I Wish Cancer Would Get Cancer and Die

Approximately three weeks ago I had my first screening mammogram. I should have had my first mammogram when I turned 40, but last year was kind of chaotic, so I finally got around to it this December. When I worked for a hospital's medical clinic in the Milwaukee area, the x-ray department was across the hall from the lab where I worked. I would go in and look at some of the films (yes, they were still actually on film back in the day) and although I am in no way, shape, or form a Rad Tech, when I see a mammo film (ok, "image"; old habits are hard to break) I have a general idea what should be seen and what shouldn't be. Three weeks ago after the tech was finished, I asked if I could see my images which were being emailed to the Radiologist as I was standing there in my bare feet and ill-fitting maroon half-gown. I looked at them and pointed to a round, white circle on my left side and asked, "What's that?" The tech answered, "That is something the Radiologist will probably talk to you about." Sure enough, two days later the Mammography Department called me and asked that I come in for "additional views of the suspect area and an ultrasound of the same area." Ironically, I received a letter in the mail the same day with the results and the word "ABNORMAL" in bold letters. So I had my additional views and ultrasound of the "suspect area" on my left breast last Thursday, December 27 at 11am. The original mammogram didn't hurt nearly as much as this one did. The tech explained that the machine was putting extra pressure on a smaller area, hence the increased "discomfort." Discomfort? It hurt like hell. Then I moved across the hall into the ultrasound suite, padding along once again in my bare feet and ridiculous maroon colored half-gown. The ultrasound didn't hurt or feel like much of anything at all; I was pleased that the ultrasound gel was warmed and not room temperature. This technician said she needed to show the images to the Radiologist who was in another viewing booth. After what seemed like all of two minutes, the tech and the doc came back into the room where I was still laying on the ultrasound table. The doc introduced himself and shook my hand. He was wearing a Mickey Mouse Christmas tie. Then he said what I was dreading to hear: "We've found something on your left breast that we'd like to have Pathology look at, which means..." He went through my surgical options, sounding very sincere until he said,"there is a lot of blood flow to the area and cancers like a good blood supply." He answered all of my questions, including, "I've known women who have had needle biopsies and said it was the most painful thing they've felt in their lives. How do you prevent that from happening?" He went on to explain how they numb the area (but of course can't numb the entire breast) and use a a needle and vacuum to suck out the suspected tissue. He then told me the needle is about the diameter of a ball-point pen. That, I didn't need to know. They left, I got dressed and this is when I started to cry. Both of my grandmothers have had breast cancer. My Grandma Krause had it in one breast and then in the other breast 25 years later. It outright killed my Grandma Porath. But it wasn't my family history that was the first thought that came to me. That was: but I haven't seen the Great Wall of China yet and I want to do that before I die. Granted, no one has said anything about dying, but when you're a woman with my crazy medical history (if something bad will happen or go wrong, it will happen to me) these are the types of thoughts I automatically have. Next I met with a Breast Care Coordinator who is like my own personal guide through the process from scheduling the biopsy to everything else that could possibly happen. My ultrasound guided needle biopsy is scheduled for Monday, 12-31-12 at 2pm. Because of the holiday on 01-01, I likely won't have results until Thursday, 01-03-13. As I write this, it's 24 hours and some change until I put on that damn maroon gown again and have a piece of my breast tissue removed and examined for cancer. I wish cancer would get cancer and die.

40 Has Really Kicked My A$$

In 11 hours and 56 minutes, it will officially be my 41st birthday. There was so much going on in my life last year at this time: Commencement happened on May 8th, which was also Mother's Day, my internship was wrapping up and I was interviewing for the job I currently have, I was finishing my first of the five classes needed at FVTC to obtain my Substance Abuse Counselor certificate, I was planning a substantial graduation/birthday party, and I was getting ready for surgery on the great toe of my right foot, made infamous by a series of photos I posted on Facebook, documenting my progress. Oh, and then there was the roller coaster I was riding related to Mark's inability to maintain his sobriety. Late last week a relatively new client asked me when I graduated from Lakeland, and the one year anniversary of graduation had come and gone without any type of acknowledgment on my part. That struck me as somewhat unbelievable because for almost an entire year, May 8, 2011 was the end-date, the grand finale, the day I began counting down to in June 2010. Yet it had entirely slipped my mind last Tuesday. That just goes to show me that what I considered to be the "most important date of my entire life" is likely to change along the way. So, how has my 40th year kicked my ass? Oh, baby let me count the ways: 1) Mark entered into 4 months of residential treatment for his alcoholism at the end of July. He was discharged on the Monday after Thanksgiving and started drinking again within two weeks of coming home. Ugh. 2) At the end of August, I happened to mention to my dermatologist that I had this "thing" on my forehead near my hairline, and would he take a quick look at it? He did more than look. He numbed me up, shaved it off and called me 4 days later with a diagnosis of basal cell carcinoma, which would require a very tedious 4-hour surgery and "full body checks" every three months for the next year. I had my second body check with him last Monday, which is the first appointment I've had in which he didn't numb me up, lob something off and send it to pathology. He did, however, take measurements and a picture of "something to monitor" near my right temple. I guess I'll know more when I see him again in August. 3) As most of you know, neither my parents nor my brother are speaking to me right now. This whole ugly process started two weeks before Christmas. Without laying down all of the bloody details, I'll just give a brief version of what happened which is very biased in my favor: Plans were made for the December 11 Packers game, plans were slightly altered four days before the game, my mother flipped out and uninvited my sister, her boyfriend and his daughters, as well as me, Mark, his daughter, and his son, daughter-in-law, and grandson from celebrating Christmas at my parents' home. Sometime between the 11th and the 23rd my mother changed her mind and re-invited me and Mark. News of their invitation being yanked didn't make it to Mark's son and his family, and when the two of us pulled into my parents' driveway on Christmas morning, Mark's son and family were already there. Not good. We all managed to get through an extremely tense three hours. On the drive home Mark and I resolved that we weren't going to go through something like that again, EVER, and decided that when Christmas 2012 comes along, we're telling everyone that we're going to be out of town for the holiday and plan on spending the day in our pajamas at our own house. 4) My maternal grandfather died on March 5, 2012. That alone was stressful, but added to it was the fact that neither my mother, father, nor my brother went to the funeral. Again, whole, big, hideous story cut short, my mother repeatedly called our house for two days after the funeral to find out "what happened and who was there." When I finally answered her call and she asked me "how it went" I wasn't cooperative. This was not to her liking, which she began loudly "explaining" to me, so I hung up. Shortly after that my brother called to inform me that I "no longer have a brother" followed by a message from my father, asking me to "just leave us alone." Message received, loud and clear. 5) Mark went back to a local hospital for alcohol detox twice so far this calendar year; once in February and once in March. After the March detox he began attending an intensive outpatient program, but he was drinking again by Easter. This is when I "moved myself" into our second bedroom to sleep, watch TV, read before bed, etc. It was a nice arrangement and the quality and quantity of my sleep improved so dramatically, even I was surprised. I say "was a nice arrangement" because he's in treatment right now in Oconomowoc and I "moved myself" back into the master bedroom for now. 6) Two weeks ago I saw my primary care MD and my blood pressure was 132/94. That is insanely off-the-charts high for me. I average 112/68, maybe 114/74; NEVER anything near what my doc recorded. I checked it again the next day at work, and it was 132/92: still WAY out of whack for me. The last time I checked it, last Friday, it had gone down to 122/84, still beyond where I want it to be. I explained just a few of the current stressors to my doc and she related my bp spikes to my stress level. Really? I hadn't considered that coorelation before. (Sarcasm) 7) I love my job and have gotten to really enjoy working with the older adult population. Unfortunately, that increases the likelihood of some of my clients dying while in my care, which is what happened 2 1/2 weeks ago, twice within 10 days, actually. This is the first time I've experienced this type of "professional loss". Grieving the death of a client, or in this case, the deaths of two clients, is complicated. As a therapist, I am the holder of people's deepest fears, darkest worries and most horrifying secrets. The therapeutic relationship is like none other. In addition to sharing in my clients' successes, I am a witness to their pain, shame, anger, confusion, and a myriad of other emotions. Often, I am the only human being who knows "everything" instead of bits and pieces of stories. It's for these reasons that therapists and neither current nor former clients can be "friends." What I know about my clients naturally creates a power differential, hence the therapeutic relationship being like none other. However, that doesn't mean that I'm not still a human being with all of the emotions that come along with the human condition. Grieving the deaths of clients is very complicated. 8) Having run out of local centers that will accept Mark as a client, last Thursday I drove him down to Oconomowoc for another detox and residential treatment. He's hasn't been there for 72 hours yet, but with hope, he'll be there for roughly 45 days. Regardless of the final outcome, I know that my stress level has already decreased. When I pulled into my driveway after work last Friday, for the first time in a really long time, I wasn't dreading getting out of my car and walking through my own front door. There are plenty of examples illustrating that my 40th year wasn't exactly stellar, but, to steal portions of a song from The Who, I've got a feeling 41 is gonna be a good year...at least I hope it's better than the last.

After 168 Hours Have Finally Passed

So maybe it's not exactly 168 hours since the Packers defeat by the New York Giants, but I know 168 hours ago I was sitting on this very couch, watching this very TV, likely wearing these very pajamas, and my heart broke.

Not because my family wouldn't be going to Super Bowl XLVI in Indianapolis (which, in all honesty, is not a very exciting town). No, my heart broke for those 53 players on the Packers roster. My heart broke for Donald Driver who played like the team's life depended on him, and for a good portion of that game, it did. There's just something magical that happens when Driver catches that rocket and rides it for 10 more yards and another first down. My heart broke for Aaron Rodgers. As a team captain, much is expected from him and generally much is delivered, but not on this given Sunday. And for the dozens of coaching staff, the trainers, equipment personnel, travel staff, and everyone else affiliated with the team that would've been eligible to travel with the Pack to Indy, my heart broke for you too.

But my heart was really breaking for the family of Offensive Coordinator, Joe Philbin. Michael Philbin was 21 years old and drown in the Fox River. The portion of the river where his body was found runs parallel to the UW-O campus and happens to be right in front of my office at the Oshkosh Seniors Center.

Had the Packers lost without the trauma of a death affecting their Offensive Coordinator, without several players likely experiencing thoughts of their own families suddenly popping into their heads, and without someone likely taking a step back from all of the hype, the spread, and questioning what was really important, would the loss have been any more or any less disappointing to us, the average fan?

Sometimes something very horrible has to happen in order for a group of people to gain a deeper understanding of life. As much as I love my Green Bay Packers, the week they spent before last week's game had to be dreadful. Traditionally men aren't very good at expressing their feelings, much less deep, sad emotions. It's never better to say nothing, no matter how awkward you feel about approaching a grieving person or someone you know who has just lost a loved one. Say something, do something, but don't just stand there and do nothing.

Maybe ask that person if he'd like to go toss the ball around. Who knows? Maybe that's just the out he's been looking for.

525,600 Minutes, How Do You Measure a Year?

It's probably a little early for the year-end tally of events that have defined 2011 for me, but the song that this title is from, "Season of Love" from the musical RENT has been bouncing around in my head for awhile, so I figured I'd get in early on wrapping up the year that was 2011.

For those that know me well and are in regular contact with me, electronically or otherwise, know that I have plenty to bitch and moan about from 2011, but bitching and moaning never accomplishes anything except leading to more bitching and moaning, so I'm not going to do that.

Here, in no particular order, are the top 10 things I'm grateful for from 2011:
1) Finishing grad school & actually graduating.
2) Finding a job I love in a field that I love; it's so true that when you love what you do for a living, you'll never work a day in your life. I know that feeling for the first time ever.
3) My skin cancer was "only" basal cell carcinoma. On Monday of this week my dermatologist took another biopsy of something on my back and he was not reassuring when he told me his initial impressions. His office called today saying the pathology was benign. I can't remember the last time I felt such a sense of relief.
4) Outside of my own cancer scare, there were no major tragedies, (outside of the issue with my husband, which I'll get to later) medical emergencies, or deaths in my family. My maternal grandparents are around for another Christmas, which, at their ages is pushing the life-expectancy envelope. And I'm thankful for that.
5) Going to the Super Bowl in February & watching the Packers win it all. This is not on the list purely for football reasons; traveling to North Texas and staying at the Great Wolf Lodge was one of the best experiences I've ever had with my family & the entire group from Packers Fan Tours which came to feel like family.
6) I fall more in love with Apollo everyday. Of course I love Angel too, but my relationship with my dogs has always been closer than with my cats. There were times during the past year where I thought I'd never feel about Apollo the way I felt about Peanut & I was right: I don't feel the same way about Apollo as I did about Peanut, but that's pretty normal and it's ok. Parents love all their children, at least good parents do, but it's ok to love them in different ways.
7) My husband has been sober since July 28, 2011. This was not an easy year for our marriage, and that's putting it incredibly kindly. However, I married a man of integrity and I knew he was buried in there somewhere. That man is showing more and more of himself. The wounds of the last couple of years will not heal overnight, but they will heal. They've already begun healing.
8) I'm one more class closer to being able to begin my internship as a Substance Abuse Counselor; 2 down, 3 to go. I'm very excited about my professional signature being: Kristine K. Sack, LPC-IT, SAC-IT, and eventually Kristine K. Sack, LPC, SAC. And from there it will be Dr. Kristine K. Sack, PhD, LPC, SAC.
9) Spending Labor Day Weekend with some of the most kick-ass chicks I know (minus 2).
10) My friends, both local and far away, who have supported me, loved me, let me cry when I needed to and kicked my ass when I needed them to.

How do you measure a year? How about love?

Why I'm Quitting Smoking, Why it's Going to Suck, & Why I'm Going to do it Anyway

So the countdown is on. I am officially quitting smoking cigarettes this Thursday, 11-17-11 which is the Great American Smoke-Out & the day before what would be one of my great-aunts 76th birthday. She died in April 2010 partially due to complications of lung cancer. My brother quit smoking that day after we got the early morning call that she had passed, & has been smoke free since, which kind of knocks my socks off & gives me hope that I can do the same.

My history with smoking overall has been inconsistent since I began smoking at age 16in late January of my Junior year of high school. Whenever I hear adults talk about "peer pressure" to engage in unhealthy behavior, I still have an image of some kid standing in the shadows with a sweatshirt hood hanging low over his eyes, a cigarette dangling from his scrawny pale fingers, whispering, "Come on, just try it once. It won't hurt you. You might even like it." But that's not really what peer pressure looks like. Peer pressure isn't even the correct way to describe it; it's more like wanting to fit in, not seeing any consequences (because who the hell sees consequences when one is 16 years old & don't even get me started on how the pre-frontal cortex isn't fully developed until roughly age 25, when executive functions actually kick in), & in 1987 smoking looked cool. I'm in no way shape or form blaming any of my friends for the fact that I chose to start smoking; I'm just describing the circumstances around it.

So I smoked from age 16 (1987) to roughly age 23 (1994) when I quit because I started dating the MD I worked for & we discovered much more addictive ways to handle stress & anxiety.

I started again in approximately 1998 when I began working with several people who smoked, people who became my close friends. Which illustrates a trend here of how easily I adopt the habits of those around me. This is true not only of my history of smoking, but also a myriad of other behaviors, which I'm not going to get into here. As a therapist, I know these are things best discussed & explored in therapy.

By the summer of 2002 I had quit smoking again, and again had taken up more addictive measures of dealing with stress & anxiety. That's one of my favorite excuses for smoking: it helps me deal with stress. It helps relax me. When I'm angry/anxious/sad/fill-in-the-emotional-blank, smoking helps calm me down & center myself. I've actually said that: smoking "centers" me. Denial ain't just a river in Egypt.

The final time I started smoking was February 2003. (See how I wrote that: the final time - that's positive thinking.) I was in residential treatment for the final time (see, again more positive thinking) & of the 10 people in the house with me for 28 days, 8 of them smoked. I was one of the 2 that didn't...at the beginning. After about 4 days I felt that all of the socialization and "bonding" between clients was happening outside in the smoking area. So on day 5 I asked to "bum a smoke" from someone who smoked the brand I had last smoked and I've been smoking ever since.

I will take my final puff this Wednesday, 11-16-11. (Final puff; more positive thinking.) I don't know if I'll stay up until midnight to get every last suck of nicotine & carcinogens that I can. I don't have any plans to. I bought my last two packs of cigarettes this morning. If I have any left on Thursday morning, I may likely play Mozart's Requiem as I crush them & flush them down the toilet, but that's all the official ceremonies I have planned. I do have plans to use nicotine lozenges for several weeks to get me through the roughest times, which statistically are related to the number 3: 3 days, 3 weeks, & 3 months are the hardest times for people who have quit. I have plans to contact a toll-free quit-smoking support line where I'm already registered & have told them my quit date. I have told most of my co-workers so they can help support me & "talk me down" which I anticipate needing. I also have a jar where I will put in the money I would have spent on cigarettes. If I slip & smoke, I have decided that I will send the money collected in the jar up to that point to an organization I really, really dislike: Sarah Palin's PAC. That's called motivation to get through the rough spots.

I've used the 12 steps, supportive friends, motivation, & a butt-load of consequences to recover from using some really nasty and addictive substances in the past. Now I will use them again to recover from one more really nasty and addictive substance.

Don't You Forget About Me

Recently I had the wonderful experience of spending the long Labor Day weekend with five wonderful women who have known me since I was approximately 13 years old – that’s about 27 years.

Of course there are people I’m friends with on Facebook that I knew in Junior High and high school, although my contact with the majority of them is pay-by-play updates during Packers games, which is great because there was no way on God’s green earth that most of us would have actually spoken to each other during junior high or high school, and the fact that we now comment on the 5/4 defense amazes me: it amazes me that I know what the hell a 5/4 defense is, but I do!

But this group of women that I spent Labor Day with (minus two who couldn’t make the trip and were sorely missed) have known me for so long, I often describe our friendship to others as: They don’t ask me why I am the way that I am. They were there when I was becoming who I am. Which to me, is a statement of unblemished loyalty, and if there’s one thing I am, it is loyal, often to a fault.

In early 2006 I had a “medical nightmare” (complications from a simple gallbladder removal that landed me in a local hospital for six weeks and included a pulmonary embolism, [a blood clot in my right lung], a buildup of fluid around my liver [I have no idea what the fancy-schmancy medical term for that is], a pleural effusion [fluid between my right lung and my chest wall] which required placement of a chest tube for five days.) When my surgeon pulled out the chest tube, his first words were, “Oh no.” Not something that I really wanted to hear. While pulling out the tube, he snapped the tip off and it was lodged somewhere in my back. An emergency CT scan pinpointed its location and I had surgery the next day with one of his colleagues (he had to be in Minneapolis for a conference, you see) to dig around in my back to retrieve it. Pre-op I asked the attending surgeon if he could put the tip in a bag so I could keep it. He flat out told me that that was an odd request. From my gurney in the OR, I flat out told him that it was odd that an experienced surgeon should make such an error. He shut up and I’ve got my chest tube tip in a biohazard bag in my underwear drawer, where most women generally keep anything of value.

Anyway, I’ve still got the card that came with a bouquet of flowers from these friends who have known me before I knew myself. It reads: Thinking of you. Get better soon! Love – followed by five names that I will not list to protect their privacy. The flowers were delivered to my parents’ house because I had to stay someplace that could provide 24/7 care, which left me with two options: my parents or a nursing home. I was 35 years old and could not envision myself at a frickin’ nursing home, so I chose to stay with my parents.

When the flowers arrived, I gently opened the tissue paper and located the card and read it out loud. My mother and I both started to cry. She because those whom she knew as kids still cared enough about her daughter to send flowers when I was gravely ill, and me because that simple gesture assured me that I had a history, that I had deep, strong roots, and that in a world of full of six and ½ million strangers, five people cared enough about me to send flowers and wish that I got well soon. It made me feel as important as the Queen of England, only much more sincerely loved.

So, on Labor Day weekend, we tossed cow chips (or bought tee shirts declaring that we were there to witness the tossing of said cow chips), ate German food we couldn’t pronounce, shared stories on the porch that got us yelled at by the neighbors (hell-raisers to the end, that’s got to be part of our motto!), and spent time eating our way around Capitol Square in Madison and visiting the only known feminist bookstore in the entire state of Wisconsin.

To commemorate this weekend (we were celebrating the fact that we had all turned 40 this year – oy!) some of us made cds with songs that reminded the cd creator of each of the weekend attendees. It seems somehow very personal to reveal the songs each of us chose for each other, so I will not list any song titles here.

After all, some things should remain between friends, shouldn’t they?

What is "happiness" to you?

At work lately I’ve been hearing quite a few people say something similar to, “My life just isn’t how I pictured it would be at this age.” Needless to say, as a counselor, that’s a very “meaty” statement to my ears and can elicit an entire universe of topics for discussion. One topic I’ve been giving a lot of personal thought to these days is how, as individuals, we define happiness at different points in our lifetimes.

Remember the summer when you were six years old? Just close your eyes and think about it for a moment. Remember the smell of freshly cut grass? Remember your dad grilling burgers and brats on Saturday afternoons, a Brewers (or perhaps a Braves) game on the radio in background, in the garage? For me it was full of riding my Big Wheel with neighbor kids, eating an endless amount of Freeze Pops, playing softball in an empty field in our neighborhood where we made “bases” out of cardboard box scraps. And I too remember fondly the smell of the freshly mowed grass and my own dad grilling out, listening to the Brewers. The Big Wheel, the Freeze Pops, the Kool Aid, all of it was happiness for me then. As a young child, those are the physical things and events that shaped my definition of happiness.

Now, remember when you were 14 years old? Ugh! It’s honestly a bit hard to think of things that helped me feel happy then, because early adolescence, heck, all of adolescence, is not usually a very happy time for the adolescent and for his or her parents. But of course there were countless times when I was happy; getting my first phone call from a boy, junior high school dances where all of the boys stood on one side of the gym and all of the girls stood on the opposite side, starting to baby-sit for neighbors and actually making money for the very first time (and this was tax-free income which was even better!) The boys, the dances, the 50 cent an hour baby-sitting money all helped define happiness for me then.

I’m sure by now you can see where I’m going with this: what made us happy earlier in life are likely not the things that contribute to our happiness now, except of course for the memories. As we age, our definition of happiness changes, and most of the time we don’t even know it! It’s not until we take stock and find ourselves saying, “My life just isn’t how I pictured it would be at this age,” that we even consider what experiences play into such a statement. When I was a little girl and “played house” with my younger sister and other girls from our neighborhood, we all declared that we were 25 years old and drove red sports cars. That’s what we pictured 25 to look like as seven and eight year-olds. I specifically remember thinking on my 25th birthday how completely unrealistic it was for me to think that 25 was some magical age, when life would be the way I wanted it to be and that I could afford a red sports car.

I turned 40 earlier this year. As the decades turn, those birthdays generally seem to be good times to “take stock” and assess the situation that is our lives. How did I get here? Do I have any regrets? Is this how I pictured my life at this age? Am I happy?

I can tell you one thing for sure, I don’t regret anything. Have I made mistakes? Of course! But I believe that if I had not done what I did at the time that I did it, I wouldn’t be the person I am today, and I really dig the person I am today. Am I happy? I don’t ride Big Wheels or spend time in crepe paper-filled gyms on Friday nights anymore, but I am happy. My definition of happiness has had to grow up along with its owner: me.