Month: May 2014

At last, the beginnings of a new theme for my website! I am approaching the point where I want to migrate content from by-words.com to this website, and I’ve created a tab for Editing & Publishing, my business (officially now known as Hazel Becker, Editing & Publishing LLC). Progress … but yes, a work in progress!
I had a vision for the theme, some of which may not work in the long run. Robert took my vision and made it happen online. I’m learning about Drupal 7, making changes as I learn. At this point, the live site is my sandbox – forgive me if it looks different every time you come here for a while.
Questions remain.

Is the banner photo too big? Does it make people scroll too soon after arriving at the site?

What content on my old website won’t make it here? I don’t need all those work samples, so I’ll have to pick and choose. But which ones? Those I love the most and am proudest of are not necessarily the most important to display on a freelancer’s website.

How will the balance between my blog and my business website come out? Am I interested enough in being an active freelancer again to make it primary, or will I relegate it to some minor slot?

Just how quickly will I learn Drupal 7? How much of the functionality I’m looking for will I be able to build on my own? How can I keep my website from being just one more online space for Robert to tend?

Will adaptive design allow me to post and change things from my tablet? Does it matter?

Do looks really matter anyway? Or is content still queen?
We’ll see where it ends up as time goes on. Meanwhile, here we are – at the beginning.
Enjoy!

A common theme on melanoma discussion forums is frustration with the length of time between scans when when patients are on the “watch and wait” regimen after being told there is no evidence of disease. It’s been bugging me lately – probably because I needed to have something to stew about to ward off scanxiety as we approach Robert’s six-month scans in early June.
So, I asked Robert’s melanoma doctor about this when we went in for the four-month check-up last week. Robert quipped that I want him to glow in the dark so I wouldn’t need a flashlight to get to the bathroom at night, but Dr. Lipson answered thoughtfully with a discussion of how much radiation is too much. Here’s the gist of what he said.
U.S. guidelines for the frequency of radiological scans to look for any suspicious growths in the body that might be melanoma are set by the National Comprehensive Cancer Network. For patients whose disease is staged from IIB to IV the guidelines call for chest xray, CT, and/or PET scans every three to 12 months for five years and annual MRIs of the brain. (The guidelines are discussed in an article published in the Journal of Clinical and Aesthetic Dermatology in September 2013.)
So, within that range, how do you decide how often to scan? You look at the extremes. The most frequent extreme would call for scans every week or two, but this would be too much because the change you see from one week to the next would be negligible. That means it would be too much exposure to radiation. One month doesn’t give enough time for something to change either. Could you do it every two months? Again, probably not; eight weeks isn’t that much time unless you’re looking at something very specific and want to know whether this particular spot has changed.
At the other extreme, is a year too long? Probably so, because if something is starting to grow you want to know about it sooner. Even nine months, he said, is “probably an uncomfortable period of time.” In our case, four to six months is the range Dr. Lipson is comfortable with.
Another factor is how closely the patient is being followed with skin and physical exams. Since Robert sees the dermatologist every three months for a thorough skin exam, including destruction and removal of suspicious spots and biopsies when appropriate, and sees Dr. Lipson every four months for physical exams, including lymph node palpation, a six-month schedule seems reasonable to him.
Then, the clinch factor is considered (at least by this doctor) – the patient’s comfort level. Since the national guidelines leave it pretty open, he said, “if … you’re really not comfortable with six months, then let’s do it every four months – that’s certainly within the guidelines. It’s an extra exposure to radiation every year, that’s all.”
Robert’s next scans are early in June – about five months since the last set were done at Johns Hopkins. He will also have scans and a brain MRI in December for his next yearly follow-up after the GVAX vaccine trial. Assuming all goes well between now and then, I’ll have to become comfortable with the six-month schedule – to prove to Robert that I don’t want him to glow in the dark!
One more wrinkle in learning to live with melanoma …

Today’s New York Times opinion piece by two nutrition researchers brings me back to a topic that was part of my last post – losing weight. It reviews a long-standing debate about what kind of calories are best to keep us from gaining and help us lose body fat. It has me thinking about altering my approach somewhat.
As I wrote last week, my solution a few years ago was to combine determination and discipline – my determination to shed pounds and the discipline to count calories – to reach my goal. Happily I can tell you that I am among the one-in-six people who have lost more than 10% of their body weight and kept it off for more than a year. However, my weight has been creeping up over the last year.
The reason for my recent weight gain was apparent to me when it started to happen. As many people do, I have competing health needs, and avoiding osteoporosis became a focus after I stopped taking hormones and Fosamax at the same time. My bone density dropped enough to raise alarm, and my physician referred me to a rheumatologist to investigate and figure out how to deal with the problem. The new doctor gave me several simultaneous strategies, including eating two helpings of yogurt a day to boost my calcium intake.
There was no way I could keep within my calorie “limit” and eat that much yogurt, even the no-fat low-calorie kind. Besides, this period coincided with Robert’s participation in a clinical trial for a melanoma vaccine, and I could not keep that much determination or discipline attached to my weight. Consequently, I’ve gained back about eight pounds. I’m still more than 10% below where I started, but I’m not happy with the trend.
A few weeks ago I decided to start tracking calories again. A follow-up visit to the rheumatologist helped bump my daily yogurt habit down a portion, though I’m being attentive to how much calcium I take in – still trying to avoid hunched shoulders and broken bones. I’m happiest eating a healthy diet anyway, but the downside of that is that it doesn’t leave me many high-calorie targets to remove from my diet. I’ve struggled with keeping my calories below the “limit,” particularly since the limit goes down every year as my metabolism continues to slow. I’m still working out three or four times a week (good, hard, high-impact exercise), but I’m eating more because that adds calories to my limit.
The New York Times article gives me a new approach to think about. It reviews the old debate – should you eat a low-fat or low-carbohydrate diet? It explains the mechanisms by which our bodies use and store calories. And, it is steering me back to something I read a few years ago, when I first started my disciplined, determined drive to get thinner.
“With reduced consumption of refined grains, concentrated sugar and potato products and a few other sensible lifestyle choices, our internal body weight control system should be able to do the rest,” the authors wrote. For me this means:

cutting out sweets (those with refined sugars and/or high-fructose corn syrup), which won’t help me much because I tend not to eat cookies and cakes anyway;

no white bread or low-fiber pastas, easier because I’m already pushing toward whole-wheat products and pastas in which at least 10% of the carbs are fiber;

making fried foods a luxury reserved for times when nothing else palatable is available, more difficult for me because I’m not the one who chooses how our food is prepared (and I refuse to ask Robert not to make fried okra anymore); and

no chips, the killer of this list.
So, I’m back to the two Ds – I am determined to follow this regimen as closely as I can, and I hope I’ll have the discipline to stick to it. If it works, perhaps I’ll write about it again here in a few months. If you don’t hear from me on the subject again and you want to know if I’ve continued to gain weight, feel free to ask in the fall. If I don’t reply in one way or another, you can assume that I’m off looking for a different answer.

Ann Patchett wrote in her new book, The Story of a Happy Marriage, about thinking up stories in her head while waiting tables early in her writing career. She perfected this technique to the point where she was able to, essentially, write entire novels in her head before scribing them on a keyboard.
I wish I could do that! Oh, I can write in my head – I just can’t get through the “scribing” part.
I can’t tell you how many blog posts I’ve written over the last two months. You won’t read any of them, though. Admittedly, it has been a strangely busy time. I lost the entire month of April, going to Florida while my 93-year-old mother began a remarkable recovery from abdominal surgery and then accompanying her on a long-planned trip to see her sister in Oklahoma at the end of the month. Then, last week, there was our trip to Asheville to celebrate my daughter Allison’s becoming a Master of Social Work – Phi Alpha honor society, straight As, what an achievement!
All those trips, and the events they surrounded, gave me lots to write about. And I did! I constructed entire blog posts about resilience, determination, living independently when you’re “old as dirt,” realizing dreams when you don’t have enough money or time to be comfortable, observations on parenting a teen and preschooler at the same time, Oklahoma!, going back to work (albeit part time) after nearly two years away, passing the two-year mark after a devastating diagnosis of metastatic melanoma (later revised to melanoma of unknown primary). Just to name a few.
I might even be able to write some of them down now that I have the time. But it wouldn’t be the same, because my thinking on some of these topics has changed. In some cases I know how the story ends, and it would be hard for me to write the words as though I didn’t – even if I could remember them.
So yes, I can write in my head, and sometimes I can scribe what I’ve written. That’s how  you happen to be reading this. But, consistently? A whole story? Or a novel? I doubt it.
That’s how Ann Patchett wrote her first novel, The Patron Saint of Liars, which I loved. She waited tables for months while thinking it up, and then she got a fellowship on Cape Cod over the winter during which she scribed it. Somehow, she dredged up the duo of determination and discipline to make it happen.
I can’t go back and reread Patchett’s essay now to check my memory because the library took back my e-book when it expired. But it’s a theme she goes back to several times in this collection of essays, some of which are about her success as a writer. She talks about having the determination in high school, and then about developing the discipline that winter in Provincetown.
I have succeeded, on occasion, at things I knew I wanted to do but had failed at before, by using that same formula. In at least two cases, I had previously tried with one but not the other. I quit smoking on January 1, 1975, after 13 years of what became a pack-a-day addiction. I had the discipline to do it before, but didn’t really develop the determination until Robert and I decided to have a baby. That New Year’s resolution was easy to keep – I quit cold-turkey, knowing that I didn’t want to be pregnant with my lungs clogged up like that.
Losing weight was a different story. I was determined to do it for a long time, but didn’t begin to succeed until I found a system that would allow me to be disciplined about it. I can’t say it was easy, but I dropped more than 20 pounds by consistently tracking calories and making sure I kept below my limit.
Determination and discipline. I know those are keys to my ability to achieve hard things. My thanks to Ann Patchett for helping me figure that out.