Monday, February 29, 2016

"First in, last out." [Trigger warning]

I was reading about Cheryl Tiegs and her comments about a woman who was modeling a bathing suit on Sports Illustrated. Something about a small waist means health. It was posted on Facebook by a few friends of mine as well, and was greatly upsetting to several woman that responded, including myself. While she has evidently since apologized, it stuck with me for awhile that a smaller waist does not necessarily mean good health.

I have fought my battles with anorexia and bulimia, ending up in a category called EDNOS (eating disorder not otherwise specified). I went through therapy and came out clean on the other side, but I will admit that there will be fleeting moments where I will think how easy it would be just not to eat, or feel that I ate too much and I could fix that easily (which is how I fell into bulimia in the first place). But I also remember the extreme loathing and hatred I had of myself, and the hospital trip when I had to admit to the nurse, in front of my mother, that I had a history of eating disorders.

I wrote this to share with you the agony of what a smaller waist might mean to someone who is struggling with an eating disorder.

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It could be just one moment, one word, one sentence, to set you off.

Thinking, knowing, understanding, that you have upset someone which in turn upsets you which in turn upsets someone else.

You feel like a right asshole now, don’t you? A failure.

Yes, you’re a failure.

You. Are. A. Failure.

The tears become unstoppable, the pain wells up. You know that pain, you remember that pain. It’s a weird, achy, full but hollow pain. It’s everywhere.

You feel it spreading everywhere.

Your hair hurts.

“Fucking cunt.” You mouth at yourself in the mirror, eyes dark with rage.

Self-loathing. Oh, the self-loathing is surrounding you.

In you.

You reach for things that may quash that loathing temporarily, shove it down into the pit of your stomach.

Bread and butter and sugar and pizza and grease and alcohol to wash it all down with.

Lots of alcohol because you know what’s coming next, don’t you, and the buzz will make it hurt just a little bit less.

In the midst of chewing, butter dripping down your chin, you slap yourself in the face as hard as you can.

Relish that pain. Feel how it spreads out and sharpens the hatred you have of yourself.

You remember the days where you lived on coffee and cigarettes and maybe half a bagel torn up into little bits so you could savor it longer.

You remember how it felt to be asked when you had the baby because you looked so great.

You were never pregnant.

The collarbones were glorious.

It was so much easier just not eating. Just not anything.

You finish the fifth, eighth, tenth, you’ve lost count, piece of bread and the hundredth swallow of whatever is was you poured in that glass.

Swipe the butter off your face as you walk into the bathroom and close the door.

Glare at yourself in the mirror.

Slap the other cheek. Do it again.

Vomit gloriously until your abdominal muscles cramp up and it feels like you are coughing up your toes.

“First in, last out.”

Do it one more time. Retch until that pain that you’ve been harboring all night has settled into a pool of bile.

Wipe off your face. Rinse your mouth.

You’re not allowed to feel anything anymore tonight.


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Tuesday, February 23, 2016

100 Word Challenge - "Paper"


Damned ludicrous, I think, staring at the elevation of paperwork. Fill-in-the-blank, please, while you’re undergoing enough drama already, now you worry about using the correct color ink and coloring in the bubble completely.
The struggle to find the right envelope with its cyclops return address window.
Don’t even look to see if the physician fulfilled the requirements, mail it in, mail it in. Deadlines loom for each of the three forms, or four, I’ve lost count…
Waiting now, for a letter or e-mail to ensure some sort of monetary promise in order to pay the mortgage on my new home.



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Monday, February 22, 2016

Sunbeams


I’ve had my issues with depression creeping in, making me feel like all I want to do is sleep. Sitting here waiting, attached to my house via a 50-foot plastic leash blowing oxygen up my nose at two liters per minute, is not something I envisioned for myself at 41. I get frustrated easily, to the point of wanting to throw something or scream profanity, and have found my mental clarity diminished. It’s not at the point where I need or even want to take medication, because I still find enjoyment in my days.  

Today I had lunch with another nurse friend who I hadn’t seen in over two months since I went on leave. She brought her little dog with her and we went to a local Vietnamese restaurant which has become our usual spot. Usually we go there to relax after crazy days at work, and this time we laughed about the fact that we were just there to enjoy, not to destress. We had fried calamari and shrimp paste spring rolls (they were as funky as they sound), and boba teas which were refreshing on a beautiful sunny and breezy day.  

I had a million blood tests run last week, and it was found that my Vitamin D levels were about 15, when normal levels are 30-100. I rationalized that I have been inside for the majority of the past several months, with two straight weeks spent in a hospital room. Today was the first day that I’ve sat in the sun and wow, was it glorious. I almost immediately turned pink, thanks to that wonderful Irish-Great Britain genepool, but it was wonderful. I came home afterwards and went straight out onto the balcony to sit in the sun some more. Interestingly, I felt better within a few minutes of being in the sun today.  

I’ve started taking Vitamin D supplements upon the advice of my physician, but just being outside is definitely more healing in more ways than one. I believe that this funk may be partially attributed to the inside lifestyle I’ve been leading. Staying inside is just going to make it worse. My plastic leash reaches out to the balcony with miles to spare, so I plan on making a date with myself to sit out in the afternoon sun and breeze and enjoy. I have one of those recliners that I bought on sale (and with a coupon!) at Bed, Bath, & Beyond, and I have a little table out on the balcony. My cat, Bandit, joined me for a while and sat contently in my lap watching the birds in the tree right outside. There was the normal noise of people coming home from work, but no loud noises at all. The hum from the street across the canyon was actually relaxing, like white noise. I brought my glass of water and some cantaloupe out with me, and simply was.  
 
My dad and every cat I know enjoy a good sunbeam. I need to listen to them more.

Even though I’m by myself a lot, I have decided to make dates with myself on a more frequent basis. I’m blogging or writing or doing a bit of cleaning here and there, but I don’t just spend quality time with me. Watching bad daytime television doesn’t count. Today, while I was with my cat on the balcony, I was able to let my thoughts wander where they wanted to, and feel my skin warmed with sunlight. I haven’t reconnected with nature in a very long time, I realized. I don’t know how many oxygen tanks I would need for that, but I do know that, as soon as I possibly can, I’m going to get back into the trees away from electronics and life’s daily drivel. 

With that, I appreciate all of you who have kept me chipper and listened to me rant and dragged me outside of my abode for meals and camaraderie. Thank you.
 
 


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Saturday, February 20, 2016

Mutant Plantain

I don't know if I've never noticed these things before or else I've come to notice them now as partners in my #SuperMutantNurse life. I saw this guy hanging out in  Sprouts yesterday and wanted to document him for posterity. He's pretty buff, huh?



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Friday, February 19, 2016

Healthcare Weirdness - A Rant


I know I’ve waxed poetic about the status of healthcare here in the United States, however I was reminded of how lucky we are here in this country. As many problems as we have, what I heard today was indicative of the differences in other countries.

I was having breakfast with a friend, and she was telling me about some experiences that family and friends had in Canada. Imagine having a TIA, known as a mini-stroke, and being sent home from the hospital with orders to follow up with your general physician. No aspirin or blood thinning medication or consult to neurologists, just “follow up with your doctor in a few weeks.” My hospital would scan your head and run extensive testing, if not sending you immediately to have a procedure to clear up the blockage. Then you’d be an inpatient on a stroke floor. Hell, I’m on prophylactic medication twice a day to help prevent a problem.

My friend’s mom also went into the emergency room (in Canada) for rapid atrial fibrillation. This means that the upper chambers of her heart were not beating properly, which can cause clots to form in the heart. The heart also works harder and doesn’t push the blood around as it should. Her mother was discharged on one medication without any further admission or cardiology consults. Instead, there were orders to follow up with a cardiologist in a few months. My hospital would admit someone with rapid a-fib to at least a telemetry unit to have their heart monitored, if not right into the intensive care unit on cardiac drips (IV medications). Instead, my friend’s mom was shown the door.

Surgeries in Canada evidently take months to schedule, and simply seeing a physician often means lengthy waits which lead to poorer outcomes. I know that we have patients in the U.S. who refuse to come in until things are literally falling off of them, because they don’t want to halt their lives or admit that they haven’t watched their health. It’s sad, isn’t it? While I’m sitting here waiting for my insurance to clear all of the tests and procedures that I need, I know it will happen in a few weeks if not days. I was shocked to hear what I was hearing.

Waiting is hard, especially when you don’t feel well or want to return to your lifestyle. We need to have a look to see what is really going on in our healthcare systems. Our people in this world are becoming more and more unhealthy, even if they try to change their eating habits or ramp up the exercise. There are limited physicians and even less nurse practitioners able to practice independently. Our world is consumed with charting and such a fear of legal ramifications that we can’t treat people, and we sure don’t have much time to give them preventative education!

I’d like to hear from anyone in countries outside of the United States, and even those of you in the U.S. What have you seen that you believe hampers the people’s wellness? What have you seen that has impressed you about your healthcare system?


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Tuesday, February 16, 2016

Insomnia is such a pretty word


Here we are again, at 2:08 in the morning. I'm grateful for the Bluetooth keyboard I have on this iPad because I wasn't in the mood to fire up the ol' dinosaur of a laptop. The only issue with this thing is that the backspace key is about four millimeters wide and my fingernails are too long. So I'm typing a lot of "====" and then have to squint at the keyboard. But it's a neat little thing so I shouldn't complain.

I've already read through more than half of my friend Dustin's new book, "And the Devil Shivered." It's nestled on my Kindle between another friend Kelly's book of poems "My Own Kind of Beautiful" and "See You in the CCU," a tale by Steve Ludwig about his experience with open heart surgery. I also have 50 Shades of Grey on there, as well as three or four books on the Mediterranean diet, so my reading tastes are pretty eclectic. 

I've set aside Dustin's book for now as I've found myself squawking with laughter in between tearing up with heartfelt emotion - I'm so glad he opened himself up to us by writing every day. He's a treasure and I encourage anyone and everyone to get his book. And Kelly's, too. Her poems will grab you... For me, I immediately felt as if she was a kindred spirit speaking to me directly in her poems about infertility. Both of these fine people I've met through Twitter; I had the fortune to meet Dustin a few years ago during a trip to the beautiful Stanley Hotel in Estes Park, Colorado. You may recognize it from "The Shining" which is a terrifying novel by Stephen King made into a movie. In the novel/movie, it was referred to as The Overlook, however Mr. King was inspired by the Stanley during a stay there. I really have gone off on a tangent, there. Twitter has brought a lot of really good people into my life, and I'm very grateful for all of them. We're spread all over the country and the world, and sometimes it feels as if they're right there in the room with me, especially when I really need a friend. What blessings.

I don't know about you all, but I really enjoy watching infomercials at night. There's something soothing about watching women drag a heated brush through their hair, or watching a miracle vacuum lift a bowling ball into a tube of feathers. I was stuck on this one commercial for IT Cosmetics Bye-Bye Foundation so ended up buying a set to try. I'm pretty happy with it. I have thin dark skin under my eyes and this stuff works well to hide the appearance of chronic insomnia. The mascara in the set makes my scraggly eyelashes appear to be even scragglier, however I also invested in Younique fiber lashes and they're fantastic for making me look like I have lashes at all.

Here's this lady on the television who must be wearing about seventy pounds of diamond jewelry. How is that comfortable at all? I don't like wearing much jewelry, maybe some small earrings or a necklace that belonged to my sister. I will be writing about her soon... I've been missing her a lot lately and it's comforting to me to wear her jewelry or something else that belonged to her. Right now it's a pair of Halloween pajama pants with sock monkeys on them. 

The other day when I was at my folks' house, my Dad and I noticed that a pair of doves had relocated to one of the planters on my parents' back patio. Usually this upsets the parents due to the amount of "splatter" residue left on the sliding door, but this planter was more off to the side. I peeked into the plant and saw that Mama and Papa Dove had already made quite an establishment within the planter, so set big brown puppy dog eyes on my Dad and asked him if we could leave the nest in. Yes, even though I'm 41 years old, the ol' eyes still have it. Dad relented and now the folks have Mama and Papa Dove happily nested in a geranium outside the window. Today I heard Papa Dove cooing loudly, and looked outside to see him standing proudly on the edge of the patio cover while Mama Dove was comfy in her nest. It was really a beautiful sight and one I was grateful to witness. Remember when I talked about the little things a few days ago? That's one of the little things.

I've been thinking a lot about writing a book. I really don't know what the subject matter would be; maybe there wouldn't be subject matter. I love writing short stories based off of prompts, and writing my dreams and whatever the hell may be going through my mind, as obviously evidenced by this ridiculous blog post. I imagine the insomnia will be a "thing" every once in awhile and I might as well make use of that time. I'm not a parent and I don't know about how great my self-help jive is, so if you all had any ideas, toss them my way. I usually get great ideas from readers and friends, and am happy to oblige opinions. 

Until next time, readers... For now, I'm going to readjust the oxygen tubing so I don't strangle myself, and try to get some sleep in before my doc appointment tomorrow. I hope you all have a great Tuesday. Stay out of trouble, and stay away from pre-verts. :-)

#LoveAndLight

(One of those coloring book apps... Also good for wasting time.)





Friday, February 12, 2016

Eggless Mocha Almond Cookies



I love baking, especially biscotti. My dad is a huge fan of my biscotti, so I wanted to make him some today. It was going great until I figured out that I had no eggs in the house, and none of the usual substitutions.

Well, crap.

I decided to wing it, and threw a bunch of stuff into my KitchenAid stand mixer (I love this thing, so so much.) The cookies turned out great, and I wanted to get the recipe down, as much as I can remember anyways.

Mocha Almond Cookies (Eggless)

2 cups white all-purpose flour
¾ cup white sugar
1 stick softened butter (I used salted, as I always do)
6 tablespoons brewed coffee (thank you, Keurig)
¼ teaspoon baking soda
1 ½ teaspoons baking powder
1 teaspoon vanilla
¾ cup slivered almonds
½ cup semi-sweet chocolate chips
1 tablespoon instant coffee granules

  • Preheat your oven to 350 degrees.      
  •  In a bowl, or stand mixer, mix together butter and sugar until it’s fluffy.
  • Add in instant coffee and stir until evenly mixed
  • Add vanilla, baking soda, and baking powder – mix for several seconds until combined
  • Add flour and mix
  • Add in brewed coffee one tablespoon at a time until the dough starts to stick together. This was about 6 tablespoons for me.
  • Add chocolate chips and almonds and combine until you don’t have a pile of either on the bottom of the bowl (you know what I mean.)
  • Use a small ice cream or melon ball scoop (or two spoons, or your hands) to make even cookies. 
  • Bake at 350 for about 12 minutes. The cookies will be ridiculously squishy at first, but let them sit for about 20 minutes and they will firm up. They’ll still be nice and soft in the center. Dad described it as “fluffy.” So good!
  • This recipe yielded about 20 medium-sized cookies.
Om nom nom....

Here is the biscotti recipe from Giada that I've modified to my heart's content, just in case you were interested. :-)

Thursday, February 11, 2016

The Little Things


It’s the little things. 

Today I received a call from my physician’s office telling me that my doc wasn’t able to log onto the state disability site due to some hang up at his old practice, and I would have to bring in a disability form to the office. I called the disability office for a form and was hung up on twice, told that there were too many people on hold then was hung up on, then I was put on hold for an suggested time of "10 minutes." I was unable to print out the form online as it’s an “order only” thing (too many forgeries?) so I decided to go down to the disability office and ask for a form. I know this is a “little thing” that is basically inconvenient, however it also involves my mom as she has to schlepp me everywhere, plus the idea that I’d be in a line for hours and I only had two hours left on my oxygen tank. While I probably wouldn’t have negative health ramifications, it’s still a thought that the migraines would come back, or I’d pass out, etc. So, off we went. (Also, it's more of a delay for disability and just an added bummer that may affect my claim.) Needless to say, my day had started off way on the wrong foot and my mood was darkened.
 
Remember what I wrote awhile back about the volatility of my emotional state? Yeah, that. I had a really wonderful day yesterday - had lunch with "my girls" and it was fabulous. Today? It turns out I just needed some boosting. And/or a kick in the ass.

We found a parking spot right outside the front door of the building.  

There were only four clients in the disability office. Three of them engaged me in conversation as soon as I walked in the door, after I spotted forms along a back wall. They were exceptionally helpful in their commentary about how to fill out the form, what do to afterwards, etc. One gentleman told me, smiling, that he was in remission from cancer. As an oncology nurse, I know what this means for a patient, and I was genuine in my congratulations to him and his son. They inquired after my oxygen tank, and I told them that I was expecting a heart procedure of some kind in the near future. They wished me the best and I was out the door in five minutes. What kind gentlemen, and I hope for the best for all of them. It definitely assisted in burning off the frustration I felt this morning. 

At the physician’s office, I quickly retrieved the completed forms and dropped off the state disability form for my physician. There was no wait for that. 

I easily transferred a prescription from one pharmacy to another which was within the physician’s office, and picked that up as well in just a few minutes. The staff was pleasant and there were no hang-ups with the new order.  

Pulling into my community, the sun was shining and the trees looked greener than ever. It was quiet enough to hear birds chirping from all over the complex. One of my cats shadowed me everywhere I went in my home. I was halfway through a cookie recipe before I discovered that I was out of eggs… I improvised and the cookies turned out great (mocha chocolate chip, if you’re wondering.)  

There was no traffic, no idiot drivers, and my oxygen was still plentiful at the end of the journey.  

Now I’m sitting here with a boba tea, with the house smelling like lasagna. A furball is rambling around the house looking for trouble, but I know he’ll be cute even if he does get into trouble. 

It really is the little things.
 
This kiddo is pretty awesome. Even if she sheds all over the place.
(I'm talking about the cat.)
 
"Sometimes when I consider what tremendous consequences come from little things, I am tempted to think there are no little things." ~ Bruce Barton

Tuesday, February 9, 2016

Surgical Consult



I met with my cardiothoracic surgeon this morning and am processing things but wanted to get it down here so I wouldn’t forget anything later on. There’s a lot to process.

What I have is called Raghib’s Syndrome and it’s quite rare. I have a variation of this which makes it even rarer in that I do not seem to have the atrial-septal defect usually seen in the syndrome. I do not have a coronary sinus (no worries, I don’t feel like less of a woman without a coronary sinus.)
 
Because I don’t seem to have the atrial-septal defect… I may not need open heart surgery, after all.  

My doc consulted with another surgeon and it seems as if I may have a narrow vessel which can take on the additional load of blood flow if they simply block off the extra superior vena cava on the left side. I may have some residual swelling on my left side due to the blood trying to work its way through a new pathway, but my body should adjust to this and even develop new vessels to help.  

The next step for me is an echocardiogram followed by a cardiac catheterization, in which they thread a tube into a large vein (probably my groin) and up to the heart. They want to test the pressures in the vessels and see if there’s anything keeping them from doing the less invasive procedure. They can also inject dye through the tubing to see detail of the vessels. The surgeon will call my cardiologist and an interventional cardiologist (doc who does the cath) in order to fill them in and have me scheduled. The catheterization will be an outpatient procedure, and if they use a vessel in my groin instead of my neck, I’ll have to lay flat for about six hours.  

After those tests are run, then it’s back to the surgeon’s office to see what’s next. Until then, I just keep doing what I’m doing. I’ve attached a video of the surgeon’s explanation of my weird vasculature for your enjoyment.
 
video
 

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Saturday, February 6, 2016

It's going to get heavy for a second, folks.


As I’ve been going through the process of hospitalizations, tests, being out of work involuntarily, and having plastic tubing up my nose all day long, I’ve noticed a few things. I’ve been told several times that people don’t want to tell me things because I’m going through a lot myself and they don’t want to put any more stress on me. I gently remind them that my heart vessels are what are messed up, not my ears. I’ve always been someone who invites people to talk with me and get things off their chest. It’s never caused me undue stress and I’m honored to keep so many secrets for the people I care about.
 

With this clearly on my mind then (and now), I have invited friends, family, and even strangers to ask me anything… anything at all. You see, I’m not the only one undergoing a life-changing experience. Whenever something major happens to someone in your life, you are unwittingly, inadvertently, and sometimes unconsciously affected. I think of my parents, family members, loved ones, and friends who are going through their own thought processes much as I am. I didn’t expect the questions to come rolling in, but I was expecting the following from an RN colleague:
 

“As a nurse, does the fear of knowing everything that could possibly go wrong create anxiety or other emotions for you?
 

Christy, thank you for the question. I don’t know if I’m “normal” in the sense that I feel some of the anxiety alleviated by my somewhat limited knowledge of cardiac surgery, but I’m incredibly thankful for the knowledge I do have of hospitalizations, recovery, medications, infection risks, etc. I’m also grateful for knowing the physiology and anatomy of the heart, because when it was explained to me that I have the extra SVC which drains into the left atrium, it’s like everything made perfect sense in about three seconds.
 

With that being said, I did reach out to a friend who works in cardiac rehab as well as cardiac units, and she drafted an excellent and rather long, scary description of what to expect. (Thank you, Anna.) The first few weeks I was anxious, scared, and my mind would not stop working overtime. I researched and researched, reading stories, blogs, and medical websites. I did research online through medical and cardiology journals exploring potential cases of patients with what I have… and I only found two, one of which was similar but not totally identical. With the results of my recent CT angiogram, I have a bit of extra anxiety over the formation of my one left pulmonary vein (vessel which drains oxygenated blood from my left lung into my heart – usually people have two left veins) but will be addressing that as well with the surgeon this coming week.
 

I know of many things that could go wrong, but that doesn’t add to the anxiety for me. Every surgery has its risks, and open heart surgery probably has some of the most dangerous risks. I know that I will be under the best care with my cardiac and surgical team as well as my nurses, staff, and other team members including my primary physician and hospitalist. All I have to do is remember that it will hurt, but it won’t hurt forever and I just have to deal with it the best I can. Honestly, the thing I’m worried about the most is waking up on a ventilator.  
 

My emotions are all over the place. I go through sadness, anxiety, hope, happiness, loneliness, irritability, anger, etc. The past couple of days have been relatively good since I got the angiogram out of the way. I’m sure that I will be going through emotion switches all the way down the road, and that’s okay. Lately I haven’t been sleeping very well, but I can handle that.
 

 I try to get out every day for a mini-walk and to feel the sun on my face. I try to have nutritious foods through the day and drink plenty of water, but don’t beat myself up for enjoying the bad things once in a while like a chocolate milkshake. I’ve become used to the whirring sound from the oxygen concentrator and it’s like white noise to me, now. Right now I’m in the middle of a House marathon on the television and will get back to working on another paper for my class when I’m done with this blog entry. As normal as possible is what I’m shooting for.
 

Thank you for reading.

Rainbow outside my hospital room window the day I was told I was a mutant.
 

Wednesday, February 3, 2016

Jelly Beans and the Weird Side Effect of Contrast



So no matter how many times I have a CT scan with contrast, I still worry that it’s not just that I feel like I have peed myself, but that I actually have (I hate you, contrast.) I don’t know if any of you have had this experience, but it’s a little startling and you’re all, “OMG, I’m going to electrocute myself and the nurses and all the staff within forty feet of me and what a mess that will be.” Nope, just the stupid contrast making its way down to the well-vascularized areas. Super.  

"Hi."
With that being said, I’m happy to tell you that I passed my CT. My heart rate behaved itself and I didn’t even need the intravenous metoprolol to go along with my 150mg of pills. I loaded up on Benadryl for my contrast sensitivity and was just fine. By the time I got on the scan table, it felt like it was time to come off again. So, yay! Seems like so little time for that ENORMOUS 18 GAUGE IV NEEDLE!!! (See below. I teased that she had a choice between "water main" and "meh" and she wanted to provide me with absolutely every patient experience.)

 



The official scan shows, of course, that I have that silly superior vena cava going smack into my left atrium, and also have just one pulmonary vein on the left side (instead of the normal two) which is shaped oddly. I don’t know if there will need to be any sort of alteration for that. But, I have an appointment with the surgeon next week and hopefully we’ll really start moving forward on this. Because waiting sucks.  

The days go on. I still work on my Masters degree, play with the cats, drag around my portable oxygen, and enjoyed Del Taco french fries today. I don’t know what they do to those potatoes, it can’t be good for you, but I’ve been craving them for four days. I know they’ll have me on that CARDIAC DIET before I know it, and that involves no salt and limited fat and essentially not a whole lot of fun.  

Speaking of fun, let me introduce you to some of Jelly Belly’s new flavors. No, I have not opened this box yet. I’m afraid to. Canned dog food and lawn clippings, along with barf flavor and moldy cheese. My sweet friend, !!! CHRISTINE !!! visited yesterday and brought these along with other beautifully corny items. I think she’s sweet, and not trying to kill me. I guess time will tell, or I’ll go in there when I’m really needing sugar. I’ll let you know what happens, but if you don’t hear from me for awhile, it’s probably the stinky socks flavor (not kidding.) 


Also in the gift basket was a meditation elephant, teas, chocolates, a duck that quacks when you blow into its hind end (I can't make this up, people), a card regarding things you don't want to hear in the operating room, strawberry jelly, hard cider, a scrub brush for my back, adult beverage napkins, and lovely scented soap. I have discovered that my friends know me better than I do.
 

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