Tuesday, June 30, 2009

Desperately seeking a profound blog topic for the day

Sorry, I don't have one. Nothing profound to blog about. I can give mini updates on a bunch of things:

1. My back hurts. Now that's news you hadn't heard in a long time. Actually this morning its about a 3, lots of dull achiness but I slept relatively well (thank you little pill).

2. The cat is regaining ALL his annoying traits. Yesterday he wanted running water in the sink like he used to get. And he let himself out in the morning and then was pretty pissed off that he got all wet - it was raining. Even though I don't like him going out, I do like the fact he isn't sitting around as a little pathetic blob all the time.

3. I had yet another job interview yesterday. This would be for some contract work for a friend of my boss at my other new job. It could be short term or it could be long term.

4. I have now planned many excursions for us. This is exciting because we just stopped traveling and doing things for a year because I was always too sick. We are going to RI for a weekend, NH for a weekend, NY for a weekend, and ME for a week. I am also going to Cape Cod for a weekend (Casting for Recovery) and then to WI for my college reunion. We currently have plans for most weekends between now and Columbus day. How can that be? Does that mean we have a life somewhat again?

5. My summer work schedule may prove more stressful than I thought but its only for five weeks and some normalcy should return. Yesterday was just crazy hectic. Today should be a little better.

6. Speaking of summer, we do not have summer yet here in Boston. Then this lovely article in today's paper states this could last a long time. This is my favorite quote out of it: '"It’s been very persistent, and it could go on for the rest of the summer,’’ said Frank Strait, a senior meteorologist with AccuWeather.' My plants are rotting. We have mushrooms everywhere. And I'm always freezing cold. Nothing like 60 and damp again....

Okay off to work, stop procrastinating, time to get organized. Maybe I can be profound tomorrow.

Monday, June 29, 2009

Artifacts

After hearing about Michael Jackson, Farrah Fawcett, Ed McMahon, and now Billy Mays all dying. But they are all leaving us with something. Michael, Farrah, and Ed had great careers and leave behind memories in the entertainment world. Then Billy Mays will be forever engraved in our brains as the man who shouted from our TV sets that we need to buy more of the 'as seen on TV' miracle product. We will remember them.

Recently in the Boston globe it was reported that during demolition of a wall in the Museum of Fine Arts, they found a letter from 1926 written by one of the workers who built the wall originally. It gives great insight into the life of the workers. I find it intriguing. Here is a man who simply typed a letter and left it behind. Over 80 years later it reappears and now he will be recorded in history.

A few years ago, I found an arrow head while digging in my garden. I like to think that some long ago Indian tribe left it but realize it could be from children playing cowboys and Indians back when this was all a wooded lot in the 1950's. I guess I have a romanticized view of the world.

But now the question comes, what do I want to do to be remembered by or for. I don't have any desire to go back and climb the corporate ladder. Nor am I going to do something like fly a balloon around the world a la Steven Fossett. Perhaps I will make my mark otherwise. I think this is a work in progress. Give me another 30 years and I am sure I will come up with something.

In the meantime, I am now late for work. Too much time on the internet. Also time wasted retrieving the cat from the front yard in the rain and he was mad he got all wet - then why did you go out there you silly cat???

Sunday, June 28, 2009

Isolation

I have been watching from the other side of the illness thing for the past few weeks. First the cat and his diabetes. When he isn't feeling well, he sleeps off in the corners and finds little places to curl up. He doesn't want to interact with anyone and has even ignored his (catnip filled) toys. As he has slowly started to feel better, he sleeps with us while we watch TV or comes up on the bed. He also plays with his toys and leaves them all over the living room floor (but never puts them away - apparently that's my job). He is also interested again in his surroundings. He would just sit staring at nothing.

Last week, my husband had a cold. He came home early from work one day and basically went to bed early, slept for two days, didn't want to do anything, didn't want to eat much, no appetite, no interest in much of anything at all, and a touch of crabbiness. Yesterday, after three days of being sick, he actually mowed the lawn. I think he only did it because it was turning into a jungle. If it wasn't so long, he probably would have put it off some more and continued to hibernate. But sometimes that is what you need to do to get better. The people that ignore their illness and continue to do everything usually end up sicker than if they had stopped and dealt with it.

I was thinking about this and observing how when people don't feel well, they don't want to interact with others. Its the nesting instinct that kicks in and makes you want to stay close to home. In the past two years, I haven't really gone out much. I do get together with my friends but only locally, and usually with my cancer friends. I don't go to parties much or off on adventures. Partly because I don't feel up to it, or I am not sure I am going to make it through it. Or sometimes I just am too upset about something to want to go. Friday afternoon, I had hoped after my doctor appointment to get together with an old friend from out of town for coffee and by the time I finally got out of the hospital and home, it was too late. And I really wasn't in the mood to see anyone.

I think there is a lesson learned in here somewhere but I am not sure what it is. Is it that it is okay to hibernate when you don't feel well? But what if that becomes all the time that you don't feel well? Is it that just because you don't feel well (and aren't contagious - back pain and cancer are NOT contagious), that isn't enough of a reason to go out and do things?

I don't know. I do know that in the past two years my world has gotten smaller and smaller. We have planned lots of little trips recently - RI, Maine, my college reunion. But we haven't planned any big trips because we don't know if I'll be able to handle the trip (riding in a car makes my back hurt) or why go some place expensive and be able to do nothing? Maybe this is one of life's changes that just happens. I will continue to ponder this.

Saturday, June 27, 2009

My doctor needs a new script writer

A few weeks back,I had my second lumbar cortisone injection (big needle in the spine adventure) and afterward I told them I had some improvement but not complete. The response I got a few days later was we want to try a diagnostic facet block and if that works a radiofrequency denervation. You may recall I was not too thrilled with this and opted to meet with the doctor first. So my appointment was yesterday and my doctor needs a new script writer. Here's the deal:

- I still have multiple problem areas in my back. He wants to do the lumbar facet block (six needles of long term - 6 hour Novocaine type substance) and if it works, proceed to the radiofrequency denervation (use radiofrequency created heat to kill the sheath on the nerve). If the facet block doesn't work, he still has a plan B.
- The next step is to look at my sacroiliac joints and give them big fat needles too.

These procedures will be done several weeks apart, partly due to scheduling and partly because they like to see how they work for a few weeks before scheduling the next one. My first one is Monday July 6 in the afternoon.

I did ask him about the progression of the pain and what can be done to reverse it (not much) and why it hurts sometimes and not others (because inflammation can start for no reason) and how my life is more limited than before (but I should be grateful for what I have). I can do what I want that doesn't make my back hurt - walking,standing, sitting, lying down all cause pain. I can lift things up to 20 lbs, including going to the gym and using little weights again - good thing the cat only weighs 13 or 14 right now.

I also asked about the whole cancer thing and reminded him of my previous medical diagnosis. He asked when was my last bone scan (last June) and how often did I see oncologists, etc (every three months). I think he feels that if I am being followed by oncologists he isn't too worried about cancer because they are more familiar with it and my MRI was clean.

Needless to say, I was not happy when I left. (I stopped at Trader Joe's to get one thing, spent $35 and when the cashier asked if I found everything I needed, I couldn't remember what I went there to buy so I called my husband from the parking lot before leaving - stress is not good for short term memory.) Then I read the lovely paperwork they gave me about the two procedures.

This statement appears on both: chronic pain from these joints really serves no purse to you except to make your life more miserable. I did not need any one to tell me pain makes me miserable. The facet block procedure is similar to the cortisone injection that I had except I get six needles instead of 1 and they use a Novocaine type substance. I will keep a pain log for the next five hours and send it back to them. The effects of the block will be judged and see if the doctor thinks the radiofrequency denervation will work. (And if so, it could only last for a year or two anyway). The description of the denervation sounds really yucky as they insert needles and then the nerves are 'heated' and the sheath is destroyed 'but you will not really feel this, as we will numb each nerve first.' (HAH!)

I am crabby and whiny as a result. I didn't want this. I don't want more needles. I am sick of pain. I want to do more in my life, not less. Today will be a whiney day. Too bad I have to go to a breakfast meeting...

Friday, June 26, 2009

A big news day


Yesterday was full of all kinds of news. First of all, this is the first morning glory flower of the season. They will bloom between now and frost in November.

The next big news is that the sun came out for the first time in weeks (not kidding) and the temperature hit 70 for the 4th time this year (really not kidding, we have all been growing mold).

Next, I grabbed every bravery molecule I have in my body and gave kitty his shot. I hate needles but Walter was (and is still) sick with a cold and sleeping late so I gave him his shot. This isn't to say that this is something I will start doing regularly but I did it once so when Walter goes on his business trip next month, I can handle it. (I was VERY concerned).

Also, kitty went to the vet yesterday. His insulin levels still aren't stable. They were too low yesterday morning. We will need to bring him back in about 2 weeks and not give him his morning shot so they can see how low the levels go. This is the problem if they can't stabilize him, there is nothing they can do.

I also got awesome news yesterday. I am definitely a volunteer for the local Casting for Recovery retreat (www.castingforrecovery.org)that I went to last year as a participant. This means I have to suffer through another weekend on the ocean of Buzzard's Bay, next to Cape Cod, for free.

I went out to dinner last night with friends. It was nice to see old friends (including one from out of town who I haven't seen since our wedding). Walter didn't go because he has his cold - just call him Mr. Sniffles. But the point is, I (me) went out (something I very rarely do) to dinner. In the past two years, I have just not really been going out. I have gone out some but they have either been with my family or with my cancer friends for our informal support group - either coffee or dinner and only occasionally with friends for fun. Life just changed.

Finally, it is very sad to hear that Farrah Fawcett died. I had watched parts of the documentary on her cancer struggle recently. I think she made some very good points in dealing with the leaks to the media on her medical developments. I was glad to hear that the medical center changed their policies and took action against the employees. Also, while I am not a huge fan of alternative treatments such as the ones she took, if your doctor says there is no more conventional medical treatment for you, wouldn't you try anything? I also was reading some article on her that said she was cancer free after treatment (and of course can't find the link to it). Um, this is wrong. You are never cancer free. They just can't detect it. Once you get it, that's it. You got it.

Too much blathering on the internet and I am running late. Have to get my act together, make breakfast, get dressed, make lunch, do my exercises and get out the door in the next 20 minutes.

Thursday, June 25, 2009

A final sad chapter in an interesting life

It was reported yesterday that Jerri Nielsen, the doctor who diagnosed and treated her own breast cancer at the South Pole ten years ago, has died from a recurrence of the disease five years ago. Now I need to go back and read her book that she wrote about her adventures in self treatment.

I remember hearing about her story when it happened - it was international news that a doctor at the south pole had diagnosed herself with breast cancer, after the last flight out for the season. I remember thinking that she was pretty incredible to go through that in such an isolated place but also since it was in such a small community, she couldn't hide it and I'm sure she would have gotten support from the others there. When you lose your hair and are nauseous all the time, you can't hide it from people you live with. But now that I have read the very nice obituary, I need to read the rest of the story and learn what really happened.

Yesterday I actually had a decent day. My back mostly cooperated, I wasn't overscheduled, managed to fit in a walk, and the cat proved he is returning to normal by tossing his toys all around the living room and throwing up on the carpet.

Today, I slept okay for about 7 hours but Walter now has a cold. I have to take kitty to the vet to check his glucose levels again. I would be surprised if they need adjustment as he is very normal (meaning a pain in the butt at times). Hopefully we will get the good news that he doesn't need to go back for six months.

The big news is that today summer is supposed to appear. But there is more rain and gloom this morning and its a sultry 60 degrees. They (meaning the weather forecasters who are paid to be wrong) claim that there will be clearing today and it will turn into a nice day. There are mushrooms in my garden. The front lawn is a jungle because all it does is rain. My flowers and vegetables need sun - but I have some tiny peppers and green tomatoes.

But I do need to get moving so I can get out of here to get kitty to the vet on time.

Wednesday, June 24, 2009

Today I want to be perky and annoy everyone

I slept for 9 hours last night. I woke up for a nanosecond and rolled over and went back to sleep. Therefore I feel perky and think I could be up to being annoying. I do have to go to my new job (where since it is new I have been carefully camouflaging my real personality until they got to know me) but perhaps it is time. Then I need to go for a walk (I didn't get my walk in yesterday because I was so tired and it was raining - as if I needed two reasons.) and will do some gardening as well as some work from home. My work from home work has been a bit neglected recently which is stupid because that is what pays me the most. Anyway, I feel so much better today.

But my back does not. It is not awful painful, just achy sore again/still. Two more days before I go to the back doctor for more solutions I hope. Actually it will probably be more 'procedures' and I will have to wait a couple weeks for them to be scheduled. Grr, grr, grr. But if I can sleep at night between now and then, I will be okay with this.

Now I am late for work. All this stimulus road construction makes my drive to work very slow!

Tuesday, June 23, 2009

You and your medical information

My husband and youngest nephew at my sister's wedding.
Of all the things I have dealt with in my life, I am learning to speak up to be a better educated patient. I was very happy to read this article in the paper how the movement is growing for patients to get access to their full computerized medical records. There is concern from doctors that people may misinterpret what they read. But I do think it is important. In the past two years, I have had opportunities to read my medical records going back to 1981 - and learned things I didn't know and other things I had forgotten.

I was happily reading away, and then this news story pops up on the TV (I was multi tasking - watching the news, reading the paper, and drinking some very important coffee since my back prevented a good night's sleep). Basically, there are no real standard systems for letting patients know the results of tests leaving many in the position of 'if you don't hear from us its normal' pool. Sorry, that's not good enough. Patients should be told good or bad, asap. After any test/procedure/fun medical event, I ask when will the results be available and how will I find them out. Be realistic - your doctor has hundreds of patients and things can fall through the cracks. If you don't hear when you expect to, call your doctor's office and ask for the results. Don't assume anything.

Today, I am procrastinating on the internet (because its what I do best) and I am exhausted. I slept from 830-1am... And then dozed intermittently after that - even with the help of a pain pill. I can see potential crabbiness in my day. I will go for the substance abuse route and drink coffee all morning, well, maybe tea too. I am working my new job this morning and my other job this afternoon and hope to fit a walk in the middle, if the weather cooperates (and I'm not too tired).

The cat is fine. He now comes upstairs to tell us every morning that he deserves more food. He did miss us but not very much.

Now I am running late. Eeek!

Monday, June 22, 2009

the wedding

The wedding went fine. The weather mostly held off - but we were on a pier in Boston and there were 25 mph winds whipping through but then slowed down. The ceremony went mostly smoothly but reason 8,000,347 not to have a dog in your ceremony - he barked through the first half and then threw up (NOT KIDDING) on the runner between the bride and groom's feet. The broke the ice, everyone laughed. We had fun.

I gave a toast which I stole off the internet and everyone liked it. I did personalize it - I think my sister was concerned I would be mean... I was nice. But I will say while we were dressing, I had my socks on and put my sandals over them just to tick her off... All her friends laughed and she looked at me and said 'absolutely not'. Sometimes you never go past this sibling rivalry thing.

I discovered something - if I drink a lot and dance, my back doesn't hurt. I danced a little and then I drank. Then my back stopped hurting. I actually slept pretty well - but that might have something to do with the drinking. This morning we are off to have breakfast with the family - parents, cousin, brother, sister in law, and the kids. We will drive home after rush hour - what's the point of sitting in traffic? How's my back this morning? I danced. It hurts but it would hurt if I didn't dance so I might has well have fun sometime... I will post some wedding pictures soon.

Later today, I hope to get in some gardening if the damn rain would stop. It has rained and been dreary for days now. We had one nice day recently. This coming week is more cloudy dreary days. I have mushrooms in the back yard, front yard, and gardens. If I thought they were edible, I would have to buy any for weeks.

Actually once we go home and check on the cat, both of us think we will go to work for a bit this afternoon. The cat had a baby sitter who came last night and again this morning to give him his shot. And refill his food dish. He turned into an oinker...

Now that the wedding is over we return to our normal lives. This week entails working both jobs and seeing an old friend who will be in town from VA, and going to the back pain doctor. Maybe we do have kind of a life...

Sunday, June 21, 2009

Going for two days in a row.


Yesterday we went to the wedding rehearsal, lunch and then sailing on a tall ship around Boston harbor. It was a lot of fun but a long day. My back lasted 6.5 hours... I am shooting for the same amount today. If we go in at 2 and I make it to about 830 that will be just about the end of the wedding. The wedding actually is at 330 but I need to get in early to get dressed since I am in the wedding.

Then, if the rain holds off we will walk the five blocks to where the wedding will take place (on the docks with a big tent in Boston... If its not raining, ceremony will take place outside with the harbor as the backdrop at the end of the pier. If it is raining, we will be under the big tent. It is not currently raining, the rain is to our south. It would be nice if it would stay there. But also being Boston, it is currently a tropical 59 degrees. We will be cold.

Now about my back. By midafternoon yesterday it was sore. Driving home was painful. I sat on an ice pack for a couple of hours and it felt better. Walter even made dinner so I could continue to ice my back. I slept okay last night but not great. I ended up on ice lying on the living room couch for a good chunk of it but feel relatively rested.
This is the bridemaid dress - actually a Talbot's dress...

Saturday, June 20, 2009

Its 530 am and I am updating my blog

Why? Because my back hurts.I have been up since 330. I gave up about 5 and got up and made coffee. The cat thinks its great that I am up so early because he gets attention that way. I am not sure sure that its a good idea but here I am. Sitting with my ice pack, waiting for the coffee maker. AS soon as my blog is updated, I will get the paper from the front walk. Yes, I did take a muscle relaxant last night but this isn't fun.

Yesterday I worked at my new job (and had a momentary flash of panic that I crashed the company's website) and my doctor's office called. I now have an appointment this coming Friday to discuss options with my back issues. Getting more sleep and reducing pain will be a primary topics of that conversation.

Today we have a lot going on. My sister is getting married tomorrow. I am the maid of honor and apparently have to give a toast, which I have barely started and can't figure out Word 2007 to format it the way I want so I need to send my desk top computer and work on it there (but I can't do that in front of the cooking shows on the DVR with my ice pack). This morning is the rehearsal followed by lunch and then on a tall ship. If the weather cooperates this will be a lot of fun.

In the meantime, I have no time to waste on line this morning. We are going for a walk in a little bit - the coffee is done so I can wake up Walter and off we will go.

Friday, June 19, 2009

You want to do what???

No, I don't think so is what I told my doctor's office yesterday when they called. This was from my back pain doctor's office in response to my call in with how I was doing after my second cortisone injection. I saw the doctor in early April and he told me 'you have lots of things wrong with your back but we'll start with lumbar injections from the lower back and see how things go after that'. The only times I have seen him since are to receive said injections - and its not a time for a conversation.

Apparently after my call into his office he wants to try a 'lumbar facet block' which is a temporary procedure where they make six (yes SIX) injections right next to your spine with novacaine or something like that which is temporary. Then I get to keep a pain diary for the next six hours and see how much relief I have. If it works, the next step would be to make it permanent with a 'radio frequency denervation' where they kill off nerves. In my spine? I DON'T THINK SO! I expressed my hesitance to the nurse and she took another look at my MRI and said maybe I should see the doctor again first. I thought that was a splendid option. I would prefer to have another conversation about my options instead of just going through procedure after procedure (and they all involve needles which I hate).

Unfortunately I can't see him until the end of July. This was rather disappointing but she did say to call once or twice a week to see if they have any cancellations. Then I started thinking about this. If I have to wait another month, I will make it a productive month and start a pain diary (or resume the one I used to keep for the physical therapist). That way when I finally get to see him, I can give him better information.

So here's the beginning of my pain diary: last night, fair amount of pain upper back before going to bed - took a pill, 230am massive leg cramp, some upper and lower back discomfort since. (I stretched and now it hurts.)

Anyway, today I am off to work and then run some errands, come home and do some work, and out to dinner with family tonight. My sister is getting married this weekend and all sorts of relatives are showing up. We also have the cat sitter stopping by to learn how to give kitty his shot so we can stay overnight at the wedding. Now I will be late for work! Gotta run!

Thursday, June 18, 2009

New concept? Patient centered care

Recently there was an article in the New York Times on the latest trend in patient centered care. I don't consider this to be a new concept. When you visit a doctor, they tell you what you should do and the results if you don't. I feel strongly that its your body and the doctor is giving you a recommendation and it is your choice to follow it or not. This already occurs frequently. How many times have you been given a prescription and told to take it per the instructions - did you? Did you take it until it was all gone, with or without meals, regularly? Or did you say "I feel better, I don't need it any more". Did you get all the tests the doctor suggested? What about eat right, exercise more, quit smoking, drink less alcohol? Do you floss and brush as much as the dentist says? Are you following all those suggestions?

Through my oh-too-many doctor appointments, I have met many medical personnel and learned that there is a substantial percentage of patients who don't follow instructions, return for follow ups, and take prescribed medications. (Then there is a whole group of people who never go to the doctor because they don't think they are sick enough or something.) I have been told that I am a relatively good patient because I do these things. Does that make me a better person and better medical patient? No, I think I do these things because I make sure I understand why I am being given this advice and the ramifications of not doing them. Believe me, I ask my doctors lots of questions and make sure I understand things (personal rule number 847 - a diagnosis is not complete unless the patient can spell, pronounce, and define the ailment).

A doctor gives you advice. You are then burdened with the responsibility of making sure you understand it and what happens if you don't take it. If you get a cancer diagnosis and surgery and chemotherapy are prescribed, it is your choice to get them but if you don't, you should understand your potential outcome. I strongly believe that it is the patient's ultimate choice to make decisions on their care and if they choose to go an alternate route, they should feel free to provided they understand the ramifications.

Life is all about choices. Its your body and you can make them. Patient centered care should not be a new concept. Educated patients should be the way of the future.

Wednesday, June 17, 2009

More cool websites

There are millions (or billions) of websites out there. And thousands upon thousands on cancer, plus blogs, plus medical advice sites, and the list goes on. But recently I found two that I like:

www.beingcancer.net - I like that it is run by someone how has a medical background and had cancer. Its not shoving some stupid new 'cure for cancer' at the visitor and it compiles information from other sites and has guest bloggers, etc. I just like the tone of it and now read it regularly.

Another new one is an opportunity from Varian (the big medical instrument company) to write your own letter to cancer and tell it exactly what you think (but please use G rated language as its a family site). The letters people have written are wrenching but heartfelt. Go write your own.

Okay, so its possible I spend entirely too much time on the internet these days. Today is a good example I have to leave in 25 minutes and still have to get dressed and take a shower (shower first, clothes second). But I did already take my walk and have breakfast. But now I am late so I should go.

Tuesday, June 16, 2009

Contemplating my ceiling

Twice a day (unless I forget), I get the joys of contemplating my ceiling. (Its a nice textured plaster in case you can't tell in the picture.) When was the last time you looked at your living room ceiling for any length of time? Or with any frequency? I only do this because I have back exercises (which I forgot to do last night when I got home from work - but don't tell anyone). The exercises are supposed to help strengthen my back.... I have been doing them for months. When I went to PT, they said here are some exercises, two sets of ten, twice day. But they never told me if I can ever stop them... Am I supposed to just keep doing them every day for ever???? Hmmm... Perhaps I could ask. But my back still isn't better so I probably do still need them.

Yesterday, I called the back doctor to report that my lower back is somewhat better but my upper back isn't. I asked when I can expect to hear back and was told usually within 72 hours... (Last time I called on a Monday and called back on Wednesday when I hadn't heard anything and was told that it can take up to a week. So much for consistency.) I don't know what the next steps are but do know it still needs something. I'll continue to be a patient patient (and suffer in silence) and wait for the doctor to call back.
Now a kitty update, he is much better. This morning he was hungry and thirsty and came upstairs to inform us of this. Walter fed him and he ate and then he came back to complain about his water supply. How do I know this? Because he tried to drink MY water. This weekend, we were going out and needed to give him his injection before we left and we couldn't find him anywhere. We both looked through every room and closet and searched the basement. This was not an issue in the past because we could shake a bag of kitty treats and he would come running - but no more treats so no way to get him to show up. Finally, we gave up and I was doing my exercises before we left and saw him sleeping under the stereo behind the smoked glass doors! He now has a pillow in there (so he's comfy) which will provide contrast and he will be easier to see.

Today is another busy day. Off to work two jobs, go for a walk, and run some errands.

Monday, June 15, 2009

The what if post

Yesterday we went to my friend's funeral who died unexpectedly and suddenly at the age of 48 due to over medicating on her inhaler and couldn't be resuscitated due to liver failure from damage from years of medication - or something along those lines. Her family had to go back to her apartment and find information on who to call - her boss, her friends, etc. Her funeral was horrible and very nice, a good balanced combination, and it made me think.

I used to work for a man who lived by the 'hit by the bus' theory - never have only one person know how something worked because what if they were hit by a bus one day and never came back and no one else knew how to do it. I always thought this was rather morbid and overly pragmatic but it does make sense.

My grandmother, who lived to be 96, made sure everything was organized before she died. She prepaid for her own funeral and had an 'In case of death' envelope. For the last 20 or so years of her life, when ever she thought of something that people should know after she died, she would write it on a piece of paper and put it in the envelope. That way we knew what she wanted in her death notice, flowers for her funeral, etc. It was very organized.

Me on the other hand is not so organized. Perhaps I should make an effort. First of all, maybe I should put some thought into what I would want for a funeral (not that it is going to happen any time soon that I know of) like flowers, service, cremation, etc. They say funerals are for those who are left but its really a chance to throw the only party you can never attend so you might as well make it a bash. A nice thing about yesterday's funeral is the minister actually seemed to know a few things about her. Nothing like going to a funeral where the minster mispronounces the person's name because they didn't know them! (One thing I will put in writing is that everyone at my service MUST shut off their cell phone - someone's rang, not once, but twice during the service yesterday.)

Also, what about all my life that is now on line? Who would update my blog? Who would know how to update my blog, my facebook page, etc? I can tell you the secrets to my life lie in my archaic rolodex. That is where I write down all my user names and passwords so that I don't have to remember them.

There is a new industry emerging with the advent of the internet and online banking and financial resources. You can hire a service to protect and locate your assets on line 'just in case'. You know how you have to go through 47 hoops if you forget your password and user ID where you do your online banking? If you are 'no longer with us' this service will allow you to predesignate someone to access your financial assets and save all your user IDs and passwords so they don't get stuck in the black hole of cyber banking for eternity.

I really don't expect to need it soon but perhaps I will put some thought into what I want.

Sunday, June 14, 2009

Just when life gets better - that little cancer jolt reappears

Yesterday afternoon, I was playing on the internet (as opposed to doing paid consultant work or gardening or cleaning the house but there was no one home but the cat to tell me what to do) and I visited the breastcancer.org website which I do from time to time. Its a great website full of resources and always has on its front page highlights from new breast cancer related advances (and anyone with cancer is secretly hoping that some day will be one announcing its cured) and it also includes a deciphering of the medical gobbledegook for us non-medical people right next to each featured article. It is a wonderful resource.

Currently they are featuring results from the recent American Society of Clinical Oncology recent meeting. And there it is "Action Needed in Early Breast CA with Isolated Cells in Lymph Nodes". That would be me. I had early breast cancer and isolated cells in my lymph nodes or what they call a micro invasion. For once, it was something I can relate to. Usually they are obscure topics that are not pertinent to me. So I start reading and then also read the translation and the linked article. Basically what they say is that if you have early stage breast cancer with microinvasion or isolated cells, you should have:
- chemotherapy - yes I did
- axillary node dissection - yes I did
- hormonal therapy - yes I am currently
- radiation to the underarm area - NO I DID NOT!!!! My radiation did not extend to the underarm area - I was told I did not need it. Screech to a stop here. So did they miss something for me? Should I go back and demand it now? But I can't. Radiation is only effective for a short window at the end of treatment.

Just when life gets all comfy and cozy again I read this stuff. Then I start researching the crap out of recurrence rates and all sorts of nasty stuff. Then I said 'I could drive myself insane doing this' and switched to waste time on Facebook instead. But the point is, that little cancer jolt can and does reappear when you least expect it. Now I have questions for my radiation oncologist when I see her in August and something to worry about between now and then.

Saturday, June 13, 2009

Saturday

Its Saturday. I am up way too early. My husband is going into work today so he (we) got up early. I can't go back to sleep so I can waste time on the internet instead. I mean I could go and be productive and go for a walk, which I might do in a few minutes, but for now I am happy with my laptop, watching the news...

I feel like I don't write much about cancer any more. Maybe its because I don't have any current cancer issues. But its always lurking. Once you have a cancer diagnosis, you are at greater risk for getting another cancer. And always hoping you don't have a recurrence. Getting your life back is learning not to over react at every pain. An example is when my back pain first started the big concern was that a common spread of breast cancer is to the bones and spine. But an MRI didn't find anything. Or my stupid rash. There is a rare form of breast cancer that shows up at as a rash. So everything gets double and triple checked. And monitored. You had cancer? Oh, we need to check to make sure your headache isn't a brain tumor. Instead of take tylenol and go home... Its a new balancing act in life.

I did start my new job three weeks ago. Those co-workers know that I have back problems and got cortisone shots (and that the cat has diabetes). They don't know anything else about my medical life and there is no reason they are going to. I actually find it to be a relief that my medical crap doesn't dominate my work life any more. I go to work, I work, I talk about work stuff, and then I go home. Its a nice change. Life without cancer - at least on one level.

We also have continued improvement on the cat front (perhaps this should be renamed Caroline's cat's blog). Last night I woke up in the middle of the night (because my back hurt) and went to check on the cat (because he has been a bit too lethargic and if I get up and walk around for a minute sometimes my back does feel better). He was sitting in the front window in the living room, staring out the window at the furry woodland creatures (who were eating my plants) out in the front yard. He did not want anything to do with me and gave me an annoyed look. I found that very reassuring that he was focused enough on something instead of sitting around passively.

Today I am going to get a hair cut. Hair cuts still are important, more important than they ever used to be. I am not sure they will ever lose their importance.

Friday, June 12, 2009

On being nice

Yesterday, I don't think I was being nice. I mean I tried to be nice all day but lack of sleep, back pain, and too much to do contribute to relative crabbiness. But also I was confronted with sales help who are clueless. I met friends at a local bakery which has little yummy individual souffles for breakfast - which are awesome (and a secret addiction). But when I got to the register, there weren't any. I asked and they said they were in the oven and would be ready in five minutes. I said fine, I would get tea now and come back up when they were ready. 20 minutes later they were still not out - even though I saw them come out of the oven so I went back up to ask. Apparently, they were letting them cool and wanted me to wait another 15 minutes... I might burn myself on them if I got one too soon. If they weren't going to be ready for half an hour from when I first asked, why didn't she tell me.

Next I stopped into a local furniture store as I had 20 minutes or so before I had to go to work - long enough to window shop in a store but not long enough to do much else. I was looking around and a nice person asked if he could help me. I asked about a piece that was marked with a sale sign but not a sale price. He said he would get a sales person who could answer my questions because he was the visual display guy and didn't know detailed price info. Ten minutes later he was surprised to find me still wandering the store with no sales help so he said he would find someone to help me. Then another five minutes go by and the sales person tells me she will be right with me. Then I see her selecting stuff for another customer so I start walking towards the door.

Finally a sales person comes up to me as I am about to leave. I said to her 'I am looking for a love seat and/or twin sleeper but now have to go to work'. She said she would print some materials out for me to take with me. I said fine but I have to go to work now. She starts printing, and then answers questions for co-workers, and then prints some more and then talks to other co-workers. I said I have to go to work and don't have time. Finally I get information, go running out the door, and am late for work. So now I have furniture information, no desire to go back to that store, which did have really nice stuff and a sale starting this weekend, but their sales people don't get it. Customer service, hello!!!

I was a tad overscheduled because I had to take the cat to the vet in the AM and pick him at the end of the day, in addition to everything else I had on my calendar. They checked him out and he is better. His blood sugar levels are almost too low so we had to readjust his insulin intake and go back in a couple of weeks to check again. He has gained back a pound of weight so he is up to 12.5 which is good. There is a chance, we won't be able to stabilize his blood sugar levels, which would be very bad.

Yesterday my back was somewhat cooperative (meaning it didn't hurt badly all day) and I got a fair amount of sleep. I was exhausted by the end of the day and never got out for a walk.

In the meantime, I have to get moving today because it is pouring rain, there are accidents on the highway, and I have to get to work on time so I can leave on time so I can meet a friend for a walk on time.

Thursday, June 11, 2009

Browsing in the Hallmark section

Apparently there are expanded Hallmark moments in life to include other significant life moments, like cancer! Yes! Last week I was in the card section of my local drug store and saw a 'coping with cancer' together greeting card showing a bald headed model - apparently representing someone going through chemotherapy - with a healthy person. Clearly there are tasteless people at Hallmark who don't get it.

If I am in treatment, I don't want to be sent a picture of someone supposedly going through chemo. There was no hint of ever present nausea and discomfort, just a healthy person without hair. If you want to send me a coping with cancer card, it should be cheery - while in treatment, you get to see people all the time with no hair who are sick. Send me a picture of something nice - or better yet - chocolate, ice cream, flowers, or a picture of a research lab which is decoding the gene pool finding a cure. You get the point. If you have cancer and aren't in treatment because you there isn't anything they can do, why do you want to get a picture of someone 'in treatment'? Helloo!! Yoohoo, Hallmark people - think about it - a picture of someone else who is faking having cancer doesn't cut it. This is my daily rant but I am not alone here, see this blog too.

Last night, I think I slept 5 hours, and then another 1.5 hours, so after 6.5 hours of sleep plus 5 hours the night before, or a total of 11 hours in two days, I am exceptionally perky (and crabby). Tonight I am going to bed early and not answering the phone so I can get some sleep. Before then I have an overscheduled day. 815 drop cat at vet, 930 meet friends for coffee, 11-12 walk, 12pm pick up tickets for movie, 12-5 work, 515pm pick up cat. (note: being in 3 places at 12pm) I have to eat lunch too... I'll have to pack that first, take a shower, eat breakfast, and finish waking up. Perhaps I should get off the internet and get moving????

PS My back hurts but I am not whiney or anything.

Wednesday, June 10, 2009

Hatred

Hatred is a very strong word and I don't usually use it. I dislike things rather than waste energy hating something. But today, after a night of little sleep due to stupid back pain, have decided here are a list of things I hate:

- cancer (doh!)
- back pain (double doh!)
- diabetes - feline and human (another cureless disease)

However here are somethings I dislike:
- mean people
- stupid people
- needles - shots, ivs, etc
- bad dog owners (who end up with mean untrained dogs)
- road rage
- computer virus creators
- spammers
- know it alls
- whoever invented parallel parking

Can you guess that I am in a rosy cheerful mood today? I went to bed in pain at 10 pm and even though I took pill I have been up since 3 am.

Anyway, an update on kitty: he is better. He is substantially better to the point that he now comes up stairs at night to tell us when his food dish is empty. He doesn't walk very well but he can now manage the stairs and getting up on the bed to inform of this issue in his life. (Once he is on the bed, he has resumed his bed hog ways as only a giant cat can.)

Today, I shall take my crabbiness to work this morning, run some errands, go for a walk, and then work from home this afternoon before going out to dinner tonight.

Tuesday, June 9, 2009

Too young for all this

As I sit here with all my medical issues, having been told repeatedly 'you are too young for this'. Yes I am. Medical issues are not supposed to compromise your lifestyle until much older. I should have had another 30 years of relative health.

But then I think of my friend Jill. I have known Jill since about 1980 when she became the college roommate of a friend of mine. Jill was a character - always with a story to tell and an adventure to go on - whether it was singing in a choir going to South American or this hot new (younger) man she was eying. She lived her life to its fullest through its ups and downs always keeping her sense of humor. She did all this with a multitude of health issues, primarily asthma and related respiratory issues. This Saturday apparently in an inadvertent mixture of her inhaler and possibly Tylenol (or some other common over the counter drug) she lost her fight and died. She could not be resuscitated. She would be 48.

When I was diagnosed with cancer two years ago, she unexpectedly dropped by my house, at a time when no one was visiting, to bring some cheer and an dream catcher as she was sure I would beat cancer and have years left to dream. A year later she is the one who fell and broke her leg. We would talk on the phone often while she was laid up. Through surgery and re incisions and infections, she still went to South America with her choir and kept her sense of humor.

In April, the three of us went out to dinner. My other friend and I had planned for about three months to get together and finally picked a date and Jill actually could meet us. We went out and laughed for hours and had a great time. Now on Sunday we will go to her memorial service and remember who she was and how she could bring a smile to anyone.

Monday, June 8, 2009

Be careful what you say

When we first moved into our house, the home inspector told us we had a mouse problem and that they found one black ant. We said we would enlist the cat to deal with the mice but then found ourselves overrun with black ants. We hired the exterminator to deal with the ants for the next couple of years. Last year, we got cheap and did it ourselves.

Last week, my husband said (this is where you have to be careful about what you say) 'We seem to have the indoor ant problem under control and there are just a few outside'. Then we started seeing ants all over the kitchen and in the bathrooms. It is clearly his fault. He jinxed us. He should have kept quiet on the topic. Yesterday, they were everywhere all over the counter in the kitchen. We ended up pulling out the stove and the refrigerator, cleaning the floors and the counters completely, and putting out lots of nasty bait. I think I found their entry point in the kitchen and filled it full of evil goo. After that I saw one more ant later on. I hate ants!

Yesterday was occupied by ant extermination for a good part of the day but I was also able to sneak in some gardening and my daily walk. Someone was giving away some eggplant plants so I had to plant them to add to my collection of peppers and tomatoes. This means I will have my own personal private supply of eggplants for the summer - yummy!

My back was feeling better for most of the day but after gardening and running my errands and ant extermination, it was not happy and I had to ice it for a while. Then I wanted to ice it more, but since I left my special ice pack out of the freezer so it got warm, I had to suffer in silence and take a pill. This morning my back felt okay for a nano-second when I woke up. Then I moved and stretched. Silly me. I should not have moved at all. But my lower back is somewhat better. Its my upper back and neck (and sometimes my hips and tailbone) that make me unhappy these days (which can result in crabbiness).

Today I am overscheduled - again. I am going for a walk and then I have a meeting this morning for work and then go to work in the afternoon. This is just a very busy week for me. I wanted to take a class tonight on ergonomic gardening but really can't because I am out the next two nights.

Yesterday we also made the big switch for kitty. His back feet don't work right now and he used to have clumping kitty litter but would walk in it after using it and ended up with clumping litter stuck to his paws. He is now using 'Yesterday's News' litter which is made from old newspapers. I was told that some times cats don't handle transition well, but apparently not an issue for kitty. He does seem a little perkier these days but still not getting around well.

Sunday, June 7, 2009

National WHAT Day?

Today is National Cancer Survivors Day. Well, lah-di-dah. What if we don't want to be part of it? First of all, I really dislike the word survivor. It is a label (as I have said many times before) and I think it implies that once you become a survivor, you are over it. Well, in cancer-speak, they say things like - remission - where cancer is inactive or no evidence of disease - which means they didn't find anything. But they never say cured... because there isn't one.

I did mention this to my husband and he said 'Happy National Cancer Survivors Day, honey'. I replied 'thanks, but I hate the word survivor'. His response was too true 'well, its better than unsurviving'.

So anyway, I digress. I dislike the label but though I would check this National Cancer S-word Day out. Well, I can't find anything. There apparently are events but you have to call and ask someone. I did call and got a nice recording that said they are unable to take my call at this time. Obviously I won't be attending an event. I can't buy any merchandise either because I am not registered. And merchandise needed to be ordered by April 3. So much for National Cancer S-word Day. I can't find an event, I can't order anything, I haven't seen ANY announcements about this until yesterday on all my cancer websites (and believe me I waste a lot of time on them). I guess I'll find something else to do with my day.

This means more time for gardening, going for a walk, a little shopping, and taking care of the cat. Poor kitty. He really doesn't get around well. Very distressing. But he is eating like a pig (when is focused on eating his canned food, he makes little grunts as he eats). So he may not have much quality of life but he is pretty funny.

Saturday, June 6, 2009

This really ticks me off!

The other day I saw this article and was completely infuriated. What does this moron (and I use the term loosely) think he is doing? He has no idea what a cancer diagnosis is really like and what it takes from your life. I was pretty steamed after reading this article initially. Then this morning I was going to blog about it and couldn't find it where I originally read it so I googled 'faking cancer diagnosis' and you wouldn't believe how many more morons are out there doing the same thing! I also found this other blog where a blogger wrote about the idiocy of these people. I liked the comment on her blog where someone said she would wish cancer upon these idiots. Now my nice normally low blood pressure is starting off significantly higher than normal today.

I am finding that working two part time jobs keeps me very busy - even though its only 25 hours a week (or so). But I do go to work every day now. And do volunteer work. And work some contract work. And go for a walk every day. And garden. Okay, maybe I'm busy.

Today I have a list of stuff to take care of that I have been putting off (actually my tiny chemo brain keeps forgetting to do them and I lost my list...) Walter is going into work this morning so I am left to my own devices - something that isn't necessarily a good idea.

The cat is doing better. He is more mobile. This morning he came up stairs and demanded more water. Walter had fed him but apparently not given him enough water on his canned food the way he likes it so he came up to ask (make that demand) more. Yesterday afternoon I came in from work and couldn't find him anywhere. I looked everywhere he likes to sleep and checked the basement and upstairs. I couldn't find him. He wasn't answering me. Apparently I was interrupting his nap on the corner of the dining room floor under the table. He just does these things to stress me out!

Friday, June 5, 2009

What are the odds?

What are the odds that the only food the cat is now allowed to eat are things Mr. Picky (his alias) will actually like? Apparently the answer is inversely proportional to their cost. The more expensive and better for him, the less he likes them. Yesterday I got him the only kind of dry food that I can get over the counter (at $10.99/small bag) and he doesn't really like it. I mean he ate a little when I brought it home and then some in the middle of the night but apparently it is not up to his standards (which apparently are very high since he tries to drink out of the toilet at times). Well, we will wait him out. How long can he suffer (and not very silently) before he breaks down and starts eating what is now available to him? I give him about 2 more days. He is eating canned food but looks for treats and dried food that he used to get. I tried giving him healthy treats - which is turkey jerky for cats and guess who rejected it?

Yesterday I started my day at the dentist. It turns out the woman who has been working there for more than 25 years and has been cleaning my teeth for at least 15 is moving out of state. Her new husband's job was relocated so its for all sorts of good reasons but now I have to adapt to change - which I am so good at! The new hygienist seems very nice but she's not the same.

Four days since my last cortisone injection I am not so sure about this. The last one lasted for about three days. This one is a little better but my back hurt last night and then I had awful leg cramps in the middle of the night - worse than a charley horse. This is what happened last time and then the effects of the shot wore off. I am being optimistic but ow!

Today off to work and then for a walk and then to the local Greek festival and then get my nails done. I know there's more but I can't remember it all now - too early, need more coffee, and chemo brain!

Thursday, June 4, 2009

An up and down day

But first some morning inspiration I stole from a friend's blog:

Yesterday was an up and down day. First I had to resolve my stupid prescription issue that was supposed to go to the mail order service. It still wasn't appearing on my account so I called and they said they hadn't gotten it but my doctor's office had tried to submit it on May 22. They had faxed back and never gotten a reply. I had spoken to the doctor's office last Friday the 29th and they were going to resubmit it. Well they did. To Walgreens. I called Walgreens to find out how much it would cost as the whole point of mail order is its cheap. Walgreen's was cheaper so I said the hell with all this and I'll keep my prescription at Walgreens because obviously either the mail order place is too complicated (I have had problems getting prescriptions submitted to them before as well) or my doctor's office just can't deal. Anyway, lots of phone calls there.

Then we went to pick up the cat at the vet. Now we can call him 'the expensive kitty'. I have a problem with needles. Kitty now needs a shot twice a day so I volunteered my husband. On the way to the vet, he tells me that he almost failed high school biology because he couldn't give a chicken a shot. (But apparently it was a little baby chicken and a giant needle). The cat is a giant cat and a little tiny needle. He is perkier but still can't get around well. His life has changed completely because he can't have treats any more! He sits around begging for them and he can't have them. I have to go get some good diabetic dried food for him and maybe we'll give it to him as treats.

He is expensive kitty because a bottle of insulin costs $95 (even with the prescription savings plan at Costco for the uninsured that apparently applies to pets). A bottle should last us just over two weeks. Plus needles. Plus expensive food ($1.00/can and he should eat two a day). Plus doctor visits that are expensive.

Any how, we got him home, fed him, went to Costco and got his insulin and then hung out with him. He is very cuddly and somewhat mobile but his back legs don't work right still. They are better but he clearly has mobility issues - perhaps this will keep him from trying to go outside this summer. He goes back next week for another follow up to see how his glucose levels are.

Yesterday I also went to work at my new job. So far it seems pretty good and I think it could work out. Today I have a dentist appointment, meeting a friend for a walk and then going to work at my other job this afternoon. I have to go to Petco and get dried food, a kitty food dish timer (so he can have a snack in the middle of the night) and another errand I can't remember right now but I am sure it will come to me (like tomorrow when its too late).

Wednesday, June 3, 2009

Be careful of what you ask for

So I have been bugging my doctor's office for all my test results. Now yes they are by right available to me on request, my doctor doesn't always send them out. Sometimes they just call and say its normal and that's it. My doctor also has sometimes said 'oh is normal, don't worry' and implies that I need to remember that new technology shows us all sorts of normal things that can sound scary but are nothing to worry about. (I think she has figured out I have a tendency to worry.)

Recently I have been feeling deprived and left out of the loop and insisted I get all my reports of recent tests. This is clearly a case of be careful of what you ask for. Because now I have to figure out what they mean. Things like ultrasounds and mammograms and xrays a nice radiologist sums up the results in a nice tidy little fashion and says things like 'no change from last time', 'negative', or 'no follow up needed'.

But then there are all the other tests - mostly blood work - which give the results and the normal range and if you are out of normal range, they indicate this with an asterisk so you can conveniently see them. So now what do they mean? If you are out of normal range, is it cause for concern? Is it enough of a difference? Is this consistent? I even have two blood tests taking two months apart to compare. So what if one is out of range but the other is fine? Is the second reading the important one? Eeeekkkk!!! I have no idea!

What am I supposed to do? 1. Go to medical school to learn how to read these. No, too busy. 2. Go on the internet to scare myself silly. No, I'm too smart for that - most of the time. 3. Ignore them. (If you ignore weird things, maybe they will go away - or at least that's my theory.) 4. Make a list of concerns on out of range results and bring them up to the doctor at my next set of blood tests in November? I think I will go with option 4 for now. But at anytime I am feeling stupid I will be sure to switch to option 2 to stress myself out and sometimes go to option 3 with the stress kicks in. But overall I think I am glad to have them. Its my body and I need to keep on top of what's going on.

Yesterday I survived another two job work day - 8-1 and then 145-615. Today I only work 8-1 but then have lots to do. The big thing is call about the cat at 3pm. I called yesterday and was told yes they need to keep him for another day because his sugar levels are too high but he's eating (and nothing gets between him and his food dish which is a very good sign - you can throw a party around him eating his canned food and he won't notice until he's done.) This makes me happy.

Now I am going to be late again. I have to learn this internet/work balance thing again. Too much time wasting on line.

Tuesday, June 2, 2009

Second cortisone injection

Yesterday I had my second cortisone injection. It went pretty well except for the fact that they were running over an hour late due to system failure - nothing like waiting for a big needle to make you feel less stressed. But it went okay. I came home and iced it and went for a walk. So far (not to jinx myself) my lower back feels better but they key is if it lasts for more than a few days. I call back in a couple of weeks to let them know.

I was home yesterday with the cat, except for the big needle adventure and my walk. He could barely walk yesterday and I carried him to his litter box twice - where he used it. We took him to the vet last night and this morning they will start measuring his glucose curve (fancy term for figuring out the insulin doses he needs). I will call this afternoon and see how he is doing. He will probably stay through tomorrow as well and then go back next week. We will have to learn to give him shots too.

Now I am late for work so I have to run!!!! New job so I am still trying to make a good impression.

Monday, June 1, 2009

I forgot!

I forgot! How could I forget? Well, perhaps I will claim chemo brain or stress or getting old(er). I forgot my friend's birthday. Actually I forgot two friend's birthdays - one was on the 18th and the other was this weekend. Call me a space shot, whatever. I have no brain.

But the real thing I forgot was that yesterday was two years since my diagnosis officially. Yes my surgeon said to me a few weeks ago that I was two years out but I was waiting really for the actual date. I think I had the clean mammogram about two years from the date of some important doctor's appointment or the first of many 'procedures'. But now I feel comfortable in saying that two years out, I am still here. And if my damn back would stop hurting life would be much better. Tomorrow is actually two years since I started this blog as well.

Today I go for another big needle in the spine. But I am okay with that as I have been through this once already and know what to expect. Its not exactly a 'pain free' procedure as the needles of pain meds hurt a lot - they burn to be precise. But its not agony and if it would make my back stop hurting, I would be much happier.

This afternoon, we are taking kitty for his hospital stay. I am packing his food dish (as he is Mr. Picky and has to start eating special food for diabetic cats and I am thinking if he can eat out of his regular dish the transition might be a little easier) and a water dish and his blanket and maybe his hair brush. He might even need his own suitcase. He is really wobbling around this morning. He spent the entire night sleeping on the bed next to me which means he drank no water for 8 hours and that is not good for diabetics. So this morning, because its his last day of his canned food and he hasn't been drinking water, he got canned food for breakfast - an unusual occurrence. He will get lots of kitty treats today because that's it, no more, ever. Unless I can find diabetic kitty treats that Mr. Picky will like.