I feel okay and maybe I am just a slug

Today has actually gone pretty well. No bone pain - still low energy. I mainly stayed in bed reading, and listening to NPR and CSPAN2 - a little sad when I decided it was okay to listen to the sunday morning shows on the radio rather than watching it on TV - somehow the 20 feet to the living room was too far. Now listening to a show about the White House - they just announced CSPAN is financed through payments from the cable companies? Who knew? So maybe the day wasn't a total bust - I got to learn some random information and to hear who did what in which rooms in the White House.

Anyway - my plan is to head into work tomorrow - but we'll see how that goes. The other thing I think about a lot is how, well I seem to be handling the treatment and wonder how much of it has to do with access to the drugs and what it means for people with less good health insurance. Partly this is due to living in Washington which has the highest mortality rate of the country. This is largely due to lateness in diagnosis and the socioeconomic characteristics of the city. That is much of the overall mortality rate is due to the black/white distribution in the city. The people who are dying don't really look like me and in part it is the tale of two DC's.

Looking up the statistics from the Kaiser site - (http://www.statehealthfacts.org/) the overall US mortality rate is 24 per 100,000 women in the country and that is up to 27.7 in DC - but for white woment the rate is 20.7 compared to the US average of 23.8 and DC is ranked 47th from the highest mortality. For black women the comparison is 32.8 for the US as a whole and 31.5 in DC, or 18th highest. So the break downs don't look as bad for DC. The numbers are worse for each racial group in states that are more rural and I'm guessing there is less health care available especially for the uninsured. When I think about this - it seems critical to fix health care access, but maybe more importantly it illustrates the need for knowledge and to try and get people to seek advice sooner. So maybe I can't be too hostile to the whole pink ribbon thing if it helps give people the courage to see their doctors.

So far so good

Day after chemo I feel pretty good - just mellow and somewhat lazy. Spent most of the day listening to the radio and music and reading the Sunday NY Times. My big excitement was going to get a shot at the hospital - needed to build up my white blood cell counts in order to do chemo every 2 weeks rather than 3. We'll see what tomorrow is like but in general this seems pretty much the same as the last treatment. I do wonder if I should have gotten more done - I do want to organize my closet and drawers but am happy to give into the sluggishness.

2 down, 6 to go: or All I want for Christmas

So I just finished chemo session 2 - what everyone wants for Xmas a lovely dose of red poison. I know the Cytoxan is also poison - but it is clear and isn't delivered through a syringe and doesn't your urine red - so it seems less scary. Of course it can cause bladder issues but drinking plenty of water isn't really a problem I have.

Because of the holiday and limited nursing staff I was sent up to 7 West to get my chemo (usually I go to 5 North). 7 West is usually used for chemo given as part of research studies but also serves as overflow - it meant I got to hang out in a private room with the choice of a bed or a chair. After they took some blood and found out my test results were fine for me to get chemo the procedure was mainly the same as last time - anti-nausea medicine, steroids then the bringing in of the chemo and my nurse donning protective gear and covering the area before shooting in the red drug.

Given 5north and 7 west seem like they should be in different buildings or different wings but they are almost on top of each other - the north and west seem to refer to the direction you work when you come out of the elevator. Things you learn when you spend time in random hospital buildings.

This time was different due to the lovely company I had with my. My friend Susan came with me and the monotony of having drugs drip into my system was broken by following her son's progress in driving in snowy upstate NY. The magic of text messaging and 17 year olds with quick fingers. He was with his dad - who we can only assume was driving - as texting and driving in a snow storm seems like a really bad idea, even or especially for a 17 year old.

I'm feeling pretty good and have gotten surprisingly mellow about my hair being gone. I wore one of the caps from Julie to chemo - (thank you Julie). It seemed overkill to wear a wig - they already know I have cancer at the hospital. The caps are cute round and actually look okay and Julie wore them when she was going through chemo last year. I have about 8 caps in different colors and textures - more than enough to get me through and to swap out with Jackie and Kiki, we'll see if I wear something besides the wigs to work.

Otherwise Xmas was good - my friend BoSoxFox was around and we saw a movie and ate vietnamese food before the Celtics Lakers game - (do you see a pattern in her life yet?) Then I came home got somewhat organized and was ready for today. I have a stocked refrigerator and freezer and may be ready for a nap.

I hope you all had a fabulous Xmas and a great time with your family and friends. I'm feeling fine but the mellowness of the drugs is starting to fall. (Kind of like fog - will try to keep posting over the next few days but word choices might be funky.)

Kim

Hair no more - but still a pretty good day

Today's Chanukah gift was blue nail polish - an appropriate color for the bald girl to wear if I really was that cool... But I'm not sure I am. Besides it is way too cold outside to leave my head uncovered - who knew hair was so insulating?

I went to a hair salon that is pretty hip and had my head shaved by a great hairdresser. At 22 Jessica is possibly more practically experienced than I might ever be - she already is married and has bought a house and has a number of cars - and while now sports black and hot pink hair, has voluntarily shaved it all off in the past. Apparently the key for rocking the bald look is to go heavy on the make-up, red lipstick and heavy eye make up - and of course the blue nail polish. Though again - I'm not sure I am that cool.

The experience was less traumatic than I thought - and it is a relief to have it done. I did pocket some of the shorn hair - largely for comparison purposes when it grows back in. According to Jessica and BoSoxFox my head is actually fairly round and doesn't look terrible bald - it looks better than I thought though my ears do tend to stick out. All in all - the shedding is over and I feel okay - though I did manage to drop a drawer on my toe while looking for my wig-cap.

What is the bigger (better?) news of the day is that I had a good appointment with my oncologist. She was happy with how well I seem to be tolerating chemo and thought the tumor was responding to treatment, it seemed to have softened and was harder to find the edges - which she took as a positive sign. This means she is happy to have me switch to a faster chemo schedule - chemo every 2 weeks. It does require a booster shot to help restore my blood cell count but will lead to a closer end date - and will mean I won't have to have chemo right before inauguration weekend. I'm still not sure I am leaving the house but it seems like a better outcome to not have to get to the hospital for treatment the Thursday or Friday before millions (okay maybe not 4 but it seems like at least 1.5 million) descend on DC. It also means I will be finished with the A-C in January and possibly all of chemo by the end of March-middle of April, which makes the whole process seem more tractable.

We'll see how I do with chemo treatment 2 on Friday - but my doctor also seemed to think my side effects should be about the same for the next treatments - with the major difference being that my fatigue will grow as I've had more sessions.

So all in all it seems like things will be okay - and it is a relief to be done with something else that seemed really daunting. The shedding is over and I no longer have to worry about when I will shave my head. We'll see if I ever rock the bald head and blue nail polish punk look.

Hair today, gone to Maui

Okay so I am now riffing off of bad puns. But I've spent the last few days obsessing over my hair and when exactly I was going to just go ahead and shave it off. The answer it seems is tomorrow or "to Maui" in pun speak. I think I am at the point where the shedding may need to stop - I keep finding hair in my food (and everything else) and at least I know it is mine. So the current plan is for me to go to the salon around the corner and have them do it. I have clippers but think not having to clean up my hair may be less traumatic. I will be bringing a wig and hat with me and then may be camped out at home adjusting to my new reality.

A bald Xmas has suddenly become much more festive as my friend Carol has sent me a box filled with 8 Chanukah presents. Note that while this was how we taunted the non-jews to try and make ourselves feel better about having what is, let's face it, a Holiday mainly based on envy - I'm not sure we ever got a full 8 days of presents. Sorry mom and dad if I am just remembering wrong and the presents didn't peter out.

I got the box today, day 2 - so got to open 2 gifts. The first a Xmas tree (sorry Chanukah Bush) made out of multicolored tinsel and that comes with 8 disco mirror balls, one to add everyday. Its probably safer than lighting candles. How can I boycott the holidays when suddenly I need to blast disco music and dance around?

Gift 2 is a limited distribution copy of her book that is coming out next month entitled: Here Today, Gone to Maui - which was in turn taken from a shirt my parents brought back for me 20 some years ago, while we were roommates in college. I'm not sure I ever wore the shirt in public but it was the basis of many a conversation that ended with lots of giggles and fun - much more valuable than most of my other clothes of the period. (Though come to think of it - any of the 80's fashions might be the cause of some humor - hot pink denim with matching shoes was quite the look.)

This also raises the possibility that maybe Maui is the place for a post chemo/surgery/radiation trip - once I have my hair back

In any case - reading the book and opening the presents will put a different spin on the whole Chemo Christmas and for that I thank you and again reminds me that I have much to be thankful for, not the least of which is people to pun with.

I'm positive I'm negative

I found out yesterday that I tested negative for the BRCA1 and 2 gene mutations. These are genetic mutations that increase both the probability of contracting and recurrence of breast and ovarian cancer. They are found more in people of Ashkenazi ancestry and given my background, my mother's incidence and the fact that I am relatively young to be diagnosed it seemed worth being tested. My mom was tested last month and was found to be negative as well. This is really good news in terms of my prognosis and in terms of likelihood of recurrence. It also means that sticking with my current treatment plan (aiming for a lumpectomy post-chemo) makes sense. If I had a positive test for a mutation I probably would have had more extensive surgery - including a double mastectomy.

Now I just have to get through the chemo treatments and see what kind of magic the drugs can work.

Helping out

Tough times show you who your friends are and I’ve been totally overwhelmed by the outpouring of love and support that I’ve received from everyone regarding my diagnosis. Thank you all so much for helping to keep my spirits and outlook up. I’m truly blessed to have so many caring people in my life and I will let you know when I need something.

However, many of you have been asking how you can help, so I’ve tried to put together a few thoughts on the topic. (This list also benefitted from a draft composed in part by some of my cancer elves - why should santa be the only one to benefit from the work of others?)

• I don’t necessarily mind talking about my diagnosis or treatment, but to be honest, rehashing the details is getting a bit old. I’m somewhat bored with myself (who would have thought?) Instead, I’d love to be part of some fun conversations about the issues of the day. What’s the latest on the Blagojevich scandal? What do you think about Obama’s cabinet selections? Alas, Sarah Palin seems to have jumped the shark. I'm also happy to talk about bad TV - I seem to be watching a lot of the Bravo reality shows, some network TV and sadly I like the WB monday night line up. Don't judge - I have cancer.
• The chemo treatments have compromised my immune system, so I need to keep away from germs as much as possible. Please try to keep your distance if you or a family member is sick or coming down with something. I realize that I’m irresistibly huggable, but please resist if you think there is any chance illness is lurking.
• For now at least, I’m all set with things like food, medical-type supplies, rides to my appointments, etc. But if things change, BoSoxFox and others have promised to help reach out to you and help coordinate my support network. And believe me, I won’t be shy to ask for things when I need them.
• I’m happy to have a food delivery system set up in the New Year – and I will have someone coordinate (Elaine, this means you) – but remember I’m a single person so a couple of servings of what you are making will go a long way. I’m thinking one donation a week could work. I also live pretty close to many restaurants so take-out and delivery has been working well for me. (Why should things be different just because I have cancer?)
• Between chemo treatments and resting at home, I’ve got a lot of down time I need to fill. Book, movie or cd loans and recommendations would be most appreciated. As would magazine clippings, board games, and puzzles. But please, no cancer or illness related materials. I’ve already got enough on that front.
• In these difficult times, I’m so lucky to have decent health insurance, ample financial resources, and friends like you to help me through my challenges. But others aren’t so lucky. I’d be honored if you’d consider making a donation of time or money to the charity of your choice to help others in need. (My favorites include Doctors Without Borders, Partners in Health, Miriam’s Kitchen, Washington Food Bank or other food banks, and NPR/WAMU, but of course there are many other worthy causes as well.)
• Please also resist any urge to send me anything with pink ribbons or things too directly related to cancer or treatment. Though any gifts of ginger will be appreciated.
  
  As you probably know from my previous blog entries, I’ve been fatigued lately and need a lot more rest than usual. I expect that this will become worse as the treatments progress. So please don’t take it personally if I’m slow to return a phone call or an email, and have to turn down invitations to go out, etc. But know that I appreciate your concern and best wishes and am happy to receive invitations. For those local, I’ll also try and maintain somewhat regular Friday Happy Hours even if I will be drinking ginger ale. Typically at 21M but check with Dana or Susan for details.
  
  Thank you all again for your love and support.
  

Recap - After Chemo 1

So it has now been two weeks since chemo session 1. The first few days I was spacy but not terrible - I mainly hung around the house and my friend Debbie did home repairs. So in some ways cancer and chemo may lead to a more together apartment. There are still closets to organize, pictures to hang etc... so for those who may be visiting it might involve some work. After Debbie left on Sunday morning I got to watch bad movies, hung around and was generally mellow. I didn't feel that sick, took my pills on schedule and was spacy and felt like I wasn't thinking as quickly. The rest of last week I just puttered around, went out for lunch a couple of times and mainly hung out. It was surprisingly easy to do. On Thursday, my friend Julie came bearing gifts, clippers, a bunch of caps to wear around the house and a pink bathrobe. So I believe I am set in terms of wigs, and hats and all things related to the next hard part, losing my hair.

Suddenly, oh around the time this blog appeared, my brain suddenly kicked in and I felt like I could think again. It may have been the end of taking the required pills, or just the timing but it felt pretty good and I felt more like myself than I had in a while.

That weekend I even went to see a movie, went out walking on the C&O Canal and generally felt pretty good. Tuesday I went back to work and felt fine. I'm not sure how productive I've been, much of last week included some catching up and there were holiday festivities and its not clear how productive anyone else was the week before Xmas. Anything I write or programs I run should probably be checked over the next couple of months. I also seem to act first and then think later about whether something I say or do is totally appropriate but I'm not sure I can totally blame that on the chemo.

So all in all I feel pretty good. Thursday was a little tough, I had a headache late in the afternoon, which got worse and required I check my temperature fairly obsessively and not take any pain medicine if there is a chance it is related to having a fever. Having fevers are really bad as they may signal infections and low blood counts. It is important not to mask any infection by taking pain relievers which means checking in with the hospital before taking any sort of pain reliever. My temperature seemed to stay below 97 degrees, and it meant I cut short my time at our work holiday party. I did get worried at one point when it looked like my temperature had hit 99.6 but it turned out the thermometer was upside down and it was 96.6. (Digital thermometers - checking which way the arrow or little man goes is pretty important.) I finally broke down and called the emergency number anyway even though my temperature wasn't high. The oncologist said I could take a tylenol which I paired with atavan (the wonder anti-anxiety sleep inducing drug of choice of cancer patients and neurotics apparently) and slept off and on for 10 hours. Friday my blood work was going to be checked anyway - so if my counts are down they will now anyway. I'm guessing the headache was weather related but the need to be careful with tylenol and advil may lead to a long 6 months.

This does mean I am (and think I need to be) pretty vigilant about my health and exposure to illness. I probably won't fly for the next few months - and will be careful about hand sanitizing and how close I get to those around me. For people I see and work with, please stay away if you have a cold or fever, have been sick or your family is sick. I appreciate your concern but mostly am worried about what it means if I do catch something. Compromised immunity is no fun.

Winter chemo comes with the upside of warms being pretty warm but the down side is winter colds.

Recap - Red Poison Session 1

After getting the Mediport put in Tuesday I had a couple of days to recover. I went back to the wig store (a couple of weeks earlier I spent a good couple of hours confirming that I really don't look good as a blonde) to pick up the wig. I ended up getting two as the owner was willing to make a deal on the second wig (can we say bundling?). I now am the proud owner of two wigs that look pretty similar though one is human hair and the other synthetic and they are slightly different colors and two styrofoam heads. Is it a bad sign that I've named them and sometimes talk to them? We'll see if the hair makes the girl by tracking behavior based on if I am wearing the Jackie wig or the Kiki wig. It may just mean I need to get a pet or that it is a really good thing that I am heading back to work tomorrow.

The next day I picked up my friend Debbie from the airport. (She had taken a month off between jobs and had offered to spend the weekend of first chemo with me.) Apparently coming to chemo is like the gold ticket item - it is a barrel of laughs but if I get to have quality time with my friends that's a bonus. You can apply for this honor at change.gov --oh wait that's for other types of positions. We hung out - went to chemo orientation where I got to hear all of the possible side effects of chemo. On the positive side some of them were clearly incompatible but I left with a whole new set of thoughts about what a drag this was going to be. The nurse was terrific and I got to meet my case manager Dorothy who made some calls and got me a full complement of my super anti-nausea drug. On the way to chemo orientation we picked up my pills including the expensive drug developed explicitly for chemo patients to fight nausea. (All four pills are to fight nausea.) Of course the pharmacy filled the prescription and apparently my insurance covered only 1 of the expensive pills - I need 4 per treatment - and charged me $40 for the one pill. After Dorothy's intervention I had all 16 pills for the first four treatments - all for the $40 co-payment.

While getting the extra pills my battery died while stopped illegally in Dupont Circle ... in rush hour. I spoke to my friend Tracy who was nearby, had jumper cables because her battery had been acting up last month and who did some rock star maneuvering to come give us a jump. Shout outs also to Debbie who knew how to use the jumper cables and we jumped my car and headed back to my house for a pre-chemo party. Melissa joined us and after some Sparkling Shiraz I have said a dieu to liquor I think for the duration of chemo. Drinking something red and sparkly seemed appropriate given the red poison about to be put into my body.

Friday morning there was a trip to the mechanic new battery and oil change, breakfast nearby and then a trip to the grocery store and then chemo at 1:30. We expected to wait a while but we ended up in a chemo chair (a lazy boy recliner for me, and a less comfortable chair for Debbie) pretty fast. Besides the fact that I seem to have lost a half an inch, when my height and weight were taken everything moved along pretty quickly and wasn't so bad. They cleaned where the mediport was and the line was entered directly - it was a little odd feeling to have the injection into the port (and through my skin) but it was much easier than any IV. They first gave me a couple of anti-nausea drugs through the mediport and then the fun began. Apparently the bright red medicine needs to be pushed in slowly to make sure it isn't leaking. So nurse Erica was there with two really large syringes pushing the A slowly into the line. It took about 15 minutes, the other drug took about 30-40 minutes and somehow even though there wasn't much waiting around the whole chemo experience took until 5:30 - so 4 hours for chemo. It was an afternoon but wasn't painful or really even that uncomfortable.

The next few days I was low energy and spacey and a little queasy at points but in much better shape than I thought I would be. I ate small meals frequently, took my pills according to schedule and everything was okay. Sunday I was a little spacier and I don't think I should have been allowed to make any life changing decisions for much of the beginning of last week but generally was okay. Thursday night - about the time the first blog entry went up I actually felt pretty great and able to think again. And have felt good since. I'll give more details on postchemo life next time. Tomorrow I start work again so may be slower writing things up - but all in all chemo session 1 has seemed not really bad at all.

Recap - A Way In

One of the hardest parts of this process (and granted it is still early) was the waiting to start. Because of the discrepancy between the ultrasound and the MRI, I ended up getting a second MRI done and then (which I think is protocol for any diagnosis) a cat scan to check if there was any evidence that the tumor had spread. Getting blood tests done has always been somewhat of an issue for me - I need to let the phlebotomist know my blood pressure is low and the needle seems to roll out after it seems like it is in. This was a positive aspect of being exposed to British beef in the 1980s - being disqualified from giving blood meant I didn't have to think about voluntarily going through the process due to the importance of donating blood. This hasn't been much of an issue with my blood tests at Lombardi - thank you Mohan, but any of the diagnostic tests that required contrast being injected has been a bit of an ordeal.

In the public service part of this blog - IF YOU ARE HAVING PEOPLE ACCESS YOUR VEINS DRINK PLENTY OF WATER !!! I thought most people know this and I am obsessive about it but according to my mom this was news to her. So being hydrated helps a lot. My problems are usually caused by the fact that often - you aren't allowed to drink (or eat) for a certain number of hours before tests. Apparently I do not store water and 2-4 hours (for the cat scan) was enough to make getting the contrast in a problem. That and drinking enough water when one is swigging banana barium smoothies doesn't always work. (Barium wasn't so terrible, use a straw and I did think the vanilla was better than the banana.)

The technicians couldn't get a line in for the cat scan - after the very patient technician couldn't get a line in she called over another person. Usually this involves the vein wrangler or the person who has the touch - well in the case of my cat scan it involved someone who just didn't take no for an answer - the new person just bullied her way in. That night my vein was tender, which turned into a huge bruise and after checking that it wasn't an allergic reaction and I could wait to check in with my doctor the next day I was on-line looking for possible home remedies to make vein accessing easier. Alas, there really isn't any suggestion of upping ones blood pressure through salty junk food eating but they did talk about mediports - or more permanent lines that were surgically put in under the skin to make access easier.

Of course, on line the examples were for people's aged diabetic parents who had vein issues. I was ready to conclude that there must be some karmic mistake - after all if I am not physiologically built to handle chemo - I can't have cancer right? I figured it was worth bringing up options and questions with the doctor. The next day I met with my breast surgeon who confirmed that the tumor was large, reconfirmed they were pretty sure about the pathology and weren't nervous about the delay in surgery and that she and the oncologist confirmed I was a good candidate to do chemo first. She reviewed my blood and test results and confirmed there didn't seem to be evidence of it spreading and then we talked about treatment.

I asked if there was anything to be done about my uncooporeative veins and she brought up the mediport. In the last few years she said that most of her patients who had chemo ended up having the port inserted. It is out-patient surgery and we scheduled her to do it the week after Thanksgiving. It is sad how giddy I was about this news. Not only could I get the port - I didn't have to be the equivalent of an 80 year old to justify it. My friend who accompanies me, BoSoxFox, thought it was a little funny that I seemed happier about the mediport than about the positive test results.

In the end my breast doctor didn't do the surgery due to timing issues and my getting it done earlier in the week. And the surgery was slightly more traumatic due to the irony that they couldn't get an iv into my hands or arm to do the mediport surgery. 10 hours no liquid - good luck finding a vein. But they did the surgery after accessing a big vein directly - I have the mediport and while it does bulge out a little I am so excited to have it. It made having my first chemo easier than I expected. And set me on my path to recovery.

Next time I'll talk chemo and introduce Jackie and Kiki - the two (styrofoam) heads that hold my wigs for when I need them.

Recap - Being Dense

So I'll try and recount the history of what's been happening here. But the good news is my brain seems to be back functioning at normal speed. I had been nervous that I would be foggy for the full time of chemo so it is exciting to be feeling more like myself.

I was diagnosed with breast cancer in the middle of October. But starting last May I had found an area of my breast that seemed to be lumpy but changed over the course of the month. I went to see my doctor - and had a regularly scheduled mammogram - which came back negative but hard to read due to density of patient's breasts. This was effectively the report I have gotten back on all 13 of the mammograms I have had since turning 30. (Early vigilance due to my mom's diagnosis 15+ years ago. She's also healthy and doing great.) If this sounds a wee bit bitter, it is because I am. But we'll come back to that. I spent much of the summer and early fall surreptitiously obsessed with whether something was happening in my left breast and finally in September went back to my doctor. She sent me for a diagnostic mammogram, which I scheduled for October 3 and after scores of pictures the radiologist saw something that might be something but it lacked dimensionality. This led to an ultrasound where the radiologist saw something about 11 mm that he wasn't that concerned about but he was willing to give me the options of having an MRI, having a biopsy or waiting 6 months. No one thought what they were seeing was different than dense, lumpy breasts.

I opted for the biopsy and had it a couple of weeks later. At this point I could feel something larger but it wasn't very distinct and was happy taking comfort in the small size. The biopsy came back positive - and I was then scheduled for an MRI. (At this point I wasn't all that surprised and had already convinced myself it was cancer.) Not to be fatalistic but since my mom's diagnosis - breast cancer has been the thing I've thought I'd be most likely to get and in some ways was resigned to it. Too many friends and friends of friends have been diagnosed. While upset, it also seems treatable and beatable - again due to the others who have had to deal with this before me.

The point where I lost it and the bitterness flowed was after the MRI - turns out my tumor is 5-6cm and there is a not very well defined grey area that is the tumor that was probably there in at least the May mammogram. I understand MRIs are more expensive and ironically I would have been eligible potentially to get one done based on my mom's age of diagnosis, but the 13 years of poking and prodding seem a bit like a waste of resources and energy.

I'm not trying to discourage anyone from getting their baseline (and regular) mammograms but it seems like there should be more discussion of whether this is that good a tool once you get into different subgroups. Turns out I might not be that unique - for women with dense breasts mammograms miss tumors. The high effectiveness rates have a lot to do with the fact that it is still the case that most diagnosed women are post-menopausal. So having a big tumor in some ways has bummed me out more than having a tumor.

On the positive side - the cancer is hormone receptive and protein negative. My doctors are great and think that doing chemo first has a good shot of shrinking the tumor to a size where a lumpectomy may be a fine option. So the pathology looks good, there is no evidence of metastization and I've embarked on 4-6 months of chemo including first A-C for 4 treatments and then taxol.

I'll report more about the testing and why I may need to adopt a diet of chicken fried steak to get my blood pressure up to a normal range. Don't I seem more volatile than someone with blood pressure that stays low should have? More about the joys of the mediport later.

I like pink

I guess the first thing I should say is that this blog will at least at the beginning be more about breast cancer and less about taxes. I decided naming it in a way that I could continue after this year ends will lead to continuity. I also want to note that I have always liked the color pink - but this doesn't mean I find the plethora of pink surrounding breast cancer comforting instead of vaguely creepy. (Can one call the pink ribbon creepy in a breast cancer blog?) I guess the other thing to note is that even with breast cancer my personality is much the same and I need to in part argue against the grain.

This might be an odd beginning post. But, hi, I'm Kim, I'm a tax geek and I was diagnosed with breast cancer about a month ago. This blog will be an attempt to be better at disseminating information about what I am going through and how I am doing, largely for the people who know me. For others who wander in, welcome but don't get mad about the snark about the ribbons and you also might need to ignore the random tax stuff.

Time for bed but I will recount more later.