Welcome water

Posted January 9, 2024

"Do we get a welcome water? I'm Elite." Bob laughed at me checking into the Rochester Marriott Mayo Clinic Area. Well, it's true. One of the perks of the AmEx Platinum with the insane annual fee is that I'm automatically Marriott Bonvoy Gold Elite, which gets me fuck all but a couple bottles of Costco water and a 2 pm checkout.

There was a moment when I thought getting in the car at 5:30 am tomorrow would be totally fine to get down here in time for my first appointment of the day, a 7:30 CT scan. That's hilarious. Instead, we got a room a half a block from where I need to be at Mayo, I can leave the hotel room five minutes before my scan, and that's much better. After that CT scan, I show up for labs at 11, then report for my PET scan study at noon o'clock, get the radioactive solution injected at exactly 12:30, go have lunch, and get rolled into the scanner at 2 pm sharp. We see my Mayo oncologist Dr. Lionel at 3:15, and that's my day. The thing I'm struggling with right now is whether I'll go back to bed between the first scan and my lab appointment, or eat the free breakfast at the hotel, which ends at 9:30. My life is full of difficult decisions.

This will be my first scan since starting the immunotherapy treatment. Bob asked me if I was nervous about it, and I said I hadn't really been thinking about it. Then I was very short tempered as we packed up to head to Rochester tonight, so maybe I'm a little stressed. Every dull ache in my belly or stitch in my side is a sign that the cancer is raging out of control. It's definitely not from McDonald's drive through or throwing heavy luggage around. It's the cancer. Definitely.

As I wait to die, I guess I can set up Practice Hospice. I'll lounge in my Recovery Lair (aka our guest bedroom), watch Below Deck and shows on PBS Masterpiece, and have a little bell to summon Bob. I'll take callers, who will bring me artisan chocolates or artisan cheese with artisan crackers. I'll eventually get bored and bribe Bob with the promise of Cat Cookies to go with me to Trader Joe's to see what they have there now.

I just looked on the Trader Joe's website and they don't seem to carry Cat Cookies any more, so that plan is ruined. Now that Abbie is gone, I don't think I can even languish properly without that dog in the bed, watching me every second. Everything is ruined and I want to smash things but I'm completely fine.

I'm fine.

Who is the asshole, Mexico edition.

Posted January 2, 2024

Who is the asshole, Mexico edition.

This one is easy: we arrived to snorkel a cenote, which is an underground river in a cave (except for places where the cave roof has collapsed, then they’re more like channels). Buff dude in the parking lot was absolutely dousing himself in some sort of aerosol product: I don’t know if it was AXE Body Spray, bug repellant, or sunscreen, but it would definitely be poisonous to the very delicate natural ecosystem he was about to put his toxic body into. A worker at the park ran over and told him to stop spraying, and that he’d have to take a shower before getting into the water. He was offended. All brawn, no brains. Asshole.

The resort where we’re staying is right on the ocean, and has a collection of chaise lounges with umbrellas and round covered lounge beds. People “save” a spot by putting down a towel, usually along with another personal item of low value, like a book, or a hat. The towels are provided by the resort in a very managed system wherein a guest is charged $40 US per towel if they’re not returned.

I think it’s an asshole move to put down a towel and then disappear for half the day. I mostly don’t pay attention to this because we don’t consider ourselves to be people who lay on a chaise lounge on a beach. We don’t “tan.” But we tried it out when I was able to nab a pair of chaise lounges in an unusual mid-morning departure of the previous occupants.

We’ve decided we’re not NOT chaise lounge people – but these were extraordinary circumstances. Our room was just a few steps away – easy to run in and grab anything we might need. It was a perfect day with a light breeze. We were able to keep shifting the chaise lounges under the shade of the umbrella. We could wander in to bob in the ocean if we got too warm. Wait staff kept bringing us food and drinks. It was pretty good. I can definitely see the appeal.

I noticed a couple arrive and take control of a lounge bed that was being saved by someone else – but with only hotel towels, no personal items. Just hotel towels is not a serious save, I agree with that. However, I took against the interlopers right away, because they removed the towels by the very tips of the corners, like they were covered in cooties. The woman then proceeded to obsessively brush every molecule of sand from the bed. This bugged me, as we’re on a beach with extremely fine, white sand and eradication is really a losing battle. Our friend Matt, with his wife Angela on the neighboring lounge bed, took offense to her lips, which were injected with filler – I just assumed she had some sort of unfortunate deformity and was taking the high road to not make fun of her appearance, until I learned she did it to herself. Matt counted her obsessive sand removal a point in her favor, as sand is a menace.

I continued not really reading my Kindle as we settled into our new life beach sitting…and then the original lounge bed savers showed up. They confronted Fish Lips and Dude Bro, who shook their heads and shrugged. What! Dude Bro had folded up the saver towels and placed them under the wedge-shaped lounge bed cushion, but seemed to be claiming those belonged to them. Liar. The young women were now looking more urgently for their towels; after all, $80 US was on the line. They asked people in the surrounding beds. They asked the wait staff. Everyone shook their heads. I couldn’t just sit idly by. If you see something, say something. I got up and told the young women that the towels Fish Lips and Dude Bro had were there when they arrived. The young women just walked over and yanked their towels from under the wedge cushion and Dude Bro didn’t protest.

You might not see me, the middle-aged woman in a giant sun hat, floral swim tee and skirted swim capris, sitting nearly upright in the chaise lounge on the end. But I see you, asshole. I see you.

Health update

Posted December 30, 2023

Health update: I keep thinking there isn’t much to report, but I guess there are a few things. Bob and I are in Tulum for a few days, then stopping in Florida to see Bob’s mom. I woke up today with terrible vertigo; this is the worst it’s ever been. I’ve had very, very brief episodes before: during scuba diving when clearing the pressure in my ears, and when running saline through my head with a Neti pot. I woke up during the night with bad congestion in half of my head, so I’m pretty confident it’s an inner ear situation. I took a Benadryl and went from not being able to open my eyes without spinning wildly to sitting up and comfortably working on my computer, so I’m definitely on the mend. Plus, we Googled some prescription drugs for vertigo and Bob picked them up at the Mexican pharmacy, what could go wrong. Don’t feel too badly for me; I am lounging in bed and looking at the ocean.

I’ve been on Ozempic since July. The Mayo endocrinologist recommended it as I essentially have metabolic disease, and all conditions will benefit from weight loss. I was pretty excited – the loophole I’ve been looking for my whole life. I’d settled comfortably into the reality of my body, and feel pretty good about it; but yet, when offered the magic shot, I’m definitely taking it. I thought that on Ozempic I could eat whatever I want, whenever I want, and be skinny!!!! Well, no. I kept eating like “normal” and nothing really happened. I kept titrating the dose up, and what eventually happens is that you lose your taste for food, and eating too much makes you feel unwell. So yes, there’s fairly regular low-grade nausea, but the weight starts coming off. Once I got with the program and adjusted what and when I was eating, everything improved.

Ozempic started prior to liver carcinoma 2.0, and I asked if it made sense for me to continue with the Ozempic, and the answer was yes. When I was first diagnosed this time around, I pledged off sugar. That didn’t take. I’m now focusing on everything in moderation. We’ve found a personal chef (which sounds sickenly bourgeoise), as recommended by our gardener (worse). She makes a week’s worth of food and delivers on Mondays. (I’ll put the most recent menu in the comments so you can understand why we’re so deliriously happy that we found her.) There are always ingredients for bowls, a couple different main dishes, sides and a paleo dessert. We’ve canceled our Sun Basket meal kits, and stopped ordering delivery, and that balances out the cost. This means I know exactly what I’m eating, know it’s as much organic as she can source, and it’s exclusively whole foods: grains, vegetables, lean proteins. Turns out that when I’m regularly eating what I’m supposed to be eating, any negative Ozempic side effects disappear. So the weight is coming off, slowly, as it should.

In other glee/guilt news, I got out of jury duty. I’d kicked that can down the road last year when I was summoned during liver cancer 1.0, so I couldn’t push it back any further. And it was true that I had an infusion during the time of my last possible window of service. My oncologist wrote me a note and I was released. I am a little bit sad, as I was kind of interested in how the process works. And I feel guilty for shirking my civic duty. Getting out of jury duty is just one of the amazing perks of having cancer! I made up for it by watching Jury Duty on Amazon, which was an absolute delight and made me very happy.

I’ve now had three immunotherapy infusions, with no side effects. And I continue to have no cancer symptoms and feel 100% great – better than “normal,” actually, as my diet has vastly improved and I’m starting to cut some bulk. Infusion Day is, at worst, a tiring inconvenience. The two drugs I receive each take 30 minutes to run into my vein, but the entire process still takes 3 hours from start to finish. I need to do blood and urine tests when I arrive, then there’s sitting around waiting for those results, followed by starting a line which sometimes goes smoothly and others involve a bit of discomfort and extra poking. As the drugs are hooked up, they need to be double checked by someone else, so there is waiting around for that person to come by. I just sit in a recliner and chat on the phone or work on my computer or make Bob go get some tea. Not taxing, just tiring.

I’m still seeing the Chinese medicine doctor weekly for acupuncture. He prescribed ginseng, which must be powerful medicine given how god awful it tastes – and I like bitter things. I have assorted other low-key additives like mushroom powders and liver tonics and other things I throw into my smoothie in the morning.

Bob is killing it in the domestication department. He’s become a kitchen cleaning fairy. Granted, there’s not much involved, as we aren’t really cooking, but there are still dishes and lots of containers in the fridge to manage. He “makes dinner” most nights: get containers out of fridge. Put food on plates. Microwave (or toaster oven or air fry or stove top). Done.

We’re in Mexico right now, and our departure from the house was by far the smoothest it’s ever been: I usually start freaking out about undone tasks just as the Uber is arriving and we’re already 20 minutes past our targeted departure time, and I’m angry and sweaty and frazzled before we even get to the airport. Bob anticipated and handled all needs, and even carried my luggage out. He is a dream husband and everything I’ve ever said to suggest otherwise is still absolutely true but the point is he’s evolving.

We’re back to Mayo on January 10 for new scans and to meet with the Mayo oncologist. He said not to get too worked up if the tide doesn’t seem to be turning at this stage; it’s still pretty early to see how/how much the immunotherapy is working, or if it’s working. I guess we’ll find out! Still very surreal to have a significant medical problem with absolutely no perceptible manifestation it’s happening.

Not the same Jesus.

Posted December 30, 2023.

My niece got married a couple weeks ago. It was a beautiful wedding in a barn on a dreary winter day (when we had winter for a few minutes). It was a perfect wedding for that couple. I was thinking how I’d revise the service if I was the one getting married – I’d start with purging all mentions of “obey,” then take out “Jesus,” and maybe change all the other words.

I texted “Found Jesus” to a friend this week, but it was a different guy. Bob and I flew into Cancun and needed transportation to our hotel in Tulum, and as Todd has a place down here, he knows who to call (actually WhatsApp) for these things and hooked us up with Don Jesus to drive us down. Departing Cancun airport is a bit of a circus, but we finally connected with Jesus and were on our way to Tulum.

Jesus had his wife with him, so he wouldn’t have to drive back alone. Terry hopped out to say hello, and it was clear that she was from the south – but not this far south. Terry is from Texas. Terry and Jesus met there when they were both in their 20s, got married, and had baby Christa. When Christa was 2, they split up, divorced, and lost touch…for 42 years. They each married other people, Jesus moved to Mexico, and that might have been that, except Christa, now 44, decided to track down her dad, found him in Mexico, and when she and her mother were on a cruise, Jesus met up with them on their day excursion to Playa del Carmen. Decades after they first met, now both newly single, Jesus and Terry re-connected, re-fell in love, and Terry is splitting her time between the US and Mexico. They’re in their late 60s and early 70s. They’re having a blast, hanging out and listening to music and living their paradise. Jesus lives!

What an incredible story. I told Terry and Jesus that even if one of them ends up murdering the other with a machete, it still would be an extraordinary real-life fairy tale.

The year of the goat

Posted December 22, 2023.

The year of the goat. The past two summers, we've hired a herd of goats to eat the buckthorn in our woods at the cabin. When the trailer came to pick them up at the end of the season this year, one goat was on the wrong side of the fence, and got left behind. Over the next couple months, there were periodic sightings of her; she eventually moved closer in to the cabins, but we'd see her, blink, and she'd be gone, likely through a portal into another dimension, as we never saw her going. There was no hope of catching her; she was entirely wild. She made it through deer hunting season, and we kept calling the goatherd with updates on sightings. Tyler would come out and search for her with no luck.

One visit we woke up at the cabin to find the goat on our deck; it seemed she'd taken up residence there in the time we'd been gone. Arzu the dog was deeply, deeply upset by the horned demon so close. Arzu's bad week got much worse: Tyler put up an electric fence trap that would allow us to easily enclose the goat if she went back to our deck. Arzu went to check out the new fence, touched it and got shocked. She couldn't figure out what the hell happened, and spent the rest of the week barking at the fence (and everything else).

Eventually, Tyler had success darting the goat and bringing her home to the herd. I'm hoping she kept working on the buckthorn while she was here...

55 and still alive!

Posted November 21, 2023.

55 and still alive! I keep a list of my birthdays on my phone (well, not surprisingly, the date stays the same, but what I do on that day changes from year to year). We're not big birthday people, but sometimes it works out that we're someplace cool on November 21: Luang Prabang in 2006. Ho Chi Min City in 2009. New Orleans in 2013. Paris in 2014. Belize in 2016. There's been plenty of quiet birthdays, too, and I really don't mind them, either, most of the time.

Five years ago, my 50th birthday, we stayed home at the cabin, as I couldn't risk catching some bug prior to my double mastectomy on Monday.

Last year on November 21, I took my mom to Fergus Falls Urgent Care with suspected pneumonia. Dad had recently broken a kneecap tripping on a dog toy, and couldn't drive. A really nice and competent PA saw us at Urgent Care, and he determined no pneumonia. A month later, he shot and killed his girlfriend in St. Paul. Apparently, his wife (also 4 kids) knew about the girlfriend. I can only imagine it would be more shocking for your husband to be convicted of murdering a girlfriend you didn't know existed? Anyway, we went through the Subway drive through after Urgent Care. Tonight we're meeting my family at Fiesta Brava for dinner. Will hopefully be uneventful.

Cancer returned.

Posted November 11, 2023.

My liver cancer has returned – but this time it’s taking up residency in my peritoneum, or abdominal lining. (My peritoneum is not the same as my perineum.) I’ve been having quarterly scans and bloodwork at Mayo ever since my liver surgery in October 2022. My scan in September showed an area of concern, which triggered an agonizingly long series of more tests and scans and biopsies. The reality is that everything moved pretty fast, but it always takes a week or ten days to get the next thing scheduled. And here we are, nearly two months later, but we finally have all of the information and a plan for next steps.

My hepatocellular carcinoma has re-emerged as peritoneal carcinoma. Because this is the spread of the liver cancer, it’s technically secondary peritoneal carcinoma, aka peritoneal metastases, aka stage 4. If you search any of these terms, Dr. Google says I have six months to live. Which is weird, as I’m completely symptom free and feel terrific. There’s a liver tumor marker blood test (AFP) I’ve been getting quarterly: Before the liver cancer was removed, it was 131. After surgery removed the cancer, it was 3 in December. Then 9 in March, 12 in June, 33 mid-September. Those numbers were moving in the wrong direction. (83 on October 30, ack.)

Receiving this news was exhausting. Jesus fuck, I JUST did this a year ago. I’m tired of it. And I’m not exactly the kind of person who’s going to fight! or think positive! or start juicing! or, God forbid, Jesus! I spent a good long while in the “I’m fucked” camp: Deal me in, boys, and pass the smokes: I’m hitting gambling, Marlboros, pizza, whiskey and milkshakes until I’m dead, which will be within six months. Four months, actually, as we’ve already lost two months fucking around. This plan will also help me look appropriately ghastly upon my death; I can’t die looking this good.

We talked to my Mayo liver doctor: with new immunotherapy treatments, one out of three patients with this is still alive in four years! That’s the good news? What the fuck. Meanwhile, we were making end-of-life plans for our beloved Abbie. Bob was feeling quite defeated in the “keep family alive” category. My work continues to be an amazing, exciting, exhilarating and critically important roller coaster; I don’t have time to plan my exit. I’ll need months, if not years, to create instructions to leave for Bob. I feel like I definitely can’t abandon him with the hoarding situation in our basement.

I tried to convince myself that I should have departed 20 years ago when my brain aneurysm hemorrhaged, and this has all been bonus time. That didn’t help. I’m not ready to go.

I don’t enjoy the existential terror.

I’ve been assigned to an oncologist at Mayo, Dr. Lionel. We met with him last week and we have a plan! He’s very optimistic about immunotherapy treatment being able to manage my cancer and give a durable, long-lasting result. So I guess we’ll just do that. I’ll get immunotherapy infusions every three weeks; they start on Wednesday. The good news is that I can do those with my local oncologist at Methodist Hospital. I shouldn’t feel any effects from those infusions; they might make me a little tired. After three rounds of infusions, I go back to meet with the Mayo team and get more scans. I am participating in a study at Mayo testing how they do PET scans for my type of cancer specifically (a targeted radioactive fluid), with a goal of getting even clearer pictures of what’s happening. This study won’t change my treatment – but it might help with how we can monitor progress with more detail.

It's weird to adjust to the idea of living with cancer. But I see people doing it all around me. Thanks to diligent monitoring, we caught it super early. Even though I lack enthusiasm for nurturing a good attitude and taking control of my destiny, to complement the world-class Western medicine treatment I’m receiving, I’ve started seeing a Chinese medicine practitioner (an actual Chinese person, not some white girl in the suburbs). I’m in regular consultation with the amazing ethnobotanist at work on the medicinal properties of different plants. I’ve cut out sugar, for the most part, as sugar feeds cancer.

I’m still not juicing.

Goodbye, Abbie.

Eight years ago today (October 28, 2023) , our dog Abbie came to live with us. He was almost two years old. Born in Arkansas, he was shipped to the Golden Valley humane society as a stray and named Jakob. He was adopted and abandoned before being pulled by a home-based foster program. Now called Scout, he lived with his foster mom Beckie for 14 months before coming to our house.

Starting right out of the gate naming a dog after a famous anarchist – Abbie Hoffman, who was Jewish – was maybe not the best move. The last animal to join the family was a cat we named Oslo (my people), so it was only logical that this pet be named for Bob’s heritage. Abbott, or Abbie for short – we saddled our boy dog with a girl’s name.

We weren’t prepared. We weren’t prepared for a dog who was smarter than us, who could open any trash receptacle, any container, any pill bottle. Who took control of the house, suffered from separation anxiety, bit, herded us (while biting), was a sociopath without remorse, ate our food, and growled at us if we tried to reprimand or move him. Called a “loophole dog” by a trainer, Abbie understood immediately what was being asked of him, but preferred to spend his energy figuring out the shortcut he could get away with.

We also weren’t prepared for how much we’d adore this dog. Always within 12 inches of one of us, or, preferably, both of us, Abbie gave himself the job of protecting me, and he took that very seriously. When he’d come in from outside, he’d tap my arm with his nose to let me know he was back and on the case. He nursed me through two cancers. He was the subject of hundreds of made-up songs, he slept in our bed. He was our best, most handsome boy.

We agreed he’d live forever, because anything less was unbearable to imagine. But he took after his mother with a long and strange litany of medical problems, including liver cancer and Cushing’s disease. The Cushing’s treatments made him really sick, so we abandoned that. He had liver cancer surgery in May. He recovered really well, and was great for a while. He started fading a couple months ago, and we perked him up with prednisone. Ultimately that wasn’t enough, and his eating slowed down, even with appetite stimulants. His back legs weren’t cooperating reliably. And then last weekend, after a great week at the cabin, he stopped eating and drinking entirely, and let us know that he was ready to go.

We would never be ready. We held him on the deck when the vet came, eight years to the week after Abbie became our family. I honestly couldn’t imagine how to continue without him, and the strangest thing is happening – I don’t know if it’s a basic survival strategy, or if I’m so depleted from the trauma of making decisions for a geriatric dog. My brain has just shut down the whole topic of feelings and memories of Abbie. I’m selfishly grateful.

Goodbye, Camille.

I heard of Camille J. Gage long before I met her. Active in the neighborhood, and throughout the city, in a crazy long list of things, from art to justice to events planning to progressive politics to, ideally, anything that combined all of the above. Oh, also the sacrality of water, music, hiking, yoga, and dancing. And her family. And her friends. And food! We know many people in common (Facebook says 86, but that is just scratching the surface).

I met Camille in person on the sidewalk in front of Grand Café (forever in my heart) in the summer of 2013, and we talked about my imminent theater debut, totally naked in a Fringe Festival show – written, directed and starring the niece (Natalie!!) of the people Camille and her husband Pat were dining with.

That fall, Camille invited Bob and me to co-host a fundraiser/friend raiser for our neighbor, Minneapolis Mayoral candidate Betsy Hodges. Setting up at that event, I mentioned that we’d been binge watching Deadwood, and we were maybe developing a bit of a whiskey problem, and I was having a hard time not calling everyone “cocksucker” in casual conversation. Camille smiled at me, said “You’re fun!” and we linked arms and then we were friends. Or something like that.

We hung out a fair amount (for us) over the next years; Camille and Pat rented my brother’s cabin for a week a couple summers, so we got to spend some time together in my homeland Otter Tail County. And we were able to finally host Camille and Pat for reciprocal dinner, as the dining table at the cabin is actually functional and not a long-term storage unit. Camille was always good for late-night texting, talking about what shows to watch and other important bits of news and information.

I’m still reeling over the news of Camille’s death. Turns out some people don’t post every detail of their medical situation on Facebook, weird as that sounds, so Camille was able to stage a proper Irish goodbye – to a huge number of friends, based on the comments of disbelief on Facebook. Details have been kept pretty private, but I found out that we shared the same diagnosis these past months; same, but obviously very different. I’m still alive. I just don’t know how these things happen. I know that it doesn’t make sense, and fairness and goodness don’t seem to factor into anything. You get the hand you’re dealt, and you play it. I guess the important part is who you’re playing with, and how much you enjoy the game. I will miss you, cocksucker. You’ve left a massive void in this realm. I’ll see you again. Save me a seat at the table! I’ll bring drinks.

Based on the timing of everything, it seems Camille might have shared an elevator with Kirstie Alley. What I wouldn’t give to have been a fly on that wall…

Goodbye, Mark.

We had a nice, calm Thanksgiving with my parents, two of three siblings, and a flyby from one of the seven grandchildren. I think this is the first time the meal was completely handled by the Hoff sisters. This is not to say my parents didn’t provide input. I chose the easy path and arrived with my contributions already prepared.

Three of my classmates lost their fathers in the last week. It’s weird being at the age where it’s 50/50 whether your parents are still alive. I can’t imagine ever being prepared to be orphaned.

A friend of mine died recently. I only found out Mark was sick a couple months ago. He’d gone in for a colonoscopy a year ago and the cancer was discovered – and it was everywhere from the very beginning. This the cancer story I dread more than any other – a grim discovery, followed by the launch of aggressive treatment, and from that moment a switch is flipped and the months and weeks leading to death are full of pain, discomfort, growing indignities and waning hope.

Mark’s funeral was the biggest social event I’ve attended in years. I guess funerals are the keg parties of our 50s. He was four years older than me, but through various inroads to that older class, including brothers of my friends and assorted parties, I met not only Mark but many in his circle; when I left my hometown, I latched on to the safety of the Fergus Falls expats living in Minneapolis. If my life was a TV series that starts when I’m 20 and just moving to the big city, Mark would be a regular in the first season, have a brief appearance in Season 3, and now in Season 5, this is the episode covering the funeral.

We didn’t “date.” We’d see each other occasionally, with no real interest for more than that. He worked at Best Buy for a while; I remember dropping in to say hi. (There were no cellphones, no texting and no Facebook – you had to drive across town and wander aimlessly in the appliances section if you wanted to do a casual check in.) If we were in the same place at the same time (we never went anywhere together), we’d dance all night. I remember, at some wedding dance, Mark’s twin sister told me, “He likes you, I can tell,” and that made me happy. I liked him, too. Very much. He always called me Kathryn. He was very funny. I remember him talking excitedly to the plants in his apartment: “Hey guys, it’s Plant Day tomorrow!!” There’s a lot of booze in his Season 1 appearances. Once I stayed with him and dropped him off very early in the morning at a weekend detention center, penance for getting caught driving under the influence. By Season 3 he was sober and slender, and recently out of a marriage to a mean wife. Season 5 flashbacks show that everything straightened out for Mark: he had a lovely, sweet and devoted wife, a beagle, and a job he liked with people who appreciated him. His wife is from Taiwan, and he traveled there with her a couple times. I’m glad he got all of that. I’m glad he was happy. I will miss him, and hold on to my vivid memories of us dancing and laughing.

So, that was weird.

I had liver cancer, but now I don’t.

I’m feeling great, essentially healed. We keep waiting for the bad news, but it still isn’t coming. The pathology report put my cancer at stage pT1b, which can be shortened to 1b. The only thing better (other than no cancer) would be stage 1a, which would be a smaller tumor. But we knew the tumor size going in – the news is that it was definitely a single tumor, there was no vascular involvement or any apparent spread, and the tumor was removed with clear margins – i.e., completely removed, including any possible sketchy stuff around the edges.

It’s a bit difficult (but I’m not complaining) to change gears so quickly. I mean, if you blinked, you missed it. “How are you?” “Great! I had liver cancer but now I don’t.” [Weird smile.] No further explanation offered. I mean, what else is there to say, really?

I left the hospital just over a week ago with 15 Oxys. I have 10 left. I didn’t have any acute pain; more like irritation and annoyance, especially by late afternoon. Bob encouraged me to stay on the pain meds, but I wasn’t in pain. He was right. The drugs target not only pain, but also soothe irritation and annoyance quite effectively. I started enjoying an afternoon Oxy just to kick the evening off with a little euphoria. Then I decided I should save them for a rainy day, or other situations warranting a bit of narcotic intervention -- from throwing out my back to bad election results.

Next up, we’ll have a video consult with a hepatology team at Mayo, then we’ll actually be back in Rochester in mid-December for new scans, post-op, and an oncology consult. I fully expect to be kicked back to my regular oncologist for whatever ongoing monitoring is necessary. I can’t get too attached to this result; with my breast cancer, there was also a hope that the double mastectomy would be the end of the story, but more test results recommended precautionary chemo. It seems that liver cancer acts differently from breast cancer, making the need for chemo unlikely…I remain cautiously optimistic.

I read that peak liver regeneration DNA synthesis is happening at day 7 post-surgery. It was a bit terrifying to realize my liver was rebuilding on a nutritional foundation of post-Halloween discount fun size KitKats and Butterfingers.

Success!

I’m back home, minus some liver. Excellent pre-surgery dinner at ThaiPop (really, really good), got my orders to report for surgery at 10 am. Perfect. The cars in the hotel parking lot were from all over: Illinois, Iowa, Wisconsin, White Earth, Georgia. Decided to reframe the “inconvenience” of driving a whole hour and a half from my house to get world-class medical treatment. In the waiting room prior to surgery, directed all of my nervous, negative energy on an older woman who was wearing one of those clear face shields, only on the top of her head like the world’s most pointless golf visor. Masks are required in all of the Mayo campus buildings, and she was apparently the exception. She never stopped talking; wanted to know what everyone was there for, asked one poor dude about his visible leg rash. I was surprised how everyone engaged with her. Too nice to actively shun her? Too freaked out about their own reasons for being in a Mayo hospital surgical waiting room to protest the onslaught of her, more likely.

I’m fuzzy about what happened next, but I woke up to being told there wasn’t a room at the hospital I was currently in, so they were moving me by ambulance to another hospital. It was early evening by the time I was settled, and I was starving – and still on a clear liquid diet. I was hooked to oxygen, IV fluids, a catheter. The nurse brought me some Jell-O cups, and Bob warned me to take it easy. I think he meant that I should NOT proceed to consume a total of seven Jell-O cups, aka all the Jell-Os on the ward. But I did. I think the last one is what pushed me over the edge; it was sugar free, so there was artificial sweetener in addition to red dye. About 1 am, I started to feel quite unwell. I had a burning pain in my stomach, I was shaky and felt like I was starting a panic attack. I asked my nurse for some Ativan, but it wasn’t on my orders, so no go – meanwhile, she was bustling around because my oxygen was low and my heart rate was high. I was obviously crashing.

For some reason I thought the vast quantity of pretty pink froth I Exorcist puked into the small tub would be cool to have for a Barbie pool party. Though I don’t know who would want to play Barbies in a vat of vomit. I felt better pretty much instantly. The hospitalist stopped to check on me, and thought I’d be totally fine if I avoided any further Jell-O consumption. The rest of my hospital stay was basically uneventful, except for later the night of the Jell-O incident, my nurse didn’t attach my catheter bag correctly, so everything just emptied on the floor. In the dark. Right where various medical personnel stood to check on me throughout the night. My nurse was pretty upset about it (she hadn’t clamped something correctly), and I don’t think she found my commentary about urine being sterile helpful. If anything was going to be tracked all over the ward…

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Brain scramblies

Every time I’ve climbed up to a high place – a bell tower in Europe, for example – I’ve really loved the view in spite of the overwhelming urge to spread out on the floor as flat and as heavy as possible, lest someone want to throw me over the edge. My safety mechanisms kick in, and my instinct is to be impossible to peel up. I also have to keep one hand holding my glasses on my head, because they’ll definitely fall over the edge. If anyone comes too close to me, my body will emit a high shrieking sound, coincidentally not unlike the sound my car makes when I’m about to back into something. It’s worse if someone approaches while holding a baby, because if they throw the baby over, the draft would pull me over, as well.

We’re getting to the “wandering about aimlessly” part of pre-surgery brain hibernation. I can’t think bad thoughts. I can’t really even focus on good thoughts. We’re undergoing a factory reset to “no thoughts.” I still have Daryl McCormack with me, though, and is he ever a comfort. I’m really disappointed with myself in the tv star adoration department, though. We watch a LOT of tv, as you know, and spend the first few minutes of every show looking up “What was he in, again?” It’s one of our favorite family games, up there with “Is that poop?”

We can recognize the mainstay actors from all over -- Irish, Scottish, Welsh, all the myriad Scandinavian, British…and we will go out of our way to follow our favorites, like Nicola Walker, for example. How could I have missed that I’ve seen Daryl in my beloved Peaky Blinders? Was I so distracted by Tommy Shelby that I was unable to appreciate the supporting actors? Even worse, we JUST finished Bad Sisters, where Daryl is one of the leads. So easy and so obvious, but no recognition. I guess Daryl as Leo Grande is the only one that really spoke to me, and he’s a great surgery escort.

Ordered Maria’s corn pancakes delivered for breakfast today. Part of the self care leading up to surgery. I’m not thinking of it as a last supper (we’ve got a reservation for Thai at 6:30), but we never know when our time will be up; eat the corn pancakes!

Daryl McCormack is my pick of the litter.

We went to Mayo on Friday for an updated MRI, pre-op exam, and blood typing. (B positive! Always be positive!) Oh, and I’ve agreed to participate in some Mayo studies, which meant another seven tubes of blood taken, and signing an agreement that says they don’t need to return any tissue samples of mine to my family in the case of my death. The Mayo can keep them, as my gift.

Data.

February 23, 2022: 2.1 x 1.8 cm

September 8, 2022: 4.3 x 4.6 x 2.8 cm

October 19, 2022: 5.1 x 5.0 x 3.2 cm

We’ve been watching Pick of the Litter on Disney +. We got the Disney channel so Bob could watch the interminable hours of Beatles footage in The Beatles: Get Back. And, like most subscriptions we have, we never got around to canceling it. I understand my sister-in-law and niece like logging in to our account and watching Disney movies, so at least it gets some use. But then I found Shipwreck Hunters: Australia which was great, and that bled into Pick of the Litter, a reality show about guide dogs in training. The steps in training these dogs are, as you would imagine, intense. There’s a skill where they’re looking for the dog to actively ignore a given command – refuse to cross the street because of oncoming traffic, for instance. (This is different from our dogs, who actively ignore commands -- not for our safety, but because they just don’t feel like doing it. Also, we’re not good dog trainers.)

My brain has started the power down process, and is ignoring commands. I don’t know if this is a safety mechanism, or maybe to conserve energy. I’m not worried or nervous about surgery this week, but my brain says, just to be on the safe side, we’re eliminating executive function. Air traffic control has apparently clocked out. My whole life is built on lists and tasks and planning and strategy and it’s just gone. I watched Good Luck to You, Leo Grande on Hulu on my iPhone the night I was doing colonoscopy prep (which ended up just being watching a movie on a tiny screen in the bathroom for no good reason). And that’s all I can think about. The show really has only two characters: Emma Thompson, and an incredibly beautiful actor named Daryl McCormack. And he is apparently the mental screen saver my brain has chosen for this week. My mind has turned to pudding by hey, there’s a hot guy! Could be worse.

The last frontier...

I had my first colonoscopy yesterday! I originally had one scheduled for shortly after I turned 50, but when I was diagnosed with breast cancer, my doc said I could kick that can down the road. I did the mail-in tests for a couple years. Now that I’ve revealed myself as a cancer magnet, my surgeon at Mayo wanted me to have an actual colonoscopy just to check one of the common cancers off my list. I was lucky to get in on a cancelation at Methodist, which meant I could have it done in town rather than driving down to Mayo. Without that cancellation, I was looking at April for openings. Or, they would be looking at my opening in April.

I’ve mentioned the zero-fiber colonoscopy prep plan, which was like a forced vacation from healthy eating, and also surprisingly hard to do. The day before the procedure, you have your no-fiber breakfast and lunch, then go to clear liquids. I’d planned ahead and made homemade Jell-O out of apple juice and gelatin. Bought a bunch of bone broth and some fun sodas. Nothing red in color. I was ready.

The night before the procedure, at 7 pm I took the prescribed four laxative tablets. At 8 pm, I started chugging Golytely. This is a powder that comes in a 4-liter jug that you fill with water. I had two jugs. At first, I thought you drink one the night before and the other the day of, but then I realized that two different doctors had called in my prescription – I actually had twice the amount needed. I hadn’t prepared by buying any Crystal Light drink powder to make it more palatable, but at the last minute was able to scrounge a couple crusty Emergen-C packets from old backpacks. It wasn’t terrible. I didn’t mind it, even without a flavor addition. Tastes like airport drinking fountain water.

We started our evening television regime, and I waited. Nothing happened. Zero. I could definitely tell a couple liters of liquid were sloshing around my belly, and there were some interesting rumbles, but that was it. Went to bed and slept through the night without issue (i.e., didn’t shit the bed). I woke up worried that I wasn’t seeing any action. So I finished the first jug of Golytely, and, just for good measure, made a good dent in jug number two. With the goal, of course, of number two. I told Bob I was worried that I wouldn’t be prepared for my procedure. “Fear not!” he replied.

He was right. I guess I thought it would be different. More. I found out later that my excellent “no fiber” prep made everything much easier. But don’t forget, I topped off my dose of Golytely, which served to ensure that I was extra cleaned out. And a bit leaky. I feel like all of my valves are a bit shot, or I need all of my weatherstripping replaced. It’s not ideal.

The procedure itself was totally fine. Really! I think I was most nervous about the, ahem, point of entry, and I honestly have zero recollection of that part. They inject the heavenly drugs timed to hit your brain just as a tube is being shoved into your butt, and your brain pays more attention to the drugs than to the assault on your ass. I enjoyed watching the tour of my colon on the monitor. Four polyps were identified and removed. I felt a bit like I witnessed one of those crane-arm games where you try to pick up a toy in a big cage. Only very pink and inside my colon.

And Bob was on the case – I had, once again, taken an Uber to the appointment so Bob could stay home and keep the dogs from eating our cleaners. This time Bob answered the phone on the first ring and hopped into the car immediately to collect me. Again, we’re still not “even” (always worth asking, Bob), but he did very, very well. One could argue that it’s still in the realm of generally expected husband duties, which it is, but since he fucked it so royally the last time, I feel I should call it out when he does it right.

Golytely into the dark night...or something like that.

Bob heard me telling someone on the phone that I have kidney cancer. “Liver! You have liver cancer!” he yelled from the other room. Oh yeah. That’s right.

I don’t feel stressed out, but I think there’s much more going on than I’m readily aware of. My brains just stop working periodically. Packing up at the hotel after Farm Aid, I went into a full sweat, severe nausea panic when I realized I didn’t have my work notebook. I do still use a physical notebook, for taking notes on calls, keeping “to do” lists… it being gone meant that I would be completely lost about what I was supposed to be doing at work the next day. We searched the hotel room one last time, I dumped out the contents of my backpack. I texted everyone I’d worked with over the weekend. In the car to meet friends for brunch before going to the airport, I filed a claim with the airline, assuming I’d left it in the gate or on the plane on the flight out. Filing a lost item claim costs $39.99, in case you’ve never had to do that. I happily paid it. I tried to convince myself that I’d survive, and was able to have a nice time with our friends before heading to the airport. Dropping off the rental car, Bob reminded me to check the glove compartment: there was my notebook.

I’m basically feeling confident about my treatment plan. A bit suspicious about my surgeon, though. What if they only give the “Head of Surgery” title to docs who suck at operating? Keep them tied up on administrative tasks. I asked the Physician’s Assistant about that. She said that she worked for this doctor exclusively her first years at Mayo, and at the time he was asked to step into the Head of Surgery position, he’d done more of the surgeries he’s doing on me than anyone in the world.

Yeah, but is he any good?

We’ve had a week of down time after all upcoming appointments were scheduled, plans finalized. Spent most of last week at the cabin, where the leaves are falling and the coots are staging on the lake. We’re back to fires in the woodstove every night. It was lovely.

Now back in the city and things are starting to move, so to speak. I have my first-ever colonoscopy tomorrow. We’re just crossing common cancers off the list. Intense prep will start in a couple hours. I’ve loved the last couple days of low-fiber pre-prep, a huge excuse to eat all the shit I normally don’t: pizza, yogurt, rice Chex with bananas and a layer of white sugar, white bread turkey sandwich, chocolate torte with whipped cream. My go-to DQ treat on the way home from the cabin: Medium cone dipped in chocolate with crunch. No fiber to be found. I’m setting aside the stringent no gluten, cane sugar, dairy, corn, soy, etc., etc. diet for the moment. There are bigger issues at hand.

Oh, and we just heard from our health insurance broker on numbers for 2023 plans:

“Small group premiums continue to raise and unfortunately, there isn’t another option within the small group space that will provide savings. There would definitely be some premium savings by moving to an individual plan through our private market, however the networks are limited, no option that includes Mayo and no option that extends outside of MN.”

I told her we’re locked into Mayo at this point. My rate only went up about seven bucks a month. Total new cost for the two of us, assuming we max our deductible (it’s only $2,400 each, so we usually do): $25,542.96 total health care out of pocket for 2023 (not counting dental or eye glasses). And I’m feeling lucky that we’re grandfathered into a small group plan, as husband/wife business owners. They don’t write small group policies like that anymore. The whole system is crazy.

Biopsy catastrophe

After the indeterminate MRI results, I was scheduled for a needle biopsy at Methodist Hospital. It’s only about 15 minutes from our house. I needed to check in at 6 am, ungodly early for us, when my phone alarm is set for 10:30 am most days. I suggested to Bob that I would just take an Uber to the hospital, he could stay home and deal with the dogs, and I’d call when I needed to be picked up. I checked about the timing of everything; I’d have to hang out for a least an hour if not two after the procedure. It was a solid plan.

Everything went smoothly. I was going to have conscious sedation, which, by all accounts, is truly lovely. I looked forward to that. I’ve had so many different IVs and procedures and surgeries that I’m not freaked out by the steady commotion getting me ready for the test. I remember being a bit irritated by my nurse, who wouldn’t stop talking. About nothing. “My sister’s name is Kathleen and someone called her Kathy once and she didn’t answer!!” Jesus. Please start the drugs.

The drugs did indeed start, and they were as terrific as advertised. It’s true that I was conscious, but I was also floaty and euphoric and just fucking great. The doctor doing the biopsy asked if I wanted to see one of my samples, and I said, “Yeah!!” It looked like a tiny red wriggler worm. One of the benefits of the drugs is that they act as an amnesiac, and while you’re awake for the procedure, you don’t remember it. I definitely remember the little red worm, and worse, I definitely, clearly, remember the doctor saying to the nurse that he’d “be surprised if this isn’t cancer.”

Well, fuck. I was running out of outs. This wasn’t the final determination of cancer, but it wasn’t sounding good. Back in my recovery room, I had to lie on my right side to put pressure on the area where a big needle was stabbed into my belly. What was totally unexpected was the feeling that there was a bear trap clamped on my shoulder. I told the nurse and she said that’s a common occurrence after this procedure, something about a nerve getting stimulated and anyway, here’s a Percocet. Okay, awesome. She also set me up with some rice cakes and cranberry juice, got my phone out of my locker, and told me I could go home in an hour and fifteen minutes. I called Bob to let him know the plan. He didn’t answer.

For 42 calls.

I’m lying on my side, high on Percocet, just found out I’ve probably definitely got liver cancer, and Bob isn’t answering his phone. My nurse keeps coming in, “Did you reach him?” No. Nope. Not yet. I asked if I could take an Uber home. Negative.

I text my next door neighbors Ryan and Anne: “Are either of you at home? This is an odd request: I just had a medical test done, and it’s time for Bob to pick me up, but he’s not answering (sound sleeper and our day doesn’t typically start for another hour). If you are home, would you mind going over and ringing the doorbell? That will wake the dogs, and that will wake Bob…”

Ryan rings the doorbell once, and nothing happens. No barking dogs. I ask if he can try again…multiple rings later, there is still no activity. No dogs, no answered phones. Nothing.

There was only one logical explanation: a carbon monoxide event has killed them all.

 We have a lockbox next to our front door, and I momentarily considered giving Ryan the code so he could go inside. But I didn’t want him to find the bodies, and I really didn’t want him to get carbon monoxided. They have young children. Anne offered that Ryan could pick me up, and being without any other option, I said thank you, that would be lovely.

My nurse seemed satisfied that I had an appropriate ride, and sent for a wheelchair transfer. I was dressed and ready to go when Ryan texted to say he was there. Still no wheelchair transfer. My nurse had also disappeared. Since she’d already gone over my discharge instructions, I said fuck it and walked out. I totally could have escaped in an Uber.

I was barely holding it together the whole drive home: I’d just found out I probably definitely have liver cancer, my husband and dogs were dead. The cats don’t sleep upstairs, so they’d likely still be alive, but they’re generally unreliable for anything important. I was going to die alone, soon. It seemed weird to mention any of this to my very nice neighbor Ryan, so I just worked to not slip into catatonia while I asked if the kids were enjoying school. I have no idea what the answer was or what else we talked about.

A couple blocks from home, I got a text from Bob. “Bob’s not dead!” I said to Ryan, who looked at me like he didn’t know Bob being dead was an option. Bob called my phone as I was walking toward our front door, and I said I was coming in the front. Got to the front door, expecting to see a very sorry Bob throw the door open, asking for forgiveness. Nope. Nothing. I rummaged in my purse to find my key and let myself in.

Bob and the dogs were still in bed upstairs. The dogs barely even lifted their heads, opening one eye like “Wait, were you gone?” Bob asked, “Did I fuck it?” as I dissolved into sobbing hysteria. “I thought you were dead! I’ve got cancer! What the fuck? Why didn’t you answer? Do not touch me DO NOT TOUCH ME!!!” 

Bob not turning on the ringer on his phone was a significant error. Bob hadn’t been sleeping much recently, due to a combination of chronic neck pain and worrying about losing his wife. However, it seems he slipped into the deepest, most restful sleep of his life about the moment I took an Uber to the hospital alone.

Bob was repentant. He promised me that he would take care of everything from now on. He would make dinner every night; I wouldn’t have to do anything. He really felt terribly that he wasn’t there for me in my time of need. He should feel bad. That was fucked up. He asked why I didn’t give Ryan the lock box code, and I explained I didn’t want our neighbor to find the bodies, but Bob had issue with this decision; what if Bob had experienced a heart attack, and was still holding on, and Ryan could have found him in time to get an ambulance? Well, I had actually considered that, because even high on drugs and nearly blacking out from anxiety, I’m able to play out all scenarios quickly and efficiently. And I decided fuck it. Too fucking bad. If he wasn’t already dead, Bob would have to wait until I got home.

I can report that Bob has made dinner every night since. We were recently in Raleigh, North Carolina for Farm Aid, and I needed some documents printed. It was late at night, and the only option was the hotel business center. I told Bob he needed to get dressed (he was already in bed) and go down and do some printing for me. He grumbled a little, but brought the documents back, and asked, hopefully, if we were even now. Hahahahahaha! Oh, hell no. Not even close. And even if he does ever make up for that colossal biopsy fuck up, he’s still got a cancer wife to take care of. He’s just fucked. Forever.

Technology and retail therapy

 I've been responding "I’ve got cancer!" to even the most innocent "how are you?" inquiries. It’s never not weird.

I really think the worst is over as far as mental turmoil goes. It escalated from not worried to probably not cancer, to probably cancer, to definitely cancer, to imminent death -- and then we dialed that back to cautious optimism for survival. This has happened over the course of the last four weeks. Over those weeks, there have been varying “fuck cancer” indiscretions. I haven’t eaten gluten, cane sugar, dairy, corn, soy, caffeine, and a lot of other things since the end of April. Until the “fuck cancer” pizza and milkshake weekend. (It wasn’t as satisfying as I hoped it would be.) My favorite store sent out a New Arrivals email, which made me realize I needed “fuck cancer” purple boots. I drove over to St. Paul straight away, and while I was there, they just happened to have a “fuck cancer” dress, two “fuck cancer” necklaces, and a “fuck cancer” pair of earrings. Weird. I might have purchased a new “fuck cancer” bag this weekend. My healthcare will not cost me anything, but cancer is still very, very expensive.

My dad has his iPad connected to all the grandkids’ iPhones, so he can know where everybody is. Since Bob and I are often driving back and forth to the cabin, a few weeks ago Dad asked if he could connect to my iPhone, then he could just look and see where I am and not need to call. Know I got where I was going safely, et cetera. Sure! This became problematic in the hazy days before we told people what was going on with my health, and I was tipped off when my dad commented on my journey to St. Paul: “Looks like you went on an adventure today.” He’s on the case. A pilgrimage to my favorite store was an acceptable reason, and I didn’t mention the irresponsible amount of money I spent and why. But this brought up a different problem: I was having a biopsy at Methodist Hospital later that week; how was I going to explain that?  

A few weeks ago, I had an argument with a sibling, and the next day, I was telling my dad that I’d thought about it, and I didn’t think I was the asshole. Dad said, “You mean like Am I the Asshole on Reddit?” My 81-year-old father can’t copy and paste text, but can electronically track his family members and knows about Reddit. It’s baffling. I shut off “find my iPhone” when I went in for the biopsy, and my absence was never noted.

Cancer 2.0!! I'm back, baby!!

Warning: Lots of swearing. Like, even more than normal.

Four years ago this month I was diagnosed with breast cancer. At that time, I searched for an appropriate domain where my blog could live. Bob helpfully suggested that "tittiecancer.com" was available. I ended up going with "cancerouskate.com", which was fortuitously general; I can easily revive it for Cancer 2.0: Liver cancer.

What the fuck? Yes, it's true! I have liver cancer. It's a bit weird because we've been doing endless testing on Abbie dog; it was looking like he might have liver cancer, and that prospect was pretty stressful and upsetting. Turns out he has Cushing's disease, which is totally manageable.

The same week we found out Abbie does NOT have liver cancer, I had a biopsy that ultimately showed that I DO have liver cancer. Seriously, though, what the fuck?

This all started in January when I saw my oncologist after slacking on breast cancer follow up because of Covid. A routine blood test showed an elevated liver number, more scans pointed to apparent fatty liver disease. Which isn't great, and it's something I count in the same bucket as gout and pre-diabetes as afflictions of middle-aged poor decision making. Shortly after that diagnosis, I started working with a nutrition therapist to try to get a handle on what I was eating, and also try to rebuild my gut flora after it was decimated by chemo and weeks’ worth of IV antibiotics. Basically, I stopped eating gluten, dairy, cane sugar, soy, caffeine, corn, peanuts and a whole lot of other stuff that my body was reactive to in blood tests.

It is almost irritating how fucking good I felt (and still feel). No more eating handfuls of Tums. No more body aches. All of my myriad inflammatory conditions improved dramatically. I lost weight without trying to lose weight -- but not in a sick way, more of a “what happens when you snack on berries rather than cookies and ice cream” way.

I was supposed to schedule a follow-up MRI on my fatty liver in three months. I was pretty sure that with all of my dietary changes, I was about to dramatically defeat fatty liver, but just to make sure, I held off a bit on that appointment to give me more time on the super clean eating plan. And I prepared to receive my medal.

Instead of a medal, I found very a very confusing result in My Chart after the new MRI. Paraphrased, it said there was one area in particular that has doubled in size, could be nothing, could be a really terrible thing, but might be nothing, but kind of looks more like the terrible thing. A quick google of the terrible thing defined it as liver cancer. Because this result arrived early evening on a Friday, I got to spend the weekend consulting with Dr. Google, who determined I was looking at a 24-month expiration date.

Luckily, with time has come much more information, and the more information we've received, the better my future looks. And longer. Like pretty much definitely more than two years, barring any rogue encounters with a Mack Truck. I have hepatocellular carcinoma. It is unrelated to my breast cancer – this is a whole new cancer. It is growing quickly, but the tumor is still small at 4 cm x 3 cm. It's unusual to find these tumors in people who don't have cirrhosis, hepatitis, or massive drinking issues (weird). It's also unusual to find them when they're still this small (good).

And I'm getting tired of this story, but the takeaway is that Mayo's head of surgery is laparoscopically removing the affected part of my liver later this month, as I don’t need all of my liver and the tumor is well situated to be just lopped off (the physician's assistant we saw at Mayo yesterday laughed and said, "Oh, this will be easy!!" when she pulled up my scans). My oncologist doesn't think I'll need any chemo or radiation afterwards, just monitoring. The surgeon said that a month after surgery, I'll be 100% recovered and good as new.

We have been lucky to be able to pay insane health insurance premiums to make sure we've got excellent coverage – and the Mayo Clinic is in-network, just in case of fuckery like liver cancer. I don't know how much I can really complain about bullshit like new cancer when I can have one of the best surgeons in the world at one of the best hospitals in the world address it quickly and at absolutely zero out-of-pocket cost to me (already hit my max for this year!). I don't take any of this for granted. But still. What the fuck.

April 20, 2020. Coronavirus time.

Who can fuck off: a list.

I’ve had a lot of time to think about this.

1. The woman in Florida who bought out all of the toilet paper from the Dollar Tree. I mean, as the world’s biggest piece of shit, I guess I can see how she might need all that toilet paper. She didn’t need to yell “Go Donald Trump!” We all knew. She later claimed to have made the purchase for charity. Chances this was her original motive? Zero percent. Fuck off, you horrible woman.


2. Donald Trump. This anal sphincter wart continues to be the worst garbage person alive. But I can’t give him the satisfaction of being first on my list. That’s right, Donald; a hick woman nobody from Florida ranks higher than you. The fact Trump has an IQ of about ten is really becoming apparent, as he can’t keep anything straight. Are the states in charge? Is he the decider? Science? He really just wants to go golfing. He wants a prize for keeping the Corona death toll so low? That would be like giving Hitler an award for only slaughtering six million Jews. Good job, Hitler! Anyone else would have done 10 million, easy! Fuck off, Donald Trump.


3. Jared Kushner. He’s saying the words in his head out loud. Oops. “…the notion of the federal stockpile was it’s supposed to be our stockpile, it’s not supposed to be states’ stockpiles that they then use.” “OUR” stockpile? Like, for you and the rest of the pod people? Fuck off, Jared. Jared is apparently appointed to all of the task forces and committees, which is pretty impressive for someone who can’t get a security clearance and isn’t actually human.


4. Governor of South Dakota, Kristi Noem. Refused to implement a stay at home order because she values individual liberty and doesn’t believe government should dictate people’s behavior. UNLESS we’re talking about a woman wanting an abortion, then we’re going to crawl straight up into her uterus. Fuck off.


5. All the people protesting stay at home orders. Sigh. I don’t give a fuck how big your gun is, I’m not doing business with you now or whenever the state is “open for business.” Because you are an idiot, the chances that you’re currently carrying the virus or will be soon are VERY high, and it’s a risk I’m not willing to take. This bullshit is continued proof that Republicans are in no way pro-life. They’re pro money, at the expense of life. They’re pro-microscopic cell cluster. I don’t think they actually give a fuck about that. They just like stripping women of agency. I am in favor of these people congregating. I know it seems like the virus is not a big deal, especially in Minnesota, and ESPECIALLY especially in rural Minnesota. But keep hanging out. Share a beer. Lick some doorknobs. See how it goes. Fuck off, and stay the fuck away from me. And for later, I send you thoughts and prayers.


6. Anyone who is about to write a response to me saying “not all Republicans” or “not all Trump supporters” can fuck off. We’re too far down a very bad road. If you’re still defending that team in any way, you are the problem. Fuck. Off.


7. Progressive foundations are the reason Trump is president. There, I said it. All the navel gazing and circle jerking and fucking online forms with character counts and quantitative results. This is the reason we can’t have nice things. There is no shortage of good work happening. Figure out a way to move that money faster and easier. We outnumber them. There is no good reason they should be winning at every turn. Fucking figure it out. (In Letterkenny, “figure it oot.”)


8. All the people who are renewing their love for Trump because Trump gave them $1200 can fuck off. That’s maybe too harsh, as their addled brains can’t grasp that this money isn’t actually from Trump. Wait, what? It’s true. Also, how long will you be solvent with these scraps? A week? Two weeks? Enjoy it, because after that you’re back to Fuckedville. For whatever good it does you, thank the Democrats who put it in the bill. And know the minute you cash that check, you're a Communist.


9. Anybody who believes the word of Dr. Phil (not a medical doctor), Dr. Oz and Dr. Drew (medical doctors, but not experts in this area), or Fran Drescher’s wingnut anti-vaxxer ex-husband over the word of Dr. Fauci, “an American physician and immunologist who has served as the director of the National Institute of Allergy and Infectious Diseases since 1984,” fuck off. You should be building a shrine in Dr. Fauci’s honor in your home, because if you’re still alive a year from now, it’s only because of his intervention. He’s in an uphill battle getting the president and his handlers on board. We would be done for if Fauci wasn’t there.


10. The person who decided to publish that zoo tigers have tested positive for corona virus. OH GREAT. I know I’m not the only one who has strategized on which pet we’d eat first, if it comes to that. Would cooking kill the virus? A nice long braise? Anyone else think it’s a little too convenient that we learn this about captive tigers just as the whole nation is watching Tiger King? Is this whole pandemic a masterfully presented ruse by animal rights activists to end wild animal captivity?


11. Anyone who thinks torture is a valid way to get information or compliance from our enemies can fuck off. It’s not a tactic that works. It’s needlessly barbaric and a truly fucked up practice. It’s because of you that we’re now plagued by a disease that is essentially the virus version of waterboarding. We do shitty things, we get shitty things. Thanks for that.


12. People who are littering their disposable gloves. What the fuck is wrong with you?