Catching Up

Good morning and apologies for my long absence. I have more than one draft post that I started since I last posted just over a year ago. Why haven’t I managed to finish another post? Where has the time gone? And what have I been up to? Well I am still working, though no longer full time. I have been and still am traveling. I am still playing at arts and crafts as I make the time, though I haven’t made anything brilliant. So where do I start to pick up the narrative? Do I skip over the past year and pick up where things are now? Do I go back and try to fill in the blanks? Maybe a little of both?

For those of you who have been long time readers, I am so very sad to tell you that Riley passed away on January 9,2022 at The Christ Hospital in Cincinnati, Ohio. He never recovered from Guillain Barre, and was finally taken from his loved ones by another bout of sepsis. Grieving seems an ever-present part of life, especially when one comes from a big family. Yet we must not let it drag us down to the depths of despair, but rather refocus our love to move forward and honor the memories of those who have gone before us.

Today I am sitting in Portland, Oregon, mid-trip to see Crater Lake, and enjoying the hospitality of family. I feel beyond blessed. Some days I am more acutely aware of the people and things in my life that so many in this world do not have. I am humbled by gratitude that I am not the one wondering where my last meal will come from or where I might find a warm, dry place to sleep tonight.

Since my last missive I have done some traveling. I would love to go abroad again, but don’t know when that might happen. It seems more likely we will visit Canada, our neighbor the north, before venturing across the ocean again. But that is for the future. To look back at the past year a couple of trips/events stand out. In September 2021 my sisters and I met in St Louis for a long weekend. It was our 19th year to have a weekend together sans any other family members. These are always special weekends of fun and bonding. It doesn’t really matter where we go, though we do try to find different places to visit. Apparently once was not enough for St Louis, so we will convene there again this year in October.

Last October Al’s sister and her husband made the jaunt down to Texas to join us in Waxahachie for the Texas Country Reporter Festival. This is the largest one day festival in Texas, with hundreds of vendors, lots of food trucks, and free live music. There’s always been an antique car show as well the years that we have gone. I think we all had a great time.

We made a trip to Kansas City around Thanksgiving to attend the wedding of our nephew. It was a beautiful ceremony with an even more beautiful bride. We wish them many years of happiness together. Since much of my family lives in the Kansas City area, it also gave us opportunity to visit some of them and some friends. We also said goodbye to our farm in Morris County, Kansas. It was truly Al’s farm as he spent many a day there with his maternal grandmother, fishing and talking. He decided that it was time to sell. It’s kind of bittersweet. We both loved going there, but the buildings were all removed before I ever met Al so there was always the question of where we might stay and we sometimes camped out. Since the passing of Al’s Mother in 2019, we found that we had less and less reasons to actually visit that part of Kansas. It was once a dream to settle there ourselves, but that dream no longer made sense to either of us. So we miss it in a tenuous sort of way, while no longer feeling a guilty obligation to go look it over. We did dig up some lillies, finding them by memory, and were delighted when they bloomed in our Texas flower beds this spring.

Speaking of spring, we made our way back to Big Bend National Park at the beginning of March. We timed our visit for the new moon so that we could get the greatest views of the night sky. It did not disappoint. We had two opportunities with telescopes, one at a private observatory in Marathon, TX and the other at the McDonald Observatory outside of Ft Davis. We also spent a night in a clear dome outside of Terlingua. The night sky was awe inspiring as was the early morning sunrise. I did not have camera equipment with me that would allow me to capture the night sky, but I was able to capture a few sunrise photos. We not only spent time at Big Bend, but also in Alpine and in Fort Davis. We found the Fort Davis National Historic Site to be quite interesting. It was one of the posts manned by buffalo soldiers. To correct everyones misconceptions based on western movies, most of the battles fought in the desert southwest involved black soldiers, not white ones. Most of the peace keeping between the Indians and the settlers was performed by black soldiers, not white ones. Our last stop was to join an organized hike to visit the White Shaman rock art site near Seminole Canyon.

This spring also brought me back to Kansas. A memorial service was held for Riley and his grandmother, my aunt. I spent most of my time in Lawrence at my niece’s house and we went and visited cemeteries. We discovered some new stories and I was able to show her the location of at least one family cemetery that she had been unable to locate. All in all it was a wonderful visit.

Our anniversary shortly followed the trip to Kansas. We struggled with what do and finally ended up going for another wildflower trip. Because we also made a trip to Hugo, Oklahoma to visit the circus cemetery, Al gave it the moniker of our Tombs and Blooms anniversary.

We hit the road again in June, this time on the Harley. We rode to Charlotte, North Carolina, to visit daughter #1 and her family. The rides we did in the Smokey Mountains were spectacular and I’d gladly repeat them. We had a small clutch problem develop on our way to North Carolina, but a stop at Moonshine Harley Davidson in Franklin, TN, had us on our way again in about 2 hours. We could not have asked for a better experience. We celebrated Al’s birthday in Asheville, North Carolina with a wonderful dinner at Ruth’s Chris Steakhouse. We also visited the Biltmore Mansion while in Asheville. In Charlotte we visited family and found a wonderful French bakery called Amelie’s. They comped our treats for who knows what reason. They were wonderful at any price. We also found the McGill Rose Garden, a work of beauty to be sure. Motorcycle wise, the highlights included the Lake Lure area, including the stretch of road nick named the sidewinder, and the infamous Tail of the Dragon, which we rode in a loop with the Cherohala Skyway. On that final stretch we were cocky enough to not put on our rain suits, despite some ominous looking clouds, and we got soaked before we found a spot to pull over and put them on simply for warmth.

While I started this over 2 weeks ago while in Oregon, i am finally finishing it in my kitchen back in Texas. I’m going to end it here and get to work on writing about our most recent adventure before it too becomes really old news.

Waffles and Wildflowers

As i start this post I am just shy of my 65th birthday. If you are seeing this post, then I have passed that milestone. Al & I have been known to create a theme for a trip, hence the waffles and wildflowers. Not a bad way to mark having reached the arbitrary age when the government says I can go on Medicare. For the most part, I will leave that to be the subject of another post, but choosing Medicare will give me the freedom to have more control over my work life as it will give me the power of “No”. For the next few months, however, my work status will stay the same.

This was a relatively short trip and did not take us all that far from home. We ventured south to Texas hill country, spending time in the Austin area before heading over to Fredricksburg and then back home. As I contemplate having more time at home in the coming year, my interest in gardening is rekindled. I have been spending time cleaning up problem areas and studying ways to improve some of our landscaping using more native plants and perennials, as well as incorporating the cottage garden approach of including edibles and herbs amongst the other plantings. The reason for visiting Austin stemmed from my desire to finally visit the Lady Bird Johnson Wildflower Center. I have long wanted to visit, but we have never managed to fit it into any of our past trips to Austin, so it was one of the primary focuses of this trip. Austin is also a great foodie destination, so we knew we’d have no problems finding interesting and tasty food. In addition to eating and spent some time hiking at McKinney Falls State Park, visiting both the upper and lower falls. A side trip including a drive along part of the Texas’ devil’s backbone with stops in San Marcos, Wimberly, Dripping Springs, and Bee Cave before looping back to Austin took up the rest of our time in the Austin area.

Fredricksburg was our last planned destination before heading back home. It is the closest town to Wildseed Farms, a place we have visited before and one that I very much wanted to visit again. Wildseed Farms is great place to visit if one is looking for Texas wildflower seeds and garden accessories. They have interesting things in the gift shop and also have a winery, so it can be fun to visit even if you’re not into buying garden stuff.

We started our little adventure with a breakfast stop in McKinney for our first waffles. Neither of us had ever been to Bill Smith’s Cafe, a second generation eatery established the same year I was born. So it seemed like the right call and neither the food nor the atmosphere disappointed. It is an old fashioned family owned cafe with plenty of regulars, but great service even if you’re a newcomer. The waffles were tasty, as was the side of bacon, so we were off to a good start. Like every other waffle we tried this past week, it had a unique, but delicious, flavor.

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We stopped in Waco for a little exercise break and took a long walk on the river walk. It’s a beautiful area and everyone is so friendly. Almost every person we encountered greeted us and it provided a nice break in our drive south.

Our first activity in Austin was a visit to the Lady Bird Johnson Wildflower Center. The late Lady Bird Johnson was a great lover of wildflowers and donated the land to the University of Texas to establish the center. It is a combination of arboretum, wildflower gardens, and research station. If one is lingering long enough there is a cafeteria where lunch can be obtained. While spring is really the most glorious season for wildflowers, there are still plenty to enjoy this time of year. The center is divided in sections based on the plantings. There is a pollinator garden, mostly for bees, a butterfly garden, a family garden, complete with a playground, and a prairie garden. There are plenty of woodland areas, some with little streams, to complement the more open areas. All of the plants presented are native to Texas. My favorite wildflower name was yellow sneezeweed, a pretty little flower. I loved all of the butterflies flitting around the garden and we found a couple of other critters as well.

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Before heading out to the Wildflower Center, we had breakfast at the hotel. We were overly optimistic about what they might be offering. It is one of the uncertainties of travel these days as some hotels are almost back to “normal” with their breakfast fare and others are pretty iffy in their offerings. Our hotel was at the latter end of that spectrum. We tried their little packaged, previously frozen, microwaveable excuse for waffles simply as a matter of keeping with the theme. But, waffle is open to interpretation, so the best waffle of the day was at lunch. We ate at Waterloo Ice House and the sweet potato waffle fries, like the burger, were most excellent. 🙂

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We spent a few hours exploring McKinney Falls State Park later in the afternoon. Unfortunately, or perhaps fortunately, this time of year is typically pretty dry so the falls were barely a trickle. A small stream of water ran through the rocks and over the edge of both the upper and the lower falls. But the hiking trails were still fun, despite the heat, and just being outside can be interesting. The park is named after the person who had originally settled the land and there are remnants of some of the old buildings in the park. One of the trees along the creek, nicknamed Old Baldy, is a 500+ year old bald cypress. It was a very impressive specimen. In general, the cypress trees that grow in the park have some very interesting root systems, undoubtedly necessary to support their massive size in the very rocky soil. We also came upon a little lizard that was willing to pose for a portrait.

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Our third day of waffles was from 24 Diner. Their waffles are very yeasty and hearty. I have never cared for chicken and waffles, but I think the waffles at 24 Diner would be the perfect waffle for this popular dish. They do serve it, but we just had the waffle breakfast. The photo is deceiving as it looks like half a waffle, but it is in fact two halves stacked one upon the other. There was an interesting old truck in the parking lot when we left. I loved the bumper sticker on the back. You just have to celebrate the junkyard survivors.

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We spent most of the day roaming the area around Austin. We made stops in San Marcos, county seat of Hays County. As historic Texas courthouses go, their courthouse is kind of bland, but still worthy of a photograph. Next stop was in Wimberly, a shopping mecca, perfect for a weekend of shopping and exploring wineries. We toured a couple of galleries and paused in the shade long enough for Al to pose for a photo. Next was lunch in Dripping Springs before a stop in Bee Cave to visit their sculptures garden. It was a surprising little find in a city of less than 10,000. My favorite exhibit was a mosaic frog, because it has hidden icons among the tiles. If you enlarge the photo below you can find several, including a Texas shaped tile, a heart, a star, and a flower, to name a few. It made for a fun little game of “I spy” as Al and I searched the entire sculpture to see how many we could find.

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On my actual birthday we headed to Fredericksburg. I must confess that I had by this time had my fill of waffles, so had breakfast tacos instead. Al, in keeping with the theme, had yet another waffle. I did have a taste of it, and, as with the others, it had it’s own distinct flavor profile. We made our first stop at Wildseed Farms, the location of the photo at the top of this post. After wandering through the walking paths and looking over all of the plants available for sale, we made our way into the gift shop. I bought a new birdbath and several packets of wildflower seeds. I’m hoping for a productive gardening season in the coming year. Of course time will tell if I live up to that idea. The Gillespie County courthouses, the “new” one built in the 1930s, and the original one, completed in 1882, warranted a couple of photos before we found a cafe for lunch. After lunch in town we had time to kill before we could check into our hotel, so we made a little side trip to Kerrville to visit the Museum of Western Art. It was time well spent. While it is not a huge museum, their collection is top notch and varied. I would encourage anyone who makes their way to this area to take the time to stop and visit the museum. Then it was on to our hotel, the Hangar Hotel, located at the airport. Built to look like an airplane hangar, and furnished to create a step back to the 1940s and the era of WWII. We have stayed here before and totally enjoyed it. We happened to be there the same time as the International Bird Dog Association, so there was quite a collection of Cessna L-19/O-1 aircraft. We had a long, enjoyable visit with another traveling couple, who, like us, also just happened to be there.

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Having accomplished our mission of eating too many waffles and looking at and buying things related to wildflowers, we headed home the next day, settling on granola bars for breakfast instead of more waffles. We decided to take the scenic route home in lieu of heading back to the interstate and going through Dallas. This gave us the opportunity to travel through Strawn, Texas. The point of that was to stop at Mary’s Cafe and try the chicken fried steak. Pretty much every TV show that talks about places to eat in Texas has had an episode on Mary’s Cafe. In a recent viewer vote on Texas Country Reporter, Mary’s was named as the best chicken fried steak in Texas. So, we HAD to try it. It did not disappoint. It is more like the chicken fry that my Mom made than what is typically found in Texas. The accompanying mashed potatoes were delicious and the gravy was excellent. I would definitely go back if I were in the area again.

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This gave us a few days at home before I have to head back to work in the morning. It will be a short week for me as I will be headed to St Louis to spend a long weekend with my sisters in the coming week/weekend. I’m very much looking forward to our time together. In the meantime, I hope everyone has a great week ahead.

A CDC Anniversary

In mid-April, my husband, Al, and I celebrated our 35th wedding anniversary. Al likes to create themes and give names to some our anniversary trips. He has become especially fond of doing so since our Ghost and Barbecue anniversary a few years ago. (If you’re interested, you can read about that here: Part 1 and Part 2) Because of Covid, he worked to come up with a theme that he could somehow relate back to the pandemic. He settled on crystal, drawing, and custard giving birth to the CDC Anniversary title.

The crystal Swarovski frog prince pictured above was the first part. Like a lot of things we do, there is a story behind the frog. When we were in Hawaii, nearly 15 years ago, we visited a shop that had enameled frogs made by the “frogman”, Tim Cotterill. I thought they were cool, so Al managed to buy one without my knowledge and later presented it to me as a gift. Then the frogs became a bit of a thing. It seemed like everyplace we went we found a frog. So we have frogs created in multiple media including metal, wire, ceramic, tile, and wood. One of the few places we’ve traveled where a frog didn’t find us was Iceland. And I mean that they find us. We do not look for frogs, they just happen to appear in some art gallery or souvenir shop that we are in. It’s not a huge collection, but, without counting, because I’m sitting in a hotel room and not at home, I think we are close to twenty frogs. Long story short, a crystal frog is a perfect anniversary gift that evokes special meaning because of the souvenirs from our travels. So the crystal frog prince is now enjoying a place of honor on the top of my desk shelf, along with all of the other frogs that have come into our lives and a few other assorted critters and knick knacks.

The D or drawing is a bit of a misnomer, though I think one could reasonably argue that we did draw. What it represents is a pastel workshop that we attended in Springfield, MO, taught by the very talented Audrey Bottrell Parks. It was an awesome workshop designed to introduce us all to pastels. We did a series of pears, each on a different kind of paper and using different techniques and varieties of pastels. Both Al and I enjoyed it tremendously and we finally found something that involved the use of color that didn’t make Al’s brain hurt. However, Al did get tired of the pears and ventured out with a landscape. Below you can see two of my pear samples and one of Al’s pears as well as his landscape.

The final C is for custard. We were first introduced to frozen custard years ago when my sister took us to an Andy’s Frozen Custard stand in Springfield, Missouri. Andy’s Frozen Custard was founded in Osage Beach, Missouri in 1986. We only discovered it after my sister and brother-in-law moved to the Springfield area, which may be a good thing because I think I gain a pound every time I go there. Andy’s has since spread through franchising to 14 states, including Texas, so we do occasionally treat ourselves by going to one of their stores in the Frisco area. It is easily the best frozen custard we have ever eaten so we always consider it a real treat when we get to partake of one of their concretes. Al took full advantage of the custard part of the anniversary trip to make stops at more than one of the several Springfield locations. It is no wonder that I returned home a couple of pounds heavier than I left.

Wishing everyone a wonderful week to come.

Overcoming inertia

One of my worst bad habits is procrastination.  At least that is my version of things.  My husband, family members, or close friends might have a different one. Yet my procrastination has been for a reason (isn’t it always?) this time.  I have spent several months working through deep grief.  Inertia is defined as a tendency to do nothing or remain unchanged; that a body at rest will stay at rest and a body in motion will stay in motion.  Beyond procrastination, I am overcoming my emotional paralysis from grief and working to re-energize myself with projects again.

My friend, Ava, died on Thanksgiving day.  In December my brother-in-law, Roland, and my sister, Brenda, were diagnosed with Covid.  Roland was hospitalized, released, then his symptoms grew severe again and he spent the final few weeks of his life mostly in ICU before losing the battle late mid-January.  My grief was overpowering for awhile, but I finally came to terms with these losses.  Neither would have wanted me to stay in the depths of grief, but it was a necessary part of my grieving process for both of them.  They were both wonderful human beings and gentle souls.  In my eyes both of them made the world a better place for having graced us with their presence.  They shall forever hold places in my heart.  I have written about Roland before, he was truly one of my heroes and taught me how to accept the worst of news with grace.  If you are interested you can read that post here.

Having emerged from grief to re-engage fully with the world again, there is also good news to report.  Anyone who has read this blog with any regularity will be familiar with my cousin, Riley.  He has continuously been in a hospital or rehab facility since his diagnosis of Guillain-Barré.  Most recently he has show very promising progress.  He is moving parts of his body that he had not been able to move for many, many months; he has been weaned from the ventilator; and perhaps most importantly, he has regained his voice.  His family may or may not agree that this is the most important thing he has gained, but for me that ability to communicate for oneself it exceedingly important.

Al and I have both been vaccinated against Covid, a step that we hope will help lead to more normalcy.  It certainly gives us some degree of relief that should either of us contract Covid that it would most likely be a mild case.  If for no other reason, I would have gotten vaccinated for Roland and the more than 550,000  other people who have died from Covid in this country. 

My spirits have been lightened most recently by all of the overt signs of spring; longer daylight hours, the many things in bloom, and leafing out of trees.  Everything here is so green of late.  It all makes my heart happy, especially the flowers.

I cannot promise that I will go back to posting on a regular basis, but I can say that I have missed the exercise. I deliberately chose not to subject the reader to my lows based in grief, but I do have some exciting projects ongoing. Al and I will be attending a pastel workshop in Springfield, Missouri being taught by Audrey Bottrell-Parks . We have taken lessons and attended workshops with her before and have always found her to be an excellent teacher as well as a phenomenal artist. I am most excited to learn how to work in this new medium as well as getting to see Audrey again. She is also one of the nicest people one could hope to meet.

On my own I have a multi-media project in the works and a couple of stained glass projects. I enjoyed my extended time off after my last surgery and I am still having to adjust to life on the road again. I never seem to have enough time to make much progress. By the time I go to the gym, do my laundry, help with the yard work, and complete more immediate projects, it often seems there is little to no time left for the things I simply want to do. Work has been a real energy and time suck lately as we convert to a new electronic medical record system. I’m starting to feel used and abused by it, but remind myself that this is a temporary situation and my time commitment is way less than that of some others.

Here’s hoping that you have had a happy and healthy Easter weekend, regardless of whether you are Christian or if you celebrate the occasion. May we all have a better 2021.

The Saga Continues

I find myself a jumble of emotions this evening. I suppose my overriding emotion is that I am so over 2020 and beyond ready to move on to a hopefully better year. Not that 2020 itself is to blame, but it seems that pretty much everything 2020 has been less than wonderful. So what makes this week or or this day any different?!

Today I am coming to grips with loss as well as celebrating victories. The two are unrelated, but seldom do highs and lows happen in tandem as they seem to be right now. I’m not even sure where to start in terms of writing this post. Good news or bad? By subject/person? I suppose I shall just dive in and let this post write itself. I apologize in advance if it turns out to be a jumbled mess.

I had surgery again on Thursday, my second in six months. Hopefully this will be the last procedure that I need for a very long time, if not forever. I believe that I have previously written about the problem, that I had developed a seroma that didn’t seem to want to resolve, coupled with a decidedly undesirable cosmetic outcome from my explant surgery. I contemplated posting photos, but decided against it. It appears that Thursday’s revision has at the least left me with a more desirable appearance and, at least for the time being, has left my right side more comfortable. I do have a drain in place and it is still quite productive with what appears to be fresh blood. Whether or not this is an issue I suppose I will learn on my follow up visit on the 21st. It does not take very much blood to give drainage the appearance of real blood loss. I am guessing this is the case here. I took my first real shower this morning and it felt wonderful. I am most hopeful that this woeful tale is almost at an end.

I will note that I am saddened by the loss of yet another woman with breast cancer that I knew. This makes three in the last few months. It makes me at once sad and angry. Sad for the loss of another beautiful life, and angry at the very existence of cancer. Interestingly, or maybe not, I never ask “why me”, but there are definitely times I ask “why her?” I do not pretend to understand, only to accept that which I cannot change, while praying that with time there will be an end to the many diseases we refer to under the umbrella name of cancer.

My emotions then shift to excitement as I learn that my cousin, Riley, is starting to show some improvement. This week brings small but meaningful physical movement. It is cause for continued prayer as well as rejoicing. I ask for ongoing prayers, positive thoughts, and meditations on healing to be directed towards Riley. He still has so far to go.

And finally, tonight, I have been releasing the tears at the news that my friend, Ava, is losing her battle with colon cancer. Her husband informs me that she is now on hospice and that her hospice nurses have said she is likely to slip the bonds of earthly life in the next 1-2 days. I still have so much to say to her, but most importantly, she has so much more to offer the world. A friend asked me to describe Ava and here is what I told him. She has a truly gentle spirit and is one of those people who finds it hard to speak ill of another, while still managing to be honest. A person of incredible integrity and a brilliant clinical mind. I very much loved her as a human being. I pray that she has a peaceful passing and send healing energy to all who love her that they might come to terms with her loss. Perhaps I should ask for the same as I am not currently dealing so well with the idea. Maybe this one is too close to home? Regardless, my loss is minuscule compare to that of her family. I thank her husband for letting me know now that Ava is no longer able to communicate for herself.

This has also been a week of sharing. I managed to finally make the time to send out some of my grandmother’s things to extended family members. It brings me joy to be able to share the physical momentos of her life with family members who find them meaningful.

This week is nearly done and perhaps the coming week will have a more welcome offering. I wish you all a wonderful Thanksgiving week. Despite the sadness I am experiencing this evening, I still find much in the world to be thankful for. I hope that you do as well.

Travels and Travails

It’s been a month. In many ways fitting of 2020 and all of the challenges the year has wrought. With my last post I left you with my cousin, Riley, still in the ICU. Riley has since transferred to an inpatient rehab facility where he continues to get intensive therapy. He is not yet able to fully breathe on his own. He is regaining some nerve function, but along with that comes significant pain. He still has a very long way to go, but a near total recovery is still considered a possibility. Please continue to pray for/send healing thoughts to Riley.

For my birthday, Al decided to humor me with a hiking adventure. He reserved a campsite for two nights at Caprock Canyon State Park. While the park is beautiful in it’s desert way, I could not help but come away feeling disappointed. We lived in Amarillo, Texas for several years and during that time I hiked frequently in Palo Duro Canyon State Park. Caprock seemed a bit like the slighted stepsister. The trail maps were not great, which is no surprise as most free maps provided by the parks are not. This was compounded by a dearth of signage. There was evidence of old trail markings in the form of 4x4s with empty bolts, and even a couple of posts that still had the metal sign holders, but not a single sign. We had an end point in mind, but, between the lack of signage and the poor maps, we were unable to locate it. The trail was also pretty poorly maintained and there were times we were unsure if we were on a hiking trail or a game trail. So, we enjoyed some scenic views, but after Palo Duro and, most assuredly after having visited Arches, Caprock Canyon was pretty much meh. It did not help that Al fell and cut his knee on the way back down the trail or that the shower house was three miles from our assigned campsite. After 5 1/2 hours of hiking in the heat a shower would have been wonderful, but as we had a rooftop tent and it was already getting dark, we opted to set up camp over getting a shower. We sponged ourselves off in the vestibule of the tent, but it was a poor substitute for the shower. I don’t think I have ever seen Al as exhausted as he was that evening. As much as we wanted to like the rooftop tent, this experience proved that it simply did not fit in with our camping style. The second day, as we had to put the tent away in order to use the vehicle, we chose to do some driving to view the rest of the park and then to head home instead of setting up camp again.

Al on the trail

I would be amiss not to mention that Caprock Canyon is the home of the official Texas bison herd. Unlike the times I have been in Yellowstone, I did not see any misguided individuals attempting to make friends with the members of the herd. They are pretty magnificent animals and it was one of the highlights of our trip. The calves are particularly cute!

Part of the herd

In some respects, the drive to the park was itself a highlight. We went through Turkey, Texas, home of the late Bob Wills. It certainly appears it could be a happening place on an event weekend. It was also awesome to see how much they embraced this native son.

Once we had left Turkey the countryside got kind of lonely. We passed a number of abandoned homesteads, some looking like the grounds were still kept up. I cannot help but wonder about these places. Who lived there? What brought them to this place? Why did they leave? Is it a case of broken dreams or moving on to bigger and better things?

Abandoned homestead

The drive back we took a slightly different route and came across an unusual sight. While it’s not all that uncommon in Texas to find fence posts capped with boots, it is unusual to find fences lined with bicycles. I had to get out and take a photo.

Bicycles and boots

This has pretty much been the extent of our travels of late. We have some possible day trips in mind, but have not yet made them happen.

At the end of September, I finally got to have a long awaited appointment with a new plastic surgeon. My fear that the very hardened right breast area was scar tissue gone wild ended up being an accumulation of fluid, or seroma. He immediately suspected that and, with my permission, proceeded to drain it, pulling about 200 ml of fluid out. Ten days later, as the fluid was again accumulating, I had a drain put in and another 120 ml of fluid was gone almost immediately. The drain is still in place and is becoming uncomfortable and possibly a problem.

This weekend I awoke around 4 in the morning shivering with the chills. We had eaten out the night before and gone to a play, which we had left at intermission because I was not feeling great. Once I got up for real I called the clinic where my primary care doctor works, as they have a weekend urgent care clinic. I had a telemedicine visit with the covering doctor and he ordered antibiotics in case the drain had become a source of infection, as well as the possibility of a diverticulitis flair since I was having some abdominal discomfort. Also, as a preponderance of caution, he ordered a COVID test. So, I am on home quarantine until the test results come back. This is not really a problem as I have continued to have a fever, though it has gone from a high of 103 on Saturday, to a mere 100.2 this morning. Acetaminophen (paracetamol) is my friend. I’m glad to report that my energy level is returning and I have actually been up all day today. Maybe tomorrow will be the day when I don’t have a fever at all? I should also hear back from the plastic surgeon tomorrow regarding the drain and maybe it will be coming out this week or next. I know I’m ready to be done with it.

Here’s hoping that you are all having a great month. Until next time.

Please Pray for Riley

Tomorrow I officially turn 64. I have incredible gratitude for my health and all of the things that make up my life. Many are less fortunate at the moment and are struggling to say the least. One young man in particular has my attention.

I have received much praise for my writing abilities through the years, but today I find that I am at a general loss for words. I wish that I had something clever to say that would move people to take action. I’m afraid that I do not. I can only make an appeal from the heart. If you believe in God, Allah, Yaweh, Jesus, mother earth, the power of positive energy, any other greater being or energy, please pray for/meditate about/ send positive energy to Riley.

Riley is my cousin, an awesome young man of 27. He has had some unfortunate circumstances these past few months. Please pray for Riley.

Riley has been diagnosed with Guillain-Barré syndrome. He has been in the hospital for more than two months now. He was recently transferred to the Cleveland Clinic in hopes that more specialized care would improve his outcome. Please pray for Riley.

I very much believe in the healing power of prayer and positive energy. I don’t talk a lot about religion as a matter of course, but Riley needs all the help he can get right now. Please pray for Riley.

Obviously, with such a long hospital stay, most of it in ICU, and so far from his parents home, financial strain is an issue for the family as well. If I had a way to request funds on his behalf electronically I would do so. But that is not consistent with the family’s wishes. That said, if you should have the means and desire to make a donation, it would be most meaningful. For anyone who feels the need to somehow commemorate my birthday, a gift on his behalf would be my request. Donations are being accepted at the Osawatomie First United Methodist Church, 504 Pacific Avenue, Osawatomie, Kansas 66064. If making a donation on Riley’s behalf, please indicate that on your check. But most of all, please pray for Riley.

Riley

The Downside of Implants

As a follow-up to my last post, this is the promised more in-depth discussion of the possible risks associated with breast implants.   If you want to read the earlier half of this discussion, you can find it here. My apologies for (as usual) taking way longer than expected to post again.

As a reminder, I recently had explant surgery because my implants were causing significant pain. My decision was to simply go flat. My plastic surgeon was so averse to the idea that he talked me into using local fat to create a bit of a breast. His preference would have been for me to have DIEP flap surgery, but I was simply not willing to put myself through an 8 hour surgery and the degree of debility commonly experienced for the first several months following surgery. I can’t say that I am either satisfied or dissatisfied with the cosmetic results, but I am ecstatic that I am not only out of pain, but have greater feelings of well being to boot. If you’ve followed this blog you might recall that my implants were of the textured variety that have been recalled. I would not have put myself through explant surgery simply because of this. I realize that this is scary to many women, simply because of the mention of the risk of another cancer. To put it in perspective though, the odds of developing breast implant related lymphoma (worse case scenario 1:1,000) is less than being hit by a car while walking (1:556) and the risk is definitely less than the risks associated with surgery. I would have been mindful, but not pursuing surgery, if my pain level had not continued to increase with time.

Before looking at the risk of breast implants, here’s a reminder of the most common risks associated with breast implants. They include the following:

• the risk associated with having any surgery
• potential that additional surgeries will be required
• breast implant associated lymphoma (anaplastic large cell lymphoma or ALCL, also referred to as BIA-ALCL)
• breast implant illness, which is not a recognized diagnosis but something that there is growing concern over; symptoms are frequently similar to those of immune disorders
• compression of the implant by scar tissue, causing hardness and/or pain, this is called capsular contracture
• breast pain
• implant rupture or deflation; or micro leakage
• infection
• interference with mammograms

Only about 20% of the women choosing to have implants are doing so as a result of a breast cancer diagnosis or increased genetic risk of developing breast cancer.  These are the people most likely to read this blog, so the audience that I particularly care about, both as a clinician and as a fellow breast cancer survivor.  Let us take a at least a brief look at each of the risks noted.

Risk of surgery

In addition to the potential risks associated with implants, there exists the risks inherent in any surgery.  Anesthesia always poses a risk, which can be greater for some women than for others; notably the older we get the more likely we are to have adverse effects from anesthesia and the longer they are likely to last. It’s important to note that anyone with diabetes, hypertension (high blood pressure), heart disease, or kidney problems are more likely to experience issues than other folks. The most common risks associated with general anesthesia are temporary confusion, memory loss, dizziness, difficulty passing urine, local pain and bruising from the IV site, nausea and/or vomiting, shivering and feeling cold, and a sore throat from the breathing tube.  Other surgical risks include infection, hematoma (blood collecting around an implant), and necrosis (skin death).  Any of the latter surgical issues could result in the need for additional surgery.

Additional surgeries

There are several reasons for possibly requiring additional surgery after having breast implants placed.  These can range from cosmetic problems, such not being satisfied with the appearance and thus having a modification procedure, to serious complications as noted above.  Multiple surgeries can compound the effects noted from general anesthesia. In addition the more down time one has the longer it will take to return to normal activities and the more loss of muscle tone is possible.

Breast Implant Associated Lymphoma (BIA-ALCL)

The causative factors leading to the development of BIA-ALCL are not well understood yet. However, there appears to be a much stronger link to textured implants, which are the type that historically have been most commonly used in women seeking breast reconstruction after mastectomy. Is is unclear if this is a cause and effect situation, only that there is some association. Since the overwhelming majority of women with these implants do NOT develop BIA-ALCL, there are likely other contributing factors, some of which are related to implants in general. The most likely potential reason for some women to develop BIA-ALCL with breast implants is the implant promoting T-cell infiltration and an immune response, resulting in chronic local inflammation. It is likely that other factors also contribute, including bacterial biofilm on the surface of the implant, patient genetics, and a given individual’s immune response. There are some recent studies that suggest that certain genetic mutations increase the potential for a woman to develop BIA-ALCL. If one wants to read a discussion of this I refer you to the recent (2020) article “Breast implant-associated anapestic large cell lymphoma: A comprehensive review”, in Cancer Treatment Reviews by Antioni Marra, Giulia Viale, Stefano Pileri, and colleagues.

So what are the signs or symptoms that one is most likely to experience if BIA-ALCL is suspected? As many as 80% of women with BIA-ALCL experience a persistent seroma, generally accompanied by breast swelling, notable asymmetry, or pain. This is a significant, but rare (0.05 – 0.1%), occurrence if it happens a year or more after the implants have been inserted. That said, more common causes of these symptoms include trauma and infections. Only 10-20% of patients with these symptoms will end up being diagnosed with BIA-ALCL. (Note this equates to 0.01-0.02% of all women who have textured implants.) Nonetheless, women with breast implants who develop a delayed serum or breast swelling should undergo immediate evaluation. Ultrasound breast imaging is usually the first step and may be followed by a breast MRI if a mass is found. Aspiration of fluid from the seroma or biopsy would be considered mandatory if BIA-ALCL is suspected. Usually a good amount of fluid (50ml, or in household terms nearly 1/4 cup) is required by the pathologist. If BIA-ALCL is confirmed, then further lymphoma workup is recommended to stage the disease. This may involve a PET scan. Bone marrow biopsies are generally not required and are usually reserved for those patients who are suspected to have bone marrow involvement or who have persistent and unexplained abnormalities in their blood work.

For the vast majority of BIA-ALCL patients ( > 80%), explantation surgery is all that is required. Chemotherapy is only recommended for patients with more extensive disease.

One of the statistics that is most disturbing, however, is that more than 75% of surgeons never communicate anything regarding the possibility of BIA-ALCL to patients prior to implant surgery. Granted the risk is very small, but women with breast cancer deserve an honest and candid discussion about all of the possible risks when considering the alternatives available for reconstruction (if desired) after a mastectomy.

Breast Implant Illness

Breast implant illness (BII) is not a recognized diagnosis. This despite a link between breast implants and systemic disease having been reported since the 1960s. Historically the plastic surgery community has generally disregarded the likelihood of BII being real and as late as April of this year (2020) one can find publications in Plastic and Reconstructive Surgery, the official publication of the American Society of Plastic Surgeons, suggesting that a significant number of complaints associated with breast implants seem to be linked to the suggestions of problems by social influencers on social media channels. Another reason for discounting the idea of BII is that only a small percentage of patients actually meet the criteria to be diagnosed by a doctor as having an autoimmune disease. Symptoms that are self-reported don’t “count”. This causes me to recall that physicians are notorious for under recognizing patient’s symptoms. In the final analysis, to me at least, this smacks of “it’s all in her head”. I don’t know about the readers of this blog, but for me it has at times seemed an uphill battle to get a doctor to take any complaint that I might have seriously. There seems to be an inherent bias, particularly among older male physicians that women are not really aware of what is going on in their bodies. This is, of course, only my opinion.

Back to the topic at hand; what exactly is BII? That is the crux of the issue. BII presents in different ways in different individuals. Many of the symptoms may be suggestive of autoimmune or connective tissue disorders (rheumatoid arthritis, lupus, scleroderma, Sjögren syndrome, sarcoidosis, etc), but the majority of women who develop these symptoms after having breast implants do not meet the criteria to be actually diagnosed with an autoimmune or connective tissue disorder. Some authors then conclude that there is no cause and effect because there is no definitive diagnosis. I fall in the camp of those who believe that it does not require definitive diagnosis of such a disease for the symptoms to be caused by breast implants. There is a growing body of work, at least some of it driven by patients (some of whom are social influencers), that suggest this is indeed the case. Following is a list of the most common symptoms that women who would self-identify as having BII might list:

• Joint and muscle pain
• Chronic fatigue
• Memory and concentration problems
• Breathing problems
• Sleep disturbances
• Rashes and skin problems
• Dry mouth and dry eyes
• Anxiety
• Depression
• Headaches
• Hair loss
• Gastrointestinal problems

My personal experience involved more pain than anything, but I did have other issues. I developed significant new allergies that have been linked to silicone breast implants, all related to the product thiuram, used in the manufacturing process of many things including elastics, rubber products, latex, many pesticides and herbicides, and adhesives including those used in adhesive bandages. For example, I spent in a day in the ER with my blood pressure near stroke range only to find later that my blood pressure elevation was an inflammatory response to the elastic in my compression socks. Now that it has been nearly six weeks since my implants were removed I can say that I had no idea how crappy I was feeling. I am ecstatic that the pain in my chest is gone, but beyond that I am sleeping much better, so feel more rested and have notably more energy. In short I would say that I feel like a new woman. I’ve got my mojo back.

The growing consensus, doubters aside, is that the symptoms women experience are real, regardless of whether or not they meet the criteria for diagnosis of a disease, but there is still no consensus regarding whether or not BII should be adopted as a diagnosis. I would guess that it will be eventually. In the meantime, if you have developed any of the listed symptoms since receiving breast implants, know that you are not alone.

Capsular Contracture

The main symptoms of this are pain and asymmetry. Capsular contracture will generally pull the affected implant upward and the compression caused by the contracture will usually make the affected implant firmer and smaller in appearance as well.

Breast pain

Implants can become painful even without capsular contracture. This may or may not be related to other problems, but is at least suggestive of an underlying inflammatory response.

Implant Rupture or Deflation

Implants do not last forever. This is something that all patients should be aware of before receiving an implant. On average, implants need to be replaced after 10-12 years. Some individuals have had the same implant for a much longer period of time, but other women have experienced implant rupture in less time. Deflation is not something that happens with silicone gel implants, the ones most commonly used in women who have had a mastectomy, but rather when a saline implant ruptures. Non-gel type silicone implants can develop micro leakage and this can cause significant inflammatory problems or can be completely undetectable.

Infection

Infection is always a surgical risk. It appears to be a bigger risk with textured implants because the rough surface is more susceptible to bacterial colonization than the surface of a smooth implant. That said, the literature suggests that this is a problem that is more related to the technique and expertise of the surgeon than it is to the implant itself. Infection may be adequately addressed by oral or intravenous antibiotics, or may require further surgery to drain the site of infection or to remove the affected implant(s).

Interference with mammogram

I find this one to be a bit odd. My experience is that in the United States we do not usually do mammograms on women who have implants. Instead we use ultrasound. This is to avoid the potential for the mammography machine to rupture the implant. In studies that involve performing mammography on individuals with breast implants, it has been shown to notably interfere with the ability to detect early cancers.

I hope that the reader has garnered something from this rather lengthy post. Perhaps it has given you something different to ponder during this time COVID-19 and the social isolation that has become the new normal in our lives. Hoping everyone manages to stay healthy. Here in Texas we have been setting unenviable records, so Al and I are doing our best to stay safe.

Better Living Through Surgery

I have previously written about my plan to have my breast implants removed.  Before I discuss this decision and the results, let me give a bit of background to those who have not followed this blog from the beginning.   In January of 2015, I was diagnosed with breast cancer, found on a routine mammogram.  For those who haven’t read about it but wish to learn the details of treatment, I refer you to the beginning of the blog and urge you to read forward from there.  About six months after I had completed chemotherapy and radiation, I had breast reconstruction surgery, which I first talked about here.  Within the first year it became clear that I would have  no symmetry as the side with radiation suffered greater scarring, so was smaller and firmer than the opposite side.  In the past year, maybe year and a half, the area around both implants began to be painful.  At first it was just discomfort, then one day last fall, after I had broken my ankle, I realized that my chest hurt worse than my ankle.  This is definitely not the norm.  After several visits to the plastic surgeon to discuss this, we set a surgery date that would not interfere with vacation plans that we had made a year in advance.  Like many people’s plans, the novel Corona virus epidemic put everything, including explant surgery, on hold.  Once the restrictions were eased and I was able to schedule, I took the first available date.  My explant surgery was on Friday, May 8th.

In deciding to remove the implants, it was my greatest hope that my pain would be relieved, or at least reduced.  My level of discomfort had increased to the point that most nights I had to take something to take the edge off of the discomfort if I hoped to get any sleep.  Wearing a seatbelt across my chest was so uncomfortable that I had developed a habit of using one hand to help hold the strap off of my chest because despite having an adjustable cushion on the seatbelt I couldn’t adjust it enough to be comfortable for more than a few minutes.  Never in my wildest dreams did I actually believe that getting the implants would make such a huge difference in my feelings of overall well being.  As a point of reference, I felt better after surgery than before.  As in immediately.  The discomfort after surgery was less than the discomfort before surgery.   With each passing day I noticed positive change.  And I slept, a lot, for the first week afterwards.  So, how do I feel better?  I have no pain to speak of.  Even my normal body aches and pains have pretty much evaporated.  I don’t have joint pain any more.  I’m not tired any more.  I feel more joy than before.  I have been noting to those who ask that I feel like a new woman.  With any luck, this will be my new normal.  One can certainly hope so.  Is this change in how I feel due to removal of the implants per se, or is it simply a result of not being in constant discomfort?  Does it matter?  Either way I have a greater sense of positive physical wellbeing.

I have been asked if I regret having had breast implants and to that I say “no.”  The why of that answer is that I gave up thinking in terms of “would have”, “could have”, and “should have” years ago.  I cannot change the past and I have to honor that I made what I thought was the best decision for me at the time.  I did not easily arrive at the decision to have reconstruction.  My original inclination was to go flat; otherwise put, to have no reconstruction.  Yet, the more I read about and thought about what path I should take, the more I leaned towards implants.  Whilst this is couched in terms of being a very personal decision, and it is, in all places one reads about implants and reconstruction, it is also a bit of a political decision, and it is easy to be swayed by doctors and even breast cancer sites that reconstruction with implants is a good, or at least reasonable, decision.   In the United States, a woman’s breasts are presented everywhere as being an integral part of her sexuality and wholly being a woman.  Had I done more historical research at the time, and relied less on reassurances of the appearance, comfort, and safety of implants, I might well have stuck to my original position and forgone reconstruction.  But that is a hypothetical.  At this point, my best option is to give some background to the reader and hope that in some small way it is helpful to at least one woman who is considering whether or not to have breast implants, whether for reconstruction after a mastectomy, or for other, more purely cosmetic, reasons.  It is not my intention to attempt to persuade against reconstruction with implants, but rather to give some factual information.

Historical Background

One might think that a product implanted into a person’s body would require rigorous medical study and would be FDA (US Food and Drug Administration) approved.  However, this is not the case with breast implants.  Breast implants, both saline and silicone filled, were first used in the United States in the 1960s.  As a young woman who came of age in the late 60’s and early 70’s, I very much recall the arguments that implants should be paid for by insurance for women who have had breast cancer and who desire reconstruction.  That having breasts is so much a part of being a woman, that no woman should be forced, by virtue of having been so unlucky as to have had breast cancer, to not have the option of reconstructive surgery if she had health insurance coverage.  The big surprise is that implantable devices were pretty much completely unregulated until 1976, the first year that the FDA required any proof that implanted medical devices, were safe and effective.  For silicone breast implants, this was not required until 1991, almost three decades after they were first used.  For saline breast implants, it was not required until the year 2000.  A Congressional report published in 1992 referred to the female patients who were paying for breast implants as human guinea pigs.

In 1992, the FDA called for a voluntary moratorium on silicone breast implants because of concerns about their safety.  New regulations that year limited the use of gel-filled devices to women seeking breast reconstruction or replacement of an existing implant, but lifted all restrictions on saline filled implants.  For the first time, however, manufacturers were required to collect safety data and monitor the health of patients for a minimum of 10 years.

1999 saw the publication of a paper by the Institute of Medicine concluding that there was “no demonstrable link between silicone implants and diagnosed autoimmune disease.”  The restrictions on gel filled implants were not actually lifted, however, until 2006.  In the years between 1992 and 2006 the use of silicone implants were restricted to clinical trials with women who, as noted above, were cancer patients or women with broken implants.

The first so called “gummy bear” implant, the most commonly used implant today for women undergoing post-mastectomy reconstruction with implants, was not marketed until 2012.  These implants have been promoted because the gel has a rubbery consistency, presumably more resistant to leaks in case of an implant rupture.  The make up of these implants are different from other silicone implants, and articles written as late as 2019 note that the long term health risks are still unknown.  The FDA Advisory Panel has never publicly scrutinized these products.  The studies that allowed them to come to market were 3-years in duration and looked at local complications, such as pain, but not for actual health problems.  (My interpretation of the data is that women who have been diagnosed with breast cancer are still fair game to be used as unwitting guinea pigs.  But I digress.)

In the United States, over 400,000 women each year undergo surgery that involves placing implants, whether for breast augmentation or post-mastectomy reconstruction.  One of the things that seems to be either ignored by patients or under-discussed by physicians is the fact that breast implants are not forever.  All implants require removal and/or replacement at some time.  While some women keep their implants for twenty years or more, the average life span is closer to ten years.

Benefits of implants

Before I look at the possible downsides of implants, it is important to recognize that there is a reason for the enormous popularity of breast implants.  I will note that this part of the discussion is largely my opinion, so you can take that for what it is worth.  There is a huge psychological impact for many women to retain, or gain, some normalcy of appearance.  There is a definite adjustment to major physical changes in appearance, and a loss of breasts for a woman is no exception.  As someone who works in healthcare I have seen more than one husband file for divorce because of his wife’s loss of breasts.  As a statistic, roughly 50% of women diagnosed with breast cancer will undergo a divorce after diagnosis.  Whether one thinks this is shallow or not is immaterial, it is the reality of these women’s lives.  There is frequently a loss of intimacy, unrelated to divorce, which can be due to the medical treatment(s) that a woman is undergoing in addition to any surgical changes.  This change in intimacy can be due to fatigue; painful intercourse secondary to physical changes that come with hormonal therapy; a general loss of desire on a woman’s part, which can also be due to medical treatment, but which may be purely psychological; a loss in her partner’s interest, either out of fear of hurting her or as a response to the physical changes; and depression.

There is a very real mourning that comes with a cancer diagnosis.  The stages of mourning in dealing with such a diagnosis very much parallel the stages one goes through when dealing with the death of a loved one, only complicated by the realities of treatment.  Denial, anger, bargaining, depression, and acceptance can all be part of the path, but, as when dealing with with death, some people get stuck part way through the grieving process.  Breast implants as a form of reconstruction can offer a degree of reprieve for some women by allowing them some continued normalcy in their outward physical appearance.  There is also the reality that women’s clothes are largely designed for women with breasts, especially for white collar professionals who might be inclined to wear more tailed blouses and dresses.  The outward appearance of having “normal” breasts can also make a difference in how a woman is treated by her superiors at work.  Work place discrimination can and does occur for all sorts of meaningless physical differences.  And finally, another silver lining of breast implants is that one no longer requires a bra for support.

In short, for some women at least, breast implants can enhance the quality of life.

Risks of Implants

Unfortunately, the list of possible risks is much longer than the list of benefits.  As this missive is already growing long, I shall make a short list here and work on a follow-up post discussing the risks in more detail.

In their Harvard Women’s Health Watch newsletter, Harvard Medical School lists a number of possible risks and recommends they be discussed with the surgeon before deciding on implants.  These risks include the following:

• potential that additional surgeries will be required
• breast implant associated lymphoma (anapestic large cell lymphoma or ALCL, also referred to as BIA-ALCL)
• breast implant illness, which is not a recognized diagnosis but something that there is growing concern over; symptoms are frequently similar to those of immune disorders
• compression of the implant by scar tissue, causing hardness and/or pain, this is called capsular contracture
• breast pain
• implant rupture or deflation; or micro leakage
• infection

It is noted that the longer implants are in place the greater the risk of a woman suffering one or more of these complications.  That said, problems can occur at any time, from immediately after placement to years down the road.  Another problem not included in Harvard’s list is that implants interfere with mammography.  In general ultrasound or other screening methods are used in women with implants since the implant can interfere with the ability to detect cancers and there is always a degree of risk of implant rupture with mammography.

It is not a given that insurance will pay to have implants removed.  Medicare only covers explant surgery when it is considered medically necessary.  Some Medicare Advantage plans have broader coverage and may cover explant surgery even in cases where traditional Medicare would not.  This is also a good time to mention that implant removal has its own set of risks, including risk of infection, potential for blood clots, the psychological aspects of changes in physical appearance which may be rather disfiguring, and pain all come to mind.

Here’s hoping that everyone is staying safe in this era of COVID-19.  Please make time to remember those who sacrificed all for this country in the midst of wartime as we observe the US holiday of Memorial Day tomorrow.  Please remember that the freedom that thousands of men and women have died for is not an excuse to be disrespectful to those around you.

Making Lemonade

In this age of Corona virus and COVID-19 it seems the entire world is in a state of flux.  The new norm of sheltering in place, not being able to eat in restaurants, and hoarding  of toilet tissue, has caused a lot of changes in our everyday lives.  In some ways it feels like a return to my childhood.  I grew up in a small town and restaurants were not ubiquitous as they are today, not that we could have afforded to go to one anyway.  Staying at home, growing our own food, and making our own entertainment was a way of life.  What is different is the lack of physical contact and the restrictions on being with loved ones.  In our oncology practice we greet patients wearing face masks and take our temperature twice a day to ensure we are not suddenly getting ill.  We screen patients and tell their family members they must wait outside, with some understandable exceptions.  Many of us have had plans cancelled and some among us have had the heart wrenching experience of losing a loved one and not being able to say goodbye.  Hoarding of toilet paper and some other goods aside, it seems this has brought out the good in most  people here.  There is a lot of virtual visiting going on with the use of the internet.  People are going out of their way to make sure their elderly relatives and friends have what they need.  For the most part everyone seems to be acting with consideration for their fellow human beings and working to make the best of a situation that is beyond our control.

Al and I had plans to go on a cruise which was cancelled.  This was probably a good thing based on the issues that a number of cruises have experienced.  Because of this, I rescheduled a planned surgery to have my implants removed, but it too got cancelled.  I still took a week off and Al and I hung out and worked on our own individual projects.  I got to spend a good deal of time outside working in the flower beds and getting some trimming done.  We went for a motorcycle ride to nowhere just to be out in nature.  When the weather was bad we worked on some things inside.  I even managed to start on a stained glass project.  I also managed to do a lot more reading for pleasure than I have done for a long time.  While Al yearns for the day when he can once again go to a restaurant and be waited on for a meal,  I’m mostly happy for the simple pleasures of being at home and knowing that so far we are both still healthy.

Our biggest inconvenience is that, as a massage therapist, Al is not allowed to work during the shelter in place order.  I am ever so grateful that we are mostly unaffected by the loss of income.  We have long maintained a significant emergency fund, a fact that made my cancer journey dramatically less stressful, so even if we were both unable to work for a few months we could absorb the blow.  I feel deeply for those who are not so fortunate, who are struggling with a significant financial impact from the economic shutdown.  I also think economies recover but dead people don’t, so the lessons from past pandemics tell us that we truly need to respect the call for social distancing.  Hopefully this will be over sooner rather than later.  The impact is clear to see when I travel for work.  The traffic is a fraction of what it was before.  My commute time has been cut in half and I am not finding it necessary to stay in hotels for most of my assignments.  It’s been rather nice to sleep in my own bed.  I cannot help but ponder if this step back from our normal activities will make changes in us as a society.  Will we emerge to place more value on eating dinner as a family than being in every sports league possible?  Will we make a point to spend more time with our quarantined loved ones, especially those who are lucky enough to still have parents and/or grandparents?  Or will we make a bee line back to the mall and all of the distractions that modern society has to offer?  Time will tell.

In a regular year we would have, at a minimum, gone out for a nice meal today or gone for a long hike or a ride on the motorcycle as it is our 34th wedding anniversary.  But this year has been anything but normal, so we put some thought into what we could do.  It was storming hard this morning, so going for a motorcycle ride or a hike was out of the question.  It happens to be Easter Sunday, but church services are all on line today, so no need to dress up or make plans to go to church.  No dining rooms are open so our anniversary dinner would be eaten at home.  But we have a sense of humor about pretty much everything so no need to be overly disappointed or get upset.  There will be other days when we can go out for a special meal and call it a belated anniversary dinner.  So, because it is Easter, I had bought us each a chocolate bunny, and we decided to celebrate our anniversary by going out for a soda and nibbling on our chocolate bunnies.  How fortunate we are to be together and to be healthy and to enjoy one another’s company.

Wishing you all the best.  Stay safe.