My Vacation Education, Instalment 2

Leather dog with tweed jacket on

The sharp attire of well-dressed Scottish dogs

I am pleased to report that I have now gone 10 days without visiting a doctor or hospital, and I am no worse for wear, except for the small burn on my arm from brushing against a scorching towel warmer. Oh well. I could not expect to go injury free the whole time I was away. At least I did not trip and fall on any of Edinburgh’s cobbled streets. Thank goodness for small mercies.

Here are a few more lessons from my trip:

1. Watch out for ill-placed towel warmers. They are HOT!

2.  I can understand why Mary had a little lamb. I too want one as a pet.

3. Despite my promise to you, I did not consume Scotland’s national dish, not out of fear of contents but out of fear of sodium counts. I learned that mounds of salt are added to haggis, likely to mask the taste of the innards.

4. This part of the world seems largely unaware of the dangers of salt or smoking.

5. You’ve seen one medieval castle, you’ve seen them all.

6. I lack the attention span to enjoy even a good audio tour, although I was riveted by the story of the brutal murder of the suspected suitor of Mary Queen of Scots. I’d consider 56 stab wounds a crime of passion, wouldn’t you?

7. I am a big phoney. All these years I’ve been telling you how tired I am, but get me on vacation, give me a bit of English breakfast tea and the odd mid-afternoon Diet Coke, and I become the Everready Bunny. J. can’t keep up with me. That’s not quite true; she can run circles around me and slows her pace to accommodate me, but even she is amazed at how much energy I’ve had on this trip. I’m still slow going up stairs and hills–strength I’ve never regained since my prolonged hospital stay almost 4 years ago now–and I suggest the odd bus trip instead of a long walk, but I get there. I can’t explain it myself. Is it all the stimulation of being in a new place? How pooped walking the dog and going to yoga regularly makes me when I’m at home? Or the holiday caffeine? I’m slowing down a bit as our trip progresses–that’s why J. was initially hesitant to book a two-week trip–but I am holding my own. And we’re on the home stretch, not that I’m excited about that. It remains to be seen whether I’ll crash after we return and, if so, for how long. And whether this is a sign that I could and should be pushing myself a bit more than I have been on a day-to-day basis. I’ll keep you posted.

8. Finally, this is not my last vacation. Of that I’m certain. Unless, of course, the burn on my arm becomes infected and spreads rampant through my body, and I cannot get to the doctor because of the current rotating transit strikes or I can’t be seen by a doctor because of the juniour doctors’ job action.

Picture of Edinburgh castle with sun shining down

 

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What I’ve learned on vacation thus far

 

I am standing facing one end of London Bridge, double decker red bus approachingI promised not to write while I was away, and trust me, you won’t hear much from me, but I’m up early this morning so I thought I’d take advantage of the free time. Since I can’t eat for one hour following my morning chemo, I must do something to distract myself, right?

These are some important lessons I’ve learned from the road:

  1. A Jewish person, not a Brit, first created Fish and Chips. Way to go, ancestors!
  2. A London bagel is nothing like a New York bagel or a Montreal bagel. It has its own identity.
  3. Despite common preschool lore, London Bridge is not falling down.
  4. 15 degrees C in the UK is sweater, jacket, and long pants weather. In Calgary, the same temperature demands shorts and a t-shirt.
  5. You can’t take a bath in the Baths in Bath, which is fine, because I prefer showers.
  6. The safest way to cross the street is to follow the lead of the locals, who know which way the traffic is coming.
  7. J. and I can blend in fairly well as locals–no carrying the map or guide book in hand, walking with energy and purpose, hanging out at the pub with the after-work crowd, and displaying our most refined manners–until we open our mouths. And I’m not even referring to J.’s British accent.

On this note, have you ever heard J. try to speak “real” English? As we were preparing for this trip, J. dropped in the odd Britishism over dinner. Gems like a “Jolly good!” here and a “Cheerio!” there. Let’s just say that my beloved’s many talents and abilities and strengths do not extend to speaking in a foreign accent. J. has created her very own British dialect, a blend of country twang and city refinement, which she peppers into every other word. Before we departed on our trip, I forbid her from speaking her dialect with anyone of UK origin. Thankfully she has complied thus far, or I would be hanging my head in shame. Even without her bastardized accent, the locals are able to understand us (at least a lot better than I can understand them), and we are able to communicate somehow, despite our differences.

Now let’s hope she doesn’t pull out her Scottish brogue when we hit Edinburgh this weekend. (As an aside, I really want to call the city “Edinburgh”, and for the life of me I can’t understand why it’s pronounced “Edinborough”. My spelling sensibilities are offended. I thought, of all people, those of this region would have their spelling down; they’ve been around a lot longer than we have.)

This weekend, envision me eating haggis. There’s even a Kosher version, although that may be hard to come by at this time of year. J., the food wimp, is going to pass. It must have something to do with her not growing up with kishka, which she seems disinterested in trying as well. I guess she does have a second shortcoming after all: a staunch unwillingness to try unappetizing food. More for me, then, I guess.

Ms. Glass Half Empty puts on rose-coloured glasses

I’ve talked about J. and me enough for you to have discerned our fundamental differences. She’s the clean one and I’m the slob. She’s the efficient one and I’m the procrastinator. “If you’re not early, you’re late!” she once told me. (On that occasion, I was early but she was earlier.) She’s energetic and I get exhausted just watching her buzz around. And her glass is half full while mine is half empty.

Glass half full or not, J. is also a realist. She wants the straight goods, even if the news is bad. She’s a big girl who can deal with anything. Me, not so much. I’m sometimes so overwhelmed that I want to plug my ears and sing, or bury my head in the sand, or…you get the idea.

Last week at the Cancer Centre, I discovered that my platelets had proliferated like bunnies since they were last tested. My count was abnormally low, but my platelets had catapulted through my usual ceiling over a short time. I hadn’t realized that a dramatic rise in platelets can sometimes be cause for concern.

I was still cleared for takeoff, but Dr. Blood decided to send me for one last blood test before I hopped on that plane. I wasn’t concerned–I was going on vacation no matter what–but J. seemed a bit preoccupied with the findings, as if there were a new potential roadblock to our trip.

The clinic was to call with results Tuesday, but nothing. I didn’t think much of it–no news is good news, right?–but J. seemed uneasy not knowing. I know that sometimes the call doesn’t come the day it’s promised. I wanted to wait, and to leave it if I didn’t hear.

But then, since J. seemed concerned, I started to stew: “What if they haven’t called because the news is bad? Maybe I’m dying but they don’t want to ruin our vacation.” This is the mind of an anxious person with her head peeking out from the sand.

I had no intention of seeking those results but I told The Realist that if she needed to know, which she seemed to, she could call. To her credit, J. accepted my thoughts and waited. Lo and behold, the next day, the nurse practitioner extraordinaire called with the findings. She confirmed all was well and wished us a good trip.

My yoga teacher’s wisdom this morning helped me understand what happened. Kathy said that sometimes, when we’re feeling overwhelmed, we need to put on our rose-coloured glasses. Without them, we’d be a mess. I took what she said to heart.

My cup may be half empty, but I still have rose-coloured glasses which I pull out on occasion. Without them, I’d be constantly thinking about having cancer and hospital stays and dying and other unpleasantries. To what end? I need a break from my life so I’m packing those glasses. If they don’t work, there’s always yoga.

A final FYI: I anticipate being too busy enjoying my vacation with J. to script witty updates–my artistry takes time, you know–so you can relish a well-deserved break from me. You’ve earned it. Ta ta for now!

Dog in rose-coloured goggles

Out of the mouths of teens

Many posts ago, I determined that I’m not smarter than a fifth grader. You won’t be surprised to learn, then, that I have no hope against a ninth grader. I wouldn’t be saying this if I hadn’t had a rude awakening the other night.

I wouldn’t really choose to watch the news, except I like the human interest story at the end of the newscast. On Monday, this story was about a 15-year-old boy who had a deadly baseball-sized brain tumour removed a few years ago. This youngster remains cancer free, although he is long overdue for a recurrence. He and his family believe an extreme diet is keeping his cancer at bay, and his oncologist is cautiously optimistic.

This young man is on a ketogenic diet, which consists of 80% fat (that’s a lot of butter, whipping cream, and bacon drippings, I imagine), 15% protein, and 5% carbohydrates. A ketogenic diet reduces blood glucose dramatically, and cancer cells need glucose to grow. Without glucose, they’re sunk.

This diet is already used successfully with some epilepsy patients who are unresponsive to treatment, but the evidence for its use with brain cancer is limited. Also, the diet is considered a potential adjunct to existing medical interventions like chemotherapy and radiation. But this boy and his family believe in it. In fact, the boy wisely said: “Do you prefer to not eat candy or survive cancer? I prefer to do whatever it takes to stay alive.” There’s maturity for you.

My diet is far from ketogenic, as you know. What is sugar if not 100% carbohydrate? Then there are all those yummy starchy foods like bread, rice, and pasta. I’d last one hour on a low-carbohydrate diet. But if there were research confirming it could keep my cancer at bay, would I do it?

First, I’d need answers to a few critical questions, such as: 1) How many cancer cells are produced by consuming one Jelly Belly? 2) How many cancer cells are produced by eating 40 Jelly Bellies? (I guess I could figure out #2 if I had the answer to #1.) 3) Would the fat in a Jersey Milk bar counter the effects of the sugar? 4) Has anyone developed a palatable ketogenic facsimile of my delicious high-carb challah? 5) How do butter and whipping cream taste unadorned? 6) Speaking of milk products, will my lactose intolerance restrict my fat consumption to bacon drippings? 7) Is there any dispensation for gall-bladderless people like me, who cannot tolerate a high-fat diet? 8) Would I have to maintain my low-sodium diet simultaneously? 9) How about my vegetarianesque diet, as it suits me? Any ideas of how to handle that? 9) With all my current dietary restrictions in mind, could you provide me with a few tasty recipes?

I don’t mean to make excuses, but I can’t imagine a life without Jelly Bellies, chocolate, and challah. I wish I had the strength of character that this young man has. If research shows the benefits of this diet for leukemia patients, I may have to reconsider. In that case, I’ll ask this young man for help; I imagine he’ll have a lot to teach me.

In the meantime, I’m feeling an urgent need for a high-carbohydrate meal. As a concession, I’ll be sure to slather my challah with bacon drippings.

Picture of two braided egg loafs (challah), one with poppy seeds, one without

Sure signs I’m spending too much time on my own

Hare eating grass

Is she really talking to me?

I’ve been spending quite a bit of time on my own lately. No clients to interact with, no telephone solicitors to tell to stop calling, and no delivery people coming by. J. is busy with two jobs–I do not begrudge her busyness for one second, as she is supporting our family by working her tail off–and I seem to have a lot of time on my hands. I normally don’t mind time on my own. Occasionally it can be nice not to have to be accountable to anyone and to have the freedom to do whatever I want.

But I’m wondering if I’m reaching solitary overload, as evidenced by my increasingly odd behaviours. This morning, for example, Jelly sneezed and I said: “Bless you.” Jelly is a dog. She does not appreciate my fine social graces. An observer, however, might have wondered why I was talking to my pet.

Earlier, I greeted the bunny that was munching on our lawn. (While we’re on the topic of bunnies, why do children leave out carrots for bunnies when what they’re really interested in are the carrot tops?) “Hello, little bunny!” I said chirpily. Thankfully no bystanders witnessed Annie talking to that animal either.

I don’t spend all my time at home, but I find that when I’m out among people, I don’t necessarily feel less alone. If I’m with people I don’t know, the loneliness quotient can sometimes be worse than if I’m home alone.

Case in point: I attend a few yoga classes during the week where I haven’t been able to forge a friendly relationship with any of the participants, even though many of us have been attending for years. I recognize all these people, mostly women, yet have never conversed with any of them. I’m not looking for friends, but brief social interaction before class might be nice.

One of these classes occurs the same day as my Cancer Centre appointments. If I’m not in the mood, I skip it altogether, but often I go after my appointment. I’ve realized that, as much as I like choosing who to tell I have leukemia, I feel especially lonely amongst people who don’t know, especially when cancer is the focus of my day.

But it’s not all about me, right? Perhaps some of these yogis are so overwhelmed by their own lives that they don’t have the energy to be responsive when I say hi. I can understand that since I can be that way too sometimes. Maybe they’d be chattier if I told them I was a psychologist. No, I don’t really want to do that. Strangers sometimes share a bit too freely when they find out what I do.

Recently, one of these yogis asked me about the blog after hearing about it. She’s been peppering me with witty and thoughtful comments ever since. Yesterday after yoga, my dear friend M. and I had coffee with said yogi by chance. I am slowly getting to know her now after years of classes together. Fancy that. But I must be careful: if she catches me talking to myself, the friendship could be over before it starts.

 

Our dog’s noble lineage, or not

Two dogs in room in front of dog bowls, arm holding bell off to side. One dog says to another: "I don't know about you but that bell's starting to put me off my food."

Jelly’s past is a mystery to us. She was found wandering as a puppy without identification and thrown into doggie jail. She ain’t nothing but a pound dog. How anyone could have abandoned the sweet little stinker is beyond us.

So we’ve had to imagine where she came from and what her parents were like. Lately I’ve been wondering whether her background is more noteworthy than what I had assumed. I’m thinking she may be a the greatest granddaughter of one of Pavlov’s dogs.

You must know Pavlov. He’s the guy who discovered classical conditioning by ringing a bell when he fed his dogs. Over time, the dogs started salivating when they heard the bell even without food because they had learned to associate the two stimuli.

I’m thinking Jelly’s Pavlovian heritage might explain her invincible biological clock. We don’t mind when Jelly awakens from a deep sleep to whine for her dinner at 6 p.m. exactly. We ignore her and feed her when we feel like it. The problem is that at 6 a.m., and often much earlier, Jelly starts whining for breakfast.

Long ago, Jelly learned that after the furnace kicked in in the morning, i.e., shortly before J. needed to get up for work, breakfast would follow. She didn’t wait until J. got up; she woke us both up to make sure she was fed on time. It’s classic classical conditioning: dog hears furnace, dog anticipates breakfast and salivates, kibble is served.

But then Jelly started awakening whenever the furnace went on through the night, thinking it must be time to get up. This didn’t go over very well with us at 2 or 3 a.m. We tried to outsmart her by turning the furnace lower and lower, and nixed the automatic start in the morning. Thankfully, it was an unseasonably warm winter or we would have awoken with frostbitten fingers and toes.

Without the furnace cue, Jelly has been searching furiously for some other indicator that it is time to start the day. She tried the newspaper delivery man who leaves our paper on our steps at 3 a.m. Then it was the neighbour who revs his noisy car at 5 a.m. workdays. With this, we had no choice but to throw the Pavlovian descendent theory out the window. It’s not like we’d feed her at those times.

So maybe Jelly is not of such noble lineage after all. If she were, she’d have learned that the only thing that will happen when she arises too early is that we will tell her to go back to sleep, which she will do, for 5 or 10 minutes or, if we’re really lucky, half an hour, until she starts whining again.

If we try to ignore her rather than getting up to feed her, she will pace until she vomits. Yes, that’s our girl. Which is the lesser of two evils, getting up to feed her, thereby reinforcing her whining, or getting up to clean up vomit and then feed her so she doesn’t vomit more? That is a question only Pavlov can answer, but he’s long dead, unfortunately.

Maybe J. and I are the real descendents of Pavlov. Jelly has certainly conditioned us to get up on her schedule. Trainable dog or trainable owners? We all know the answer to that.

Dalmation says: Day 19, I have successfully conditioned him to smile and write in his book every time I drool. -Pavlov's dog

The Form

7-point questionnaire scale with faces from smiling to frowning

How do all of you feel about rating scales?

Have I ever told you about The Form? My apologies if I’m repeating myself. (I’m told my memory isn’t the greatest lately, but we’ll get to that later.) The Form is a Cancer Centre outpatient questionnaire addressing how I’m feeling spiritually, emotionally, and physically since my last appointment. Some questions are on that ridiculous 1-10 scale. If I’m depressed or anxious or having trouble finding the meaning in life, I note it here. If I’m constipated or short of breath or having night sweats, I check a box. If I’ve been in hospital since I was last seen, I record it. I tell The Form if I need any medication refills.

Imagine going to a psychologist and having to fill out a form before every session. I won’t ask you how you’re feeling; I’ll get you to complete this form so we can discuss it in our appointment. “I see your depression has gone from a 4 last session to a 9 today. Can you please explain?” There is a place for questionnaires in assessment or research, but not in the kind of therapy I do. If a psychologist had me rate my feelings on a questionnaire before we met rather than asking me directly, I’d fire her forthwith.

I must sound like I really resent The Form, and I used to. If you want to know how I’m feeling, ask me. I don’t resent it anymore, though, because I’ve seen the huge numbers of patients that go through the clinic each week, and realize that medical staff need some way to streamline the process. When it’s my turn, they still ask me how I am; they can just focus their questions better since I’ve listed my concerns for them. And they always make time to address any major concerns I might have.

Not only do I accept The Form, J. and I like to have a little fun with it. In fact, over time The Form has become a highlight of our Cancer Centre visits. J. scribes for me and we try to inject humour to keep everyone on their toes.

This is how we approach the task: J. pretends to ask me how I’m feeling, and then decides on the answers herself. Every so often I make her change her response. For example, when she circled “10” for anxiety yesterday and refused to change it, I made her add a happy face beside it. Then I challenged her for checking the memory/concentration box–I just finished our taxes!!–by asking for an example. She said she couldn’t remember any. Yes, we both laughed.

Our favourite part is the list of specific cancer concerns at the end. J. always records the few I have–e.g., should I be worried about the low-grade fevers I’ve been getting lately (no)–and then adds a curveball. Yesterday’s zinger? “Why is she so bitchy lately?” We both thought this was quite funny, as did the nurse, thank goodness.

The Form aside, my appointment went well, my blood counts have rebounded from the infection-related bone marrow strike, and we’re up, up, and away next week. Now if I can just stay healthy through the end of the month….

More torment over coming out

Beagle (head only) with hat and glasses on

My real name is Regal Beagle Incognito.

I have received incredible support for the previous blog post through both comments and emails. Among this support has been encouragement to send the post to the local newspaper. I can think of no higher compliment. So why am I hesitating?

In the spirit of saying something nice about myself, which I try to do on rare occasions, I am very proud of that post. I think it’s well written and powerful but somehow funny too. It makes an important point and addresses a difficult issue. I’ll admit I needed J. to vet the piece to ensure it wasn’t too caustic to publish, but her support helped me feel more confident about what I had to say. Your positive feedback tells me my pride is not misplaced.

You’d think I’d want to send writing I’m proud of to a wider audience. What writer doesn’t want to be published and recognized and even applauded for her writing? Sure I’d love my blog to go viral, as the young’uns say. Who wouldn’t? The bigger the audience, the better. If I were just writing for myself, I’d keep a diary; I’m writing publicly because I want others to be part of my journey. That’s why I appreciate your thoughts and comments and reactions so much.

If all that is true, then why am I hesitating? If I were to send that post to the newspaper, I’d have to sign my last name to it, and I don’t think “Doe” would suffice. I’m not sure I’m ready to go all the way, if you know what I mean. At this point, having cancer is part of my identity whether I want it to be or not. I live it and breathe it, and it will probably be the death of me. How much of this do I want John. Q. Public, including Jane X. Client, to know?

I’ve worked hard to protect my privacy thus far in this blog because I felt it was important to protect my clients from what I’m going through. I’d have shared my full name long ago were I not a psychologist, but I can’t get my head around the client issue. What would it be like for them if I came out publicly as having leukemia? Sure, I’ve told a few, including all of those I’ve seen since my cancer diagnosis, but I haven’t divulged the news far and wide.

There will be a time when I’m ready to disclose my last name, but I’m not quite there yet. Maybe it’ll be when I stop seeing clients altogether, but I just renewed my professional registration, and my little shingle is still hanging. Please don’t remind me of how quiet my office phone has been lately. I know, I know.

For now, you’ll have to trust I appreciate the validation and support, the comments and the questions, and the editing feedback. (My verb tenses have been a mess lately, I realize. Grammarians, don’t hold back!) I hate discovering careless editing errors after the fact, knowing that you’ve all spotted them but no one has told me. That’s something I’m not at all proud of.

Let me be the judge and the jury.

Kermit drinking tea with caption: "I don't need to walk a mile in your shoes. I can see you are a train wreck from way over here."Did you hear the one about the Calgary woman who faked cancer to raise money through a GoFundMyHeroinAddiction account, bilking supporters out of $15,000? Sadly, this is no April Fool’s joke. The woman’s lawyer sought probation only for her, but this week, Ms. Faker (Ms. Attention Seeker? Ms. Despicable?) was sentenced to 60 days in prison to be served on weekends, 100 hours of community service, and financial restitution to a cancer foundation.

Ruling on this woman’s abhorrent behaviour could not have been easy. Despite the judge’s knowledge of jurisprudence, I believe my experience with cancer might better qualify me to determine the appropriate punishment. By now, you have certainly picked up how judgey–and by that I mean “judgemental”, not “judge-like”–I am. If not, I’ll remind you.

Dear Well-Meaning Judge:

I appreciate your thoughtful consideration of an appropriate punishment in this case, but I have several problems with your ruling. I trust His Honour won’t mind hearing me out.

I am glad that Ms. Faker will serve time, but on the weekends only? I have cancer 7 days a week; I don’t get scheduled breaks. If I did, I’d still be working to support my family.

I believe that Ms. Faker would learn more by serving her time on consecutive days in our Cancer Centre. Consider it an experiential incarceration: she could live and breathe cancer! Let her sit for hours in cramped waiting rooms amongst patients who are truly suffering. Radiation and chemotherapy waiting areas? Outpatient hallways? All are overflowing with sick and dying patients.

Ms. Faker may benefit from a round or seven of IV chemotherapy to truly understand cancer treatment. Immerse her in the exhaustion, nausea, lack of appetite, swelling, and jaundice, among other discomforts. Radiation is no walk in the park if she’d like to try that too.

When these interventions suppress her white blood cell counts, rendering her vulnerable to an opportunistic infection, Ms. Faker can spend time at the cancer inpatient unit until she is better. This could take a few days, weeks, or months, depending on how ill she gets, and may require a field trip to the ICU. If the cancer units are full, there’s often turnover in the palliative wing, which is not the liveliest setting. Only one person died during my brief stay there.

These varied cancer-like experiences will allow Ms. Faker to fulfill her 60-day sentence, after which she may complete her community service hours on site. First, she will need to seek a spot each morning in the cramped parking lot–no discounted parking for her. (I realize this daily fee may slow her financial restitution, but I’m trying to create a genuine cancer experience for her.) I’d suggest assigning her to admonishing those hovering outside the Cancer Centre doors for smoking on hospital grounds. Or perhaps she’d prefer to hang out in the lobby, directing the hordes of terrified newbies to their first appointments.

Sadly, these experiences will not create the overwhelming anxiety a cancer diagnosis does. She’d have to be diagnosed with cancer to appreciate that. But maybe the exposure could at least deter her from trying the same scam when she is next short on cash.

Thank you for considering my input.

Sincerely,

A genuine leukemia patient