Blood, spots, and tears

Mark Twain's quote: Denial ain't just a river in Egypt.

I think we need to clear one thing up. I’M NOT BRAVE. J. is the brave one. She’s the one who’s facing this loss head on, she’s the one who’s going to be left after I’m gone, and she’s the one holding everything together, except when she’s not, which we can all appreciate. Her plate is much fuller than mine.

Sure, the meetings with the rabbi and the funeral director last week weren’t easy, but they were comforting. This week we’ll talk to a community nurse about what the end-of-life placement options are. Will a hospice be better for me, or a hospital, or do I want to die at home? This too will be a hard discussion, but we both need the information to be able to make informed decisions when the time comes.

If you think I’m handling this well, you’re somehow missing my denial. I don’t really believe my death is imminent. I don’t mistrust my doctor; I just don’t feel like a dying person. In fact, this past week, I’ve felt better than I have in some time. No wonder the optometry assistant didn’t grasp what I told her last week; I don’t look palliative, or at least not to the average Jane.

If you look a little closer, you’ll notice my colour is a bit off, and I sport an ugly bruise on my hand that is getting worse rather than better. The rest of my body’s decline is well hidden, mostly under my clothes. Don’t worry, I won’t show you; I haven’t lost all sense of decorum (yet). I’ll just tell you about it all in vivid detail.

My critically low platelets are leaving their mark. Small children would cry were they to see me in a bathing suit. I am covered in large ugly bruises over my limbs and trunk. Over the past few weeks, I’ve also developed red spots of various sizes and shapes. An unyielding waistband, a shoe that is too tight, the arms of my glasses–all of these minor contact points have the potential to spotify me. If I deign to scratch an itch, the evidence of my negligence is imprinted in my skin.

Blood vessels in my mouth are having a heyday as well. I can wake up with a huge burst vessel on my cheek or my tongue that makes eating a challenge. Don’t worry, nothing stops this gal from eating, and the pain and discomfort pass within the day. What is more troublesome is that this is but one of many constant reminders that my body is ailing.

Sometimes I am overwhelmed by all these visible signs of my illness and, yes, I start crying. The tears are close to the surface lately. ((I hate to admit that sometimes denial fails me.) Crying is a huge problem because I am dealing with near-constant nosebleeds as well, and a good cry inevitably gets my nose flowing again.

I’m sure you’ve seen the commercial, “Do you pee a little when you laugh?” Well, it turns out I bleed a little when I cry. So I’m just going to have to turn off the tap already. If I’m feeling well, however marred my body, I must stop weeping and start living. I have no time to waste.



How to survive a jump off the cliff

Whoops! I guess I’ve been misspeaking by calling my CML drug chemotherapy. The daily medication I’m on is not technically a chemotherapy. My tyrosine-kinase inhibitors (TKIs) are actually called targeted therapies. They stop my CML-causing genetic mutation from producing leukemia cells, and they really work. At last count, there were very few of these deadly cells hanging out inside me.

The only problem with TKIs is that they have side effects that can render them intolerable for some patients. I’ve had few difficulties with the medication–I barely notice I’m on it–with occasional exceptions. While it effectively inhibits my cancer cells, my TKI reduces the production of my white cells and platelets as well. That’s why my white blood count is much lower than it used to be, which is not a bad thing. It’s the TKIs’ platelet-lowering effect that is proving to be problematic of late.

When my liver was misbehaving a few weeks back, Dr. Blood Lite was concerned about my lack of platelets. There just weren’t enough of those sticky cells swimming around. This makes me vulnerable to bruising and bleeding. I had noticed small changes that I had attributed to the perils of travel. I always come home bruised from vacation, mostly due to my clumsy suitcase handling. This time I was covered in black and blue, although I hadn’t had any major incidents like falling or walking into walls. I must have been going through a sensitive period.

My bruises started healing upon my return, and indeed my platelet counts had risen when last assessed. Over the past few days, I may be having a little backslide, however. One bruise I can attribute to yesterday’s gruelling dolphin pose in yoga class. God did not intend for my body to mimic the dolphin. Dolphin pose puts a lot of pressure on my elbows, so the bruising is almost expected.

Only this morning’s repeat blood test will confirm whether my platelets have tanked again. If they are low, Dr. Blood Lite may insist I suspend my TKIs for a few weeks to allow my bone marrow a reprieve. As he said, my drug has been working so well that a few weeks off should not be a problem.

A drug holiday is not a problem for him, I’m sure, but how about me? If you were on a medication that was keeping you alive, would you want to tamper with it? To me, this feels like bungee jumping with a faulty cord. Oh, and a deadly fear of heights. I know rationally that a break from my TKIs will not make my leukemia cells proliferate wildly, but I’m not always rational at times like this.

If the doctor suspends my TKIs, I will take that leap of faith since I trust him with my life. I will close my eyes and jump. I may know that I’ll be fine with a short reprieve, yet I’ll feel better once I can resume treatment again. To me, it will feel like being back on solid ground.

In the meantime, no more dolphin poses for me. Better safe than bruised.

woman bungee jumping in midair

Pride comes nowhere near the fall

Woman who has fallen off bike, bike lays on ground

If a woman stops eating in the forest, will anybody notice her pants falling off? Does it matter?

I am here to confirm what the research has been saying for years: your stair master is lying to you. Weight loss is about eating less, not exercising more. Trust me, I know. But keep exercising because it’s good for you in so many other ways.

Many moons ago, I was dating an avid cyclist. I made the mistake of trying out one of those fancy road bikes with the skinny wheels at the prohibitively expensive cycling store. Of course this bike had fancy clip-on pedals, so I sported an ill-fitting pair of those absurd looking clip-on shoes for my trial ride down the block. Needless to say, I did not make it far before I teetered over and, unable to unclip my shoes, fell to the ground. It was not pretty. No bikes were purchased that day.

Things haven’t changed all that much over the years. I no longer need the fancy bike or the clip-on shoes to fall to the ground, however. On Wednesday, for example, I took Jelly out for her morning constitutional. As we returned to the house, I failed to properly negotiate the small rise from our lawn to the driveway, a rise that has been there since the cement was poured 15 years ago. Somehow I found myself flat on my face, with skinned hands and knees and badly mangled glasses. Surprisingly, my recent weight loss did not seem to lighten my fall.

Thankfully my trusty therapy dog was at my side, as she often is when I fall, since I do most of my walking with her. She sighed, “Oh mom, not again.”

Jelly has has been PALSing around for 6 months now. She has visited retirement homes, hospice patients, university students, and a variety of special-needs populations. She has offered wags and kisses far and wide. People marvel at how calm she is in even the most chaotic of settings.*

She had an especially successful visit with a hoard of high-needs preschoolers. Somehow, in the midst of all the activity, she napped. One of the children saw Jelly sleeping, and observed, “She looks dead.” He repeated this statement several times. I was ineffective at disabusing him of this notion. I even placed his hand on Jelly’s belly so he could feel her breathing, to no avail. At least he wasn’t upset about Jelly’s apparent demise.

When she has her little PALS outfit on, Jelly is an equal-opportunity love sponge. She will take affection from anyone who will give it. I wouldn’t say she’s one of those miracle dogs who is drawn to the person who needs the comfort the most, but I may need to reconsider in light of my mishap.

After my fall, Jelly immediately rushed to my side, started kissing my face, and then waited patiently until I got up. I collected myself and arose slowly. Other than a few bruises, I’m absolutely fine. J., on the other hand, believes, for good reason, I am unsafe to venture out so I’ve been grounded.

Happy Canada Day! And be safe.

*I too marvel at how calm Jelly is in these special settings, since she’s often utterly frenetic at home. Remember the dining room table incident?

Things I should know by now, but sometimes forget

Handicapped door button

I’ve been going to have my blood taken on a regular basis for 17 years now. After all that practice, you’d think I’d know all there was to know about the process. This is what I know to do following the procedure:

  1. Put pressure on spot where the needle left a wee hole for at least a few minutes to promote clotting and minimize bruising.
  2. Anything that interferes with clotting makes this pressure all the more critical. Consider factors such as being on blood thinners (that was me once) or being low in platelets (that is me now).
  3. Any heavy lifting soon after the procedure, like holding the absurdly heavy lab door open for the person behind me as I exit, is contraindicated because it could interfere with clotting.
  4. Wearing a white shirt to the procedure is just plain dumb in light of my propensity to bleed.
  5. If any of these procedures aren’t followed, I may end up with blood stains on my clothing and/or a bruise.

Can you tell where this story is headed? Do I still get to tell you what happened this morning when I went to the lab to have my blood taken? It started off well. The needle prick was painless. I placed pressure on my wound following the needle withdrawal and, upon inspection prior to bandaging the spot, I appeared to be clotting well. Then I got up, put my jacket back on, walked through the waiting room, and pushed the heavy outside door open with the same arm that had just been taped up, first allowing the woman behind me through.

As I got outside, I felt a strange wetness on the same arm of my blood draw. “What might that be?” I thought curiously. “Why is my arm feeling increasingly drenched as I walk toward the car?” No lightbulb yet.

I’m sure you know exactly why my arm was wet. I too should have known, but it was fairly early in the morning and all my cylinders were not yet firing. I stood by my car, the unexplained wetness spreading down my arm, at which point the blood made its way beyond my jacket to my exposed hand. I have felt this wetness many times before, yet the physical sensation was not enough to jog my memory; I needed visual proof before accepting that I’d need to do a load of wash that day (or two, because I was wearing a white t-shirt).

With my evidence firmly in hand, I returned to the lab, using the handicapped button to open those heavy doors. I marched straight to the desk to seek help from the phlebotomist. My bloody hand proved sufficient evidence for her rally her troops to clean me up forthwith before I spread my gift of life all over the lab.

Oh well. What’s another load of laundry? Easy for me to say since J. does the laundry. She worries I’ll fall down the basement stairs. The ways I can be a danger to myself are infinite. Oh, and I bruise easily. Let me show you my arm….

The real cost of extended health care benefits

It’s been over two months since J. left her real job. This job provided J. with a regular paycheque and benefits, including those for extended health care. We probably got our money’s worth from those benefits, and not only because of my expensive medications. J. appreciates the occasional massage, and we both go to the dentist regularly.

I figured once J. lost her benefits, we’d immediately purchase a private health plan. We’ve even budgeted for the cost. As it stands, my drugs are mostly covered regardless by my private drug-specific plan, which I’ve had for years. Otherwise, we remain uncovered. We’re trying to assess whether private health benefits, however affordable, are worth the cost. Feel free to weigh in.

If I go to the dentist for a cleaning every six months, the cleaning would cost less than the fees for six months of benefits. On the other hand, if I knock out a tooth during one of my klutzy falls, or I need another root canal, I’ll be paying a hefty bill out of pocket. Is this risk worth taking?

Ambulance on roadA plan would also cover the cost of an ambulance. I did call 9-1-1 once when I was doubled over in escalating pain. Within a few minutes, the paramedics were inserting an IV and I was mainlining morphine. Then we set off on the most circuitous route possible, and it wasn’t my place to redirect the driver to the hospital. Every minute felt like forever. Had J. driven me to the hospital, as she has all other times I’ve gone, and I’d waited for triage writhing in pain, I would likely have been seen faster, assuming I passed the whiner test. I’ve decided that if I were to need an ambulance in the future, I’d gladly pay the going rate of $385.

Then there’s limited coverage for the allied health professionals. If I have an ache or pain, I’m worried about cancer, not scheduling physiotherapy. By the time I rule out cancer, I trust my pain will have dissipated.

Sadly, massage is out too. J.’s massage therapist sounds like a miracle worker, but I’d be bruised all over if I let her use her deep-tissue technique on me. Even J. comes home black and blue yet oddly grateful sometimes.

Don’t forget the paltry coverage for a psychologist. The therapist I now rarely see is a skilled Ph.D.-level clinician, but because she is not a psychologist, she’s not covered. That benefit does not benefit me.

J., of course, is fit as a forty year old and is banking on not needing health coverage ever. She’ll pay for the rare drug the doctor prescribes, she’ll get her perfect teeth cleaned once a year, and, knowing her, she’ll drive herself to the ER if ever she needs emergent care. Also, her next few massages are free thanks to a thoughtful gift certificate for The Bruiser from yours truly.

I may have cornucopia of expensive drugs, but beyond that, my medical expenditures are surprisingly low. (Our generous government may beg to differ.) For now, we will monitor our health-related expenses. When I slip on an icy sidewalk and knock out my front teeth, I imagine I’ll change my tune. Or maybe not. Who needs front teeth?

boy smiling without front tooth

X marks the eye

Doctor in OR garb sleeping while standing upright

Don’t worry. I can do this in my sleep.

I’ve been searching for forgiveness in my heart for the ophthalmology speciality. Sure, I’ve had contact with two different specialists that were less than ideal, but I’ve tried to let that go. Maybe my judgements about the field have been unduly harsh. Maybe I am just a negative person with unreasonably high standards. Nah, not me.

Yesterday I experienced assembly-line medicine for the first time. Imagine me as a wee cocktail wienie in a wiener machine. I was but one of many ca-chings in Dr. Eye Surgeon’s day. I’ll share an abbreviated run-down of my experience on the line.

First step: Move me into pre-op and remove my glasses, rendering me visually impaired. Put a sticker with my name on my shirt, and draw an X above the right eye. Over the next 45 minutes, ask me four times to repeat the eye I’d be operated on. This seems odd since: a) it’s more important that the doctor know this information than me; and b) if the doctor inspects my left eyelid and there is nary a lump to be found, I imagine he’ll inspect the other eye.

Second step: Talk to the anaesthetist, who asks why I am there. He follows my explanation with: “You’re in good health otherwise, right?” Well, Dr. Dozy (should that be Dr. Numb[skull]?), no, in fact, I am not in good health. Perhaps you might review my file. Or should I provide a complete medical history? Better yet, sedate me so we can abort this conversation.

Step 3: Move me to the OR, where I lie amidst several doctors and nurses, none of whom introduce themselves or address me. Look blindly at the ceiling–no glasses, remember?–and shiver. Imagine the cold keeps surgeon from breaking a sweat as he runs from patient to patient.

Step 4 (trumpets sound): Enter stage left, Dr. Eye Surgeon–that’s Dr. Asleep at the Wheel to me. After convening with staff present on several other matters, Dr. AATW asks me how I am feeling. I say I will feel better following sedation. Dr. Dozy wanders in, does not address me, shoots two drugs into my IV, and leaves. Despite his stellar lack of communication skills, I have no idea what he has given me or how it will affect me.

[There could be several more steps in here, including a painful needle and a little eyelid snip, but my memory is vague. I do recall Dr. Eye Surgeon saying: “This is so small I don’t think we needed to remove it.” Perhaps he might have figured that out sooner and thrown wienie me into the discard pile?]

Step 6: Seat me in a post-op area with no nurses and no glasses. Theoretically I am to be monitored for a negative reaction, but monitoring is sparse. In other words, this defective wienie may show up on someone’s dinner table. A nurse eventually wanders in, returns my glasses, applies insufficient pressure upon removing my IV, and leaves me bleeding profusely. Following a quick mop up, I am free to go, with prescriptions but no aftercare instructions.

Maybe Dr. Eye Surgeon did an excellent job. I have no idea. All I have to show for my experience is a black eye. Nonetheless, I’d fail him on his practical exam in Patient and Family Centred Care.

The Truck Scale of Holistic Well-Being

Red and white 18 wheeler with long loadLast Tuesday, following all the weekend excitement–out-of-town company, crying at the Pride Parade, visiting with friends, and perhaps a bit of the flu thrown in for good measure–I felt crummy. I had the kind of day I call a Leukemia Day, where I’m acutely aware that I have cancer. On a scale of 1-10 of general unwellness, I was a 10.

But I’ve told you before that 1-10 scales don’t really work for me. Either I feel sick or I don’t. I’m concrete and I can’t distinguish fine gradations easily. Am I a 4 or 5 or 6 today? I have no idea. And I can’t compare how I feel today with how I felt yesterday. I was a 4 yesterday and I’m a 6 today? Beats me.

But I get annoyed by people who complain about things and don’t come up with a solution. So, in order to practice what I preach, I created my own wellness scale that I thought would better capture how I’m feeling day to day. I’m speaking of global wellness here, which may include fatigue, pain, mood, and whatever other factors make a person feel unwell.

Because I prefer pictures to numbers, I decided to use trucks as reference points, hence the Truck Scale. This scale is based on the size of truck that has hit me that day. (For you to accept this premise, you’ll have to suspend concerns about my bruising or even getting killed when the truck hits me. If I can, you can.)

There are rare days when I don’t get hit by any truck at all. No sleeping drivers send me flying, no zombie-like Annie walking out into the road without looking both ways. Those days are the best, and are lowest on the scale. I don’t have tons of days like these.

Next on this scale are the days I get hit by a Tonka truck or maybe one of those electric vehicles parents buy their overindulged preschoolers. Those days aren’t too bad, but I’m still aware I’m not quite myself. Maybe I’ll forget to do up my fly or lose my wallet or some such half-awake thing.

Getting hit by an F150 would fall somewhere in the middle because F150s are built Ford tough. I imagine it wouldn’t feel great if a truck this size took me down. And imagine how I might describe my unwellness that day: Sorry if I seem a bit out of it, honey, but I was RAMmed by an F150.

On the worst days, I feel like an 18-wheeler with a full and heavy load has taken me down. Recall Tuesday. I felt crummy all day, napped hard in the afternoon, and got very little accomplished. I hate those days. I also get frustrated when I wake up feeling okay (smaller truck day), and crash later (18-wheeler appears out of nowhere).

Wednesday wasn’t much improved, perhaps an F150 day. Come to think of it, I’ve been up and down the Truck Scale all week. During those 18-wheeler days (a.k.a., Leukemia Days), I remind myself that those days don’t occur that often. That helps.

Tonka truck

Only some pictures tell 1000 words

A cartoon of Isaac Newton under the apple tree apple falling on his head

Often people ask me where I find the pictures for my blog. Well, dear readers, you can find anything on the internet. Last post, I typed in “The grass is greener”, added “images”, and found many possibilities to choose from. (I suggest you do not search “toy penis images”, however, because your search history will follow you forever.) Then I decide on the one picture that best complements my subject matter. Hopefully I’m not breaking all sorts of copyright laws in the process.

This image search is one of my favourite parts of posting because an image often makes the point clearer. But sometimes finding the perfect one is a challenge. If can’t find an appropriate image, I don’t want to post only text because, well, how boring is that?

With this in mind, I posted a fairly sad picture a while back. J., my voice of judgement and reason, felt a need to intervene. She nixed the sad pix and insisted on only happy images from then on. I’ve been trying, I really have. You may have noticed an increase in silly dog pictures, for example, or other frivolous imagery. But some posts just don’t lend themselves to rainbows and butterflies. If Sadness is okay, shouldn’t sad pictures be okay, at least sometimes? I don’t want to be a downer all the time, but can’t I be a downer every so often?

Even before this, J. had drawn one boundary that I’ve always respected: no pictures of my physical disfigurements. I thought time-lapse photography of the recent bruising from knee to cankle and into my foot might intrigue you, but she forbid me altogether. I guess if you’re not into those graphic medical shows, you might be grossed out. Thus, I will be forced to provide only a verbal description of the progression of my self-inflicted bruises, since I’m sure my words will disgust you less.

Women my age are often concerned about the effects of gravity on specific body parts. Science lovers or not, you all should understand gravity because at some point you learned about Isaac Newton and that apple. ( I’ve since discovered that Newton likely wasn’t hit by the apple but might have seen one falling. I preferred the bonk-on-the-head imagery myself.)

Always the outlier and not caring much about sagging body parts, I choose to obsess about gravity’s effects on my bruised lower body. Since I’m platelet impoverished, when I bruise, I swell, and this swelling has to go somewhere. So, just like the apple, the excess fluid travels down. In the process, a bruise that starts in one place, in this case my knee, eventually spreads throughout my lower leg and foot. Yes, rather than looking like I bumped into a bathtub, I look like I was thrown from a motorcycle.

J. was right: I really don’t need a photograph for you to get the picture. Just envision the current state of my swollen, discoloured leg as a physical representation of my drama queen persona.

Annie’s Believe It or Not

Woman falls on icy, snowy sidewalk.

If only I could blame the icy conditions.

Oh hey, yes you, I see you there, check out my legs but don’t you stare. You’ll see my bruises everywhere!

On Friday past, I dragged my shoe, I tripped and fell. What else is new?

Oh my, oh me, I hit both knees. I scuffed my hands, I wet my pants.

[‘Twas pouring buckets up ’til then. What did you think I really meant?]

Those bruises that adorn me now, they’re old and new, black and blue, red and yellow, purple too.

Oh yes, that’s right, they’re small and big, I’m all beat up, oh darn, oh frig. 

And so I say to readers all: Why stand upright when I can fall?

I wish I were not such a mess, I cannot help my clumsiness.

Yes, I have become the protagonist in a heretofore unpublished Dr. Seuss epic. Does Sam ever end up eating Green Eggs and Ham? And will I ever regain my balance?

Thankfully, since we were meeting for coffee, M. was there within moments of my dramatic encounter with the sidewalk. She helped me up, and, once I had my wits about me, she escorted me home. I cleaned myself up and nursed my wounds while she put away my groceries. Then she provided the perfect distraction–good gossip–and she left once she felt I was no longer a danger to myself.

Believe it or not, my bathtub encounter was unrelated to my clumsiness or inattention. In contrast, I’m sad to report my sidewalk fall was completely and utterly my fault. I have always been a klutz, but this propensity for falling is newer. Why is that? I can’t really tell you because I have no idea.

Where is my helicopter parent when I need one? Clearly, I can no longer be left unsupervised, so I’ve decided I’m going to have to hire a manny. (Don’t tell me you need a definition–take “nanny” and go from there.) I figure if I have someone by my side at all times, that person can help me to minimize my danger to myself. He can drive me around and keep me on a short leash. No more monkey bars at the playground, no more bike riding (I’m getting a trike), and walking in only the most comfortable shoes. One critical job requirement is reaction time that is faster than my own. (Everyone has reaction time that is faster than mine.) I will be paying my assistant to scan the environment–those nasty curbs, black ice patches, and random hazards which, I’m learning, are everywhere–and help me avert disaster.

Why not a nanny? Well, I need someone with a little heft to keep me upright. I haven’t been someone you’d describe as “petite” since Grade 1. What’s the point in having a constant companion if she can’t stop me from falling? Plus, think of how everyone will talk if I’m seen hanging out with a young, handsome brute. Hopefully no one will notice my clutching his arm for dear life.

Hindered by a healing hematoma

Yesterday was a momentous day in Calgary: E. was called to the bar. We’ve known E. since she was 14 (14? really?), but now she is full grown and fully employable. J. and I were honoured to be invited to her celebration.

I know this post should be all about E., but of course we need to start with my day, which was spent obsessing over what to wear. You see, I have a huge, ugly, multicoloured hematoma on my shin, and as it heals, my lower extremity is bruised and swollen. It is not pretty.

J. immediately nixed my wearing a dress, fearing I’d scare any small children in attendance. In fact, one little boy ran crying from the room during the proceedings, but I don’t think that was my fault. I decided on dress pants and a blouse, hopefully rendering me passable in the company of sharply attired lawyers.

Two feet with painted toenails with cankles, hard to distinguish between calf and ankle

These are someone else’s cankles.

Then there was the footwear challenge. Thanks to my injury, I have a full-blown cankle on my right leg. What, you’ve never heard of a cankle? In psychology speak, a cankle is a blurring of boundaries between calf and ankle. Chubby people have cankles, but so do people with swollen legs. My cankle is especially attractive because it is black and blue. Until this swelling subsides, my footwear options are limited. My overly casual sandals would have to suffice.

Finally there was the hair. I had booked in with my hairdresser that morning because a shearing was long overdue. He primped and preened me, even liberally applying the hair products I normally refuse. I prayed my nicely coiffed hair would distract people from my other wardrobe failings.

Because the event was scheduled during nap time, and all those difficult wardrobe decisions had exhausted me, I nodded off on the couch before heading out. (I was trying to preempt my sleeping at the event itself.) I often look like I’ve just gotten out of bed, but remember those hair products applied earlier? So much for smartly coiffed hair; after my nap, the right side of my do was completely flattened.

We’d all agree I looked a bit dishevelled by the time I arrived at the event. I could say I was trying not to steal Ms. L.L.B.’s thunder, but really I just looked like I do most days, if a little worse for wear. But I did manage to stay awake through the eloquent and insightful speeches which captured the new lawyer in all her glory.

If I’m honest, my psychologist self is a little jealous of this whole call-to-the-bar thing. I had to write my own speech, commonly called a thesis defense, and squirm through undermining challenges and questions on my insignificant research. I’d have much preferred listening to extensive adulation, with a little mockery thrown in for good measure, wouldn’t you?

Truth is, after years of hard work, Ms. L.L.B. deserves to be so proud of her accomplishments. Way to go, Princess! An exciting and stimulating career awaits. Here’s a nonalcoholic toast–what? no Prosecco?–and a huge Mazel Tov from me. Keep up the good work and you’ll be in Who’s Who Legal in no time.