Trudge, Trudge, Trudge

Nico is almost as stressed as I am

I used to walk, then I strolled, moseyed, and now I trudge.

So the update on the fluid retention situation that started a couple of months ago is that it continues. I've gained 25 pounds of fluid, from below my chest down to my feet.

My mobility is much more limited and I have more shortness of breath. Standing still for more than a couple of minutes is difficult, even with the assistance of a cane. My appetite is lower than its usual low.  The whole thing feels cumbersome and heavy and just pretty unpleasant.

I am really grateful that I can still drive. I've got to get out of the house and it feels good to be able to do that myself (even if I can't walk much once I'm out!)

I started taking a diuretic this week to help reduce the fluid in my legs. Next week on September 1 I'll have a paracentesis done, where a doctor will drain fluid from my abdomen. I understand that will provide very temporary relief but I'll take it.

Friends and family have helped us out a lot lately. Running errands, installing grab bars in the shower, providing meals, trimming hedges, giving rides to me and to C - these have all been so great. (Most of this assistance has come from close friends and family I talk to frequently rather than the whole Helping Hands community if you're wondering whether you've been missing requests on that website).

I continue to take the non-chemo, cancer-fighting medication at home, which thankfully does not bother me. I'll have my next CT scan on September 10.

In the meantime, what I'm most appreciating now are visits at my house or yours or the occasional coffee or sit in a park where I don't have to walk much. Phone calls are good, too. An hour is kind of max for me, then I get tired. I don't get tired every hour when I'm home alone, but being social, while fun, takes it out of me. But seeing people is essential for my well-being.

I hope it will be easier for me to go to movies and out to eat soon if we can get some of this fluid retention under more control.

This continues to get harder emotionally, and I have good support to help me with that. Over the last couple of years, the anxiety and emotional stress have been at least as challenging (and sometimes much more so) than the physical difficulties of the disease and treatment.

The kids have been so great this summer - very helpful and kind - and also are leading normal teenage lives, with some physical activities like crew and swimming and a lot of screen time. They go back to school September 9. It will be M's senior year and C's freshman year in high school.

I can't say enough great things about my husband, B. He takes care of so much and always, always listens. That just scratches the surface of how awesome and strong and supportive he is. I could gush for many paragraphs. 

A Few Thoughts on What to Say to Me When You Don't Know What to Say

A few people have let me know that it's hard to know what to say to me. Should they ask about my illness? Should they let me bring it up and never mention it? Sometimes they avoid talking to me because they don't know what to say.

I get it. I myself find it hard to know what to say to people going through something really challenging, especially if we're acqaintances and not best friends.

Recently I came across this article: "How Not To Say the Wrong Thing", and I think it describes a pretty good rule of thumb.

I also think this collection of empathy cards for people with a serious illness, designed by a cancer survivor who created cards she wished she had received, have messages that are really spot on.

Personally I know that people in my life want the best for me, and if that means they sometimes say something that bothers me, I don't dwell on it. So my intention by sharing the article and the cards is not to give you a set of rules that you better perfectly follow if you want to be my friend, but rather some ideas if you're feeling unsure about what to say and not to say.

Honestly, sometimes I want to talk about it, and sometimes I don't. Sometimes I'm feeling good about my day, and sometimes I'm not. Sometimes a simple question like, "How are you?" feels almost impossible to answer - other days it's a piece of cake. It's kind of a crap shoot.

I'm always interested in hearing from you, and if something you do or say doesn't sit well with me and I feel like saying something about it, I'll do so and we'll move on! Or I will simply change the subject. I don't simmer with resentment. I didn't before I got cancer either; now I'm just better at it.

Here's the Latest

Central Park from my friend's parents' apt on the 78th floor

New York was great! I had a great time with old friends and seeing Byron and the kids and various sights. I was pretty exhausted by it all, but who isn't? That city has a lot of intense energy, especially compared to my laid-back Northwest city.

So now back to reality. I started the gemcitibine last Friday, April 17. I receive that once a week for two weeks, have the third week off, and then start a new cycle of two weeks on / one week off. I'll keep going with this and then have another CT scan in July to see what's happening.

I'm not feeling as good as I was a couple of months ago, and that has made me think more seriously about asking for help. It's been hard to recognize when we need help, what to ask for and how to ask for it. I just wrote about this on the "Lotsa Helping Hands" website that local friends and family are hooked into to learn about our requests for help. If you are not a member of my community on Lotsa Helping Hands and want to be, just go here and request to join the community.

Rather than be like your Aunt Mabel who has trapped you at the buffet table at the family reunion to describe all of her ailments in detail, I'd like to tell you a little bit about what I'm dealing with in the context of activities that I frequently do with you.

Taking Walks

I love walking with friends. I love walking the dog (when he is not being Mr. Dawdlepants). However for the last several weeks I get short of breath very quickly, especially going up stairs or walking up even a slight hill. I need to sit down for a little bit and recover, even if I've been walking on flat ground for as little as 10-15 minutes. Standing still for any longer than 5-10 minutes can be challenging. Just picking out birthday cards at the store today required me to lean on the shopping cart (not a big deal, but a change for me). Waiting in the security line at the airport (25 minutes) was a real endurance test.

So please understand that if we go on a walk, it will be slow and kind of short. I will huff and puff. You will not get a workout. But I do need to get out there and get fresh air and walk some, for my health and sanity. I just need to do it differently.

My doctor thought I might have blood clots in my lungs, but this was ruled out by a CT angiogram. So the latest theory is that the shortness of breath is overall related to the cancer changing and not just the last chemo I had. I don't really know what that means, but I'm just working on adapting to it.

Eating Out 

I also love going out to lunch, dinner, and coffee to restaurants and people's homes. But for the last couple of months, my appetite has been down (very common side effect) and some food just doesn't sound good to me at all. I'm not nauseated or sick, but I am often not very hungry.

So if we go out or I go to your house and I don't eat very much, please don't take it personally. I'm kind of funny about food right now.

Making Plans

I love making plans. However lately it is not uncommon for me to develop a fever out of the blue, and then I need to lie down and rest. These are usually pretty low grade and sometimes last for just 3 hours, but I feel very, very tired. If I ignore a fever and push through with my plans instead of lie down, it all just gets worse.

The last full day we were in New York I got a fever and spent most of the day in the apartment while the rest of the family ran around. That was a bummer, but I did what I needed to do. Sometimes I feel very tired even without a fever, and I need to rest rather than go do that next thing.

So if we make plans and I cancel even at the last minute - sorry, I just have to lie down sometimes. We will reschedule!

So in addition to being more open to asking for help, what I'm adjusting to is living life more slowly. I need to take it at my pace, which is slower than the pace of other people my age. I need to pick and choose more carefully what I take on in a day. I still have days when I feel pretty "normal", and that of course feels great.

The Hair Report

Oh yes, the hair. The last time I mentioned it I said that hair thinning / loss was a common side effect of the last chemo I was on. As it happened I did experience hair thinning for a few weeks in January-February, and then that stopped. Good thing I had a ton of thick hair to start with.

So now I have thinner hair and have new bangs to sort of mask the thinner hairline, but I am thrilled to still have my own hair.

This new treatment can cause hair thinning / brittleness, so we'll see what happens.

Thanks for hanging in there with me. I always like to hear about YOU and your life, because God knows I spend more than enough time thinking about my own.

I hope you're enjoying all that's blooming in your part of the country right now.

Team Heather

Yeah, I know the name is corny. But it beats "Heather's Homies" and "Heather's Honchos", two stellar ideas contributed by B. and M. for what to name the online group we set up through Lotsa Helping Hands.

So Team Heather it is. If you're in our city and want to know about meals, rides, and whatever else we think of that would be helpful, you can go to https://www.lotsahelpinghands.com/c/710014/ and request to join the community. Then after you're "approved" you'll receive instructions on how to sign in.

You can check the calendar on the website showing what we're asking for and sign up for anything that works for you.

I'm glad to have learned about this website because I think it will make it easy to ask for support, even with little notice, without feeling like we're putting anyone on the spot. (I won't hesitate to go ahead and put family and close friends on the spot, however!)

If you know someone who might be interested in helping out sometime, please feel free to share the above link. I don't think I can have too many people in this group - the more the merrier.

How I'm Doing

I continue to do very well after the first chemo treatment. It's been wonderfully uneventful. Also the trip that B. and I took a week or so ago was incredibly relaxing and a true vacation. You parents especially understand the difference between a vacation and a family trip. This was a vacation!

Not going to the medical center in the past two weeks has certainly helped me get back into "regular" life and feel less like a full-time patient with a really depressing diagnosis.

So I'm savoring the good times and moving through this, step at a time.

We've Got a Plan

It always feels better to be in action than to be sitting around waiting for test results.

After a couple of consultations with oncologists, I've got a chemotherapy game plan to start with this Thursday. The fact is that there are many options to choose from, and it's kind of "dealer's choice" on what to pick first.

The plan we've chosen to start with requires an infusion at the medical center every 3 weeks. After two cycles, we'll check the tumor markers (that's a blood test) and see if there's a change. After three cycles we'll do another CT scan. If it appears to be working, we'll continue with it. If it isn't, we'll move onto the next chemo plan.

This chemo regimen does not cause hair loss. Yay for me. There are other side effects of course, and we won't know just how this regimen will affect me until I'm on it. It can cause platelet problems, bleeding problems, liver damage (not really what I need), nausea (not as severe as the drugs I had last year apparently), and of course, fatigue (all of them cause fatigue).

But my oncologist says it's "generally well tolerated" so we'll go with that.

So far my liver function is very good and it isn't inflamed. How that's possible with five nasties in it is a mystery to me. Again, yay.

Technical Details

Some people reading this blog have some experience with breast cancer, so I thought I'd include the details of this regimen. You can gloss over this section if you want!

The cancer is still strongly ER/PR/Her2neu positive, which is good news. As I understand it, it means that a variety of drugs, including herceptin and its herceptin-like pals and anti-hormone treatments may be effective against it. Although the cancer returned while I was on tamoxifen (an oral estrogen suppressor for pre-menopausal women), so I'm off of that medication now.

The chemo regimen I'm starting with Thursday is TDMI (brand name of Kadcyla) (which sounds a lot like Godzilla). It's herceptin with a chemo agent "welded" to it. It was just approved by the FDA this year. In a study it looks a little better than another option, capecitabine with lapatinib, so that's why we're going with it as a first choice. We may move on to capecitabine later (or something else) if need be.

Chest Port

Tomorrow I go in to have a chest port placed to make all of this easier (the veins in my arm therefore get to relax). I had one placed in May last year and it was removed this June after I completed a year of herceptin. But back in it goes.

I'll be at the med center for about 6 hours tomorrow, counting all the waiting you do beforehand and the observation time afterwards. I'll have IV sedation during the procedure, so whatever.

How My Family's Doing

Everyone's hanging in there. B. is always amazing and supportive and can be counted on for anything, no matter what. That's really incredible. But he's also tired and stressed, so he's looking for times he can relax. He's going to a baseball game with his brother tonight, which is a good start. Hikes, photography, driving his 1950's car, reading, and going out for a beer with a friend are all things he wants to be sure to keep doing.

The girls are sometimes worried, but most of the time are just moving forward in their lives. They're both having good starts to the school year and are busy with extra-curricular stuff and friends too.

Thank You

I've received a lot of really wonderful messages and hugs lately. Thank you! I appreciate them all. I will let you know what kinds of practical help we might need as we figure that out.

This may turn into a bit of a marathon, so I'm hoping people don't "burn out" in the next few weeks helping us. Save something for months from now!

Please keep thinking positive and hopeful thoughts about me - that makes me feel really good. 

It's Back

Well, shit.

I learned yesterday that the masses in my liver are indeed the return of last year's breast cancer. There is no evidence of cancer anywhere else, so that's something.

The treatment is chemotherapy, and I'm scheduled to start that on Thursday. Before then I have a couple of oncology appointments to learn more about the recommended regimens and to pick one.

There's no cure for stage 4 breast cancer - instead the goal is control, and I've learned that some women are living quite a long time with the disease. I'm choosing to focus on hoping that I'll be one of those.

We will need a lot of help, but I don't know in what forms yet. This will be a day by day experience. The last three weeks have been truly awful and B. and I are both grieving - I think that's the best word that encapsulates the essence of where we're at. Grief comes in cycles as you know, so along with grieving we are living and we are hopeful.

What You Can Do
 
Think positive, hopeful thoughts and imagine the best outcome for me. Stick with me - I'm fighting this, and I need you. B. and the girls need you. Don't stay away because you don't know what to say - we're all just stumbling through this. Don't stay away because you're worried I'll cry or you're afraid you'll cry. That's all part of it.
 
I'll do my best to keep the blog updated with the latest facts and to let you know about practical things we might need.
 
In the meantime, I'm making every day as good as it can possibly be and keeping my loved ones close. Thanks for your continued love and support.

Chemo Starts Monday, June 11

Decision Made

I finally made a decision about which of two chemo regimens I will go with.

This wasn't easy because the first oncologist favored one and the second favored the other. Both said I could pick either regimen. There's no study that shows that one is more effective than the other. It came down to a matter of opinion and which factors weighed more heavily in which oncologist's mind. It was up to me to select a regimen, and it was really hard to figure out how I was going to make that decision.

I went over and over my notes, I talked with B., with each of my parents, with a couple of other people. I slept on it for two nights. And then I made my decision. And I feel good about it.

This was a really strange and stressful situation because there was no right decision or wrong decision, yet obviously to me the stakes feel very high. I kept wanting there to be a right choice, a wrong choice, and some kind of guarantee.

Oh, and how about we throw in a free trip to Europe and a magic carpet, since I've now ventured into Fantasy Land.

Chemo Details

So I have my first chemo treatment on Monday morning. I'll have a total of six treatments, each three weeks apart. If I stay on schedule that puts my last treatment on September 24. Not that I've counted or anything.

I don't know what to expect about how I'll feel next week. I have to take steroids the day before and the day after the treatment to help combat fluid retention. Those I expect will amp me up a bit. I'll have anti-nausea medications to take. I'm pretty sure there will be some fatigue in the picture.

But rather than go through the extensive laundry list of possible side effects with you now, I'll just wait and see what happens. Have you ever checked the list of possible side effects on something innocuous, like a bottle of Advil? There's always something nasty on there, like severe stomach bleeding or seizures or shut down of major organs. Those things have never happened to me after taking the minor stuff, so I'm not going to memorize all the possible effects of the drugs that are entering my system next week. I'll just have to see how it goes and manage what comes my way.

How I'm Doing

I'm still so relieved to be in this phase of preventing recurrence rather than battling existing, known cancer, that starting the chemo process, while a huge bummer, is now something I just want to get through and be done with.

Also it still feels surreal, maybe because I don't know what to expect. I feel rather numb. I expect to feel nervous Sunday night and Monday.

Ways You Can Help

For the locals, there will be another round of dinner delivery opportunities. An email should be coming your way about this soon.

Here are other ideas for local folks:

Be in touch. Don't worry about bothering me - text or email if you don't want to call. Send a note. I love to hear from you. We can talk about me, but I really want to hear about you and your regular, everyday life.

If you're going for a walk, see if I want to come with. I'm supposed to get out every day and stay as active as possible. I'm also up for offers to have tea or just a visit.

If you or your children are friends with my kids, feel free to invite them along to something fun you're doing, or just to hang out, especially after school lets out for the summer. We'll be in town!

If you're friends with B., be in touch with him. Go out for a beer, a ride in his car, coffee - whatever. Being the spouse of a person going through chemo treatment is tough. I know he feels a lot of stress from all directions right now. He needs breaks and fun things to do and offers of specific help. He knows he can ask for help, but he (like me and pretty much everyone else we know) is not great at recognizing when he could use help or asking for it.

If you or your children like dogs, feel free to call or email with an offer to walk Caleb the Wonder Corgi anytime you want. Around the block is not too short. An off-leash park is not too long. He loves fetch in the yard, too. Come once, come ten times - whatever works. He's available!

If you're at a grocery store or drugstore nearby and you think of it, call and see if we need anything.

Drop anything by. Recently friends have brought flowers and cookies. Those are such day-brighteners!

And for anyone, local or not:

Be in touch!

Send me anything funny, amusing or distracting. Links to YouTube videos are good. A friend gave me Tina Fey's book Bossypants for my birthday last month (which you simply must read if you haven't already because it's hysterical). Any of your favorite TV shows that don't involve people dying of cancer or feature gritty violence that puts you into an existential torrent for days I definitely want to hear about. Any music you're listening to you'd recommend? I haven't downloaded any new music in a long time.

Play "Words With Friends" with me (it's a Scrabble app on your smartphone or on your computer through Facebook). This will be fun for you because I'm not one of those players who knows all the 2-letter words that no one has ever heard of, and if I get "chemo brain" I will be even easier to beat.

I probably will come up with more ideas as time goes on.

Healing, Oncology and Lessons from the Cereal Aisle

It's a good thing I have nothing else to do with my time than go to medical appointments. Otherwise imagine how boring my life would be.

It's been awhile, so I'll catch you up with the highlights.

Healing from Surgery

This continues to go well. I'm gaining more and more range of motion in my shoulder and have been back to a regular routine for a while now. I don't have the same energy I did before surgery, but it's coming along.

There are a couple of hiccups that are delaying full healing (one is an infection I'm taking antibiotics for and one is just kind of gross so I'll spare you). But those will be resolved by the end of the month.

What's Coming Up

I've been to four appointments this week (nurse visit, surgeon follow-up, physical therapy, and a consultation with Oncologist #1, Dr. N.) There's heaps more fun coming up. Here's a rundown:

May 24: Port placement

I'm going to have a port inserted into my upper chest so that my veins don't have to take all the poking and prodding I'll be having in the next year. Instead the chemo drugs, blood draws, and whatever else will be going in or coming out through the port. It'll be completely under the skin but the outline of it might be visible. I'll be sedated for this lovely procedure.

May 25 and 31: Various scans

They want to check my heart so they can see how strong it is. And I need a CT scan of the chest and abdomen and a bone scan.

June 1: Phone visit with Dr. N., to review results of scans.

June 4: Consultation with Oncologist #2, Dr. F., to hear what he has to say about the chemo regimens he recommends for me.

Soon after that: Chemo begins. 

Consultation with Oncologist #1

I learned a lot today and feel positive about my visit with Dr. N.

I could be in one of three groups, and there's no way to tell which group I'm in ahead of time (this goes for everyone, by the way).

Group #1 is people who have cancer removed (as I have) and then do not experience recurrence, even with no further treatment.

Group #2 is people who have cancer removed and need treatment to prevent recurrence.

Group #3 is people who have cancer removed, have treatment, and just don't have the biology (she used that word - not really sure how to explain it) to prevent recurrence.

So based on individual factors of my individual situation, and in case I'm not in Group #1, she recommends the best course of action for me as surgery (check that one off), chemo/herceptin (herceptin is the drug I get through the port every 3 weeks for a year that targets only bad cells), radiation, and tamoxifen.

She presented two different chemo options and told me which one is her first pick and why. But the second choice pick is a completely viable option, too. There's no data that categorically states that her first pick is better than her second pick - it's her opinion based on her experience. She believes that if I asked 10 oncologists, 6-7 of them would agree with her. I'll be seeing another oncologist June 4 to see what he says.

The regimens differ in terms of intervals and drugs. In general, an every 1 or 2 weeks regimen is going to be harder to take yet also gives the cancer cells the least opportunity to fight back. Every 3 weeks is easier to take but could be easier on the cancer cells.

Either way you slice it, I will be losing my hair. That's a given. (Eyebrows and eyelashes might be spared a bit, but the rest will be temporarily gone). More on that in another post.

Another key thing I learned is that the whole process is constantly monitored, evaluated and tweaked for the highest level of comfort and efficacy. My heart function, information about my platelets and all kinds of other things will be looked at frequently. There are a variety of anti-nausea drugs, a variety of this and that to try, and everyone's response is individual. There are a whole host of possible side effects, some of which I may experience and some of which I may not. We just have to see how it goes.

In general I was told to expect ups and downs.

How I'm Doing

Right now I'm really saturated with information and am tired of thinking about it. I haven't slept well the last few nights and am tired.

I'm also very hopeful and am still dedicated to finding positivity everywhere possible. I do this on my own and with the help of my friends and family. Even the lady at the front desk in oncology who spent 10 minutes with me telling me about how I could call on her for tea, crackers, a hug, a bed to lie down on, etc. helped.

I'm up and then I'm down. I can be totally distracted from this and enjoying my life and then really sad and angry about the whole thing. I think that's pretty typical.

What Helps

Hearing from you, funny stuff, seeing friends, meeting with clients (good distraction), family, sunny days, exercising.

What Doesn't Help

In case you were wondering, it doesn't really help to quiz me in the cereal aisle at the grocery store about how many cycles of chemo I'm going to need to go through and what my prognosis is. (This actually happened, and no it wasn't you - it was someone I know very casually who doesn't know about this blog).

It's natural that when we hear about something challenging we want to know the end of the story. So we ask these kinds of questions:

What's your prognosis?
Do you think you'll win the custody battle?
Is your company going to lay off your team? What will you do then?

Of course we want to jump right to the happy (or not so happy) ending. But what's most helpful for people is to be with them right where they are.

I know I've asked people who were in the midst of a struggle questions that were about satisfying my own curiosity. I meant well, but I wasn't attuned. I know better now.

I've come up with a basic line (that's polite) that I can use with people on the periphery who are being too nosy for my taste. (The rude version I can say in my head). I realized after the Cereal Aisle Incident that I have to be able to protect myself with such a line, because although it may seem like I can chat about this as if we were talking about a remodel or M's classes next year at high school, I really can't without some kind of mood recovery plan. And I don't always have the time for that.

As always, thank you so much for your continued positive thoughts, supportive cards, dinners and everything else great that you're sending my way. It all boosts my spirits!

Surgery Set for April 30

Oh boy, another month of waiting!

This time I don't mind. I've got April to plan for taking time off work, getting some logistics for the kids in place, for B. and I to maybe go somewhere for a weekend, and just to enjoy normal life.

I'll be in the hospital for one night, then home sometime Tuesday, May 1, assuming there are no complications.

Yesterday I brought B. along for the pre-surgery appointment. I had the opportunity to talk to the surgeon, Dr. C.,  more specifically about what she's going to do and what I can expect.

Surgery

Dr. C. thinks there's a good chance she can get clear margins, even with the tumor proximity to the chest wall factor. So radiation later is a possibility, but definitely not a foregone conclusion.

As is standard, she'll do a sentinel node biopsy to check on the status of the lymph nodes. Before the surgery I'll get an isotope injected and then during surgery they inject some kind of blue dye and based on what Dr. C. sees in the lymph node area, she'll remove the lymph nodes she needs to. Her guess is that she won't have to take many. I didn't ask why she thinks that - I just went with it.

I believe I'll get a call later that week with some information about the pathology report and then will go into that in further detail with Dr. C. on May 7, when I have a follow-up appointment with her. At that time she'll have at least an overview of what I might expect in terms of additional treatment.

After Surgery

Then I'll see either a radiation or medical oncologist to talk about the plan. (We'll see how long the wait is for that appointment!) I was surprised to learn that I may have some choices to make. I assumed I would be told what to do and would have no options. But Dr. C told me that oncology could present a few options with different pros and cons and that I'd get to pick. Interesting.

What seems to be expected is that I'll go on Tamoxifen (technically oral chemo) for five years. This is a standard drug that pre-menopausal (used to be all women) breast cancer patients go on to suppress estrogen (and maybe some other stuff) and reduce the odds of recurrence or a 2nd cancer. I'm sure I'll learn all about this later.

I also expect to hear about the drug Herceptin, which I mentioned several posts ago, because there is a factor about this cancer that indicates it's receptive to this drug. This factor also indicates that the cancer is on the aggressive side. But for now I'm really trying not to leap too far ahead. (Have I mentioned this is not my strong suit?!)

How I'm Doing

I'm both happy to have a surgery date and dreading it. I'm happy because the sooner I can do this, the sooner I can get through the rest of it and adjust to being a breast cancer survivor instead of be a breast cancer patient.

But I'm dreading it because the surgery marks the beginning of physical changes that I'm just so sad to have to go through. What will I feel like? How will I be changed? What will be my new "normal"? These are all mysteries I wish I didn't have to explore.

Of course at the heart of all this is determination to become cancer-free and be well. But since this cancer doesn't cause symptoms I can feel, it feels surreal to be fighting an invisible intruder. After all, if I hadn't had a mammogram in January, I'd just be living my life as if nothing much were going on.

So while I'm grateful that I don't feel bad physically now, facing the breast cancer surgery and treatment process feels like the beginning of pain rather than the beginning of relief, even though I know it will relieve the cancer. 

Expectations for May

Dr. C. said that she wants me exercising (there are special ones to help gain full movement of my arm and shoulder) right away.  I'm supposed to stay active and I might be able to resume driving after only a week or so.

Of course I'm not supposed to lift more than ten pounds for six weeks,  and there are some other guidelines to follow.

The nurse yesterday said that it can take a month for the general anesthetic to clear your system and that a very common side effect is mood swings. This would be on top of the emotional challenges of this surgery and of facing more treatment.

OK, May is officially Be Kind To Myself Month.

And if you've got any funny stories to tell or distractions to offer - save some for May for me!

No Need to Walk on Eggshells

When someone I know gets bad news, a lot of the time I don't know what to say. Do I mention it? Do I pretend like it's not happening? Should I offer to do something helpful? Should I wait to be asked? Is there anything wise I can come up with to say? It can feel frustrating and awkward.

So in case you're wondering what would be helpful to me, here's where I'm at right now:

• It's OK if you choose not to say anything to me about this diagnosis - I won't be offended. I like living my regular life and having breaks from thinking about this situation.

• It's OK if you want to acknowledge this news. A simple "I'm sorry" or "This sucks" does the job well.

• I'm at the very beginning of this journey and am trying to take this one step at a time. Anything faster quickly becomes overwhelming. So it would be helpful if we didn't talk about things that are many steps down the road, such as the pros and cons of reconstruction, tamoxifen and other post-treatment drugs, and recipes for anti-cancer smoothies. :-)

• I love to talk about other things besides cancer, so when we do connect, let's talk about you. I really don't care how mundane it is - does your cat need to go to the vet? Are you considering an iPhone? What's up at your job? I might be able to come up with some non-medical topics myself.

• If I don't get back to you right away, it's not because I don't care. I just may have a lot going on. So apologies ahead of time if it seems like I'm ignoring you.

• I will reach out when I need help. This isn't exactly my strongest skill, but I'm working on it.

My mood, outlook, and general anxiety level change frequently. But this is where I'm at at this exact moment.