Life is a lot like Vegas

Life is like Vegas. We are all playing the odds. And, depending on our belief systems, someone else is the House.



Yes, whether you believe it is God or Karma or Fate, Vishnu or Krishna or They Flying Spaghetti Monster, something else has the odds in its favor. We will be gone; the rest of the world will be here.



Just last week, a young mother here in town--daughter of one of the most popular pastors in town, graduate student at the university, beloved wife, and, most heart-breaking, mother of kindergarten-age twin sons--was killed coming out of the Kroger parking lot. BAM! The odds weren't in her favor at that moment, and she lost. The 81 year old man who ran the red light and hit her car? Clearly, the odds weren't in his favor at that moment. I'm sure he didn't head out that day to kill someone. I haven't followed the story at all, so I don't know what condition he is in. I know that the accident has been described as "Worst. Accident. Ever." by my 17 year old son who arrived on the scene shortly afterward (talk about odds...given his gender and age, hearing sirens while he was out driving struck fear in my heart...will his odds come up?) and "horrific" by my 14 year old's physical therapist who witnessed it, and "horrendous" by aFacebook friend who witnessed it.

My supposition is that the elderly man was also injured, but I don't know for sure. It would be easy to say that he should have died instead. He is 81 and has lived a long life. However, we don't know what his life was like before this incident. Maybe this accident is the icing on the cake of a long, horrible, shitty life. Maybe someone is thinking, "...and to top it off, he was responsible for killing someone in a car accident." Maybe when he dies, no one will be at his funeral. Maybe, because of his injuries, he'll live several more years in agonizing, excruciating pain, wishing he were dead. Maybe, he doesn't care at all. Regardless, going with my assumption that he didn't cause the accident intentionally, the odds were also against him that evening, and he, too, lost to the House.

It all seems so random. The vast majority of people who get lung cancer smoke. Most people who smoke, don't get lung cancer. Who decides? While we know what increases the risk of breast cancer, why do some people get it and not others? Certainly, my weight could have been lower; clearly (as evidenced by my weight), my diet could have been better; undeniably (once again as evidenced by my weight), my lifestyle could have been more active. I'm willing to accept that I had some risk factors. Yet, I breastfed for 13 years nonstop. In general, our family diet, with the exception of certain periods where we fell off the wagon, wasn't horrible. Not nearly as bad as the "typical American" family's diet.



Even worse, I have a friend who has led a breast cancer unfriendly life. In general, she's done everything right, and snake eyes for her, too. In a sense, she lost twice. Her tumor had two characteristics that contribute to recurrence. I only have one. Plus, she's even younger than I am.



A lot of people I know are counting on having breastfed and not having a family history of breast cancer to protect them. That's like buying lottery tickets hoping to retire well.


I know when people go to Vegas and gamble, some people choose their game of chance by what the odds are. Yet, most choose because they like a particular game or feel proficient at a particular game.

Some people do have certain skills that increase their odds of beating the House. Some are better at statistics than others (I would be one of those "than others" in this situation) and, therefore, play smarter than others. That's the old "You've gotta know when to hold 'em, know when to fold 'em" player. There are people who can count cards. The House considers that cheating, but it's really more playing to the advantage of the intelligence and skill of the ones who can count cards. There are other ways of cheating that I only know about because I like to watch detective shows on TV.



Increasing your odds of winning at gambling can still result in losing. If a player, like my one son, has internalized the various odds, and therefore plays smarter than most, eventually, someone else will be dealt a better hand. At some point, that will be the House. He loses. All professional gamblers accept the fact that they will lose big on occasion.



Players who can count cards, I see as a metaphor for those people who do it ALL right. They are the equivalent of people who are so intent on living healthy that the joy is sucked right out of their lives. Those people full of rules and who never break them. I've known a few people like that. Counting cards, to my knowledge, isn't "illegal." But it does take the fun away from other players, whose odds of beating the card counter drop dramatically. Games are supposed to be fun. The playing field (table top?) is supposed to be level. It's the House that really hates card counters. It's the House that goes after them. It's the House that, in respectable places of games of chance, will throw them out. In other places, will break their hands or worse. If they get caught. Smart card counters know how far to push the limits of success. They don't get greedy. But others, BAM. Of course, none of them goes into it expecting to get caught.

I think we've all known those people who, either because of fear or hubris or whatever--maybe a desire to just be perfect--, focus their lives on preventing. I know I have known them: the mothers who show up at birthday parties with their own food for their precious offspring. I don't mean the ones whose children have legitimate dietary concerns, such as allergies or who live in an vegan family and want their child to be able to have fun, too. I mean the ones who just "don't allow sugar." At all. Ever. Because sugar is bad. I mean the people who, when invited to dinner, quiz the host about the origin of the food. Again, not because of legitimate health concerns, but as one of my friends said, "I think you don't care about contaminates." So, OK, my chili probably isn't good enough for you.


It's one thing to do your best to be healthy. It's something totally different to let that be your overriding focus. Life needs to be joyful. Joy can be found in sharing food with others. occasional piece of candy, an occasional slice of white bread, an occasional non-organic apple most likely won't hurt.


The irony is that even these "perfect" people lose to the House on occasion. Consider Jim Fixx as an example.

Once you've been diagnosed with cancer, a different kind of odds comes into play: the odds of survival.

Those are the odds I don't like to talk about.

In fact, I'll let you in on a secret here: I haven't asked my oncologist about my odds of survival. I know myself pretty well. I wouldn't say I'm a "glass half empty" kind of person, but if I hear "60% odds of survival," I'll think, well, that's nice, but that means there's nearly a 50% chance of not surviving.

I also avoid all references on the internet about this kind of stuff. Early on, I made a statement that I didn't want to hear about people who have died from breast cancer. Six months later, I still hold fast to that.

I have yet to talk to any person who has a serious illness who enjoys questions about survival. Outside of my immediate family, no one really has the right to ask me about my chances of survival. Or even my prognosis. The thing is, we are all hoping to be on the far right hand side of the survival bell curve. So, let don't drag us back to reality. Believe me, most of us face reality. We have doctors. They give it to us straight or most of them do. Let's just assume that things are going to end as well as possible.

The first time I met with my oncologist, she declared my cancer "garden variety." She has also assured my youngest son that "mom will get better." She is the mother of sons herself. I trust that she is operating under the assumption that cancer will not kill me. That I am going to beat the House in this particular game. That's all I need to know. However, she's an aggressive player, hence the extra chemo. Her patients do incredibly well. She's at least a smart player. Maybe she's even a wise card counter: not trying to make her fortune by beating the House, but also not drawing unnecessary attention to her play. I'm hoping the House isn't going to come after her where I am concerned and break her arms.

That doesn't mean that I'm not also trying to increase my odds of survival. I want to play smart, to give the House a run for its money. I'm willing to make changes in my and my family's diet. I'm dedicated to increasing my exercise. There appears to be a direct correlation to the type of cancer I have recurring and exercise. So, damn, an hour a day, at least 5 days a week, will become a non-negotiable as soon as I'm physically capable of it. I'm trying to figure out ways to decrease my family's exposure to environmental toxins.

The problem lies in how to be sane about this. The House is still out there. I can win at this game, but lost at another. The next time I get in the car, I could be killed. Heck, a meteor could land on me while I sleep in bed tonight. I could choke to death on my green smoothie. I'm not arguing that these things are likely to happen, but they could. I do what I can to decrease my odds of dying in a car accident. I wear my seatbelt. I drive defensively. But who knows when someone will run a red light and kill me? I'm not willing to avoid driving.

Just the same, I'm not willing to make my family a martyr to avoiding cancer. I'm not going to insist that my kids don't eat at friends' houses, nor am I going to refuse to allow junk food into my house. I'm certainly not going to serve a soccer team of teen boys sautéed kale and expect that they will return to my home. Nor am I willing to make homemade, whole wheat, organic sauce pizzas for 10 hungry boys. So, store bought will have to do.

I've been reading the book Anti-Cancer: A New Way of Life. This guy has done his research. Based on other research, I disagree with some of his claims, mostly in the area of the anti-cancer mind. I do agree with other of his claims. The relationship of the increase of cancer to changes in food production seems clear, for instance. The research related to exercise seems pretty black and white. In fact, when asked, both my oncologist and my breast surgeon claim that the one lifestyle choice everyone should make to greatly reduce their odds of cancer or recurrence is to exercise an hour a day.

Yet, there is no way I can feed my family totally organic. We can make some wiser choices, but there's no way we can go totally organic. Do I cancel my kids' soccer and use that money for organic food? Do I not pay my medical bills to buy every single recommended supplement?

Once again, the House is out there, and it will win at the game of life. So I have to work with what I've got. To make the choices I can make, when I can make them. To play smart in all areas of life. But I have to have fun at the game. To enjoy my life at much as possible. To balance living in the moment with looking toward the future. Because that's all I really have: this moment, this game, and what comes next.

So, yes, in a lot of ways, life is like Vegas.

The more things change

...the more they change.

I've always been one to choose fewer medical interventions over more. When I was having babies, I chose midwives. When I chose midwives, I chose ones that were not interventionist. I had one baby at home. I managed my son's ear infections with alternatives to ear tubes when it looked we were going to be encouraged to go that route.

When I have a cold, I have my own way of handling it that has always worked pretty well.

It's rare that I take antibiotics; my kids need clear symptoms of bacterial infection before I'll give them antibiotics. I was all about minimizing antibiotic usage before the medical community jumped on the bandwagon.

Then the whole cancer thing happened.

Once a person is diagnosed with cancer, there is no "bandwagon" per se. It's a high speed bullet train. Or at least it is with breast cancer. There are scans of various types: CT, PET, MUGA, MRI, probably more that I've forgotten. There are blood tests and appointments. Various minor surgeries: biopsies and port placements.

Suddenly, you have to decide on doctors to treat you. Before, I'd always chosen doctors willing to work with my quirky ways. Our family doctor, I chose because I knew I had a kid with pneumonia, our current doctor (at the time) couldn't see him and wouldn't call in an antibiotic until he did...instead he suggested I take the kid to the ER, so I called a doctor who was advertising for new patients in the paper. It's a good fit. His passion is sports medicine. We've used him quite a bit for that, too, and he at least doesn't argue with me about my quirkiness.

But when it comes to cancer. Wow. How do you decide? A bad decision could hasten death at best, result in imminent death at worst. I am very fortunate that I had a friend I could turn to, and I chose her dream team of doctors. My cancer is pretty black and white. "Garden variety" as my oncologist put it. The treatment is pretty much the same from doctor to doctor, clinic to clinic.

This is not something that I want to take chances with. I've read of people "going off the grid" so to speak with their cancer treatments. I respect those choices, but I'm not willing to do that. I'll take my supplements to enhance treatments, to support my health during treatments, but not in place of treatments.

Um, no way.

I did make one unconventional choice in all of this. That being to have a tissue expander inserted on the side to be radiated. My plastic is OK with it; it's pretty cutting edge in the literature; it makes the radiation a little more challenging; it gives more options for final reconstruction if it works. If it doesn't work, nothing is really lost. Because I heal well, my breast surgeon and my plastic surgeon trust that--physically--I won't have a problem. It's up to the expander. It needs to survive the radiation. The radiation oncologist I first saw wasn't pleased, but he was young and had little experience. I've since switched to a different doctor in the same practice (there really is only one radiation oncology practice here) who has 25 years of experience, was recommended by my plastic surgeon, and didn't bat an eye at "the plan." Personally, I'd not choose the guy as a friend. He was pretty off putting, didn't make eye contact, hadn't read my chart before coming in to examine me, very off putting bedside manner.

And that's the thing. I'm NOT choosing a friend. I"m barely choosing a partner in my care. He can be horribly offensive to me, as long as he's good at what he does. I am trusting he will not damage my heart too badly (there will be heart damage, it goes without saying). I don't have to live with him. Or even share a meal with him. I need him to do his job, do it well, and I have to trust that neither my oncologist nor my plastic surgeon, both women very proud of their work, would recommend someone if they thought he was going to impede their work.

All of which is a long way of saying that I've made some choices in the last six months I might not have given great consideration to in the past. For instance, my family all got the H1N1 vaccine. No questions asked. My family and I all got the seasonal flu vaccine. My first ever. Tynan's first vaccine ever. No questions asked. I didn't even investigate other alternatives. Whatever was in the doctor's office was fine.

And today, I started taking antibiotics for a cold. Why? Because if it is more than a cold, it needs to be dealt with. I don't have an intact immune system. I'm sure it's a virus, though, because I don't have symptoms of a bacterial infection. Plus, I've already taken a child to the doctor for this same illness, where I was told, "It's a miserable cold." Truth be told, my child was so miserable that I was hoping that he'd be prescribed antibiotics. Alas, he just had to suffer. Even cold medicines barely touched the symptoms. Then, the other two kids got it. Same progression of symptoms. No fever. Typical cold symptoms .

At the same time, if I'm on antibiotics, there is that much less of a chance that I'll get a secondary infection. Or, the antibiotics will cure any little bacterial infection lurking in there. Hard to imagine that there isn't some sort of bacterial infection in full, snotty sinuses.

Even more importantly, if I'm on antibiotics, I'm less likely to be turned away from chemo on Friday.

The only thing worse than getting chemo is not getting chemo.

As much as I dread it, it needs to be over. Friday is my last chemo. It just needs to end. And if I take these antibiotics, the infusion nurses are less likely to freak out about less than ideal health.

So, without even thinking about it, I skipped off to pick up my zithromax. Yep, Z-Pac for a cold. I've never taken such a strong antibiotic in my life. None of my kids have taken it.

Interestingly, two hours after taking the first dose, I actually think I feel better.

Maybe it wasn't just a cold.