No Thank You!

Hmm. Maybe I should wait to do that until after my surgery.

Hmm. Maybe I should wait to make those plans. My surgery is coming up.

You know what?

Fuck that. Absolutely, unabashedly, fuck that noise.

In other words, NO THANK YOU.

I'm not sure when I decided that I wouldn't wait on things. At first I hesitated because I didn't want to make the decision and then not be able to follow through. And then I hesitated because I had a temper tantrum about not being able to make plans for anything at all ever. And then at some point I just...decided to stop waiting.

This has been a long year and I was tired of waiting for my health to improve before I started working on my bigger goals. I just couldn't wait any longer.

And hoo boy, do I have some bigger goals.

I was talking to someone today about boundary setting and incorporating three words regularly into their vocabulary: No Thank You. In this particular instance, they were feeling parented by a peer, and I introduced them to the "no thank you" of it all. If this person decides that they want to give you advice when you didn't ask for it and didn't want it? No thank you. That literally needs to be your only response.

If someone tries to invade your boundaries? No thank you.

(It's not mean. We just think it is. And, if it feels like shit, then that means we're doing necessary boundary work. It's a good thing.)

I decided to try it with myself. Why do I really want to wait on these things? 

Maybe I should...

No thank you.

I'm not doing enough of...

No thank you.

I have to make sure that I don't forget this or that, or the Very Bad Consequence will be...

NOPE. NO THANK YOU.

I'm not doing as much as I should be and I'm going to be totally unprepared to not work for four weeks...

No thank you.

In other news, I think I'm going to have to wear a post-surgery turban. One of my friends suggested that there is funnier headwear, and I agree, so I'm going to try to make it hilarious.

Maybe I'll have people sign it like a cast.

My point? Shit's getting real, kids. On several fronts.

By activating my inner "No Thank You", I've found myself to be ready for every single bit of it.

Maybe I should make sure that all of my electronics are charged so I can bring them to the hospital and make sure that people can get in touch with me.

No thank you. Rob's going to do that and he has already volunteered to do that.

Maybe I should make myself a to-do list for when I get bored while I'm out.

No thank you. Napping will be just fine. You have a team of Very Capable People that can do all of these things, and if they can't, then they can wait. Seriously. THEY CAN WAIT.

Maybe I should make a plan for exercise so that I can start doing that as soon as possible. That marathon ain't going to run itself.

NO THANK YOU. You're getting a treadmill delivered after Christmas, and it will be walking only for at least three months. WALKING ONLY.

Maybe I need to eat better in this time so that I can prepare myself better for surgery.

No thank you. Use this panic time to eat whatever the heck you want. Eat healthy after, which is also what your doctor recommends. And yes, you may go home and make that second box of mac and cheese today. Do it up, friend.

It's amazing how much inviting in No Thank You has also invited in self-care. I'm kind of floored and in absolute love with this idea.

More to come. Stay tuned!

Adversity as an opportunity

Friends, my meningiomectomy is coming. (I'm not sure if that's what it's actually called, but that's what I'm calling it.)

Marvin is getting evicted, tentatively, December 15. I'm ready. This is the last thing in the unending tirade of medical bullshit that has come my way this year. And, if Marvin is benign, this surgery is curative. CURATIVE. After this is done, all that's left to do is recover and to heal. And to have a Ceremonial Burning of the Medical Paperwork of 2021. Let me tell you, I have A TON of it. Like, a ream and a half of paper. Of course, I have to have another colonoscopy in January, and then there are the every-three-months follow-ups for a few years with my endocrinologist, but I will not be in a doctor's office three times a week come this time in four months. If I am, I'm going to strongly consider quitting my job and being an arsonist as a next career move. (JUST KIDDING. I AM NOT A SAFETY RISK TO OTHERS, I ONLY MAKE VERY INAPPROPRIATE JOKES.)

Anywho, with, y'know, brain surgery coming, it's given me a fun opportunity to delve into the world of hairstyling. A fairly significant portion of the left side of my head is going to be shaved, and while Rob thinks that the best course of action is to shave my entire head, I'm not so sure. I don't want to freak out my clients, we'll be going directly into wintertime, and I don't want to wear a hat everywhere, so there's a lot to ponder. Pinterest has some very interesting wormholes in the world of hair, let me tell you. I so rarely take care of my hair - I go to the hairdresser maybe once every four to six months - and so I've got a lot of pondering to do about it. My hair is curly, which adds another dimension to it, but I think I'm finding some really, really fun stuff.

Of course, I say that I'm going to sit with it and figure out what I want and be methodical, but given that I have an impulse control problem, I'm likely going to the hairdresser tomorrow. Yeah, I'll be going into the office on Tuesday with all of my hair chopped off. I've wanted a new hairstyle for a while, and I'm super stoked to change it up a bit.

I've also decided that the thyroid cancer has not spread. I'm having a total body scan in a week and a half to see where the radioactive iodine is concentrating, and it will show no spread. It just won't. The surgeon took two lymph nodes and one of my parathyroids in the thyroid surgery just to make sure, and they were all negative for metastasis, so the chances of that being true are pretty good. My geiger counter came in the mail today, and I've been having a hilarious time holding it up to things and seeing if they emit radiation. I imagine I'll find it less entertaining when I have to hold it up to myself and it dictates whether or not I'm able to leave the house, but I digress.

Also, my hate amalgam is ruined. RUINED. KYLE IS A REALLY NICE DUDE WHO IS JUST TRYING TO DO HIS JOB. To add insult to injury of the death of this hate amalgam, my therapist was all "How about you just feel the anger that you feel, Ryan?" PFFT. WHAT DOES SHE KNOW OTHER THAN THE MOST INTIMATE DETAILS OF MY LIFE AND MY DEEPEST THOUGHTS AND FEELINGS THAT I WOULD NEVER SHARE WITH ANOTHER PERSON EVER. I mean, this is a great opportunity to be able to actually delve into my feelings about all that has happened over the past year, so there's that, but I'm just so MAD about it. Everything is annoying, and I am Most Definitely Not In A Place Where That Can Be True. I'm trying to run a business and bring on new clinicians and be supportive of my clients and navigate all of this medical stuff. My feelings can take a number. The reality is, my feelings are currently the Karen in the Deli Line that's all "I don't have time to wait for this! UGH" and has a temper tantrum and everyone just wants to shut her up and just lets her cut to the front of the line. There's a lesson to be learned there, which is that my feelings need their turn in the front seat for a little while so that they don't jump on the hood of the car, but I don't want to learn it. I just don't. There's a big part of it that's fear - if I open up that well of rage, will I ever be able to close it again? I was able to practically cement it shut in years and years of therapy and trauma work, and I didn't expect to have to let it out again, but here we are.

Who knows. Maybe I'll pick up boxing. Punching things feels like a good idea and a good way to get out some powerlessness and frustration and rage, and it's WAY more productive than what I'm doing currently, which is nothing.

A Rant About Ableism

Recently, one of my doctor's appointments was made without consulting with me. I was called by the nurse that made the appointment (and yes, it was the real-life Kyle) who just called and told me the appointment time. No negotiation, no "pick from a list of these times". It SUPER bothered me at the time. At first, I wrote it off as just being bothered by everything lately, because I am, and so just add this to the pile, but it continued to stick. I couldn't let it go. It was for my radiological oncology appointment - my first one. I called to change the appointment, but I couldn't without messing with the timeline for treatment, and the conversation yesterday (after trying three times unsuccessfully over the past week and a half to get this appointment changed, I finally got someone on the phone) went something like this:

Me: Hi! I'm scheduled for an appointment in early September, and I need to change it.

Scheduler: Ok! We can get you in for a consult in mid-October.

Me: I can't wait that long without messing with the timing of treatment, which has to be done within 3-6 months of my diagnosis, and I'm already 6 weeks post-surgery, so I'll figure it out and just keep that time. Also, can I ask? Why was this appointment made without consulting me in any way?

Scheduler: That's just how we do it.

Me: You should change that practice immediately. My very busy life does not center around this diagnosis and I'll have to change my whole schedule around to make it. Moreover, who says that's a good practice? Why is that policy in place?

Scheduler: Well when works better for you? (Do you see how she turned it around there and didn't answer my question? Her tone also suggested that I was being entitled about it. Nope!)

Me: I don't understand how that's relevant, but mornings work way better for me.

Scheduler: Ok. We'll remember that for the future. In the meantime, we'll see you on September 9 at 1:30.

I had a meltdown of nuclear proportions about this. I was so pissed that I didn't even know what to do with myself. Once I was done melting down about it, I sat with it. Why such a strong reaction?

What I realized is that the reason for this is because they have me by the balls, and they know it. I had another doctor's appointment at that time and had to cancel it, and I also had times that I needed to see my clients during that time and I had to shift it all around. 

The thing for me is this: they deal with cancer patients all day. There's a sense of powerlessness that I've felt about this that I've never felt before. I'm in the middle of a time in all of this medical stuff where I need to be able to have some semblance of control over what's happening to me and my schedule is where I find it in spades, and it was taken away from me in a blink. Is this objectively a big deal? No. To anyone who isn't going through this, of course it's not. But, I can imagine that for other people going through similar, or even more severe things like this, they may feel the same way as I do. The person on the other end of the phone doesn't know or realize that, and neither does Kyle. Neither does anyone who has never been through it. There's a privilege that comes with not having to grapple with something like this that I think a lot of people don't realize.

What I also realized was that this wasn't just about the appointment. It was about the powerlessness. I felt a big piece of grief yesterday that I've been pushing away for awhile, and it has to do with my utter powerlessness to stop what's happening except to accept it and go through the motions of being treated, and there are many things about which I don't have a say. It's so surprising how some of this stuff bubbles up, and what can push on that button unexpectedly.

There's also a piece of this that isn't about me at all. When you have multiple medical things that you're juggling, it's its own full-time job. For someone to just swoop in and assume that you can make it work and figure it out, it goes beyond rude. It goes beyond disrespectful. Due to the nature of my work, I know a lot of people who are managing multiple medical things; I've heard time and time again the frustration of trying to manage schedules and "Oops I have two doctor's appointments at the same time, I can't believe I did that, and so now I need to use my triage skills and figure out which one to keep and which one to reschedule", and from a patient care standpoint, the idea of just scheduling a time for someone without their input is so deeply ableist. It hits two ways: The first is that medical organizations, by doing this, show you that they operate under the assumption that you can't or won't do it yourself. The other is that if you can't make it work, that's just further proof that you can't manage it on your own. The power differential between doctor and patient is only further reinforced that their time is more important than yours, and they have you by the balls, so you are the one who has to make it work. Patients are screwed either way and are treated like they don't know what they need in terms of their own care.

This is changing how I practice clinically, without a doubt. My availability is drastically changing due to all of this medical stuff, and while I don't have control over that, I'm definitely putting more of a priority on letting my clients have more say over when we meet when I'm able to do that. I think that the more say we can give someone when they're going through something hard, the better. Also, the more we can give them the space to say "I need help with this" to the people who are there to help them, the better. Make it safe to ask for help and to change things up a bit in the most basic of ways, and I think people underestimate how much easier that will make people's lives.

I understand that doctors be doctoring. I understand that I'm not the only patient. I understand that they have schedules to keep and patients to treat, and there is a limited amount that I can do about that. All I want is a shred more of understanding that I need a say, too.

At least that's what I'll be telling the patient feedback department when I call them later to start the advocacy train rolling about this.

What a Difference a Year Makes.

I'm rounding out a year since my Lynch Syndrome diagnosis, which is the definite marker for all of this stuff starting. It's weird to think about so much happening within the past year for me health-wise, but I have to remember that this health stuff is not the only stuff. For instance:

1. We adopted a dog. Three months later, we lost our eldest dog in a way that ensured that he did not suffer and it was as quick as we wanted his end to be without too much suffering on his part, and for that I continue to be infinitely thankful, as hard as this grief has been. We still miss him every day.

2. I gained my confidence as an independent clinician and finally figured out what the hell I want to do with my life, and made active steps to go toward that.

3. I SURVIVED A DAMN PANDEMIC. (This still continues.)

4. I totally tweaked my working style and how I operate and I got used to doing telehealth 8-10 hours a day.

5. Once I had all of my ducks in a row logistically, I filed paperwork to start my own business in November 2020. I picked a logo. I started advertising.

6. I dipped my toe in starting said business in January and as quickly as I opened, my tiny caseload filled.

7. After my hysterectomy, I jumped in with both feet into the deepest possible end of the pool and gave my notice at the group practice at which I worked, and started making plans to hang a shingle in an actual office.

8. I surrounded myself with colleagues who are amazing and supportive and I'm creating the exact business I want, and it is booming.

9. I taught 6 classes! All while managing health stuff and starting a business and figuring out a pandemic and moving it abruptly online a year and a half ago!

10. Mostly, I realized that I can't wait on my health being better to be the point at which I start taking care of myself better and more intentionally.

The Universe is sending me a BIG sign. I was out for tea with one of my favorite humans the other day, and he was like "Um. Either the Universe needs to send you WAY less harsh signs, or you need to listen when there are less harsh signs being sent." (I have a hunch it's the latter.)

There are a lot of things over the past year that I've realized that I don't have time for. I don't have time for how other people's opinions if their intention isn't to be helpful. I don't have time for people who assume that just because I'm talking about something that it means that I want advice about it. I don't have time to waste on people who aren't as curious about me as I am about them (if they're not my clients). I don't have time for people who invalidate what I'm going through. I don't have time for other people's reactions about my incision scars or how I will look after said surgeries. I don't have time for other people's opinions about my body.

But you know what I unequivocally, without a doubt no longer have time for? I don't have time to not avidly and rabidly take care of myself anymore. I put it aside in all the wrong ways for so long at the expense of my health at every turn, and at the expense of so many other things. The past few weeks in particular have been an eye-opener. Self-care has become my foundation and it's the first question I ask myself before taking on something new - "Is this in the best interest of ensuring my mental and physical well-being?" If the answer is not an unequivocal yes, then I say no to it.

I've been openly avoiding using the c-word when it comes to my thyroid stuff, and I can't anymore. I'd been scared about this moment for literally decades, and here it is. When my biopsy came back as questionable back in November, I started having to put myself in the mental place that eventually, I'd get a thyroid cancer diagnosis. I envisioned what that might feel like, and how I might react. When the diagnosis actually came after my thyroid surgery, it was nothing like what I expected. I didn't feel as scared because I felt mentally prepared, I knew what the likely plan would be, and I had done so much digging and ruminating and spiraling that I'd already done the hard part emotionally. Also, the types (two) of cancer that were found have an astronomical cure rate - 90-95%! And, the first line of treatment had already been done - surgery - so, the rest of it will seem like a cakewalk compared to the recovery from the surgery, which has been hard and is not yet fully done. My numbers are currently so good that "they're what I'd expect to see from someone post-radioactive iodine," my doctor said to me. As of right now there is no spread, but I'll know more once the full body scan happens in a few months, and the radioactive iodine will get it no matter where it might be in my body. But for now, we adjust to the unabashed fuckery that comes with trying to get my hormones in balance after eliminating estrogen, progesterone, and thyroid hormone-producing organs and suppressing my pituitary gland so that it doesn't freak out and make my body start regrowing thyroid cells, which is a tall order. We caught it so, so, so early. I feel like a little bit of a fraud because I don't have a "hard" kind of cancer that's going to require chemo and months of pain and suffering to kill it. Will suffering happen? I won't be able to come in contact with my husband for five to seven days because I'll be radioactive, and there's all kinds of weird stuff that's going to have to happen from that, but by and large, easy peasy, but yeah, there will be. I have to internalize the idea that I have to be monitored for recurrence for the next 10 years. My chances are GREAT because it didn't spread anywhere and we got it all, but it's still a hard thing to sit with.

My point is that I have to make room for this stuff, all of it. I have to make physical room and logistical room in my schedule, and that means adjusting my caseload and taking enough time to do everything logistically, and making sure that I'm tending to my own physical needs at the same time, because all of this stuff is really physically taxing. I also have to make room emotionally. The amount of support I have gotten during this time from my family, my friends, and my colleagues has been nothing short of astounding, and I just feel really fortunate. At the same time, this is really hard. There's a lot to work through here, and it's just a matter of giving myself the space to do it.

I also have to recalibrate my definition of easy peasy. I talk about this medical stuff and I've been able to internalize it because it's literally three surgeries, with this thyroid stuff a couple of extra things, and then it's done. That feels easy to me, even though intellectually I know it's not. Recovery from these things has been hard. Coordinating this care has been hard. Having my literal life in the hands of a system that I don't inherently trust has been hard. Not being able to operate at full capacity has been really, really hard, especially since I have so many exciting things happening, and it feels like I can't be fully present for them.

These next few months are going to be a journey. I'm facing the hardest leg of this health journey yet, and that's not lost on me. I am facing treatment not just for the cancer, but also potentially brain surgery within the next few months if we don't take a wait and see approach (which is looking less and less likely judging by how my body is behaving since my hormonal system has totally changed).

That being said and weirdly enough, I feel physically better than I have in a really, really long time. Migraines have gone from weekly to rare, I sleep like a champ when I can get there, and my mental health is pretty great at the moment. As soon as I get over this hump, I'm training for a marathon. It's happening. My goal is to run one by 45, and I think I can do it. The beautiful thing about this health stuff is that it's all one-and-done - there's no prolonged treatment, there's no having to go through super long periods of recovery (though my thyroid surgery recovery has felt super long, I definitely know that it's only been six weeks, which is basically nothing) after really difficult treatment, and I'm going to bounce back from all of this and be better than before. I just know it. There's a ton of hope to be had, and I'm here for all of it, even when things get hard.

Calci-Yum

"It'll be a snap," I said to myself as the ramp-up to my thyroid surgery came and went. Monitor my calcium levels for a few weeks, get some rest for about a week, then have a few days off to myself where I won't have to worry about any of that shit.

The spot that my thyroid used to occupy is laughing the laugh of the righteous at this present moment.

My calcium levels aren't rebounding the way the doctor would like to see. (I have a hunch it’s because of low vitamin d.) I'm taking 4,000 mg a day of calcium (AND LET ME TELL YOU, THE SIZE OF THESE PILLS IS BONKERS.), and no change. What that means is that my parathyroids aren't working yet. It's fine! They get bruised, it takes some time for them to heal. No cause for alarm. There are four of them, and I actually technically only need one. So, three could totally dip out forever and I'd be fine.

You'd think this would be the stuff that dreams are made of, right? I can eat all of the cheese with reckless abandon! I can eat all of the ice cream! Just all of it! (And trust me, I certainly am.) Also, butter! Also, oreos and milk when my throat is up for it! Just, all of the dairy that I can handle!

I've had to get blood drawn every day since I left the hospital. Except Wednesday. Wednesday I was off the hook. 

(Can we also acknowledge that I've lost two full days of my life this week? I have no idea where they went. I literally went to sleep on Monday morning in the hospital and feel like I didn't wake up until Wednesday afternoon on my couch at home. I have some fuzzy memories, but overall, it's just...gone. I find that totally unnerving.)

ANYWAY. Because my calcium is still low, when my doctor called Thursday, they were all, "you have to go again tomorrow so we can make a plan of action over the weekend and also take three pills instead of 2 of the calcium for each dose and here's a prescription to help your body absorb it." It rebounded a little yesterday but it’s still low, so I shove even more calcium in my face and go get poked by medical vampires again on Monday. I’m sick of it already and still have to do this for like another month easily.

Other than occasional tingly feet and slight brain fog, I feel great! I'm clearly healing nicely, I still have a weird voice, but I'm hoping that as I continue to rest, it'll rebound more quickly. I can breathe better, and as soon as my epiglottis starts doing its thing again, I'll worry less about choking on things, which happens almost every time I put something in my damn mouth. I've sat down and gotten a shitload of work done, and while I know that mentally I'm ready to go back to work, I'm not physically ready yet. I have clients scheduled for next Friday, and I may not be physically ready by then, and I'm mentally preparing myself for that. But in the meantime, I have a bunch of things that don't require talking, and I'm staving off the boredom by doing those things. They're a bunch of tiny things that kind of always are there, and to check them off feels nice.

I’m also starting this really awesome grief class that’s running for the next few months, and it’s coming at the perfect time because I’m teaching a grief class in the fall. But, it’s causing me to examine my own, and while I’m generally pretty good at being able to recognize when it’s my grief talking, I could always be better about it. Why am I talking about this now? There’s a MOUNTAIN of grief work that I need to do around this past year or two, all around my health, that’s right in front of me and I have basically been pretending it’s not there. I am upset and very angry that I’m going through this health stuff, and I know that it’s normal to feel this way intellectually, but not acknowledging how painful this has been for me emotionally is going to keep kicking me in the pants until I address it. I’ve dipped into it a tiny bit in therapy, but it’s the softest spot I’ve had in a really long time. As in, I didn’t know I had emotional spots that soft anymore. I’ve also been trying so hard to triage and deal with this medical stuff as it comes I haven’t been able to unbury myself enough to look at the bigger picture of the grief that I’m feeling. It has affected literally every single facet of my life, and I think I’m finally at the point where I can take a good look at the mess and see where I want to start picking up the pieces. There is no grief like the failure of your own body, of that I’m intimately aware at this point. Denial has been powerful and incredibly effective for me, but I think I’m reaching the end of where it’s helpful and it’s time to address it. Now is timely as well because I only have one more medical hurdle, and so it is starting to feel like my brain finally has the capacity to do this work. Weird, I think, because what I have internalized as the scariest part hasn’t even happened yet, and I feel like I’m handling it better than any other part of these shenanigans so far.

In the meantime as I ponder that, I’ll go eat ice cream with cheese on it for breakfast. Just kidding.

Maybe.

Let's Get Weird.

I wish I didn't know this about myself, but two weeks pre-surgery, I go a little batshit, and it happened right on cue. It was almost comforting. It's endearing, I think, but it follows a pretty specific pattern: First, I start sleeping less. Then my anxiety goes up. I get a little impulsive. I have trouble focusing and remembering things. I have my own therapy sessions that I can't make it through because I literally cannot show up to do the emotional work. (That happened a couple of weeks ago and it was REALLY special. I've never had such a disaster of a therapy session ever.)

Back in March, I was working from home and so Rob was the only one who bore witness to it. It was a very interesting time. Now, I have two interns, an office manager, and a few colleagues who are going to bear witness to it. It's not so off the chain that I can't hide it, so my clients generally don't see it, or maybe they do. What the hell do I know.

What I do know is that there have been and will continue to be periods of time where I'm barely holding it together, and at the two-week mark is where that starts. I had my pre-surgery screening and asked a million questions to the nurse about food and what I'm supposed to do about it while staying overnight when I can barely eat anything at all. (I won't be hungry anyway, but it's nice to plan.) I panic shopped on Amazon and bought things that people on Reddit recommended for post-surgery. I did the same thing in March, and it legit saved me in certain ways. I asked about front-loading calcium to maybe help my parathyroid along. I wanted to ask if I really needed to spend the night if I'm going to have to go and get bloodwork every couple of days anyway and I'm allegedly going to have a drain that I'm going to have to go home with and why do I have to stay if I'm just going to have to do all the same stuff at home except in a hospital room where I'll be woken up every five seconds and can't I just come home and sleep in my own bed. (I knew the answer was going to be no, so I kept that one to myself.) 

I have so much shit to still do before Monday that it's bananas.

I'm generally able to tolerate all of this medical fuckery. The switch flipped the rest of the way on Monday, when I was a week out. Intellectually, I know that this surgery is likely going to drastically change my quality of life for the better. That doesn't change the fact that I might have paralyzed vocal cords for a little while. It also doesn't change the fact that my hormones are going to go ALL KINDS of bananas and there will be very little I can do except alternate frantic calls between my endocrinologist and my OB-GYN Oncologist so that I don't annoy the shit out of them both. They have both told me not to worry, but we all know how that advice lands with me. I've read the articles and the data. Thyroid hormones and estrogen mess with each other. There's no way around it. I just have to put my emotional helmet on and board this roller coaster that I'm about to take a ride on for several months and know that I just have to hang on tight and wait it out because every time my hormones are changed, I have to try it for 4-6 weeks before I make any other requests. Except when I was on Premarin. That one was almost an immediate difference by comparison, and so Dr. Awesome changed my estrogen prescription pretty quickly.

But I digress. Everything will be ok, and I will be through this and home resting and recovering before I even know it, and then it's on to addressing the meningioma.

Fun fact about Marvin the Maddening Meningioma (yes, I named it. Why not have a little fun?): It was found by accident. ACCIDENT. I don't know whether to be relieved that it was found in the first place or to totally and unabashedly flip my shit. The half-red-face thing? Nope. Not caused by it. The impulse control problems and the occasional aphasia and the personality changes? Yep. Do we know what's causing me to look like two-face every time I exercise? Nope. Might it be made worse or entirely go away because of the thyroid surgery? Maybe. Her theory is that it's possible that my thyroid is pressing on a nerve that's causing it. If not, I go for a chest and neck contrast CT, and we take a wait and see approach with the meningioma, which I am not at all here for, and I told her so. I go back in 3 months for another contrast MRI to see how it's behaving, and then it's likely going to be a surgical thing. Radiosurgery is not something I'm a candidate for because of the Lynch Syndrome. Regardless, I wanted a quick answer and I didn't get one, which kind of makes me want to go outside and throw a tree.

Also, if you have an MRI taken of your brain and you're tempted to look at it, REALLY check your tolerance for looking at freaky things. I mean, REALLY sit with it before you decide to take a look if you get a copy of your imaging. I did, and I didn't sit with it and just went for it, and that proved to not be the best idea. That thing is HUGE. AND, I saw an MRI image of my face, and that's just something you can't shake. I looked like a character from those books, Scary Stories to Tell in the Dark. But, for now we wait and see. Which I'm super good at and by that I mean I'd stage a sit-in at Dana Farber if it meant that I could have answers faster.

HRT Nonsense and the Rule of Three

Phew. Hormone replacement therapy is no joke. I started out on the Estradiol patch, which is the best way to get estrogen because it's bioidentical.

It turns out my body REALLY REALLY REALLY doesn't like estrogen replacement that isn't bioidentical. You see, I was on basically the lowest dose in the patch form right after my surgery, and it would work great for a few days and then just...wouldn't. I'd get hot flashes, but most of all, I'd get murdery. This would start every Friday, and then last through Sunday, and then I would change the patch on Mondays, and then the mood cycles would start all over again. I had to give it six weeks, and I gave it a bonus seventh week because I apparently can't quit my OBGYN-Oncologist.

ANYWAY. I called him and he was all, "We're going to switch your HRT to Premarin and it's a pill" to which I said to myself (and to him) that I'm terrible at taking pills and that I likely won't be able to take it consistently because of this fact, and he was all, "let's just give it a try."

Sigh. Fine.

I actually did pretty ok with it...for two weeks. Then I was pushed off of some kind of emotional cliff. I had some stressful stuff happen both professionally and medically within a couple of days of each other, and I just...suddenly could no longer handle it. Any of it. In short, I unabashedly lost my shit for about two weeks, and then I had a lightbulb moment one random Sunday. Maybe it's the estrogen. I was handling all of these transitions and this medical stuff like a champ until I VERY SUDDENLY wasn't. Something biological changed, and that was literally the only thing I could identify. I also got my first genuine migraine in two and a half months and I was PISSED about it.

So, because I apparently still can't quit my OBGYN-Oncologist, I called again a couple of weeks ago. I was all, "Please switch me back to Estradiol. I have become a murdery insane person who can't stop sweating." The nurse was all, "Are you sure it's not the hot weather?" and I was like "UM I WEAR SWEATERS WHEN IT'S 90 DEGREES OUTSIDE. It's not the hot weather." (Yes - if you saw me that day at my swanky new office, I was absolutely, without a doubt, wearing a sweater over my dress.)

I'm positive it's the placebo effect, because he both increased my dosage AND has me now change patches twice a week instead of just once. Bless this man and his very attentive ears and brain and face. I feel so good that I could kiss him on his married mouth. I'm also less overwhelmed, and I'm able to focus and I actually checked a bunch of lingering stuff off of my to-do list. It's super awesome. I'm also genuinely tired instead of hormone tired, and for once, I laughed. Like, genuinely laughed at something I found funny instead of feeling perpetually uncomfortable and omg is it going to show how awful I feel and everything sucks and I am back at pre-therapy-level Ryan with my moods and who's going to notice and UGH EVERYTHING IS TERRIBLE.

Speaking of everything being terrible, there's this thing about the rule of three that has stuck with me for a very long time. If one or two things happen, even if they're not for you, there's always a third thing. Pet loss? I hold my breath whenever two friends lose pets. Illness? Absolutely, you bet I'm stacking on the vitamins.

So OF COURSE there's a third medical thing, because of course there would be. I would never hope a medical thing on anyone else so I'm pretty happy it's happening to me instead of someone else, but still. There's a third thing.

About five years ago, I went out on a boat with some friends and got sunburned on exactly half of my face. Literally, you could draw a line down the middle of my face and the left half was sunburned and the right half was not so bad. I thought it was the direction that my face was in the sun (which makes no sense in hindsight whatsoever, because I was in the middle of a lake - so there was no way that my whole face was not toward the sun the whole day), it healed, and I moved on with my life.

Then about six months after that, I started running again and started noticing that that same half of my face would turn red! Did I get sun damage on half of my face, I wondered? I felt a little pressure on the left side of my head, but it was weird. I brought it up to my doctor and they were like, "Are you in any pain?" and when I said no but I felt a little pressure, they were like, "Then it's no big deal" and let it go. Yet it kept happening.

Then I switched PCPs, and they also dismissed it.

Then I switched PCPs to who I have now, and they are Colossally Not Dismissive, and so when I had a med check a few weeks ago (and a few days before it, I went for a run and it was worse than ever - I looked like Two Face - and so I snapped a selfie and sent it over the patient portal to them), they were like "Let's get you a brain MRI to make sure there's nothing weird going on."

Great! We can get a clean MRI back and I can move on with my life, right?

Nope.

When my doctor called me with the results, her first words were, "Before I tell you the results of your MRI, I need to tell you that 85-90% of these are benign, but even if they are, they need to be addressed."

Shit.

I have a meningioma above my left frontal lobe. From my copious amounts of digging, what I can gather is that it's caused by one of two things: Hormone imbalance or head trauma. Unless this has been growing since I was 12, the head trauma is out, which leaves hormone imbalance, which makes sense given how much better I continue to feel after the hysterectomy. Regardless, I've been trying to get in with a neurologist, which is the next step, but have struck out time and time again if I want to get in before September. So, I'm going to Massachusetts at Brigham & Women's, and I'll be able to get in hopefully in July. The next step could be one of two things: Either surgery, at which point they will break open my skull, remove it, and then stitch me back up, or radiosurgery, for which they'll use targeted radiation and both cut off the blood supply and shrink it. Surgery will leave me out of work for weeks, radiosurgery for a couple of days, so put me under that gamma knife, baby.

But for now, I wait while eating pasta salad, getting adjusted to my new office, and then getting my thyroid removed in three weeks.

But, as soon as I have a course of action, I'll know that this chapter will be closing. It has to at some point, right? (Yes. The answer is yes.)