I am posting about something a bit different today.

I haven't said much about this, yet, but we are moving into our dream home in two weeks.  Thirteen days, actually.  Mark is keeping his job and telecommuting, and I will be starting my new job on June 25.  The house is at about 7,000 feet elevation, on 55 acres of land that abuts on the eastern side to BLM land.  That land is a stone's throw from Colorado National Monument, pictured below, an imaged I pulled off of Wikipedia.  Within the month, I will have photos from our own land to post.

Our new community comprises of 160 people.  My commute to Grand Junction is 35 minutes through the Monument, via a gorgeous stone-swept, meandering road to the city of 60,0000, which is 2,000 feet below where we will live.  (Do I sound like I'm bragging?  Sorry, I don't mean to.  I'm just excited.)

I've been de-cluttering and packing for the past three weeks.  Now that we are two weeks out, Mark and Chase have joined in.  The new house is almost 2,500 square feet (but I suspect they are counting garage??) and we live in 1,350 now.  Mostly, I want to de-stuff because I hate clutter.  I don't want to pack it; I don't want to move it.  And I have a wonky hip and lots of metal body parts, and frankly, I just need less crap in my life. 

Chase is actually more like me in that way.  You could get rid of 90% of the stuff in his room, and he'd be fine.  He's not like me in that he is motivated to *clean* at all, but when I asked him to thin his books, he did so very easily.  When we give him trash bags for his room, he will have a much easier time with parting with stuff than his father will parting with his stuff.  I think that's true of most parents, though.  That includes me, because the first thing I asked him is what books he wants to preserve.  (Because I preserve books.)

Mark is the one in the marriage who keeps stuff....ALL KINDS OF STUFF.  One of those stories we'll be telling after we've been married for 50 years is the day he found a 35 year old piece of Valentine's candy and wanted to keep it, because it was cool.  You know, those chalk-tasting pink hearts that are printed with small phrases like "Cutie!" and "Love Bug!" that nobody really likes but bank tellers put out for people?  Yeah.  It's gone now.  So is the vat of lentils dated 1989 (in fairness, they still looked intact) that I discovered in the pantry when I moved in (in 2007).  But he has been so good about letting things go the past few months.  The boxes of beer cans are gone, and he'd been doing small projects.  This past week, he's been good about getting rid of stuff in earnest. 

It feels SO good.  I don't want to bring our garbage and baggage to the new home.  I want to bring what makes us happy.  I donated probably a third of my books.  (That is a HUGE number of books, several bookcases worth.)  Out goes the breadmaker that at best, makes meh bread sometimes and sometimes doesn't cook through.  Out goes the stuffed honey badger.  One of the biggest things is that my father-in-law just closed his office and gave us furniture we weren't planning for.  So I'm taking the new nice desk he gave us and replacing my trusty old, cheap, well-loved sewing table.  Out goes my first sewing machine. 

We have mens' roller blades, a couch I always hated, and a weight bench, two spare sleeping bags, MANY kids' sleds....on and on.  Four carloads to ARC so far, without the furniture we're going to call them for.

I believe in magic in the sense of acting in accord of what you do and what you want from your life.  Obviously, science is science.  But magic is as simple as setting your will, acting in accord, and ....yeah, that's it.  It really isn't more complex than that. 

Caveat:  Here I will check my privilege.  I am a white woman, and I came from parents who loved me, worked hard, and made education a high priority for me.  I am lucky.  Even though I know what it's like to eat rice and nothing but rice because I could not afford anything else, I realize that doors opened for me more easily than they do for other people.  Even more so for Mark, who came from a family with more money than mine had.  So a person may still need to set their will, act in accord, and have the benefit of things like affirmative action and laws that don't discriminate on whatever basis, and people having a little more help that need it.  I am a liberal who leans more Democrat than Liberatarian. 

Back to what I was saying.

Feng shui is the Chinese art of defining spaces in such a way as to encourage more "chi" to flow not only in your home, but in other areas of your life as well.  I don't follow it strictly and I'm not attached to this quarter of my house must be such-and-such a color or whatever, but the general principles have always been important to me.  Cluttered minds always have cluttered houses.  And Mark and I have been very, very cluttered for several years.  We wanted this home to get away from the grind-ness and the traffic and the people and the STUFF-ness of the front range, once Chase was old enough to not need us to live in suburban Denver anymore.  So, to me, what we have been doing is alchemy and magic.  It feels stressful to look around my house and see boxes, but holy cow, it feels great after I drop another load at ARC or when the trash guys come on Mondays.

It's subtly difficult.  Finding the photo of Steven and Aspen in a beautiful frame in my grandmother's hope chest hurt.  But I showed it to Mark and Chase, who'd never seen a photo of them.  Mark is digging through old papers, and I know he's touching his old things and remembering too.  It's good for us to let some stuff go.

So after working on packing/decluttering/shredding for most of the day, I rented the movie, Minimalism:  A Documentary About the Important Things. It was done in 2016, and I really enjoyed it.  Good things about it were that I think the basic message is a good one, and a lot of Americans in particular need to hear it.  There were some great ideas, even and especially if you don't want to take decreased consumption to the extreme that many of the interviewees have taken the message.  We're not buying a tiny house.  We are buying a 2,500 square foot house and I'm not going to apologize for that.  But I want that house to be full of light and air, not dust and clutter.  I think it's worth hearing that so many of us have anxiety (guilty) in part because we have to maintain stuff. 

The documentary is a bit guilty of being sanctimonious at times, and silly in the sense that the path of two single white, straight guys is the main thread of the documentary.  It reminded me of Jon Krakauer's Into the Wild.  That's a great book, portraying a young man rejecting materialism to go live life more fully and freely.  And if you're not a wide-eyed young adult, you also see that this young man's life was wasted because he died horribly and alone in the Alaskan wilderness, not actually that far from civilization that could have spared his life.  Angry young men might be "against society," but society has penicillin, IV fluids, and Wi-Fi. 

The Minimalism documentary suffers some of that pure, untempered, idealism.  The parts that I liked the best from it were the interviews with couples and families, where the message was more about decreasing, conserving, saving, and compromising.  A father talked about how his son easily jettisoned toys he no longer wanted, but his daughter loved to collect dolls, rocks, twigs.  He talked about allowing his children to make those choices with reasonable parental guidance, and living an example that his kids he hoped would absorb as an option.  I would want nothing more for Chase, than hope that he has absorbed whatever good his father (and mother and stepfather) and I are, so he knows that the good we do are choices he can make for himself. 

I want to read more and YouTube less.  We are moving to a place that will make pizza delivery impossible.  Even the post office doesn't come to our new home.  (But yes, UPS and FedEx do.)  I want to transplant some of the blackberries that grow so well here in our yard (like...INSANE amount of blackberries) to our land, so we can feed bears.  I want to plant catnip to see if the bobcats will come investigate. 

It's a new phase of our lives.  My surgeries are not done.  I know.  I've had six in two years, having been almost continually recovering from something, preparing for something.  One more next spring.  There's something magic about that, too, I'm just not sure what it is or will be yet.  My lungs will be fully open and cancer-free and body parts that needed replacing or welding together are fixed.  More light and air.  Less to weigh us down.

Yeah.  My hip is rested now; Chase went back to his mother's for this coming week.  Now that we've gotten rid of the Christmas trees (Yay!), I get to go through the ornaments.  For now, I intend to keep stuff with memories, and get rid of those ornaments you buy when you're young to fill up the tree....and then by the time you're middle-aged, you no longer need because your tree is full of kid-made ornaments, or hand-me-downs, or the ornament from Maui/Italy/the family picture in Alaska, etc.  Destuffing!

If you're too busy to watch a two hour documentary (and you might be), here is the trailer/gist of it:

It's been three weeks as of yesterday.  This recovery thing is boring and tedious.

So, yes, I'm back to work.  I saw the surgeon on the 23rd, and told him I wanted to go back to work the next day.  I also told him that we're moving, and that I'm quitting the week of the 15th.  He didn't understand why I would bother at first, until I flipped it by pointing out I was still loyal to my docs.  He doesn't want me lifting patients, and doesn't think I'd even be able to handle eight hours, much less ten, yet.  He said the worst of it would be the fatigue, and he's right. 

I was able to do three hours Thursday, then took myself out to lunch, crawled home and slept for four hours.  Friday I did four hours, and felt like I could barely make it to my car at the end of it.  Today, I made it four hours, feeling tolerably rough after that when I was done.  Was able to go get some lunch (because I still do not want to prepare food that has more than three ingredients).  I didn't have to sleep this afternoon, but I was able to do....nothing.

But sit here and stew about it.

Sure, pain, but when haven't I had pain for the past two years solid.  From something or another.  Ridiculous upside-down boob implants.  Wires tied to my ribs poking up until the scar tissue formed.  Walkin around on a broken fibula because denial is fun.  Whatever.  Fatigue is a lot of it, far more than it has been a factor with the other surgeries...deep to the core of your body, and sleep is kind of beside the point.  I'm mentally very awake.  But I can't do much of anything.  It's nice to be able to read non-school books again, but I have things to DO.  I do remember some fatigue after the pectus surgery, but it was just so exciting at the time to have my left lung open....I wasn't so bloody over it and bored of my own medical problems.

I've also had three weeks of tinnitus, which is I think related to the oxys.  Maybe withdrawal?  I don't know.  Sometimes I am getting nauseated still, the day after I have any narcotic.  So I'm not excited to take any at all.

The only things I really know about withdrawal are from taking care of my patients from the ICU, who typically weren't in a state of erudition to be able to explain particularly well.  (And you know.  Typically I had to tie them down.)  And Trainspotting.  When I think of withdrawal from opiates, I picture Ewan McGregor crawling out of a toilet.  I feel like I'm crumpled enough to fit somewhere small like that, but what I'm going through is just not that cinematic. 

I finally broke down about an hour ago, and took one so that I could get downstairs easier. 

I'm only writing my complaints because someday I will look back on this and know from whence I came.  (Yes, I used the word 'whence'.)  It's gonna be better, and I do know that I'm improving every day.  It's just too dang slow.

Yeah, I know, I am a terrible patient and I just don't have time for this.

I think the hip is recovering well.  I guess.  I mean, this is supposed to take six to eight weeks and I'm going on three and it's not done yet.  Which is annoying. 

They gave me #60 of oxy 5s on discharge.  In the last year, surgeons have heard that there's an opioid crisis and so they've taken the opposite approach to what they used to do.  For my pectus, I had gallons of drugs.  On one hand, 300mg of oxycodone should (and is) enough to kill me handily.  But the script is to take 5 - 10mg every 4 hours.  Do the math there.  At max dose, it's not even enough drug through the end of the week.

I called one week later and spoke with the ortho nurse (who had been very kind and professional), and explained that at the rate I was taking it, I'd be out by the following Thursday or Friday.  I said he could either send me a script for more, or let me start taking ibuprofen in between (ibuprofen, for you non-clinical people, creates a higher risk for bleeding, and is often a no-no postoperatively).  We decided another #30 and to keep on the aspirin. 

I ran out Thursday.  I think 60 tablets over ten days freshly post total hip isn't bad.  (Especially spending one night in the hospital, not two). 

It is Sunday.  No script has arrived in the mail.  Maybe it will arrive by my post-op appointment Wednesday.  The voicemail I left for the RN Thursday night mentioned that narcs can be e-prescribed now.  (No callback Friday.)

I'm so glad we're fixing the opioid crisis, patient by patient.

Glad I fought for the Zofran, because since off the oxys (and some times before), I have been nauseated most of the time.  Anyone who's been through both will tell you that the nausea is the worst.  Pain you can have some strategies to work through, distract yourself, yell or cry through...not so much nausea.  Underneath it, you might be perfectly happy and yet, you must be this useless lump sitting somewhere in your house.  Not getting anything accomplished.

I've lost about 8lbs since the OR, which is of course mostly fluid.  But I am only eating about two-ish meals most days.  And an apple with peanut butter is a meal right now.  The swelling in my leg is better, but it's still significant.  It feels enormous.  I wish I could have just one dose of 40mg of Lasix, and that would probably make me feel better, too. 

So I'm a little discombobulated, but I'm hangin in there.

Am working with a physical therapist at home.  She's okay.  She's not a nurse, which is fine when she isn't trying to be one.  Am dutifully doing exercises. 

And I'm supposed to go back to work Thursday.  It won't be a 10 hour day.  I hadn't thought much about that until this past week, but it can't be. 

*grumblegrumble*  I have things to do. 

What's a year without another major surgery?

Yeah, that's my left hip.  Better images to come once I can get to them.

After the roller-skating episode, I was on a scooter for several weeks.  Then when I got off of it and started walking, I started to have this problem with intense pain in my left hip and having it give out on me.  I'd just be walking and all of the sudden, I couldn't support my own weight.  I did the requisite several months of ignoring it, and telling myself I'm fine and it's just week.

Then I saw my PCP, who sent me to one orthopod, who sent me to an injection.  The injection was FANTASTIC.  She was alarmed when i literally hopped up off the table and starting hopping around in circles, suddenly able to move.

Which was diagnostic for the fact that it was truly a joint problem, not a muscle weakness problem.  Had the MRI, the barrage of Xrays.  They diagnosed femoro-acetabular impingement (FAI) (CAM type, if you are a person who cares about these things).  Which sounded like not a real thing to me at the time.  People insist it's a real thing, and medical literature insists it's a real thing.  It's basically that my acetabulam (the socket) is cupping too much over the head of the femur, restricting movement.  That's sounds like rational physics.  What I am having difficulty squaring with is why I could abduct my left leg last year, and couldn't now.

The surgeon also said I had very significant arthritis for my age.  Cool.  And that the cartilage was barely there.  This makes sense to me.  My cartilage...which is of course, the root problem of the pectus. 

They gave me two choices, one minimally invasive, an approach to try (keyword was try) to correct the FAI, and hope the cartilage grew back.  "Try" didn't sound very good to me, and "hoping" my cartilage would behave in a way I wanted it to also sounded like a bad idea.  They said I'm very young for a total hip replacement.  I said I'm very young to not be able to do exercise for the next twenty years, even if I do have to have a second replacement in my sixties.  And buying that twenty years of mobility in my hips is important for every other aspect of my health.

So a total hip replacement it was.  Monday.  I came home Tuesday.  I have a physical therapist coming out to the house three times a week.  I have a walker.  I have ordered a purple and green feathered boa for it. 

So I have a metal plate on my left humerus, left fibula, lowest left ribs, a new left metal joint, and two metal bars in my chest. 

And no, the surgeon didn't want to go through the paperwork of giving me my hip bone back.  He actually said to me, "You don't want that."  I blinked.  "Yes.  I do."  Surgeons.  Honestly.  It would be good for all of them to interact more with people who are conscious.  I didn't get my bone.

I think he was good though.  He's the head of the infection control committee, and I was fussy about infection prevention, and I believed him that he was particular.  In all other ways, the surgeon was a good guy.  The incision is healing well, looks clean and good.  I had 500cc of blood loss, which seemed like a lot to me, but I don't know what's typical for an ortho surgery like this.  I still feel the effects of that; my heart rate has been running high all week, and I can feel that my pressure it lower than normal.  Just a faint light-headedness.  I keep drinking a lot of water, but honestly, I think it's just giving me an edematous left leg, not really pumping my pressure up.

Post-op, my recovery was pretty difficult.  They didn't want to give me a scopalamine patch (my first choice) or Zofran (second choice) because of my QT interval immediately post-op was a little long.  Therefore, I got hypotensive, tachycardic, diaphoretic, and was vomiting for several hours.  I told my night shift nurse to please call the resident and get me a scope patch and I offered to have her put the resident on the phone with me, so I can suggest some places where he could put that QT interval.

I got phenegran and a fluid bolus.

Mostly, I stopped vomiting because I stopped taking IV morphine.  (Which I only had because I was throwing up the PO oxy.)

The nursing care in the hospital was really great, from pre-op to discharge.  I had good people.  I had a lot of PAs this time, and I thought I got good care from them.  I asked one of them who is soon to be sitting for his boards why PA and not NP, and he said he thought the NP was less flexible.  Which is puzzling to me.  Then he admitted he didn't know about it before he started PA school.  Curious.  I think we as nurses do not do a good public relations job for ourselves.  NPs are far more flexible, career-wise, than a PA.  More independent of scope, and better-rounded.  He would have made a good NP. 

I'm doin okay at home.  I walked a half mile, around the track once with Bex yesterday (with a walker).  I'm doin all right.  There's a lot goin on in my world, so I'll post some more in the next few weeks.

Got more metal in my body now, so had to share photos.

Apparently, I still have readers.  I haven't looked at the blog in weeks, and I have some visitors.  Welcome.  Or welcome back. 

Here we are again. 

I went rollerskating with nurse friends!  And this happened....

(Incidentally, the profanity post-it note on my computer is unrelated to the image you see.  That was put on my computer screen far prior to this.)

I went from the image on your left, to the image on your right.  (Don't judge my lack of pedicure...had been a little busy....)

Yup.  Surgery.  The FIFTH surgery in FIFTY-THREE WEEKS.

Six weeks non-weightbearing, and a scooter.  I was cleared to walk again the second week of JULY.

I was over it nine months ago.  It is midsummer, fifteen months later and I'm BEGINNING my real recovery.  Because my brain has been so underutilized, I dove into school again (just a day away from finishing summer semester).  Have gotten accepted into the Masters of Science in Nursing - Informatics program at CU.  Am working already on my next professional portfolio/promotion.  And I have to get a new certification because my CCRN will expire in January. 

Overcompensating?  Who, me?

My coworkers got me a gift certificate to a foo foo bra store.  Was so sweet and fun of them.  <3  The package arrived yesterday, but I was too out of it to notice.  I opened it this morning.  It came in this Chinese food takeout box, all wrapped up in yellow ribbons and stuff.  Was adorable.

Can't wait to go use it.  I checked out the website, and holy shit, those are some expensive bras.  I'll go for a fitting and pick out something nice, though.  As soon as the incisions are reasonably healed.  And I heal fast...(too fast, actually, I keloid)...so I may even be able to go by the end of the week.  The swelling should be gone by then.  It's down a little today.

So for the good news:  Surgery went well.  I really like Dr. Aycock.  Preop was easy.  My preop nurse was Sandy, as I said.  I wish I remember the name of the OR nurse, too.  When I told her I'd gotten an infection at Mayo, she didn't bat an eyelash about telling me they'd prep me twice.  I'm not sure if she understands how much that meant to me, and eased my mind.  I felt safe, and in really good hands.

Brittney was my CRNA, and she listened to me, too.  I told her I threw up every time I had anesthesia, and so she said she'd give me drugs instead of the gas.  Propofol, apparently, and Versed and Ketamine.  Again, it's these little things people do that they aren't aware make all the difference in the world to a patient.  I am so grateful to her, because my recovery was a snap.  I was able to start ice chips within 10 minutes of waking up in PACU. 

I remember them wheeling me into the OR.  She gave me 2mg of Versed (of course, I asked) and I tried to look around me and specifically remember.  I remember them rolling me on a pram about 25 feet in preop, and then nothing again until I scooted myself onto the OR table.  I remember looking up at the OR lamps (not yet turned on), and wondering why they were colored blue.  I was able to talk, and then I remember nothing. 

Rachel was my PACU nurse, and she was fantastic.  She's been an RN 25 years, and she is really good at what she does.  It's the little things.  She gave me extra fluid...in PACU alone, she gave me 2L of NS, by drip.  In the ICU, you have to use channels and pumps for most things....like you don't let Levophed or insulin in by eyeballing the drips.  You don't run in stuff for hemodynamically unstable people...(well, unless they're hemodynamically unstable because you NEED to be slamming in fluid, blood, etc.)  (Or in HF, obviously.)  But more than you suspect just doesn't matter if it goes in drip.  I can look at a drip and guesstimate what's about 75cc/hr.  Rachel had the 2L run in pretty fast.  It was the best. thing. ever. for me.  I think it also helped prevent nausea, and cleared the anesthesia faster.  And I felt really good this morning.  That's due to Rachel and Brittany, and also the skill of Dr. Aycock. 

We were home by noon, and I was able to keep down fruit.  The drive made me a little nauseated, but I had 4mg of Zofran, and I was golden. 

Didn't sleep well last night, not sure why.  Dropped off to sleep sometime after 1am, I think, and woke up when Mark went to work.  Am feeling good today, and then forgetting, and doing a little too much.  Can't shower yet, but I am doing laundry and litter box, and probably should not.  Also, want to cook one of the Blue Aprons today...it's cloudy and cold-ish out, so am thinking the Udon Noodle Soup sounds great.

Anyway.  That's the good news.  Remember:  I can breathe now, freely for the first time in my life.  I no longer have a chronic cough, and so far, I'm not getting upper respiratory infections at the drop of a hat.  And I no longer have, and will never get, breast cancer ever again.  Big upsides here.

There's complicated news, too.  Dr. Aycock wants to show me pictures of my chest at my postop appt.  I should have seen this coming, and I did actually think of this....I just avoided thinking hard on this.  So.  The silicone implants are UNDER my pectoral muscles, right?  So what's between them and my pleural cavity?  Nothing.  That's inherently a not-great idea.

On the slightly less concerning side, the left, is a plate Jarozsewski used to affix my rib that she fractured when correcting the rib flare.  Had to be done so the bone wasn't poking my ventricle.  (I showed the CT to Dr. Johnson last week, and I may not soon forget the look on his face when he said, "Michelle, you could have died."  Something about hearing that with that level of seriousness from him....anyway.)  (Not like I didn't know, but it's different when it comes from him.) 

So there's a bag of silicone that will always be rubbing against a plate.  Aycock wants the plate out.  That's reasonable.  It means more general anesthesia, more cutting, more annoying time off and scheduling....but she is right.

On the right, one of the bars is coming up above my ribs, "poking" out.  It's not really "poking," as it is a smooth bar.  It's my anatomy.  The right side of my chest, the right cartilage, has been the most warped, because the sternum was rotated medially, and deeply, toward the right.  (Look over at the page with my CT if that does not make sense.)  So the cartilage is more jacked up on the right.  The bones are fine; pectus is a cartigilatinous malformation.  So the bar is higher than the cartilage, probably.  However, that bar is constantly up against the silicone implant.

This isn't good because implants rupture without help.  And if...and Aycock says all implants will rupture in time...and when it does, silicone dumps into my pleural cavity. 

That would be bad.  A level of bad fairly equal to a bone shard poking my ventricle.  The bone shard would have been a quick and painless death.  How do you get silicone out of pleural space?  Even if you surgically went in and suctioned, how would you ever get it all?

So we don't want that to happen.  But it's not as urgent as the bone shard, and after all I walked around for four months like that, and only knew about it for about six weeks. 

So I'm not really done.  Multiple options.  Aycock wants to talk to Jaroszewski, which I support.  Aycock wants to know J's thoughts on taking the bars out early, which I would prefer not to do.  My sternum could easily collapse back in and all of this was for mostly nothing...I mean, the no-breast-cancer thing stands, but then I go back to a life of URIs and dying sucking on a ventilator.  Aycock also said I can consider a flap surgery, which would eliminate the silicone-bursting risk completely, of course.  I didn't want to do a flap initially because it's a longer recovery.  But it may be safest in the long run, and right now, she's proposing only the right at the moment.  However, if the left pops, I have buffalo chest....the silicone would still go into my pleural space.  Not just the left...my left and right are connected now.  Aycock may not be aware of that....it was Lavelle who told me that when he supervised the taps.

Aycock wants to go back and do something about this within the year or so.  So I'm not really done.  I have to work at least 2000 hours before I can get FMLA again.  All of this is damned irritating. 

I asked Lavelle to order a CXR for me, and he did.  Will get that snapped this week, so we can kinda see what all Jaroszewski did in there.  Aycock has pictures of the innards, but I think it would help with planning to understand the placement of stuff.  Aycock wants to consider regular MRIs as well, though she isn't sure how well she'll be able to visualize with the hardware. 

So.  There you have it. 

Recovering well today.  Will try to do somewhat less, because I need to remember to not lift stuff.  Will work on readings for school instead, that'll keep me sitting.  Took Advil today, which am not really supposed to do due to "bleeding risk," which I'm not.  But I'd rather do the Advil than oxy if I can.  I think I had two oxys total since coming home yesterday around noon, which is pretty decent.   And yeah, Udon soup.  That's the plan today:  homework and Udon soup.

I am in pre op, calmer here than when I woke up this morning. Maybe it's hospital smells or sounds that is unconsciously telling my brain that it's just a normal workday.
(Pre op does not smell badly.)
My nurse, Sandy, set my IV in the left wrist and for me on the first try.

I'm glad this is the last of it, the surgeries. More than anything I have a headache because my body needs its main nutrient: coffee. And I could eat.

Tissue expanders suck, in case you didn't know. They are like baseballs under your skin. You can't sleep on em. They're shaped a little like drops so they have a direction. And because I can't seem to have ANY surgeries without complications, my right one flipped. Completely around. It looks very odd. Odder than tissue expanders look anyway. Dr. Joyce says it has never happened to one of her patients before. Only me.

It's hard to do this on my phone, even with the Android swoopy typing thing. 

I'm here. It is 7:34a.m. and they are supposed to cut at 8:30. 

Hungry, headachy, but okay.

So you know that beautiful plan I had a few days ago?

2016 isn't done with me yet.  It decided to give me a stupid (and particularly nasty) rhinovirus.  I was gonna go anyway.  It was miserable enough that I had to leave my new nurse orientee by herself at work Friday for the last two hours of the day, cos I just couldn't make it.  (There was at least a fabulous nurse in ID who I trust completely to be there, but still...)

I had to get up at 11pm last night from bed to go to the couch because I was too restless.  And then I laid there for another 20 solid minutes trying to get up the energy to walk the last 10 feet to the medicine cabinet to get ibuprofen and Vicks Vap-o-rub.  That was when I said to myself, there's no way I'm going to make it 364 miles to Moab. 

I'm only up this early because the pain in my head was so great, I forced myself back upstairs to a hot shower.  And then sat down and cried in frustration, because I really will be even more miserable if I go.

I hate you, 2016. 

I got the best email ever from Jane (my mom in law) this morning, though.  And I'm the luckiest daughter-in-law to have her in my world.

And I was still sitting on the toilet, crying in frustration.  Well.  My sinuses benefit from the extra humidity.

Mark is sick, too.  Not as bad off, but he has this crap, too.  I'm annoyed as hell I can't give him a little alone day at home.  He hasn't had one since APRIL.  Because I have gone NO.  WHERE. by myself.  We took TWO WEEKENDS away...one to Oregon, and one to Estes.  That's IT.  (All right all right all right....first world problems, checking my privilege...)

Yeah.  Still feeling whiny and like wallowing in my pity party. 

I'm back on the couch, armed with water, ibuprofen, vitamins, sudafed, coffee (I don't give up coffee no matter how sick I am), and at some point I will search for soup.  And a large trash can and two boxes of kleenex. I can hear the Mark got up briefly to hack and cough, but I think he just crawled back under the covers. 

I am going to watch Curse of the Golden Flower for the 100th time.  Because a) Gong Li is the best actor on the planet.  She can do more in five seconds of dead silence with a stony face and perfectly laquered fingernail than most actors do in entire movies (And she can do it dressed as the Han Empress or dressed as a dumpy massively-pregnant pissed off peasant, with dirt on her face.  You could cover her face in mud, and she still looks flawless.)  ....and b) like so many Chinese movies that manage to make it to an American audience...at the end, almost everybody dies or goes mad, and the bad guy (i.e. the Emporer) wins.

Yeah.  I think that's about right.

We'd planned the usual Christmas this year.  Although the day-long argument Mark had with Chase's mom over when we could get him for the holiday was actually not typical, the 2pm cookies-and-wine hosted by my stepmother and father in law is the usual thing.  As the alpha female in my family, I'm still beholden to the needs of other women's holidays.  I have never really cared much about this, being pagan.  Whatever.  I just want to give presents.  Yule is not, has never been, about presents.

Yule is usually a workday and most people don't know it's Solstice.  Unlike Samhain or Beltane, Yule has always been quiet for me, and for this little family unit.  Quiet as stars in the sky. 

Four things happened today.

A coyote crossed the road in front of me today.  He was in no danger of being hit by my car; being far enough away to see his winter coat well, but not having to do much than brake gently.  I told him hello, wished him good hunting.  It made me happy to see a full coat and that he looked well-fed and healthy. 

I had coffee with a friend and coworker who is fighting the real fight with breast cancer.  I was lucky.  But I understand her, and she understands me.  That little time I had with her was a gift.  I hate cancer with her.  I'm not a pink ribbon person, and neither is she.  But I will help her in whatever way I can.

I went to Racine's after work, and Pandora (the free radio station) told me to go to Utah this weekend.  As if it had speech.  Specifically, it kept flipping to Joshua Tree songs.  If you laugh at me, I'll smack you.  Hard.  Desert sky, dream beneath the desert sky...the rivers run but soon run dry...we need new dreams tonight...  What that song woke up in me was a hunger for the big sky and the big quiet.  Before I was a nurse, I would go hike Delicate Arch on Christmas Day.  Me, and usually five to seven other people.  Jews, Muslims, atheists.  Those people that think they're celebrating Christ by arguing with their loved ones on the holiday?  I was happy, those years, deeply happy, to celebrate a belated Yule, sitting on the rim of the canyon, looking out over the dun-colored mounds and hoodoos. 

When I came home, I asked Mark if he'd be okay with me ducking out of Christmas obligations this year.  He is.  And I called Chase, too, because I want him to be okay delaying opening presents.  (And I suspect he will be.)  (Not only did he already put his present together, and is using the new gaming computer, but being a kid with four parents for the majority of his life, he's used to being less fixated on The Day Of The Holiday,)  I got Chase's voicemail.  I told him I want to go to Utah this weekend, and hoped he'd be fine waiting a day or two for present-unwrapping... reminded him in the voicemail that after all, we're pagan, and the holiday we're celebrating belongs to the people we love, after all.  And I told him I'd take his father and him with me if I could. Cos I would.  Cos my family, my little family, understands.

They know that Yule is quiet, too.

And then the fourth thing is opening a box from one of my oldest and dearest friends.  It was southern cooking that she did not bake (which adds to the charm for me), but also old photos.  Of me and her when we were 19, 20, and 21.  One night when we dressed up before Rocky Horror Picture Show.  That was from the Halloween apartment on Sheridan.  A day we spent apple picking in south Chicago.  Some black and white portraits of me that for some reason I did for a class, but SHE took the photos of me.  I remember developing the sheet of negatives.  And ornaments from our tree at the apartment on Loyola Avenue.  It made me remember things I didn't know I'd forgotten, and it made me cry, and it made me remember how much I love and miss her.

I have very, very few friends left who still call me Meisha.  I remember that day apple-picking.  It was a spectacularly happy day.

It is the longest night tonight.  And I am once again, overwhelmed with gratitude.  For the coyote.  For coffee with a friend who's going through a hard time.  For miles of sandstone that will be mostly empty of humans this week.  For my husband and stepson.  For old friends who remember who you are and also don't cook.

So I'm going to Utah.  I will probably call my in-laws to bid them Merry Christmas in advance.  Two of the three will understand.I will miss my niece and nephew, too, which is a bummer, but I think it'll be okay.  I'll call my parents on Christmas Day, and they will likely be baffled that I'm spending Christmas day without my family, but I will remind them that I've spent 45 years of doing not what they want me to do very often...so they should really stop having expectations.  They'll be fine.  Part of them might understand. It's weird to them that I'd be apart from Mark for Christmas.  But Mark will be doing the family obligation, and I would bring him with me (and Chase too) if I could.

I think I'm just going to duck out of what other people need from me this Christmas.  I'll go back to being the responsible wife and stepmom next Christmas.  (Or, maybe all three of us will say the hell with it and go to Hawaii.)  (It could happen.)

For the first time in ten years, I am going to spend Christmas Day alone, hiking delicate arch. 

A very bright and peaceful Solstice to everyone.

Warm sun still spills onto the bed, and I wake up slowly from my nap.  The cats stir as the rhythm of my breathing changes, both waking with me.  Cat families sleep in the sun together, and they are happy that Mommy is home this afternoon.  Bella arches up from the divot in the bed made by Mark's shoulders, purring softly.  She sniffs my face and licks my nose.  Beau's four white paws remain in the air (he sleeps on his back when he's happiy and warm), but he turns his head toward me, interestedly, and thumps his tail once. 

The kitties hate that I've gone back to work.  They have had more time with me than they have their entire lives this year. 

When Beau moved in with us, he decided it was his job to "supervise" when Mark or I take showers.  (Sometimes Chase's showers, too, but not always for some reason.)  Every morning, he jumps down from the bed and leads each of us to the bathroom for our morning ablutions.  But this week, as soon as Mommy puts on scrub pants instead of her Jack Skellington glow-in-the-dark pants, the look on his face becomes baleful.  If you aren't a cat person, you may not realize that cats actually do have expressions.  He hangs his head, and looks up at me, looking dejected and glum.  He does not purr, even when I scratch his butt.  He follows me from room to room, and as I leave for work, he sits, a pensive pouff of orange and white, inducing as much guilt as he possibly can.

Bella is more vocal about her protest.  Cats often don't maintain eye contact, as it is often a sign of aggression in cat speech, unless "I love you" blinks are exchanged.  Although our cats have learned the behavior that humans don't intend aggression when we look at them, they do not ever tend to stare.  Once an "I love you" blink has been exchanged, they will look away. This week, Bella has been staring straight at me, yowling, and daring me to look away from her.  She is indignant.  She begins crying as soon as she sees the scrubs, and does not let up until I walk out the door.  She'll pause briefly to allow me to kiss her head or rub her ears, but the second I step six inches away from her, she continues her kitty harangue.  She doesn't care about the soothing noises, full of explainations about working so I can pay for her cookies that I make at her.  She is UP.  SET.  about this going-back-to-work business.

So they are happy this afternoon, showing affection not just because they love me but to ensure I remember what I'm missing when I go off to wherever it is I go half the day that can't possibly be nicer than where we are.

And so here I am, in a warm puddle of grateful.  The pain in my ribs isn't bad.  After I left work today, I had a "fill" done into my tissue expanders...an injection of saline into each breast implant.  I was achy enough to take the oxycodone by the time I got home.  Of the thirty tablets I had on October 6 when I was discharged from the hospital, twelve remain.  Ibuprofen, and honestly, the distraction of being a useful person in the working world again, are making those less and less necessary. I will likely save them for "fill days," which will likely get more difficult.

This was my first week back to work, part time.  I work with awesome people, and it's done my heart so good to catch up with everybody.  It's good to see patients.  It's good to be a nurse.  I spend my working time in a place I genuinely enjoy, being with people I genuinely respect and appreciate.  While Bella is right that it's not as wonderful as a warm sunny bed full of happy, drowsing cats, it's still pretty damned good. 

Nine weeks away meant a lot of change has occurred.  That's true of any hospital, but the change is seismic with new management at a teaching hospital.  Old ways of doing things are being gutted, and I think it's fabulous.  I'm a Scorpio.  I'm okay with burning unnecessary or archaic things down to make way for new.  But it hasn't been easy on any of them.  I am so impressed about how my team's kept it together, though.  They may feel like the clinic has been a "shit show", because they don't see what a beautiful job they've been doing.  It's fantastic, the improvements they've made, the efficiencies they've built.  They don't see it because as they've been fixing processes in the clinic to make patient care better, the sheer VOLUME has gone up.  Sam's doing better than some because she sees the numbers...call volumes, visit volumes, etc.  I mean, they've been killing it.  But they're tired.  They want to offload.  They've more than earned it, and I'm really glad I'm coming back because I want to help. 

Reconnecting.  Stuff happens, people move, people are bidding on condos, some show me pictures of their new flooring, some kids have started school, some kids are seniors in college now, babies are due, Halloween costume pictures swapped, big exams are coming for some, new vegan cupcake recipes have been learned.  Several new people were hired, new faces to get to know. 

Not everybody knew about the cancer.  I've been pretty frank about telling people.  "I'm cancerless, which is cool, but also boobless."  We're all medical people, so nobody flinches about the way I talk about what I've been through.  People cannot help but look down at my chest when talking to me, so I'm getting used to that.  Quite a few of the nurses and MAs have poked at my fake boobs curiously as I've talked about the process.  One of my NPs today told me she noticed how firm I was with the hug I gave her yesterday.  We laughed about it, but I think I have to think about that in the future.  These babies are freakin hard, and I imagine I could hurt somebody with them.

I am deeply happy that I have such a home there.  I am so grateful for this place, these people. 

Chase is practicing trumpet in the basement.  We told him he doesn't have to go down there, but I think he would prefer we not hear any mistakes (?).  I'm still listening to him, obviously.  Sometimes, he's doing scales....he's really getting good.  With trumpet, the higher notes are more challenging, and I can tell the difference in how much better he is doing with those notes.  He's learning/recording an assignment that's due (for upload) tonight.  "Chase Fridays" (i.e. every other Friday) tend to be a family night of pizza and unwinding in front of screens of some kind.  He's already inhaled his half a pizza, and I'm sure he'll switch to screens soon and be up until one in the morning killing the avatars of other teenagers in Smite or Hearthstonne or Heroes of the Storm.  (We're the set of parents that are far more lenient about things like bedtimes and screens and internet.  We realize that he is sixteen.  But we also see that the kid's getting his homework done on a Friday night first, with no prompting from us.  I don't know that any of us can take credit for who he is and is becoming, but he is a good.  kid.)  (I guess I could start calling him a young man, but I get verklempt when I think about that.)

Mark's new toy arrived tonight:  a gaming laptop.  He didn't tell me it's a gaming laptop, because he realizes I'm aware that the word "gaming" means "add at least $500 to the price", but I don't care.  He will be fussing with that, installing things and downloading things on and off all weekend I imagine.  He's so excited.  It is "Omen by HP, with Bang and Olufsen audio."  It's a computer that they named.  The keyboard glows red beneath the black keys.  (Okay, I'm a little jealous because he his keyboard is cooler than mine.)  (I just asked him again how much it cost just because I'm messing with him.)  I wish he would let me buy these things for him for Christmas or birthday.  He has that look on his face that I had when I was ten years old and Dad bought me that Lego tractor.  (That was such a cool tractor.) 

We've got tickets to a movie tomorrow mid-day, some superhero thing.  Sunday, I'm heading to a stich and bitch with a friend, to meet some new people.  Haven't decided what project to bring...mostly because the projects I'm working on now are too big.  Darn, I might have to go to the yarn store tomorrow to pick out a skein or two to make a scarf to practice a few new stitches I want to learn.  Then my mother-in-law (and possibly father-in-law) is coming down for the Sunday afternoon Packers game, and I'll probably hang out, too.  It's family time, and I try to be present as I'm getting better.

It's been a hell of a year.  I'm not done with my medical stuff yet, but I think....today, anyway....the end is in sight.  February will be the last of this scalpel business for the forseeable future. 

I signed up for another class for the spring....nursing informatics, which sounds interesting to me.  We'll see how things go. 

I'm okay.  I'm better than okay.  The song that floats into my head is "Beautiful World" by Colin Hay.  It's a song that has the same feeling as the book The Unbearable Lightness of Being, which I read when I was too young to understand it (I was in my 20s.)  It's an ambiguous, but profound happiness.  Contentment with the fleeting nature of things.  And I do think you have passed some milestone or milestones in your life to feel that.  I don't know what those milestones are, but I know that I didn't get it when I was younger.  I'm sure the Germans have a word for that (and if you're reading this, Adisa, I'd love to know what that word is.)  When you can say "This is as good...as it gets..." and it can completely fill you with the brightest gratitude... If you don't know the song, you should, so here it is:

The cats are back on the bed, dozing.  Mark just asked the computer, "Hey Cortana, find psychological strategies to get your wife to increase her breast size."  Obviously, I smacked him.  "I can stop now, you know..."  I hear Chase snicker, and then close his bedroom door.

This is as good as it gets.