Here’s my thought process today.  I slept from 2-6:19 a.m.  That was after taking a Norco for pain and an ativan for anxiety.  I meditated, I counted blessings, I propped myself with pillows supporting every body part (picture a square of pillows around me and between my knees.)  Finally I slept.  For a scosh.   My body aches all over.  My joints and muscles have no energy in them.  I have developed bruises behind my knees from crossing my legs, and even have a small bruise from an acupuncture needle almost two weeks ago.  I am exhausted but I cannot sleep.  Many of those are symptoms of leukemia, which is a known possible side effect of two of the chemo drugs I have had and radiation.  So of course in the middle of the night I was obsessing about that.  Which is silly and completely human.

This morning in the shower I found a lump.  I found the original lump in the shower too.  This one is on the right side instead of the left.  It’s about the size of a marble, well formed and a little hard.  Very much like the tumor on the left felt when I first noticed the upper part of it.  Well I was already out of my mind with worry, on top of a very stressful week at work and a very expensive car repair, and my likely imaginary case of leukemia.  Luckily I was already going to the oncologist today about my aches and pains and already had an appointment at the breast surgeon for Monday to look at those old films with me.

Dr. Jones (onc) told me to stop taking Tamoxifen for a month.  He said Tamoxifen can cause bruising and joint problems.  He also said the antibiotic I have been on, Levaquin, can cause tendon problems.  He is worried about my leg pain because my thigh bones hurt and ordered a bone scan.  He palpated my chest wall and said that he thinks Dr. Canavan should biopsy it when I’m there on Monday.  Biopsies suck.  BIG needle and scraping, and you are awake for it.  Dr. Jones also ordered a lot of bloodwork, CBC, hormone levels, tumor markers, vitamin D level.

All of this happened today intermingled with work and my three children who were out of school.  And while I was prepping to have a dozen preschoolers and their families for a pool party at five.

I told him that I had hoped to feel pretty good about now in my cancer journey.  I asked if I was wrong to expect that.  He said he had hoped I would feel better by now, too.  That was validating for me because at my low moments I was thinking that maybe I was just going to feel like crap forever.  He gave me hope that if we can figure out what the problems are I might feel good again.

Monday I’ll have a biopsy of the new lump.  It could be scar tissue (fat necrosis, yum!) or a malignancy. I’ll have a bone scan sometime next week to rule out metastasis in my thigh bones.  I started thinking about all the scans I’ve had since January and I can’t remember them all!  So far they have all shown no cancer – here’s hoping these two tests will also be clear!!

Friday morning I received an email from the sales tax auditor from the state that he’ll meet me at 8:30 Monday morning at the office by Bachman Lake for the audit.  Which he said he planned to take the entire week.  I’m not worried about the audit because we follow the rules and pay sales tax but it’s just such a pain.  So today I packed the rental SUV full of all the files from 2008 to current to drive to Dallas in the morning.

You’d think will all that that I would give this last week an F.  I have to say, there were moments where  I would have.  But Friday I went to Isaiah’s movement program at school.  It was my last preschool program until I become a grandparent a VERY long time from now.  It was so fun watching him perform and sing.  And now that activities are wrapping up we have more time in the afternoons and evenings to play and hang out.  Friday afternoon we left for Robbers Cave State Park in Oklahoma with friends.  It was fantastic.  The cabins were much nicer than I expected, and the woods right outside the back door were beautiful and green and smelled great.  There was a playground right by our cabin and loads of good friends all around us.  The kids were black by the time we went inside Saturday night.  We had hiked the cave, tromped through the woods, scootered, played ball, made s’mores and hiked and scootered some more.  And we went to the viewing of the snake feeding which was quite enlightening.

Trees!!

This morning my friend’s daughter, who is 16, supervised my three kids making pancakes.  Bless that child, she was a saint to do that and I had a blast watching them.  We drove back in the late morning/early afternoon.  Tonight we sat on a patio at a local pizza place and had a lovely dinner.  I got homemade gifts of poetry and paper flowers and vegan chocolate dipped strawberries with edible flowers in the chocolate.  I am blessed.  Even with a rearranged body, and all the aches and pains that go with it.  I am blessed.  I knew that before I got cancer, but now I know it on a whole other level.  Perspective!

My Three Blessings

“I think it’s cancer.”
Positive for malignancy.
Poison in your veins.
Hair gone.
Can’t get out of bed for days.
Breast amputation.
Getting your arm taped down
one piece of tape at a time
because you can’t raise it over your head.
Radiation burning your flesh.
Recurrence.
More radiation.
More surgery.
More scans.
More appointments.
More medicine.
All layers of hell.

But in all of them
joy is also present.
In a friend who makes you laugh,
a nurse that gives you a hug;
a tree blooming outside the bedroom window;
a bouquet from a loved one;
a funny card sent the old-fashioned way;
children running into the room
professing love with hugs and kisses.

The beautiful lotus flower
blooms up from the muck;
Joy grows even in hell.

Flash forward to present day.  I have a persistent sinus issue, a weak immune system, lymphedema in my left arm, armpit, and breast, joint pains from Tamoxifen, and a little depression from all that physical junk.  One of my smart physicians offered acupuncture, which is of course a good idea for all of those symptoms.

But I am afraid to go.  Every time I think of it since I made the appointment Monday I find myself tensing up and holding my breath.  But then I become the observer of those reactions, drop my shoulders and take a breath.  Tomorrow I will drive myself to the appointment, get out of the car, go inside and lay on the table.  It will not be easy; my body will try to keep me from going.  My mind may well be freaking out.  But my spirit is strong and it will overcome all the arguing going on inside me and cause me to do what I know will help me thrive.

“May God cause you to change your life the way you know you should.”  Rumi

I’m learning that just like treatment remission means a lot of different things to different people.  Cancer is not one-size-fits-all and remission isn’t either.  And because the treatment medications are so numerous and the number of variables in the equation are so large I think there are an infinite number of things that can go right, or wrong.  Ultimately the “right” thing is to keep the cancer from coming back ever, or at least for a really long time. Another “right” thing is that plastic surgeons can put us Humpty Dumptys together again with way better tools that duct tape and chicken wire.  So I’m alive and I have boobies – two really great things!!

Along with that, though, I have a loooooong list of ailments, some caused by chemotherapy that I had last year, some from surgery, some from radiation, and some from Tamoxifen, the drug my doctor recommends I take for ten years.  I still have some neuropathy in my extremeties from chemotherapy, and I have chemobrain.  I have been fighting infections ever since my surgery two months ago for reconstruction – sinuses and kidneys alternating and then infected at the same time.  Also I have grown three seromas from surgeries.  Seroma is fancy word for pus pocket.  They develop after plastic surgery and breast surgery.  I currently have one that the doctor thinks will resolve on it’s own.  The other two I had drained - with really giant needles and no numbing.  I am still really sore from all of the incisions from four surgeries, especially where I had radiation.

The lymphedema in my left arm is persistent since I had the mastectomies in August.  It will more than likely be something I have to manage forever since I have no lymph nodes in my left armpit and upper chest area.  To “manage” it I have to wear a compression sleeve every day all day which is hot and ugly and uncomfortable.  And I pay to get lymphatic drainage massages every two weeks.  Insurance doesn’t cover lymphedema therapy.  Probably because there are no drugs for lymphedema, nobody wants to study it, and there’s no money in any treatment of it so it’s a VERY ignored area of the experience of breast cancer survivors.  And it hurts.  The fluid buildup creates congestion in your arm, so your arm is weak and throbby.  And your fingers get numb.  Neuropathy and neuropathy and neuropathy.  I didn’t know what it was before cancer but I sure do now.

Then there are the maintenance drugs.  My MD Anderson doc says a lot is riding on these for me because I was chemo resistant and I already had a recurrence.  And I despise them.  I started with Femara, which is for post-menopausal women, which I am not.  So they gave me injections to keep my sad, chemo-riddled ovaries from turning back on.  The Femara made my joints ache and my right hand got so messed up that I could hardly hold a pen before noon.  After a few months I switched to Tamoxifen, thinking it would be better.  Well now I can hold a pen but my hips and feet and hands all hurt.  When I stand up I feel like I’m 80 shuffling around with a hitch in my getalong.  And I have a hard time sleeping because my feet hurt so badly.  When I’m not here alone with the kids I take sleeping pills but even with those I only sleep about six-seven hours. Those side effects do not usually go away with extended use, nor do they often go away when patients are done with treatment and graduate off of them.

Because my immune system is depressed as a result of chemo I am prone to infection.  The two infections I have been dancing around with for two months also belong on the list of side effects.  I have no more fever, but kidney pain is persistent, as are the sporadic headaches, dizziness and vision issues from the sinus problems (although all of those symptoms could also be from chemotherapy).  I had to call five ENT’s before I found one that takes Medicaid.  And if the kidney problems do not resolve within a couple of days I’ll have a CT scan to check them out.  Which involves a needle.  And more rads.  The good news is that CT scans zap you with 6 or 7 rads, and radiation treatment is over 6,000 rads so what’s 6 or 7 more when I’ve been so exposed already?

I tell you this not because I want pity or a hundred comments about how sorry you are for me, or how Juice Plus or some other fill-in-the-blank treatment is my only hope.  I am using the wisdom I possess about my own body to treat all these ailments in the best way I can and will continue to learn and seek according the the path I feel is right for my body, mind and spirit.  I tell you this story because I had no idea what remission meant until I experienced it.

I have a few other friends in remission.  Some are further out than me.  Some common threads that weave us together are fears about losing care because of insurance issues, the loss of vitality that we experienced before cancer grew, difficulty working, fear of tests and test results, menopause, anxiety, chemobrain.  I could probably go on.  We won’t usually talk about all that stuff if you ask because it’s exhausting.  And we think it exhausts others around us as much as  it exhausts us.  I mean how many times can you hear “I’m too tired to ___” and not think, “Get over it already!”  We do think sometimes you are thinking that because sometimes we are.

I also don’t mean to sound all doom and gloom.  Not a second goes by that I am not grateful to still be mothering my three children.  (OK well maybe the moments when they are fighting or talking back I’m too busy to be grateful, but the rest of the moments I am).  And I love sharing the wisdom that I have picked up with others.  I am going to teach my first yoga class in over a year on May 6th.  I’m thrilled to bring a restorative yoga and meditation class to cancer survivors and caregivers.  You can find information on my facebook page, EaseYourMind.org.  I hope to make it at least a monthly class, and start teaching it at other studios as well.  Returning to teaching is another step toward taking a piece of my former self and incorporating it with my new self.  I feel so divinely led in this area I know this is the way I am supposed to help and give back.  If you know someone who will benefit from the class please pass along the info or ask them to message me on facebook. Namaste!

I am raising lovely people.  Whether my kids get married or not, have children or not, cure cancer or not, are gay or not doesn’t matter to me.  What matters is that they are more-or-less independent and able to follow their own still, small voices into their perfect places in the world.  My dad’s comment was a reminder that sometimes old ideas get the in the way of that simple mission.  And I am aware that sometimes the old ideas are my own, that I didn’t even know I was harboring in the dark recesses of my brain.

While I have been ruminating on the subject a friend called me specifically to say that she is tired of people feeling sorry for her children, who have divorced parents. She has a lovely blended family and her husband adores her boys from a previous marriage, and they have a sister now.  And her boys’ father is remarried with a child and all four parents love them.  They have plenty of clothes, food, shelter, friends and all the stuff kids need to be healthy.  Yet people give her the puppy dog look when she talks about her family.

The other morning a friend posed this question on Facebook:  “What do you think the most difficult thing is that a single parent has to face?”  There were many responses and one common thread is the guilt that single parents seem to feel.  One person, though, posted that her adult children thank her for divorcing their dad because they now see that everyone was better off after the divorce.

As a divorced mom, then also a cancer survivor mom, I have wrestled with guilt over my children.  The oldest, especially, expresses that she wishes we weren’t divorced.  One night she even said she wondered if god loved her because her parents got divorced and her mom got cancer.  Every life has adversity.  Through the past few years my children have learned that when life is difficult you just keep going.  They have learned that when you’re sad it’s okay to cry and take an extra nap.  That it’s okay to say you’re angry or that you need to have some time alone.  They have learned that even when life is crappy you can still have fun, laugh, and go to the movies.  They have learned that friends will feed you and take care of you when you need help.  They have seen the hands and feet of Jesus working for our family, and learned how to accept those blessings.  Many people don’t learn those lessons at all in life, much less at age eleven, or eight, or five.  I’m sure Grace has the richest understanding of the past few years’ events and she can articulate her feelings well.  But I know that all three children have been impacted in their own ways.

It’s easy to feel sorry for ourselves when we have adversity, and it’s really easy to feel sorry for children facing adversity.  But it does make us spiritually stronger, and that’s a blessing at any age.

I posed the question one morning. Grace answered.

When I was at Dr. Hotter (plastic surgeon) the next day for a follow up I told him about the incident with Caleb and that I was grateful that he (Dr. Hotter) returned to my children the experience of snuggling against my chest.  The man got misty-eyed.  I didn’t have the intention of having a moment with him while I was there, but it happened.  All kidding aside about how completely gorgeous and well-built he is (one friend referred to him as “Movie-Star Good Looking) he is a highly-trained, extremely compassionate man with the loveliest heart.

In over a year now of working with many doctors, nurses, therapists, surgeons, and other medical technicians of all sorts I am amazed that almost everyone I have dealt with is so compassionate and passionate about what they do.  Almost everywhere I have gone they have remembered my name after my first visit.  Not just the docs, but the receptionists and the nurses.  I walk in the door and they say, “Hello, Ms. Sellers.” Recently I took my kids to the pediatric dentist, where we have been going for NINE years and they didn’t recognize us.  I realize it’s not quite the same, teeth cleaning and chemotherapy, but the level of service in the cancer world is, in my experience, remarkable.

Last week I also had a brain MRI because I had a bad headache for over two weeks and some vision issues, both of which are symptoms of brain metastasis.  I was nervous, along with my doctor and a slew of other people.  When you have an MRI of your head they put your head in this cage thing to keep you immobilized.  And you go  head-first in an enclosed tube with just your lower legs and feet hanging out.  My shoulders touched the sides.  The machine makes a series of noises, in what seems like no pattern whatsoever.  Clomping and banging and beeping and buzzing and whirring.  It’s so loud they give you ear plugs so your ears aren’t damaged.  The technician let Cliff come in and stand at the foot of the machine with his hands on my feet/lower legs.  (MRI’s use magnets, not radiation and he had ear plugs, too.)  This helped some but it’s an extremely nerve-racking forty minutes or so. Oh, and there’s an IV involved.  I loooove IV’s.  Luckily, I got the results the next day.  “No disease progression.”  Yippeeee! The headache was caused by impacted sinuses, which was surprising to me because I don’t even have a runny nose.  But I started a Z-pack and it’s a little better, and I’ll see an ENT for follow up.

That MRI did wonders for my emotional state.  I think part of me had wondered since October if there was a problem in my brain, and finding out there wasn’t made me the most hopeful I have been in a really, really long time.  It’s amazing that our mental state can be so affected by fear and worry of things that aren’t even happening or true.  And yet we base our current thoughts and actions on those future possible events.  That is a big lesson that I keep learning on a deeper and deeper level during the unfolding of myself through cancer treatment and getting to the other side:  Don’t worry about tomorrow.  Don’t worry about tomorrow.  Don’t worry about tomorrow.

It’s common for people to feel lost when they finish the active part of cancer treatment and move on to the maintenance part.  The active part takes up so much of a life, going to the doctor and chemo and blood work and surgery and blood work and radiation and blood work and more doctors and tests and blood work.  Did I mention blood work?  It becomes a huge part of your identity because it is not only what you do with your time, but it affects how you feel and physically function.  Saying goodbye to that identity is great, but it’s also daunting.  I’ve been thinking, “What did I do with my time before I was diagnosed?” And do I want to go back to those activities or do I want to make new wagon ruts taking my life path in a different direction?  And I know I want to use the lessons I’ve learned this year to mark my choices in the future.  I don’t want to wait to do work I think is important.  I don’t want to wait to take trips.  We’re going to Disney World.  I’m not to buy a house.  (Can’t get a mortgage anyway because I don’t earn enough money now.)

To stay on Medicaid until I can get private insurance I have to keep a low salary.  Not having Medicaid is not an option because PET scans cost $7,000 a piece, and that doesn’t include doctor bills and meds and blood work.  Plus I think it will take a long recovery time before I could work a 40 hour week again.  It was a negative at first, but then when thinking about what I want to do to earn money I found myself liberated because it truly is not about how much a job pays.  How often do people have the chance or give themselves a chance to abandon the salary aspects of a job and purely pursue what we have to give to others by way of a career?  I’ve been thinking about my charity, Ease Your Mind, and the ways I can help other cancer patients.  I’m scheduling a free teacher training workshop for other yoga teachers to learn how to teach yoga to breast cancer patients.  And for now I’m still working for my dad 3-4 days per week out of my house.

While I’m doing what I’m passionate about and spending oodles of time with my babies I’ll be quietly dealing with maintenance drugs, blood work, and scans every six months.  I’ll have a hysterectomy in June – robot surgery!  How cool is that?!  There’s almost no recovery time.  Hopefully I’ll get my port out in July after another clean PET scan.  As for the potential for an early demise – I know I am not a statistic, I’m a person, and I am preparing to live each day one day at time with as much passion as possible!

The next day I woke up feeling totally drugged, thank God.  I’m pretty sure if I hadn’t been I would have been screaming in pain.  I had six drains – two under each armpit and two in my lower abdomen, underneath an incision that makes a smiley face starting at the side of each hip, further back from where your jeans seam would be on the sides.  I had an incision on each breast – about an inch long from the side, then in a circle about the size of an areola, then another inch.  Picture Harry Potter glasses with cleavage in the middle instead of a nose piece and that’s what my incisions look like.  The inside of the circle on each breast is flesh from my abdomen, and instead of breast skin full of frankenboobies my breasts are now full of fat from my belly.  Hence my belly button was removed and replaced back in the middle after they cut and stretched my stomach skin and stitched me back up.  So yes, in a long and roundabout way I did get a tummy tuck.  Don’t for a second be jealous because I would gladly have my old saggy boobs and stretch-marked belly back instead of going through all this!

Reconstructed Breast

Frankenhooter

The drains are plastic tubes with bulbs on the end that provide continuous suction.  They are completely gross.  They have to be “stripped,” which means that you hold tightly the part right where it enters the body then pinch the tube with your other hand and pull toward the bulb while compressing the tube.  Then when the bulbs fill up you empty them.  The ones by my breasts were small tubes, maybe ¼” in diameter, the two by my abdomen are bigger, almost as big as my pinkie fingers.  They are stitched in to my skin at the insertion points.  As much as I dislike them they are my friends because they drain off all excess cell waste from surgery (a.k.a. pus.).

The first couple of days are blurry.  I was bedridden.  Taking a lot of Norco.  And I had a magic pain button that gave me dilauded when I pushed it (but not more than once in nine minutes). The ICU nurses were not stripping the drains like they were supposed to so the ones by my abdomen kept leaking at the insertion point and making a mess everywhere.  I had some visitors, I think I remember who all came but I could not tell you what we talked about.

Sunday my platelets and white cells were low, which contributed to my feeling miserable.  I didn’t get to leave the ICU.  Monday there was no room for me on the surgical oncology floor so I stayed in the ICU that day as well.  They took out the catheter and physical therapists came to get me up to walk.  When they swung my legs around the side of the bed the drains leaked all over the place like I was having a baby and my water had broken.  It was mortifying and of course the PT’s were both men.  I had to stand there while the nurse cleaned it all up and the PT’s held my arms, my legs wobbling, holding six drains and a small bag holding a numbing medicine that was continuously going into my abdomen with a tiny catheter inserted by my right hip and taped to my side. I was wearing a hospital gown and nothing else, and we all know how private those are.  Cancer treatment is even more invasive than childbirth, because at least childbirth is over in a day or two.  Using a walker I walked out of my room and about five feet past.  It was utterly exhausting.  My legs were weak, and I could not stand upright because the skin on my front side is too short for my body and needs to slowly stretch.  It hurt my back to walk hunched over.  The effects of pain meds and ten-and-a-half hours of anesthesia left me achy and twitchy.  I have to say, though, that my throat was not sore after surgery and my breath was strong.   That anesthesiologist must have been really good because after previous surgeries my throat and lungs felt awful.

By Monday night my right arm had rebelled against IV’s.  My left arm cannot be stuck because I have no lymph nodes in that armpit.  The doctor didn’t want to use my port-a-cath for the IV so he ordered that I get a PICC line put in.  A special nurse consultant came to put it in at about 10:00p.m.  I had already had a sleeping pill and 2 pain pills but sadly was not asleep.  She prepped my arm and put a sterile dressing over my body, then put some lidocaine in my arm and proceeded to put in the PICC line, which is a line that went into my vein in my arm just above my elbow and actually ended up in the same vein by my heart as my port-a-cath.   I’m certain that I could not feel pain with all the drugs that I was on, yet I was very traumatized by the insertion of the damn PICC line.  For one thing the nurse that came to put it in was like a young version of the crazy cat lady with poor social skills.  Then she tried to get me to wear a sterile mask, which I promise you smelled like cat pee.  Also she raised the bed waaaaay up in the air so that it would be at a good level for her, which I understand.  But my poor drugged up self was completely freaked out being up high, covered with this sterile sheet and not knowing what all she was doing to my arm.  I looked the opposite way and kept pressing that dilaudid button.  If it gives you medicine it beeps once, if it’s too soon for medicine it beeps twice.  I basically pressed that damn thing continually for the duration of the insertion of the PICC line, causing this awful beeping noise the entire time.  As near as I can tell, the actual insertion is a three-part process.  I remember feeling something going in my arm, past the muscle.  Then I heard something that sounded like a drill and then she said, “OK now this is the big part going in.”  The BIG part?!!?  By the time she left I had had it.  Two women came in with a portable x-ray machine to take an x-ray and make sure the line was in the proper place.

PICC Line

PICC Line after it was out that long purple tube went from my arm to my chest.

As I think I have mentioned, I was a little drugged up.  So this is where it gets funny.  The ladies came in laughing.  They were petite and I perceived them to be little Polynesian women having a roving hospital party.  One of them came to my bed and said, ”We’re going to lay your bed flat.” I told them no because I can’t lay flat.  So they slid this (probably lead) board behind my back and took the xray, then slid the xray board out.  When they left I told my nurse that if the PICC line didn’t work they were all fired and I was leaving.  Then I called Cliff crying and told him that he was going to need to come pick me up because I was ready to go home and could we get margaritas on the way home.  Smart man that he is he said of course he would come get me and take me for margaritas.  Luckily the PICC worked and I went to sleep.

The next morning I awoke to Dr. Hotter by my bedside.  He did his assessment; I can’t really remember what he said.  But when he left I giggled because I realized that a hot doctor had woken me up.  Facebook post from that morning:

Totally hot dr woke me up today just like in my dreams!  Except in my dreams we are at a beach house and he’s naked too.

Later that day I got released to the 7^th floor surgical oncology ward.  Moving there from ICU is like moving from solitary to the general population in prison.  There’s a window in the room that you can see out of from the bed and the bathroom has walls around it and a door.  My male nurse that day was adorable.  Facebook status after moving to room 712:

Jake Gyllenhall is my nurse on the 7^th floor.  I am not even kidding.  Or hallucinating.  Lordy!

I spent the next few days on the 7^th floor walking a bit on my own with no walker, and watching a lot of TV.   The day nurses were excellent, the night nurses were not so excellent.  One told me I would be getting a shot at 11:00 in the afternoon.  Um, okay.  The same nurse didn’t give me pain meds in the night, so when I woke up at 4a.m. I thought I was going to die.  One night nurse pulled on a stitch, pulled on a drain, tried to give me the wrong sleeping pill, and didn’t run the right labs, which caused me to have to get IV meds in the middle of the day instead of early morning, which meant that I had to drag the damn IV pole with me every time I got up for four hours.  They did not endear themselves to me.

Thursday night I ordered a Gardenburger for dinner from the cafeteria.  I took a bite and started chewing and then realized that it tasted wretched.  I looked and saw that it was a turkey burger.   When I called room service about it she said, “Well you didn’t say veggie burger, you said Gardenburger.”  Turkeys grow in the garden?  I was pretty annoyed.  But Dr. Potter came at about 8:40 that night and that made it better.  Facebook post from Thursday night:

Dr. Hotter came to tuck me in tonight.  I think he has a crush on me.  I mean, he did a few dr things while he was here but I think they were just an excuse to see me.

Friday came – eight days of being in the hospital were enough!!  I got to come home Friday night.  Audra came in town to take care of me.  I am blessed with incredible friends.  She drove me home – free at last!!  Except that it took me quite a while to get up the stairs.  Ouch!  With over 37” of incisions on my body it was not easy.

Not easy, in fact, describes the last year.  BUT that was the last big surgery on this mountain of cancer.  A reprieve from surgeries is welcomed – I’m running out of body parts!