20 September 2011

Hospital Room #3223

This has been an incredibly difficult post to write, and I'm still not happy with how it turned out, but I've decided to post it anyways & move on already. I didn't realize until I tried to revisit my mindset how incredibly HIGH I was the whole time I was in hospital. No wonder I was able to cope so well with such devastating news! Honestly at the time, I thought I was getting just a little loopy once in a while on breakthrough pain meds, but for the most part I honestly believed all the drugs were doing was controlling my pain. Ah live & learn... so anyways, my recollection of this week is much fuzzier & disjointed than I would like it to be.

I was in the hospital for a little over a week following my diagnosis. Whether it was the wonder-drug Dilaudid or a Freudian slip, most of the time when I went to say "hospital" I would say "hotel" instead. After a month of pain, having a constant staff of nurses ready to give me pain meds and care for me was heaven. Although Sterling & everyone else assumed I'd want to get home ASAP, part of me was actually afraid to leave.

Tuesday, 28th June 2011 The overlap day between this post & the "Diagnosis" one. I was admitted to the hospital through the ER in the wee hours, had exploratory laparoscopic surgery in the afternoon, and after I woke up I was wheeled up to my new home for the next week, Room #3223. After calling my work to let them know I wouldn't be in tomorrow, they sent the first of what ended up being nine flower arrangements. (My dad ended up telling people not to send more because there was no more room on the window sill.)

Early that evening the surgeon Dr. Wankling came in & told me I had cancer. Sterling made a trip home to feed the cats, pick up a few things, and at my request braved FaceBook for the first time to post this update: "This is Sterling updating for Holly. Trip to the ER late last night resulted in a overnight stay + exploratory surgery.... Found Cancer in the Omentum. Staying in the hospital until they track down the source. Room #3223 at the PG university Hospital. More when we know."

I should describe all my hookups... I had the IV in my right forearm that the ER had put in in the wee hours that morning, and I was getting fluids through it. I had what's called a butterfly patch on my upper arm just under my right shoulder - it's a little IV dangly thing that let them push morphine for breakthrough pain. After it became clear that the morphine didn't work for me, they removed it & replaced it with a new one for the Dilaudid. They had also put in a catheter. I honestly don't remember if they put it in during the surgery or after I woke up - testament to the pain drugs. There was a giant patch with an anchor to secure the catheter attached to the inside of my right thigh. Lastly, both of my calves were strapped into a device that was kind of like blood pressure cuffs, rhythmically filling with air & releasing, which were supposed to help prevent blood clots. I was also getting little shots in my belly several times a day to help prevent blood clots - they told me that the sooner I got up & walking around, the sooner those shots would stop, which was motivational - they hurt! From the surgery I had two little horizontal incisions, each closed with 4 staples. One was across the bottom of my belly button, the second at the top of my pubic hair. I joked that the least they could have done was shave or wax me while I was unconscious.

After a whole pile of phone calls, Sterling made the couch in the room into a bed, and we slept. And so started the crazy dreams - looking back I suppose it was the drugs, but I had crazy crazy dreams every night I was in the hospital. The good thing was they were all benevolent - even imagery that sounded a little scary when I described it in the light of day I experienced at the time as comforting & entertaining. Guess I was high even in my sleep!

Some of what I wrote in my little notebook that night: "Cancer. I have cancer. I am a cancer survivor! I, Holly Marie Hill, will never let something as stupid as cancer beat me. I will survive & thrive. Life begins anew. I don't think I can. I know I will." (I was big into underlining.)

Wednesday, 29th June 2011 We wake up & life goes on, even though I have cancer. Who'd have thunk it? Sterling makes the important discovery that there is a Tim Hortons in the hospital. Visitors & more flowers arrive. The first visitor to stop by was my GP, while Sterling was down at the Tim Hortons & I was alone. We have the most incredibly awkward conversation. I was so angry with him, I could barely speak. Right from my first appointment with him at the beginning of this whole mess, I had been terrified that something was seriously wrong, and it turns out I was right. But he never took me seriously & never acted with any urgency. At my last appointment, just two days earlier, he had even talked about how his role as my GP was to help me navigate through the medical system & specialists, and then he had immediately failed miserably at that role. He had never managed to effectively control my pain, and now that I was in the hospital & it was starting to come under control, and I was experiencing what it was like to work with professionals who cared about my pain, it made his failure all the more clear to me. Needless to say I was not comforted by his visit.

The rest of my company was much more welcome. Coworkers & friends came by in a steady stream. The most gorgeous flower arrangement arrived from my father-in-law (he has such impeccable taste, it's hard to believe he's a straight man!) & three of my guests arrived with plants. It was one of my coworkers last day at the company, and I jokingly apologized to him for "stealing his thunder", as today should have been all about him at our office, rather than me.

I was self-conscious about the catheter, having a tube of urine in plain site of my visitors, especially my coworkers. So much for my professional image, peeing in front of everyone! What can you do though? Fortunately I was HIGH enough to just shrug & make fun of my discomfort. The catheter was often physically irritating too - I would feel like it wasn't draining properly & have to fiddle with it. Also for the first couple days it ran red with blood - the nurses assured us this was normal after surgery, but it was disconcerting.

I was really overwhelmed by how sweet & thoughtful all my friends & coworkers were. Due to bullying when I was young, deep down a part of me always believed that no one really liked me, they were just being polite/pretending/putting up with me. But when this happened, it really sunk in on a whole new level that that's not the case, that there was a surprising number of people who really do care about me deeply. To paraphrase Sally Field, they like me, they really like me! I did notice a pattern though: the first time people visited, a lot of them were terrified. I could see in their eyes they were on the verge of tears, very nervous. But everyone always seemed to be much reassured by the time they left, and were back to treating me more or less normally after their first visit. I was so positive & upbeat that it seemed to be very reassuring to everyone. I did worry that people would think I was putting on a show, a brave front for their benefit, but I really wasn't - like I said, looking back I think a lot of my bravery & grace under pressure was the pain drugs.

One visit of particular note was when the CEO of the company I work for came by to talk about the benefits program at work. Now there's something important to note here. I worked for the company first on a temporary contract basis, followed by a short-term contract to cover a maternity leave, before being made a permanent employee nearly a year after I first started working there. When I was finally made permanent, I was offered the chance to join the benefits plan... and turned it down. The previous two workplaces I'd worked hadn't paid very well, didn't have very good plans, plus I was young & healthy so why not pay-as-I-go & save a little money? But this time when I tried to opt out, both the CEO & my immediate supervisor the CFO talked me out of it, said it was a very good plan & I needed to take advantage of it. So I joined. I'm not religious, but I am convinced that there was divine intervention working through them that day. Because if I had opted out, I would be seriously screwed now. Instead I am taken care of by an awesome benefits plan, plus the CEO spoke with the chair of the board of directors and they decided to go above & beyond the benefits plan to support me. Financially, everything is taken care of & that is one stress Sterling & I don't have to deal with. By the end of the conversation all three of us (me, Sterling & the CEO) are holding back tears. Northern Development Initiative Trust's above-and-beyond response to my cancer diagnosis is the way all companies should treat their employees, and how many companies claim they treat their employees, but sadly in reality very few do. NDIT is awesome & I feel so blessed.

One last thing from my notebook, that night I put on my iPod & the first song shuffle chose was "Eye of the Tiger" by Survivor. :)

Thursday, 30th June 2011 My entire immediate family arrives! Mom flies in from Fort St. John & Sterling goes & picks her up from the airport. Later, the little caravan of two vehicles containing 6 adults & 2 bulldogs arrives from Calgary. There are many hugs & much visiting. Three more flower arrangements are delivered, carnations from my grandma, daisies from my cousin & her husband, and a big bouquet from an aunt & uncle. A friend also comes to visit for the first time & brings a pretty yellow teacup rose plant, bringing the total arrangements in my room for my stay up to nine.

Today is also the day they get me up & walking for the first time since the surgery. As it turns out, I am wobbily standing beside my bed when I get visit #2 from my GP. This time I try & express how I feel. I tell him that I am angry with him, that I don't feel he took my symptoms seriously enough & didn't act urgently enough. He does not apologize, just says that it's good to have my feelings out on the table, but that no one expects cancer in someone my age. I understand that he probably couldn't apologize outright without risking a lawsuit, but there are ways of apologizing without apologizing, you know? And he didn't do that. I got the distinct impression that he doesn't feel he did anything wrong, that if given a similar patient he would act the exact same way again. And I am not OK with that. I am even angrier with him when he leaves.

In stark contrast, the surgeon Dr. Wankling's visit is much better. The biopsy results are back, and they indicate that the primary cancer is in my stomach. This was his guess right from the beginning, as he once had another patient, a girl even younger than I am, with a very similar case. He says that he eventually removed her stomach, after which he lost track of her. He was very positive & optimistic. He even asked me if I wanted to go home during the weekend, if they could get my pain controlled. He said he was on vacation the following week, but he was booking me with his colleague on Tuesday for "scopes from both ends" (endoscopy & a colonoscopy) to confirm that the primary cancer was in my stomach.

My work was sweet enough to bring me my work laptop & an internet stick on the condition that I use it for fun & communication only, and not try to do any actual work. I posted these FaceBook updates at 11:26AM: "Hello everyone! My super-awesomely-supportive workplace (Northern Development Initiative Trust) arranged for me to have access to a computer & interwebs while in the hospital, since I am the last Luddite on earth to not have a cell phone, let alone a web-enabled one. So I am typing this myself from my hospital bed." "Feeling better, pain management has progressed a great deal over the last few days. Still no new info, but biopsy results are expected later today. I'm overwhelmed with all the good wishes & prayers - thank you all. I feel so blessed to have so many wonderful people in my life."

Then at 10:29PM: "Update! My surgeon (the awesome Dr. Wankling) came by late this afternoon with the biopsy analysis. Definitely cancer, looks like from the stomach (not definitive). Probably next Tuesday, I'll get scoped from both ends to see if they can confirm by finding it. (Advice from uncle: make sure they clean it well between the two scopes!) Chemo in my future. Also, the family has arrived en masse!! :D"

Friday, 1st July 2011 Happy Canada Day! There was actually a little card on one of my meal trays to mark the occasion, a nice touch. I was on "liquids" meal trays for most of my stay, so lots of soup & jello. The food in the hospital was surprisingly good; weeks later when I mentioned that to my psychologist he said that there are some little old Ukrainian ladies who cook at the hospital & make it much better than most institutional food.

The day was taken up with visiting. My family worked out shifts of sorts so they weren't all there at once. They also insisted on cleaning our house. It was hard for me to accept this help. I'm a lousy housekeeper at the best of times, and the month leading up to my hospital stay was far from my best of times. I was ashamed. But I knew they were all feeling helpless, and wanted badly to have something helpful to do, so I let them. Later when thanking them, I would manage to choke out, "Thanks for not thinking less of me."

There was also a surprise visit from Dr. Wankling, who stopped by on his day off because he wanted to bump up my scopes to the first possible day, Monday. Given this bump, and the fact that they were still having trouble finding the right dose to control my pain, it made more sense to keep me in the hospital until after the scopes were done. I would have the prep on Sunday & be scoped first thing Monday.

I think this was my bad night. I know my bad night was the first night after the catheter was removed, and I think this was it. It was in the wee hours, and I woke up & had to pee really badly. They had taken the catheter out but I was still getting IV fluids. But before I could get out of bed I had to release the cuffs around my shins. They were velcro, and I was able to rip one open & off, but couldn't manage to reach the other one (I was not so bendy after abdominal surgery). I would have pressed the call button to get the nurse, but it was tied to the bed rail which had been lowered, and I couldn't reach that either. I started to call to Sterling to wake up, but after three tries I realized that while I was trying to wake him up, I was also trying to do it quietly enough so as not to wake him up, because I felt bad about disturbing him. By this time I was in tears, partly from the pain, partly from panic. I finally managed to wake Sterling up, he took off the cuff and helped me up & to the toilet, and then went to get the nurse because at this point I was hysterical, bawling my eyes out & apologizing over & over. The nurse came in & gave me pain meds & helped calm me down. Looking back now I realized that this was the terror & horror of my finding out I had cancer finally coming out. I had been so HIGH and upbeat for my constant stream of visitors, I hadn't really had time for the negative emotions to surface. This was the start of them coming out.

Saturday, 2nd July 2011 More visiting. Looking at it now, it seems like I should have been bored with not being able to do anything but lie in bed & visit, but I don't remember it that way. I do remember getting worn out but not wanting to nap because I wanted to make the most of my visiting time with my family, at the same time that they were insisting I should rest & nap.

I wasn't in bed all the time, I was also getting up & doing laps around the floor, pushing my IV pole. There was a big front pocket in my hospital gown, which I'm sure was designed to hold some piece of medical equipment, but I used it to take along the little stuffed hamster a friend had brought me. I named the stuffed hamster Ponyo, an obscure reference to the titular character who loves ham (ham - hamster - get it?). The getting out of bed & moving was something that was greatly encouraged by the nurses, as it prevents blood clots & speeds recovery time. I joked they should post the best times around the floor, I was sure I could beat them! I was a bit annoyed because even though I was the most mobile patient on the floor, I was still getting the little belly shots to prevent clots. At some point a nurse finally told me she thought it was an oversight that the doctors hadn't stopped the shots, and I could refuse them, which I started doing.

I guess this as good a place as any to put in some other details that happened but I'm fuzzy on when exactly. At some point the IV in my right forearm started leaking, so they had to put in a new one. I have itty bitty veins that run & hide from needles, so this was a challenge, and it took two nurses three tries to get a new IV in. They finally succeeded with a child's needle & put the IV in my left hand, which sucked, because the IV in your hand is awkward to deal with for things like washing your hands. Also at some point I was strong enough to get my arm wrapped & taped in plastic & have my first shower. That wonderful feeling after being sick in bed for days & finally feeling well enough to bathe - heaven!

One last thing about being in the hospital: they had a wonderful machine that kept hot blankets. I loved them - they were so comforting. The nurses showed Sterling where to get them & help himself, and I was indulged often.

Sunday, 3rd July 2011 My brother, his girlfriend, and my stepmom all have to leave to drive back to Calgary - they have to work on Monday. We take pictures like these before they go:



We all look so happy, you would think the teddy bear (a loan not a gift from my brother's girlfriend) was a baby & we were all gathered at the hospital for a happy occasion, rather than for a life-threatening disease.

After a last visit with the three who had to leave, and hugs & goodbyes, the nurse comes in with the first bottle of super-laxative stuff to prep me for the scopes the next day. I have a first dose, followed by a second dose in two hours. My mom asks, why two different doses? The nurse can't really explain why, but afterwords, I will describe it like the space shuttle taking off. You know how they have one engine that burns out, then drops off, and the second one kicks in to take them the rest of the way? That was how I experienced the cleanse. After the first hour, I was like, this isn't going to work, maybe I just don't have anything in my system because of the liquid meals I've been fed in the hospital. After an hour & a half, it finally started to work. After the second dose, oh my goddess! My family kindly stays away for most of the afternoon, as no-one wants to be around for this, except Sterling. Dear sweet Sterling... I worried that after this whole ordeal, there wouldn't be much mystery left in our romance, but he was a rock the whole way through.

Monday, 4th July 2011 Scope day. We kept expecting me to get called downstairs for the scope, but after several hours of the nurses saying "they'll call when they're ready for you" my Dad insists our nurses call them. Turns out there was a paperwork screwup & I wasn't on the list to get scoped that day! My dad had to go for a walk to calm down after that, although I have to say that throughout my hospital stay he controlled his temper & urge to take charge admirably well. I am put on the scope list for the last appointment of the day & the surgeon doing the scopes comes up to talk to me about them. Unfortunately he did not have Dr. Wankling's stellar bedside manner. Have you ever had someone who explains something to you, you ask a clarification question, and they just repeat the exact same thing they said the first time? That was this surgeon. My only real concern was that I wanted to make sure I was unconscious for the scopes... a coworker had an endoscopy (scope down the throat into your stomach) that he was conscious for & did NOT recommend it. Eventually after several go-rounds with the surgeon, it was confirmed that I would be awake enough to respond to their commands to shift & rollover & such, but I would not remember any of the procedure. Good enough for me! I was finally taken down for the scopes mid-afternoon, but as soon as we got there, they claimed they hadn't called for me and I was sent back upstairs, where the nurse said they most certainly did call for me, so yet another communication error had to be straightened out, and I was taken back down again. What a gong show! The actual scopes went fine, I don't remember anything after being sedated until I woke up in the scope recovery room, being encouraged to pass gas (this is an important thing after scopes). I was full of air which was very painful so each burp & fart I managed was a great relief. The surgeon came in & showed me pictures of the big cancerous ulcer they'd found in my stomach, confirming that what I had was stomach cancer that had spread to the omentum (Dr. Wankling had described what he found in my abdomen was like cancerous seeds scattered through my omentum). The surgeon also explained he was only able to do a partial colonscopy; while the scope showed the inside of my colon was clear of cancer, it had likely spread to the outside and because of that he hadn't wanted to be too forceful with the colonscopy, especially since they'd already confirmed that the primary was in my stomach.

I was wheeled back up to my room & was finally allowed to eat something. That had been rough - after the prep solution the previous afternoon/evening, I couldn't eat anything until after the scope, which wouldn't have been such a big deal if it had been first thing in the morning like it was supposed to be, but because of the screwup I spent nearly all of Monday not being able to eat.

That evening we all met my oncologist Dr. Katakkar for the first time. He came up to my room to see me after office hours. He was & is wonderful. He's been a doctor for over 30 years & for 20 years he ran his own clinic in Arizona. He was recruited to come up & head our new northern cancer centre here in Prince George just this past January (news article). He is a sweet little East Indian man who always sports a bowtie. His youngest daughter is the same age as I am. He very patiently answered all our questions (facing not only me, but a questioning family panel of Sterling, my Mom & Dad, and my sister & brother-in-law). We all felt like I was in good hands with him.

Dr. Katakkar explained that the file he received was incomplete, so he wasn't sure at this point if I had lymphoma that had spread into my stomach, or stomach cancer that had spread to my lymph nodes. He was hoping it was the first one, as lymphoma is much easier to treat & my odds would be much better. If it was the latter, then I would also need to be tested for a mutant gene that about a quarter of stomach cancers are positive for. If I was positive for the mutant gene, that would also increase my odds. He also explained that whichever it was, my cancer was stage IV, which provoked a strong emotional reaction from us all, even though if we had thought about it we should have been able to figure that out for ourselves.

I immediately decided to harness the power of positive thinking, deciding that it was definitely lymphoma. At 8:19PM that night I updated my FaceBook status to: "OK everyone, I need your help! Today I was scoped from both ends, and as expected, they found the primary cancer in my stomach. There are 2 possibilities: it's either lymphoma that happens to be in the stomach, or actual stomach cancer. We REALLY want it to be lymphoma; it is more common and more treatable. So please if everyone could pray/vibe/fingers crossed for lymphoma. Should know tomorrow. Thanks!!"

Tuesday, 5th July 2011 First thing in the morning, Dr. Katakkar came in & gave us the news: I have stomach cancer, not lymphoma. Fuck. I started crying really hard - I was devastated. Brokenly, I said, "I was really hoping to catch a break." Dr. Katakkar gave me a hug & said, "We just all have to do the very best we can." I bounced back reasonably quickly... yay narcotics! Dr. Katakkar is going to get me downstairs for my first chemotherapy right away, within hours. Later, my Dad will talk with other experts & they all say this is amazingly quick, but Dr. Katakkar has the sense of urgency about him, "there is no time to waste!" that I craved & never got from my GP. But first, I say my goodbyes to my sister, her husband, and my dad, who are driving back to Calgary. Sterling heads home to shower, and my mom & "chemo kitty" (a stuffed cat that a coworker brought me) accompanies me downstairs for my first chemo. My mom was supposed to fly out the next morning, but after talking about it she decides to change her flight to a day later, so she can stay until I am discharged tomorrow. They have decided to keep me in the hospital one more night so that they can observe me for any adverse reaction to the chemo.

The chemo I receive is the GIGAVECC protocol. Even though I already have an IV in my left hand, the cancer nurse insists on putting in her own. The good news is, chemo nurses have a reputation as being the very best at putting in IVs, and she gets it first time. First I get a cup full of anti-nausea pills. I am pleasantly surprised to learn that science has come a long way, and rather than puking for a week after chemo, the goal is that we find the right combo of anti-nausea drugs so I never experience nausea at all! My right arm with the new IV is wrapped in an electric blanket, while the nurse uses a huge syringe of bright red liquid to slowly push the first chemo drug Epirubicin. I am asked to tell her immediately if I feel any pain, because if the drug leaks out of my vein it will cause serious burns under my skin. Yikes - I struggle to not develop hypochondriac pain through the power of suggestion. Fortunately, the nurse also warns me that this drug turns your next pee bright red, otherwise my first trip to the bathroom after receiving it would have been very shocking! Next I get a bag of saline, followed by the Cisplatin. The final of the three chemo drugs, Capecitabine, is four pills a day, two with breakfast & two with dinner. I'm given a three week supply in three fancy blister-pack books. I'm to take my first dose with tonight's dinner, and my last with breakfast the morning before my next chemo session.

Not long after I am setup with the chemo, who should come by to see me but my GP. I was so stressed out seeing him, and I fired him. I told him that trust is very important, and that the way everything played out, I just couldn't trust him anymore, and that one of my coworkers had offered to help me find a new GP. He seemed very hurt & after we spoke he spent quite some time at the nurses station a few feet away filling out paperwork. I was very uncomfortable & couldn't look at him. I just held Sterling's hand & he kept having to reassure me that I had done the right thing. Months later I am still currently without a GP but am still convinced that this was the right decision for me to make. The very thought of the man promotes a negative emotional reaction throughout my body, not exactly conducive to healing! For now, the BC Cancer Agency has taken great care of me.

My first chemo session was also serious information overload. It was explained to me that the BC Cancer Agency has five professions that work as a team: doctors, nurses, pharmacists, nutritionist, and social workers. The last three all stopped by during the chemo to introduce themselves, what there role was in my treatment, and hand me a pile of paper to read. I ended up creating a whole binder I entitled my "Cancer Ass-Kicking Manual" for all this stuff.

Later that evening, after my mom had gone back to my house for the night, I felt so great (aka HIGH) that Sterling said if he hadn't seen the drugs administered for himself, he'd not have believed I'd had chemo. When we went for our evening walk, I decided to leave the floor for the first time. I wanted to see the Tim Hortons everyone kept disappearing to. As we walked past the main entrance to the hospital, I looked out and saw 15th avenue, and had the most surreal moment. That's a street I regularly drove home from work along. It felt like a whole other life, an alternative universe, but really it was only a week ago, and there it was right outside, just beyond the glass from this strange new life, this rabbit hole I'd fallen down.

That night at 7:57PM I updated FaceBook with: "Well, it's stomach cancer, not lymphoma. That's OK, just means a more epic battle & more glorious victory! Had my first chemo treatment this morning (11AM-4PM) and it wasn't too bad! Amazing team of doctors, nurses, social workers, nutritionists, and pharmacists in oncology... information overload, lots of handouts to read as homework. Kicking cancer's ass: I've started!"

Wednesday, 6th July 2011 Dr. Katakkar wants me to have a ECG (electrocardiogram) before I'm discharged, but the department won't return his phone calls. He seems quite frustrated, I think because he is used to running a clinic in the states, where when he wanted something, it was simply done & right away. Because I'm going to be discharged soon, I am moved from my private room to a shared room. I am finally eager to get home. Eventually it is decided that I'm not getting in for an ECG any time soon, so I'm free to go. Discharged, a disgusting sounding word for a lovely thing. We pack up all my stuff to move out, and I give the lady in the other bed my box of the good Kleenix a visitor had brought me & I wish her luck.

Before heading home we have to make a stop at London Drugs to fill my anti-nausea prescriptions. Then it's home... which is so clean thanks to my family that it's barely recognizable! I am glad to be back in my own space, and to see my kitties. Home, there really is no place like it.

Thursday, 7th July 2011 Mom's plane leaves at 6AM, so counting back we have to get up VERY early to take her to the airport. Both Mom & Sterling think I should get more sleep & not come to the airport, so I agree that we'll see if I'm up or not when they leave, and we say our goodbyes the night before just in case. But I'm awake, and insist on going to the airport. Later that day, at 12:54PM I update FaceBook: "I'm HOME! Discharged from the hospital yesterday afternoon. Trying to settle back into my space. The chemo seems to be kicking in, very tired today, slept most of the morning." Then at 6:54PM that night "FANTASTIC NEWS! 25% of patients with stomach cancer have a particular mutant gene. If you have it, they can add a targeted gene therapy to your chemo that improves your odds. My oncologist left a message this afternoon: I have it! :D Extra-sweet bonus: I'm a mutant, which means practically an X-Man, right?!"

So that's it, the story of my hospital stay! I have one more historical catchup post planned to bring my story completely up-to-date, and then I can actually blog "in the moment" which I think will be easier & more therapeutic for me. As always, thanks for reading!