Antidepressant reduction

Did I mention that I've been tapering off my antidepressants? I've been taking Cipralex (also known as Lexapro) ever since I was diagnosed with the mets and I ended up on a fairly high dose of 30mg/day. I'd been wanting to try to decrease the dose for a few years now, mainly because I sensed that my brain was a bit fuzzy: I felt like I wasn't getting to enjoy things quite as much as I wanted to and that my thinking was duller than it used to be. I also felt like my body and brain were missing a connection and I didn't feel quite right.

However, my family doctor didn't support the idea when I first talked to him about it a couple of years ago. I could sort of see his point as at that time I was still undergoing some pretty intense therapy to deal with my childhood and my traumatic past and my new tools for dealing with life's events weren't as well-used.

However, about six months ago, after having spent two years with my psychologist, I felt ready to try to slooooowly taper off the Cirpalex. I knew I didn't want to do this too quickly because I'd heard about some unpleasant side effects (SSRI discontinuation syndrome) that could happen if the dosage was reduced too quickly. I also wanted to be sure that I really could handle life without the antidepressant (or at least this level of it) and I was confident that I could. My psychologist was also careful to make sure that I knew that it might not be possible for me to go off of the Cipralex entirely; it may be that my brain requires the chemical to function.

My psychologist helped me set up a self-monitoring plan to chart things that were early signs of worsening depression and/or poor coping skills. Each day I track the amount of sleep I get at night and from naps, how cranky I am, and how many commitments I'm dropping (the more I drop, the worse I'm doing). I also track more general signs of depression each week. She agreed to help monitor me as I do this as well, and somehow all of that convinced my doctor that I was doing this taper in a responsible way and he said I could do it.

I've been dropping 5mg/day every six or eight weeks or so and this week I just got down to 10mg/day (remember I started at 30!). The only side effect I've noticed is that I'm more tired and easily fatigued when I first drop down a level. It's as though my brain has to work a little harder when the dosage is reduced and gets tired more easily. Aside from that, I haven't noticed any other issues.

I saw my psychologist today and she agrees that I'm doing well. I'm feeling creative and my brain feels alive in a way that it didn't before. Apparently this 10mg/day is the level beyond which I might not be able to go and if that turns out to be true I'm ok with that. I'm still going to try to get down to zero and if I make it, that's great but if I don't, things are pretty good right now. Even if I do go to zero, I won't rule out taking an antidepressant (or increasing the dosage) in the future if I need it. It's a tool in my coping toolbox and it has its place. In the meantime, I'm looking forward to life without quite so many chemicals in it.

Screen Actor's Guild Awards 2014 Red Carpet

I bet you didn't think you'd get another red carpet post so soon after the last one! Well, you're in luck - it's awards season and I'm interested in what they're wearing this year. I don't think I usually look at the SAG Awards red carpet but I figured that I finished the Golden Globes post in time so why not do this one?

Enjoy the pretty (and not so pretty, and downright strange)...

One more thing

I forgot to mention one thing that came up in yesterday's appointment - I got so focused on the nurses' new best practice's that everything else left my brain.

When I got my flu shot this year, it knocked me flat for days. I couldn't figure out why but then I realized that the flu shot uses the immune system to build antibodies. The denosumab/Xgeva I've been receiving every month for a while now is a monoclonal antibody and also uses the immune system to do its job. Even though I got the flu shot halfway between my denosumab shots, my immune system still ended up overloaded and couldn't handle making antibodies for both. Hence me feeling like I was run over by a truck.

I mentioned this to my oncologist yesterday because denosumab is anew product and they're still gathering side effect information. We agreed that getting the flu shot is very important because I can't afford to get sick and that being laid up like that isnt ideal. So for next year, I'll skip a month on the denosumab and get the flu shot six weeks after the last denosumab injection. That should give my immune system plenty of time to heal up.

I know this isn't a big deal but I wanted to bring it up here for others who are on the denosumab and get flu shots.

Oncology appointment

Today was oncologist day. My tumour markers from November were at 40 (still well within my norm) and I'll get today's tumour markers when I see her again in three months. We've decided that since I'm still so stable, I'll see her every three months instead of every two. It used to be that I had the tumour marker bloodwork done two weeks before I saw my oncologist but it stopped being scheduled that way and I got tired of calling them to change it.

I think things are going to change when I get my bloodwork, though. I've been getting it done in the chemo suite because I have a port-a-cath. My veins are super-crappy from my primary cancer treatment and the less they have to be accessed, the better. I've kept the port because I figured I was going to need it for treatment - and long before now, to be honest - and because it could be used to do bloodwork at the hospital, eliminating a regular assault on my crappy veins. My port gets flushed by the home care nurses at their office in between hospital appointments.

However, at today's bloodwork appointment, I was told that their new best practices are that they don't access ports unless the person is receiving treatment that day. In other words, their best practices tell them to not access ports just for bloodwork to reduce the risk of infection. In my case, the port has to be flushed at that time anyways so it's not like it would be getting an additional access to it.

I spoke with my oncologist about this and she told me that the nurses run everything there and to push back against them. The policy doesn't make sense for me or for anyone who has bloodwork the day before they have treatment (as was happening to someone while I was there). Hopefully I'll be able to convince them to continue accessing my port instead of forcing me away.

Golden Globes 2014 red carpet

I'll bet you never thought you'd see another red carpet post from me. I've actually started a few over the last year but by the time I got to working on them it was so far past the event that it didn't seem worth posting them. This time, I really wanted to get one done. So here it is!

Most of the outfits people wore looked ok although there are always a few that are not quite right for the occasion. I'm happy to report that the strapless mermaid dress is fading from view but sad to tell you that the mullet skirt (shorter in front and longer in back) is showing up more frequently. Sparkles and embellishments are more subtle than they used to be which is a pleasant change.

Enough of me talking; go and have a look at the outfits. Enjoy!

Metalsmithing projects I have finished

One of the biggest changes for me in the last few months is that I've actually finished some metalsmithing projects. You read that right - I finished a couple of projects. I have many projects that are partly-done but very few finished objects. To prove that I finished something, I took some (rather bad) cellphone pictures.

Two sterling silver rings that I made. Each was carved out of carving wax, cast by my instructor, and then polished and finished by moi.

A side view of the rings. One of them, as you can see, has a peak all the way around while the other has just the one pointy bit.

Another view of the rings. You can see that the pointy but on the one ring is kind of a pyramid shape.

A top view of the pyramid ring so that you can see the point. You can also see the side view of the other ring.

I guess it would have been useful to include pictures of me wearing the rings, huh? Well, you'll just have to imagine them on my finger (my middle finger, as it happens). I'm quite pleased with these rings, especially considering that they're my first real attempt at carving and casting anything. They aren't perfect but I love them.

We'd learned carving before but I was having trouble carving something that looked good. I was having a hard time keeping my carvings balanced; often when I tried to file away the wax I didn't want I'd end up filing too much off of one side and my design would end up torqued. I did some research and found a fabulous, step-by-step pdf file that helped me tremendously. The best tip from that guide was scribing center and other guide lines on the wax. That tip alone helped me keep my designs from torquing.

Now that carving is easier for me, I'm finding it a very relaxing thing to do. I'd like to do a few more rings around the pyramid theme and maybe some others involving more complex carving. We'll see; I have some other projects I need to finish, too. And still others that I need to start :)

Our fluffybutt, Gozer

I'm sure you're all wondering how Gozer has been doing. She thinks she's the center of our universe so you must think so, too, right? Ok, maybe not, but since she is the center of our universe I want to talk about her.

It was a rough fall for Gozer. Just before Thanksgiving she was being treated for yet another ear infection and the vet suggested that she had food allergies. She was constantly scratching and licking and developing ear infections, all of which are signs of food allergies in dogs. She had also developed red spots on her abdomen.

We switched her over to a new veterinary food, Hill's Prescription Diet z/d Ultra which has hydrolyzed proteins and tried that for a few weeks. She stopped licking and getting ear infections but her stool was very soft. The vet kept urging us to stay on this food because it's great for dog's digestion but our dog needs to have good, solid poops and these were not them.

We switched her over to a Lamb and Potato mix and within a week she was licking like crazy so we had to take her off that right away. We moved her over to a limited ingredient Turkey and Pea protein food that she seems to be tolerating fairly well. We're giving her the treats we were first given with the Hill's diet because she likes them and tolerates them. We'd tried other treats but she seemed to still be licking more than when on these treats so that's what she gets.

After we started the turkey food, she developed red sore-looking things under her arms and the vet told us that we had to put her on antibiotics for two weeks. These antibiotics were very hard on her, giving her an upset tummy, very loose stool, and lots of lethargy. She was barely eating anything at all and so we tried giving her canned pumpkin mixed with her food to make her eat. It worked for about two days before she stopped wanting to eat again. We ended up hand-feeding her some of her food and playing with other parts (so that she could hunt for her kibble) so that she'd eat.

It's been a few weeks since she finished the antibiotics and she's now eating full meals again. We had to reduce her "full meals" to ensure that she finished them, but she is eating everything in her bowl now. She's also having regular, well-formed bowel movements. That's all good.

On the downside, she's got a yeast problem. I thought that corn-chip smell she had was just her smell but it's actually the smell of yeast. We're using one of the eardrops we'd been previously given for yeast infections which seems to be clearing that up, and we're also trying a new shampoo to try to clear the yeast off of her paw and thighs since she's still licking there occasionally. The old shampoo was good for her but it has oatmeal in it and I read somewhere that yeast like oatmeal so it isn't necessarily the best way to clean her and get rid of the yeast.

A little bit more concerning is that she's having anal gland issues. After she finished the antibiotics she was clearly having problems there because she was licking like crazy and appeared uncomfortable. The vet expressed them and said that they were almost impacted. I figured that this had happened because the antibiotics had made her stool very soft and her glands weren't emptied properly with her bowel movements.

The vet told us to have her glands expressed no more than every six weeks. Since she's being groomed every six weeks and they can express her glands then for only $15 extra (compared to a normal vet visit of $90), we're having it done then. Three weeks after her glands were expressed, she was groomed and we had her glands expressed again - we figured it wouldn't hurt and it would help us get into the habit of having it done.

It's just as well that we had her anal glands expressed because they were quite full again. I thought that this might have been because her stools weren't completely regular or well-formed at that point. However, now I'm questioning that conclusion because she's been licking her butt again and is looking uncomfortable. I think her glands are in need of expressing yet again and it's only been about three weeks since they were last done.

Our sweet little rescue doggie has turned out not to be maintenance-free. I hope that in 2014, she stays stable on her food, her yeast infections go away, and her anal glands start working properly.

Some updates

So... I guess it's been ages since I updated you about my cancer, hasn't it? That's because nothing's changed, really. I see my oncologist every two or three months, we do CT and bone scans every nine months or so, and a mammogram once per year. All of them have come up clean.

Well, that's not precisely true: in fact, my bone scans reveal that the cancer lesions are continuing to heal. This is great! It's also weird. So much of the last six years have been about me coming to terms with having cancer and having a terminal illness. But if the lesions go away then my illness really is controlled and I don't have cancer in the same immediately terminal way that I thought I had it.

When other cancers disappear like my lesions are doing, they say that the cancer goes into remission. However, it's different for breast cancer because once the cells travel outside the breast and nearby lymph nodes, they can hole up and stay dormant for ages. Therefore, we who have stage four breast cancer are said to have No Evidence of Disease (NED) when the cancer can't be detected by scans.

Most of the people I know who get a NED status are thrilled about it - and I am, too - but it still feels strange. If I'm not the person who has cancer, who am I?

I should tell you that my tumour markers have stayed stable as well. They tend to oscillate up and down fairly regularly - in fact, I made a chart of their values over the years (up until August, 2013) that shows the oscillation very clearly:

Well, hello there

It's been quite a while since I was here. Several people have asked me what I planned to do with my blog and I haven't really had an answer for them.

I started this blog as a way of keeping my family and friends informed about my cancer status and treatments and then as my cancer stayed stable it became a place to keep my family and friends in touch with my life. It also became a place for me to think through and talk about things going on in my life.

After my mom died I found myself having a hard time posting here every day, partly because I was depressed and partly because in my head much of my blog was a way for her and I to be closer. Then of course I had the breakdown and didn't know what to write, and later it was enough for me to post small updates as my Facebook status.

These days, I'm finding myself missing the ritual of writing my posts and it's no longer enough for me to put something on Facebook, so I'm thinking that I want to start posting here again. I don't know that this means that I'll post every day but I do hope to post a little more often I'd posted over the last couple of years.

Oncologist and some stuff

I'd planned to write more about our trip but I wanted to include pictures and they haven't been processed yet. We took a couple of thousand photos on the trip and the task is a bit overwhelming so I haven't done it yet.

I saw my oncologist today. My CA 15-3 tumour marker at the end of May was 34 and at the beginning of August was 39, which is still within my normal range. Yay! My oncologist wants me to do regular bone and CT scans just to be sure that I'm still doing fine. She wants to do scans twice a year - which is fine with me - and my last scans were in December. I'll see her again for the results in a few weeks.

I wanted to say that the way I talked about being in the US stereotyped people as gun-loving nuts and cops as thugs. I didn't say that outright but I'm sorry to say that I did kind of have that view in my head when I wrote it. For the record, people in the US are people, and although there are people who own guns, not everyone has one. Moreover, while some cops everywhere may be thugs, the ones I'd encounter there are no more likely to be thugs than they would be anywhere else.

There are things going on in the US that I don't like, such as: the loss of women's reproductive rights in many states; the rampant racism in Florida and other places; the fact that the NSA has been electronically spying on Americans (and that Canada, being an ally, was involved); the increased militarization of US police forces; and the US drone strikes. Even though these are policy issues that have very little to do with the ordinary people in the US, my head got caught up in all these events and I transferred my feelings about them into paranoid stereotyping of the people in the country. My apologies.

Atlantic Canada road trip, part 1

We returned on Tuesday from a 12-day road trip to and from Atlantic Canada. I'd have mentioned that we were going away before we left but it didn't seem like a good idea to say to the world that we wouldn't be home. Not that so many people read this blog but we felt that it would be better not to take chances.

We decided to take our time driving there and back because we had Gozer with us and we weren't sure that she could handle being in the car for too long. Therefore, we limited our driving time to a maximum of six hours per day. We figured that even we had to make lots of long stops, we'd be on the road no longer than ten hours per day and with both of us driving, that would be no problem. As it turned out, Gozer is better in the car than we are! She could stay in the car for hours at a time but we didn't know that before we set out.

Today I'm going to talk only about the route we took and the three interesting challenges we faced but I'm not going to go into detail about what we saw or the things we visited. I'll save all that for the next post or two.

To make for a varied trip, we decided to drive through Quebec on our way there and through the US on the way back. I kind of feel weird about going through the US because of the number of guns and the police climate there. We were careful to stay near the speed limit or with the flow of traffic so that the police had no reason to look at us. Weird, I know, but there it is.

On the way there, we stopped in Gananoque, ON; then Levis, QC (a suburb of Quebec City); and on the third day we ended up in Fredericton, NB. After leaving Gananoque we encountered our first challenge: we'd left our laundry bag behind with the clothes we'd worn the day before. Although I called the hotel the next day, they haven't called me back to tell me they found it.

In Levis, we had our second challenge: I broke my glasses. The left temple snapped off of the front frame between the hinge and front frame and since the frames were acrylic they couldn't be fixed. I temporarily taped them together that night and the next day Ian got some Krazy Glue and strong tape. For the rest of the trip I rocked the hipster taped-up glasses look.

After Fredericton we made our way to Moncton, NB, where we stayed three nights while we explored the Bay of Fundy, Moncton, and PEI. On our first full day there, after spending time over at the Bay of Fundy, we developed a flat tire - our third challenge. We did buy the roadside assistance but it would have taken an hour to and hour and a half to get a tow truck to us and we were tired and hungry after overdoing it that day. So Ian successfully changed his very first flat tire :) This challenge took a lot of our time since we had to spend the next morning getting the old tire fixed; I'd wanted to swap cars but none were available. We had planned to go to PEI that day and we still managed to do that even though we didn't get to spend as much time as we'd hoped to spend there.

Fortunately, that was it for challenges and the rest of our trip was smooth sailing. Or driving. Once we finished up in and around Moncton, we headed to Halifax, NS for two nights so that we could explore the region around Halifax and the city itself. From there, it was homeward-bound through Portland, ME and Liverpool, NY.

I know that this sounds like a lot of traveling and driving but it turned out to be not too bad. Ian did most of the driving while I read or napped but I was ready and willing to drive whenever he was tired or migrainy. We stopped every couple of hours for a bathroom break and to stretch our legs. We managed to not exhaust ourselves by driving which meant we had lots of energy to spare when we were walking around looking at stuff. More on that next time.

Me and my anti-depressant

It's been quite a while since I've posted here. True, nothing much has happened, but that hasn't stopped me from posting before.

I think part of it is that I originally started this blog to talk about living with cancer and, well, it's been seven years since that all started and I'm still alive and stable. I don't think about the cancer most days because it isn't part of my daily life. And I kind of feel like so much of my life isn't worth writing about, you know?

As it happens, I do have something to write about now. After taking 30mg/day of my antidepressant Cipralex for seven years, my family doctor has finally agreed to let me start tapering down on the antidepressant. I'll be reducing 5mg/day every six weeks until I can't handle it.

I've thought a lot about this and I wanted to approach this responsibly. I talked to my psychologist and she suggested that I monitor how I'm doing by rating my anxiety and depression out of a scale of 0-10 (0 is none and 10 is the worst possible) each day as well as counting the number of chores I don't do, social commitments I back out of, and sleep I get each day. Then each week I'll rate other specific questions about how I'm doing. This way, I can chart how I'm doing, and if I start not doing well then I can stop the taper.

Apparently I'm taking higher than the recommended maximum dose and my doctor wants me to at least go down the maximum recommended dose. If I need more than the maximum for this antidepressant, he'll switch me over to Wellbutrin.

There's part of me that would love to go all the way down to zero so that I don't need to take the antidepressants anymore. I don't know if that's possible since I've been on this one for so long. My psychologist said that my brain might not be able to go back to normal after being on this high dose for so long. If I can't go to zero, I can accept that; as much as I'd like to do that, I know it might not be in the cards for me.

So we'll see what happens. Let's hope this works!

It's been a tough month

This last month has been tough. My friend Steph C's death left me devastated because it was so unexpected. It really was. Normally I have an idea about when someone is getting really close to the end because of the things that happen to them; the decline is there if I want to see it (and I almost always would rather bury my head in the sand), so the end, even if it happens quickly, is something I'm kind of expecting. Knowing that it's coming means I can sort of be ready when it happens; I'll still grieve, but it's a different kind of grief.

With Steph there was no decline at all. She had developed new mets, just like before, and was going for the liver biopsy to find out whether or not her tumour had changed. Apparently during the biopsy, Steph's hepatic artery burst and she died. About 1 in 10-12000 die because of the liver biopsy and there's just no way to prepare for that when it happens to someone you know. The kind of grief I felt was different than usual because I had to process the suddenness of the event. I imagine people whose loved ones are killed in accidents feel a similar type of grief - and of course that kind of grief is there when someone dies by suicide.

Compounding my grief over Steph was what would have been my mom's 65th birthday a few days later. Big grief events always seem to remind me of my mom and dad... it's like I feel the grief for them all over again. The grief for my mom and dad come up during different anniversary days. Some are more significant than others: my mom's 65th birthday would have been a major event even though now I don't know how things would have changed.

On top of all that was Father's Day. It's been five years since my dad died and I still miss him. I didn't do much for my dad for the day but I'd call him and we'd chat for a bit and I miss that.

So all of that grief and sadness all combined together to take me out for the last month. It's just been so overwhelming. I ended up seeing my psychologist early, which helped because I could talk it all out.

I also went to Steph's memorial service/celebration of life in St. Louis this past weekend. Going to that really helped because I was able to have some closure around her death. Being around so many other people who loved her and lost her was cathartic for me. I cried the whole time, of course, but I knew it was going to happen and I brought lots of tissue with me.

I think I'm feeling better now, or at least not quite so sad and devastated. I think next month is going to be much better.

My friend is gone

My friend Stephanie C. died last night. I sent her a facebook message this morning, went over to the mets support board, and found out that she had died the night before. I'm shocked and so sad, and I know I'm not the only one.

She had posted just last week that scans showed some progression in her liver with a bunch of new tumours. They were biopsying the tumours to see if they had the same markers and she would have had the results at the end of this week. And then somehow, something went wrong and she died. It was sudden and unexpected, even though she was facing progression in her liver, because she was posting and had contacted people as late as Sunday. No one yet knows what happened.

Steph was a wonderful, caring, compassionate woman and I already miss her terribly. She was my co-admin on our support board and I loved working with her. She was funny and talkative and always welcomed people with a kind word. She was just so nice and such a centered person. She was so open and loving and saw the best in people. I admired her and strive to emulate her because she was such a good person - one of the best I know.

She leaves behind her family, her husband, her kitties, and many, many people - including me - who loved her so very much. She will be dearly missed and it will take a long time to deal with my grief. Rest in peace, Steph. I love you.

Updated to add that my friend was featured in this news article. The Kadcyla she mentions is the last chemo she ever received; it didn't give her the results she had hoped it would, and her liver mets grew while she was on it. Oh, I miss her so much.

Gozer's ophthalmologist appointment

Gozer saw the veterinary ophthalmologist for her three-month follow-up appointment. We spent just over an hour there this morning because Gozer needed her pupils dilated. The technician didn't dilate her pupils at first so the appointment took a little bit longer than it should have. From now on Gozer's pupils will always be dilated at the beginning of these appointments to save everyone some time.

Gozer's cataract is unchanged, which is fabulous news. It means that the cataract isn't growing quickly even though it kind of appeared overnight.

The only thing that made us nervous was that when the technician first tested the pressure of her eye, the pressure of her cataract eye was considerably higher than that of her normal eye but when the doctor re-tested her eyes the pressure was about the same. Of course they get these numbers by putting a drop in her eye to harden the cornea and tapping it with an electronic measuring tool so I think it's possible to tap a little too hard and to give a false reading. The doctor did the test a few times on her cataract eye and came up with two numbers that matched the non-cataract eye and one that was near the original measurement. Clearly that test isn't always reliable.

We're to continue to give Gozer the drops we've been giving her and we'll go back for another checkup in six months.

Was feeling sick but I think I'm getting better

For the last couple of days I've really felt "off". I was really tired at the beginning of the week and then on Wednesday I started to feel not right. Over the last two days I could only eat half of my breakfast and couldn't drink my coffee; I couldn't eat anything else through the day. I felt queasy and the thought of food wasn't appealing at all.

I was also exhausted and weak and having chills and shakes (although I didn't have a fever) and I was having trouble with woogly back (like restless legs, I guess, but all over my back). I couldn't stop moving and I couldn't get comfortable at all so I was ending up in these awkward half-upside-down positions while moaning and whining. Sometimes having a very hot bath followed by a nap helped but other times nothing helped.

Gozer knew that something was wrong and she tried so hard to comfort me. She tried licking my face and climbing on me but I couldn't bear her weight. When I slept, she curled up very close to me (often taking my blankets) and carrying around my stuffed monkey. Ian wasn't happy to see that Gozer was on the bed but I liked having her there.

I thought that the problem might have been that I was constipated since my diet was different during our trip. The only thing that calmed my woogly back was percocet which would also have calmed my intestines - which wouldn't help if I was in fact constipated. Still, last night I was so desperate to stop the woogles that I had to do something. I asked Ian to get me some Ducolax (in case I was constipated) because I figured that would offset the effects of the percocet.

I also wondered if there was something wrong with one of my painkiller patches. I wear two of them and alternate changing them so that I don't have to go through withdrawl symptoms. Since the percocet helped, it's possible that the patch that got changed this morning was faulty or had been changed incorrectly beforehand or something. But then, what I was feeling wasn't quite the same as the feeling of opiate withdrawl that I've had before, which for me always involves a crazy amount of sweating. I wasn't experiencing that this time around.

I slept twelve hours last night and woke up feeling a LOT better. No woogles, I was hungry, and I wanted coffee. I had some jam on toast and had my regular morning coffee, and I had some toast later on in the day. I was even able to go outside and do some very light yard work, which I couldn't even have thought of doing over the last few days. The Dulcolax did achieve some results a bit later in the day but I wouldn't say that I was actually constipated. Or maybe I was, but I don't know if that was what was wrong and causing such terrible woogles, queasiness, and chills.

I still don't feel 100%; I don't want to eat all that much and chewing gum makes me feel very, very queasy. But I feel so much better than I have over the last few days. I think I might even be able to walk Gozer tonight, which is something I haven't done this whole week. I hope I keep getting better but I wish I knew why I've been so sick this last week.

Sick with a side of whine

I don't know why but I'm feeling like crap today. I'm exhausted, I've got a headache, and my stomach is queasy. I hope I didn't catch anything while I was away.

I'd thought about going to Toronto on Thursday for the Society for North American Goldsmiths conference - it's for metalsmiths in North America and it's held in different cities each year. Having it practically in my own backyard is an opportunity that's almost too good to miss. However, the conference goes from 8:30am to 5pm which means that I'd need to be awake at 5am and wouldn't get home until 9pm.... and I'm not sure I'm up for that.

If I hadn't been away last week or I wasn't feeling quite so sick today, I think I could probably do the conference without exhausting myself too much. However, I'm worried that if I do push myself to go, I'll end up even more exhausted and it'll end up taking days or weeks to recover.

But I really wanted to go. It's a little frustrating to run smack into my limitations. The grown-up thing to do is to accept that I have limitations and not go to the conference on Thursday. Sigh. I can travel to the conference another year.

Our trip

We're back! Ok, we got back on Friday night but I've been really tired. The trip to the Dominican Republic was ok. We stayed at a 4 1/2 star all-inclusive resort and we've never been to a place quite that fancy. We don't really want all the services that such a fancy place provides, like turn-down service at night (where they close the blinds in the room, turn the comforter down and leave chocolates, and leave slippers by each side of the bed) and the luggage-handling.

They wanted to take our luggage up to our room themselves when we got there and that's weird to us; then when we left, they had us pack a couple of hours early so that they could get the luggage out of the room early. I know that the staff at such a fancy resort can be trusted and all that but I'm uncomfortable having my luggage out of my sight and control.

The resort itself was lovely in that manicured, pesticide-spraying way. The pesticide meant that there were no mosquitoes, which was nice, and better(?) than getting malaria. There were a ton of different kinds of palm trees there which was really neat. There wasn't a lot of air-conditioning there; the buildings were open to the breezes and had fans that helped to keep the areas cool. The room (which was actually a suite with a kitchen, dining area, living room, bedroom, jacuzzi-tub room, and bathroom) was air-conditioned and had fans to keep the air moving.

The beaches there are beautiful; the sand has the texture of sugar. They're kept fairly clean with the seaweed raked off the beach each morning. The ocean is very, very warm and lovely to swim in.

The resort had a number of restaurants but we ate at the buffet restaurant for breakfast, lunch, and dinner. There was a good selection of foods for each meal and while we had to extend our low-fat diet a bit we were able to keep to it as much as possible.

The major excursion we did was this snorkeling tour. There was a big group of us and they took us to this "snorkel park" with penned up sharks and manta rays. I didn't go snorkeling because I've never done it, I suck at swimming, and I'm not sure I'm fit enough to do it. It's just as well that I didn't go because they offered no instruction at all on using the snorkeling equipment; as well, the people from the tour company that were in the water spoke no English. I'd like to try snorkeling but in a more controlled situation, and this wasn't it.

The tour also went to "Paradise", a natural pool just off the coast. It was fairly shallow for normal adults at just over four feet deep and it was perfectly calm. A number of tour boats were there and some were doing line dances there. Unfortunately it was a little cold because it was cloudy so swimming in the natural pool wasn't as fun as it could have been.

The weather was fairly hot and humid and it rained over a couple of the nights that we were there. The sun, when it was out, was super-hot, so we wore sunscreen and sun protection clothing. We did spend some time reading on the beach under these cabana things that provided shade.

One thing I discovered is that I don't handle the heat very well, especially when it's mixed up with me being tired. I get super-cranky and lose all of the tools I've developed to handle situations where I feel out of control. It was worst when we arrived at the resort and again when we were waiting for our transportation home from the airport.

When we got there, I was exhausted from waking up at 4am and dozing but not really sleeping on the plane and then walking into this wall of heat and humidity. Our room wasn't ready until an hour and a half after we checked in and I was frustrated, hot, exhausted, and terribly cranky. On the way back, I was again exhausted from waking up at 5:30am to see the sunrise and then traveling through the heat. By the time we got to the airport I just wanted to crawl into a hole and  sleep. But we had to wait for our transportation to arrive. Sigh.

I'll talk to my psychologist about ways to handle these situations where I'm completely overwhelmed and tired. Avoiding them is best but that's not always possible; really, if I could just accept that the thing I want the most - to be in my own room or at home - can't happen right that second, I'd be better off.

So that was basically the highlights of the trip. We wouldn't choose to go to a hot destination again because we didn't love the heat at all and I'm not sure about the whole all-inclusive resort thing, but I'm glad we had this experience. We did have fun there and I'm happy we went.

Yesterday's Toronto trip

I promised that I'd talk about my appointment in Toronto. I don't know if I mentioned it before, but my oncologist referred me to a clinical trial at Princess Margaret Hospital. Apparently there are about 200 known DNA mutations in different cancers and they're going to figure out whether my tumours have any of those mutations. They've found some treatments that can target those mutations as well.

If another mutation becomes known they'll test my tissue for that, too. They'll even send my oncologist the results to my oncologist so that if the mutations are associated with treatments I can get those treatments. I had thought they were looking for new mutations but they're not doing that; they're just working with what's known.

While I was there, they took my blood so that they could compare generalized mutations (the ones that would show up in my bloodwork and tumour) from cancer-specific mutations. Because I was traveling throughout the day I didn't have as much water as I normally do so I was a bit dehydrated. As a result, the technician who came to take my blood couldn't get any out of my (admittedly pathetic) veins. She walked me down to another place and they accessed my port. I hadn't wanted to go down to the lab because I'd heard that they can take a long time but they weren't busy at all.

After all that, it took my three hours to get home when it should have taken an hour and a half. Poor Gozer was home all by herself for almost eight hours :( When Ian got home he could hear her barking because she was alone. At least we don't have to leave her alone like that very often.

Shopping, shopping, and more shopping

I've been so busy lately with at least one appointment or commitment pretty much every weekday. So far I haven't been too overwhelmed but I'm starting to feel tired and edgy.

I've had an additional pressure for the last few weeks from getting ready for a trip next week. We have an opportunity to go to Punta Cana in the Dominican Republic and even though we don't like the heat or a lot of sunshine, a trip like this doesn't come around too often. Besides, we're staying at a resort, which we've never done before, and we might discover that we love the experience.

Going someplace hot and sunny means that we swimsuits for the pool and ocean as well as sun-protective clothing. In addition to my usual complement of activities - metalsmithing class, physiotherapy for the lymphedema, and doctors appointments - I've been doing a LOT of shopping. Yesterday, for example, I had an appointment in downtown Toronto (more on that tomorrow) and on the way there I stopped by the Sunveil store for a new sunveil jacket for each of us. I have a light blue button-up shirt that I bought years and years ago that's got grime on the cuffs that won't come out so I wanted to replace it.

I also stopped by the MEC to buy some long-sleeved sun-shirts/rashguards that have built-in sun protection for both Ian and myself. Finding long-sleeved shirts like this was quite difficult as the selection for adults is very low in local stores. While I was there, I bought myself a couple of bathing suits. During the last week I've been trying on swimsuits in all sorts of stores to try to figure out which styles are flattering and minimize the difference between my boobs. I don't really want to wear a prosthetic breast while in the pool or at the ocean but I also don't want the difference to be obvious to everyone. It turns out that halter tops with patterns work pretty well.

Trying on swimsuits is one of the most demoralizing activities ever. In my head my skin and muscles are firm and although I'm soft, I'm soft in a curvy way. The reality is that my skin is sagging, as are my muscles, and my legs are less shapely than lumpy and share certain characteristics with tree trunks. The wrong sized suit creates an unattractive muffin-top effect at my hips. I'm not the young woman I used to be and trying on swimsuits is a sad reminder of this fact.

In addition to the stuff I bought yesterday, I'd ordered sun-shirts/rashguards, swimsuits, and board shorts for me online. Not everything fits properly so much of it is being returned but some of it works.

I'm looking forward to the trip. It's a short one (only three nights away) so it'll be long enough to get a sense of what the area and staying at a resort are like. Plus now I have some relatively flattering suits and swimwear :)