What Bitch?

The picture above is my cousin, Jeremy, with his wife, Shannon, and their three adorable munchkins. I am confident that anyone who has read this blog can appreciate by now what an incredible source of support, love, laughter and medical know-how both Jeremy and Shannon have been for Pete and I throughout this whole ordeal. I cannot in my wildest dreams imagine surviving these past few months without them in my life -- we are soooo blessed to called them family. We love you, Team Illinois!!!

Courage doesn't always roar.
Sometimes courage is the
quiet voice at the end of the day saying,
"I will try again tomorrow."

~Mary Anne Radmacher

Animal, Vegetable, Miracle

I have a GREAT book to recommend to anyone who is interested in learning more about the stuff I have written regarding diet and nutrition. The book is called Animal, Vegetable, Miracle and it's written by one of my favorite fiction authors, Barbara Kingsolver. This happens to be a non-fiction book in which she chronicles a year in the life of her family as they vow to eat only those foods which they can either grow themselves or buy locally. It is an incredibly interesting and thought-provoking book, and throughout, she weaves in a vast amount of information about the food industry, the not-always-consumer- friendly politics that have shaped the food which is available to us in our local grocery stores, and examples of why and how Americans have completely lost touch with what "healthy eating" even looks like.

Before reading it, I had a general understanding of organic versus conventional foods, but never really understood the importance of locally grown foods nor the difference between hybrid versus heritage fruits and vegetables and why this difference is crucial. I also never really comprehended how "off track" our eating habits had become as a generation and as a nation. Now I completely get it and am totally on board!! Anyway, the book is a bit dense to read, but well worth it for anyone who is committed to feeding themselves and their families in a way that supports health and longevity.

Interestingly, just yesterday I got my daily newsletter from Andrew Weil which touches on the same theme...read on...

Food is Getting Sweeter

If you’ve gotten the impression that more and more sugar is being added to common supermarket foods – you’re right. A report in the May 6, 2007 London Sunday Times, based on an examination of an industry handbook on food composition, found that food companies have doubled the amount of sugar they add to their more popular products since 1978.

For example, in 1978, Kellogg’s Special K cereal had 9.6 grams of sugar per 100 grams. This has now nearly doubled to 17 grams. Some canned soups have shown a similar increase.

Interestingly, even fruits and vegetables are now sweeter, probably due to market pressures forcing growers to breed hybrids with higher sugar content. Between 1978 and 2002, the sugar in a banana rose from 16.2 grams per 100 grams to 20.9 grams; pears and carrots got sweeter by a similar percentage.

Is it any wonder that obesity and diabetes are becoming worldwide epidemics? The only rational response to this situation is to bypass the industrial food complex as much as possible. Buy unprocessed foods from farmer’s markets and health food stores, and, if possible, select non-hybrid, heirloom varieties of fruits and vegetables over modern hybrids, which are quickly becoming analogs of sugar beets. Best choice of all: grow as much of your own food as you can.

Feeling Stronger Every Day

It's been exactly 2 weeks since my surgery, which is so hard for me to believe. It seems like just yesterday that I was writing about being nervous and now it's all behind me! Granted, I was knocked out on morphine for the first 4-5 days, so that certainly helps the time to slip by unnoticed. Ha!

I am slowly getting stronger and stronger. Each day I notice that I am able to do a bit more than the day before. I am still not out hiking and am probably a good couple months away from going for a run, but I can finally bend over and pick things up off the ground when I drop them (which is handy in the shower when I drop the soap! ha!) and I can get out of bed in the morning without wincing and I am able to slowly walk about a 1/2 mile through the neighborhood....all little baby steps that will hopefully lead to bigger and bigger steps before long and eventually to the San Francisco marathon in 2008.

The hardest part is being confined to my house. Not that I have to stay here, it's just that I can't drive yet and, even if I could, once I get somewhere I can't walk very far anyway and so it's easier to just stay home. So here I sit in a state of forced relaxation, letting my body heal. Come on, body -- HEAL!!!

Bitch-ectomy

I just got a very funny get well card from my good friend, Jan. In it she refers to my recent surgery as a "Bitch-ectomy".

HA, HA, HA, HA, HA!!!!

I LOVE that!!!

My Friend, Bonnie

I have a very sweet and dear friend, Bonnie, who has been battling leukemia for the past 4 years. Every time I see her, I am reminded of a small pixie fairy, for Bonnie is small boned, with short cropped black hair, and a constant twinkle in her eye. The only thing that she is missing is a magic pixie wand -- if she had one, I am confident that we would see her flutter around creating fun mischief and magic! Bonnie is also one of the most giving people I have ever known. She is one of the first people whom I called when I learned of my cancer diagnosis and she immediately sprang into action. In fact, I remember her first voice message back to me said "I'm here for you. Hang in there until we can talk. Everything will be fine. I called my oncologist and here are the names of doctors who you must meet at UCSF -- they are the best." I think that Bonnie knew, as only another cancer patient can, how incredibly overwhelming the first few weeks post-diagnosis can be and she reached out immediately and earnestly to help.

The bulk of what Bonnie and I talked about initially centered around my treatment: the pros/cons of being treated at UCSF versus a community hospital, the role of the various doctors (e.g., what the heck is a radiation oncologist and how is he different than a chemo oncologist), what chemo feels like, what radiation feels like, etc. Bonnie had been through it all! Two years ago, when her leukemia resurfaced, she had a cord blood transplant (which is the same idea as a bone marrow transplant, but more cutting edge). In order to perform this sort of procedure, she was basically taken as close to the brink of death as is humanly possible and then given a "new life." Literally...Bonnie now has a different blood type than she did before!

Once we had navigated through all of my "logistical" questions, though, our conversations slowly turned to the emotional side of having cancer. How do you actually get through this? I asked. How in the world do you stay strong when faced with a daunting prognosis? Please tell me how I keep from crumbling into a useless heap of tears?!? I will always remember what Bonnie said. She told me that the one thing she knew with all her heart is that she wanted to fight her leukemia with grace. She understood that there is so much about cancer that is unknown; so much that is out of the patient or the doctors' control. But Bonnie realized -- and taught me -- that the one thing that can be controlled is our reaction to cancer. Bonnie didn't know whether or not she would survive to see her two young children grow up (her girls are now ages 6 and 4), but she felt adamantly that she wanted them both to always know that she faced her "mountain" with grace. And she has!!

I feel blessed to have been taught this lesson early on. I am sure that there are some cancer patients who flounder for weeks or even months, unable to pick themselves up off the ground and move forward in their life, and I am glad that I was shown a different path. I have had so many people tell me that the way I have handled my own cancer diagnosis has been an inspiration, but I owe so much of my response to Bonnie. She has been my teacher, my friend, my "sherpa" as I ascend my own mountain.

Unfortunately, Bonnie just received bad news this week: her leukemia has come back again. She is being sustained through the weekend on blood transfusions so that she can celebrate her daughter's 6th birthday, but then she is headed back to the hospital next week for more chemo. And, unfortunately, she has one hell of a mountain to climb this time. Cancer that has re-occurred is never easy to treat. By definition, cancer that has come back was resistant to the first round of chemo (or else it would already be dead) and so different drugs -- if they are even available -- must be used. But I know Bonnie and I know that she is a fighter. And I know that if there is a way to beat this cancer down again, she will find it. And I also know that regardless of which path Bonnie's life takes her down, she will go gracefully with a twinkle in her eye. And there is so much I can learn from this....So much I can learn...

I Will Survive

Three of my closest and dearest friends came to visit me yesterday and, while they were here, we conference-called four other of our closest girlfriends so that they could be part of the "party." These are all friends whom I met while in graduate school 10 years ago and we have all remained incredibly close since then. When I think of these friends, the qualities that they all share (and which I love most about each of them) is that they are all strong, feisty, determined, smart, fun-loving, beautiful souls. We all became friends in our late 20's and, through our collective friendship, I think that we all gained an incredible amount of confidence about ourselves at a time when we were all struggling to define who we were and what we wanted our lives to represent. Together, we learned that we all have a tremendous amount to offer this world and that we should never compromise on our goals. Most of all, though, I learned how powerful and comforting and healing female relationships can be. Graduate school was an enormously influential time in my life -- I absolutely would not be who I am today were it not for that experience -- and I give these 7 women so much credit for helping to shape me into who I am today. I feel so incredibly blessed to have each of them in my life!!

One of the trademarks of our friendship has always been the song "I Will Survive" by Gloria Gaynord. During graduate school, the song carried a tremendous amount of symbolism for each of us since it represented the feisty, determined, strong individuals that we were becoming. And since that time, whenever we get together we play the song just for old-times sake and laugh about how much we have all changed and how much we have stayed the same.

Anyway, in keeping with their ever-witty, clever personalities, my friends showed up yesterday with a modified version of the song in hand (see the lyrics below). When I read what they wrote, I immediately burst into tears. I was overcome with such an incredible sense of love for each of them and it gave me so much comfort to know that they are here for me, that I am not in this fight alone. I can see each and every one of them standing at the top of my mountain dancing around, shaking their hair, and screaming these lyrics at the top of their lungs. And when I get to the top, I know that they will be waiting for me there ready to sweep me off to another girls weekend where they will help me relax and laugh and begin to put all of this behind me. I know this, because this is what best friends do for each other.

I Will Survive

At first I was afraid, I was petrified,
Found out the Bitch had latched onto my inside
Then I spent so many nights thinking what had gone wrong
and I grew strong.
And I learned how to get along.

When chemo and radiation in place
And walking everyday, you best be damn sure I'll win this race
I'm going to eat that vegan crap
I'm going to take my daily nap
There's just no way you're going to come back and bother me.

Go on Bitch, go get out of Me
I've got my friends and my family
Weren't you the Bitch who tried to break me and metastasize
Did you think I'd crumble
Did you think I'd give up and cry
Oh no, not I!
I will survive

For as long as I know how to love,
I know I'll stay alive
I've got all my life to live
And I've got all my love to give
I'll survive I will survive
Hey hey

(I, I will survive)
Hey hey
(I, I will survive)
Every day
(I, I will survive)
Oh yeah

It took all the strength I had not to fall apart
I've been puking, sick and tired and feel like an old fart.
And, I spent so many days blogging on my site
And with Luke, Kyle and Pete I will not lose this fight.
You see me, someday new,
I'm healthier now, so Bitch F-U.
So you felt like dropping and and messing with my Chi
But I am stying here, so Bitch, Good-bye!

Go on Bitch go, get out of me
I am stronger than you'll ever be
You just picked the wrong person because I was born free
Did you think I'd crumble
Did you think I'd give up and cry
Oh no, not I, I will survive

For as long as I know how to love, I know I'll stay alive
I've got all my life to live
And with so many friends, my love to give
I'll survive I will survive
Hey hey.

Further Info Re: Pathology Report

Ohhh, it's so nice to have doctors in the family who can decipher medical mumbo-jumbo!!! I just got off the phone talking with my cousin, Jeremy, and he was able to add further insight into my pathology results.

First of all, he said the fact that there was a "single focus of well-differentiated adenocarninoma" is a really, really great thing. Specifically, the fact that the cells were still well-differentiated means that they retained many characteristics of being normal cells, rather than completely wacked-out, unrecognizable cells. Jeremy said that "well-differentiated" cells are much less aggressive and that there is a higher success rate in treating patients in this case. Ironically, early on in this whole process, Jeremy totally predicted that this was the case!! Here is the email that he wrote me on February 16th:

"Another thing I thought of is that it's actually a GOOD thing, in a way, that you've had symptoms for this long. That could well mean that your tumor is low-grade, i.e., a less aggressive histology. A more aggressive cancer would have done more damage more quickly if given this much time. It will probably cry like a little bitch as soon as it sees its first dose of radiation."

And hence, the name "The Bitch" was born.

The second thing in the report which Jeremy deciphered for me is a sentence that reads "There is no angiolymphatic or perineural invasion and a peritumoral lymphocytic response not seen." See what I mean....total mumbo-jumbo!! Anyway, according to Jeremy, this is also great news! In layman's terms, this means that the pathologist looked at all of the blood vessels and the nerves that surrounded the tumor and did not see any sign of an cells having entered these structures, which further indicates that the cancer likely did not spread anywhere else in my body.

I am going off to do a little dance around my house now...I'll check back later! :)

More Great Results

Pete and I met with my chemo oncologist, Dr Gullion, yesterday; he had received the final pathology reports from my surgery and reviewed the results with us. There were basically five things that we were waiting to learn from this report:

1) Final written confirmation that the liver biopsy was negative;
2) The status on whether they were able to detect any actual cancer cells within the tumor and surrounding tissue (remember, both of my prior biopsies showed that the tumor contained "atypical cells", but this is different than confirming that the cells were actually cancerous);
3) Confirmation that the "margins" (e.g., the ring of normal cells around the tumor) were large and clear of any sign of cancer;
4) Confirmation of the number of lymph nodes removed during the surgery; and
5) Confirmation as to whether these lymph nodes contained any cancerous cells or showed any signs of ever having contained cancerous cells (apparently, sometimes they can detect dead cancer cells within the lymph nodes which indicates that there was cancer there at one point but that the chemo and radiation killed it all)

The results on all five of these factors was fabulous!! The report confirmed that:
1) The spot on my liver is completely benign;
2) There was a "single focus of atypical glands consistent with residual well-differentiated adenocarcinoma, blah, blah, blah.".....I think that this basically means that they confirmed there were cancer cells present, but that the cancer was practically gone due to chemo and radiation
3) The margins were clear and wide with "> 1 cm away from the tumor". Dr Gullion seemed to be very pleased with the "> 1cm" part...personally, I would have preferred to have margins that were closer to "> 1 foot"...
4) Twelve regional lymph nodes were removed. Dr Gullion commented that this is an extraordinary number of lymph nodes for the surgeon to have obtained from this particular part of my pelvis (usually he only sees 3-4 removed), which I think speaks to the skill level of my surgeon.
5) None of the lymph nodes removed contained metastatic cancer or showed any sign of ever having contained cancer (e.g., no dead cancer cells). Dr Gullion explained that there is a huge correlation between the number of "clean" lymph nodes removed and the prognosis for a complete cure -- apparently, the more lymph nodes that they can detect which are clear of cancer means that there is less and less chance that there is cancer floating anywhere else in the body.

So net-net, the results were FABULOUS!! Both Dr Gullion and Dr Poen agreed that, at this point, I am technically either very early stage 3 or possibly even stage 2. And in either case, my chances of a complete cure at this point are very high! WOOOOOOOOO HOOOOOOOOOO!!!!

But in the spirit of "no regrets", we all agreed that Dr Gullion will throw the kitchen sink at me one more time in the form of four more months of chemo. We are giving my body a couple more weeks to continue healing from surgery and then I'll tentatively start my first round of chemo on Monday, July 9th. And from what I can gather, I'll go in for a treatment every other Monday and will likely feel like crap for a few days afterwards, but then will hopefully bounce back to feeling better for a few days before I need to go in for my next treatment.

So that is the scoop. We now know exactly what we have been up against this whole time. The funny thing is, this outcome is EXACTLY what I predicted 4 1/2 months ago. In the days following my colonoscopy, when Pete and I were scrambling around having the various tests done to figure out whether or not the tumor was cancerous and, if so, what stage the cancer was, I made a prediction to Pete. We were sitting outside of a coffee shop between doctor's appointments and I said to him: "I think that what they found IS cancer, and I don't think that it's just stage 1. But I also don't think that it has spread anywhere else in my body." Isn't it crazy that, in the end, I was right? Your mind really does know what's going on in your body. Your job is to stop and listen when it's trying to tell you something.

Dear Lord,
So far today I am doing alright.

I have not gossiped, lost my temper,
been greedy, grumpy, nasty, selfish,
or self-indulgent. I have not whined,
complained, cursed, or eaten any chocolate.
I have charged nothing on my credit cards.

But I will be getting out of bed in a minute
and I think that I will really need your help then.

Home Sweet Home

Hallelujah! I am finally home and am in a complete state of bliss!

After proving to the doctors that I could finally pee on my own, I was discharged late yesterday afternoon and had a wonderful, tearful reunion with my family. Last night, I had the BEST night's sleep that I think I have ever had -- God, hospital beds are just disgusting!! -- and have spent today slowly (repeat, sloooowly) acclimating to being home. I have to mention as well that my complete superstar of a husband spent every single night with me in the hospital and his bed was even worse that mine (it was a plastic, fold-out chair that was only about as wide as a cot). It was so nice to have him there with me; hospitals are dreadful and I would have been so lonely and sad without him. Instead, we spent each night watching funny Friends and Seinfeld reruns that our friends bought us and talking about life.

Needless to say, Luke and Kyle were thrilled to see me. I spent half of the morning just snuggled on the couch with Luke. The honesty of young children is so touching....as we were snuggling, Luke kept trying to re-create the face that he had when he found out that I was coming home. It bordered on almost tears, almost nervous, and very excited. He also admitted that it seemed like I was only gone for a day and this made me sooo happy! I have my parents, my in-laws, and a handful of close friends who had him over for play dates to thank for this. Without their constant love and attention, our children would have been really miserable (and possibly even scarred) by my hospital stay. Instead, it went by in a flash for them and they seem just as wacky, loving, and silly as ever.

So now that I am home, I am on a mission to heal this body of mine. I have a month to go before I start chemo again and man, oh, man am I ever sore! I still have a couple incision points that cause stabbing pains if I move the wrong way and so I am moving ever so slowly to avoid feeling like I am splitting open. But I did just get back from my first slow, short walk through the neighborhood and it felt great. Pete suggested that I measure my progress each day by how far into the neighborhood I can get. I love this idea!! We live in a wonderful neighborhood filled with amazing people who have been so supportive of us during this past few months (bringing meals, making weekly batches of "Magical Mineral Broth" soup, walking our dog, planting a special garden, etc) and so I feel like it will be my tribute to each of them as I make my way, house by house, through the neighborhood.

Well, I hear the sounds of Luke upstairs. He must be home from his birthday party. So I am off to go hug him again and tell him how much I love him. Ohhhh, I am so happy to be home!!

Funny Little Life Stories

My parents and my in-laws have been an incredible God-send during my surgery. Pete has stayed in the hospital with me every night and so they have all been working 27/7 to care for Luke, Kyle and Shadow. Besides the usual things that being a caretaker entails (such as keeping everyone well-fed, well-exercised, and shuttled around to various activities, etc), they have also done an amazing job of capturing the funny "life moments" of each day and bringing these stories back to us in the hospital. These stories are so incredibly helpful in keeping me connected to my real life outside of the hospital and definitely give me a yearning to heal fast so that I can get out of here and be back home!! For example, my dad sent me the following email yesterday to go with the pictures above:

Good morning Jules…

After dinner last night, Kyle got to work on writing your blog entry, but, sadly, developed writer’s cramp before he got too far.

The good news is, the writer’s cramp didn’t seem to affect his ability to kick a ball.

PA

Apparently, while everyone else was relaxing after dinner, Kyle wandered into the office, wiggled his way onto the chair and pulled my dad's laptop onto his lap. I'm not sure what he was trying to type (perhaps an update about my progress?? or a recap of his day?? or...) , but I am sure that, were it not for the writer's cramp, it would have been quite profound! Ha!

Three Steps Forward, One Step Back

The past couple days since I last wrote have been filled with lots of tiny little "progresses" and one minor set-back.

First, I am now finally eating again. Who knew that the body could go for 6 days with no food and not even feel hungry! I am not joking -- I did not eat one single bite of food from last Wednesday at midnight until yesterday afternoon. I have obviously been on an IV to prevent dehydration but the doctor confirmed that there were no calories in it, just water and some electrolytes. I joked with my doctor that, before this, the mere mention of the word "diet" would have given me immediate and severe hunger pains, but I guess the whole game changes when you've had abdominal surgery. I think that it has taken my colon this long to just come out of surgery-induced shock. Anyway, I am now eating tiny, simple foods and so far so good in terms of no nausea, severe stomach cramps or vomiting (which is what the doctors are keeping an eye out for).

Secondly, I am able to get up and walk my laps around the halls with a bit more ease. The stomach pains where I have all of my various abdominal incisions (as it turns out, there are actually SEVEN!) don't hurt quite as much and so I have progressed from caterpillar status to something more like a slower-than-average turtle. But I am not complaining -- progress is progress!

Third, I am a day away from being able to be removed from my IV. Basically, once I have mastered the art of eating real food I can also transition to pain meds taken by mouth. And once I am able to do that, there is no need for me to be hooked up to an IV any more. So hopefully everything stays on track on that front and I'll be a "free" woman tomorrow.

So those are the "three steps forward" ... the "one step back" happened yesterday when the doctor thought that I was finally ready to be done with my catheter and so had it removed. Unfortunately, my poor body rebelled; apparently, peeing in a toilet rather than laying leisurely in my bed and peeing into a tube was too much to handle. And so every time I tried to pee, nothing came out. And yet I could feel my bladder getting fuller and fuller. It finally got to the point that my bladder got so full it was pushing upwards onto all of my very sore and tender internal organs and causing me excrutiating pain and so the nurse put the catheter back in. I think that it was a great call seeing as almost a LITER of pee poured out of me. Yikes!! I told the nurse that I think having a liter of pee in my bladder would have been painful even without surgery!! I'll try again tomorrow to be sans-catheter, since this is obviously a hurdle that I need to clear before I can be sent home. Hopefully, things will go better.

Overall, though, I am feeling better and slowly getting my strength back. The thought of going home is less and less daunting with each passing day. If all goes as planned, I think that they will discharge me on Friday.

That's all for now...I need to head back to my room and lay down again. Thanks for all of your prayers and emails and loving thoughts! :)

Hi -- Me Again!

Hi! It's me again. And I'm alive, I am ALIVE!! And finally feeling well enough to write in my blog again. Yippee!!

It has been a rough few days to say the least. All of the awful pain that I was dreading leading up to surgery actually came true -- I wish that I could say it wasn't as bad as I thought it would be, but unfortunately that is not the case. On Thursday before my surgery I went for a great 3+ mile run with Pete and today I can barely walk down to the end of the hallway and back, and when I say "walk" what I really mean is hobble along about the speed of a caterpillar. I ended up with about 5 different incision sites on my abdomen and man, oh, man do they hurt! But it's all worth it. I am sure that by now you have read the blog that Pete posted with the results from my surgery, and it all turned out exactly as we hoped and prayed. I can rest in peace that the main tumor is finally out of my body and hopefully the chemo later will sweep up any and all remaining straggler cancer cells. And then I can finally put this chapter of my life behind me forever!

So for now I just envision myself climbing up this next section of my mountain...I am in the middle of the hardest part right now, but I am confident that the climb will get easier the higher I go. And I can clearly see to the top of my mountain, where all of my friends and family are cheering me on...the group has gotten so much bigger, as more and more friends join the group to lend their love and support, and so the cheers and shouts of encouraging words are almost deafening, but at the same time, it's music to my ears. It's music which provides a rhythmic pulse for my climbing. It's music which warms my heart on the cold nights here in the hospital. I am climbing with all my strength and soon I will back on the top of my mountain and I will embrace each and every one of you and thank you for all the love you have given me during this challenging climb. I could not have done this without you!!

Birthday Fun at the Hospital (Pete)

Again, I have little to report -- and we're all very thankful for that. Julie is right on track with her recovery from the surgery, with no signs of complications. She was up again for two walks today...this time for a lap around the nearby nurses' station (tomorrow we're aiming for a lap around the whole floor -- one step at a time!)

The highlight for the day was Luke's visit to the hospital, which was made even more special by the fact that it's his 6th birthday! He was sooooo excited to see Julie, and she of course was equally thrilled to see him. Julie rose to the occasion (after we spent about 15 minutes concealing wires, tubes and various other contraptions beneath blankets!) and mustered enough energy for a fun visit with lots of laughs.

Enjoy the pictures! Note: the second one was the "craft project" that Luke and I did -- basically blowing up a surgical glove and attaching it to the head of his stuffed toucan. He was ever-so-proud as he strutted past all the nurses with it!

No News Is Good News (Pete)

Today was a very uneventful day -- exactly the kind we want. The anesthesia wore off through the course of last night, and Julie became increasingly more awake and alert today. She accomplished both of her "required" tasks for the day, the first of which was to get on her feet for two very short walks down the hall, and the second of which was to exercise her lungs with a little breathing device that helps prevent post-operative pneumonia.

Her abdomen appears to be healing well, and there are no current signs of any other complications. She's still in a fair bit of pain, but is otherwise in good spirits. We chose not to bring the kids in for a visit today (she's still attached to too many scary looking tubes and devices), but she's looking forward to seeing them tomorrow.

Many thanks to all you for all the emails, calls and responses to yesterday's post. We're able to get a laptop in front of her every now and then, and she loves hearing from everyone!

Yesterday's Post -- the Twist (Pete)

As I shared with a few of you today, there was actually a little twist to yesterday's blog post -- which is that it was almost entirely written Thursday night -- before the surgery.

Julie and I are both big believers in positive visualization, and we knew the outcome that we wanted -- so I just went ahead and put it into words. I obviously had to insert a few actual quotes from yesterday, but I was otherwise ~95% accurate in predicting the timeline, the fact that the spot on the liver was a hemangioma, the summary briefings from the doctors, and the way we'd feel overall at the end of the day.

Adios, Bitch (Surgery update from Pete)

The only “bad” news for today is that you’re getting the second-string back-up guy as the writer, instead of the ever-so-eloquent blogging star to whom you’re accustomed. Kind of like that inevitably second-rate columnist who fills in when your favorite columnist goes on vacation.

Yep…but that’s where the bad news stops. It’s been a long – but wonderful – day. “The team” was all up well before 5:00 AM. My parents arrived yesterday, and got right to work with the crack-of-dawn shift looking after the kids, while Julie, her parents and I headed off to the hospital at 5:30.

The 7:30 AM surgery slot definitely had its benefits – primarily since the fine folks at UCSF hadn’t yet had a chance to get “behind” for the day….which they seem to do on a reliable basis by about 9:00 AM most days (Julie and I can describe the details of most waiting room walls and ceilings in excruciating detail). Admission went smoothly, the pre-op discussion and preparation was swift and to the point…and before we knew it they were whisking Julie off to surgery.

It’s a uniquely surreal and somewhat un-nerving experience watching your spouse get wheeled on a gurney past those double doors marked so officially with “Authorized Personnel Only - Do Not Enter”. You’re turning over your wife, your best friend and your soulmate to a team of people whom you’ve barely met (if at all). Talk about trust. I could only stand there and hope that they’d all had a good night’s sleep and the right amount of coffee.

Then, time stood still. Julie’s parents and I read, paced, chatted, read, chatted, paced, went to get food, read, paced, and then paced some more. Roughly two hours later (at about 9:30 AM), a nurse entered the room to let us know that the intra-operative liver ultrasound had been completed and that Dr Warren (liver surgeon) would be out shortly to speak with us.

A few minutes later, Dr Warren entered and quickly cut to the chase (unlike me with this blog post, I suppose). “It’s all going very well – she’s doing great.” He said that he and his team were able to get a very close look at the liver, and that he was able to confidently determine that the “suspicious spot” on the liver was actually a hemangioma – a cluster of blood vessels that was completely benign (a formal biopsy later confirmed this) and that would not require any further action. He also confirmed that there were no other lesions anywhere else on the liver.

At that point, tears welled up in our eyes. Tears of joy, that would be. It was the answer that we expected; the answer we had hoped for; the answer that we knew in our hearts; the answer that Julie’s body was suggesting…but it was so incredibly comforting and emotional to finally hear it from someone who -- well, someone who actually knows something about livers. I wanted to get up and hug him like a 5 year old who’d just met Santa Claus in the wee hours of Christmas Eve. Phew….one down, one to go.

We knew that Dr Garcia Aguilar (colo-rectal surgeon) and his team were now at work. Again, time ground seemingly to a halt. After another two and a half hours (roughly 12:00 noon), another nurse came out and said that they were wrapping up the primary operation, that “Julie was fine”, and that Dr Garcia Aguilar would be out shortly to consult with us.

Twenty minutes later, Dr Garcia Aguilar came in and ushered us into a private consultation room. He was still in scrubs and looked remarkably at ease, which I took as a good sign. His summary was that the surgery had gone fully according to plan – i.e. it was very “clean” and highly successful. Julie had handled the anesthesia well, and had lost little blood.

He confirmed what the PET/CT scans had suggested – that the primary tumor in the colon was almost entirely gone (thanks to the chemo and radiation), and that only a very small residual was actually visible. As planned, he had removed the remnants of the tumor and a significant amount of damaged tissue in the area, and then re-attached the remaining portion of her colo-rectal tract. He also did a comprehensive exploratory evaluation throughout the pelvic region and saw no signs whatsoever of any other areas impacted by cancer. All good. All according to plan. A shutout. A perfect “10”…whatever you want to call it.

He said that Julie was still asleep from the anesthesia, but resting comfortably in the post-op recovery room. He estimated that she would be there for another 2-3 hours for observation as they brought her out of the anesthesia.

By mid-afternoon (~3:30 PM), we finally saw her again – nearly 8 hours after they had wheeled her away. Soon thereafter, we settled comfortably into Room B-519, our new home for the next 6-7 days. Julie is still pretty groggy and was still taking oxygen as I left the room a few minutes ago. We were, however, able to have a brief conversation as the nurses were settling her into the room.

“How did it go?” she asked. “You did it, honey,” I replied. “The Bitch is gone. Gone. And the liver is clear”. Tears welled up in both our eyes, and she simply said, “I love you. Life is good….”

So, the path to the top of the mountain has gotten a bit more manageable; the skies have brightened; and our guides are that much more knowledgeable and confident about the route to the top. We’ve still got a long, long way yet to climb, but today we’re stopping to enjoy the view, to celebrate how far we’ve come, and to reflect on how blessed we’ve been to be in the hands of some of the best doctors in the world, and to have had each and every one of you supporting us along the way.

Whoever you are, and wherever you find yourself tonight – give someone a hug, say a prayer of thanks, and take comfort in the fact that Julie is resting peacefully and starting down the path to recovery from the surgery. On the other hand, the Bitch – though not in the “lonely tumor graveyard” just yet – is at least in a cold, metallic tray in some sterile pathology lab down the hall, lamenting the fact that she’s just had her ass kicked by the courageous woman that I’m proud to call my wife. Way to go, Julie. And adios, Bitch.

Over and out…

The Mysterious Hole

One of the alternative therapies that I have been experimenting with throughout my treatment is something called guided imagery. Guided imagery is basically the practice of creating self-directed images in your mind. In my case, I am doing this so that I can call upon these images in times of need (for instance, tomorrow as I am being wheeled in for surgery) in order to reduce my anxiety.

Every time the guided imagery session begins, my therapist asks me to think of a "healing place". This is a place where I imagine myself to be that is very comforting, soothing and relaxing. It doesn't always have to be the same place, but somehow I always find my mind drawn to the Marin Headlands, which is a national park preserve down the road from our house. In particular, I envision myself to be on the trail where I always run or at the beach at the end of the trail (Tennessee Valley Beach). I think the reason my mind is drawn to this area is because every time I am I there I reflect on the fact that there must be a God somewhere because places this beautiful cannot exist merely by accident.

The last time I met with my therapist she asked me to also create an image in my mind that represents my body. It only took a split second for the beautiful cliffs at Tennessee Valley Beach to come to mind. The mountainside on the north side of the beach is absolutely stunning; the cliffs that face the ocean drop dramatically straight down and are pounded by the waves day-in and day-out. In the spring, the hillside that faces away from the ocean is covered in gorgeous yellow flowers and at any time of the year you can see a variety of wildlife scurrying around. The most spectacular thing about the cliff, though, is that a huge hole exists in the side of it. You don't notice the hole at first as you approach the beach from the trail, since it is hidden by the natural contours of the mountainside. The hole is only seen by those who venture off the trail and onto the beach, closer to the waters-edge. No one know for sure how the hole got there. Did it start as a small clam hole that grew larger and larger over time? Did the sands and crashing water slowly erode the rock until a hole was formed? The true answer will always be a mystery, and the mysteriousness simply adds to its beauty.



The thought of this cliff, with it's stunning hole in the middle and the ocean waves crashing relentlessly at it's base, reminds me of myself. After tomorrow, I will also have a "hole" in the middle of me. Just like my cliff at Tennessee Valley Beach, we will never know exactly what caused my hole...was it genetics? Or something in the environment? Or something about my diet? Or simply bad luck? We'll never know...the true cause will always remain a mystery. But again, just like my cliff, the fact that I have a hole in the middle of me will not diminish my strength. It will not affect my ability to stand tall and strong against the winds of time, nor will it cause me to crumble under the crashing of the waves at my feet. The hole will simply be a mysterious part of me that makes me who I am.

I will be hanging on tight to this image tomorrow and in the weeks and months to come... I need this image to remind me that I am strong enough to get through whatever lies ahead. I need this image to remind me that sometimes imperfections can be breathtakingly beautiful. And I need this image to remind me that only God can create something as beautiful and as mysterious as life, and that he is with me every step of this journey.

No Doubts

Pete and I went for a "last chance" hike/run today in the Marin Headlands. As we were running, I found myself reflecting on the multitude of emotions that have flowed through my body today...

Determination...Optimism...Nervousness...Courage...Fear...
Sadness...Anxiety...Strength...Hope...

The most exhausting part of it all is that these emotions would each cycle through me about once every half hour -- I felt like I was on a never-ending roller coaster!! As we were nearing the end of the trail, though, I had an incredible realization: despite the many emotions coursing through me all day long, never once did I experience any "doubt". The thought really struck me....I didn't have any doubt!

Yes, I am terrified about my surgery. It's pretty major surgery...I think that I'd be a bit wacky to not be scared. But being scared about the surgery and the possible complications and the pain afterwards is completely different than having doubt about whether it will actually work. And that is the part that I realized never crossed my mind. The thought never occurred to me to have doubt as to whether or not the cancer would be gone. I think that I just have such a sense of peace in my heart that everything will be fine and so my mind didn't even bother with such emotions. It was truly a beautiful epiphany for me and it definitely put a bit of spring in my step!

New Surgery Time

My surgery time just got changed. I am now schedule for surgery at 7:30am PST, which means that I need to leave the house by 5:15am. Yikes -- I never wake up that early!! I think that it's good, though...the sooner I get started the sooner it's over.

Check back for updates from Pete....and please say lots of prayers for me!

Aiming for a Hole-In-One

Jacqueline Gagne, who took up golf only 4½ years ago, has smashed all the known records for golf in an incredible run that began on January 23, 2007 when she hit her first hole-in-one of the year at her club in California. Since that time, she has hit 14 holes-in-one. To put this in perspective, the odds of achieving 14 holes-in-one in four months are almost impossible to calculate. When Ms Gagne hit her tenth, Michael McJilton, a statistician near Palm Springs, took a stab and came up with 12 septillion (that’s 12 followed by 24 zeroes) to one. By comparison, to date, Tiger Woods has hit only 18. Jack Nicklaus hit 20 in his career. A US amateur, Norman Manley, claims a career total – and world record – of 59.

When Ms Gagne was asked what her secret is she replied "I aim for the hole." Apparently, this is something that most people -- even professionals -- don't do. Instead, most professionals attempt to set themselves up for the perfect birdie.

As I read the article, I couldn't help but think about the analogy to my own situation. When I first started understanding cancer and cancer-related terminology, one of the first phrases I learned was "5 year survival rate." Apparently, this is the way that most of the oncology world measures how effectively a patient has responded to treatment...Did they survive at least 5 years post-treatment? And early on, I definitely found myself falling into this "logic" as well. I would think "God, please let me live another 5 years. Luke will be 11 then and Kyle will be 7 and I will have had so many more moments with them and with Pete and with all of the other people whom I love." But lately -- even before reading the article about Jacqueline Gagne -- I have changed my mind. I don't want to just live 5 years. Five years is not enough. I want to live for many, MANY more years. I want to have a very long, full life filled with precious memories and magical moments. I want to look back and view this time as a short, challenging blip in an otherwise long, fulfilling life. And so I am now aiming completely and totally for the hole! Forget setting myself up for a "birdie" -- I don't WANT a birdie. I WANT a hole-in-one! I WANT to live as long as my Great-Aunt Jo. And for those of you who haven't had the pleasure of meeting my Great-Aunt Jo, she is 97 and still very much alive.

Diet and Survival Rates

I just received some VERY interesting information from my neighbor, Michael (he is the one who is a Gastro Oncology doctor at UCSF whom I wrote about earlier). He just got back from attending an oncology conference and one of the things that was presented there was information about the impact of diet on the success rates for stage 3 colorectal cancer. The researchers of the study (who are affiliated with Dana-Farber, one of the top cancer centers in the US) followed more than 1000 stage 3 colorectal cancer patients and had them chronicle what they ate during the phase of treatment that I am about to enter (e.g., post-surgery chemo) and for 6 months after treatment ended. The foods were defined as being either "Prudent" (fruits, veggies, whole grains, legumes, fish, low-fat condiments, etc) or "Western" (red and/or processed meats, refined sugar, refined grains, high- and low-fat dairy, etc). Without going into all the statistical details, the summary is basically that there is a significant correlation between eating a healthy, "Prudent" diet and surviving stage 3 colorectal cancer. Specifically, the conclusions of the study said:

> "Compared to patients in the lowest level, those in the highest level of Western pattern intake experienced a tripling in risk of recurrence or death." (tripling!! yikes!)

> "These data suggest that a diet characterized by higher intakes of red and processed meats, sweets and desserts, french fries, and refined grains increases the risk of cancer recurrence and decreases survival."

The day that I came home from having my colonoscopy (and before I was even officially diagnosed) I vowed to change my diet forever. I just knew in my heart that the way I had been eating for years was not as healthy as it should have been. This was due in part to my being a working mom and having no spare time and in part to the fact that I have always been pretty healthy and active and so I took my body for granted and due in part to the fact that I developed some less-than-optimal eating habits when I was younger that I never bothered to change as I got older. For example, I used to eat a disproportion amount of carbs (usually in the form of breads, crackers, and sweets) and I justified this by buying whole grain. I also did not eat nearly enough fruits and veggies; certainly nothing close to the "75% of your plate" that my nutritionist has since recommended. I was also a huge dairy fan...cheese, butter, milk, yogurt...you name it. And, as I mentioned before, Diet Coke was my staple drink. And so, since that day, I have tried my hardest to eat what the study refers to as the "Prudent" diet -- lots of veggies, fruits, whole grains, very little dairy, zero red meat, moderate chicken, lots of fish, and loads 'o water and green tea, etc -- and overall I have done great. I have definitely had moments of weakness (like this weekend when we celebrated Luke's 6th birthday and I just couldn't resist having a piece of his yummy carrot cake), but overall, my diet is so much healthier than it used to be. And so I take comfort in the study results and I am grateful that Michael shared them with me since the information keeps me incredibly motivated to make sure that the only things I put into my body are those which will help it to heal and stay strong. The study results fit perfectly into my new "living with no regrets" life plan.

Three Days Until Surgery

Well, only three more days to go until my surgery!! I am not sure whether to be scared or thrilled -- a bit of both, I think. Anyhoo, I am crazy busy trying to get about a million things done before I become incapacitated for awhile so I don't have much time to write at the moment. But I figure that I'll be on forced bedrest here very soon, so I am keeping a list of all the things that I want to write about....so stayed tuned! :)

In the meantime, though, I did want to share a couple things pertaining to my surgery. First, I gave Pete instructions last night about how to use my blog and so, starting Friday, he will get on and share regular updates about my surgery and recovery. So check back here and you'll get the whole scoop.

Secondly, a number of friends have asked whether I am up for having visitors or not. The short answer is "I don't know." The two most important visitors that I want to reserve my energy for are Luke and Kyle and so I'll just have to play it by ear to see whether I any extra energy after they leave. Again, stay tuned....

Lastly, many people have inquired as to where I am having the surgery. I will be at UCSF - Mount Zion Campus at 1600 Divisidero Street in San Francisco. I have to be there at 9am on Friday (surgery is scheduled for 11am) and am expected to be in the hospital for a week, give or take a day or two.

Okay, that's all for now...I am off to go running in the beautiful Marin Headlands and have another conversation with God and the Bitch! Hee, hee! :)

Cancer is so limited.

It cannot cripple love,

Shatter hope,

Corrode faith,

Eat away at peace,

Destroy confidence,

Kill friendship,

Shut out memories,

Silence courage,

Invade the soul,

Reduce eternal life,

Quench the spirit,

Or lessen the power of resurrection.

~Anon