Round

My mindset & my weight have been holding steady this week.  That’s pretty good & I’ll count it as a victory.  I’ve lost weight steadily every week for quite a while now, so a flat week doesn’t freak me out, I actually think it’s a bit more normal.

I also headed back to exercise last week - more seriously than the slow walks I’d been doing after surgery, I acutally went to the gym 3 times & 2 long walks last week, and was glad to see my appetite return along with the energy expenditure.  I’ve had very little appetite since the surgery & was starting to wonder about it — since that’s not very normal for me, and there were days when my calorie intake was very low because of it.  Luckily, it looks like it was just a phase, and I am generally feeling more ‘me’.  I was careful not to overdo it (except for Friday, when I did overdo it) & was really happy that the gym sessions didn’t result in any pain or other ill effects.

This weekend we went to visit my in-laws in Brittany.  Whenever we go there we always visit a special creperie which has the BEST crepes I’ve ever had.  I knew we’d go there this trip again, and I was debating what I would do about my diet on such a visit.  Do I try to find a way to eat low carb & skip the crepe? Or do I just go with the flow and enjoy it?  Finally, I decided to go with the latter solution, as we only visit there once a year or so, and those crepes are totally worth it.  They’re actually not horrible from a carb standpoint - the crepe batter is made with whole grain buckwheat, and they have tons of fat in them (butter for the griddle, cheese, egg, etc).  It’s higher carb than my regular fare, but not like I’m diving into a cake of flour and sugar, so I just let myself enjoy it & then returned to regular eating (almost — I did also dip my hand into the chocolates a few times that evening…).  But yesterday was back on track & today will be too.  Life is too short to turn down everything.

This week the scale has been dancing around a lot — and higher than usual, which is a bit weird.  I figure some is from the intensified exercise, and other must just be readjusting to a new normal.  At the same time the scale was up a few pounds (back today to the same weight as last week), my clothes felt looser again.  I finally decided to retire the jeans that have seen me through since March.  I confess they were pretty tight in March, but now have a saggy butt & saggy thighs & I have jeans in about 6 sizes in the depths of my closet, so I went digging.  I was surprised that there were pairs of jeans that I need to skip over — they would have worked 10 pounds ago but are already too big.

I was inspired enought to go through my professional clothes this morning — since I start back to work on Wednesday.  I found 2 suits I bought in February that were tight then that are too big now & still have the labels on them.  I got rid of 8 pair of pants & a few jackets, and have room (and encouragement) enough to try on some of the suits that I had banished to an upstairs closet 2 years ago when I realized they were just making me feel bad every time I got dressed — some of them probably fit again now! It’s like going shopping without spending anything or dealing with the crowds.

I’ve gone through my sweaters too, and even put a few items that are tight into a box to open again in 10 or so pounds.  I’m loving the feeling of discovering new(ish) items so I figured they were better off waiting for me to re-discover them instead of taking up space in my mind & closet right now.

I’m largely back to my usual self.  This year has been a hard one, the endometrial cancer dominating everything else, but it’s also been a year of learning.  I’m still learning.

When you read about people getting news of a major life change or getting a scary diagnosis you sometimes see reference to it as a ‘life changing event’ in that people will talk about their time before the event, and after.  I’m pretty sure my experiences with endometrial cancer this year will fall into this pattern.

Every day I see that my priorities & attitudes have shifted.  Some of the shifts are slight, some are major.  I am more tolerant, more compassionate, less easily annoyed with human foibles (slow cashiers, unfriendly people, etc).  At the same time, I have more appreciation for everyday life - a nice cup of tea, a walk around town, time spent with a friend.  I also am less willing to spend my time & my energy on things that are draining for me.  I suspect this will have some impact on my professional life when I head back to work next week — I just don’t care very much about corporate politics or corporate goals.  I’m happy to have a job (and one that I like) but I also know that the job is not my life, and I won’t give it that kind of energy.

I had lunch yesterday with a friend of mine from the States who has moved back to Switzerland.  I haven’t seen her for several years, and haven’t been in touch much these past few years either, but for several years before I moved to France I had dinner w her & her husband every few weeks, and I worked closely with her husband for several years.  Seeing her was nice - especially since they’re back in Europe & hopefully we’ll manage to see more of each other.  I was looking forward to talking to her, to see how I could handle talking about what I’ve been though this year without it becoming a pity party but merely part of the ups & downs of life.

When she asked how I was (saying she could tell by our brief phone conversation something was up) she thought it was my marriage that was the problem.  I had my heart beating hard, as I said “no, that’s been the rock for me this year”.  I am so grateful I found this man, pushed myself to open up to him, and that I’ve managed to build such a solid relationship with him.  We’ve had some hard moments this year - but a lot of those hard moments have brought us closer.

This friend married later in life, like I did.  She’s about 10 years older than I am, never had children.  I suspected talking to her would be helpful & I was right.  I told her what had happened, and she was very nice about it but also not dramatizing it (nor was I).  That was nice, and gave me good practice for explaining some of the situation to my work colleagues & direct reports when I head back into professional mode over the next weeks.  We talked about a lot of stuff, but the work conversations which had always been a big part, were gone — both her & her husband are now retired (him 6 years ago, her earlier this year), and the importance of my career in my life has been on a steady downward trend for several years now — and of course right now I have zero interest in it.

After our nice lunch & lingering over tea, we parted, but I was very happy to be able to see that I am living a good life.  I braved the rainy weather & walked home, wandering through neighborhoods I don’t know so well & ducking into shops from time to time.  I spent about 2 hours heading home (normally would have been a 40 minute walk) and found a book I’d been looking for & some ingredients from a specialized grocer.  I listened to a book on tape. I took a few pics of this pretty city.  I appreciated my life.

When you eat low carb, your breakfast options are largely egg-based.  Of course, you can eat anything, but for a girl who ate oatmeal, unsweetened cold cereal or museli every day for like 15 years this has been a big shock to me — and one I’ve not particularly enjoyed.  For a few weeks eating omelettes & fried eggs was fun, but the grab-and-go side was severly lacking, and sometimes eggs just smell too strong for mornings.  I sometimes eat non-egg things for breakfasts, but needed some faster options, so I started experimenting with egg casseroles & quiches a few months ago.

I am now the Queen of Quiche.

I have made the basic recipe so many times I don’t even measure anything anymore & I know tons of substitutions if I’m short on an ingredient.  My quiche Lorraine is now a refined recipe from trial & error that my (very French) husband says is among the best he’s ever had.  I’ve made many other kinds of quiche, and I’m now able to improvise with whatever veggies, meats & cheeses are in the fridge.  Currently in the fridge is sausage, leek & feta.  Before that it was ground beef, ricotta & arugula.  A few days before it was ham, sheep’s milk cheese & broccoli.  We had a brunch the Sunday before my surgery where I made one quiche Lorraine & another which was mushroooms, chicken & goat cheese.

For all of these quiches, I make them crustless.  I use a silicone pie pan (American depth, not the thin French tart pan depth).  None of the recipes are low fat or particularly low calorie, but without the crust they are approachable for those of you counting calories, and with a few changes you could make them lower cal & lower fat.

What’s really nice is that they always turn out well, always can be a quick supper or lunch (served with a salad) or zapped for a minute in the microwave are a quick breakfast option, full of protein.  I freeze what I don’t eat in a day or two into individual slices (in ziplock bags) then zap in the microwave to eat.  Unless the cheese is very strong it’s a much less invasive smell than cooking eggs in the mornings…

My basic recipe is the following :

- preheat oven to 200° C / about 400° F

- butter a silicone pie dish (could use Pam for example, or skip this)

Prepare the fillings for the quiche :

• I use about 1 cup of veggies (cooked, unless tomatoes), about 3/4 cup meat, and about 3/4 cup cheese.
• Ideas for veggies : carmelized onions, zucchini, broccoli, mushrooms, spinach (don’t need to pre cook leafy veggies)
• Ideas for meat : crumbled bacon (or in France, lardons), sausage, ground beef, ham, leftover chicken.  Can also easily leave out the meat & just do more veggies
• Ideas for cheese : I tend to use mainly grated swiss cheese (gruyère) because it’s the most traditional & has a very mild flavor so the other flavors come out (it’s also easier for me to find in Paris than other grated cheeses).  You can use anything but be careful with stronger cheeses as they can intensify in cooking.  When I did goat cheese I did about 1/2 swiss & 1/2 dots of goat cheese.  I recently did ricotta (dropped in small spoonfulls all over the quiche) but again added some swiss because it melts so well.

Egg mixture :

• It’s basically a flan mixture, but I’m eating low carb (& higher fat) so I have a fattier mix that most of you reading probably would.
• My mix : 4-6 eggs (depending on what’s in my fridge & their sizes), 1 cup or so of cream or a few spoonfuls of crème fraîche and some milk.
• Likely mix for you : 2 eggs (maybe an extra yolk or two) and 1-2 cups of milk.  No need for the cream really except it’s lower carb than milk (well, and it makes it really creamy, but it’ll still be good without).
• Mix the egg mixture & add in a good amount of black pepper & about a 1/4 tsp of nutmeg.   I haven’t salted any of my quiches because cheese itself is salty (and gives the salt to the rest of the dish) but there is room to play - I am now making sure the veggies are seasoned before I put them in, because my mushroom/chicken/goat cheese quiche was a bit flat - lacked salt - because nothing had been seasoned.
• Add other spices if you are pretty sure they’ll work, but go gently so as not to overpower.  A pinch of basil, thyme or oregano.  One of my upcoming quiches will use a can of green chiles (imported from the US) and cheddar (imported from UK).  The spices should be mixed into the egg mixture (I use a stick mixer to mix up the egg/cream/milk/spices, but it’s not necessary, I’m just lazy.

Assemble the quiche :

• If using a silicone pie pan, put it on a baking sheet to avoid it spilling when you transfer it to the oven (baking sheet + pie pan will go into the oven so you have a solid base, otherwise you risk a big slop of eggs on the bottom of your oven which is NOT FUN)
• Put the veggie & meat ingredients into the pie pan in an even layer
• Sprinkle the cheese on top (if using 2 kinds of cheese, start with the shredded one & then put the drops of the other one)
• Pour the egg mixture gently over the top (trying to keep it even & keep a layer of everything all over the quiche)

Put the quiche in the oven, drop the temperature to about 170°C / 375° F and bake for about 30 minutes (start checking at 20-25 minutes, cooking may need up to 40, depending on your oven & your bakeware).

Can be served hot from the oven or warm (room temp).  Cool it completely before putting it in the fridge (I take it out of the pie pan after about an hour then cool on a plate.  Put a clean shower cap over it (or plastic wrap) and it goes in the fridge.   To re-heat for one slice it’s about 1 minute in the microwave.   Keeps well for at least 4 days.

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Thank you all so much for the outpouring of support and virtual hugs.  The shock of the news is now passed, and I’m past my short-lived pity party & into action mode of making the appointments for the second opinion & the re-reading of the pathology.  I feel like it’s quite manageable now, and while I’m still more scared about future health than I had been, in some ways I think it’s a good thing because it makes me remain more vigilant about guarding & appreciating my good health.

The scale showed another pound loss this week, reinforcing the steady consistent & almost effortless weight loss that I’ve been having since March — I’m in m 34th week and have lost 32 pounds (and during that time had a jump up in weight from our summer vacation & then another several pounds from IVF drugs).

So yesterday I went to see my doctor for the post-game wrapup session. The surgical report, see how everything is healing up. Oh yeah, find out about the pathology report which I’ve been trying so hard not to obsess about over the past 2 weeks post-surgery.

The healing is going well, especially when I don’t overdo it, and more and more even when I do.  I have almost no pain now and haven’t taken anything stronger than Tylenol for over a week, and nothing at all since Monday.  He said everything is healing well, all the inside stitches seem to be doing what they’re supposed to, and he gave me some treatment to stop the end of the discharge/bleeding that’s been continuing.  The treatment lasts one week, then I can take baths & go swimming.  (And make whoopee, although before we saw him my husband & I agreed to tack another week or two on to the healing time no matter what he said, because he never seems very conservative with healing).

Surgical report had nothing special in it, nothing he hadn’t told me when he came to discharge me from the hospital, so no surprises there.

Can you feel it building up?  Yeah, so could I.

The pathology report was in, and it wasn’t perfect.  I mean, it’s fine, I most likely don’t need any further treatment (to be confirmed today or Monday at the tumor board meeting held today).  But instead of a nice pre-cancer state of affairs (my pre-surgery diagnosis), they found cancer.  And not even the earliest stage of endometrial cancer, but a tumor that had started to invade the uterine wall.  Official stage is 1B in the old staging system (they just changed all the staging classifications in the last few months).

What does this mean?

• Well, for one thing the decision to go ahead with the hysterectomy instead of pushing my luck with hormonal treatments was clearly a good one.  With a tumor already penetrating the uterine wall, I could have easily been one of the scary 5% who have their disease significantly advance despite hormone treatment.   The risks of the hormone treatment seemed out of hand already when I thought we were dealing with pre-cancer, but now I am very reassured we went the surgical route.
• Maybe this explains why we had such a difficult time having a baby.  Sure, my age has a good amount to do with it too, but my hormone tests have been okay and we have had many shots at good embryos or good timing with IUI & maybe nothing could really stick around & grow because of so much abnormality in my uterus.  One thing for sure, the feeling I had in June that my embryos would have a better chance in someone else’s uterus (surrogacy, which we are pursuing) is clearer than ever for me.
• Keeping my ovaries long term may not be a good idea.  In fact, I’m not so sure about keeping them shorter term either, and have been thinking a lot about this.  Since most of the time they remove them without discussion there is basically no data on what kind of risk I’m running.  I will, of course, have lots of follow up testing and monitoring to try to pick up anything amis, but I do wonder how effective that is.  I need to give it some more thought, but will likely go back to one of my second-opinion doctors from June and get another person’s thoughts on this.
• Do I do another re-reading of the pathology?  What will it prove, what will it help? The decision to do or not do anything will probably be based on what the second opinion doc says.
• I know I face years of worry - intense during the testing phases as they come up (more frequent in the first years, then decreasing, then much less frequent as time goes on).  That worry factor probably would have been there with another diagnosis, but is obviously increased now.
• Good luck getting me off the carb-restriction thing.  I started the carb-restriction stuff just for weight loss several months before the diagnosis.  Then as I was researching what wellness changes to make I saw all kinds of stuff about how sugar feeds cancer.  I was already liking low carb because I felt so good, no hunger & it was working for my weight, but the sugar (and other carbs) feeding cancer thing sealed the deal for me.  Still does.

Otherwise, the pathology results of pre-cancer, stage 1A or stage 1B have the same further treatment recommendations : NONE.

So in some ways I’m worried about nothing.  On the other hand, I found out yesterday that there is a big difference emotionally between pre-cancer & cancer, even if the physical treatment side is the same.

I don’t know if my reaction is normal or not.  My husband seemed to think I was creating drama when we had “good news”, but since I had really focused on having either the surgical result be pre-cancer or stage 1A I admit I was really shocked & scared when my surgeon told me of 1B.  I do think it’s something I’ll need time to process.  Luckily I have a new counselor who I am really liking.

I’m back in the kitchen, although when my husband or mom notice they often come and shoo me out.  But I’ve made beef bourgignon (pretty much the Julia Child recipe) and a few other things in the past week.  We had mushrooms twice in the last few days, and both times I secreted a few out of the sautéeing pan & into a tupperware in the fridge with the idea of making soup.

Today as lunchtime rolled around I got started with the ends of bacon I hadn’t used, some leftover thyme sprigs (in a cheesecloth thing) an onion & clove of garlic, and the most ordinary of mushrooms in some beef stock.  I let it all cook for about 15 minutes, then hit it with my stick mixer (love that thing) then stirred in rather a lot of crème fraîche (maybe half a cup?) and the added in the 2 fancy kinds of mushrooms (which I left as slices).  I let the whole thing simmer another 10 minutes and then had the wherewithall to chop up a few sprigs of parsley so it was really pretty (I admit I rarely do this).

It was easy.  It was delicious.  I had two bowls.

I’m feeling a lot better.  I’m still trying to keep taking it easy, it’s still hard for me because most of the time I feel fine & it’s not until a few hours after overdoing it that it hits me.  Tomorrow I see the doc & hope to get authorization to swim & exercise a bit more than I’m doing now.  What I’m really hoping for is a clean pathology report, actually, but I’m trying not to think too much about it.

My mom left this morning.  She really got on my nerves last week for a few days, but then suddenly she didn’t, and I really enjoyed having her around for the last week.  I’ll miss her.

I’m on the road to recovery pretty solidly now.

After Tuesday’s debacle I’ve paid more attention to taking it easy, and my mom had a reminder from her sister (who nursed her after her hysterectomy 20+ yrs ago) of how hard the recovery was & suddenly my mom is insisting I sit down, etc.  The pain has significantly reduced & 22 hours a day I’m feeling good (the other 2 hours I’m behind on taking my Tylenol & waiting for it to kick in).

I see the doctor on Thursday & hope hope hope to get the all-clear from his exam and the pathology report.

In the meantime, I’m walking a bit (trying for around 30min/day) and don’t have a huge appetite (my mom thinks from the surgery, I think from the carb-restricted diet).  The end result?  Another 2 pounds gone this week!  That brings my total to 31, which is damn respectable.  I’m so glad to have gotten in control of my weight this year.  And beyond pleased to have found an approach that works so effortlessly for me.

Well, as some of you cautioned, I have indeed overdone it.

My mom keeps insisting that we go out for a walk every day and I keep going no matter how I feel.  And she believes in making it longer and longer each day.  So yesterday was an hour and twenty minutes and after we got home I felt light headed for over an hour and then had terrible belly pains all evening (continuing today).

My husband (who has been telling me each day that I’m doing too much & that I need to rest) was really upset last night & told me that today I needed to listen to him, why was I listening to my mom?  Well, because she’s a doctor (retired, and with no knowledge of surgical recovery).  He said, no, she’s here to be a nurse to you, not a doctor.  Good point.

So here I am curled up on the couch with my swelly belly… but the idea of moving nauseates me, so it must be the right decision.

I think all the collective good will (friends, family, all my eFriends like you all) really helped me. The surgery went well and it’s been an easier recovery than I had feared. They were able to do the hysterectomy via laparoscope, which means far less abdominal cutting, and I was up on my feet about 16 hours later. I did so well in my recovery they let me out a day or two early from what is typical at my hospital. The only pain meds I had since the night of surgery is Tylenol and sometimes I boost it with an anti-inflammatory. I’m walking daily - trying to go about 5 min longer each day but I overdid it on Sat so trying to be a bit calmer about it.

My weight is hardly been my preoccupation, but I did start on the carbs 2 days before surgery (bread, dessert) and then in the hospital of course you don’t control your diet. They had me on a glucose drip for surgery & 24 hours after and the first things I was able to eat were breads and sweetened things (yogurt, applesauce). But the day after getting home from the hospital I got back on track, and I saw the 6 pounds of bloat (from carbs & surgery) fall away over 3 days).

I haven’t had much appetitite - small amounts of food satisfy me, and ‘normal’ portions make me nauseous (probably effects from the anesthesia & the mucking around the surgeon did in the gut). It helps me to not overeat, however.

All told, surgery was easier than expected, recovery is easier than expected, & emotionally I’m doing better than I expected.

Thanks again for all of your support over the past 6 months.

I am off to the hospital this evening, surgery first thing tomorrow.

I’m scared.

I’m sad.

Mostly I want to put this behind me & hear my doctor tell me that he got it all, there is no more treatment needed, and that everything looked really good - and then to go on to have a perfect recovery.

Thanks for all your well wishes - and if you can find it in your hearts to think of me one more time, the best would be tomorrow morning French time (so middle of the night or wee early morning in the US).