Helping Your Kid Find Resilience and Post Traumatic Growth (PTG) in the Middle of a Shit Storm (at least that’s what I hope we are doing)

Our son, B.D., was six when Garry was diagnosed with cancer. Two months prior to that our eight year old boxer, Dempsey, was also diagnosed with cancer. To be honest if I had the slightest idea Garry would be sick within months I would have gone a very different direction when talking to my kindergartner about his dogs illness and impending death. I’ve been a nurse for over two decades and the vast majority of that time I’ve worked in hospice and palliative care. So, I’m a little aggressive when it comes to conversations about death and dying

Hospice is always palliative care, but palliative care is not always hospice. Palliation is the relief of suffering. All suffering. As a nurse I concentrate on the physical, but true palliative care is comprehensive and covers emotional, spiritual, and so on. Hospice as we know it means end of life. In the true legal sense of the word you are eligible for hospice if your physician can certify that they believe you have six months or less to live. Palliative care, outside of hospice, is not time limited and can and should be accessible to anyone with a chronic or life limiting disease regardless of life expectancy.

This is the world I live in. It’s my profession and my passion. Last I checked the global mortality rate is still 100%, but we all act like its super rare and should only be discussed in whispers. I dated a very sweet guy in college who referred to death as the D-word…. It’s a good thing our relationship didn’t work out. I would have made him incredibly uncomfortable eventually, and although I may have found that immensely enjoyable I doubt he would have.

When Dempsey got sick we had a very direct conversation with B.D. that Dempsey had cancer, the doctors couldn’t fix the cancer, but they could make Dempsey more comfortable and we probably had a few weeks or months before we would have to say goodbye. B.D. appeared to absorbed everything very seriously until we said we would have to say goodbye, and then he looked at us incredulously and said “WHY?”. To which we replied “because he’s going to die”. And that’s when the wailing started… I realized pretty quickly that although he seemed to understand what we were saying he simply didn’t have a real grasp of disease and mortality to connect the dots, and when they were connected for him it was brutal. Not my best work.

That was February. By April we knew Garry had cancer. How do you tell a six year old??? Especially after the traumatizing way we busted out the news about the dog. Dempsey, by the way, was alive and well at this point. Steroids are wonderful drugs and bought us an extra six months with the old bear. They were good months too. He did really well, until he didn’t. I’m actually really proud of how we handled his final days and death with our son, but we can get into that later.

Telling B.D. about Garry. That was impossibly hard. There was no way to do it without showing our own emotion and fear, so we did the best we could. We waited. We waited until we knew how bad the cancer was and until we had a treatment plan, that we ended up scrapping and chose clinical trials instead. But we waited until  were able to say “this is what daddy has and this is what we are doing about it”.

B.D. is little. He was so little in kindergarten, and he sat in Garry’s lap barely visible beyond the giant arms and shoulders wrapped around him.  I could see the trust in B.D.’s eyes and the pain in Garry’s, so I started. We explained that Daddy had cancer, but there was lots the doctors could do, and that the best scientist in the world were working on Daddy’s cancer in labs and hospitals everywhere. It’s not the same as Dempsey or Grandpa Dave. Daddy is not the same. B.D. cried. He didn’t ask a lot of questions. We emphasized how strong Daddy is and what a fighter he is. We told him about people he knew who had survived cancer and we could see him relax. He was quiet the rest of the evening. He didn’t eat much dinner and then he threw up. He’s always had a stress stomach. His stomach was wrecked the whole weekend. I emailed the school and Jiu Jitsu to make sure they knew what was happening at home and could support him. We kept assuring B.D. that we would always let him know what the plan was and that we would tell him if anything changes. I became obsessed with making sure he could trust me. I was worried that soon I might be all he had, and he needed to know I’d be straight with him. No one appreciates a blind side and I needed him to know I’d be honest. I tried to keep things age appropriate, but I know he was the only kid in his class that could tell you what an oncogene was.

I made mistakes that first six months and one of them was putting a premium on Garry and B.D.’s time together. I found myself stepping back and letting their relationship take center stage. I lost time and interaction with both of them that summer, and it wasn’t good. It wasn’t good for Garry and I. Their relationship is important, but I’m part of that relationship.  It was a tactical error on my part. One that I’ve always regretted. There was no permanent damage, but I can’t stress enough the importance of moving together as a family, not as individual relationships. You can not let that family relationship fracture. You can’t. Your intentions may be good, but it’s a dangerous stupid game. Don’t do it.

Garry started his first clinical trial and we knew pretty quickly it was working. We took a four night raft trip on the North Platte and Garry was in his element. Strong and solid. Life was good. We waited for the first scan and it showed improvement on the tumors. They all shrunk, and no new spots appeared. With this disease no growth is a win. Shrinking tumors is amazing. We were teasing out our new normal, because there was no going back. The only way out was through, so through we would go. I wanted B.D. to see Garry in treatment, and meet the doctors and clinical team caring for him. Garry was gifted an Elitches Six Flags pass by his coworkers,  and he and B.D. would go to Denver for treatment every other Friday and then spend the rest of the day at Elitches. That fall B.D. told me “it was the best summer ever”. I disagreed, but I was so pleased that was his experience.

Pro-tip: Life can always be fun. Sometimes “jumping for joy” means you actually need to work for it. It may feel like it’s out of your reach, but jump for it. Get it. Do it for you, and do it for your loved ones.

Midsummer Dempsey started to decline. His mobility decreased and breathing was hard. He dug a hole in the back yard and would go lay in it at night. Garry would carry him inside and lay with him on the floor. Dempsey had been MY dog until I was pregnant with B.D. I spent a few month on bed rest and it was then that Dempsey declared his allegiance to Garry. I had gotten fat and lazy and Dempsey was over it. Garry had his heart now and he never looked back.

Garry was watching his dog die of cancer while battling his own. He kept his heartbreak to himself, but I knew this cut deep and in ways I couldn’t possibly understand. I was at work and Garry called me. I could tell he was holding back tears and he said “Dempsey can’t walk. It’s time.” I grabbed my things and went home.

I found Garry sitting on the floor Dempsey in his lap his breathing labored. Garry looked up at me helplessly. I had called the vet and they knew we’d be coming. B.D. was at the neighbors across the street I told Garry “I want to get B.D. I want him to have a chance to say goodbye”. At the neighbors I dropped down eye level with my son. I said “Dempsey is dying. There isn’t much time. Do you want to say goodbye.”

If you know my son you know he is never in a hurry. He hates to be rushed. The world spins a little slower under his feet. He can spend twenty minutes getting his shoes on, but that day he’s never moved faster. He had his shoes on and was out the door almost before I finished the question. We returned home to Garry and Dempsey still on the floor. Our puppy Rose anxiously pacing around them. I explained to B.D. that we were going to the vet and they would give Dempsey medicine to be comfortable because his body wasn’t helping him any more, and then Dempsey would let go of his body and die. B.D. nodded his understanding and said he wanted to come with us. He stayed in the treatment room with us while they gave Dempsey his sedative, and once Dempsey was sleeping his breathing regular and peaceful B.D. said he was done and wanted to leave. Garry stepped out with our son and I stayed with Dempsey for the final injection. I held him until he was gone. I found the boys outside. I told B.D. how proud I was of him for staying with Dempsey as long as he did, and how brave that was because death is hard, goodbyes are hard, but mostly because he listened to his heart and knew when he was done and needed to leave. I told him most adults don’t know how to do that.

B.D. was only eighteen months old when my dad died, and although they were very close he was much too little to understand death. Dempsey wasn’t the first, but it was the first one my son could process and that was really important to me. This was foundational for how he would process death and dying the rest of his life, and given our circumstances it was really important that we did it right. Everyone should have choices in how they approach the death of a loved one. Control is comfort. Control is safety in the face of something scary. I wanted B.D. to have as much control as possible, and that meant understanding what was happening and being able to decide what he could handle for himself. I didn’t want to deprive him a chance to say goodbye because I thought it would protect him from pain. Studies on children and post traumatic growth show that protecting them from their circumstances inhibits growth. I grew up very protected and not at all prepared for life as an adult, and I’ll be damned before I do that to my son.

A year and a half later, after eighteen months of promising scans, Garry’s tumors started growing. Worse still he had what we call distal mets. That is metastasis or new tumors growing far away from the primary tumor, and it’s a bad sign. We needed a new drug trial and that takes time. We would spend Christmas knowing the cancer was spreading and not actively combating it. It was grim, but we were determined to make it a special time. It was a break from cancer treatment and in some ways Garry felt better. Our son knew what was happening, but we tried to put the best spin on it for him and ourselves. B.D. knew enough to be worried though. He told me one night during prayers that he liked the old treatment and he was scared of the new treatment. We talked about how new things are scary, but how the old thing wasn’t working anymore. We trusted Daddy doctors and knew they had a plan. Again I reassured him that he would always know what was happening and we’d figure things out together, because this is happening to him too and that matters.

Earlier I mentioned that I notified B.D.’s school and Jiu Jitsu gym almost immediately. I knew our son would need a support system outside of us. He was pretty established with the school, but had only just started Jiu Jitsu and we wanted him to stick with it. Physical exercise is so good for coping and mental health. In my twenties I competed in martial arts and I love them. It’s a thinking physical exercise. There’s strategy, there’s defense and offense, and the body mechanics you learn in martial arts translate well into any other sport. Plus you learn to lose and win with grace. You learn to fail and keep trying. You have to get back out on the mat because every time you lose you learn. It’s about bouncing back. It’s resilience, and my kid needed resilience. It’s a life skill that couldn’t wait. They’ve been amazing. The coaches and owners are amazing. B.D. still goes twice a week. It’s consistency and commitment and it’s good for the soul.

As a kindergartener and first grader B.D. told very few friends about his dad’s cancer. I would encourage him to pick friends that felt safe and share with them. I explained how much my friends helped me. I frequently reminded him that cancer isn’t a secret. It’s nothing to be ashamed of and it doesn’t define us. It’s something that happened to us, but it isn’t us. We would talk about how his friends mostly wouldn’t understand what life was like for B.D. and the fears he has, but that many of them understood the concept of uncertainty and may have experienced that in big or small ways. I also brought up that it was a good thing his friends didn’t know what it was like to have a parent with cancer and we hoped they never would. B.D. always agreed with this. Over the past two years he has built a support group of friends who know about Garry, and they share pretty openly with one another. Peers are only going to become more important, and he will need them. I’m glad I pushed. In my exploration of kids and PTG I’ve learned that peer support becomes pivotal to growth especially as he moves closer to his teen years.

Last summer Garry completed a TIL (Tumor Infiltrating Lymphocyte) trial and it meant two weeks in the hospital. He came home home twenty pounds lighter, septic and without an immune system. B.D. given the choice spent most of the time in Denver between the hotel and the hospital. When he’d had enough he asked to go stay at his uncles and we got him there. As the summer faded away, and B.D. was preparing to go back to school he told me he wanted to talk to the school counselor and see if she could help him forget about our summer and what they did to Daddy. I agreed it was hard to watch, but I was so happy we had that opportunity and how it was likely saving Daddy’s life. I suggested that sometimes you can “re-frame” a hard or bad memory and make it a good memory. By Christmas break he was calling the time in the hospital our “Denver vacation”. He re-framed the memory into something fun.

When it’s all said and done, B.D. is much better at this than I am. In no way will that trial ever be a vacation for me. Nor will that first summer after diagnosis be “the best summer ever”. All of it has tested me, and overall I’m proud of what we’ve done as a family. I think I would be proud of that even if we didn’t have the good outcome we are enjoying now. As I see my son thriving, I find I worry about myself. Have I grown? I have over-functioned. I love to over-function in a crisis, but I know it’s not sustainable. Garry got cancer and I handled it by losing 20 lbs, going back to school, changing the course of my career, and starting a blog. I’ve watched my son honor his sadness and grow from it. I have two gym memberships and very nearly have my masters degree, but have I grown? Is it durable? Is this all borrowed and I haven’t really done the work? When school is over and we are living life, real life, not scan to scan life, I think my kid will be ok, but will I? As parents we teach by example and although I do think I’ve given him the best tools I could, have I lead by example? I don’t know, and that’s hard.

Grandma Butt

We’ve recently had our house remodeled and one of the greatest things about it is our new six panel doors. When we got rid of our crappy-almost-cardboard 1979 doors I also got rid of my cheap Target door mirror. I have replaced it with a big glorious metal framed full length wall mirror that hangs on the other side of the room between our two bedroom windows. It is a huge mirror and has access to a lot of natural light. All good things right? Wrong. It shows all the details, and trust me when I tell you the devil lives in my details. Hunny, I’ve got some details.

This all went down last fall before I started CrossFit or was even considering starting CrossFit. There I was looking at my bare ass in said mirror while my husband lay on our bed staring at the iPad. That’s when I noticed that sometime (hopefully in the recent past) I had developed a nasty case of grandma butt.

***Apparently not everyone knows what grandma butt is just like not everyone knows what a car poo is, and I find that baffling. So let me break it down for you. A car poo is a black chunk of ice and snow that falls off the bottom of your car. They are everywhere this time of year. You have them in the garage and on your driveway and they are all over the roads. They are also totally unrelated to this blog post, but I’m always shocked by how many people don’t know what a car poo is, so consider it a blog post freebee. You’re welcome.

Grandma butt is, as the name implies, a sad fact of the aging body. As you age you lose collagen (God, I miss you collagen), fat and muscle mass. All of these lost ingredients can lead to grandma butt, which is the loose skin one develops at the bottom of their butt cheeks. It kind of hangs there like a turkey wattle. Don’t get excited gentlemen, grandpa butt is alive and well, and just as prevalent as grandma butt. You boys are not immune.

I don’t know if every woman is as eager to point out their flaws to their significant other as I am, but it’s one of my favorite pastimes.

“Babe, I have grandma butt!”

Not looking up from the iPad, “what’s grandma butt”.

I explained it, and he responded, “Babe, you’ve had that for years.”

Inside I gasped in horror that I’d had a turkey wattle for an ass “for years” and not known it. I was also kind of mad because he knew it and didn’t tell me. My friend Libby’s dad is a marriage counselor and he claims that people only get married because they can’t see their own butts. I like this theory, because it means Garry only had one job. ONE JOB, and he failed. So, my grandma butt is now officially his fault and not mine. On the other hand Garry’s completely indifferent reaction reminded me how men really aren’t the least bit particular, and we think they are much bigger critics than they are. In the fifteen years that Garry and I have been together I have been all sorts of shapes and sizes. Although there were times I was pretty sure only one of us should do it with the lights on, he has never complained. Lets face it, dudes like flesh. He likes me jiggly and juicy and he has no complaints about my grandma butt. He’s just pretty happy when he’s getting attention and I’m showing flesh, even if that flesh resembles a turkey wattle.

If you have never been to a Crossfit gym you should Google or Bing CrossFit athletes, and you will see the most perfect derrieres on God’s great earth. After eight years of Garry begging me to join CrossFit and workout with him, it was becoming a viable option. Behind the scenes in this whole scenario we are planning some big celebrations. First there is Garry’s miraculous response to the last three years of cancer treatment, and I’m finishing my Masters of Jurisprudence in Healthcare Compliance Law this May. This summer we will do our usual week long raft trip, but we are also going to Costa Rica, and I have been buying bikinis like crazy. One in particular is a little problematic. For one thing it is not age appropriate for a 45 year old, but whatever, I’m leaving the country and mommy’s still got it. I’m wearing it. It’s super cheeky. It’s basically a thong with little mud flaps to cover my butt cheeks. A slight breeze and that baby is a thong. I kind of want to rock it, though. Which means I have work to do, unless I can figure out a way to get my crossfit coaches butt on my body.

Garry is, as always, my greatest supporter and fan when he knows I want something. He sees me lifting my butt into place in front of the mirror and will smile and say encouragingly “it’s looking good, Babe. It’s getting better”. Although I’m pretty sure all men are willing to lie to us about how we look out of a survival instinct, I think the turkey wattle is shrinking and being replaced by actual beefy muscle. I’m never going to have the butt I had in my twenties…. But I can have a pretty good butt for a middle age woman who pees her pants when she jumps rope, and I’m totally cool with that. Plus my husband thinks I’m hot.

Lookout Costa Rica, my grandma butt in a pseudo-thong is coming your way.  Sorry. Not Sorry.

You can’t get your old life back, but you can build a new one.

WARNING: I swear a little/a lot, and make references to Marvel Comics characters. If you are sensitive to language or not very nerdy you may be offended or confused.

Thirty-six months ago my husband told me “I have a swollen lymph node but I’m not sick and it doesn’t hurt”. My first thought was “he’s wrong, and I can make it hurt”. He pointed out a walnut sized lymph node in his left groin. I knew it was walnut sized before I touched it, because I could see it bulging under the skin. I poked it hard and asked if it hurt. He shook his head “no”. I knew he had cancer.

A year prior to that Garry had developed a knee to groin blood clot in his left thigh. He had no risk factors for a DVT (deep vein thrombosis) so much so that I decided it was an impossibility and stupidly said so as the ultrasound tech rushed out of the room to notify the radiologist of his giant DVT. We spent the better part of the next year trying to figure out how a non-smoking, active, thin, 39 year old male who was obviously not taking birth control pills could develop a DVT. The only reasonable assumption could be that he had a genetic clotting disorder. We knew cancer can cause hypercoagulation. My dad had multiple clots in his lungs during his battle with Melanoma just a few years prior. Garry even asked “could I have cancer?”. The answer was always a “no” without hesitation.

Garry always said he’d stop rafting commercially when he was 40 years old. He developed the DVT the spring before he turned 40, and because he would have to be on blood thinners decided it wasn’t worth it to raft that summer, but he’s never forgotten his stolen final summer on the river. A year latter he was gearing up to take that summer back. He decided he would go off his coumadin and try to thin his blood with fish oil and aspirin. He would raft. I agreed with the stipulation that he would consult a hematologist before he put his plan into play. He already had the appointment with hematology/oncology when the lymph node made its presence known. I told him to show her the lump.

After that first visit it was decided that we would wait a month and see if it changed. It didn’t, and a biopsy was scheduled. Garry had a pre-op appointment with the surgeon the following Wednesday. I did not plan to go with him and had meetings and a training that afternoon. Garry is the oldest of five boys and his love language is largely based on teasing. If Garry fucks with you, it means he loves you. He loves me a lot. He started texting me that the surgeon thought they lymph node was superficial enough that he could remove it at the pre-op appointment in his treatment room. I was certain this was bull shit and pretty much told him so. What I didn’t know is he barely had a signal and his texts were going out but he was not receiving mine. I continued working because I figured I was being had, but still worried he might actually be getting cut open at the same time. I finally told my boss who said “go to him!”. I told her I thought he was messing with me, and she said, “what if he’s not”. Irritated I finally got a hold of him as I pulled into the parking lot. He was already done and out and walked up to my car. I rolled down my window and said “you pulled me out of a meeting, did you really have surgery?”

“Yes” he replied.

“I don’t believe you. Prove it”

“You want me to drop trou in the parking lot”

“Yes!” I said emphatically.

*****Nurses are great empathetic caregivers until we’re not. I have friends who didn’t believe their kids had broken bones and made them suffer for days before going to the ER. I knew I had appendicitis, but was so worried I’d be the girl in the ER with gas that I suffered all night until the pain localized to my left lower quadrant. Admittedly we are not always to best caregivers even to ourselves. This was not my best moment.*****

Garry dropped his pants in the parking lot and sure enough there was a nice surgical dressing on his left groin complete with shadow drainage of blood through the gauze. “You married an asshole” I told him and he agreed.

    I didn’t think we’d hear back from pathology for a week. I fully expected a cancer diagnosis, but had convinced myself Garry had a nice treatable follicular lymphoma. At work we were going live with a new electronic medical record (EMR) and me and our IT person were running point on the project including moving all current patients from the legacy system into the new one. The first week in a new EMR is always a nightmare. It was the Friday after Garry’s biopsy and our go live was Monday. When Garry called me that Friday, I was in my office just off our education room. My boss and three or four other coworkers were in the education room working on transferring patients into the new system. What happened after that is foggy and incredibly clear. Time stopped and sped up all at once. I’ll do my best with the recollection, but I make no guarantees that any of it is 100% accurate.

    Garry never called me during work. I figured maybe it was about the biopsy, but remained unworried, because I felt prepared for manageable bad news. I shut my office door and answered the call.

    “The doctor called. Are you sitting down.” I could hear the stress in his voice and started rehearsing my comforting speech in my head.

    “I’m sitting.”

    “I have melanoma. It’s melanoma. They want me to come in at 3pm.”

I heard someone wail the word “nooooooo!” and maybe a scream. I remember thinking “who is doing that? That is not helpful”, but also realizing it was me. This defied reason. This was outside any concept I had of the existence of a loving God. God was drunk. He was drunk and had forgotten that my dad died of melanoma less than five years prior. The world shattered. My world shattered. I remember sending an angry prayer to the heavens, “sober up and fix this!”.

    “Where are you?” I asked.

    “At work. They just called.”

    “What are you doing until 3?”

    “I don’t know. I don’t know what to do.”

    “I’m going home. I’ll meet you there.”

I clearly remember packing up my things and walking out of my office. They had heard the screaming and knew things were terribly wrong. Cathy, my boss, stood up. I told them I was leaving and Garry had melanoma. I remember Cathy’s hug. It was a mothers hug. She took my face in her hands and said, “You will be off next week. Let us know when you are ready to come back. We will be fine”. I remember thinking that was crazy. I’d be back on Monday. Cathy was right though. There is no working the week after a diagnosis like that.

I think I called a couple friends on my way home. April and Meghan. I don’t know if I actually spoke with them or just cried into their voice mails. I don’t remember how we spent those hours waiting to see the oncologist. I think we talked about how and when to tell our six year old son, and Garry’s mother.

It’s hard to explain what those first hours and days were like. Agony. It was agony. On diagnosis we knew it was metastatic melanoma, and that is bad. Eventually we learned it was mucosal, and had started in Garry’s gut. This was on some level a relief to me, because if I had missed something on his skin…. I’m a nurse. My dad died of this. If I had missed something. I couldn’t live with that. But on the other hand mucosal melanoma is much more aggressive than its cutaneous cousin, and much less responsive to treatment. If cutaneous melanoma is Ronan the Accuser than mucosal melanoma is Thanos.

The week was spent finding out how bad is bad. There were blood draws and scans and waiting. There was very little sleep and lots of nightmares. There was too much Googling. Ultimately Garry had no metastasis beyond the localized lymph nodes, and that was good. It meant he had somewhere between a 20-30% chance of being alive in 36 months. He would look at me and say “I just want to be his dad”. When given all the choices we decided to pursue clinical trials. We would roll the dice and hope for better odds in the experimental world than in the known world.

So far the gamble has paid off. At Garry’s last scan I asked what were the chances that he would have no more measurable cancer on his next scan. The answer was “It’s likely”. Coincidentally his next scan will be on the anniversary of his diagnosis. Fuck you, Thanos. I spent the rest of the day walking on air. It was a medical miracle. It was not possible when my dad was sick. This was amazing. But then while I was making dinner the rage hit, the gratitude melted, and I was pissed. “Are you fucking serious?” I thought. “Is this it? I want the last three years back! This shit changed me. I’m not remotely the same. He’s not the same. Our son is not the same. This is bull shit. We need payment for the last three years! It took our time and our money and who we were. I want it back. I want it all back!”.

It’s so very human to critique a blessing. To find the flaw in the diamond. Our oncologist can’t give us our life back. It’s not what she does, but she gave us time to build a new one. Maybe a better one, but that is up to us. There is no living like cancer never happened. Cancer casts a really long shadow, but great things happen in shadowy places. Life adapts, we evolve, we thrive, or we don’t. I think it is the creatures who spend their lives looking for a way to return to the place that is no more, who can’t survive. The poor souls stuck in the “I want it back” that fade away. I’m angry. He’s angry. We get to be angry, but we don’t get to be stuck. We have a life to build, and we have the infinity stones. Fuck you, Thanos.

Not Smelling Like R Kelly’s Sheets and Other Lofty Goals

If you were hoping to read an impassioned speech on the evils of sexual harassment and assault, I’m sorry. This blog post isn’t about that. This blog post is about piss, my piss. If you don’t understand the reference you clearly haven’t acquainted yourself with the lyrical genius of Macklemore, specifically his song Thrift Shop. Go do that now, and then come back. This blog ain’t going nowhere.

I came home crying from CrossFit this morning. Tears were the second form of secretions I lost control of today. The first was piss. This is not new for me at least not since I had my son.

We have a trampoline park in town and I have never joined my child for the bouncy enjoyment. When he was really little and I explained that bouncing makes me pee he earnestly assured me they have a bathroom and I’d be fine. Oh, you sweet tiny man with a long urethra that you can angle up to defy gravity…. My urethra is about an inch and a half, and it points straight to the center of the earth, the very source of earth’s gravity. Additionally, I pushed a giant noggin through its next door neighbor about nine years ago. I don’t want to brag but I can push a baby out like a rock star. That baby popped out in three pushes. I hemorrhages my eyes I pushed so hard. I looked like I’d been strangled, and I’m convinced I eternally rearranged my innards.

Approximately, one in three women between 35 to 55 years have some stress incontinence. Over age 55 the percent only increases. Stress incontinence is considered leaking or dripping urine when sneezing, laughing, jumping, lifting, etc. For me it’s only a problem when I jump. Jumping rope is my kryptonite nemesis. The evil male trolls that invented CrossFit are in love with jumping rope. Yeah F—- those dudes.

I’m going to go ahead and declare that jumping rope is an ageist-sexist exercise. If one in three men pissed themselves during a particular exercise no one would do that exercise. Think about it. NO ONE WOULD DO THAT EXERCISE. Once again F—- those dudes.

So there I was at 7am with yoga pants clearly soaked at least halfway to my knees. I don’t do double unders either. I do singles, and I can barely do those because I’m so distracted by my ever increasing drip rate. At some point it ceases to be an effective workout. It’s mostly an exercise in humiliation and misery and has become my official deal breaker with CrossFit. F—- those dudes. All the dudes. If you have a penis, I resent you.

When I started CrossFit I had three goals;

  1. Build muscle mass.
  2. Build bone density.
  3. Look good enough to do it with the lights on.

I have a new goal.

     4. Don’t smell like R Kelly’s sheets.

Jumping rope predisposes me to fail at goal #4.

By the time I arrived home I had regressed to a three year olds level of irrational stubborn frustration. I found my husband in the shower and proceeded to berate the evil bearer of a penis on my mornings trauma and how I’m NOT GOING BACK THERE IF THEY EXPECT ME TO JUMP ROPE. Then I left to take my own shower and wash my piss off like the sexy classy woman I am.

My husband and I have traditionally had some intense conversations while one of us is showering. Some of them result in life changing behaviors or decisions. When we were newlyweds I was the clinical director of a facility and worked ALL the time. I was supposed to have a Saturday off with him, but someone called in sick and I couldn’t get it covered. So there I was crying the shower because I had to go cover another shift. He popped his head in and looked at me sympathetically. With the best of intentions he said “Awe Babe, even your boobs look sad”. I quit that job within the month. I’m willing to work hard and go the extra mile, but not if it gives me sad boobs.

Within five minutes of my melt down during his shower, he was sticking his head in my shower and doing his absolute best to comfort me while holding back laughter.

“They have a surgery” he offered.

“I’m not going under general anesthesia so I can jump rope! I fail to see the benefit over the risk!” Of all the first world problems…..

He tried several other solutions all of which I dismissed, because I was still an angry three year old, and angry three year olds are not solution oriented. Plus it’s not like I haven’t tried exercises or over the counter interventions. To be honest some of those things have made it worse. However, I have not tried physical therapy which probably makes the most clinical sense, and I have friends that swear by it. Garry brought physical therapy up as well, but I was still playing by preschool rules and stubbornly told him it wasn’t going to happen.

Throughout the day I have received multiple text on how sexy and beautiful I am (in spite of my incontinence and personality issues). As a result I have forgiven him for his impeccable bladder control and I am feeling less frosty to his earlier suggestions.

In defense of CrossFit, no one MAKES you do anything. In fact it’s been my experience that they work very hard to ensure you push yourself but in no way compromise your health and safety. I’m fully aware that all I have to do is ask a coach to give me an alternative to jumping rope, but in the moment, rage born from humiliation is more fun than reason or problem solving.

If the last three years have taught me anything it’s that somethings aren’t worth it. Nobody is or ever will pay me to jump rope. It’s completely replaceable in my life. I have no fitness goals that require me to jump rope. In fact, as of today I have a no piss policy and jumping rope is the prime violator, so it can piss off. That said, I’m going to try the physical therapy because there is nothing wrong with a healthier pelvis, and if I can jump on a trampoline with my kid or even someday do a double under it might be nice. In the last few years I’ve also learned that there’s nothing wrong with prevention and taking control of what you can, or at least giving it your best shot. In the meantime that cute pink jump rope I bought can F— it!

Wouldn’t it be great if it did?

Lucy Kalanithi is a physician and a widow. Her husband, Paul, died of lung cancer. He was diagnosed as he was completing his neurosurgery residency. They had a plan before cancer. She was already working as an internist and when Paul would finish his residency they would have the time and finances to start their family. If you’ve heard Lucy speak you’ve heard this story. They knew he was terminal and discussed the possibilities of going ahead and having a family. Lucy asked Paul “Don’t you think saying goodbye to your child will make your death more painful?” and Paul replied, “Wouldn’t it be great if it did?”.

Nothing has ever made more sense to me. Nothing. I can’t explain why. There is knowledge and there is knowing. Knowledge is explainable it lends itself to language and description. Knowing has no language, because the soul is without speech. “Wouldn’t it be great if it did?” is something I am deeply knowing.

Early in his diagnosis my husband said “This would be so much easier if I didn’t have you and our son”. I was not offended. Easier rarely means better. Having us to worry about, to care for, to fear leaving was not easy, but it was better. It was so much better, and infinitely more difficult.

My dad died of melanoma in 2011. He was diagnosed nine years prior. It was discovered in a small black spot behind his right ear. Our family physician removed the spot and sent it for biopsy. Skin cancer was not new to my family lineage, but melanoma was. We were of Scandinavian descent and prone to highly treatable skin cancers. Both of my paternal grandparents had had multiple excisions on their faces and ears, with no additional treatments needed. The cancers were cut out and by nature of their removal cured. Melanoma is a different beast entirely.

Cancer in its simplest form is unmitigated growth. Cancer is not simple, but that is my simplest explanation. There are countless variations and complexities that exist under the formidable umbrella of cancer. Melanoma is one of the uglier ones. Melanoma cells grow quickly and worse still spread to other parts of the body. We call the spread metastasis. When my dad was diagnosed from an initial small biopsy of his skin. We went to Uchealth Anschutz Pavilion to see Dr Renee Gonzales. He was the regional melanoma expert at the regional teaching and research hospital. We were lucky to be living within 70 miles of his expertise. They removed a larger section of skin and a local lymph node. The pathology report came back clean. They had removed all the cancer. The treatment plan was to have annual checks for the next five years to make sure it didn’t come back. We left rejoicing in our good fortune. But secretly I heard the echoes of a nursing professor whispering in the back of my mind, “I hate melanoma. It’s like breast cancer. You think it’s gone but then five years later it shows up in their liver, lungs or brain.”   

I interviewed for my first hospice job on April 20, 1999 in Denver, Colorado. I sat in reception waiting for my interview. The receptionist was busy on the phone because nurses in Littleton were finding it hard to get to their patients as there was a large police presence and road closures around the high school. As I interviewed for the job that would become my passion, children and a teacher were being massacred at their high school a few miles away and because of that I have never forgotten the date. They hired me, and those initial patients of mine have not been forgotten any more than I can forget the events of the day.

One of my first hospice patients was a consummate lady and a consummate Texan. She sat comfortably in the sunny living room of her daughters house. Her family had moved her from Texas to Colorado, as she was widowed and her cancer had advanced. She was dying and needed to be with family for care and comfort. She was impeccably dressed and very at ease. In her slow soft drawl she explained what was already clear in her demeanor, she was not afraid to die but did wish to be more comfortable. Transversely her daughter stood the whole time, ringing her hands and anxiously awaiting an opportunity to get something or do something that might ease her mother. We signed paperwork. I ordered medication and medical equipment. I instructed them on how to give the medications and why. I suggested dietary changes and positioning that might aid swallowing. Finally, I asked if they needed anything else or had any other questions. Her daughter with face tight and desperate eyes asked “have you ever known anyone with cancer before. I mean, not a patient. Have you ever loved anyone with cancer before?”. My answer was “no”. I was twenty five years old and looked eighteen. I understood why she was asking. I knew my answer was disappointing. I didn’t know what she was going through. I didn’t. How could I?

Five years after Columbine and two months before my wedding day my dad developed a weird cough and upper respiratory discomfort. I talked him into getting a chest xray to humor me. They found a spot. It was completely unrelated to the cough, but I had a gut feeling…. They removed the tumor in his lung, but two days before my wedding they found a spot in the liver. They gave my dad three months to live. My mom picked up her phone to call me, and my dad took it away. He forbid anyone telling me until I returned from my honeymoon. It was a huge sacrifice on his part and the best wedding present we would receive. My aunts all cried during the father daughter dance. I found it extremely uncharacteristic. My dad, who never sang, tried to sing the song to me. It was Butterfly Kisses, and his voice kept breaking. I should have known, but I didn’t. I was in love, and in my mind all was well with the world.

He didn’t die in three months. He lived until the day after our fourth anniversary, and passed away peacefully in my parents home. In those last months we spoke about dying. I remember asking “what is the hardest part? Are you afraid of dying?”. He said, “No, I’m not afraid of dying. I’m afraid of the goodbyes”.

My husband would develop melanoma within five years time. Only his diagnosis of mucosal melanoma was much worse than my dads cutaneous melanoma. It’s incredibly rare, highly aggressive and has a poorer prognosis. My husband, like my father choose clinical trials over the normal standard of care, and has been incredibly, miraculously successful. Although he carries a sort of survivors guilt that he is living and thriving when my dad died. He feels guilty that I am living through this disease again, and although its brutal and cruel and I often think God must be drunk. Isn’t it great that it hurts? Because it can only hurt when you have loved deeply and are loved deeply. I wouldn’t have it any other way. Isn’t it great that it does?

Dear Grandma

Today I find myself paying the high price of mortal love. I should have written you long ago. I’m bad about writing. You wrote the sweetest letter to me when Garry got sick, in your shaky script. You were 102 years old and still handwriting letters to your granddaughter.

I’ve cancelled our flight, hotel and rental car that I had reserved for our annual visit on your birthday. You told me last year I wouldn’t be back because you weren’t having anymore birthdays, but you’ve said that before. However, I believed you and we all said goodbye. Then the months dragged on and you were still beating everyone at Uno and Bingo, and I booked a new trip. I figured we take you to Red Lobster. You’d jump out of the car and run in the building before anyone had a chance to help you walk, because you hated help. You’d get a margarita and my son would ask you questions about growing up in Chicago. Instead we will make other travel plans to say our forever goodbyes at your funeral. I will have a margarita.

When I was twenty-four you told me “in my time you would have officially been considered an old-maid” and you suggested that I marry the first boy who was nice to me. I followed your advice, but it took me six years to find a nice boy and another four to convince him to marry me.

You referred to yourself as dopey because school was hard and you never finished. School was hard for me too. I’m dyslexic and it’s genetic. Perhaps it’s one of the many things I shared with you. You were never dopey. You read more in a year than I will probably read in my lifetime. You raised three brilliant boys and you were so proud of their academic and professional accomplishments. I have lost track of the total of degrees between my father, uncles, cousins and brother and me. Not to mention published works. You loved books. You loved history and westerns. You loved big band music and you could dance. You love teddy bears.

My dad loved teddy bears and would buy them for me when he traveled, which was all the time. I love teddy bears and still have part of my childhood collection. My son is literally swimming in them. Garry has a strict “no more stuffies” rule that I make a practice of ignoring and getting the lecture when I get caught. Today after I received the call that you had died, I decided my broken hearted boy and I needed bears. I defiantly told Garry I was getting more bears, and his response was a simple “as you should”. It was extenuating circumstances after all. You always had bears on the door of your apartment, on your bed, and on the walker that you tried not to use. You began to give them to the other residence in your facility because they brought so much joy and comfort and you would say “everyone needs something to hug”.

I remember you told me that you grew a cup size with every pregnancy. You warned me that other women would tell me my boobs would shrink with pregnancy, but not to believe them. You were right. It’s a good thing I only had one baby. You had three and you had a rocking figure all 104 years and 50 weeks of your life. You were a babe, Grandma.

The single greatest thing about you was my dad. He attributed his phenomenal parenting skills to you. He read to us until we were late into our teen years, and his love of books was decidedly from you. When my Dad died the hardest part for me was calling you. I was a mom of a little boy and couldn’t fathom a call like that. It didn’t matter that you were 97 years old. You are not supposed to outlive your children. I’m so sorry that happened to you.

When I shut my eyes and think of you the image that stands out the most is one I saw countless times. It’s of my dad rubbing your soft wrinkled cheek with the back of his hand and saying “you are a very good mommy.” There is no greater legacy than that. I hope someday I have that in common with you. When my son is a grandfather if he still looks at me and thinks “you are a very good mommy” then I will have succeeded in the very best part of life.

Why CrossFit? Why Now?

The first time I heard about CrossFit was from my brother in law Kyle who had gone to a WOD with his soon to be mother in law (whom we lovingly call Christmas Carol). Christmas Carol had started doing CrossFit and was hugely successful with her overall fitness and weight loss. Kyle, who is a bit of a beast, figured he’d try a class and crush it. Kyle tried it, probably crushed it, and promptly threw up. This was nearly a decade ago, I was pregnant, vomiting daily already, and not at all looking for a new exercise program. Kyle however was hooked on this new emesis producing fitness regime.

Alice, Kyle’s soon to be wife, joined shortly after Kyle. I remember Alice telling me she had to have her wedding dress altered because she had not anticipated how much CrossFit would change her measurements. By this time I was trying to lose the baby weight and getting my boobs to fit into anything and not look obscene was a miracle. I contemplated CrossFit briefly, but I wasn’t sure it would pair well with lactation. Additionally, my dad was dying, I was a new mom and working full time. Sandwich generation guilt prohibited me from taking on anything that meant less time with my dad or son. Meanwhile Garry was all in. He went from 0 to 60 overnight and I was not prepared or supportive, but I was very resentful.

Garry completed his “check off session” and literally HAD to go to CrossFit five days a week. This was quickly followed by some new fresh hell he called the paleo diet. Apparently paleo people who had not discovered corn or potatoes, BUT were master brewers and distillers who died at the ripe old age of 35 had cornered some kind of market on healthy eating, and we were going to emulate them. Garry declared himself Paleo one night before bed, and woke up the next morning with nothing he could eat available in our home except maybe a banana and some frozen breast milk.  I found it hilariously unrealistic and figured he’d give it up like his plan of opening a bar on a beach in Thailand, but he did not. HE ACTUALLY WENT PALEO. He was Paleo for years. I complained incessantly, but I started cooking paleo. I can do amazing things with a plantain (insert inappropriate joke here). I even tried the paleo diet for a solid month, and have never been more homicidal in my life, aside from my first trimester because I am a very angry pregnant woman.

For those of you who knew me during this period you knew that I hated two things, CrossFit and the Paleo diet. I declared CrossFit a cult. In my mind it met the definition of a cult because it took all our money, told him what to eat and worse still stole his relationship with family. I was so convinced that the later was true that I did a time study on how much of BD’s life Garry was missing while he was at CrossFit. I like data. I love anything measurable, peer reviewed, and if possible replicated in a lab. You rarely hear me use the word “anecdotal” without immediately following it with the words “bull” and “shit”. For example I will frequently say things like “that’s just anecdotal bullshit” or “anecdotal evidence is bull shit”. So I gathered the data and formatted a point by point presentation on how CrossFit was robbing our son of his father. Data is best when paired with a story to support the data. Having been a hospice nurse for 15 years I am absolutely swimming in stories of what people do and don’t regret at the end of their lives. Let’s just say everyone wishes they spent more time with their kids and no one has ever said “I wish I worked out more”.

I like to pride myself on my powers of persuasion and I’m usually successful because I’m willing to give a little. If everyone walks away feeling like they “won” something deals are more likely to hold. The base of my argument was not that he leave CrossFit entirely or give up the Paleo diet, but it was to cut back from 5 days a week to 3. I gave my presentation and presented my data in WEEKS a year not spent with BD. WEEKS not hours, WEEKS. I was actually pretty proud of myself. He didn’t budge. He defended his position by stating that he was doing all of this so he is in good enough shape to DO all the things he longed to do with BD as he grew up, such as rafting and snowboarding or whatever BD wanted to do. He was simply playing the long game and the time away would pay off in time together later.  Needless to say, Garry has unrepentantly been going to CrossFit five days a week for the last eight years. Not that anyone is supposed to win or lose at marriage, but if you’re keeping score, I might be losing.

About three years ago I signed myself up for adult beginner swimming through the city. I took swimming lessons as a kid, but I am and always have been deathly afraid of sharks in all bodies of water. I know it’s not rational, that’s why it’s a phobia. As a kid this notion grossly impeded my advancement through swimming lessons. To this day I’m no longer afraid sharks will show up in puddles or the bathtub, but I’m pretty sure they are everywhere else. So although I can swim, I’m not very good at it. Oddly enough I have no fear of drowning, which being in a landlocked state and married to a raft guide is probably much more likely to happen.

It’s being married to a raft guide and giving birth to a human fish that made me decide I needed to learn to swim, and swim well. That and I’ve basically had an orthopedic surgeon on retainer since I was twenty-one. Swimming can be done long into life with minimal risk of injury and that seemed about perfect for a girl like me. I’ve become a regular at the senior center. I swim at least three times a week, and I’m pretty solid. But my bubble was burst when my knee started hurting so bad I was walking with a limp. The only time it didn’t hurt was when I was swimming. I was pretty sure I needed another surgery, but opted for the steroid injection and physical therapy instead. In physical therapy we reviewed all the great things about swimming but kept coming back to the fact that swimming is non-weight bearing, and it doesn’t do much for bone density or muscle mass, and muscle mass is what I need to compensate for my genetically inferior knees. Damn it. CrossFit builds muscle mass.

Over the years I have created several theories about CrossFit that have not held up under scrutiny. As a result I’ve decided my favorite pie is humble pie, because I eat so much of it. I like to wash it down with tequila and Xanax. Delicious.  I think I’ve mentioned that I like data. I spend a lot of time with data at work and in my free time I read every study and journal article I can on melanoma. I also dabble in literature related to cancer survival rates and recurrence. It’s actually an exciting time in the world of cancer. Survival rates are increasing and prognosis in becoming a moving target with new treatments. Currently there is a growing interest in making sure cancer survivors are able to age in a healthy way. We never worried about their long term cardiovascular health when they weren’t expected to live long enough for it be a problem. The day of telling them to eat whatever they want because calories are calories, or to only exercise if they feel like it are gone. Recently there was a study on breast cancer recurrence that showed women who workout five days a week, even if it’s a brisk half hour walk had a 30% decrease recurrence of breast cancer than their counterparts who worked out three days a week. THIRTY PERCENT! That’s what we call statistically significant. It didn’t matter how many hours a week they worked out. The data clearly demonstrated that working out five days a week was key. Remember my little time study tantrum about Garry working out five days a week??? Humble pie is delicious. Those extra hours at the gym are theoretically giving my son years with his dad that he may not have had otherwise. I LOVE humble pie. So tasty!

To make a long story longer I joined CrossFit three weeks ago, and I have never been so grateful for our new comfort height toilet seat. I also realize that for the last eight years when my husband would tell me what he did at crossfit I was obviously tuning him out.  For one thing they speak their own language, and I don’t speak crossfit. Additionally, hearing about someone else’s workout is boring. Nobody wants a play by play of your yoga poses anymore than they want to hear about your reps and Rx and PR’s (see they have their own language). I have decided it’s only a matter of time before my boob/boobs fall out of my top while attempting one of the many horrible inverted exercises they make you do. I spend most of the pre-workout huddle questioning my life choices and thinking I’ve made a mistake that I dearly regret. BUT life between the workouts is better. It’s a new thing I share with my husband, and it’s palpable how much he loves sharing this part of his life with me. My waist is smaller. I will need new pants and swimsuits sooner than later. I think my kid is proud of his mom. More importantly, I’m proud of myself. I used to be pretty competitive. I loved competing in martial arts, and my husband has always said “you’re a good little athlete when you want to be”. It’s like waking up. This feels like me. I feel like me. I’m going to bitch and moan about it but I’m going to keep going back, and that speaks for itself.