tag:blogger.com,1999:blog-78868665666232379672024-03-04T23:27:11.109-05:00Nobody Asked Me, But...What is the purpose of a blog, but a place to tell your story on your own terms, or to express your unsolicited opinion on the topics only you care about?MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.comBlogger63125tag:blogger.com,1999:blog-7886866566623237967.post-29954453110491545962023-12-26T21:25:00.000-05:002023-12-26T21:25:04.126-05:00Chapter 5 - DCIS TreatmentJump ahead to my second lumpectomy, which went off without a hitch. I asked for Xanex again, and the surgeon agreed, since it was such a small dose. After the surgery, my incision healed even cleaner than the first time. I had been afraid that the scarring would get worse, but it did not. Then we met with the oncologist, who talked with us about the type of cancer I had and my treatment options. Again, MG went with me to this appointment, and I introduced her to the doctor as my partner. The oncologist was very respectful of our relationship, and addressed MG as a concerned partner in dealing with my diagnosis. <div><br /></div><div>The oncologist said that my cancer tested positive for estrogen and progesterone, and that if I was older (I was only 35), she would recommend Tamoxifen, which is an estrogen blocker, and keeps estrogen produced by your ovaries from binding with any breast cancer cells in your body, so the cancer cells won’t become tumors. But because I was so young, and my cancer was not invasive, putting me on Tamoxifen would unnecessarily put me at risk for other health problems that are associated with premature menopause. Also, at the time, you could only take Tamoxifen for five years, and then you could not take it again. </div><div><br /></div><div>She advised us to reserve Tamoxifen for use later in life, should I ever get breast cancer again. Which, of course, we all hoped would not happen. But if we used Tamoxifen then, and I did get breast cancer again, I would not be able to use Tamoxifen in the future, so better to save it as a back-up plan. This made sense to me. She said that because the cancer was non-invasive, I would not need anything like chemotherapy, which was a great relief to me. She talked to us about what radiation therapy might be like, and her office set up an appointment with the radiation oncologist. </div><div><br /></div><div>I liked the radiation oncologist when we met her. She was also respectful of MG and of our relationship, as was her physician’s assistant, Steve. She was very detailed in her description of what radiation therapy would be like, and answered all of our questions and concerns. Basically, I would be getting radiation treatments once a day, five days a week, Monday through Friday, for six and a half weeks . The first five and a half weeks I would be getting radiation over my entire left breast, and the last five days, the radiation would be focused only on the tumor site. She dispelled my fears about developing any secondary cancers from the treatment – she said the risk was 1 in 3 million. We talked about how the technology involved and the location of the tumor made it possible to irradiate the breast without involving the chest wall, which would minimize any side effects like anemia or anorexia. There was a possibility of some fatigue, but every woman is different, so we wouldn’t know how the treatment affected me until I was going through it. </div><div><br /></div><div>We scheduled my first appointment, at which the technicians would identify the target zone for radiation and mark me up with a sharpie (they keep the sharpie marks fresh throughout radiation therapy – a necessary but unfortunate daily reminder of what you are going through). MG went with me to that first appointment, which took place the day after my 36th birthday. Happy birthday to me, right? </div><div><br /></div><div>After that first appointment, I went to my radiation sessions alone. For the first few weeks, my sessions took place at 8am, before work. Each session took only about 5 minutes from walking into the radiation room, getting settled on the table, being irradiated, and walking back out. It took longer to get undressed and redressed than it did to be treated. The first session was pretty emotionally traumatic. Just the reality of being on the table, and the awareness of why I was on that table, were pretty overwhelming. My drive to work from treatment took me right past our neighborhood, and I knew MG was still at home, so I stopped at the house and cried on her shoulder before heading in to work. </div><div><br /></div><div>As time when on, treatment sessions were less emotionally painful, or at least I got used to them. I got used to seeing the other patients in the waiting room, but never for very long, because they did an excellent job of moving patients in and out of the waiting room quickly. However, the treatments themselves were increasingly physically painful as the radiation started to work. Even before my skin started showing signs of radiation burns, I felt a deadening feeling in my breast, which eventually became pretty painful. As soon as I started to feel that pain, I asked for samples of Biofine Emulsion Cream, which is supposed to help prevent permanent discoloration from radiation burns. The physician’s assistant resisted giving me the samples, saying that I “shouldn’t be having pain already,” and that I didn’t need the cream, but I was persistent until I got what I wanted. The cream did not seem to help with the sensations I was having inside my breast, but ultimately it did protect me from permanent skin discoloration in that breast. So, whether I really “needed” it so soon or not, I’m glad I started using it when I did. </div><div><br /></div><div>He may have been right, as it turns out that months after radiation was over my breast surgeon identified an infected lymph node at the tumor site through my first post-treatment mammogram. This infection may have been what was causing me to have pain so early, or the infection could have been caused by the radiation itself. Either way, if not for this infection, I probably would not have been having pain so soon into treatment. </div><div><br /></div><div>If you are going through a health crisis, cancer or anything else, it is important that you be your own best advocate. Nobody else knows what is happening inside your body like you do. If you have pain, and the health care professionals around you say, “you shouldn’t” have that pain, you need to be persistent about finding out why you are having that pain. At the time, I didn’t now enough to realize that I should have been more persistent about getting help with the pain in my breast, but as I continued on my cancer journey, after learning my lesson from this thankfully mild infection, I paid closer attention to what was happening in my body and became more vocal about it. I got better at being my own best advocate. </div><div><br /></div><div>When I was going through radiation therapy in 2002, the treatment protocol for DCIS was five and half weeks of irradiating the entire breast, followed by 5 sessions of radiation targeting only the tumor site. By the time we got to those last five days, my tumor site was already so painful that I couldn’t wear a bra. The targeted radiation ended up creating a raw, seeping blister, which just happened to form on that fold between my breast and my armpit. So then, in addition to the pain I was feeling on the inside of my breast, I was having all of this pain on the skin of my breast. The only shirts I could tolerate wearing were men’s cotton t-shirts and even those could not prevent the blistered skin from folding in on itself. Which was very painful. </div><div><br /></div><div>In the days following the conclusion of my radiation therapy, I often found myself crying for no apparent reason. Or for little, inconsequential reasons. Really, I think I was crying for a lot of deeper reasons: frustration with the pain, anger that I had to go through treatment at all, relief that treatment was over, and fear that the treatment had not worked. I remember going to my sister’s home for Thanksgiving that year, the same sister that came to town for the surgeries, and just being very emotional the whole time we were there. </div><div><br /></div><div>Fortunately, the blister eventually crusted over, became less painful, and started to heal. I also became less raw emotionally, although I continued to struggle with my fear of recurrence. The radiation burn on my breast eventually faded. When sufficient time had passed, I was directed to go in for my first post-treatment mammogram. This mammogram did two things: it confirmed that there was no cancer left in my breast, and it indicated that one of my lymph nodes was inflamed. My breast surgeon did an in-office needle aspiration of that lymph node, to test it for infection, and in the meantime put me on a general antibiotic. By the time the test results on that lymph node were back, and confirmed that there was an infection in the tumor site, the antibiotic was already working and the pain I had been feeling for months was finally gone. </div><div><br /></div><div>This in-office procedure, even though everything turned out fine, was just the first of many false alarms that MG and I went through after my first diagnosis. That is the life of someone who has been treated for breast cancer, or for any cancer really. Anything that looks remotely related to your cancer, even if it was an early-stage and successfully-treated cancer, means extra tests and holding your breath until you get the “all clear” yet again. And no matter how many times they tell you that you are fine, you still <span style="font-family: "Times New Roman", serif; font-size: 12pt;">feel what we survivors call “scanxiety,” and I’m not sure you ever really get used to it. The further you get away from your diagnosis, the more practice you have focusing away from the anxiety, but it never really goes away.</span></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-31189727517415630962023-06-04T18:59:00.002-04:002023-06-06T16:08:45.350-04:00Chapter 4 - DCIS Diagnosis (Part 2)<p style="text-align: left;"><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">The Xanax worked great. I slept easily the night before the surgery, even though I was nervous about the next day. And I was relatively calm in the morning. Even though my fear wanted me to refuse to walk into the surgery center, my feet kept moving me forward. Once I had been admitted and they had gotten my IV in, they let MG, E, and C come back and wait with me for the surgeon. (Again, this was pre-COVID. I miss those days when the patient could have their support people with them during these difficult moments.)</span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">This was my first surgery ever. I was afraid of the possible diagnosis, but what was most upsetting was being on a gurney. It reminded me of my Mom’s crisis that summer; I think for my sister and for me, and that was upsetting. It was scary laying there on that gurney, not really knowing what this was going to be like, and having to put my life in the hands of the medical staff, when my mother had almost died in another hospital not that long ago.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">We didn’t have much time to dwell on that before the anesthesiologist came with a syringe of Valium, and after that, I really wasn’t nervous or upset at all. (Since that day, I have known that whenever I am facing a procedure or surgery, I just have to stay calm until they come with the “happy juice” and then I know that it will be smooth sailing from there.) Then they came and wheeled me into the operating room, which was cold and filled with equipment and nurses and my surgeon. Before I knew it, I was out. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Then, for some reason, I woke up. At first, I had no idea where I was. All I could see was blue, which was a surgical drape that they had hanging in front of my face. I think they do this to keep the surgical field sterile, but it also kept me from seeing what the surgeon was doing. I was crying when I woke up, which I have learned is how I react to most anesthesia when I’m waking up. I called for MG, who obviously wasn’t there, and then I called for the surgeon. She answered me. I said I wanted to see her, and she said she was busy, and that I needed to try to calm down. Another moment that is funny looking back on it. Then the anesthesiologist said that I could look at him, and I turned my head to look at him, and the next thing I knew I was waking up in the post-op room. Crying again and asking for MG, with the nurse assuring me that I would see her soon.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Soon I was awake enough to understand where I was and to remember why MG wasn’t with me. Then the nurse moved me to the recovery room, where MG, E and C came in to wait with me until I was ready to go home. First, I had to successfully drink ginger ale and eat some toast. Then, my sister had bought me this teddy bear in the gift shop, which came with a container of peanut M&Ms, and I ate all of them. So the staff agreed I was ready at go home. They won’t let you leave until you pee first, and are able to walk to and from the bathroom without passing out. Then they let me get dressed, which is when I noticed how sore my breast was from the surgery. They gave me more pain medicine, I rested for a few minutes, they brought me a wheelchair, and it was time to go home. MG went to get the car, the nurse wheeled me down to the entrance, and we were on our way home.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">As we were leaving, I gave the teddy bear to this young woman who was in the recovery room with her one year old son. He had just had back surgery, not the first of his young life. He had a while to wait before they would let her take him home, and he was getting restless, so I thought he could use the distraction of the new teddy bear.</span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Recovery from this surgery was more painful and took longer than recovery from the biopsy. The incision was near my left armpit, and I had to wear these front-zip sports bras, which I could get on and off without raising my arms over my head. I could only wear button-down shirts, which was fine, since it was still summer. The bras fit pretty snugly to provide compression, but even so, when I was sitting up or standing, the weight of my breast made the incision hurt. Also, my skin had a pretty painful reaction to the surgical tape that was holding the bandage in place. Every time we changed the bandage, we could see that the rash was getting worse. Eventually, my skin started coming off with the adhesive, which hurt. This reaction to medical tape got worse with every surgery I had after this, so now medical adhesive is always on my list of allergies.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">The first time we changed the bandage, I saw the incision and the stitches and got really queasy. I was afraid to even touch it. MG was not queasy at all, thank God, so she had me look away and changed the bandage for me. Over the next few days, it got a little easier for me to look at the incision, probably because it got less bloody and bruised, but I never really got used to it. Bathing after breast surgery was a little difficult, but not too bad; at least, not after a simple biopsy like this one. (Which didn’t feel simple at the time, believe me, but in comparison with my later experiences, it really was.) I had to use a mild, anti-bacterial body wash, and my surgeon told me not to let the water hit the incision directly. At first, the incision was sealed in a waterproof bandage, like plastic. But once that bandage started coming off, we started having to tape fresh, non-stick gauze over it every day. It had to be non-stick, so it wouldn’t pull on the stitches. When I showered, I would lather up my shoulders and neck, and then stand with my back to the shower, so that the lather would rinse down the incision, cleaning it but not letting the water hit it directly. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">After about a week, we went in to have the stitches taken out. I was nervous, assuming it would hurt. However, other than a little tug feeling when she snipped the knots on the threads, I didn’t feel anything. After the stitches were out, I could shower like normal.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Getting the stitches out was easier than expected, but hearing the results of the biopsy was not. Dr. G told us that inside the precancerous tissue they found a very small malignancy (tumor), less than a centimeter across, and that I had what they call ductal carcinoma in situ (DCIS)<a href="applewebdata://BC025D39-3E49-423B-87C1-5A16F78D5E3F#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[1]</span></span></span></a>, or non-invasive breast cancer. In other words, the breast cancer had not yet escaped its original site in the milk duct nor begun invading the tissue surrounding the original tumor. At first, though, all I heard was the word “cancer.” All I could feel for the first few minutes was the fear that comes with hearing that word. “Am I going to die?” That was the first thing I thought of. Cancer. How could I have cancer? I felt fine. We hadn’t found a lump, I had no symptoms, nothing. We had been talking about the odds being in my favor at every step of this process, but here I was, with a diagnosis of breast cancer. I felt numb, in shock. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Dr. G thought she had gotten the whole tumor out, but she needed to go back in and make sure they had clear margins<a href="applewebdata://BC025D39-3E49-423B-87C1-5A16F78D5E3F#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[2]</span></span></span></a>around the tumor site. This news was almost more upsetting to me than hearing the “C” word. I didn’t want to have another surgery; I was just getting over the last one. Plus, we had reservations for a long weekend in Provincetown, and I didn’t want to cancel it. The surgeon assured us that the second surgery would go just as smoothly as they first, and that we could wait until after our vacation. She said that I would need to meet with an oncologist to talk about treatment options, which would probably include radiation therapy. So we scheduled the next surgery for after our trip, and she gave us a referral to an oncologist. And then MG and I were supposed to go back to work.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">You have breast cancer, but you have to go back to work. How do you do the that? How could it be true that I had breast cancer? I felt fine. There was never any lump; the image on the mammogram was just microscopic specks. I saw them myself. How could they be cancer? I couldn’t just go back to work. Instead, we decided to have lunch at the Friendly’s in our neighborhood. We had met at the doctor’s office, so I had to drive myself to the restaurant. Somehow I got there. While I was waiting for MG, I was trying to wrap my mind around this new identity: “breast cancer survivor.” What did that mean? Was I a survivor if I was never sick? What would radiation therapy be like? How could I prepare myself for something I could not even imagine?<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">More importantly, how could I go back to a job that felt meaningless to me now that I knew I was vulnerable to something like cancer? I didn’t want to die… ever… and have my tombstone read “she wished she’d done something useful with her life.” Back in 2001, I had spent 6 months being unemployed, and MG and I had talked about my going to graduate school for my master’s degree in social work. At the time, the idea of returning to school was intimidating: What if I wasn’t any good at it? What would our lives be like without my income? What if I didn’t like the new career after spending all that money getting the degree? I was just too afraid of so much change, so I didn’t look into it. I just kept looking for another job in my field until I found one. But that day, the day I was told I had breast cancer, I decided that it was time to take the leap. So, for the next few months, while I was going through treatment, I was also applying to graduate school. It felt good to be taking charge of my life in one area when my health felt so out of my own control. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">We often hear people refer to cancer as a kind of “wake up call” in their life. It could be about their career, as DCIS was for me, it could be about their relationships, or about how they take care of themselves. There’s just something about being confronted with your own mortality that gives you pause, makes you take stock of your life, inspires you to change those things that don’t work. Unless it doesn’t, which is perfectly fine! <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">“Life is too short” – we hear that a lot. When you have cancer, life can suddenly feel so short you don’t want to waste any more time doing anything that doesn’t feed your soul or make you happy. This is why some people call cancer “the great motivator.” It's also why some people talk about looking for the “silver lining” of cancer, or even worse, tell you that you should find a silver lining in your own cancer. They talk about the “power of positive thinking,” the importance of having the “right attitude.” What IS the right attitude? Really, nobody has any right to expect any particular attitude from you. We shouldn’t put that kind of pressure on ourselves, let alone on anyone else. If you feel positive at any point during diagnosis and treatment, that’s great. If something positive comes out of your experience, I am happy for you. I also know, from my own experience and the experience of countless other cancer patients that I have known, that even if embrace the idea that a positive attitude will help, even if we find positive moments, we can also have some negative moments along the way. We have pain, we have fear, we get angry, we get frustrated and impatient. We grieve our losses. We ask “why me?” We get sick of people saying “you look great” when we hate the way we look in the mirror. Those moments don’t mean we aren’t being positive. We can be positive and still have negative feelings. Don’t let anyone tell you otherwise.<o:p></o:p></span></p><div><br clear="all" /><hr align="left" size="1" width="33%" /><div id="ftn1"><p style="font-family: Times; font-size: 10pt; margin: 0in;"><a href="applewebdata://BC025D39-3E49-423B-87C1-5A16F78D5E3F#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 10pt; line-height: 15.333332px;">[1]</span></span></span></a> Ductal carcinoma in situ (DCIS) is often considered the earliest form of breast cancer, or stage 0. In DCIS, abnormal cells multiply and form a growth within a milk duct of your breast. DCIS is noninvasive, meaning it hasn't spread out of the milk duct to invade other parts of the breast. DCIS is usually found during mammogram screenings, but it can be difficult to detect. Because of increased screening with mammograms, the rate at which DCIS is diagnosed has increased dramatically in recent years. While DCIS isn't life-threatening, it does require treatment to prevent the condition from becoming invasive. Most women with DCIS are effectively treated with breast-conserving surgery and radiation (http://www.mayoclinic.com).<o:p></o:p></p></div><div id="ftn2"><p class="MsoFootnoteText" style="font-family: Cambria, serif; font-size: 10pt; margin: 0in;"><a href="applewebdata://BC025D39-3E49-423B-87C1-5A16F78D5E3F#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 10pt; line-height: 15.333332px;">[2]</span></span></span></a> Clear margins mean that the edges of the tissue around the tumor are free of cancer cells. If the margins are clear, all the cancer had been removed (http://www.breastcancer.org/symptoms/diagnosis/margins.jsp)<o:p></o:p></p></div></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-15883015259476162922023-06-04T18:12:00.004-04:002023-06-06T16:08:08.633-04:00Chapter 4 - DCIS Diagnosis (Part 1)<div style="text-align: left;"><br /></div><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">From the moment my gynecologist said there was a suspicious area in my left breast, things started moving really, really fast. I had my first appointment with Dr. G just a few days later. She was going to review the images and decide if I needed any tests, but other than that, I had no idea what to expect. Dr. G said that based on the images, which showed what she called an area of clustered micro calcifications<a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[1]</span></span></span></a> we should have a stereotactic core needle biopsy.<a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[2]</span></span></span></a> I had an appointment for this biopsy in less than a week.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">The morning of the biopsy, I was feeling very anxious. In part, because even though Dr. G had described it in detail, I was still having trouble imagining what it would be like. But mostly, I was anxious because I was getting tested for breast cancer. Even if you don’t have any breast cancer in your family, it is hard to go into a procedure like a breast biopsy without some degree of anxiety. That morning, I prepared my bowl of cereal, set it down on the kitchen counter, and my kitten Stanley jumped up, flipped it into the air, and spilled milk and cereal all over the kitchen floor. In retrospect, this is a funny moment, but at the time, it only added to my anxiety.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">While MG and I were in the waiting room, her Mom came by to wish us luck and to tell us not to worry. I hadn’t told my own mother about what was happening. She was still very demented from her own health crisis, but even if she wasn’t, she had never been the kind of Mom that I would talk to about things like this until after they were over, if at all. So to have MG’s Mom there for us was very comforting.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Hearing the details of how the biopsy was going to work was one thing, but actually going through it was very different. For one thing, there was the table. It was a wide table, pretty tall, with a hole at one end. The nurse prepping me for the biopsy had me climb up and lay face down on this table and put my left breast in the hole. This hole was then closed until it was a clamp around my breast, basically anchoring me to the table. This is to keep the breast from moving during the procedure. It felt as weird as it sounds, but it did not hurt. The radiologist used computer images of my breast to help him find the cluster of microcalcifications, and then used the computer to guide the machine to take out tissue for the biopsy. I asked to see the images before the procedure, and frankly, the cluster was so microscopic I couldn’t believe anyone ever noticed it. It made me really appreciate the technology of mammography, but also the skill of the radiologists who reviewed the images. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">The Novocain they used to numb my breast started to wear off during the biopsy, probably because set-up for the test took longer than usual. They gave me a second shot, which kept my breast numb, but which also caused a pretty strong physical reaction. My body started getting twitchy, and I started getting emotionally upset and agitated. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Novocain numbs the area where you inject it, and it contains epinephrine to minimize bleeding. Unfortunately, I am sensitive to epinephrine, although I didn’t know this about myself before the biopsy. The second shot was a little too much for me. When it kicked in, I started twitching so much that the attending nurse had to hold me down on the table by my shoulders. When the biopsy was over, she had me turn over on my back so that they could ice the biopsy site. I was still shaking all over, and I didn’t understand why, so I started crying pretty hard. I felt hysterical. Luckily, the nurse was very patient and understanding, and she let me cry myself out. We talked about the test, about my fears about the results, and about what I had been through with my Mom during that summer. After a while, she figured out that part of what was happening to me was a reaction to the Novocain, although part of it was clearly my anxiety about the test and about my Mom’s health.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">After a few minutes, I was able to calm down enough to get off the table and return to the changing room. After I was dressed, the nurse bought me out to MG in the waiting room. She explained about my reaction to the Novocain, and made sure that we both understood the instructions on how to take care of the biopsy site and what to do if I had any problems. They call these “aftercare instructions” and you need to understand them so that you don’t get an infection, and so that you can recognize signs of infection if you develop one. They always warn you about the potential for infection, and the potential for excessive bleeding. I’m sure this is because these risks are very real, but none of these things ever happened to me, although I felt like MG and I were prepared for the possibility, because we made sure to understand the aftercare instructions for every procedure or surgery I had.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">I was still a little jittery when we left, even as we were walking out to the car, but about five minutes into the drive home, the jitters passed, as did much of my emotional upset. This convinced me that most of my reaction to the biopsy was caused by the epinephrine in the Novocain. This is a good thing to know about yourself – since then, I have had my dentist use Lidocaine, which is Novocain without epinephrine in it, and I have learned that I am not nearly as anxious when I am getting fillings as I used to be.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Physical recovery from the biopsy was pretty easy. The procedure only leaves a little incision and some bruising and swelling, which is minimized by the epinephrine in the Novocain. The nurse had given me this little ice disk, about 2 inches across, which I could tuck right into my sports bray, and I used it to ice the incision site every hour or so, and I took some Ibuprofen for the pain. I was able to return to work in a couple of days. My breast surgeon had said the results would be back by a specific day, so MG and I planned to meet up at my office and call her together for the results. MG came over to the office, we took my cell phone outside, and called the surgeon. I remember that it was a nice, clear summer day in early August. We got Dr. G on the phone, and she told us that the biopsy had revealed what she called “atypical ductal hyperplasia<a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftn3" name="_ftnref3" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[3]</span></span></span></a>” or precancerous tissue in my breast. It was her recommendation that we go to the next step, a surgical biopsy, to remove all of the precancerous tissue from my breast.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 10pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">As scary as this news was, she sounded pretty confident that the odds were in my favor that this would not turn out to be a diagnosis of breast cancer. So, we set a date for what she called an excisional or surgical biopsy, which is also known as a lumpectomy. This time, based on the amount of anxiety I had before and during the core needle biopsy, I requested some medication for anxiety, and she prescribed one Xanax pill, half of which I was to take the night before the procedure, and half that I would take that morning. The biopsy itself would be done in the outpatient surgical center in her office building. My sister E and her husband came into town the night before, to be with MG and me the day of the surgery. After the surgery, they would stay with me at the house for the afternoon, so that MG could go back to work.</span></p><div><br clear="all" /><hr align="left" size="1" width="33%" /><div id="ftn1"><p class="MsoFootnoteText" style="font-family: Cambria, serif; font-size: 10pt; margin: 0in;"><a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-family: "Times New Roman", serif; font-size: 8pt;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 8pt; line-height: 12.266667px;">[1]</span></span></span></span></a><span style="font-family: "Times New Roman", serif; font-size: 8pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 9pt;">Breast calcifications are calcium deposits inside the breast which appear as white spots or flecks on the mammogram image. Microcalcifications appear as extremely fine white specks on the image, are usually benign but can sometimes be a sign of breast cancer (Mayo clinic).</span><span style="font-family: "Times New Roman", serif; font-size: 8pt;"><o:p></o:p></span></p></div><div id="ftn2"><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: normal; margin: 0.1pt 0in;"><a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 11pt; line-height: 16.866667px;">[2]</span></span></span></a> <span style="font-family: Times; font-size: 9pt;">A core needle biopsy is a “through the skin" (percutaneous) procedure that involves removing small samples of breast tissue using a hollow "core" needle. For lumps or lesions that can be felt by hand, this is accomplished by fixing the lesion with one hand and performing a freehand needle biopsy with the other. In the case of non-palpable lesions (those unable to be felt), stereotactic (computer-guided) mammography or ultrasound image guidance is used. Stereotactic mammography uses computers to pinpoint the exact location of a breast mass based on mammograms taken from two different angles. The computer coordinates help the physician to guide the needle to the correct area in the breast. With ultrasound, the radiologist or surgeon watches the needle on the ultrasound monitor to help guide it to the area of concern. The needle used during core needle biopsy is larger than the needle used with fine needle aspirations (usually done in your doctor’s office), and has a special cutting edge. </span></p></div><div id="ftn3"><p class="MsoFootnoteText" style="font-family: Cambria, serif; font-size: 10pt; margin: 0in;"><a href="applewebdata://CCD76B0B-3478-4260-A11D-3B4F10EE2BD7#_ftnref3" name="_ftn3" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 10pt; line-height: 15.333332px;">[3]</span></span></span></a> <span style="font-family: "Times New Roman", serif; font-size: 9pt;">Atypical hyperplasia is caused by a disruption in normal cell growth in breast tissue, which causes an over-production of normal-looking cells that accumulate and begin to look abnormal. These cells can develop into ductal carcinoma in situ, or noninvasive breast cancer in the milk duct. This can develop into invasive cancer, which can invade the surrounding breast tissue, lymph channels or blood vessels (Mayo Clinic).</span><o:p></o:p></p></div><div id="ftn4"><p style="font-family: Times; font-size: 10pt; margin: 0in;"><br /></p></div></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-20972796603804217082023-05-02T12:17:00.001-04:002023-05-02T12:19:10.628-04:00I'm Lucky To Be Here<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcx7Iu1YLVhZjhDeHpM6CKKgSpTamsy6xGcKA5QzpK8O8raAQ356YlJKxdJFCDY9V6PvlRGomBx7o7_vpTQKCaEGbZJ_zOMEMDhCI610l4o4C7qDWt30saKkZomlgqN0FI9aQzuCF_HeiYm3fYP2HVmdTBtWAvGneKhMrd902wvRKBZDuHGk91G_fc/s604/misneach.jpeg" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="453" data-original-width="604" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhcx7Iu1YLVhZjhDeHpM6CKKgSpTamsy6xGcKA5QzpK8O8raAQ356YlJKxdJFCDY9V6PvlRGomBx7o7_vpTQKCaEGbZJ_zOMEMDhCI610l4o4C7qDWt30saKkZomlgqN0FI9aQzuCF_HeiYm3fYP2HVmdTBtWAvGneKhMrd902wvRKBZDuHGk91G_fc/s320/misneach.jpeg" width="320" /></a></div><div class="separator" style="clear: both; text-align: center;"><br /></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;"><span style="font-family: inherit;">On May 2, 2008 I got my last chemo treatment.</span></div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">At the time, I knew it was "the last one" but I had trouble believing I wouldn't be back there again. Now, 15 years later, I think I believe it.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">This <span style="font-family: inherit;"><a style="cursor: pointer; font-family: inherit;" tabindex="-1"></a></span>is the tattoo I got on May 2, 2009 to celebrate my first year of survival. It's "courage" in Gaelic. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">In very early sobriety, I heard things like "Fear is the absence of faith, faith is the absence of fear" and "Courage is fear that has said its prayers." I used to keep a copy of the courage phrase on the side of my computer monitor at work, to remind me that if I was stuck in fear, faith was my way out. During treatment, I asked my family and friends to help me remember that if I was filled with fear, I needed to remember to have faith. They often reminded me of that on my lowest days, and for that I will forever be grateful.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Cancer treatment requires a lot of faith: faith in yourself, that you can endure it - that you have the physical and emotional stamina for the surgeries, the radiation, the chemo, whatever is required of you to fight; faith in your family and friends, that they will hold you through it; faith in your doctors, that they will administer your treatments safely and correctly, that they will pay attention to you, help you with what you need; faith in your insurance company, that they will pay for your treatments and minimize the hassle so you can focus on treatment and recovery; and faith in whatever higher power or god you turn to in the darkest moments of the night.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Not all faith is rewarded. For sure, you will be disappointed by your insurance company; in America, that goes without saying, really. Some of your doctors my fail you. Some of your friends and family may disappoint you. Sometimes your closest person will disappoint you. Your body may fail you. Your outcomes may force you to question even your faith in that higher power.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Today I am grateful that I had very few disappointments during treatment. I had the support of my wife, our families, friends, professional colleagues who became friends, my doctors, nurses, clinical staff (back when healthcare in America wasn't so broken as it is now). My body was able to handle all of the trauma I endured during treatment. My cancer responded to treatment, and so far it has not returned.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Not everyone is as fortunate. I have known people whose partners left them during treatment, who lost their jobs and health insurance because they couldn't work during treatment, who struggled to get the support they need from family and friends, whose bodies couldn't take the trauma, whose cancers were too advanced, or whose cancers were untreatable.</div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">If you know someone who is facing cancer, please think about them. Patients seldom have an answer for "just let me know wha you need," but that doesn't mean they don't need you. It's hard to ask for things. Offer specific types of support, and they can react to those specifics. Maybe they can use help with the expenses associated with their cancer - I have seen some very successful fundraisers to support individual cancer battles. If you're the organizing type, you could do that. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Or maybe you prefer to organize a meal delivery network with family and friends; this is especially useful if they have kids, because kids have to eat no matter what. I used to sign up on a meal calendar to make lasagna for friends while the Dad was going through chemo. It helped them on that day, but it helped me feel like I was paying things forward, too. If you're not big on cooking or managing a meal delivery network, you could take donations to buy them a home delivery meal plan. Or to hire a housekeeper for them. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Maybe you could take their kids once a week to the zoo, or a trampoline place, or rock climbing, so they can forget for a while that their parent if sick, and their parent can have an afternoon to just rest and focus on themselves. Maybe you have other ideas of how you can support them. </div></div><div class="x11i5rnm xat24cr x1mh8g0r x1vvkbs xtlvy1s x126k92a" style="caret-color: rgb(228, 230, 235); font-family: system-ui, -apple-system, BlinkMacSystemFont, ".SFNSText-Regular", sans-serif; font-size: 15px; margin: 0.5em 0px 0px; overflow-wrap: break-word; white-space: pre-wrap;"><div dir="auto" style="font-family: inherit;">Any little thing can make a huge difference to someone in cancer treatment or recovery or who is living with cancer.</div></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-37370827798351908252023-01-13T22:13:00.000-05:002023-01-13T22:13:07.933-05:00Chapter 3 – Coming Out to My Breast Surgeon<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmwSHSwvuCnqC_6p4FYGbdcHDCEEVVbYgm_Nn-Jvlj5dkwZ5xmM0GHRAdVqwlDZ6sH4Idja6hc9OEyO6kQzG5mJI5mmDgEnt0-3o2hM7QfwOnqzPPjbClwRONUXpA1n2a5rJJNBCq_D_60N5-VjIPkz7vvVcayO7QKrJuLEKcBAgVYEEvQZ-mbWGoD/s604/IMG_3607.jpeg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="403" data-original-width="604" height="214" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgmwSHSwvuCnqC_6p4FYGbdcHDCEEVVbYgm_Nn-Jvlj5dkwZ5xmM0GHRAdVqwlDZ6sH4Idja6hc9OEyO6kQzG5mJI5mmDgEnt0-3o2hM7QfwOnqzPPjbClwRONUXpA1n2a5rJJNBCq_D_60N5-VjIPkz7vvVcayO7QKrJuLEKcBAgVYEEvQZ-mbWGoD/s320/IMG_3607.jpeg" width="320" /></a></div><br /><p align="center" class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in; text-align: center;"><br /></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">When I was diagnosed in 2002, it was not uncommon to hear about lesbians experiencing hostility in healthcare settings because of their sexual orientation, or for partners to be left out of each other’s healthcare altogether. And it wasn’t very common to hear about lesbians who were open with their healthcare providers about their sexual orientation or same-sex relationships. This is the context in which I was facing breast cancer. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">Even though my gynecologist knew I was connected to MG and her family, we had yet to tell her that we were a couple. From our perspective it seemed implicit, but we weren’t comfortable yet making it explicit, and it hadn’t seemed important enough in that setting to take the risk. I was so used to just answering no to birth control questions, and having that be the end of that particular line of questioning. I had never had a gynecologist pursue the topic any further or ask for clarification about my sexual orientation, and there were never any questions about sexual orientation or non-heterosexual sexual activity. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">But now we were facing the possibility of breast cancer, and I needed MG by my side and visible to the doctors, so MG went with me to my first appointment with the breast surgeon. We were both nervous. While we were waiting for my appointment, we saw two other women in the waiting room, who looked to me like a lesbian couple. I thought, hmmm, maybe this doctor is going to be okay. I mean, if she’s a breast surgeon, most of her patients are women, so she has to have her fair share of lesbians among those women, right? So, when we met her that day, I introduced MG as my partner. I wanted to make sure that she was aware of our relationship right out of the gate, rather than waiting until the “right moment” or an “appropriate time” and finding myself paralyzed by fear in situations when I need MG the most. She didn’t even blink, which I loved about her. She included MG in the conversation that day (and every appointment after that) asking her if she had questions, making sure that she and I both understand what she was telling us. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">This is the kind of reaction you want from your potential surgeon, or from any healthcare provider. And if you are lucky, it’s the kind of reaction you get. Now, if she had been freaked out about my partner being a woman (something I have not encountered even once on this journey, thankfully), I would have had to either talk to her about her reaction and see if she could find a way to be more accepting, or I would have had to reconsider my choice of surgeon. Since we really felt comfortable with her all around, I’m very glad that we didn’t have to worry about her acceptance of our relationship.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">In addition to her acceptance of our relationship, the surgeon became an important source of information for me when I was facing new cancer care providers and medical settings. Based on her reactions, I was more confident about being open with new providers about our relationship. My ability to approach new providers with that confidence, as well as the changing attitudes towards the LGBTQ community in this area and in our community, may be why I have always had positive experiences with cancer care providers, as well as any other healthcare providers. In addition to her influence on my confidence levels with other providers, if I ever had any doubt about the kind of reactions I might get, I could ask her if she felt that provider or facility is safe. She was very familiar with the local health care system and, as a heterosexual provider, had a great “insider” perspective on other providers’ attitudes about LGBT patients. She always understood why I might be concerned, and she never steered me wrong about the kind of reaction I could expect in any setting. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">Because of our confidence in my breast surgeon, we came out to everyone else involved with my cancer care. With the oncologists, radiation oncologist, with nurses, office staff, with everyone. And this also extended to being more open with my other healthcare providers as well – primary care, gynecology, allergist, just about everyone. Not that many of them needed to be told; I think it was obvious to most of our routine providers already, they just never brought it up on their own. Their intake forms never asked, their routine medical records update forms didn’t ask. MG was always my emergency contact, but I was never sure what I should list in the “relationship” box next to her name. Even after our wedding in 2005, it wasn’t until 2010 when our state passed legislation for insurance providers to recognize same-sex marriage performed in other localities where it was legal, that I felt comfortable listing MG as my spouse, rather than my “significant other” or “partner.” When the US finally recognized same-sex marriage as legal in 2013, we could feel comfortable choosing “married” as our relationship status or listing each other as “spouse.” <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">I remember being particularly concerned in January 2008, when I was preparing for my mastectomy and reconstruction, which would involve a few days in the ICU before being moved to the regular post-surgery unit. I was very worried that MG would be denied the right to stay with me in the hospital. Especially the first night. This was pre-COVID, when you could have people stay with you overnight in your room or, in the case of ICU stays, in the family waiting room but with access to you throughout the night. But I had heard stories about same-sex partners being denied that right, and I had one family member who suggested that she should be the one to stay with me that night instead of my wife, as she was my “real family.” If my own family member could be so wrong about how important MG was to me, I worried that nurses or staff physicians might also be that wrong. I took that concern to my breast surgeon, and she assured me that she had other lesbian patients have the same procedure in the same hospital, who stayed in the same ICU, and none of them had ever reported facing homophobia there. She also offered to mention how important MG was to me, and to assure that she would have full access to me in the hospital. Because she was so understanding about my concerns, I had full faith we would be treated just like any other patient and their partner. And we were.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Calibri, sans-serif; line-height: 32px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;"> </span></p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-20280295860960686612022-12-06T23:38:00.001-05:002022-12-07T09:42:39.728-05:00 Chapter 2 – This Autobiography of My Breasts – 2006-2012<p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Trigger Warning: child sexual abuse</p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I’m not sure where to begin, or even how much of this story I can put into words. It is hard to imagine that anyone, even if I could adequately articulate my feelings, could understand how I came to have such conflicted feelings about something as simple as having breasts. And yet, it is a story I am compelled to tell; it is a central thread of my identity. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Except that I never really “had” breasts; it’s more like my breasts had me. Once they “showed up” people started looking at me differently. And treating me differently, and not always in a good way. Most of my life, I hated having breasts. First, because they made me feel awkward and different for not having them, and then for having them. Second, because of the unwanted attention they got me. I blamed them. I hated them. And then … well, let me start at the beginning, or somewhere close to it.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I have not always had breasts. Until puberty. Which was late, by the way, and don’t think that didn’t bother me, either. In Catholic School, when you “start to show” you have to wear a tank top under your uniform blouse, at least, that is, until you are ready for a training bra. I was probably one of the last girls in my class to have to wear either of these articles of clothing. The tank top is always obvious, so you know when “it” is happening to someone else.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Like many things in my house, my parents had never mentioned what I should do when the nuns tell me to need to start wearing a tank top, and that I should probably get a training bra. I didn’t even know what a training bra was, or what I was training for. I don’t even think my mother was around at the time. She spent a lot of that year, my 12<sup>th</sup> year, in and out of the hospital. And not the kind of hospital where you worry about something bad happening and her not coming home. It was more like the kind of hospital where you are glad she finally went away, and you worry about her coming home too soon. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">So, anyway, she wasn’t around. Not that I had the kind of relationship where I could talk to my mother about anything personal like breasts, because I didn’t. Her mental illness made it difficult for her to really notice anything outside of her own experience. Which left me with my father, which was totally embarrassing. It turns out that Dad didn’t know when a girl needs a training bra, any more than I did, so he had to look at my breasts and try to guess if it was time. Just for a second. From across the room. But still, yuck!<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Fast forward two years.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I am living in a foster home. I am 14 years old. My foster mother’s youngest son, “F”, who is 28 years old, has taken to teasing me in public about the size of my breasts. He nicknames me “plank” because he says I’m as flat as a board. His favorite joke is that I got in the “pits” line by mistake, instead of the “tits” line, and asked for seconds. If any of the other adults in his family think this is inappropriate, nobody challenges him on it. He makes this joke a lot in front of his kids, who are 4 and 6 years old, because they and any other kids who happen to be around, think it’s really funny.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I find these comments on my breasts completely humiliating. I become very self-conscious in school, refusing to change in the locker room with the other girls. I hate to be looked at. I take to wearing my very long hair as much in my face as possible to avoid being seen. This habit will eventually earn me the nickname “Cousin It” in high school.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">In private, “F” has become obsessed with my body, with my breasts in particular. He says that I am irresistible, and that if I weren’t so irresistible, he wouldn’t have to make me “do stuff” with him. I don’t know what to do. He warns me that if I tell anyone what he is doing to me, he will go to jail. Later on, he changes his threats so that I am not protecting him with my silence, but myself. First, he tells me that noone will believe me; that I will be thrown into the street; in later years, he threatens my life.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">His mother suspects that something is happening between us, my 14-year-old self and her adult, married son; she chooses to believe that whatever is happening is my fault. At the same time, she chooses to ignore what is happening. She calls me a whore, even as she pretends not to hear him coming into the house and my room at night. She refuses to let any social worker or doctor interview me privately; she lies to them about my eating habits and symptoms, even during my senior year in high school as we explore possible physical causes for fainting spells. The night before the annual hearing to evaluate my placement in her home, she threatens to have me thrown out, but during the hearing she praises me as a well-behaved and lovable child. I am so grateful that she is not abandoning me, that I say nothing when the judge asks me if there are any reasons why I should not continue living with her. I am confused and afraid and powerless.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">From the minute “F” started molesting me, I stopped eating. What was happening to me, and my inability to talk about it, made me sick to my stomach. Nobody seemed to notice. But my breasts stopped growing, which was all right with me. I hated my woman’s body, in particular my breasts, and I would have done anything to be rid of them once and for all. These choices, not to eat, not to become a woman, they were not conscious choices. They seemed to be happening to me spontaneously, rather than involving any sort of internal decision process. Even as doctors were evaluating me for brain tumors because they could not locate a reason for my fainting spells, even as they were asking if I was eating, I could not connect these health problems with my starvation. I just didn’t see how one thing was related to the other.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;"><span style="height: 282px; left: 0px; margin-left: 190px; margin-top: 149px; position: absolute; width: 44px; z-index: -1895826432;"><img height="282" src="blob:https://www.blogger.com/489e8213-7377-4961-be2e-1fd66eec735a" v:shapes="_x0000_s1026" width="44" /></span>This was the beginning of my anorexia. Years later, when people started talking about anorexia in the media, they said it was the affliction of young women who were perfectionists and who struggled with unreasonably high expectations of themselves. I did not recognize myself in that description, even though I weighed only 100 pounds at 5 feet 8 inches. I did not see myself as a perfectionist, although I recognize that in myself today. Back then, all I knew was that I hated having a woman’s body. And not because I thought I was supposed to be a man. I hated my body for the attention it got me. And I hated my breasts because they were the focal point of all that unwanted attention. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">For years after the abuse, which lasted until I was 18, I was numb from my neck to my knees, literally. I would allow men to be intimate with me, but I would not feel anything during those physical acts of intimacy. I learned how to fake emotions and physical reactions because otherwise people got upset that I was not “enjoying” myself. I could only have sex if I was drunk or stoned. I selected for partners people who were so self-involved they didn’t even notice that I would dissociate during sex.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">When I came out as a lesbian at 22, I wasn’t really sure how to deal with other women’s breasts, either. For a long time, I was unable to understand how any woman could derive pleasure from her breasts or tolerate anybody, especially me, paying attention to them. It was difficult to relate to women sexually, because it seemed like I was aligning myself with “F”. I had trouble seeing women, myself, my lovers, as other than victims of their sexual experiences. I could not have put this into words back then; even now, it is difficult to explain. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I finally began addressing my eating disorder and putting on weight in my mid-20s. I was no longer able to pretend that I did not have a woman’s body. I started to fill out. My breasts were one of the first areas where my weight became apparent. I almost immediately developed fibrocystic breast syndrome, which involves the development of painful cysts during certain points in your menstrual cycle. So now I not only had to live with my breasts, but they caused my physical pain as well. I hated them even more.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">This was all very distressing to me, and it took years of therapy to begin to come to peace with my new body; I still work on this today. In Alcoholics Anonymous we have a saying “I don’t have to like something to accept it, but I must accept it.” This attitude worked for me when I had to face difficulties in life, and it worked for me in terms of accepting that I had breasts. My body, once I started nourishing it adequately and accepting its existence, began to lose that numbness that I had lived with for so long. I began to feel my relationships with other people, in ways that I never had before. This was both a blessing and curse. But a few more years in therapy, and it became less of a curse… more of a blessing... it took a while.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">My mother was diagnosed with her breast cancer when I was 28. And even though I knew this meant that I had a higher risk for breast cancer myself, I ignored it. When my gynecologist said that I didn’t need mammograms before 40, I chose to believe her, even though I heard different opinions in the media and from friends.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">In the summer of 2002, the radiologist found that suspicious area in my left breast and referred me to Dr. G. Before I knew it, I was getting a stereotactic breast core needle biopsy.<a href="applewebdata://DE6D5A40-FB20-4F5F-833F-00DABDEC276B#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt;">[1]</span></span></span></a> Within days, I was diagnosed with a precancerous condition called atypical intraductal hyperplasia. <a href="applewebdata://DE6D5A40-FB20-4F5F-833F-00DABDEC276B#_ftn2" name="_ftnref2" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt;">[2]</span></span></span></a> A few weeks later, Dr. G performed an excisional or surgical biopsy to remove the precancerous area, and the pathologist found a small malignant tumor inside that precancerous tissue. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I was diagnosed with ductal carcinoma in situ (DCIS) – breast cancer that had not yet escaped the duct, or Stage 0 breast cancer. This made perfect sense to me. All of my bitterness and resentment about the sexual abuse lived in my breasts; I had blamed them all my life for that abuse. It seemed like the perfect way for them to get back at me for rejecting them all those years. Clearly, I still had work to do.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">A friend recommended that I read Bernie Siegel’s book <u>Love, Medicine & Miracles</u>. Siegel writes about needing to live an authentic life, to love your body, to think of your body and mind as one being. Your life is stored in your body. If you have cancer in your body, you need to focus your love on the part of your body where that cancer lives.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Great! Now I had to love my breasts. Accepting their existence was not enough. And now, when suddenly faced with the possibility of losing them, I didn’t want to. Whether or not I ever liked those years of inappropriate and painful attention, my breasts had woven themselves into my identity as a woman. The idea of having them removed was very anxiety-provoking. I would do it if I had to, and I knew that it was survivable, but I was terrified by the possibility.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I was fortunate. The cancer was very early and had not spread beyond the duct. This meant that I could survive with a lumpectomy and radiation. Siegel also writes in his book about visualizing God’s love as a healing light, shining on the cancerous area. This was my daily visualization during radiation therapy. Rather than focusing on the humiliation of being laid bare on that table, and the pain the radiation caused, I imagined that the radiation was white light, the love of God, shining down on my breast. I know it sounds weird, but that’s what I did. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">It worked. The radiation did anyway, because [at the time I originally wrote this essay] I remained cancer free for four years. The visualization worked, too, I think. The love that I practiced feeling for my breasts helped me in my recovery from the treatment. It’s a struggle, after being treated for breast cancer. First, there are the months it takes for the tissue in the affected breast to heal, from the surgeries, from the radiation, from the experience of having such a private part of your body being poked and prodded by medical professional after medical professional, day after day. Suddenly, that part of you is this impersonal thing, a site of disease or cure. It’s hard to incorporate it back into the rest of your body, into your intimate relationship with your partner, or to look at that part of your body in the mirror and see anything other than the scar or the fear. You have to want all of your body to exist as one; there is no room for hating any of it.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Somehow, though, the afflicted part of your body becomes one with the rest of you again. The disease has been cut out, burned out of it. I finally forgave my breasts. I could see that they were just the excuse that he used to justify his violation of me, and I accepted them as part of this womanly body that is me.<o:p></o:p></p><p align="center" class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: center;">************<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">I originally wrote this essay in the fall of 2006, four years after my first breast cancer diagnosis. In 2007, I was diagnosed with Stage 1 invasive breast cancer, again in my left breast, and it is that experience that I will be writing about for the remainder of this book. Prior to this new diagnosis, I thought I had completely forgiven my breasts for their part in the sexual abuse. When I received this second diagnosis, I was faced once again with my anger at my abuser and with the need to forgive my breasts for being the focus of his interest in me. <o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">Because I had already received radiation therapy, I could not receive radiation again, and so my only option was a mastectomy. I had already had one biopsy of my right breast, which was benign, but I did not want to worry about finding cancer in the future, so I decided to have a bilateral mastectomy. I also opted for reconstructive surgery. After all of the work I have done to accept my breasts, I found them integral to my identity as a woman and could not imagine a life without them. As it turns out, reconstruction did not restore me to anything like my original body, but I will go into that later in the book.<o:p></o:p></p><p class="MsoNormal" style="font-family: "Times New Roman", serif; line-height: 32px; margin: 0in 0in 6pt; text-align: justify;">My bilateral mastectomy gave me a chance to excise my abuser from my body once and for all. And although I felt more liberated from him than ever, I found myself faced with entirely new challenges around body image and sexuality. Perhaps these issues are universal for women undergoing breast reconstruction, or perhaps they are intensified for me because of my history of eating disorders or sexual abuse. Whichever is true, and as difficult as this journey may be, I face it with confidence that my body is free of cancer, and free of the stains of sexual abuse.<o:p></o:p></p><div><br clear="all" /><hr align="left" size="1" width="33%" /><div id="ftn1"><p class="MsoNormal" style="font-family: "Times New Roman", serif; font-size: 12pt; margin: 0.1pt 0in;"><a href="applewebdata://DE6D5A40-FB20-4F5F-833F-00DABDEC276B#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt;">[1]</span></span></span></a> <span style="font-family: Times; font-size: 9pt;">A core needle biopsy is a “through the skin" (percutaneous) procedure that involves removing small samples of breast tissue using a hollow "core" needle. For lumps or lesions that can be felt by hand, this is accomplished by fixing the lesion with one hand and performing a freehand needle biopsy with the other. In the case of non-palpable lesions (those unable to be felt), stereotactic (computer-guided) mammography or ultrasound image guidance is used. Stereotactic mammography uses computers to pinpoint the exact location of a breast mass based on mammograms taken from two different angles. The computer coordinates help the physician to guide the needle to the correct area in the breast. With ultrasound, the radiologist or surgeon watches the needle on the ultrasound monitor to help guide it to the area of concern. The needle used during core needle biopsy is larger than the needle used with fine needle aspirations (usually done in your doctor’s office), and has a special cutting edge. <o:p></o:p></span></p></div><div id="ftn2"><p class="MsoFootnoteText" style="font-family: "Times New Roman", serif; font-size: 10pt; margin: 0in;"><o:p></o:p></p></div></div><p><a href="applewebdata://DE6D5A40-FB20-4F5F-833F-00DABDEC276B#_ftnref2" name="_ftn2" style="font-family: "Times New Roman", serif; font-size: 10pt;" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 10pt;">[2]</span></span></span></a><span style="font-family: "Times New Roman", serif; font-size: 10pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 9pt;">Atypical hyperplasia is caused by a disruption in normal cell growth in breast tissue, which causes an over-production of normal-looking cells that accumulate and begin to look abnormal. These cells can develop into ductal carcinoma in situ, or noninvasive breast cancer in the milk duct. This can develop into invasive cancer, which can invade the surrounding breast tissue, lymph channels or blood vessels (Mayo Clinic).</span> </p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-69939755918456925422022-11-26T23:39:00.001-05:002022-11-26T23:39:51.304-05:00Chapter 1: Mom<p class="MsoNormal" style="line-height: 29.333336px; margin: 0in 0in 6pt; text-align: center;"><span style="font-family: Times New Roman, serif;">**Copyright 2022 Maria Teresa Brown - All Rights Reserved**</span></p><p class="MsoNormal" style="line-height: 29.333336px; margin: 0in 0in 6pt; text-align: center;">Part 1: The First Go-Round (or Ductal Carcinoma In Situ)</p><p class="MsoNormal" style="line-height: 29.333336px; margin: 0in 0in 6pt; text-align: center;">Chapter 1: Mom</p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">I will start my story by telling you that I am not the only woman in my family who has had breast cancer. While neither of my grandmothers had it, as far as I know, or any of my aunts, my mother did. It was found during a routine mammogram, and she had a complete mastectomy on that side, but no other treatment. After the mastectomy, she wore a prosthetic or not, depending on her preference on any given day. Her cancer was found when she was 63, and she remained cancer-free until her death at 81. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">At the time of her diagnosis and mastectomy, I was in my late 20s. I had been sober for a few years, but was still a heavy smoker. Around that time, I knew of a women in my local community who had breast cancer and was a heavy smoker – she had a mastectomy, kept smoking, got metastatic<a href="applewebdata://A88FBDCF-B3B3-4B44-9117-365B921331E4#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 12pt; line-height: 18.4px;">[1]</span></span></span></a> breast cancer, kept smoking, and then she died. All within a few years. It seemed really fast and frightening to me. All I could think about when I heard my Mom’s diagnosis was that now that breast cancer was officially “in my family” I didn’t want to be dealing with having breast cancer and trying to quit smoking or being unable to quit smoking and dying from cancer because of it. That was the year that I began making my first serious attempts at quitting smoking. It took several years and multiple failed attempts, but I did finally quit smoking for good the year that I turned 32. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Now, I don’t know for sure if cigarette smoking has ever been proven to cause breast cancer, but if your mother, a heavy smoker, had any kind of cancer, you would probably find yourself wondering if her smoking had anything to do with it. In my mother’s case, she did not quit smoking. Ultimately, she developed COPD, and her official cause of death was “complications of COPD.” Mom’s smoking was not something I could change. But I could change my own habits, and so I focused on that. And one of the first things I thought the first time I was diagnosed with breast cancer was “thank God I quit smoking when I did!” <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">Since my first diagnosis, alcohol abuse has also been linked with breast cancer. As I mentioned before, I was already sober a few years when Mom had her mastectomy, and I was sober 12 years when I had my first breast cancer. My doctors have always been confident that my history of alcoholic drinking was distant enough not to be linked to my breast cancer. I am not as confident, but I am certainly grateful that I was not still drinking when I was diagnosed. Because the only thing that was harder than quitting smoking for me was quitting drinking. And I would definitely have been told to do both once I had breast cancer. Whether I would have been able to, though, is highly unlikely. <o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">This chapter is about Mom, not just because of her history as a smoker and a breast cancer survivor, but because of my role as her caregiver throughout the years that I was dealing with facing and surviving breast cancer.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">I was diagnosed with my first breast cancer in August of 2002. I had already spent pretty much every day of that summer at the hospital, trying to figure out what was happening to my mother. That spring, she had been moved out of the apartment she shared with Dad into a homeless shelter for mentally ill women, and eventually into her own apartment in an enriched housing program. Her enriched housing program was essentially independent living for older or disabled adults who qualifid for Social Security Disability, Medicaid, and public housing. It was not a good transition. She was very unhappy, and her health was bad. While she had lived with bipolar disorder all of her life, she was additionally depressed about being separated from Dad, but he just didn’t want to, or couldn’t, take care of her anymore. She also started getting really forgetful. More than I even realized at the time. Nobody was aware of it, but she was experiencing a medical condition – hyperparathyroidism – that was causing all the calcium in her bones to leak out into her blood. This caused hypercalcemia, which caused the memory loss and started making her fall. The worst fall broke 2 vertebrae in her back and split her head open, landing her in the ER. They discharged her back to her apartment that day, which felt unsafe to me, but I didn’t know what else to do. A week later, she was completely incapacitated and had lost most of her ability to speak. She was back to the ER, and this time admitted into the hospital. Within a week, and before they could figure out what was going wrong, she ended up spending 20 hours in a coma. She survived the coma but was what they called “severely demented” for weeks afterwards. When she was well enough, they discharged her to a nursing home. And she lived in nursing homes for the rest of her life. Her dementia became less severe after that initial hospital stay, but she never recovered her short-term memory or her capacity to take care of herself well enough to live outside of a nursing home.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">In the middle of Mom going through all of that, I went to the gynecologist for an annual exam. I had been living in Syracuse with my partner for a year and a half and had not been to the gynecologist since before I moved. Which meant I was overdue for an annual exam. I hated going to the gynecologist, mostly because it is an unpleasant experience for any of us, but also because of repeated questions about birth control (no matter how many times I told them I didn’t have sex with men, they just kept asking those questions!) and my history as a sexual abuse survivor. So I had been putting off my first visit to MG’s gynecologist. Eventually, her mother told her to just make the appointment for me if I wouldn’t do it myself. The best advice ever, it turns out. MG made me the appointment for that July, and so like a good girlfriend, I went. The gynecologist’s office was in the same building as an imaging office, so she sent me right over for my baseline mammogram.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt; line-height: 32px;">I was only 36, and since Mom’s breast cancer a few years earlier, the former gynecologist had told me I didn’t need a mammogram until I turned 40, because Mom’s cancer was post-menopausal. But MG’s Mom, and their gynecologist, believed in early baseline mammograms, so that you have images to compare to when you start your regular mammograms at age 40. This is why I was sent over to imaging for a mammogram. The physical examination of my breasts was totally normal.</span></p><p class="MsoNormal" style="font-family: Cambria, serif; font-size: 11pt; line-height: 29.333336px; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif; font-size: 12pt;">The events of that afternoon are not entirely clear anymore, it was so long ago.</span><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 12pt;">I know they wanted a magnification of my left breast, because the radiologist wanted to take a closer look at it. Which means that I had to have extra mammograms done on that side. And I know that the area they were concerned about was very close to my armpit, so they really had to pinch my breast in the machine, which hurt. After the second image, the technician sent me back to my gynecologist, who told me that there was a suspicious area in my left breast and they needed to refer me to a breast surgeon.</span><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span><span style="font-family: "Times New Roman", serif; font-size: 12pt;">Before I left their office, I had an appointment with Dr. G, who ended up being my breast surgeon for both breast cancers.</span><span style="font-family: "Times New Roman", serif; font-size: 12pt;"> </span></p><div><br clear="all" /><hr align="left" size="1" width="33%" /><div id="ftn1"><p class="MsoFootnoteText" style="margin: 0in;"><a href="applewebdata://A88FBDCF-B3B3-4B44-9117-365B921331E4#_ftnref1" name="_ftn1" style="font-family: Cambria, serif; font-size: 10pt;" title=""><span class="MsoFootnoteReference" style="vertical-align: super;"><span class="MsoFootnoteReference" style="vertical-align: super;"><span style="font-size: 10pt; line-height: 15.333332px;">[1]</span></span></span></a><span style="font-family: Cambria, serif; font-size: x-small;"> </span><span style="font-family: Times New Roman, serif;"><span style="font-size: 9pt;">Metastatic breast cancer is when the cancer has spread to other parts of your body (like your liver, brain, or bones)</span><span style="font-size: 9pt;"> or comes back (recurs) after you have complete treatment for the initial cancer. Some people might call it systemic cancer, or stage four cancer, or end stage cancer. At this point, the cancer is not curable, although depending on the particular details of an individual case, it may be manageable with the appropriate treatments, and some women have been known to live for many years with metastatic breast cancer.</span></span><span style="font-family: Cambria, serif; font-size: x-small;"><o:p></o:p></span></p></div></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-32944109168429117062022-11-13T20:49:00.004-05:002022-11-14T21:25:30.205-05:00My Breast Cancer, My Mother, My Wife, and Me: One Lesbian’s Breast Cancer Journey<p><br /><br />I've decided to use this blog to share my breast cancer memoir, which I hope to self-publish. The title of this post is one of the titles I'm considering. Please tell me what you think of it in the comments.</p><p><br /></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8ZrS4HdPxg7hfvwe0--C6TeSBL0h0a6I7iqeK8_IrkXSDFNjcv54SzbsSLvdiFOQ_UosZz9A6UdCHSStM-_r3MV0gNKJbDyH7va25bBDDQI526WWKW6FbYghF94zeG03C0ETQjVog8phk_QpFeuOn6IxAi086M-5rI3Ud6oB6bdynyLq4t2BtUY7X/s3456/IMG_6249.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2304" data-original-width="3456" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh8ZrS4HdPxg7hfvwe0--C6TeSBL0h0a6I7iqeK8_IrkXSDFNjcv54SzbsSLvdiFOQ_UosZz9A6UdCHSStM-_r3MV0gNKJbDyH7va25bBDDQI526WWKW6FbYghF94zeG03C0ETQjVog8phk_QpFeuOn6IxAi086M-5rI3Ud6oB6bdynyLq4t2BtUY7X/s320/IMG_6249.JPG" width="320" /></a></div><p></p><p><span style="font-family: "Times New Roman", serif;">Lesbians, and other members of the LGBTQIA+ community, are essentially invisible in mainstream breast cancer literature.</span><span style="font-family: "Times New Roman", serif;"> </span><span style="font-family: "Times New Roman", serif;"> </span><span style="font-family: "Times New Roman", serif;">Mainstream books written to guide breast cancer survivors through recovery from treatment are written with an unacknowledged assumption that all survivors are cisgender heterosexual women, and the authors of commonly available cancer memoirs are cisgender heterosexual women. While lesbians may still find useful information in literature written from and for the heterosexual survivor’s perspective, their invisibility in these written accounts of cancer and recovery experiences effectively communicates that their cancer experiences are unimportant. Many lesbians may see these heterosexist assumptions as barriers to seeking the help and support they need during one of the most difficult times of their life. Because lesbians with cancer may not have a community of other lesbians with cancer around them, and cannot find themselves in the cancer literature, cancer can be a very isolating experience. They may hunger for information from other lesbians who are going through the same experience.</span></p><p><span style="font-family: Times New Roman, serif;"><br /></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAkPsNxpiwyNk5MIJ7Tr02N8Pt3RYIqF8CSimuNBCfTXTm0ssPXfvfSG3InlhHLq_AGdb_nzgi7XbstYLfVTdhSLGJJeVYPda4meGVNeCXMUjRIQIbX1iJbqgTQRGe41hImBuq1MliWiWI0VzFvAPbEj2Wiv3r7vTzFX2HSFx44Z7In6NRVFF5LcYM/s3456/IMG_6257.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="2304" data-original-width="3456" height="213" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgAkPsNxpiwyNk5MIJ7Tr02N8Pt3RYIqF8CSimuNBCfTXTm0ssPXfvfSG3InlhHLq_AGdb_nzgi7XbstYLfVTdhSLGJJeVYPda4meGVNeCXMUjRIQIbX1iJbqgTQRGe41hImBuq1MliWiWI0VzFvAPbEj2Wiv3r7vTzFX2HSFx44Z7In6NRVFF5LcYM/s320/IMG_6257.JPG" width="320" /></a></div><p></p><p class="MsoNormal" style="font-family: Cambria, serif; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">I was diagnosed with my first breast cancer less than ten years after my mother survived her own breast cancer. As a survivor of two breast cancers (DCIS in 2002 and Stage I in 2007), I have been through multiple lumpectomies, radiation therapy, a bilateral mastectomy with reconstruction, chemotherapy, and a hysterectomy. In addition to being relatively young for each of these cancers, 36 and 42 respectively, I am also a lesbian. I was fortunate in that, at the time of my first diagnosis, I personally knew two other lesbians who had also been through breast cancer. I quickly realized, however, that all of the support resources offered by local and national breast cancer organizations assumed that all patients are heterosexual, and that at fundraising events in my area, it was assumed that we were all heterosexual. If I wanted a community of </span><span style="font-family: "Times New Roman", serif;">lesbian </span><span style="font-family: "Times New Roman", serif;">cancer survivors, I would have to create that community. In 2008, I created a Facebook group for lesbians with cancer and their partners. Our membership currently numbers 321 lesbian, bisexual, and gender non-binary patients, survivors, and partners or caregivers from around the United States and the world. Publishing this cancer memoir is another step in providing lesbian cancer patients and survivors some sense of community with other lesbian cancer survivors.<o:p></o:p></span></p><p class="MsoNormal" style="font-family: Cambria, serif; margin: 0in 0in 6pt;"><span style="font-family: "Times New Roman", serif;">I tell my cancer story using a combination of narrative text, email messages, private journal entries, blog entries, and messages from family members and friends. Throughout my cancer experience, I have made sure my sexual orientation and my relationship with my wife were visible to healthcare providers, and my wife has been an active partner in all of my treatment decisions and in my relationships with my healthcare providers. While I have always had to be intentional about that visibility, and sometimes had to risk that visibility in uncertain environments, I have been very lucky in terms of providers being respectful of me and of us. </span><span style="font-family: "Times New Roman", serif;">This is an important point for those </span><span style="font-family: "Times New Roman", serif;">lesbians </span><span style="font-family: "Times New Roman", serif;">who may be putting off preventive screenings for fear of discrimination and homophobia in healthcare settings. While these negative experiences do sometimes happen, they are not inevitable. Depending on where you go for treatment, you may find providers who are more accepting than you expect. In this context, my memoir also communicates the importance of being proactive in terms of regular healthcare and cancer screenings, and provides a list of available resources for lesbians and their partners facing cancer.</span></p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0New York, USA42.283827 -75.05982616.970694033465175 -110.216076 67.596959966534826 -39.903576tag:blogger.com,1999:blog-7886866566623237967.post-46686288862426238192022-08-22T22:45:00.003-04:002022-08-22T22:47:40.719-04:00Ruminations of Ithaca, August 2022<div class="separator"><p class="MsoNormal" style="clear: right; float: right; line-height: 16.866666793823242px; margin-bottom: 1em; margin-left: 1em; margin-top: 0in;"><span style="font-family: arial;"><br /><br /><o:p></o:p></span></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEgAtQdGDnIWssCIqZlXSR9jAoVwsLKwCDYWIjH5uqjIlWoxfvW1bE_phA0fdeflr1-nmMtevlifGAcFW1XplVpl6C_87lzFwz5cYwVwbFEi4PYAGQQt4MzXBxkf0MFBrUcJlzYjwIKDMvuPG3OvHuPym8z9dhUTVfcpEyXSrEkCQJ9b3LY-B88kohqP" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="font-family: arial;"><img alt="This garden smells amazing!" data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEgAtQdGDnIWssCIqZlXSR9jAoVwsLKwCDYWIjH5uqjIlWoxfvW1bE_phA0fdeflr1-nmMtevlifGAcFW1XplVpl6C_87lzFwz5cYwVwbFEi4PYAGQQt4MzXBxkf0MFBrUcJlzYjwIKDMvuPG3OvHuPym8z9dhUTVfcpEyXSrEkCQJ9b3LY-B88kohqP=w150-h200" width="150" /></span></a></div><p></p></div><p><span style="font-family: arial;">Sometimes you forget how Ithaca feels until you haven’t been here in a while. You forget how it feels to be here - like the fact that in the summertime everything smells really good. People have so many flowers - their whole front yard and the grass between the curb and the sidewalk are full flower gardens - wildflowers, unbelievable smelling neighborhoods. </span></p><p><span style="font-family: arial;">You forget how many trees there really are here. And those trees have changed so much since the last time you were here. Every house you walk by reminds you of someone you used to know who lived in it. When I used to live here it felt like some people lived in the same rental the whole time I knew them, but in retrospect it may be because I didn’t really know them very long. Whereas other people, like me, moved all the time. Sometimes 2 or 3 times a year. </span></p><p><span style="font-family: arial;">You never knew where I was unless you knew someone who knew me. Here are just a few of the houses I lived in.</span></p><p></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEiiTgCGkW-qxjbH6nyLB24dSRLeoyvNFYgLwP_HeJTAZ-Y3AwWObH1SPgbOCX_L_aL0BZzXMb90XeRctr5V3hNrxLPs9hpBATW0TYzEivIcAwu5df034sYHQF-bxo26DjpakTB3rapB_evWFei9F5w1B9VQKRczwjON1T1yUgpvJ6iPSm2PSB9W-R8O" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="clear: left; float: left; font-family: arial; margin-bottom: 1em; margin-right: 1em;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEiiTgCGkW-qxjbH6nyLB24dSRLeoyvNFYgLwP_HeJTAZ-Y3AwWObH1SPgbOCX_L_aL0BZzXMb90XeRctr5V3hNrxLPs9hpBATW0TYzEivIcAwu5df034sYHQF-bxo26DjpakTB3rapB_evWFei9F5w1B9VQKRczwjON1T1yUgpvJ6iPSm2PSB9W-R8O=w150-h200" title="We lived on the first floor, my bedroom was in the front" width="150" /></span></a></div><span style="font-family: arial;"> <a href="https://blogger.googleusercontent.com/img/a/AVvXsEg1vA9rVVqdk0IYp1KWBjCuF6y46iGt2j3-Jgh4JLnNDtLqr9wP-n6TDDGCfB9otp0R1ZXzkuhxcHdOBuFy4hOLftO3T2-p9vE-qw5f_TmOdhW3TeSHskgahZJFbL_rOMC1HIE7yS07c9pvV5o0NFGkts0fslaygMnixxPJZYsN3xr5bT4FpCk8udXJ" style="clear: left; display: inline; margin-bottom: 1em; margin-right: 1em; text-align: center;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEg1vA9rVVqdk0IYp1KWBjCuF6y46iGt2j3-Jgh4JLnNDtLqr9wP-n6TDDGCfB9otp0R1ZXzkuhxcHdOBuFy4hOLftO3T2-p9vE-qw5f_TmOdhW3TeSHskgahZJFbL_rOMC1HIE7yS07c9pvV5o0NFGkts0fslaygMnixxPJZYsN3xr5bT4FpCk8udXJ=w150-h200" title="I lived in the attic of this house for 2 years" width="150" /> </a></span><p></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEhkleqJbwr3wYALviMcWctTv91EjqyjudSS6rhJf3elebeVcIvO9ii69Tet1hDGRdgzhWnQpzHu6J5N2PxbM4ScZYZ2yyX7YKzerFBwLBkEj9kVc1cw-H2eFITqX3xBbihEp9Dql2SIhprNrsIBDWr2k0cQJ0ljwOcyJrx84JnjspdYGgGwEVNXyhel" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="clear: left; float: left; font-family: arial; margin-bottom: 1em; margin-right: 1em;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEhkleqJbwr3wYALviMcWctTv91EjqyjudSS6rhJf3elebeVcIvO9ii69Tet1hDGRdgzhWnQpzHu6J5N2PxbM4ScZYZ2yyX7YKzerFBwLBkEj9kVc1cw-H2eFITqX3xBbihEp9Dql2SIhprNrsIBDWr2k0cQJ0ljwOcyJrx84JnjspdYGgGwEVNXyhel=w150-h200" title="I had the whole second floor, living room above the porch" width="150" /></span></a></div><span style="font-family: arial;">Some of these houses look like they haven’t changed since the last time I was here, and some look like they haven’t changed since I lived here 22 years ago. </span><div><span style="font-family: arial;"><br /></span><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">Houses that used to be glorious are run down and haven’t been painted in a while, or have random boards holding up the columns on the porches. Every place seems a little run down compared to what it looked like 22 years ago, except for the apartment building at 501 Tioga. It’s newly painted and fresh looking, and it used to be tenement housing in the 90s. Most properties are rentals, and you can tell which ones are rented and which are owner-occupied by how run-down they are.<o:p></o:p></span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">Things have changed but things have not changed and I’m liking that. Actually, it’s nice to see things that remind me of old times and in between them things that I have no recollection of whatsoever. Like the two tiny houses on Auburn Street that were built in the side yards of other houses. </span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEg6V92RP33LF062DHvARvT2Wvs4uGjpJaQWURIwxGoTztP2prEy7DuKkjagUXItsFpdGPam_jEMMU855A2SEBiykQ6okVL0rEvICrvFjb5qm-aEiibRhKCT3eQ_suX9AJaQhLSlbQf3FzyTqJPZglZT8V9mUwv6kz-S3IvppKgE4SySU4kIzLR2Mqyb" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="clear: left; float: left; font-family: arial; margin-bottom: 1em; margin-right: 1em;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEg6V92RP33LF062DHvARvT2Wvs4uGjpJaQWURIwxGoTztP2prEy7DuKkjagUXItsFpdGPam_jEMMU855A2SEBiykQ6okVL0rEvICrvFjb5qm-aEiibRhKCT3eQ_suX9AJaQhLSlbQf3FzyTqJPZglZT8V9mUwv6kz-S3IvppKgE4SySU4kIzLR2Mqyb=w150-h200" title="One of the new tiny houses" width="150" /></span></a></div><span style="font-family: arial;">The other thing you forget about Ithaca when you’re not here for a while is that almost everybody has a dog. They take their dogs everywhere and everybody will talk to you about their dog, whether they know you or not. Like one dog was sniffing me and I was holding my hands behind my back, and the owner said I could just pet him if I wanted. I said oh I know that’s probably true but no one can pet my dog, so I don’t test other people‘s dogs by petting them. She laughed, I said goodbye and walked away. She turned around and shouted “he approved of you, you know! The dog approved of you!” I thought that was really sweet, although how can you tell? The dog just sniffed me, that was it! </span><p></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">Or another guy in the intersection had a golden retriever, and the dog’s face was just so open and friendly and happy, so I said “your dog has a great face”, and he said “oh thank you!” like it was the best complement you could pay him. But the dog DID have a great face. That’s the kind of thing you can say to complete strangers in Ithaca. I probably wouldn’t do that walking around Syracuse. Maybe in the University neighborhood or on my own street, but that’s about it. In Ithaca everywhere is the University neighborhood, I guess that’s a difference. </span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;"><o:p></o:p></span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEg6hCgSxjedSHdD0T6z77gsE2ZWZqNaRpAJ_mFM_fuxd7Gzzqpyd1ZHfXw2TQGWIEvnZ68Ps8kJ75bG76skHJd3WXzmRauLBxqGbLUtrcnHY-vt77OKD2RoLSKBZmKkumUTo5xnGLIFXMu8HIHbMWDKdveCkA-nfy2YPzy9KmYSoI41OeQ81A5WXa08" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><span style="clear: left; float: left; font-family: arial; margin-bottom: 1em; margin-right: 1em;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEg6hCgSxjedSHdD0T6z77gsE2ZWZqNaRpAJ_mFM_fuxd7Gzzqpyd1ZHfXw2TQGWIEvnZ68Ps8kJ75bG76skHJd3WXzmRauLBxqGbLUtrcnHY-vt77OKD2RoLSKBZmKkumUTo5xnGLIFXMu8HIHbMWDKdveCkA-nfy2YPzy9KmYSoI41OeQ81A5WXa08=w150-h200" title="The other new tiny house" width="150" /></span></a></div><p></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">When I saw Tom Holton today at the farmers market, he recognized me right away, even with my mask on. He just saw my eyes and he knew it was me, whereas I knew it was him because he was in the same stall he and his wife have been running at the farmers market since they got married, like, 29 years ago. But I haven’t seen anyone else yet that I recognize. I see people that could be people I might know, but that pretty much counts everybody. In Ithaca looks like someone you might know, but you also know that most people rotate out of here after a few years, so it could be that nobody here is anybody I know! it’s an odd cultural thing that happens here, this rotating citizenry with the University cycles.<o:p></o:p></span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">The other thing that always changes here is that businesses keep moving in Ithaca, so things that you assume will be here are not here. For example, there was a Gimme Coffee on State Street last time I was here, next to a lesbian bar, but no such thing exists now. Or the new business that took over the old women’s bookstore building. Or the fact that a number of the residential houses on Green Street appear to be businesses now, and vice versa. So the house I used to live in on Green Street is unrecognizable to me – could be it’s been torn down, or maybe they painted it, or maybe it’s so rundown I don’t recognize it.<o:p></o:p></span></p><p class="MsoNormal" style="line-height: 16.866666793823242px; margin: 0in 0in 10pt;"><span style="font-family: arial;">They are also really dedicated to renewable energy in Ithaca, like this one building that has 30 solar panels on it just because it can.</span></p><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/a/AVvXsEhzF8Xx2755gFRnqeXJRWS8FYOAw4IuIF_NUfmEq1CfZ-kdjbBv4egcH-Mher3MffHsFtDxRSnn2DbguTSIMRjQyEDbOK8SsfeJzUEqRr0v1WGyw7Die0rybU1COKyYdU0x662t2eJoyeGjn2zuG7Wp2Tf0vwviGz80ZpzUeWr8aNN2y93Edze6E6hw" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><span style="font-family: arial;"><img data-original-height="4032" data-original-width="3024" height="200" src="https://blogger.googleusercontent.com/img/a/AVvXsEhzF8Xx2755gFRnqeXJRWS8FYOAw4IuIF_NUfmEq1CfZ-kdjbBv4egcH-Mher3MffHsFtDxRSnn2DbguTSIMRjQyEDbOK8SsfeJzUEqRr0v1WGyw7Die0rybU1COKyYdU0x662t2eJoyeGjn2zuG7Wp2Tf0vwviGz80ZpzUeWr8aNN2y93Edze6E6hw=w150-h200" width="150" /></span></a></div><span style="font-family: arial;"><br /></span><br /></div></div>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com1Ithaca, NY 14850, USA42.5128688 -76.4983051999999941.705038860995856 -77.59693801249999 43.320698739004143 -75.39967238749999tag:blogger.com,1999:blog-7886866566623237967.post-34742167678407560372022-04-13T13:07:00.005-04:002022-08-22T22:53:44.346-04:00Things that make you FEEL like a failure, but don't MAKE you a failure...<p>We all develop at our own pace. This list echoes the concerns of so many young adults, however, who feel like they are failing relative to society's expectations or what they see their peers accomplishing. Set aside for a moment the truth that we should not compare our insides to other people's outsides because we have no way of knowing what they are really going through.</p><p>Things that don't make you a failure (Reddit user <a class="_2tbHP6ZydRpjI44J3syuqC _23wugcdiaj44hdfugIAlnX oQctV4n0yUb0uiHDdGnmE" data-click-id="user" data-testid="post_author_link" href="https://www.reddit.com/user/qevoh/" style="border: 0px; color: #787c7e; font-stretch: inherit; line-height: 16px; margin: 0px 3px 0px 0px; padding: 0px; text-decoration: none; vertical-align: baseline;"><span style="font-family: arial;">u/qevo</span></a>):</p><div style="text-align: left;"><ul style="text-align: left;"><li>Ending a relationship</li><li>Admitting you need help</li><li>Not owning your own house</li><li>Having a different timeline than others</li><li>Not being married by 30 or 40 or 50</li><li>Taking longer to reach your goals</li><li>Taking a break from a stressful life</li><li>Feeling like you're behind</li><li>Not having your dream job</li><li>Not wanting the same things as everyone else</li></ul></div><p style="text-align: left;"></p><p style="text-align: left;">Many of the achievements referenced in this list assume that we all develop at the same pace - owning your own house, being married by a certain age, etc. While other items that can be construed as indicators of failure - taking longer to reach your goals, having a different timeline, feeling like you're behind - are based on preconceived notions of what development is supposed to look like. But existing models of development may be based on outdated notions, or may be ignorant of the role of trauma.</p><p>I remember taking a human development course in graduate school and learning what the developmental tasks were for each decade of adulthood, according to Erik Erikson's <a href="https://www.verywellmind.com/erik-eriksons-stages-of-psychosocial-development-2795740 " target="_blank">stages of psychosocial development.</a> </p><p>I was 37 at the time, and I realized that up to that point, I had consistently been a decade behind where Erikson said I should be. Now, keep in mind that his stages were developed in the 1930s, and our lives were moving at a different pace 70 years later. But also, I think childhood trauma can create delays according to this model, because Erikson's theory leaves no room for recovery from childhood trauma. </p><p><a href="https://www.ncsl.org/research/health/adverse-childhood-experiences-aces.aspx" target="_blank">Adverse Childhood Experiences</a></p><p>Exposure to more <a href="https://mariabgood.blogspot.com/2020/02/when-it-comes-to-cancer-childhood.html">ACEs</a> leads to higher risk of behavioral and health problems later in life, like:</p><p></p><ul style="text-align: left;"><li>smoking</li><li>alcoholism</li><li>lack of physical activity</li><li>depression</li><li>diabetes</li><li>cancer</li></ul>Those are just the risk factors <a href="https://mariabgood.blogspot.com/2021/06/i-am-work-in-progress.html">I have seen realized</a> in my own life. I think ACEs can also distract a person - to put it mildly - from their own psychosocial development. <p></p><p>For example, I scored a 7 out of 10 on the <a href="https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean" target="_blank">ACEs quiz</a>. I went on to develop an eating disorder, alcoholism, and a penchant for dysfunctional and abusive relationships, by late adolescence, during the time when I was supposed to have been navigating the "identity vs role confusion" stage. </p><p>Which meant I spent my 20s figuring out "identity vs role confusion" when your typical 20 year old was supposedly figuring out "intimacy vs isolation." I didn't get to intimacy vs isolation until my 30s. Luckily, I didn't meet my wife until my mid-30s. By then, my psychosocial development was picking up the pace, so by my 40s I was on track. </p><p>Realizing this explained SO much of my struggles during my 20s and 30s, you have no idea.</p><p>All of which meant that at any time in my 20s or 30s, I could check off almost every item in our original list of things that can make a person feel like a failure. Which could not be further from what I really was back then or what I really am today.</p><p>The moral of our story, then, is that we should not judge ourselves too harshly, or anyone else for that matter, because our biography exerts as much or more influence on our development as society's expectations. And the clue to determining our success lies in that biography.</p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-33601388349822169182021-10-09T12:44:00.000-04:002021-10-09T12:44:54.042-04:00College Friends - Spoiler Alert<p>I'm not sure what possessed me this morning to watch "About Alex." I'm only 1 hour into it, and already I'm tired.</p><p>Somebody obviously thought "The Big Chill" needed a millennial refresh. Or maybe we make a maudlin movie about college friends for every generation in their 30s? And I just thought it was a novel idea when The Big Chill came out, because that's how self-centered you are at 18. And I'm pretty sure there was a Gen-X version, but somehow it's escaping me right now.</p><p>I remember sitting in the big lecture hall in Textor, watching The Big Chill right around this time of year, during our sophomore year at college. There were 3 of us who had gone together, all of us connected in some way to Sally. Me, P, and D. But Sally wasn't there. She was at her Dad's wedding, I think. </p><p>At first, in the opening credits, I didn't understand what had happened. It wasn't until they all started showing up at the church for their friend, Alex's funeral. You see, in The Big Chill, their Alex was successful in his suicide attempt. Not like the Millennial Alex, who survived his. At least, 1 hour in, he has survived it. I haven't watched the rest to find out if he tries again. Don't spoil it for me, I may still watch it.</p><p>Anyway, the rest of the movie seems pretty similar so far... old tensions resurface, people start having sex, pot is smoked, alcohol drunk, people fight, etc. One big difference is they all argue about why he tried, including getting angry at him when he intimates that he may have attempted it to get their attention. There aren't as many players in the cast, and don't get me started on the script or the acting. I can't even. <br /></p><p><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3nP7U_chPTmwRwdloCwik2SzK0VaJgla2mjuyNJDYG5rZvdq2kYl1YMelNPSg_nKSPa7ROq4puIW9V2NFjkv3OlLP2XOXXpYk8jnwI6tUE8BaApBOyPTB8oCphvBwxrwjVbJpw9UxRF8/s320/IMG_3079.jpg" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img alt="Sally pre-1983" border="0" data-original-height="240" data-original-width="320" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh3nP7U_chPTmwRwdloCwik2SzK0VaJgla2mjuyNJDYG5rZvdq2kYl1YMelNPSg_nKSPa7ROq4puIW9V2NFjkv3OlLP2XOXXpYk8jnwI6tUE8BaApBOyPTB8oCphvBwxrwjVbJpw9UxRF8/w320-h240/IMG_3079.jpg" title="Sally pre-1983" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Sally pre-1983<br /></td></tr></tbody></table>But back to 1984. We are watching the funeral scene, and I turn to P and D and I say "thank God Sally's just not here because she's at her Dad's wedding!" To which one of them replies, "Yeah! Right?" And then we watch the rest of the movie. At the time, I thought that somewhere in the distant future, we would all have some kind of college reunion weekend, and wondered what that would be revolving around. Something to do with Sally. I was sure of it. </p><p>I adored Sally, worshiped her even. She was the first person to ever convince me that I was beautiful and lovable. I met her at a frat party first semester freshman year. She "caught my eye" as I was walking over to the keg, smiling that smile with her sparkling eyes, stuck her hand out, and said "Sally Auchincloss." </p><p></p><div class="separator" style="clear: both; text-align: center;"></div><div class="separator" style="clear: both; text-align: left;"> The next time I saw her was at a Bob Weir concert. She was a few rows behind me and my "date" -- I thought we were friends, he thought it was a date, then he got removed from the concert for smoking pot, but handed me his stash and pipe right before they nabbed him. What can I say, life is not fair but sometimes it works in your favor. I digress. As my "date" and I were waiting for the concert to start, I looked around to see who was there, and she caught my eye again, and waved. </div><div class="separator" style="clear: both; text-align: left;"> </div><div class="separator" style="clear: both; text-align: left;">After that, we were constantly together. She lived in the next dorm and I spent every minute I could with her. She wrote me little notes about how great I was; she turned me on to Cat Stevens and James Taylor, but mostly Cat Stevens. We commiserated about bad dates and disappointing boyfriends, we celebrated each other's new infatuations. On Valentine's Day she bought me a single red rose. When we were both dating boys and seeing less of each other that spring, we took a Wednesday off, skipped all our classes, and spent the day walking around downtown. She was a Presbyterian and took me inside the church she was going to to show me the rose window. <br /></div><div class="separator" style="clear: both; text-align: left;"> </div><div class="separator" style="clear: both; text-align: left;">Over the summer, we wrote each other letters about how much we missed each other and how great the other was as a person, about how we couldn't wait to see each other again. I sent her an outline of my hand with the caption "everyone needs a hand to hold onto." When I was reading her letters years later, it occurred to me that these letters were love letters. </div><div class="separator" style="clear: both; text-align: left;"><br /></div><div class="separator" style="clear: both; text-align: left;">That same summer I was also writing letters to my friend W, and I can tell you those letters, even though he and I were on-again-off-again, were so much less romantic than the letters with Sally.<br /></div><p></p><p>(Seriously, I had no idea I was in love with her. Up to that point in my life, all relationships were painful, and I thought that to love someone was to be miserable. W was a good example of that. When we were "just friends" he was the kind of friend anyone would want - loyal, thoughtful, present; but when we "got romantic" he became emotionally unavailable. Plus, I thought I was straight, so I couldn't possible have feelings for a girl. I didn't give up that ghost until I was 22.)<br /></p><p></p><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhc4WavMX4pdFBSmx561M3n9lytqa84GgU9j6pIkwekflAc73esjM6FkI4AUQVZShUSvdNeMoZ40eKfqzKPfVS0y0lvrIo7p4AM3k17xybqRKl1uRgINzPnjSYNArOKuCLUPKLbk9TlmNc/s320/IMG_3074.jpg" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img alt="Me 1987" border="0" data-original-height="240" data-original-width="320" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhc4WavMX4pdFBSmx561M3n9lytqa84GgU9j6pIkwekflAc73esjM6FkI4AUQVZShUSvdNeMoZ40eKfqzKPfVS0y0lvrIo7p4AM3k17xybqRKl1uRgINzPnjSYNArOKuCLUPKLbk9TlmNc/w320-h240/IMG_3074.jpg" title="Me 1987" width="320" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">Me 1987<br /></td></tr></tbody></table>My first day back on campus sophomore year, I saw her on the quad. We had this big running toward each other reunion, and a big hug. But I could feel the change in her energy. She was different. And I was scared, so I backed off, kept her at arm's length. Literally at that moment, but also the rest of that semester. We were still friends, good friends. We still hung out a LOT, but she lived across campus and ate in a different dining hall, and had new friends. And I felt awkward and uncomfortable whenever we were alone together. We never actually talked about it, but everything between us was different. Very soon afterward, she started a relationships with P and admitted to me that she was into girls. And yes, I was jealous, but I could not admit it to myself, let alone to her or P. Did I insinuate myself between them at every possible opportunity when we were hanging out together? Yes, yes I did. Did I have any insight into WHY I behaved that way? No, no I did not.<p></p><p>Then we went home for holiday break in December, and I never saw Sally again. She died in early January. And suddenly we were back on campus planning her memorial service. And our comments during the funeral scene in The Big Chill, and our complete lack of awareness about her health problems at that time, have haunted me ever since.</p><p><br /></p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-33960017737838603462021-06-12T22:06:00.000-04:002021-06-12T22:06:12.440-04:00I Am A Work In Progress<p>I hate my neck. Or, more correctly, I hate my mother's neck, which I have inherited. And with all the video conferences this last year, I cannot get away from it. I doubt anyone else notices, or if they do, they don't care. Why do I even care? Why indulge this vanity? (I remember learning for the first time in my 20s that vanity cuts two ways - obsession with your own beauty, and obsession with your own flaws - and all that time I thought hating my appearance was a good thing?)<br /></p><p>I was driving the other day, listening to P!nk's "I am here," and thinking about how much I hate my neck.<br /></p><p>Chorus:</p><p>I am here, I am here<br />
I've already seen the bottom, so there's nothing to fear<br />
Know that I'll be ready when the devil is near<br />
I am here, I am here<br />
All of this wrong, but I'm still right here<br />
I don't have the answers, but the question is clear</p><p>I've always thought about my history of survival and addiction when I listened to this song - surviving my childhood, surviving foster care, surviving sexual abuse, surviving my eating disorder, surviving my alcoholism. And recovering from all of these things. These are all things I've seen the bottom of, and reasons I know I'll be ready when that devil is near.</p><p>The most recent thing I've survived, of course, is my breast cancer. And this was my train of thought while listening to this song the other day. But then it hit me. I am here. Other people are not. All of it's wrong, but I'm still right here.</p><p>When I was going through chemo, I got caught up with an infomercial about how to get rid of your wrinkles, and I thought, wouldn't it be nice to live so long as to have wrinkles... I swore I would be so grateful to get through this cancer that I would be happy to get old. And I am happy to have that chance. So, why, then am I obsessed with my neck?</p><p>I am still here. Nadine is not here. Karen is not here. Steve is not here. Other Steve is not here. And so on... all lost to cancer, but not me. I won't pretend to know why me and not them; I won't even go down that road at all. There's no benefit to it.</p><p>But I was reminded on that day, and as I have listened to this song every day since, that I am so lucky to still be here, that I cannot indulge in obsessing about how much I hate my neck. I'll keep working on it.<br /></p><p>What vanity would you abandon, for gratitude of being here?<br /></p><p><br /></p>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-60711471740064731662020-02-24T23:37:00.000-05:002020-02-24T23:38:54.431-05:00When it comes to cancer, childhood experiences matter<div class="MsoNormal" style="text-align: left; text-indent: 0.5in;">
<br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">I am a 12 year survivor of Stage I
invasive breast cancer, and a 17 year survivor of non-invasive ductal carcinoma
in situ (DCIS). When I was first diagnosed with DCIS in 2002 and, I confess, again
when I was diagnosed in 2007, I allowed myself a few hours of indulgent, melodramatic,
self-pity – why me? Haven’t I been through <a href="https://mariabgood.blogspot.com/2019/12/december-23-1979.html" target="_blank">enough already</a>? Why do I have to
have cancer, too after <a href="https://mariabgood.blogspot.com/2018/01/foster-kids-and-state-support-for.html" target="_blank">everything else</a>!? I think a lot of people diagnosed with
cancer go through some version of "why me" as we struggle to cope with the
diagnosis and all the fears that come with it.</span></span></div>
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">So many people think that if a
person has been through a lot of adversity in their life, they just shouldn’t
have to go through cancer, too. Where is the justice in that? We all want to
believe that there is a limit to how much pain and suffering one person should
be forced to endure. </span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">Of course, we are learning more all
the time about how these early exposures to adversity actually DO increase our vulnerability to
getting cancer. The evidence is growing that there are strong links between childhood
adversity, in particular, and health problem like cancer in adulthood. When I first heard about the research around <a href="http://adversechildhoodexperiences.net/" target="_blank">Adverse Childhood Experiences</a>,
or ACEs, I decided I needed to learn more. </span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">ACEs have been proven to harm
developing brains, can change how children respond to stress, and can even profoundly
damage our immune systems for decades afterward. ACEs can lead to chronic
diseases later in life, to mental illness, and to high-risk health behaviors in
adulthood. It comes as no surprise, then, to see research that links childhood
adversity and abuse to mental illness, drug addiction, and certain disease,
including cancer. According to the research so far, two-thirds of Americans have
been exposed to one or more ACEs. </span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">So, I had to see, what are these
ACEs, and how many of them did I have when I was a kid. I started by taking the <a href="https://www.npr.org/sections/health-shots/2015/03/02/387007941/take-the-ace-quiz-and-learn-what-it-does-and-doesnt-mean" target="_blank">Adverse Childhood Experiences Quiz</a>,
and learned pretty quickly that I had been exposed to 7 out of 10 Adverse
Childhood Experiences. SEVEN out of TEN.
</span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">Here are the ACEs the researchers
identified:</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpFirst" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">1.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Physical abuse</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">2.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Sexual abuse</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">3.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Verbal abuse</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">4.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Physical neglect – not having enough food or
clean clothes, etc.</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">5.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Emotional neglect – absence of being made to
feel loved or special, or to feel close to other people in your family</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">6.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Witnessing a mother being abused</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">7.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Having a family member in prison</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">8.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Losing a parent to separation, divorce, or some
other reason</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpMiddle" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">9.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;">
</span>Living with someone who is depressed, diagnosed
with a mental illness, or suicidal.</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><br />
<div class="MsoListParagraphCxSpLast" style="margin-left: .75in; mso-add-space: auto; mso-list: l0 level1 lfo1; text-indent: -.25in;">
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">10.<span style="font-feature-settings: normal; font-kerning: auto; font-language-override: normal; font-optical-sizing: auto; font-size-adjust: none; font-stretch: normal; font-style: normal; font-variant: normal; font-variation-settings: normal; font-weight: normal; line-height: normal;"> </span>Living
with someone who is a problem drinker or alcoholic, or who used street drugs.</span></span></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><style><span style="font-family: "Trebuchet MS", sans-serif;"><font size="3">
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ul
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<br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">Learning about ACEs really changed
my perspective about my cancers. If the link between ACEs and cancer is real,
that means that instead of asking “why
me” when kids like me grow up and get cancer, we should be asking “why not me”
when kids like me grow up and do NOT get cancer. </span></span><br />
<div class="MsoNormal" style="text-indent: .5in;">
<br /></div>
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">In addition to my cancers, I also
have a history of alcoholism and anorexia, and am now dealing with chronic
health conditions some which can potentially be the result of cancer treatment
or lifestyle choices that I have made. There’s always the chance, based on this
research, that many of my health concerns can be linked to ACEs. Which does not
mean that I, or any of us, should just throw up my hands and say, “look, I can’t do anything
about this, it’s inevitable!” </span></span><br />
<br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">Instead, I think this means that we have to fight
twice as hard, to counteract our history, if we want to overcome our childhoods and live a long and healthy
life.</span></span><br />
<br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">Which I do. </span></span><br />
<span style="font-family: "trebuchet ms" , sans-serif;"><span style="font-size: small;">
</span></span><style><span style="font-family: "Trebuchet MS", sans-serif;"><font size="3">
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<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1uUPfJGcA5PwdNwnws3HwwbccQq9Qc5BIjWzQklk8nhyphenhyphenvKAfR-N9NaXkO1mboHcJhPaYx5os7p67ZS4LTvzyJC5AMxN6ZUw-rou6UisHfcAjGKWWHwz_dS3xl8bfTAvK37KhYc2bAujs/s1600/Age+17.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="414" data-original-width="414" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEi1uUPfJGcA5PwdNwnws3HwwbccQq9Qc5BIjWzQklk8nhyphenhyphenvKAfR-N9NaXkO1mboHcJhPaYx5os7p67ZS4LTvzyJC5AMxN6ZUw-rou6UisHfcAjGKWWHwz_dS3xl8bfTAvK37KhYc2bAujs/s320/Age+17.jpg" width="320" /></a></div>
<br />
I say he made the choice on this date, but he really made the decision to follow this path months before. First though, he had to groom me, which took awhile. He had to test me by disclosing increasingly inappropriate secrets to see if he could trust me to be silent, obedient. Took me with him to places I should not have gone, and told me not to tell my foster mother. Told me personal stories, and asked me to keep them confidential. Said things and did things that I should have reported to my social worker or my foster mother, but swore me to secrecy, and waited to see if I could be trusted. Fed me alcohol at family functions, and waited to see if other adults would challenge him or if I would tell other adults where I got it.<br />
<br />
After months of testing and grooming, I was sent to his home to babysit while he and his wife were out at 2 different activities. He came home first, asked for help wrapping gifts for her, fed me wine while I was wrapping them. After a couple glasses of wine, he acted on his decision.<br />
<br />
It started like a seduction, if you want to call a 28 year old man molesting a 14 year old girl "seduction." Nothing violent, nothing intrusive, nothing like the events he would escalate to over the next year and sustain until I was 17 and leaving for college. The first evening was confusing, a mix of gentle kindness, talk about my need for "instruction in sex" and inappropriate intimacy. Leaving me anxious, nauseous, confused and afraid. Swearing me to secrecy, a secrecy that knotted my stomach and left me unable to eat for 3 days.<br />
<br />
Three days in which family and friends descended on my foster mother's home, making privacy and alone time impossible. Three days in which I became entirely invisible to any of the adults around me. Three days in which I was scolded for not eating, but in which no other adult in my life had the presence of mind to ask what happened to make me unable to eat. Or they didn't want to know. Three days in which he fed me alcohol and nobody noticed or they chose to look the other way. Three days in which he grabbed at my butt or my breasts in rooms full of other adults and nobody said anything. Three days in which he made dirty and inappropriate comments to me in earshot of other adults and everybody laughed at my embarrassment.<br />
<br />
Three days to solidify a pattern of ownership over my physical and mental self, with noone to defend me or challenge his behavior. And three days for me to establish a pattern of coping through starvation and alcohol use.<br />
<br />
Three days to alter the course of my life forever. It took me ten years to finally ask for help, to address my eating disorder, to get sober. Forty years later, and his choices, and the choices of the adults responsible for my safety and well-being, still haunt me.MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-69053190621450742082019-07-31T23:39:00.001-04:002019-07-31T23:45:40.162-04:00What kind of person would I be if I wasn't ...... born into poverty, would I have compassion for the poor?<br />
... born to mentally ill parents, would I have compassion for the mentally ill?<br />
... female, would I have compassion for women who need access to affordable reproductive healthcare? Would I be pro-choice?<br />
... the daughter of an Irish immigrant, would I have compassion for immigrants from other countries? <br />
... a lesbian, would I have compassion for people in the queer
community? Asexual people? Trans people? Non-binary gendered people?
Genderqueer people? For people in other minority groups?<br />
... a foster child, would I have compassion for young people struggling in that system? For young people struggling as they age out of the system?<br />
... bullied in school, would I have compassion for the underdog? <br />
... physically and sexually abused as a child, would I have compassion for child abuse victims and survivors of childhood sexual abuse?<br />
... raped, would I have compassion for rape victims? <br />
... someone with an eating disorder, would I have compassion for people struggling with eating disorders or food addiction?<br />
... an alcoholic, would I have compassion for the addicted?<br />
... sober, would I have compassion for people struggling to stay clean and sober?<br />
... a caregiver to parents with dementia, would I have compassion for people with dementia and their caregivers?<br />
... a breast cancer survivor, would I have compassion for people without adequate health insurance? Without access to adequate healthcare? Living with a pre-existing condition?<br />
<br />
We are the product of our environments and life experiences, and I know that I have relied on and benefited from the compassion of others as I faced all of the challenges stemming from these different aspects of my identity, my childhood, my adult life.<br />
<br />
I would like to believe that had I lived a different life, I would still be compassionate and know right from wrong on all of these issues, but what if that wasn't the case? Every moral, social and political value that I hold dear is rooted in my experiences with different kinds of oppression, with the consequences of being neglected and abused as a child, with facing my own mental health issues, eating disorders, addictions, breast cancer, and the resulting chronic health concerns resulting from these experiences. All of my choices are the result of my experiences. But is that the only thing that makes us who we are?<br />
<br />
I am surrounded by people who have not had all of these experiences, who are just as or more compassionate as I. But there are also people in this world who have many of the same experiences who do not seem as compassionate.<br />
<br />
What IS it that makes us compassionate? What is it that makes YOU a compassionate person?MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-53410138484210915112019-02-03T14:39:00.000-05:002019-02-03T14:39:37.141-05:00Think locally, act locally... to rescue abused and neglected animalsThe ASPCA has such heart-wrenching commercials. Absolutely heart-wrenching. They are designed to make you feel guilty if you don't send them money. <br />
<br />
But what do they do with the money you send them? <br />
These commercials seem to be focused on raising money for a national organization to rescue abused animals. But most of what they raise isn't spent on the animal rescue efforts they highlight in these commercials. In fact, they spend almost $40 to raise every $100. And about $35 of that $100 on administration and overhead. Which is why charity watchdog organizations give the ASPCA only a C+ rating. Additionally, the ASPCA has a long and conflicted history, none of which is reflected in these commercials, and they <a href="https://www.activistfacts.com/organizations/american-society-for-the-prevention-of-cruelty-to-animals-aspca/" target="_blank">may not even be that focused</a> on the animal rescue and cruelty prevention that they advertise as their main purpose. They may also be <a href="http://johnsibley.com/2012/09/14/aspca-rescue-by-killing/" target="_blank">killing animals</a> rather then rehabilitating and rehoming them.<br />
<br />
And where do they operate? <br />
They appear to be a national organization, but focus most of their work in the New York City area. And although they may provide links on their website to local shelters in your area, very little (if any) of the money they raise is sent to those shelters.<br />
<br />
Other national animal charities have a higher rating. If you are really motivated to donate to a national animal charity, your money might be better spent by A+ rated <a href="https://www.charitywatch.org/ratings-and-metrics/petsmart-charities/595" target="_blank">PetSmart Charities</a>. PetSmart spends 93% of the money it raises for programming, and every additional $100 raised only costs them $4. However, your money may be better spent donating pet food and supplies to local PetSmart stores, who give those donations to local animal shelters. Or adopting the rescue animals that you can find in their local retail locations.<br />
<br />
Or, you might want to donate to your local animal shelters or SPCA organization. For me, that's organizations like the <a href="http://www.cnyspca.org/" target="_blank">Central New York SPCA</a> or the <a href="http://www.humanecny.org/" target="_blank">CNY Humane Society</a>. This local organization is NOT related to the ASPCA, so your money stays local, your aid goes to local animals. Donating to your local organization can also mean you have more control over how they spend your money. You can visit or volunteer at the local shelter, and see first-hand how they treat the animals in their care. You can donate food and other supplies, or items on the shelter's wish list, instead of cash, if you want to make sure your donations are going directly to animal care. And, of course, you can rescue animals yourself by adopting them from your local shelter.MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com1tag:blogger.com,1999:blog-7886866566623237967.post-89962584705349659782019-01-04T12:26:00.001-05:002019-01-04T23:05:57.216-05:00Just Exactly HOW Does Someone Overcome Poverty? It's Not Easy.<div data-contents="true">
<div class="" data-block="true" data-editor="90fir" data-offset-key="1uq0b-0-0">
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
<span data-offset-key="1uq0b-0-0"><span data-text="true">I saw a post on Facebook today about how it is <a href="https://www.facebook.com/TrendingFuss/photos/a.156978354495506/684729871720349/?type=3&theater" target="_blank">virtually impossible</a> to save money when you are poor. It reminded me of a book review I read last year that argued that for someone living in poverty to lift themselves out of poverty, they need <a href="https://www.theatlantic.com/business/archive/2017/04/economic-inequality/524610/" target="_blank">nearly 20 years with nothing going wrong</a>. </span></span><br />
<br /></div>
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
</div>
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
<span data-offset-key="1uq0b-0-0"><span data-text="true">I remember - having grown up on welfare and then in foster care - how difficult it was to gain financial traction in my early and mid 20s, and to finally leave poverty behind me in my 30s. And now in my 50s, I still live with a very real, although more and more faint, fear of falling back into poverty, especially in old age. I think once you have been poor, you just never forget how it felt. You might be more equipped to cope with poverty again as opposed to someone who has never been poor, but you also know you never want to be in that position again because you know how hard it is to live in, and to overcome poverty.</span></span><br />
<br /></div>
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
</div>
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
<span data-offset-key="1uq0b-0-0"><span data-text="true">Multiple things - some positive, some negative, some resulting from my own efforts, some a matter of good fortune, helped me climb out of poverty in those 15 years after college. Not the least of which is the color of my skin, because White privilege gave me access to understanding, support and assistance from friends, landlords, employers, loan officers, etc. that I might not otherwise have had.</span></span><br />
<br />
<span data-offset-key="1uq0b-0-0"><span data-text="true">The more I wrote about this, the more I remembered about the events that facilitated my overcoming poverty. It's complicated. There are actually many, many details that I am not including here (like how many times I moved during those years, or how many roommates I lived with so I could afford rent, etc.), but I think this will give you a pretty good picture of how overcoming poverty, at least for me, was a combination of education, good and bad fortune, hard work, and the emotional and financial support of other people: </span></span></div>
<div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
</div>
<ol>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">My first job out of college at age 21 was walking distance from my apartment, so I didn't have any transportation costs for the first 3 years on the job, which helped me save up for a down payment on my first used car at age 25. Even then, I could only buy that car after a friend promised me that I could live with her if I became homeless because I couldn't keep up with rent, student loans, AND car payments. I never had to take her up on that promise, but I needed the security of it to take what felt like the huge risk of taking on car payments.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true"><span data-offset-key="1uq0b-0-0"><span data-text="true">I worked
full-time in a corporate setting where I had access to health insurance
and paid time off benefits. And where I was able to start saving,
however slowly, for retirement through a 401k. And I was lucky enough to
stay with that corporation for 13 years, and to advance in
responsibility and income over that time. Stable employment and
advancement in employment are a MUST if you are going to overcome
poverty or become and remain financially stable.</span></span></span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">My landlord for my first apartment was also my landlord my senior year in college. I graduated from college 5 months behind in rent to her, and she allowed me to set up a payment schedule to make up that debt while paying rent on the new apartment.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">During my first year on the job, I moonlighted as a bartender, and the tips from that second job helped me pay my landlord that back rent and also save money for rent and security deposit for a new apartment. </span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">My landlords for that new apartment were VERY flexible about my paying rent on time and not charging me late fees. Which was helpful because I got paid weekly and lived from paycheck to paycheck. So some months I had to delay my rent check by a week so that I could make my student loan payment on time. And anyone who has ever been poor knows how late fees can be the bane of your existence, keeping you from getting ahead of your debt no matter how hard you are working.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">That second job </span></span><span data-offset-key="1uq0b-0-0"><span data-text="true"><span data-offset-key="1uq0b-0-0"><span data-text="true">also resulted in my getting sick often that year,
which ultimately cost me that second job and extra income. However, I
had insurance to get medical care and paid sick time from my day job, so
I didn't lose any of THAT income when I was sick. </span></span></span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true"><span data-offset-key="1uq0b-0-0"><span data-text="true">There were multiple providers in my town that offered sliding fee scales for care - like the therapist I needed for several years to cope with childhood trauma, or Planned Parenthood, which was my only affordable provider of OB/GYN care during my 20s. And my primary care provider, who was willing to prescribe antibiotics over the phone for my *many* bouts of sinus and respiratory infections during those years, so that I didn't have to come up with copays every time I got sick.</span></span></span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">Being
anorexic (from age 14 to 28) meant very low food bills, so I never had
to choose between eating and making student loan payments or paying rent
or making car payments. Thus helping me to avoid catastrophic financial
setbacks, although also contributing to my lack of stamina in terms of working second jobs and my tendency to get sick.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">My first car was a used car, and I had an honest mechanic who accepted payment over time for major maintenance. For example, when my car died outside of Scranton, NJ, and he had to come and tow me back, he let me pay for the tow and the subsequent repairs over time. And he fixed the car just enough that I could trade it in for another car.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">My second car, at age 28, was the smallest, most stripped-down new car for which I could afford payments, thus reducing the risk of catastrophic car problems. And it was this car that enabled me to keep my job when the office moved out of our downtown location to a more rural setting.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">And actually it was a car accident in that new car, and a small insurance settlement from that accident, that enabled me to build up enough savings to qualify for a mortgage on my first little house at age 32. And again, I had health insurance and paid sick time to cope with the back problems that resulted from that accident, and which also led to that insurance settlement. </span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">I was still poor enough to qualify for a subsidized second mortgage to help with the down payment and closing costs for the house, and the house and accompanying mortgage payments were small enough that I was actually able to start saving money on housing costs after purchasing the house. </span></span><div class="_1mf _1mj" data-offset-key="1uq0b-0-0">
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<span data-offset-key="1uq0b-0-0"><span data-text="true">I
would say that it was the purchase of that little 700 square foot
bungalow that marked my exit from poverty. The challenge then was to
stay out of poverty.</span></span></div>
<span data-offset-key="1uq0b-0-0"><span data-text="true"> </span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true"></span><span data-text="true"></span></span><span data-offset-key="1uq0b-0-0"><span data-text="true">When I sold this house 3 years later, I had improved upon it enough, and the market had gone up enough, to make a small profit on the sale. Which resulted in my having more savings after selling it than I had from the car accident settlement when I bought it.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">By then, I was in a stable relationship with a fiscally responsible and non-poor partner, so we could take the profit from this house and invest some of it in improvements to the house that she owned and that I was now living in with her. And the rest could be kept as savings and a cushion against emergent needs in the future. This was a luxury and a sense of security that my always-poor parents never had.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">I did not encounter my first breast cancer until I was 35/36 (my second was 5 years later). By then, I was financially stable because of that first house, and I had the financial support of my partner to help with my cancer-related costs. And health insurance, and paid time off. The importance of these benefits cannot be overstated. My total bill for radiation therapy for my first cancer - just radiation therapy alone, this does not include the multiple biopsies and surgeries for that cancer - was over $15,000.00. However, the portion for which I was financially responsible was only $700. If I had to pay that full bill and the bill for all of the procedures and surgeries out of pocket, it would have exhausted our combined savings and perhaps even required me to take out a personal loan or borrow money from my 401k.</span></span></li>
<li><span data-offset-key="1uq0b-0-0"><span data-text="true">Finally, I had my savings from that home sale and the financial support of my partner, both of which enabled me to go to graduate school after recovering from my first cancer, at age 37.</span></span></li>
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<span data-offset-key="4ltsa-0-0"><span data-text="true">As you can see, it was a combination of fortuitous and not-so-fortuitous life events that helped me overcome poverty. Not everyone is as fortunate as I have been.</span></span><br />
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<span data-offset-key="4ltsa-0-0"><span data-text="true">For example, owning a car can enable you to find a better paying job, which could be the first step out of poverty. However, if you are poor and own a car, it is probably a used car (because poor people cannot afford or do not have credit ratings to finance affordable new cars). Used cars require more maintenance and are at greater risk of breaking down. If you are forced to buy another car because your current used car has broken down more than once, and you need that car to keep your better job, then any money you have accrued from your better paying job could be lost to that one catastrophic event, which means it will take longer to get out of poverty. </span></span></div>
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<span data-offset-key="6226i-0-0"><span data-text="true">Similarly, many lower-income workers work 1 or 2 or even 3 jobs to make ends meet or, if you're lucky, to start saving money. Usually the poor need multiple jobs because most employers (think retail, food service, manual labor, "unskilled" labor, etc.) restrict hours to avoid providing benefits like health insurance and paid time off. Working multiple jobs, none that offer health insurance, exposes workers to higher levels of stress, increasing the likelihood of getting sick. Getting sick without access to paid time off means losing income from all of your jobs. And without health insurance, getting sick can also drain your finances if you need medical care. So any extra money you had been making is lost, which means it will take longer to get out of poverty. And if you have a catastrophic illness like cancer, you may never get out of poverty.</span></span></div>
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<span data-offset-key="b175j-0-0"><span data-text="true">If you take the time to consider it, I'm sure you can see how life events that don't derail the finances of the non-poor can be devastating if you are poor. Whether they were born into poverty or ended up there because of catastrophic events in their lives, it's this understanding that people in poverty need. It's this understanding that can inform our political support for safety net programs and ensure access to services and supports that address these risks and enable people who are poor to one day overcome poverty.</span></span></div>
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MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-63786976380015257692018-06-13T12:56:00.001-04:002018-06-13T13:40:57.808-04:00World Elder Abuse Awareness Day and Reaching Out to Socially Isolated Older AdultsJune 15th is World Elder Abuse Awareness Day - the National Council on Aging is working to raise awareness about the different <a href="https://www.ncoa.org/blog/shining-spotlight-elder-abuse/?utm_source=newsletter&utm_medium=email&utm_campaign=06122018_NCOA%20Week" target="_blank">kinds of abuse </a>that older adults experience.<br />
<br />
Most cases of elder abuse are unreported and untreated. A <a href="https://www.ncbi.nlm.nih.gov/books/NBK98802/" target="_blank">report </a>on elder mistreatment from the National Institutes of Health estimates that only 1 in 14 cases of elder abuse are reported. That's less that 10%.<br />
<br />
Lately, I have been interviewing service providers in my area who work with older adults, and they are confirming what we see in the literature about elder abuse. That the most prominent factors that put seniors at risk of abuse are <a href="https://www.ncoa.org/blog/how-to-fight-loneliness-seniors-this-holiday/" target="_blank">social isolation</a> and mental impairments like dementia.<br />
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Nationally, in about half of reported incidents of elder abuse and neglect, the person responsible for the abuse is a family member, usually a spouse or adult child. The research also indicates that the abusing party is often the only source of care or support the victim has, and so they are reluctant to tell anyone what is happening, for fear that the will lose that relationship and end up completely alone or in a nursing home. This is certainly what my interviews are reporting so far.<br />
<br />
So, how do we identify older adults around us who are socially isolated, and how do we break that isolation? The National Council on Aging suggests 4 <a href="https://www.ncoa.org/blog/how-to-fight-loneliness-seniors-this-holiday/" target="_blank">steps</a>:<br />
<br />
1. increase communication with isolated older adults - if they are family, reach out to them more than you have been; if they are neighbors, make an effort to get to know them, invite them out for coffee or a meal, or ask if you can help them with yard work or accompany them on a walk; engage other neighbors in reaching out to them as well<br />
<br />
2. offer to accompany them to social activities at a local church or senior center<br />
<br />
3. explore their interests and hobbies - are they a gardener? maybe you can ask their advice about your garden or invite them to help pick out plants for you at a local garden center; are they a reader? you can ask them to join a book club with you;<br />
<br />
4. help them identify opportunities for support whenever they need it - if they are online, they can access a <a href="https://www.inspire.com/groups/mental-health-america/" target="_blank">support community</a> through Mental Health America; if the prefer talking on the phone, give them the number for The Friendship Line: 1-800-971-0016. This is a nationwide 24/7 warmline and also a crisis intervention hotline, that specifically serves older adults or adults living with disabilities. They also reach out to their callers on a regular basis, to monitor their health and well being.<br />
<br />
In addition to these ideas, you may want to reach out to the person or persons who are caring for an isolated older adult. Sometimes they are just as isolated, and it is that stress and isolation that can lead to some kinds of elder abuse.<br />
<br />
If they are family, what can you do to assist them in caregiving? Are there ways you can offer them respite, or time off from their caregiving responsibilities? Can you stay with the older adult while they take time for themselves or run personal errands? Is there a way to help them take a vacation? Can you connect them with services through your local Office or Aging or Alzheimer's Association chapter? Perhaps they would benefit from learning about challenges faced by other caregivers - this can be accomplished by attending a caregiver support group relevant to their loved one's condition, or they could access online resources like Caregiver Matters of CNY, where I provide <a href="https://www.facebook.com/CaregiverMattersCNY/" target="_blank">links </a>to articles and resources related to caregiving, or <a href="https://www.youtube.com/channel/UC_20I34JgQyMsElWYPPAe9g" target="_blank">videos </a>about issues faced by caregivers.<br />
<br />
If they are not family, perhaps you can introduce yourself to them as a neighborly resource, interested in helping them and their loved one. Offer to put some of the above ideas in place for their loved one, or ask them if there is anything specific that you can do for them. Maybe you can help with mowing the lawn or shoveling their snow; perhaps you can offer to check in on grocery days to see if they need anything from the store. After establishing trust by proving yourself to be reliable and consistently engaged, you may be able to offer them opportunities for respite as well.MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-39220778707170806272018-04-29T00:24:00.000-04:002018-04-29T00:24:02.860-04:00Who Said Life Was Fair?Nobody who has ever had cancer, that's for sure. Or who has loved someone who had cancer. Or lost someone to cancer.<br />
<br />
Today I found out that a friend who has been incredibly successful at surviving longer than medicine originally predicted he would may not be with us much longer... <br />
<br />
I don't know why some of us get cancer and some do not, or why some who get cancer get to have a "curable" cancer and others do not. Or why good people die and bad people don't, or some people with children and grandchildren to love and watch grow die, and some do not. I have lost a beloved mentor to the same cancer I had, I have lost friends to the same cancer I had, and I don't know why I was able to survive it and they were not. <br />
<br />
Everyone diagnosed with cancer, any cancer, is given their odds - odds of a cure, odds of survival, odds of recurrence. Odds. Statistics. Numbers. Numbers that may mean something, or may not. And you have a choice, fight the odds or believe that they dictate your future. Statistics may not reflect individual experience. Unless they do.<br />
<br />
After my first biopsy in 2002, I was given excellent odds - very small chance that the atypical tissue they found would be breast cancer. Except that it was. Early stage, DCIS, but there it was. Once you have DCIS, you are at risk of getting it again. But not necessarily of getting invasive cancer. Unless you do. Which I did in 2007. Again, the odds of getting it were lower than the odds of not getting it, but the odds betrayed me. Now, I live with incredibly small odds of recurrence, and because I did everything I could to lower even those small odds, according to the medical understanding at the time, I work at training my brain not to worry about it.<br />
<br />
I think most of us, when first diagnosed, feel hopeless. Maybe we believe the odds are too great. Maybe we consider the treatment too frightening. The future in front of us is suddenly uncertain, or we are just painfully aware of how uncertain the future really is. What if we can't beat it? What if we can? What if it comes back? What if it doesn't?<br />
<br />
When my friend was first diagnosed, he almost didn't fight because he was told his odds of survival, even with treatment, were incredibly low. But then he decided to fight, for his kids, for his wife, for their future. Treatment made him so sick, he almost gave up. But then he didn't. And after months of chemo and radiation, he bought himself years of survival that the statistics said he would not have. <br />
<br />
Some of us beat it, and some of us don't. There is no way to know which we will be. And beating it once doesn't mean it won't come back or that you will beat it again if it does. Some people who develop late stage or metastatic disease can enjoy long periods of remission after treatment, but not everyone. And nobody seems to be able to predict who will fall into which group.<br />
<br />
For the patients and their loved one, this uncertainty can be unbearable. Or you find a way to bear it.<br />
<br />
And then some other damn thing like an infection finds it's way in to your body because of the treatment that has been keeping you alive. And there it is. Suddenly you are losing the fight, and it's the fighting that makes you lose. You can follow all medical advice, and take every possible precaution, and there's nothing you can do to predict if or how it will happen. It ambushes you, it ambushes your family. All are powerless in the face of it. No matter how brave you are, or how determined, or how loved, or how worthy. Even knowing this a disease that can kill you, there is no way to really be prepared for losing the fight. It's maddening, maddening and heartbreaking. <br />
<br />
It is heartbreaking knowing that the world is going to lose someone who is a good person, who has children and (soon) grandchildren to love and watch grow up, who has fought bravely and beaten horrible odds to live this long. Heartbreaking and infuriating. And unfair.MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-40916330935973768972018-01-30T13:45:00.000-05:002018-01-30T13:45:50.891-05:00Foster Kids and State Support for Tuition<div data-contents="true">
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<span data-offset-key="4b400-0-0"><span data-text="true">Wisconsin aims to become the 29th state to offer some form of <a href="https://thinkprogress.org/wisconsin-free-tuition-foster-kids-505bb7814902/" target="_blank">tuition support to foster youth</a>.</span></span></div>
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<span data-offset-key="4b400-0-0"><span data-text="true">I hope they are able to pass the legislation. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3969135/" target="_blank">Research </a>shows that between 31% and 46% of foster kids experience some period of homelessness between "aging out" of foster care at 18 and their mid-twenties. They either live on the street, in homeless shelters, or "couch surf" in their friends homes. </span></span></div>
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<span data-offset-key="4b400-0-0"><span data-text="true">College gives foster kids (my siblings and I entered foster care system when I was 13) a chance to develop as independent young adults, to be competitive in the job market, and in many cases, to rise above the poverty we grew up in. According to the <a href="https://www.ecs.org/" target="_blank">Education Commission of that States</a>, there are now <a href="https://www.ecs.org/50-state-review-tuition-assistance-programs-for-foster-youth-pursuing-postsecondary-education/" target="_blank">28 states</a> that offer foster kids varying levels of financial support for college (tuition waivers, grants, or scholarships), and New York is one of them through the Foster Youth College Success Initiative established by <a href="https://www.nysenate.gov/legislation/laws/EDN/6456" target="_blank">McKinney's Education Law section 6456</a>. This bill provides grants to SUNY schools (and CUNY schools in the NYC area) to cover tuition, fees, books, transportation, housing, and summer college prep, including advising, tutoring and academic assistance. So financial and academic support, to better ensure their success.</span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">These supports were not available when I graduated from high school in the early 1980s. The rare foster kids who dared pursue a college education (of the 75 kids who lived with my foster mother during her career as a foster parent, only 3 of us went to college, and only my brother and I graduated from college) back then had to make our own way. Our family was rare; three of us were still in foster care when we graduated from high school and we all went on to college. All of us relied on some combination of scholarships, financial aid, student loans to pay for school. </span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">To apply for financial aid back then, foster kids had to provide financial data from their parents, even if they had no relationship with them or access to that information or access to those resources. In my case, my parent's poverty helped me get some financial aid I might not otherwise have gotten, so it worked in my favor that I had enough of a relationship with them to get that information. But they only gave me a total of $75 towards my college expenses, so not much financial support there.</span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">I was 17 when I graduated high school, so unlike many foster kids, I would have been able to continue in foster care until the next fall when I turned 18. That might have been enough time to get a job and save some money so I could afford a place to live, but for many foster kids, it isn't enough. Which is how they end up homeless or in jail. However, I didn't have to find out what would happen to me if working and being on my own at 18 was my only option, because I was able to go to college. </span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true"><span data-offset-key="7jg00-0-0"><span data-text="true"><span data-offset-key="7jg00-0-0"><span data-text="true"><u>The Big Breaks That Allowed Me To Succeed</u></span></span></span></span></span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true"><span data-offset-key="7jg00-0-0"><span data-text="true"><span data-offset-key="7jg00-0-0"><span data-text="true"></span></span></span></span>Because I went on to college, my Medicaid coverage was extended from my 18th birthday until my 21st birthday, and my foster mother got her monthly stipend for my room and board until I was 21. Legally, that money was hers, but every month college was in session she deposited it into a shared checking account so that I could use it for expenses at school.<u> My first, and perhaps most important, big break.</u> Without that extra money, I don't know what I would have done. And because she was still getting that stipend, she also allowed me to continue to stay with her during college breaks and summers, although I had to bring everything I owned with me back and forth to school, or store it in a barn while I was away. And everything stored in that barn became water-damage by my junior year.</span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">I turned 21 during the fall of my senior year of college, and that's where my health insurance and my foster mother's support stopped. I had minimal coverage through the health center on campus, so I didn't really notice the loss of health insurance. But without that monthly stipend, I had to pick up a second job to help cover my rent. I was already doing 20 hours a week at a work study job. The second job did not last; it was too much to keep up with school work and my first job, my social life, and also get enough sleep, so I was fired for missing a mandatory, unpaid staff meeting at the second job on one of my days off. Retail - horribly abusive to their employees. As a result of not being able to manage a second job, I fell behind in rent. </span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">My <u>second big break</u> was that two of my brothers were able to loan me some of the money I needed to keep up with my rent the first half of senior year. Even so, by the end of senior year, I was five months behind in rent. </span></span></div>
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<span data-offset-key="7jg00-0-0"><span data-text="true">This was where I got my <u>third big break</u> - my landlord let me carry that debt until I had a full-time job and could pay her back. She even rented to me again for the</span></span><span data-offset-key="7jg00-0-0"><span data-text="true"> following year, deferring the required first month's rent and a security deposit until I found a job, so that I had somewhere to live after graduation. I paid her back in full as soon as possible that first year.</span></span></div>
<div class="_1mf _1mj" data-offset-key="7jg00-0-0">
<span data-offset-key="7jg00-0-0"><span data-text="true"> </span></span></div>
<div class="_1mf _1mj" data-offset-key="7jg00-0-0">
<span data-offset-key="7jg00-0-0"><span data-text="true">Without these big </span></span><span data-offset-key="7jg00-0-0"><span data-text="true">breaks, I don't think I would have finished school or had anywhere to live senior year. In other words, I would have become homeless. And that possibility was always there in my mind during my early 20s, when I was living paycheck to paycheck, paying back my debts from senior year, and barely scraping by. But instead, because a handful of people were willing to provide needed financial support, I was able to finish school and find a job, and become successful.</span></span></div>
<div class="_1mf _1mj" data-offset-key="7jg00-0-0">
<span data-offset-key="7jg00-0-0"><span data-text="true"><br /></span></span></div>
<div class="_1mf _1mj" data-offset-key="7jg00-0-0">
<span data-offset-key="7jg00-0-0"><span data-text="true">And now, in 28 states across the country, foster kids have a chance to do just that, without having to hope that the people around them will come through in a crisis. This is good news for foster kids in those 28 states, but we need the rest of the country to catch up.</span></span></div>
</div>
</div>
MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-6905426673800401572017-01-05T13:41:00.003-05:002017-01-05T13:41:51.131-05:00Balancing Survival and Serenity in Trying Political Times - How Are YOU Doing it?<span data-offset-key="1mptv-0-0"><span data-text="true">What is the balance between awareness and resistance, which seem necessary for survival, and peace of mind, also necessary for survival? Any ideas? I'm open to comments!</span></span><br />
<br />
<span data-offset-key="1mptv-0-0"><span data-text="true">In A.A. we often talk about accepting that you are powerless (over alcohol, over other people's actions, over the future), doing the footwork, and not projecting about future outcomes. So, do what you need to do next to achieve a goal, but don't worry about whether that goal will be achieved. </span></span><br />
<br />
<span data-offset-key="1mptv-0-0"><span data-text="true">Just as I have always had to be vigilant about my sobriety, however, I feel that I need to be vigilant about tyranny, like a President who believes he can violate the Constitution to suit his own financial gain and a Congress that appears to support that behavior, and political maneuvering to strip vulnerable Americans of basic protections, like freedom of speech, the right to dissent, and access to affordable healthcare.</span></span><br />
<br />
<span data-offset-key="1mptv-0-0"><span data-text="true">Sobriety happens one day at a time. You cannot be sober on Saturday night if it's only Thursday morning; you can only be sober on Thursday morning. But you can plan to be somewhere Saturday night that doesn't put you at risk of drinking, and you can coordinate with someone </span></span><span data-offset-key="1mptv-0-0"><span data-text="true"><span data-offset-key="1mptv-0-0"><span data-text="true">who will respect your sobriety </span></span>on Thursday morning to be there with you on Saturday night. Do the footwork with the intention of staying sober on Saturday night, but not project about how Saturday night will turn out.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">That approach I understand, and after all these years it's like second nature. I don't drink, I don't plan to drink, but I do that one day of sobriety at a time.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">All of the steps, principles, and suggestions of A.A. should be transferable to any life problem, concern, event, relationship, job, and usually they work for me no matter what the situation. My dissertation? Write it a day at a time, have a deadline for finishing a draft, don't think ahead to that deadline, just decide what you need to get done today to move in the direction of the goal. When my Dad was on Hospice? Monitor the situation one day at a time, do or say whatever you need to today in order to be at peace with him and within yourself , and to make sure that he is getting good care, so that when the day comes you have minimal regrets. But know you cannot predict that day or really know what it will be like until it arrives. </span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">I'm not perfect at it, and some days it is harder than others, but most days I can "work my program" so that I am accepting life on life's terms, taking whatever actions I need to, and feeling generally calm and able to enjoy life.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">So, then, I should be able to apply these principals to the transition from my favorite President of all time to someone who I believe is a liar, a con artist, and a threat to democracy and the civil rights of most Americans. But so far, I haven't been able to do that. Every day, there is something more outrageous than the last, more appointees who would <a href="http://www.nytimes.com/2016/12/09/business/dealbook/goldman-sachs-no-2-seen-as-a-top-economic-adviser-to-trump.html?_r=0" target="_blank">shred consumer protections</a> and corporate regulations; blatant indicators that Presidential favors are <a href="http://www.teenvogue.com/story/trump-mar-a-lago-conflict-of-interest" target="_blank">for sale</a> on an unprecedented level; attempts to undermine the <a href="https://www.yahoo.com/news/house-gop-guts-office-congressional-160439893.html" target="_blank">Office of Congressional Ethics</a>; proposed legislation to <a href="http://www.huffingtonpost.com/entry/security-embassy-benghazi-jerusalem_us_586d61f8e4b0b949393baead?section=us_politics" target="_blank">cut security for US embassies</a> after years of being obsessed with Benghazi, when security had been underfunded by Congress but the outcomes were blamed on the State Department; reviving <a href="http://federalnewsradio.com/congress/2017/01/blast-past-house-reinstates-rule-targeting-agency-spending-employee-salaries/" target="_blank">archaic rules</a> from the 1800s that allow Congress to devalue Federal workers and agencies on a whim; or the Senate beginning the process to <a href="https://www.yahoo.com/news/capitol-hill-showdown-battle-over-185400394.html" target="_blank">repeal the Affordable Care Act</a> without a plan to replace it.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">Every time I choose to pay attention, it takes only minutes for my head to start spinning with anger, apprehension, and anxiety. But when I choose to look away, it is with the knowledge that even more outrageous things ARE happening or COULD BE happening, and I dread being taken unawares. It's sort of like the last few years of my Mom's life, when I would take a break from paying attention to the daily details of her care, only to be called while away on vacation because she had a fall or an ER visit or some other crisis; so I never really stopped worrying about her even if I wasn't actively engaged. It feels like that, only on a much larger and more frightening scale.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">So, I don't know how to make the move from this constant state of apprehension and anxiety to the one day at a time approach to surviving this new administration. But I'm working on it.</span></span><br />
<span data-offset-key="1mptv-0-0"><span data-text="true"><br /></span></span>
<span data-offset-key="1mptv-0-0"><span data-text="true">How are YOU managing it?</span></span>MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-74476796976941654822016-02-26T11:23:00.000-05:002016-02-26T11:23:59.594-05:00When will we realize that ALL Black lives matter?The #<a href="http://blacklivesmatter.com/about/" target="_blank">BlackLivesMatter</a> movement is focused on the many "ways in which Black citizens are intentionally left powerless at the hands of the state (<a href="http://blacklivesmatter.com/about/">BlackLivesMatter.com/about/</a>" around the U.S. Most of us who have peripheral relationships to the Black community,
or who even just follow this movement in the news and social media, understand the
movement as focusing on violence committed against Black Americans by representatives of the state, or the ways in which the state ignores violence against Black Americans and denies justice to the Black community. The faces of the movement, to many of us on the outside of it, are young men like Trayvon Martin, whose murderers are acquitted while their victims are blamed for their own murders, or women like Sandra Bland or <a href="http://www.newser.com/story/221131/suit-inmate-died-because-she-was-denied-water.html" target="_blank">Joyce Curnell</a>, who die preventable deaths in police custody.<br />
<br />
However, there are so many other ways that we as a nation deprive Black Americans of their "basic human rights and dignity (<a href="http://blacklivesmatter.com/about/">BlackLivesMatter.com/about/</a>" that are so much more subtle than outright violence or refusal to take action against the individuals committing that violence. As a social gerontologist, when I think of specific Black lives that matter, but whose human rights and dignity are ignored by our larger culture, I tend to think about the lives of older Black Americans. Older Black Americans, as the result of a lifetime of social inequality, discrimination, and unequal access to appropriate healthcare, face greater risk of diabetes, high blood pressure, heart disease, stroke, and dementia. And the people that take care of older Black Americans in the community, their families and neighbors who we in gerontology refer to as "informal caregivers", do not have access to the same supports as White informal caregivers. This unequal access can be the result of a history of discrimination which prevents Black caregivers from asking for services, or it can be the result of their not even knowing what services are available because the agencies providing these services do not actively promote their agencies in the Black community.<br />
<br />
Now, most agencies feel like they are doing outreach to the Black community because they do outreach in general. What they fail to realize is that people who have endured decades of institutional discrimination is not going to assume they are welcome in your agency. You need to specifically reach <u>into</u> their community, build relationships and trust, and make sure that your services are offered in a way that are compatible with that community's culture. We call this "culturally competent" practice, and it's an important concern whenever someone from the dominant culture is providing services or supports to people from an historically marginalized culture. And because most of the people working in social service agencies are White, we really have to work at developing cultural competency when we are offering services to people who are not White. But most of us don't perceive ourselves as needing training in cultural competency, simply because we do not think of ourselves as "racist" (or classist or homophobic, etc.).<br />
<br />
It's not that simple. There are so many ways that we, as Whites, can be blissfully ignorant of how our thoughts and actions effect, and are perceived by, our colleagues or clients who are not White. That is what growing up in a culture of White privilege does: it blinds you to any experience outside of the White experience.<br />
<br />
The reason I am blogging about this today is because I have this brilliant and dedicated colleague (whose name I will not mention here because I don't have her permission), who has been a public health educator for decades, and who has been very successfully providing faith-based public health education and intervention programs to the local Black community for over 20 years. She has won <a href="http://www.nimhd.nih.gov/documents/2008%20Proceedings%20Summary.pdf" target="_blank">national awards</a> for this work, and has been funded by a variety of local and regional foundations for programs targeting different health conditions in the local Black community. She is Black, as are the pastors and churches she partners with to deliver her programs. For the past couple of years, I have been fortunate enough to be able to work with her on these programs. I generally stay behind the scenes doing work like writing grants, evaluating outcomes, and writing reports to our funders. She is the founder and face of the program, and the community has known her and trusted her for a long time.<br />
<br />
This week, we had a meeting with a potential funder, locally known for it's commitment to the same neighborhoods in which my colleague has been doing her great work, about a new program targeting Black informal caregivers of people with dementia. My colleague, myself, and another representative from our University attended this meeting. Two of us are White, and my colleague is Black. The representatives from the potential funder were also White.<br />
<br />
When we take meetings with outside groups, I defer to my colleague because of her
leadership in this initiative and because she has so many more years of experience doing this work. As a junior colleague, I do sometimes
have useful information to add to the conversation, but I generally do
not interrupt or assume anything; I follow her lead as best as I can.
Which gives me the opportunity to observe the dynamics in the room.<br />
<br />
Here's what I noticed in this meeting: my colleague, the award-winning public health educator and founder of this program did most of the talking, as was appropriate. The funder's representatives sat across the table from her focusing on their tablets. They asked questions, but barely looked at her while she spoke. When they asked a question that I had the information to answer, I answered. And they looked up and made eye contact with me for as long as I spoke. Then my Black colleague would start speaking again, and they would look back down at their tablets. Until our other White colleague spoke, at which point they would look up and make eye contact with her until she finished speaking. Then my Black colleague would start talking again, and they would look back down at their tablets. This happened consistently for the full length of the meeting. Ostensibly, they were using their tablets to take notes about what was being said. But why did they <i>both </i>need to take notes while she spoke, and why did they only need to take notes while <i>she </i>spoke, and not when I or my White colleague spoke?<br />
<br />
To be honest, at first I didn't even notice the pattern. At the same time as I was observing their behavior, I was also struggling with my frustration at their general lack of interest in our program and their failure to even read the description we sent them in preparation for the meeting. Most of the time, I was thinking: How can they not be interested in what she is saying about the program? When I <i>should </i>have been thinking: Why is it that they aren't looking at the one Black person in this room when she speaks about a program that is successful within the Black community? Why does it feel like they give more weight and credence to what I say about this program, than to what the person who created it and makes it successful says about this program?<br />
<br />
When I spoke about this dynamic with my colleague this morning, she smiled at me and said: "It happens all the time; we cannot let ourselves be distracted by it." I know she is right that she cannot let herself focus on dynamics like that. She has to keep her eye on the ball - what is important about the work and how we can get it done. But as her ally, I don't think I can just let these things pass. I wish I had done something proactive while we were in that meeting. Like asked them to pay better attention to her, or something. She thinks it was fine to let it go, but I don't feel good about letting that happen. At the very least, I need to bring it to the attention of our other colleague in the meeting, and they to get her to notice dynamics like that in future meetings with other colleagues.<br />
<br />
And I want to make you think about it, too. How often do you or other White people in the room pay closer attention to each other than to any Black person in the room? What can you do to change that dynamic the next time you see it?<br />
<br />
This experience definitely reminds me that when we think about how much #BlackLivesMatter, we White liberals need to broaden and deepen our understanding of <u>what </u>Black lives matter (all of them) and in <u>what settings</u> (most of them) White privilege is blinding us to those lives and how they matter. <br />
<br />MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-91185601507693119572016-02-05T16:31:00.001-05:002016-02-05T16:31:27.002-05:00Scanxiety or Opportunity?I woke up this morning at 4:30am, wide awake, thinking what if
instead of choosing to be filled with anxiety about my annual breast
MRI, I instead take this opportunity to revisit my mortality and think
about the quality of my life in the face of that mortality? Similar to
what you reflexively do when you are first diagnosed with cancer.
Except that now, you are NOT facing a horrifying diagnosis, you are just
being forced to think about it a little, until you get the next
all-clear.<br />
<br data-mce-bogus="1" />
<img alt="Onondaga Lake March2012" class="alignnone size-large wp-image-13" data-wpmedia-src="https://mariabgood.files.wordpress.com/2013/01/onondaga-lake-march2012.jpg?w=1024" height="265" src="https://mariabgood.files.wordpress.com/2013/01/onondaga-lake-march2012.jpg?w=680" width="400" /><br />
<br />
It's
been eight years since my bilateral mastectomy and reconstruction -
January 30th 2008, and the completion of chemotherapy - April 30th
2008. Every year I have a breast MRI, and every year it's a stressful
experience. There's the stress of having to face the possibility of
recurrence, which on most normal days you can pretend isn't there.
There's the stress of going through the scan, laying face down on that
weird foam form, and how painful it can be, the feeling of the contrast
as it enters your veins, the way the contrast in your body afterwards
reminds you of the way that chemo felt in your body. And for me there's
the additional stress of having trouble getting the IV in. This year,
it took 3 needle sticks - one by the tech in the crook of my elbow and
the 2 other by the IV specialist in the middle of my forearm and
finally, the one that worked, on the side of my wrist. I've had worse - 2
years ago it took 5 needle sticks; I felt like a pincushion.<br />
<br data-mce-bogus="1" />
The
day of the test is always a rough day for me physically, but it's hard
to separate that physical stuff from the emotional stuff. So I spend a
day or two leading up to the test in a state of anxiety, as well as the
week between the test and my follow up with my breast surgeon. Who, most
likely, will say "all clear." Of course, knowing that is the most
likely outcome would not be causing me anxiety; instead, that anxiety
comes from my fear of the other, less likely announcement. The one that,
for whatever reason after all these years, is easier for me to
imagine. The "it's back" announcement. After all, it's happened
before. <br />
<br data-mce-bogus="1" />
In 2007, what should have been a
routine mammogram after 5 years of being free from my first breast
cancer turned into a repeat of the diagnostic nightmare from 2002, only
this time it was invasive cancer. So that's always there, the
possibility that it could happen again.<br />
<br data-mce-bogus="1" />
I
have tried over the years to turn this annual scan into "my annual clean
MRI" with mixed success. I think I have less anxiety in the days
leading up to the test, but I'm still way more freaked out than I want
to be. But this 4:30am wake-up was reality-shifting. What if this IS
just an opportunity for me to remember what's really important about my
life, what I love about it, what I want to change, what adventures I
want to have, how satisfied am I with the work I am doing now, what is
the quality of my relationships... lots of things to think about that I
CAN do something about, rather than focusing on the one thing I canNOT
do anything about. I can't know if cancer is in my body, and I can't
predict what my surgeon will see in these MRI images. So how can I find a
way to focus on something else?<br />
<br data-mce-bogus="1" />
So here's
what I can say about my life. It's a great life. I'm healthy and
active, and have the good fortune of getting older. My wife is
absolutely the best partner in the world for me. I'm so grateful that I
found her when I did, and that she has been with me through all of the
trials we have faced in the last 16 years. Her family, my in-laws, are
totally awesome. Her Dad is the best Dad you could ever hope for, and
somehow I get to have his support and help. I am so grateful that I got
to know her Mom as long as I did. Her siblings are really loving, caring
people and completely hysterical at the same time. As are their
spouses. And I love my nephews and niece - just the one - on that side
of our family. Love watching them grow up, seeing the kind of young
people they are becoming. As much as I love knowing and watching the
nieces on my side of the family. My relationship with my youngest sister
is supportive and encouraging for both of us. I have a good
relationship with my older brother. I have great friends. I choose to
focus my energy on the relationships that are positive in my life, which
I have not always been able to do. I love my job, and the work I get to
do in that job. I love the amount of choice I have in my work, and that
I can make a decent living doing it. I enjoy the mutual respect between
myself and the senior faculty in the institute. I am fortunate enough
to have long-standing relationships with like-minded colleagues around
the country, and the chance to travel to conferences multiple times a
year where I get to interact with those colleagues.<br />
<br data-mce-bogus="1" />
It's all good. This year, we visited Nova Scotia for the first time. I
still want to visit Alaska and New Zealand. And Ireland again, always
Ireland again! I still dream about traveling around the country in an RV
with my wife - although not in that off-the-grid way that braver women
than I are living (you know who you are!).<br />
<br />
<img alt="20130620-083006.jpg" class=" size-full wp-image-55 aligncenter" data-mce-src="https://mariabgood.files.wordpress.com/2013/06/20130620-083006.jpg" height="240" src="https://mariabgood.files.wordpress.com/2013/06/20130620-083006.jpg" width="320" /><br />
<br />
Whatever
may or may not have shown up on this scan, my life is good, and I
choose to focus on that. And I will make that choice, as often as I need
to, for the next 6 days until I can confirm the results of the scan. MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-51082447945627613292015-12-10T12:09:00.000-05:002015-12-12T20:36:13.272-05:00Why should we care about sexual minority women with breast cancer?<!--[if gte mso 9]><xml>
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<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">I have s<span style="font-family: "times new roman" , serif;">aid this in previous <a href="http://mariabgood.blogspot.com/2015/12/the-costs-of-invisibility-for-sexual.html" target="_blank">blog posts</a>, and it bears re<span style="font-family: "times new roman" , serif;">peating: <span style="font-family: "times new roman" , serif;">w</span></span></span>hen
an entire body of cancer-related literature basically ignores a
particular community of women, we all remain ignorant of the experiences
of that community, even those of us who are a member of it.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">To try to shed some light on t<span style="font-family: "times new roman" , serif;">he breas<span style="font-family: "times new roman" , serif;">t cancer </span>experiences of sexua<span style="font-family: "times new roman" , serif;">l and gender mino<span style="font-family: "times new roman" , serif;">rity women<span style="font-family: "times new roman" , serif;"><span style="font-family: "times new roman" , serif;"> (lesbians, bisexual women, queer women, women who have sex with women, gender queer and trans women - MTF and FTM, intersex <span style="font-family: "times new roman" , serif;">peop<span style="font-family: "times new roman" , serif;">le</span></span>)</span>, </span></span></span></span>I am conducting a study of <b><a href="https://syracuseuniversity.qualtrics.com/SE/?SID=SV_0rlucU4S6ThIejz" target="_blank">social support and sexual and gender minority (SGM) women</a></b>
with breast cancer. So far, recruitment has been fairly slow, as this
is a difficult population to find. So to directly access a larger number
of women and improve response rates, I am using crowd-funding to <b><a href="https://www.indiegogo.com/projects/breast-cancer-research--9/x/12827169#/" target="_blank">raise money</a></b> to recruit potential subjects through the Susan B. Love Foundation's Army of Women. Please donate for this important <span style="font-family: "times new roman" , serif;">study!</span></span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Over <span style="font-family: "times new roman" , serif;">a <a href="http://mariabgood.blogspot.com/2015/12/sexual-minority-women-with-breast.html" target="_blank">series </a>of </span>blog
posts, I <span style="font-family: "times new roman" , serif;">am</span> sharing detailed sections from my original research
proposal, so that you can see what my thinking was in choosing this
topic and what I hope to accomplish with the study. I hope you find my
argument compelling enough to make a donation to my<a href="https://www.indiegogo.com/projects/breast-cancer-research--9/x/12827169#/" target="_blank"> Indiegogo campaign</a> and to share the study link with any women you know who might qualify or know someone who qualifies. </span><br />
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Today's post is about <span style="font-family: "times new roman" , serif;">t<span style="font-family: "times new roman" , serif;">he background of my study - a discussion of <span style="font-family: "times new roman" , serif;">t<span style="font-family: "times new roman" , serif;">he existing literature on bre<span style="font-family: "times new roman" , serif;">ast cancer and non-hete<span style="font-family: "times new roman" , serif;">rosexual, non-ci<span style="font-family: "times new roman" , serif;">sgendered women<span style="font-family: "times new roman" , serif;">. I hope you will read it, and post any questions you <span style="font-family: "times new roman" , serif;">have in t<span style="font-family: "times new roman" , serif;">he comments. </span></span></span></span></span></span></span></span></span></span></span></div>
<br />
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<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"></span></div>
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<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Study Background</span></div>
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<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">The invisibility of sexual
minority women in breast cancer literature is incongruent with what researchers
have identified as differential levels of breast cancer risk among women based
on <span style="font-family: "times new roman" , serif;">SGM</span> <span style="font-family: "times new roman" , serif;">identi<span style="font-family: "times new roman" , serif;">ty</span></span>, and a greater risk for fatal breast
cancers among </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women. Based on these
greater risks, one would expect to find more representations of the breast cancer
and survivorship experiences of </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women. </span></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">This invisibility in the breast cancer
literature, combined with experiences of heterosexism and homophobia in health
care settings, and barriers to health insurance and access, may contribute to
under-utilization of breast cancer screenings by lesbian and bisexual women.
Increasing the visibility of breast cancer in the lesbian community, and improving
understanding of the <span style="font-family: "times new roman" , serif;">experiences of</span> </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women with breast cancer could improve utilization of breast cancer
screenings and reduce heterosexism and homophobia in health care settings.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-pagination: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Previous studies of lesbian
and bisexual women cancer survivors indicates the importance of social support
in negotiating the cancer experience, as well as the sense of isolation
experienced by </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women, many who do not personally know other </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women who have had cancer.<span style="mso-spacerun: yes;"> </span>Some studies of female </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> cancer
survivors indicate that for sexual minority women, sexual identity is not as
important to the cancer experience as one might expect, and female </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> cancer survivors may not be experiencing higher levels of anxiety or
depression than <span style="font-family: "times new roman" , serif;">heterosexual or <span style="font-family: "times new roman" , serif;">traditionally-gendered women</span></span>. </span></div>
<div class="MsoNormal" style="line-height: 200%; mso-pagination: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Other research indicates that
older women living with female partners are generally more likely to need some
assistance with activities of daily living than those living with men . More specific to cancer survivors, female bisexual
survivors are more likely to smoke but less likely to report physical
inactivity then female heterosexual cancer survivors, and <span style="mso-spacerun: yes;"> </span>lesbian and bisexual
female cancer survivors report poorer self-rated health than heterosexual
female cancer survivors. Other research has
identified perceived discrimination and perceived social support as impacting
the quality of life of female sexual minority breast cancer survivors . The diversity of findings from the handful of
studies of sexual minority women with breast cancer indicates that additional
research is needed to understand the stresses experience by this population,
and of the supports needed by, and available to, them as they navigate breast
cancer treatment and survival.</span></div>
MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0tag:blogger.com,1999:blog-7886866566623237967.post-74690198191190634292015-12-08T12:00:00.001-05:002015-12-12T20:37:44.468-05:00The costs of invisibility for sexual minority women<!--[if gte mso 9]><xml>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Closing"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="true"
UnhideWhenUsed="true" Name="Default Paragraph Font"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Continue 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Salutation"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Note Heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Block Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Document Map"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Bottom of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Definition"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Sample"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Variable"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal Table"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation subject"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Simple 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Classic 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Grid 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 6"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 7"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table List 8"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Contemporary"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Professional"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Web 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Balloon Text"/>
<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Theme"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
<w:LsdException Locked="false" Priority="1" QFormat="true" Name="No Spacing"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
Name="List Paragraph"/>
<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
Name="Intense Quote"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 1"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 4"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 3"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 4"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 4"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 4"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 4"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 4"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 5"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 5"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 5"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 5"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 5"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 5"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 6"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 6"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 6"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 6"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 6"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 6"/>
<w:LsdException Locked="false" Priority="46" Name="List Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="List Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="List Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="List Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="List Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="List Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="List Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="List Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="List Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="List Table 7 Colorful Accent 1"/>
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<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">When an entire body of cancer-related literature basically ignores a particular community of women, we all remain ignorant of the experiences of that community, even those of us who are a member of it.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">I am conducting a study of the <a href="https://syracuseuniversity.qualtrics.com/SE/?SID=SV_0rlucU4S6ThIejz" target="_blank">social support and sexual and gender minority (SGM) women</a> with breast cancer. So far, recruitment has been fairly slow, as this is a difficult population to find. So to directly access a larger number of women and improve response rates, I am using crowd-funding to <a href="https://www.indiegogo.com/projects/breast-cancer-research--9/x/12827169#/" target="_blank">raise money</a> to recruit potential subjects through the Susan B. Love Foundation's Army of Women.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">Over <span style="font-family: "times new roman" , serif;">a <a href="http://mariabgood.blogspot.com/2015/12/sexual-minority-women-with-breast.html" target="_blank">series </a>of </span>blog posts, I will be sharing detailed sections from my original research proposal, so that you can see what my thinking was in choosing this topic and what I hope to accomplish with the study. I hope you find my argument compelling enough to make a donation to my<a href="https://www.indiegogo.com/projects/breast-cancer-research--9/x/12827169#/" target="_blank"> Indiegogo campaign</a> and to share the study link with any women you know who might qualify or know someone who qualifies.</span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span> women<a href="https://www.blogger.com/blogger.g?blogID=7886866566623237967#_ftn1" name="_ftnref1" style="mso-footnote-id: ftn1;" title=""></a>
are essentially invisible in academic and mainstream breast cancer survivor
literature and in breast cancer advocacy movements</span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">.<span style="mso-spacerun: yes;"> </span><span style="font-family: "times new roman" , serif;">B</span>ooks written to guide breast cancer survivors through
t<span style="font-family: "times new roman" , serif;">reatment or </span>recovery <span style="font-family: "times new roman" , serif;">assume</span> that all women with
breast cancer are heterosexual and traditionally gendered. Commonly available breast
cancer memoirs are also written by heterosexual women</span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">. While </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women may still find
useful information in <span style="font-family: "times new roman" , serif;">materials</span> written from and for the female heterosexual
perspective</span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">, the heterosexism in these written accounts of breast cancer and
recovery experiences <span style="font-family: "times new roman" , serif;">tells</span> </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> woman<span style="font-family: "times new roman" , serif;"> that their</span>
breast cancer experience<span style="font-family: "times new roman" , serif;">s are</span> unimportant. The heterosexism in breast cancer
and recovery literature also reflects the heterosexism many </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span>
women encounter, or expe<span style="font-family: "times new roman" , serif;">ct to en<span style="font-family: "times new roman" , serif;">counter,</span></span> in health care settings.
An additional result of this invisibility is that care providers lack a real
understanding of how their interactions with </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women and the different influences in the lives of </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span>
women function as sources of stress or support for </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women facing
breast cancer. </span></div>
<div class="MsoNormal" style="line-height: 200%; mso-layout-grid-align: none; mso-pagination: none; text-autospace: none; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">For </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women, heterosexist assumptions in the breast cancer
literature and in health care settings may serve as sources of stress and as barriers
to seeking the help and support they need during one of the most difficult
times of their life. Because </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women with breast cancer may not
have access to a community of other </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women with breast cancer for
support, breast cancer can be a stressful and isolating experience. Women may
hunger for information from other </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women who have been through
the same experience. As one survivor in the Lesbians and Cancer Project (LBCPT)
stated: </span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: .5in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-weight: bold; mso-fareast-font-family: "MS Mincho"; mso-fareast-theme-font: minor-fareast;">I
don’t have other lesbians who are survivors around, or I don’t know other
lesbians who’ve had breast cancer. And so I haven’t really had a chance to
explore other issues that could come up (</span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">2004, p.
6)</span><span style="font-family: "times new roman" , serif; mso-bidi-font-weight: bold; mso-fareast-font-family: "MS Mincho"; mso-fareast-theme-font: minor-fareast;">.</span></div>
<div class="MsoNormal" style="margin-bottom: .0001pt; margin-bottom: 0in; margin-left: .5in; margin-right: .5in; margin-top: 0in; mso-layout-grid-align: none; text-autospace: none;">
<br /></div>
<div class="MsoNormal" style="line-height: 200%; text-indent: .5in;">
<span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;">This study <span style="font-family: "times new roman" , serif;">asks if</span> sexual
orientation and gender identity are related to stresses and support in the
lives of </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women with breast cancer. This is an exploratory study,
using <span style="font-family: "times new roman" , serif;">personal stories</span> to <span style="font-family: "times new roman" , serif;">learn about</span> the experiences
faced by </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;"><span style="font-family: "times new roman" , serif;"> women who have breast cancer</span></span>. Data is collected using an online surv<span style="font-family: "times new roman" , serif;">e<span style="font-family: "times new roman" , serif;">y<span style="font-family: "times new roman" , serif;">. </span></span></span>The specific aims of this study
are to: 1) learn about the breast cancer experiences of </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women; 2)
to explore sources of stress encountered by </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women facing breast
cancer; 3) to explore sources of support available to and needed by </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women facing breast cancer; and 4) to develop written resources for </span><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif; mso-bidi-font-family: "Times New Roman"; mso-bidi-theme-font: minor-bidi;"><span style="font-family: "times new roman" , serif;">SGM</span></span> women facing breast cancer.</span></div>
MariaBhttp://www.blogger.com/profile/15107598921522194970noreply@blogger.com0