When talking with people about the difficulties of having cancer, I often tell them that the most challenging part (after trying to get the insurance company to pay claims) is dealing with/managing the reactions, actions, and expectations of those around you.

75% of marriages/relationships end when one partner is diagnosed with a serious or chronic illness. Most people simply do not know how to or do not want to deal with the changes that occur when they or the person they are close to, is sick.

I just finished reading "My Sister's Keeper" and without spoiling the story, there are characters who each deal with a serious illness in very different ways. One, it is the primary criteria of all decisions made personally and for the entire family, another refuses to reveal or share with anyone the existence of an illness, a third climbs into a bottle and drugs, and so on. And these characters all give up a lot of the good parts of living because of the fears and anxieties associated with the illness.

I am planning another trip abroad. I've been asked, "what will you do if you get sick while you are there?" and variations on this theme. I am baffled by the question on a surface level because I suppose I'd take my medicines and if it is really bad, go to a hospital. Same as I would do here. I know these questions are motivated by fears and at a deeper level these people are saying if I would just stop living, then I might not die.

No one has complete control over their life. We are all dying. My having life insurance and a will won't keep me alive, nor will it prevent a tragedy from befalling my closest friend who is perfectly healthy and anticipating a very long life.

As Les Brown said, "Too many of us are not living our dreams because we are living our fears."

In no particular order:

1. Jen, you have been sick for five days. Was that from the new chemo? Not really. I stopped three drugs, and started three different drugs on Friday. This alone is a lot for the body to take, then I caught a virus and all hell broke loose.

2. So do you get the good drugs now? Uh, they all suck really. I've had all the most powerful breast cancer drugs already: Epirubicin, Cytoxan, Tamoxifen, Femara, Estradiol, 5-FU, CMF, Xeloda, Abraxane, Avastin, Aredia, and now Doxil. There aren't lots of studies on drugs that will work for ER+/PR+ tumors where all hormonal therapies consistently fail. The pain meds I am taking are a patch rather than a pill for slow, continuous skin absorption.

3. Can I do anything to help you? My standard answer this week was 'sure - shoot me' I am starting to recover from the virus and we've finally gotten my pain back under control so flats. I need lots of flats. And not those icky Payless things or anything from a store with "Mart" in the name.

4. What do these new tumors mean for you? Well, the leg pain and hip pain is made worse by my sexy wedges and fabulous heels so most of my favorite footwear is going into retirement. I do get handicapped parking so you'd better take me to fun places and we'll all get to park close!

5. What are the new drug side effects? Will you lose your hair again? Oh boy: canker sores, fatigue, thirstiness, diarrhea, hand and foot syndrome, hair loss (DAMMIT!), and sensitivity to sunlight. As far as the other drug's side effects, avoid sunlight, no extreme temperatures, and absolutely no alcohol. NONE. (DAMMIT, DAMMIT!)

6. Are you still taking your trip to France in July? YES.

7. How often are your treatments? Just once a month. Nice.

8. Are you still going to work? Of course. For heaven's sake, I'm not a TV character.

9. How is your uncle with lung cancer doing? He lives in Oklahoma and has the worst insurance plan ever devised. My oncologist has offered to review his pathology once he gets it back. There is definitely no sense of urgency about his treatment or care there.

10. So what am I supposed to do when you fall off the grid for almost a week? Call my mom.

Tests confirmed the progression of my illness. I have tumors aggressively growing in my pelvis (as before) and now also in the lymph nodes in my chest and abdomen as well as in my femurs. I resumed a more aggressive chemotherapy today as my pain has become unmanageable. A drug named Doxil with the Aredia. Several x-rays were taken today to evaluate the stability of my legs. I may require radiation and perhaps other treatments to prevent fractures or collapse. I will see my oncologist again next week to review all of the results and options.

For the moment, I am no longer on Oxycontin or Vicoden. I am on longer lasting and more powerful painkillers. A few hours of those and I cannot declare complete relief but I am able to walk upright without sweating or crying so there's some improvement!

Ironically, I am told I look much healthier and better than I have in a long time. Talk about putting lipstick on a pig. HA!

Thursday was National Take our Daughters and Sons to Work day. Without even realizing it, the possibility thinking of childhood is diminished simply by the reality of kids' lives. By opening the doors of our offices, inviting kids to interview adults in the workplace, and taking them through structured activities that link their school lessons to life, kids can uncover different possibilities for their futures. Most of the adults interviewed said they themselves had never been to work with their own parents as children and had little idea of what to expect. Ah-Ha! Many people choose a career by default. For example, they come from three generations of an occupation and therefore they choose the same. Ah-Ha!

The most profound moment for me was after commenting on how "cool" our office, desks, colors, work environment is during the day, at the very end my niece asked me, "What does it take to get a job like yours in a cool place like this?" At fourteen, she is back to possibility thinking. Although pop star is probably career choice number one, she now has another possibility.

My MRI did not show anything different from what the bone scan and last PET revealed. Some tumors are quite happy, fortunately not feeling compelled to spread their joy just yet. So we will continue with the current pills and monthly IV chemo. Next scans are in May.

Yes, that is my senior year photo in my last post and that hair was all mine.