I typed too soon about good breast cancer news

Cancer runs strong in my family. My mother had kidney cancer at age 60, her brother died of pancreatic cancer at 53, her mother died of ovarian cancer at 75 (though my grandmother, still mourning the loss of my grandfather the year before decided not to treat it so she could reunite with her love of a half century) and several of my grandmother's siblings died of cancer. I always thought I was the one with the ticking cancer time bomb. Turns out I was wrong (at least for now). The bomb was in my wife.

My 41 year old wife's breast cancer is Stage I. She had a lumpectomy two weeks ago and this week we read the pathology report that told us her lymph nodes were negative and her margins were clear. All good. But the pathology report had other information. The tumor itself, although small at 1.2 cm, was a high grade aggressive cancer which means there is a higher risk of relapse. Also, from the time of the initial biopsy just 4 weeks before surgery, the tumor had grown and was about to be on the move. Not good. However, this isn't the dark ages of the mid 20th century and I need to keep reminding myself of that.

Even without the results of her Oncocyte DX test my wife's oncologist is already looking to put her into a clinical trial that will put her in an aggressive chemotherapy regimen (once every 2 or 3 weeks for at least 4 1/2 months) because her Bloom-Richardson score was so high. The Bloom-Richardson score information is used for prognosis / risk of recurrence and scoring an 8 out of 9, which my wife did, means that the risk of recurrence is higher than someone whose tumor was a grade 2 or 3. Additionally, because the the tumor was hormone receptor positive for estrogen and progesterone she will be put into a medical  menopause so she can take inhibitors to take all the estrogen out of her  system (she can't take Tamoxifen due to potential blood clots). At least no more birth control.

I grew up in a home where my parents got sick while I was still young. I know how insecure that has made me and how I over worry about every little thing. When you become a parent, you hope you can learn from your history and not make the same mistakes your parents did. Unfortunately, this is one "mistake" (cells going rouge) that is out of our control. I worry that the cancer will come back, though I know I shouldn't waste my time on something I can't control. 

And then I still get angry at the unfairness of it all, especially when I see happy, healthy, older people. We are not 60 or even 50 when you realize something like this can happen. We are in our early 40s, the prime of life. We are still young. But now, suddenly, we are not. Forget about coming to the realization that we may not grow old together, I worry that she won't even see our children finish high school, especially our youngest who is only 7. And I feel sad not just for me and our children but for her too. Who plans to check out in the middle of the game?

I have had thoughts about life as a single parent but have decided to file that away if/until I need to think about them again as they are incredibly unfair to my wife (thoughts like I can always sell the house to pay for college if we are a one parent/one paycheck family when the time comes). And then I get mad at myself for thinking me, me, me and not her, her, her (although my me, me, me thoughts tend to revolve around the possibility of raising the children on my own, the thought of being with anyone else really does not feel possible). What is worse, is that I am really worrying about something that is, at worse, a few years off or, at best, may never occur or not occur for decades. It is as if I have forgotten how to live in the moment, doing normal things like enjoying life, saving for a new car or vacation (though my wife's illness is forcing me to reconsider my preference for saving and paying in cash over borrowing as who knows if we'll all still be here the day I can pay in full comes -- she wants a mini-van to replace her small passenger car, I'd buy it tomorrow except I really want to make sure she doesn't run out of sick time first).

Writing about this and seeing my thoughts on screen helps a bit. So will the therapist I will start seeing once the dust settles (still trying to decide if I see one on my own first or just go into family therapy with the children). Like most people, I can be a real jerk at times and this isn't helping. While I am trying my best to correct those bad habits, some so ingrained that I don't see them, such as yelling at my children as that was how I was raised -- everybody yelled in my neighborhood, it will take me time. And time may be running out.

Margins are clear and the lymph node was negative

It was a dark and stormy morning the other day in the Big Apple but, fortunately, that is no longer the mood here, though the clouds still remain on the horizon. Two months ago I barely understood that hearing the margins are clear and the lymph node was negative from a breast cancer surgeon was a good thing, but that is what my wife heard this morning. In plainer English my wife's breast cancer did not spread into her lymph nodes and the surgeon says he got all of the cancer and she doesn't need more surgery. Now she waits for the result of  the Oncocyte DX test (analyzes the activity of a group of genes that can affect how a cancer is likely to behave and respond to treatment, the higher the score, the more likely there will be a recurrence, meaning the benefits of chemotherapy outweigh the risks) and sees the oncologist to see if chemo is necessary (probably) or she can get away with just radiation. 

One troubling bit of information though. We examined her pathology report a bit more thoroughly after she returned home. Her Bloom-Richardson score was 8 out of 9 (details below). This information is used for prognosis / risk of recurrence and scoring an 8 means that the risk of recurrence is higher than someone whose tumor was grade 3, for instance. Also, from the time of the initial biopsy just 4 weeks before surgery, the tumor had grown and was about to be on the move. While it means that by catching it early we were incredibly lucky, this is not good. What this ultimately means is unclear. Short term, we see what the oncologist says. Long term, the outlook is unknown, but then that is the case for all of us. Still, it is one of those times where I wish I didn't have a cold, unemotional but logical skill set for work. Hopefully her oncologist can set our minds at ease when she starts planning out my wife's treatment plan.

To really put it in perspective, my wife has a co-worker, 40 (just a year younger than my wife), who is not as "fortunate."  This woman had her first mammogram a few weeks ago and her doctors discovered not only much more cancer than what my wife discovered, but that hers had already spread into very bad places. She hasn't even been staged yet but from what my wife said her outlook may be very grim -- the cancer may possibly already be in the chest and bones. Worse, she is a single mother, living paycheck to paycheck with young children and already out of sick time. So, from that angle, we are blessed (by whom I have no idea) to have gotten away with just a speed bump -- for now.

For now, we are focusing on the positive. As far as most of our friends and family knows, all is well and, for now, that is the truth. In the mean time, her next appointment at Sloan is not until January 2013, and then every 6 months until 2018. Nice to have long term plans. Hopefully we can keep them.

Stats from the pathology report:

• Histologic grade was 3 out of 3 possible (minimal or no tubule formation)
• Nuclear grade was 3  out of 3 possible (marked variation in size and shape)
• Mitotic Count was 2 out of 3 possible (8-16 mitoses per 10 high power fields)

See website links for detailed explanation

http://www.breast-cancer.ca/staging/infiltratingductalcarcinoma-grading.htm

http://www.cancer.gov/cancertopics/factsheet/detection/tumor-grade

Back to waiting on the roller coaster

My wife was talking with our rabbi this morning about blogs as she consumed some cookies from one of the nicer bakeries in the area brought over by one of our neighbors. Since her surgery, as she waits for the pathology report, she has been reading blogs from cancer survivors, noting most have poor endings. She has most recently been reading one from a woman who was also diagnosed at a young age and died less than 2 1/2 years after diagnosis (she was doing a search on lymphedema, as her arm is swollen from where the lymph node was taken and found this woman's site). Reading the woman's initial entries, her diagnosis and initial report seemed much like my wife's, but different. Almost 2 months passed from the time she discovered her lump to a diagnosis of cancer, my wife's diagnosis came within 3 weeks. I think part of that time difference is that the other woman, who just happened to have been my wife's age (both born the same year), was diagnosed in 2005. Reading the blog, though it got depressing in the end, shows how much has changed in treatment in just 7 years. It also shows how much is the same at the begging with optimism and hope. The rabbi noted that the ones with happier endings pretty much stop after surgery and treatment because, fortunately, there is nothing more to write about. So for the few who are reading this, I'll add another post. But I also don't have much to say.

Tomorrow my wife goes back into the city to have her followup post surgical appointment and, hopefully, get to hear if the cancer had spread to her lymph nodes (as of Friday afternoon the labs hadn't come back). Afterwards, she will meet with an oncologist at the hospital to get their opinion for followup treatment before meeting with another later in the week closer to home. Just as in the initial days of diagnosis, we are back on that roller coaster of nerves. Tempers are getting frayed. Food is being consumed (those cookies were good). Weight is being lost (I tend to eat when stressed, my wife likes to exercise and finally headed back to the gym the other day).

I am learning much about myself the last few weeks and some things I do not like at all. Cancer does make one appreciate things more but it is also bringing out some dark thoughts and I wonder how, if things go bad tomorrow, I will be as the husband of a sick wife, caring for her like we cared for my mother when I was in my early 20s and how I would fare as a single parent. I don't like some of the thoughts that pop into my head when I give myself a true self assessment. My temper is already shorter than usual and I find myself screaming about meaningless things like spilled iced tea. My office offers psychological therapy and as soon as things calm down, or at least get into a predictable pattern, I think I shall take advantage of it.

One thing I've noticed is a change in my thinking when I am alone with the children. Like many modern fathers, I am more involved in their daily lives than my father was in mine. Due to a flexible work schedule, I get them off to the school bus in the morning and work at home several times a week so that I am home in the afternoon to take them to after school activities. While I do the weekly grocery shopping, cooking and some chores around the house, my wife, like most women, still does the bulk of the house work. However, the last few weeks as medical appointments and other things have kept my wife out of the house more often then usual, I find I have to do a little more. Suddenly I am getting an insight of what it must be like for single or otherwise widowed fathers and I don't like it.

My wife's disease is making me realize how important it is to have two parent families and what a struggle single parents must go through. We are fortunate to have friends and family willing to help us now with the children, others are not. We also have the resources available to learn as much as we can, while paying all out bills. Others do not.

Speaking of the children, we are trying to keep things as normal as possible for them. We were supposed to go on a week's vacation last week, which we cancelled as we didn't know how my wife would feel. One of the nice things about living where we do is that we can hang a left onto a major north south road outside our development, drive 100 miles south and be in a popular vacation spot that is totally different world in about 2 hours (for day trips, we live 30 minutes from the NYC version but that isn't as relaxing as getting out of Dodge). So by mid-week, when she felt well enough for a long ride in the car, we quickly packed, arranged for a neighbor to watch our dogs, and headed down to the shore for a few nights, opting to stay in a quiet town at a fancier hotel than we normally do when we head down there so my wife could take it easy. No rides on the boardwalk this time, just the beach, pool and zoo. Oh and did I mention the hotel had several bars and restaurants attached which meant we could actually have a few drinks and not worry about driving? It was a nice break.

Now break time is over. Friends, neighbors, family and fellow congregants from our temple are asking when we will need child care again (don't know, a lot depends on Monday). My wife hopefully returns to work on Tuesday and I return to my office Wed (telecommuting for now). Soon my wife will begin radiation or chemo (or both) depending on what the oncologists recommend. Once that happens, the rest of our summer, and possibly our year, will be mapped out. But first we have to wait to hear from the pathologist if the cancer had spread. And that is the roller coaster.

Stage I never sounded so good

About 15 years ago, I had the best hamburger and watered down beer ever. It was from a local diner type of place in Brooklyn Heights that had different burgers. The occasion was me finishing off the NY and NJ bar exams after studying like a mad man for the previous two months. Though, it would be months until I would find out if I would be paying NY and NJ money every year just because I passed their exams, the burgers tasted so good, at least in my memory, because it came right after a stressful situation -- in other words it was my relief burger. I thought I would never repeat and have a burger taste so fine ever again, but I was wrong. Last night we had a burger that tasted just as sweet -- the post-lumpectomy hamburger.

The stress had been growing the last week. We went to a comedy club last week on spur of the moment (and also because my brother volunteered to babysit) and it was such a relief to go out and eat, laugh and chat with another couple we met there without someone asking my wife "how are you feeling?" Meanwhile life carried on as we approached the date of surgery. The day before my wife bussed into the city for her last round of pretests. Of course the hospital didn't call us to tell us her admittance time so, with her cell phone battery going red, she made one final call to me, from the hospital, to call the hospital to find out the time. She later discovered that was a good move as the outpatient department can be very bad about making those calls in a timely matter.

They told us her admittance time was 2 PM, so we immediately called our morning/get the kids on the school bus sitter and said they were relieved. This disappointed our daughter as one of the women was her Sunday school teacher, Upon hearing this, she decided to come later in the evening (once we realized we had a later surgery time, we knew we'd be home late) to relieve the after school sitter, which was very sweet. The nice thing about the late start was not only was my wife able to go to the Y for a final work out, but that I was able to work a few hours and was able to vacate my planned day off, saving it for a nicer occasion. 

The other advantage, and those in the NYC area will know what I mean, is that we managed to avoid both the morning and evening rush hours. Driving into and out of Manhattan is not that bad if done out of peak times. And once in the city, traffic moves at a slow but predictable pace. While I don't love driving in the city, I equate it to driving my wife's Civic over my larger car. In her car I feel the road while I generally float in my car. When driving in the city, all my defensive driving sensors are on full alert, a big difference from driving in our fairly quiet suburb. 

Since it was post-rush hour, I guesstimated that the trip would take 90 minutes which was right on the nose (despite Google maps telling me it would take 1:04 or 1:14 with traffic) -- 60 minutes to get to and drive through the Lincoln Tunnel, another 30 to get across town. We wanted to get in a  bit early so we could stretch and walk around a bit before going to the hospital, so we left home around 11:30 and had the car parked in the hospital's subsidized lot (rate I paid was the same as nearby commercial garages I had coupons for -- pro tip: if driving into Manhattan, print out coupons for garages near where you are going, you can save a ton of money -- but was actually connected to the hospital by tunnel) by 1PM. We wandered a bit on the east side, just talking, burning off some energy and then, at 1:45, entered the hospital.

The waiting room was crowded and my wife's surgery was delayed, so we sat. We found out later that it was due in part to complications with some earlier surgeries. So while my wife's actual surgery was scheduled for 3:40, she didn't actually go under the knife until 5:20. We found this out as we sat in a consultation room she had been called into at 2:30, and where she changed in, as she couldn't get a room in the outpatient ward right away due to overcrowding. At least, once we knew surgery was going to be late, we could inform our child care people we would be home late. We had some more waiting before finally being called into an outpatient room.

We met the anesthesiologist, who explained what he would be doing etc. And then, after mistaking the patient monitor for a flat screen TV (thought it looked funky) and getting a nurse to come in, my wife more or less kicked me out. So, while she waited and did  some sit ups, I took a walk. Now we used to live in downtown Brooklyn/Brooklyn Heights when younger and used to wander the city but foot often on weekends and I decided to repeat the experience. So from York and E.66th St, I wandered up to 92nd Street & Park Ave. I stopped for a slice of real NYC pizza on Second Ave somewhere in the 80s, seeing first hand what some merchants have been complaining about, that their stories are buried behind construction equipment for the Second Ave subway (no idea how those businesses can survive as pedestrian traffic is routed away from their doors)  before continuing on my mission. Our wedding anniversary is this weekend and I wanted to find a nice piece of jewelery for my wife and there is no better place than Madison Ave on the Upper East Side.

Perhaps I should have specified that I wanted a piece that would be less than our mortgage payment. While we make a nice living, I forgot we don't make a Madison Ave living. Sheesh. Fortunately I finally stumbled upon one of those old NYC type of throwback stores -- an upscale, old fashioned pharmacy, with sales clerks and a vast fragrance selection. Reminded me of the little pharmacy that was in my old neighborhood that also offered that rare thing these days -- customer service. With just a few questions (after I told her I had no idea what perfume my wife wears, heck I don't even know what I wear as my wife buys all my cologne) she was able to pick out a $100 perfume that my wife later told me was perfect.

Unfortunately I wandered a little bit more than I realized and I got back to the hospital just as my wife was being taken into surgery for her procedure. While that did give me another chance for a last minute trip to Bloomindales for a last chance for the jewelery I was looking for -- I basically just sat down with my book for the wait. The nurse said the surgery should take about 50 minutes, so I could expect to speak with the surgeon in about an hour. One hour came. Nothing. 6:30 came. Nothing. My phone rang, it was mother-in-law. I told her my wife was still in surgery. She told me she would call the house and speak to our children.

And then I waited some more. 6:45. Still nothing. And that is when I began to get a little nervous. Fortunately, as I was about to bite some one's head off, the staff came for me and told me my wife was in recovery and the surgery went well. Whew. I called home, spoke to our son, and told him mom was doing OK. He was relieved. And of course he hung up before I could speak to our daughter or sitter. Kids.

The surgeon got held up so they eventually brought me to the recovery room. My wife was alert and talking, unlike my grogginess after I had wisdom teeth removed, she said she was wide awake alert as soon as the drugs keeping her sedated were removed. The nurse gave her some basic instructions and then the surgeon came in.

The surgery went very well, he said. The tumor, though over 1cm, was small and he got all of it plus clean margins. The tumor was in the skin and he only took one lymph node. Pending on the lab reports, he said the tumor was Stage I and he believed that this would be it. Whew. What a relief. If you told me 6 weeks ago I'd be happy to have my wife's breast cancer staged as a one I would have thought you were crazy. Funny how fast your world can change.

We left the hospital and walked up to First Avenue looking for a bite to eat as my wife was starving, having not eaten all day. We soon found a nice, Irish pub -- they type of place we used to frequent when we were in law school and didn't have the parenthood pressures and responsibilities that put those days to an end for us a long time ago. We looked at then menu, considered our usual healthy meals, then said to hell with it, we wanted hamburgers. Nice big, juicy, greasy hamburgers. I also had a beer (wife was still on Vicodin). I gave my wife her anniversary gift a little early, which made her extremely happy. The beer and food arrived and we devoured our burgers with glee. While we ate and drank, we felt a huge weight lift off our shoulders. Though we still don't what is next, we felt like we were free of what has been keeping us down for the last month. Best dammed hamburger I had in the last 15 years.

Mood bouncing like an elevator

It was a beautiful sunny morning yesterday in my part of NJ but all I could feel is that it felt like the storm clouds were racing towards us and darkness was falling as we approach the surgery date, one week from Thursday. My mood is literally bouncing like a bad elevator, shooting up to the happy penthouse one minute, crashing down to the basement the next. One moment I am OK, the next I just want to cry. My wife is somewhat the same as the gravity of her breast cancer diagnosis continues to strangle us.

Sleep is becoming ever more elusive. Waking up at even 4AM and not being able to go back to sleep is becoming more and more common. While I have always been OK with less sleep, my wife has never been and she is feeling more and more exhausted, which worries me. She has been working out at the gym and eating right but she still needs her rest. She goes into the city again this morning for more tests so hopefully she will be able to nap on the bus (unlike much of the country, mass transit, even in the suburbs is pretty decent around here, especially if you are commuting to NYC, Jersey City, Newark etc. We live 1/2 a mile from a NJ Transit commuter bus stop that will get her into the city in a little over an hour, depending on the Lincoln Tunnel). I keep hoping that one of those tests will say "oops, misdiagnosis," especially as I can't even feel her lump anymore (denial isn't just a river in Egypt) but every day I am coming closer and closer to accepting that is not the case.

My wife took her first Xanax a few nights ago. She said it doesn't help much, but that it at least did change her dream channel from chemo nightmare to the more I missed the bus and now I need to walk home bad dreams. She is really tense these days, can't relax at all. It didn't help that she took one of those online life expectancy quizzes the other day that showed right now, before she has even been staged, her life expectancy is down 2.6 years. Nothing I can do can ease her mind and let her take at least a few moments of bliss while she forgets what is on her mind for a moment or two. I haven;t heard her laugh in days, even when the children do something funny. These seems to be no joy now.

I don't like the way I am becoming cross with the children. I was working at my desk the other morning, before the school bus came, when my 7 year old daughter came up behind me. She does this often, tries to get me to play or something, despite the standing rule she is not allowed in my office when I'm working. Usually I either let her watch or nicely chase her out. Sometimes I just tell her to get out, but I at least face her. Not this time. I was doing something a little more intense than usual for early in the morning, looking for the answer to a tough problem when she came up to me. As I growled at her to get out I saw she was smiling, giggling, that mommy had left her tea cup in her room the night before. Before I could stop the words were out and she stormed out of the room, upset. God. Maybe I should be taking the Xanax. When things calm down a bit we definitely need to get a family therapist.

Later, when I took the kids to the corner to wait for the school bus it was sunny and temperatures were in the 60s. The birds were singing, some butterflies were fluttering around. The other children at the bus stop seemed happy -- well as happy as children can be waiting for the bus. And I am miserable. After the bus left, and I had chatted a little bit with one of the neighbors regarding my wife, I walked the dogs back home when they stopped to smell the scenery. While they were seeing what messages were left by the local wildlife I stared off into the sky, thinking how beautiful it was out, listening to the sounds of late spring, smelling the fauna, which is delightful this time of the year, when suddenly I realized I had been standing and staring for several minutes and I wasn't enjoying it one bit.

I am getting to the point where I am hating to go out when the weather is nice. No, let me rephrase it -- I am hating to see people. The other day I decided to work at home not simply because I have a lot of work I want to wrap up before I take off a few days, which I do, but because I just really didn't want to see people. Yesterday morning, I showered, shaved, dressed for work and then didn't go in. Even though most people in my office don't know what is going on, I am finding it grating to see people having friendly, happy conversations with co-workers. Fortunately, the type of work I do can be done anywhere I can connect my laptop to the internet (well not anywhere, I find the sun is too bright on my deck, even with the umbrella up, to see my screen easily).

One of the papers ran a series of pictures from the Shore the other day in one of those "welcome to summer" type stories. Online were the typical series of pictures of pretty late teen and early 20 something women in bikinis at the beach. For the first time since I was 13 or so, I didn't care to look at the pictures. Where normally I could at least admire the women in the pictures (polite way of saying that even though I'm in my mid-40s, there is still a male teenager in me somewhere) all I saw were pictures of happy and healthy women without a care in the world, unlike the woman I love. And I can't stand it. 

I know these feelings are narcissistic, as it all seems to be about me, but I find it much easier to worry and complain about stupid things like this rather than confront the 300 pound gorilla -- that the cancer, because of where it is and the apparent suddenness of it is, is much more aggressive than we realize and beyond Stage I or II. We know there is no point in thinking about all that until after the surgery and the tumor and her lymph nodes have been examined, but we can't help it. And this is bringing us down.

What is worse are the feelings of guilt I feel when someone shares good news and I feel upset, such as when a childhood friend announced on Facebook she is cancer free. She has been fighting for a long time and I am really happy for her, especially as I had another friend who wasn't as fortunate, but when I first read her post I got upset. Misery really does love company.

Basically, aside from reading whatever we can on breast cancer, we are on automatic. We both do our jobs (which, because they both require mental work, can be therapeutic), yet don't ask me what I've done (which has been surprisingly good according to the project leads on this new product that is supposed to transform the way we deliver services to our customers -- I have been a leading contributor from the start, designing standards and procedures, overseeing others work, offering guidance and training, now we see how good I was). Our day lilies are blooming, but so are the weeds in the flower beds we haven't felt like pulling. The house is clean, yet it is a mess. The groceries have been bought, yet we still have a shopping list. I only cleaned the gutters because I realized that plants growing out of them was probably not a good thing. The children still get taken to their after school classes and birthday parties as we try to keep things as normal as possible. This may be all that is keeping us sane at this moment. I realize that sometime soon we will need to speak to a therapist to help all of us through this.

The life expectancy quiz I mentioned earlier is just another nail in my heart that makes me realize that not only may my wife hit the finish line in our journey sooner then I, something I never truly believed would happen as I am a few years older with a history or heart and cancer issues in my family, but that our journey may be much shorter than either of us realize. I guess that is true for all couples, you never know when an accident or  sudden illness will cancel your trip, but you never really believe it will happen to you until one afternoon you get a phone call and realize that is happening. It doesn't help that we have been reading several breast cancer books that explain pretty much everything so my wife can make informed declensions when she talks to her oncologist at the end of the month. Ignorance, while not healthy in this case, really is bliss. I want some serenity now.

Losing our minds

This whole breast cancer thing is really beginning to take a mental toll on us. I am beginning to wonder what is going to happen this summer when my wife is doing chemo and radiation and we are really running ragged. If we are this flaky now, then this summer should be interesting.

Our mood is like the weather these days: periods of sunshine followed by afternoon clouds and storms with a 20% chance of wanting to put my fist through the wall. She filed her FMLA intermittent request forms with her office yesterday while I, after a call with my immediate supervisor and HR, got my ball rolling today. It is amazing how drained I was after I was done speaking with them -- I've been using work to keep me from thinking about my wife and it was hard to focus on her and her disease, even for just a few minutes.

My wife continues to exercise like a mad woman to take out her frustrations. She finds the working out to be very therapeutic. The other evening, she told the karate instructor at her woman's self defense class to not go easy on her because she needed to beat the crap out of something. So far she hasn't broken any machines at the gym and has happily noted that she has lost 4-5 pounds in the last month with all the exercise (she also doesn't have much of an appetite and we generally heat healthy, low calorie meals so she is actually forcing herself to eat some of the junk food lying around her office just so she gets some extra calories). She is starting to worry about losing too much weight but, depending on the treatments, her exercise routine will be sharply curtailed soon and the chemo medication may make her gain weight to boot, so might as well lose as much ahead of time and get as fit as possible.

I have been doing something similar. For the last few weeks I have been transitioning to becoming a home based employee (basically working at home 4-5 days a week in lieu of 3) and have been using my commuting time to spend more time at the gym and, in lieu of walking around campus during my lunch hour, taking the dogs for a nice walk or, when the weather is poor, as it has been for most of the last month, or so it seems, hitting the treadmill for a good sweat. Streaming Dr. Who episodes from Netflix on my iPad is not a horrible way to spend 42 - 46 minutes (well actually 21 to 23 minutes -- I usually split the episodes, half of one on Monday, the other half on Tuesday) and burn off some extra energy so I can concentrate on my work when I head back to the laptop. Unlike my wife, who tends to not eat when stressed, I am the opposite and there is only so much celery, grapes and other fruits and veggies I can eat before my daughter's cheese sticks appear on my radar screen. Fortunately, at least, the extra exercise is combating the extra calories.

But, even with the extra exercise to calm us, this is starting to take a mental toll on both of us. I find my temper, which can be short, especially when the kids are yelling at each other and the dog is barking, getting shorter. Just recently I totally blew up at my daughter's dance school because of something stupid (I was mad at them anyway for lack of emails and communications with us but this time it all came out which actually made me feel worse). I growled at one of the workers at the Y that a few of the TV controllers weren't working properly (there are 10 TVs spread around the ceiling, many of the machines have devices you plug headphones into so you can tune into a specific channel -- that was actually a worthy growl as I was able to explain in detail what was wrong so the maintenance people would know what to look for).

My wife, who has always been foggy (her term), is getting even more forgetful. Last Friday she forgot to pick up our daughter from the karate school (our son has a 2.5 hour session on Fridays) to take her to babysitting at the Y where she can play with other children. That was bad, but I chalked it up to a change in her routine for the day. This morning I found the container of cinnamon my wife sprinkles on our daughter's pancakes in the microwave (no reason it should be there) and she plated my son's toast before putting the toast in the toaster oven, meaning both the plate and bread went in. Good thing I cook dinner.

We don't sleep well anymore, both of us waking up in the middle of the night, unable to easily fall back asleep (unless totally exhausted). Even then, my dreams are haunted. In one dream I threaten to leave my wife because she wouldn't come back from the gym early so I could go (not sure what that means, fear that her health issues will prevent me from maintaining my own health when my family needs me to be strong?). In another I severely punish our son for trying to run into the car while it is moving (pretty sure that stems from the death of my younger brother from car surfing when we were teens). At least I bounce out of bed now when the alarm goes off as I'm usually half awake by then (of course that could also be because daylight is now creeping into the sky at 5AM, which enters our room as the shades are up to let fresh air in, so I'm naturally starting to stir). A vacation we had planned while our floors were being repaired from a leak is cancelled, in part because my wife will be recovering during that week from surgery, also in part that once the breast cancer arose, I stopped getting bids and didn't even get the pets to the vet for their border shots (usually have a neighbor watch the pets, pets have to be out of the house while wood floors are fixed) or make them their reservations.

I still haven't decided whether to be insulted, relieved or amused that so many in our congregation are willing to provide meals for us while my wife recovers on the assumption she does all the cooking. First of all, we've always been a working couple, meaning we end up splitting domestic chores. While she still does more than I (child care) I do all the grocery shopping and cooking. That started back when I was a teenager and my mother's health started to fail. It was either frozen microwave dinners, eat out or cook for yourself. And while I, like most people that age, did take the easy way out and just nuked food, that eventually gets old (and makes you fat) so I learned how to cook. I also learned how to do laundry, though my folding standards never reached my wife's approval (she worked in a GAP during college and still folds to those standards -- maybe we can get a GAP employee in here on laundry day).

I am really getting pissed at the doctors who don't leave messages on my wife's voice mail (she has a job that requires her to leave her cell on buzz or silent so instead of leaving her a message they call my cell so I can email her to call them -- augh!). Seriously, leave a message or, if you reach me, tell me more then we'll call her back. She works full time. You will not reach her at the house, her cell is on buzz and she is rarely at her desk. I can get her by text and email, just leave me a message of who you are, really important with all the different people calling, and a phone number. Saying you are X, without any context such as X from where means nothing. The privacy laws under HIPAA don't mean you have to be so cryptic that you can't tell me that you are X from my wife's breast surgeon's office and are calling about the FMLA letter my wife needs for work. We are under enough stress already, don't add to it.

While it is nice to get support from friends and people in our community, we are getting tired of the looks of pity we are noticing. While it is understandable, and trust me, we both see those same looks in the mirror, it is starting to get to us. We are all over the place emotionally.  One moment we are thrilled that the mother of one of our daughter's friends, who lives a block from the karate school, said our daughter can come over during karate this Friday, while my wife is in the city for a few per-surgery doctors appointments, and then we crash when we think of all the other child care arrangements we have to make (and that is with many people volunteering to help us out). While it is wonderful that we have people who can help us out getting the kids to and from school, we still need to make sure they are mentally prepared to see strangers, or at least people they don't know well, in the house. Not helping is that we won't know until the day before surgery next week when we will need the help. Just adds to the stress, and mine is relatively nothing compared to my wife's. 

Let's face it, I'm not the one facing being cut open, having some of my body extracted, then being poisoned the rest of the summer with chemo and radiation -- and that is if things go well and the cancer is not more aggressive than the doctor thinks and that it has not spread into the skin (tumor is very close). I'm not the one facing a life and death situation and believe me we have had that discussion too. My wife keeps wondering if she did something wrong. Maybe this started back in 2009 when the last birth control pill she took, before deciding on the diaphragm, screwed up her hormones and estrogen levels (this cancer is fed in part by them). Maybe it was something we ate, we only recently got very serious about what we eat. Maybe it is just the luck of the draw. Maybe the Xanax she was prescribed will help her take her mind off all this. At least it is less caloric than the alcohol she can't have anyway (but I can, I had bought her a good bottle of 18 year old Scotch for Mothers' Day -- hey don't judge until you have children -- which, though I am making sure won't reach 19, will probably still be around when the doctors give the ok for drinking again -- I'm not one of those who can down scotch after scotch, 2 drinks in a night is a lot for me and 2 nights in a row is still rare -- an evening cup of tea is more my thing these days and, fortunately, the cool weather we are having now in NJ allows me to have my tea and not have a heat stroke like a big ball of wibbly wobbly... time-y wimey... stuff ... Started well, this sentence. It got away from me, yeah -- maybe I'm the one who needs to talk to somebody).

All I know is that right now, we are tired of the waiting and wondering. We just want to get it over with and move on with the followup treatment and all the "joys" that will bring (at least she won't be the only baldie in the house). However, one problem with going with a good hospital and a good surgeon is that they are very popular and we have to wait our turn. In the mean time we continue to read the breast cancer books to better inform ourselves as to what lies ahead. We have one friend who is a nurse who joked we are the patients doctors fear -- we're analytical and informed, however I am beginning to worry we are becoming over informed which is also starting to affect us. Hopefully we don't lose our minds during the wait.