#floridafriday – Anhinga Trail at Everglades National Park

I was a somewhat reluctant Floridian. I always said it was a lovely place to go on vacation but not to live. The heat was too much, you have to drive everywhere, the people seemed too old for me. While my maternal grandparents migrated to Southwest Florida from Wisconsin in the late 70s/early 80s and my parents followed suit in 2004, I stayed away – college in Michigan, back to Wisconsin afterwards, then overseas for a few years, and then NYC. But after my cancer diagnosis in late 2013, it was decided (not really by me) that I needed to be closer to family, so off to Florida I went – temporarily, I told myself.

Well temporarily turned into 3.5 years at this point with no intention to leave anytime soon. Florida actually has a lot to recommend it. Yes, there's the heat, traffic and politics that can drive me crazy. However, for someone who loves swimming, there's not many better places than a state almost entirely surrounded by water. And the nature doesn't stop at the beach. Florida is full of county, state and national parks where you can do anything from short walks to long hikes, observing the bird life and wildlife all around.

One of my favorite walks is the Anhinga Trail at Everglades National Park. About an hour south of Miami, off of Route 1, there's two small cities, Homestead and Florida City that are gateways into the park and have what you might need as far as hotels, food and supplies. Everglades National Park spreads out over the whole of the southern park of mainland Florida, and I certainly intend to explore the more backcountry, less accessible areas in the future. But for now I'll just focus on the Anhinga Trail, which is very accessible once you get into the park (admission only $10 per vehicle) and an easy walk of a little less than a mile consisting of pavement and boardwalk.

Younes and I went for our "mini-moon" right after the wedding and later came back with my parents. The trail is a fantastic place for bird-watching. You will see a lot of anhingas (hence the name) as well as double-crested cormorants, herons, ibises, spoonbills, eagles, hawks and vultures. Of the non-winged variety, there are turtles and tons of alligators. Although the path is short, you can spend hours looking at the various wildlife.

In fact, I think it might just be time to go back – once it cools off.

Tri-colored heron

Cormorant

Anhinga wing spread

Three musketeers

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#tbt and How I Met My Husband

Since yesterday's post was on the trials of getting residency for a foreign spouse, I thought I'd tell the story of how I ended up with said foreign spouse.

After leaving Swaziland, in Fall 2011, I went on a six-month backpacking trip of Africa and Europe. Morocco was definitely on my agenda, as years before, I thought I might be going there for Peace Corps before I found out I was going to Swaziland instead.

My second week there, I was in Marrakech when a handsome young man with a great smile approached me. He worked for a tour agency, and upon finding out that I was American, invited me to a cafe to chat. He had a tourist visa for the US and was thinking about going within the next year and wanted the perspective of someone from there.

We chatted for about an hour and then parted for the night, but he told me he would be outside his office the next evening. I went there the next night but didn't see him. Apparently he did see me from the upper window; however he wasn't sure if I was looking for him or just passing through. I went about my evening, but I was disappointed not to see this charming stranger again, so I wandered back to his office a few hours later and there he was.

We spent a good chunk of the weekend together and he asked me to stay longer, but after 2.5 years in a landlocked country, I was aching to spend some time by the seaside. I bid him farewell and headed to Essouria, a hippie town on the Atlantic coast. A few days later, he called to say he was dropping off another backpacker for the weekend and asked if he could see me again. I said "of course!" We spend another weekend enjoying each other's company before I bid farewell to Morocco and traveled on to Europe. He was excited that I was going to be in Europe for so long and said he would be visiting friends around Christmas and maybe we could meet again. I thought, "Yeah right, he'll meet someone else before then."

But he did not, and neither did I. We met during December and traveled Germany and Poland together, staying with his friends and falling for each other in the cold, frosty air of Christmas markets and glittering town squares. We went our separate ways for Christmas itself, but after the new year, I went back to Morocco to meet his family and see his hometown. I played with his oldest niece, ate his mother's cooking and explored his beloved Atlas Mountains and desert with him. I learned about his heritage – the heritage of the the Berbers, the Amazigh, the "Free People." I brought my parents a Berber rug for a belated Christmas present and books by Moroccan authors, we ate lunch at roadside cafes and took breakfast overlooking canyons and valleys. My father called with the news that my grandfather had died – at the age of 88 but still quite unexpected – and Younes comforted me and supported me as I grappled with whether to abort the last weeks of my journey and go back for the funeral or stay (I stayed – my grandfather was a practical man who would've cringed at the thought of me paying upwards of $500 to change a flight).

When Younes and I parted for me to go back to the US, I was heady with new love but I knew the cultural and distance barriers were immense. But as long as he made me happy, I was going to give it my best shot…

TBC next week with how we ended up married.

Our first picture together, Sept 2011

Exploring his hometown, Jan 2012

Seeing him with his nieces was a major "awwwwww"

#WhineWednesday – Time for ranting

Wednesdays on this blog will be dedicated to rants of all types.

This Wednesday, I'm annoyed with immigration.

I married a foreigner. When we were dating, we were undecided on which country to live, but one of the pluses in my opinion, of moving to his country (Morocco) was not dealing with the mounds of paperwork and red tape that defines the US bureaucracy.

My cancer diagnosis took that choice away from us, and after a few months married, Younes and I began the process of him becoming a permanent resident. This process has multiple steps:

• Applying for the two-year green card. We sent a massive binder that included a application from him, an application from me, biographical information, birth certificates, copies of passport pages and ID cards, passport photos, medical exam paperwork filled out by a doctor, application of financial support, tax returns and evidence of legitimate marriage, which included pictures together, our wedding invitation, mail addressed to both of us, bank and credit card statements in both our names and affidivats of our relationship. And a check for a lot of money to the US Citizenship and Immigration Service (who I have dubbed the US Tree-Killing Service for all the paperwork they make us print out). After about 4-5 months wait, we went for an interview, where we brought even more evidence of our relationship, including our wedding album, insurance paperwork and updated bank account statements. After a brief lecture on getting on the same phone plan to provide additional evidence, Younes was thankfully approved. (FYI – the card is really green.)
• Less than two years later, we're back in the hotseat as we apply for Younes' 10-year green card. If we fail to apply, he would get deported. We send another application, more passport photos, bank statements from 2014-2016, apartment leases, car and health insurance paperwork and another big check. The US Tree-Killing Service is backed up on these applications, so we, as well as many others, have been waiting a full year for a decision on his green card. We've been waiting so long we can now start the citizenship process.
• The citizenship process involves another application, another big check, more paperwork including leases, insurance papers and every single bank statement going back to 2014 – even if we sent the evidence before, we have to resend it. After that, there will be another 8-10 month wait until he can have his interview, take his test and finally take his oath.
• Some do not pursue citizenship – the most common reason being that they are from countries that don't allow dual citizenship (Morocco thankfully does). Those people have to renew their green card every ten years for as long as they live in the US. I don't know what the renewal process entails, but I imagine it involves more dead trees and another big check.

Finding out when this process will move along has been near impossible. The US Tree-Killing Service has been very unhelpful and the only reason I know as much as I do is because of my other immigration-weary peers on the Internet forums.

Bill Bryson's English wife applied for residency after they moved back to the US and he puts the frustration well:

"After awhile you begin to understand why flinty-eyed cowpokes in places like Montana turn their ranches into fortresses and threaten to shoot any government official fool enough to walk into their crosshairs."

Our mound of paperwork for Green Card #1

#sciencesaturday – “What The Health” is a WTF

People are flipping out over the new Netflix documentary, "What The Health." While I am a proponent of a plant-heavy diet, I am automatically skeptical of claims that a foods are a miracle cure. I prefer to get my nutritional and health advice from my doctors, and if I see some outlandish claim on the internet, I investigate it on a site like "Science-Based Medicine" – a site I will wholeheartedly recommend to anyone. They had their own thoughts on "What The Health":

https://sciencebasedmedicine.org/what-the-health-a-movie-with-an-agenda/

But what I want to explore today is an article by Vox, and one particular criticism in general.

https://www.vox.com/science-and-health/2017/7/25/16018658/what-the-health-documentary-review-vegan-diet

"6) Five to 10 percent of cancer is caused by genetics, and the rest is caused by food. Repeatedly in the film, Andersen overstates the role food plays in driving disease. What we eat is only one factor affecting our health. Some of the best research we have on contributors to cancer risks suggests some 30 percent of new cancer diagnoses could be cut by improving lifestyles — but not just our diets. Behaviors that cut a person’s cancer risk involve never smoking, cutting down on alcohol, keeping a healthy bodyweight, and exercising."

I've encountered the "5-10% of cancer is caused by genetics so the rest must be caused by lifestyle" fallacy before and it irks me for the following reasons:

• Cancer is not a singular disease. Look at the National Cancer Institute website (https://www.cancer.gov/types). How many types of cancer do you see? A lot, right? Now think about this. For most every type, there are different subtypes. Take breast cancer. Within that cancer type, you have ductal carcinoma, lobular carcinoma, inflammatory carcinoma, hormone positive, triple negative, Her2 positive that may or my not also be hormone positive. You have postmenopausal, premenopausal and male breast cancer. And that's just the most common subtypes. Now think about all the different kinds of cancers and all the different kinds of kinds of cancers. Do they all have the same risk factors? Does smoking contribute to multiple myeloma in the same numbers it contributes to lung or throat cancer? Of course not. So to say "cancer is caused by meat/sugar/carbs/dairy" is, at best, a huge oversimplification, and at worst, outright false.
• Environment, meaning exposure to carcinogens we can't control, such as those in the air and water, are a very unexplored area of research. I am not a ZOMG EVIL CHEMICALS person because, guess what? Everything contains chemicals. I do believe there's environmental causes of cancer we haven't been able tease out, but that's not the result of some massive conspiracy or cover-up. It's because it's just plain hard to isolate single factor over such a large and diverse group as cancer patients. See this article from Newsweek which explains why it's so hard to prove the existence of "cancer clusters." (http://www.newsweek.com/2016/07/29/geographic-cancer-clusters-industrial-polluters-481423.html)
• Sometimes cancer is the result of chance, or bad luck, as some studies have shown. While the oft-quoted Hopkins study in 2015 was widely criticized, the scientists came back this March to explain further.(https://www.scientificamerican.com/article/most-cancer-cases-arise-from-bad-luck/). As they said, they are not giving people a license to smoke, drink excessively, never exercise and eat donuts all day, but they are explaining why cancer arises in people who are young with no family history and who lived healthy lifestyles. I know many people who fit that description.
• 5-10% of cancer caused by genetic mutations refers to KNOWN mutations. BRCA is the most common of the known mutations and those who have a personal or family history who meet a certain criteria are offered testing. But few are offered testing beyond that, such as testing for the CHEK, ATM, germline p53 and other lesser known mutations. So there are likely lots of people walking around with cancer-causing mutations that don't even know. Then there are Variants of Unknown Significance of a mutation, which is basically "it's likely to be ultimately negative so we treat it as a negative but we can't know for sure (I've tested for a few of those in my large-panel genetic testing). Then there are mutations yet to be discovered. I've known far too many young cancer patients with an extensive family history who came up negative on genetic testing to believe that we've found all the cancer-causing mutations there are.

As for my personal theory on why I got cancer at 28? A combination of genetics (mother, mother's aunt and paternal grandmother all had breast cancer and that's in a very male-dominated family) and super shitty luck (why I got it so young). I'm not ruling out that there's also some lifestyle and/or environmental factor at play, but there's nothing obvious to me there, and until science proves there is, I'm going to continue to enjoy my occasssional cheeseburger.

#truckingtuesday Things I won’t miss from the trucking lifestyle

I just dropped Younes off at his truck. He will be going for this run alone, as I stay back to work on my writing, breast cancer advocacy, and take care of some medical appointments.

I enjoy many things about traveling in the truck, most of all the company of my husband. However, there are a few things I definitely don't miss when I'm away from it.

• Lack of restroom facilities.
• Especially in the middle of the night.
• Or when we pull up to a shipper or receiver and they claim they have no facilities for women. (What if a woman applies to work in your warehouse JERK?!)
• Not getting a daily shower.
• Especially in the South in the middle of summer.
• And having to wear shower shoes when you finally get one, just like in college.
• Lack of fresh vegetables. (I had asparagus last night, charred leeks tonight. SO TASTY.)
• Sharing a single bed with a six-foot tall guy who has a tendency to whack me with his elbow in his sleep.
• The alternative is he sleeps separately in the top bunk. I miss the cuddles then.
• All-day long waits at the shipper or receiver.
• Sitting all the time/lack of movement.
• Clumsy people like myself find lots of pitfalls, like balancing food on my lap while the truck is moving and spilling all over myself and wiping out on the pavement as I climb out of the truck.
• The terrible choice between Popeyes and Taco Hell at the truck stop. This is only surpassed by…
• The only choice being Subway.
• Subway graces almost every truck stop and it gets old fast.
• Especially the smell of it.
• GAG.
• Unreliable internet.
• Getting lost.
• One word. Breakdown.

So while there's fun things about the trucking life, there's also some very not fun things. Now excuse me while I eat some more fresh veggies, enjoy my private shower, and then drift off to sleep while watching Law & Order using the reliable internet on my iPad in my queen-sized bed.

Younes posing for a picture during a breakdown

#MetsMonday and the time I really wanted to be wrong

This is going to be a new series too, chronicaling my experience with metastic breast cancer. Yes, what I had feared when I wrote about it in October 2015 came true. Monday is #metsmonday on social media, so Monday will be my cancer blogging days.

 

When you have Stage 0-3 breast cancer, even a highly aggressive kind like mine, follow up scans after treatment are generally not done. Scans are only done if there are symptoms or funky bloodwork. The reasoning is that metastatic spread has the same life expectancy if it is found through symptoms rather than scans.

For the most part, I was OK with not getting scanned. The one exception was my brain. The highly aggressive protein (her2) which drives my cancer made me much more likely than the average breast cancer patient to get brain metastasis. As I did not want to risk having a seizure while driving or wake up with part of my memory gone. I asked about routine brain scans and was told the whole not without symptoms spiel. I thought about alternative – second opinions or even faking some bad headaches once a year – but then something happened. I started to move on from Cancerland. And I didn’t want to go back.

I finished nine months of an early stage clinical trial back in June 2015 but it was also an end to nearly a year and a half of active treatment. The great European/Moroccan adventure over that summer (which I will get back to writing about!) was a bit of a reset that dragged me away from cancer and got me refocused on living life again. And in September, my oncologist released me from follow ups for the next six months.

Fall 2015 was pretty awesome in a lot of ways.

Younes and I settled into our first grown up apartment together.

I started an awesome new job where I got to work with kids every day.

Younes refurbished a used bicycle for me and I took up cycling.

I swam a 5K open water race at beautiful Siesta Key beach.

Younes and I celebrating my successful 5k swim with cocktails and dancing

Younes and I went on one of our “bucket list” trips – camping on a remote island, which I will write about soon.

And, on the grimmer side, my elderly grandmother, my last remaining grandparent, was in her final decline.

So, as you can see, I had a lot going on in my life besides cancer.

But something was brewing in the background. Something bigger than my worries of metastatic disease that had haunted me since this whole mess began.

The day I found out about getting my job, and two days before my swim, Younes and I were running some errands when I started to see a wavy line in the very bottom of my left line of vision. I continued to see it for about 15 minutes and then it went away. We hopped into the car, and as Younes drove, I looked it up on Dr Google. One of the first hits I got was “ocular migraine.” I am prone to migraines and have been long before my cancer diagnosis, but they have never manifested in ocular symptoms before. But, I reasoned as I lept into the river of DeNial, since I was on estrogen suppression to keep the cancer away, it would make sense for my pattern of migraines to change. The wavy line didn’t return, I pushed it it the back of my mind.

Two days before our island camping trip, right after we finished dinner, I started feeling an intense tingling that moved up my left arm. It continued for about five minutes, and then went away – leaving me baffled as to what happened. I knew I should get in touch with my oncologist, but we had waited 18 months for this trip and I didn’t want to mess it up. We went camping, and had a wonderful, symptomless time. The tingling happened a few times more, but it was brief and sporadic, and in DeNial, I told myself it was lymphedema, a side effect of the 17 lymph nodes I had had removed from under my arm in July 2014. I was also having real symptoms of lymphedema, so it was an easy conclusion.

Mid-December, I had tingling in my arm, but that time it resulted in shoulder spasms. I was freaked out, and this time I looked up my symptoms on Dr Google and I realized I might be having localized seizures. But Younes and I were about to visit my grandma and then get a Christmas tree. I didn’t want to miss seeing my grandma, as I always worried it would be the last time. I didn’t want to screw up my family’s Christmas like I had two years ago (I was originally diagnosed December 23rd, 2013). I didn’t want to take off work the week before Christmas vacation and be seen as a slacker. I decided not to do anything until after the holidays.

A few days later, I was at work, surrounded by hyperactive 3rd graders, and I started seeing flashing lights out of my left eye. My first thought was “I have to hold it together long enough to help this little girl with her handwriting, even though I know in my gut I have a brain tumor.” After class was dismissed, I was determined to go to the hospital – screw Christmas – but there was no one to take me. Younes was working as a mover at that time and unavailable. My co-worker was in the office instead of on-site that day. None of the people at the school knew my medical history. So I locked myself into a bathroom, curled into fetal position on the floor, and cried and hyperventilated. After a few minutes, I figured that if I was stuck at the school, I might as well finish the workday. 20 minutes later, all symptoms had vanished. By the time Younes picked me up, I felt fine. I got into the car, described what had happened and asked if he thought I should go to the hospital. He said it was probably a bad migraine. I texted my mom and a friend, and they said the same thing. Even Dr Google said it was a symptom of ocular migraines. I knew deep down it was brain metastasis, but I really wanted to be wrong…

TBC next #metsmonday.

#tbt Travel Series – Grand Canyon hiking and biscuits and gravy

Look at that skinny, awkward teenager hiking the Grand Canyon!

 

In the spirit of Throwback Thursday, I’m going to begin a weekly post about travel experiences I’ve had that I have yet to write about.

This goes way back, but traveling around the US and staying at truck stops led to lots of greasy spoon type meals. One ubiquitous offering, especially in the South, was biscuits and gravy. I took the opportunity to have some every time, not because of the yummy factor – mass-produced gravy somewhat resembles glue – but because of the memories.

I am transported back to 1999. I am 14 years old and have just graduated from middle school. My mom is turning 50 over the summer and she has wanted to see the Grand Canyon for ages. We take a birthday trip out there for her special milestone (or tragic occurrence, depending on one’s view of turning 50). As most 14-year olds are, I am eager to test both my parent’s boundaries and my own.

We stayed close to the Bright Angel Trail, which led deep into the canyon. My parents, surprisingly, gave me permission to hike alone, something I am grateful for to this day. Seeking adventure, I would awaken at 4:30, drag my usually lazy-in-the-mornings butt out of bed,  lace up my hiking boots, and hit the trail well ahead of the scorching summer heat. Being an inexperienced hiker and also being alone, I would only hike an hour down into the canyon and then turn around and hike back out, but the beauty and solitude was one of the most exhilarating things I had experienced in my young life. It was made all the sweeter by my newfound independence. I could linger at the vistas I wanted to, break for water when I wanted to, and not have to pose for 85473758 photos. It was like being a grownup.

I would arrive back at our cottage, shower off the sweat, and join my parents, who would suggest going out for breakfast.

Now, my 14-year old self was a somewhat picky eater. Hard to believe these days, given that there are almost no foods I don’t like. But 14-year old Amanda was 100% NOT a breakfast person, yet I had two parents who loved a good, hearty breakfast. Most times if we went out for breakfast, I would make do with nibbling a bagel.

After two+ hours of hiking, a bagel would not be sufficient fuel, and it was far too early in the day to get a burger. I turned my nose up at eggs, bacon grossed me out, and pancakes were only acceptable if my mom cooked them. So, with few choices left, I tried something new – biscuits and gravy. To my rumbling stomach, they tasted like heaven. I had them every morning that week.

So 18 years later, I rarely turn down the chance to indulge in biscuits and gravy, even though I’ve since developed quite an enjoyment of all traditional breakfast foods. Not because I’m a Southerner, not because they even objectively taste that good. To me, they taste like gorgeous vistas and freedom.

 

Keep on truckin’

After a long hiatus, I’m starting this up again. My husband’s latest job has given me the perfect opportunity to write about my favorite subject – which, of course, would be travel.

About two years ago, Younes was looking for a good-paying job that didn’t involve 2-4 more years of school and gobs of student loan debt. So he decided to go into trucking. As in, big rig trucking.

So he went to trucking school for a few weeks (seriously, the programs are that short), passed his test, and got his Commercial Driver’s License (CDL). At the time, I was working full-time, so he headed off on the road alone. He did that for about six months. My grant was not renewed so newly jobless, I joined him last fall.

As a child, I did a good amount of domestic travel with my parents. By the time I left for college, I had traveled to over half the states in the US. Those trips were a huge highlight of my childhood, a source of wonderful memories.

But after I went to college, the lure of international travel distracted me from domestic travel. From 2003-2013, I only made it to two new states, and one was just passing through (New Jersey on my way to New York where I lived for a brief time). In my defense, I was out of the country for nearly three of those 10 years. Anyway, riding along seemed like to perfect opportunity to get back into the swing of adventuring around my home country.

And what an adventure it has been. Breakdowns in the mountains of West Virginia and Colorado. Watching, white-knuckled, as Younes backed into a dock across four lanes of oncoming traffic in the Detroit ghetto (he did fantastic). Sharing a single bed in the sleeper berth. Learning to cook in the truck in relative darkness, which took me back to my Swazi days. Seeing a New England fall. Getting back out to the west. And yes, I did knock off 12 more states, bringing my total to 43.

It isn’t all fun though. The interstates can be incredibly boring, especially when you know beauty and adventure are just a few miles away, but time restraints and lack of truck parking prevent you from accessing it. The chain truck stops lack character of the yesteryear truck stops. The waits for loads are long. I passed the time by reading, especially two books by Bill Bryson, which ponder the complicated relationship current and former expats have with this country. It’s something I can greatly relate to and in the spirit of Bryson, I’d like to ponder that too.