Sandy

The lights are on. The children are back in school starting Monday. The gas lines are gone. Our offices are open for business. It has been a crazy two weeks here in my corner of NJ: first Hurricane Sandy knocked our lights and heat out for a week, then a Nor'Easter that turned into a snow storm when it sucked more cold air than expected which snapped several of our trees in half. I am ready to move to Nevada.

The day of the hurricane started out simply enough. My wife's office and our town's schools closed for the day, giving the rest of my family a day off. My office closed for the day but many of us were able to telecommute as normal. I did my early morning workout as usual and, upon leaving, noticed the sign that all classes after 5PM were cancelled. When I got home, I told my wife that her evening spin and dancing classes were cancelled, so she decided to go early while I worked and kept the children from killing each other. Things quickly deteriorated weather wise. Before long she was calling me to say the Y would be closing at 1:30 due to weather. I told her to try to get bread as we were running low, the one thing I forgot to buy enough of before the storm. Ha ha. By then all she could find were bagels.

She came home and I finished my work day as usual. Dinner and watching TV that evening were also pretty normal, except we were just watching the news from NYC. The lights started flickering around 6PM and at 7, just as flood waters were starting to hit Manhattan, we lost most of our cable stations, save the ones from Philadelphia. I soon turned to Facebook, which became a lifeline for us through the following week. Friends from the city started posting pictures of streets flooding in Manhattan, and not just in lower Manhattan. Just as I was thinking this going to be worse than realized, the lights went out with a sudden certainty. At that point we knew that was it for electricity and we were back in the 19th century. 

The next morning the storm had mostly passed. I put the tea kettle on my outside grill to make instant coffee for my wife and I as we dined on cold cereal, mostly to get rid of the milk. I took the dogs for a walk around the neighborhood, checking out the tree damage and walked up to Route 9, a major north/south highway with many commercial establishments that adjoins our development. Traffic was moving, but as I walked up to the nearby intersection with a traffic light I saw it was dark. Uh oh. Our development has underground wires, so I  knew we'd come back once the grid was re-energized. At that time I didn't appreciate how long that would be.

We didn't have much storm damage, just some big branches down on our lawn, and we are far enough away from the shore to not have to worry about flooding, so we took a long walk around the development with the kids after lunch. We saw many large trees down, but, with a few exceptions, little damage to structures and cars. After seeing power was still out on 9, except for the generated powered supermarket, where things were so crazy that the police were called and employees were checking receipts (I now know it will take less than 48 hours for this town to go full anarchy if there ever was a disaster worse than a power outage). We went back home, turned on the radio to a NJ news station, lit a fire and settled in for the night. Except, unlike previous blackouts, we had smart phones and were able to keep track of very local news.It was then I learned that almost the entire town (and surrounding areas) were without power (I swear Facebook kept me sane). I also saw a very brief clip about a fire in the Rockaways, near where I went to high school, and flooded basements in my old hometown of Howard Beach. It would be another day until I saw how bad things were. My wife said we should just consider it camping out with comfy, if cold, beds. Fortunately we have a fireplace, a full rack of wine, and, courtesy of Sandy, plenty of fuel for the fire, so we spent the evening relaxing in front of the fire, the kids on their newly charged video games, my wife reading a book with a flashlight, and me reading an ebook I downloaded from the library just before the storm, on my back-lit iPad, as I knocked out a bottle of wine.

Day 3. I cooked the remaining eggs, egg whites and cheese in two giant egg omelets on the grill, along with the instant coffee (I am definitely buying a stove top peculator as soon as I can find one, the camping sections of nearby sporting goods stores are still pretty empty). My brother, about 20 miles away as the open roads went, had power and our freezer was starting to defrost so I loaded up the car with our electronics, freezer and family and drove over there. It was then I finally understood how bad the power situation was. Not a single traffic light was functioning on Routes 9 and 18 (similar to 9) until we got to the NJ Turnpike (fastest ride ever, as the intersections were blocked, making the road seem like a real highway). I noticed no gas stations and few generator powered stores open. On Route 1, we again saw not a single light or open business, except for a liquor store, of course, until we neared my brother's house. Suddenly, we saw a working light and then we were in a horrific traffic jam. It took us over 10 minutes to get to the next intersection, but before we even got that far we realized what the problem was, a gas line at an open gas station (I wisely had topped off my car's tank the night before the storm). We eventually made it to my brother's and, after unloading my backpack of electronics, I lost it when I discovered my iPad was not in the box. I basically went into one of my old rages (I later realized that I probably had forgotten to take my meds that morning, once we didn't have heat, lights or electricity, our schedules got all messed up). Very disturbing, but now I know -- 2 days of a disaster is all I can take.

Anyway, we asked my sister-in-law if we could put on the news as we really had no idea what was going on outside our immediate area, especially in New York. It was then I finally saw the videos of the burnt out Rockaways, the flooded Howard Beach and Broad Channel, and all the damage at the Jersey Shore. I saw a report taken from the wrecked the boardwalk a block from the police station near my high school. Not a big deal until I remembered the boardwalk used to be two blocks away. It was very devastating. Anyway, as our county had a 7PM curfew and we left our dogs at home, we went back home. Again, lights were out. The open  gas station we had passed earlier was now out of gas, but we passed another huge jam at a newly open station on the way home. We spent the evening as we had done the night before: fire, video games and wine.

Day 4. By then we had gotten into somewhat of a routine. Heat up food and water on the grill and begin the rotation of the electrical devices to charge in the cars, running partially on the car battery and partially starting the cars up. Our freezers were now our refrigerators, still cold enough for milk, but not for anything frozen, though the water bottles I had stuck in them before the storm were still pretty solid. One fortunate thing aside from the fireplace; because we have an old water heater that doesn't need electricity, our natural gas fueled hot water heater kept on giving us hot water for showers and baths, which things a little more tolerable as the temperature inside slipped into the 50s. This was the day my son and I went out for supplies, seeing what was open. We had two goals: extra batteries and bread, especially the batteries as we had been running our radio pretty much all the time while we were awake, listening to news, music, talk or sports. We went to the CVS near us, no dice, so we decided to go to our local supermarket, on the other side of 9. With the traffic lights down, the only way to cross 9 was to drive north or south to overpasses to cross over. We started down the road to 9 when, about 1.5 miles from 9, we got stuck in traffic. At the time I thought it was traffic trying to merge onto 9, so I detoured to another intersection and found no traffic. Oh those fools, I thought, they really need to detour. It was after I had looped around and headed back towards that intersection, I saw the reason for the traffic -- the gas station on that corner had reopened for gasoline sales. Yipes. The long gas lines had arrived in my town.

We proceeded to the generated powered supermarket and it was there we received our next taste of a disrupted supply chain. The store was half lit with shelves emptied of non perishable staples. Cashiers were checking receipts with the police keeping watch. When I asked if things were really that bad, they said yes, a little anarchy had apparently returned with some power to the store. One major focal point: the line for the coffee bar which apparently stretched all the way through produce, past all 18 cash registers and to the liquor store at the other end of the store. The line for cheap wine was shorter than for fresh coffee so I resupplied myself with what I needed to get through a few more cold nights with the kids. I also managed to buy 6 bags of ice, bread and some grape jelly.

When we got home, my wife told us the cancer hospital called and they wanted to squeeze her in for chemo that evening. It was then we discovered how bored the kids were when they begged her to take them. So, we all got in  my car for it's last long trip until the gas crisis eased, and drove to the hospital. The route closely paralleled the trip to my brother's. We noted a few more traffic lights working, plus an open WaWa with a long line for gas. The kids were so happy to be someplace with lights, hot prepared food, plugs and cable TV, even if it was tuned only to the news. We were like electric junkies getting our 21st century fix. By time we left, the sun had set and we got a better idea of where there was power and where there wasn't. At that point, there were way more without. Power to the north of us, power to the south, but we were stuck in the middle in the dark with the wine and firewood.

Day 5. Rinse and repeat. Except this time, as we were running out of food that we could easily cook, I made more of an effort to find prepared food and batteries. We got some food at Wegmans, but they were out of batteries. We went back to CVS where we were told that if we come back at 4PM, we could get batteries. When we got back at 4, the new batteries were already gone. Sighing, we drove a bit down the road, where I saw 7-11 was still closed, and then made a right at the next light. Yes light, the traffic light was working. So close! As we were going down the road, I looked to the left at the YMCA we go to and noticed their exterior lights looked to be on. Could it be? Well, yes, if you lived on that side of the road. That night another fire, a dinner warmed on the grill and another bottle of wine.

Day 6. Rinse and repeat, though this time the gym was open, so after 4 days I was able to work out again and watch TV. Almost normal. Later, while doing my now daily supply run, my wife called to tell me a friend on the side of the road with power had invited us over. We brought the food and electronics and enjoyed a day of heat and internet. The end was near. Still, when a landscaper cold called our friends to see if they wanted to pay them to cut up their fallen tree and haul it to the curb, I ran out and asked them to cut about 20 pieces of fireplace sized wood from the tree for me. Another night in front of the fire, reading, listening to the radio and sacrificing another bottle of wine.

Day 7. First day of standard time, though with no clocks to change the time and us rising with the sun anyway, it made little difference to us. When I went outside to place the tea kettle on the grill I noticed how cold it was that morning and thought that this was getting old. I started feeling very depressed, even my wife said this had cured her of the camping bug for a long time. My son was still going away that night with a friend so I dropped him off over there and got some extra Irene wood they had (they had borrowed a generator and were now powering their furnace). When I got home, my wife asked me to take our daughter out for lunch, as she needed the daylight hours to fold the laundry we had done the day before at our friends. First I tried to take her to her favorite casual hamburger place in a shopping center with power, but they weren't opened yet. I then tried to go to a nearby diner, but they had lines out the door. We finally ended up at the mall, which had also gotten power back the previous day. We walked by the many chairs, tables and extension cords around the center of the mall that management had set up for people to recharge and warm up. My daughter and I settled in at Johnny Rockets where, around 2PM, I received the message I had been waiting days to hear -- we have power! Woo hoo!

My mood was elated as my daughter and I walk around the mall. Even though I knew our suffering was nothing compared to those who still be without power as i write this almost a week later, or who lost more than power (one woman I went to high school with lost her Rockaways house, business and father in the days after the hurricane), I was getting mighty down about living in a cold dark house. We got home and I flipped on a light switch for the heck of it. Our long cold, dark nightmare was over. Hellooooo 21st century.

And then, after the cable came back on not long after halftime during the NY Giants loss, I put on the weather channel and saw that a Nor'Easter was forecast. Bring it I thought, after Sandy, this can't be too bad. Oh how I was wrong. I should have had another bottle of wine that night.

Into the chemo battle we go

It has been 5 days since my wife's first chemotherapy and so far, so (mostly) good.  The results of her final test showed she has an intermediate chance of recurrence so, once that was determined, her oncologist felt it was time for chemo. 

I went with her the first day and it was, all things considered, uneventful. We parked the car, signed in, got our parking ticket validated (valet parking, $4 all day) and went right in. Before long, she had her IV dripping into her chest and, with a little help from IT, got the WiFi working on my laptop (so I could work and save my time off) and her tablet. We saw the oncologist, nurse and resident for a quick chat, and then, before we knew it, a nurse was pumping the red devil into her. At that point she had me take a picture of the "poison" going through the tube so she could show it to the friend who loaned her her fight like a girl breast cancer shirt (which I thought was a karate shirt before this).They even gave her lunch (I had to head out to the cafeteria, next time I will check out the sushi place around the corner). Aside from feeling a little lethargic and dozing off while we waited in the radiology department after as we waited for the nurse to check her PICC port, she felt fine. She even went to work the next morning, though she had to return to the cancer institute in the afternoon to have her blood counts checked (pre-planned appointment).

What has been more amazing is that she has not had, as of yet, some of the followup symptoms she was warned about. While she hasn't felt 100%, and has complained of chemo brain fog and a yeast infection she hasn't had the nausea or fatigue that we were warned about. A friend confirmed that there will be weeks where she feels 100% after treatment and will go to the mall that is halfway between our house and the hospital to go shopping and other weeks where she will stop at the mall on the way home so she can take a rest. It helps that she has been drinking all the recommended water, eating right and still managing to go to the gym -- though taking it a little easy. 

I, on the other hand, have not been eating and drinking right. I still find bouts of anxiety popping up for no reason, especially later in the evening when my work is done and the children have gone to bed. Unfortunately I have always been one to go to food when stressed and have been making some unwise late night snack choices. While I have corrected that over the last week, I still seem to be enjoying/needing a nightcap too often now. I go to my own doctor this week for my annual physical and will see if he can prescribe me something to help me take the edge off.

I could go on about all the drugs she has to take now to function, but I will leave that to the medical sites. There is so much going on when I look at her medicines in the tray on our kitchen counter that I am bound to get them wrong. Instead she counts down the days left until the mouth sores appear, the digestive problems start, and her hair starts to fall out and does whatever she can while she can. Once she has to really start taking it easy, the new countdown to when she can resume all normal activities will begin.

Doxorubicin, cyclophosphamide and paclitaxel for breast cancer chemotherapy, oh my!

Her hair is cut short. Her chemo bag is packed. The PICC line is in. Her eReader has been loaded with books. The cancer institute's WiFi and valet parking have been checked out. The laptop lapdesk has been purchased. Child care has been almost taken care of (since we don't have a precise chemotherapy schedule yet we have a lot of contingency plans set up). I guess we are ready.

It has been almost 2 moths since my wife was diagnosed with what we later discovered was Stage I breast cancer with a very aggressive tumor (and I've blogging about it ever since). Due to the aggressiveness of the tumor (pathology report showed a high mitotic (cell division) rate and weird nucleus), she has decided to take chemotherapy instead of just radiation treatment, even though her margins were clear and her lymph nodes negative after her surgery. She likens it to killing an ant hive found in your house. Though the exterminator killed the hive (the tumor), there still may be a few ants  wandering around the house (microscopic cancer cells in the bloodstream) that could cause havoc later. As she put it, it was bad enough telling our children she had cancer now, it would be worse telling them in a few years that it had come back and she hadn't done everything possible to make sure that wouldn't happen. I worry what the chemotherapy will do to her health, both short and long term, but I don't really see any good alternatives.

Doxorubicin, cyclophosphamide and paclitaxel, oh my! doesn't have quite the same ring as "lions, tigers and bears, oh my!" but it does invoke that same level of fear as it did when Dorthy exclaimed those words in  the Wizard of Oz. My wife will be part of a NSABP Protocal B-49 phase III clinical trial where she will be taking a combination of doxorubicin and cyclophosphamide once every other week for 4 cycles (8 weeks) followed by paclitaxel once a week for 12 weeks for her chemotherapy. These are all chemotherapy drugs that have been used for quite some time, the trial is playing around with dosages, seeing if there can be changes. Though this treatment will be rougher than average, she is happy to be in the aggressive trial, and the followup procedures for the next 12 years, as it hopefully reduces the risk of recurrence, but it sure looks like it will take a lot out of her. Fortunately she is young (41) and her heart is strong (according to the tests she had done to see if she could be in this trial).

The thought of chemo is obviously getting to her already. The other day, while taking the children to a movie, she raided the theater's candy section eating more junk in an hour than she has eaten in a month (she was amazed her weight was the same when weighed at the hospital yesterday). Then she went shopping like a mad person to get a birthday gift for one of my daughter's friends that she had forgotten about before arriving home and noticing the 7 on the invitation wasn't for the date of the party but for the friend's age. She told her mother over the phone that she wonders what will happen when the drugs really begin to affect her mind. She keeps expressing fears that she won't be around to see our children grow -- many of the blogs we've found don't have happy endings, which makes sense as the ones with happy endings stop writing pretty quick for obvious reasons.

It's getting to me too, I found my pants were a bit snug the other day. Not really surprised, I've been over doing it with late night snacks lately and I've noticed the wine rack is looking a little depleted (it had been filled with small bottles from Trader Joe's, those can get knocked out with a few glasses). Fortunately, for both of us, we also enjoy taking our frustrations out at the gym and there was a nice 45 minute spin class at the Y last evening to battle our food sins. Today will be an hour on the treadmill I think.

She is upset that she won't be able to do any heavy exercising the weeks she has treatment (blood vessels can rupture from pressure). And she may have to readjust her FMLA paperwork from intermittent. Fortunately we have emergency savings for when/if her leave becomes unpaid. She also decided to get a wig for when her hair falls out, not so much for her but our 11 year old and 7 year old children, who have become noticeably more clingy and are looking to take advantage of our slightly reduced disciplinary standards (Dad, May I have ice cream? Yes. May I have a glass of diet soda? Yes. May I have a cookie? Now, wait just a damm minute!)

Yesterday she had the outpatient procedure to get a PICC line implanted in her chest for her chemotherapy infusions (better than getting stuck with a needle each time). It was a quick procedure that she watched being done on YouTube beforehand (amazing what is available online). She remained awake for, we spent more time waiting in post-op. We talked. She is obviously worried, not so much for the short term, which is looking OK, but for the long term. She is hoping this treatment gives her at least 12 more years (the time frame of the clinical trial), if not more. 12 years would get our youngest into college, at which point I could sell our house (which will be paid for by then) if something happens to my wife (or vice verse as I will be in my mid-50s in a dozen years and something could easily happen to me) and we don't have her income anymore to help our children. We both have substantial life insurance policies but now I am realizing we may be under-insured if something happened to one of us while our children were still young -- I don't know how I'd save for college on just my salary while the children were still young, especially, as a single parent, I would have to make sure I stayed in a non-traveling, flexible work position. She threatened me by demanding nothing happen to me as she doesn't think she can do this herself.

It is interesting how the mundane gets in the way of all this. While waiting for her prescriptions to be filled, I wandered over to the office section of the store and purchased a laptop lapdesk so I can work while waiting for my wife -- trying to conserve time off for more pleasurable activities, or for times when I really need it. She checked out a web site of things to do before chemotherapy and quickly made appointments with her OB/GYN and dentist. We are constantly updating our phone calendars to see if anything bumps into various doctor appointments. Long term plans are non-existent these days. Short term plans are questionable.

At least we are discovering who our friends are. The amount of the support we've been given has  been overwhelming. One neighbor baked cookies for us. Another took our children into her home before 6:30AM yesterday (we had to be at the hospital at 7) and drove our children to camp. One friend has offered to take our son to Six Flags Great Adventure  (near here). Another friend will take our daughter to the shore tomorrow.  Another will have our son over for dinner. Another from our temple will watch our children all day if we have to get chemo on a non-camp day (all these friends have children around our childrens' age, which is how we became friends with them). Our son's karate school, which is a few blocks from the last friend says our son can hang out at the school during morning classes if he wants.

A lot of scary things are about to happen to our young family and I hope we can look back on these days in a year and think, one bump over and done with. But I will tell you the most scary thing I've seen recently, my wife's hospital bill from the day of her surgery -- over $26,000, almost all covered by insurance fortunately, that was only for that day. Looking at the statements from the hospitals she estimated her insurance company has already spent over $50,000 on her and she hasn't even started the chemotherapy yet (plus the years of aftercare). I am getting a better understanding of how easily it is for the middle class to fall  into poverty due to one little medical disaster. Though we are in the top 10%, which with NJ's high cost of living is truly middle class, a $50,000 medical bill would sting. And we're lucky -- we have 401ks we could deplete and a house not underwater that we could sell (we were smart enough not to listen and buy more house than we could afford at the time -- now that we could afford a bigger house we see no need to do so, we were also lucky enough to have bought our first co-op in 1997, just as the NYC area market started to take off). Fortunately we have good insurance and, looking forward, at least for now, don't need to worry about lifetime insurance caps or an inability to get coverage due to what is now a preexisting condition. But that can always change. Man plans, God laughs.

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.