Category: Uncategorized

Get the Scary Skinny on Question 1

by Seaglass4Nicole, posted in Noteworthy Articles, Uncategorized

The general midterm election is finally here and with it comes more than simply electing the next wave of lawmakers, with it comes an opportunity for voters to have the power to help shape policy for our state. Here in Massachusetts, we’ve all seen loads of Question 1 signs scattered throughout neighborhoods across the state. The signs for and against the proposed mandate look insanely alike and the platforms each one is running also sound confusingly similar—patient safety being at the heart of each. Because quality healthcare is important to me, my family, and my community, I needed to learn more about this to see if the healthcare quality I’ve come to love and trust would somehow be at risk.

VOTE NO on Q1

Here are the five basic truths I’ve learned about the proposed mandate that helped me go from confusion to clarity:

  1. Fact: Simple Is As Simple Does

At first glance the question sounds quite simple. After boiling it down, however, you realize that is exactly where the problem lies. Such a simplistic formula does not take into account the numerous factors that impact the level of staff a patient should receive. Mandated ratios without structure to help achieve ratios will undoubtedly force hospitals to make trade-offs in other services or investments with the end result being unintended negative consequences for patients.

This simple plan hasn’t been fully baked and like most half-baked, bankrupt ideas that come from a government mandate, Question 1 comes with oodles of caveats. It’s a frightening move that would impose rigid, exorbitant, and scientifically unproven nurse-to-patient staffing ratios.

Staffing is a collaborative process. While not always perfect, there are processes in place to appropriately staff each unit based on individual patient needs and the training, expertise and capabilities of the nurses, nursing assistants, case workers, nurse managers, physicians, and other caregivers on that unit. Hospital staffing models are continuously adjusted to ensure safe, high-quality care on the basis of patient need and the experienced judgment of nurses on the floor. A mandated, fixed ratio does not allow that flexibility and innovation in a care team.

  1. Fact: Quality of Patient Care and Safety will NOT Be Improved

I am proud to live in a state that is home to some of the highest-ranking hospitals in the world—many of which are consistently ranked nationally for health and quality of care. These hospitals are already held accountable and are consistently delivering a high standard of quality, safety AND adequate staffing levels by national and local organizations such as The Joint Commission, the Centers for Medicare and Medicaid Services and the MA Department of Public Health. Many hospitals in the state (if not all) also voluntarily pursue additional accreditations and certifications from national organizations, such as the American Heart Association, the American Stroke Association and the National Accreditation Program for Breast Centers, to name a few.

There are no scientific studies or reports that credibly show that this mandate will improve the quality of care for patients in Massachusetts. There are also no studies that support or recommend specific, at-all-times ratios for nurses. Mandated ratios have unintended consequences and have not substantiated any improvements in patient safety outcomes. California—the only state to implement mandated nurse staffing ratios—is a prime example of how this mandate has caused more harm than good. Hospitals and nurses all over California have seen the harm it has caused including:

  • Increased safety concerns
  • Limits in technology and innovation
  • Increased costs and budget cuts
  • Poor Emergency Room experiences
  • Dismissal of key ancillary staff

Setting arbitrary, rigid ratios ignores the many variations in patient care, including differences in nurses’ education and experience, ever-changing patient conditions, the composition of the entire care team, and the varying technologies and physical attributes of different facilities.

  1. Fact: One Size Does NOT Fit All

The simple formula of this proposed mandate would apply to every hospital, in every unit, at all times—across Massachusetts. So regardless of the size or location of the hospital or the unique needs of each patient—staffing decisions would be taken out of the hands of experienced nurses and doctors at the bedside and put in the hands of a bureaucratic mandate. That means across the board: longer wait times, reduced patient services, and higher operating costs within every hospital across the state.

It’s seems fair to say the safest and best patient care is when staffing decisions are made in real time… not by union leaders and rigid government mandates.

Widespread implementation here in Massachusetts will slowly bankrupt the nursing profession as nurses become underpaid and overworked, some nurses at the top of their field even doing work in areas that were designed for non-nursing staff—making confidence and morale that much worse.

  1. Fact: Our Healthcare Costs WILL Go Up and Vital Community Programs will Go Down

This mandate is literally unfunded. That means more costs will be passed on to the consumers in the form of higher taxes, insurance premiums, copays, and deductibles. Don’t let anyone fool you into believing otherwise. So many people I know in this state are already struggling to pay for healthcare. This would make it far worse.

Additionally, to meet the staggering cost of this unfunded mandate, hospitals would have to cut vital community health programs such as cancer screenings, opioid treatment and prevention, early childhood intervention, domestic violence programs, and pre- and post-natal care.

  1. Fact: This will be Catastrophic for Behavioral Health

The number one issue affecting our state is behavioral health which includes the opioid epidemic. Statewide, it is projected that we would experience a 38 percent reduction in available inpatient mental health services. This will further reduce access to critically needed psychiatric beds statewide. There is already a nursing shortage especially for behavioral health nurses and recruiting the numbers of nurses required to meet the mandate means an estimated 1,000 of the approximate 2,900 beds currently in service, would need to close. Other hospitals and facilities providing behavioral health services would need to close entirely.


The overarching fact is: Question 1 would have a severe, negative impact on every hospital and community in Massachusetts.

Instead of taking steps to threaten the quality of care, increase costs to patients, and blatantly disregard the professional judgment of qualified healthcare professionals in hospitals throughout the state…

we should stay focused on implementing sustainable, thoughtful and proven solutions in an effort to make significant improvements to patient care and healthcare as a whole.

 

Gioie della Tavola

by Seaglass4Nicole, posted in Home, Inspiring the Senses, Raising Princes in a Pauper Society, Uncategorized

Tuscany

For Italians…the dinner table always serves as reminder that we’re connected to each other and to life itself.

Evoking feelings of nostalgia isn’t a hard task. One scent, one picture…or even one smile can drift you back to that sentimental place or time in the past. After a recent conversation with my Mom, I took a little nostalgic journey back in time, back to a period in my childhood where the “Council” existed. The Council, as it was known, was a regular gathering at my Great Aunt Rita’s house—made up of mostly Italian women—who would congregate around a large dining room table and talk and talk…and talk (usually in debate-style) about life, love, family, politics, memories—all while naturally being encouraged to mangia, mangia over the Italian yummies laid out before them (and yes…I can recall the redolence of anisette in the air from those fresh Italian cookies).

When it comes to Italians or Italy, let’s face it, the first thing people usually think of is the warmth, joy and utter magic created around the dinner table. It’s well known that Italians are accomplished in the gioie della tavola, or “the joys of the table.” In fact, the dinner table is one of the most steadfast images and emblems in Italian art—celebrated in our paintings and films, from the Renaissance to present day.

If you were an outsider looking in on those gatherings of the council, you’d likely be dizzy with confusion—because just like many large Italian families, all gathered around that table would not only talk at higher than normal decibels, but also all at the same time…and don’t forget the hands, which also spoke volumes. But it was there at the table, where hearts would open, and life’s greatest celebrations and sometimes even dramatic battles would unfold.

We all seem to crave time that will create nostalgic memories, like our winter bones crave the warmth of summer. Time with family. Time with friends. Time to reconnect to oneself. Just. More. Time. Yet the irony comes during the week when all we wish to do is speed that time up…a magical fast forward to Friday, where the challenges of the week can be left behind.

For me, with work and school dominating our days, and homework, sports and activities dominating our evenings, there often seems to be little room for creating memories as a family around our dining room table—but they’re a necessity. My boys crave “family nights” in the dining room during the week and they always become the high point of any day. There we connect. We laugh. We pray. We share our struggles and joys…and ultimately we strengthen the bonds of love and friendship.

There aren’t many members of that beautiful Council left on this side of Heaven, and though the table is still there in my Aunt Rita’s house, all you can really see is what is not there anymore. I guess a table is not simply an object in a room, it’s the people gathered around it that bring it to life.

Time is short and precious. Embrace more moments in gioie della tavola…appreciating the magical synergy that is created when the joys of conversation and intimacy commingle with the pleasures of amazing food and drink.

“What must be broken apart in order to bring a family close together? Bread, of course.”

The Swollen Truth about Lymphedema

by Seaglass4Nicole, posted in Beachcombing My Way through Breast Cancer, Uncategorized

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Lymph–what?

Before I personally became affected by its dreadful presence post-cancer treatment, I simply joined the rest of society’s collective yawn in not really concerning myself or knowing much about lymphedema at all. In fact, here we are at the end of March and until a mere 24 hours ago, I had no clue that March was Lymphedema awareness month. Who knew?

So what exactly is it?

This seldom talked about, yet debilitating condition known as lymphedema, means that your lymph vessels are unable to adequately drain lymph fluid—typically from an arm or leg—causing edema or swelling to develop. This blockage of the lymphatic system can be either primary (occurring on its own) or secondary (caused by another disease or condition). Secondary is far more common than primary lymphedema. In fact, one in five individuals who receive conventional breast cancer treatment will be affected by Lymphedema at some point in their life post-treatment. That 20% statistic can sharply increase (even as high as 70%) if any of the following were part of the treatment:

  • Full axillary lymph node dissection (removal of lymph nodes above, below, and under the pectoralis minor muscle—known as levels I-III)
  • Radiation to the lymph node areas after lymph node surgery
  • Extensive cancer in the lymph nodes
  • Chemotherapy
  • Mastectomy rather than lumpectomy

So for me that would be:  check…check…check…check…and CHECK.

Now, if I’ve been consistent with anything on this journey, cancer has surely put me on the path of consistently landing in the bad side effects’ category breast cancer treatment can often induce and even the bad side effects to those side effects.

So lymphedema has joined my world. Permanently.

Now What?

When you’re in the warzone of cancer treatment, your sole focus is simply—getting through it. What happens on the other end of treatment is an entirely new battle, one with less direction.

About six weeks after my bilateral mastectomy, I noticed what appeared to be ropes forming under the skin, extending from the armpit where my lymph nodes were removed down my arm to the wrist. At my next surgical oncology appointment, I talked about the pain and reduction in movement in that arm, and after examining it she told me it was “cording.”

Cording? Apparently axillary web syndrome (AWS) or “cording” is a common sequelae of breast cancer surgeries, especially those involving axillary node dissection with mastectomy. The general school of thought is that trauma from surgery causes a hardening of the connective tissue, which causes those tight cords to form. While there is still a lot of mystery surrounding its occurrence, when you are affected by those thick rope-like strands visible under the skin—you painfully know it.

For me as with many others, post-mastectomy cording was the foreshadowing of lymphedema to come.

It wasn’t long after 35 rounds of radiation to my chest and remaining lymph nodes, that I began noticing pain and weakness in that arm. It was subtle at first, my arm feeling sore and tight, until it progressed to…me catching a football on the field, leaving an indent so deep on my small arm that you could practically see through to the other side. This is what doctors and nurses would refer to as a +4 on the pitting edema scale—very deep indentation lasting for over 15 minutes.

Throughout my entire course of active and hormonal cancer treatment, lymphedema was certainly not the first side effect to rear its ugly head. In fact, when all of my finger- and toe-nails began oozing with infection before lifting off from the poisonous chemo cocktails I was taking, I might have even prayed “anything but THIS side effect.” But the difference between that temporary side effect and lymphedema…is just that. Lymphedema stays for the long haul. Nails grow back and heal. Lymphedema lives on. And with that you must learn the most effective ways to live on with its ugly presence. So I found ways to help reduce the swelling and discomfort. How?

  • Physical therapy. Here I learned ways to help retrain the lymphatic system to recirculate waste to other lymph node areas in the body through self-massage;
  • Compression sleeve. I got fitted for a sleeve, and though it feels constricting, it helps ease the discomfort of pain while encouraging the lymph flow to not get blocked;
  • Exercise plan. Under the discretion of your lymphedema specialist, a regular regimen of stretching and range-of-motion exercises can help strengthen the lymphatic system; and,
  • Lifestyle changes. I’ve had to mindfully change the way I would once mindlessly use my affected arm. For instance, not carrying heavy items in that arm (groceries, handbags, etc.), trying to avoid trauma to the arm, and vigilance in keeping my hands gloved when cleaning to reduce infection/irritation.

These approaches are not the magic cure, but have certainly been beneficial in my case. Other, more advanced treatment options are also available for those with more severe cases of lymphedema.

Side Effects to Side Effects? Really?

russian-nesting-dolls

I’ve always loved Russian nesting dolls. As a child, I would line those beautifully painted little wooden figures up, mother matriarch all the way down to the itsy-bitsiest solid figure, sometimes seeming to go on endlessly. Breast cancer for me has been the mama matriarch in what seems to be an endless set of Russian nesting dolls. The big C has given birth to a multitude of so many other “surprises” on this unchartered journey—lymphedema being one.

Sadly, I would love to say it was that final itsy bitsy solid figure to add to this proverbial nesting-doll-lineup, but of course, that would be somewhat boring…and Lord knows this journey has been anything but dull.

Having lymphedema as a side effect to cancer treatment means as a result, you are likely to face new, more serious side effects and challenges. For me those challenges have come in the form of infections. Complications from these infections can ultimately result in amputation of the affected limb or even death.

Last fall, I woke to what appeared to be a very red, swollen, extremely sore arm and my index finger (where I had pulled a painful hangnail from the night before), was also swollen. My first thought was, maybe I slept on it funny. So I took some ibuprofen and started my morning routine. I remember brushing my teeth thinking, why do I feel so weak this morning? Even though the pain and redness continued to worsen and spread, I realized I had no time to be whining, because my workday schedule was jam-packed and I certainly couldn’t afford to stay home sick.

By the time I reached my office, I collapsed on the floor.

A colleague rushed me to the local emergency room. My heart was beating out of my chest, my teeth were chattering with the chills, and my breathing was extremely rapid. After blood tests confirmed I had sepsis (and clearly going downhill), they rushed me via ambulance to Boston. That became my home for some days, infection reaching my lungs, around-the-clock contemplation of amputating my arm and pretty much my life falling apart.

But here I am, praise God—alive and well.

Sepsis is a systemic extreme inflammatory response to an infection that has spread throughout the blood and tissues. The extremely low blood pressure that often comes with sepsis limits blood flow to the body and can often result in organ failure and death.

As a cancer patient and more significantly…a lymphedema patient, I am more susceptible to these infections because my body is immunocompromised, and because of the weakened lymphatics, my affected arm is considered immunodeficient.

Sidebar: I urge everyone who has lymphedema to be under the care of an infectious disease doctor. These physicians are specially-trained in the recognition, treatment and prevention of infections. Mine has literally kept me in the palm of his hand, and I would hate to not have him as an emergency contact in my phone.

By me pulling a hangnail the night before, not only caused trauma to my affected arm, but it was the very tiny opening that allowed strep bacteria to enter the skin. That’s all it took to put me on death’s doorstep.

Suffering in Silence

Overall, oncology as a medical profession has all too often instilled in patients the idea that there are worse things than some of these silly side effects, including lymphedema, and the only real noble approach to deal with it is to stop complaining and suffer as quietly as possible. Who wants to do that? Because remember, lymphedema has moved in permanently.

Be proactive. Much of my knowledge surrounding lymphedema has been through my own self-education and talking to others dealing with it.

Suffering in silence results in one thing and one thing only—continuing to bask in society’s collective yawn. Change only comes when we demand it. Change only comes when groups coalesce around a compelling cause and systematically advance their agenda in every forum imaginable.

Breast cancer–related lymphedema is a real concern in the breast cancer community and though it’s been difficult to quantify due to both the delayed onset of symptoms and the lack of standardized diagnostic criteria, there is a need for more awareness and education. Be the voice for demanding more support.

One encouraging message about lymphedema is that effective management and skilled experts are available to help you. However, until there’s a collective voice drawing much needed attention to this condition, it is our responsibility to educate ourselves and ask questions along the way. It is our responsibility to get informed and share that information to help others along their, often debilitating journey.

Lymphedema Resources

Books:

Lymphedema: Understanding and Managing Lymphedema after Cancer Treatment by the American Cancer Society (American Cancer Society, 2006)

100 Questions & Answers about Lymphedema by Saskia R. J. Thiadens, Paula J. Stewart, and Nicole L. Stout (Jones & Bartlett, 2009)

Websites:

National Lymphedema Network, lymphnet.org

National Cancer Institute, cancer.gov

Smiling from the Valley of Shadows

by Seaglass4Nicole, posted in Uncategorized

smiling through the shadows

“It is impossible for you to go on as you were before, so you must go on as you never have.”

― Cheryl Strayed

Books.  Some of my best experiences have come from the pages of a writer’s mind.  I’ve been held captive in more books than I can count…some even revisited from time to time when I desperately feel the need to recapture the feeling I once had in between the lines on a page.  I once read that a book is truly the only place in which you can examine a fragile thought without breaking it.

When a friend recently did a random “how well do you know your friends?” quiz with me, one question was:  Does your friend prefer books or movies?  Though she knows I love movies and has actually never really been around me reading a book, she still guessed right away that I was a lover of books. I guess it’s the subjective and evocative nature of written fiction that creates a real intimacy between your mind and emotions—proving Edmund Wilson’s point that no two people have ever read the same book.

Once in a while, however, a movie will come along that resonates deep within me and stays with me like the pages of my favorite reads.  Two such movies have had my mind reeling recently—Wild and American Sniper—both based on memoirs I had yet to read, while also being politically and socially controversial—intriguing me even more.

Wild is a beautiful film based on Cheryl Strayed’s memoir, recounting her solo 3-month, therapeutic journey along the Pacific Coast Trail from the Mohave Desert through California and Oregon to Washington State.  As an inexperienced hiker, Cheryl’s journey was a desperate pursuit, a battle of sorts, to find herself once again after losing her young mother a few years earlier, and further messing up her life through a careless and dangerous fling with heroin leading to a failed marriage.  Her soul’s “sole” mission on the journey was simple:  “walk myself back to the woman my mother thought I was.”  This beautifully poignant memoir carries with it not only the physical weight of Cheryl’s immensely heavy backpack she wore along her journey, but through a series of mini-flashbacks, she further carried the emotional weight of the haunting memories of her loving mother and her own reckless lifestyle.

Truth be told, when it comes to American Sniper I didn’t realize how much this would stay with me.  Both gripping and unforgettable, it highlights US Navy Seal, Chris Kyle’s masterful account of his extraordinary battlefield experiences, in what I consider to be one of the greatest war memoirs of all time.  But ultimately Chris’ biggest battle begins at home, in his desperate attempt to piece together his life on the other side of the battlefield.

Two very different movies, yet both sharing a common thread:  both Cheryl and Chris were each walking through their own personal valley of shadows and found it hard to find the light casting them.

In the late Fall last year, I began experiencing panic attacks and levels of anxiety daily that I have never experienced before.  Often they would even wake me from a sound sleep…in a torturous effort to bind fear and brokenness.  In those dark moments, even with prayer at my helm, I couldn’t shake the 3AM attacks that came out of left field.

For many reasons, I kept the problem tucked away safe within the confines of my mind—finding it too difficult to discuss with anyone, mainly out of guilt.  I felt guilty that I could even be anxious about anything, especially as I watch friends in the cancer community—many in the active battlegrounds of treatment, others actively dying before our eyes.  What could I possibly have to panic or feel anxious about?  Part of me knew that a “positive” attitude in prayer should instead have me celebrating the fact that I’m finally through with active treatment and almost nearing the end of reconstructive surgeries.

But it wasn’t that simple.

At a regular appointment with my oncologist in early December, I broke my silence about the situation.  When she first told me what she believed was going on, I was in denial. There must be another “PTSD” than post-traumatic stress disorder, I thought.  How can someone compare my cancer journey to the many war veterans that legitimately have PTSD, like the Chris Kyle’s out there who have heroically served on the front lines and witnessed firsthand the horrors of battle.  After all, I am just an ordinary person, a simple girl, who happened to go through what millions of other people before me have gone through in the realm of surviving a cancer diagnosis.

My oncologist went on to share with me that though it’s often easy to only place victims of PTSD with war soldiers returning home from battle; in fact, the condition is believed to be caused by the experience of a wide range of traumatic events including death, serious illness or some situations in which the individual felt intense fear, horror, or powerlessness.  She also revealed that what was going on with me was common timing among many young cancer survivors out of active treatment.  That said, she suggested I go on a short term, mild antidepressant that was considered a popular, safe choice with many cancer patients.  I took her advice and after a few weeks on the drug, I found myself in the small percentage of patients who had extreme adverse effects, including racing heart, blurry vision, unbearable muscle cramping, vivid nightmares, severe depression…and much darker thoughts of suicide—something completely foreign to me.

Currently, as I’m on the upside hike of that downhill spiral, it seems I had built such a wall between my cancer diagnosis and treatment experience and how I felt about the entire experience that I was incapable of reliving both simultaneously.  I could talk about everything that happened, even walk through treatment and surgeries with a smile, but I couldn’t feel them.  When I tried to bring it all together in the fall, when I tried to remember how I had felt and the frenzy the last two years had been…I disappeared in my own head.

Chris Kyle’s journey from the throes of war back to civilian “normalcy” was clearly no easy feat… his memories of life in battle and his longing to be “back to normal” in civilian living were nearly impossible to experience simultaneously.  As Chris finally found the light casting his dark shadows through passionately serving soldiers struggling with the fight to overcome PTSD, he went on to shine the spotlight bright on the condition, co-founding FITCO Cares, the non-profit foundation dedicated to help ease veterans back into civilian life.

As Cheryl Strayed’s journey along the Pacific Coast Trail progressed, as she shed the physical load and symbolic emotional weight from the backpack—some of those deep wounds of death and destruction were able to find air to breathe…and heal.  Towards the end of Wild, approaching journey’s end at the Bridge of the Gods over the benighted Columbia River, Cheryl writes: “I felt fierce and humble and gathered up inside, like I was safe in the world now.”  Cheryl, too, had found the light that had cast her darkest shadows.

Carrying heavy loads we were never intended to carry, filled with things such as fear, worry, discontent and heartache—make it easy to grow weary and worn out.  We all fight battles in one form or another, and sometimes it’s our frail human nature that desperately pleads for these battles to be taken away from us.

Many times we carry these loads as we walk through the valley of shadows…never realizing that it’s only in struggling with these shadows that the light is made manifest.

Though I am but a work in progress I will never cease to thank you, Lord for Your mercies that are new every morning…

Psalm 57:1

Have mercy on me, my God, have mercy on me, for in you I take refuge.  I will take refuge in the shadow of your wings until the disaster has passed.

chris kyle

Chris Kyle’s service, life and premature death will never be in vain.

Promises Live on the Other Side of the Rain

by Seaglass4Nicole, posted in Uncategorized

Rainbow

There is no pain so great as the memory of joy in present grief.

Aeschylus

I’ve been sporadic at best in blogging, but in all honesty life has been anything but mundane.  In fact “blur” is the only four-letter word that could adequately describe the past month and a half—well perhaps not the only four-letter word.

My family is still reeling from two harrowing losses, only three days apart—my Grandmother, the matriarch of our family and her youngest daughter, Dolores, my Aunt who was only 53 years old.  The shock is still fresh—with the chaos of funeral arrangements and such, making it both easy to compartmentalize the grief while simultaneously making it hard to focus on the heart’s cry.  I often feel like my life is sadly akin to my drafts folder—those half-articulated writings I fully intended to finish and publish, but instead they sit, waiting hopelessly for my procrastinating hand to press send. My drafts folder in life seems to consist of the many thoughts and pain, those areas I’ve started to deal with, but instead put them on the mental back burner.  I guess some things are just too overwhelming to take in all at once.

Rain.  I have a sort of love/hate relationship with the rain.  It can be the very sound of comfort and nostalgia, rhythmically helping me relax and sleep at night. Yet rain, when you’re seeking solace under the warm sun—becomes disheartening at best.  Though we can’t predict the weather, I can always predict disappointment when you wake up on your first day of vacation, to grey skies and the sound of rain pouring down on the roof.  Over Spring break I arose to such a morning on the Outer Banks in North Carolina.  It may sound childish, but inside I had a bit of a mental temper tantrum.  I so desired some long overdue down time for the entire family—sunny opportunities to escape the responsibilities and realities of daily life as we know it.  The rain was killing my buzz.

The Outer Banks was my escape plan.  When you receive a cancer diagnosis, everyone in the family receives a cancer diagnosis.  There, I planned to be still and enjoy beach life, while also taking a bit of time to reflect on the past year and a half—the challenges of treatment, and the challenges and triumphs of balancing family, work, life … and cancer.  I was excited for my entire family—even my sweet German Shepherd, Miles—to finally get away from our chaotic daily routines and instead enjoy sun-filled, fun days … away from it all.  My disappointment was soon turned around as the weather became sunshine and blue skies, blessing us with beautiful days amidst a surreal backdrop of fantastic beach and dunes.  The promises and desires for that Spring family holiday lived boldly on the other side of the rain, and I will forever cherish the memories made.

Unfortunately, it was during one sunny day on our Outer Banks’ adventure that the phone call came in from Maine, informing us that both my Grandmother and Aunt were brought to Maine Medical Center, both in critical shape.  We learned my Aunt had been brought into surgery to help stabilize blood clots that had formed around her lung and heart.

In the few days to follow, they managed to stabilize my Aunt and she appeared to be doing well enough to leave the intensive care setting to a regular hospital room.  My Grandmother, however, had reached a point of finality in her long journey with Leukemia & rare blood disorder.  After two and half years of (often weekly) blood transfusions, she was worn out.  She informed her doctor she was done with treatment.  We all knew some day ‘that day’ would come … but it’s never easy when it does.  We all stood coping with the realization that Grammie would decline quickly without her transfusion and would now be entering Hospice care—in a long-term care facility in Portland.

Two days before my Aunt’s untimely death—Michelle, my Sister, captured the phenomenal rainbow pictured in this post, outside my Aunt’s hospital room window.  My Aunt was fascinated with its beauty and in a short call with me and my boys that same evening, she said, “Just think, I’ll be going home, good as new on Tuesday.”  I believe in my heart, that is just what she did.  As the ambulance arrived to move her to rehabilitation Tuesday afternoon, amazingly to the same long-term care facility my Grammie was in, my Aunt coded. Gone at 53 years old.

She did go home as good as new that day to a place where she will run and not grow weary, walk and not be faint … have a clear mind—no longer battling bipolar-depression.  Physically and mentally, free at last.  We all joined together around my Grammie in those final days still trying to exhale the shock of my Aunt’s death.   My Grammie went home to be with the Lord three short days after her baby girl.

We celebrated their lives in one service together…as they always were—together, for the past 53 year.  Our hearts ache, though we find comfort in the knowledge that they are forever intertwined in Heaven—free.

My sister and I gave the eulogy at the service, and though difficult, we felt compelled to share our hearts even though we knew without a doubt we would fail to perfectly articulate the immeasurable and indescribable Mother, Aunt, Grandmother, Sister, Cousin, Great-Grandmother, Niece and friend found in the two beautiful women who have been an integral part of our family our entire lives.

Grief is the price we pay for love, just as it is impossible to capture the rainbow without the rain.  Though I know I will find myself searching the crowds for their faces for years to come … the truth is I am blessed for the love and rich memories I will forever hold in my heart.

I am honestly not inviting you to a pity party, but my life has been seemingly under torrential rains since the dreaded day I heard the words ‘you have Stage III breast cancer.’  Tomorrow, I face the long reconstructive surgery exactly one year from the dreaded bilateral mastectomy.  Though I would be lying if I said I’m not a bit nervous to undergo such a big operation … my heart’s desire is that it will bring me one step closer to seeing the beautiful promise only a rainbow can bring … on the other side of the rain.

Your thoughts and prayers for a seamless procedure and recovery are greatly appreciated.

Like the appearance of a rainbow in the clouds on a rainy day, so was the radiance around him. This was the appearance of the likeness of the glory of the Lord.

Ezekiel 1:28

The Gift of Living Well

by Seaglass4Nicole, posted in Uncategorized

candles

God gave us the gift of life; it is up to us to give ourselves the gift of living well.

Voltaire

Last year on this very date I sat in a room … a room with a view, in fact.   Sitting 9 floors above the hustle and bustle of city life, instead of celebrating my birthday with a view from a hotel suite, my view was in a chemo suite at Dana-Farber Cancer Institute.  Bald and weary, I sat with an IV drip—on my 7th week of chemotherapy.  I clearly remember thinking:  Wow, how is it that I’ve complained about birthdays … while only dancing into my 30s … and now I’m not so sure I’ll live to see 40.

So though I don’t typically like to toot my own birthday horn—if getting through this past year has taught me anything, it’s that I cannot afford to be casual or glib about birthdays ever again.

So my birthday wish this year when I blow out those candles tonight will be all about a prayer to live well … seizing each day … moment to moment … hour to hour.

Thank you, God, for giving me the gift of life.  Forgive me for all times I’ve squandered precious moments and opportunities to live it well.

Today I celebrate the gift of life.  I’m alive.  Thank God.

Nicole

Sailing Strong in the Winds of Affliction

by Seaglass4Nicole, posted in Beachcombing My Way through Breast Cancer, Raising Princes in a Pauper Society, Uncategorized

Adversity is the diamond dust Heaven polishes its jewels with.

Thomas Carlyle 

On the tender heels of Thanksgiving, my 11-year old, Colby asked to share a bit of his heart from this past year.  I’m overwhelmed posting this … but it’s wonderful to see my 3 beautiful boys holding on and pressing in to the gift of Faith that they have eagerly unwrapped.  I am blessed.

A Year of Cancer through the Eyes of a Child

Colby

Thanksgiving was a really good time for me to look back on my life, including the rocky road of the last year and find all of the blessings that abound.  I truly thank God for my life, my health and SO much more … my family, house, food in my stomach, a free country, my Mom’s health, my education, and the very air I breathe.  I realize that sometimes God throws tough times (tests) at you.   In order to get an A+ on each test, you must remain faithful to Him, and never give up.  Even though this was a struggling time in our family we never gave up on Mom, or God.

So the big test, the journey we never expected to take was this past year.  The test has been the most difficult one I’ve taken so far in my 11 years.  On December 26, 2012 my Mom and Dad called my brothers and me into their room.  As they told us that the call came and a stage III breast cancer diagnosis was confirmed—I felt a sudden pain in my gut.   At that moment I knew it was serious … this was really happening.   My parents were open and honest about everything they knew, and that alone helped to make us feel safe.  Though I know people who have gone through cancer, it’s hard to imagine it happening to my Mom.  It was very hard to believe, and though at first I didn’t want to, I knew that I had to face reality and trust God to take the wheel.

Before that dreaded day, we knew “cancer” was definitely a possibility.  But regardless of that thought lurking days before Christmas, my parents made everything as normal as possible and full of love.  They still showed us the wonder and generosity of the season in the face of such upsetting news.  Shortly after diagnosis, the next challenge was learning that chemotherapy treatment would be the first thing my Mom would experience.  My parents helped to explain chemotherapy and the side effects that would likely happen.  It helped me to know that if and when Mom was sick, it was not because the disease was making her sick, but instead because the medication was attacking the cancer cells with the intent to make her better.

My Mom was strong and worked through treatment.   Every Thursday for 20 weeks starting in January, she would go into Dana-Farber Cancer Institute. Though I was not able to go with her every week, my Mom made special arrangements to be sure we went with her at least a few times.   I think my mom wanted my brothers and I to see that chemotherapy wasn’t scary.  The first time I went to Dana-Farber I was a bit nervous, thinking it would be creepy with a lot of very sick people there.  It didn’t take long to learn that my fears were far from the real thing.  Though difficult for the patients experiencing chemo, the people and atmosphere were both warm and welcoming.

Chemo was still sometimes scary for my brothers and me.  It’s awful when you want so much to take away someone’s pain but can’t.  During this time I tried to help in every way possible throughout the house.  Since mom was getting weaker after many treatments, her ability to do all the things she used to do in the house decreased.  I tried to spend time after school doing some simple cleanup and chores around the house.  It felt good to give back to her, especially when she was tired and struggling with a serious illness.  I hated seeing her sick and really loved making her happy. I knew that as tough as chemo was, it was made to help stop the cancer in its tracks.

When my Mom started to lose her hair during chemotherapy, as a family, we gathered and made a family time to shave her head.  I know it was hard for her to lose her beautiful hair, but we helped to lighten the mood with a little “buzz” party.

Chemo was a very difficult time, but we got through it as a family.

Things moved fast.  After Chemo was finally over, Mom was trying to get strong for surgery.  The goal of surgery was to remove any remaining cancer out of her body.   I was very scared for her. Every night I prayed, and prayed that she would be fine. The day of surgery finally came (actually on my younger brother, Logan’s birthday).  My Mom was a brave person on that day.  She was in the hospital for 5 days and we missed her so much.  My grandparents watched us and helped prepare for Mom coming home.  Before she arrived, we made her a big “WELCOME HOME!” sign.   She lit up seeing that and it made us so happy!  When she got home, things were tough for a while.  She was always very sleepy and never felt good.   But, The Lord is good.  He kept her safe through all of this.

Radiation treatment came next.  Mom was a little anxious at first, but then she learned that it wouldn’t be as bad as the other treatments.  I was so thankful that she had gotten through the treatments before. Through the house, all of us were asking questions like “Doesn’t radiation give you cancer?” and “Won’t you get burned?” All of the questions were answered, and we weren’t as anxious as before. The family got together and prayed that mom would get through the last treatment. Mom did get some burns, but she took it in stride … nothing too bad.

I love that my parents have been honest with everything going on.  They always make us know that we can go to them anytime with any question and we trust and believe that they will answer it honestly.

I thank God every day for Moms health. I hope and pray that God will always keep her in his healing hand.

My heart goes out to other kids traveling this same road.  My prayer is that they will have Faith and believe that God has them in the palm of His hand regardless of the situation.  Thieves can’t take you away when you’re resting in the palm of His hand.

–Colby

“For by grace you have been saved through faith, and that not of yourselves; it is the gift of God, not of works, lest anyone should boast”      —Ephesians 2:8-9

Swinger of Birches

by Seaglass4Nicole, posted in Uncategorized

birches

. . . So was I once myself a swinger of birches.  And so I dream of going back to be. It’s when I’m weary of considerations, and life is too much like a pathless wood where your face burns and tickles with the cobwebs broken across it, and one eye is weeping from a twig’s having lashed across it open. I’d like to get away from earth awhile and then come back to it and begin over.  May no fate willfully misunderstand me and half grant what I wish and snatch me away not to return. Earth’s the right place for love …

–Robert Frost

I love birch trees … I always have.   The beautiful bark and graceful branches and shape have long been sought after landscape choices for many seeking beauty and exquisite charm in a simple, artistic way.

Some months back I remember traveling and as the passenger looking dreamily out the window, I saw what seemed to be a good mile of nothing but clusters of birch trees.  I was mesmerized by the beauty and remember commenting to John how I’d love to be lost there in the woods amidst the birches.  Fortunately, John’s known me long enough to know how “unique” my imagination is . . . but also how crazy I am; therefore sped up a bit, most likely afraid I would ask him to pull over and drop me off—me all too eager to be lost in the “forest of birches”.

Surgery happened.

My surgical oncologist is a rock star and knowing a bit about my music interests and the frame of mind I was in, I let her choose what music would be played in the OR.  So after praying and being wheeled down the hall, I entered the bright OR with the very unique and melodious Dido—calming my nerves incredibly.  My surgeon and anesthesiologist held my hands until I slipped away to Dido’s beautiful voice, remaining in never-never land for the next 7 hours.

I don’t actually recall awakening per se, but I do remember in my dreamy, morphine fog, seeing John for a moment, next my mom, and then my sister.  My eyes couldn’t stay open for long, but what I later realized was that I had to be alone that night, which killed me.  My family was told they were only allowed about two minutes to see me as we learned the hospital was over-capacity, meaning  there were no rooms to send me to—so I would be spending at least one night alone in the PACU, no visitors allowed. The pre/post anesthesia care unit (PACU), consisted of a lovely 2×4 curtained-space where I was surrounded by sick people going in or coming out of surgery.   Not to whine, but I honestly felt helpless and alone, knowing that my ONE expectation and comfort pre-surgery was that I would have my family around me when I awoke.  In my mind, I needed this more than ever, because though this necessary “thing” needed to happen, this surgery (that I still don’t vocalize all that much), the thing that was vainly and intensely dreaded—yet eagerly anxious to get over with, hoping to remove this thing called cancer out of my body (with the goal:  for good)—I felt more vulnerable and weary than ever and desperately needed people who loved me around me when I awoke.

Now let’s face it— typically, any type of amputation is a day surgery these days with insurance or at best an overnight stay.  Staying 4 nights was over the top for my little “Angie Jolie” procedure.   The result of my surgery was apparently “beautiful” …. odd choice of wording, but okay, whatever.   By the middle of day two in PACU-ville (still no room available) I was told I would have a private room by dinner time.  Yay.  What I didn’t know was that in all the unseemly unfairness in my “lonely Nicole land”, the staff, some very special angels in my midst who really understood my emotional struggle really hooked me up—BIGTIME.  My room was in the “celebrity hotel quarters” of the hospital, or the place where those who choose to spend a month’s salary per night out of pocket after insurance go to heal—private chef and all.  Honestly, God is good, because this is NOTHING I would ever choose even if I were celebrity-status, but after my disenchantment post-surgery, it was indeed a lavish treat, though not exactly one of my “bucket list” return spots of interest.

In and out of sleep the last two weeks, I’ve thought and dreamt about birch trees … I don’t know why, but they’ve visited me in my dreams.   What does the birch tree symbolize?  I guess from what I’ve gathered, the birch tree symbolizes a fresh start and can bring courage and determination especially to those of us who are treading the path of spiritual growth and weariness.   Although the birch does appear fragile, in all its “romantic” carving ability . . . (y’know , the way lovers can permanently make a mark on its writeable bark), instead, the birch tree is extremely hardy—teaching us that in apparent weakness there is often to be found great strength.

Worldwide, birches also promise new life and love, and are great symbols of purification and renewal, helping to focus our attention on our potential for change and on the consideration of new directions and goals to be experienced in our lives.

When I think of Robert Frost’s masterpiece—“Birches” I’m reminded of the swinging motion—the substance of the poem and the deep force that comes with such a motion.  My life is filled with the contrary pulls of truth and imagination.  Tangible and spiritual.  Control and abandon. Flight and return.   The upward “swinging” substance of the poem brings me to imagination and escape—away from the ultra-heavy truth of cancer and all the changes and uncertainties it has brought to my life and those I love.  The downward “swing” and truth of Frost’s brilliance, brings me back to earth, to face the challenges set before me and to look with fresh eyes at the many areas of my life that need clearer focus, new direction, deeper love.

I’ll be honest—Truth with a capital T for me is that I often desire to get away from the earth awhile these days, becoming a swinger of birches.  The thought and attraction of climbing a beautiful birch, leaving the difficulties and weariness of this journey behind is in many ways a no brainer.  Who wouldn’t want to escape?  Life is so much like the “pathless wood” Frost speaks of.  One easy way to navigate would be to climb a tree, high above every obstacle below.

God, however is Love and has intricately put each of us here for a plan and purpose bigger than ourselves.  When I think of that, it motivates me to pursue all He has planned for me regardless of how much time that may mean here on Earth.  I love how Frost says in his poem:  “Earth’s the right place for love.”   For now, he couldn’t be more right.  In my deeply imperfect state, constantly craving escape, I must return from my upward swing and come back again … to keep going where He wants me.   I’ll always want to push toward Heaven, where difficulties and heartache don’t exist, but as His plans have me here, I need to know the limits and limitless abilities my Father has chosen for me, and pursue them now with passion.

Yes . . . I love birch trees.  They are the perfect vehicle.  A thrill to climb, yet firmly rooted in the ground—never allowing one to sever the ties God has with His plans for us here on Earth.  Swinging down takes experience, skill and courage . . . leaving that higher place.  It means that you take risks and you explore the mysteries of life. Being a swinger of birches means I can look back on life and be proud of the accomplishments and challenges.

I’d like to go by climbing a birch tree, and climb black branches up a snow-white trunk toward heaven, till the tree could bear no more, but dipped its top and set me down again.  That would be good both going and coming back.  One could do worse than be a swinger of birches.     

Tomorrow’s a new day, and actually the day I will learn of my pathology results and hopefully have these dreaded drains removed … (for all you who’ve had them, you know EXACTLY what I’m talking about).  I will keep you updated on the news of my results.

Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day.      

2 Corinthians 4:16

Nicole

 

 

You Just Can’t Overstay Hope’s Welcome

by Seaglass4Nicole, posted in Uncategorized

spring

Hope (hōp)

Verb:   to cherish a desire with anticipation

Do not spoil what you have by desiring what you have not; remember that what you now have was once among the things you only hoped for.

~Epicurus

Hope brings significance to each and every moment we encounter.   Without it . . .  there’s no meaning to anything under the sun.

I know it has been a while since my last post.  Truthfully, this month has been a challenge—physically, mentally and spiritually.  Early in the month, I started my new chemo regimen:  dose-dense AC infusions—every other week.   I didn’t realize how emotionally bankrupt I would soon become.  I guess as my blood counts drop, zapping my energy level  like a nuclear missile—my spirit seems to wither too, much like the beautiful,  luxurious flower arrangement my nieces sent my way recently, one I’ve been desperate to keep alive.

Spring.  It’s funny the little things a girl thinks about as Spring emerges:   manis, pedis, new open-toed sassy stilettos  . . . perhaps a new outfit or two.  I covet my yearnings for these things that are simply not to be for me this year.  As I try desperately to hide my hideous nails in public, each one purple and black, lifting from chemo-related blood and infection . . . and my equally hideous, neuropathy-plagued feet, no longer acceptable for open-toed sassy shoes or pedis­­—I indeed feel deprived and sad.  Today, Lance, my 7-year old, in all his sweet honesty, pointed out the other sad fact that my eyebrows are disappearing, the final hair follicles to die.  The simple fact is:  it’s hard for me to have a Spring in my step or outlook these days.

Regardless of my thoughts filled with vain minutiae, Spring continues to unfold and as the crocuses begin to blossom in my yard, it’s impossible not to hear the heralding trumpet of new life spring forth.  With it comes a glimmer of excitement—a hope that day by day the season will continue to blossom, inspiring beauty in its warm welcome.

These days, my life is filled with urgent intention.  In fact, I find myself anxious and depressed when I’m too fatigued to move because I’m afraid I’m going to miss a moment, a great memory I can’t afford to lose . . . a picture that can never be recaptured.  Reflection has become part of my season of change.  Like Spring’s weather, this season of my life is a gentle reminder that I need to be cognizant of the rebirth taking place all around me—those  blossoms that not only take shape in my yard, but in my relationships . . . in my children, in myself.  Just as I need Faith to hold me together, I need hope to push me forward.

Making it a mission to treat hope as a verb, I choose to actively cherish my desires for the future with anticipation.  Spring is here.  It’s the start—a rebirth from seeds of hope.  I must cherish this moment.  This place.  This time.  It knows no bounds . . . you can never overstay Hope’s welcome.

Rejoice in hope, be patient in tribulation, be constant in prayer.  ~Romans 12:12 

Breaking Through My Shell

by Seaglass4Nicole, posted in Uncategorized

chick

When we lose one blessing, another is often, most unexpectedly, given in its place. 

~C.S. Lewis

I cherished every part of today.  The message of Easter is the very heart of Hope.  Redemption . . .  resurrection  . . . rejoice!  The key event surrounding that first Easter over 2,000 years ago is the very event central to my Faith:  the empty tomb.  It never gets old to hear the Easter story, and this morning was no different, only it was extra special to have my parents and sister and her family with me in church and throughout the day.

So many times in life, it is easy to be consumed by disappointment.  Circumstances.  Relationships.  The very things and people that create amazing and beautiful memories can also be the very source of pain and heartache.   Just as I have been astonished at the people in my life who have gone above and beyond to bless my family through this trial, I am equally dumbfounded to see the “friends” in my life who have disappeared since diagnosis.  Deep down my heart longs to give grace to those who are clearly too consumed by their own “discomfort” about my diagnosis to acknowledge me at all, but the honest reality is that it’s quite disappointing and in many ways makes me wonder how they were ever part of my life pre-diagnosis.

Each one of us is in search of a Hope that is everlasting.  It’s impossible for people or things to fulfill that desire.  If we allow the disappointments of events in our life dictate our happiness, we will all eventually be left in a state of discouragement.

On Saturday, my youngest son, Lance learned that after building a wonderful relationship with his piano instructor for several months, she left the music school—disappeared without so much as a note to her students.  My heart sank for Lance.  The situation, however, was the perfect opportunity to reinforce to each of my boys that even in the face of disappointment—a blessing always awaits on the other side.  I’m not denying that those moments aren’t painful or frustrating, but what’s great is that each one can be used as an opportunity to grow in our Faith, the only true source of contentment.   We can take the “dis” in disappointment and turn it into “divine” appointment.

God’s infinite love and mercy was revealed that first Easter morning, and through His resurrection, we can confidently stand with the precious Truth that He is alive and that His hand is upon our lives.  Today, at the root of all the joyous revelry that was celebrated, was the good news—“He is risen!”

Right now I feel like that tiny chick waiting to break through my shell, into the light.  I’m further reminded that the darkest part of night comes just before the break of dawn.  Out of the darkness, emerges new life, a new Hope.

I am excited to take my current DISappointment in life and turn it into a DIVINE appointment.

Nicole