Hard days and tiny needles...

It's been a hard few days but things are looking up. After a wonderful Thursday through Saturday, I felt lousy on Sunday. Even though we had a wonderful visit with the Tucson family, I had to take a nap. That evening, my lung drained 175 cc after having dipped to 25 the day before. And my platelet count dropped to 1! Plus, I am really fighting nausea. Bad to go backwards. I felt tired all day Monday and Tuesday. Despite my best intentions to stay positive, I found it hard to resist the thoughts that this was all a big exercise in wishful thinking. Of course, it might be. But it's no good to think that way. Today, I feel better, although I still drained 150 cc this evening. I had a meeting with my medical team tgus morning and they made me feel better. Wanda, the doctor in charge of the insulin chemo is convinced I will be just fine. She is unconcerned about the platelets, sure they will go back up with the help of the nupagen shots they are giving me. She sees how robust I still am and feels sure I will do well. There are a number of possible explanations for why I feel lousy. 1. I am being overtaken by the cancer and the treatment isn't working. 2. The vitamin c is making me feel lousy (this is common) 3. What I am feeling is mainly cancer die-off that makes the body feel lousy or 4. Combo of 2 and 3. They seem to think that's the most likely. The other reason for optimism is that the cancer may have stopped advancing, though it's not yet retreating visibly. I am having some pain in the affected area on my chest, which Wanda thinks is is a sign that the chemo is attacking it. I am worried that my lung continues to drain, but they say its too early to be worried. So, what we are doing to do is back off a bit on vitamin c, add an additional treatment with ozone and UVB designed to make me feel better, and go for acupuncture for the nausea and fatigue. I managed to make an appointment today for acupuncture, which I've never had. The doctor was extremely kind. I started the treatment lying down on a massage table in a gown. I always was mystified and intrigued by the idea that you could insert needles, no matter how small, without it hurting. Guess what, you can't! It doesn't hurt much, but it doesn't feel great. Each needle goes in with a tiny prick. In each area, I could feel a reaction, a slight tingling. But my right shin started to really hurt, all of it! I told the doctor, and he removed the needle, saying that, for people with a lot of nausea, this area could be very sensitive. Then he turned on a tape and left me with a nice-smelling eye pad on to meditate and listen. The woman on the tape encouraged me to focus the tones (music played on what sounded like a small gong, cymbals and harp) on various parts of my body. I don't really know what that means but I did find that, by concentrating, I could imagine the music vibrating in the skin of my abdomen, chest, face, etc. Kind of cool. After about 20 minutes, he came back in, removed some of the needles (which also hurts a tiny bit), and did some acupressure on my feet. After more listening to music, he came in and took out the rest of the needles and worked on some pressure points on my head and arms. This felt fine, but worried me a bit when it came to my left arm, where my lymph specialist tells me hard pressure is not good. Then he had me sit up and massaged my shoulders and back. He then applied glass vacuum cups to my back, which are supposed to adjust my chi, and which pinch. I am most skeptical about this process, but have decided it won't harm me and is part of the package. We'll give this process a few weeks and, if it helps, I'll continue. If not, it's another cool experience to add to the adventure. So I feel a bit better and hope we are on a slightly adjusted and better track. I said goodbye to Margaret, who is flying home for week and driving back with my Dad so she has a car to use (too young to drive a rental.) She and I had a wonderful time with my brother Colin, who's still here for a few days. I'm excited that some of my oldest friends, Kristen, Susan, Bridget and Jacqueline arrive tomorrow or the weekend. I hope I'm up to some fun stuff with them but we can all just hang out and talk if that's all I'm up for. Hooray!

Margaret/Maggie arrives out of the blue....

My platelet count dropped, so they have given me an extra injection this morning and want me on more b vitamins.  With this, plus the antibiotic they’ve added, my biggest challenge is nausea.  I am glad to have the Compazine and Zofran left over from sloan kettering. 

The big development is that Margaret is here.  She decided that she wanted to be here rather than in London doing the internship.  Yesterday, while we were at Staples faxing invoices to the insurance biller, we got a phone call from her saying “I’m at JFK and will be there at 10 tonight.”  Wow!  Fortunately, Ann and Jef (with whom she is doing the London internship,) were not only understanding, but encouraging.  Ann, with her Irish belief that too much hope tempts the Gods, thinks I am definitely dying.  Incredibly generous as always, she put Margaret on the plane.  What a friend! 

We are more positive about my expiration date, but understand how Margaret would want to spend time with me either way.  It’s not clear yet how long she will stay.  She wants to stay all summer but may change her mind if I am doing better, or being here gets too boring and depressing. She’s welcome back in London anytime.  My preference would be for her to be there (not for me, but for her), but she knows her own mind and heart and I respect that.  Plus, it’s great to have her around.  She’s a great caregiver, compassionate but calm and level-headed.  We are invited to Aunt Margaret’s for their annual Father’s Day get-together on Sunday, and it will be nice to finally get the two Margaret’s together and to meet that side of the family.

A story I keep forgetting to tell…the Whopper Junior.  The day I decided to come out here for treatment was not easy.  I knew the process of pulling together my records and sending them here would be anxiety-producing, so I asked Devra to come up and help.  She was a great comfort as we dug through all the paperwork and found the key tests and bloodwork they wanted.  I also had to write a bullet-point summary of my cancer story.  Going through all this again felt like someone had picked up a smelly, filthy lead-lined overcoat out of a dumpster and threw it over my shoulders. It brought me to my knees, with feelings of dread, rage and grief overwhelming me.  By the evening, I was in a foul and fragile mood.  All of a sudden, I announced to Steve, “I want a Whopper Junior!” (At the time, I was still on a vegan diet.)  In two minutes, he had googled the nearest Burger King.  My inner two-year-old in charge, I replied “Forget it, it won’t help.”  He, wise man, just waited.  A minute more, and I said grouchily, “Okay, let’s go.”  Driving through the dark, I just let go of any dignity or reserve and wailed. I keened in fear and rage, an inchoate protest that doesn’t hope to be heard and doesn’t care.  Finally, I took a deep breath.  Shakily, but firmly, I said “Okay.”  Pause.  “Okay.” And it was.  We got to the restaurant, Steve ran in and, in just a few minutes, I sank my teeth into burger and fries.  Heavenly. We laughed on the way home, me feeding Steve fries as he drove.  Sometimes, you just have to take a break from being good!

So treatment continues apace.  I am hearing good things about this place from people here who’ve done much more research than I did.  They seem to have a good record of success, and I am talking today to a woman who had lymphoma and was here 8 months.  She is now on follow-up and doing wonderfully.  She looks like a million bucks.  Always good to see!

Enjoying the sunshine and getting better....

i left my electronic plastic room key in the direct sun for 15 minutes and it warped too much to be usable. it is hot out here! we are having a nice time. treatment seems to make me queasy and tired, but nothing like "real" chemo. We have settled into a routine. steve goes for a walk with Butters in a local park with Abraham, the walking buddy from Syria he talks to about world events. On non-fasting days, I eat and then we head to treatment for 7 a.m. On chemo days, like this morning, I fast and arrive hungry. After a bout 20 minutes of saline and magnesium drip, they inject the insulin through port. Lucinda wanted to know the dosage. It is 24,000 of humalog, for whatever that means. Hope i got that number right. After 15 minutes or so, she tests my blood sugar. Once it hits 50, she quickly injects the chemo and I drink juice and start to eat. Its not a good feeling to let your blood sugar get that low, I have to say. My hands were shaking as I started eating, but it lasts just a while. After this, I moved to the injection room to sit with everyone else and get my ionic foot bath and foot massage (yum!) while getting my multi vitamin treatment through the port. today I also did the hypergravity machine. this is a very weird experience of being vibrated very quickly as you stand on the machine. By keeping your knees slightly bent and leaning forward onto the balls of your feet, the vibration doesn't go to your head, which feels better. SImply standing on the machine is strenuous, its hard to explain why. Anyway, it is supposed to increase lymphatic drainage, which makes some sense, since that circulatory system is activated mainly through muscle movement. Based on Steve's research, we have decided to do IV vitamin C 3 x week instead of once. It seems, if nothing else, to make me feel better (although it can also make me nauseous.) I had a coaching call with a client and have gotten Mary BEth onto the task of setting up regular appointments with everyone I coach. Coaching a few clients a day in the afternoons is very do-able. It is good for me to keep the connection, and I hope good for my clients! ANyway, we are off to Wal-Mart for vitamins and supplies, as well as to fill a prescription for an antibiotic that will hopefully discourage the cancer going into my bones. Good idea! We have been having a wonderful time with Steve's cousin Lisa and Aunt Lucinda. What a great couple of women they are, and watching them bask in the desert sun and brun away their Seattle dampness is fun. They both love it here! We met two of Lisa's dear friends for drinks after a lovely dinner in Scottsdale last evening. Tonight, they'll come here to meet Butters and we'll have dinner nearby. We'll be sad to see them go, and hope to persuade them to come back again!

First day of treatment

First day of treatment. The place is 5 minutes from our hotel and we arrived at 8:30 a.m. I was able to eat at 5 but fasting since then. Hungry! We were welcomed by Janice, one of the many warm, relaxed and cheerful people we met there. I filled out paperwork, including a 14-page medical history. One thing you notice about allopathic or wholistic providers is that they care about a lot more things. They want details on what you eat, how much you exercise, sleep, tons of symptoms other providers don't ask about. It's a pain, but does make you feel looked after at a whole new level. We then met with Dr. Deane, the director who admitted me, and Dr. Zieve, who will take care of me. Anyone interested can read his book, Healthy Medicine. One jarring question was "why did they do the mastectomy?" If the cancer is already beyond the breast, then a mastectomy is not indicated, apparently. Our answer was that they thought it important to remove the initial tumor. They said nothing, but its apparent from the result, that I would have been better off without the surgery. Grrr! it was reassuring to once again hear Dr. Deane say that they have had "good success" with triple negative breast cancer. Glad to hear someone has! Anyway, after paying by credit card for a week of treatment (some, but not much of which will be reimbursed through insurance), I spent a few moments envisioning our retirement spent working at Wal-Mart and living in a trailer park, then focused back on the idea of living to retire at all! My main treatment today was IPT, the insulin-potentiated chemotherapy. I was worried about this and made Steve stay, but it was easy. they accessed my new port (still sore and not psyched about being stuck with a needle, but oh well), took some blood, gave me saline and then delivered the insulin. Shortly after this, which left an odd taste in my mouth and made my heart race slightly, she gave me the chemo. they are able to deliver a cocktail of 5-6 chemo drugs that they find work well in synergy. You can't do this with normal chemo, as it will kill you dead. Then i could eat. Yay!!! they followed this up with oral supplements (broccoli extract was one!) and the "pink bag" of IV vitamins and minerals and I was done. We were there from 8:30 to 1:30 all told. I feel good, my lung drained only another 50 ML today, and, provided this stupid rash goes away and the catheter entrance heals up, i should be able to soon stop moving around like an old woman, slightly hunched over to not pull on the tubing, and slowly, not to jar my poor, sore side. For someone who walks fast as a matter of personality, this has been a drag. We went out to Wal-Mart to buy hats (we have a magnificent collection of hats at home that are, alas, at home, and various household things you need when you move via airplane and don't want to lug around, say, dishwasher detergent. On the way out, Steve encouraged me to get the pedicure I was coveting. I had removed the polish and, in a fit of detox-thinking, resolved to leave them plain. Alas, the chemo has damaged the nails, so they were discolored and yucky. I found it depressing looking at my feet. So now, I am sipping a very tiny glass of wine and admiring my hot pink toenails. A very lively color, a spunky color, a color for a woman who plans to live a Hell of a long time. Steve said he loves them, that they are a sign that we just left the bottom behind and are on our way up!

Breathing is a beautiful thing...

Great truth for the day: life is easier without two liters of fluid in one of your lungs. That said, it's not so hot to get the fluid out of there. The first try was yesterday morning. It sounded easy enough, a simple procedure to do right in the room. A little local anesthetic, a needle inserted into the lung through the ribs (ugh) slide in the catheter and drain the fluid into bottles. I sat on the bed and leaned my arms onto the tray table. The local injection hurt, but it seemed okay. I felt reasonably calm and looking forward to getting it over with. All of a sudden, I felt lightheaded. I tried to ignore it, but it got worse and worse. I had to fess up and they helped me lie over onto my side. I felt terrible, but better with my legs up. I lay there giving myself a pep talk to get this over with, slowly sat up again, and the doctor reinserted the needle. Instant blackout reaction. I was sweating, leaning over the tray table and praying to make it just the few more moments needed to get the catheter in and draining. I couldn't do it. I was shaking, crying, and almost unconscious. They lay me down on the bed, making apologies and telling me this happens, I shouldn't feel bad, etc. As if my biggest worry was whose fault it was, rather than that I'd just gone through Hell and still had all this crap in my lung! They were able to get enough fluid to send out a sample for testing. Choices of why this happened include cancer in the lung (bad, bad, bad), infection (unlikely), and injury. Not worrying about it. Results in a day or two. It took a long time to sort out plan B but they finally told me I'd have it done the next morning under sedation. Although this meant no food or drink after midnight, I was thrilled at the idea of being under during the drainage. I slept well. This morning they came to get me at 8:30 and wheeled me down to cat scan. I lay there for awhile on a stretcher until the nurse came and described the procedure. As I listened, I realized she hadn't mentioned any sedation and asked. When she said no, an "Oh no!" burst out of me, in a voice obviously fighting tears. How embarrassing. But how crushing, not only the thought of the whole nasty thing, but what if I fainted again? Karen was very reassuring, putting on a blood pressure cuff and telling me she would get me through it. I had to lie on my side and get a cat scan first. To give you an idea of the state of things (me), they wouldn't let me get up or help myself onto the table. They just slid me around on a board like a big sack of meat. Okay, so here we were again. Not to whine or anything, but I wish they'd give you pain meds for the damn numbing injections. It hurt, and it burned, and I've just had about freaking enough of this crap, okay? But I have to say, he worked quickly and well and the catheter was in very quickly and, hallelujah, we were draining! Then Karen told me that I might start coughing when the fluid drained and the lung started to expand. Thank God for the warning. Lying on my side immobilized, I coughed, coughed again, and then again. And I was coughing hard, unable to catch my breath, fighting panic. "Breathe out like you're putting out a candle" and I was brought back to LaMaze class as I puffed away, squeezed Karen's fingers, gasping, whimpering, trying not to panic. Somehow, I got through it and we we done. Two freaking liters of fluid in one lung. The fluid builds up between the pleural sac that encases the lung and the airways. My poor little airways, squashed in by all that water, we're basically collapsed. Lying there, every breath hurting and feeling pain I my shoulder, hip, back, it was easy to think something had gone wrong. But, as soon as I could stand it, they shoved me back into the scanner and announced that all was well. The lung reinflated fully, my cheeks looked pinker. Success! Getting the lung back to normal ain't going to be a picnic. Good news is there is no pain when i breathe normally. But every deep breath hurts a lot. And, a sharp intake of breath to laugh, cry or just move quickly creates an unbearable spasm. So I am on Percocet to take the edge off and instructed to use the incentive spirometer to stretch the lung tissue back out. As I write this, I am sitting up in a chair and feeling quite good. I can walk around my room and no longer have to cough every time I say more than 10 words in a row. The pain when I breathe in is getting better. Home tomorrow! Despite the lousy news, I am cheerful, even joyful. For the first time in my life, I feel fully justified in living one day at a time. Doing my best not to worry but to work hard at getting better, staying a step ahead of the cancer, hoping for extremely good luck and loving being alive. Time flies...off to my breathing exercises!

Life is good...

In between surgery and radiation there is...life! I am off dairy, sugar and reined starches. Last week, Steve wanted to make a simple pasta dish with kale, onions and garlic. But I, always having to raise the bar, find a vegan recipe for creamy kale pasta sauce. Honestly, the picture looked delicious....Poor Steve! Here he was, after a long day, following my directions given from the couch. If I weren't in some kind of delusional state, I would have known that any roux made with olive oil and almond milk was a BAD idea. Then, I asked him to chop the kale in food processor and add it in, sort of boiling it. Another bad idea. Long story short, after almost an hour of work, he brought to me with the heartening comment "I don't know, Babe...". I took one bite. Disgusting! I felt terrible but, far from being angry Steve looked, well...relieved! I started laughing, really laughing hard. We both laughed harder and harder as we dumped the revolting, gluey, smelly mess into the trash. In fact, we laughed off and on for about two hours. The thought of Steve valiantly cooking away while trying not to gag and me cheerily calling out instructions....hilarious! We called both kids to tell them how ridiculous their parents are. The laughter did me far more good than that food would have, believe me. This week, Steve was traveling, so I went to stay with my parents for a few days. My wonderful Dad drive 3+ hours each way to come get me and Butters. What a great time we had. I got there on Sunday, my Mom and I walked the dog to Whole Foods and she made us salad for dinner, along with the chicken my lovely friend Priya had dropped off as we were leaving Jersey. I am so well taken care of! In two full days there, I managed to have dinner with 4 wonderful high school friends, lunch with 6 Keenan relatives, dinner with my cousin Lynn, and get a lymph drainage massage and education on lymphedema at the health building next door. My parents live in a wonderful condo right in downtown West Hartford that is just the best place to be. I'm tempted to go up there again next week when Steve's away again, but it's a schlep and I hate missing my activities here. Speaking of which, I went to my first LiveSTRONG fitness program at the YMCA. This is an awesome free 3 month program for cancer survivors to get back into shape. Most of the folks are much older than me, so I look pretty strong. It actually made me feel great. The fitness tests were pretty easy, I can stand on one leg for a minute, walk for 6 minutes, bench press a decent amount, etc. Seeing just how tough this disease and the treatment can be, I feel grateful to still be so lively and strong. In fact, I feel terrific right now, energetic and strong. I'm looking forward to really getting fit. It will be interesting to see how the radiation affects me, but at least I have a few more weeks to strengthen before then. It is odd being at the gym after my mastectomy. I don't want to bother with my fluffy, somewhat itchy fake boob, so I am simply lopsided. I simply forget this fact for most of the time, then remember and feel a bit awkward. I am finding being one-breasted harder than being bald, I'm not sure why. Maybe it is that being "disfigured" is simply more brutal. I mean, it's a form of amputation, and I think we all have a visceral response to seeing an animal of any kind missing a chunk of what we expect to see. Or maybe it's that bald is a choice men and even some women can make for fashion reasons. I don't think anyone ever cut off their boob to make a fashion statement (if someone did, please don't tell me!). I find it interesting that I am self-conscious about it. But not self-conscious enough to put in a falsie for working out, at least not now. I might later, and I do feel much more comfortable in public with both boobs in place. There is definitely something to be said for not making a statement everywhere you go. But I guess I wish it's didn't bother me at all. But who wants to look funny if you don't have to? Another issue with the falsie is that it hurts. They tell me I may heal the nerve damage that left my left arm and chest with spots that are sore to the touch, making bras, shirts or clothing of any kind irritating, but that it will take months. Fun! Anyway, I feel great and am looking forward to singing again tonight. Today is a very good day for me to be alive in. Hope yours is good, too! Colleen

Why I love my cabaret class...

Just got back from cabaret class. I am enjoying it more than ever because I now sing without fear of failure. I am just beyond worrying about sounding perfect or being judged. So my friend Jill asked if I'd try singing "I will always love you" with her as a duet. When I got up to the mike, I said I'd need some time to work on it because I don't really know the song. Our director Maria wisecracked "You've got one try, Colleen, just get it right!" so I took of my baseball cap to expose my shorn head and shouted "hey, don't you know I've got freaking cancer??? Maria shot right back "God, I'm so sick of hearing about that!", so I pulled out my fake boob and threw it at her head. God, I love that class!

Pathology results are in....

I met today with my surgeon. She had the pathology results from my mastectomy and went over them with me. Here is what I understood: there was a tumor of 2.4 cm that had tendrils going into the skin, the nipple and the blood vessels to the lymph nodes, all of which we either knew or suspected. One of the many lymph nodes they removed under my arm had tumor cells in it. The margins looked good, which means there was no cancer spreading into the edges of the tissue they removed. The surgeon was not alarmed by any of this. I will go over it again with the oncologist in 2 days, but here is what I gather at this point. Mastectomy was the right call (I am not surprised). Radiation is clearly called for. Since they did not remove any of the lymph nodes above my collarbone that were cancerous (at least before the chemo) and one lymph node still showed active cancer, blasting the entire area with radiation might kill any cancer still in those local lymph nodes. Of course, since the lymph system is all connected, we can only hope that the chemo or my immune system killed any cancer cells that escaped beyond the local area, or that none had escaped. My good pet scan results seem to indicate reason for optimism. So listen, it's a bummer that they still found active cancer cells. It would have been awesome to find nothing left. But there is no reason not to be optimistic. There is no doubt that I responded extremely well to the chemo. I am clearly healing well (she was delighted with how my incision and area around it look.). Besides, there's nothing to be gained from worrying, except when it motivates me to take really good care of myself. So here's what that looks like: I have stopped consuming dairy products, because I find the epidemiological evidence that groups who consume no milk (the Chinese) have almost no breast cancer to be compelling. I am continuing to take large doses of vitamin C and niacin. I am also getting lots of sunlight and uv lamp exposure when it's rainy in order to produce lots of Vitamin D. I am eating a diet of primarily vegetables, fruits, complex carbs and some animal protein. No added sugar and not too much fruit. Steve and I are still reading to come up with an optimal diet that is also enjoyable. Lots of theories out there with often conflicting advice. What everyone agrees on is veggies are good for you! I'm still regaining strength and getting my lungs back on line, but exercise is going to be hugely important. Steve is excited to help me get into great shape without trashing my crapola joints. So onward we go. I may have more info after meeting with the oncologist on Wednesday, which I'll share then. Looks like radiation will start in 2-4 weeks from now, and Steve will be traveling, so I may go spend some time with my folks in Connecticut. The only problem is they don't have a sun porch! Hoping to visit with some old friends if I'm up there. You can all admire my salt-and-pepper crewcut!

Gory details

So many of you have asked, that I wanted to give a quick summary of where I stand with treatment. If this isn't your bag, just skip this posting!

1.  Got diagnosis of Invasive Ductal Carcinoma - Stage 3+ that is not fed by Progesterone or Estrogen.  Test for whether it is responsive to Herceptin is pending.  Herceptin positive is bad = more aggressive but good = can be treated with Herceptin (which is also bad for your heart.)  If its non-responsive to all 3, its considered triple negative.  Biopsy of lymph nodes under my arm show breast cancer.  Lymph nodes in my neck then swelled - not yet biopsied.  Breast biopsy shows small mass that has already travelled.  Bone scan and CT Scans of body negative.

2.  Recommendation of first team was 2 months chemo (doing it ahead is called neojuvant) then mastectomy, then radiation, then 9 months or more of chemo.  Adriamycin and Taxotere.

3.  2nd opinion Sloan-Kettering NJ.  Surgeon thinks lumpectomy adequate but have to await oncologist.  PET Scan shows large lymph nodes in neck (duh!) which are scheduled to be biopsied next Friday - after I meet with the Oncologist on Wednesday.

4. So we are still waiting for SK team to weigh in on the staging and treatment plan.  Will let you all know.  Thanks for all the wonderful emails and calls!!!!

Is it okay to pray for strangers?

Last night, three weeks after learning I have cancer, two weeks after learning I have breast cancer, and one week after learning that I have invasive, (probably) triple-negative cancer that is already in my lymph nodes, I was getting my hair done.  I joked with Liz about the wisdom of dropping $175 on foils, color and cut when I don’t know when they want to start chemo and it all might end up falling out. 

She offered me a free promotional massage and, after I said yes, the owner called me aside.  Gently, he reminded me that I can’t because of fear of spreading.  He then suggested I come in to let them shave my head right away when I start to lose my hair (this was already my plan.)  And he told me something people have started telling me lately, which is that breast cancer is “no big deal” anymore, tough but do-able.  This is meant to be reassuring, of course, but it’s certainly not true.  In fact, I think it’s going to go into my new book “21 Stupid Things to Say to People in Trouble,” in the chapter “Minimizing Their Pain.”  I am collecting, along with tons of incredibly love, support and wisdom from others, a lot of material for the book these days!

So, after all of this, and just because it was TIME, my grief started to roll in on me.  Grief comes in waves, and a major Tsunami that has been building under the surface started to crest.  Liz came out as I was leaving and gave me a hug. I paid, added the tip and got ready to leave, all the while avoiding making eye contact with the woman behind the counter and obviously struggling not to cry.  I could feel that she wanted to say something, but she didn’t.  As I turned to leave, I caught her eye and she asked me “Is it okay to pray for strangers?” 

All I could do was nod, get to my car and let the flood gates open.  Such an odd question, isn’t it?  She was, in effect, asking my permission to care about me, even though she doesn’t know me.  Who would need permission for that, yet I felt the caring and humility, the delicacy, to use an old-fashioned word, in her question.  A bit of delicacy and compassion in a vulgar reality-TV world goes a long way when you are holding body and soul together with scotch tape and chewing gum.  I am grateful.