Happy New Year

For me, actually getting to 2010 is an accomplishment. As I think about this last year, I don't have any particularly philosophical or witty insights to share. It was a good year which has given me all kinds of wonderful memories, and that's enough.

No resolutions for 2010, either, except that Psalm 118:24 has been running through my head a lot. (Ha! Some of you thought that I wasn't religious enough to know a Psalm, and others aren't religious either and don't know just what verse I was thinking of. Well, do what I did -- google it.) As far as I'm concerned, most of the rest of the psalm is testosterone-filled Me 'n' the Lord beat up on all my enemies (verse 12, for example), and then there is the wonderful verse 24, which makes for as good a resolution for the new year as I could ask for.

Okay, it's "This is the day the Lord has made. We will rejoice and be glad in it."

Just after I wrote the last blog, the dryness and heat of the corner of the living room hit our Christmas tree, and leaves and oranges started cascading onto the table. As I took down the ornaments, more fell until the tree was almost bare. We watered it well and took it out into the sunspace, hopefully to recover.

I thought of writing something about this all being the snarky response of the universe to my sentimental post, but Jerry put it much better. "Just tell them," he said, "that yesterday we had a great harvest of oranges from the tree in our living room."

I think I'll make marmalade.

The changing face of Christmas

First of all, it was a wonderful Christmas, including all of the warmth, joy and love I could ask for. (The food was a lot better than last year's hospital meal, too.)

It's interesting, though, how traditions have changed over the years, and our "Christmas tree" symbolizes some of the changes. We didn't want a full-sized tree and don't like fake ones, so we did what worked for us. More and more what works is becoming something less than the traditional while trying to reflect the traditional, and not just for Jerry and me.

For one thing, I don't think I know anyone whose family all got together at the same time in the same place on Christmas Eve or Christmas day (I can't speak for Hanukkah, though I'd think that seven days would give more leeway). What do you do if you have at least three sets of grandparents and a couple of ex spouses or partners, some of whom don't get along with each other, to see on The Day? You need a spreadsheet to figure out the logistics. Usually what happens is that The Day stretches out to two or three, or maybe a full week that crashes into the New Year's Eve celebrations. By the time everyone has celebrated with, eaten with and given gifts to everyone else, they are all exhausted, cranky and ready to avoid the whole family for at least six months.

What's the solution? I have friends who have made themselves miserable this season because "it isn't like it used to be." I wonder if it ever was, but I'm no expert. When I was growing up in Catholic and Muslim countries, my family's Christmas was never what the magazines and movies showed, so I never expected it to be or assumed that back in the States whole intact families were all going to the midnight services and then drinking eggnog together. Maybe they did -- but does that mean they always have to?

An orange tree makes a great Christmas tree. Celebrating with family on a day that doesn't happen to be December 25th is wonderful. Getting rid of stressful traditions and building new ones keeps the holiday meaningful.

Music hath charms

The trombone section at our last concert (we do clean up nice, don't we?)

Music therapy has been shown to help cancer patients, though music therapists always issue two warnings -- first, that music doesn't take the place of traditional therapies, and second, that it should be carried out under the care of a qualified professional. I think they're saying "Don't try this at home." They don't say anything about school gyms, churches, community centers, or any of the other places we've played during our Christmas season.

And it's been wonderful.

Therapeutic, too. Who could ask for anything healthier than to make joyful noises with a bunch of people who don't wince when I accidentally miss an accidental, who make jokes at the right (and sometimes the wrong) moments, and who seem to be having as much fun as I am? Trombonists, or at least the ones I know, don't suffer from the competitiveness of trumpet players, the ego of flutists, or the nerves of double reed players.

Not all music-making is therapeutic, though. A Romanian high school student of mine once warned me that it is a well-known fact, in Romania at least, that all bassoon players eventually go mad. It's something about the way the vibrations hit the nerves in the chest. He told me that trombone players don't have to worry about going mad, because you have to be crazy to take up the trombone in the first place. Nice to have one less thing to worry about.

Us and God's Little Creatures

The picture is actually from last spring -- these are the wild turkeys who live in the neighborhood and love the dropped apples from our tree. I saw them the other day, first time this fall, and the flock is even bigger than it was last spring. I counted thirty, all gathered around the crab apple tree, one so excited that he managed to fly to the top of the tree (a whole six feet), land on a branch, and chomp away at the crab apples above his clan's heads. It's always fun to watch the wild turkeys.

On the other hand, there's our skunk. No picture, because last week when I saw him sniffing around our garage door I quietly and slo-o-owly went in the front door. Our next-door neighbor told us proudly that he always puts out food for the skunk, which explains the glossy coat, weight, and general air of satisfaction. Jerry and I don't share the satisfaction. We just wish the skunk would live over at the neighbor's house instead of under our barn.

And then there are the squirrels. When the weather got bad last week several of them decided to move indoors for the winter. They chewed a hole in the grill over the gable, got into the attic, and ran races with each other every morning just before we were ready to wake up. Something had to be done. Jerry covered the wood grill with mesh. They got in through the edge. He nailed it down harder. They went through the other grill, higher up. He put one ladder up to the roof and nailed another to the roof, and balanced a Hav-a-heart trap baited with crackers and peanut butter on the roof ridge. He nailed the trap in place. That night the wind blew the ladder down and the bait out of the trap, though thanks to his workmanship the trap didn't come down. The squirrels retreated into the attic, where it's nice and cozy and there's plenty of room for their races. Jerry got some heavier mesh and rigged it up around a large funnel so that, theoretically, the squirrels could get out but not back in. The squirrels spent the next day chewing the plastic funnel and enlarging the hole. Jerry, now seeing this as a personal challenge (man against nature) went out and got a metal funnel, which he modified so that sharp edges would discourage the squirrels from even trying to get into the attic but would still allow them to get out. (Man:0 Nature: 3)

I think the latest may have worked, but last night Jerry kept waking me up by saying at intervals, "Did you hear that? Are they back in? Next time I try a shotgun."

Stay tuned.

A year ago today

The ice storm froze roads, downed power lines, and brought our area to a standstill. Jerry and I didn't lose power, and didn't realize for three days that our next door neighbors were managing with wood stove, candles, and going out for meals and showers. The town set up a warming space in the community center, complete with power and wi-fi so that people could charge their phones and check their emails.

All of this was completely overshadowed for Jerry and me, because on the 15th I went into the hospital for emergency surgery on a perforated duodenal ulcer. I was in the hospital for ten days (getting sprung on the 25th was the best Christmas present of all), being cared for by nurses and staff, many of whom didn't get electricity back in their homes for several days, but who were all both professional and gentle. (We still wonder how Audrey's chickens are doing.)

Now, a year later, most of the uprooted trees and broken branches and debris have been cleared away. All of the emergency services have decided that they did a pretty good job last year but are now better prepared for any future disasters. And the stitching on my duodenum has held beautifully.

Physical effects of loneliness -- not me

In Cancer-Ridden Rats, Loneliness Can Kill
Included In: Psychology / Psychiatry; Preventive Medicine
Article Date: 08 Dec 2009 - 5:00 PST

Socially isolated female rats develop more tumors - and tumors of a more deadly type - than rats living in a social group, according to researchers at Yale University and the University of Chicago.

"There is a growing interest in relationships between the environment, emotion and disease. This study offers insight into how the social world gets under the skin," said Gretchen Hermes, first author of the paper and a resident in the Neurosciences Research Training Program in the Yale Department of Psychiatry.

The leading suspect seems to be stress, triggered by being separated from a group. Stress is linked to many negative health outcomes - including activation of cancer-promoting genes.

To test the hypothesis, researchers followed the development of spontaneously occurring mammary tumors in rats that lived in groups or in isolation. Although both the solitary and social animals developed tumors, the isolated rats developed 84 times the amount of tumors as those living in groups. Those tumors also proved to be more malignant than those found in rats living in groups.

The results show that health effects of isolation need to be studied more closely in a broad range of human disease, particularly psychiatric disorders, Hermes said.

...."The results of this study make a physiological link between loss of the social network and disease states, and may help explain the shortened life expectancy of individuals with mental illness."

Source:
Bill Hathaway
Yale University

So is this another example of mind-body connection? Or is it an example of mind-body-social group connection?
If social isolation is a risk factor for disease states, there is yet another risk factor(like obesity, smoking, and eating red meat) that doesn't explain my situation. (And I'm neither male nor African-American -- two other risk factors for pancreatic cancer.)
On the other hand, I'm sure that my healthy habits are part of what has kept me going so well, so far. And this study (even though I'm not a rat) suggests that, as Jerry and I have said all along, the love and support of family and friends is another big part of my continued good health.

Concert Season

The winter concert of the Keene State College orchestra was Wednesday. Here they are, setting up (the first bassoon is to the left of the harp). They did a wonderful concert, including The Egmont Overture, the Peer Gynt Suite, Night on Bald Mountain, and a suite from Carmen.
(No, they didn't play on a cruise ship. It's tilted because I just can't get horizons straight.)
They did all that work for just one concert, but oh, it was lovely.





And here is Westmoreland Town Band, setting up in the Troy Congregational Church for our second concert of the season. I think we have a classier venue, at least to look at. Of course, we're so spread out that we can't actually hear each other, but frankly that can be an advantage.

Our first concert, at the nursing home, was marked by a train wreck in The Canadian Brass Christmas Medley at the point where the first trumpet and the first trombone play a haunting duet. Unfortunately, the trumpet, whose meds definitely need adjusting, came in a measure after he was supposed to, and continued to trail through the entire section. The duet was more than haunting. It sounded quite modern: The Canadian Brass and Zombies. However, the audience, most of whom had never heard of The Huron Carol, didn't seem to mind. They sang along anyhow.

Last night we played at the church, and because everyone had to get there through the first snow storm of the season we had a small turnout. We attacked the Canadian Brass again, and this time the first trumpet didn't play the Huron Carol at all. Much as I love trombones, I have to admit that this doesn't quite work as a trombone solo.

We have another concert today. I can't wait.

CA19-9, CA 125, PSA, B2M and like that

I got the results of my latest CA19-9 on Wednesday. The good news is that it hasn't gone up much, but the bad news is that it has gone up (110 in October, 115 in November). This isn't a major jump, since the numbers can go up into the tens of thousands, so it has basically remained stable for the past three months.

I started wondering, though, about other tumor marker blood tests and discovered that there are a lot of them out there -- Wikipedia lists 24. They range from the most familiar, the PSA for prostate cancer, through CA125 (ovarian), CEA (colon and rectal), and B2M (multiple myeloma, CLL, lymphomas). All of these have been developed since 1965, when CEA became the first successful blood test for a common cancer.

So if we have all these great tests, how come people are still diagnosed too late?

There are problems with these tests:
* Most healthy people have at least some of all these markers in their blood, and so far it's impossible to tell which people are healthy and which have an early case of cancer.
* On the other hand, some people don't show the markers at all. About 5% of people with pancreatic cancer don't show a CA19-9. If you just went by the marker, they'd look healthy.
* Elevated markers don't always show cancer. An inflammation or other problem might temporarily raise the marker.
* The markers themselves vary from month to month in a kind of sine wave (I'm waiting for the downward swing of mine).

So why worry about the tumor marker levels at all? Basically, because except for CT and PET scans, the markers are, at least for some kinds of cancer, the best thing we have. And that, while it's better than nothing, is really frustrating.

It's about the turkey

It was a wonderful turkey -- and a wonderful day. Thanks, Anya and Max.

As far as Thanksgiving goes, I'm a traditionalist. I appreciate that the vegetarians and flexitarians among us won't eat turkey, and I'm willing to make an exception for grilled salmon or some fancy veggies, but for the rest of us? It's gotta be turkey. I'm almost shocked at the friends this year who had (in one case) pork loin with quinces or (in the other) roast goose a la perigord. These are delicious and special -- but they aren't Thanksgiving.

When I lived overseas, Thanksgiving was, more than Christmas or even the fourth of July, the holiday that brought Americans together. I remember how the women of the American expat community always struggled and improvised to put together something approaching a real Thanksgiving feast, successfully enough that our Non-American friends begged for invitations.

There was only one time that American imaginations failed. In Somalia we said the hell with it and went to the Chinese restaurant for sweet-and-sour wart hog. It just wasn't the same.

Every Thanksgiving, every family gathering, is a chance to reconnect. Sometimes, when times are bad, there's a feeling that we're circling the wagons. Other times, we celebrate growth and success. There's always the feeling: we're here. We made it through, and we're together.

And besides, there's the turkey.

Thanksgiving

I have so much to be thankful for. To keep this from turning into a Stephen King-sized book, I'm going to skip the family and friends I value and appreciate every day and take a look back at the past year. Here's just a few snapshots of what I am thankful for this year, without a lot of comments.

November: Obama's election. I was here to see it, and no matter what challenges he faces or whether I agree with all of his decisions, I am proud of what our country did in electing him.
December: The wonderful people at the Cheshire Medical Center who took such good care of me during and after my emergency surgery -- while dealing with the aftereffects of the ice storm.
January: Being able to eat real food again and feeling my zest for life come back.
February: The first anniversary of my diagnosis. I beat the odds.
March: Our trip to Cancun. I like luxury.
April: Our trip to northern Minnesota. And the volunteer cherry tomato that grew in our sunspace that we ate, ceremonially.
May: First concert of the season for WTB. It's wonderful to play with them again.
June: Boston trip with the group that has been Doing Boston together (mostly) for something like twenty years.
July: The incredible trip to Utah, the highlight of the entire year.
August: Miles stayed overnight with us.
September: The jam and jelly factory went into full production mode.
October: Cinda's visit. New car. Max and Anya and Miles came up for the Pumpkin Festival. (October was full of good stuff!)
November: The wonderful kitchen project is done. I am so spoiled.

National Curry Week in the UK

My online friend Margaret, whose url which I suddenly am unable to link to: http://margaret.healthblogs.org says that "November 22-28 is “National Curry Week” in the UK.... A Google Alert this morning took me to an interesting Liverpool Echo article (http://tinyurl.com/ydmobdo), which includes information on turmeric, chilli, garlic and ginger (and a curry recipe, too, on page 2)."

It seems as though a good curry masala includes just about every anti-inflammatory and anti-cancer substance you could ask for, good for everyone, not just those of us with cancer. And delicious.

So -- Americans are going to have all these leftovers this weekend. A good curried turkey dish (check out http://www.curryhouse.co.uk/chef/turkey.html) will be good for your health and will increase cooperation and understanding among Americans, Indians, and Brits. Who could ask for anything more? Except to make the links work.

Julie

Last week my friend Julie died of pancreatic cancer. While the disease was one thing we had in common, there were others. Her husband had been one of the founding members of the Keene writers' group. She was part of the local Friends Meeting at the same time as my family was. She played cello in the local orchestra where Jerry plays bassoon. Our lives, while not close, had many meeting points, even before the day I called her to say that I was newly diagnosed and had heard that she also had pancreatic cancer. She immediately arranged for us to meet so that she could share her own experiences, and this first meeting turned into an occasional get-together for an "anti-cancer meal," including as many healthy (and delicious) foods as we could think of, and conversations that included but were not limited to our states of health.

It isn't often that I get words of wisdom from TV shows, but a bit of dialog from House MD has stuck in my mind. A patient wanted to check herself out of the hospital so that she could go home and "die with dignity." House went into a rant, saying "You can't die with dignity. No one dies with dignity -- all you can do is live with dignity."

Julie proved him wrong. Both in her living and her death she showed immense dignity and grace. I will miss her.

Chemobrain: I've got it

A couple of books have recently come out announcing (surprise, surprise) that chemobrain actually exists. It's like false labor. Ever since Lucy roamed around East Africa, women have had false labor, but the medical establishment didn't believe in it until Drs. Braxton and Hicks studied the phenomenon and named it. I bet they were both men, too.

In any case, there's now been research on what some experts are calling "cancer- and/or cancer-therapy-associated cognitive change." (They would, wouldn't they.)

In one survey, primarily of breast cancer patients, at least 50% rated their symptoms as moderate to severe in the categories of
*lack of concentration
*short-term memory loss
*difficulty with word recall
*inability to organize daily tasks
That's not to mention the dyslexia, problems with interruptions, fogginess, and problems with follow-through of projects.

However, the experts assure us cheerily that most people regain at least some of their smarts after chemotherapy stops. For those of us whose cancer is a chronic condition that depends on indefinite chemotherapy, there's an image of brain cells running out like sand in a timer -- not a cheery thought.

I've been lucky. As far as I can tell, and please don't correct me if I'm wrong, I've only had two major cognitive changes from all my years of chemo. First, I have real word retrieval issues, and wouldn't you know, the problems always seem to happen when I'm telling a story to several people at once. I suddenly lose a key word. I grope madly for it, while the listeners wait patiently for me to be profound, or witty, or even coherent. I finally grab at something, anything, to finish the sentence. The word is usually blindingly umm, starts with an o, has three syllables, what is it? blindingly ... clear, but that isn't it exactly ... easy to think of.

The second isn't even a problem, though it would be if I were still a student or a teacher. I can't remember anything I've read for any length of time. I can pick up a book I read a month or two ago, reread it, and enjoy it as much as I did the first time. It's nice, because I read so fast that now I don't have to worry about running out of reading material. This isn't true of books I read years back, by the way; I remember those clearly.

Of course, there are always upsides to anything. It's a great excuse for any kind of forgetting or fogginess. Jerry once claimed that he had Chemobrain Through Lateral Transmission.

Some people

A nice chat in the infusion room with a woman whose daughter had accompanied her to pick up a continuous chemo system. She was going to get a fanny pack to hold the drugs which would be administered through her port while she went about her daily business, getting the chemo 24/7 for several days. However, there had been a glitch and the system wasn't ready.

She and her daughter seemed upbeat and friendly, and we exchanged the usual what-are-you-here-fors. She has esophageal cancer. Most of the time, though, we talked about Scrabble. She was clearly a good player, knowing about qi and wiz, looking over Jerry's shoulder and spotting good plays, so we agreed that if our schedules ever lined up it would be fun to play together.

As time went by, though, she got more and more annoyed at having to wait. Finally I overheard her saying to her daughter, "Well, it looks like we'll have time to go out for a cigarette," and they got up and left. They came back rather quickly, probably after they found out that Dartmouth-Hitchcock is a non-smoking campus and they'd have to walk a fair distance to get to where they could smoke.

So.... am I totally bigoted in being horrified that someone on chemotherapy for esophageal cancer is still smoking? I found myself emotionally pulling away from this very nice woman just because of that. On the one hand, who am I to judge anyone else? On the other, how can she?

Hoofbeats

When the doctors finally put my symptoms together and we found out that I had pancreatic cancer, one of them explained why it had taken so long. "In medical school they told us that when you hear hoofbeats, the first thing you should think of is horses, not zebras." In other words, the common explanation is usually the right one.

But when you're in a situation where the common explanation wasn't the right one, you tend to think zebras the next time you hear the hoofbeats.

Last week I started coughing, so of course my immediate thought was metastesis. What else could it be? Jerry, more realistically, said that I sounded like I was coming down with a cold. I got out the zinc, vitamin C, and my new best solution, elderberry extract, dosed myself up with all at frequent intervals, and drank lots of tea with honey and lime, and I feel fine.

Sometimes they really are horses.

The Kitchen

Jerry said to wait until the tiles for the backsplash are in, but I couldn't. He also has the new and improved island to do, but meanwhile I'm cooking and enjoying the spaces, the prep area, the SINK, and the window into the laundry room.

The bright pumpkin orange ended up a bit too bright, so Jerry toned it down to more of a turmeric color, and I love it. The backsplash will be the same burgundy as the trim.

Gorgeous, hmm?

Signs and Portents

We live at the southeastern corner of this crossroads. I took the picture from Pleasant Street, which is the official street we live on, looking at the signs for (from left to right) Ryan Road, Frost Hill Road, and Bixby Street.

The more I think about this, the more confused I get. For one thing, even after forty years of teaching ESL, I'm not sure what differentiates a road from a street.

For another, this picture sums up just why it is that people from, say Utah just to pick a wild example, get so confused in New England. Four roads (streets?) meet at an otherwise uninteresting point, and instead of road A crossing road B and continuing to be road A, it suddenly becomes road C. Why?

Then there's the question of the names themselves. Pleasant St. is simply and appropriately named. Frost Hill Road is clear, except to the flatlanders who come around during leaf peeping season and want to know if this is the actual road that the poet lived on (someone actually asked me that once). But who were Bixby and Ryan, and what did they do to deserve the honor?

My big question, though, is why there are only three signposts at the corner. Even though Pleasant St. is the main road up the hill from the town, it doesn't rate a sign of its own.

Perhaps this is all some sort of philosophical metaphor. Here I am on this unlabeled (but pleasant) street, at a sudden crossroads in the middle of nowhere, facing cryptically named roads leading off -- where? Should I be thinking in terms of treatment options, lifestyle choices, or my immortal soul? I won't even get into the fact that one of the roads, but I won't tell you which, is a dead end.

Or maybe this is the place where the traditional New England jokes about lost flatlanders originated.

"Does it matter which road I take to get to Jaffrey?"
"Not to me, it don't."

Progress!

Jerry wouldn't agree, but I think the whole kitchen project has gone incredibly smoothly. The walls and floor are now probably more true and even than they ever were before, the cabinets are all in and filled (drawers that slide in and out without tugging!), the countertop and SINK are in and working, and the first coat of primer is on the walls. Jerry's putting the second coat of primer on now. Wait till you see the final colors.
I spent Saturday morning putting things away, and, as promised, throwing out the worst of the paper goods. It's a wonderful feeling.

Anniversary season again

With all of the kitchen and car projects, I let an anniversary go past. Two years ago on the 12th of October I started getting the symptoms that eventually led to my diagnosis. I look back on the four months between the onset of the symptoms and the diagnosis itself and remember that the pain and confusion were just a part of other health problems -- we worried that the operation on Jerry's ulnar nerve wouldn't work and would leave him unable to play. We worried that his cardiologist would find something odd about his aortic valve, and he did, though it turned out to be nothing to worry about. Jerry also had a painful UTI during this time. And a few weeks later, I took my fall down the slippery hillside and completely blew out my posterior tibialis tendon. It wasn't surprising that the stomach pain and jaundice seemed like just one more thing instead of The Big Thing that it's all turned into.

Yet here I am, two years later, and in amazingly good shape. Yes, I take a variety of pills every day, though a lot of them are self-prescribed vitamins and minerals. Yes, my energy is good except when it suddenly disappears. Yes, I have to plan each week that I'll spend one afternoon at the treatment room and the next day lying on the couch feeling as though I'm coming down with the flu. Yes, I'm relieved that I'm not still working and getting exposed to all the germs little kids share with everyone around them.

But these are small things. What's important is that family and friends continue to support me. Every day truly is precious. There are still new things to learn, laugh at, and glory in.

And next year's anniversaries to expect.

A quiz for you: Which is the new car?

Yes, we did it. A 2010 Kia Forte, and while it doesn't have the heated seats and GPS they tried to sell us, it still has enough bells and whistles to give us a learning curve, including a neat system in which you can move from automatic to a kind of manual transmission without a clutch. Just right for our needs.
And, of course, we still have the '76 Volare for backup, though I'm not sure if it can actually back up.

It's nice to get that out of the way. Does anyone really like buying a car? My fantasies never include long, fast car rides with the wind in my hair and loud music surrounding me. I just want to get from point A to point B as smoothly and efficiently as possible. And up the hill to our house in the middle of winter.

Remodeling Kitchens Can be Hard on a Marriage

We've been through this before. When Jerry and I got married, we (or at least I) never thought that owning a house would be in our future. I'd grown up in a series of rented places in strange countries, with a father who was so unhandy that he wouldn't let me push pins into the walls for posters because he wasn't sure how to cover the holes up when we left. So marriage to MacGyver led to some real culture shock. Not only did he want us to buy a house, but he wanted to remodel everything, including the kitchen.

We started from opposite philosophies. In his mind, the perfect kitchen was a 4' by 4' square. The cook stood in the center and swiveled to get to everything. In mine, the kitchen was the heart of the home, enormous, welcoming, and who cared if you had to carry a potful of boiling soup across a half acre to get it from the stove to the table.

This may have been why our only vicious fight in the past 42 years was over some detail about a kitchen remodeling three homes back. (We won; we're still together.)

The present project has gone amazingly smoothly, in part because I think Jerry has come to his senses about size. His wistful suggestion that if we simply cut the kitchen in half we'd have room for a grand piano didn't really fly.

We haven't fought about cabinet placement or materials, the new microwave/hood exhaust over the stove, or even countertop material or color.



However.... We're still in disposable mode (the sink doesn't get delivered until maybe Friday), and tempers are beginning to fray.

Somehow, over the past 25 years in this house, we'd accumulated an amazing number of paper plates and napkins, and plastic utensils. Every time we had an informal party we'd buy more, and then stash the leftovers where we couldn't find them again. The latter are supplemented by my packrat tendencies. I collect little knives, forks and spoons from airplanes, fast food joints, and occasionally from potluck parties. After all, they're perfectly good.

Well, they aren't. This experience has pushed me to discard the forks with missing tines and the spoons with the jagged edges, and to suggest that we should throw everything out and get some decent ones.

Jerry, caught by his own packrat-itude, refuses, and, certain that we're going to run out of paper plates and have to eat off the bare table with our bare hands, goes out and buys more to supplement what we've got. But because it's only for another week or so, he gets the cheapest. Coffee exploded in his crappy styrofoam cup in the old microwave yesterday. And somehow we've ended up with a couple hundred knives and three spoons.

I don't do this often, but I'm laying down the law. The minute the new sink is in and we can really truly wash dishes again, I'm throwing out all the limp paper plates, defective coffee cups, and slasher utensils.

Jerry says, "But we might need them some time."

I say this is beyond physical need. It's a matter of our marriage.

Kitchen progress

While we were out admiring pumpkins, Jerry kept busy. He took out everything but the kitchen sink, and then he took out the kitchen sink. We're using paper plates and plastic, and feeling as though we're totally destroying our carbon footprints as we do this. The nondisposables, mostly knives and pots and pans, Jerry washes in the bathroom sink, now tastefully decorated with a drainboard that slopes into the bathtub.
It works, at least for the time being.
Jerry says that when people say that "they don't make things like they used to" the only answer is "Thank God." Hiding under the kitchen walls and floors all these years were substrates made of what looks like cardboard. I don't know what was holding the kitchen together -- unless it was what J put in when we first moved here.

It strikes me that this is a real Green Bananas project. We have faith that my health is going to hold, not only for the next few weeks through the process, but for a long time after that.

Meanwhile, I'm enjoying the feeling of camping out. Remember Colonial House and Frontier House? I think they could get a good reality show out of Kitchen Remodeling House.

Pumpkin Festival

Keene's Pumpkin Festival was Saturday, with a record of 29,068 carved pumpkins lining Main Street and on scaffolding in two places. Actually, Boston beat our record three years ago (talk about Godzilla meets Bambi). Lots of creative, beautiful, funny carving; lots of pumpkin-flavored goodies; good weather, good time. Miles liked the giant pumpkins, the bouncy booth, and the pumpkin that looked like a hamburger, with pumpkin seeds on the "bun."
I loved wandering around with Max, Anya and Miles. Jerry loved staying home and avoiding the crowds.

Life is Good

It's been a wonderful last couple of weeks, despite Jerry's trying to pull rusty nails out of the wall with his bare hands. One of the nurses at the cancer center pulled his stitches on Tuesday, and his hand is fine. He can play bassoon and continue with the kitchen remodeling with no problems.

This past weekend was full of family -- what a joy! Cinda should visit more often (hint).

Of course, there are also physiological reasons for my feeling so up. My various blood counts (white counts, red, platelets, neutrophils or whatever they are) had been way down for a while, but as of last week had gone back up to normal. I really think it makes a difference in my energy levels and my spirits.

And other good news is that my CA19-9 has gone from 129 to 111 this month.

With all of that, I went to band rehearsal three hours after my last chemo. The next day, usually my "chemofunk day" I even got out to exercise. I could get used to feeling like this.

Family, wonderful even when the flash doesn't work

Me, Max, Miles

Me, Cinda, Max

Cinda, Jerry

Anya, me

I know that there are some incredible families out there, loving, joyful, intelligent, and funny.... but mine is the greatest.

Sometimes things gang aft agley

Yesterday I wrote that the kitchen project was on hold during Cinda's visit, but I was wrong. By yesterday afternoon, while she lay on the couch recovering from the redeye flight and I lay on the other couch recovering from chemo, Jerry was out creating storage for the cabinets that are to be torn out. The storage, by the way, in the top picture, is made from boxes he built in Liberia which have followed us and been used everywhere we've lived since.

Cinda and I moved everything from the cabinets into the temporary storage (pots and pans are, for the moment, on the end of the island), and Jerry started the demolishing project.

Throughout our marriage, there have been times when I come home to find a blood-stained note on the kitchen counter: Have gone to ER, don't worry. . This time, with much less drama, when I came back from the Y he showed me a large bandaid over his palm and said it was nothing.

I shouldn't have believed him. We went out for a very nice lunch, and when we came back and he was getting ready to go to orchestra rehearsal he stripped off the bandaid and asked me to help put a new one on. It was like looking into the Grand Canyon.

Cinda and I sent him off to the ER. Because he wanted to go on to orchestra and we just have one car, he had to drive himself.

Result? Nine stitches and a tetanus shot later he came home, having missed orchestra. No damage to blood vessels or tendons, so he's lucky.

Me? I was going to write a sentimental post about how much having Cinda here means to me, and it does. But there's Jerry, wounded warrior, and part of me feels almost happy to be the one who's doing the fussing and being the caretaker for a change.

All ready

The new closet is done, and as you can see, beautiful. Jerry's moved the refrigerator back against the wall, out from the middle of the room. He won't start the next phase of the remodeling for a week --

Because Cinda arrives for a week's visit tomorrow. Yay!

H1N1 and me

No, I don't have it. And, apparently, I'm not at risk. You can't imagine how great this makes me feel. I get my regular flu shot and make Jerry get his every year because the experts always point out that people with compromised immune systems including people with cancer are especially at risk.

But the CDC lists the following in descending order as those most at risk for H1N1:
*pregnant women
*those with asthma or diabetes
*people between the ages of 6 months and 24 years
*health care workers
*people who care for infants
*people between the ages of 25-64 with other health problems

I'm not in there. This makes me feel so ... healthy. Sure I'll get the shot, eventually, but right now I'm glad to be in line behind all those vulnerable people. Me, I'm made of steel.

Why we need a new car

Or do we? Could we get along comfortably with just one car (okay, two if you count the 1976 Plymouth station wagon that we use for going to the dump and getting sheetrock)? But the other real car, which means the one I can drive, is getting old and rusty, and has trouble getting up our hill in the winter. Last December we needed a car that would get us, post ice-storm and nervous, to the ER at 3:30 a.m. It would be nice to assume that we won't have any more emergencies, but who knows?
We loved the KIA, but the body of mine at least seems to have been made of tinfoil, so we're thinking of something a bit more solidly built. Other requirements: small, all-wheel drive, automatic. Any suggestions?

Friday evening

From the Fire Mutual Aid Log in the Keene Sentinel
Friday, September 18 5:54 p.m. Swanzey Fire Department to 767 West Swanzey Road, motor vehicle crash, two injuries.


All those years I teased my high school students as they prepared for their drivers' tests, "While you're out practicing, just watch out for my car and go up on the sidewalk to avoid it, or you'll get an F in my class." So we got rear-ended by a high school kid with a learner's permit who didn't notice that Jerry had slowed down and turned on his blinker for our turn into the restaurant parking lot. Jerry and I, in the front seats, were fine but shaken, but both of our passengers felt their necks were whiplashed.

It was amazing how quickly the emergency vehicles arrived. As a matter of fact, one of the fire department people told me that he lived a few houses down, heard the crash, and alerted the fire department. In no time, we had two fire trucks, three police cars, and two ambulances flashing lights around us. Everyone was completely professional and sympathetic, checking in at frequent intervals on Barbara, who kept cracking jokes, to their surprise.

The teenager looked shocked, his father as though he might have a few choice words to say to him when they got home. Jerry and I stood there answering questions. I suddenly realized that we were the people by the side of the road that all the cars slowed down to gawk at.

Barbara and Bill were carefully loaded into ambulances for a trip to the ER; our car was towed away; and a police officer gave us a ride home in the patrol car, pointing out that it would be a much pleasanter experience than most people got, since we wouldn't be wearing the handcuffs.

Regrets:
We were in the newer car rather than the older one.
I didn't have my iphone with me, so can't post dramatic pictures.
Our grandson wasn't there to watch all of the emergency vehicles. He'd have loved the sight.
And I feel bad for the poor kid who caused it.

Relief:
Barbara and Bill are okay, with no apparent permanent harm.
We're both fine, as are the people who were in the car that hit us.
The insurance seems to be taking care of getting the car repaired.
I've had new experiences that I never expected to.

Signs of Fall

I'm not talking about taking down the hummingbird feeder, or the ducks leaving the pond across from the house, or even the first red leaves appearing on a few maples. For us, there are three definite signals that summer is over and we're getting ready for autumn and winter.



We get out the crockpot and start to eat mush for breakfast instead of cold cereal. Jerry puts a secret mixture of various grains (and for all I know, slightly used sawdust) into the pot at night and in the morning we have a hot and stick-to-the-ribs breakfast, at least until the weather warms up again and we switch back to cold cereal.



I get overwhelmed with the worry that we're going to starve during the winter if I don't preserve everything in sight. I want to be sure that we're prepared for anything like last year's great ice storm. Of course, ironically, I was in the hospital for that and wasn't allowed to eat anything, but if it happens again this winter and I'm out and around, we're ready for it. It better happen, too, because otherwise what will we do with approximately 60 jars of jams, jellies, chutney, salsa, sweet and sour sauce, and relish? For two of us. (Pat, I owe you a jar of peach jam in return for those wonderful peaches.)



But the real way you can tell that fall is coming is that Jerry starts a major indoor project. Inspired by Max and Anya's kitchen redo, he started talking last week about what we could do, if we really wanted to, but really, he was just thinking about it and playing around with the idea. Yesterday was the magic day when he came in with the crowbar, so I guess we're committed now.

I love spring and summer best, but fall is good, too.

Patrick Swayze

No man is an island,
Entire of itself.
Each is a piece of the continent,
A part of the main.
If a clod be washed away by the sea,
Europe is the less.
As well as if a promontory were.
As well as if a manner of thine own
Or of thine friend's were.
Each man's death diminishes me,
For I am involved in mankind.
Therefore, send not to know
For whom the bell tolls,
It tolls for thee.

John Donne

Anyone who knows me knows that I'm not exactly celebrity-obsessed. All of us with pancreatic cancer, though, feel connected to Patrick Swayze. I was diagnosed at about the same time as he was, and like him, I was unable to have the Whipple procedure. Over the past 18 months I've followed his situation through the media and through the pancreatic cancer forums, which pick over any scraps of information like archeologists trying to determine the shape of a pot through a few scratched shards.

A typical conversation on the forums went like this:
"Does anyone know what treatment Patrick Swayze is getting?"
"He's being treated at Stanford, so he's probably getting something better than the rest of us."
"They say it's experimental."
"Don't be an idiot, the govt only oks Gemzar and Tarceva, so anything else is experimental, it doesn't mean he's getting better treatment than we are."
"I wish he was on the boards so he could tell us."
"Give the man his privacy, who wants to suffer in public?"

It was a combination of knowledgeable and sympathetic. Today the boards have reflected posters' feelings of personal loss. For us, he was not just a wonderful dancer and a great entertainer. He was one of us, in part important because he was a public face of the disease. We run through our poster boys rather fast, and he's been the most famous one since Randy Pausch died last year. More than that, though, he went through what we go through. Chemo was not easier for him because he was famous, and the best doctors at Stanford weren't able to make the Whipple possible for him.

He was a piece of the continent that is pancreatic cancer, and all of us hear the sound of the bell tolling.

Lots of good news

a) My CAT scan shows no change in my innards since last September. This is amazing and very good news.

b) My CA19-9 has gone down from 180 last month to 129 this month. This is what we want it to be doing.

c) Dr. Nickerson says that since my appetite continues good, I haven't been losing weight, and (except for chemofunk day) I feel well, I am well. No changes in my chemo regimen, no extra testing needed for a while. Another relief.

And, as far as the slight pain and nausea (and inability to eat french fries) are concerned, I'll start taking pancreatic enzymes with meals, which is something that most people with pc have to do from day 1. I've been lucky to do without for so long.

So all is well.

Tuesday testing

Tomorrow I go in for a CAT scan and more bloodwork. No picture of the bloodwork, to save Jerry's sensibilities. He usually goes out to get coffee while they draw my blood.

We go in to see Dr. Nickerson on Thursday to get the results of these tests and decide what happens next. I've been having mild stomach pain a lot of the time with something a bit more major whenever I eat things like french fries or more than a half a glass of wine. I suppose not eating anything fried or drinking anything alcoholic is an option. I suppose.

Plus there are the rising CA19-9 numbers, so generally it seems as though it's time for the retests and then to revisit my treatment plan and see if it needs tweaking.

Meanwhile we've had about two weeks of celebrating our 42nd anniversary, including getaways to our favorite getaway places.

Creativity--the planter and la cloche

Jerry can't leave an awkward pipe just sticking up in the middle of the lawn, so now we have a planter. What's in it now is just for illustration, but come spring we'll put in something bright and flashy. Or maybe tomatoes.







I play around with artisan breads (ie anything that isn't shaped quite symmetrically) and for ages have wanted a cloche, a pottery bell that encloses the bread as it bakes. Miriam, sister-in-law and amazing potter, created a cloche for me and I tried it out yesterday. Perfect!

I like hanging out with creative people. Shall I mention the wonderful colors and patterns Anya chose for their new house? The ways that she and Max bring Miles up? Luther's incredible quilting? And that is just my side of the family. If I added in the Germer side and included my writing, knitting, musical friends this post would go on forever. I am so lucky.

Half-anniversary

Eighteen months since diagnosis, hangin' in there. To celebrate each six months I take little jars of jam in to the oncologist, nurses and staff at the cancer center to thank them for their part in keeping me going so smoothly. Virtual jars of jam to all of you, as well, for your support.

Today is "chemofunk" day, during which I feel as though I might be coming down with the flu. It's turning out to be very predictable: the evening of the day I have chemo, almost precisely at 8:30, I suddenly fade, begin to have head- and body-aches and exhaustion. The next day the aches and pains continue, along with exhaustion that can be enough to leave me just lying on the couch doing nothing. And by evening, I'm fine.

People have asked me about nausea. Very little, and no vomiting, nothing like all those scare stories out of the 70's and 80's. However, it seems that I'm going to have to give up french fries, for a while at least. They don't set so well.

On the other hand, isn't it great to live in a world in which coffee, tea, red wine, chocolate, garlic, fresh fruits and vegetables, and candied ginger are all considered healthy! I had dinner with a chiropractor the other evening who tried to persuade me that none of the above except garlic, fruits and vegetables are actually good for you. He said that all the testing on the rest was done by the big corporations, and therefore couldn't be trusted. He sounded like a spoilsport to me. To his wife, too. She took some ham.

I wish you all a happy, healthy next eighteen months.

Water water everywhere

The pump was going on at odd times, so we finally called in the well people, the ones who fixed the pump last year. It turns out we had a leak in the pipe to the house, not in what was fixed before, therefore not covered by any kind of warranty. The workers did their thing, we paid enough for both of them to take a nice little vacation, and the pump no longer goes on when it shouldn't.

The other two results are that our water has been the color of Earl Grey tea for the past week and we have this standpipe in our front yard. It has to stick up to grade apparently. Jerry's told me twice what it's supposed to do, but somehow the information hasn't stuck.

It opens up all kinds of possibilities. We started with the idea of planting a bush in front of it to hide it. I saw a beautiful Rose of Sharon the other day that would look nice. Or we could balance a pot on top with some kind of drooping foliage and flowers; not so good if we get high winds.

On the other hand, maybe we don't want to hide it. Jerry could probably take some wire and turn it into a miniature version of a cell phone tower, the ones that are supposed to look like trees but never quite do. Or (and this was my brilliant idea), we upend a bathtub behind it, stick a L'eggs container on top, paint the pipe pale blue, and have our very own Our Lady of the Bathtub in the front yard.

My teeth are clean

However, getting your teeth cleaned when you're on chemo isn't as simple as making the appointment and then dragging yourself in to see the dental hygienist. First you have to make sure that it's safe.
It all comes back to blood counts. A side effect of Gemcitabine is lowered red and white blood counts. The former could lead to increased bleeding and the latter to a chance of infection, so before any dental work I have to get my blood drawn and tested.
I had my regular chemo session on Tuesday so I went in early to get the blood work for both that and the teeth cleaning.
Unfortunately, my levels were low. I protested that I was willing to take the chance, that the levels weren't really that low, that my gums don't usually bleed, and that it's hard to reschedule an appointment at the dentist. The nurses insisted on calling the oncologist, who eventually decided that I could go ahead with both the cleaning and the afternoon's chemo.
My teeth are in good shape.

Alternatives and complements

Melody's comments meant a lot to me. I certainly wish her husband's uncle the best as he and the family struggle with this.
I was also interested in her suggestion for other treatment, which I'll definitely look into, but it got me thinking about the various kinds of complementary treatments I've tried over the years through both bouts of cancer.
I do not do alternative treatments, but I am interested to try most complementary types. "Alternative" generally means something in place of standard treatments, and I have no doubts that surgery/chemotherapy/radiation is the best way to go, so far, for cancer treatment. "Complementary" just adds something to the standard stuff -- in my mind a complementary treatment probably hasn't been thoroughly studied because it won't bring in any money to the health-care industry.
That doesn't mean that there aren't things we can do to back up the usual treatments. Here are what I've tried:
-- supplements, some of which, like fish oil for appetite, are recommended. Some, like curcumin, though they're considered a bit weird, are actually being studied at well-respected cancer centers. Others, like Black Seed Oil, have only anecdotal evidence to back them up.
-- body work. I've been reiki-ed and massaged (I prefer the latter). I do yoga, but since I have for 35 years I can't really count it as a complementary therapy for cancer.
-- the same with meditation.
-- I've been rolled with magnets.
-- I've used mushrooms: Reishi, in the form of capsules which a Thai friend gave me, Shitaki from the supermarket, and Hen of the Woods, from the woods. I also eat Trumpets of Doom, not because anyone says they're good for cancer, but because they taste good and the name is cool.
I don't do coffee enemas or anything else gross.
If you hear of any other complementary therapy, especially if it's cheap and sounds like fun, let me know.

Not totally great news -- CA19-9 is up

It could be a lot worse.

My CA19-9 tumor marker is up to 180; last month it was 85, the month before 83. Dr. Nickerson wants me to have another CAT scan at the beginning of September to try and get some idea of what's going on. Obviously, I'm not happy about this.

For a while the numbers were down to the low 30's, ie normal. The highest was at the beginning of all this, when it got up to about 350. The range is from 0, which is unusual, to somewhere in the thousands, depending on the particular test. One statistic that I read was that 65% of the patients in a particular study had levels above 200. I haven't been able to find out just how high it can go, but it's clear that even my earlier 350 was fairly low. 180 is minimal -- except that it's the direction and the rate of change that are the true markers.

However, the CA19-9 doesn't even tell exactly what is going on. It can be knocked higher by infections or another disease, and some people don't even show any results at all. This is part of the reason it can't be used as a test for pancreatic cancer. The other is that if you're one of the people who does show the marker, and if you don't have any other condition, the CA19-9 only starts to rise when the cancer is advanced. We still need a simple blood test that will a)show whether a particular person has even the early stages of pancreatic cancer and b)accurately track what's happening once a diagnosis has been made.

I've had a couple of things going on that might be reasons for the marker numbers to rise. Inflammation from the ulcer could have affected it, and my off-and-on chemo sessions of the past few weeks might have messed things up. I avoid thinking about the alternative, though of course it's in the back of my mind.

Meanwhile, I feel very well. Chemo Monday didn't give me any side effects to speak of, my weight is stable, my appetite and ability to enjoy food are unchanged, and (except for the damned marker) life is good.

Miles slept over

And it may have been the first time that 24 whole hours went by without his being photographed. We were too busy going to Stone Pond, playing Legos, reading books, and eating to take pictures. Miles is a total delight. I remember when Max was an infant I hated our being around other mothers and babies, because I knew they'd realize how much more wonderful he was than their inferior offspring and would feel terrible. I have something of the same feeling now with my grandson. Yes, to other grandmas, your kids are cute, but mine is incomparable!

He picked and arranged the flowers above, choosing with great concentration and identifying as many as he could. When we were talking about the trip to Utah, he mentioned the playground at Russ and Rita's house, and the party at Mary and Howard's where the kids all played in the wading pool and ran around, but the first thing he said was, "I remember the flower garden at the place where we stayed." Maybe in a few years we can send him out to apprentice with Lonna.

As I said, he's a joy to have around.... But I am thirty years older than I was thirty years ago. We went to bed early last night.

EUS today

That is, an endoscopic ultrasound to see whether the meds I've been taking have affected the ulcer.

We (and the Dartmouth-Hitchcock Med Center/Keene) have this all down to a science. I was in and out in two hours, with the procedure itself taking less than ten minutes. The rest of the time was prep and recovery. The oncology nurses had told me to get as hydrated as possible so putting in the IV wouldn't be so difficult, but the OR nurse was annoyed that I'd finished my coffee at 7:15 when the instructions had clearly said 7:00 at the latest (two hours of empty stomach needed). In any case, my veins cooperated, and the anaesthesiologist didn't seem upset, because he started knocking me out before 9:00.

Good stuff, too. I was out like a light, and came to without grogginess, though I seem to have given Jerry quite a lecture on the three ways to knit sleeves in the round and why Magic Loop and four needles isn't as good as two circs. He didn't seem too disturbed by this.

Dr. Krishna says the ulcer has shrunk to 1/4 its original size. Yay! and double yay! that I can discontinue the pill that I was supposed to take four times a day and kept forgetting. I'm just on the other one, twice a day, and I can manage that.
So good news all around -- except that when I asked Jerry about my babbling about sleeves, he said, "You were very clear. There are three ways to knit sleeves: one has a very long needle, one has a lot of little needles, and if they don't work you send the sleeves off for your daughter to finish."

Was that what I said? I must have been groggier than I thought.

Vacation from cancer

Any time we get away it's a vacation from cancer. If it had turned out that I couldn't get along with my in-laws, or that Jerry was allergic to hot, dry weather (you can see I'm stretching for the impossible in both cases) it still would have been worth going, just to be away from this reality for a bit.

Don't get me wrong. The nurses and staff at the Kingsbury Cancer Center are warm, professional, and fun to hang out with, but that doesn't change the fact that they are punching holes in people in order to fill the people with poisonous substances that make them feel worse than the disease does. Jerry does his best to make the chemo sessions as tolerable as possible. (Sometimes I even win the Scrabble game, with the nurses and some of my fellow patients cheering me on. Jerry feels like The Viper in a World Wrestling Entertainment match, except that nothing about our Scrabble games is staged.)

But the fact remains that we know the next day I'll feel exhausted and generally low, and that the cancer is still there, lurking.

I bless my sister-in-law for saying at the end of the Utah visit, "None of us wanted to talk about the elephant in the living room, but you know we love and pray for you." I bless everyone for giving us this extra vacation from thinking about it.

It's given us both renewed strength to go on dealing with the cancer.

Family jams

What else could I add? (Except sound, which I'm not wired for)

How to sum up perfection?

Just a few of the 65 people at the family reunion last Friday:

Three brothers -- Russ, Jerry, and Ray:

Two of the three Mileses in the family. We missed the other one:


The rest of the photos I took show us, in various combinations of family members, either eating or playing music. Rob, son-in-law extraordinaire, brewer of beer that we didn't get to taste (only regret on the trip), and all-round wonderful person, has agreed to set up a family Flicker account so that we can all share pictures.

Too many high points of the trip to mention, since mentioning one might mean neglecting another that was equally wonderful. We saw Friends and friends we hadn't seen for years; spent a morning on Antelope Island in the Great Salt Lake; thanks to the kind present owners got a tour through the first house we owned and Jerry remodeled; had time to hang out with our immediate family; and it all built up to the incredible reunion.

Friday I realized that probably most people in the world aren't able to look around at 65 relatives (more or less -- the kids were running around and messing up the count) and know that it would be great to spend a lot of time with any of them. What a bunch of interesting, intelligent, decent people!

And, except for getting a bit tired out at the end, I felt fine the whole time.

logistics

It wasn't until a few weeks ago that Jerry and I began to believe that the Utah trip might actually work. We had a superstitious feeling that we couldn't count on it or something terrible would happen.
But Saturday evening we'll be in Utah!

The logistics get complicated, though. First the gastroenterologist had to say that the ulcer seems to be in remission, or whatever it is that ulcers do when they aren't giving any trouble. He kept saying, "It was a really big, deep ulcer. And you didn't have a lot of pain?"
"Nothing that Tums wouldn't take care of."
"So you had a really big, deep ulcer with minimal symptoms. Just keep taking the two medications and we'll do another ERCP in August."
In other words, because I didn't feel much pain from it, there's no way of telling if the meds are working until he sends the little camera back down my gullet. But as long as my stomach doesn't hurt (and it hasn't since I got the new meds) I'll assume everything is fine.

Then I had the regular appointment with the oncologist. I can tell when Dr. Nickerson feels I'm doing well, because our conversations stray off into other territory. We spent most of this one talking about how hard it is to fly from the East coast to the Western part of the country (his parents live in Wyoming) without going through Houston or LA. So he apparently isn't worried about my missing a chemo.

However, because of the ERCP, I'll miss another chemo anyhow. So I had one Monday, have another the Tuesday after we get back, then miss one, then have one? Two? Three in a row? In any case, the next month is going to be so easy!

Another bit of logistics is remembering and packing the various meds that I need or should have on hand just in case. Jerry hates to check baggage and has a habit of packing at least a week ahead of every trip. He wants us to just use two overhead bags, and he packed his to show me that it will be possible. I seem to have more stuff than he does, though it may be because I have to carry the travel scrabble game. I got my bag packed just to see if it would work, and it does, though I'm not sure where to put all the different meds. If he carried them in his jacket pocket, would the Homeland Security people think he was a notorious drug smuggler?

I can't tell you how much I'm looking forward to the next week. I may not get a chance to blog while we're there but I will when we get back -- with lots of pictures.