KonMari: Part Deux

Y'all.

This summer, we started decluttering the house.  We're following the "KonMari" method, in which we go through all of our possessions, touch each of them, decide if they give us joy, thank them and donate them if they do not, and keep them if they do. 

So far, we've gotten through everyone's clothes, Dave and my books, and the twins' toys.  Wow.  That's it.  Really?  Yeah.  It takes a while.  And mostly, we've just been able to do the second floor of the house.

But Holy Guacamole! 

The second floor is so CLEAN and TIDY now.  And it's *easy* to keep clean and tidy. 

There's just less shit in our house to pick up and put back in its special place. 

I swear to you, I walk up the stairs and there is a weight off my chest looking at clean and organized rooms. I know it's not perfect.  And there is still about 20% more crap to go through just upstairs, but (((sigh))) it does bring me joy.

And I swear that even though we donated more than half the kids' toys (AND STUFFED ANIMALS) to the Salvation Army, no one misses anything. 

We've still got Conor's room, the guest room (junk room), the kitchen/dining room, and some more upstairs crap to go, but I can see the end in sight.  And right now, our house has less crap and less cleaning of said crap.

That brings me great joy.

False Positive

It has been a really tough semester.

Our department on campus lost a colleague and a friend in a senseless act.  It is not possible for me--I mean, I do not have the ability--to fully express the loss and grief we feel.  And the pain we all imagine for our friend and her family and her lifelong friends around the country is stunning.  This is all I'm going to say.  Her loss is not about me or my suffering.  My--OUR--loss is about her and the hole in the universe of our lives and this community we are all forced to acknowledge.

So, tough.

In a much different vein and selfishly focused on me is that I started a new administrative position at the university.  There is a steep learning curve to any new position, but this is a very positive event and I am excited about it.   Still, eustress is stress.

And then there was this year's annual screening mammogram.  I'm at the age where so many of my friends are getting breast cancer.  And I mean MANY.  I have close friends, close neighbors, close colleagues, celebrities and it feels like pretty much everyone in between is getting breast cancer.

My screen came back this year with "changes."  I've been going regularly for several years now and I always get a 3D, tomosynthesis mammogram AND YOU SHOULD, too.  It used to cost about $35 to $50 extra, but it's such an improvement over traditional mammograms that many insurance companies are starting to cover it.  Get the 3D mammogram!

So, the good news is that tomo mammos reduce the number of False Positive call backs (the number of people called back who do NOT have breast cancer) while still NOT reducing the number of actual cancers detected.  I've seen lots of estimates, but generally, about 8% of people get called back after a screening mammogram, and generally, only about 13% of them have cancer.  The remaining 87% are False Positives.  ((All my friends who are in the 13% are now rightfully shaking their fists at the screen))

I hope you note from these links that I don't do Google Searches, I do medical journal searches.  Big Diff.

So I went in for my diagnostic screening.  Based on what I read, I expected them to use ultrasound (US, also known as sonography) to find a lump, look at it to see if it was a fluid-filled cyst (Yippee!) or something more solid. Then they would do a biopsy, wait a few days and tell me: You lucky dog!!  You're one of the 87%.

So, I overheard the US tech say that it was a 1 cm oval with (blah, blah) edges (Later, I found out she said irregular edges).  She started poking around on my left boob.  She took out a ruler, measured my boob, and looked around some more.  She went to get the radiologist and I asked him if my husband should come in. "Not yet," he said. "We can't find it!"

First, I was relieved!  There is nothing actually there.  But then I thought to myself, "Myself, why does the ultrasound/sonography show nothing when the highly sensitive tomo mammo show an enlarging 1 CM mass?

They asked me to sit in the waiting room for a moment, a moment in which I sought out Dr. Google who said that not finding a mass on US is rar-ish.  Doctors, according to Dr. Google, will sometimes use an MRI to get a better idea of what is going on.

Then the radiologist asked for some more mammos including a spot mammo.  This is where I curse the stars that in an effort to get my diagnostic screening done as quickly as possible I agreed to go to a satellite office, which had just gotten the capacity to do tomosynthesis.  These require a bit more time to learn to use and interpret correctly.  FURTHER, the research I found later said that a spot mammo after a tomo is not protocol.

ANYHOOOOOOOOOO.

After all these new mammos were done, the radiologist brought me back and showed me what seemed to me, an enormous white mass on the screen.  "This is what the screening mammo shows," he said. "But here is what we just found.  It looks smaller than what they found. At least, I think that's what they were talking about. But I can't biopsy it because I can't see it on ultrasound.  But I'm sure it's not cancer anyway."

:-/

So you take a poorer image on new equipment and claim it's a better view than the one the techs  who have had years' experience took, can't do the procedure you expected to do because you can't see it on US, and tell me "but I'm sure it will all be fine."

Oh, the confidence in his bedside manner.  Reviewer #2 rejects your thesis and its data and asks for a completely new submission.  ((Academic humor))

I ask for an MRI.  It's expensive, he says. But won't insurance cover it?  Yes, but think of ALL the false positives it will see, he says.

:-/

I leave.

I do more medical research.  It takes a while to find the articles because I don't really want to know what Dr. Google says.   I want to know what real medical doctors and radiologists use as in the field, which is apparently NOT,

"HOLY SHITE.  THEY CAN'T FIND THE MASS ON ULTRASOUND BUT IT LOOKS LIKE A BIG HONKING SPOT ON MY MAMMOGRAM!"

So the actual medical words are Tomosynthesis detected and sonographically occult. Occult?  Who knew I'd need Buffy the Vampire Slayer. Should I make a pentagram of salt around my boob?

So, there are a few articles out there involving this issue. I even find an article that ISN'T EVEN IN PRESS YET (but is available online).  The university library gives me full access to this article and I am happy to send it to you  But the gist is, of spots/masses/lesions found on 3D mammogram but are not found on ultrasound:  approximately 25% are cancer, 25% are suspicious lesions that need surgery, and 50% are benign.  Them's some very different odds than I've seen before.

Other papers report that masses that have architectural distortions report similar results. You can also add non-palpable and find the same papers.  Palpable takes you down another path.

So I ask for a second opinion from the competing radiology clinic HOPING they would take new mammograms, since my trust of the diagnostic set from the satellite office are suspect. I also asked my primary care doc if the radiologist mentioned architectural distortions.

So, the radiologists at the other clinic read the mammos from my last 3 years, the screening, and the diagnostic visit.  They all agree my BI-RADS score is 3 (probably benign) My primary care doc said no mention of architectural distortions, just asymmetry. In the brand new, hot of the presses study above, *all* of the masses that reported just asymmetry in the masses and were tomo detected and US missing were benign. ALL. 100%.

A friend said cancer jumps out of the mammogram and screams at you.  (Figuratively, of course)

I go back for another diagnostic in 6 months.  And you can damn well bet I am going to the main office.

Yes, I actually would like another diagnostic screening RIGHT NOW at the main clinic.  But I think what's going on is safe enough for me to wait 6 months.

So, um, yeah.  It's been a tough semester.  Nothing compares to the loss of how this semester started.  Everything pales after that.  But it's still been rough. I think we all have to just sit with it and let it process through and wait for time to make it less raw.

Decluttering

(((Sweet peas on toast*. I started this last week and have been dying to try to keep up with everything I need to do.  Maybe this is part of the reason I want my house de-cluttered))

I was going to label this "Cleaning."  But I cleaned really hard (AND FOR NAUGHT) two summers ago.  I could say, "that's not true; I clean every week," but you'd know I was lying.

But yes, two years ago, I cleaned everything.  I found everything's "place." You know, the place where everything is supposed to live.  Its "special place."  As in the rhetorical question involving a pointed finger and a stern voice saying "Is THAT in its special place?!"

Yeah. That didn't work.  While *I* knew where everything was supposed to go and occasionally was motivated enough to try to get everything back to its special place, the house never stayed clean. Our house continued to look like we just finished grad school.  Actually, quite a lot of the time, it looked like a fraternity house with food and animals and underwear strewn everywhere.

As I've asked people when they've come over, "Please don't call DSS!"

Then I read "The Life-changing Magic of Tidying Up" by Marie Kondo.

The point of this book is not really cleaning up or storing your shit better. It is really an anti-consumerism theology of identifying which physical objects in your home give you joy and appreciating them.  And then donating/dumping the rest of your crap that you bought to fill the gaping hole in your soul and doesn't actually do it.

I would to write an academic post on the topic of human interactions with physical objects ((see the first sentences above for why that hasn't happened)).  But until then, here's the thesis: Psychologically (as in theory and research support this), we do have relationships with the inanimate objects in our lives; these objects hold meaning.  I like the idea of only keeping the few objects in my house that hold happiness and joy.  ((You don't think you have feelings about your objects? Put all your clothes on your bed.  Pick up each piece.  Most them are neutral or annoying.  Some of them you grab and go Yes!!  Keep those.  Toss the rest.))

I also like that the books gives me the freedom to say to some objects:

• Thank you for the joy you gave me at the time. You can go now!
• Thank you for being a gift from someone who loves me.  You can go now!
• Thank you for teaching me that I should never buy anything ever resembling you again!  You can go now!

It is taking a REALLY LONG TIME to go through the crap in our house.  Because as good Americans, we are over-consumers.  So far, I've done everyone's clothes, Dave and my books, the laundry room, and the Harry Potter closet.  I've also had to teach everyone how to fold their clothes in the Konmari method.  It takes a moment to figure it out.  ((And watching the video, I realize I haven't been doing it correctly.)) NONETHELESS,  look at these pictures.

Every time I open a drawer or go in the closet, I can easily see every item of clothing that I *love.*  It's so easy to get dressed.  Even picking out socks and nundies is easier using her folding technique. Seriously.

One of the things the author encourages is to ask what you want from having a decluttered house.  I finally wrote my wishes down in my bullet journal last week.  I want more free time. I don't want to clean as much.  I want to live in a beautiful, clean, loved house. And I think having only the things that make us happy around the house will help.  Yes, it has occurred to me that occasionally that may include tossing a child or two outside for an extended period of time.  But fortunately, school starts back soon.

Aren't they cute when they are unconscious?!

I think it's going to take quite a few more months to get through the house.  But fingers crossed, it will be cleaner for longer and full of the few things that truly make the family happy.

*A new fake swear phrase that is beating out the baby lemur.

Conor's Birth Story 2004: Part 2

The Birth Story Part 2:  Ready or Not, Here comes the Bun

We left the hospital at 10:15.  My water broke at 11:00, and we were back in the car at about 11:05. 

Dave was very tense as he drove the car.  I couldn’t open my eyes, but I could tell we were going very fast.  I kept having contractions and I kept feeling liquid running down my legs.  I was sitting on a towel so that whatever I felt leaking out during the contractions would not strain the car seats. 

Later, Dave and I found out that we were remembering the same part of the childbirth class.  I kept repeating in my head “Once they know there’s a problem, they can get the baby out through a 5 minute c-section.  5 minutes.  If there’s a problem, the baby’s out in 5 minutes.”  Dave’s mantra was “All hands on deck.”  It’s the phrase our instructor used for how the medical staff responds to an emergency c-section.  Everyone leaves to help get the baby out. 

We were both very, very scared in the drive back to the hospital.  I still tear up thinking about it.  I have honestly never been so frightened for my health in my entire life.  We had just been told 45 minutes earlier that nothing was going on, and now I had fresh blood streaming down my legs.  It was OK to think that something bad could be happening to me, but I could not let the thought enter my head that anything would be wrong with the baby. 

We arrived at the front entrance of the hospital.  A security guard came running towards Dave.  “Do you need a wheelchair?” she shouted.  “Yes, take her to the 8^th floor!”  Dave responded.  She ran to the car with a wheelchair, and helped me in.  “Honey,” she told Dave, “You just park the car.  We’re going to take good care of her.”  Dave later said her reassurance was the first time he felt things were going to be ok.  She put me in the wheelchair and ran with me towards the elevators.

We arrived back at the 8^th floor.  They put me back in the same room.  A new nurse took over my care.  I immediately took my clothes off as soon as I walked in the room before the door was even shut.  I told them my water had broken and that I was bleeding.  From all the liquid I felt running down my legs, I was fully expecting to see bright red stains down the legs of my pants.  But there wasn’t.  What if they didn’t believe me again!?

I told them that I’d had fresh red blood at home.  “How much?” they asked.  “More than a cup or less than a cup?”  I paused for a moment and said, “Definitely less than a cup.”  On the one hand, this felt like good news; maybe less than one cup of blood wasn’t a life threatening emergency.  But on the other, what if less than one cup of blood meant they didn’t believe me and told me again that nothing was going on? 

“It’s running down my legs!”  I insisted.  “That’s OK, Anita,” she said.  “That’s still your water.”  Well, that was the first unexpected news that didn’t frighten me.  Apparently, when your water breaks it doesn’t all come out.  For me, it continued to trickle out at every contraction until we were ready to push. 

I got back into the hospital bed and they started to attach me to all the machines.  Dave walked into the room and announced that Shelli was coming back and would be there shortly.  Someone came in to give me an internal exam. 

The checked my cervix and announced that I was dilated 7-8 cms.  From the time my water broke 20 minutes earlier until that moment, I had dilated 7 to 8 cms.  FINALLY!  Finally, I had proof that I was in labor!!!

Now, if I had been in any way similar to my regular self, I would have stood up in bed and commenced to give a two handed bird-flipping salute to every person in that room, and several others in the hall as I loudly shouted “I fucking told you I WAS IN LABOR!!!!!!!!!”  Fortunately for whatever dignity I had left, I only moaned. 

Contractions were becoming horrendous.  I was grabbing Dave’s hands and trying to do my relaxation breaths with very little success.  I was so incredibly scared.  Despite knowing that I had proof I was in labor and knowing that I wasn’t being rushed in for a c-section, I still had the panic from coming back to the hospital the way we did and I still wasn’t sure what was going on.  I really wanted an epidural.  My revised goal had been to get to where they would give me an epidural and now I believed it was possible. 

The doctor came back in and checked me.  I was dilated to 8 cms.  She began to question me.  Are you sure you don’t have endometriosis?  No.  Do you have fibroids?  No.  Have you had dysplasia?  Have you had a cryo process?  Dave responded No.  I responded Yes.  Yes, I had had dysplasia 20 years ago.  And yes, I had a cryoprocess---essentially freezing my coochie----20 years ago.

Ding ding ding ding ding.  I could hear the bells going off over the doctor’s head.  I saw the light bulb flashing.  I saw the relief on her face as she understood what had happened.

She explained to us that I must have had a good deal of scar tissue left over from that procedure.  My cervix had not been dilating because scar tissue is very inflexible.  The fresh blood I saw was from blood vessels breaking as the cervix expanded so quickly once all the scar tissue gave way.  It was not anything to do with the baby, or my placenta or my uterus.  It was not anything harmful to the baby!  I immediately asked her how this would affect future pregnancies.  (Yes, even at this awful painful point, I wanted to know if I could have more babies.)  She said that now that the scar tissue had broken, we would never have this problem again. 

So here I was.  I had what I thought was a normal beginning to labor only to be told it was not.  Then I had an experience that clearly wasn’t normal at all.  And now I was finally at a normal stage of labor.  Unfortunately, that stage was transition—the one stage of labor I was dreading the most.  And I’d started it in a panic and my doula had not yet come back.     

They had put an oxygen mask on me to help the baby.  During each contraction, I was chewing on it as I grabbed Dave.  Our nurse came over to help telling me to relax and breathe through the contractions and that I was in control of this situation.  If I’d been able to cuss, I would have had a few choice words for her, but she was foolish enough to let me hold her hand.  Her protests that if I broke her hands she couldn’t help me gave me a little bit of comfort. 

I really tried to breathe through the contractions, but I was so frightened it was difficult.  I’ll be honest and say that when I could relax and breathe through them, it was very doable without drugs.  But I was having a really hard time keeping focused at that point.  And when I could not get my will around the pain, the pain was truly awful. 

By the time they were ready to give me the epidural, I was 9 cm dilated.  The doctor, the main nurse and the anesthesiologist all asked if I was sure I didn’t want to go natural all the way.  To be honest, my trust was running low and pain was running high.  Although things were moving quickly now (it was about an hour after I’d come back to the hospital), I was still in the “it’s going to be 48 hours before I’m in labor” mindset.  Shelli had not come back yet due to some unlucky bad Charlotte traffic and Dave and I were struggling together through this bad stage by ourselves. 

My labor, at this point, was like a really, really, really bad marathon.  I was at mile 24 and only had 2 more miles to go.  I was going to finish the race, but I still had the choice to run it in or walk it in.  In either case, I’d done a boatload of work and I was going to finish the marathon.  So I chose to walk the last 2 miles of this marathon. 

Shelli arrived just when they were putting in the epidural.  We updated her on what was going on and what we had discovered.  She began calming me down and helping me through the contractions explaining what was happening in my body.  She also explained why I kept feeling like I had to “poo” at every contraction:  The baby was moving down and my body was getting ready to push.  This was a good thing.  I have to admit though that feeling like you’re peeing yourself (the water still trickling) and feeling like you have to “poo” are not the most glamorous feelings in the world, even if they are helping you give birth. 

Here’s the weird thing.  I don’t remember any difference in pain from before and after the epidural took effect.  I’m not kidding.  To be honest, I don’t even remember the pain of the contractions in transition before the epidural.  Instead, I just remember that when the epidural took effect, I was getting calmer and more like myself.  I knew something was happening because all of a sudden I remembered to tell Dave to get the camera so that we could get pictures of the baby.  Before I was just trying to make it through each contraction.  After I was more like me. 

However, I could still feel when I was having each contraction.  And I still felt like I had to poo with each one. 

Finally, it was time to push.  Apparently, despite being a big woman, I have a narrow-ish pelvis.  Who woudda thunk?  Pushing was more difficult than I anticipated because I couldn’t feel my muscles.  I couldn’t concentrate my efforts on what I was doing.  Yes, at some point here I wondered if I would have been better without the epidural, but I’m not going to regret it.  They were doing some pretty vigorous perineal massage and I’m not sure I could have stood that without the epidural 

I pushed for 30 minutes.  The doctor used a mild vacuum to help him out because his cord was wrapped around his neck.  As soon as his head popped out, she clamped and cut the cord.  And then he was out!!

They placed him right on my belly and he was warm and wet.  And then he let out a loud, lusty, full blown squeaky cry!  It was the cutest thing I’ve ever heard.  Most babies’ cries are irritating, but our little guy has the cutest squeaky cry in the world!!  I fell in love with him at first squeak.  (He continues to squeak and chirp on a regular basis and I absolutely love it! He cries, too, but even that is a very cute.) 

Dave went with them for the cleaning and first weighing.  He’s officially 7 lbs 2 oz and 20 ¾ inches long.  He has the longest arms and legs I’ve seen on a baby.  He gets his feet and hands directly from Dave.  His foot is the length of my middle finger:  3 inches.  His toes and fingers are sooo long.  He certainly lives up to his nickname of little monkey! 

He scored 8 and 8 on his 1 and 5 minute APGAR scores.  He was counted off 1 point both times because he’s so pale.  The nurse explained this saying they were a little concerned because they couldn’t tell if there was a respiratory reason for it or, as she paused and gave a long look at Dave, if it was genetic.  A respiratory technicial, a resident pediatrician and a nurse practitioner all checked him out and decided that our son takes after his very pale Irish father. 

He was born at 1:30, 2 hours after we returned to the hospital.  According to the official records, I was in labor for 2 ½ hours.  According to me, I was in labor 20 hours.  In either case, the little bun has popped out of the oven. 

I was so glad to have him out of me that day.  I honestly don’t know how I could have taken the pain for 12 to 48 more hours.  I still don’t know if the pain I was feeling was “normal” contraction pains and I’m a big fat wuss or whether the pain I was feeling was due to the scar tissue trying to stretch.  I was hurting a lot when they kicked me out of the hospital. But they had no way of ascertaining whether I was a wuss or something was wrong, either. 

The frustrating thing about pain is that you are the only one who ever knows what your pain is.  No one else can ever “feel your pain” and in this experience, there was no objective way for them to see that my body was trying to progress into labor. 

So why wasn’t the dysplasia or my procedure in my chart?  That is the question.  When my primary doctor came to check on me the next day, he was visibly upset that he did not know about this part of my history.  It’s hard to remember back one year to my first OB-GYN visit, but I do believe that what happened is that I downplayed it to my doctor’s nurse (“I had dysplasia 20 years ago and was frozen to fix it and I haven’t had a problem since!”) and she didn’t mark it down on the chart.  My impression of the nurse on that first visitwasn’t all that positive, so it makes sense to me.  I honestly have no idea if that’s what happened, although it feels like it to me.  And I don’t really care.  I know the dysplasia and the cryo process are a big deal and I always bring it up.  (BTW, both the doctor and my nurse had had dysplasia and the cryo process, I believe.  The nurse—Ms. You Can Control This Pain--- even shared that when she gave birth she was begging for an epidural at 4 cms.  I did cuss at her in my head, but out loud, I simply said, Ahhhh.)  As far as what I’ve thought about my own procedure, I’ve always focused on the dysplasia more than the process, and after 20 years, I’ve had no problems with dysplasia.  I am sure I downplayed how much of a problem it is in my life today. 

The good news is that I’ve had my son and I shouldn’t ever have this problem again.  It was very scary and very painful, but I survived with most of my dignity intact.  I’m proud of myself that I didn’t curse during transition.  Dave swears that nubain is the anti-swear drug because the worse things I said were “God!”, “Jesus!” and “Poo”  and I don’t think I’ve ever said “poo” in my life.  I wish I could have handled myself better in the transition phase, but I don’t see how anybody could do well in that stage after starting it as frightened as Dave and I were.  Breathing and relaxation did work in reducing the pain.  Even in transition, I was able to handle it whenever I could focus enough to breathe and relax. 

So yes, we had a labor with a few unexpected twists and turns.  I’d really rather have had the textbook labor, but it’s done and we have a baby.  And, to be honest, we’ve got a story with a couple of scary twists but a good ending to tell our son about his birth day.