Addis Ababa, Ethiopia January 28-13

After adjusting to a nine-hour time zone difference and some jet lag, our entourage came to life with the beaming sunlight pouring through the hotel’s restaurant windows.

Winnipeggers have a funny way of connecting with others.  Who would think that the owner of the hotel we’re staying at spent 14 years in our city studying business administration at Red River College and the University of Winnipeg. He and his family returned to their homeland three years ago to run this modern hotel. 

It is a beautiful little hotel in the city and an unknown jewel in tourist circles.  The owner, Mckonnen, is still working on marketing it with the travel hotel website links. Business is good he says and reminisced fondly over breakfast about the time he spent in our city. He says it was a highlight in his life.  Once again Winnipeg proves that six degrees of separation are actually one or two.

Addis is an interesting city. People who call it home live here in two worlds—dire poverty and progress at the same time. It’s not uncommon to see Toyota vehicles on one side of a street and on the same block see donkeys carrying cargo and herds of sheep resting on the roadsides of the main thoroughfares. 

A primarily agrarian nation, 84 per cent of the population of 82 million lives in rural areas. The influence of agriculture is everywhere in the downtown areas of Addis—one could even see a Russian Belarus tractor with farm workers jostling for position on the crowded streets.

I wouldn't want to be a driver in this city.  Driving is an art. One must be on constant watch for pedestrians who come out from everywhere all at once and pay little attention to the vehicles on the road.  There are many traffic circles and many lanes of traffic.  There are some traffic lights in this city of four million, but few of them work.  Tonight on the way home from our dinner, we saw one working for the first time in our two days of travels zipping around the city.

Addis is a city of stark contrasts. The poor and homeless are everywhere. There is no specific ghetto area as the poor live on the sides of the streets, boulevards, and back lanes and in neighbourhoods where those of higher economic status also dwell.  There are gate guards everywhere.  Those with means live amongst those who have nothing, rich and poor coexist in this city of contrasts.  Metal shanties and luxurious homes are located on the same blocks.

Addis is the major international city for the continent of Africa.  The United Nations has a presence here, as do many embassies from around the world.  On our trip to the hotel from the airport we passed by the British, Kenyan, Russian, German, French, U.S., and Egyptian consulates. Today we drove by the Canadian and South African embassies.  All were very different and distinct in their presence and location within the city. 

This morning, we were held up in getting to a briefing meeting with our church members and aid partners by military police directing traffic in the area we were to meet.  It’s a big week here in Addis as the African Union is meeting with international leaders from around the world.  Tonight we happened to be in the area again where the meetings are being held and saw presidential limousines and a heavy police presence on the streets after the meetings adjourned for the day. Canada’s Minister of International Cooperation, Julian Fantino, is representing Prime Minister Stephen Harper at these meetings.  There is heightened security everywhere in this city because of the dignitaries.

There are many more sights and sounds to share, but I must sign off to prepare for meetings tomorrow.  We will be travelling 395 kilometers to a rural area to visit one of our projects.  At night, I will be taught how to cheer for soccer Ethiopian style as the national team is playing Nigeria in the African Cup soccer tournament.  We will watch it from Kucha with our project colleagues. I'm told all activity comes to a halt when soccer—the nation’s favourite team sport is on television.

I am living every moment with joy in this relatively young city in an ancient country.  For the gift I have been given in a second life after cancer and in experiencing a world so far away, I will greet each day with Strength, Courage and Determination.

Eager for Ethiopia

Jan 23/13                 

Ethiopia--a country in central Africa that has intrigued me since I was a young child.  Seventy-two hours from now, a work colleague and I will be on the last leg of our work trip to Ethiopia.

The trip is now moving from the surreal to real. As a cancer survivor, living almost three years with no evidence of disease, the trip is a gift to experience and a dream come true.

My boss asked me in early December if I would like to visit some of hunger relief projects in Ethiopia with some of our members and partners. Then, the end of January seemed so far away. The time is now very near. The need to finalize my schedule, accommodations, and visits has made this trip real.

While I am away, I will spend two weeks in the field in southern Ethiopia. My stops will include visiting projects in Kucha Woreda, Woliata Soddo, and Zeway.   Some of the time we will be in hotels, other days we will stay in primitive guest houses. At one project, I will meet with international colleagues from the United Kingdom who will be visiting at the same time.

I am having a hard time comprehending how far it is from Winnipeg to the capital of Addis Ababa. The trip of 7,590 miles (12,211 km’s) will take about 16 hours with a stop in Toronto to transfer, wait for a connection, and then fly directly to Addis Ababa.

I am eager to soak in the experience of Ethiopia.

It is the birthplace of coffee, to be enjoyed in a land where coffee ceremonies have you partake in coffee being roasted, ground, brewed and served with popcorn. The international city of Addis Ababa holds much to see. There will be the beauty of rural Ethiopia to savor. And, with some luck perhaps, sightings of wild animals in their natural habitat.

Ethiopia is also the home of a World Heritage site and some say the 8^th wonder of the world—the stone churches of Lalibela. I am told that once you have visited the 11 churches all connected underground by tunnels and hand hewn out of mountains centuries ago, the experience stays with you for the rest of your life. I have my flight booked to spend a weekend there.

What I am most looking forward to, is being amongst the people whom we are helping to end hunger. All of the projects we will visit involve some form of food security in helping local citizens to become self sufficient in feeding their families.

The language we will hear spoken is Amharic, although English will be heard in Addis Ababa and Lalibela. We will have field staff and interpreters with us at each site that we will visit. I will have a sense of what it feels like to be a visible minority in a foreign country.

I am going with an open mind and an adventurous spirit. I eagerly await this trip of a lifetime and will joyfully be present with Strength, Courage and Determination.

New Year’s and the Fragility of Life

As New Year’s day approached earlier this week, I had thought about writing about New Year’s resolutions and the countless new people that I would meet in the gym this month who resolved that 2013 would be the year of exercise. They would come in earnest for the first few days, fewer the next week, and by the end of the month it would be the same die hards in the gym that I usually spend my time with.

But New Year’s resolutions seem trite today. 

In the early morning hours of New Year’s day as our daughter and son-in-law were walking home from a friend’s house, he slipped and fell into the path of an oncoming car.

He is lucky to be alive.  Once again, like in the cancer journey, our family is reminded that life is fragile.

Considering that he got hit at 55 kilometers an hour, he’s alive.  He is so fortunate that he is not paralyzed, did not suffer a brain injury or even a concussion.  Rushed by ambulance to the local trauma hospital in critical condition, he primarily suffered lots of broken bones on his face, and a broken shoulder blade. We are grateful he is still with us. 

On Friday, he underwent 9.5 hours of reconstructive surgery to reset his facial bones and create functionality for him. In time, he will be able to live as others live in enjoying food, in being able to speak, and looking like he did (as best as possible) prior to the accident.

Through all of this, we are all faring well. We’re tired. We’re fighting stress-induced colds. We’re making many trips to the hospital. We know our son-in-law is being very well taken care of. All of his medical caregivers have been exceptional.

With his care well in hand, our concerns are now focusing on our daughter.  She was with her husband when he slipped and saw the whole accident unfold in front of her. She is being so strong to get through these first few difficult days, but knows she will have to deal with her own trauma as her husband recovers. He too will relive the accident in his own way, but perhaps fortunately, does not recall it happening.

As we have spent many hours in the surgical intensive care waiting room this week, we witnessed much outpouring of love for our kids.

Prayers, well wishes, offers to wait with our daughter in the waiting room, offers of rides, offers of cleaning their apartment, and offers of food were made over and over again. Words of love were expressed in person, in social media, in phone calls, and in bedside visits. They are being held tightly by so many. Our daughter was overcome with emotion many times as she read messages, took phone calls, and waited in the presence of those who loved her. This freak accident will be a life-changing experience for her and her husband.

We soldier on. These next few months will be hard on all of us for different reasons. Our lives are all changed because of what has happened. And just as I had to deal with my cancer journey one day at a time, so will we deal with this aspect of our lives one day at a time. I will be there for my kids as they were for me with Strength, Courage, and Determination.

My Christmas Gift--the Gift of Peace Returning

Ten months have passed since I wrote my last blog. February 13,2013 seems so long ago. It is a long time ago.

In this time away from blogging, I wondered if the blog’s only purpose was a cathartic one as a way of journaling my experience of living with cancer and sharing the story with friends and family who joined me in this journey. With cancer treatments and rehab behind me, I thought that perhaps no one would be interested in continuing to read a cancer survivor’s blog. Apparently I was wrong.

It is with encouragement from family and friends that I return to writing this blog. They have told me that they periodically visit the blog and haven’t seen any updates. They are wondering what my life is now like post treatment, so I will resume writing this blog and will share with you how my life continues to evolve as a cancer survivor.

Many things have happened since February. Some good. Some bad. Only now in looking back, do I realize how much has happened since my cancer diagnosis of March 2010. 

It has been nearly three stormy years since that life-changing diagnosis day.  I can now say, that I have recently started to live my life with profound peace. Interestingly enough, this peace coincides with the Advent season.

My Christmas gift this year is the return of peace in my life and being able to live

joyfully each day.  It has been a long time coming.

The experience of diagnosis, treatment, and surviving feels like a bad dream, but the scars on my body, my radiation tattoos, and taking of a potent daily drug (for five years) to keep cancer from reproducing are reminders that it was, and is, real.

My last post talked about post-surgery jaundice and an unknown cause. After tests and scans and a few visits with a nephrologist, no definitive diagnosis was ever found.  An unusual and unexplained occurrence I’m told, that still requires yearly monitoring of some small lesions because of my cancer history with the liver being one area where breast cancer can metastasize. I am still far away from the five-year mark of living without evidence of cancer, so these precautions are warranted.

Our son Josh and his wife Jill eloped in Honolulu in July and called to tell us later that evening. We happily celebrated after their return, by hosting a backyard luau reception in their honour. The weather cooperated as family and friends brought well wishes and their celebratory presence. It was so much fun meeting their friends and spending time with them as they honoured the newlyweds.

In July, one of my dear friends of almost 30 years died of brain cancer. I was with her during the last few days and saw her only hours before she passed. I relived being a cancer patient all over again with the gamut of emotions that comes with it. As she was only a handful of years older than me, I could clearly visualize that it could have been me that was dying. I miss her and always will remember what a gift she was in my life.

In October 2011, I was appointed as an Executive Sponsor to the Manitoba Cancer Partnership Steering Committee by CancerCare Manitoba and Manitoba Health, as a patient advisor. I work with a Co-Executive Sponsor, another cancer survivor on the steering committee. In addition to this, we co-chair a six-member cancer patient advisory committee. 

I have never worked with such a group of dedicated and determined people who want to make a difference for other cancer patients in Manitoba. It is rewarding volunteer work in advocating for other cancer patients to improve their journey through the healthcare system. Our voices are being heard and we will continue to push for positive changes for cancer patients.

We recently completed our first year of a five-year term on the steering committee and are starting to see some positive changes to make the cancer treatment journey better for patients and their families. I will write more about this in future blogs.

Returning to work as a cancer survivor has been difficult. It was far more difficult than I could have imagined.  Fighting cancer and surviving has changed me as a person. It has changed how I want to spend my valuable time because each day is a gift. It has also taught me what is important in life, and what I value each day.

This past fall, after working for 11 years with my former employer, I left my position.  I needed to follow my heart in a job where my spirits could soar. I wanted to return to the not-for-profit sector.

I found a new job quickly.  I had applied for three positions in early fall, had three interviews, and two job offers. The job I really wanted was offered to me, and is one where I joyfully go to work each day and follow my heart. 

My new employer is a non-government organization that I was acquainted with in the past as a corporate funder. It is so satisfying to work each day in a job that serves the poor. At the end of next month, my new job will take me into the field as I visit projects we are involved with in Ethiopia. It is a trip of a lifetime as Africa is a place I have wanted to visit since I was a child.

Life is good! Cancer taught me to live one day at a time and I still do so. I don’t look too far into the future and live more in the moment. I greet each day with a new sense of purpose, and I do so with Strength, Courage, and Determination.

Mellow Yellow Fades Away and Cancer Free Again

Relief.

I’m cancer free, round three. The mellow yellow jaundice of the last seven weeks has now cleared.

My recent CT and bone scans to screen for a possible cancer recurrence came back clean this week, and my elevated liver enzymes are dropping. I have won yet another round of chasing possible cancer. My shoulders feel lighter and the bounce is back in my steps.

However, the mystery of what has caused this post-operative jaundice remains unsolved. My doctor says indications are leaning more and more to a hypersensitivity or allergic reaction to anesthetic. A full review of my surgical files of the last eight years has been ordered to see if there have been multiple exposures to an anesthetic that may have triggered the reaction.

If this is the case (through a hepatologist consultation), we’re hoping this solves the mystery so that any future surgeries that may be required will prevent the use of the offending anesthetic, as it could be life threatening the next time. Anesthetic reaction is not a common side effect, but none of my many cancer treatments these past two years have been straight forward and without complications.

So, I live with an enhanced gift of awareness and gratefulness for my life. Two new scares of possible cancer since May 2011 have been to say the least, arduous and stressful. I am hoping that as my current cancer-free state continues, that I can move beyond the “identity” of being a cancer patient and find some good that has come out of this experience.

My life is slowly returning to its new normal. I’ve been cleared to return to work starting next week, and have renewed my gym membership for those daily workout treks that help reduce my risk of recurrence. For balance and personal interest, I round out my life with continued volunteerism with the Immigrant Centre, CancerCare, and my recent appointment as a patient representative on a provincial steering committee that is tasked with reforming cancer patient care.

The cancer “lemons” have been difficult to digest. I am resolved to make lemonade out of the cancer patient experience to benefit thousands of other cancer patients in Manitoba, and will do so with Strength, Courage, and Determination.

Mellow Yellow and a Medical Mystery

In the time that has elapsed since my last post-surgery blog in late December, an interesting post-op complication lingers. A few days after surgery, I developed a mild form of jaundice, which has stayed with me these past five weeks.

It’s a medical mystery, currently under review by an array of doctors. We have ruled out pre/post-surgery drug interactions, and a reaction to anesthetic from the two surgeries I’ve had since spring 2010. The only clue as to what is going on with my body is an elevated liver enzyme, without a known cause.

As a recent cancer survivor, I undergo quarterly medical check-ups and blood work, which includes testing for white blood cell counts, cancer markers, hemoglobin levels, liver enzymes, thyroid and bilirubin counts.

In September, October (pre-op prep), and December, all of these levels were normal. Between first noticing jaundice, seeing my doctor the week of Christmas, and then again two weeks ago, one liver enzyme (alkaline phosphatase) climbed to four to eight times the acceptable range. There are no other irregularities with my most recent blood work results.

I have no pain, swelling, or loss of appetite. I am tired, but am still recovering from major surgery. I am somewhat fatigued all the time, as my cancer drug Tamoxifen is a form of chemo, and fatigue is a side effect.

My medical team does not know why this jaundice is occurring, as the symptoms are unusual. My doctors have put on their detective hats, and are trying to solve this medical mystery.

The diagnosis of jaundice is done by the elimination of possible contributing factors. We know that drugs and anesthetic don’t appear to be the problem. I did not have a blood transfusion during the last surgery. Other potential causes could be hepatitis, a blocked bile duct, inflammation, cancer, or an unknown cause. Because of my cancer history, the medical team is being prudent in further testing as breast cancer can return to my other breast, bones, lungs, liver or brain.

Discussions have taken place between my family doctor and surgeons, anesthetists, and my medical oncologist. The oncologist and family doctor have determined that I need to undergo more blood work tests, a CT scan, a bone scan, and a referral to a hepatologist (liver specialist) to see what may be triggering this problem. It feels like the suspicion of cancer and diagnostic screening all over again.

My nurse educator tells me that every time something suspicious arises with my health, the fear of cancer returning is a normal reaction that all cancer survivors go through as part of their journey with this disease. As my surgical oncologist once said, “women with a breast cancer history live the rest of their lives with the feeling of a guillotine hanging over their heads.“

The stress levels are creeping up. This time of anxiety is so familiar. I am on another roller coaster ride in living with a cancer history. I am still off work, and am trying to stay calm and busy with mindless home projects to distract my worried thoughts. It is a difficult topic to talk about…

I am resolved to work through this medical mystery one day at a time and trust that all will be well. I will do so with Strength, Courage, and Determination.

The Cancer Treatment Journey Continues

In a few short weeks, it will be two years since I started my journey as a breast cancer patient. It has been a life experience I could have never imagined, had I not been diagnosed with the disease.

Last year at this time, I was winding down my radiation treatments as part of my ongoing battle to fight breast cancer. I was looking forward to moving on with my life. I started resuming activities like going to the gym for daily workouts starting on January 1, going through rehab to regain the use of my body post-treatment, and eventually returning to work this past fall.

In January 2011, I began taking Tamoxifen, a cancer drug that is used to block the production of estrogen, which forms cancer cells. I was hopeful that my body would accept the drug without complications. It did for a short while until March, when I started to have complications that I should not have had with the drug.

My doctor and I monitored the symptoms for a few months. I underwent a gamut of diagnostic tests and watched to see what would develop. In September, another complication surfaced, and a specialist was consulted. A decision was made to act quickly to treat the complication, so that I could continue to use Tamoxifen. I was scheduled for major surgery to remove organs at risk in developing cancer.

The surgery took place in early December. Even though, I had been in excellent physical health prior to the procedure, the bounce back has been brutal. It has been a trying time physically, mentally, and emotionally. And like the earlier treatments I had, this one too posed rare complications, which I am being tested for, and await results for treatment.

This latest cancer prevention treatment has been a setback and a disruption—particularly because I finally returned to work in early October, ending the last piece of unfinished business in my life post-treatment. I hope to “begin again” at work by the end of January.

As frustrating as this is, a medical mentor of mine, who is a cancer survivor, comforted me a few weeks ago. “Once you’re a cancer patient, you are always a cancer patient. It doesn’t end. This is a part of living with the disease. Your life will never be the same, this is your new normal.”

This latest treatment, coupled with the news these past two months that three friends of mine are in active treatment for breast cancer, is yet another reminder that the lives we live are often take for granted. As a breast cancer survivor, who is now journeying with friends through their treatments, I am reminded again how fragile life is.

The gift of life—my second gift of life, compels me to keep fighting and continue living this new normal life, with Strength, Courage, and Determination.