Wednesday, July 16, 2014

About that running thing... (this month's update)

William Rimmer - Flight and Pursuit
I went to oncology today for my monthly check in and injections.  Fortunately it was another good visit.

Most of my numbers look good.  No tumor markers for today yet (those take some time to get the results on) and my white blood cells are continuing to drop downward, which isn't great, but the thinking is that that's due to the radiation therapy and it's effect on the marrow in the several large bones that were radiated.  They're doing a WBC panel to better see what's going on, but, especially coupled with last month's stable scans and the dropping tumor markers, it doesn't seem to be really worrisome.  I guess I'll need to dig out the Purell supply I laid in the last time this happened and try to stay clear of sniffling people.

But since I'm feeling well, with only some hip and back pain that was there before the good scans, etc, and isn't getting worse, it was a lot of "keep it up!" and not a lot of worry.  I've had my share of the worry filled kind of appointments, so I'm just going to take this one and enjoy it for all it's worth!

While I was there, I asked about biking and running, and that didn't go quite as well as I had hoped.  The consensus is that biking is ok as long as I don't fall off, but running is definitely out and is not likely to ever be back on the table, at least not in the foreseeable future.  Looks like my "Couch to 5K" dream will need to be truncated to just "Couch," as the 5K part is not going to happen.

From what I understand, with impact absorbing bones fragile with cancer, and radiation therapy adding brittleness to the mix, high impact activities are just too risky.  Yep, that's right, I'm still a delicate flower.

I didn't exactly expect to get the go ahead today, not while my scans are still showing activity (my "stable" scans last month mean that the cancer isn't spreading now, but it doesn't mean the lesions are gone or healed at this point), but I was hoping they might tell me that it was likely in a few months maybe.  Instead, I was told it was unlikely that I'd ever be cleared for high impact stuff.

But, know what?  I'm actually ok with that.  I'm enjoying my walking and I definitely don't want to trade that in for a hip fracture and indefinite bedrest, pain, and rehab just because I went for a run.

Plus, not only do I feel better than before I started walking, I also saw today that my pulse has been dropping each month since I started the 10,000 steps a day in May--for many months before that I'd been having the same conversation with different techs:
"Is your pulse always, um, kind of high?"
"Yeah, it's always like that, Dr.___ is ok with it."
"Oh, ok, 'cause it's kind of scary high."
"Yeah, it's always like that."
But last month my pulse was right on the edge of normal-high and today I've dipped into the normal range, so that's nice (not to worry, my blood pressure, thyroid, and weight are fine and my doctor isn't worried, my pulse is just sort of naturally scary high, or was anyway).

Also, gentle biking is back on the table (as long as I just don't crash).  And I've been muttering through some Nordic Track workouts lately when the weather is bad, which is sort of like running in a throwback workout kind of way.  And I could also do an elliptical workout or other things like that if I were to rejoin the Y or something, so there are still lots of options, just no high impact options.

I guess a big part of adulthood is realizing that most of life is filled with tradeoffs.  That's certainly true in cancer care.  Side effects in return for more time alive?--I can deal with that.  Can't run but get to walk and live fracture free?--that sounds like a pretty fair trade to me.

Sunday, July 13, 2014

Half a million

The view from Georges Island  - We went there on a day off
because it is both beautiful and walkable.  20,000 steps that day!
You may remember back in May how my oncologist recommended I get more exercise and suggested I try and walk 10,000 steps a day (if you don't remember, the post is here).  At first, 10,000 steps a day was an effort.  And that's putting it nicely.

But, despite whatever grousing you may see here, in all this cancer stuff I do try and be grateful for everything I can do that helps fight cancer.  With that (and the fact that my smart oncologist said to), I've worn a pedometer every day since and made the 10,000 steps a day goal my own.

The rest of this post comes awfully close to a long brag, so unless you already love me and my family, this may be a good place to call your post reading done for the day and congratulate yourself on good a decision.  But, if you do love us or are exceptionally brave, well, here we go!

Last week, I hit day number 50 of this walking 10,000 steps a day effort.  I haven't always hit the 10,000 point each day, especially in the beginning, but my average over those 50 days is above 10,000.  Which means--get this!--since May 22 I've taken over 500,000 steps.  Half a million. Crazy, right?

A few weeks into it, I bought a FitBit to replace my mechanical pedometer.  By then I'd proven to myself that I was pretty committed to the walking, and the mechanical pedometer kept periodically jamming which was frustrating (to say the least).  I'm finding the FitBit more accurate than the pedometer I was using, plus it doesn't click when I walk (annoying at work), and not only does it call me "champ" when I hit my goals (love that), it also tracks lifetime stats--so without a lot of effort, I can now tell you that since I began using the FitBit, I've walked 120 miles.  That's spread out over a number of days, of course, but it still feels pretty cool!

To be fair, many of those steps and miles were steps and miles I would have taken anyway just going about my day.  But I've found that I can't get 10,000 steps just going about my day (even if I park a few spaces farther, or make a couple trips to the photocopier, or make separate walks to the printer and inbox instead of combining them into one trip), but instead, for my lifestyle, it requires the extra effort of going out for a walk daily.  So, I still feel pretty proud of myself for accomplishing this goal.

Well, proud of myself and also grateful for my family.  I mentioned a few weeks ago (here, if you want more info) how my husband helped me get the steps on a particularly bad day--every day since that day I've had the company of my husband and/or my daughter on these walks (and when she was over here my grown stepdaughter, too).  They're consistently good cheerleaders which is immensely helpful. My mother-in-law has begun tracking her own steps which is pretty cool, and, especially because she knows what goes into getting those steps, she tells us regularly how impressed she is that we're doing this, which also feels pretty good.

All this "way to go" attitude has been good for me and I obviously enjoy it. But, for someone like me who tends to mistake urgency with importance all the darn time, even more important has been my family's attitude that getting the steps in is important and how they've made it a priority.  Because, in all honesty, even knowing it's important, without their support it would be way too easy for me to say, "Eh.  Today I [am busy/have a lot to do/feel tired/(whatever other excuse you can think of)], I'll just skip it today and try again tomorrow."  I can be kind of lazy that way, especially when in the moment.

And it is important that I get some exercise.  Aside from the general knowledge that fitness is good for  people (even people like my cancer-free husband and daughter, actually), there have been lots of studies showing that women who have breast cancer and who exercise tend to have better outcomes than those who don't.  You may have seen the flurry of news about one such study that hit mass media a few weeks after my oncologist made the recommendation (one such article here).  I wish I could say exercise was guaranteed to cure me, but the best I can say is it might help and it certainly won't hurt.  Which is actually still good enough to make me think it's worthwhile to do.

And, truthfully?  I'm really enjoying it.  I love the time with my family.  I love feeling a little fitter and a lot better (really, I do feel healthier now and walking is no longer embarrassingly difficult for me, which is definitely progress).  I like the feeling of achieving a daily goal. I like being out on the town track with all sorts of other people of all ages doing similar things, and I like being there looking pretty much like everyone else because when I'm walking I'm cancer patient incognito. And most of all, since I don't actually know how to cure cancer, I feel better being able to take action myself on something that might be helpful (in addition, of course, to the Faslodex, Lupron, and Xgeva that others prescribe and inject into me--I do my "show up for it" job really, really well, but that's not the same thing, obviously!).  And, I suspect taking whatever action we can is part of what my husband and daughter are feeling, too.  There isn't really that much we can personally take the lead on to fight this cancer, but this is the thing we can do, so we are bound and determined to do it.

Want to know something crazy?  I've lately been wondering, assuming I stay stable or show regression and regrow some bone, if I might someday be able to work through a "Couch to 5k" program and sometime in the next few years run in a 5k road race.  I would need to get medical clearance before taking on high-impact stuff like running on these cancery bones, of course, but who knows what might be possible?  Besides, I've read that running may be even better than walking for breast cancer survival....

(Edited to add:  My husband read this and thinks I'm not bragging nearly enough, so let me assure you, I'm all kinds of "FREAKING HALF A MILLION STEPS AND KEEPING THE 10,000 THING UP FOR 50 FREAKING DAYS!!!!!!!!  EEEEEEEEE!!!!!!!" but on the inside, of course.  Well, mostly on the inside.  Well, sometimes on the inside, anyway.)

Saturday, July 5, 2014

Again with the garden

Heliotrope: Too poison for rodents, too textured for
slugs, and still it smells lovely in the evenings
Remember a couple of months ago I wrote about the garden I was planting this year and how I was trying to stop putting things off?  (here)  Since writing that in early May, the weather has warmed (maybe a little too warm) and summer has come.   All my little windowsill seedlings are long since gone from my windowsills and sent out to the garden to take their chances with the uncertain world outside.

Unfortunately, as it turns out, the world outside has not been very gentle with them.  The very first week some kind of animal (chipmunks or rabbits, probably, I've seen both around from time to time) decided to eat all my broken plate 4 o'clock seedlings, all my moppy white snowdrift marigolds, 11 out of 12 of my summer berries scabiosa, and 11 out of 16 of my 2 types of zinnias.  It was a massacre out there, no doubt about it.

After the first strike, I sprayed liberally with Havaheart Deer-off (promising to repel deer and rodents, not, I should note, purchased because I was feeling like "having a heart" at that moment, because I really wasn't. Not at all.).  Deer-off, all promises aside, didn't seem to do much at first and the carnage continued, but eventually either the rodents got sick of Deer-off flavored seedlings or they found better things to destroy somewhere else.  At any rate, the 1 remaining scabiosa and the 5 surviving zinnias still live, so at least that's something.

It was depressing and maddening and not at all what I planned to happen.  That sort of thing seems to be happening a lot to me lately (Hi there, cancer, did you hear me say that? Yes, I meant you.).

After I got done screaming (figuratively, not literally), I ended up plunking more dirt in some seed trays and planting the remaining 4 o'clock seeds and some lunaria seeds that I had gotten as a freebie a few years ago (it was too late in the game to replant scabiosa or start again with giant marigolds).  I then went to the garden center and purchased some thick, healthy vanilla marigold seedlings (kind of like the snowdrift ones, but not as mopsy) and some heliotrope that I'd never heard of before.  I sprayed them 3 or 4 days in a row with Deer-off because by then it was like a talisman for me.  Also because I was already psychotically dousing the zinnias and that poor lonely scabiosa with it daily, so it wasn't much effort to get the other plants while I was at it.  And I laughed with evil glee when I read that heliotrope is poison to most animals and they tend to avoid it.

(And yes, I do know that a smarter woman would have probably skipped the marigolds and 4 o'clocks entirely instead of going for exactly the same darn things that got devoured last time.  All I can say is I wanted them so badly that I thought I might as well give it one more shot before giving up their ghost.  Besides, how much did I really have to lose at that point anyway?)

For reasons I can't explain, the rodents never even tried to eat the new marigolds and things seemed to be turning out safe enough for the new 4 o'clocks and lunaria (I'd like to thank Deer-off, but since it didn't save things much the first time I'm not really convinced it suddenly upped its usefullness now, but one can hope).  That was until I found out that slugs really, really like lunaria.  And vanilla marigolds. And also the purple nicotiana that I had previously thought was safe since it seemed to be of no interest to the rodents.

Those stupid slugs look relatively small and not very fast or smart, but, especially in large numbers, they can take down a ton of stuff in very little time.  My lunaria were mostly leafless, my marigold buds were half gone (not half the buds, half of each bud, which makes the blossoms look lopsided, nasty, and very obviously slug bitten), my nicotiana looked like Swiss cheese and never got any bigger because every time it made one small bit of progress, the slugs made two.

And again I was depressed and dismayed and kind of ticked off that no matter what I did, half of everything seemed to be failing and my stupid, beautiful garden plans were rapidly spinning into nothing more than a tasty treat for an ever increasing army of rodents and slugs.

But then I thought about these:


The crazy half-double petunias (or maybe double petunias, they look more double to me) that I'd never gotten around to planting last year and was determined not to put off again this year were blooming.  And no one was eating them. And they were making me happy and unreasonably proud.

So, after screaming and stomping my feet and shaking my fists didn't scare away the slugs (the neighbors are probably a different story...), I turned into slug hunter.  I bent over the garden in the mornings and again in the evenings, picking off the white slugs, picking off the orange-brown slugs, digging holes to sink in cut open soda bottles filled with beer (I'm told slugs like beer and the yeast smell lures them, if not maybe free beer will at least win back the neighbors).  Finally it looks like the slug population is dwindling.  My plants are starting to grow faster than the slugs can take them down and my slug hunting isn't turning up that many of the nasty slimy things anymore.  There are, of course, plenty more slugs in the world, but for now I seem to have the upper hand.

So now I have this:



And I have hope that the various remains of my poor ravaged garden will finally recover and grow and maybe, eventually, have more blossoms for me.

And, because metaphors are almost as much fun for me as imagining rodents grimacing and running off making gagging noises after eating Deer-off drenched 4 o'clocks, I'm sure you can see what I'm reading into this.  Plans getting thrown off over and over and over again; dealing with one problem (rodents, stage III) only to have to jump right back in with the next problem (slugs, stage IV); trying to keep one step ahead; and very consciously doing what I can to try and move past the setbacks.  And, hey, at this moment I'm winning on both fronts so that's something good.

Plus, for what it's worth (for those of you who read the first garden post), so far nothing at all seems to be bothering my morning glories.  No blooms yet, but they're vining all over the place and pretty morning flowers shouldn't be that far away now.

Friday, July 4, 2014

Tumor Markers (or more good news!)

Chagall - Dance
This weekend I spent a day with a bunch of fabulous ladies who I've been friends with since my days as an overstressed and insecure undergrad (yes, that's right they knew me when and like me anyway, how about that?).  It was a wonderful time, and, truth be told, it was also just what I needed.  I've been a bit of a stressmonger with all this cancer stuff, and hanging out with old friends chatting, eating, and mulling over life was really nice.

And, you know what else was really, really nice (and cancer related)?  While I was there I got a call from my husband telling me I got a report in the mail from my doctor with the results from a recent tumor marker test which, like my scan results, point to good news.

I had gotten a blood work order in the mail in late March or early April that indicated I'd be getting the usual cancer blood work and also something called CA27.29.  At the time, reading the list of tests, I had actually assumed this CA business was something to do with calcium--not true, but what I thought at the time.

In fairness to myself, Ca is the chemical symbol for calcium and bone mets can put too much calcium into the blood because it dissolves the bones and Xgeva can leave you with too little calcium in the blood because keeps the bones from dissolving in a superpowered kind of way, so it wasn't that crazy a guess (or at least that's what I tell myself).

I really do try not to get my cancer knowledge unquestioned from the internet, but of course I later googled it.

It's obviously true that I'm not an oncologist and also true cancer doesn't give you super cancer knowledge because it turns out CA 27.29 has nothing at all to do with calcium.  The CA actually stands for "cancer antigen" and, as it happens, the test checks levels of a specific something that cancer can give off into the blood (for anyone interested, the best website I found on it is here).

I'd read other people posting about "tumor markers" and it turns out that these are what they were talking about--who knew?

So, not to belabor the point (or at least not to belabor it more than my belabor loving self can't help but do), I had the same test again on my blood work order for June and I got a report in the mail last Saturday.  The report listed my CA 27.29 lab report for June and a note from my oncologist:
This tumor marker came down from [number here] in April--Looks good
I'm still not an oncologist, and I do understand that at some point things will most likely change and we'll need more and more different treatments and "out of the woods" isn't something that happens with metastatic cancer, but when my oncologist says "Looks good," well, what the heck, I'll take it!


Sunday, June 22, 2014

Magic comes with a price

Katie Thamer Treherne - illustration from
A Little Mermaid
Yesterday was not my best day ever.

I had my Faslodex, Xgeva, Lupron last week.  I'd even been upgraded to a 3-month dose of Lupron (1 injection, more medicine, lasts 3 months before needing the next injection), so for my next 2 visits I'm down to only 3 injections (Faslodex is 2 shots per dose).  So that's cool.

But in addition to the usual bruses, aches, and soreness from the various medications, and the physical side effects that are part of their life saving action, I've been noticing for a while that in the days after I get them, there are other side effects as well.

For one thing, they mess with my sleep.  Fortunately my oncologist has other things to help with that.  But, I've also been noticing more recently that they seem to also make it harder for me to be resilient emotionally.  I find myself less able to process stressful words, actions, events, right after I get the shots.  And I don't think that's something my oncologist can help me with.  So yesterday I was feeling that.  And even understanding that there was a chemical contributor, it was still a hard day.

Have you ever noticed that in some children's books magic is treated as a free gift with no-strings-attached, while in many, many others magic always comes with a price?

Mary Poppins is the free gift kind of magic, as she comes flying in out of nowhere to add interest and adventure to the lives of the Banks children.  Even when she flys out again, there's sadness, of course, but no one is the worse for wear, and there's even the promise (in French, in the book version anyway) to return again.

But in many other books and stories, when there's magic there's a bargain to be made, be it some sort of trade, tithe or blowback right from the start, or some sort of later discovered change or enslavement that turns out to come with all that power, or the dawning realization that the power or the situations you created with your magic because you thought they would be so lovely aren't all that lovely after all.

Medicine is kind of like that, too.  Some have side effects so minor that all you really get is win, but others have short or long lists of side effects and, like magic in books, the balance comes in determining if the reason to use the magic/the condition you need to treat with the medicine is worse than the side effects themselves.

I don't really find myself regretting the side effects of my medicines.  Especially after those nice stable scans that I also found out about last week, I'm feeling pretty warm and rosy about those little injectable buggers.  But they do have their price.

It's not as bad as the price of chemo, of course, and one of the biggest reliefs of the good scans is that it means I'm not back on chemo today.  Someday I probably will be (I'm learning to accept that), but I'm plenty happy that that day is not today.  Also, the permanent side effects from my previous chemos are really, really minor and managable, so that's also good.

As I heal up from the side effects of the latest radiation and am able to comfortably go for those 10,000 steps, I don't regreat having done that, either.  It occurs to me often as I go for those walks or tend my growing garden, or even use stairs easily on a regular basis, that those were the reasons I chose to get the hip radiated and here I am doing those thing, just like I wanted! 

But yesterday I wasn't feeling so jubilant.  And lack of jubelation was snowballing.  Among other stressful things to my resilliance-free self, I had not gotten in my 10,000 steps the day before (lots of driving and people over, so not bad reasons, just reasons) and had intended to make up for the missing steps by doing more yesterday.  But the worse I felt about it, the less I was able to just get up and do it, and the more time passed when I hadn't been able to get up and do it, the worse I felt.

Finally, my husband came home from work and I was at a paultry 3000 steps.  Not, necessairly the biggest deal in life, of course, but the walking is a "medicine" whose only real unpleasant side effect is time.  And it's something my oncologist recommended.  And it could help.  And it's something I can do, I can control in as world where the cancer seems to say "I'll do whatever I damn well please and there's nothing you can do to stop me." Which we deal with using "There are some major side effects but we hope it will slow down the cancer whose major side effect is death" medicine.  So getting in the steps feels really important.

And there I was at 3000 steps, failing at something important.  And that, tacked right on to my increasingly long list of other things that weren't being dealt with, seriously stressed my lack of resilience.

The crazy good part of all this is that when my husband came home from work, he suggested we take care of that walk right then and there, just go out and do it.  So, we drove to the local track (yes, we did drive out so we could walk) and together we walked around and around and around that track until we reached the 10,000 step point.

Instead of being a death march, walking with my guy on a summer evening, with other people coming and going and doing their own thing, watching the sky turn golden pink, seeing the birds and bees flit around in the overgrown border of weeds and wildflowers, it felt precious.

And, somehow, wasting the day and pulling it through at the end, against all odds, also felt important.  More important, even, than being virtuous all day and not needing to grab the fat out of the fire would have felt.  I guess it's because life is that way a lot of the time, crappy things happen, or are said, or come up as a consequence of something else, and sometimes resilience is in very short supply.  Yesterday I was coming up short on so many things, but we were still able to make good on a bad day.  It was like, for that day, with his help, the greedy gods of cancer and the dark price of magic were unexpectedly, at the very last minute, actually appeased.

With the work accomplished, we went home.  My husband baked chocolate chip cookies and my Fitbit dashboard called me a "Champ".

And I felt a whole lot better.

Wednesday, June 18, 2014

Good news!

Cliff Chiang's Wonder Woman
I got my scan results today and despite the hip pain, despite my fear, my cancer is looking stable, which is excellent news!

It seems a bit strange, I suspect, to people not dealing with cancer like this, because basically my scans told them I have cancer in a number of bones, but it's the same cancer in the same bones and not cancer spreading to new places.  It's not in new bones and it's not in my organs, so that's very, very good news.  Cancer gone would be nice, but stable is the name of the game and stable I am!

I'm thanking God tonight, that's for sure!

I was thankful to get more injections and be able to continue getting the injections.  Thankful to look at the paltry number of steps I've gotten in today and plan to go out when the heat abates to try and sweat through to 10,000 steps for another day.  Thankful to set my alarm to wake up and go to work and not  have to plan to add chemo to my schedule.  Thankful to take a little Advil for the hip thing since I'm no longer wondering if I'll need to stay off blood thinners so they can insert another port for infusions.

I'm sure I'll be back to complaining soon enough, but it would really take some doing to bring me down tonight, that's for sure :)

Saturday, June 14, 2014

Post 48, In which I am Jacob (sort of)

Paul Gaugan - Vision after the Sermon
It seems like some bible stories get a lot of play both in and out of a religious setting (Noah, I'm looking at you!), some seem to never, ever come up in or out of churches, and some are just sort of "also rans" in the world of bible stories.  I think the one about Jacob wrestling with God (or an angel, I think it depends on the translation) is one of these "also rans," but it's one I've been thinking of a lot lately.

For those of you who didn't grow up with Arch books and Taylor's Bible Stories (which, let's face it, is probably all of you except my brothers and I) and are not fascinated by Puritan naming traditions or fangirling on the Mayflower passenger Wrestling Brewster (which, let's also face it, isn't going to be a lot of you), although I trust some of you still know about Jacob wrestling, let me give a very brief summary:

Jacob stole his twin brother's birthright, ran off to another land, worked for the right to marry one girl but was tricked into marrying her sister, worked some more and married the girl he wanted to marry, had a ton of kids through both sisters and their maids, stole some more stuff from his father-in-law and ran out in the middle of the night to return home to his presumably still really ticked off twin brother. 
On the night before he was to cross the stream into his brother's land, he sent his family across and spent the night alone.  Some strange man came up and fought with him but neither of them could overcome the other and, at dawn, the stranger tapped his hip and put his leg out of joint.  Finally they agreed to stop, Jacob demanded a blessing, the stranger revealed himself to be God (or sent by God) and blessed Jacob, but his hip never did get better.

I can see why this one is in the "also ran" pile, it's kind of a weird one and hard to make out exactly what the heck it's supposed to mean.  Good thing I blog about cancer and not biblical studies, because I'd totally throw up my hands and shrug over this one.

But, as I've mentioned before, even though my cancer is in a number of bones, it's really only my hips that have been painful and fragile enough to require me to remember not to do certain things. Radiation for me is not curative but just palliative (to kill enough cancer to stop the pain), and the radiation therapy I've gotten at stage iv has only been to my left hip.  And while I was feeling better for a while after that, in the last week or so, I'm feeling pain again not in the left hip but, this time, in the right.

So, lately I've been thinking of Jacob and God putting out his finger to give him life-long pain in his hip and wondering what it all could mean.

With cancer, probably at any stage, there's a lot of wrestling with God (or the universe or fate or whatever for those who don't believe in God).  I wish I had some idea what it all meant.  Why am I the one who puts my family through this? And why them? What have I done that I'm the one wondering if I'll live long enough to see how things turn out?  Why would anyone pick my sweet husband to be widowed and these kids to have to deal with this, my daughter to be motherless?  It's, to put it frankly, a pretty crappy thing.

I wish I could be like Jacob and just demand a blessing and limp over the river at dawn to a spiffy new life in a new-old land (at least until the whole Dinah so his sons murdered everyone in town, followed by the whole famine and Joseph sold to Egypt thing, which is another popular one, which I know because even my public middle school did a production of "Joseph and the Amazing Technicolor Dreamcoat" back in the day, so you know that story's made it to big-time).  And maybe I will end up with a great outcome, because, afterall, who knows?  It could still work out great.

But the new hip pain worries me, because, while I don't know the cause right now, new pain is not a good sign and could often indicate that the treatments I'm on are not doing a terrific job of keeping the cancer from continuing to grow.

Unlike Jacob, of course, I do have medical imaging and the combined forces of research and oncology on my side.  I had a bone scan and a CT scan last week, results to be discussed this coming week, so I'll have a few more pieces of the "what does this all mean" puzzle soon (at least in the physical sense. I don't know what kind of image it would take to clear up the spiritual questions but whatever it would take would probably net a pretty penny on Ebay).  Also, where this is all going to go in the end isn't something scans can tell me right now, although they should do a good job of helping decide whether we'll stay the course or go to something harder.

Modern medicine could have totally fixed Jacob's hip, or replaced it, or whatever.  But the story would still be really strange because a medical diagnosis wouldn't have answered the bigger questions like why God picked a fight with him and damaged his hip in the first place and what it was supposed to mean (it also wouldn't have kept him from being kind of a jerk and stealing from all kinds of everyone and being a really dysfunctionally bad father even after all the blessings he got, but that's going to have to be someone else's blog topic, not mine)

For those of you who've followed this whole indulgent post and have managed to keep your questions about brain mets to yourselves, thank you (and, for the record, brain mets are unlikely right now, not enough symptoms).  For those of you desperately looking for the exits, here's the TL;DR version:

My other hip hurts and I don't know why but I had some scans.  Also, I'm having trouble figuring out what it all means in the physical and universal senses.

More news later this week.