Asking new questions

"This is a time for straying, for losing one's way, for asking new questions. 

A sacred activism. A slowing down that knows enchantment is not in short supply."

 (LOST)

Lets just title this for what it is - I am a Goddess.

I am allowed to not be perfect

I am allowed to feel some things and say some things and do some things

That I am not too happy with

That I am not too proud of

Are those I seek assistance from imperfect too? 

Is Kuan Yin, Durga, Kali...are they without imperfections?

I'm in the midst of falling prey to them once again

perhaps the answer is to fall pray?

The problem is I have these memories

And I keep coming back to them

Whether they were 35 years ago

or 5 minutes ago

I remember, analyze, doubt, criticize. I would make a great judge.

But what if I don't want to be a great judge.

What if I want to just melt into the earth and let my roots hug those of the trees?

What if I want to be the lotus reaching for the sun?

Can I merely exist in that radiance?

Can I remember instead my sovereignty in each moment and exist in that?

Can I shine that radiance like a lamp around an infinite circumference?

4 of 7 days this week I felt like I was trying to fit all of this feeling into a nicely packaged box.

Into sentences that made sense when I said them

Grammar, succinct, inspiring 

translating my soul ink on to papers

But none of this fits into sentences

None of this can be summed up nicely

Because it is not these separate little parts

But together they make a whole

The whole of me

Goddess

Love

Sum

.

.

I love me some melancholy!

If that were in style, I would be rich.

I am even trying to make this Goddess work perfect

Not make a mess

I spilled some water today when I felt another's microgestures 

in response to my cheeky response 

I left it on the floor

I let my door creak

Maybe it wants to express itself too?

Laugh - it was trying to be a joke!

Oh the hard edged nuances of language. 

No more planning

It's the full moon

Let me open and howl

Let me flow free

a-mid-st night

Let me see the beauty that is all around me, rest

instead of chase it around every corner, unattainable

Just as the dirt path unfolds for me

Each stone, each root took it's own path to get to the place where it rests, now

I see that it is perfect, flower

bud opens, enjoys and is enjoyed, and 

falls to the ground, and yet

its nectar still lingers in the air

for the passerby to wonder, perhaps

to seek the path based on its scent

the clear yes and the clear no

how does one become clear to hear it?

all those background murmurings creating a fog

the smoke wafting into the room

the mirror reflecting it back as real, as me

It is not me, but it circles around me, saying

look at me! don't forget about me, it is I

who kept you alive

who kept you company

in those moments where you were confused

you won't be safe, should you choose not to look

not to listen

It's time. 

It's time to blow it all to pieces

It really doesn't have to be that dramatic

but we like it that way, don't we?

Ok, perhaps a satire

Let's play this game.

Spin the wheel and see what number shows up

The price is right, wrong direction though

Jump! when I say so

The secret: There is no right and wrong

There's always going to be some crazy shit and some beautiful shit

What do you choose to do with the crazy shit?

What do you choose to do with the beautiful shit?

Hopefully the same thing. Breathe into your belly, Queen. Sigh into the bowers.

Wonder at the sanctity of it all, for in the end it is all 

God

.

.

Play and laugh. When did I stop doing this all the time?

What are we doing anyway? we asked. 

Doesn't really matter does it :)

We were having fun

We made first friends, fast friends

Can it be that simple always?

What is introduced

in this life

is not just this garden of many flowers

but these delights that sparkle at us

some sparkles catch your eye a little more than the rest

And you settle your gaze there

and before you know it

you are resting your soul 

upon her laurels

The enchanting scent luring you into your lessons

your karmic twists and turns

making this life certainly color full

Then you are in it

And you forget

to play 

to laugh

when the path is a little rocky

You forget

the mountaintop is not the destination

with 1.5 kids, paired with only one

the color is God's play

the light shining on the lake

the shadows of the boulders providing reprieve from 

the cruel noon sun

light playing games with your eyes

shadows become light, and back again

What is real?

This in my heart

is real.

And it is

speaking.

Sharing

Something I wrote November of 2021 when I was still in Taiwan and I was just about to meet a new love in my life. And...I was about to find out a few months after that, that the cancer had spread in my lungs, requiring me to drain the left one and get cyberknife and start some new medicine. This was 9 months ago that I wrote this. And by the way I am getting stronger and better everyday, still dancing...

It has been awhile since I’ve shared how it’s going on this healing journey I’ve been on, dancing with cancer for the last 11 years. Goodness. Part of  me felt like I had to have it all figured out from step 1 through 10 before I could report back. (that strategist, perfection energy that lives within me). Part of me felt like you all would not be interested in it -- because people like to feel happy and inspired and do not like to hear about the darker shadowy things that come up with healing. Me too. I have cleverly looked at it and told myself that just a glance and a quick ID was enough. The officer in me said that was good enough and I can be on my way. I have found that it is this darkness that requires just as much attention and love as the love and the light that we all love to bathe in. So my update is that I have been wading through the darkness, saying hello, really looking. I have had help. I have had guidance. Super necessary for some of these things that have hidden themselves so cleverly in my psyche as ways of survival -- perhaps through generations. It has not been an immediate process. I have opened to taking responsibility for my thoughts, words, and actions. Seeing the grief. Seeing the anger --there is so much anger. Seeing the shame for feeling the grief and the anger. Feeling the fear that arises too. 

The main message I want to communicate today is that I don’t have it all figured out. I was taught from a young age through school and through work that I had to have a plan. Once you gather all the pertinent information, then you work up a plan and stick to it. What I’m finding is that I am not the one to make the plan. that logic is not necessarily going to bring you to a decision that is in alignment with your heart. What I am learning is that I am the one to await the plan to be revealed to me--and I only get one step at a time and my mind has to be quiet for me to hear it. This is my surrender. I am surrendering over and over again, every day. I surrender in my dreams. I surrender in this waking life. This surrender sometimes feels like just taking an actual full deep belly breath in a moment where I can identify that fear is taking over again. 

I am not sure you want to hear this. It’s uncomfortable right? But if you are reading this far, thank you.

So I am listening for my plan, for my path to light up before me. The message comes from your heart, from a higher spirit that is within us that is giving us gifts in the form of these challenges we face so that we can learn to truly listen and move in this world from that space. This is so different from how I am wired or programmed to operate -- from my mind, from what makes sense, from a space of fear. I am moving towards living life from my heart and I cannot tell you what that’s going to look like. It may not result in a clear CT scan of my lungs. I do not presume to know what healing cancer will look like. But I have caught glimpses in those sweet magical moments in life where I may know what it could FEEL like. Sun warming my body, a gentle wind in my hair, warmth in my heart for all beings on this beautiful earth. We are being put through the wringer, each person living through a different movie reel, so that we can come out the other side in a world full of magic, mystery, and love. Meet you in that golden field. Let’s go back again and again. 

The most beautiful part about this is that we have each other, we are not alone on this path. But we need to hear the hearts nudge --to ask for help. There are sisters and brothers and those non-human kin, and Spirit who are waiting for us. We need only ask. 

Meet you in that field. I look forward to giving you a big giant hug.

We all need a little love

I had another MRI done December 14, the results for which I received this past Friday, January 11. Suzy, the NP, let me know that there didn't seem to be anything concerning in the MRI, but that this time there was a lot of background enhancement. In other words, the background is brighter, which is annoying to radiologists and doctors because you can't see things (growths) as well in the MRI. In summary, my boobs are brighter. :)

They thought they also saw some small "washout kinetics" (5mm) on my right side so asked me to do an ultrasound to see if they could see anything (which they didn't expect to). They didn't see anything, and asked me if I would do another MR biopsy to be perfectly sure. I told my NP I really didn't want to do another MR biopsy for something that they couldn't even see very well. That was pretty damn painful the first time. It is not a fine needle aspiration type of biopsy; it's a core needle biopsy. Not a fun experience. As one of my good friends said, "Your right boob just wanted some attention.". Yup!  We all need a little love.

I like both my doctor and the NP very much. They know my approach, but still remind me of what is recommended - because they have to. The doctor tells me each time: 1) DCIS can blow up anytime and we have to recommend surgery, 2) if you don't want surgery, would you consider taking Tamoxifen?  To both items, I still say no and they understand. For the tamoxifen, at this point, I am not putting things I don't know in my body. It's that simple.

So on I go: eating as healthy as I can while enjoying food, leading a lifestyle that is less stressful, and doing things I love to do as much as possible. Here's to another happy new year!

Results Are In

Sutro Baths, near Ocean Beach in San Francisco

After finding out that I have DCIS a year ago in July 2011, I received my second set of MRI results on Friday. These results were compared to my MRI taken on January 25, 2012. As with the January MRI, Friday's MRI showed that there was no change in the tumor. No growth and no shrinkage. I am not going to lie, was pretty anxious about this one, as I have been taking the Chinese herbs since August 28th of 2011 and eating well, but have not been as consistent in other areas of my awesome holistic approach! No growth. Thank the gods, all of them.


Dr. Ewing and Suzy Eder NP took about 2 hours to look at the images, comparing them to the last ones. They agreed with the radiologist's take that no change can be seen in the DCIS (by way of reminder: Ductal Carcinoma in Situ). Dr. Ewing asked me if I wanted to get surgery, I said no. She then told me that I have the option of taking just Tamoxifen, which Suzy later explained to me is an option that some DCIS patients take if they don't want surgery. Because my estrogen receptor tested positive, Tamoxifen would help surpress any tumor growth. I told them I would think about it. I have stopped taking the herbs for a little while as I reassess my situation and determine my plan going forward.

I see these as my options:
1. Continue Chinese Herbs, continue lifestyle changes - support with MRIs every 6 months
2. Tamoxifen for 5 years (1 pill a day), continue lifestyle changes - support with MRIs every 6 months
3. Continue lifestyle changes, take nothing - support with MRIs every 6 months

The last thing Dr. Ewing said to me is that "yes, no change is good, but DCIS tends to blow up". That is exactly what she said, and it is still ringing in my ears. She left me to discuss more with Suzy Eder. I told Suzy that I realize that I am not taking the approach that they recommend, but that I appreciate their support. Suzy responded by saying that it's true - not most hospitals would support this kind of monitoring; they would most likely recommend surgery. However, she said that at this point, data is still being collected on patients with DCIS. Since DCIS has really been seen in the last few years because of the more sensitive equipment (better mammograms and MRIs with high resolution). Patients are either choosing surgery to just get rid of it or tamoxifen to try to keep it under control...and then there are patients like me, who choose not to get surgery and use an alternate approach. She said there is no evidence that the decision I've made to do neither is wrong. If there was reason for me to get surgery and I was choosing not to, they would tell me I was being foolish and that I should get surgery. That's not the case and they support what I"m doing now. Whew.

So I am now scheduled for an MRI 6 months from now on December 28 and a follow up with the doctor and NP on January 11, 2013. In the next few weeks, I'm going to refocus my efforts, think about my options, decide my path forward. More to come as I figure things out!

Remembering Mom, 10 Years Later

Here is something I wrote on this blog when my mom passed, 10 years ago (link). I'm spending the day with my family today in Sunnyvale, and FaceTime-ing with Ixi and Max in Cincinnati. It is a good way to remember her.  We have nothing but love for her.

*******

July 12, 2002

Something happened a couple years ago. It almost seemed like you became extremely wise. A more likely scenario: I began to listen. I don’t remember exactly what you said, and I probably should have written it down, but I do know that whenever I had a problem, after talking to you I always knew what the right thing to do was, even if you didn’t explicitly say it. I remember being amazed more than a few times after you’d got off the phone with me or left the room after talking to me because of the clarity you brought to any problems I had. Of course! It’s so simple!

It was through this disease that became a part of your life that you learned many lessons; lessons that you passed on to every person you came into contact with, be it for minutes or for months. I know our family in particular has learned these lessons first-hand through the example you set for us by fighting through your pain with a smile on your face. Many times you didn’t have the energy to speak. Your voice was very soft and sometimes I think that it became that way for a reason: it was not because of the cancer, but because the things you had to say were so important that we had to lean in a little, and listen intently to hear it.

You gave many people the opportunity to know how it feels to really help someone, and I’ve slowly realized that no matter how small the deed, the appreciation is, many times, multiplied on the other end. Some of the other things I’ve learned I cannot put into words, and some lessons I probably have yet to fully comprehend, but as I live my life and keep in my mind all that I have heard, seen, and felt these past years with you, these lessons will become clear at the right times—I’ve no doubt in that. And from the stories I hear from your friends I believe they feel the same way. Selflessly, you fought through your disease for years just to pass on these lessons. Thank you for everything. I love you very much.

I picture you smiling because that is how youlooked every moment of your last years here with us. I know that you are in a better place. To me, you were my mom: a warm, loving, beautiful, intelligent, courageous and amazing young woman that I am proud to have known.

PLEASE DON'T STOP THE MUSIC

There was a slight tweak in my MRI date - I got it on Friday, June 29th at USCF. Usually, getting an MRI is slightly uncomfortable for me; it's about 45 minutes of laying perfectly still face down, propped at the head and below my breasts. There is a series of loud beeps when the images are being taken so they give you earplugs. Laying in that tunnel, listening to the loud beeps, my mind starts wandering and I undoubtedly start thinking about what the results will be.  

This time, however, was at the Post Street location where they have a bigger and more sensitive MRI machine ("for people that have claustrophobia or that are obese") and have set up the room so that Pandora can be hooked up to earphones and I can listen to any station of my choosing instead of the loud beeps. Genius! Guided through Florence + the Machine like artists, I was rocking on instead of thinking, thinking, thinking. Time passed easily. 

I am now a little anxious for the results, as my focus has been good in some aspects of my life, but not consistently all.  I get the results on Friday, July 6, when I meet again with Dr. Ewing and NP Suzy Eder. Good thoughts please!

UPDATE: MRI RESCHEDULED


I called UCSF earlier this week to confirm my appointments and they had failed to schedule the MRI so I have been waiting for a cancellation this week. There are none - so I have rescheduled my MRI for June 22 and follow up appointment for June 29. When you can get this type of MRI is very much limited to specific dates during your menstrual cycle - during the May window I will be in Taiwan on vacation so had to wait til June. I guess this is good after my findings yesterday? This ish is expensive!

MARCH MADNESS AND NEXT MRI

I was on my snowboard for most of March - in Tahoe and in Colorado. A couple of late nights and early mornings. I'm back on the ground now and sleeping really well. Incidentally, I had a lower tolerance for certain people last month and it probably showed. Not sure if that was related to less sleep!

Lemon tree buds in my backyard

I'm glad it's April now, the end of which means I go get another MRI at UCSF. The three months since my last MRI in January has really gone by  fast. I spent some of this afternoon in conversation with my health provider to confirm that my second MRI is covered. It is. However, as I started talking to them, I started looking more closely at my claims from my first MRI (which I should have done earlier) and realized that the actual "patient responsibility" cost was much more than they originally estimated back in October. After an enlightening Q&A session with my provider, here is how it breaks down:

Original Estimate: $291

• $111 - Breast MRI + dye 
• $180 - Interpretation of results

Actual Out-of-Pocket Cost: $760

• $44.27 - This was for the dye injection
• $476.60 – For the actual MRI procedure
• $1146 - This is for the 3D rendering with interpretation and reporting of MRI  (waived this time)
• $239.39 - This was for my follow up appointment with my doctor

That is kind of different than the estimate, don't you think?  The nice lady on the phone said it all depends on the type of MRI they end up claiming. How many types of breast MRIs are there? Lesson learned: They tell you they will never know how much it will cost you, even if you give them the facility name and the procedure details - and they are right. There is no telling how much it will cost you. I find a situation like this pretty unacceptable - where you agree to buy something but you don't know the price until afterwards. Where else in our society does that happen but in our healthcare system?  

My current plan consists of MRIs every 3 months to monitor progress and the Chinese medicine, but given that it potentially will cost me $700 each time, I think I need a new plan. 

IN LIKE A LION?
February was a busy, busy month. I've done a pretty good job but I have to admit...it's a little difficult to keep this up! I slept later than I wanted to a lot of the month, had a slight lapse in my alcohol intake...had a quarter of a glass of wine and 2/3 of a beer one night and the next day was hungover. Yes, hungover. I will probably revert back to having none or just a few sips when I'm out with people. I have been having a lot of fun though, which has to count for something!

I purposefully took a two week break from the Chinese herbs during which had a consultation with my Chinese doctor (Dr. Chris) to lay out the plan for the next three months. The general plan is to continue as I am with the following changes:

• Dr. Chris will change the herbs to focus on breast-heart-liver-lymph clearing to reduce/remove heaviness in breasts before my period (which apparently is an indication of toxin removal)
• Ways I can help focus on liver toxin clearing: eat more sour foods - lemon, lime, vinegar (some put garlic in red vinegar and take a tablespoon of it a day);
• Refrain from alcohol, this could slow down progress; emotional stress can affect progress as well

Generally, he said my body vitals are looking very good. He also said that my progress, compared to others that have not had surgery is about average. For some, results are seen quicker, but everyone's uptake of the herbs is different. This month I want to focus on removing any barriers to progress.  These girl scouts are not helping! :)

RESULTS ARE IN...

I got my MRI results on Friday. The DCIS is the same size as it was before. This is good - it means it is not growing or moving anywhere, and it means that what I am doing is not making it worse. However, I would like to see it shrink in the coming months. My genetic test results also came back: the results are 95% negative, meaning that it is not hereditary. Surprising.

Upcoming: I will get an MRI in three months to continue monitoring the size. I need to make sure that the MRI is covered every three months, which is more accurate than a mammogram (which is covered). If it is not covered every three months they want me to get a mammogram, which would only be accurate enough to see if the DCIS became invasive. I will continue to make more good lifestyle changes, looking at where, environmentally, carcinogens may be entering my system...through the products I use on myself and around the house or the food I eat.

UPDATE

With the new year comes...flexible spending use for my appointments. :)  The appointments started last week with getting blood drawn for a genetic test. I'll get results in about two weeks. My upcoming MRI, doctor's appointment, and consult with the plastic surgeon was rescheduled for January 25-27.


Generally, I'm feeling very good these days. Here is a summary of what I've been doing:

Sleep:  I've had an average of nine hours of sleep a night usually starting by 11pm.

Consumption: I am still boiling herbs, drinking a cup before breakfast and a cup before dinner. I've had probably seven sips of alcohol, three bites of cheese, two yummy bites of dessert - representing the extent of my alcohol, dairy, and sugar intake for the whole month. Before you think that I'm just eating things like granola and veggies, I'll tell you that I'm still eating to my heart's content and eating well.

Body: Although I still fit in some tennis maybe once a week, it's been quite cold, so what is more regular is I've been doing yoga 2-3 times a week. I started the new year with a wonderful Empty Cup yoga class on New Years Day. I soak my feet at night in an Epsom salt bath. Oh, and I floss every day! My dentist would be so proud. Physical State: Lighter and leaner than before, stretched out, clean.

Mind: I meditate every morning (almost) and have been reading a lot. I am working but work from home or coffee shops, so it's a little more relaxing although I do miss working with people. Currently on my shelf is "There is a Spiritual Solution to Every Problem" by Wayne Dyer (mom read this) and "My Stroke of Insight" by Jill Bolte Taylor, lended to me by friends. Mental State: calm and conscious with occasional moments of ego. :)

My body and mind are active during the day and well-rested at night. I can tell you that it feels very different than the schedule that I used to follow. Not traveling has really been a nice change, too. I can tell my body is thankful for it!

LOVE 

I thought I'd write about love for a minute here as we start the new year. I've been thinking about it a lot lately after having read this article shared by a friend on FB. In its essence, this article is about love, not about religion or about sexual preference. At its core, it is about how giving love affects the other people in your life.

Expressions of love

There are so many ways to show love. The book, Five Languages of Love, talks about this idea. I didn't read the whole book, but the concept has stayed with me for years. When I think about relationships, it's not uncommon for me to think about the book's main idea. The concept is simple: people show love and recognize love in different ways. There are five main ways: physical touch, quality time, words of affirmation, giving and receiving gifts, and acts of service. Since showing love everyday is the single most important part of a good relationship, the goal is to understand what your languages of love are and find out what the other person's languages of love are, and then do or say those things in a language they understand so they know you love them. Sound simple?

Who needs love?

Showing love extends outside our romantic relationships to everyone we interact with, whether it be our family members, our friends, or our work relationships. We can easily forget that showing love is just as important to the stranger walking by us on the street; to those that think differently than we do, love different kinds of people than we would, or practice a different religion. We are connected to everyone in this world. Everything we do affects everyone else in our collective consciousness. As much as it seems like we are separate from the crazy homeless guy on the street or the evangelist on TV, we are really not. (Sorry if you are reading this and you are an evangelist on TV.) We are very much connected.



"To love and be loved is to feel the sun on both sides" - David Viscott

Being Conscious

How conscious are we in our interactions with other people, what vibes do you send out to others? When you walk by someone, do you look away? When in a conversation with someone are you listening to what they are saying...or are you thinking about what you are going to say next? The quality of our consciousness is the single most influential thing about us and the most important thing that impacts others. When we are conscious, the time we spend with people is tons more meaningful. Try it out. For example, see how much of a difference these things make in your daily life:

1. When you walk by someone on the street and say hello, maybe ask them how they are doing
2. Make eye contact and smile
3. Listen to someone when they are saying something, and respond to it
4. Ask your friend or family member how they are doing...then listen to their response
5. Give someone a big giant hug (a little one is good too)
6. Give someone a kiss
7. Say "nice job" or "thank you so much", when deserved of course!
8. Tell someone that you appreciate them and love them 

There are endless ways to be conscious in our interactions with others. And guess what? By doing these little things, you've just acknowledged your connection to someone and put a little love and positivity in the world where there may not be enough. You may have just made a difference in a stranger, friend, or family member's day...or life.  It really doesn't take much to be there, instead of somewhere else. Just a little focus.

Hugging Republicans and Democrats

There is entirely too much separation in this world - people are labeled based on their religion, their political affiliation, how they dress or look, the part of town they live in, even who they love. Why does any of that matter when we are talking about love? Does any of that make someone less deserving of love? Yeah, I don't think so. To show love...you surely don't have to be flagrant, you don't have to go around hugging people with opposing political views. There are many subtle ways to express love, ways that show you acknowledge the presence of the people around you. Even better, show them that they mean something to you. Be creative, use your favorite language of love, or use the list above as a starting point.

What vibes do you send out wherever you go? Are you satisfied with the quality of your consciousness? These are good questions to ask yourself, and there is no better time than now.

Happy 2012, everyone. Love you all.

UPDATE

Chestnut mandibled toucan, Costa Rica

I took a little hiatus from posting over the holidays - travelled to Costa Rica, to my sister's in Cincinnati, to the bay area for Christmas and back. General update is that I'm feeling well most of the time, but there was a short period of time when I had some slight pain, noticeable uncomfortableness around the tumor site, and I could actually feel it. It scared me and made me think lots of "what if" thoughts but after about 3 days of this, it was gone. I am staying put in Sacramento for awhile now, no traveling on planes! I've started up with work again on relatively easy schedule, and concentrating on getting to sleep on time, eating well, and meditating in the mornings.

My UCSF appointment that is currently scheduled for January 18 (MRI) and January 20 (Follow up assessment) needs to be moved a week later because my period was a week late and the MRI is very sensitive to timing apparently. However, they are booked up that following week, so I am waiting to hear what the next steps will be. 

More to come...

AM I DOING THE RIGHT THING?

When I found out about my diagnosis, I met with the doctor and he laid out his recommendation: mastectomy. At least one boob, two if you want to be safer - you pick. He was very matter-of-fact and firm. It seemed so black and white.

It turns out, it's not so black and white, as it is with most things. The question I wanted to answer started with, "How do I get rid of the cancer in my body?" Then my focus shifted towards answering, "What is the best holistic approach to whole health?" As I started finding out more information about the answers to these questions, I realized that the two questions were not separate but very much related.

Truth: you are born with a certain genetic makeup. However, your health of your body and mind are up to you and very much in your control. There is no such thing as pre-disposed death. A holistic approach to whole health incorporates many aspects of how you live your life - from what you eat, the environment you live in, how you deal with stresses in your life, what you share with others, how much you give and receive love, and your attitude towards life. Basically, whether you take the time to take care of yourself.

At this point, although I my holistic approach is currently focused on a non-invasive solution: improving nutritional health, understanding all I can about myself emotionally, applying what I've learned daily, being "empty" (as they say in Chinese) and humble enough to receive what I need to learn, and taking care of myself...I have not ruled out the fact that I may need more invasive measures to get through this. I am still working with UCSF to continue to monitor this, and determine in January whether I will go with the surgery or continue on with my current approach.

Every once in awhile I wonder whether I'm doing the right thing. What I realized during this process and talking to people about their experiences is that the "right decision" is different for each person. The right decision for treatment is the approach you feel comfortable with. For others, it may mean surgery, chemo, or radiation. For me, it means things like boiling Chinese herbs, eating differently, having a few sips of alcohol while I'm out instead of a full drink, and continuing to arm myself with knowledge and perspective. It was not an easy decision for me to forgo popular beliefs in favor of a more natural approach. But as soon as I made that decision, it felt right and every action I've taken since then has been easy. I will continue to learn more, and with that, it may mean that I shift my thinking and shift my approach.

We'll see if it works.

TAKE A LOAD OFF: THE CASE FOR POOP

Since I have made some lifestyle changes in my diet and sleep along with my Chinese herbal treatments, I have really started paying attention to my daily bowel movement. Yes, poop.

A good bowel movement is so underrated. Some people are able to talk about poop, while others find it to be an embarassing topic. I definitely fall into the category of talking about it, particularly with those I feel comfortable with so, friends, watch out when we get to a certain level of friendship! All kidding aside, poop is one of those things that is directly tied to how happy your body is with how you are living your life. It is a big deal.

Good poop is defined as at least one bowel movement a day, in the morning. Long and firm, and should not require too much effort. Should also feel complete. I can hear chuckling. Remember - poop = big deal! What kinds of things help you achieve a nice poop? Here are some things that work for me:

1. For everyone it is different, but generally getting good fiber in your diet helps give the poop structure so that it's not all so soft. It also helps it move along the intestinal tract. If you're not used to eating fiber, ease into it so you don't get gaseous. Find a list of high fiber foods here.
2. Eating foods that don't make you feel bad later, generally. Each of our bodies is designed to digest foods differently, some better than others. Listening to what works and what doesn't will help you have better poop. A friend of mine went years not knowing that she was lactose intolerant. Once she got rid of dairy, bowel movements were great.
3. I've also found a direct correlation between a good amount of sleep and good poop. Giving your body rest time at night so that all the organs can do its thing to create the perfect poop in the morning, then...
4. Giving yourself enough time in the morning to do your thing.
5. Drinking enough water during the day - your body needs water to do pretty much everything. 8-9 cups a day. Camelbak makes a nice 1L (~3-cup) water bottle that makes drinking water almost effortless. Filler up 2-3 times and you're good to go.
6. You may have also noticed that your stress and anxiety levels have a direct correlation with your pooping ability. Finding ways to lessen your stress and anxiety will help you and your poop. Try meditating 10-15 minutes a day, take a yoga class, a bath, go on a run, listen to music, consciously breathe during the day, deeply...whatever it takes for you to take a load off...so that your body can take a load off too. :)
7. Breathe when you eat. Eat slower. Chew your food!

Like I said, a good bowel movement is underrated. Doing good things for your body will yield a good bowel movement. People that have good poop know this: when you have one of these said bowel movements, you will want to jump up with joy and tell someone about it (ok, maybe just a silent fist pump).

If you are just cringing reading this, you feel like poop is still a dirty, dirty subject and you cannot imagine talking about it, you'll find that if you add a little humor to it, it can be so much fun. Keeping it private is ok of course...but don't ignore your poop. Happy pooping is a gateway to good health.

MAXWELL 若谷

We welcomed Maxwell into our family on November 4 at 6:10am!  He has a consciousness about him even with just a few days under his belt. This little man is so cute and makes all kinds of funny faces.

Love him!

        

      

I freakin' love UCSF.  Thanks to the film department and the doctor's assistant for making things that can be and should be easy...easy. It is very much appreciated!

UCSF POST-APPOINTMENT UPDATE

Met with my breast surgeon, Dr. Cheryl Ewing and the nurse practicioner, Suzy Eder, on Friday. I'm continuously impressed by the balance between efficiency, caring, and openmindedness at UCSF Medical Center. It's just right for me for where I am on my journey. They had a meditation center in the lobby, a place to bring some space and consciousness into your day.


My mindset: I went in ready to listen, weigh options, while keeping my intentions in mind. I wanted to stay true to my short-term goals - which are no trauma, nutritional and herbal approach towards health. This would mean that if they'd asked me to do a biopsy or take tamoxifen, I would have declined. If they recommended a genetic test or further ultrasounds, that would be ok. My long-term goals are obviously to be cancer-free. How I get there may change over time as I see how what I'm doing helps or doesn't help.

The consult: This was a same-day appointment, which means the breast surgeon and her team (nurse practioner, radiologist, etc.) get together and determine what they think is the best route for me. They would perform any necessary tests that day and based on those results discuss and determine next steps. They brought me to my exam room and I sat there for about an hour and a half, close to two hours. I used that time to get my thoughts organized and did a little sitting meditation. When Dr. Ewing and Suzy Eder came to visit me, the consult was only about 15-20 minutes long. Here are the main points:

1. Dr. Ewing recommends a mastectomy: Based on their review of the MRI images (received a week ago) with the radiologist, she no longer thinks a lumpectomy is the way to go and recommends a mastectomy. Reason: the tumor spans a larger area than originally reported by UC Davis. There is a main area around 2cm, but there are tentacles that stretch down the duct toward the nipple; this area, though not a full mass is around 4.3cm long and all contained within the milk duct. I really dislike that word tentacle, but it's really the only word that I can think of that describes it correctly. She also said the MRI from UC Davis is not the best quality (not sure why) and that the radiologist wants to do another MRI to clear the right breast, which UCD thought was clear...apparently, UCSF is not so sure. To prepare for a mastectomy, I will be having a consult with a plastic surgeon, in the next few months as well.
2. Moving forward with Plan B MRI monitoring: Setting aside mastectomy in the short-term, we discussed going forward with Plan B since I have chosen to continue with the Chinese herbal treatment, nutritional, and lifestyle changes. UCSF will monitor my progress with breast MRIs, the first of which has been scheduled in January, which is 5 months after my last MRI and 4 months after I started my herbs and nutritional changes. I'll have another same-day assessment at UCSF after the doctor has had a chance to compare the MRI image with the first MRI image. We discussed that if no progress is shown or if the situation has worsened, we'll move forward with the Plan A mastectomy treatment plan. If progress is shown, then I will continue with my natural treatments and schedule another MRI 3 months later.

They never did ask me to take tamoxifen or do another biopsy, which I had expected for the smaller mass near my nipple since they saw the connection between the main mass and this one, which the UCD may have missed.  Radiologist interpretation of the blacks, greys and whites in images is a whole other topic of discussion. It's kind of a big deal to be able to do this well!  It would be nice to be able to be in the room with the doctors while they are looking at and interpreting the images.  Some additional interesting notes from my visit can be found here.

And then...Some Fun

I had a really good time in visiting some of my family and friends in Sunnyvale, Berkeley, and SF, too. It was a gorgeous couple of blue-sky days filled with laughter, friends, family, food, and art.



This is where I sat to eat lunch near UCSF Mt. Zion

 

The sun in the Sunset district near Parnassus

  

At Berkeley Bowl...have you seen so many heirloom tomatoes?

 

We went to Vik's for lunch on Thursday in Berkeley, best Indian food around...just look at this saffron and cheese cake with pistachio on top (I had a sliver)



Some garden art in Berkeley, CA by whimsical artist and sculptor Marcia Donahue...this is just a taste, her entire garden is really beautiful and worth visiting, part of the garden conservancy and open on Sundays:

   

COMING SOON TO A THEATRE NEAR ME: UCSF

My UCSF same-day appointment is on Friday. I'm staying at Erin's in the sunset, which is quite convenient. Thank goodness for friends in the city!  Not to mention the tasty food that we'll be eating before and after.  This appointment is to review tests that I've had done since the last appointment, which was on 9/15, get some genetic counseling to determine if I want to move forward with genetic testing (I think I do), and get any additional tests done that my doctor wants done.  I think she's going to want a biopsy of the other 6mm suspicious area, *shudder*. All the people I need will be in one place so that I don't have to schedule return visits to get stuff done. Good on UCSF.

I see two goals coming out of this appointment: 1) Find out what the doctor thinks treatment should be now that I've had some tests done (minus the genetic test, which I'll likely get that day) and 2) probably forgo the recommended treatment (for now) and schedule my first MRI to monitor my tumor shrinkage or growth. Now, their ability to support #2 is dependent upon the doctor's interpretation of my hormone receptor tests, which are currently progesterone-positive and estrogen-negative. The estrogen result is arguably a false negative in the medical world. If both are positive, it re-confirms that the cancer is not aggressive and the "Plan B" MRIs can be an option they provide to support and monitor progress of my TCM treatments.

For more information on why it's arguably a false negative, see this article sent to me by the UC Davis pathologist.

Updates post-appointment!

LIFE IS A SERIES OF HELLOS AND GOODBYES

Today was my last day in Atlanta. It was a little bittersweet leaving - happy to be going home but feeling a little something about the city and the people I've met there. It was a memorable time. I definitely learned a lot while I was there - first about my new client counterparts and the project team, and then I started exploring the heck out of the city...tried the awesome restaurants, listened to live music, explored the neighborhoods, said hello to the people. Then I realized at 32.7 I can still meet lifelong friends.

Props to ATL...the city has a lot to offer and is very honest and raw. Sharing a couple of photos from today of the city before I made my way to the airport. It had just rained and the sun was starting to come out and there were these big puffy clouds.

Incidentally, as I my flight was leaving and I was already feeling a little nostalgic (even though I was still there), there was a thunderstorm and it started pouring rain. How fitting.

THE CLEAN 15 AND THE DIRTY DOZEN

 

As you know, I've been making a conscious effort to incorporate many colors of fruits and vegetables into my diet. I try to get my produce from my garden, from local farmer's markets, my local co-op or stores like Whole Foods. I also try to keep it organic but that sometimes that costs a bit more.

 

 

I've been recently gathering information around the part nutrition plays in health and healing. A friend of mine shared with me a LIVESTRONG article about nutrition's affect on disease prevention. A part of the article I found most useful was a list of fruits and vegetables that contain the lowest and highest pesticide residue levels based on a review done by the Environmental Working Group (EWG), a nonprofit in DC. Here are the results:

 

The EWG's Clean 15 are the fruits and vegetables that have the lowest pesticide residue levels that you can feel comfortable buying non-organic. They are:

1. Onions
2. Sweet Corn
3. Pineapples
4. Avocado
5. Asparagus
6. Sweet Peas
7. Mangoes
8. Eggplant
9. Cantaloupe (U.S.)
10. Kiwi
11. Cabbage
12. Watermelon
13. Sweet Potatoes
14. Grapefruit
15. Mushrooms

The Dirty Dozen are the fruits and vegetables that have the highest pesticide residue levels in non-organic fruits and vegetables that you should buy organic when you can. They are:

1. Apples
2. Celery
3. Strawberries
4. Peaches
5. Spinach
6. Nectarines (imported)
7. Grapes (imported)
8. Sweet Bell Peppers
9. Potatoes
10. Blueberries (U.S.)
11. Lettuce
12. Kale/Collard Greens

Or, you know, start a garden. It's both good for your health and easy on the wallet, and not to mention good for your soul. If you do start a garden, don't use crazy chemicals like Roundup if you plan on eating what comes out of your garden. There are plenty of natural ways to keep those weeds at a minimum.

 

INSURANCE INSIGHTS

I called my insurance company and found out some eye-opening things in the process of claiming services:

1. You might see what seem like duplicates on your bills because there is a separate charge for the doctor's services and the facility you were seen.
2. There are multiple procedure codes a facility may use for a single procedure, so you can never be sure which one the will claim, therefore you never know how much it will cost you out of pocket.
3. Each facility charges a different amount for a single procedure, even a single procedure with the same procedure code.
4. While your insurance company can help you look up procedures to see how much they would cost at a particular location, often the listed procedures are either a) so vague compared to the procedure you need or b) the procedure you need has a hundred different codes that don't match key words (e.g., genetic test) that you cannot find a suitable procedure to determine your out-of-pocket estimate.
5. For a single procedure, there may be several accompanying procedures that each have their own code that the facility will claim.
6. For a single procedure, there may be several people involved so the facility will charge for the services of the doctor, the technician, the second technician, and the pathologist, for example.
7. If the facility makes an error or needs to do a procedure again, you're paying for it.

I'm sure there is more that I'll learn...I'll add when I find out!

AND THE WINNER IS...

 

Looks like I'll be getting the MRI in the US and just vacationing in CR!

• Costa Rica MRI = $794
• UCSF MRI (with coverage, and it's covered) = $740 x 15% = $111

MEDICAL BILLS

Medical bills are freakin' expensive. Herbs are not cheap either. Doing both western and eastern medicine approaches together...well, you can imagine.  I need to go through my bills - I got one for $1000 and another for $200 after paying $120 - and check to make sure they are right. Then I need to rethink what I need vs. what the doctor ordered to see if I really need it. I probably need to call my insurance company each time something is ordered to weigh the cost vs. the need (in accordance with the treatment plan I want to pursue). Upcoming for me is a genetic test, the last half of my receptor test, and an MRI.

Does anyone know if there are tricks to this trade? If you do, call me please!

NEXT APPOINTMENT

Same-day assessment at UCSF, Friday, Oct 21, 2011 with Dr. Ewing and crew. :)

UPDATE ON PROGRESS

Since the end of August, I've been taking an herbal treatment prescribed for me by a Traditional Chinese Medicine doctor. Along with that treatment and based on suggestions from the TCM clinic and numerous reads about nutrition and the role it plays in healing, I've made some lifestyle changes - in the name of making my internal  body environment more alkaline and less hospitable to disease. These changes include cutting out refined sugar, dairy, artificial sweeteners, coffee, alcohol and other things that contribute to a more acidic environment in favor of a diet full of whole foods, less meat, and as many colors of fruit and vegetables as I can handle. Additionally, I've made an effort to sleep earlier, drink 8-9 cups of water a day, eat a full breakfast and lunch each day, and an earlier dinner. In short, I've made a conscious effort to take care of my body and watch what I put in it.

For example, at brunch today. When I want to eat this (note: I love this):

I eat this instead:

After a month of doing these things, I've observed some changes in my body. There definitely is a ways to go, but for one, my poop is a lot better - back to where it used to be when I wasn't traveling (although I still am traveling). Generally, it's very good and sometimes twice a day. There is no shame in talking about these things. Poop is serious! :) Also, since I am drinking a lot of water, my pee is the right color - light, clear yellow. I have a ravenous appetite, and yet when I eat these days I don't feel heavy nor do I have a food coma post-meal.  I feel lighter. I feel more healthy. It feels right. Goodbye to toxins, hello alkaline nutrients.  Watch my cancer shrink!

THINGS ACCENTURE TAUGHT ME, REALLY

I've worked a lot at Accenture over the past 10 years (read: many overtime hours). Gave some good energy in lots of different projects that have done well. I don't know if every minute of it was worth it, but I do know that throughout the process, I've had the chance to hone my ability to communicate effectively with all kinds of people and make good decisions. I'm by no means an expert, but am definitely more aware of how to do better. Initially, I thought these abilities were only applicable to the clients and the work that we were doing. But as I started growing up (yes, I have a little!) and experiencing more things, some of the things I've been able to "practice" at work really have helped in other areas of my life.

How to Communicate Effectively
Do you understand the words that are coming out of my mouth? -Smokey, "Friday"
I've found that people are very different. (Um, duh!) Each person brings a lifetime of assumptions of what certain words mean and feelings around certain words. So, when talking to someone we need to learn to listen to the other person, even if they are not saying anything, and tailor our communication to get our point across. There are effective ways to do it and not as effective ways to do it.  It's a constant learning experience to take what I'm thinking in my brain and translate what is coming out of my mouth into something someone can understand. Words mean something. You can't just say whatever stupid stuff that comes to mind - no one will know what the heck you are saying.

How to Make the Best Decision 
We can approach every decision we are faced with methodically, whether it be about how to design a system best or what the best treatment decision is given the information that we know.
1. Be clear about what your intention is.
2. Then, start asking questions. As many as you need to to make a decision. If you have a time limit, ask 'em fast. :)
3. Throughout, stay calm and keep an open mind.
4. Identify the options.
5. Weigh the options.
6. Pick the best option.

Seems simple, no?  This works in 90% of our decisions. I made up that percentage.

What I have realized is that in the 10% of decisions that are related to those you love, you can be methodical and logical but, as you assess in step 5 and make your decision in step 6, your must let your heart in to help guide you to the best decision. The most logical decision is not always the best one.

UCSF APPOINTMENT THOUGHTS

I had my appointment on Thursday with Dr. Ewing, a breast surgeon at UCSF. She was very straightforward, informative, and positive. Smiled a lot too. Funny how different outlooks different surgeons can have.  UCSF is definitely more on the "do as little harm as possible" side within western medicine and are much more informed (or used to hearing about) options that include alternative treatments. They are, in my opinion, more responsive and relevant in terms of what the patient wants in terms of their treatment.

I have some action items to take care of before final recommendations are made, but in short, the surgeon thinks that lumpectomy is still an option since there is only one known cancerous area. Her final recommendation would also depend on results of the genetic test, hormone receptor test, and her review of my images. When I told her about wanting to try Traditional Chinese Medicine before doing anything invasive, she (very carefully) said that it is not something she recommends but if that is the treatment that I choose then they can support that approach with MRI monitoring every three months as long as my insurance covers it.  She believes it does, but I would have to confirm.  She also said that I could do this only if my hormone receptor test comes back positive (hormone sensitive), which means it it is less likely to grow agressively.

OPTIONS

The options she gave me are:
Option 1. Lumpectomy of the one known cancerous area with radiation of the left breast. I would need continue to do MRI monitoring each year.
Option 2. Mastectomy of the left breast (either nipple-sparing or non-nipple sparing) where all breast tissue is removed and no radiation is needed. Centinal node biopsy would be done to check lymph nodes.
Option 3. After discussing my desire to start with non-invasive TCM treatments first, she also gave me the option of MRI monitoring every 3 months with Tamoxifen.

Dr. Ewing said she also wants to biopsy the 6mm mass to rule out the need for mastectomy...but I don't really want to do another biopsy. I don't think it's worth the trauma on my breast tissue - it may cause more harm than good. Obviously, I don't really want to take Tamoxifen too. It's drug that prevents the growth of invasive breast cancers by interfering with estrogen. I remember when my mom took that.  Perhaps it has less side effects now.

An interesting thing Dr. Ewing shared with me about Option 1 vs. Option 2 is that in young people that have developed cancer, the most recent studies show that there is no noticable difference in recurrence rates between those choosing lumpectomy vs. mastectomy.  Did you know that recurrence rates and survival rates that doctors refer to are based on a 5-year time period? She mentioned there are studies in the 10- to 15-year range, but these are not the numbers that are most widely referenced. Additionally, it takes many cancers 5-10 years to grow to a detectable size, so what do these numbers really even mean with respect to how healthy you will be for the rest of your life?

BENEFITS OF UCSF

I asked what the difference between UCSF and UC Davis are - she said they have more experience in doing mastectomies.  Still to be confirmed.

A really good thing about UCSF is that after I get the results of the genetic test and hormone receptor test and get my images on disk, I can bring these results and images to an all day consultation at UCSF where I have access to the full UCSF team to get everything I need done all in one day. Dr. Ewing, her mammography team, and any other specialist I need would be on hand to provide whatever I needed at one time. No scheduling and returning for another appointment. How thoughtful!

NEXT STEPS

1. Get a genetic test
2. Get the estrogen/progesterone hormone receptor test
3. Go to UC Davis to get my medical films on disk
4. Call insurance company to see if MRI monitoring is covered
5. Set up an all day appointment at UCSF

And then we come back to food...

I had this beautiful meal at my friend's parents' house in SF after my appointment - homemade Vietnamese eggrolls and pho with the works. Thanks for feeding us, Vu's! 

Quick update - tomorrow I have my second opinion appointment at UCSF Medical Center. I have some of the same questions for them that I did for the UC Davis Medical Center surgeons, but I also will be asking them whether there are treatment options that provide some more flexibility to allow me to incorporate some of the traditional chinese medicine treatments into the overall plan. I'm interested to see what their treatment recommendation is and whether they can provide some flexibility and coordination of treatments. 

On the herbal front, I've sent my body vital readings (see 8/26 blog post) back to the doctor.  I discussed it with him and asked him how, from the readings, I can monitor whether my weak heart is getting stronger.  He said it has to do with how warm my hands and feet are - they should be very warm to the tips even when I'm in, say, an air conditioned environment. I know that my hands and feet - at the tips they still feel cold at times. Generally, though, my body vital readings have improved over the two weeks. These can possibly be attributed to the herbs, but can also be attributed to my diet and sleep changes.  Based on my results after 2 weeks, he prescribed a new set of herbs for me.  Unfortunately, they sent them to my CA address instead of my Atlanta address (even after two confirmations), so they overnighted some powder pills to me today.  I will take them until I get home on Friday, at which point I'll be able to make my herbal tea. 

Ok, more on how the UCSF appointment went after tomorrow!