Hello and welcome to An Altitude Problem, where the altitude is lending itself to frozen fingers and toes in the morning. We dogsat Raisin last night, which meant I had to stand outside in the 20 degree temps for four times as long as usual this morning. Raisin has a backyard that she does her business in, so she has not learned about hurrying. She has to sniff and explore and has no idea why we are out in the yard. Andy is fast. Two sniffs and a squat and he is done. He knows that this trip outside is for business, not pleasure. Later, I will get out my bike and he will explore and sniff to his heart's content and he knows this and is okay with delayed sniffing gratification.

I got home late last night from another trip to Houston, after slapping my face, opening the windows to let in the freezing midnight air at 12,000 feet, and peering blearily through my windshield for the last 50 miles in an attempt to wake up. The trip back from western Kansas seems to pass more quickly every time I drive it. It helps that the closer I get to home, the more of my attention is required for driving. It is a different story driving out there from here. Since I always leave after work it is late by the time I hit the empty flatlands and I am the only living thing for miles around, except the occasional coyote or jackrabbit peering out of the weeds, or the deer that so far, have refrained from jumping in front of me. The trip to Kansas gets longer every time because of this. It is far more mentally draining than driving home, hitting Denver traffic and a mountain pass and radio stations that jar me awake instead of croon me to sleep about the time I start to nod off.

Since many of my parent's friends are also my faithful few, this seems like a good bulletin board to post an update on the cancer front.

We left Kansas for Houston early on the 9th and drove the 14 hours it takes to get us there, checked into our motel several blocks from May's clinic and the MD Anderson tower, and the next morning, walked over and met with my mom's oncologist for a long-awaited consultation, the consultation that has been pushed back once already because of a late-scheduled biopsy on her unnaffected side, which they thought, after lokking at mammograms, might be affected. Turns out, there was no cancer detected on the right side. That was the most encouraging news we heard all day, although in hindsight, it did cost us a precious two weeks of letting the cancer plot it's evil course unhindered.

Here is what he had to tell us. This tumor is a higher grade than previously assumed. A lumpectomy will most likely not be as affective as a mastectomy in removing all fingers of the tumor. If she did opt for a lumpectomy, radiation would also be required. Since this cancer is slightly more aggressive than originally thought, it is important to move on it quickly, but getting a consult with a surgeon will take at least two weeks, and it will be at least two months after that before she can actually get an operating room and staff booked. With the delay in surgery in mind, he wants to start her on chemo now to begin to shrink the tumor in the meantime, as well as kill any rogue cancer cells that might be the cause of recurrence in the future. If immediate surgery was an option, that would be his first choice, followed by chemo to clean up the excess, but since the United States seems to be experiencing a cancer epidemic, it appears that someone not yet at death's door does not merit immediate attention or a spot in an O.R. more needed by someone else, especially in a mega cancer center (our observations, not his). On a side note, after the surgery, the chances of reaccurance without chemo are 30 percent, 15 percent with it.

I must admit, we have been fairly cavalier about the cancer thing, thinking the most she was going to have to go through was the loss of one or two body parts, rehab and possibly reconstruction. We had expected to have this nightmare long behind us, except for lingering rehab issues, by the holidays. She told me before the consultation that she had stopped thinking of herself as a cancer patient, already accepting it as gone, so the news that she must now start two 12 week chemo sessions was an enormous setback to her happy, survivalistic state of mind and took a bit of reeling to absord. Unless she responds unusually well to the chemo, it will be next spring before it is behind her. The last 12 weeks of the treatment will be the hardest- the first 12 weeks, the most common side effect reported is loss of energy. The second 12 week treatment is a much more nasty sort of chemo, with all the side effects usually affiliated with chemo- nausea, tiredness, hair loss, etc. Which finally forces us to realize that this thing is about to get a whole lot more real.

The oncologist requested the name of an oncologist we would like to administer the chemo closer to home, and since we did not have a name, we agreed to email it to him by the end of the day. Then we left. We plugged in her laptop and tracked down the name of the oncologist closest to where I live, and my dad, who was ricocheting around the lobby, his preferred method of dealing with bad news, decided not to wait for her present oncologist to contact her future oncologist. While mom and I cringed a bit at his aggresive manner of handling crisis, and told ourselves it was okay because health care professionals deal with people every day in states of grief who are not their normal sweet selves and they are trained to be understanding, in the end it turned out okay because he got her scheduled to meet with the Colorado oncologist on Tuesday, day after tomorrow, snatching up the last opening for a few weeks. If all goes as planned (and anything can change at any moment) she may have a port put in under her skin on her upper chest as early as Friday, and begin receiving chemo.

We spent the rest of the day tracking down her medical records, pathology, trying to make arrangements to have all that information with us when we go to Edwards, which is where the cancer center is, on Tuesday. It was closing time when we finally escaped the glass buildings, mom with blisters from all the walking through skywalks between buildings, our shoulders tense from lugging a leather case full of laptop, paperwork, medical records, and books for all the miles we had walked that day between clinics and reception areas. In the meantime, my dad had spent two hours on the phone, my mom had found a gazebo in a park and had a bit of a cry, and we finally found food after we were all three of us hysterical from low blood sugar from not having eaten all day.

Then we crawled into a sweltering little car and headed for home- through Houston downtown rush hour. We made one tiny mistake, were in the wrong lane in a massive interchange and found ourselves on the wrong road, and the trusty GPS was completely confused by all the levels and concrete and had no idea where we were but we finally found ourselves sitting high above houston on a HOV overpass behind a single-file line of vehicles several miles long while the interstate zipped by us on the other side of the barricade. It took us two hours to get out of Houston, at which point B booked us two rooms in Ft Worth for the night.

We drove the rest of the way yesterday, then I drove home yesterday night an arrived to a clean house, thanks to B, and two large dogs, a Black Lab and a Golden Retriever, who acted as though I had come back from the dead. Raisin has lately begun to think that I am the doggie-goddess Andy thinks I am, so there was much tail-wagging and face licking and leaning against my legs

Tomorrow, my plan is to take my mom's records to Edwards and leave them there for her oncology team to peruse. My parents plan to be here tomorrow night so they can be at the cancer center first thing in the morning to start the admissions process and meet with the team of oncologists, radiologists, and surgeons. Already, it is beginning to seem easier dealing with a small cancer center than a big one. MD Anderson told us what we needed to know, with the added benefit of being a cutting edge facility, but now that we have the "best" opinion, it is time to find a second opinion, and in a place that cares about individuals, which is something we found starkly lacking in Houston. Houston turned out to not be the "one stop shop" we had expected. We honestly thought that in the course of two weeks, during which time we would stay down there, they would have her diagnosed and would present her with a course of action. Turns out, their biggest draw- that they are the biggest, have seen it all, and know first what works the best- is also their biggest drawback- they are too busy seeing it all to care about a walking statistic in their waiting room.

And now, I must run.