Blog to blog

I don't follow many other breast cancer blogs, partly because they scare me. When the writer fails to post for a long period, one assumes she's died, or dying. Of course, it's possible that she's not posting because life is going swimmingly well, but I hate wondering. If and when the disease silences me, I hope I'll have time to tell someone else how to gracefully end this blog.

Occasionally I stumble on breast cancer blogs when I summon the courage to Google aspects of my illness, and I was glad I did this morning. Sort of. I came across this blog by Trisha Ekstrom (not updated for some months, alas) when I Googled "numbness" and "breast surgery," and found this passage:

I stand in the bathroom doorway, half dressed, trying to explain to Cary the funny feeling running along the back of my armit. The sensation is more pronounced today than on other days. It's like this numbness... It's tingly... It's not painful, but... I struggle to find the right words to explain it. Like your foot is asleep? Cary offers. Yes. That's kind of it. I don't like it...

Convinced I have lymphadema, (which I don't--lymphadema specifically refers to swelling of the arm), I grab two of my many books on breast cancer to peruse before going to sleep. I consult Living in the Post-Mastectomy Body first--a book I initially hated. (Sorry Lana. Keep in mind I at first hated Susan Love's The Breast Book too. In fact, I stomped on that one.) Right next to the section on lymphadema is a section titled "Numbness". I read avidly:

"You may notice numbness in the surgical area after your mastectomy. This can occur in a a very small localized area, or extend into the surrounding tissues. There is a major sensory nerve in the armpit and nerves in the chest area that can be cut or injured during surgery. It is usually described as a numb sensation, but that is not how my friends, clients, or I describe it. Numbness implies that all sensation in gone, but what I experienced after surgery was a mixture of numbness and an unpleasant feeling that was very uncomfortable, distracting, and annoying, but not exactly painful.... The numbness seems to come and go with changes in the weather and is influenced by how much the area is rubbed by clothing. I have noticed that fatigue makes it worse..." (pg. 41).

Yes! That's it exactly. Not only that, but it was raining and I hadn't gotten much sleep the night before. Now that the book has been redeemed, I make Cary come listen while I read the section aloud to him. Satisfied somehow to see a description of what I'm feeling in print, I can go to bed (as soon as I read the chapter on treatment for this discomfort).

That is it, exactly. It's a horrible feeling but not exactly painful. I went on to do more Googling and discovered scads of women with similar symptoms -- in some cases they went away, and in some they were permanent. Though I've come to accept that the lymph-node removal resulted in a lot of nerve damage (I can't for the life of me think why I didn't research this more before my surgery, or why my surgeon didn't fully explain it), I hadn't realized that similar sensations can occur when breasts have been removed, which has made me think twice about prophylactic mastectomy.

Trisha Ekstrom was part of The Scar Project, which I also discovered for the first time through her blog: a series of photos of partially naked women with breasts missing, breasts reconstructed, nipples missing, scars in full or partial view. They're beyond striking, often disturbing, sometimes erotic and sultry, always brave and beautiful (don't click on the link if this sort of thing is too much for you), and they made me feel stronger and less fearful, to my surprise.

Through Sitemeter, I can sometimes get a faint picture of those who find my blog when they Google various terms. As you might imagine, some fairly comical connections are made (somebody in Brooklyn found me by entering "burning armpits pleasure" into Google, and I get quite a few hits from people looking for images of Bif Naked since I posted one a while back). Others reassure me that I'm not alone in suffering my weird feelings ("sore numb armpit upper back pain," Googled somebody in Lake Mary, Florida).

Meanwhile, I'm feeling kind of shitty. Yesterday afternoon, though my cold is a fairly minor one, I suddenly got so weary I ended up sleeping all afternoon. I think it may be the heat.

Dr. Third recommends Dr. Second

This is the week I'm supposed to be feeling not so bad, but I picked up a cold on the weekend, so I'm not 100%. My poor dad was the source of the cold; still, we had a really nice family Father's Day lunch, so it was worth it. And I've had worse colds -- despite research to the contrary, echinacea always seems to halt the progress of colds for me, and I always take it. It's been six weeks now that I've been coughing, however. In any case, I have more energy than I did last week and have been trying to walk every day. My back is behaving very well, but I mustn't push it.

On Monday, I made the pilgrimage out to Mississauga to get a third opinion from an orthopedic surgeon about spinal surgery. Dr. Third was very nice -- perhaps because I brought with me a lovely and generous woman who is a friend of a cousin and was operated on by Dr. Third for similar problems -- and overall he said the same things as Dr. Second did: I've got junctional kyphosis and compression fractures in my upper spine and spondylolisthesis in my lower spine. He says he's pretty sure it's mechanical and not cancer. He was a little more cautious about surgery, saying it isn't something to go into lightly, and I shouldn't do it unless I'm in serious pain. He agreed that the surgeon would take out as much of the steel rod as possible, and as for whether a "pedicle subtraction osteotomy" or a "Smith-Petersen" procedure (basically different ways of removing parts of the vertebra) would be called for, he said any surgeon would probably not decide what to do until he got in there. In fact, because the former procedure could cause excessive bleeding, they could go in and stop halfway through and resume at a later date! He said that once I'm opened up, anything could present itself, including a spine too osteoporotic to operate on.

But when I told him that Dr. Second sounded quite confident that he could help me, he said, "If he says that, then I'd believe him. I've seen him do amazing things." He told me that Dr. Second is highly experienced at this, even more so than he is himself. As for the first orthopod I went to, who was very discouraging about surgery, Dr. Third volunteered that that guy is not very experienced at all.

The experience thing is interesting: my brother has been going to Dr. Second for years, and putting off surgery because initially Dr. Second was discouraging about the odds of its succeeding. But lately, says my brother, Dr. Second has been more optimistic. I suppose that techniques have improved in the years he's been seeing him, but also his own skill has no doubt improved by leaps and bounds. Our biggest fear is that by the time we decide to have surgery, Dr. Second will have decamped to the U.S. like all the other good orthopedic surgeons before him.

Anyway, I'm experimenting with the Naproxen and will stop taking it again soon just to see if my back gets worse again. That will help me make the decision about surgery. Of course, just like a woman, I have to admit that despite the recent improvement in pain levels, I would most like to have the surgery for cosmetic reasons: to regain my lost height and eliminate that horrible hump at the base of my skull.

In the meantime, I'm again thinking about double mastectomy; more research to do.

Pollyanna moments:

• My neighbour Daryl drove me to the appointment in Mississauga and later we got lost trying to find a particular restaurant he likes. But it was interesting to be driving somewhere I never go, even a leafy suburb.
• Matt and I just used iChat to do a videoconference between Toronto and Red Deer, and I got to see all his house renovations and he got to see my backyard jungle. Plus I got to see his mom, which was nice since she recently had heart surgery.
  

Guilt

It's been about 10 days since the last chemo treatment, and yesterday I started feeling a little human again -- more energy, less weakness, less burning numbness in my mouth and throat, less coughing. This round was not as bad as the last one, perhaps because I was given Neupogen for five days right away.

But the days of feeling like a dishrag have gradually made me seriously addicted to lying on the couch watching CSI and Star Trek while playing Solitaire or doing jigsaw puzzles on my laptop. There's a fine line between feeling sick, and being lazy and self-indulgent, and navigating that line is emotionally exhausting in itself. I feel guilty for wasting so much time on mindless non-activities but I feel even more guilty if I do something productive, because it leads to the question: "If I can spend the afternoon blogging and filing old photographs, why shouldn't I be working at my paid job?" That guilt makes it easier to choose laziness; if I'm not doing anything but lie on the couch and watch TV, then I must be really sick. I fear that if someone sees me walking to the grocery store or weeding my garden, they'll say, "Why is she collecting disability insurance?"

Would I simply rise to the occasion if I was compelled to go to the office every day, and therefore get better faster? So many people, without insurance, have no choice, although I believe research shows that cancer patients who don't take time off during their treatment are more likely to get infections, not complete their treatment, etc.

One of my brothers, who has a terribly painful back condition, is a stoic and I think he believes that to stop working is to give in and to put oneself in the unhealthy position of having to stay sick in order to justify one's disabled status and benefits.

The truth is, I am sick, but sick is a moving target that shifts from one week, day and hour to the next. Where I am in my chemotherapy cycle is a big determiner, but how I feel is still somewhat unpredictable. I've been puttering around the house this morning and even made a cake for someone, and felt almost normal, except for the steadily increasing numbness and tightness in my armpit and breast. Then I walked to the local post office (which, I discovered to my dismay, is closing down). A walk that normally feels like nothing left me ... I can't describe the feeling: I'm not really winded, though I am breathing a lot harder than usual, but my body just doesn't seem to respond correctly. It's heavy and doesn't want to move. It's like dragging weights on my legs.

It's one thing to say I could do a couple of hours of work each day, but not all days, and another to be capable of working full-time.

At least my back is allowing me to walk, as long as I take the NSAIDs; that's a huge improvement. I've been taking note on the couple of recent occasions when I've sat in a restaurant reading a book that I can't sustain that position for more than a short while before my shoulder blade begins to burn and ache, and I really wonder how long I could sit at a desk and copy edit a magazine.

Anyway, I must try not to worry about others second-guessing my level of illness. It reminds me of the days when I had severe sciatica, especially in my 20s, when I could easily run for the streetcar, but once I got on could not stand in one spot without terrible pain and sometimes came very close to begging someone to give me a seat. No one would have done so, of course, after watching me run for the streetcar. Disability is not easy for anyone to judge, sometimes even the person who's disabled.

And I've been cutting out some of the TV watching and reading books instead; just finished Love's Civil War, the letters and diaries of novelist Elizabeth Bowen and Canadian diplomat Charles Ritchie (one of those books that isn't 100 percent successful but whose last line is devastating and completely changes the way you view the whole book), and now I'm reading Barack Obama's Dreams from my Father and The Gathering by Anne Enright.

Pollyanna moments:

• My house is still cool even though it's warm outside (I have no central air, so that's crucial).
• Last Sunday afternoon, Diane and I had a lovely hour sitting on the lakeshore at Ashbridge's Bay, watching the geese and the blue water shining in the sun. But, because we cheated a little when parking Diane's car, we ended up getting a $105 ticket! We decided it was worth it.
• On my walk this morning, I actually stopped and smelled some roses!

Self-pity and PET scans

Apologies for that self-pitying rant yesterday. After all the excitement of the previous week, I think I crashed a little. I admit I am feeling isolated and lonesome, along with the fatigue, but I hope to get outside today and I know that will perk me up.

New topic: I'd be curious to hear from any Canadians who have had a PET scan for breast cancer. My medical oncologist is suggesting I have one, I suppose in hopes that it might finally confirm whether I have bone metastasis or not. But because it's not covered by medical insurance, a PET scan would cost me $3,000. The doc says she's been told that the technologists sometimes negotiate the price downward, but she can't confirm that. This article from breastcancer.org suggests that the test isn't very reliable, and my radiation oncologist didn't seem very enthusiastic about doing one. Other articles I've read suggest that the PET scan doesn't pick up breast tumours very well, but it can detect spread in the bone and elsewhere. This one seems hopeful, but it doesn't have a date on it! God, that makes me crazy.

Meanwhile, will Canadian government fuckups over the production of radioactive isotopes at Chalk River prevent me from having a regular bone scan when my treatment is done? They really dropped the ball on that one; it's shocking.

80/20

Right on cue yesterday morning the side effects of the Docetaxel kicked in, though not as heavily as last time. I'm very tired, feel numb and tingly all over and have a big lump in my throat. I want to eat all the time to drive away the taste in my mouth, although it's hard to taste my food. The home-care nurse came this morning and started me on another five days of Neupogen shots -- apparently I'll have them as a matter of course since my white-blood-cell count went so low on the last round.

On Thursday, I went to my radiation oncologist to discuss the next stage of treatment, which will start at the beginning of August, after I've had a month to recover from chemo. She feels less and less inclined to think there's cancer in my bones, and she's only going to radiate my armpit for now. "Bone mets aren't life threatening," she said, "and if there are some later, we can treat them later." Bone mets may not threaten my life themselves, but -- I thought, but didn't say -- they're a sign that your life is being threatened.

Still, I made the mistake of asking her what my chances are of collecting my pension; though she declined to give an answer to that specific question, she gave me worse odds than I'd expected: I could swear that my surgeon told me some months ago (to my surprise at the time) that, with chemo and radiation, there was an 80 percent chance the cancer would NOT spread further; this doc said it was 20 percent, so I guess I got it reversed. And that's only if there are no bone metastases. If the cancer is in the bones, there is no cure, for sure. In any case, she reiterated that this cancer is aggressive and serious, and everything rides on the chemo and radiation since it's not sensitive to any hormones or proteins and therefore there are no long-term drug therapies for me.

Actually, I had initially assumed that as long as the cancer was in the lymph nodes, there was no cure, so I suppose I should be happy there's any chance at all that it won't return, even if 20 percent isn't very promising. The ups and downs of this diagnosis have made it hard to plan what's left of my life. But I guess we're all in that boat to a greater or lesser extent.

The radiation doc said she doesn't think I have lymphedema since my hand isn't swollen, but sympathized with the breast swelling and discomfort I've been in since the surgery. She says there's a five-percent chance I'll get lymphedema from the radiation.

Pollyanna moments:

• The weather is nice, though I'm mostly lying on the couch in a windowless room. I managed to do a little weeding in the front garden yesterday morning until my back gave out, and it was lovely to scratch around among the thyme, which looks like it's dying but still smells great. I've been reading Vanity Fair this morning, and envying Johnny Depp his yacht in the Caribbean, as I look forward to a long, isolated, urban summer. But though I occasionally fantasize about getting out of the city to some exotic destination, what I mostly long for is to visit my ageing aunts and uncles in the places I call home: Massey, Manitoulin Island, Pembroke. I miss them, and treasure the visits I made there in the past couple of summers. My trip to Manitoulin with my parents and brother last year was heavenly, both because it's a magical place and because it was probably the last time I got to sit around with my mom and dad and aunts and uncles and sing old songs to the fiddle and the harmonica.
  

Speechifying

OK, so here's the text of the speech I made accepting the Outstanding Achievement Award from the National Magazine Awards Foundation:

June 5, 2009, The Carlu, Toronto

Thanks, Maryam [Sanati, editor-in-chief of Chatelaine], for that kind introduction. I always said I’d be able to tell people one day, “I knew you when…”

When Patrick Walsh telephoned me to say I was being given the Outstanding Achievement Award, I rather gauchely accused him of messing with my head. It’s an enormous honour to be included in the list of past recipients, about 10 of whom I’ve worked for at some point over the years. People like Bob Fulford, John Macfarlane, Peter Newman and Barbara Moon, whom, sadly, we lost just a few weeks ago, taught me so much of what I know about magazines. The other day I was reading Diana Athill’s book Stet about her 50 years in book publishing, in which she said that as a copy editor she was one of the “humbler but still essential people who tidy texts.” For much of my career I have been proud to be simply a text tidier for those illustrious bosses of mine.

Then I recalled the first time this award was given, in 1990. The Foundation chose at that time to honour Prue Hemelrijk, a legendary fact-checker. At the time I was thrilled that we were recognizing the contribution of one of those “behind-the-scenes” magazine folks, someone whose career was devoted to research, accuracy, and the kind of attention to detail that elevates magazine writing, in my opinion, above other genres. And although I’m also a writer and an educator, in giving me this award, the Foundation has chosen again to send the message that fact-checking and copy-editing, which have comprised a large part of my career, are vital to magazines, are indeed a large part of our currency, what we offer the people who buy what we have to sell. In other words, magazine readers love magazines because their texts are tidy and what they say is true.

Fact-checking and copy-editing are often referred to as junior editorial skills. Prue Hemelrijk and I are just two people who belie that definition. I am junior neither by age nor by years on the job. It’s true that copy-editing and fact-checking are excellent training grounds for interns and new staff. But magazines with high standards also call upon wisdom and experience for this important task. By giving me this award, you are honouring a host of other checkers and copy editors who uphold these standards. I’m talking about people like – and I’m going to miss some here – Veronica Maddocks, Eileen Whitfield, Geri Savits-Fine, Charles Rowland, Dawn Promislow, Catherine Dowling, Brenda Thompson, Ruth Hanley, Barbara Czarnecki, Pam Capraru and so many others, many of whom are also excellent writers and creators and editors. I’m talking about people who are earlier on in their careers, like Megan Giffith-Greene, who are also doing a great job of helping writers in their task of getting everything right.

Apparently Prue shared with the world her most embarrassing moments as a text tidier, and perhaps I should do the same. Typos on my watch have mostly made people laugh, and I like doing that almost as much as I like getting it right, so I confess I’m not kept up at night by mutual funds defined as a professionally managed pool of asses. I did lose some sleep when Bob Fulford wrote a profile for Toronto Life of Holy Blossom Temple and I let a pullquote slip that called it Holly Blossom.

But I lose even more sleep over the future of magazine copy-editing and fact-checking. I don’t know whether people who decry apparently sliding standards are just Chicken Littles. Maybe that’s just what we do. But I know the pay rates for fact-checking are sliding. And as the editorial staffs of print magazines inevitably merge with the online sides of those magazines, I wonder which side’s standards will prevail. I urge those of you who have something to say about this to pay attention to the care and time and effort that has, after all, distinguished magazines in the first place in the minds and hearts of our audience.

I tried to leave the magazine business. Several times. I could never quite make my escape. In the end I kept coming back to it for one reason. My writing has often focused on the idea of community, and what I found in the magazine business, even on those days when I wondered why the hell I was sticking around, was a community. Tonight is the best evidence of that. I’ve been coming to this shindig for nearly 30 years, missing very few, and I’ve always been amused by the uneasy mixture of cynicism that magaziners fall prey to and pride in our accomplishments – the mixture of competitiveness and camaraderie -- that the Mag Awards typically mark. Today we are undergoing profound change intertwined with economic struggle, and what our industry will look like in a couple of years is a troubling mystery. I believe it is all the more important – not less important -- at this time to celebrate ourselves and to gather for a night like this – to reaffirm our sense of community in the face of obstacles – and I commend people like Kim Pittaway and Brian Stendel and D.B. Scott and all of the individuals they mobilized to contribute financially so that tonight could happen.

I want to thank the Foundation, its board members and the people who wrote letters supporting my nomination. I want to thank the many students and interns I’ve had the privilege to work with over 21 years of teaching. You’ve taught me all about learning, which is the most satisfying thing any of us can ever do. Finally, I’d like to tip my hat to my cheering section here tonight, a group of amazing people who have been helping me through my cancer treatment.

Thank you, thank you, thank you.

Pollyanna and the City

When my oncologist suggested that I postpone my chemotherapy treatment by one week so I could attend the National Magazine Awards gala at which I was to receive the Outstanding Achievement Award, I was a little skeptical: should I endanger my life to pick up a plaque? Then she added that I would benefit from the emotional high that would ensue from having a fun night and being the centre of attention; she said it would boost my immune system and make the chemo work even better. "We don't pay enough attention to the psychological and emotional effects of such things on our immune systems," she said. I was even more skeptical.

But I believe her now. I have had such a great few days, and I'm sure it's helped my health. Joan D. flew out from Calgary on Wednesday and we attended a dinner party with some of my old Ryerson classmates at Liz's, which was fun. On Thursday, Joan and I rested in my backyard -- the weather has been sunny, dry and not too hot, my favourite kind -- and went for a short walk to the local coffee shop. My back is behaving better since I resumed taking the Naproxen, and as far as chemo effects, I am feeling almost human again, despite a hacking cough.

On Friday, the day of the gala, Mom and Rosemary arrived from Kitchener, and we had a girlie afternoon; I decided to wear my sparkly Indian lengha and to go completely bald instead of wearing the wig. To enhance the effect, I had a neighbour of mine come over and do my makeup -- not just any neighbour, but Diana Carreiro, who is a top makeup artist with The Artist Group, and who is featured in that award-winning "Evolution" video from the Dove Real Beauty campaign (you can't see her face very clearly, but it's her doing the makeup and hair). She does a lot of charity work, including for Look Good Feel Better, and I was thrilled to be the recipient of her largesse. The makeup made a big difference, I think. With a bald head, as Diana said, it's go big or go home. It felt like a lot of paint to me, but Diana told me that when she did Sophia Loren's face at the film festival, the actress wouldn't have left the room with as little makeup as she put on me, so I guess it's all relative. Anyway, I think it worked.I had a table of 10 friends with me at the gala, which was held at the magnificent Carlu -- women who've been unbelievably helpful to me during my illness. My award was the first one -- I think the organizers planned it that way in case I didn't feel well enough to stick around. But I felt pretty good, and ended up staying the whole night. I'm sure adrenaline helped me stand upright, but the right drugs and having time to recover from the chemo was the key. It was a magical evening. Maryam Sanati introduced me, and made me blush. Worse was the gale of laughter that went up around my table when Maryam repeatedly noted how "quiet" I am. Not sure what she meant by that! It's not an adjective most people who know me would use. Nevertheless, I was moved by her kind comments.

My own speech was a little on the long side, and I rushed through it, but I think it went over well. I took a stand for those of us who do the behind-the-scenes work of fact-checking and copy-editing, decrying sliding standards as magazines migrate to the web. Quite a few people came up to me later and said I'd made them resolve to do better. It's probably a futile quest, but I had to use the opportunity of having a platform to speak my mind.

I was well aware that I had been selected for this award partially as a representative of all the unsung people who do this kind of work, and the best part of delivering the speech was the opportunity to name as many of them as I could, and to hear the crowd cheer after each name. That was special. Perhaps I'll post my speech in a separate entry.

I wasn't nervous, but when I finished reading the speech and started down the steps in front of the stage, Maryam had to grab my arm because my legs simply turned to water and began to shake. I guess it was an adrenaline response.

My "Doris & Me" story didn't win anything, but I didn't expect it to, so that was fine.

Anyway, it was great to see lots of colleagues and to feel like a human being, let alone a celebrated human being. The next day, Mom went back to Kitchener (my sister was kind enough to look after my dad for the night so Mom could attend, for which I was really grateful; my Dad is aware enough to understand that I was receiving an honour, and I've saved a sweet phone message in which he congratulated me in his halting voice). Diane, Joan and I had breakfast at the local greasy spoon, and last night Joan and I went for dinner at Gio Rana's Really Really Nice Restaurant, a hidden Leslieville hot spot in what used to be my old branch of the Bank of Montreal. The food there is wonderful -- kind of neo-Italian, and they serve small plates that combine to make a splendid meal -- and I had a glass of wine for the first time in months.

It sounds silly, but I felt as though all those episodes of Sex and the City I watched last week when I was so sick had come alive for me for a few days (minus all the relationship angst -- thank God that's all behind me). The memories will help me as I head into round five of chemo.

Encouraged

The most difficult thing for me to handle when it comes to my health is not knowing what's causing my symptoms. I'm far too controlling and self-absorbed to handle the fact that the human body simply throws more and more weirdness at us as we age, much of which will remain a mystery. If I don't understand what's happening to me, I feel anxious.

So I was relieved after my long-awaited appointment with Dr. Second yesterday, the orthopedist I last saw in February. First of all, he was still confident that he can successfully operate on my spine. More reassuring still, when I got a good look at my X-ray, taken from the side, it was really obvious why my upper back hurts so much and why I've got this ugly hump there now and why I've lost an inch and a half in height. The metal rod is still aiming skyward, but my spine has curved so far forward that it's amazing the rod hasn't come right through my skin. Any wonder I hurt so much! Still, the doctor agreed that the pain lessened a few weeks ago because the fractures healed and there is a bit less movement there. And last night I concluded that the reason I've been in more pain this past week is that I stopped taking the NSAID. I may start taking it again today. Reasons, reasons: that's what I need.

Dr. Second was in a great mood, to my surprise. In the past I've found him a bit arrogant and humourless, but then I've mostly seen him with other men around; last time Jay came with me, and there have always been young male surgical residents in the room, too. This time I was with Jocelyn, and the doc was accompanied by a female nurse practitioner. In any case, unlike all the folks at my usual hospital, who insist I can't have an MRI because of the metal in my back, he says he can take an MRI of my spine, after my radiation treatment is done; it may not be a clear picture around the rods, but he'll be able to see some parts at the top and bottom. He says he will assess the situation at that time and we can decide whether some repair is needed in my lower spine as well, which he can do at the same time (more dangerous, and it would diminish my ability to tie my own shoes) and we will decide whether to simply fuse the upper spine (pretty safe) below the neck, or to remove the broken vertebra as well (which will, oddly, restore more height, but is more complicated). He had told me before that the vertebra removal is called pedicle subtraction osteotomy; he seemed a bit reluctant about it this time, and suggested another procedure called a Smith-Peterson osteotomy, which is somehow less invasive (I don't understand how).

Depending on what he does, the surgery could be up to six hours long. He says he might not be able to do a biopsy if he doesn't do the osteotomy, so I may never know if there was cancer in my spine (he doesn't think so). He says he usually recommends patients donate their own blood in advance of surgery, but in my case it's not a good idea because of the cancer. Apparently, they also usually recycle a patient's own blood during surgery, and I won't be able to do that, either. So I'll need a big blood transfusion.

I told him I was going for a third opinion from Dr. Third in Mississauga, and he agreed that was a good idea and assured me that Dr. Third is very skilled at this, as well. So I know I've found the right doctors for the job.

The idea that I might be able to get my upper back straightened out -- for pain reasons and cosmetic reasons -- lifted my spirits. But I know too well that as often as not these procedures fix one thing and screw up something else. Still, I am going to call today and book the MRI for September and the surgery for November. I can always cancel. Dr. Second does not recommend being in a hurry to do the surgery; he wants me to be fully recovered from the cancer treatment, and says if the pain does not impede my lifestyle, I should hesitate. We'll see. At the moment, I still cannot imagine leaning over a desk for any length of time.

In the meantime, I am coughing up a storm and still feeling pretty miserable, though I'm walking better than I was on Sunday. But, based on reports from others, I have concluded that this cough is a result of allergies -- I don't usually get this in the spring, but I sometimes do in August. Once I get a post-nasal drip going, it's not long before it turns into a deep, hacking cough. And my coughs last forever without treatment. I guess I should drag myself to my family doctor.

Pollyanna moment: Diane and Jill took me to the Royal Botanical Gardens on Sunday. I had to be in the wheelchair the whole time, and didn't feel very well, but I really enjoyed the beautiful "Lilac Walk," the largest collection of lilacs in the world. It was peaceful and smelled heavenly.