As we start to make plans for our annual vacation on Cape Cod, I have, within the past couple of weeks, been struck with a scary, almost paralyzing thought: what if this trip is just as awful as last year's "vacation?"
From a common sense point of view, the situation is not the same. No infection to be monitored constantly in case of an emergency trip back to the hospital in New Jersey. No stitches. None. Even my basal cell removal site has no stitches and has ALMOST stopped itching. No healing drain holes, no complicated hour-long shower sessions (with drive time, almost two hours) at a remote (my dad's house) location. No presenting, as they say in the medical biz, reason for a revisit of last year's experience.
I would very much like to go back to vacation two years ago, in which we miniature golf course-hopped at night, arriving at the last to finish our games at closing time. We ate whatever we wanted, mostly. I spent hours sitting on a giant float tethered to the dock, doing Hebrew grammar exercises - it was heavenly. I read and sat and we went to the movies with my dad to see "Up" - we were the ONLY people in the theater and it was great! (Middle of the afternoon, mall cinema, gorgeous weather. Only crazy people and locals go to the movies under those conditions - and we are some of both.)
My depression last summer started just before we left, and ended maybe a week after we came back. So, the common denominator between these two vacations is the time to sit and think, and there's a danger that too much thinking will lead to sadness, and then spiral downward from there. Last year's trip was fully a month after my surgery, so the time passing in and of itself cannot be proof to me that it will not happen again. It started before we actually went away, so that tells me it wasn't just the inactivity (although when I returned and started working hard again, it seemed to dissipate - coincidence?)
I have tried to do everything I can to prepare and organize so that there is no excuse to be sad and worried and anxious to get home as opposed to enjoying myself. We have, in addition to Jackie checking in with Mario and Luigi two of the nights we're away, one of Ari's friends keeping an eye on the temperature in the room during the day and taking in the mail, and we've hired professional pet sitters who happen to also be members of our synagogue and live here in Oakland, to come on all the other nights and see to the chinchillas' needs.
I have stopped the paper; we have laid out everything we can think of on the dining room table and the list gets checked off every time something new goes to the table. Alex and Ari have been reminded about a hundred times what they'll need to help with. I have a stack of 9 "reading" books to go, as well as books loaded onto my iPad and there's another smaller (but not by much) stack of reference books for studying.
I am determined to continue trying to eat more healthily even while we're away. So maybe only one or two lobsters, one order of fried clams, and a limit of two visits to Friendly's for sundaes! Lucky for me, the penny candy store's greatest lure is salt water taffy, with maybe one tiny piece of penuche (brown sugar fudge) for old time's sake.
Instead of being afraid of this vacation being as terrible as I now know it's capable of being, I want to just cast off the old crap from last year and enjoy myself, but there are just still those things that chip away in your mind and I can't entirely banish the fear. I've got one more meeting with my therapist before I go, and I've always come out of there with more tools for handling rough situations (real or imagined, past or future.)
I hope to be able to come back from the Cape understanding that last year was (an exceptionally awful) exception and that this year we took up right where we left off two summers ago - sitting by the lake, time with my dad and brothers and their families, watching our boys get together with their cousins whom they rarely see, and generally doing the "nothing" that is really something special to us.
Monday, July 4, 2011
Sunday, June 26, 2011
Selfish or Self-help?
As often happens, my last remaining vestige of my depression crutches, my therapist, made me feel a lot better about something that's been bugging me. I was very upset that I was unable to "remember" what my body felt like (from the inside) in the area of my surgery, before the surgery. Probably because I feel the weight of the implants so keenly, I thought I ought to remember the lack of weight, or something - anything - about how I was before. I know my skin had feeling, at the very least, but I can't remember it. (As I said, I was really upset.) I compared it to being unable to remember the sound of a departed loved one's voice, or touch. She pointed out that I probably never thought about it much in the many years before the surgery, and she's right to a point. I remember what nursing the boys felt like, and I remember other things, but, whether I'm unconsciously (sub-consciously?) protecting myself or not, I don't seem to remember anything else. And, since I wasn't in the habit of taking pictures of myself topless, the fact that my brain also refuses to remember what I looked like, well, it's really, really frustrating sometimes.
So why has it taken almost a full year to worry about this now? I think I was (am?) actually in some form of shock, taking care of things as they needed to be taken care of, but not fully realizing anything about my loss that could stop me from functioning altogether. And I'll bet it's common, too. After all, I know I'm not the first one to be in this situation, and I certainly (and unfortunately) am not the last.
I also was distressed that I seem to have turned more inward over this past year, and worried that this perceived "selfishness" had somehow been harmful. I wonder, did it hurt my family and friends? Did it cause my work to suffer? As it turns out, what I term selfishness probably saved my sanity (if indeed I am still sane.) I had to turn inward. I had to focus on myself, whether it was by taking care of my own drains (even though many people offered to help) or by making sure I ate and drank what I liked, or by forcing myself to do what the doctor(s) said, even though I could have just stayed in my chair and been waited on. I tried to take every opportunity to get better, at least physically. I think I had no energy to work on my psychological recovery, so that got put on hold for a long time.
My work did suffer a bit, in my estimation, but only in that I felt myself less in control - of my paperwork, of my organizational tasks, of little things. As for my family and friends, they just let me be and although I know it went directly against their urge to help, it was a very great gift.
Now, two days away from the day I started trying to figure out how to heal not just my physical parts but my "whole," I worry that too much introspection will set me back. On the other hand, I have to believe there is still work to be done there, and I hope I can tell the difference between self-care and self-pity along the way.
So why has it taken almost a full year to worry about this now? I think I was (am?) actually in some form of shock, taking care of things as they needed to be taken care of, but not fully realizing anything about my loss that could stop me from functioning altogether. And I'll bet it's common, too. After all, I know I'm not the first one to be in this situation, and I certainly (and unfortunately) am not the last.
I also was distressed that I seem to have turned more inward over this past year, and worried that this perceived "selfishness" had somehow been harmful. I wonder, did it hurt my family and friends? Did it cause my work to suffer? As it turns out, what I term selfishness probably saved my sanity (if indeed I am still sane.) I had to turn inward. I had to focus on myself, whether it was by taking care of my own drains (even though many people offered to help) or by making sure I ate and drank what I liked, or by forcing myself to do what the doctor(s) said, even though I could have just stayed in my chair and been waited on. I tried to take every opportunity to get better, at least physically. I think I had no energy to work on my psychological recovery, so that got put on hold for a long time.
My work did suffer a bit, in my estimation, but only in that I felt myself less in control - of my paperwork, of my organizational tasks, of little things. As for my family and friends, they just let me be and although I know it went directly against their urge to help, it was a very great gift.
Now, two days away from the day I started trying to figure out how to heal not just my physical parts but my "whole," I worry that too much introspection will set me back. On the other hand, I have to believe there is still work to be done there, and I hope I can tell the difference between self-care and self-pity along the way.
What is happy?
Alex is taking an online summer course on philosophy, and he is writing a paper. For part of it he has to define happiness. So he came down to ask us how we would define being happy. I told him that I thought it was something about doing things you like most of the time, whether you're paid for it or not - or maybe it was about liking the things you do most of the time, which is a bit of a difference. And is contentment the same thing? I think not. For example, I am not currently "content" but I am mostly happy.
If this was the first time I had this kind of conversation in a week, I wouldn't have given it a second thought (and you wouldn't be reading about it, either.) It's all good, as the kids say, at home. But, I was getting not so much joy out of my work as usual (and that's odd because summer is a great time for one who likes to organize and buy school/office supplies!) and I couldn't define why I was sort of unhappy (as opposed to sad, or depressed, or cranky.) I knew that with our rabbi out on sabbatical, the dynamics of our workplace would change a bit, but okay. We'd already been through that last summer, and it didn't seem so terrible. An email conversation with a friend and former co-worker (shout out to Colorado!) revealed that this summer is different for ME, not for the synagogue. I probably didn't even notice much last summer, what with the life-altering surgery and all.
This summer, I am feeling all the discomfort that our "team" is experiencing as a result of its absent guiding force. To ourselves, we say it is not as much fun around the place, but it's more than fun - it's more like the normal stress that's usually on everyone for day to day things, like pastoral items, interpersonal staff relations, and member care, feels tougher because we're missing a piece of what makes us work so well. We're all separately strong, but I think we feel kind of brittle. Of course, I can only speak for myself, but for sure I'm not the only one feeling the strain. But.............1 month down, 2 to go, and I've got to admit the quiet is kind of nice.
However, I'm not happy with not being content. (How's that for a concept?) Once I identified the problem for myself, I started working on the solution. The answer is to press on and focus on all the cool stuff I get to do that is unique to the summertime work environment, which is, in addition to organizing/purchasing, covering for both rabbi and cantor, so I get to work with students practicing their Hebrew and their chanting (one of my favorite activities that I don't get to do much) and also to help students prepare what they will teach at their Bar or Bat Mitzvah. And, I get to work more closely with our administrator than I do the rest of the year, when there's simply not enough time to talk about trying something new. We conspire on how to entice prospective members and she's a great sounding board for some of my whackadoo ideas for the coming year.
And tomorrow, we're going out to lunch for my birthday. Gotta love a job that includes going out to lunch!
If this was the first time I had this kind of conversation in a week, I wouldn't have given it a second thought (and you wouldn't be reading about it, either.) It's all good, as the kids say, at home. But, I was getting not so much joy out of my work as usual (and that's odd because summer is a great time for one who likes to organize and buy school/office supplies!) and I couldn't define why I was sort of unhappy (as opposed to sad, or depressed, or cranky.) I knew that with our rabbi out on sabbatical, the dynamics of our workplace would change a bit, but okay. We'd already been through that last summer, and it didn't seem so terrible. An email conversation with a friend and former co-worker (shout out to Colorado!) revealed that this summer is different for ME, not for the synagogue. I probably didn't even notice much last summer, what with the life-altering surgery and all.
This summer, I am feeling all the discomfort that our "team" is experiencing as a result of its absent guiding force. To ourselves, we say it is not as much fun around the place, but it's more than fun - it's more like the normal stress that's usually on everyone for day to day things, like pastoral items, interpersonal staff relations, and member care, feels tougher because we're missing a piece of what makes us work so well. We're all separately strong, but I think we feel kind of brittle. Of course, I can only speak for myself, but for sure I'm not the only one feeling the strain. But.............1 month down, 2 to go, and I've got to admit the quiet is kind of nice.
However, I'm not happy with not being content. (How's that for a concept?) Once I identified the problem for myself, I started working on the solution. The answer is to press on and focus on all the cool stuff I get to do that is unique to the summertime work environment, which is, in addition to organizing/purchasing, covering for both rabbi and cantor, so I get to work with students practicing their Hebrew and their chanting (one of my favorite activities that I don't get to do much) and also to help students prepare what they will teach at their Bar or Bat Mitzvah. And, I get to work more closely with our administrator than I do the rest of the year, when there's simply not enough time to talk about trying something new. We conspire on how to entice prospective members and she's a great sounding board for some of my whackadoo ideas for the coming year.
And tomorrow, we're going out to lunch for my birthday. Gotta love a job that includes going out to lunch!
Monday, June 13, 2011
Zipper neck
I've had several "good looks" at the stitches since the bandage came off on Friday morning, and the whole effect is scarily similar to parts of Frankenstein's monster! The line of stitches is about 4 times longer than the original "little pink itchy spot" ever was, but I was told (and it makes sense) that they need two parallel lines to make a nice (i.e. tiny) scar outcome and the surgery leaves more of an ellipse shaped wound. At first glance, because the stitches are dark, it looks like there are a lot more of them than there actually are. I've tried to take a couple of photos to show what they look like, but close-ups of that area make everything look pretty terrible (!) so you'll see me in person or use your imagination.................
They have to be washed twice a day, and always be covered with bacitracin or something similar. I'm allowed to leave them uncovered (which eliminates the itch quite a bit) but since it looks a little scary to "others" I have a new stock of gigantic band aids. Mind you, in my eyes the band aid draws more attention, again and again, while people wonder what's under there. If they just saw the darn stitches, they'd know! If the weather cooperates and does not become "stinkin' hot" again then I also have an assortment of scarves to accessorize and camouflage. The stitches are scheduled to come out on June 23, but before that we have a prospective member BBQ and outdoor service/open house that hopefully will necessitate lots of tours and talking about (selling) the school. I think band aid AND scarf for that :)
It's only sort of funny that now that I can go fairly low-cut and bra-less on occasion, that I have to cover up! And on that side(s) of things, I am finding that there are many times going without a bra is actually uncomfortable. I think there are still things healing, so the "pull" on the interior support work on the right actually stings if I twist the wrong way or pick up something heavy, or reach too high. On the left, I guess I shouldn't be surprised that a muscle used to being in one place and doing one job for over 50 years would take a lot of time to get used to its new surroundings and new job. Talk about teaching an old dog new tricks!
You would think that all of last year would teach me perspective, or more patience, or whatever, for the healing process of this, relatively minor, surgery. But noooooooooo. I chafe at the itchy stitches, (and necessary band aids,) I'm tired of covering up, and I'm just a little short-tempered. (Here I know I am being ridiculous, since it's only been since last Thursday, but if I can't kvetch (complain) here, then where?)
Although my constant supporter Rod has been incredibly patient (less the zipper neck comment, which he contributed) it's a busy time with a couple of graduation parties, the annual staff dinner/end-of-year meeting, and in the middle of it all, Ari's finals, always a bit of a cliff-hanger considering what a smart kid he is. So I have a feeling that what it comes down to is: we'd just like to survive sophomore year of high school. It's just a matter of enjoying all the other stuff along the way because it's mostly all good stuff!
They have to be washed twice a day, and always be covered with bacitracin or something similar. I'm allowed to leave them uncovered (which eliminates the itch quite a bit) but since it looks a little scary to "others" I have a new stock of gigantic band aids. Mind you, in my eyes the band aid draws more attention, again and again, while people wonder what's under there. If they just saw the darn stitches, they'd know! If the weather cooperates and does not become "stinkin' hot" again then I also have an assortment of scarves to accessorize and camouflage. The stitches are scheduled to come out on June 23, but before that we have a prospective member BBQ and outdoor service/open house that hopefully will necessitate lots of tours and talking about (selling) the school. I think band aid AND scarf for that :)
It's only sort of funny that now that I can go fairly low-cut and bra-less on occasion, that I have to cover up! And on that side(s) of things, I am finding that there are many times going without a bra is actually uncomfortable. I think there are still things healing, so the "pull" on the interior support work on the right actually stings if I twist the wrong way or pick up something heavy, or reach too high. On the left, I guess I shouldn't be surprised that a muscle used to being in one place and doing one job for over 50 years would take a lot of time to get used to its new surroundings and new job. Talk about teaching an old dog new tricks!
You would think that all of last year would teach me perspective, or more patience, or whatever, for the healing process of this, relatively minor, surgery. But noooooooooo. I chafe at the itchy stitches, (and necessary band aids,) I'm tired of covering up, and I'm just a little short-tempered. (Here I know I am being ridiculous, since it's only been since last Thursday, but if I can't kvetch (complain) here, then where?)
Although my constant supporter Rod has been incredibly patient (less the zipper neck comment, which he contributed) it's a busy time with a couple of graduation parties, the annual staff dinner/end-of-year meeting, and in the middle of it all, Ari's finals, always a bit of a cliff-hanger considering what a smart kid he is. So I have a feeling that what it comes down to is: we'd just like to survive sophomore year of high school. It's just a matter of enjoying all the other stuff along the way because it's mostly all good stuff!
Thursday, June 9, 2011
Right around 3 p.m...........
Is when the numbing medication wore off all the way. Doctor called around 1:30 to check up on me; things were getting a little itchy, but he said the bandage could go first thing in the morning, then shower and bacitracin. (It's possible part of the itch is from the bandage.)
Round about 3, though, the real pain showed up, so I tried to stay in a lying down position for most of the afternoon. (Seems when I stand up or sit up straight something pulls and it hurts more.) I tried out 3 advil, which only worked a little, but I am determined not to suffer through the night. So, out will come one of the heavy-duty painkillers I can break in half and get a good night's rest. Then tomorrow will be better. But I'm glad it's over. In the morning we'll get a good look at the stitches!
Round about 3, though, the real pain showed up, so I tried to stay in a lying down position for most of the afternoon. (Seems when I stand up or sit up straight something pulls and it hurts more.) I tried out 3 advil, which only worked a little, but I am determined not to suffer through the night. So, out will come one of the heavy-duty painkillers I can break in half and get a good night's rest. Then tomorrow will be better. But I'm glad it's over. In the morning we'll get a good look at the stitches!
Post-op post
Without a hitch. That's how my foray into the world of specialized microsurgery went. We got there at 7:05, they took me in at 7:10, got started right away, and the doctor was extremely nice about the shot. He also checked continuously to be sure I wasn't in pain. Actually one of the most relaxing things I've done in a while! I had the option to stay in the treatment room or join Rod in the waiting area while they checked the newest samplings. We were packed and prepared to be there all day and, of course, I was skin cancer-free and stitched up by 8:15.
Stitches to be removed in two weeks and until then (after the first 24 hours of not touching my bandage)simple care: wash with soap, cover with bacitracin and use a bandage only if I want to.
So simple, so painless (mostly). Piece 'o cake. I'll let you know what happens after the long-acting deadening shot wears off. But in the meantime the two teeny ativans I took to ward off anxiety are making me sleepy. Nap time:)
Stitches to be removed in two weeks and until then (after the first 24 hours of not touching my bandage)simple care: wash with soap, cover with bacitracin and use a bandage only if I want to.
So simple, so painless (mostly). Piece 'o cake. I'll let you know what happens after the long-acting deadening shot wears off. But in the meantime the two teeny ativans I took to ward off anxiety are making me sleepy. Nap time:)
Wednesday, June 8, 2011
Irony
Ever since I met Rod (over 30 years ago) he has had more than a few spots of basal cell carcinoma, that least nasty form of skin cancer, diagnosed (and removed) due to many bad childhood sunburns on very fair skin. Now, roughly at the same time I had my little (first-time) biopsy, he had two (count 'em, two) biopsies on suspicious spots.
So what happens? For the first time EVER, his spots are nothing. Mine (just above my breastbone, right where a necklace would hang) is "suspicious for basal cell carcinoma" or, as the dermatologist said "we don't even really consider that cancer." But, based on my current medical situation and the radiation I had in that area some years ago, she recommended Mohs surgery. Further explanation of Mohs can be found here http://www.skincancer.org/mohs-micrographic-surgery.html?gclid=CILJ8oKfpqkCFURd5Qod-VnIug
but suffice it to say, it's a method that ensures complete removal with the most desirable cosmetic results.
So tomorrow I'm having that done beginning at 7:10 in the morning (yawn) but hopefully to(a) be the first patient in so no backup yet and (b)get out of there sooner in the day.
When the nurse called me about two weeks ago to go over choosing the date and time, I asked all the usual (for me) questions:
Me: So, you need bloodwork and an EKG?
She: Um, no.
Me: Should I stop taking any of my medications now because it's only two weeks away?
She: No, take everything you usually do.
Me: No eating after midnight, or earlier because my appointment's so early?
She: We want you to eat, and drink.
Me: But if I drink, what will happen if I need to go to the bathroom during the surgery?
She: You get up and go.
Me: How early do you need me there for preparation - 5:30ish?
She: Just be on time.
So, you can see, I am now used to a whole 'nother world of surgery that this is clearly NOT. When I got off the phone after that call, I thought "she probably thinks I'm nuts." But when I read the presurgery directions they sent, they were heavy on the "make sure you eat well" and "bring snacks" - so funny!
Since there is at least one needle involved, I'll be fully prepared with my lidocaine cream slathered liberally on the area an hour ahead of time (I'm such a wimp.) The paperwork does indicate that they try to make it a long-acting shot so that the area stays numb for a really long time. Apparently they cut some off, stick a temporary bandage on you and send you out to a waiting room while they freeze and examine the tissue looking for clean margins, side to side as well as depth. So there's a lot of back and forth and in the worst case, I could be there all day. Hence, their main concern for prep is that you have comfortable clothes, enough food so you don't faint, and plenty to keep you busy while you wait.
This is the most "opposite" set of pre-surgery directions I have ever gotten - bring food, bring possessions! Nice change from the "we want to make you the most uncomfortable you've ever been before we maybe don't kill you under anesthesia so you can't do anything you usually do for at least two weeks and don't bring anything with you that makes you feel less anxious" directions of my four previous surgeries :)
The biopsy for the suspicious patch took a lot of care, since it was an open wound; tomorrow's surgery will leave me with stitches, which I have grown to appreciate. They aren't as pretty, but at least (after 24 - 48 hours) you can shower them and there will be a much smaller scar.
All this on what is predicted to be the hottest day of the year so far. I won't be out sunning, in any case!
So what happens? For the first time EVER, his spots are nothing. Mine (just above my breastbone, right where a necklace would hang) is "suspicious for basal cell carcinoma" or, as the dermatologist said "we don't even really consider that cancer." But, based on my current medical situation and the radiation I had in that area some years ago, she recommended Mohs surgery. Further explanation of Mohs can be found here http://www.skincancer.org/mohs-micrographic-surgery.html?gclid=CILJ8oKfpqkCFURd5Qod-VnIug
but suffice it to say, it's a method that ensures complete removal with the most desirable cosmetic results.
So tomorrow I'm having that done beginning at 7:10 in the morning (yawn) but hopefully to(a) be the first patient in so no backup yet and (b)get out of there sooner in the day.
When the nurse called me about two weeks ago to go over choosing the date and time, I asked all the usual (for me) questions:
Me: So, you need bloodwork and an EKG?
She: Um, no.
Me: Should I stop taking any of my medications now because it's only two weeks away?
She: No, take everything you usually do.
Me: No eating after midnight, or earlier because my appointment's so early?
She: We want you to eat, and drink.
Me: But if I drink, what will happen if I need to go to the bathroom during the surgery?
She: You get up and go.
Me: How early do you need me there for preparation - 5:30ish?
She: Just be on time.
So, you can see, I am now used to a whole 'nother world of surgery that this is clearly NOT. When I got off the phone after that call, I thought "she probably thinks I'm nuts." But when I read the presurgery directions they sent, they were heavy on the "make sure you eat well" and "bring snacks" - so funny!
Since there is at least one needle involved, I'll be fully prepared with my lidocaine cream slathered liberally on the area an hour ahead of time (I'm such a wimp.) The paperwork does indicate that they try to make it a long-acting shot so that the area stays numb for a really long time. Apparently they cut some off, stick a temporary bandage on you and send you out to a waiting room while they freeze and examine the tissue looking for clean margins, side to side as well as depth. So there's a lot of back and forth and in the worst case, I could be there all day. Hence, their main concern for prep is that you have comfortable clothes, enough food so you don't faint, and plenty to keep you busy while you wait.
This is the most "opposite" set of pre-surgery directions I have ever gotten - bring food, bring possessions! Nice change from the "we want to make you the most uncomfortable you've ever been before we maybe don't kill you under anesthesia so you can't do anything you usually do for at least two weeks and don't bring anything with you that makes you feel less anxious" directions of my four previous surgeries :)
The biopsy for the suspicious patch took a lot of care, since it was an open wound; tomorrow's surgery will leave me with stitches, which I have grown to appreciate. They aren't as pretty, but at least (after 24 - 48 hours) you can shower them and there will be a much smaller scar.
All this on what is predicted to be the hottest day of the year so far. I won't be out sunning, in any case!
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