Triggers and more

Things are going well.

Yet it doesn't take much to push me off track into what my friend PJ calls The Dark Side. Yesterday's trigger was a New York Times story headlined "Transplant Patients Put at Risk By a State's Financial Distress," about a new law signed by Arizona Gov. Jan Brewer eliminating Medicaid coverage of certain kinds of transplants as a cost-cutting measure.

Not everyone in need of a life-saving organ or bone marrow transplant is entitled to government money to receive one, but this was a case of patients in line to receive transplants and then denied them. For example, one man was prepped for a liver transplant and then told that his family needed to bring $200,000 as a deposit; he was discharged, and the liver went to someone else.

Despite how you feel about where to draw the line on government spending for health care, this was a heartbreaking story. The part that got me personally came when different sides started bandying about leukemia statistics. The state Medicaid agency had presented an analysis of the transplants that were cut, saying that 13 of 14 patients who received bone marrow transplants over a two-year period died within six months.

"But outside specialists said the success rates were considerably higher, particularly for leukemia patients in their first remission," according to the story.

So?

Statistics, except of course the really good ones, make me jittery. I know each of us is an individual, not a statistic. It was reassuring to hear specialists saying success rates are higher, but the words "particularly for leukemia patients in their first remission" made me shudder. What about patients in their third remission? The story implies success rates are lower, and I have no doubt that they are, but I don't want to hear about it.

I also started worrying about my Medicare services being cut. What if....? Everyone knows that asking "what if" gets you nowhere. But still, when you get stuck in the Dark Side, it's hard to stop.

While perusing the calendars at the Odyssey Bookshop before I read the story, I came upon a wall calendar with a few calming sentences for each month by Buddhist monk Thich Nhat Hanh. They are a way to help you focus on your breath, such as "Breathing in, I calm my body. Breathing out, I smile." I read them on the wall calendar but didn't buy it. I have them in a book; although they are helpful, you don't even need to say them. You can just count your breaths, for example up to 10 and back.

After the Times story got me going, I couldn't remember any of the sayings. My heart racing, I thought of taking an Ativan. Instead, I sat down on the couch next to the dog and read a book.

Meanwhile, due to having two teeth pulled, I didn't do much during the week except walk Maddie. I decided to go to yoga today, but there was no class that fit my schedule (read: too early) where I usually go. So I went to another studio where I like the teacher and the space.

I came out crankier than when I went in.

A kid yoga class (read baby-sitting) was going on in a walled-off space inside the studio. You couldn't see the kids, but you could hear them. They squealed and laughed and tumbled around while their instructor had them take monkey pose and such. I got more and more annoyed. I told myself to chill out. Hey, it was the sound of children laughing, not anything terrible like bombs dropping. It didn't work.

I asked a man on our way out if the kids bothered him.

"No, I didn't hear them at all," he said.

"Bad yogini," I scolded myself.

Afterwards I took Maddie for a long walk through the woods and around a field. It was a dreary day, cold and gray. But I stopped several times on the path and looked up at the bare treetops, dark against the sky. It was quiet and soothing. I had a few words with Maddie, who insists on grabbing big sticks and staying close to me, whacking my legs along the way. I finally got her to go in front of me, and she looked so cute trotting with her over-sized stick that I had to laugh.

This post is getting too long, but I have one more thing to say.

Several of us have written lately that we are unhappy about our looks.

We are not having a contest for most messed-up face, but still, I am going to lay claim to that title. The swelling has gone down on the cheek where the teeth were pulled, but I have a big black-and-blue mark reaching under my chin and over my lip.

I am not going to post a photo.

Eating blueberries, staying calm

Many people quote Thich Nhat Hahn's sage but simple advice for mindful living: "While washing the dishes one should only be washing the dishes." The author and Buddhist monk goes on to explain in his book, "The Miracle of Mindfulness," that if you are following your breath and are conscious of your actions, "There's no way you can be tossed around mindlessly like a bottle slapped here and there on the waves."

Focusing on the here and now is hardest for those like me whose minds starts to chatter the minute we wake up. But we can keep reminding ourselves and keep trying during the many opportunities that present themselves. (Many are described in the book.) Our dishwasher broke, and washing the dishes was a good place to practice.

I thought of this today when I was putting fresh local blueberries on my granola. This is the end of blueberry season, marking for me the end of what little summer we had. Most of my favorite farmstands have stopped selling them. The other day my good friend Nancy came for a short but sweet visit from Syracuse, N.Y., arriving mid-afternoon after a four-hour drive. I had an appointment and hadn't finished my shopping, so she came with me to look for the few things on my list, including blueberries. After coming up empty-handed at the farmstands, we drove about 15 minutes to a bigger store, Atkins Farms. They still had blueberries! I bought three boxes.

I had hoped it wouldn't turn into a wild goose chase for Nancy, but she said she was enjoying the drive in the country, and it turned out well because we got the blueberries. So?

When I was putting them on my cereal today, my mind drifted off onto how I needed to go to Atkins to look for some more, and what if they didn't have them, how sad it would be to switch to the smaller less delicious ones that come from Michigan. (Just so you don't think I lack perspective, please understand that I am exaggerating a little here about my level of concern.)

Then I remembered to enjoy the blueberries I have, to taste each one and savor it for what is rather than not even tasting it while ruminating on what may not be. This may sound silly, but it's a way of looking that's difficult to keep up but also very useful for cutting down worry.

Worry is something I'm very good at:

Tomorrow I head back to Cape Cod for two nights. I am going with two of my friends from tennis, Donna and Deb, to attend the wedding of the daughter of another tennis friend, Debbie. (Yes I know they're all D's.) We'll be right on the beach and it should be great. We are even bringing our tennis racquets. But worry is cutting into my anticipation.

When I went to the clinic on Monday, my platelets were 11 and my hematocrit was 24. White count was an excellent 7.2, and everything looked basically fine except for the pokey platelets and rbcs.

I got a bag of platelets and, instead of the usual two bags of blood, my doctor said I could try getting away with one bag and a shot. Yesterday and today I felt a little sluggish. I walked to and from the lake and around it, about one-and-a-half miles, and I wasn't exactly dragging, but I felt more tired than usual. My explanation: I should have gotten the two bags of blood. My crazy mind: Your counts are crashing and something bad is happening.

I called Dana-Farber and talked to one of the nurses in the stem cell transplant program. Trying to extract the soothing comment I was seeking, I told her my theory and said, "I assume that since I was there Monday and everything was fine, it's just the red blood and not a sign of some big crash, right?" I didn't get the big, "I'm sure you're fine!" How could she know, after all? She said probably it's nothing to worry about, but I should get in for a CBC as soon as I could. Between my schedule and theirs, that turns out to be five days from now, which turns out to be the time slot I already have, on Thursday, 10 days instead of the usual week from my last visit. Meanwhile they said of course to call if I start to feel really bad.

Obviously they don't think I'm ready to keel over. Obviously I don't feel that way. But it's so easy to get spooked. The way to handle it: Stop running scenarious. Settle on the logical answer, and then proceed, knowing that the problem will be remedied soon. Enjoy the friends over the weekend. Enjoy another chance to get to the beach, and, of course, the chance to share in the happiness of a beautiful bride.

Take a box of blueberries with me. Savor them one at a time.