No, I haven't disappeared off the face of the earth. Since my last post, I've been holding down the jobs at Macy's and Nordstrom and one of my cats got sick. She was diagnosed with diabetes and kidney failure, and now--in addition to being an effective nocturnalist and itinerant rural hospitalist--I am also learning how to give her subcutaneous fluids (twice a day), insulin (twice a day), and vitamin B12 supplements. She's got diabetic polyneuropathy so she can't really walk around, which means I'm changing a lot of linen and investing in waterproof crib liners to keep the house habitable.
I've coped effectively with the upheaval in my professional life, Noo's melanoma diagnosis and subsequent critical illness--but my cat getting sick sent me over the edge. So I've been crying a lot and succumbing to retail therapy and generally being fairly insane, but things are getting better because my cat is getting better, so I'm hoping to resume thoughtful blogging about the life of a rural doctor soon.
You are right. There are times when one more thing just feels like it will break you. You've had a lot of stressors of late. Hang in there. Just take it one day at a time as you've been trying to do, and try to do somethings that feel good to you. Even if it's just a soak in a warm bubble bath. Something that recharges you and protects your immune system.
Posted by: Chrysalis | October 01, 2009 at 01:56 AM
Thank you for your blog. Ironically, I stumbled onto your blog while googling 'parking near the UCSF melanoma center'. I was there for my first appointment after having half my left index finger amputated due to a melanoma under the nail. I suffered a bad splinter all the way under the nail bed about 5 years ago. Months later the nail turned dark. It was diagnosed as a fungal infection and I spent the last several years trying various treatments including having the nail removed, scrubbing the bed with hydrogen peroxide, finding out I'm allergic to ketaconozole, etc. The pain and swelling ebbed and flowed and it became increasingly apparent that the nail needed to come off again. All along, I'd been researching finger infections and fungal infections but the possibility of melanoma never came up with my doctor, at the er, or in my research. Within about 2 minutes of stepping into the dermatologist's office my finger was being biopsied. At some point this 'resistant fungal infection' had become a stage 1b melanoma, 1.8mm deep.
I visited Yellowstone Nat'l Park with my family while waiting for the biopsy results. I hiked to beautiful places and began to tuck those moments and places into the corners of my mind, to pull out during the sleepless nights of fear of the unknown. I came home just in time to have a rockin' party to celebrate the life of 'lefty' with family and friends, make a hand cast and finger cast (my brother-in-law has promised to make me some kick ass attachments for my now much shorter finger), and head off to sentinel lymph node mapping and amputation.
So there I was, stuck in the waiting room at the melanoma center for 2 hours, thinking 'what am I doing here? Everyone here has cancer. I have cancer?' It was surreal to say the least. I read your blog on my iphone until it was finally time to head in and see the doc. Your perspective not only as a physician but as caregiver and champion for your partner gave me renewed gratitude and love for my husband, who's been my rock through this ordeal.
My final pathology results are pretty good: no ulceration, lymph nodes normal, no bone involvement. The tumor was a little deeper than the biopsy showed, 2.2mm. Hopefully, healing, a little hand therapy and being on the 3 month rigorous check up schedule will be my follow up care, but am still waiting for final say from the Oncologist. He is 100% certain that the ongoing trauma, irritation and inflammation in my fingertip triggered the melanoma. He says that a case like mine (I'm 42, caucasian, very healthy, etc) where trauma becomes melanoma accounts for less than 5% of melanoma cases. I certainly had no idea there was a connection between trauma and melanoma before.
I have learned that I get to choose how I respond to this; that humor, grace and the whole foods I eat are some of the strongest weapons in my arsenal. The way I respond inspires my children, family, and friends to respond likewise. It has, in the strangest way, been an empowering journey. Finding sources of inspiration and good information are vital. The very best to you and to Noo as you continue your journey together. I think of you often. Take care~ Mary
Posted by: Mary Zehr | September 30, 2009 at 05:04 PM
That is really great to hear. So far she's doing pretty well, and as long as she has some quality of life--sunny spots, eating, hanging out--Noo and I are committed to the long haul.
Posted by: Theresa | September 29, 2009 at 02:58 PM
I don't usually comment but just had to this time, because this exact thing happened to my old kitty when she was living with my mom. (Cat was already quite elderly.) She had it bad, just as you describe, with the neuropathy and all...and had to have insulin and the whole enchilada. And then after about 18-20 months, IT WENT AWAY. Apparently the condition can reverse itself. She lived for some time after that, too, despite being really old at that point!
Posted by: digamba | September 27, 2009 at 01:19 PM
Hope things are better soon.
Posted by: Jamie | September 27, 2009 at 07:11 AM