Pre-Operative Assessment Clinic

You might think that at your Pre-op you would get a feeling for what to expect in your upcoming visit to the hospital at which your surgery will be... a feeling for the facility and the nurses and the other medical professionals that will be taking your life into their hands.  What to expect when you're under the knife, and how you will be handled afterward.  

I am here to tell you that that is not always how it goes - or at least I hope that is not why my day went the way it did yesterday!

I left the building with more confusion than I had when I went in, not very much confidence in the staff that looked after me, and with painful bruises on both of my cubital fossa! (hehe cubital fossa = the inside of your elbows, like, where they put in the needles to take blood - brutal vampire nurse yesterday, just sayin'!)

My Mom and I bombed down to Toronto East General Hospital yesterday to get the lay of the land for my surgery next week, and to provide health stats, bloodwork, and any information about my life that my surgeon may be missing; get all my ducks in a row for surgery.  Other than the bloodwork I think it could all be done by phone or skype, or fax, or smoke signals..?   But no, I had to physically trip down there to dot the i's and cross the t's.

I have done this before, I clearly remember how my pre-op was at Sunnybrook before my surgery in May, and it was no fun either - I am starting to think it may just be a symptom of pre-op visits that they are a shit-show?  You don't actually get to see the surgeon, it is all looked after by nurses and pharmacists, and sometimes the anesthesiologist, though I did not see mine yesterday. 

Overall, the visit did not provide a fantastic first impression of the hospital in which I will spend some time next week.  Maybe I have been spoiled by the excellent care I receive at Sunnybrook, or maybe I just have a bad attitude about this thyroidectomy and node dissection(S) because I hate surgery. AND because I find it truly inconvenient that I have to have parts of my precious body removed, when really I didn't ask for this in the first place! Yes, could be a slightly bad attitude, but I digress.....   

After a lengthy wait in an empty holding room (which to be fair, was nicer than Sunnybrook's pre-op hole in the wall waiting cell), I was escorted to an assessment room to have my vitals taken and my visits with various parties participating in my surgery prep. 

How my blood pressure remained lower than normal through this ordeal I do not know.  The nurse didn't even look at when introducing herself to me, and I find that inexcusable.  I cannot imagine my paperwork being so engrossing that there wasn't time for eye contact.

   

Ah well anyway, after a bunch of paper shuffling and calling of other nurses to figure out just how many vials of blood I needed to give, I was very grateful that my family physician had sent extra printouts for me to take with me in case TEGH didn't receive the faxes from Sunnybrook etc.  Turns out that was smart -yay Doc thanks so much for having my back!  Apparently there was some miscommunication from the surgeon?  Or not enough orders provided? Or..? 

Two hours later, all done, bandaid on one sore cubital fossa (now please remember I get tonnes of pokes these days and I am not fussy about it, I don't watch them do it but I don't cry or wince or bitch either, but this nurse was OUCHIE) (GRRRR), jacket on and in line at the Timmies in the lobby to get a cuppa joe for the long ride home in rush hour traffic, and I hear "hellooooo hello! Hello? Look up!" 

A voice in my head?? Is a deadly chandelier going to fall from the ceiling of this dump and end all my complaints about cancer in one quick crushing blow?  Nope. No such luck.  It was my no-eye contact vampire nurse calling from the open balcony above the lobby, asking me to please come back up - she found the paperwork and she was so glad she caught me in the lobby!  grrrrr

Two more bad pokes and five more vials of blood with two more nurses involved to confer over whether or not they had the right vial colours for my apparently fancy blood test orders (does "ionized calcium" ring a bell to anyone?) that had to be contained on ice, and another 20 minutes later I was heading back downstairs to my exasperated MotherBear who had somehow contained her obvious criticism of the situation (remember, she is a retired nurse who has many times offered to do my bloodwork for me herself! LOL). We ditched the coffee run and instead broke free for the parking lot.  Yes, we actually ran. As in, get us outta here!!!  

Overall, not a great first impression of TEGH, and I said as much to my surgeon's assistant this morning.  She apologised for the inconveniences and assured me she needed to know how things went so she can monitor their dealings with other hospitals at which her boss works.  She said that I should in no way doubt my surgeon, that despite the bad first impression of the hospital, she is completely confident that I will be well taken care of next Wednesday when directly in my surgeon's hands.  oh dear.  I hope so!!  yikes.

One of the highlights of the excitement yesterday, and the reason for my hasty call to the surgeon's office this morning, was that the nurses blithely stated that I should plan on a three day stay in the hospital - THREE DAYS IN ADDITION TO SURGERY DAY.  WHAT?? I asked several times if she was sure, if that is common, if she was sure, as the surgeon told me himself that as long as everything goes okay I will be released the next day.  

She said yes plan for three days and I asked repeatedly how I could find out for sure as this would be crucial information to know as I have a young family and we live three hours away!?  She said she didn't know but was pretty sure - I suggested that having a backup plan in case of emergency something goes wrong is far different from PLANNING for a three day stay.  Aaaarrrghhhhh 

Long story short, this morning my surgeons office confirmed that I need only plan for one nights stay, unless there should be an emergency.  They used to keep people in intensive care for three days after a thyroidectomy, due to necessary monitoring of calcium levels, but not anymore.  So... as it stands, I am expecting to come home Thursday Dec. 4.  

Lots of shuffling has happened since I got the surgery date, but we are now one week out and I think it is all organised.  Scott will be taking me to my operation, we will be in Toronto Tues. Dec. 2 through Thurs, Dec 4, and my Mom is coming to stay with the girls and taxi them to and from school, ankle x-rays, and play performances etc.  Then Scott leaves for work likely on the Friday, Mom will stay until Sunday, and Grandma Iris is coming first of the following week to help taxi and look after the girls while I rest and recuperate for a few more days.  Yes, I do expect to get some much-needed rest in my cozy master suite LOL - can I start now??  ;-) 

No confirmation of post-operative assessment date, but looks like it will be one week after surgery, on or about Dec. 11, 2014.  

In any case, I suppose I am grateful that the pre-op is over with and an accomplishment to add to my cancerous list, but I am grateful that my post-op care will continue at Sunnybrook and the whole thing will be behind me about a week from now.  I will be tired I am told, and I will have to start taking a supplement to replace my natural thyroid function, and I will have to start taking a calcium supplement, but otherwise everything is rolling along as it should. 

I am just about to the point where there is nothing else I can do to prepare for this thing, so I have to let it all go and just roll with it.  I lost control of this bus ages ago!!

I'm not supposed to look this stuff up, but if you want to know more about my diagnosis of Papillary Thyroid Cancer, this is where I would maybe start looking. Here too.  :-)  Oh and Canadian site here: http://www.thyroidcancercanada.org/

Thyroid Hormone Replacement and Papillary Thyroid Cancer?

Regardless of whether a patient has just one thyroid lobe and the isthmus removed, or the entire thyroid gland removed, most experts agree they should be placed on thyroid hormone replacement for the rest of their lives. This replaces the hormone in those who have no thyroid left, and to suppress further growth of the gland in those with some tissue left in the neck.

There is good evidence that papillary carcinoma responds to TSH secreted by the pituitary, therefore, exogenous thyroid hormone is given, which results in decreased TSH levels and a lower impetus for any remaining cancer cells to grow. Recurrence and mortality rates have been shown to be lower in patients receiving suppression.

Chemo Brain

I have recently and reluctantly discovered that I am experiencing a reasonably common but little talked about medical condition nick-named "Chemo Brain."  

Though I have always been fantastic at multi-tasking and typically have abundant energy for professional and social details, I have also been able to laugh at myself for being occasionally dippy, and I am known for forgetful little things such as over-introducing people LOL -oops so you have already met this person I am introducing you to again? Several times? at my house?  I chalk that up to social graces and making sure nobody is left feeling uncomfortable not knowing each other.  ;-) 

But in the past few months I have noticed some uncomfortable changes in myself and my patterns of thinking. A few of my close friends, and my family doctor, spoke to me about my shifts in thinking being more negative than usual, and my depressy and lackluster approach to things seemed to be overpowering my usual cheerful-laugh-in-the-face-of-danger personality traits. Turns out there is medication for that, which I have never taken before in my life, but apparently is commonly prescribed to patients receiving the type of immunotherapy treatments I am. Since taking the meds I am feeling a bit better in the depression side of things, but I am still very aware of the Chemo Brain.

Though I am not taking a traditional chemotherapy (because melanoma does not respond to chemotherapy, it was not offered as an option in my treatment plan), I am indeed taking a chemical treatment that affects the human body head to toe.  

Though I don't have the intense nasty physical side effects of what we commonly know about chemotherapy, I do have the same potential for long-term organ and tissue damage, like chemo.  It is a risk, but apparently one worth taking. We shall see. 

One of those long-term side-effects which I am already finding to be affecting my life is Chemo Brain.  For the mothers in my reading crowd, you may be able to relate if you ever had "Baby Brain" during and after pregnancy?  It's kind of like that (speaking from experience!).

I took myself to see a fantastic movie in theatres a few weeks ago, and it had an unexpected cancer twist.  Without giving away any plot I can tell you that there was one scene where the main character had to openly discuss a health issue he had been hiding from his family and the public.  This character was a highly esteemed officer of the law and he did not want to admit his challenges with mental setbacks for fear of losing credibility.  

In one scene where he was being interrogated about something very important that he could not recall whatsoever, and his cancer treatment side-effects were being blown open to the public, he easily admitted to the nausea, vomiting, exhaustion, headaches, physical weakness, etc. But when asked about his memory loss and decrease in mental sharpness he defensively exclaimed "But that doesn't apply to me!"  This scene stuck in my mind, and I could relate to his reluctance to admit a decrease in mental function.  I can tell you about my physical limitations but I don't want to admit to my feeling like I'm losing my mind! I am too strong for that!  I can handle this! 

Why do we do that?  Are we weak if we admit defeat?  Are we weak if we admit that we are struggling with something, that we are afraid of the future, if we are afraid that we may never feel back to "normal" again?  Are we perceived at losing an edge or not being "positive enough" if we admit that we are not running on full mental capacity?  I'm sure there are plenty of mental health studies on that and I don't want to elaborate on mental health at this point, except for how my experience with cancer treatment is affecting mine.  It is a real factor, and I have no choice but to be open about it.  

My kids notice it the most LOL and they just tease me and take it in stride when I can't finish a sentence without searching my brain files to spit out what I started to say... or when I intend to say one thing and an entirely different thing pops out of my mouth.  I think their favourite (beyond my mixing up their names - to their faces - a 12-year long saga of twin parenting I'm sure) is my asking them to please tidy up their broccoli! and make sure their dirty laundry goes from the hamper to the fridge!? Geez Mom you're losing it!! 

I am easily exhausted, physically but mentally as well, I find I am overly sensitive to noise, I don't like surprises as much as I did before, I like my peace and quiet alone time even more than before (my best friends all know and lovingly understand and respect what I mean when I say I'm hibernating, but they do haul me out of bed if they feel I have been hibernating too long).  I have to write everything down, and I practically carry my calendar around with me to make every note in one place, pink sticky notes and paperclips have made my "calendar" quite thick. 
Driving my beloved car is a more stressful experience than it has ever been, I have questioned my own judgement a couple of times, which scares me.  My eyes get all burny feeling when I talk too much, and I have to lie down flat when the dizzies take over, which makes me angry and frustrated therefore tired and uncommunicative. I find I don't even want to drink anymore (after all this complaining about having to keep my liver clean) I feel uncomfortable with the loss of control even a little fireball or wine causes. Eeek I never thought I would say that!?! 

I worry about this side-effect specifically as it relates to my job.  I know it has been a while since I have been there.. but believe me I am actually gainfully employed. LOL I am pretty open with my boss about how I am feeling and he seems confident that I will recover and get back my "edge" needed for my busy multi-tasking management position, though I lack that conviction right now and I fear that I will not be able to do my job with the same physical AND mental prowess I had before.  Time will tell... until then I am comfortable knowing that I just have to look after my family and their broccoli troubles. And my friends can tease me about re-telling my stories, and enjoy the fact that they can re-tell me theirs because I am largely unaware of what I have already been told. :-) 

I'm thinking this is a main reason for this blog... y'all can read about how I'm feeling, and if I repeat myself it's just because you're re-reading. ;-)  I can look back on my written word to see if I'm repeating myself. Point for self-preservation - phew! 

I found a great article about Chemo Brain and I will share some points from it, in addition to the link to it:

What is chemo brain?

Here are just a few examples of what patients call chemo brain:

• Forgetting things that they usually have no trouble recalling (memory lapses)

• Trouble concentrating (they can’t focus on what they’re doing, have a short attention span, may “space out”)

• Trouble remembering details like names, dates, and sometimes larger events

• Trouble multi-tasking, like answering the phone while cooking, without losing track of one task (they are less able to do more than one thing at a time)

• Taking longer to finish things (disorganized, slower thinking and processing)

• Trouble remembering common words (unable to find the right words to finish a sentence)

"Doctors and researchers call chemo brain many things, such as chemotherapy-induced cognitive dysfunction/impairment, cancer-therapy associated cognitive change, or post-chemotherapy cognitive impairment. Most define it as a decrease in mental “sharpness” – being unable to remember certain things and having trouble finishing tasks or learning new skills. Some doctors call it chemo brain only if it doesn’t go away or get better over time. How long it lasts is a major factor in how much it affects a person’s life. When it starts, how long it lasts, and how much trouble it causes can vary a lot. So the term “chemo brain” is not completely accurate. Still, it’s what most people call it right now.

For most people, brain effects happen quickly and only last a short time. Others have long-term mental changes. Usually the changes that patients notice are very subtle, and others around them might not even notice any changes at all. Still, the people who are having problems are well aware of the differences in their thinking. Many people don’t tell their cancer care team about this problem until it affects their everyday life."

What causes brain problems during cancer treatment?

"Studies suggest that there may be more than one cause of chemo brain, especially for the short-term symptoms. Some people with cancer have very real brain problems even though they have not had chemo. Still others notice problems when getting hormone treatments, such as estrogen blockers or androgen deprivation therapy (treatments to lower testosterone levels). For some, problems start after surgery. Along with chemo, many different things can worsen brain function.

For instance, brain function problems could be caused or worsened by any one or any combination of these factors:

•    The cancer itself

•    Other drugs used as part of treatment, such as steroids, anti-nausea, drugs used during surgery (anesthesia), or pain medicines

•    Low blood counts

•    Sleep problems

•    Infection

•    Tiredness (fatigue)

•    Hormone changes or hormone treatments

•    Other illnesses, such as diabetes or high blood pressure

•    Nutritional deficiencies

•    Patient age

•    Depression

•    Stress, anxiety, worry, or other emotional pressure

Most of these cause short-term problems, and get better as the underlying problem is treated or goes away. A few, such as depression, can cause long-lasting brain problems unless the cause is treated.

So far, there is no known way to prevent chemo brain. For some people, treating their cancer will mean trouble with thinking, memory, planning, and finding the right words."

 Source and more interesting info: http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/chemotherapyeffects/chemo-brain

Italy

OK I'm doing it... re-posting an old blog article.  Some of you may know that I used to have a blog years ago - yep, I've looonng been a blabbermouth. 

Combine that with my dreams of travel back to Italy, and the restful part of this snow day affording me some tinker-time with the computer, and here it is:  the "Maserati" part of my inspiration for this blog. Enough about the Motherhood and Melanoma for a minute... let's talk Maserati.  :-)

In 2009 I wrote about my March 2007 trip to Italy (funny, only seven-ish years ago and I happened to notice in the photos that my hair was remarkably darker then than it is now).  Here goes... as I remember it:

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Ahhh Tuscany... it even smells like purple.  I had the memorable pleasure of exploring Florence(Firenze), Italy in March 2007.  Several hundred photos remain of this trip, and I have filled a journal and two photo albums with notes and observations, but for the purpose of this blog I have included just a few of my favourites.  Another excuse to sit and daydream about my experiences there...

We flew from Toronto to Frankfurt, Germany, then on to Milan, Italy, arriving on a Sunday morning.  By early afternoon we had navigated our rental car to Pisa, in Tuscany.  While there we just HAD to see the famous tower, and of course, sample authentic pizza in Pisa, for the kids of course. After a few hours there we got to our hotel in Florence, on the Oltrarno side of the Arno river, away from the touristy downtown core.

 

Pizza in Pisa:

 

Monday we drove to Siena, found breakfast and an unforgettable morning of touring around the stone streets, savouring the pace of life there.  Laundry hung from window sills in the sun, and palm trees dotted the lush vegetation.  Siena is worth another visit, longer next time.

Siena streets:

   

                 Siena grocer:

 

 

Monday afternoon we drove into Florence downtown, and found the Duomo (you wouldn't think that such a large structure could be so hard to find), some lunch in a little ristorante (a real caprese salad!), and walked around the piazza.

  

I won't even begin to describe the food... that would take up the rest of this post.  I love to sample new foods, perhaps even more adventurous when travelling (I wouldn't try octopus in Meaford!).  To say that I have always been a fan of Italian food would be an understatement, so this trip was really a dream come true for me in the ristorante department.

 

That evening we walked from our hotel to a nearby ristorante called La Piazzetta, wonderful place, charming, cozy, hip, everything you might expect from an eatery in fashionable Europe.  We had an entertaining (and sort-of-english-speaking) server who helped us decipher the menu and order a beautiful sampling of local dishes. The pici pasta was unique, Chianti better than any I had tasted at home, and dessert was a surprise, two selections made by our server.  He seemed to know just what we would like and capped off the meal perfectly.  If you are in Florence and want a quiet but fun place to eat delicious authentic food, go to La Piazzetta.

 

We noticed this little car wash while walking off the Grappa. Perfect for their little cars:

Tuesday I was on my own, and I did some extensive walking around the city following my Lonely Planet travel guide to Florence suggested walk tours (excellent - I highly recommend those).  Found so many interesting things.  Ponte Vecchio is still my favourite!

Medieval gate to the city Florence:

Santo Spirito:

 

                    Back of Ponte Vecchio from a private balcony:

                           View Ponte Vecchio from Uffizi Gallery:

               Inside Ponte Vecchio, priceless modern day jewellery:

 

Me @ Basilica Santa Croce - to this day I can hardly believe it

Wednesday morning I spent at the Uffizi Gallery - breathtaking, indescribable, highlight of the trip for me.  In the afternoon I found the Cappelle Medicee (Medici Chapels).  After a fascinating tour of the interior of the chapels, including an incredibly close look at Michelangelo's marble sculptures 'Night/Day' and 'Dawn/Dusk' as well as some early - incomplete - sketches preserved on the walls, I dazedly wandered through the ancient jewels and treasures displayed on the lower levels.  I was glad I had taken the advice of the jewel merchant behind Ponte Vecchio to see the Medici collection.

                               Behind Medici Chapels:

 

Thursday I set out on another hike, had a few errands and another cashmere pashmina to buy, then up to Piazzale Michelangelo over-looking the city.  The weather was perfect for walking, sunny and warmer than March here, but not blistering hot like summer in Tuscany.  I walked past Fort Belvedere, along the road where Galileo lived for a time, 

<-------- Galileo lived here

and found the monks chanting at San Miniato al Monte, up on the hill above the medieval city.  This place is gorgeous!  Stephen and his Russian colleague met me up at Piazza Michalangelo, and we enjoyed the view before we descended to dinner again downtown.

                                         Fort Belvedere:

                             Exactly like in 'Under the Tuscan Sun'!

                   San Miniato al Monte - romanesque with contrast:

 

                               Remnants of medieval city walls:

 

                 View from Piazzale Michelangelo:

Friday we left Florence to spend a day in Verona before heading back to Milan to fly home early the next morning.  What a trip - as we drove north to Verona we saw incredible orchards and vineyards, unique (and new) architecture as a contrast to the historic vistas of the week.  Had lunch at a sunny caffe in Verona, then toured on foot the arena and several touristy stops.

 

Arena, Verona:

                 The famed balcony of Juliet ~ Romeo... Shakespeare:

Views from atop arena, inside it:

 

It was torture to be so close to Venice but not have enough time to go there - next time for sure. On the way back to Milan from Verona we hit a traffic jam, reminiscent of Toronto, except with way cooler vehicles - not a pick up truck to be seen.  Flights home were good as well, except that Air Canada fed us - of all things - pizza!  (yuck)      Wonderful trip overall, can't wait to go back! 

Bonus pics, love the vehicles...

                                NOT Maserati:

MASERATI:  :-)  :-)  :-)

Grateful

Wow I am truly overwhelmed today, with gratitude, for everything in the past day or so.  I sincerely appreciate the calls, drop-bys, offers of help, and deliveries of stuff today and yesterday.  I can't even express how helpful it has all been, whether by email, text, phone, or in person, I have had so much assurance, that I am almost starting to believe that things will be okay over the next few weeks.  You are such amazing friends thank you thank you thank you!

Snow removal today was huge - several people arrived throughout the day to plow out the driveway, one of which I was aware had already been gifted to us by my very special you know who you are. :-) Thank you!  And to the others, thank you also, I will track you down at some point and figure out who you are?  LOL 

(umm... that's my car...)

Food - oh wow thank you! I have been feeling so worn out from the treatments, that my usual hobby of cooking seems to be taking a break at the moment, I have no desire or energy to shuffle around the kitchen after covering silly other little basic tasks like waking up.  Thanks to all of you who have heard me and brought stuff by.  The girls extend their thanks too!  yummmm  Pea soup with smoked turkey, fresh fruit and veggies, cauliflower soup with cheesy garlic croutons, chicken and quinoa soup, pecan pie, pasta casserole, pork chops in gravy, cupcakes, omigosh all SO delicious! AND stuff for the freezer too! And healthy, mostly hehe!

Another act of kindness today happened at Sunnybrook but affects me in a huge way:  this morning on my parole call I spoke with the nurse about my last CT scan (Oct 27) results which I was reading online for the first time this insomniac morning around four.  

I read the paragraph written by the radiologist about my neck CT, and noticed there was description of problem lymph nodes on my left side as well as the right. They describe the nodes with measurements in millimetres, yuck, they're not supposed to be that big.   I know the surgeon examined my neck with ultrasound when I met him, but he didn't look around my left side very much. I could have been reading the report wrong, but I brought it up to the nurse on the phone as I would hate to have my thyroidectomy plus central and right nodes removed, only to find out a few months from now that I need to have another surgery because they didn't get it all?

The nurse OFFERED to print the report for me and physically walk it to my surgeon today and bring it to his attention - I was blown away, as they are awesome down there, but this was above and beyond what they normally do.  Not only did she do that, but she CALLED me back this afternoon to confirm that she did actually take the report to my medical oncologist and together they took it to my head and neck surgeon.  

Do you know how many phone calls and voice mail systems I would have had to endure to have that happen without her help?  Oh geez I thanked her so much... she is the one from up here; we were talking about small towns this morning and I was gushing about how lovely our snow day is today and how fortunate I am to have such wonderful support around my family.  She said she was raised in Goderich and misses that feeling not living in a small town now. 

I do love this small town, and I love a good solid snow day like today, but this has to have been the best one in my history.  I had someone ask me today how the heck I can get any rest with everything going on here, as I should be taking it easy leading up to my surgery, and it's a good question! But I have been able to rest easy today (between visits) with all of your help. 

Oh shoot one more thing (will I ever post a SHORT blog??) - amazing news for Claire:  I spoke with her leader at the upcoming theatre production, and while we were chatting about play rehearsals being cancelled due to weather tonight, I gave her a heads up about Claire's ankle.  I explained how upset Claire is that she may not be able to be in the play as she wouldn't be able to swing it all with no weight-bearing on the broken tootsie 2 1/2 weeks from now, and she said not to worry, they will figure out some way to make it work!  

Claire and Cass are "wood nymphs" in the play and this lovely lady told me to hug Claire and tell her not to worry she would NOT have the play without Claire being on the stage.  Yes here I am blubbering again... she told me that their costume designer is a genius and if they have to decorate Claire's cast as a tree stump and wrap her crutches with "vines" then that's what they would do to have her participate.  Claire is happy - happy tears all around. 

So... full bellies, warm and cozy not drifted in anymore, and our eyes leaking out... we may be a bit of a mess over here, but we are a happy mess.  Thank you my friends, how can I ever thank you?

Snag #7842703

So in my last post I mentioned my fated Mario-style constant jumping and diving of obstacles, on fire.  Well Claire and Cassie seem to have inherited my love of adventure... and their Dad's love of breaking bones. Sorry Doug, I am blowing wide open our long-standing joke (reality) about all of the girls' broken bones growth plates bumps bruises etc. being from your end of the gene pool.

Claire broke her ankle Thursday evening playing basketball.

Yesterday we spent the morning together at Meaford Hospital (you may recall I was desperately avoiding the place just this time last week?) and emerged with an air-boot cast thingy, thankfully I was able to talk the Doc into that instead of a plaster cast.  

Claire can remove it for showers - thankful again for the bathroom reno we did this past March which includes a walk-in shower with seat/bench - and to change her clothes but otherwise she has to keep it on and pumped up.  

How does this affect our family dynamic you ask?  Yes we are a bit busy these days... did I mention the stage play in three weeks?  Claire is bound and determined to continue with the play, her super-woman approach scares me.

I just called her at her Dad's, she said the cast is very uncomfortable to sleep in and she has to plan her activities to allow more time, her armpits and hands are already getting sore from her crutches, but she is actually pretty experienced at this so she is adjusting quickly.  Dad is pampering her with her breakfast of choice today, chocolate chip pancakes I hear.  :-) Phew, happy to talk to her and to Cass.

Cassie did just remind me on the phone that she now needs to be extra careful again because their injuries seem to alternate... Claire Cassie Claire Cassie Claire Cassie sigh sigh sigh AGH!  I asked her if she could please wait until the new year as November and December are sort of booked up.  She huffed - the nerve! ;-)

On facebook last night I posted that I will be getting the girls bubble wrap for Christmas, and a membership to a CHESS CLUB.  Seriously, for those of you who know us you may be mentally trying to tally the breaks and bumps the girls have had in their short active lives, I think one of my jobs today will be to go back and add them up.  We started with Claire's broken collarbone (ice skating) when she was in senior kindergarten, then Cassie's concussion (a climbing mishap at school) in grade one, Claire's broken and dislocated toe which needed surgery, Cassie's broken wrist (then broken thumb from an ATV accident while in the cast for the wrist - just saying!), at least a couple more broken toes and a thumb (TWICE) since then.... I'm exhausted. 

Trouble is, Claire will be too.  Luckily this break is in the growth plate, so it should heal quickly (she is gulping milk with her pancakes), follow-up xrays in three weeks - oh yah I can't make that one.  :-(   But the next three weeks will be interesting, she will have to foist off her babysitting job(s) - phew for a twin, Cass said she'd take over in the interim.  And their dog-walking job will have to have other arrangements - somehow I see myself being roped into taking the less active pooch around the small block with Cass and her active puppy charge?  Not to mention the play and rehearsals. Grade three piano lessons/practice without pedal. And school, they are smiling over the fact that they will get rides to and from school now for at least three weeks. HA HA Mom. 

Just to throw in my whiny cents worth again this morning... I have to mention that this affects our home life too.  The girls have been doing a great job at helping out around the house extra and now I've lost my star helper, and the secondary star helper as she will be tending to her sister. For everybody who has or has had kids with broken bones and crutches etc, you know how incredibly invasive the damned things are to your daily household routine.  I will have a full-time job on my hands trying to keep the kid down and resting more let alone pick up her slack in the chores I already have been having trouble doing.  

I think I am going to finally take up CCAC (I have ongoing nursing care, thankfully!) on their offer to help around the house.  I have been resisting that thinking that housework is therapeutic for my rehabilitation, and my family has been great at picking up the slack. But it may be time to call in that favour.  And... again... I find myself thinking that I need to get better at asking for and accepting help from all of my friends and family who are offering to help us. Damn my independent streak - buddy I think we are fighting a losing battle!?

I am going to sit down today and make a list of the stuff I/WE need help with in the next month-ish and I'm sorry to say... I will be in touch.  Thank you.... and did I mention... thank you. Thank you thank you thank you.  :-) 

Some injury pics from the Richardson girls' archive:

 Claire's baby toe fracture and dislocate - 

surgery with pin Owen Sound, Nov 2011

 Cassie's broken wrist, biking, June 2012

Thyroid surgery date

So.. three weeks from now I will be without my thyroid gland and all the lymph nodes in my throat and right side of neck. Ew gross, I guess that sounded a bit graphic. Blech  Surgery grosses me out SO much!!

I finally got the date confirmed yesterday, my next surgery will be Wed. Dec. 3, 2014.  Complete thyroidectomy, central node dissection, and right node dissection. Hey did I mention I don't want to do this? I can say I have had a "node dissection" before and it's not friggin pleasant. 

Oh and did I mention that that week is crappy timing??  Claire and Cassie are in their "Kids in the Meaford Hall" Christmas 2014 production of "The Lion, the Witch, and the Wardrobe" for which they auditioned in September and have been furiously practicing twice weekly. *sigh*  Yes, I know, I can watch the dvd.  But this is Cassie's first play, Claire's second, and they both have stage roles with lines for the first time.  :-(  Not to mention the sheer number of performances (2 Thurs, 3 Fri, and Final show plus cast party Sat, THEN Meaford Santa Claus parade Sat. evening, in which the girls will be on the Bill's valu-mart float) and all the dress rehearsals and people-shuffling that will be going on from our house that week, Dec. 2-6 will be a total write-off.  Someone - Please sedate me!!

If you have kept reading through my whinyness again so far today, I will continue with a few quick details. LOL Thanks for listening.  :-) 

The surgery will be at Toronto East General Hospital. Yep.. why not throw us another curveball - I'm someday going to accept that I am just like one of the Super Mario Brothers: constantly jumping and diving obstacles. On fire.

I asked if I should be concerned that my surgery won't be at Sunnybrook and my new best friend at Dr. Higgins' office assured me that no, this happens all the time, and I should only be concerned if I was to not have Dr. Higgins. OK. So pre-op admission appointment and surgery date will be at Toronto East General, and post-surgery appointment will be back at Sunnybrook. 

My lovely and loving Mommy :-) will be taking me to surgery again and putting up with my sorry ass seeing purple tarantulas in the recovery room, and will assist me home upon discharge which should be the following morning Thurs. Dec. 4.  As for the situation at home I am still working on that, thank you for all the offers to come stay with the girls, we will work it out ASAP.

Pre-surgery date is Tues. Nov. 25, and it's looking like post-op will be Dec. 11 but that is not yet confirmed. (hey... why not wait til the last minute?)  I do currently have my Week 18 clinical trial check-in appointment for Dec. 8 but that will have to be moved, as will my Dec. 9th 6-month follow up with my first surgeon for the "right groin node dissection" surgery I had in May. hehe How many more times can I say "dissection" today?  YUCK.  Don't even ask me how to pronounce that - I think it's something like what I used to do to frogs and earthworms and cow eyeballs in high school biology.

OK enough bitching for now... have a great weekend everybody.  Thanks again for your xo's and support.