Monday, June 3, 2019

Reaching for the Sky

     It's no secret that 2018 was a terrible year for me.  Recovery has been my toughest physical challenge ever...harder than stage 4 cancer.  

     What I didn't appreciate until several months into my year of rehabilitation, was how my psyche had taken a hit.  In my continuous effort to balance that triad (my mind, body and spirit), I realized that, although my body was on its way to recovery, my mind and spirit were lagging behind.  It was as if I was experiencing some version of PTSD.    

      I have a good support and friends.  But, despite many long conversations, questions about why my femur broke and indescribable uneasiness about my traumatic 2018 remained close to the surface of my consciousness. So, I did two things:
  • #1 - I made an appointment with a counselor
  • #2 - I made an appointment with the surgeon who did my first hip replacement
     I've sought counseling assistance to navigate my life, every so often, since my early twenties.  It was during graduate school (for genetic counseling) that I learned that talk therapy adds a different, and most times, healthier perspective. With my hip/femur trauma and cancer, coupled with life's other "stuff", what better time to seek another perspective of this overwhelming life of mine.  It has definitely helped me and I recommend it for anyone who finds themselves in "that" place.  You know. 

      It was also important that I met with the surgeon.  (Not only was he the guy who did the initial hip replacement, but he's also the attending physician that decided not to get an X-ray despite me telling his resident that I heard a "clunk" and had shooting pain down my leg on my maiden walk).  He was clearly nervous when he came into the meeting and started out, not unexpectedly, defensive.  I told him that I needed him to hear what happened to me...from me, (without interruptions), and that I had questions I needed answers to.  With hands up, palms facing me, he said, "OK...I'm listening."  I was sure he knew what had happened to me after that initial surgery.  My second surgeon is his partner and I was told they had communicated about me.  In any case, I wanted, needed, him to hear how each complication affected me and my family.  Wynn and I asked him a slew of very specific questions about my surgery...what he did and how he did it.  His answers were, in turn, very detailed.  When he finished, I asked, "So why did I fracture?" and he said, "I don't know."  

      We let him know that throughout the whole ordeal, the only person on his team to apologize was his physician assistant, who said that she was sorry this was happening to me.  We read no admission of guilt in her apology, only genuine sadness. He tried to remind us that he had apologized when he came to see me in the hospital, but we told him we recall his contrition and were hoping to hear the words, "I'm sorry" from him, but didn't. He said, "Well, if I didn't say it before, I'm saying it now.  I'm sorry.  I think about you all the time, wish I had ordered an X-ray, and have changed how I practice because of you."  So we said, "Like how?" 
  • #1 - He has lowered his standards for ordering an X-ray.  
  • #2 - Rather than having a check list for patients' benchmarks for discharge after his surgeries, [ie. Can walk 20 yards with a walker, Can walk up and down one flight of stairs, etc.], he now attaches quality measures [How well did the patient do these tasks?, and What is the patient's pain score when doing these tasks?] 
     Given that the guy doesn't know why I fractured, I have to swallow, yet another, pill of uncertainty.  Before the surgery, I recall a thorough consent discussion about risks, benefits and limitations.  And although I don't specifically recall any discussion about the possibility of a femur fracture, because I have metastatic disease in my femoral heads, I understand that this could happen.  Our discussion with the surgeon helped me put to rest the question of whether, or not, major mistakes occurred during surgery.

     Before this meeting, I thought about how the interaction might go.  And since then, I've spend more time contemplating how I feel and how I can move forward.  I have come to a place where I can live with more uncertainty, mostly since he was a nice guy about hearing me out, answering our questions, apologizing, and letting us know what he's learned from his experience with me.  I hope that, at minimum, he is a better doctor.  I feel that I'm on the path to finding my peace and hope I can successfully put 2018 behind me.


     It's not possible for me to come across a living thing, like this tree, without seeing some symbolic meaning.  I found this tree on the trail to ShiShi Beach on the Olympic Peninsula.  Look how it fell over, then contorted and twisted itself to continue to grow.  It looks like it had to work hard and stay the course to keep living.

     The center trunk in this picture is the top portion of the twisted tree above.  After some obvious challenges, it reached for the sky and grew tall and strong.  

     I hope I can do the same.

... Wish me luck.

Monday, April 29, 2019

What a Difference a Year Makes

Regal bald eagle, Olympic Peninsula, WA

     April, 2018...the lost month.  During the last week of March (2018), I had two major surgeries, and a third one in mid-April.  I spent all of April in the hospital and by the time I returned home, I had lost 20 pounds and was so weak that I struggled to sit up.  The only way I was able to get around my house was with a walker. A WALKER!

     In early May, I started going to physical therapy three days a week.  Initially, even getting to PT was a big deal...I was never sure I could get up and get my ass in the car. I had to prep myself before each appointment with a nap, and came home from each session needing another.  That went on for weeks.

     Incrementally, I got stronger and incrementally, I became hopeful.  Since then, I've been committed to exercising every day. I am stronger.  On most days, I don't need my cane, (except to go upstairs in my house).  I'm still a bit clumsy and trip fairly often, especially when fatigued.  I gained some weight back, which I needed to do in order to build stamina.  Overall, I'm doing OK.

Port Townsend

     April, 2019, has been much different. During the first week, combining work with pleasure, I spent three days with my dear friend, Stefanie, hanging around the Olympic Peninsula. We shopped, went on long walks, and hiked near ShiShi Beach. Then I  attended a genetics conference in Seattle.


     This is the trail to ShiShi Beach.  It's a 4-mile hike from the parking lot to the beach and back.  I didn't make it this time.  We arrived mid-afternoon and I didn't have the strength nor speed to get to the beach and back by sundown. So...I guess I need to go back when I'm stronger. I'm happy to try again.


     I came home for one week, then Wynn, Nina and I flew to Lisbon, Portugal.  Nathan and his girlfriend, Banshamlak, flew from Israel to meet us for part of the time. It was a glorious trip - not only because Portugal is beautiful and fascinating with a long, rich history and friendly people, but because we were together. From Magellan to the soccer superstar, Ronaldo, the Portuguese have lots to showcase.  It's a profoundly Roman Catholic country and we were told that 97% (that's a lot) identify as such. 

The Church of Sao Francisco

     The day after flying into Lisbon we took a train north to Porto, Portugal's second largest city.  This is a spectacular church in the heart of Porto.  Its (overly) ornate everything speaks to Portugal's history of exploration and colonization of other countries, then bringing riches home to decorate; a common practice back then.  

      On day 2 in Porto, we hired a guide to take us to the Douro Valley - the place in the world where port wines are made.  The hills along the Douro River were terraced hundreds of years ago and the terrace walls are protected by the UNESCO Heritage Foundation.  Grapes are grown in this valley, made into port wines, (wine with grappa or brandy as a preservative), then trucked an hour and a half to Porto to age in the cooler seaside air.

      We visited two vineyards; one small, family-run vineyard called Marrocos, where the operations are very different than larger ones, but both still stomp the grapes by feet. Because there are very large vineyards, some owned by foreign entities, there is a controlling body called the Port Wine Institute that regulates everything - how much wine is produced at each vineyard, the types of

grapes grown, the quality and distribution.  Each
legitimate bottle has an Institute sticker. We were told that the Institute protects the smaller vineyards from being bought out by the larger ones.
       We also visited and tasted ports at a large, British-owned vineyard called Croft.  Port wines are sweet, and I loved them.

     One of my favorite parts about traveling is noticing local residents.  This man is a friend of our guide and has lived in this region his whole life.  When I asked him if I could take his picture he said, "Why not?!" a charming Portuguese accent.

     No hotel rooms on this trip...we rented AirBnB apartments.  Although we ate out a lot, we enjoyed shopping at local markets for a few home cooked meals.  This is the garden of the place we stayed at in Porto.  That's Nina sitting and planning our day with the Douro River and Vila de Gaia, the city across the river from Porto, in the background.


     We planned our trip a la Rick Steves' Portugal travel book.  We did several walking tours he suggested, which brought us to this beautiful city park.

     We walked across the bridge from Porto to Vila de Gaia.  In the olden days, these boats brought the port wine barrels from the Douro Valley to Vila de Gaia to age.  You can go to tasting rooms here, too, and the view of Porto from this side of the Douro River is beautiful.

Drinking cherry liqueur in chocolate cups is a thing in Portugal.  It's called Ginja, and is a great treat anytime of the day!

     The Portuguese love painted tiles and mosaic sidewalks.  This is just one example of the hundreds, perhaps thousands, of miles of mosaic sidewalks in this country.  Most streets are cobblestone and since they are so old, some are very uneven.  I saw several people turn an ankle while strolling along.  I may have missed a few sights because I was looking down while walking.  

     We walked through an open market one day.  The fresh finds were mouth watering.

     After a few days in Porto, we returned to Lisbon to meet Nathan and his girlfriend.

     This is the Monastery of Jeromimos in the Belem area of Lisbon.  It's massive.  If size and grandiose-ness was the measure of importance to these people, then religion was paramount. 

     This is a view of the church's dome from inside the monastery's courtyard. The Moorish architecture is throughout and like most all old churches in Portugal, the insides are covered in gold leaf.

     Close to the Monastery, on the banks of the Tagus River, is Padrão dos Descobrimentos, the Monument to the Discoveries.  It was built in 1960 and you can appreciate its size by the people in the bottom of this picture.  Henry the Navigator is at the tip with the likes of Magellan and Vasco de Gama represented.  It's also massive,  so discoverers must be important to the Portuguese as well.


     We spent a day with a guide, Hugo Martins, who took us to Sintra, Portugal.  It was a 20-30 minute drive from Lisbon and is home to many old palaces, castles, and beautiful parks.  On the top of the hill behind us is the Pena Palace.

     This is  the mansion and grounds of Quinta da Regaleira.  A really rich guy built this 19th century gothic home, gardens and chapel.  It's another UNESCO World Heritage site.

Nina and me

     This is the Initiation Well (Poço Iniciáticoin) at Quinta da Regaleira...

...and this is a view of the garden from the mansion.

Nathan and me


     Our guide, Hugo, drove us back to Lisbon along the Atlantic coast.

     I took this picture on the last day in Lisbon.  It's from the bedroom window of our AirBnB.  I love the sky, the church, and view of the Atlantic Ocean...note the ginormous cruise ship.

     This trip was really special to me.  Portugal is a hilly place with very steep streets in Lisbon and Porto.  Despite pushing myself to walk a little faster, go a little further, and stay up a little later,  I am certain I was still the limiting factor in some of the activities the rest of my family wanted to do.  But you know one complained!  We all did our best to make this trip memorable...if for no other reason than there were no blowout arguments 😀.