losing days

I've just finished my third week on my new thyroid meds regimen (dropped my Cytomel completely, sticking with my previous level of Levoxyl.*) The entirety of this experiment, I've also had a sinus infection, and I also just started on a new med for my post-gallbladder-removal digestion problems.

Yesterday was my last day on my second round of antibiotics for the sinus junk, and much to my relief, the morning nausea I was experiencing hasn't shown up today. Evening nausea is definitely related to taking the Questran on an empty stomach, or too soon before eating: ideally, I take it right before dinner, then it works perfectly without making me feel sick. Actually, it works perfectly even when it makes me feel sick, but I can do without the feeling sick part.

The worst of what's going on relates, I have to believe, to the thyroid meds. I keep waking up not knowing what day it is. This has happened to me a few times over the years, but now it's getting to be a regular thing: I wake up in a panic, because I've overslept and the kids will be late for school and there's nothing already to go for breakfast or lunch... and then I realize it's Saturday. Or this morning, I panicked thinking it was Wednesday, which means that DS1 would be gone with DH to physical therapy, and oversleeping is a very big deal because I have to get the peewees off to school. But by the time my feet hit the floor I remember that it's Tuesday and there's no need to panic because I overslept by 15 minutes; DH has already got the kids up and they're all doing their morning stuff and everything is surprisingly calm and OK. Except inside my head, where the panic takes a while to subside.

I understand where the lost day feeling comes from, in part: yesterday I got called in to substitute at 7:35AM, needing to be there by 8AM, and needing to shower, dress, and eat as well! Remarkably, we made it, although only by breaking my previous record for fastest shower ever. The little ones made it much easier by actually being ready to go when I needed them to be, miraculously. It helped that DS1 was out at PT! There's always more friction when the three of them are around.

I'm functional for the most part, though the house is pretty much a disaster. I'm sure my meds could us an uptick, but I'm going to hold out for one more week before I go and have my blood drawn for the new labs. The sinus junk is as persistent as ever, although the Nasonex really does help. Now I must wrestle with whether or not to go to the ENT or just hope it goes away... while I chalk up my newest difficulty swallowing to the virulent post nasal-drip that just will not quit.

---
(*) I dropped the Cytomel because it's very expensive, and because I wanted to see if I really do need it, after all. My endo decided to keep my dosage of Levoxyl the same as what I was taking before (125mcg) because I was taking such a tiny dose of Cytomel (5mcg). I'm expecting to need an increase in the Levoxyl, but we wanted to see how much effect the Cytomel was having before adjusting the Levoxyl upwards.

I've already determined that if my endo won't increase my Levoxyl I'll just go back on the Cytomel -- I really don't like this fuzzy-headedness! Someday I'm going to forget something really important.

lessons

Today, just one: no amount of dark chocolate, however luscious, can compensate for having managed to get only 4 or so hours of sleep for past three consecutive nights.

Yesterday's lessons:

1) A two-hour mid-day nap helps, but not that much.

2) Never, never eat corn chips out of the bag while reading. Eventually the bag will be empty and you will be wondering where the chips all went, and then you will realize that you've eaten them all quite without noticing. Always take out a bowl and dish yourself a serving. That way your clothes will still fit you in the morning.

3) Staying up late knitting is no more virtuous than staying up late doing any other mildly obsessive behavior. Especially when you're working on a sweater for yourself:

from Knit Simple Spring/Summer 2007
What? I need a new beach cover-up (my old denim shirt is falling apart), and I've had this yarn since before the Woolworth's in Boston's Downtown Crossing went out of business. I knew if I waited long enough, I'd find the right project for it.

mantra

I started to say "new mantra", but honestly I've never had a mantra* before, that I can remember. So this is a first for me, and I'm hoping it will help me curb some of my self-destructive habits, such as staying up all hours watching Turner Classic Movies or obsessively scouring the web for delicious content:

Make good choices.

Easy enough, right?

If only.

----
(*) What is a mantra, anyway? I looked it up, and it seems that I'm somewhere between the two meanings, the first being a sacred verbal chant, the second being a commonly repeated phrase. Obviously "Make good choices" isn't explicitly spiritual. It is a directive to me (think about and do what's best) and an abbreviated plea for help (Lord, help me figure this out!), simultaneously. So it's not really a mantra in either meaning of the word, but I'm going to keep calling it my mantra anyway.

a wee bit fiesty

On Monday nights, I teach a class of fifth graders Religious Education (RE). The majority of the class made their confirmations in early February; the remainder will do so in mid-April with their siblings. Due to the oddities of this scheduling (we're playing catch-up with these younger grades because of the newly Restored Order of the Sacraments (pdf)), we completed the sacramental preparation part of our course by the end of January, and since then, we've been working through a traditional fifth grade RE text.

There's no way we're getting through the whole book, so last week I reviewed the table of contents and the lessons and started pulling out which lessons we would go over. Last week we covered Lent and started the section on prayer. This week we finished the prayer lesson, and started the lesson on the Sacrament of Reconciliation.

And somehow or other, with about 10 minutes left to go in the class, we came around to one of the students asking me about the recently-aired documentary on the Tomb of Jesus.

(rolls eyes)
Don't get me started...

Fortunately, I had read enough around the web to be able to thoroughly refute the idea that the Jesus in the tomb was, you know, The Jesus. But I also managed to convey to them the very earliest history of the Church: if Jesus really was buried somewhere, that means the Resurrection is a lie. Why would the apostles lie about something like that? Why would St. Peter, and all the apostles, go to their deaths professing the truth of the Resurrection if it was just some bizarre joke they were playing?

And then we got started on the DaVinci Code... and I got a bit impassioned about what garbage that is, and even more impassioned over the Church's supposed suppression of women. Hmmm, let's take a look at that idea, shall we? Mary, the mother of Jesus, is the most revered human (aside from Jesus, who is also God), who ever lived. And she is? Yes, a woman! We can talk about countless saints who also happen to be female, but I prefer to go way, way back to the morning of the Resurrection. To whom did the Angel appear in the empty tomb, to announce what had happened? To the women, members of society viewed as property, valued only slightly above slaves, with very few rights of their own. At that time, women were not even allowed to testify in court.

If you were going to make up a story, why would you choose the most unreliable witnesses, according to your culture, to be the ones to receive the most important message ever? It doesn't make any sense at all as a lie, does it?

Anyway, there was some good question-and-answer stuff and many of the kids were actually engaged in the conversation -- we even ran over by about 2 minutes, which has never happened before. One of the other topics that came up was the subject of Mary's perpetual virginity. I struggled to explain how, if you truly believe that Jesus is God, it's the only thing that makes sense: what human is fit to occupy the space that once held God? Such a space is sacred, and always should remain so. As these things often go, the best analogy occurred to me much later:

The tabernacle isn't a breadbox.

airhead

Yesterday, I used a knife to butter and cut up the kids' pancakes... and then I put it back in the silverware drawer instead of the dishwasher.

I don't feel spacey when I'm around people or actively working on something. I only seem to screw up auto-pilot things, like turning off the stove. I know, people do that sort of thing all the time, but I can't ever recall having done it myself. The burner was set to the lowest possible setting, so that it was difficult to see the flame. I only realized it was on later when I noticed the air was warmer over that burner. No harm done. (So far.)

Sinus meds are doing something because the big node under my jawline has subsided. But my face still feels clogged up. Is this a chicken-and-egg problem? Will the sinus thing ever resolve if my thyroid meds are whacked? How can I tell what's a sinus symptom and what's a thyroid symptom? This is annoying.

I have a sense of waiting for something to happen, and I was trying to figure out what that was. I think I know: I'm waiting for the sinus infection to resolve, and for my thyroid meds to be calibrated. I'm waiting to feel like me again.

new meds status report

Thyroid hormones: it may be just my imagination, but I'm feeling brain fog settle in. I made a spectacular blunder this week -- no need to detail my embarrassments here, and I was able to reschedule -- and I can't blame that on not getting enough sleep. Last night I got 8+ hours and I still feel fuzzy-headed. Of course, that could just because the...

Sinus meds aren't working, and my PCP called in a new prescription for me today/ I'm clinging to the hope that this new antibiotic will knock the infection out, but just barely. I'm not in the mood for expensive tests and invasive treatments. But I am disappointed that regular use of my Nasonex and Mucinex, combined with the Biaxin, haven't had more of an effect. If anything, I'm worse today than earlier in the week. I have a headache, but it's more like my face hurts -- behind the eyes and nose. Ick.

Last but not least, the Questran seems to be doing its job, more or less. You really can't tell about that kind of thing when you've just started on a course of antibiotics. At least I can't, because antibiotics routinely screw up my digestive system. So while the situation isn't perfect, I will say that it is improved, and that is a very good thing.

I've played hooky today: not working, and nothing pressing that really needed to get done. I haven't been a total slug, though -- I've got some laundry going, and I made some primitive efforts to save the rose bushes that have flopped over.
March 2005: DD fleeing from the monster rose bush...
Recent high winds combined with the heaviness of the bushes led to trellis failure for three of our Lady Banks. Fortunately, we were planning on de-trellising them anyway and training them along the privacy wall, so it's not that big a deal. Except that now we basically have no choice!

Sometimes life just makes decisions for you that way.

I really don't want to know

I don't understand tattoos, or the impulse to get one, at all, and I wrote about it some time ago, here.

At the time, my friend Tom joked in the comments that I should "copyright and patent the term Tattoo Taxidermy right now," and I would become rich beyond my wildest dreams.

So... should I be disturbed by the recent Google searches for "tattoo taxidermy" that have brought new readers to my blog?

Like I said, I really don't want to know.

continuing education

Over the past week or so I've learned the following interesting medical facts:

Bones grow faster than muscles. I knew that bone growth occurred at the bone plates, but I never gave a thought to the fact that the musculature often doesn't keep up. This is a big part of DS1's gait/coordination problem: about the time of my original cancer diagnosis, he was going through a major growth spurt, and because of all my medical dramas, he wasn't enrolled in any kind of organized physical activity. He lost ground there, and has been playing catch-up ever since. (Here's an article by Dr. Sears which talks about this problem.)

Vitamin D deficiency is the latest buzz in early detection and treatment. I was surprised when my endo ordered a whole Vitamin D panel on my last bloodwork. I'm coming in on the low side of normal, but still within range -- the value we're shooting for is 50, and I was at 39, which isn't too far off. (The dr was not concerned). What's the big deal? From Science News Online:

over the past decade and especially the past 5 years, research has linked a broad range of additional benefits to having ample vitamin D. It's shown that the nutrient fights cancers and diabetes, is the pivotal feedstock for a hormone that protects muscle, and inhibits autoimmune disorders from multiple sclerosis and lupus to inflammatory bowel disease.

Who knew? Not me, and I thought I was relatively on top of this stuff.

Yoga is probably not the best exercise for preventing osteoporosis. I talked this one over with my endocrinologist also. I'm at high risk for osteoporosis because I'm tall, on the thin side (not so much these day!), and I'm on that suppressive dose of thyroid hormones to keep my cancer at bay. The new dr stressed that the joints really need to be pounded -- she suggested jumping jacks -- to get the bones to respond the way they should. It's the repeated stress on the bones that makes them grow stronger. But strength training exercises are important also.

Acute sinus infections left untreated can become chronic conditions requiring more invasive measures to resolve. The entirely personal information I learned today on this topic is that I've been to my primary care physician 5 times since August of 2006 for sinus infections. He (PCP) suggested I take this to my ENT, it may be time for a CT scan of my sinuses. But what I'm really going to do is take the vile anti-biotic he prescribed (14 days! ick!), use my Nasonex faithfully every day, and just try to get over this one and prevent another one. CT scans are expensive and I'd rather not unless I absolutely have to. Fortunately I have a good game plan and rather comprehensive information.

Sometimes, the intended use of the drug is "off-label" even though it's exactly on point. Case in point: bile acid sequestrants are often prescribed to post-cholecystecomy (gallbladder removal) patients, because without a gallbladder, too much bile flows into the intestines causing various "digestive transit" problems. My g/e doc prescribed some Cholestyramine for me. Reading the drug information sheet, I noticed there was not a word on it -- not anywhere -- about this use. The closest it came was noting that it can relieve itching associated with liver disease. Fortunately, the web comes through and backs up the g/e dr's treatment plan with the first hit from my "cholestryamine gallbladder" search. (You really have to know how to construct those queries!)

It's a good thing I read that sheet, too: the cholestyramine can interfere with thyroid hormones when taken too close together. Fortunately, I take my thryoid meds first thing in the morning, and the Questran will be an afternoon thing. It's not sticky or goopy like fiber drinks -- it's more fuzzy. This, I'm sure, is because it's a resin, and resins simply do not dissolve in water (what they will dissolve in, you would definitely not want to drink.)

So now I'm on a boatload of new drugs:
1)Mucinex, for the sinus infection
2) Nasonex, for the sinus infection
3) Biaxin, for the sinus infection
(damn sinus infection!)
4) Questran, for the rapid transit issue

In addition to all that, I'm still taking all my other usual meds, plus ibuprofen every four hours to take the edge of this never-ending flare.

Meds, meds, meds. What I really need to do is 1) consistently exercise and 2) consistently get at least 8 hours of sleep each night. On point 1, I'm not doing badly at all -- even swam today. Point 2 is my undoing, and I'm sure is contributing to my upwardly-creeping weight as well.

There's always tomorrow (notes time). (Ahem) Well, the rest of today...

spring breakdown

That has to be one of the most over-used puns this time of year... I don't care.

I'm up too late and wondering why and realizing it's because I'm going crazy, having to deal with the kids literally all day long.

We're not used to it. I'm not used to it, in a major way.

The real problem is that I have been going non-stop since before the workshop, and I really need a day (a school day) at home to just get everything in order without anyone else around. I can do the straightening up when there are other people around, I just prefer to do it when I'm alone and uninterrupted.

It's stupid to be taking "alone time" from sleep hours. I will pay, I know. But (ha!) it's too late now (literally).

Maybe more sleep would reduce the need for alone time? Hmmmm.

the great experiment

It's always interesting when the subject is yourself. The current experiment involves dropping the Cytomel (T3) from my drug regimen and seeing how I do on a straight T4 (Levoxyl) regimen. I have been on a combined T4/T3 dosage since 2002, because I believed that the T3 would help with all my auto-immune issues (Hashimoto's thyroiditis, rheumatoid arthritis, etc).

To date, my RA has been remarkably mild and stable, for the most part. I have been flaring for the past 3 or 4 weeks, but I've also been under a lot of extra stress and I have also, sadly, fallen out of the habit of doing my daily exercises. The exercises make a huge difference, as does getting enough sleep. So even though I'm feeling rather crummy these days, RA-wise, I'm tending to blame it on lack of exercise and lack of sleep, rather than the disease advancing or anything like that.

So, after all these years on the T4/T3 combination, why am I doing this now? Well, the T3 costs me more than $800/year. If I can safely drop it, and still feel well, that's $800 (actually closer to $900) I don't have to spend on T3. I honestly don't know whether or not it's helping, and I won't know until I'm off for a while -- hence, the experiment. As a long-time champion of the combined T4/T3 regimen, I have a sense that I should feel guilty about going off the T3 -- but I don't. If I don't need it, why take it?

Today is day 2 off the T3. I'll go for bloodwork in about 6 weeks to see how all my thyroid hormone levels are doing; my T4 may need a little tweaking to make up for the absence of T3. That's OK -- I can get a year's supply of T4 for $60, including shipping charges.

Note that I'm doing this under my new endocrinologist's supervision -- it's a very bad idea for thyca patients to tinker with their meds without talking to their doctors, first. Happily, my last ultrasound came back unremarkable, and my Tg was OK, too. We'll gear up for another round of Thyrogen and a nuclear scan in August, just to keep an eye on things -- and if that one's clear, I'm hoping we can scale the testing back to every 2 or 3 years with periodic bloodwork monitoring.

It's quite a relief to have this feeling that I'm over the active phase of my cancer. Even if it's not true (the doubt still creeps in occasionally), it's still nice to feel like it's OK to get on with life and not worry so much all the time.

half past busy, quarter til dead

I'm exhausted.

Mom left Monday morning, and it feels like my responsibilities exploded at the same time.

Work: Monday, Wednesday, today and tomorrow -- but tomorrow is an early release day, so that's not too bad. Monday was fifth grade, OK. Yesterday was middle school language arts, and that was a pip because all the classes had library/computer time. Today and tomorrow: second grade. Oy. Even though the class is small, it's still frazzling.

I'd been trying to figure out why that is and I realized that part of the problem is that DD, who is in second grade, is more mature than most of these kids. Of course she's older than most of them, having a birthday in early November, but that's not all that's going on. Some of it is personality and capabilities, and some of it I can chalk up to "behaviors I will not put up with," like baby talk. I can't imagine using baby talk to a teacher ever, but I've run into it a few times this week, and not just in second grade. Weird.

When I haven't been at work, I've been trying to get other stuff done like taking DH's car to have the tires rotated and balanced, or grocery shopping, or finally trekking over to the swim shop in Tempe for DD's fins and stuff for the swim team. Also house cleaning, which went long neglected in the run-up to the workshop, and laundry, which falls back to me since Mom isn't here to do it anymore.

I'm ready for spring break! And I'm ready to find out my test results. I choked on my own spit twice today, once in class -- fortunately not while I was doing a class lesson. I can't have that thing happening in school with any frequency, it's too disturbing. It's not that I'm actually choking or in any danger at all (not even in danger of having a panic attack), it just looks and sounds very bad. Can't go scaring the little ones! So if it's not recurrence then I shall try to get in to see my ENT to hear what he says.

Meanwhile, Cooper had ear mites but no urinary tract infection, so there's no explanation for him peeing on the clean laundry other than him marking it for his own (ewww).
Yes, I'm quite comfortable. Why do you ask?
We've just determined Alice (above) is deaf, and that will necessitate another trip to the vet for a check-up to see if there's anything we can do for her. She's a happy cat so I shouldn't feel sad for her, I know, but at this point in the week I am so depleted that every little thing falls like an anvil.

Obviously I need to work on both my physical and emotional stamina.

"I heard there's a riot going on down here"

So sayeth the security guard, late yesterday morning, as he sauntered down the hall towards our conference rooms.

Yes, I replied, but we've got all them all safely contained in there now.

We all cracked up. ("We" being me and the other two or three women who were staffing the registration desk and generally rounding up stragglers.)

To say the workshop (the first Arizona Thyroid Cancer Survivors' Workshop, that is) was a success would be an understatement. Apparently, our first time out of the gate, we managed to hold the largest regional ThyCa workshop ever, with 118 registered attendees.

It was just an unbelievable day. So many people saying things like, "I never knew anything like this existed," and "No one has ever even heard of this disease," and "I am my doctor's only thyroid cancer patient, I get to be his teaching case," and on and on and on. So many "thank you"s, so many "This is fantastic!"

We were all quite overwhelmed -- and that includes the speakers. The sense of gratitude and relief among the survivors and their families and friends was palpable. Everyone was talking to their neighbors and sharing their stories, giving advice or just commiserating. It was awesome.

I remember the relief I felt when I found real live people to talk to about my thyroid cancer. Yesterday, I saw that look mirrored in dozens of people's eyes, the recognition: I am not alone.

We worked hard and we helped a lot of people.

Sure feels good.

ready?

The van's all packed up, my lunch is waiting for me in the fridge, and as far as I can tell, I haven't forgotten anything, and I've managed to think of some things to bring that might be helpful in emergencies (kleenex, tape, scissors, that kind of thing. And chocolate.) I've even written my intro speech.

Tomorrow's the big day: the first ever Arizona Thyroid Cancer Survivors' Workshop.

Even with traffic closures on Loop 101, I'm sure we'll have a great day.

Doctors: how to annoy your new patient

First Visit
When she arrives in the office, make sure the reception desk staff ignores her completely for one to two minutes while they finish up whatever tasks they are doing.

When she gives her name -- and hands over her insurance card -- make sure the receptionist can't find her appointment. If the patient then corrects the spelling of her last name and points out her time slot to the receptionist, instruct the receptionist to say nothing more than, "Oh."

Accept only the office's new patient information forms from the patient. Require a blank stare in answer to all questions regarding other medical records the patient has brought with her. Make the patient ask several times what to do with the records before finally telling her to hold onto them and give them to the doctor during the appointment.

Do not call the patient in for her appointment until at least 45 minutes past her appointment time.

Kick off the appointment with the obviously-correct-nearly-all-the-time assertion that the patient is "a typical case and just needs the usual follow-up." After all, there was no need to even skim through that new patient information packet, right?

Allow the office staff to interrupt you when with a patient as much as they like. Can't find an insurance code? No problem! The patient can wait.

Insist on scheduling scan appointments and follow-up appointments separately, without consideration for the fact that the patient lives well over an hour's drive away.

Send the patient off with an incomplete lab slip for blood draws, and have office staff call her on her cell phone to tell her what other tests need to be ordered.

(Blood work was done a few days after the first appointment.)

Second Visit, about 2 weeks after the first

Once again, make sure office staff focus only on their very important phone calls, and do not acknowledge the physically-present patient with even a flicker of eye contact. The fact that they are on the phone gives them license to ignore a patient for up to a full five minutes.

Make sure that the patient waits for a minimum of 30 minutes past her appointment time, again -- consistency is key!

Make sure the financial responsibility form states that the patient will be having a test that is no longer possible because the organ to be scanned was removed a year and a half ago.

When the patient informs the tech that the release form is wholly inapplicable, make sure the technician responds, "Oh, I didn't look at your history" so that the patient knows just how thorough your practice is.

During a scan, never ever give any information to the patient regarding what you're seeing.

If the patient asks for a copy of her lab test results, ask her if you have reviewed them with her yet. If the answer is "No, but I want them for my personal records anyway," refuse to comply and state that you will give her a copy at the follow-up appointment in two weeks.

Leave the examination room while the patient is still straightening up, post-exam, so that you don't have to deal with any potentially troublesome questions.

* * *
Every single one of these things has happened to me recently with a doctor who came very, very highly recommended. I'm giving this doc one more shot -- the aforementioned follow-up meeting in two weeks. We'll see how that goes. My expectations are set very low. I just want to get my tests results and get out.

Of course, if the test results reveal anything requiring treatment, I'll be needing to deal with this doctor a lot more. But I'm going to remain optimistic and say everything's fine, in which case I won't need to go back for six months. I think I can live with that. It's a pain but less of a pain than going all the way to Houston.

bully

It was a long day. Started early (6:15) with a call from the school, could I come in? And by the way, it's field trip day... yes, sure, I'll be there.

School was fine, the field trip was fine, everything OK. This particular class I have subbed for before, so I knew the kids' names, which is very helpful on a field trip.

The last time that I subbed for this class, there was the usual "oh, there's a sub, let's see what we can get away with" behavior, which I worked hard to squelch with only moderate success. Part of the squelching efforts included telling one kid not to abuse classroom privileges by making distracting noises.

That reprimand started what has become for me a situation, because the kid's parent also works at the school. The next time the parent saw me, I heard about it: You yelled at my kid. I wasn't sure whether or not it was a joke, and I didn't realize that this person was the kid's parent. I didn't even remember having issued the reprimand until the details were laid out. Apparently -- again, I'm still not sure whether or not the parent was just kidding with me -- I made the kid cry. I certainly didn't see any tears at the time, that's for sure; they would have been a disproportionate response.

Anyway, since then, which is 5 weeks ago to the day, whenever I see this parent I inevitably hear things like, So, did you make any kids cry today?, or comments to other staff members like, She's really mean, you know. She yelled at my kid and made him cry.

To which I can only shrug my shoulders and respond, I didn't yell at the kid.

Up till today, this has irritated me but not to the point where it followed me home, so to speak. Today's encounter was different, because I was once again subbing the kid's class. Today I got something like this: You better be nice to my kid or I'll beat you up. That's not an exact quote, but it gives the gist.

Understand this: I'm not a small woman, even just wearing tennis shoes I'm fully 5'8", but on the thin side. This parent is at least 3 inches taller than me and could definitely beat me up. My response to the comment was(resorting to humor because really, what choice did I have?): Yeah, you probably could. I have to put on heels to even look you in the eye.

That happened mid-afternoon, and then I was busy, and took DD to try out for the swim team (she endured the entire practice!), came home, had a quick supper, and headed up to Scottsdale for the thyca support group meeting, which was actually a "stuff folders in preparation for Saturday's workshop meeting." And then home again.

And during those long drives to and from Scottsdale, I realized that I was being bullied. Even if it's unintentional, I still have to put a stop to it.

I talked this over with DH and he agrees. So my strategy is to say nothing unless I hear another comment, and then my reply will be: You know, that's getting old. I wish you'd drop it. And then if it's not dropped, I can talk to someone in the administration about it.

I'm not trying to get anyone in trouble here, but I'm tired of being bad-mouthed this way, even if "it's just a joke!" (Which is what I'm sure the parent would say.) I am an inexperienced teacher and I do make mistakes, but I don't need this kind of second-guessing. Worst of all, I can't tell whether or not the parent really is upset with me; when the subject was first broached, I answered the questions about what happened sincerely and apologized if the kid got overly upset by being told to hush. But seriously, am I suppose to let a kid do whatever for fear of a parent's nasty reprisals?

Being a substitute is hard enough, and for the most part I'm flying by the seat of my pants. I'm happy to listen to criticism if it is paired with advice on how I could've handled that particular situation better. I'm not happy, and never will be happy, with being threatened with a beat-down and being tagged as mean, even if those are supposedly some kind of joke.

Am I overly sensitive? Do I even have a sense of humor about my own faults? No to the first, yes -- hell, yes -- to the second. But this stopped being "just a joke" at least a week ago. Now it's just old, and it's got to stop.

press coverage!

Super Cancer Volunteer Lady, Gail (right) and her sidekick (me, left)
photo credit: Tim Hacker, Tribune

In today's East Valley Tribune: Seminar focuses on thyroid cancer

It's a great article, with the minor quibbles that it was Gail who came up with the "cut-throats" moniker, which I had never heard before, and it gives me too much credit. This workshop is Gail's baby, I'm just her sidekick.

I want to say I hate the photo, because I never like the way I look in them... but this one is at least accurate in that Gail & I were completely cracking up the entire time the poor photographer was trying to shoot us.

confidence

I had a dream about the upcoming workshop.

In retrospect, I suppose it was a nightmare, but the more I think about it, the more amused I am by it.

It's the day of the workshop and everything is going very well. There are many attendees, the speakers are all doing fine, and I even managed to find a suitable outfit. So what it is that makes this a "nightmare"? I realize that I've left the freebies for the attendees at home! Horrors!

In the dream, I stressed because the round trip drive is at least 90 minutes (without traffic), blah blah blah.

It's funny because if this happened in reality, I would just call DH and tell him to bring me the stuff. Or we'd just let it go. Not that big a deal, you know?

Funny how the subconscious latches on to certain things and blows their significance all out of proportion. I love, love, love that my subconscious believes we're going to have great attendance and I'll even figure out what to wear. That's confidence that you can't fake.

99%

DH and I took DS1 to a developmental pediatrician for a second opinion on his Asperger's Syndrome diagnosis which was delivered a couple of weeks ago.

The bad: The doctor's office is way north, up off Cave Creek Rd, and it took us about an hour to get there.

The good: everything else.

I loved the doctor's demeanor and the way he spoke to us and to DS1. I liked the way he managed the appointment. I appreciated the way his simple assessment tests revealed DS1's strengths and weaknesses.

The bottom line is that DS1 has some delays in his expressive language, which is not something I was willing to admit before, but with the tests the doctor administered, became obvious. The school-administered tests showed the same deficiencies, but I frankly didn't believe it, because I didn't see the test itself and DS1's answers, I just saw the assessments. The kid has a tremendous fluency with language in almost all situations. But now I see that there are some areas where he just isn't where he should be, especially considering how well he does in the other areas.

We reviewed a lot of material, and it was profoundly relieving to hear the doctor say that we were already doing 99% of what should be done to help our boy. We were also happy to hear that he would get better as he gets older, even though we have already been seeing that for ourselves all along. The school's psychologist had said that DS1 wouldn't really grow out of this, and I can see her point: he's always going to have these traits. But that doesn't mean he won't be able to learn coping techniques and ways to compensate for the things he just doesn't have a natural ability for. He's not doomed, not at all, especially given how well he's doing now.

99%, I think, that's pretty good. This doctor feels that the labels -- Asperger's Syndrome vs Asperger's tendencies -- are meaningless because the treatment is the same. I agree, but at the same time I can see that if the label had been there earlier, maybe DH wouldn't have been so resistant to some of the things I was trying to get him to read! It's water under the bridge now, and we've always wanted the same thing, anyway -- the best life for DS1.

At the end of our time, the doctor appointed himself our consultant, and gave us some resources to look into. He only wants to see DS1 a few times a year to monitor his progress, but doesn't feel as if he needs to implement some big complicated plan: he agrees with what we're doing now, with only a few additions.

It's such a relief, on so many levels. I'm feeling so positive about this that part of me is countering with skepticism: Am I reacting this way, agreeing with everything, because this doctor is telling me what I want to hear? But I know that's not it at all, because the doctor most assuredly told us that DS1 does have some delays (not to the extent of needing formal therapy, and most likely not to the extent that insurance would cover anything we decide to do for them), and that he would need a lot of help and protection navigating through middle school and junior high. That's not easy to hear, over and over: you've got to protect him, but I can see that it's true. But I'm still very relieved and optimistic about the future: we know better now where the troubles are, or where they could be, and we are working on a plan to address them.

smart ... discomfited

My co-facilitator G and I were interviewed -- and photographed -- yesterday by the East Valley Tribune, for a story about our upcoming Arizona Thyroid Cancer Survivors' Workshop.

I'm thrilled that we're getting such great newspaper coverage -- really, I can't express how important it is for us to get the word out, and to encourage thyroid cancer survivors and caregivers to come to the workshop. This kind of newspaper story, with photos and everything, is simply tremendous for increasing our visibility. (When the reporter emailed us, asking to set up the interview, I literally did the Happy Dance.)

And I am happy, but I'm also discomfited -- self-conscious and a little bit embarrassed -- because this is not about me, and I don't want it to seem that way for even a second.

When I first contacted the paper asking if they would do a story, the reporter told me that they get tons of requests like this, and that we would need to "put a face on it". In other words, we had to come up with a story to wrap around the workshop announcement, because the fact that we're having the workshop isn't enough of a story on its own. (Personally, the fact that thyroid cancer has the fastest increasing number of cancer diagnoses for women would seem to be something of a hook, but I can see that it's not much to hang an entire story on.)

So we talked over how we should approach this, since G had already done an interview with another thyca survivor for the other paper, and she thought it would be better if we took a different approach. So the "face" that we decided to put on the hook was mine. I wrote an email outlining my story: from sick mom to support group participant to facilitator, and hey look, now we've got this workshop going on...

It's all true, of course, and I'm glad I sent it, because that email, and my follow-up calls, in which I tried to convey our dedication to this cause without being a nag, were enough to get us the interview. (Yay!)

I was very relieved when the reporter asked to interview both of us -- it wouldn't be about me! (whew) But then G totally threw me when she said, right off the bat, I asked Joan to facilitate with me because she's smart. (paraphrasing there, but that's the gist.)

Yikes! Here's the thing: I am smart, but I'm also dumb about a lot of things, naive almost. I've been at home with the kids so long and I'm so out of practice navigating in professional situations that I sometimes say things that I really shouldn't, simply because I don't consider what all the unintended consequences might be. It's bizarre, really, because I constantly filter and tailor information so that it's appropriate for the kids, but for some reason when I'm with adults I figure that I don't have to do that kind of thing at all, which is ridiculous on its face.

Oh, well. G meant that I have a good handle on the ins and outs of thyca, and that I can definitely agree with. Of course I can't imagine ever matching her knowledge and experience, because she is quite simply amazing. She knows everyone and everything.

I don't exactly know why I winced when G said I was smart. I am smart, it shouldn't bother me to have other people say so, right? But it goes back to that same idea: this is not about me! Don't make it about me!

I realize I have absolutely no control over how the reporter puts this story together, and that's fine. Realistically, whatever she writes will be at least a little about me, otherwise why do the interview? That's OK. I'm smart enough to recognize that significant newspaper coverage of the workshop is much more important than any insecurities plaguing me.

February's column

Unforeseen circumstances led to a delay in the publishing of this month's Low Carb Luxury online magazine, but it's out there now, including my recipe for an indulgent brie snack.

From the column: Sometimes, you want something really delicious, that's neither chocolate nor difficult to assemble. This snack fits the bill exactly.

Arizona Thyroid Cancer Survivors' Workshop

If you live in or near Arizona, and have thyroid cancer, or have questions about caring for thyroid cancer patients, please come to the first Arizona Thyroid Cancer Survivors' Workshop on Saturday, March 3, presented by ThyCa Phoenix, in cooperation with the Virginia G. Piper Cancer Center at Scottsdale HealthCare in Scottsdale, AZ.

With less than 2 weeks to go until the workshop, we're in the final stages of assembling all our workshop materials, which includes trying to round up our presenters' PowerPoint presentations. There's an astonishing number of ducks which need to be lined up for this event, which dwarfs any other that I have helped organize.

I have this feeling that I'm just holding my breath until it's over. I know, no one can hold her breath for two weeks but I think that gives the sense of it: deep breath, dive in, keep going until it's over.

We have a tremendous program. It will be a really splendid day.

here, have a cookie

I'm sure it's just coincidence, but I'm happy anyway: Blogger's cookies are finally working, so I don't have to log in every single time I launch a browser session.

And only mere days after I filled out a Blogger questionnaire complaining at some length about how annoying it was! Maybe I should've complained sooner, but "cookies not working" oughtn't be high on anoyone's critical bug fix list.

Life goes on, some interesting things that I find myself unwilling to write about here. That is interesting, and different. But I'm employed now, and I'm also involved in a public volunteer effort, and so that means certain topics are automatically off-limits. For some topics it's a matter of common sense, and for others, simple respect. It's difficult trying to balance the personal with the public/professional, and I expect it will take a while for me to figure it out to my satisfaction. For now, I'd rather err on the too-taciturn side than say something I will later regret.

no use in crying

DS2 turned six today, and his day was pretty much stellar, except for a couple of melt-downs in school when things didn't go exactly, perfectly the way he wanted them to. He recovered, loved his presents and his brownie cake and ice cream, and is looking forward to his friends-party on Friday.

The birthday made today complicated, because tomorrow is Valentine's Day, and we just were not ready. For some reason all the teachers waited for the last minute to say what the deal was with V-Day this year, and I was irrationally hoping I wouldn't have to deal with it. It's ridiculous, but I do it because it's expected.

DS1 can't get past the ridiculous aspect, and this is where his differences manifest. He has never been into crafts of any kind -- decorating a V-Day box is sheer torture to him. He hates to write and simply writing his name on twenty-odd Valentine cards amounts to even worse torture. Combine the prospect of having to do both with an incomprehensible (to him) math homework assignment and a very late dinner, and you get a major meltdown, the worst we've had in years. I can't remember the last time he got so upset -- and remained so unconsolable -- and perhaps that's why it didn't occur to me that a big part of the problem is that he was hungry.

So of course now I feel like an idiot for forgetting one of the most basic rules of DS1-management, which is to make sure the kid has eaten if he starts losing it.

In the end, he did stay up late to finish his other homework, but by then it was OK because he ate a good dinner and felt much better. He even enjoyed having some of DS2's brownie cake and ice cream, and watching the peewee open his presents.

Eventually I approached him, and in my best neutral voice, asked him if it would be OK with him, would he like it if I made a Valentine box for him, and if I did up the Valentine cards for his class. I couldn't suggest this earlier because he went on and on about how much he hates V-Day, it's all crap and really stupid, etc etc etc. The kid has a point, I thought, and I told him: I agree with you, and I told him that he didn't have to do Valentines this year. Then I told him that it's rude to refuse gifts, so that when the other kids gave him Valentines, he needed to be gracious about that, anyway.

It was a very difficult conversation. The hardest thing as a parent is seeing your children suffer and not being able to do anything about it. Even though he's huge I had him sitting in my lap. It's good that he's so tall because he couldn't see that few seconds of crying I did, holding him and feeling totally useless because he just doesn't like what most kids like, and there's nothing I can do about it. (Maybe there will be someday, but today, no.)

We did finally recover, with dinner and with time. I found a box I covered with plain white paper, and wrote his name in red on the lid. And I put together his Valentine cards and signed his name for him. In previous years I would never have done such a thing -- he needs to do it himself! I would've said. This year, with the big uproar and everything, it just wasn't going to happen. I really do want him to participate, it's important for him not to isolate himself from the class culture. And so I did it, and his relief at not having to do it himself was palpable.

Trying to do a post-mortem on this day I can see so many mistakes I made. I'm trying not to be negative so I'm balancing those with the good things I did, but I think overall it was horrid. Maybe that's just my own exhaustion talking, and my feeling of being pulled in sixteen different directions for all my waking hours today.

One thing's for sure: if I'm going to sub I have to get more sleep. The lack of sleep lately is killing me... or maybe it's my having gone off my night-time pain meds, and what sleep I'm getting isn't very good. I can't even justify going off them, I just decided to stop, and I don't think that was a good decision. Everything's killing me and my hands are non-functional, so it's back on them tonight, with the hope that tomorrow will be better.

talk talk talk

Spent the day on the phone, or felt like it. Setting up appointments, figuring out how certain things are going to work, whatever.

It was a productive day, I suppose: had my blood drawn (only 3 sticks! w00t!) post office, grocery store, set up a birthday party, RSVP'd to another, was interviewed, read and wrote chatty emails...

Some days, I think there have been too many words.

TV was underwhelming this evening: Lost, meh. Lots of stuff happened, but I notice, once again, that it's simultaneously too much talk and too little actual content. Makes me crazy, or would, if I let it.

I'm suspended somewhere between disbelief and irritation over Friday Night Lights, because, frankly, in the second round of the playoffs, in a town as football-crazy as Dillon, TX, there is no way that all those black players are going to walk out of practice no matter what dumber than dumb comments the assistant coach makes. Not. Going. To. Happen.

Aside from that, the storyline with the powderpuff football game was adorable. My heart completed melted watching the Coach actually getting to coach his daughter. And poor Tami, thinking that a "dialog" would be productive! She's so sweet and naive... and so, so stupid. How could she not know it would degenerate into a huge mess? That, however was a misstep that I could buy, unlike the racial-tension-crap they're foisting on us in the main plotline.

These boys, most of them, have worked for and with this coach for years, they know him -- and this is how they react? What kind of statement are they making here? What possible good is going to come of this? If the black kids won't play, then the white ones will -- and then what? The black kids look like spoiled brats to a lot of people, except the few who appreciate that they're standing on some supposed principal. Well, how about some honest conversation before taking such an extreme stance, huh Smash? When Mac shut Smash down, Smash could've gone to Taylor with his grievances, but chose not to -- why is that, again?

It's completely bogus that Smash leads the black members of the team in a walk-out just so he can get into Waverly's pants. Smash was right to call her racist, in insisting on different behavior from blacks and whites in the same situation. Shut up, Waverly! Too much talk, too much indignation, not enough thinking-through of the consequences.

Also: yes, it sucked that Mama Smash's loan approval was pulled, but she herself admitted that they would only be able to afford that new house if she never got sick or no one ever had an accident. That's exactly the kind of loan a bank doesn't want to give to anyone. With a Mama so smart I have to wonder whether the various traumas that football has visited upon Smash's head have rendered him completely stupid (the steroid use seems to be evidence of this), or whether he's just an unfortunate loser in the brains category of the genetic lottery. I know, I'm being very harsh, but the kid has just about destroyed the one thing that he had previously held most dear: his team. It's just ugly.

On the upside, the preview for next week's episode was brilliant, promising lots of Coach-n-Tami. Yay!

The Departed, part 2: the nagging questions

Why wasn't 344 Wash locked up? Open and abandoned as it was, it should've been a) stripped clean and b) a haven for the homeless and the drug dealers and users. Right?

And why was there still electricity in an otherwise abandoned building? Yes, I get how the elevator was used to heighten the tension, but the thing shouldn't have been working at all.

(If Asperger's Syndrome is inheritable, I'm probably more responsible for my son's condition than my husband is. He's normal, always has been, God bless him. I sometimes wonder what that's like.)

long, tough day

I should note that it started out as well as could be expected: I was tired and icky-feeling, the after-effects of my indulging the attack of the munchies that hit around 12:30AM. It's like I have some inflexible rule that insists that all junk food must be disposed of (as in: eaten) as soon as possible. How else to explain the amount of Doritos I ate last night, when I shouldn't have been eating anything at all. I had a food hangover this morning!

Got the kids off to school without incident, then did some errands with Mom, finding a nice bobble yarn on sale at Michael's for Mom's next knitting project, a little shrug for DD. Got home, put away the groceries, had a quick lunch and then it was off to school.

DH met me there -- I'm so glad he was able to come -- to hear the results of the testing recently done on DS1. Review, review, review: above average in many areas, noted certain areas of social difficulties. Recommendations? Mostly things we are doing anyway, have been doing for years. The shocker was the school's psychologist's declaration: He has Asperger's. Not, as we had known for years, Asperger's tendencies, no. She feels he's got the full-blown syndrome.

Of course this was something of a blow, even though all the staff assured us that DS1 is a great kid and doing very well. That's the thing, he really is doing well, and this year especially seems to have cleared some major hurdle in socialization on top of being able to handle all of his other responsibilities. I wasn't worried before I went in there. I was feeling confident. Now I'm wondering if had any business feeling confident, but I'm not going to second-guess myself here. I'm looking at my son and what he is capable of, and what his mood is, and how much he achieves, and I know that he does not meet many of the criteria for a clinical diagnosis of Asperger's Syndrome.

On the other hand, I know that he does meet some of them. Reading through various articles, so many times the "yes, that's him" recognition bell rang -- but at the same time, the realization that his symptoms are very mild, and that the problems most AS kids have, he does not have...

Still, our plan is to have him thoroughly tested by an independent doctor to get a diagnosis we can trust, and then figure out where to go from there. DH and I had been talking about physical therapy for his gait problems. (He walks with a pronounced limp these days, but always insists "It's just the way I walk!") It turns out that an odd gait is a hallmark of AS. Who knew? An official, on-the-record diagnosis will have both good and bad effects (I don't want my kid labeled!), but it's important to have it done, regardless.

After leaving the school, I went to see my new endo, who was fine but a bit hurried and harried. She did a great exam and has me going for fasting bloodwork asap, then I'm back to her office for an ultrasound at the end of February. I'm nervous about getting back into the cancer routine again. I don't want to be, but I don't seem to be able to help it. I should console myself with my slight pudginess; whenever I've had cancer, I've been quite skinny. Is that a reliable indicator?

On the way home, I got stuck in traffic on the 101, what a nightmare -- and also in a difficult cell call to DH, who expressed regret that we hadn't a diagnosis for DS1 sooner. That bothered me because I feel as if from the time he was about a year and a half old I have been trying to figure this kid out and find ways to help him navigate our world -- he is in our world, but not of it, it seems -- and many is the time when I've tried to get DH to read an article or consider a new technique for dealing with certain situations only to get rebuffed with a dismissive comment about "pop psychology bs" or something like that. In a word, the conversation re-opened a lot of old wounds.

But, and this was pretty major, instead of both of us getting all pissy and hanging up, I said something on the order of, "This is not the conversation I wanted to have," and he replied, "Neither did I," and we both stepped away from the past and looked to the future and all of sudden, it was OK.

Then I got home and found out that DD had accidentally locked Cooper in her bedroom this morning, and he'd used various parts of her room as a litter box. Poor kitty! Also, poor me, having to scrub cat poop off stuffed animals before washing them in hot water with triple-strength solutions of OxyClean. Not forgetting, either, the bedding, including the comforter and mattress pad... and of course I'd just put clean sheets on last Friday. Ah, well.

After handling all that, I decided to clean up DD's room so it's not a kitten-hazard, so she can leave her door open when she's not home. This is the second time a kitten has been trapped in there, leaving me with nasty-smelling laundry. Who needs it? The effort was 95% me and 5% DD, but the room looks great now and I don't believe there's anything out that a kitten could strangle itself on. I hope.

I'm exhausted. At least House was decent this week. Not great, but not the mess that last week's episode was. Tomorrow will be better.

big day tomorrow

Two appointments.

The first is the "multidisciplinary team evaluation results" (or somesuch gobbledygook) discussion of DS1's recent psych/developmental tests at school. If they say anything other than "He's a boy, he'll grow out of it," I'll be 1) amazed and 2) annoyed. Most likely. I keep brushing that chip off my shoulder but somehow it keeps resurfacing there. We'll see how that goes.

Directly after that, I motor on up to Scottsdale to meet my new endocrinologist. She will be following my thyroid cancer for me locally, so I don't have to fly to Houston to get an ultrasound and some bloodwork done. This meeting, I'm nervous about. What tests will she order, and when? What will the results be? Things have been feeling more "lumpy" than usual, and I have been having problems swallowing, but I did just have strep throat and I do still have the remnants of a cold. Nothing to worry about, right?

Over the next few weeks, I have DS2's birthday and the Arizona Thyroid Cancer Survivors' Worskhop; in all honesty I'm still not recovered yet from DS1's birthday/sleepover (a couple of weeks ago) and his Confirmation (this past Saturday). I have a sense of lurching from one event to the next, scrambling each time to put everything together properly. So far, so good... the problem is in keeping it up.

The Departed

Went with DH to see The Departed, and mostly thoroughly enjoyed it.

(spoiler warning!)





Everybody dies! Nearly always with a bullet through the brain, too. Very grim.

No, wait. Not everyone dies...there are two guys left. One who knows everything, and one who thought he knew everything and didn't know anything at all. The two guys are played by Alec Baldwin and Mark Wahlberg, but I'm not going to say which is which.

What didn't I like? Everybody dies, mostly; I'm enough of a romantic that I wanted the good guy to bring down the bad guys and get the girl. Of course the movie is fine the way it is, it's just that I'm a softy that way.

Also, the final shot was totally cheesy.

Other than that, brilliant, and for me nostalgic, since I grew up in similar neighborhoods, although they weren't that bad when I lived there, more than 30 years ago. Between all the swearing and the thick Boston accents in this movie, I'm going to need to pay close attention to how I talk the next few days.

DiCaprio, Damon, Sheen, Baldwin -- all fabulous, as was Vera Farmiga. Jack Nicholson chewed up a lot of scenery, some of it in a good way, but mostly, as they say, OTT. That's Jack for ya. Why just act when you can, you know, over-act? DiCaprio, on the other hand, was note-perfect, and I admit to admiring his more recent choice of roles along with his performances.



The movie is a vivid reminder of just how God-awful Boston's City Hall Plaza is, how grungy the trains are, and how casual racism persists in many neighborhoods. Of course it's all amped up for the film, but I still had occasional flashes of "I know guys like that."

It's up for several Academy Awards. It should net Scorsese his coveted Best Director (he's due) and William Monahan the Best Adapted Screenplay. I'll just have to wait and see (or perhaps follow someone else's live blogging of the event), because there's no way I could stand to watch Ellen Degeneres for 3+ hours hosting the show.

well, that explains it

I took my last dose of Biaxin XL (clarithromycin) for the strep throat; the Z-pack I started off with was completely ineffective in alleviating my symptoms.

I would say I'm feeling better -- I am, strep symptoms-wise -- but I'm really not. I've been feeling very hyper (as in, hyperthyroid), even though I've actually lowered my meds by a smidge to see if I can get rid of an annoying twitch (check out the comment thread!) in my lower right eyelid. It is apparently not visible to anyone else, but it happens frequently so it's hard to ignore, and I would like it to stop. So far no change with the eyelid, and if anything I'd expect to be feeling hypo, but I'm not.

In addition to feeling hyper, I've been obsessing about stupid things, like the recent Top Chef finale. There was really no reason to stay up past 2AM reading the entire discussion forum over on TWoP, especially since I don't post at all on TWoP anymore since they suspended my account for being too political in a discussion of Lost.

So that was one really stupid late night, and right now is another. I broke a serving platter today, part of a chip-and-dip set that DH and I had received as a wedding gift from our best man and maid of honor. It seems silly to call it a chip-and-dip set; it was a large carved Bill Campbell piece, and truly beautiful. We've been married for twelve years now, so it seems unlikely that I'll be able to replace it. I did see another platter that should do the trick, though.

When I sat down at the computer this evening, I didn't even know the name of the artist who created the piece and began by searching for "art deco chip and dip". That brought me somehow eventually to Majolica pottery which led me finally to Bill Campbell. Once I found a photo of the mark on the bottom, I compared it to the one on the still-intact bowl; they matched. Now I've checked every single Google and Yahoo link, plus nearly all the links listed in the state-by-state gallery guide on the Campbell website. Tomorrow I'll call around to a few local galleries to see if they carry any Campbell, and then maybe I'll go shopping...

You see what I mean? I can't seem to let go of anything. You should have heard the conversation that DH and I had this evening, over the correct way to pronounce "caramel." He says "car-a-mel", I say -- like everyone else in Boston -- "carmel", or, more precisely, "cahml". It is, apparently, a regional thing, but the conversation went on way too long. (Much like this blog post)

So, after satisfying myself that an exact replacement platter is not available, I remembered the other thing that I wanted to look up, which was the side effects of this drug. Here's the paragraph that leaped out at me, emphasis added:

Transient CNS events including anxiety, behavioral changes, confusional states, convulsions, depersonalization, disorientation, hallucinations, insomnia, manic behavior, nightmares, psychosis, tinnitus, tremor, and vertigo have been reported during post-marketing surveillance. Events usually resolve with discontinuation of the drug.

Great, huh?

The best part is that usually usage up there, talking about the reversibility of the side effects. Please, let me be one of the ones whose side effects dissipate... quickly!

happens every time

Start at a new school, get sick.

Tuesday night I came down with strep throat for the first time since I was in college. I can't remember the last time I had a fever that wasn't the typical mild post-op elevation of temperature, the kind that doesn't bother anyone.

Tuesday night, I had chills so bad my teeth were chattering, and I was torn between letting them knock (painful) and trying to clench them together so they didn't (also painful, and likely to trigger my TMD again.) In the end I just took both Aleve and then Tylenol a couple of hours later, and went to bed. And woke up with a fever on Wednesday.

I felt terrible all over and didn't notice much of a sore throat, but I decided to look at my throat anyway, hoping it would be strep so I could get treatment -- and relief -- right away. I was shocked by how red my throat was! So I hauled my poor sick self off to the doctors, and they did the rapid strep and it came back positive.

Now I'm on the Z-pack and I do feel a lot better. The fever has dissipated completely but my throat is still very painful. I'm still astounded by how much my throat hurts. I hope it stops soon. (I just realized it's killing me right now because my meds have worn off, but I'll hold off taking more until I'm going to bed.)

So I've been home from work these past two days, but not exactly idle, even though I've been feeling icky. Both days Mom and I did errands to get ready for DS1's birthday party tomorrow; today I brought the kids to the Y and waited during DD's dance class. I drafted two columns while I was waiting -- I was running the nutrition numbers Tuesday night when the strep descended on me -- and then I wrote up both columns after dinner. Now I'm off the hook until April, which is good because I don't want to have to be thinking about a column while we're wrapping up the prep work for the thyroid cancer workshop on March 3... which has also been occupying my time, and my thoughts, as the day creeps ever closer. More on that, later.

teaching is not parenting

(Last day of the four-day week of my first substitute teaching stint)

It rained today, and that made it a very difficult day at school.

The day is structured so that the kids have significant blocks of free time after intense periods of work, so that they can recharge and run around a bit after sitting still and thinking so hard. The key part of that is the running around, which they can't do when it's pouring outside.

Importantly, when the kids have recess, the teachers get a break, also. Today the only break I got was the 15 minutes I grabbed to wolf down my lunch. I spent most of the school day in some combination of thirsty, cold, and having to pee. Today should have been a three cups of tea day, but I only managed one. And when you don't get breaks and the kids are in a perpetual state of fluster, it's hard to find a chance to get to the bathroom. Without that time for me to recharge my own batteries, I wasn't able to keep on top of the class as well as I had earlier in the week. At any given time having six kids asking you for something is the type of thing that can make your head explode -- that didn't happen, but there were a few times when so many were asking for something at once that at one point I said "yes" to too many people, and so we had half the class working out in the hall, when usually only 3 groups of 2 or 3 are allowed to go! Whoops.

By the end of the day, I pretty much gave up trying to keep them quiet. On a normal day, when they've finished all their work they can have recess until their bus leaves or their parents come to pick them up. Consequently they're geared to finishing stuff up at the end of the day, and that's what they did today. But 2:30 and no work pending on a rainy day is a bit of a disaster, with the class breaking down into groups wanting to play different games, and the limited classroom real estate threatening to turn into a battleground. They left the room a mess and I was too exhausted to make them stay and clean it up.

I felt pretty down by the time I left, because it ended on such a chaotic note. But in looking back over the week I think it's stupid to be disappointed. We covered all of the material that the teacher had left for them to do, and then some. It seemed something strange happened every day, but there were no major crises.

I'm still trying to figure out the best way to handle the Class Wit and the Class Lawyer types. You know, the kids who are very smart and very quick with the funny quip, and will argue with everything you say six ways till Sunday. I've been struggling with this all week, and I think I know why. With my own kids, I really appreciate their jokes and I respect their reasoning ability. So I'm conditioned to respond positively to this kind of behavior, as long as it's respectful.

However, making a joke at the family dinner, or arguing with me about something one-on-one, are very different from doing these things in the classroom. In the classroom, they're a disruption, and they steal time away from everyone. Obviously the solutions are 1) to cut off any response to the witty remarks immediately and 2) to not engage in any kind of back-and-forth with the lawyer types. Knowing this and being able to do this consistently are unfortunately not the same! Practice will help.

After school it took a conscious effort for me to get out of teacher mode and not get all grouchy when the kids were making jokes at dinner. It's hard to switch it off once I get into that mindset, and Lord knows I don't want to squash the fun out of my kids.

This is going to be very interesting, I can tell. Even today, which was a hard day, was still satisfying. My disappointment comes from wanting to do a better job, and be more effective at keeping the classroom at an even keel. I have to remember that for the most part we were on task, and we were certainly on task enough to finish them all; that's huge. And it's really cool that I was comfortable with all the class materials -- I didn't just say, "Open to page X and start reading," we had actual lessons. I taught. That's totally cool.

In spite of the bad day and hard moments, I'm officially declaring success.

the importance of visual aids

What I learned substitute teaching, day 3...

Today was in some ways better -- I know all the kids' names now -- and in some ways more difficult, since the kids know me better, also, and somehow concluded that it was OK to interrupt me every 3.5 seconds.

Eventually I realized that something must be done about that, and I drew an empty box on the board. We had about 5 minutes of material to get through, and every time someone interrupted me or spoke out of turn, I made a tally mark in the box.

These kids are not stupid. I admit I took some pleasure at seeing the discomfort and near fear on some faces: What are those marks for? What are you going to do when the box is full?

I explained I didn't know yet, that the purpose of the box was just to show them how often they interrupted me. By the time we reached the end of the material I wanted to cover, there were 22 tally marks, but the last 10 or so were made by one kid who tried his hardest to get kicked out of class all afternoon. (Dealing with that situation made the day seem very long.)

So now I feel I have a pretty good handle on this group of kids, and of course tomorrow is my last day with them. But that's OK, because all of this experience is invaluable.

By the end of the day my voice was giving out, and my feet were killing me. In spite of that, though, I'm loving this, way more than I expected to. It's pretty awesome to have a job that I really love. I can't say I've ever had one before, at least not one that earned any money.

what I've learned about substitute teaching...

Fifth grade edition. Two days down, two days to go.

Fifth graders are interesting. They are, for the most part, autonomous, and can do their work with little or no supervision. The reality is that they will do their work about 60% of the time, and would easily spend the remaining 40% of the time chatting and otherwise goofing around. I don't think this is particular to this class, because I saw exactly the same behavior in the other fifth grade class today when we had a combined class period. I am astounded by how much energy they spend trying to get out of doing their work.

But I digress. Here are the high points:

1. Be decisive. Even if you make the wrong decision, any sign of wishy-washiness will immediately be exploited. If they peg you as a softy, you're toast.

2. Don't smile. This was the advice given to me by one of the other subs at the school, and with this particular age group, it's imperative. Smiles are interpreted as signs of friendliness. I am not there to become a friend. I'm there to make sure they get their work done.

3. If they don't have enough work to do, they'll act up. This afternoon I took away "free" quiet study time because they were neither quiet nor studying, and made them copy out their times tables for 10s, 11s, and 12s. The benefits (to them) of this became obvious when several began asking "What's 12 times 11?" My response: Figure it out. You're supposed to know this stuff already. Plus, the hoped-for result of a quieter classroom was attained, at least for a little while.

4. Impose consequences sooner rather than later. Day 1, I resisted imposing consequences for all the chattiness. Day 2, the class had already lost 5 minutes of recess by 9 o'clock. They were stunned: Did we just lose 5 minutes!? Me: Yes. Them: Can we get it back? Me: No. (Lest you think I am a complete dragon lady, I had already shushed them 3 times, and warned them if I had to shush them again they'd lose that 5 minutes. It's remarkable how quickly a classroom with 27 5th-graders can go from quiet to noisy.)

During reading, the two kids that were fooling around the most got sent out into the hallway to finish reading on their own, some three minutes after I had told them to settle down. (If it had been 10 minutes, I might have gone with another warning; at that point, though, it was obvious the first warning had been meaningless, so why waste another one?)

5. Avoid choosing students via the hand-raising method. Picking a reader or someone to answer a question can be difficult if you don't know the kids' names, so use whatever system the teacher has set up for random selection (we used popsicle sticks with the kids' names on them -- choose a stick, there's the next kid to read), or start at one row or table and proceed from kid to kid.

6. If they think they're finished with an assignment and want to turn it in, they're done, regardless of what's on the paper. I know some of the papers that have been turned in don't represent these kids' best work, but that's their choice, and they'll have to live with the consequences. Contrast this to my philosophy regarding my own children's homework: if it's poorly done, I'll ask them, Is this the best you can do? and give them a chance to notice their mistakes and correct them. But they're my kids, and it's homework.

7. Deny the attention-seekers an audience. In every class, there will be one (or two, or three) kids who dramatize every tiny thing. Usually they're very entertaining. They're also distracting, and often disrespectful, flashing wide innocent eyes as they proclaim I wasn't doing anything!, which is precisely the problem. Nip any such performances in the bud. Sending these kids to work solo out in the hallway is tantamount to banishment to them, hence, it works.

8. Separate the kids who are too chummy. Sometimes, you have to break up the friends or the work isn't going to get done.

9. When covering class material, focus. It's easy to get led far afield from the topic at hand. We were discussing how the Spanish brought slaves from Africa to work their colonies there after many Indian slaves died, and all of a sudden we were talking about the economics of European land ownership. Yes, it was an interesting discussion and the kids probably learned something, but it was tangential to the topic at hand. Unfortunately at this age the kids will fixate on some exotic detail, and pick that out as the most important item of information to remember. Their intellectual sorting and prioritizing abilities are still developing, so if you throw in a lot of extraneous materials, it isn't really doing them any good.

I explained to the class today something I've told my own kids dozens of times: I can't make you do anything -- each of us is responsible for our own behavior -- but I can make your life pretty miserable if you don't do what I ask. There was some resistance to this idea of self-control and personal responsibility, because "It's not my fault" is part of the daily vocabularly of a few of these kids, along with a variety of other excuses. I universally dismiss such excuses, and encourage the kids to move on to the tasks at hand. This is crucial to avoid getting bogged down into a discussion assigning blame, etc. Pass! There's no point. Just get on with the work!

I told some stories at dinner tonight. DS1 told me: Mom, you're great as a mom, but you're scary as a teacher.

That's exactly what I was aiming for.

milestones

DS1 had his first sleepover this past Saturday, and had a fantastic time. I was surprised by the amount of anxiety I managed to sustain over the time he was gone.

I have a problem, generally and chronically, with what I call "negative ideation" -- I'm not sure what the technical term would be -- but basically my imagination wanders down every possible horrible path, constantly. I have to, for example, remind myself that of course my daughter isn't going to smash open her head if she slips and falls on the tile, running around in stocking feet. But that's the kind of scenario that flashes through my brain at nearly every possible opportunity -- whether it's the milk cup upending, a glass jar smashing, or a child falling, these scenarios usually involve 1) large messes and 2) great personal injury. I cope by using short phrases to reign in the kids: That's not safe, and also: I worry. If I have to be a little crazy like this, I figure the least I can do is not nag them about it.

Anyway, the boy had a great time and now we're planning a sleepover for his birthday party in a couple of weeks.

In other news, DS2 lost one of his two front teeth, and it's taking all of my willpower not to mock him constantly for his new lisp.

Look everyone! No tooth!
Last but not least, Mom arrived today, and seems much the same as ever, perhaps a little more unsteady on her feet. It feels very comfy having her here. I'm so glad she got away from NE before she had to deal with any snow.

Oh, yeah... I start substitute teaching tomorrow.

go with it

I'm having second thoughts about this substitute teaching thing before I've ever set foot in a classroom as a sub. I met this morning with the teacher I'll be subbing for, and she has most excellently arranged for everything during her absence. Earlier, that seemed like a really good thing; my stated substitute teacher philosophy is, "I'm here to maintain the status quo."

I'm not subbing to do my own thing, I'm subbing to see how well I stand up to the classroom environment. So I won't be taking over any classrooms or leading any classes on wild goose chases, although far-ranging discussions are still possible.

But just now it popped into my head how confining it may feel to have to stick to someone else's schedule, all the time. Well, at least unil the end of the school day.

That may be my biggest stumbling block, right there. I really like not being bossed around, and schools are extremely structured environments. It's going to take some getting used to, but I'll go with it.

don't say it, don't even think it: what not to say to your thyca patient

Medblogger Life (and death) posts about a thyroid cancer patient, and begins:

"If I had to pick a cancer to have, I'd pick thyroid cancer."
That's what I tell my patients...

My reply:
Speaking as a thyroid cancer patient, I can tell you that I cringe every time I hear that "If I had to pick a cancer..." line. No one would ever, ever choose cancer, and your saying so is patronizing and annoying. Your patients may not appear to be annoyed when you say this, but that's because they're still in shock from hearing the diagnosis of cancer, and they've still got that word, CANCER, echoing in their brains and they're trying to figure out what's going to happen them, etc. Take my word for it, they'll be irritated later.

Thyroid cancer is not the cancer you'd choose, and it's not a good cancer, either. It is often a manageable, treatable cancer, and the management and treatment options are the good things, not the cancer.

You are correct in that, for the vast majority of patients, thyroid cancer is a die with cancer rather than a die from cancer, but it's still cancer, and it is a cancer that we patients must confront every single day of our lives, post-thyroidectomy. Can you name another cancer that forces its patients to take suppressive chemotherapy every day for the rest of their lives, or they'll die? Our thyroid meds do double duty, providing us the necessary thyroid hormones our absent thyroids would produce, and also keeping our thyroid stimulating hormone very, very low to help prevent the growth of any remaining cancer cells. We have to take this medication every day without fail; we cannot survive without our thyroid hormone supplements. And if our dosage is incorrect or we take it incorrectly, we may face a recurrence that could otherwise have been avoided.

That's not to say that thyroid cancer patients are doomed to a miserable existence. I'm 27 months from diagnosis, and 15 months from my second surgery, which involved four neck dissection procedures. I'd say it took about six to eight months after my diagnosis to get my medication levels correct, and that was rough. Having to go on the low iodine diet prior to follow-up scans is tedious and, because it's easy to make a mistake that can invalidate the scan, nerve-wracking. Day-to-day, I have an active, full life with family and friends and work. But I still have cancer, and my tumor markers are hovering in a gray area that means I have to go for follow-up every few months, so I never get to not-think about it for very long. And even on days when I don't have to think about, I still have to take those meds.

My 8-year-old daughter asked me when I could stop taking my meds. Her experience with medication is limited to analgesics and the occasional antibiotic for strep throat or an ear infection, all of which are limited in time. I told her, "When I'm dead," and she was startled. I had to explain to her that I have to take them every day, for the rest of my life.

I'm OK with it now, but the idea does require some mental adjustment. I urge you not to continue to downplay the significant impact that a thyroid cancer diagnosis will have on your patients' lives.

I also want to apologize if I'm giving the impression that I think you don't care, because it's obvious that you do care, and care a lot. I'm just trying to counsel you against committing the most frequent insult to thyroid cancer patients' intelligence.

Friday Night Lights: more of the same... yay!

I can't keep up with everything that's going on these days, so my informal reviews of Friday Night Lights will be even more haphazard than before, and in fact may disappear altogether if I can't make time to write about it.

That most recent episode, "Nevermind," gives an exceptionally strong episode after a couple of relatively weak ones -- relative being the operative word there, since a "bad" episode of FNL towers above the typical televised dreck out there these days. (Although, to be sure, the quality-to-dreck ratio is increasing every year, miraculously.)

There was a lot of pain and frustration in this episode, and not typical teen angst crap, either: no whining about not getting to use the car or stay out late, but real pain -- a father who can't see how his indifference is destroying his son, and real frustration -- a young man who can't do anything he used to, and has to learn to deal with that.

But balancing all the pain were the brilliant scenes with Landry and Riggins, slogging through Of Mice and Men and forging some kind of bizarre friendship on route to a B- for Riggins' oral report.

The writers are once again trying to snow us with Lyla's purity and overall goodness, in spite of her previous ruthlessness in pursuing Riggins. Has she paid enough for her transgressions? It seems that Jason will forgive her. For what it's worth, I agree with Tami's statement, "There's no shame in forgiveness," up to a point, and that point is where the person you're forgiving continues to play you for a fool. I am starting to believe that Lyla is a headcase and needs serious psychological counseling, above the level that Tami could provide. I wonder when Jason will figure it out.

Matt Saracen just breaks my heart, and I wanted to smack his father upside the head and tell him to stop undercutting his son. Matt had a done a fine job leading the team through the season to date and yet his dad still has to come up with the confidence killing "Don't go folding under the pressure now, son," spew -- which, of course, pretty much crushed Matt.

I don't believe for a minute that Matt's going to Oklahoma, so we'll just have to see how that works out. I mean, what would Landry do without Saracen? Riggins will only tolerate so much of him, after all.

There was no Smash this week, and no Tyra; didn't miss 'em, but I'll be happy to see them when they return. The Taylors continue to be the most realistic married couple on television, and the tussle over bringing out that last trash can was hysterical -- but who ever just throws their trash in loose like that? That'll get you critters for sure. That's the kind of gaffe that's beneath this show, but since it happens very rarely I'm more than willing to give it a pass.

Will Coach Taylor make it to UT as QB coach? I think that depends on whether or not NBC greenlights another season. I was beyond psyched that NBC picked up the full season this year, but whether or not they'll fund another year for an under-performer in the ratings is questionable. I'm not sure how expensive this show is to produce -- no special effects, but a huge cast and lots of locations, so I'm guessing it's pricey, and of course that factors into the decision. If they can maintain this standard and finish out this season, telling one set of complete stories, I think they will have produced some of the best television, ever.

Obviously I hope they do get picked up for another season, or seasons. But I don't want that to happen if it means morphing the show into something it so far hasn't been: a teen high school drama. For now, I'm enjoying what we have.

let us our songs employ...

I noticed this Christmas season at Mass that the powers that be (or at least the powers that type up the song sheets we use each week) have changed the lyrics to "Joy to the World" from the traditional "let men their songs employ" to the active voice, and I'm sure it's just a coincidence, politically correct gender-neutral "let us our songs employ."

I like the idea of participating in the joyous chorus of the heavenly hosts singing the praises of Jesus's birth. But it rankles just a bit that they've tinkered with the lyric.

I won't even get into the discussion I had with DD, in which I had to insist that the use of the term "babe" in "What Child Is This" was not a typo.

her time

DH is in CT for his grandmother's funeral.

She was a charming, petite woman, and she lived to 99-and-one-half years old. It was her time to go. When I first met DH she had already fallen into that habit that older generations annoy younger ones with, the repeating of the favorite stories. I can't tell you how many times I heard about DH's letters from camp to his Gram, and how he spelled school "s-k-o-o-l."

I didn't see Gram all that often, so it was easy for me to be patient with her. I know for my in-laws, she was often a trial. In these past few years, Gram had obviously given up. She started using a wheelchair four or five years ago, simply because she didn't want to walk anymore. There was no reason for her to use the wheelchair, she just didn't want to try anymore. Her awareness would slip in and out, and I know the last few times we saw her, she recognized that we were somehow related, but she really didn't know who we were. That was in sharp contrast to the early days of my marriage, when we'd visit her with DS1 and she'd take us all around and introduce us to all her friends and the staff, saying how we'd come all the way from AZ to see her (which was, more or less, true). Her decline seemed gradual until it became abrupt, and then suddenly, she was gone. At least that's how it seemed from a distance.

DH took off Thursday morning; the services were Friday. He'll be home Sunday night, and I'm glad he's spending some time with parents and his brothers and their families now. There was no question of all of us going, the expense would've been crushing, and DS2 is just now feeling better after being sick for two weeks.

I know it's the right think for DH to be there, but I wish he were here, too. My mom finally got a diagnosis for her shortness of breath, and it was something completely unexpected: it's her kidneys. Here's one reference to shortness of breath and kidney-related illness which blatantly uses the words kidney failure. This question presciently asks the most important thing:am I going to die? The answer is vaguely hopeful, talking about dialysis and transplants. The thing is, my mother already has a DNR and I'm pretty sure she is not on board with the idea of dialysis. I'm slightly panicked that if Mom gets a serious diagnosis she'll just give up entirely and decide it's her time, too.

Of course I'm operating with only partial information here, and am probably jumping to all sorts of unnecessarily bad conclusions. Mom said her condition is "not life-threatening," but that is so the kind of thing she'd say so I wouldn't worry. This is, after all, the woman who came to my (put together in a week) wedding without mentioning that the very next day she was having a mass of pre-cancerous tissue removed from one of her breasts; she ended up getting a masectomy. She "didn't want to ruin [my] day." I was the only one of my siblings that didn't know; she forbade anyone else telling me. Of course I found out the next morning and stayed with my Dad and sister during Mom's surgery -- but she accomplished her goal, which was for me to enjoy my wedding and not worry about her until afterwards, which was an amazing gift, but also makes me feel like an idiot for scheduling a wedding so close to my Mom's surgery date... which I didn't know about!

Mom's funny, sometimes she's ready to throw in the towel -- she really misses Dad, living alone is difficult, her health is keeping her away from the travels she loves -- but other times, she's psyched about something, like her upcoming 80th birthday party, or traveling to China with one of my sisters-in-law. There's too much variability there for me to predict how this is going to go, and without knowing how serious her medical condition is, there's no point in predicting, anyway.

I'm just not ready for it to be her time. Not yet, not that I believe I ever will be ready. Maybe when she reaches the cusp of 100, it will be OK, the way it was with Gram. I don't know, I don't know. I just know her time should not be soon, and it certainly should not be now.

Spontaneous generation: DS2 told his kindergarden class about Gram's death. His teacher asked him how he felt about it, and he reasoned it out for himself: She didn't live here, recognizing that he didn't really know her, but she loved him. Then: I love her. I'm glad she's in heaven with Jesus.

wading into the maelstrom

Before the holidays, there were so many things going on I felt breathless. I thought, Let's just get through this, and then everything will settle down.

I was wrong. It's great to have cleared the decks of all the holiday stuff -- they were delightful, glad they're over -- but looking ahead, there's just as much to do, because somehow or other I've ended up with three jobs.

The oldest "job" is my column, which has been neglected lately. December's deadline for the January issue blew right by me, and I never did write a column last month. There were just too many real-world commitments, complicated by the illnesses of various children, and I wasn't disciplined enough to churn out a column. I have guilt, but not all that much, considering the pittance each column earns me.

The second job is the ThyCa facilitating business. The workshop planning continues apace, with letters and phone calls and all sorts of arrangements to make. These things seem much more like "real" work to me, rather than the goofing around in the kitchen and at the keyboard that the column often is (at least in the creative phase; I can recognize that the finished product is something to be proud of). Because this work feels more "real" it is tremendously satisfying. But before I can get too cocky about my abilities here an email will trickle in from a new patient with questions I have no idea how to answer -- yikes! I'm glad I'm the junior co-facilitator.

The third job will become a reality shortly; I will finally be making a little money when I start substitute teaching over at the kids' school. I didn't expect to be brought on as an employee, but I will be. I like that they'll take care of withholding and Social Security and all that. I'm not terrified -- yet. When my start date (looking like Jan 16 now, but may be sooner) draws closer, I will probably be paralyzed with fear. I've never done anything like this before. What an adventure!

Further adventures await me this week, as DH heads back to CT tomorrow for his grandmother's funeral. He'll be away until Sunday, leaving me to hold down the fort with the kiddos. (sigh) There was no point in all of us going, and it's right for him to be there. It's weird to be so conflicted: I want him to go, but I want him to stay here, too.

For now, the kids are all (finally) healthy, and we're getting back into the school groove. How weird to think that I'll be in the school groove soon, too.