Monday, July 28, 2008

I'm about $40 off of hitting my complete out of pocket expense


It's July 28th and I just got my hospital bill from my recent surgery. With that bill, I'm just $40 something dollars away from reaching my complete out of pocket for 2008. I think this is both a good thing and a bad thing.

It's good because I will not have to pay anymore money for my insurance for the rest of this year! This doesn't include my recent gynecological visit, oncology visit, follow up with my breast surgeon tomorrow, blood work to check my glucose and thyroid, my CT chest, pelvis and bone scans, my implant switch, nipples, tattoo, and my final visit with my oncologist for 2008.

The bad thing is that I've spent almost $4500 on insurance this year and it starts all over come January 2009. As often as I complain about my insurance company, I'm also very thankful that I have insurance and most importantly that I can afford to pay for my high deductible.

I haven't splurged on much the past two and half years but Italy is on my bucket list. It will give me an opportunity to start saving the last 5 months of this year so I can scratch Italy off my list!

Friday, July 25, 2008

Gandhi's Top 10 Fundamentals for Changing the World

A friend sent this along to me and it was so wonderful that I needed to post it to share with others. I am trying to focus on being proactive (from Covey's Seven Habits,) live in the now (from Tolle's Power of Now) and trying to finish up Eat, Pray, Love by Gilbert. My group is doing a book discussion on Eat, Pray, Love so I'll share my thoughts on that when I complete the book.

Gandhi’s Top 10 Fundamentals for Changing the World

Gandhi’s Top 10 Fundamentals for Changing the World“You must not lose faith in humanity. Humanity is an ocean; if a few drops of the ocean are dirty, the ocean does not become dirty.”

“The difference between what we do and what we are capable of doing would suffice to solve most of the world’s problem.”

Mahatma Gandhi needs no long introduction. Everyone knows about the man who lead the Indian people to independence from British rule in 1947.

So let’s just move on to some of my favourite tips from Mahatma Gandhi.

1. Change yourself.

“You must be the change you want to see in the world.”

“As human beings, our greatness lies not so much in being able to remake the world - that is the myth of the atomic age - as in being able to remake ourselves.”

If you change yourself you will change your world. If you change how you think then you will change how you feel and what actions you take. And so the world around you will change. Not only because you are now viewing your environment through new lenses of thoughts and emotions but also because the change within can allow you to take action in ways you wouldn’t have – or maybe even have thought about – while stuck in your old thought patterns.

And the problem with changing your outer world without changing yourself is that you will still be you when you reach that change you have strived for. You will still have your flaws, anger, negativity, self-sabotaging tendencies etc. intact.

And so in this new situation you will still not find what you hoped for since your mind is still seeping with that negative stuff. And if you get more without having some insight into and distance from your ego it may grow more powerful. Since your ego loves to divide things, to find enemies and to create separation it may start to try to create even more problems and conflicts in your life and world.

2. You are in control.


“Nobody can hurt me without my permission.”

What you feel and how you react to something is always up to you. There may be a “normal” or a common way to react to different things. But that’s mostly just all it is.

You can choose your own thoughts, reactions and emotions to pretty much everything. You don’t have to freak out, overreact of even react in a negative way. Perhaps not every time or instantly. Sometimes a knee-jerk reaction just goes off. Or an old thought habit kicks in.

And as you realize that no-one outside of yourself can actually control how you feel you can start to incorporate this thinking into your daily life and develop it as a thought habit. A habit that you can grow stronger and stronger over time. Doing this makes life a whole lot easier and more pleasurable.

3. Forgive and let it go.

“The weak can never forgive. Forgiveness is the attribute of the strong.”

“An eye for eye only ends up making the whole world blind.”

Fighting evil with evil won’t help anyone. And as said in the previous tip, you always choose how to react to something. When you can incorporate such a thought habit more and more into your life then you can react in a way that is more useful to you and others.

You realize that forgiving and letting go of the past will do you and the people in your world a great service. Spending your time in some negative memory won’t help you after you have learned the lessons you can learn from that experience. You’ll probably just cause yourself more suffering and paralyze yourself from taking action in this present moment.

If you don’t forgive then you let the past and another person to control how you feel. By forgiving you release yourself from those bonds. Then you can focus totally on, for instance, the next point.

4. Without action you aren’t going anywhere.

“An ounce of practice is worth more than tons of preaching.”

Without taking action very little will be done. However, taking action can be hard and difficult. There can be much inner resistance.

And so you may resort to preaching, as Gandhi says. Or reading and studying endlessly. And feeling like you are moving forward. But getting little or no practical results in real life.

So, to really get where you want to go and to really understand yourself and your world you need to practice. Books can mostly just bring you knowledge. You have to take action and translate that knowledge into results and understanding.

5. Take care of this moment.

“I do not want to foresee the future. I am concerned with taking care of the present. God has given me no control over the moment following.”

The best way that I have found to overcome the inner resistance that often stops us from taking action is to stay in the present as much as possible and to be accepting.

Why? Well, when you are in the present moment you don’t worry about the next moment that you can’t control anyway. And the resistance to action that comes from you imagining negative future consequences - or reflecting on past failures - of your actions loses its power. And so it becomes easier to both take action and to keep your focus on this moment and perform better.

6. Everyone is human.

“I claim to be a simple individual liable to err like any other fellow mortal. I own, however, that I have humility enough to confess my errors and to retrace my steps.”

“It is unwise to be too sure of one’s own wisdom. It is healthy to be reminded that the strongest might weaken and the wisest might err.”

When you start to make myths out of people – even though they may have produced extraordinary results – you run the risk of becoming disconnected from them. You can start to feel like you could never achieve similar things that they did because they are so very different. So it’s important to keep in mind that everyone is just a human being no matter who they are.

And I think it’s important to remember that we are all human and prone to make mistakes. Holding people to unreasonable standards will only create more unnecessary conflicts in your world and negativity within you.

It’s also important to remember this to avoid falling into the pretty useless habit of beating yourself up over mistakes that you have made. And instead be able to see with clarity where you went wrong and what you can learn from your mistake. And then try again.

7. Persist.

“First they ignore you, then they laugh at you, then they fight you, then you win.”

Be persistent. In time the opposition around you will fade and fall away. And your inner resistance and self-sabotaging tendencies that want to hold you back and keep you like you have always been will grow weaker.

I think one of the reasons people don’t get what they want is simply because they give up too soon. The time they think an achievement will require isn’t the same amount of time it usually takes to achieve that goal. This faulty belief partly comes from the world we live in. A world full of magic pill solutions where advertising continually promises us that we can lose a lot of weight or earn a ton of money in just 30 days.

8. See the good in people and help them.

I look only to the good qualities of men. Not being faultless myself, I won’t presume to probe into the faults of others.”

“Man becomes great exactly in the degree in which he works for the welfare of his fellow-men.”

“I suppose leadership at one time meant muscles; but today it means getting along with people.”

There is pretty much always something good in people. And things that may not be so good. But you can choose what things to focus on. And if you want improvement then focusing on the good in people is a useful choice. It also makes life easier for you as your world and relationships become more pleasant and positive.

When you see the good in people it becomes easier to motivate yourself to be of service to them. By being of service to other people, by giving them value you not only make their lives better. Over time you tend to get what you give. And the people you help may feel more inclined to help other people. And so you, together, create an upward spiral of positive change that grows and becomes stronger.

9. Be congruent, be authentic, be your true self.

“Happiness is when what you think, what you say, and what you do are in harmony.”

“Always aim at complete harmony of thought and word and deed. Always aim at purifying your thoughts and everything will be well.”

I think that one of the best tips for improving your social skills is to behave in a congruent manner and communicate in an authentic way. People seem to really like authentic communication. And there is much inner enjoyment to be found when your thoughts, words and actions are aligned. You feel powerful and good about yourself.

With these channels in alignment people tend to really listen to what you’re saying. You are communicating without incongruency, mixed messages or perhaps a sort of phoniness. Also, if your actions aren’t in alignment with what you’re communicating then you start to hurt your own belief in what you can do. And other people’s belief in you too.

10. Continue to grow and evolve.

”Constant development is the law of life, and a man who always tries to maintain his dogmas in order to appear consistent drives himself into a false position.”

You can pretty much always improve your skills, habits or re-evaluate your evaluations. You can gain deeper understanding of yourself and the world.

Sure, you may look inconsistent or like you don’t know what you are doing from time to time. You may have trouble to act congruently or to communicate authentically. But if you don’t then you will, as Gandhi says, drive yourself into a false position. A place where you try to uphold or cling to your old views to appear consistent while you realise within that something is wrong. It’s not a fun place to be. To choose to grow and evolve is a happier and more useful path to take.

Thursday, July 24, 2008

Fertility


I've recently visited my sweet nephews in NM over the 4th of July. They are so precious to me. I'll be hitting 32 this year and will need to be on Tamoxifen for another 3 years. My oncologist believes I'll have the capability to naturally conceive.

From what I have learned, if you are close to menopause or even in your mid or late 30's you may be thrown into complete menopause after finishing your treatments, mainly chemo and hormone inhibitors. I completed chemo at age 29 and will finish Tamoxifen at 2011 and right before my 35th birthday. My cycle returned 4 months after my last chemo treatment and while I was on Tamoxifen.

Because everything was such a whirlwind, I never looked into fertility assistance. I met with a counselor prior but the cost and the uncertainty of whether or not it would work made me leave my fate of having my own biological children to mother nature. I would adopt if I was left infertile.

Fertile Hope is an organization that helps provide resources and financial assistance to those that need it. http://www.fertilehope.org/

I never wanted any children until I had my second batch of students here in Austin. They were the sweetest, funniest and most darling group! From that point I thought having one child would be ideal for me. I'm not the typical woman that wants 2 to 3 children. I taught children for 8 years and adore them. However, I also know what I can "handle" and one is where I think (hope) I would make the best parent.

There is a test to see if I am or am not fertile. I go see my ob/gyn today so I'll need to inquire some more about that. I need to do more research on this but will keep you posted. I also posted about Jessica Queller who wrote Pretty is What changes. She faced this same problem not due to treatment but due to age.

Of course, I would not be able to breast feed. Mother's Milk Bank costs around $4 per ounce of milk! There are many things to ponder.

Saturday, July 12, 2008

My Expanders

I had my third and final fill June 30th. I have a total of 330 cc in me. The first week was pretty uncomfortable but I'm doing well now. I am getting used to the size and I can go on slow jogs now.

They also recommended using Scar Guard to help minimize the scarring. I've been brushing that over my incision every night and topping it with extra vitamin E for good measures. So far, so good.

I had the opportunity to play badminton with my nephew while I was in NM. Besides reaching for some birds and feeling a pull, I felt pretty good. Mary Ann has inspired me to start playing tennis again. I may have a ways to go before I can do that but it's on my to do list!

Another thing that I have found difficult to do is to hold a baby. My expanders are pretty firm to the touch so it makes it difficult when I'm trying to hold the baby close to me. It makes me sad because know many women that were diganosed while either pregnant or breast feeding.

Monday, June 30, 2008

My Bucket List


Bucket List came out in 2007 starring Jack Nicholson and Morgan Freeman.

Two complete opposite men are forced to share the same hospital room throughout their treatment. They both discover that they only have months to live. Carter creates a Bucket List of all the things he would like to do before he "kicks the bucket." The two unlikely friends go on a search to complete their bucket list. Through this, they find the true meaning of love, life and friendship. Below is their bucket list:


  • Witness something truly majestic
  • Help a complete stranger for a common good
  • Laugh till I cry
  • Drive a Shelby mustang
  • Kiss the most beautiful girl in the world
  • Get a tattoo
  • Skydiving
  • See the pyramids
  • Get back in touch with...
  • See Rome


Because I have a chance of recurrence, this movie hit home. I cried with 20 minutes left of the movie. I cried 20 minutes after. I cried for 40 minutes straight.


It's a wonderful film but I'm sure it impacts me at a deeper level now that I know how precious life is. I don't have a time frame for my life. We all don't. I still feel I have a better chance of passing away from a car accident than cancer. I don't stress over the little stuff as much but I'm the type of person that needs the constant reminder to do more fun things for myself. I've been obsessed about my bucket list since last night. So here it is:

  • See Italy & the Sistine Chapel
  • Buy a hybrid
  • Own my own puppy or dog
  • Inspire my nephews to become better people
  • Make a lasting impact in the education and/or cancer community
  • Find my true love
  • Run a 10K
  • Learn how to ballroom dance and swing dance
  • Speak basic conversational Spanish
  • Find my true home
  • Master one hobby well enough that people would purchase

I will continue to add to my bucket list and to revisit this list. What is on your bucket list?



Monday, June 23, 2008

My Second Saline Fill



As I am writing, I'm waiting for my hydrocodone aka Vicodin to kick in. I had my second filling today. I added another 60 cc making it a total of 270 cc. I'm pretty happy at 270 cc so we discussed now next Monday's fill will be my last one. My plastic surgeon joked how his job was not to change my career. :)

The confusing part about cc vs cup size is that it really depends on our body type and the type of mastectomy. It is safe to say that typically, around 250 cc is a full B. A fellow Cowgirl told me that her 350 cc was a D but she is also very small framed. I will turn to my Cowgirls to get their filling size and go from there because implants already come in predetermine sizes.

My filling today was much like my first filling. The only thing was that my right breast continued to leak saline from my injection port for several minutes following my fill. He said it's fairly normal due to the pressure. The picture above shows how an expander looks like and the gray circle is the port. He nicely placed the port slightly above my incision scars so the expansion port doesn't bother me on a daily basis. My future blog will be my decision of saline or silicone?

Besides some discomfort, I didn't feel much pain until driving home. My breasts started to feel sore. I arrived at the gym around 6:00 pm and put in a little over 30 minutes on the stationary bike. I downed a Larabar in the car and headed home. While I was preparing dinner and my green drink, my breasts really started to ache. I took my bra off and it immediately felt better. Ten minutes go by and the throbbing continues. I debate back and forth whether to take a hydrocodone, ibuprofen or nothing at all. I chose nothing at all until I couldn't stand the pain. It's now 10:16 pm and I'm getting some relief. I was told to take my pain meds at the onset and not to wait. I blogged how I would take my meds as I needed to but today I failed to listen to my docs and myself. Next Monday is hopefully my last filling. I will arm myself with by hydrocodone and ibuprofen. I will take one of them as soon as I feel any discomfort. Lesson learned.

Pretty is What Changes

I read this book over the weekend. It's about a woman in her 30's that discovers that she carries the genetic BRCA 1 breast cancer mutation that puts her in a higher percentage for both breast and ovarian cancer. My first thought of it is that she doesn't understand because she never experienced cancer herself. As I forged through in my reading, I realized three things. 1. She's a wonderful writer. 2. Her mother passed away from aggressive cancer. She had both breast and ovarian cancer. 3. She is raising awareness and in many ways she is a survivor.

While reading this book, it made me think back to my days of making my decisions and telling my friends back home back in the fall of 2005. I remember gathering my friends at our favorite coffee shop The Flying Star over Thanksgiving break back in Albuquerque, NM. We chatted, laughed and caught up. Because I didn't want to spoil our fun, I waited until my sister was waiting to pick me up. I remember getting very choked up telling them that the lump they biopsied ended up being malignant. I remember telling them that "I have breast cancer."

In my opinion, the book was that good. I liked how it didn't paint the prettiest picture and her ending was open ended. It's about a single woman in her thirties dealing with difficult decisions.

Above is the picture on the cover of her book. Below is the article that appeared in the New York times that told the world about her dilemma and opened many people's eyes concerning genetic testing. Like her, I think knowledge is power.

Amazon:
tag=jessiquell-20&camp=14573&creative=327641&linkCode=as1&creativeASIN=0385520409&adid=1NMGWW0DC0ZAZ73P6D42&

Website:
http://jessicaqueller.com/description.php

Link to NY Times that is pasted below:
http://www.nytimes.com/2005/03/05/opinion/05queller.html?_r=2&scp=1&sq=jessica+queller&st=nyt&oref=slogin&oref=slogin


Cancer and the Maiden


By JESSICA QUELLER Published: March 5, 2005
Los Angeles

FIVE months ago, I took a test for something called the BRCA genetic mutation, which is often referred to as the breast cancer gene. My mother had fought off breast cancer and she waged a ferocious battle against a second cancer, ovarian, when it ambushed her body seven years later. The cancer won.

After my mother's death, doctors and other cancer-savvy friends suggested that my sister and I should, at some point, be genetically tested for the faulty BRCA gene. I was 34 when I took it. I tested positive.
BRCA mutations are known to cause early-onset cancer, and statistics show that having the mutation means it's almost certain that I will develop breast cancer at some point in my life. It also means that I have a greatly increased chance of developing ovarian cancer. I share this gene with my mother, but I now have something my mother did not: the warning that, in all likelihood, cancer will be coming for me.
With tests like these, modern science acts as a crystal ball - warning us of dark events that may come. We seek such knowledge so we can take measures to protect against illness. Unfortunately the test for the BRCA gene is just a decade old, and doctors can offer no definitive guidance to women diagnosed with a genetic predisposition to cancer. In the case of BRCA mutations, science has outpaced our understanding of what to do with the data. Because the test is unaccompanied by any clear medical recommendations, it doesn't provide solace so much as open a Pandora's box.
My mother never took the test. In 1993, when she was 51, the test did not yet exist. As far as she knew, she was a paragon of health when doctors delivered the crushing news that the barely discernable spot on her mammogram was breast cancer and had already spread to five lymph nodes. She was a healthy, vibrant, beautiful woman who ran four miles along the Hudson River each morning before donning her Manolo Blahniks and catching the subway to her designer's showroom in the garment district. She didn't smoke or drink. She was slim and a careful eater. She hadn't the vaguest notion that she had a genetic predisposition to cancer.
My mother came of age in the early 1960's, and was a portrait of the "modern" woman. She had been raised by a single mother in a small house on the outskirts of Beverly Hills. With little but raw talent and determination my mother flew east to New York City, and by her mid-20's she was a successful clothing designer on Seventh Avenue. Along the way, she found an adoring husband (my father) and gave birth to two daughters. My mother was among the first generation of women that balanced family and career. She lived her life freely, choosing her spouse, her profession and the timing of her children according to the natural rhythms of her life. Then she was blindsided by cancer.
I see my life as the negative image of my mother's. I'm 35, accomplished in my profession, vital, healthy - yet weighed down by the burdensome information of my genetic legacy. It's akin to Eve taking a bite of the apple. Once you have the knowledge, there's no turning back.
Although I'm currently cancer-free, the knowledge of my genetic predisposition requires me to squarely face excruciating life choices - yet with inexact information. Breast cancer genetic screening is so new that doctors don't really know what to tell women with BRCA mutations except to be vigilant about increased surveillance. Preventative chemotherapy has proven effective for women who carry the BRCA2 mutation, but it does not work for carriers of the BRCA1 mutation (the one I have.) The surest way to prevent breast and ovarian cancers is to have your breasts and ovaries removed. Recent studies show that undergoing these radical surgeries will reduce the risk of inherited breast and ovarian cancers by 90 percent.
However, I'm single, dating, and I want to have a family. I won't consider having my ovaries removed until after I've had children (thankfully the risk of ovarian cancer is slighter than that of breast cancer). But what about a double mastectomy? Having witnessed the death-grip of cancer, I'm not inclined to wait around for it to strike, especially since inexact surveillance machines do not always catch it at an early stage. Aside from drastically interrupting my life, how might a double mastectomy adversely affect issues of sexuality? My romantic future? How early in the dating process do I reveal the information about my faulty gene, with all its ramifications?
My sister is 31. She's not certain whether she will take the test. She remarked recently on the diametrically opposed approaches we have taken: knowing that cancer is often a genetic legacy, I sought out the knowledge that would permit me to make informed decisions. Knowing that there is a 50 percent chance she did not inherit the gene, my sister is not yet willing to give up the luxury that our mother had - to live her life freely, unaffected by the shadow of illness.
I empathize with my sister's point of view but in spite of the burden, I believe that women like me are fortunate to have the knowledge, imperfect as it is, of the likelihood of cancer - to know what our mothers did not.
I can say without question that my mother would have traded those 51 years of innocence for the dark knowledge that could have potentially saved her life. My mother would have done anything to live.