Category Archives: Uncategorized

What Is a Weekend?

“Stay at home” order beginning week 3. It feels like it’s been longer, but time itself is beginning to get weird, only tracked by the clients I see virtually for their regularly scheduled appointments. It has so quickly come to, “What is a weekend?” Now that the scramble to establish some form of normalcy (?) while isolating ourselves from real human contact outside of our group of two has subsided, we have come to the challenging space of relearning how to “be.” Overall, as a species, we have developed genius methods of distracting ourselves from being, or from noticing our being, and those devices left to themselves without the additional distractions of being constantly on the move, rushing from the moment our feet hit the ground until our faces hit the pillow every night, are beginning to take up less space. I am entering the phase of noticing more, but am not yet interested in trying to fix.

My honey and I went to church yesterday, or as some call it, nature. We got away to the mountains to go for a hike. I woke up feeling heavy, and a little sad, the morning progressed, and by the time we hit the trail in the early afternoon, I was in full blown sadness. I usually want to find a way to fix these emotions. Oh god, I’m sad, what do I do? How do I make it better? I must know what I’m sad about! Yesterday, I walked, and I felt sad. For 10,188 steps, up and down over slick rocky trails, somewhat flat meandering paths, and up to the tree line of mountain pines, I walked with it. For a solid two thousand of those steps, I wept with quiet tears sliding down my cheeks. By the time we got back to the car, I was exhausted from the hike and the grief, and I felt cleansed as I slumped into the seat. I also didn’t try to figure out where all of it came from. The emotions were there, and letting myself be with them seemed like plenty, and I think it’s because I know that there is time to let whatever it is manifest itself naturally. I don’t have to do anything. The work is to be present enough to let the feelings in to do whatever it is they came for. Living in a town like Austin, or a world like ours, almost requires that you are more in the hustle than you are in yourself, which leads to an entirely different kind of exhaustion.

I’m noticing other things, too. People are really seeing each other. We spend a lot of time during the day working from the front porch. I think we both like to watch the world go by. This is something we do a lot when I visit, too, and most often people walk by on the sidewalk with their heads down, eyes directed straight ahead, earbuds shoved in their ears, heading purposefully to their destination. People are looking up, now, turning their heads to meet our gazes, and then waving with a smile. We are looking at each other. On our evening walks through the neighborhood, neighbors are saying hello, making small talk, working in their yards, and dining al fresco, out front. People seeking connection with other people. We are reconnecting as neighbors. Why do I think things are different, now? Because in the real world, we are comically busy. By the time I have navigated the minimal (by Austin standards) amount of traffic I have to deal with in a day, run my errands, hustled my hustle, done my writing, cleaned my house, seen my people (which is medicine), practiced my practice, and done every productive thing I can think of to convince myself that I am a worthy human being, and then stepped out on the sidewalk or trail to be in the natural world, I am solidly on MY time. I don’t have time to look at you, I’m walking, and walking is very important business. I’m listening to a great audiobook or playlist, the weather is probably lovely, and I have planned too carefully to carve this time out for myself today to actually engage with the rest of you. I’m busy!

We aren’t so busy today. Our walks are real time. They are not a chore, they are not a task, they are not only exercise. They put us in the world, and in our community, which feels more and more like a community of people who see each other. I love this. I also say this as couple who have no children who must be fed, educated, bathed (although in this new world…), and then fed some more all at the same time you are still trying to work from home. That is a layer I have no idea what to do with. FaceTiming with friends with littles has made me realize how easy we have it here at casa couple with no kids, which might be why I keep pushing for a dog. What’s a little extra challenge to a couple of fiercely independent adults who are suddenly on top of each other 24/7 for more than just a good time? Surprisingly, he doesn’t seem to be budging on the dog.

I hate the reason we are slowing down, but I love the slowing down. I love it that I am seeing so many families outside playing together. I love that we are taking more time in the evening to make meals together. I love that we are suddenly looking each other in the eyes more, and at our devices less. I love that we are reengaging with each other. I love that we are being made aware of how incredibly important our service and medical workers really are. I love that my focus right now is what is happening in this space today, and not on what I am hustling for at some future date. I love being forced to be present. This is so hard, but it is happening, so along with the parts that are hard, I am also going to take what is good.

Good lord, what is a week-end?

Things That Happen To Us

Hey, everyone! Hiiii!!!! Omg, hi. I hope you’re all doing alright, and settling into a manageable rhythm in this strange new world. Life is weird in it’s present state. Really, really weird, and of course it has me thinking about when things in life happen to us. Things that happen to us are different than other things that happen. Things that happen to us are usually jarring, and often unexpected. Things that happen to us are a little scary, and tend to leave us feeling untethered. This is not a good feeling. To this day, cancer is still something that happened to me. I never saw it coming. Not once. I have been completely shocked every time, even when I told people I was ready for it, and now here we all are, in the middle of something that is happening to us.

The thing about things that happen to you, is that there is usually a feeling of complete loss of control. The coronavirus is grabbing for the wheel, and it might feel like you are being steered off the road, or that suddenly you can’t find your way to the most familiar places. To top it all off, you might have been feeling like you were on a highway that was taking you exactly where you want to go. Freakin’ detours. You did nothing to deserve this, there was no bad decision making that got you here, this is not your mess, but it has made itself your mess, and now you have to deal with it. Dealing with it sucks. However, on the bright side, you are dealing with it! Seriously, if you’re still breathing, you’re dealing with it, and I would also imagine that the majority of you are incorporating your old routine into your new routine, and are carving out new spaces for yourself in your old, familiar spaces. You are surviving a global pandemic. Welcome to survivorship! Survivorship is where you go when things happen to you. You, too, are a born survivor, and survivorship is where you learn that right here inside yourself exists all the skills you need to get off the island.

Survivorship is uneasy because it involves a lot of unknowns: will I survive, can I make fire by rubbing two sticks together, can I live in 1200 sq. feet with my significant other day in and day out? All good questions, but the nice thing about unknowns is that there’s gold in them there hills (read in my best prospector’s voice). There is growth in discomfort. I can say this after spending a lot of time surviving over the last number of years. After all this time, what I know about things that really shake up my life and sense of security, is that there is something for me here. Whether I want to or not, I’m about to learn something new about myself, so that means that I’m also going to be doing some things that ground me, make me happy, and help my brain to chill out for a minute. Things that feel good. Tapping into the things I can take for myself. I am taking time to walk when the spring winds in NM aren’t blowing too wildly. I can think when I walk. Thoughts present themselves to me like gifts when I walk, and the fresh air and sunlight feel good. I am taking some time every day to talk with family and friends. They ground me, remind me of life outside of this home and news of the virus, and they make me feel connected. Feeling connected feels good. I am lucky to still be working some virtually, and seeing most of those clients at the same time I see them in the studio. The normalcy feels good. I’m drawing in my journal and writing a lot of letters to Love. This feels very good. You get my point here. Do things that feel good in the face of a global pandemic that doesn’t feel very good at all. Survivorship might not be easy, but it doesn’t have to be awful.


One of our evening walks. I love these walks so much. We talk and talk and have loads of commentary on the world around us. Quality time defined. And me as usual coming in for some love. I can’t help it. Look at this guy. And I’ve given up makeup completely. Freedom.

I went on a telephonic walk and talk with a friend earlier last week who also happens to be an amazing executive coach. She was telling me about getting some of her clients to indulge in the mental game of reimagining this as the best thing to ever happen to them. What would that mean, or look like, how would it feel? How would their perception of this situation change if they flipped it on its head, and reimagined it as something they had chosen? Try indulging in this for a few minutes, and really let yourself go deep. What if you had chosen this? I dropped into this exercise rapidly when I chose to stay in NM. It’s a muscle I’ve had the opportunity to strengthen. As another disturbance in a steady line of disturbances over the last few years descended, I took something for myself quickly by taking advantage of the opportunity to spend more time with my guy. What would it feel like for us to live together all the time? This was something I had considered often, but my life is good in Austin, and it is so hard to change good things. That was the beginning of the reimagining, and there will definitely be growth here. Lord have mercy. I can also feel other things rearranging, reimagining, rethinking themselves. I can feel them in the fluttery part right below my diaphragm. I don’t know what this growth is, yet, but it will assuredly present itself. I’m not quite there, though, because I’m so recently here, and here is being in this new space, adapting, and finding myself happy in my current situation, if not pretty dazed, and sometimes uncertain. This is kind of big. People usually prepare for changes this big. For months! Settling in to this new space is plenty for right now. It’s a good start, and the nice thing is that sometimes when I get a little (or a lot) freaked out, I remind myself that I took this, and then I act as though I chose it, because I did. I’m not a victim, I’m a survivor again. I’m a survivor who is walking toward growth. But still, fuck. Just when I had gotten back to living.

The thing I know for certain about things that happen to us, is they inevitably change us. In some way, this period will change the way you live. For those of you who are looking at a bleak situation, you will learn that you are more resilient than you ever imagined. Know that you will survive, and you will rebuild. Human beings are freaking amazing beasts. Even if things are still pretty good for you, the period of forced slowing down may show you some things that are essential, and some that are not. This information is precious.

You have been dropped in the middle of a dense jungle. There is a treasure chest in this jungle, and all you have to do is a little bit of hunting to find at least one valuable gemstone. Go on the hunt. Take time to be still and listen to the sounds of the jungle, because no one is giving you a map other than the faith that intuition is waiting patiently to guide you. Welcome to survivorship.

*many thanks to Ad Meliora Coaching for the excellent mental exercise. Do you have friends who inspire you, or make you feel expansive? Now is a great time to engage those people.





This Was Unexpected


This is me, figuring out how to teach virtually. Also trying to figure out what’s going on with my shoulders, because every single picture had this weird right vs. left arm thing happening. Whatever.

This is not the post I was planning to write this month. March is Colorectal Cancer Awareness Month, and I was planning to shame you all into getting colonoscopy’s immediately, especially those of you aged 45 years or older. Did you know the new screening age is 45? You should know this, because the age of bowel cancer patients at diagnosis is trending downward at a rapid rate, but there’s no way I’m asking any of you to schedule an elective procedure today, barring the fact you have rectal bleeding, then I might tell you to get on it. Is coronavirus or colorectal cancer more alarming? That question is above my pay grade. I was finally going to write about Pilates and GYROTONIC®, because from where I stand today, I am able to really speak to the benefits of both in terms of rehabilitation. Why did it take me so long, you might wonder? Because for a long while I was just too close to the illness, and still struggling too much trying to survive to see the forrest for the trees. In light of the world going into lockdown, though, none of this has felt especially relevant, and now, as so many are struggling in this new reality, I find myself on comfortable ground. Luckily, Glennon Doyle’s book “Untamed” just came out, and she described one of my skills far better than I could: I can do hard things. It isn’t a skill I wanted, but it is certainly one I’ve earned.

There will be a lot of people going without paychecks, families unable to see each other, friends separated, life work balances thrown completely to hell, and so many big, scary unknowns that we will find ourselves compulsively drawn to the internet for answers that aren’t actually there. It is a strange, strange thing for the world collective to be living in the great big unknown, and surprisingly I will tell you that it does not feel better to have company here. Come to find out, I liked it better when most of you were on the other side of the glass, because selfishly, I only had to worry about me. Right now, I’m worried about you, too. All of you, and not because I do not know beyond a shadow of a doubt that you can do hard things, but because unknowns as big as this are such an existential mind fuck. If you’ve ever wondered what might be floating around in the recesses of your psyche, be prepared for it to come bubbling to the surface in the coming weeks. It’s okay, and after the initial shock, rarely as disturbing as it seems at first glance.

When I was first diagnosed, and each time I’ve been diagnosed since, other cancer patients strongly discouraged me from Googling, but knew I would regardless of their sage advice. For the last three days, I have been unable to stop myself from incessantly checking the real time infection rate by country and state. The number won’t stop going up, and I am compelled to watch it. This is going to have to stop, now, and the answer isn’t because it’s making me nuts, but because it is taking up precious time. All I ever want is more time to write, and today I have a ton of it. I want to cook more, but always say that cooking for one isn’t as satisfying. I’m staying in New Mexico with my person for the next little bit, so this is a good time to flex that muscle. There are one million and one downsides to this situation. I might not see my family for awhile, and everyone knows I keep them close. I wander through the house like I’ve lost something, and realize that I want my friends. I just completed my final certification in GYROTONIC®, and all I want is a damn tower to move on. My finances just got seriously screwed, but that’s been the norm every time I’ve had to have surgery over the last 5 years. I was getting back on my feet in a real way this time, but…

But, nothing. I’m still on my feet. I know now that I am not so breakable as I once thought I was, and that I’ll be okay. That is the gift I can finally say I got from cancer. These times will pass, and we will be okay. I’ve seen the dark side, I’ve luxuriated in it’s pain, and in the end, I keep finding ways to turn to the light. This is what I want you to do, too, and please, not at the expense of feeling your emotions fully, because you must do that. This whole situation is insanity, but can you kick and scream or cry in a tight little ball or break every plate in your house, and then find some light? Even if it’s just a tiny sliver, what is your light? What do you want to create? What do you want to build out, build up, build bridges to? What are you curious about? What excites you? What do you want to know? I have seen “Fame” so many times that I can almost quote the movie verbatim. Yesterday, I took a dance class from Debbie Allen, and have decided I’m a dancer, now. Today, I downloaded Jane Fonda’s 1980’s workout from YouTube, and kicked it old school. Holy god, I need my leg warmers, STAT! Fyi, my leg warmers are in Texas with the rest of my stuff. I came to NM for the weekend with an overnight bag so that no one besides me would touch my luggage, and then decided that if I was going to be quarantined, I was going to be with my beau. I never anticipated a time where I would be grateful that his jeans fit me, but here we are.

The world is going to feel surreal and strange for awhile. Can you ease into the strangeness? Can you get a little weird, and meet the absurdity of this situation half way? How creative are you willing to get, because I am dying to see all of it! If we are forced by circumstance to slow down in almost every conceivable way for however long this lasts, what are we capable of doing with this precious time? I take none of this lightly, but I spent so much time over the last few years consumed with worry about the future and fear that I would never feel real again and shame over being financially broke that I don’t have it in me to worry anymore because worrying never helped. It was unavoidable sometimes, but it never helped. 

If there is anything at all I can do for you, I will be right here. In the meantime, make me something beautiful or dark, but create so I can be inspired by you. I need it, too.

What if what, cancer?

Happy new year! It is January 6, and I am staring out my window trying not to think about getting the results of my latest scan this afternoon. I’m exhausted, and I have been exhausted since October. Is this a sign of an impending cancer diagnosis? Am I finally done for? Probably not, because I live in central Texas, and each year at this time our skies are flooded with cedar pollen, leaving most people feeling a little fatigued and fluish.  And isn’t almost everyone fried after the holidays? This is what January is supposed to feel like, which is why most people cleanse through at least the first half of the month. However, that nagging voice in the back of my head is being a complete punk at present, and won’t stop whispering, “what if?” With minimal fanfare, I quietly pumped my fist in the air through the last days of December in celebration of finally going a full year without having anesthesia pushed into my veins, or experiencing the pleasure of once again rehabilitating my body. Unfortunately, I did it with the sneaking suspicion that there is something nefarious waiting on the other side of this scan, even though there most likely is not. “What if” what, cancer? Freakin’ punk.

The beauty of where I currently find myself, is that while I am nervous to hear what my doctor has to say, I’m not afraid of it. In looking back on the last 10 years, it has been beautiful, devastating, and wild. I got divorced, I got Brazil, I got the most amazing group of friends, I got cancer, I got to experience real, unexpected loss, and I got pulverized repeatedly. Multiple jabs right in the face, only to feel a more intense sense of well being than I have ever experienced in my life. What if what, cancer?

We put so much effort into cancer prevention in this world that is becoming more and more carcinogenic everyday. We talk about cancer prevention because we love to live under the delusion that just by doing everything right, we can prevent it. There are too many cancer patients who were living otherwise healthy lives for this to be a reasonable expectation. I get to live from the privileged position of knowing that even if you do many things right, it still might come for you, so I no longer treat my body well because I’m afraid of what will happen if I don’t, but now treat my body well because it feels better when I do. My jeans are a little tighter, and I’m a lot happier. Fear doesn’t get drive this train. What if what, cancer?

Financial toxicity? Living it, and doing okay, thanks to my parents, but still, I have learned how to make a dollar stretch, so as I’m working my way back up, every single dime becomes gold bullion. In middle age, I have had the opportunity to realize the value of a dollar, and the value of using those dollars to help people in need. Worst case scenario, and I can’t afford to live on my own anymore? Fuck it, I rent my place out, and  move in with my sister and her family. I love those people, and they put up with me joyfully! What if what, cancer?

If it’s everywhere? I spent most of 2019 putting a lot of thought into how I want to live. I have become actively, radically kind and generous with myself, which has been very helpful in returning me to my natural state of being radically kind and generous with others. I’m entering this year super excited about pouring energy into creative pursuits, and opening my eyes to all the awe the cosmos would like to put in my path. Translated? I’m feeling generally peaceful, and pretty good about things. What if what, cancer?

No matter what my doctor says later today, for the first time, I feel like it won’t really change the foundation of how I live. Early on I was traumatized that my lifestyle was so drastically clipped, and afterward, always furious that my efforts to dig myself out from under the detritus of this stupid disease were once again curtailed. For a while, I was still focused on the old things that I thought were important. As the last decade comes to a close, I find myself not so much changed in my position, but in my wisdom. The last ten years have taught me that I am not only tenacious, but resilient, and able to take a hit and still come out loving, which has been the most glorious realization of them all. Although I’m reasonably sure it’s allergies, what if fucking what, cancer?



The last post I published was in September of 2017, three and a half months after my first cancer recurrence. If I’m publishing again, while it could mean many things, it probably only means one. Now, before anyone takes this too seriously, as of Monday morning, November 26th, I was out of surgery for a fast growing tumor to the upper lobe of my right lung, and am once again NED (cancer talk for “no evidence of disease”). At this point I’m feeling qualified to say that every time I’m diagnosed with cancer, it’s a different experience. The first time, I charged in with the beautiful, naive optimism of Joan of Arc, certain that fearlessness and fortitude were all I needed to knock cancer soundly on its ass. The second time, soul weary and not quite recovered from round one, I muddled through in a haze of depression and defeat. This time, the third, has shown itself to be something altogether new, because now I’m starting to develop cancer wisdom, or as I’ve taken to saying, I’m a frequent flyer in a super sucky miles program with questionable rewards.

Since January of 2017, I’ve gotten a CT scan every 3 months. In the beginning, it was to follow the sketchy speck that became my first cancer recurrence, and afterward, to err on the side of caution. From July of 2017 to November of 2018, I had 6 clean scans. Nothing to see here, not a single change, not a twinkle in my tumors eye. Life was good, and I was going like gang busters. My schedule in the studio picked up to relatively full time, the prescriptive exercise pilot I presented to the LIVESTRONG Cancer Institutes at Dell Med School was moving forward, and I was strong, happy, and in love. I got comfortable, so comfortable in fact, that when my oncologists office was running painfully behind the day I was to get my most recent scan results, I abandoned their waiting room to go to the studio, and told them to leave a voicemail if I didn’t answer. Their voicemail went something like this, “we would still like to offer you the chance to come in to get your results in person, anytime you are available. You can call ahead or walk in.” A voicemail like this from any doctors office is the equivalent to being moved into the private room with a view following your colonoscopy, bad news is on its way.

I got their voicemail about 4 hours after leaving the office, and like any sane person, I drove straight to Neiman Marcus to get my gown for a close friends wedding the following weekend in Mexico City. What did you think I was going to say? That I went screeching into Texas Oncology? It is very important in life that one knows how to prioritize, and if you’re going to get crap news like having cancer again, then knowing there’s a brilliant dress hanging in your car really does soften the blow. After I picked up my dress I drove down the road to my oncologist office. And then sat in the parking lot deciding whether or not to go in. You can’t hide from the truth forever, but it never hurts to try for a minute.


This is the back of said gorgeous dress. The front will come in the next post when I describe how I learned what it’s like to deal with this disease in a somewhat new relationship. I’m sure my boyfriend will be super psyched about that. (just imagine the hanging strap peaking out from the back tucked all the way in).

So there I was, by myself/alone/flying solo in the waiting room for the first time in nearly 3 1/2 years (someone who loves me had always insisted on coming with), and for the first time ever in that waiting room, I wept. Having never cried before when I got the news, this felt like a somewhat delirious luxury, to let emotion spill out and be a little angry that my cancer won’t just go away and leave me the fuck alone. I didn’t cry because I was afraid of what was coming (I’m not scared of much anymore besides snakes), but because of what I knew would be coming: pain, fatigue, recovery, rehabilitation, more scar tissue, and one more, hopefully mild, bout of depression. I was crying because I was getting prepared, and I was crying because my life is about staying prepared. I was crying because having cancer sucks.

A perk in oncology is the speed with which they give you news. I think I waited all of 5 minutes before being ushered back to Dr. Yorio’s office (which means my cry in the waiting room probably lasted about 3 1/2, no need to drag these things out), and then maybe waited 2 minutes for his soft tap on the door. In the last 3 months, with no warning, a small lesion had flourished in my lung, growing to the small size it had taken its predecessor almost a year to reach. Previously, my cancer had been described as indolent, meaning it was slow growing, a bit lazy. There was comfort in this, probably because it gave me the illusion of time. That buffer was nonexistent when my oncologist told me there was a 1 cm lesion in the upper lobe of my right lung, and we needed to schedule surgery. 0 to “here we go again” in 30 seconds. The speed with which the new cell had grown threw me, and continues to throw me, for a real loop. It was new, and I’m learning that when it comes to my cancer, I don’t like new.

This was 3:45 pm on the Monday of one of my most anticipated weekends in years. On Thursday of the same week, many of my best friends in the world and I and my beau (heart hands), were leaving for the wedding in CDMX, and returning late the following Monday, which just happened to be the week of Thanksgiving. Fast growing lesion, time to celebrate, Thanksgiving holiday. What do you do? Go numb, act quickly. I had an appointment with my thoracic surgeon less than 48 hours later, and a wedge resection scheduled for the Monday following Thanksgiving. He assured me that this lesion was better located for removal, they had better eyes on it, and this should be an easier surgery to recover from. Walk in the park? No. Because even with easier lung surgery, lung surgery is lung surgery, but less bad is always good.

Here’s what I knew, I was much stronger than I had been when I had lung surgery in 2017, in a far better place mentally and emotionally, and reasonably knew what to expect. I was as prepared as you can be when you’re unprepared. What didn’t I know? How to share this news with my relatively new suitor who is also an old friend, or how this diagnosis triggers me in a way that I can’t hide so well from the person sleeping next to me. This was as new as my fast growing lesion, and I’m not entirely sure I was very good at it.


*Welcome back, friends! I’m going to try an experiment in keeping this blog updated in 2019, some posts I will share to social media, and others will just go up, so if you have any interest, check in on occasion.





The Hyder House in San Miguel de Allende February 2013 for Fay’s birthday celebration.

“Our deepest fear is not that we are inadequate. Our deepest fear is that we are powerful beyond measure. It is our light, not our darkness that most frightens us. We ask ourselves, ‘Who am I to be brilliant, gorgeous, talented, fabulous?’ Actually, who are you not to be?”
― Marianne Williamson, A Return to Love: Reflections on the Principles of “A Course in Miracles”

It is officially the first day of summer. The sun is shining brightly, the humid air is sticky with moisture, clothing is getting looser, bodies are moving more slowly under the oppression of summer’s heat, and I am fatigued by grief. A week and a half ago, without warning, someone I love shook off her earthly suit. The suddenness of this event rocked me on a cellular level, and fractured the last vestiges of the flimsy barriers I had constructed to push back pains I didn’t want to feel. For a moment I cracked and went completely dead inside, numb at the shock of this loss, stunned by its swift blow. Then my senses began to return, and the numbness was replaced by sorrow, and something magical happened, I began to wake up. For the first time in a long time, a little over an entire year, maybe even longer, I began to truly wake up.

My friend was HUGE. Her life force was magnificent and she was incredibly tall with a head full of massive curls that were constantly unrestrained. She had an insatiable curiosity for experiences and people and life. When she was with you she was present, often gesticulating wildly or leaning in more closely and pronouncing with greater articulation to make her point. She travelled and she explored, both the world and the inner workings of her spirit. She sought experiential knowledge, and found it over and over and over. In short, she lived. This is why, even in the earliest expressions of my despair, it never occurred to me that she hadn’t had enough time. hadn’t had enough time with her, but she had been making the most of her days, and that has had a more profound effect on me than the greatest self help manual yet to be written.

In the midst of our friendship I didn’t see the impact she was having on me. Maybe it was the slow burn of someone you see regularly, but probably more so than anything else the simple fact that I hadn’t actually ever thought about it. I only knew that she was my friend and she was wonderful…doesn’t that so very often seem like it’s enough? And it was. But in retrospect, over the course of  years and many hundreds of moments, I was listening and learning and getting to know her. Her life was making its mark on my soul, and luckily I was paying attention, because with the swift kick in the stomach of her death it all came flooding in.

TINA gave time and attention to the aspects of life that were important to her. She loved her art and textiles and creating, so she found a workshop (which she ended up ditching recently because it had a rodent problem, BUT she sought space for her creativity). She loved the Texas Playboys baseball club, so she became the supreme Nut (the name of their booster club), and attended almost every game, supported the team, and cheered them on with unmitigated enthusiasm. She loved her family, so she scheduled time with her sisters and nieces who lived out of state, flew to them on a seconds notice when needed, and prioritized them in her life. They knew without doubt they were loved. She sought knowledge of herself and believed strongly in our connection to the Absolute, and so she studied and wrote and read and devoted time to her personal development. She cherished her friends, old and new, and so she created time for us. She carved out hours, or sometimes minutes, to nurture the relationships that she held dear, and there were a lot of them. She LOVED to travel, and so she did. She made this happen even when finances and time were tight, and these experiences enriched her in countless ways.

My friend struggled against the same mortal coil that affects us all. She wasn’t magically immune or inoculated against the stresses of daily life, but she believed in abundance and had felt its presence in her life. In general, she truly believed that the universe was conspiring in her favor, and even in the moments when life wasn’t easy, as it so often isn’t, she believed. If something is important, you do it. If something vexes you, express it and move on. If you are called, answer. She showed up for her life, and she didn’t hesitate to say yes. So many of us are plagued by second guessing. Is this the right thing to do? Does it make sense? Can I make this work instead of will I make this work? So many questions when what we usually need is to simply say “yes,” and then show up for what we said yes to. She was expert at this.

I take away from her life that being present brings a treasure trove of riches, developing new and real friendships is never a bad idea, and that jumping in with both feet is only scary for approximately the first 5 seconds. I got cancer and lived. TINA got poison ivy and died. This is a supremely fucked up truth. The most beautiful part of her death is that she did not leave behind a lifetime of regret. If she was conscious in her final moments and knew what was happening, I sincerely doubt that she thought about the trip she should have taken, the adventures she should have said yes to, the friends she could have met, or the conversations she might have had. If she had a thought, I imagine it was more along the lines of what a glorious ride life had been.

I am fatigued by grief. I have struggled against low grade sadness for too long. Her death shook the foundation of that sadness and woke me up to potential. I am horrified by the idea of dragging out the sorrow of the last year for another second. It’s passed. It’s past. Today I am alive, and there are things I want to do. My friend had many lives in her 53 years on this planet. She started fresh multiple times, and was dedicated to action. First things first, live. Be in the world. Learn. Dive in and see what happens. Don’t be afraid of what will happen, be terrified of what won’t happen. “Who am I [not] to be brilliant, gorgeous, talented, fabulous?” The best way I have to celebrate her life is not to have regrets about mine, the risks I was afraid to take, the challenges I didn’t accept, the brilliance I turned my back on. She was part of my life and that meant something. Her life and beauty and presence affected me. It mattered and it was real.

I love you, TINA Pumilia. I am grateful every moment for the years I spent knowing you and for the knowledge of you that gets to be mine forever. I am better for your presence in my life, and I will live in such a way that the cosmos will shake with your laughter and delight. Cheers to your glorious, raucous, vibrant life! Cheers to you!

“No one ever said that you would live to see the repercussions of everything you do, or that you have guarantees, or that you are not obliged to wander in the dark, or that everything will be proved to you and neatly verified like something in science. Nothing is: at least nothing that is worthwhile. I didn’t bring you up only to move across sure ground. I didn’t teach you to think that everything must be within our control or understanding. Did I? For, if I did, I was wrong. If you won’t take a chance, then the powers you refuse because you cannot explain them, will, as they say, make a monkey out of you.”
― Mark Helprin, Winter’s Tale






There Are Shadows


Lifecycle of a Butterfly

Note to self, there will be shadows. The physical wounds are healed, CT scans reveal no signs of metastasis, and the chemo drugs are long out of my system. By all accounts, I’m well, and not only well, but surprisingly vigorous apparently, because according to most I’m vibrating health. 8 hours of sleep each night, loads of water, and a diet rich in fresh fruits and vegetables tends to have this affect. But there are shadows, an underlying current of heaviness that I wasn’t quite expecting.

It’s impossible and unrealistic to believe you will go through something like this and not be changed. As much as I thought I lost my innocence many, many moons ago, I was wrong. I had a million experiences, placed myself in ridiculous situations, and always played on the edge, pulling back just in time to never face real consequences. Almost every pain I had ever known I inflicted on myself. Who knows, I might have even inflicted this cancer on myself, as rectal cancer is linked to heavy alcohol consumption, a diet high in animal proteins (my past love of bbq and foie gras is no secret), and a diet high in fat, but there’s no way to know that, so I choose not to assign blame. What I do know is that the lightness, perhaps we could call it whimsy, glee, merriment, that I once felt on a mostly daily basis is gone. I held on to mine longer than most, and for that I’m grateful, but I now truly know what the term lost innocence means, and I think I’m mourning.

Please don’t misunderstand me. I am delighted that the experience is past, I survived, and my outcomes have been so, so good. I am on my knees appreciative of this, but like a dear friend of mine often says, you can’t unknow what you know. There’s no going back to a time when my body appeared to have countless, mysterious fail-safe mechanisms, my brother-in-law thought my liver was sprinkled with fairy dust, and I bragged about my iron clad constitution. There is no going back to a time when being tired simply meant I might need rest. Although I know it’s irrational as I’m only 6 short weeks past my last surgery, which was piled on top of a year worth of physical assaults meant to preserve my life, but I still feel tired, so I scan my body for signs of cancer. Am I tired or am I fatigued? I got it so fucking wrong last time.

It’s time to return to work, but the idea of going back into physical therapy inspires dread. Please, goddess, please don’t make me be around sick people, right now. I don’t have it in me. The coffers are empty, and, for now, I have so little to offer. Therefore, I’m searching for something different, a way to wake up the light that feels dormant, not gone because I feel that, too, but needs to be aroused, stimulated, and nurtured much the same way I’m trying with full commitment to nudge my physical body back to health. I feel shadows, and at times I think they are so present that I can almost see them. They are not the heavy weight of depression, or the feeling of helplessness in a dark night. My shadows are sheer black, almost imperceptible, but ever present in the periphery. In the daily effort to make something new happen, hoist myself up and start fresh, believing that anything and everything is possible by simply acquiring momentum in a single or multiple directions, I am with my shadows. The shadows tell me that I can’t unknow what I know, there is no certainty in this life I used to live so flippantly, that I’m grieving the harshness of the last year. What I previously only knew in theory, and thought I was comfortable with, I now know in practice. Theory and practice are very different things.

My shadows are not comprised of fear, they are comprised of knowledge. I imagine that these shadows are the seeds of wisdom, and that one day they will fade and integrate, becoming part of me, inherent in my functioning. For now, though, I feel like I woke up one day and was middle aged, and can feel the years everywhere, not that my body feels old or even my mind, but that all of the knowledge I gained over time and with experience suddenly jelled into something tangible and real, and I feel the weight of it. I often find myself wanting to remind my friends that I used to be a helluva good time, a walking disaster, but a whole lot of fun. Probably because life doesn’t feel fun, right now, and to be absolutely truthful, that kind of sucks. I actually struggled with the thought of publishing this post, but then realized that without it I was painting an incomplete portrait of this experience. The physical and mental bodies are intimately, inseparably linked, and trauma to one causes trauma to the other. In being so forthcoming with the physical experience, it seems unfair to gloss over the emotional one. There are no hall passes here, no get out of jail free cards. My emotional body has been wounded, too.

But, you know what they say, life is short but it’s wide, and this too shall pass. A time will come when I can’t see the shadows anymore, and then they will slowly melt away into my consciousness, where we will only meet in dreams or memory. Life will take on it’s glow again, and my cracks won’t feel so wide, but until then I experience this healing for what it is: unsullied, pure, physical and emotional healing. The kind of stuff that makes you human.

I truly thought that I would come out of this final recovery period like a rocket, launching straight up with speed and power, but now I’m beginning to realize it’s more like the butterfly coming out of it’s chrysalis:

When the butterfly first emerges from the chrysalis, its wings are soft and crumpled. The tired butterfly rests, and then slowly unfolds its wings to dry. After a few hours, the butterfly will be ready to fly.  Lifecycle of a Butterfly

If you compare the life span of a butterfly (about 1 year) to that of a human (about 71 years), you get my drift. Right now, my wings are soft and crumpled and I need to rest, and over time I believe my shadows will evolve into something beautiful and kind and compassionate. I believe that my life will be more important to me because I came through a metamorphosis that left permanent scars on my body and psyche, and for now I just need to be at peace until I’m ready to fly.


This should light my way for the time being. Who in the world doesn’t feel at least a little joy looking at this photo?






Mine! The Gut Microbiome


Neil deGrasse Tyson is so cool.

“All disease begins in the gut”– Hippocrates

The gut microbiome is set to be all the rage in 2016. Large scale research studies are in effect, dietitians are pulling their focus to a diet that encourages a diverse intestinal environment, and scientists now actually consider gut microbiota an organ, an acquired one, but an organ nonetheless. As humans, we are covered and filled with tiny microbes on our skin, in our nose and mouth, and throughout our intestinal tract, living in a symbiotic and, mostly, harmonious relationship. These microbes outnumber our human DNA 10-fold, and the number of genes in all of those microbes’ genomes is roughly 100 times greater than the number in our human cell genome. Whoa. According to the group “Gut Microbiota for Health,”

“Our gut microbiota contains tens of trillions of microorganisms, including at least 1000 different species of known bacteria with more than 3 million genes (150 times more than human genes). Microbiota can, in total, weigh up to 2 kg. One third of our gut microbiota is common to most people, while two thirds are specific to each one of us. In other words, the microbiota in your intestine is like an individual identity card.”

What this means, in essence, is that while any two people in the world, no matter age, sex, location, will share %99.9 of the same DNA, only about %30 of their gut microbiota is the same. Two-thirds of your gut microbiota is as unique as a fingerprint! You can see why scientists are so excited about this.

I first learned about the gut microbiome in 2012. My brother-in-law has a rare disease called Primary Sclerosing Cholangitis (PSC), which causes inflammation and fibrosis of bile ducts inside and/or outside the liver. 75% of individuals with PSC also suffer from a form of irritable bowel disease, mostly ulcerative colitis. He was winding up in the hospital approximately every 6 months with complications from colitis, and Monica desperately wanted to take him off one of the medicines she thought was causing this. Having just returned home from a recent hospitalization, Moni was especially on top of her research game and called to tell me she had a plan: “It’s called fecal transplant. I’m going to give him my poop.” I pulled my car off the freeway and sat slack jawed while she explained the process, mostly responding with highly intelligent comments like, “oh my god,” “ewwwww,” and, “huh.” You know what, though? She nailed it. They went through this process before the FDA decided to take it over, and it worked. He’s had very few flare-ups of ulcerative colitis since then, and when he did a couple of years ago, she just gave him her excellent bacteria again. Now that the FDA has stepped in, fecal transplant with a known donor is regulated and difficult to access unless it’s treating c-dif, but that’s a story for another time.

A few short years ago, it was the commonly held belief that infants were born sterile, with no exposure to bacteria, fungi, or other microorganisms, but recent research has indicated that the amniotic fluid surrounding the fetus may have bacteria present that are important in establishing the early immune response. For sure, during vaginal birth, the infants microbiome is colonized by skin bacteria from the birth canal and from the colon of the mother, and from there it’s off to the races. Your gut microbiome is a direct indication of the environment you were raised in (country, city, suburbs), the food you ate (McDonald’s, home cooked, processed, organic), and whether vaginal birth vs. c-section/breast feeding vs. formula.

Why, you might be tempted to ask, does this matter to me? I became interested because they have linked response to chemotherapy to intestinal microbiota, and I have a minty fresh colon that I want to really treat right this time around. Here’s what they say about the chemo thing:

  • “Researchers have shown that the efficacy of one of the molecules most often used in chemotherapy relies to an extent on its capacity to mobilise certain bacteria from the intestinal microbiota toward the bloodstream and lymph nodes. Once inside the lymph nodes, these bacteria stimulate fresh immune defences which then enhance the body’s ability to fight the malignant tumour” Gut Microbiota for Health

This could be a game changer for people receiving chemo. My response to chemo was impressive, and I’m set on developing a super microbiome in the off chance I ever have to do it again. Now, why does the gut microbiome matter to you? Because, we are absolutely, positively products of our environment and diet, and guess what? You really are what you eat, and for that matter, what you eat off the floor. Oh no or yay, depending on who is reading this, but your diet and environment matter. Recent studies have linked certain bacteria and/or lack of diversity in the gut microbiome to obesity, diabetes, rheumatoid arthritis, multiple sclerosis, muscular dystrophy, fibromyalgia, other auto immune diseases, and some cancers. As well, variations in the gut microbiota are linked to anxiety, depression, bipolar disorder, and other stress related psychiatric disorders. Do you get where I’m going with this? 80% of your immune response is in your microbiome. Your helpful, lovely, dynamic gut microbiota help you to digest your food,  in the production of certain vitamins, to combat the aggression of other microorganisms, and to modulate inflammation related with numerous disease processes. As you can see, they are busy, and they are important. It is suggested that a future is imminent where “microbiota typing” will become a standard of medical care. Analysis of the urine and feces would reveal the unique make up of an individuals microbial community, which might indicate why an individual was sick and what may make them well. Researchers are seeking pathways to develop antibiotics that are targeted rather than global to decrease disruption of the gut microbiome, and someday we might be able to deliver drug therapy’s that are geared to your unique intestinal environment.

Research indicates that the human gut microbiome has been drastically altered by our addiction to processed foods, antibiotics, and an increased number of elective c-sections. City living doesn’t help much either. People born in rural areas, in the vicinity of livestock, appear to have a more diverse and healthy bacterial load. We are basically sanitizing ourselves into ill health. The good news is that our microbiome is affected with each meal, and that a recent Harvard study showed that the gut microbiome can be drastically altered in a few days with a significant alteration in diet. We actually have control over the bodies first line of immune defense through diet and a discretionary use of antibiotics. That is phenomenally exciting news! With the myriad life events I have minimal ability to impact, I love to embrace the things I can actually affect, and after my year of living cancerously, I am all about impacting my healthy positively on every level.

So now that you know that you are much more inorganic than organic material, what in the world do you do? Get down and dirty with your diet, darling. As per usual, it all comes down to what you stick in your mouth. Seriously, don’t forget that we have a skin microbiome, too. Haha. Sorry. Moving on:

  • Fermented foods: plain yogurt with active cultures, kimchi, sauerkraut
  • High fiber foods: especially the fructan and cellulose fibers. The rough fibers. The parts you don’t usually eat. Stalks of broccoli, the tough end of asparagus, leeks, the parts that get stuck in your teeth.
  • Foods that are low in sugar and unprocessed
  • Farm to table: get your food with bacteria on it! Buy your food as close to the source as you can. Austin is rich with urban farms and farmer’s markets serviced by numerous local vendors. Utilize these resources here or in your own community.

There you have it. My new obsession, and the good news is, you can get involved in all of this exciting research! From the creators of the Human Genome Project comes the Human Microbiome Project. You can add your unique gut bacterial composition to that of thousands of others in America and around the world and get results of your data sent back to you. Find all this info at The Human Food Project.

P.S. 1 year ago today I was diagnosed with cancer. Wow, just wow.

P.P.S. 3 years ago today my uncle George died from complications from multiple myeloma. I miss him.


Happy Endings

“Dearly beloved, we are gathered here today to get through this thing called life.” This post isn’t a tribute to Prince, but a tribute to the final step in the most challenging year of my existence, so far. Prince is also dancing around in my brain almost constantly after news of his death last week, therefore it would be impossible not to bring a little of him into this.


One last ridiculous meal. Restaurant Helen in Houston. I can’t praise the food and entirely Greek wine list highly enough! See how happy Monica is when we’re going crazy with food and wine? My parents look similarly pleased on the opposite side of the table. Except my dad, it’s approaching 7pm and he wants to go to bed. (

On April 14th I arrived at the hospital with my parents and sister in tow for my final operation. Having the ileostomy reversed is much less harrowing than the first surgery, and I’ve been poked and prodded so often this year that an IV or two and a few extra shots don’t actually stress me out anymore. This time they gave me the option of an epidural or an Exparel shot for the post-op pain, and because I think it’s always better not to have something injected into my spinal cord, I chose the Exparel. What’s Exparel? It’s a nerve block that they inject directly into the surgical site to numb the area for about 4 days. How do I remember the name so well? It was on a wrist band I wore in the hospital. Very rock ‘n roll. In theory this is an easy surgery, cut out the part of my small intestine that was my darling stoma, sew the two ends back together, and drop it back down through the astoundingly taut and toned layers of my abdominal musculature. My words, obviously. And it was easy. Everything went beautifully. Except the fact that for some reason the Exparel didn’t kick in until about 4 hours after I woke-up.


Looks like Dr. Frankenstein took a hatchet to my stomach, however, I’m saying it was a Brazilian knife fight. That’s my story and I’m sticking to it. #knifefightinRio

I now know what it feels like to be in so much pain that it makes you want to vomit. Yay, more lessons from that barbarous teacher named cancer. The last thing they want you to do after abdominal surgery is puke, and I was nauseous and in pain, but when they would ask about my pain levels all I could say was “maybe a 6 or 7? “Why in the world am I such an idiot? I have no clue. All I can think is that in my incapacitated state I thought that if I didn’t say it, it wasn’t so. I do love some good delusion, but thankfully my sister, who knows me pretty well, pulled the recovery nurse out into the hall and told her that if I was saying 6 or 7, it was probably a proper 10. She also said I looked like I might die. I love her so much. From there they kicked into action. In under 1 hour I got 2 IV doses of phenergan, a dose of emend (both strong anti-nausea meds), 2 IV doses of dilaudid and a bump of morphine. I was flying for the next 24 hours, AND, because MD Anderson is the best place ever in the history of everdom, they continued to give me IV Dilaudid every 6 hours with hydrocodone and tramadol thrown into the mix in-between to keep me comfortable. Oh la la, I was very, very, very comfortable. I didn’t know my name, actually didn’t care, but I was very comfortable.


Sweet Graham came to visit, and honestly, I know we had fun, but I only remember it because of this photo. Truth train. (And I don’t know how to scale photos on my blog, so our faces are HUGE!)

The goal following an ileostomy reversal is getting your bowels to move, or to pass gas, and they won’t discharge you until one or the other happens. I don’t think I was asked any less than 60 times in those first two days if I had experienced any activity. Everyone is super interested. Even my friends. They asked A LOT. So we walked and walked and walked. My mom and I actually got our 10,000 steps that second day! Which is amazing because I wasn’t moving quickly. Too loopy. I quickly went from a liquid diet (who knew that an Ensure slushy can be delicious) to soft solids, and the astounding feeling of absorbing nutrition after 8 months of absorbing almost none was beyond inspiring. The end result is that I felt much better than I ever anticipated. About a month after finishing chemo, I found myself incredibly perturbed that I still fatigued quickly or couldn’t keep a train of thought. I understand that chemo brain is real because I still have some memory loss, but I didn’t realize how much malnutrition was affecting my ability to think or concentrate. After two Ensure’s (which are gross and chemically…don’t drink them unless you must) that first day in the hospital, I started to perk up immediately. When I began to add other foods I thought I might dance out the front door. The end of the story is that on night two my bowels began to work and they discharged me the next morning. According to everyone, I’m really good at recovering from surgery. It’s a skill.


Having friends send gorgeous orchids always helps with a speedy recovery. Thank you guys so, so, so much!

My mom and I drove home with floods bearing down on Houston, and started trying to figure out what I could eat. The first 5 days were lots and lots of white foods. They call this the low-residue diet and I stuck to it. White bread, eggs, bananas, rice, mashed potatoes, sweet potatoes, blah blah bland bland, but it works. Most people post-ileostomy have uncontrollable diarrhea and can’t be away from a bathroom. Their anal sphincter is unconditioned and weak. Not to toot my own horn or anything, but not me. Toot toot. My stools were firmed up the day after discharge, my bowels tended more toward constipation so I actually needed to add some foods with higher fiber to my diet instead of eliminate them, and because I have diligently been doing my anal kegels since last October, I can actually hold my bowels. Side note: this newfound ability to talk to openly about the state of my bowels is astounding, which is a good thing, because it comes up often. Anyhow, I’m able to drink coffee without upset, thank god, and I am now, 2 weeks post-op, walking for about an hour most days…away from the house! Ta. Dah. The goal is to slowly add foods to my diet, only one new, higher fiber food every couple of days, and find out what affects my stomach and what doesn’t. They say that your sensitivities  will be similar to the ones you had before. Luckily for me, I’ve never had a super sensitive stomach. Except for that time my sister drove me to madness in Barcelona and I bought coffee from a questionable vendor. Who deprives someone of coffee for the first 3 hours of their day? Is the Sagrada Familia really that great? Yes it is, but I still needed my coffee.


Starting here. Cashew citrus milk. Sprouted nuts, good for the guts, and it’s got me back in the kitchen. Miracles do happen! Recipe by Sweet Laurel Bakery ( She has multiple recipes for delicious nut milks on her blog.

The lesson this taught me that I knew before but had forgotten because bbq, tacos, sweetbreads, fried chicken, and old fashioned’s ARE a way of life, is how completely nutrition affects our physical well-being. The way the human brain and body respond to even the most minimal amount of nourishment is awe inspiring, and I am super curious to see what happens if I focus on super nutrition. To that effect, you will see me cooking more, hitting the farmers markets more, and repopulating my gut microbiome with healthy, happy, helpful bacteria. How many people actually have the opportunity to repopulate their gut microbiome? It’s a rare opportunity and I intend to take advantage. By the way, if you haven’t been turned on to the gut microbiome, yet, I suggest you do some research, or read my next post, because all I can think about these days is my gut! So far I find that with a little more fiber in my diet (important for the gut microbiome) I void more at once, which is important because I don’t have much of a rectum left. It’s all about getting my colon back into tip top shape and teaching it to act as a rectum, and I’m well on my way to doing it. I also have to believe that my Pilates practice has had something to do with my success. Maybe it’s the internal massaging the happens during many of the exercises, or keeping the abdomen toned. I don’t know, but according to my doctor I’m experiencing the best possible outcome we could have hoped for, and we’re both thrilled.

Now its time to move on and focus on beginning a new work life, moving forward, taking care of what I now know is an extraordinary machine (seriously, I should have bred when I had the chance because, in general, my genes are super stars), and keeping these lessons with me. What I’ve learned in the last year is that I have an extensive and dedicated support network, how to ask for help, and how to, at times, be weak in front of others. I have learned that even during crisis, I am really good at getting “through this thing called life.”


The Road Back to Houston


Thank you, Mr. Churchill. I think this is very good advice. I like very good advice.

On Thursday April 7, exactly one week prior to my scheduled ileostomy reversal at MD Anderson and 4 days prior to my pre-op testing, I learned that my appeal had been approved by BCBSTX and I would be returning to Houston for my final surgery. The two ends of my gorgeous small intestine would be reconnected by Dr. John Skibber, and I would be free’d from the suspended animation of the last year.

In the weeks leading up to this, I felt as though I was living in the dystopian and surreal world of the film “Brazil,” where a totalitarian, bureaucratic government with it’s dysfunctional and farcical systems made and changed rules at their whim, always looking for another stamp to be stamped, “t” to be crossed, or “i” to be dotted. In short, there were times I thought I might be going crazy. Under the nurturing blanket of my new Diazepam prescription, and the advice of my once again brilliant sister, on April 5th I threw a hail Mary pass and called the Texas Department of Insurance to lodge a verbal complaint against BCBSTX with a human. Their response was swift and efficient. I was once again informed that part of the deal with BCBSTX dropping this last individual PPO included mid-treatment cancer patients maintaining continuation of care, and that I was never supposed to be forced to jump through these hoops. They told me that in the months preceding this they had received multiple complaints regarding network adequacy. Then the faceless angel on the other end of the line told me that one of their agents would be contacting BCBSTX that day on my behalf, that she understood the urgency of my situation, and that they would be going to work on my complaint immediately.

Early that afternoon a TDI representative called to get a few more pieces of information and informed me that she had spoken with BCBS. She seemed confident, so confident in fact that she told me that if I didn’t hear from BCBS about my appeal by the following afternoon to “call me”, that if I didn’t like what they had to tell me to “call me”, and that in general if I were displeased with my service by BCBS in anyway to “call me.” Later that afternoon I had an incredibly pleasant and reassuring call from a BCBS representative. By Thursday afternoon my appeal had been approved, and I was on schedule for my pre-op visits and surgery the following week. I can’t begin to express how incredibly impressed I was by the rapid response by the TDI. While the written complaint process may take up to 3 months to process, and they told me the written information is important to have on file, the efficiency and efficacy of this agency in righting this wrong was mind-blowing. I am grateful in an overwhelming way.

BCBSTX spent months hoping that I would get tired and resign myself to an in-network surgeon. Suckers. I learned these very, very important lessons during this process that I urge you to pass on to anyone you know who is going through this process:

  • Appeal: 95% of first time denials are never appealed. They are banking on the fact that you will think it is entirely to much trouble to go through the appeals process. It is a hassle, but it’s worth it. If they deny that appeal you have the right to engage an Independent Review Organization (IRO) to look at your case. You can request a peer to peer review so that your physician may speak to another physician regarding medical necessity. You have and rights and you have options. Exercise them.
  • Watch out: I was amazed to find out how spot on my sister was when she told me to “trust no one” in their organization. She counseled me that they would look for any excuse to deny my appeal, and it was true. The day before they approved my appeal, a nurse case manager from BCBS called me to check in and make sure I had all my needs met. We discussed that their physician finder service was out-of-date and a surgeon who had been recommended was not on their list on in-network providers, but actually worked with Texas Oncology and took my insurance. 2 hours later I had a call from my representative in the appeals department stating that the nurse case manager had told her that I had found an adequate surgeon in Austin. Had I not complained about patient/caregiver privilege, deceptive business practices, and calling the states nursing association to file a formal complaint, I think this could have derailed my appeals process. Tricky, trifling, nurse case manager bitch. Trust no one. Unless they’re from the…
  • Texas Department of Insurance (TDI): If you really feel as though you have a valid complaint, and that your insurance company is wrong, call the TDI immediately (or your states governing agency for insurance) and file both written and verbal complaints. Go ahead and begin the appeal process, but find out what your rights are. When I think of how much time and energy I could have saved if I had called them after my initial denial…wait, I’m not thinking about that. Ever. I will always be amazed at how quickly they made things happen for me. Not only did they do their jobs ridiculously well, but they were kind, and at that point I desperately need that kindness.

So that was it. After all that time and effort, that was it. Monday April 11 I went to MDA for a barium enema and proctosigmoidoscopy. I won’t go into detail about either because they aren’t very pleasant, but both are performed to check for perforations in the colon and rectum. Dr. Skibber was once again incredibly pleased with my results, we discussed the coming surgery, and I went home for two quick days to prepare for one more left hook from my rectal cancer diagnosis. What a year. For the love of all that’s holy, what a year.