Knowing Your Boobs Could Save Your Life

On Tuesday, the American Cancer Society published new Breast Cancer Screening guidelines reducing the recommended frequency of mammograms for women over 54 to every 2 years and increasing the age for a first mammogram to 45 for women with an average risk of breast cancer.  They also kicked the clinical breast exam to the curb.  How much can a physician know about my boobs and my “normal” by feeling them once a year?  Now me, I can touch them every day if I want, and I certainly see them during my daily ritual.   Early diagnosis is key to beating breast cancer and many are triggered by women who notice a change in the look or feel of their boobs.  Our breasts feel differently in each decade.  Natural changes occur, especially as we bear children and get older.  Tiny, swollen, lumpy, I know intimately the phases my boobs passed through to land happily at soft tissue.  I know what my skin looks like, where there are stretch marks from pregnancy, and the color of my areola, however I need to use the mirror more often with arms raised.  Rashes, dimpling, or swelling also occurs in the breast tissue on our sides, and is more likely to go unnoticed.Breast Exam

The American Cancer Society is careful in its language, stating a woman should have the choice at 40 to request a screening mammogram and become educated on mammography limitations.  Women at high risk (20-25% lifetime risk) should begin annual screenings at 30.  They recommend breast MRI in conjunction with mammography for women at high risk because the two detect different types of cancer, so if I found a lump or had other breast cancer symptoms such as skin or nipple changes, my plan is to request both.  False positives are more likely with breast MRI, but despite the American Cancer Society’s concern about causing me ” a lot of worry and anxiety”, I prefer an unnecessary biopsy with a huge slice of peace of mind to later-stage cancer.  And despite a statement that self exams do not show a clear benefit, I trust my judgement on this one and will continue to feel myself up in the mirror on a regular basis because self-love is a beautiful thing and the new guidelines for breast cancer screening are not definitive, but leave the responsibility with me.

 

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Leave Joe Biden Alone

U.S. media and the Democratic Party are propelling Joe Biden toward a 2016 presidential bid that he does not want, but why?  Joe cusses when he doesn’t know the microphone is on, calls for wheelchair-bound Senator Chuck Graham to stand up and let the crowd see him, and extends condolences to the Irish Prime Minister on his mum’s death while she is alive and well.   Joe Biden is not smooth; he is genuine.  They will rip him to shreds, every gaffe in Joe’s past revisited by the G.O.P., who mistakenly admitted the Benghazi investigation was a political move to degrade Hilary Clinton’s support.  With Joe’s more than 40 years of public service, they are  likely collecting mud already.  He is a t.v. producer’s dream.

And how will he hold up after all he has endured?  In true Irish fashion, I imagine he will give his honest opinion, as he usually does, however when faced with stupidity he won’t hold back.  Joe’s colorful rhetoric is yet another potential distraction from the very real American concerns about costly education and healthcare, job creation, immigration, justice equality, environmental conservation, and gun-violence.  I voted for Joe in the 2008 presidential primary, eight long years ago.  In September Joe said in a speech that he was unsure if he had the emotional reserves for a campaign and told the Democratic National Committee that his “heart and soul are pretty banged up”.  I believe him.  Beau and Hunter, Joe’s sons, survived a car accident which killed his wife and baby girl in 1972.  While recuperating from broken bones that put him in a body cast, 4-year-old Beau often laid next to his brother Hunter who had a skull fracture and said, “Look at me, Hun.  I love you.”  Beau sat his dad down two months before he died from brain cancer this year and made Joe promise that he would be o.k.  Joe says Hunter, his wife Jill, and loving family and friends are supporting him and he has to get up every day or he would be letting them down; he’d be letting Beau down.  If Joe decides not to run for president, he is not letting America down, he is letting his heart mend, something only time and care can accomplish.

Dismantling Fear

Beyond survival, fear lurks not only in the dark corners, but also in the joyful moments, waiting for an invitation to withdraw serenity and instill anger and sadness.  Fear often wears a disguise of concern,  uses ego as a henchman, and usually surfaces as “what if?”.  What if I express an idea and people reject it/me?  What if I look stupid?  What if I fail or make a mistake (and look stupid)?  What if an accident or an illness takes away someone I love?  What if my health declines?  Thoughts run in gangs and possess a mob mentality.  I desire an upbeat, kind, and intelligent gang of thoughts to hang out with, but how do I control non-essential fear, the bully of my gang?

Fear lives in the amygdala, our base emotional center, where fear conditioning occurs and unconscious evolutionary memories are stored apart from complex reasoning in the cortex and higher learning in the hippocampus, .  The amygdala soaks up sensory input from our experiences and assigns emotional tags.  In similar situations we may feel threatened, fear triggered by a smell, a room, a voice, or an action.  Wired to react quickly to fear, I can easily damage relationships or sabotage my work by overreacting or withdrawing, two perfectly reasonable fear responses.

The amount of fear hiding out in my amygdala is understandable, thousands if not millions of memory bits collected long-ago during  times of abuse and rejection.  Understanding fear is a biological process, evolving with our experience, re-frames unreasonable fear responses as manageable.  Desensitization can minimize or even destroy unreasonable fears using exposure and relaxation exercises.  A rise in blood pressure and cortisol dumps dictate a two-pronged approach with relaxation at the center.  I am not addressing a phobia, but an imaginary fear, so I begin by imagining my worst fear.  Creating a list of fears aids in choosing the biggest, baddest and most destructive fear bully.

I can pick apart my fear of rejection, imagining a rejection letter, a negative blog comment, or an in-person query regarding what I do all day.  I can imagine “what if?” and write the story to its end, even if only in my thoughts.  Imploding from shame does not happen in real life, so I survive to write, live, and love another day.  Using diaphragmatic breathing and a memory of Lake Huron’s waves lapping the shore helps me release anxiety induced by my imaginings.  I also use exercise to reset my brain and confirm I am alive and safe, even if I do look stupid.  I’ll repeat my exposure and relaxation exercises until looking stupid or being rejected is unimportant and what may happen holds no power.

“Don’t give in to your fears. If you do, you won’t be able to talk to your heart.”
Paulo Coelho, The Alchemist

 

 

Conscious Coupling, Because Divorce is Expensive

“Conscious uncoupling”, a descriptive term for a mindful ending where two people try not to rip one another to shreds out of hurt and disappointment. Perhaps “conscious coupling” will prevent the need for untangling ourselves, separating our lives.  It certainly seems worth the effort when I consider the life we built, the love we share, and the amount of money we do not owe.

We are consciously committing to the following habits, because neither of us is going anywhere so we may as well be happy.

  1. Hugging every day for at least 30 seconds.  Hugging bonds us, releases stress, and cultivates trust.  A good long hug wipes other thoughts away and makes us conscious in the moment.
  2. Habitually expressing gratitude prevents us from falling into a habit of taking each other for granted.  Every one likes to feel appreciated and partners contribute to our happiness in dozens of ways.
  3. Doing kind and thoughtful things for one another.  A phone call, a message, flowers, a back rub, a listening ear, a favorite dinner, a bubble bath, lit candles, there are a million ways to say “I love you”.
  4. Holding hands.  It tells the world “we’re together” and strengthens our bond.
  5. Playing board games.  We talk when we play a board game, we compete, we let someone else get ahead for the sake of keeping the game going.  Board games are sexy.
  6. And we cannot forget about sex.  Sex changed as we changed, and is not the star of the show as it was when we first fell in love.  What counts is connection.  If I am in pain or exhausted, that may consist of our feet touching under the covers.  If nurtured, intimacy grows,  eclipses good sex, and expands our comfort zone with that one, and only that one, lover.

 

Endometrial Ablation, An End to the Bloodbath

 

*Warning:  If discussions about menstruation and lady parts make you queasy, this post is not for you.

Since perimenopause set in eight years ago, I developed penis envy, not so much because I’d like one, but simply to eradicate several unpredictable and exquisitely painful periods per month.  Never prepared, no matter how many bloody tidal waves assailed my linens, my pants, my chairs, my life, I was taken off guard.   I am unaware of a more irritating interruption than a distinct gushing feeling in the middle of a meeting, especially when you are the one taking minutes.  Several times I prayed for a fire alarm.  When my red blood cell count fell to a level worthy of a gynecological consult, I felt relieved.  Dr. Burns, well into his 8th decade, said I seemed a good candidate for an endometrial ablation as long as fibroids did not lurk in my uterus.  Two tiny fibroids, one smack dab in the middle of my uterus and likely the painful trouble-maker, showed on ultrasound.  Fortunately, Dr. Burns has practiced for more than 40 years and was competent in more than one ablation procedure.  The simplest ablation procedure used a triangular mesh electrode that expanded in the uterus and delivered an electric current which cauterised and destroyed the uterine lining, and if needed, he had a back-up plan that used a roller-ball for the trouble-maker fibroid.

Elective surgery, while not typically as serious, entails risk and pain.  Infection is the scariest risk to me, likely due to a 3 month post-surgery infection following a previous gynecological mini-surgery.  I did not agree to an endometrial ablation sooner because of it.  Fear is a bitch, worthy of a post all its own.

Dr. Burns used the electrically charged mesh with success.  Prepping me with information, introductions, consent forms, and anesthesia took longer than the ablation, positively making me comfortable before asking Patrick to hurry up with the anesthesia in the operating theater.  Such a simple procedure to require such a dramatic environment, but…the risks.

My recovery nurse enjoyed my eyes-closed rendition of Gin and Juice and said I was her new favorite patient.  Apparently, I had my mind on my money.  Over the next few days I got to know the pain-killer norco as my uterus healed and I laid about on the couch drinking lots of liquids and eating toast.  So this is what it’s like in the 5th decade.  We endure procedures, therapy, and surgery to make life doable, and in this case, better than previous decades.  Little spots of blood every couple of months are all I have now.  Feminine hygiene companies are devastated by the decline in sales.

 

 

Walking & Gawking in Ireland – Part 4

While visiting the pubs in Kinsale we met a happily drunk group of Canadian golfers who insisted we absolutely had to visit Old Head where they lost their golf balls in the sea.  One of the revelers called “Mikey” snuck away to the Actons Hotel with the intention of one last whiskey after a comedic rendition of Tura-Lura-Lural.  Intending one last beer, we found Mikey and everyone’s good intentions flew away as good conversation ensued.  A brilliant business man, he counseled me on building a customer base, his winning personality and eyes shining.  The first to comment on our ages, Mike said he wished he’d brought his wife to Ireland when they were younger; she died a few years ago.  We heard versions of his sentiment throughout our holiday.  The messages we brought home are live every day, joy comes through experience rather than possessions, and saving for old age is a gamble at best.  Again, human connections rounded out our day of sight-seeing and we slept with a cool salty breeze blowing in from Kinsale harbor.Old Head Kinsale

K at Old HeadA hardy Irish breakfast under our belts, we drove the long way to Kenmare via Old Head Kinsale, which took us up the cliffs, then wound us through country back roads all the way to Killarney National Park and Ross Castle.  Not the quickest route, but the Canadians were right.Ross Castle

Ross Castle, built in the 15th century and home to the Earls of Kenmare, is beside Killarney’s lower lake, Lough Leane.  It was the last stronghold in Munster to hold out against the bastard Oliver Cromwell.  I think the prefix is part of his legal name in Ireland and Scotland.Muckross House in Killarney

Built in the 19th century, Muckross House is comparably modern.  We chose to skip the tour for a walk that tuned in to a hike around Killarney’s middle and upper lakes.  Path in the gounds of Muckross House

A pathway next to Killarney’s middle lake led us away from the crowds and into the woods, which provided a rougher uphill  terrain, and made me grateful once again for a splurge on high-quality hiking boots that tightly cradled my ankles and supported the arches.  Waterproof hiking boots are my #1 footwear suggestion for Ireland and my # 2 is Sketcher Go-Walks for ladies on pavement.Killarney Upper Lake

Killarney Upper Lake

The path dwindled after the upper lake, but still, I hoped that it would lead me back to the immaculate flat lawn of Muckross House.Muckross WoodsYou never realize a path disappeared until you are well off it, however we were halfway back, just a little lost.  My stamina almost spent, I could not hike back the way we came, so my husband went up a hill to appraise our options.  Luckily he found a shortcut.  Unluckily, it entailed me climbing over a log,  up a steep hill, and down again to our original woodland path.Muckross hike

As I weighed my options that really were not options, he of course snapped a shot of me.  Unaware that I mistakenly set the camera to video, it caught an under-my-breath reference to sweating like a $2 whore.  Nice souvenir.Muckross House lawn

After resting on the lawn for a good half hour, we drove a short way down the road to Torc Falls.  Killarney National Park covers 26,000 acres, basically a walking and gawking expo.

Torc Falls in Killarney National Park

Torc Falls in Killarney National Park

Ring of Kerry

The Ring of Kerry, terrifying drive with large tour buses crowding a trim road, but luckily there are pull-offs to catch your breath.

Down the road from Killarney is Kenmare and Sheen Falls Lodge, our accommodation for the next two evenings.  Kenmare is the jewel in the Ring of Kerry,  and Sheen Falls Lodge, a fantastical manor hotel to which I often return in meditation.

Fish & chips stop in Kenmare

Fish & chips stop in Kenmare

Sheen Falls Lodge

Kindly Siobhan led us to our room on the second floor of Sheen Falls Lodge and handed us a key with a huge fob on it.  A king size bed dressed in pure white and light gold, a bathroom the size of most hotel rooms, and Louis XV cream brocade chairs still left plenty of room to walk around comfortably in our opulent haven.  We built in a slow day midweek so I could write, rest, and gain energy for my husband’s walks that turn into hikes and other escapades, and he could go fishing.  My swollen ankles and fatigue indicated perfect timing. Sheen Falls

First, however, a Portugese gentleman in the lounge regaled us with pictures of his seaside villa and hilarious stories about marriage to an Irish woman who didn’t go home after holiday.  An older Irish gentleman, to our benefit, competed for our attention.  Jokes and stories kept us up laughing and making new friends until midnight, a pewter statue of Molly Malone as witness.

Rushing water and birdsong

Rushing water and birdsong

The next morning I sat on the balcony at 7:30 a.m. in a soft white robe with a cup of coffee and eased slowly into my unstructured day, while my husband had to meet his fishing guide with a full-on hangover, so rushed down to breakfast after groaning about that last pint, or maybe the last two.  I almost felt sorry for him, but we were in each other’s company every minute of the past four days, and pulling rainbow trout out of Loughbarfinnity is to him what writing is to me.  We were both better for it.Sheen Falls Lodge

Following a light breakfast, I found the pool.   A pungent herbal aroma  and lilting Celtic notes lent to a healing vibe as I lazily floated on my back.  A couple laps and a soak in the blue glass hot tub were restorative.  Then I explored the hotel with my camera and notebook.

Getting lost at Sheen Falls Lodge

Getting lost at Sheen Falls Lodge

I settled on the patio next to the river and wrote some horribly flowery prose in my state of infatuation, then sought out a book of Father Brown’s photography I spied earlier in the library.

When he returned hungry from his adventure and found me with tea in a sunny yellow drawing room, he smiled and shook his head a little at my extravagance, then showed me the picture of his fish and told me about Damien the guide on the way to the car. 

 

 

Chapel on Ring of Beara, where tour buses cannot fit.