Hey, all!

I've been in one of my quiet (but busy!) phases of late. However, I leave tomorrow for a conference at the Mayo Clinic in Minnesota. It's a conference I've always wanted to attend: one of the most comprehensive anywhere on the kind of work I do (cardiac ultrasound, specializing in congenital heart disease and stress echocardiography). I've worked in congenital heart disease for twenty years, on and off (adults for 28 years but who's counting?? ). I've taught it for a long time. But I'm looking forward to learning something new and seeing old friends and acquaintances. It's a small world, professionally, that I inhabit; the smaller still for the fact that I worked all over the US and Canada demonstrating and training on ultrasound equipment. One of the key presenters, in fact, gave me my first job in pediatric cardiology. I was his research assistant for six months in 1979, and he still remembers me (vaguely ).

I'm looking forward to it. This is its twentieth year, and we never could afford it before (it's a LOT of money, not to mention the trip or the fact that I have no roommate at my hotel). My DH said it would be my birthday present, though, and I am grateful!

My DH and DD are a bit too eager for my departure. I have secured my husband's promise, to be broken early I'm sure, to feed R at least one green vegetable a day. I don't think that's too much to ask, do you?? My DH says that it will be a gift, being on my own for five days, and it will be -- but I'm going to miss them (e-mail notwithstanding). We share our house with an ever-changing family of cats. My DD has been working cat adoption every Saturday since she was in second grade, and we always have one or two fosters kicking around). One of the ies is going to her new home on Monday, while I am gone. She's a character; we named her "Frida" because her markings look a lot like Frida Kahlo, though in reverse: a black and grey streak on white (with a tabby tail -- she's a funny-looking kitten). I'll miss her, too!

I've had some news on the health front that leave me more confused than ever. My tests show that there is no ovarian remnant syndrome, no endo (probably, CA-125 is low and mine wasn't before), and the ThinPrep was normal . Also, in the last week, my symptoms had abated. I seem to do fine, as long as I eat very carefully (and very little). I'm actually down to my ideal weight, more or less, with my waist a couple of inches larger than it was at that weight before. It's not fat, and it's not "thickening." It's definitely bloat, since my girth goes up two or more inches over the course of the day.

But you know, I can live with it, and my pain control is adequate. I have bad discs in my neck, too, and I cannot take anti-inflammatories (my toxemic pregnancy left my kidneys "insufficient" ). It only takes half a Vicodin to deal with my pain, if I need to work or exercise; if I can "veg out" then I can just live with it. I just pray it's not going to go to obstruction, is all.

Part of my dilemma has to do with my DD. Many of you may know that she had her large intestine removed in the first few days of life, thanks to a whole lot of factors that stemmed from the above-mentioned toxemia. She's had three abdominal surgeries. It struck me, on my birthday Tuesday, that I never really got to see my child without the scars on her belly. I did get to hold her once while I was in ICU, but only for a few minutes and I was so sick I couldn't do much (no glasses, either -- didn't get those back until the day I got out of ICU). I don't know why, but that thought made me unbelievably sad all of a sudden. I never got to have that "perfect" experience or count the fingers and toes, all that. Most of the time, she lives a normal, happy, incredibly busy existence. She scored literally 100% on most of her third grade standardized tests, practices cartwheels, is learning Hebrew, American Sign Language, and of course English, takes care of kindergartners and cats. She's popular, and if you've seen the pictures, she really is strikingly pretty too (yes, OK, so I hate her ). It's easy to think of her as totally normal, since in so many ways she really is.

But she has been having increasing abdominal pain. I've tried to hard to disguise my pain from her, but we seem to be becoming sisters in pain. I don't want to put her -- or me -- through this. It's hard, but she seems to have learned to live with pain, mostly. However, it's beginning to break through that more often of late. Much of it is dietary, and DH doesn't really help (he's just not used to taking the effort to make vegetables or other high-fiber foods, and he's tired too, it's not active sabotage, just lethargy). It's hard to change his habits: he's 55 years old and changing at that age takes some crisis usually. Obviously, I hope not. I wish our love for him could help him change his habits on his own. But now his dietary habits do seem to impact her: if they eat "junk food" (they'll go to McDonald's, I haven't been in a couple of years) she is uncomfortable afterward.

Her gastroenterologist agrees that it's likely adhesions, especially since she had multiple dead areas in the small bowel. Doing all the testing to prove the point would be unpleasant, invasive in a way that even the most mature of pre-teens will find traumatic, and likely not yield information. More surgery, just like with me, runs the risk of new adhesions. This, too, makes me sad. I'm grateful that she's an old soul. But I know the pain, and it saddens me that we share that in common along with our straight hair.

I leave early in the morning; the course begins Sunday morning in Rochester. Hopefully I can get on and keep up...but then there's reality

Audrey

A friend asked me if I was scared, and my instant, gut level reply was that no, I was furious (not the word I used ). I am. I'm angry at this disease, and at all the doctors who didn't treat me more aggressively when I was younger. The younger ladies around here have a few choices, and at least doctors know what endo looks like. My first laparoscopy was done in 1974, one of the first that these surgeons had ever done. All I remember of that time is that I'd been running a fever with excruciating pain for over a month. I'd gone through several antibiotic courses, and was needing very strong pain meds. I'd finally been in the hospital for a week for pain control. I had the laparoscopy and never was told the results (they were filtered through my mother). No one really knew what endo was back then!

I'm beginning to get scared, too. I was hoping to put this all off until January, but that's not possible now. And I'm scared that I've either developed more endometriomas, bowel obstruction, or cancer. My Pap came back CIN, so I've got a few things on my surgical plate. I've been in medicine for over thirty years and I know my own body. This is not easy, or low-risk.

My hyst was done by the oncologist, in part because of the elevated CA-125 and complex mass. But it was also because it was clear that my intestines were involved. At that time, it wasn't a huge problem. Now, though, it's two years later and the scar tissue is just too much. I'm going to a new group that specializes in these complex surgeries, and works in an interdisciplinary way with the gastroenterology people, since I have lifelong problems there too.

Yeah, I'm scared. I just don't want to do this, you know? I'm lucky, in a way: I've got good doctors who work with me, and I hear this new group is the same way. They're used to working with professionals as patients, and work as a team with you. I'd be in good hands (not to mention G-d's, of course). And somehow, I have faith -- not that it will be easy (since it won't) but that I'll get through it, as I've gotten through so many times before. My DH and I don't talk about it much; he's a medical professional too, and he can see how much pain I'm in. I'm trying to keep the household as normal as I can while working and being in pain. We're both very matter-of-fact about it, very clinical, and maybe that's my defense. It won't be real to me until we start discussing surgery dates -- and until I know more about what is going on!

Keep coming here. We'll get through this together, with guidance from ladies like (((mei))) who've been down this path already .

Big s .

Audrey

Last night, my DD had a huge hay fever attack. I think I wound up falling asleep in her room about 2 a.m. When I awoke, I wasn't in the kind of pain that I'd been in this weekend (more on the details later), but I was just exhausted.

I was supposed to work my pediatric cardiology clinic this morning -- my Monday job -- and in four years, this was only the second time I'd called in sick, other than for my surgery leave. But I've been working in such pain, and it finally has come home to me that I need to slow down. And when I need to slow down, well, then it's time to do something about it.

I did do something about it. I called in and got an appointment with my internist (first time in over a year) but not until the first of October. As uncomfortable as I've been, I don't know if I can wait that long, but my boss on my Wed-Thurs job can get me in. He's a friend, too, and whenever I've needed anything, he's pulled strings in the community for me. That's because I will do any "add-on" -- anything for our patients. Many of the community's doctors are our patients as well.

I also contacted the GYN-oncology group that I want to get into. I've decided, rather than go to the gastroenterologist for my current woes, to go to the oncologists. Why? Well, the GI docs don't seem to understand the impact of endo on the intestinal system, nor do they seem to understand the different anatomy post-hysterectomy. However, the oncologists are very familiar with the intestinal system. Also, the center I'm going to has also a world-known GI center that treats multi-factorial GI disease (such as pulmonary fibrosis from chronic GERD, which I have). I'd like to have my care all in one place, for a change! The oncology group, though, can't make appointments until they've seen my paperwork. I've already requested it, and will pick it up Friday when I have my Pap smear. I'm going to ask for a repeat CA-125 as well. My endo was sensitive to it, and it would be nice to know where it is right now.

Here's the laundry list of concerns:

High among them is this constant feeling of fullness, and bloating. My weight is at my ideal -- normally at this weight I'd have a 27- inch waistline (used to be 24, but that's before a c-section and 70-lb pregnancy weight gain...sigh...). But my waistline is more like 30 in the morning, 32 at night. My legs, too, swell, by at least an inch a night (more on the right). The bloating starts right below my ribcage, and I'm about the size and shape I was when I was about five months pregnant.

My intestines are not functioning optimally. I've had some days of incredible cramping and diarrhea, that leaves me groaning from the soreness of it and the feeling of being scoured inside. I've had searing pain, especially in the ureters. I'll think that I'm done with the diarrhea, only to have to return -- sometimes it feels like I will explode inside! When I need to move my bowels in the morning, there's a change in the force and direction of my urine stream. I still have reflux, which gets into my sinuses and is causing horrid drainage in the morning. Is it any wonder I hate mornings? My toilet and I are far better connected than I would like to be!

Interestingly, I've not been as nauseated as in the past. I still seem to want flavors, and textures, just not the bulk. My chest and back ache when I eat more than about a cup of food or liquid. I can't bend over or else .

In the hormone department, I've had these weird cold, oily sweats. (((Locki))), over on the Road, suggested thyroid antibodies, which wouldn't surprise me. I've got hallmarks of Sjogren's syndrome, without the specific antigens. However, 33% of patients with Sjogren's have negative labs for it, so my doctor and I have been treating it symptomatically. Like most healthcare workers, though, I am terrible about the "routine maintenance."

I've got significant dental problems too, but a root canal with crown in my community is pretty much $1800 per tooth, and our insurer doesn't pay for those, only cleanings. Now those are starting to become more troublesome; they're not infected or loose (I've kept temporary fillings in them for a long time now) but my jaw is beginning to ache, so I know it's time for that as well.

I used my day off to take stock, make the phone calls and the appointments. In the midst of this, I got a call from the workers' comp company that managed my herniated discs three years ago. I'd been declared 50% disabled; they paid off some of my salary when I had to go from five days a week to two. But I'd gotten a letter a year ago saying that my case was closed. Out of the blue, the case manager calls me: they're auditing my old claim officer's paperwork, and want me to go to the doctor at my workplace again to find out if I'm "more than 50%, or less."

Now, I just saw the neurosurgeon this last Friday, and he essentially reiterated the same thing: things are stable, not likely to improve at all (those discs have now turned to bone) and my lifting/pushing restrictions permanent. I paid for this consultation out of my own pocket, since I figures WC was out of the picture.

The poor case manager. I don't think she knew what she was getting into. I didn't go off on her -- exactly -- but I was a bit impatient with what she was trying to tell me. If I've been closed out at 50%, why do I have to return? She hems and haws, saying finally that they want to know "if (your) rehab goals have been met. Fifty percent is too high, and that's unacceptable to us." Huuhhhh??? My case is CLOSED: no more money, WC laws in California have changed, so no more treatment. No financial gain for me, or for them, as it's been two years since my payments stopped!

This occupational medicine doctor does little other than talk to me, sign the paperwork, say, "Yup, you're 50% all right!" and cheerfully tell me that "everyone over forty has degenerative disc disease. Learn to live with it." (Gee, has anyone here heard that before??? ) He's based at the hospital, a thirty-mile drive from my house. Somehow, I'm unwilling to take the time in the midst of all that's currently on my plate, health-wise, to go down to spend an hour waiting and ten minutes with this guy, only to have him tell me that nothing has changed. Especially since it's only to "complete their audit." The case manager was clear that no money would be forthcoming, even if he said that I was 100% disabled ("Oh, no, of course your case is closed" ).

I simmered down, a teeny bit, and suggested that she ask the claim rep if the note from Friday's visit to "Dr. Occupational" would suffice. After all, why shoot the poor messenger? I told her a bit of what is going on, and asked her to check on it. She called back ten minutes later, and said that would be enough to close the case.

This whole WC thing has been hard for me. I cannot push equipment any more, period. Luckily, my workplace has some small, portable equipment that I can push, and people to help during the day. I can't get a job in a hospital ever again, nor can I work full-time ever again. That may also be due to the endo stuff, though, hard to sort out at this point. Luckily, I normally make enough that it's not an issue, and my two jobs are pretty darn permanent.

But the thought nags at my brain: what if I did need cervical spine surgery at some point? I've lost twenty percent of nerve conduction in my right arm, at least two years ago I had. That's probably more now. I work very hard to keep up the strength, though, and if you don't ask me to lift, carry, or use my arm for more than a few minutes, you can't tell. It's just that the female stuff supercedes the neck stuff, for now (although the pain management from the neurosurgeon is blessedly useful for the pelvic stuff too).

All my current symptoms are identical to the previous ones when I had my hyst. They did warn me that ovarian remnant was indeed possible, and I wonder. I had adhesions everywhere with the hyst, and extensive "extra" blood vessel formation, so it wouldn't be a surprise that they didn't get every single little cell. The fact that I've had CIN with one of the high-risk strains weighs on my mind as well.

I think my DH is resigned to the fact that surgery is going to take place sooner rather than later. I just want to be able to make it to the Mayo Clinic course I'm going to at the beginning of the month. It's all the CME credits I need before December, and it's a course I've always wanted to attend (20th anniversary, echocardiography and congenital heart disease). I don't care if I have to attend with an NG tube -- I've enrolled and I AM GOING! I figure it will take that long to do all my testing anyway!

Well, for a day off, it was action-packed. I just feel like I don't want to face this, you know? I just want to be able to live my life, and enter the new year healthy, whole, and without physical worries other than how to find enough time in the schedule to work out.

Oh, well. At least I've broken my addiction to sugar.

audrey

I don't see Walmart as a union/non-union issue. In fact, although my maternal grandmother was a rabble-rousing union activist, I've voted against whenever the elections have come up; I'm uncomfortable with the idea of health care being unionized anyway.

My concerns extend beyond Wal-Mart itself. For most of us, our family economies are such that we MUST buy the lowest-priced item of those items we need and use. The cold truth is, to live in Los Angeles county (family of four, rent for 2 bd apt, health insurance, ONE car, and ZERO extras, like dinners out or vacations) requires a MINIMUM income of $70,000 per year. At least, that's what it cost last year . I don't know where in southern California you live, but in my neighborhood, it probably costs more than that. So I understand the need of consumers to find value wherever they can.

I also understand the dilemma of an employer facing ever-greater health insurance costs, particularly the new statistics reported recently that say that it takes $10,000 to cover an employee. Many employers also are "self-insured," meaning that their risk pools are their employees and the company pays the expenses itself. The insurer is just the administrator. For example, my DH's employer is nation-wide, and self-insured. We had Kaiser HMO coverage, which we had good experiences with.

In 1995, my DH was told, four families in this nationwide company of 20,000 or more had health expenses of over half a million dollars EACH. One of those families was mine: that's the year my DD was born, and two months of ICU care, two surgeries, a month of care for me, including ICU care, etc. added up to close to that. BTW, that's the lifetime cap on my insurance now -- per family .

Employers, in an era of cost-cutting to maximize profits -- or to stay afloat -- cannot afford health insurance for everyone. Even though ours now is "employer-paid," the truth is that we pay $550/month ourselves for this insurance, which pays only about 20 cents on the dollar, average. I understand Wal-Mart's position on that. Walmart DOES provide jobs, in some cases to people who'd have a hard time being employed. My friend's adult developmentally delayed son was encouraged to apply to Walmart.

I don't hate Walmart. What I'm uncomfortable with is the price the rest of the world is paying for our reasonably priced, up-to-date fashions. The squeeze, then, is the people at the bottom of this food chain: the seamstresses, part-time Walmart workers (who don't make enough to live in southern California), maquiladora employees on the Mexico-U.S. border.

This doesn't mean I expect everyone to share my discomfort. I just know that, for me, I've always preferred to pay a bit more (or use hand-me-downs, or thrift shop/resale) to hopefully know that the company from which I buy is paying its people a semi-living wage.

We're also somewhat thrifty around here. I don't have any "latest styles." I still wear dresses that are ten years old (sometimes even to work) and have two or three pairs of shoes that I expect to last for years. I have one pair of boots that I've worn for nearly ten years now. They'll finally have to be replaced -- maybe next year. We recycle everything and throw out very little. My DD has toys that others have given her, but we haven't paid for much other than art supplies in the last few years.

I just wish we had an economy that had less to do with consumer goods and more to do with keeping the people here in the U.S. employed. If all your toys are made in China (as most of them are), then what work is there for U.S. toy manufacturers? I'd rather buy one toy or doll, knowing that it was made by people earning a living wage (and was made sustainably) than an assortment knowing that it may have been made by people whose own children have no toys to play with. Luckily my DD isn't particularly demanding.

Walmart provides a lot: it provides employment (albeit low-wage, long hours, other HR issues detailed in Barbara Ehrenreich's book). It provides a wide variety of appealing goods that people want -- at a price they can afford. Their foundation offers grants across a wide variety of needs and in local neighborhoods. I don't deny any of this. And I'm probably the wrong person to ask anyway. I hate shopping with a passion!

(((Solana))), good for you and your portfolio. Their stock is an excellent buy, and you have the additional memories of your mom and her happiness there. I, too, remember the grocery strike here. We don't buy much at the chain stores, so it didn't impact us that much. I would not cross the picket lines (and never did, the whole time). We had some friends that really paid a price during that time. Even then, I saw it as a clash between the economic realities of doing business today (although all three chains continued to make profits the entire time, many smaller business, suppliers and the like, did not fare as well). I thought it was appalling that the two chains locked their workers out when in fact only one chain of markets was struck. But no company one can afford to shoulder the burden of the entire healthcare costs for an employee AND their families.

I guess this is what it is to be a Libra...You really do see both sides. Makes it hard to make a stand. I don't mean to offend anyone, truly. This is such a HUGE subject to wrap just a mere journal entry around!

I've actually never stepped foot in a Walmart; where we live, there'd be no room for one anyway. This isn't meant to be a flame against Walmart, but Moonchime's entry and solana's comment struck this particular chord in me tonight.

My feelings about Walmart came, in part, from two sources: one a series of stories in the L.A. Times written by a neighbor of ours, for which she won the Pulitzer Prize this last year . Another book that is interesting reading is "Nickled and Dimed: On Not Getting By in America," by Barbara Ehrenreich. She worked in a Walmart for a bit and had some interesting experiences there.

Many employers are going the way of Walmart: pay minimally, treat poorly, work hard. The consumer goods we can get in Walmart, K-Mart, etc. are made in countries where wages are cheap enough that, say, six skirts can be made in one hour by one worker. We may pay $20 (I'm thinking kids' clothes here), but that worker may only get $5 - or less - for a ten to twelve hour day, no benefits, no breaks. And she may only be 12, or 14, with this sort of work her only option in life (and it IS, nearly always, women workers).

I understand that in many countries, that $5 can go a long way, and in fact may be the sole source of cash income in a household. But I am uncomfortable wearing those items, or using those goods. There are companies that use independent monitors to check on their subcontractors, and I try to buy from those companies where I can. There are also some local apparel manufacturers that are committed to excellent employee care and a good, well-made, low-environmental-impact items. I support them as well.

This is easy to say, since I am in a position where I can afford to spend a bit extra on my clothing. But I actually don't: we have good vintage stores here, and I only buy from one or two labels anyway (Lands' End; April Cornell, Coldwater Creek) and nearly always on sale. Kids' clothes are much more difficult to find. My DD is fond of Limited Too, and certainly our clothing dollars stretch pretty well there. But I still look at the labels, and try to make her conscious of the fact that someone sits, hunched over a sewing machine for hours a day, 7 days a week, to make that cute skort she just bought.

Same with the produce we eat. We buy direct from the growers at certified farmers' markets. When I buy a labor-intensive item, like strawberries or raspberries, I do try to finish all of them rather than wasting those last few. Someone's back ached, terribly, to pick those berries -- I should honor that labor rather than wasting it! That being said, yes, I've certainly found mouldy berries in my fridge. But I do try to be conscious of the fact that hard, unrelenting, low-wage work went into my clothing, the food that I eat, the toys my kids play with, and the electronics that we buy.

Audrey

It was a very long day at work today, with some small, special moments:

Special moment #1: I work where I had my surgery, and have kept in touch with one of the nurses who took care of me (and was the best of the lot). She feeds, "neutralizes," and tries to socialize the many feral cats around our large hospital campus. We also work cat rescue as a family -- for the last two years, my DD has spent her Saturdays with a cat rescue organization at our local Petco. We've fostered six kittens for them over the years. Turns out, this friend of mine had socialized a kitten and brought it in to adopt out to another nurse today.

I had a patient on her floor who reminded me of "there but for the grace of G-d, go I." I was nearly homeless (but for the kindness of family and friends) for about a year, living with chronic fatigue and liver failure (viral from mono). I had lost a pregnancy, and had had a complicated one. I've been depressed, in despair, yet clinging to dignity and pride when I had nothing else.

She told me that she'd had cats when she was growing up, and this little lit up in my head. I told her about the kitten, and she got this wistful look on her face, "It would feel so good to cuddle a kitty again." I made no promises, but went to find my nurse friend, "Do you think we could arrange a ... visit?" Now I know how totally illegal this all is, but healing happens in funny ways, and I was willing to take my chances.

She OK'd it, and I brought in this 12-week old orange fuzzy kitten to my patient. She didn't get to hold it for long -- it still needed a flea bath, for one thing . But for those fifteen minutes, she got to hold a small, warm kitten on her chest, settled into its baby blanket (of course "stolen" from the nursery -- shhh... ).

It's not anywhere near enough to heal her heart, or to ensure her future. But I'd like to believe for those fifteen minutes, at least, that she was able to visualize herself in a home, with an orange tabby kitten of her own, and a future to look forward to.

Special moment #2: I went with my DD to get a couple of videos while DH was out getting our dinner. We had literally counted up the change in our purses, drawers, etc. as we'd given him all our cash to pick up dinner. BTW, this is not a statement of family poverty, just that DH has to go to the cash machine tomorrow! .

We're counting out our quarters and dimes, and it turned out that we had about 80 more than what we needed. So my DD turned to me and handed me the quarters (I use them for the bus and for parking) and took all the dimes, nickels, etc, and dumped them into the charity box at the counter (HIV services -- our community is probably 40% gay and lesbian). I said to her, "That's a good use of the change." It's a family tradition that change is donated to tzedakah (charity). My DD will also drop dimes and pennies in areas where she sees homeless people; I leave ALL pennies in change with the cashier ("someone will need them today&quot. We just think of these small gestures as good ideas on a karmic level.

The cashier gave us a couple of extra "rent 10, get one free" stamps, and commented something about being "gifted." Now, DD is gifted intellectually, etc. But it struck me that he wasn't saying that. I had one of those momentary, tiny, magical epiphanies. We have been "gifted." We have a home that we can afford (well, it's a rental, but still, we can afford the rent). We can afford to donate to classrooms, to work, in small ways and in bigger ways.

Although my DD was so ill at birth, she is gifted; her extreme lack of oxygen at birth would normally have led to delay, brain injury, devastation. Yes, she did have surgery at two days of age, again at six weeks, again at three years. She's not done, either, nor am I. Yes, I'm facing ongoing health problems. But I was physically able to work a full day, and, tired as I was, go with my child to rent a video. My DH was understanding of my fatigue and willing to buy a roasted chicken dinner so I didn't have to cook. Difficult as our lives often are, we're OK. I that my patient will be able to come through her difficulties in her life, as G-d's grace allowed me to.

I turned to the cashier. I said to him, "You know, you're right. We are blessed." I looked at my beautiful, healthy, impatient daughter, beckoning me to hurry. But for that instant, I stood in the sunshine of G-d's light.

We are blessed -- no matter what happens. If I can come through homelessness, two near-death illnesses, emergency surgeries, cancer worries, mental illness -- anyone can! I can't say that it's been any superior strength, morality, or intellectual capabilities on my part. But G-d has taken care of me -- of us.

Audrey

...but I want to warn you all, this is LONG. I don't post often (reasons below) but when I do, boy, watch out .

This started out as a comment to you, Moonchime, but I quickly realized that I had a whole journal entry of my own on this subject. I lurk a lot around here, but don't get much time to comment as much as I'd like. I do follow the stories of many of you, and wish I had the opportunity to be more fully a part of the community. But Moonchime's words really hit home today especially.

I love fall for the renewal. So many people consider fall to be a time of dying off, readying the world for winter. But not me!

My birthday is at the end of September, and usually falls right around the Jewish High Holy Days, otherwise known as the "Days of Awe." For me, it truly IS the new year, physically and spiritually. This year, I'm singing in our synagogue choir for the first time. I'd always wanted to do that. My training was in voice, originally, and choral music. Medicine was my "day job," but after thirty years it's so much more than that to me! I never would have made it as a singer, professionally, especially now with asthma. But I CAN sing in worship. So much choral music is on Christian themes. It's special to me to finally be able to sing Jewish liturgical music .

One of my vows to myself for the new year is to start sharing more with my words. When I'm not in class, I'm not as disciplined about my writing -- and right now, sitting at the computer is quite uncomfortable. But those words, and the feelings that they describe, are a part of me. To journal, or post about myself, is a form of truth-telling. After all, if I don't write anything, then maybe it doesn't exist . It's the whole "tree falling in the forest" thing. No one, including me, can hear what I have to say if I don't say it!

Telling the truth to yourself is the most difficult thing of all, I think. Journalling keeps you much more honest with yourself, where it really counts. Whether it's public or private isn't really the issue. It's exposing the truths of your (OK, my ) life to the sunlight. I'm really good at hiding my own truths behind my work with other people; I let slip hints here and there, but that's not the same as exposing reality.

Maybe, (((Moonchime))), you're able to be so spiritual because you journal, in part. After all, if you are able to look at all parts of yourself, dark and light, positive and negative, they start to lose their power to control you, particularly the negative. This frees your spirit to be able to absorb the intangibles of your life. After all, if you're not looking down at your feet as you pick your way through the minefield of secrets, you can look forward. And you can move on!

Our rabbi last Friday night discussed the whole new year vow issue. He said that so often we think we have to fix everything about our lives, and then always feel failure and give up when we can't do that. He suggested picking one issue in our lives, vowing to work just on that for the year. If other positive changes follow, well, that's excellent. But he said to look for the one thing that is keeping you "stuck" in your life, whether it's a relationship that is not working, an addiction (cigarettes, drugs, food, alcohol) or other issue (changing jobs, whatever). That one thing would be your vow for the year. After all, if you can't work something out, such as in a relationship, it's harder to grow and move forward.

Just then, it clicked with me that I really needed to work actively on my health. I've put it off, citing the need to make up financially for our trip back east to see my stepson this summer. I say that's what my DH would want me to do. Heck, that's what I want to do. If I don't work, I don't get paid and then neither do the bills quickly enough. We lost a year financially with my hyst in 2002; while I was recovering, our single car was stolen and we made the commitment to a new car (which I rarely get to drive, but that's a small quibble). Once we'd paid those bills off, we still had taxes and then decided to take this vacation. We'd not seen my stepson since the summer before, when his mother moved him to Maryland's eastern shore from Seattle. Getting him to Los Angeles is complicated and expensive. And we'd not had a vacation in over three years.

See, I have so many excuses. But I really can't deny my symptoms any longer. I started the process of facing it by a long post on the Road. Although I've not had confirmatory testing (yet), thirty years of medical experience combined with my knowledge of my own body tells me that the adhesion issue has moved from "just" a pain problem to a possible threatening problem. Leaving it go longer, just because I don't want to go through either testing OR surgery, is no longer safe, I can tell . Plus, my DH is 55 and a smoker (though NEVER around me, he knows how I feel about it), so one of us has to take care of ourselves for the kids. My DD is 9; stepson is 12, and HIS mom has melanoma in remission. I'm not so young either...

One of my co-workers (cardiology office in which I work 2X/week is small, like a family really; I've known her for 15 years or more), asked me if I was "scared." My response startled us both, I think: I told her that, no, I was p*ssed. Truth, coming out at last. Yes, I am scared; it's entirely possible, given my history and symptoms, that I'm either dealing with an ovarian remnant, residual endo, and/or cervical cancer (last Pap was clear, new one next week -- but CIN with a high-risk HPV strain). I also have such a strong family history of related cancers and high risk factors for ovarian CA, that my oncologist told me that my risk was NOT zero with my hyst/BSO. Everything was so adhered to everything else, that nothing would surprise me at this point.

I'm asking for a CA-125: my endo was producing it, and the levels dropped after surgery. That, combined with an FSH (if it's low, that's the signal that there's a remnant) should tell me in part what is going on. But the real problem is the adhesions. Something is blocking my intestines. It's weird: you can see the peristalsis moving under my skin (I call it the "alien," which is what I called my DD when she started to move). I'm in so much discomfort when I've moved my bowels, and I can tell when they "kink" and then loosen up. It's also affecting my bladder; something is fastened to it, and when that part of intestine moves, with gas or whatever, it leads to bladder and (I think) ureter spasms.

I feel full SOOO easily (bad for a self-confessed "foodie" and family cook), and I look like I did when five months pregnant, although I've lost weight (ten lbs, which isn't a bad idea, but it would be nice to get into the size I should be for that weight. I'm not a big person, and can't lose too much more. I've tried all the dietary maneuvers; I take my supplements, including digestive enzymes (otherwise nothing would ever go down! ). When I do eat, or when I move my bowels, my entire chest and ribcage ache. I've also tried NOT taking most of my medications and supplements; I've tried cutting out my estrogen. That was inspired by all those endo posts in the Oasis and Jungle, where ladies will say that they ripped off their patches and felt better "immediately." Didn't work that way for me, and I've got osteoporosis, so it's a risk I can't take.

Something has happened to my hormone balance, too, which is part of my concern. I now break out in these cold, oily, soaking sweats at times when I would have had hot flashes before. I tried cutting out testosterone and DHEA, but it didn't change. I've been an insomniac of late, but am physically exhausted (something all too many of us share in this particular community! Isn't that when the best writing gets done?? ).

I'm keeping going, but now find that I often need naps (like once or twice a week, at least, where it's all I can do to keep my eyes open). At least I'm not sleeping all day on my days off. I'm still doing some housework (never my strong suit at the BEST of times) and cooking healthy meals and spending as much time with my DD as I can. She is so energetic it's hard to keep up with her! I'm still mostly managing my 10,000 steps a day, but it's definitely getting harder.

I don't know how to discuss this with my DH. He, too, is an experienced clinician, so he's no fool, he can see what's happening. He's not happy about it. It just seems like our married lives have moved from one crisis to the other. When we got together, his son had just been born (ex kicked him out once she was pregnant, in part due to hormones and in part due to the fact that she realized that she really, really did NOT want to be married...but that's a whole other chapter. She and I are friends now, though, but her life is not easy either). My dad was in a coma that would last three months.

We got married on the same day as the birthday my DH shares with my dad -- I thought it was good karma. By then, my dad was beginning to recover. Visitations with the baby were stressful, as my DH and his ex had not yet reached a peaceful place. About ten months out, my DH had a herniated disc in his neck, and a life-threatening reaction to steroids. It was about six months before his body, spirit, and mind were back to "normal." Eight months after that, I had the ectopic pregnancy. It was in the cul-de-sac, so recovery and hospitalization were prolonged.

Then there was the 1994 earthquake; my parents live in Northridge and brothers live in other hard-hit areas. About six weeks later, they closed the hospital DH and I had been working in, abruptly. We were told that we had only a few hours to move everything to another hospital in the same complex -- which was not prepared to receive 100 patients, some critical, and all the equipment, etc. A year after that, we are forced by ex's declaration of bankruptcy to file ourselves to pay off taxes that she was responsible for (we're a community property state). In those years, I'm in and out of emergency with bad asthma.

Then came pregnancy -- something we'd been told would never occur (at least, not safely). Complications, unusual ones, cropped up early, at 26 weeks. Severe pre-eclampsia (but atypical, no hypertension) lands me on bedrest, able to walk only with a walker, at 32 weeks. No work, no money. Thirty-six weeks, in hospital with early kidney and liver failure. Thirty-seven weeks, DD is born after a 36-hour labor and horrific "crash" c-section, baby purple and hypoxic and me bleeding out. Two days later, I'm released from ICU; that evening, DD has emergency surgery for rare complication, 50% odds of survival.

Our lives did not get easier after that. We're forced to leave our rental house that we love since we can't afford to buy it; six months later, DH is transferred to Seattle. Now, stepson lived there at the time, but hostilities are still close to surface. And his company transfers him back one year later to California. DD continues to have intermittent health problems (otherwise living a normal life). We move, don't have enough money to get furniture out of storage, and then have to move again six months later (but to our former block across the street from loved house and amid loved neighbors). A year later, I have my hyst, car is stolen; next year, stepson moves and my MIL dies suddenly.

So, OK, you've heard this litany. Our lives have actually moved of late out of crisis mode and into "pro-active."

And now this. Is it any wonder that I'd like to bury my head in the sand? I just wanted things to be easy for a while, you know, and to enjoy being able to go to the yarn store and afford to buy whatever I want, heck, to be able to afford groceries! to go on an occasional date with my DH, to LIVE.

But noooo...

Well, thank goodness this is a journal, and rambling is expected! Time to pick up DD from second day of school. Gotta admit to praying that everyone, all over the country, could have the first day of school, with all its innocence and hope, that the terrorists didn't allow the Russian kids. We did, and I'm grateful to G-d! It's going to be a good but hard-working year for the kids. We're lucky to have one of the very few wonderful L.A. Unified schools.

Listen, s to you all -- if you got THIS far! See what you started, Moonchime??? It's all your fault!

Well, I don't know who started this one, but it's been fun reading the replies. So, in the spirit of disclosure (since I tend to write to others and not that much about myself), here goes:

1. What time do you get up? Between 7 am and 8 am in the summer; 7 to 7:30 during the school year -- and on weekends, all bets are off! (not after 10, though)

2. If you could eat lunch with one person, who would it be? living or dead. Hmm, that's a tough one. In the "famous person" department, probably Helen Taussig (one of the surgeons who performed the first surgical procedure to ameliorate a congenital heart defect). Family would be my grandmother and her mother -- but not at the same table!

3. Gold or Silver? .... Depends upon what I'm wearing it with, but probably silver

4. What was the last film that you saw at the cinema?.........Not counting kid movies? Hmmm...Shakespeare in Love (yeah, I know, I've got to get a life!). We also saw Winged Migration

5. What is/are your favourite TV shows?...... Gilmore Girls, Joan of Arcadia, ER, Nightline, Nova

6. What did you eat for breakfast?........whole wheat blueberry waffle and nectarine -- normally a soy shake, though

7. Who would you hate to be stuck in a room with?....Hmmm, got to get back to that (can we edit journals???)

8. What / who inspires you?........ My patients who are often in their 80s, with heart disease, still working and working out and active! I even have a couple of patients in their nineties who still travel, do their own yard work, and are productive

9. What is your middle name?..........JoAnne

10. Beach, City or Country?............Well, let's see: I've lived at all three (including six months in the third house down from the famous Venice beach boardwalk); I live in a nice area of Los Angeles with tons of wildlife and greenery all around; and I've lived in the mountains. I'd have to say "country" as long as it's within an hour of an urban area -- and as long as I didn't have to report to work every day!

11. Favourite ice cream? ......... Dreyer's low-fat chocolate chip or mint chocolate chip

12. Butter or plain popcorn? .......kettle corn, with just a touch of sugar and salt

13. Favourite color? .........any shade of blue, violet, green

14. What kind of car do you drive?....... 1994 Ford Thunderbird (no laughing -- it was my dad's, and the price was right ). I wish I drove the "family" car, since I commute 200 miles a week -- that's a 2002 Camry LE, VERRRRY nice. But nooo, the DH gets it...

15. Favorite sandwich?......Tuna, with celery, mayo, pickles, lemon juice on whole wheat, lightly toasted, with a giant beefsteak tomato slice on it and cucumbers. OR, homemade French dip with mayo mixed with salsa

16. What characteristics do you despise ?..... bigotry, intolerance, greed, laziness (I'm a good example of it, though, the laziness at least )

17. Favorite flower?........any bulbs, but particularly Dutch iris and specialty daffodils

18. If you could go anywhere in the world on vacation where would you go ? Kyoto, Japan; back to Vancouver for a whole month; Australia/New Zealand

19. What color is your bathroom?....... medium blue, black and white w/red and green accents

20. Where would you like to retire?...... Seattle or Portland; maybe Albuquerque, although I don't do well at altitude

21. Favorite day of the week?.........Sunday (Hollywood farmers' market, not working!) Tuesday a close second -- a day to myself

22. What did you do for your last birthday?.......Lord, who knows? At least I didn't have bronchitis (used to be an annual birthday present)

23. Where were you born?............Cheyenne, WY

24. Favorite sport to watch?.........Figure skating

25. Who do you least expect to send this back to you....???

26. Person you expect to send it back first?....????

27. What fabric detergent do you use?......All Clear, with liberal doses of Oxyclean

28. Coke or Pepsi ?.......Yuck to both; DH is a Coke kinda guy but just switched to C2. sometimes I like Schweppes raspberry ginger ale with lime, but it's water 99% of the time

29. Are you a morning person or a night owl?........night owl, totally (look at the time on this post!)

30. Do you have any pets?.....Two cats, a snake (he's really NOT mine). We also foster cats; my 9 yo DD works for a cat rescue organization every week and we take in kittens for them

Sorry this is so long! That's what I get for being an estrogen-deprived, insomniac, night owl!

I love reading all the journals; wish I had time for more writing of my own, but I'm going to get back into it...soon...

Audrey

*

Just had to get that out there. I got back an hour ago from the dress rehearsal for the play my almost-nine-year-old is in this weekend. We've been taking her to rehearsals for 8 hours a week for the last three months, and we've done some of the set and wardrobe stuff (not to mention selling tickets, of course ). And I've seen my DD in less "professional" productions.

In this play, she has five small parts, monologues in each. I was backstage most of the time: lots of costume changes for sixty kids! She begins as a bride (in a type of dress that I know she wouldn't be caught dead wearing when she really is a bride). She t hen is a TV hostess (think Vanna White) in a slinky black sequin dress; from there she changes into a strappy tank top number over a long satin skirt, and then wears a velvet black mourning outfit.

Well, I still hadn't actually seen her perform yet; I've heard bits and pieces of the music and choreography (it's an original play) but have not read the script. I came out and joined my DH in the audience for the finale and curtain calls -- the final song is "In Your Eyes" and it truly is a show-stopper. I cried, openly. She looked so beautiful and alive up there on the stage. Nearly nine years ago, when she was two days old, they gave us 50% odds on her survival as they wheeled her into surgery for the first time. My survival wasn't a sure thing either at that point, although I was at least out of ICU (probably a couple of days too early, but then I wouldn't have been able to hold my baby before her operation). That first surgery took several very long hours. At the occasion of her third surgery, when she was three years old, I was speaking with the surgeon at the post-op visit. He looked over at her, doing forward rolls on the carpet, to the delight of the nurses, and said, "I gave you fifty percent odds of survival that first night. If you'd asked me about her odds of thriving, I would have said no more than 10%."

She came up to us, begging for the lollipops that she knew the nurses kept (from prior appointments), and after getting my permission, I turned back to the man who was the key to her future and said, "I'll not take anything for granted. I'm the last person to say that miracles don't happen."

Ever since, I've cried at key times. Crying isn't second nature to me; it was beaten out of me rather early by my mother and by years of chronic pain. But I cry when my DD gets her perfect attendance awards -- working on her fourth year now. I cry when she brings home her report cards. I cry when I see her on stage. Tonight, I cried. She was so beautiful, and looked so at home. This is where she belongs. As I see her grow, and become the person she will be, it will always be a gift. From the moment of the dream I had, of a four month old baby girl named *** at a Thanksgiving celebration at my aunt's house, to the moment of actual conception, where my DH and I looked at each other and knew; from the severity of my pre-eclampsia to the fears of her surgeries and the pain she suffers now from adhesions, I never did see her future. But tonight, I saw the woman she will become. I'm in awe, a bit proud (I'll admit to it), and grateful to G-d for the gift that is this life.

There are pictures of her in my photo album, if you're interested in putting a face to this story. It's part of the book I'm writing. It's just such a miracle to see this person, this baby who by all odds shouldn't even be here, let alone intelligent and talented, on the stage and to see her future. It's also a miracle that my DH and I are here to see it; he faced death too many times to count in two tours of duty in Vietnam, and I've looked at dying from a close-up and personal perspective myself a time or two, including at the time of my DD's birth.

It's just unbelievably cool.

audrey

I've been out of touch these last couple of days, sorry!

Thursday night is call night; I take that day so I can sleep if needed Friday. Well, this was one Friday when I needed that sleep! They called me in for a "blue" (cyanotic) baby at 4 in the morning this morning. These babies can have heart disease, problems with their lungs -- or both. The neonatologist who called me in shared a memorable middle of the night with me over a very sick baby with complex heart disease a couple of years ago. Since I hadn't gotten into bed until 1:30 (it's the only time I can write, and 30 pages are due by next Tuesday night), I was pretty beat when I finally returned at 7:40, just in time to see my DD off to school. After a 52-mile drive, I was really hoping to hear Bob Edwards' farewell speech (you NPR listeners know what I mean) but fell asleep to the radio.

Beeper alarm goes off at 11:30. I am surrounded by cats (three) and my temperature is just right. However, I have to pee, so I stumble awake, head into the bathroom, and somewhat painfully later, I feel my way back, turn back on the heating pad, and go back to sleep. Needless to say, it doesn't take long.

Finally I'm able to rouse myself, finish reading Anne Garrels' book on her time in Baghdad (it's a great book) and try to at least clean up enough to head up to school to let DD know that she could hang out there since I was WAAYYY too beat to consider anything but the mandatory library visit. Can't do without that! I sure can't afford to buy all these books...

Finally get the long-delayed shower at about 4 p.m. My intestinal problems and pains have been difficult today, likely due to the lack of sleep. My back is bad, but that's from a whole day of CPR training. I'd let my card lapse, and so had to do the entire day, rather than just taking the written and demo tests. It was worth it, though, but I'm sure there's an article in it too: there's something more than a bit weird about the three sizes of reusable rubber face masks, one set per person. They actually have faces, though not much in the way of lips. There's the baby ("Baby, baby, are you all right?" Like the kid can really answer...). Then there are the "Junior" and adult torsos. Ours had a jaw that dislocated repeatedly, making it difficult to get a proper airway. The resistance of the mannikins is nothing like a real person, either; it was a workout to do CPR on the mannikins!

However, the good news also was that they were very short of instructors. I said I'd be interested, and the class is in October, so I'm planning to do it. I only have to commit to two eight-hour days per year at my regular rate of pay, and I'm an AHA-certified instructor,, so I'd be able to teach elsewhere as well -- like for my DH's 40-member respiratory care department, who is having trouble finding local resources. Like every other type of healthcare provider, apparently CPR instructors are in short supply. This might be an alternative source of income!

I'm off to work on the chapter (s) that are due on Tuesday (plus I have two classmates' manuscripts to read and edit). It's been a bad pain day; I was supposed to call the GYN-oncologist I was referred to, but it was a lost day. We won't even talk about the housework I was supposed to do...sigh. At least DH understood, even going so far as to warn DD not to mess with me (of course, she did, being a mouthy, tired almost-nine-year-old).

But I also got in a walk with her and we were rewarded by a good look at the herons; we saw the dad in flight (amazing, they're so huge), mom, and we think three babies. This is down from prior summers, although I'm told that there is another nest. They'll be flying soon and then we'll be able to get a better head count. We go out with the good binoculars and share our binoculars with any passers-by who are interested. We are a walking neighborhood; the daily parade ranges from 90 year olds to newborns, miniature terriers in braces of two or three or toy chihuahuas overrun by enthusiastic giant sheepdogs and golden retrievers. We have our regulars here, many of whom already know the nest. Right about sunset is the best time to watch the birds, but we have these little tiny midgeflies that swarm at that hour of the day, a perennial nuisance during spring and summer. It's tough to be running, panting your way up a hill, right into a swarm of the midges -- before you can close your mouth. Yuck!

Today I just walked; sometimes when I walk, it feels like shards of glass in my urethra and even higher up. I still do walk, figuring that there's not much I can do for this pain that I'm willing to do. But today was like that, just breathing through the pain and figuring that it will improve with a change of position. I've been ignoring too much of this for too long, since I know the implications of further surgery. I guess I just want to make sure that by waiting I'm not courting something more dangerous, like intestinal obstruction.

I'm yawning, and instead of fixing my chapter, I need to be off to bed. Nothing eloquent tonight, just a lost day...

This quarter, my class is in advanced memoir writing, taught by Samantha Dunn (who wrote "Not By Accident," among other books. I've also taken class from Hope Edelman, who wrote "Motherless Daughters." They've both been great, and I'm hoping to try some of the results on my reading audience (if any .

I've alluded to working on a book; although it is about my reproductive journey (which included pre-eclampsia that was nearly fatal to my daughter and to me) it is a series of essays, not a particularly straightforward narrative. It's time some of these things get written about more (MoeKay, Maureen, Empresse, if you're reading this, I hope you're writing as well!).

So I figure I'll have LOTS of places to stay when I do my book tour -- all you Hystersisters! In the meanwhile, though, I have thirty pages of my story to get out before next Tuesday. Some of it; much of it really, is already there, and written. It needs integrating into a book, more easily said than done.

Tonight, this minute, I am praying that my new Pap comes out clear. Up till now, I think I've been operating under some instinctive assumption that I am dealing with some early malignancy problem (CIN, CIS). This has the potential to really screw up my plans for this summer, frankly, and right now, I would love to elect feeling strong, and healthy, and surgery-free. I've got good pain control, really, more for my neck than my pelvis; however, there are days where the low-level cramping, the bloating, the shooting vulvar pain demand their Vicodin time. Some days are good: my core is strong, I feel up to exercising (I probably walked a total of three miles today, and LOTS of stairs!), I am not bloated, I can feel my abdomen, I don't have bladder spasms. Other days are, well, lost in some way. I can, however, still get through a day. I've not had to call in sick in two years (other than a bout with the flu, one day). I still mother my child; I still take "me" time to write, except when I'm writing about something truly important, in which case I stall and want to sleep . Housework pretty much leaves me the same way.

Today I did little housework, but at least got some picking up done; the stack of newspapers is a third of its former self, the stacks are down to two, one for me and one for my DD, the beds got made. Of course, I know that it's a little less than my DH's comfort level, but he emptied the dishwasher I didn't get around to. It's WAAYYY too hot around here to even think about cooking. Our house got up to 86 inside and that's with a window air conditioner going. Outside, we recorded 102. Don't let them fool you, folks; global warming is REAL. It's gonna be a long, hot summer. I've spent a couple of those in Bethesda, Maryland, half a mile from the Naval Hospital and NIH, without air conditioning. I grew up in Tucson. I guess you could say that heat is my friend , at least when my blood pressure is high enough that I don't pass out!

I have to write my teacher and clarify the homework; if anyone is interested in reading and offering concrete suggestions, you guys are my reading audience. PM me.



Audrey

In Los Angeles, I live near a city reservoir called Silverlake, which gives its name to the entire neighborhood. A mix of up-and-coming musicians, already-made-it writers and producers and musicians (with some actors) and Latino families in their long-time family homes.

Among the SUVs and the cell phones (which don't work near the reservoir, thanks to a community-wide effort to ban a "repeater" on the lake property) there lives a whole other world.

We have a family of free-loaders in the backyard, three at last count. Their elegant tuxedo colors bely the overwhelming chemical that is their spray. They are quite brazen; unlike most of the area's skunks (and there are many family units nearby) they venture out in the daytime, taunting the dogs next door. I arrive home at 2 AM from a midnight call to Long Beach, only to find a skunk on my front path. What to do? You can't honk; even fourteen years of neighborhood good will can't overcome that rude awakening. You don't want to get out of the car, either; better to sleep in the car than have to go buy tomato juice at the 24-hour pharmacy in the midst of the asthma attack such an assault is sure to cause. And then there's the little matter of how long it would take to rinse off: no, I stay in the car. The standoff ends when I open the door; it toddles off to its nest in the weeds of my (or my neighbor's) backyard.

Whenever we find a new sign "Lost kitty, no collar. Greatly missed by family," we all look at each other and nod knowingly. The coyotes are hungry again. They, too, can be brazen, particularly if construction has disturbed their habitat in Griffith Park, a mere couple of miles away. One morning, as I sat at my desk checking e-mail, I saw a dog-looking creature trot briskly into my neighbor's front yard fig grove. He (yes, it was obvious) could be easily diffentiated from a dog, particularly by a lean but bushy tail, similar to an anteater's. He clearly had a destination in mind. I have also seen feral dogs in the older part of the neighborhood, once in a pack of three with the leader conveying a (hopefully) dead cat in his jaws.

My nearly 9-year-old daughter still remembers the night when she was three. Taking out the trash, I found a family of raccoons, nine in all. The babies were no more than 5 inches long. She was ferrying them one by one, shepherding them across a brick retaining wall and over some discarded lawn furniture in the neighbor's yard. It took some time, and apparently we'd come upon the beginning of the process. We were as silent as a three year old could be, and apparently the mother decided we were no threat; she only interrupted her moving party for the brief moment it took her to acknowledge our presence.

Today, although it is 95 degrees outside ("Only mad dogs and Englishmen go out in the midday sun," wasn't it Kipling?) I went to find our local heron nest. We have had blue herons nesting at the lake for as long as I've lived here and as long as anyone can remember. Although their numbers are depleting, and the eucalyptus trees are struggling to survive under the burdens of some disease, they still return. It was a hallmark of my early hyst recovery, that 1 mile walk down to see the heron nests and babies with the binoculars daily. Many were the days that I took that walk, clutching my side and bent painfully as though arthritis had crippled me. I even took my stepson for the one day he was in town, fertile ground for a significant, equal, "I'm listening to you and you're listening to me without judgement on either side" conversation.

Last week, a blue heron flew low overhead as we surveyed the remains of a traffic accident on the street below the house. They were back! It was a male, bright blue, with a long, distinctive neck and a skinny beak. Today, I found at least one of the nests, and hit paydirt: mama was feeding the babies. Drab brown, she chittered at the nestlings (too small to see their heads, just yet) and was settling herself in the midday heat. The only view I had of her was standing in the hot sun, with the heated pavement underneath, but I could sense the coolness in the shade of their nesting spot. It's a good big nest, back from the street (less stress for the babies; it's a thoroughfare on a small scale, with buses every half hour). Too far back even for the 300 mm lens, unfortunately. But they'll be flying in a month or so, and I know their feeding times from prior years. Just like the herons, I'll be back!

Overhead, nearly into the sun, I hear an insistent chatter of two different species. This isn't the mockingbird's imitation (must be the Los Angeles official bird; they're all proficient actors) but calls of intention. As I look up, I spot the two crows or starlings -- and then I see the hawk. Red-tailed, she is circling fairly low (does she have prey? a nest she protects?). Both crows are harrassing her, trying to double-team her defense. Yet she continues in the same tight, lazy circle, her alleles lifting up like little ecru sails against the wind, smooth with it. Finally, one black tormenter gives up, a process that has taken five minutes, all of which I watch with my binoculars. But his partner persists, continuing time and time again to attack in any way he can: dive-bombing, ambushing from below, head-on. The hawk appears unfazed, although her circles start to move ever higher, as if to consign the crow to lower airspace. I continue to watch, although at times my neck is physically incapable of the contortion necessary to follow the entire circle of flight. Finally, the crow gives up; she circles back down, spilling air rapidly to lose altitude. It is too hot, and I'd have to look into the sun to see her landing spot. I am out of water.

I give up and return to my own domestic wildlife -- and this essay.

...but we kept ourselves busy at the LA Times Festival of Books. They pretty much overrun UCLA (HUGE campus!) with publishers, bookstores, authors, readings, signings, and the like. Got glimpses of Julie Andrews and Jay Leno (for the star-struck -- I've lived here too long and in the wrong neighborhood for that, since I'm likely to run into actors at the grocery all the time). Empresse, if you're reading, I thought of you here. What an orgy!

I have a goal, nurtured at the book festival, of being an author there two years from now with my book. I don't think my DH really believes that; he's pretty convinced it's not going to happen, and in the meanwhile the housekeeping around here is going to he** in a handbasket (which is where some of the dustbunnies should go instead). Of course, he can get home from work, sit and read for two hours while DD is at rehearsal and I am still working -- and not get the coffeepot washed until dinnertime. I grumble, although I shouldn't. He does do laundry -- nearly all of it -- and I no longer have to cook dinners by myself. He sees that I just don't have the mental organization to answer kid questions, hold a discussion (intelligently) AND cook dinner. Can't imagine So he does a lot more than most.

Still, it would be nice, in his ideal world, if instead of talking about writing -- or writing at night -- I would do some more of the picking up. That's what tomorrow is about; that and schlepping the DD from Hebrew to rehearsal to a party, back to rehearsal. He'll do the driving, and hopefully I'll be feeling up to doing the housework all afternoon. There's so MUCH to do!

My GYN has recommended that I go back to see an oncologist to assess whether or not it is time to go after the adhesions. Bless her heart, she has a good friend at a hospital not too far from me (C-S for any Los Angeles girls that are lurking) to at least get an opinion. I asked about waiting for the Pap results but she recommended getting established at least. She feels that trachelectomy may not be necessary, but the strain is high-risk, and if this Pap comes back CIN again after the cryo, then it's time to discuss a whole lot of things.

I know my DH would love to go on vacation this summer; back east to Ohio to have a reunion, then on to D.C. and Maryland and Zach. We got a vacation in 2001, ruined for me by the acute nerve pain of my herniated discs (although I did get some pain relief, and had a good time overall, it was a tough trip for a whole lot of reasons). Then 2002 was the summer I had the hyst, and the car was stolen while I was still out of work. Last year was spent catching up financially from it all and DH's mother died; he went back east then but we couldn't all go. A vacation is badly needed from his 24/7 management responsibilities and pager; from my commute and working weekends to try to get back ahead again.

I think I do need surgery, and the thought scares me. The devil I know (pain, but manageable) is so much better than the devil I don't. But I have to do something; when my waistline goes up 3-4 inches in a day; feet and legs swell and the edema doesn't even go away overnight -- it's time!

I'm heading off in few minutes to yet another GYN appointment, this time for a Pap smear to see if the cryoablation of cervical "stuff" (CIN) took the last time. It's decision-making time; things don't feel quite normal, and I suspect this Pap isn't any better. I'm asking, this time, for DNA testing of the HPV; if it is one of the high-risk categories, it's time to find a new GYN-oncologist closer to home.

We all would desperately love for this to come out well, negative and all that, but even my poor long-suffering DH is postponing any vacation planning. We were going to take a "real" vacation back east this year, visiting family. But if this is a high-risk strain, well, this summer may go the way of two summers' ago: all about my surgery (for suspected ovarian cancer that time that turned out to be severe endo) and recovery, both physical and financial. Now that we're back on our feet, I know that he is hoping that everything is fine, and we can go on to making our plans. I wish I felt that sanguine about it; even if I don't have CIN still, there are some adhesion problems that likely need addressing.

I don't know how much history to add here; here is the link to my Hostess story to give an idea of where I've come from. This has already been a very long journey with an unexpected development, and I will continue to write as I can and as I go along!

I am in an advanced writing class (in the UCLA writers' program) and working on a book about endometriosis and what it has been like to live with this. Haven't seen endo (or its evil cousin, adenomyosis) hit the "Disease of the Week" best-seller list just yet! Maybe I can change that ...