We had only been back in Tucson for one week before we had to head to Albuquerque. Originally, I wasn’t going to go, but when John’s 5-day business trip got extended to two weeks at the last minute, I decided I’d go with him.
Not only did I not feel like dealing with record rainfall and mosquitos and roof leaks all by myself in Tucson, but the weekend between John’s two weeks in Albuquerque was our 13th wedding anniversary.
The first week in Albuquerque did not start out well for me. This is the second or third time that I have had a migraine for the first several days after arriving in Albuquerque. I think I am no longer acclimated to the high elevation (about 5,500 feet in our neighborhood). But I didn’t miss much during those first few days when I wasn’t feeling well, because my decision to go out there was so last-minute that I hadn’t managed to schedule visits with friends and other activities until toward the end of the first week anyway.
Initially, we considered spending our anniversary weekend camping. But New Mexico is getting monsoon rains. I haven’t noticed as many mosquitos in New Mexico as I have in Tucson, which has been suddenly inundated by them, but there are gnats, some of which bite. Plus, monsoon = mud and you know how much I love mud! Especially when camping.
Instead of camping we decided to do a 3-day weekend “staycation”. It turned out we had an amazing time, right there in Albuquerque!
On Friday morning, we kicked off the weekend with a fun hike in the east mountains. I always like to do the challenging activities first, and take it easy later, or else the challenging activities might not ever end up happening!
This is the overlook at the end of the Tree Spring trail, one of my favorite trails in the Albuquerque region. It starts on the east side of the mountains, partway up the mountain. That leaves a shorter climb to the top than the trails that start all the way down at the edge of Albuquerque on the west side of the mountains.
Also, this trail is in the trees from the start, which is another reason why it’s one of my favorite trails in the Albuquerque area. The trails on the other side of the mountain start lower and head up through the desert for a long time before finally getting high enough to be in the trees.
Here’s what it looks like when we start from our house at the bottom of foothills on the west side. You can get up into the trees, and even all the way up to the top of the mountains from the west side, but it’s a long hike from that side.
Trees at the trailhead works for me!
I’m definitely continuing to get stronger. There’s no way I would have made it to the top last year, even on this modest hike.
I don’t like cliff edges, so that’s about as close as I got.
It’s monsoon season, so it’s exceptionally green and we even have mushrooms.
Later that afternoon we went to the Sawmill Market, got ice cream, and listened to a guitarist.
While listening, we played a game I designed called “Phrase Cards”.
I started putting the game together many years ago with Laura’s help, and then John’s been helping add to it ever since we’ve been together. I wrote about it once before. Basically it’s a bunch of cards with metaphors on them, which help us consider ideas. We ask a question and draw a card, and try to relate the phrase on the card to the question.
For example, we asked “What should we do for Kristina’s birthday at the end of August?” We drew a card that said, “The first snow brings excitement, the last snow is greeted with grumpiness”.
What does that have to do with what we should do for my birthday in August? There’s no snow in the desert in August! But it’s a metaphor, so it doesn’t actually have to do with snow.
Perhaps it’s referring to Kristina’s chronic grumpiness? LOL, why would you say that? I’m not grumpy person!
I interpreted the general meaning of the metaphor to be about how people often get tired of the status quo and look forward to change. Most of us like variety in our life. So what would be different; what would be a welcome change for us at the end of August? We live in the desert, so what would be different than the desert in August?
We aren’t comfortable flying because of the pandemic, so it would have to be something “different” yet still within driving distance. Snow would be different. We could drive high into the mountains. Or we could go to the ocean – the ocean is a lot different than the desert. Let’s go to the beach!
San Diego is about 6 hours drive away. We like it there but we’ve been there many times and it doesn’t sound all that different or special. And the card is about change, a new and fresh experience. Oh wait! How about Rocky Point at Puerto Pañasco, Sonora, Mexico? Turns out Rocky Point is only a 4 hour drive from Tucson! Now there’s an idea! A beach only a few hour’s drive away. And it sounds like an adventure – Mexico!
What do you think, should we go to Mexico?
By the way, if any of you would like a set of Phrase Cards, let me know. Maybe I’ll make a few sets during the holiday season. I order the business cards, and then I print labels that have all the phrases, and stick the labels on the cards by hand.
I’ve thought about having the sets commercially printed, but I don’t think it’s affordable to have custom cards made with different text on each card (unless I ordered in bulk and was planning to sell hundreds of sets on Amazon or something, which I’m not).
I print the labels at home and stick them on the back of the inexpensive business cards. Low tech. A full deck is about 250 cards. So it gets a little tedious to stick all those labels onto the back of the cards, but it’s not a big deal.
If it turns out a lot of you want phrase cards (which I doubt, but if so), I’ll probably have to ship you the cards and the labels and you can stick the labels on the cards yourself. Now there’s some exemplary customer service. Phrase Cards – some assembly required!
The last time Laura and Alex went on a backpacking trip, their dog, Zane, wore his paws raw on the sharp gravel and rocks. The poor guy couldn’t even walk by the time they got back to their car.
But Laura doesn’t want to leave him home on the next trip. Ergo – doggie booties!
Laura has bought Zane dog boots, and is wisely working to get him accustomed to them before the next backpacking trip. The videos she sent me are hilarious; much, much better than the inanely boring videos I usually post on this blog.
I’ve been impatient to plant fruit trees ever since we bought the Tucson house in September of last year. I have always wanted citrus trees, as part of my lifelong dream of having a Mediterranean garden. We had been delaying planting trees because we want to do some repaving and extending courtyard walls, and we don’t want new trees in the way. Also we are frequently gone and we didn’t have irrigation for them.
At the beginning of July, shortly before leaving on our big west coast van trip, John went to a hardware store for some last-minute fix-it item and came back with several big, heavy patio pots.
We set them along the wall near the pool and left on our trip. When we returned nearly a month later, there they were, sitting in the rain by our muddy pool, empty and beckoning.
John and I aren’t ones to leave empty pots empty for very long. And we realized they could solve our fruit tree dilemma. These pots, although heavy, can be moved. If we planted our fruit trees in them, we could move them out of the way when we finally got around to repaving and extending the courtyard wall.
We were due to leave again in two days for Albuquerque, and we would be gone for another two weeks. Did we have time to put something in these pots? John would need to run drip irrigation to them (despite record rains, it’s still the desert).
We went to Mesquite Valley Growers, which turns out to be an absolutely awesome, enormous nursery. We were standing, helpless and bewildered, among acres of fruit tree saplings, when a wise, no-nonsense elderly employee named Jody showed up with a go-cart and told us to hop in. She took us on a fact-filled tour of the premises and we have never had such a great tour in our life!
Jody assured us that fruit trees did fine in pots, and we could always plant them in the ground in a few years if needed. That’s what we wanted to hear! She showed us dozens of kinds of citrus and helped us pick out a few.
In the end, we bought a key lime, a finger lime, a tangerine and an orange. I also want a lemon and a grapefruit, which Jody says will be available in September (they were sold out, but they grow their own trees and she knew the next batch would be available soon).
Here’s John getting ready to plant our new citrus trees! (Or – citrus bushes to be more accurate).
The finger lime is the strangest. The limes aren’t round, they are pod-shaped.
The insides of a finger lime are little round beads, like caviar, except pale green in color. According to John, YouTube says you’re supposed to slice them in half the short way, and squeeze out the round beads. But I suppose you can do whatever you’d normally do with a lime. Which in my case, isn’t much, but I still love to have them because they smell so good.
The finger lime tree is not the best looking tree. The leaves are very small (well suited for the desert). And it’s more of a scraggly bush than a tree, even though it can get quite large in a hedge-like way. It also has thorns. But we still thought it was cool.
The Mexican lime, which is a local term for a specific type of key lime, already has a lot of limes on it. The orange and tangerine don’t yet.
John managed to get everything planted and onto drip lines before we left for Albuquerque. Yay, citrus trees!
I’ve decided to write a post which I would have titled, “Contemplating Dying”, except I don’t want to panic anyone. No, my cancer has not metastasized (that we’ve been able to tell so far). I’m fine, you’re fine, we’re all fine – but we’re all going to die, some sooner than later, and most of us don’t know how to talk about it.
If you’re one of the majority of people who don’t want to contemplate dying, then skip this post. There’s no huge piece of news that you would miss otherwise.
Why Talk About It?
I’ve been deliberately contemplating death for about a year now, and it’s been an extremely valuable experience for me. No, it has not caused depression. The opposite – all these van trips – even the purchase of our house in Tucson – all these fun things we’ve been doing are directly because I’ve been talking and thinking about death.
Facing the idea of dying, head-on, with courage, has been empowering and freeing and clarifying to an amazing extent. If you’re feeling led to think and talk about death, it may be very useful for you. And if you have a friend or family member who starts talking about death, don’t automatically shut them down. It can be a very valuable process.
Of course, depending on the situation, it may be important to bring in a health professional, particularly if someone is very upset, afraid or despondent. And I do have a therapist. But thinking about death can be natural, normal, and useful, particularly for older people, and people who are impacted by difficult diseases like cancer.
I’m currently considered a “cancer survivor” which of course is true. I have, thus far, survived. Anyone who has ever had cancer, or currently has cancer, is considered a cancer survivor. The term does not mean you’re cured.
I am not yet dead, but my life expectancy right now is a fair amount less than the average boomer, and I’m not even a boomer, I’m Gen-X (the lost generation, the ignored generation sandwiched between the boomers and the millennials). Thus, I’m not really all that old! I feel like I ought to outlive my parents, but it turns out I might not. That does sort of annoy me. But such is life.
Most people don’t want to think about dying. It’s too scary, or sad. But some people, like me, do better when we work things through openly. So I have a therapist and I have a cancer support group, both of which are great. And I have a lot of loving friends and family, but I don’t want to burden them. I figure writing about it in my blog isn’t going to bother anyone, because if you don’t want to think about death, you don’t have to read this post. There will be more vacation pictures very soon, I promise 😉
Now I admit, there are types of thinking about dying that aren’t helpful. For example, sometimes people can get into a worry loop, or an anger loop, where they’re just thinking the same thing over and over and ramping up their emotions for no useful purpose.
But just because someone is talking about a difficult topic, does not mean they are in a negative thinking loop. It may be useful processing. Possible useful thinking may sound something like this: “How have similar situations affected other people? How may my situation affect me? Are there things I could do to mitigate those effects? Is there anything I could be doing differently that would be helpful for me or those around me?”
I had some ongoing trauma for awhile when I was young, and I learned through the many years since then, that I do better when I periodically take a look at it quite directly and learn what I can. The more I know about how others in similar situations are often affected, and the more specifics I learn about how I might have been impacted by that past trauma, the more I can make smart decisions about how to mitigate those potential impacts. For example, did the trauma impact my ability to trust others? Then maybe I can deliberately look at that, and learn to build trust.
If I don’t think about the difficult aspects of life, those experiences will still affect me but in a sneaky sort of underhanded way. If I don’t think about, and learn about, and talk about those events, I won’t understand how the impacts are affecting me and I won’t be able to do anything about the impacts. But if I think and talk about it, I can get smart about how to proactively limit any lingering effects of the original trauma.
Well, the same goes for current or future trauma. If you address it head-on, you might be able to learn to handle it well. If you ignore it – it’s still affecting you whether you like it or not – and you’re not learning how to handle it well.
If a friend or family member brings up a difficult topic like death, it’s perfectly legitimate to ask yourself whether you’re willing to listen. If you don’t want to listen, that’s fine, go ahead and change the topic. You don’t have to be a captive audience to something you don’t want to deal with or think about.
But be clear in your mind – are you are changing the topic because you don’t want to talk about it or because you don’t think someone else should be talking about it? It’s fine if you decide you don’t want to talk or listen or think about a difficult topic. Just don’t assume that your friend or family member shouldn’t be talking about something difficult.
Before you quickly push them in a more positive direction, stop and ask yourself…are you sure it’s wrong for them to be talking about something that seems negative to you? Maybe it’s useful processing time for them. Are you automatically assuming they’re going to end up too sad, and they shouldn’t be thinking that way?
50-50 Chances
After a fair amount of research, I’ve determined that the best data I can find suggests that I have a 50% chance of being cancer-free in 5 years. This data is for patients aged 60-65, and I am just now turning 55, so it isn’t quite right, but it’s as close as I’ve been able to find. It’s highly unlikely that my somewhat younger age is going to help me much. It’s not about my age; it’s all about the type and stage of my cancer.
This data is particularly useful because it provides relapse-free data that are based on one’s T and N numbers. The “T” number indicates how advanced the tumor was when it was discovered. The “N” number means how many surrounding lymph nodes showed signs of cancer. Having cancer in even one lymph node is quite risky, because it means the cancer has started to spread.
Most data tables lump all that together, which makes the data nearly useless. It turns out the T and N numbers are absolutely crucial data. Look at the difference between relapse free rates for T3N0 at 79%, compared to T3N1 at 49%, and T3N2 at 15%!
OMG! Outcomes range from almost 80% to a breathtakingly low 15%. It’s hard to believe that most charts lump all of those together, creating an utterly meaningless number somewhere between 15% and 80%!
So all those other statistics I’ve cited in this blog in the past have been nearly meaningless because they haven’t differentiated between the various types of tumor (T) and lymph node (N) conditions. I had no idea it made such a difference!
I’m in the T3N1 category. T3 means the tumor invades through the muscularis propria into the pericolorectal tissues. N1 means the cancer was discovered in one lymph node.
The 5-year relapse-free rate for T3N1 is a middling 49%, which I have taken the liberty to round to 50%. There’s something almost kind of cool about 50% – it’s just so perfectly up in the air. 50-50; it doesn’t lean in either direction. So my mind swings back and forth, back and forth, like a perfect pendulum. Relapse-free or not relapse-free. Either one, equal chances.
So why does this matter? Well, anything else in life, if you had a 50-50 chance of something happening, you’d want to prepare for both options, right? …right? And what does that look like, preparing for a 50% chance of dying in the next few years?
To Treat or Not To Treat
Now you’re probably like, wait, Kristina, even if you do have a 50% chance of relapse over the next 5 years, that doesn’t mean you’re actually going to die of it, does it? Can’t you treat it again?
Well, yes, we could try. Will it do any good? Probably not. The effectiveness of treating metastasized (stage 4) cancer depends on the type of cancer. Some people live a nice long time in stage 4. Some people can even recover from stage 4. It depends a lot on how good the chemotherapy is for that particular type of cancer. Some types of cancers have really good treatments.
Unfortunately the types of chemo available for colon cancer are mostly old styles, that aren’t very targeted, and aren’t nearly as good as some of the newer treatments developed for some other types of cancers. Chemotherapy for colorectal cancer works basically by killing all your new, young, rapidly dividing cells. That’s very damaging to the body and not very targeted to the cancer itself. I think that’s the primary reason chemo doesn’t work as well with colon cancer as it does with some other types of cancer, some of which have more targeted types of chemotherapy available.
In my case, we’re not too worried about the chances of local reoccurrence around the area of the original tumor. The bigger concern is distant metastasis – in my liver, lungs or bones. In that case it would not be a simple tumor which could then be cut out. It would be spread all over, and the only treatment option would be chemo.
By the way, it would still be called colon cancer (or more accurately, colorectal cancer) if it shows up elsewhere such as in my liver or lungs, because it’ll still be the type of cancer that started in my colon. So if it turns up in my lungs, I would still have colorectal cancer, just spread to the lungs.
As I researched my choices and outcomes if I were to have a stage-4 relapse of colon cancer in my liver or lungs or bones, I decided that I’m not going to treat that kind of relapse. Sure, if I have a little stage 1 or 2 tumor somewhere, I’ll get that cut out. But I’ve decided not to do months or years of chemotherapy if it turns out to be metastasized. I deliberately won’t treat the cancer in that situation. And untreated metastasized cancer kills you.
Why wouldn’t I treat it, knowing that it would kill me? Don’t get me wrong – I’m not arguing against chemo. By all means, if you get a cancer diagnosis, do your chemo!
But in my specific case, if the round of chemo I did last summer did not work, and the cancer metastasizes in the next couple of years, more chemo is unlikely to do me much more good. And I’m not going to spend my last year or two on earth pumped full of chemo that can’t cure the cancer. Because that is not the way I want to die.
Last summer I did as much chemo as my doctor felt my body could handle. I couldn’t finish the chemo – I did as much as I could – at the end we were just trying to keep me out of the emergency room (in middle of a pandemic). My lymphocytes were crashing, my mental ability was crashing, I was suicidal, my intestines were not working – I was an utter basket case. We kept trying to lower the dose to a “tolerable” level but my body was crashing. By the way, when you’re talking about chemo, the term “tolerable” doesn’t mean feeling ok. It means the chemo isn’t killing you faster than the cancer is.
I went through all that because it may have made a huge difference; last summer’s chemo may have saved my life. But more chemo is unlikely to succeed.
Therefore, logically, I don’t care about mere survival-to-5-year rates, I care about actual relapse-free rates. Because if I have a reoccurrence within 5 years, I’m not going to treat it and I will die. Merely “surviving” for 5 years isn’t going to do me any good. I need to be cancer-free if I am going to live for awhile. That’s why I’m using 5-year cancer-free data rather than 5-year survival data.
So, am I cancer free? We can’t tell yet. We don’t see it yet – but then, we probably wouldn’t see it yet even if I was heading into stage 4. Colon cancer grows somewhat slowly. On average, if I do still have cancer in me, we would expect it to start showing up on my scans later this year, or sometime next year. Or even a couple of years from now. We don’t see it yet, which is great, but we just don’t know yet.
Living life in case I die
So back to my earlier question, “What does that look like, preparing for a 50% chance of dying in the next few years?”
After a lot of thinking and talking and processing it through, I decided that there isn’t really any bucket-list item that’s going to make me feel ready to die. I don’t have a project I’m desperate to finish, or a place I’ve always wanted to visit, or an activity I’ve always wanted to do.
The primary reason I want to stay alive is because I want to be there for my family. There’s not much that I could do right now, for John or the kids or anyone, that would prepare them for me to be gone. I want to still be around for when things come up later.
Once I realized that, I realized that there’s really very little I can do to prepare to die. So all I’m doing is spending as much time as I can with John and the kids, and trying to support them in small ways for as long as I can. And to live as openly and actively as possible meanwhile.
Through contemplating death, I have become more aware that I am alive.
In addition to fallen branches, we had a couple broken ones still stuck way up high in the tree.
In my last post I mentioned how impossible it is to get a roofer out immediately after a rainstorm in the desert. Well, it’s also nearly impossible to get tree and branch removal done. Plus, we had been dilly-dallying in California while all our Tucson neighbors got a jump on it. By the time we got back out to Tucson, neighborhood cleanup was already in full swing.
You snooze, you loose!
We figured the stuck branches were a liability, so we decided to get them down ourselves. I probably would have just thrown things at them for awhile. But John is methodical. He bought a tree hook, and set about trying to get a rope over the largest of the two broken branches.
It kept not working.
Over and over it kept not working. It was painful to watch. After awhile he tried throwing the rope over with a rock a few times, but that didn’t work either.
So he went back to trying to get a rope around it with a tree hook. I’m pretty sure that filming him trying to snag that tree branch was almost as tedious as him trying to snag it. I took lots of enormously boring videos, hoping to catch the exciting event. Like boring!!!
That was surely the most boring video ever published.
Finally he gets a rope around it.
Okay, here’s the big event!
Or maybe not. Awww. Time to start all over again. I went inside while he continued to try to get the rope around the limb. Finally he got it.
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Please try again."}},"email_for_login_code":{"placeholder_text":"Your email address","initial":{"instruction_type":"normal","instruction_message":"Enter your email to log in."},"success":{"instruction_type":"success","instruction_message":"Enter your email to log in."},"blank":{"instruction_type":"error","instruction_message":"Enter your email to log in."},"empty":{"instruction_type":"error","instruction_message":"Enter your email to log in."}},"login_code":{"initial":{"instruction_type":"normal","instruction_message":"Check your email and enter the login code."},"success":{"instruction_type":"success","instruction_message":"Check your email and enter the login code."},"blank":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."},"empty":{"instruction_type":"error","instruction_message":"Check your email and enter the login code."}},"stripe_all_in_one":{"initial":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"empty":{"instruction_type":"error","instruction_message":"Enter your credit card details here."},"success":{"instruction_type":"normal","instruction_message":"Enter your credit card details here."},"invalid_number":{"instruction_type":"error","instruction_message":"The card number is not a valid credit card number."},"invalid_expiry_month":{"instruction_type":"error","instruction_message":"The card's expiration month is invalid."},"invalid_expiry_year":{"instruction_type":"error","instruction_message":"The card's expiration year is invalid."},"invalid_cvc":{"instruction_type":"error","instruction_message":"The card's security code is invalid."},"incorrect_number":{"instruction_type":"error","instruction_message":"The card number is incorrect."},"incomplete_number":{"instruction_type":"error","instruction_message":"The card number is incomplete."},"incomplete_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incomplete."},"incomplete_expiry":{"instruction_type":"error","instruction_message":"The card's expiration date is incomplete."},"incomplete_zip":{"instruction_type":"error","instruction_message":"The card's zip code is incomplete."},"expired_card":{"instruction_type":"error","instruction_message":"The card has expired."},"incorrect_cvc":{"instruction_type":"error","instruction_message":"The card's security code is incorrect."},"incorrect_zip":{"instruction_type":"error","instruction_message":"The card's zip code failed validation."},"invalid_expiry_year_past":{"instruction_type":"error","instruction_message":"The card's expiration year is in the past"},"card_declined":{"instruction_type":"error","instruction_message":"The card was declined."},"missing":{"instruction_type":"error","instruction_message":"There is no card on a customer that is being charged."},"processing_error":{"instruction_type":"error","instruction_message":"An error occurred while processing the card."},"invalid_request_error":{"instruction_type":"error","instruction_message":"Unable to process this payment, please try again or use alternative method."},"invalid_sofort_country":{"instruction_type":"error","instruction_message":"The billing country is not accepted by SOFORT. Please try another country."}}}},"fetched_oembed_html":false}
