Monday, June 30, 2008

Ask who?

I feel for patients, really I do. Medical school teaches doctors to use stupid words like umbilicus instead of belly button or abbreviations like BOOP (for bronchiolitis obliterans organizing pneumonia). We tend to throw words around like everyone else should get it. When, of course, they probably shouldn't.

One abbreviation I discuss a lot with patients is ASCUS. It's a common abnomal finding on a Pap smear (the test for cervical cancer). We usually pronounce it like it looks, with a hard C. It stands for Atypical Squamous Cells of Undertermined Significance. That's so we docs can say "Uhhh...dunno" and still sound smart.

Today I saw a new patient. She told me that years ago she had an abnormal Pap, but since then it had always been normal.

It was an ASK ME.

Sunday, June 29, 2008


Another fabulous Dave Matthews Band concert last night. This was my third, in what's turned into an annual tradition with Mr. Smak and Sister Smak. Bonus that no one puked on or near us this year. We did, however, get an eyeful of the bottom of the quite toasted lady next to us in the parking lot. She asked Mr. Smak to hold her beer while she relieved herself two feet from him. Apparently, when you're toasted and it's dark, Mr. Smak looks like Bruce Willis, and I like Juliette Lewis.

The emotional highlight of the 2007 show for me was Sister. It's a beautiful, and simple song, and anyone who has a sister should listen to it.

Last night, the emotional point for me was So Damn Lucky. It's a song about how life can change in an instant. We've all had those moments. Mine, which occured in the interim between the 2007 and 2008 show, was on my mind throughout the song.

Amazing what a minute can do...

Friday, June 27, 2008

"When does my cancer be gone?"

I'm hearing this question more and more often.

I'm really at a loss as to how to answer.

He can't understand the subtleties of remission versus cure. Now that I think about it, no one has even used the word remission with us anyway. Are we there yet?

I'm afraid that if I tell him it's gone, I'll have to tell him it's back.

Is that worse than telling him that it's still there, but hiding?

Ugh. Transposing my layered and complex thoughts to a three year old with a concrete brain...

Sunday, June 22, 2008

Wii Boxing

There is something so wrong with trying to knock out your son's avatar when he's bald from chemo.

But we had a good time.

Saturday, June 21, 2008


A patient asked me this week if it was okay that she was taking her pig's tramadol (a pain medication).

No one can say that family medicine is boring.

I told her I'd rather she not take it, and happily prescribed her some FDA approved-for-human-use tramadol. Same dose. Same name. Likely the same manufacturer, though I didn't check.

Though really, my best guess is that it's ok. Anyone?

Friday, June 20, 2008

Shades of Gray

I've recently arrived at a life-altering decision.

I will not be coloring my hair.

The grays started appearing years ago, but easily pluckable. Recently, I've been unable to keep up. It's not yet presbyopia, which I'm beginning to sense is around the corner, and it's not exactly lack of time (though my poorly groomed eyebrows may tell you differently). And it's not just because I'm cheap. I am, but that's not why I won't color (there's a plan there, I'll get to that in a minute).

Part of it is laziness. Coloring takes a lot of upkeep, with the roots and all, and I'm just not that into my hair.

Part of it is attempting to embrace myself as I age, of choosing to be happy with what I've got.

Part of it is noticing how beautiful women who don't color their hair look, when it is a silvery salt and pepper.

Part of it is looking at all of those women with horrible dye jobs.

And, like I said, I'm cheap. But not completely without vanity. So, I've decided, that $160 that I could be spending every six weeks to keep my hair colored will be my designated shoe fund.

Do you think Mr. Smak will go for it?

Monday, June 16, 2008

Thank a Teacher

I met a new patient today, 30+ years of teaching Social Studies in our county, from grades 6-12.

He could be taking better care of himself, and I hope to help him on that path.

I have an old family friend that also taught, in the adjacent county where I grew up. My new patient knew of him, and asked me where I went to school.

Then he asked me if I remembered Mr. Zink.

Mr. Zink was the coolest teacher in my middle school. Everyone liked him: nerd, jock, cheerleader alike. He taught science, and if you were lucky you got him two years in a row. In those few minutes after the lesson finished, but before the bell rang, he would tell us the grossest stories that he knew.

I still remember them. The one about the kid playing basketball with his class ring on, who left his ring and its attached finger on the rim after a dunk, connected by all the tendons from his finger to his shoulder. (Can that really happen?)

Anyway, Mr. Zink was cool. He made science fun. He's one of my few fond memories of middle school, a thoroughly painful and tedious time of life.

Thanks, Mr. Zink.

Thursday, June 12, 2008

Meditative Knitting

My mom has always been a knitter. My grandmother before her. She taught me to knit at a young age, but I haven't done it for years.

During our stay in Baltimore, I ended up at a lovely little knit shop in Fell's Point. I don't even remember the circumstances of how I got there, but it was just what I needed. Something to pass the time in the hospital. Something to do late at night when I couldn't sleep. Something I could see growing due to my efforts.

This little knit shop was so intriguing--like the setting for a wandering independent film. The proprietor is a former nun, now on her second husband. The last day I remember spending time in a group, I almost stepped on the seeing eye dog who was lying on the floor next to the blind man, sat next to the young attractive gay man munching on his Whole Foods salad, and chatted with several lovely retired ladies. A motley crew, indeed. Sister Lorraine (as we affectionately referred to her) talked one day about how knitting was like saying the rosary, in the repetition and rhythmicity.

I'm not a person of faith. I don't pray. I've been very reluctant to bring this up on the blog, for a number of reasons, but I'm guessing that it's fairly obvious. Most religious people would have mentioned god somewhere in 9 months of cancer treatment for their son.

But I understand religion. I respect faith, and prayer, and what it means to other people. There's been more than once that I wished I was one of those people, but I'm just not. I've never been able to meditate either, at least not formally. I think I'm too lazy, my mind too undisciplined to really focus on it.

But knitting has worked for me. It keeps my mind, my conscious mind, busy enough to let me listen to what's going on under the surface. I think of my thoughts like a movie on a screen, and when I'm knitting I can be in the little projector room. The movie is still playing, but I able to focus on the behind-the-scenes processing. And sometimes, I can begin to get a layer even deeper than the projector room.

Without knowing, I'm guessing that's what a lot of people gain from prayer and meditation. I'm knitting my rosary.

A Dry Spell

Some readers have noted that I'm not posting much. Everything's ok. Actually, everything's pretty good.

I'm back to work now, trying to fit in a few days a week without ditching Mr. Smak too often to deal with the radiation beast on his own. Work is quite busy, our usual summer lull has been overrun by my cut in hours and the departure of a colleague. Home is busy too, we haven't quite caught up from the chaos of the last 6 months. We're getting close, though.

Henry has had a great week. Whatever made him so sick last week is no more, and he spends his days after morning radiation eating nonstop and virtually vibrating he has so much energy. Since we had a negative head CT last week, I can stop dreaming up horrific things every time he stumbles, at least for another few weeks.

My garden is growing, but I'm not spending nearly as much time tending it as usual. And I find that I'm not reading the blogs the way that I used to. It may be because I'm a bit busier, but it's also because I'm a bit obsessed with my new hobby, knitting. You can't knit and blog at the same time.

Tonight as I've gotten caught up on my favorite blogs, it appears that mine is not the only dry spell. No one seems quite as prolific as usual this month. Maybe it's vacations, maybe it's summertime.

Or maybe everyone else started knitting too.

Monday, June 2, 2008

Careful what you wish for

The last few weeks Henry has intermittently complained of a headache.
Really, Henry? Does it have to be a headache? Couldn't you say your foot hurt or something a little less ominous?

So I soothed myself with the knowledge that his last MRI was a scant 3 weeks ago. And that his headache preceded the it couldn't be the tumor.
At least he's not vomiting. Then I'd really worry.

Until last Friday night. When he woke, in the middle of the night, and vomited.

The last time that happened, that way, was the week preceding his diagnosis. So Friday night was a very long night for my husband and I.

Since then, Henry's better. But it gave me just a taste of the anxiety that is to come, for the next several months to years....if I'm lucky.

Every headache, stumble, vomiting illness will bring it all back again.

If I'm lucky.

I need to learn to embrace life with cancer. It's the life I've got, and it's like that old saying goes "Getting older sucks, but it's better than the alternative."

Worrying about all these little things just might make me crazy, but really, it's what I want most.