hard to ignore. But I will take this victory with gratitude and in it find the strength to continue my efforts towards perfect health.

What Would You Do With a Little Feedback?

Admittedly, it has been a long stretch since my last blog. In a nutshell, I’ve spent the last 4 months healing from the many side effects caused by the Radiation and Chemotherapy treatment I completed. But I am happy to report that I am feeling great, eating extremely “clean,” exercising nearly every single day and ensuring that I get ample sleep. From all the reading I’ve done, my best bet is to keep my immune system in excellent shape, and all of these things help that to occur.

But there are mental side effects too….I asked my physicians and nurse practitioners – “What can I do differently to make sure the Cancer doesn’t come back?” Those of you who know me know that I have been a very healthy person – I have always exercised, eaten really well, and tried hard to manage my stress. And their answer was “We don’t know, since we don’t know why you had this kind of cancer.” Given my action-based, over-achiever personality, this did not sit well. Surely there is SOMETHING I can do other than wait, feeling like a ticking time bomb, between every check up and CT.

Enter the FitBit. It’s a little sensor that you wear on your body day and night and it can tell you how many steps you are taking (10,000 per day is the goal), how well you are sleeping (your sleep efficiency score), how many calories you are burning and taking in, and how many flights of stairs you’ve climbed.

I ordered the FitBit after attending the Institute for the Future (IFTF) conference in San Francisco a few weeks ago, where I was blown away by some of the self-monitoring technology that is close to becoming a reality. Blow into you tube connected to your iphone and see if you have an infection? Yep, it’s in the approval process with the FDA. Use your iphone camera to scan a rash and then have it diagnose it for you? Yep, that too is at the FDA for approval. Take a personalized pill to ensure your "gut flora" is in optimum balance? Not so crazy, scientists have just finshed cataloguing the hundreds of thousands of microbes that exist on and in your body. It excites me that in the not too distant future we will actually have access to some amazing tools to help us take more control of our health, and our health care.

But back to the FitBit. This type of sensor-driven feedback technology is showing up in more and more places. Ever see one of those speed signs by a school that tells you how fast you are going? Research shows that this almost always causes a driver to slow down, when a “SLOW” sign in the school zone barely gets noticed. Since wearing my Fitbit, I am consciously more active all day, reaching for that 10,000 step goal. I watch my sleep habits throughout the week, and can also see the nutritional breakdown of the foods I am eating. It has changed my behavior, and helped me develop new, healthy habits. But more than that, it has given me some peace of mind, because I get immediately feedback of what I can control – how much I move, what I eat, how much I sleep.

Friday is a big day for me. I will undergo a battery of tests to ensure I am remaining cancer-free. I am going into that day feeling much more hopeful, much more in control, much more certain that I will be given a clean bill of health.

But I also am not about to count only on myself, so my dear family and friends, I’ll ask you to think of me in your prayers, and send hopeful, healthy thoughts my way.

#Gratitude

If there was a single word to sum up how I'm feeling today, its Gratitude. If you are a user of Twitter, you will understand that using the # symbol, or hashtag is a way to mark key words or topics in a Tweet. I love that it was created organically by Twitter users as a way to categorize messages. Within Twitter, you can search on #Gratitude and see what the multitude of Twitter users across the universe are grateful for. As I look around, I think there's a huge opportunity for everyone to be a little more diligent about identifying what they are grateful for on a daily basis.

As I emerge from these past few trying months, that is one of my new habits. Each day I am writing down at least three things I am grateful for - as well as three positive things I am envisioning for my future. The act of writing it down makes it much more real for me.

Today's list so far? Well, first, I had not one but TWO cups of coffee this morning. For me, this is huge step forward because it symbolizes that food and drink are actually beginning to taste and feel normal. Second, I am grateful to be living in an amazing and beautiful location. It's still February, but today we will flirt with 80 degrees. The sun shines 300+ days a year. Having undergone treatment in January and February, it was such a blessing to be able to travel to the clinic each and every day in 60 or 70 degree temps and beautiful sunshine. I think it did so much to help my attitude!

And finally, I am so grateful for the love, friendship and support of so many people in my life. Doing my morning reading and meditations, I came across this blog and wanted to share it because somehow the people in my life either intuitively knew, or knew from experience, how to do every single thing on this list. You know who you are!

http://www.huffingtonpost.com/suleika-jaouad/cancer-advice_b_1290008.html

If you have a friend or family member with cancer - or even if you've had the good fortune not to face this, I found this to be an incredibly accurate list from a patient's perspective.

The secret of happiness is to count you blessings while others are adding up their troubles

The End of a Chapter, the Start of a New

Last Thursday, I had my final radiation therapy treatment. That made 28 of those treatments, every week day for nearly six weeks. As you can imagine, I got to know my radiation therapists quite well- and I am really grateful for the incredible care they gave me and the compassion they showed each and every day.

Here's me, ringing the bell that says I am done with treatment. Anna and Allison are with me - as they should be! It was a team effort and I thank them - and Andrea and my other therapists who rotated in occasionally - from the bottom of my heart for helping me get through this.

It is my sincere and deep hope that I will not have to endure a regiment such as this ever again. Yet in a way it will be hard to move forward because there seems to be no explanation for why I got cancer. No significant family history. A very healthy lifesytle. Hardly ever been sick a day in the last 10-15 years. And so, without a why, I am left to wonder what I am supposed to do differently, or better. What I am supposed to eat - and not supposed to eat. If there was something in my environment that caused this to occur. So many questions - so few answers.

But here's what I can do. I can choose to focus only on the positive. To think the best of myself and others. To rid my life of those things that no longer hold value, or offer joy and happiness. To spend my time with people who lift me up, and on activities that I am passionate about. I challenge each of you to ask yourself if you are doing these things. You don't need to have had cancer and undergone treatment to make the same choices!!

I know that it will be a slow, but steady climb physically to resume my normal activities. Last week, my blood counts were (hopefully) at rock bottom, causing the nurses and my doctor to marvel that I looked as good as I did. I have to be very careful not to expose myself to illness - I don't have many white blood cells to fight germs. I am to avoid knives - or injuring myself - because I have few platelets to clot my blood. Perhaps most frustrating for me is my lack of hemoglobin - which carries oxygen to my muscles. I get winded walking up a flight of stairs. But these are all temporary and I have to believe if my healthy cells have been this impacted, that the double-whammy of chemo and radiation has completely eradicated any remaining cancer cells in my body.

It's beginning to feel trite to say "thank you" to those of you who continue to lift me up with your cards, emails, texts, prayers, gifts and good wishes. I will say it again: You will never know how much all of your many expressions of love and support have meant to me. I am truly, deeply, completely blessed.

Yes, I am Alive and Well!

I know it has been awhile since I last blogged, but to be honest that last round of chemo really knocked me down, making me even more grateful it was my last session. I am just now, nearly two weeks beyond the treatment, overcoming the nausea and fatigue. And, proof that I no longer take the little things for granted... today was the first time in over a month that I had a morning cup of coffee that tasted and felt normal! Progress!

I have one more week of radiation treatments and then I am done - hopefully forever. This week I will learn more about my follow-up, but what I do know is that I will be seen at least every three months for the next two years and undergo several scans during that period to make sure that nothing else is brewing.

During my most difficult days, so many of you continued to reach out to me - through emails and cards and gifts and texts - and you will never know how much those things meant to me, nor how much they helped me fight the inevitable frustration and impatience with my physical condition. Surrounding myself with people who love and care about me has truly been my lifeline during these last three months. Here's a darling photo of my sweet niece, Kerstin, sent to me during this time:

The other thing I've done is found words to inspire me and keep me going. I thought I would share with all of you a couple of blogs, email feeds and the like that I have discovered and whose words I now crave. Check out:

marcandangel.com
tut.com
tinybuddha.com

Throughout these challenges, perhaps the single most important thing I have learned is the power of hope and positivity. Chasing away negative thoughts, moving away from negative people, focusing on the best of every situation and expecting the most positive outcomes will, I hope, be ingrained in me forever.

Unexpected, Unbelievable Good News!

When my diagnosis first became clear, and I met with a cadre of physicians - gynecological surgeon, radiation oncologist, oncologist - each assessed me from his perspective and then together, they crafted my treatment plan. After surgery and the pathology of my tumor was clear, the radiation oncologist and oncologist took over treatment planning.

So, throughout these past weeks, I've met with my radiation oncologist each week to discuss my progress and side effects. But this past monday, after three rounds of chemo, it was time to meet with my oncologist.

I went into the meeting with some trepidation. At the outset, he told me that he wanted me to complete four cycles of the chemo - six if I could tolerate them. And, he hinted that that might not even be enough - but he wanted to do some more reading, consulting with colleagues and examining the latest literature before making a final call. So, image my complete surprise, delight, relief and overwhelming joy at his news Monday that THIS WOULD BE MY LAST ROUND OF CHEMO!

So yes, if you are keeping track of my calendar, Tuesdays are chemo days and so I am OFFICIALLY DONE!

His decision stemmed from the most current literature on my rather unusual situation. You see, he told me, usually there is no radiation or chemo indicated for Stage 1B1 cervical tumors, BUT in my case, the cancer was a very rare and somewhat aggressive signet ring cell adnocarcinoma - and therefore it was collectively decided that it was very much in my best interest to endure this double whammy of chemo and radiation. In his research, four rounds of Cisplatin is pretty tolerable, but once you go beyond that patients start to experience permanent side effects, like hearing loss and neuropathy. He felt that the risk of continuing would outweigh the diminishing benefits, given four treatments is the standard.

So yesterday afternoon, I made it through my last chemo session, again with the help of some amazing and incredible nurses. Maddie, Amanda, April and others. As they were removing the catheter from my arm, 15 nurses came into my curtain with tambourines, blowing bubbles and cheering for me and presented me with this certificate:

Well... of course I cried. And then the nurses told me their rule - if you cry, you bring brownies. Guess I'd better get baking!!

I do however continue my radiation therapy sessions to completion - 28 total. As of today I have 12 left to complete!

It's Halftime

Living in a household of all boys, I'm pretty comfortable with sports analogies. And so, today I'll use one to declare that for me - it is HALFTIME.

Yesterday at 4 p.m. AZ time, I had my 14th radiation treatment, which marks exactly the halfway point. Earlier in the week (Tuesday) I had my third chemo treatment, also the halfway mark.

All in all, this has been a little better week than week two. In my pre-chemo blood work, we learned that my magnesium levels had dipped really low, and so I'm on oral supplements for that now. My nurses told me that could have contributed to the much more severe fatigue and nausea I felt last week. In any case, I'm trying to take each day as it comes, with no pre-conceived notions about whether its a good day or a bad day until I'm actually living it. And while I'm so excited to be halfway done, I'm also trying not to look too far ahead.

I am grateful for everyone's continued support! The emails, texts, cards, visits, phone calls and packages are so uplifting and so very appreciated. Two special gifts this week: a beautiful book on Paris from my dad, and a special package from a relative of mine who is using my dad's place in Texas. She found a knit blanket/shawl that my mother wore often and sent it to me (with my father's blessing) so that I could wrap myself in it and feel my mother's presence.

Today, I will leave you with this beautiful work by Rumi:

Don't run away from grief, o soul
Look for the remedy inside the pain.
because the rose came from the thorn
and the ruby came from a stone.

And now for the Men

Doing my morning reading today, I was immediately drawn to the headline "Cancer Gender Gap." It seems that word "Cancer" jumps out at me from all over the place these days, when in the past I may not have paid all that much attention to it.

In any case, a new study has found that 32 of the 35 types of the disease are more prevalent in men. I have to say this shocked me a bit because it seems that women's cancers seem so much more publicly discussed, probably because of the huge focus on breast cancer in particular.

The authors of this study suggest that gender differences could be explained in part by different exposures to environmental and behavioral factors such as smoking, occupation and alcohol consumption, but the majority of the gender gap probably results from key biological differences between males and females. "If we could find out what causes the male excess of cancer and somehow eliminate it, we could prevent roughly one-third of all cancer," said Dr. Ellen Chang, the study's senior author. One third!!

So men (and women who love them), you can't shirk your health responsibilities either! I implore you, too, to get your annual check ups, milestone preventative care procedures and - most of all - don't ignore changes in your body or how you feel.

For the Ladies

So, enough about me. Let's make today's post all about you, Ladies. I'm going to explain in more detail my situation as a way of imploring - begging - urging you to dutifully get your preventive care testing LIKE CLOCKWORK.

Some of you may have heard that the old guideline of annual pap smears has changed. Here's the straight scoop on the new guidelines from the National Cancer Institute:

According to the new ACOG guidelines, women aged 21 to 30 years should be screened every 2 years using either the standard Pap test or liquid-based cytology. Women 30 years and older who have had three consecutive negative (i.e., normal) cervical cytology test results may be screened once every 3 years with either screening test. 

So, I had had a string of normal pap smears, the most recent of which was a year and a half before I saw an OB/GYN in my new city in late September. I actually went because in my state you have to have a prescription from a physician to get a mammogram, and of course, being over 40, those are suggested to be conducted annually. It, too, had been a year and a half so I was getting nervous that I should get screened.

My mammogram was great - perfectly normal! But the first week of October I got a call from my OB/GYN's office saying that my pap was abnormal... and not just a little abnormal but VERY abnormal. They set an appointment for me to come back in two weeks later for a more invasive procedure to look at the cervix. A polyp was found, and a biopsy was taken. On October 31, waiting to board an airplane, I received a call from my doctor with the dreaded words "It's definitely cancer."

I had followed all the rules. Lived excessively healthily. No family risk of cancer. Zero symptoms. And yet had I waited the recommended 3 years between Pap Smears, I shudder to think what I might be facing now.

And of course, being the overachiever I am, it was not just a typical cervical cancer. Oh no. It was exceedingly rare. The tumor had the pathology of a digestive cancer - mostly likely colon - called signet ring cell adnocarcenoma. There were no estrogen or progesterone markers at all. And so, physicians began an very invasive hunt through my body to make sure that the cancer had not started somewhere else and already spread. They examined every millimeter of my esophagus, stomach, liver, pancreas, intestines, appendix, gall bladder, ovaries. In the end, thank God, it was a primary tumor in the cervix, Stage IBI, and at the end of this treatment plan I'm told I have a 90% chance I am completely cured.

One other note. cervical cancer can be largely eradicated through the widespread deployment of the HPV vaccine. I implore those of you with daughters to carefully examine the benefits of giving them this vaccine to prevent the most common and widespread risk factors for cervical cancer. For me, it would not have changed anything given the pathology of my tumor (non HPV-related) but anything you can do to help your girls avoid the absolute shock of receiving a cancer diagnosis and subsequently enduring a challenging treatment regimen is something to seriously consider.

So back to making this all about you. Please get your annual screenings. Endure more frequent pap smears if you possibly can. Don't miss a mammogram. Have a colonoscopy when you are 50. And listen to your body. You don't have to wait until these milestones if you are feeling like something isn't right.

As I went through several sedated procedures to get to diagnosis, the nurses preparing me had of course studied my chart and had a million questions. Did you have symptoms? Do you have family history? When did you last have your pap smear?  After told them the answers, every single one of them said to me,  'I'm calling my doctor to schedule an appointment today!!"  PLEASE do me a favor, and do the same!!

The New Normal

One of the biggest challenges I am facing during my double whammy of chemo and radiation therapy is my "new normal." Less than three months ago, I was healthy, active and busy with a to-do list a mile long. I got up at 5:30 each morning, had my morning coffee, read for an hour, showered, worked a full day, hiked if there was daylight, had dinner, watched TV or read and hit the pillow about 9:30 or 10:00.

My new normal is quite different. This second week post-chemo, I've been much slower to recover, especially from the nausea and fatigue. I need a couple of power naps during the day, and last night I went to bed at 8:30! Nothing sounds good to me - even my morning cup of coffee has been sacrificed because it only upsets my stomach. I was warned by the nurses to avoid my favorite foods while nauseous because my brain would trick me into thinking I don't like them any more. I worry because I have been consistently told that this regiment of treatment doesn't really follow a weekly "cycle" of ups and downs, but rather it is like a steep climb. Each week will get harder because of the cumulative effect. I wonder how someone older or less healthy than me can tolerate this!

Once again, the universe sent me a message just in time. I subscribe to a number of daily quotes and reflections, and late yesterday, this arrived in my in box: "He is able who thinks he is able." - Confucius

And so I will continue to place a tremendous amount of energy into believing that I am up to this challenge and that the end result of possibly being "cured" is just reward for this struggle.

Paris

As a high school student, I took four years of french. I was fascinated by the language, intrigued by the city, and determined to experience it for myself some day. The closest I've gotten is Montreal, Quebec, where I was the designated sign reader for my family. I wanted so badly to order a meal in french, to use what I had practiced so hard to master, and was devastated when the waitress said (in English), "What'll it be?"

I am a person who believes in signs. And so, as I watched the lovely movie "Hugo" about an orphaned boy living in the Paris train station, keeping the clocks running and working to fulfill what had been his father's dream, I was charmed all over again. I said to myself, "I'm going to live in Paris for a month one day."

Shortly after seeing Hugo, I started my radiation therapy. And there, lying on the table in the small area where I wait each day while they set up the room, there are not one but TWO magazines with stories on Paris. I read a little more in each of these every day. And I've taken this as a sign - a confirmation that indeed, I must find a way to see Paris one day.

What are you putting off? What are you dreaming of? Please don't wait until it's too late to do what you have always wanted to do!

It's time to check your filter

Let's start with the big stuff. TWO DOWN!! That means only four more chemo treatments to go. I am dutifully marking the days off of my calendar and it just feels soooo good.

Yesterday, as I reported for chemo, I got a huge chuckle out of my nurse Maddie. As she walked me back, she asked me my full name and birthday (I've repeated this information literally a thousand times over the last few months - every check in, every nurse, every time - more on this later) and then explained dryly that they really don't want any impostors getting in. As if! No way I'm gonna let some one else have this experience (heavy sarcasm)!

Sitting in the chair, IV in place, looking out at the mountains outside my window, it occurred to me just how extensively my viewpoint has changed as a result of this experience. It is strange to think that for weeks and months and years, other people, each with their own very important stories, have been sitting here facing the same thing as me and yet I never ever gave cancer, chemo, infusion, radiation, surgery, tumors, side effects - any of it, a second thought. Oh sure, I knew people who had cancer and were facing these things and I felt very empathetic and compassionate for them. But, like anything, until you actually EXPERIENCE it, it's really hard to know exactly what it all feels like.

So, I truly do see the world differently now. And its little things. The sense of gratitude for the smallest things (which I've written about before). The notion that what you see on the outside of someone is just that - what they look like. It isn't who they are, and chances are there are some wonderful and fascinating stories inside that person too. I've become very interested in learning about what I put in my body - and its ability to help me fight to health and keep me there. I've been reading a ton about spiritual realms and healing, archetypes and the sacred contract we each have in this life - our purpose. I am growing impatient to see more of the world and experience the mind-blowing impact of travel to new lands and cultures. And most of all, I am realizing how quickly we pass through this life. There isn't a moment to lose.

So at the risk of sounding preachy, I would offer you something to consider.

Be willing to open your mind (clean your filter) - in fact find things that are way outside your normal patterns and do them - read them - taste them - listen to them - see them, and do so with an open mind. Aristotle once said "It is the mark of an educated mind to be able to entertain a thought without accepting it." Even exposing yourself to these new things will open horizons for you beyond what you might have imagined. Of course, it has taken an extreme situation for me to find this truth - I would will the joy of it for all of you without the drama!

Ding! Ding! Round Two....

Like a fighter resting in his corner, I'm waiting to hear the bell to signal another round. It's Tuesday - chemo day - and I am desperately trying to get mentally prepared for the day ahead.

Last week I reported my relief at finally getting to the great unknown - what will chemo be like? How will I feel? How will it impact me? And now, the trick is I KNOW. I know that the nurse will be completely gowned and gloved to bring the bag with the chemo solution to protect herself from the poison should the bag break, but she capably hangs it on my IV stand and connects it to my infusion catheter and begins sending it into my body. I know that within about 15 minutes, I will taste the metal in my throat, feel it burning down my esophagus and it impacting my stomach by sending it into flips. I know that the infusion will take two hours from start to finish. And I know that the next few days I will be managing nausea, fatigue, lack of appetite and digestive issues.

But on the other hand, here's what else I know. I saw my surgeon yesterday for my 6-week post op visit. I got more emotional that I expected. The emotion was extreme gratitude for his skill, his compassion, his talent which may well have saved my life. (I hugged him - TWICE!) I know that this 6 weeks of chemo/radiation is a huge insurance policy against having to endure all of this again someday. I know that I am surrounded by family and friends who are so encouraging, so inspirational, so kind and compassionate that I am humbled beyond words. I know that it has been a tremendous gift to have my son Taylor here for the last 3 weeks, bringing me laughs, joy, and some wonderful distraction from how I'm feeling physically. And I know that this experience is challenging me to be a better person, to become laser focused about my purpose, to not put off what I want out of this life.

So, ring the bell. Let's get on with Round 2!

Take Nothing for Granted

During these past few months, I have learned many valuable lessons, but perhaps one of the most simple yet piercing is the notion of taking nothing for granted. Every day, we all move through our lives and spend precious little time thinking about how some of the most basic things make our life rich and pleasurable. Here's a few examples:

Do you ever stop to think about just how wonderful food tastes and what a gift that is? If you've had to fast for a few days because of medical tests, or you've been nauseous, there is a moment when something as simple as a blackberry or a warm piece of freshly toasted bread enters your mouth and tastes amazing. I'll never take the ability to savor food for granted again.

What about energy? Like most of you, I never even gave a thought to conserving my energy. I simply went where I wanted, when I wanted, as often as I wanted. I hiked, walked the dog, exercised, shopped, spent a night out on the town or cleaned the house without giving it a thought. I'll never again take for granted the ability for my body to have boundless energy at the ready for me to use.

Do you take the time to notice the beauty all around? Do you stop to breathe in the fresh air? Observe the cobalt blue sky? Hear the birds singing or the breeze rustling the trees? Admittedly, I was always in such a hurry that I didn't always appreciate the incredible beauty of the earth even right out side my front door. Now, the mountains that lay just beyond my house are a formidable reminder to me to stop and appreciate all of God's handiwork.

In no way do I mean to be preachy about this. I'm just saying that there is joy there for the taking if you're willing to look!

C is for Courage, not Cancer

So after all the anticipation of the first day of my treatments, I let the bottom fall out yesterday. I wasn't feeling very well physically, and then it occurred to me that this really was just the beginning. Not even mile one in marathon terms!

I allowed myself some tears, but then that old self talk kicked back in, reminding me that I am young, strong, courageous and have so much yet to do in this life.There are countries to see, mountains to climb, and most of all health care to FIX!

It certainly helps that hardly an hour passes without hearing from one of my friends or family members. It's like this whole brigade standing with me making sure when my knees buckle there's someone there to prop me back up and give me a little shove in the back. You know who you are! And you will never know just how much your relentless support of me has made the difference between this journey being impossible and bearable - and yes, even more than bearable because I am learning so very much! About myself, about the disease and how to live going forward, about what and who are important.

Aristotle said, "You will never do anything in this world without courage. It is the greatest quality of the mind next to honor." I am bound and determined not to be defined by Cancer, but rather my courage!

Calling all Angels

Yesterday finally arrived to my great relief. As a life-long planner, both personally but more so professionally, it has been my mission to understand everything that will go on, down to the minute, and to plan for every eventuality to make it - an event, a publication, a campaign, an announcement , a meeting, a trip or news conference - go flawlessly. Imagine my frustration when the most I could learn before starting this process is "everyone is different." So I feel a bit like I have been blindfolded and placed on a wild roller coaster with no sense of where its going and where it will end up. Not my favorite thing!

I started the day with a huge blood draw at the lab so all my levels could be checked pre-chemo. Next, on to radiation therapy. A few weeks ago, they performed my "simulation" so they could design the exact direction and dosage of the radiation. As part of that process, I received three small tattoos so that I could be consistently lined up in the same spot every time (28 times, to be exact). Laying on the table, there is a massive arm with a large round camera that swings 360 degrees around you. I felt nothing during the procedure (a blessing).

Then, an hour and a half wait for the chemo. The nurses there needed to check my labs before starting, and the lab has a two-hour turnaround time so my son Taylor and I, who went with me yesterday, found some lunch and hung out and read. (Sidenote: My husband Bill has been amazing. During November and my lengthy testing for the diagnosis and subsequent surgery, he has spent countless hours driving me to appointments, and sitting in waiting rooms and hospital rooms. In addition, Bill's wonderful father, Dick, passed away in mid-November with end-stage colon cancer. Bill also spent many hours with him during October, so it was nice for Taylor to be able to give him a little break before he goes back to college next week.)

As we sat in the waiting room waiting to be called for chemo, I told Taylor how much I missed my mom, Karen, during this chapter. I miss her every day, but even more so now, when her warm, loving touch and comforting words would be so effective. I also know (inside joke here for my sisters) she would tell me "This is character building" and "This, too shall pass.") Here's where the angels part comes in. A few minutes later, we were called back, and introduced to my two nurses: April and Karen (!).

Now I've really never been one who believes things like this are coincidences. It seems to me it was a very tangible way my mother was showing that though she is not on this earth, she is very much with me. That belief was only reinforced by the caring, compassionate demeanor of my two nurses. They took ample time to explain everything that was happening to me - what I would experience, and feel during the infusion. The drugs I would be receiving. The immediate side effects I would feel, and the ones to expect down the road. Suggestions to make things not so bad. These are they traits of angels among us.

If you are a nurse, there are not enough thanks in the world for what you do. And I have been incredibly blessed to have the most amazing nurses at every step in this process. Nursing is an increasingly difficult profession, but I want to affirm to all of them that they can make or break a patient's experience. Please don't ever lose sight of how important your work is, or how much your patients value your kindness and compassion, not to mention your amazing technical skills. You are, indeed, angels among us.

FEARLESS

Mind over matter.... mind over matter.... mind over matter. I have been working diligently to approach today with just the right attitude. I've tried to envision that the cancer-killing drugs and radiation I'll start today are actually purification agents, designed to purge my body of all things less than perfect - including thoughts, feelings, attitudes and past mistakes. I've imagined that at the end of these six weeks, I will have the gift of a clean slate - a new start, something that not everyone gets in life. I've told myself that the oldest child, perfectionist, achiever in me will do this BETTER THAN ANYONE HAS EVER DONE IT BEFORE!

Thanks to my sister-in-law Lori, I'll be sporting the necklace below. By no coincidence it arrived by UPS just minutes after the call in mid-December from my healthcare institution that outlined the rigorous schedule I would begin today (a 13-page itinerary with a total of 56 appointments between Jan. 3 and Feb. 9 including daily radiation therapy, weekly chemo, lab visits, physician visits, exams, etc.). It's actually a scrabble tile with the letter "U" on the back. Lori and I have endlessly played the notorious "Words with Friends"scrabble game (made uber famous by Alec Baldwin) throughout my diagnosis, surgery and recovery. So it was a special, meaningful and perfect gift symbolic of the army of supporters in my camp.

Needless to say as positive as I am trying to be the fact still remains that what I am facing is daunting and damn scary. And once in awhile I give myself just a tiny bit of permission to feel overwhelmed.

So, off I go on this new adventure. It's an opportunity to continue to experience from a patient's viewpoint what should be the world's greatest health care system - but continues to struggle and fall short in quality, safety, patient experience and cost control. My hope is to use this experience to influence what I can down the road in making it a better system for everyone.

No Man's Land

I fully admit that when the good Lord was handing out virtuous attributes, I somehow missed the patience line. For me, waiting - for answers, for action, for resolution, for anything - is the hardest part. And so I supposed it goes without saying that these three or four weeks of waiting to start my radiation and chemo treatments tomorrow has been one of the biggest challenges I've faced.

So this morning, as I write this, the next 28 hours feel like 28 years. I am so ready to start - because the sooner I start, the quicker I will finish. Thankfully, our son Taylor is here helping me pass the time. Thanks to his zest for life, he actually got me out of the house PAST MIDNIGHT on New Year's Eve! Here's a picture of us on the light rail going to a huge celebration down in Tempe:

Thankfully, we will also have a bevy of visitors during January and February (a benefit of living in Arizona when many of your friends/family live in much colder climates - they come visit!) and that, too, I am hopeful will help speed the time along.

Today's lesson is this: Always surround yourself with great people and make nurturing those relationships your greatest priority because in challenging situations, this becomes your rock. I have been humbled by the cards, flowers, emails, visits, calls, gifts and meals from my family and friends - and have even been contacted by friends I haven't spoken with in years. Make a vow that in 2012 you will reconnect - or connect more deeply - with people who make you happy!

 Welcome 2012!

A Little Music, Please!

I love music. I'm one of those people who lives their life to a soundtrack. During the two weeks of intense testing to arrive at my diagnosis, I relied on Mozart while I waited for what seemed like years for my endoscopy and colonoscopy procedures to begin, and during the two lengthy MRIs I experienced. Being claustrophobic, music was the only way to get me through the nearly two hours I spent in that tiny, confining tube.

I've done so much reading lately about the mind/body connection and the power of positive, happy thoughts in healing. Those patients who take control, who fight like hell and who have hope and positivity seem to do better in every respect - managing side effects, healing and in ultimately becoming cancer free.

And so it seems only natural that I should hunt through my music library to find the most empowering songs in my collection and put them into my playlist for my first chemo and radiation sessions. I'm gonna show those cancer cells who is boss! Here's the list so far:

Strip Me by Natasha Bedingfield
Skyscraper  by Demi Lovato
Born This Way by Lady GaGa
SuperGirl by Saving Jane
Know Your Enemy by Green Day
Brave by Nichole Nordeman
Be OK by Ingrid Michelson
Heal Yourself by Ruthie Foster
Hit me with your Best Shot by Pat Benatar
I Dare You by Shinedown
Bulletproof by La Roux
Survivor / I Will Survive by the Glee Cast
It's Amazing by Jem
Darlin' Do Not Fear  by Brett Dennen

These titles are really for anyone who wants to move their mood to a place of power, control and positivity, so I invite you to sample from my list!