The Assertive Cancer Patient

The Lazy Cancer Blogger Returns

It's been almost a week since I last posted something to my blog. It seems that summer--and summer house projects--has me in its grip. Also, the garden.

Even though my ability to multi-task has been severely compromised by all my years of chemotherapy, I still TRY to multitask ... sometimes with disastrous results.

The multi-tasking (really a fancy word for leaving a lot of projects half-done) around here is not disastrous, yet, anyway--as long as you don't mind not having a single clear table to sit down and eat a meal, or anywhere to relax indoors with friends or visitors.

The porch, however, is open, and that's where we've been eating dinner.

The treehouse garden-in-the-bamboo (photo to come) is also a great place to have coffee in the morning or a beer at sunset.

My Projects
At the present time, I am:

Cleaning (on hands and knees) and reoiling the wood floors in my 1908 house.
Painting the dining room (done), living room (not done), and hallway (ditto) in warm shades of copper.
Scraping, sanding, and touching up weather damage to the paint on the outside of the house (in progress).
Digging up and planting the parking strip in front of my house (in progress).
Painting an old wooden child-size chair (in progress).

The mosaic mirror I made for the kitchen wall is finished but not hung.

Still to come:
New moldings around the doors in the dining and living rooms.
A new front door. (I will buy an old door and refinish it, then hire a carpenter to hang it.)
The old front door will replace the back door out of the kitchen.
A new screen door on the front door.
Rebuilding the carport so the Corvair can come in out of the winter rains. (Who am I kidding? Fall, winter, and spring rains.)
A new back gate.

I guess this is what happens when you go off chemo for three months!

Will I finish by the end of summer? Stay tuned to find out. (And remember, my summer runs through late September.)

Medical Update
I saw the Bone Guy this morning for a follow-up X-ray and consultation, and he pronounced me good to go. I can exercise and use my arm with no restrictions other than to stop if it hurts. (Duh.)

He also gave me a clearer explanation of what had happened. Basically, the edema in the marrow of the bone in my upper right arm was caused by the radiation I had almost six years ago. It flared up because of over-use, but the underlying cause was the radiation therapy, which apparently compromises circulation (even in bone marrow) FOREVER.

I never knew that. Not that I had much choice about the radiation at the time: I had a 5 centimeter tumor there.

As far as chemo goes, my break is continuing--three months now. I have another tumor marker test in mid-August and then we'll see. I've already discussed what treatment will probably come next, and I'm pretty calm about that. Will blog about it when I get the chance.

The Garden
I haven't blogged about my garden recently, which doesn't mean that I haven't been spending a hour or two a day working in it and harvesting the results.

Recently, I've been eating new potatoes, zucchini, green beans, carrots, and a few berries--blueberries and boysenberries. The strawberries are done, although I have a couple of quarts in the freezer from this year's harvest. I'm debating whether to make another batch of jam or save them for smoothies ...

Younger Son, one of the world's truly picky eaters, arrived home yesterday, just in time to sample the first cherry tomato from the garden. (When he was younger, he claimed all the homegrown cherry tomatoes for himself.) And he ate ZUCCHINI for dinner--and loved it. Success.

@ Jeanne Sather 2007.

Animals at the Office

I wrote this story for the Puget Sound Business Journal as a freelancer. The PSBJ published it April 1, 1991, but it was not an April Fool's joke.

When Beryl Gorbman goes to work, so does Doopie.

Gorbman is president of The Write Stuff Inc., a technical publications and translation firm in the University District. Doopie, a black Labrador-Newfoundland mix that Gorbman picked up for free at a garage sale, has been a fixture in the office for more than a year.

"I think Doopie really enjoys coming to work," says Gorbman. "If I go out in the morning and don't take her, because I have to go to a lot of appointments, she's devastated."

Having animals in the office "takes some of the starch out of your collar," says Robert Patchell, who has three dogs at Exhibit Team, a Redmond-based firm that designs and manufactures trade show exhibits.

Patchell has had dogs at work for most of the seven and a half years he's been in business. Two of the dogs there now were strays coaxed in from a nearby park.

Not only do they take some of the starch out, but animals can make an office a healthier, less stressed place to be. Veterinarian Tina Ellenbogen numbers many working pets among her clients, in part because she goes to the patient, calling at her patient's house or office, as the case may be. She says animals are a great stress-reliever.

"Physically, petting an animal reduces blood pressure, whether you're normal or hypertensive," Ellenbogen says. "That's been documented."

Because animals usually are friendly, non-threatening, and non-judgmental, she says, they act as good social bridges between people. "They defuse a lot of tension because they don't take sides."

One of Ellenbogen's former patients was a parrot who commuted by bus to a downtown office with her attorney owner. She says, "People would come in and talk to the bird to take a break and reduce the stress of the day."

There's no doubt that having animals around changes the atmosphere of the workplace.

This is true both for the people who work there and for visitors, which is why some dentists and pediatricians have aquariums--watching the fish reduces blood pressure, anxiety, and stress in nervous patients.

Linda Hines, executive director of the Delta Society, a Seattle-based national organization that studies human-animal bonding, says that people with animals are seen as friendlier and more approachable, and that the same should be true for places with animals.

"Places with animals are seen as friendlier places to be," she says.

Psychotherapist Dennis Azaroff, who takes his dog Daisy to work on occasion, says, "I guess work is changing."

"My clients love Daisy," he says, "and sometimes they'll come in and ask why she hasn't been there lately, and they seem to really enjoy having her around.

"And I do have clients who come over ad ask if they can take Daisy for the afternoon or take her for a walk."

But he says the animal is not a formal part of his work.

Some animals do play a professional role in their owner's business, however.

Megan Wallace, whose husband Bob started the software company Quicksoft Inc., is a professional artist who drew an appealing cat to use as a company logo in manuals, newsletters, catalogs, and at trade shows. "When we started Quicksoft," she says, "we wanted to use a cat as our symbol, because cats are quick and soft."

But it was only after she had drawn the logo that the company acquired its cat, Micro-Soft, named for Microsoft Corp., the firm where Bob got his start.

The Wallaces, who already had several cats at home, went to a local animal shelter to find a cat that looked like the one she had drawn.

"We were using my drawings of the cat before we actually got the cat in 1985," Wallace recalls.

She says Micro-Soft was a very effective marketing tool for the firm:

"People really loved the cat. We'd go to trade shows and people would come and tell us stories about their cats. They'd write us letters. We never solicited them, but they would send pictures of their cats in the mail, from all over the world."

One drawback was that Quicksoft couldn't hire people who were allergic to felines.

"Of course, when people were applying for employment, we had to ask them if they were allergic to cats," Wallace says. "We had a few who were, and of course we couldn't hire them."

The Wallaces sold Quicksoft to Leo Nikora in January [1991], and Bob Wallace now works for the firm as a programmer out of a home office, with Micro-Soft by his side. "He moved his office home and the cat went with him," says Wallace.

Most of the workplaces that welcome animals are small businesses or entrepreneurial firms where the owner is an animal lover. There are no warm and fuzzy creatures on the premises of The Boeing Co., for example. Russ Young of Boeing's corporate communications department says the only animals at Boeing are guide dogs for the visually impaired.

"That's the only animals that I'm aware of that would be on the premises," says Young.

After all, professionalism is an issue when there are pets underfoot.

"Not all clients find it professional," admits Patchell of Exhibit Team. "We try to keep the dogs away from where they'd be."

Gorbman agrees that some clients may be put off by Doopie.

"I don't care," she shrugs. "We run our office the way we want to.

"So we have clients who think that's a nice way to run an office. Or they judge us on the quality of our work--which I hope they would do."

Ellenbogen thinks the response to pets at work is more favorable than not:

"Will your customers mind? Unofficial data seems to suggest that's not the case. It makes for a more relaxed atmosphere for everybody."

Before bringing in a cat or dog from home or acquiring a new pet for the office, however, there are a couple of serious issues to be considered: safety and suitability.

Veterinarian Skip Nelson of the Exotic Pet and Bird Clinic in Kirkland has a menagerie of office pets at his clinic, including Charlie the parrot, B.D. the ferret, a couple of rabbits, a cockatiel, and a rat.

Nelson cautions that any birds that come into contact with the public should be checked regularly for parrot fever, which can be spread to humans through a sick bird's droppings.

"I would have a great deal of difficulty with a bird in a public place that was not thoroughly examined," he says.

Ellenbogen says people who are considering bringing pets to work should screen the animals. "You don't just bring any animal to work," she says. "You don't bring a dog that's going to run and charge out and bark at your customers."

She says she tries to help people realize that they can select pets for temperament. And she suggests talking to a veterinarian or the Delta Society about the type of animal that would be compatible and also about the suitability of an individual animal.

Still, the most important consideration is probably whether or not you like animals--if you don't, bringing one into the workplace is not likely to reduce your stress level.

Gorbman says she brings Doopie to work "because I like her."

"I could tell you it's because it relieves stress," she says, "or it's a good breaking-the-ice point for clients, but basically it's because I like her. I like having her around. I just like Doopie's company."

Support this blog:

@ Jeanne Sather 1991-2007.

The Porch Is Open

This is where I am eating my meals and taking my afternoon naps these days, watched over by my faithful dogs, GB and Constant, the wannabe service dog. (The dogs are not so much faithful as hoping that something tasty will hit the deck so that they can snatch it.)

I’m sending out e-mails to my close friends tomorrow, inviting them to come and spend some time with me on the porch. Summer is all too short.

The Menu

Iced Tea
Iced Coffee
Beer
Sparkling Water
Smoothies (strawberry, boysenberry)
Mochi Ice Cream (strawberry, mango, or green tea)
Watermelon
Fresh Garden Carrots
Fresh-picked Blueberries (quantities limited)
Cold Japanese-style Chinese Noodles (This one sounds better in Japanese: hiyashi chuuka)

WILDLIFE ALERT: Hummingbirds have been spotted from the porch on at least three occasions to date.

@ Jeanne Sather 2007.

Melanoma Checkup

I had my first three-month checkup since having a melanoma removed this spring, and I'm more than happy to report that everything is OK.

Dr. Grabowski and his nurse checked every mole, freckle, and bump from the top of my head to my toes, but found nothing unusual. So I go back again in three months and call if I see anything suspicious before then.

Meanwhile, my break from chemo continues, and I see The Bone Guy next week, I believe, for another X-ray of my right arm, the one that had edema in the bone marrow. That is gradually getting better. I've stopped wearing the splint and don't need the heavy-duty pain meds any more, just naproxen once or twice a day.

The Right Sunscreen
I've written quite a bit about skin cancer recently, being newly sensitized to the disease now that I've had it. Dr. G gave me a sample of the sunscreen that he recommends to his patients.

It contains Helioplex, a true broad-spectrum (UVA and UVB protection both) ingredient. The brand I have is Neutrogena Ultra Sheer sunblock with SPF 70, but I believe you can buy other brands with Helioplex.

@ Jeanne Sather 2007.

The (Almost Forgotten) Joys of Rain

I live in green Seattle, which gets 36 inches of rain a year.

I grew up in a small town called Hoquiam, a place that makes Seattle look dry. Hoquiam, in Grays Harbor County on the coast of Washington, is only a few miles from the rainiest spot in the 48 states--with something like 12 FEET (that's 144 inches) of rainfall a year. That spot, of course, is in the rain forest on the Olympic Peninsula, a place I truly love.

So I know rain.

But this has been an exceptionally warm July in Seattle, with temperatures in the 90s only a week or so ago, and I'd almost forgotten the joys of rain until this morning.

I slept until 11:30, lulled by the rain on the roof and the coolness of the air.

My garden flourished in the heat, but now it needs rain--the deep soaking that it gets from 12 hours or more of steadily falling rain. A hose or sprinkler can't provide that.

Then there is the character-building exercise of walking the dog in the rain. (And dealing with the wet dog after the walk.) This is next on my list of chores for the day.

Constant, my wanna-be service dog, is only 2, and he can't go a day without a walk without his behavior seriously deteriorating. So, as soon as I find my rain jacket, off we will go to Ravenna Park.

@ Jeanne Sather 2007.

The Buttons Are Coming, The Buttons Are Coming

My Boycott October buttons arrived the other day from the Busy Beaver Button Co. (www.busybeaver.net).

The text reads "Boycott October! Don't buy PINK products. Don't EXPLOIT women with breast cancer," and the buttons are pink, although not the sickly, girly pink used by the pink marketing folks, a color I disliked even before it became tied to breast cancer marketing.

I'll be mailing out buttons September 1 to anyone who writes and asks for one. Just send me an e-mail: jeanne.sather@gmail.com.

Don't know what I'm talking about?

Read:

Boycott October

Boycott October Press Release

Breast Cancer Barbie

Get a Boycott October Button

@ Jeanne Sather 2007.

What DON'T You Blog About?

Well, I thought this was a great idea, but obviously I was wrong.

Last week I got some very upsetting news concerning a member of my family, who is apparently dying of cancer. And I desperately wanted to blog about it, because blogging helps me cope with so many aspects of my life with cancer.

But one topic I have NEVER written about, in my blog or in my other writing, is my estrangement from most of my immediate family. There are good reasons not to write about this; the biggest reason for me is that I don't want readers to give me advice or tell me what to do.

However, I wanted the relief of blogging, so then I thought about rounding up all the usual suspects, my cancer blogger friends, and asking them to write linked posts on what we don't blog about. This seemed like a way to write about the topic of my family and cancer without really giving the personal details or, hopefully, opening the door to criticism of my way of coping with the situation.

That's what I thought, anyway.

But, when each and every one of these bloggers declined to participate, I decided to listen to them. And I agree. There are some topics that I don't want to discuss in detail on the Web.

For the record, the one topic I won't touch in my blog is family estrangements. How about you? What don't you blog about? No details needed, just the topic. Add a comment below, or send me an e-mail: jeanne.sather@gmail.com

Feedback From a Smarter Blogger Than I
Here's what one smart blogger had to say in response to my request:

The few specific things I don't and won't blog about are so sensitive that I don't even want to
list them, much less discuss them to the extent of explaining why I don't blog about them. They're not secret; they're just out of bounds for public discussion. Period.

There is one tip I would give your blogging students, though, and you have obviously already thought about this, but I would just second it: Even though the blog is a great place to spill one's guts, get things off one's chest, think things through, etc., I still recommend maintaining certain boundaries. You never do know where information will wind up, or how it will be distorted by the filter of other people's experience. People can get hurt by what you say about them behind their backs, even when you think there's no way they can ever find out, and even when they never do find out.

Also, it's very important to think about whom you would let into your personal relationships. Everyone has an opinion, and what, one in twenty? one in a hundred people who read what you say will actually post a comment? And they don't know you, or him (or her), and yet it's crazy, or maybe just naïve, to think that what they say won't affect you.

Boundaries are good.

As I said, smarter than I. I'm taking this advice.

Reader Alert
I've posted this message, or one very like it, at the bottom of several posts that were on sensitive topics, and so far my readers have been very thoughtful in their responses. What I mean is, they didn't e-mail me and tell me how to handle the situation, or that I was full or it; they just wrote messages of support--without the usual cliches, too! For this I am profoundly grateful.

Note: If you are new to my blog, you may not realize that I am extremely sensitive about people giving me unwanted advice.

Please do not e-mail me telling me what I should have done in this situation. Or post a comment saying something like, “No matter what happens, it will all turn out for the best.” Or, “You did the best you could.” This is not helpful.

Words of sympathy and support are gratefully accepted.

@Jeanne Sather 2007.

The Break Continues!

Good news on the cancer treatment front: I saw Dr. Lee yesterday to get the results of my latest tumor marker, and we agreed that my break from treatment can continue.

So, except for a jammed N key on my laptop, I am one very happy cancer patient. Having to stop and slam the N key every time I need it does interfere with the flow of my writing, but I'm hoping Older Son will be available this evening to help me fix it. Otherwise, it's off to the computer store.

It is now two and one half months since I last had treatment, and I continue to flourish--more energy, more enthusiasm for life, a clearer head ... it's wonderful. Even my stress is under control. I've dropped a couple of the meds that I was taking to control side effects (meds for high blood pressure caused by the Avastin, for example), which is also great.

For those of you who want the medical details, read on. If you're not interested, stop here.

My tumor marker was stable from the last time I had it drawn at my new cancer center, which is good news. The PET scan, however, showed some "disease progression." That means that several tumors in my bones (I only have bone mets) are lighting up hotter on the PET than they did on the last couple of scans.

So the two tests are somewhat contradictory. We could jump all over this and put me back on treatment, but I need this break, and Dr. Lee understands this. During our fairly lengthy but relaxed conversation, he said it was up to me (LOVE IT), but his recommendation was to wait for symptoms. These would include pain, and I don't have any pain in the spots where the mets are, or danger of a broken bone. None of these spots is large enough to break a bone right now.

This decision wouldn't work for everyone. It isn't even the decision I would have made a few years ago, when my response to any signs of disease was, basically, "Nuke it!" But that was when I was still hoping for a long-term remission, and that's not very likely at this point.

I am willing--actually, eager--to live with active disease because I so badly want this break from treatment to continue. So, for now, watch and wait and continue to enjoy the summer.

Read more:

A Cancer-Free Month

A Break From Treatment

@ Jeanne Sather 2007.

Medical Billing Woes

Well, this was a mistake, on a 97 degree day I was paying bills for July (always a problem for me, see Paying Bills), and I decided to try to straighten out one of my pending medical billing problems, since the mail included a letter from a collection agency concerning the bill.

The bill was from Swedish Medical Center, for $72, for "ongoing outpatient care" with a date of service of 11/28/2006. Now my insurance provider, WSHIP, has a contract with Swedish, so after I've paid my out of pocket deductible and copays of $1,000 a year, I don't pay any more for medical care during the year as long as I stay with the providers on the list. (If you've been in cancer treatment, this will make sense to you. If you haven't, it may not. It's a whole new vocabulary out there in Medical Billing Land.)

Since I always manage to reach my deductible each year during the month of January, I was pretty sure this bill was a mistake--by November I have paid my out of pocket max and I shouldn't owe anything.

This bill has been sitting in my "to do" pile for a couple of months, but those of you who read this blog regularly know that I've been busy with medical problems during the past little while and haven't had time to get to it.

But, as I've said before, we cancer patients amuse ourselves with these phone calls, so today was the day to clear it up, I thought.

I called Swedish, and talked to Julia. She said my insurance company had paid $30.60 on the bill, leaving a balance for me to pay of $41.40. Any error, she said, had been made by my insurance company.

Before calling WSHIP, I checked for an "explanation of benefits" from WSHIP for that date of service, but didn't find one that matched the amounts. So I called WSHIP and talked to Jackie (Jacki, maybe).

Jackie was very helpful, as the folks at WSHIP generally are, and she told me that WSHIP did not have a claim for that date of service that matched the amount. There were two charges for 11/28, both for my radiation oncologist, and those had been paid.

So, what to do?

This is where it gets really weird, but it always gets really weird when dealing with medical billing. I called Swedish back and talked to Julia again.

This time, she said that, despite the date of service on the bill, that claim was for January 30, 2007.

"That's how the billing system works," she said. "There's nothing I can do about it. I've brought it up with my supervisor, but there's nothing we can do about it."

When I asked how I was supposed to confirm the date of service on the bill, there was a long silence. A very long silence.

I won't be paying that bill any time soon.

A note on letters from collection agencies: This letter, like all collection agency bills, says that I have 30 days to dispute the bill. If you get a letter from a collection agency, whether you think it is an error or not, don't ignore this. Send a letter--this is not the time for a phone call, you need to start a paper trail--and say that you dispute the bill. In this case, I will give the collection agency the info from WSHIP and invite them to call WSHIP to confirm.

I will, however, be sending another letter to the head of Swedish. He never replied to my first letter, published here as 15 Phone Calls, but he has sent me form letters asking for money.

How about if I offer him a deal: You (Dr. Einstein is his name) sort out the billing department so I don't have to waste my time with unsolvable (by me, anyway) problems like this, and I'll leave Swedish a donation in my will. Seems like a fair trade here--we are dealing with an illness that is going to kill me before too long, and I'm really not at the top of my game when it comes to ridiculous situations like this.

Will Swedish send a collection agency after me for $41? You bet they will; they already have.

Read more:

How Cancer Patients Spend (Waste) Their Time

Medical Billing & Insurance Woes: "Payment reduced per sanctioning policy" and other mysteries

@ Jeanne Sather 2007.

97 Degrees!: The Garden Is Flourishing, the Writer Is Melting

The dogs are melting as well. Turning into limp puddles of fur on the front porch, in the shade, of course.

We DON'T get 97 degree weather in Seattle (well, obviously we do, but very rarely), so we're not prepared for it. No airconditioning, for example. I may have to spend the rest of the day in my car, which has AC, or at the movies, ditto.

To add to my woes, my keyboard has something under it that keeps sliding around, causing one key after another to jam. Today it's the N, which is making my writing life difficult. I know the keyboard lifts up, I'm just not sure how to lift it without breaking it. This may be a job for Older Son, who generally solves my computer problems for me.

So, a short post today. I want to put up some garden photos--I have zucchini already, and tiny tomatoes comig along, also berries (I first thought they were raspberries, but I was wrong, they are boysonberries. Delicious. I covered them with netting to keep GB, the golden retriever, from eating them, but he's still managed to get a few).

And I covered my nashi, Japanese pear-apples, with nylon stockings, which I never wear anymore anyway, to keep the pests off. Turns out I have 13 little nashi on the tree. It looks ridiculous, and a bit obscene, but it is a pesticide-free solution.

Nashi are just about my favorite fruit, so well worth the trouble.