Nature abhors a vacuum, and if I can only walk with sufficient carelessness I am sure to be filled. –Thoreau

There is a way that nature speaks, that land speaks. Most of the time we are simply not patient enough, quiet enough, to pay attention to the story. ~ Linda Hogan

We spend Sunday morning surrounded by the snap, snap, snap of strawberries being plucked by stem from vine, over and over, the sound crisp and clear in the air that hangs thick with river fog and the sweet scent of strawberries. The picking has been phenomenal this season, but today, the particular kind of strawberry we gather seems entirely worthy of the lavish attention its getting from the scattering of families, who easily fill four, five flats with the ripe fruit before heading home. At the center of everyone’s focus is a strawberry that seems quite quintessential in character--tidy and plucky off the stem, shapely, and brightly crimson in color, with a muted texture and sweet taste that tickles the tongue—a veritable starlet on this summer outing. We are lucky.

Thunderstorms have sent us inside, where we read on the red couch, watch the rain pour down the windows, and try to settle the dog, who has decided that Armageddon has come to play out its final battle on our lawn. I’m trying to take it easy, in between hulling strawberries and writing up our end of year progress report for the school district, but the booms and claps of thunder sound like calls to attention, and I’m trying desperately to figure out what I’m supposed to be doing.

I’m impatient, drowsy, and melancholy. I haven’t quite kicked off the residual effects of the anesthesia, or perhaps, it’s more than that, and the recriminations and tides of change have crept up and found me here, wondering when my light will shine again, this heavy blanket of slumber shadowy and still, obscuring the edges of my sunshine. Soon, soon, I tell myself, in pockets and patches and sunbursts it’ll come, at first a fleeting, shimmering display, then quieter, still, a soft glow radiating inward, and I’ll catch it with nimble fingers and set it to sing from my heart.

And so, I wait. I am used to waiting, but it is wearing on me. I skirt the edges of activity, try to maintain compliance, and follow doctor’s orders, but I have been forgetful. I reach for a pot hanging on the ceiling rack, and I reprimand myself. Let someone else get it for you. I lift a watermelon onto a cutting board, and feel the all too familiar pinch and roll of the fish flapping in my chest. Ouch, that didn't feel right. At night, I wake myself up just as I’m about to roll over to sleep on my left side. Nope, can’t do that. I feel like Hagrid spilling secrets to Ron, Harry and Hermione: Oops, shouldn’t have said that.

After my mastectomy, there was a lot of swelling, stiffness and intense soreness to stop me from putting my arms over my head, from lifting much of anything. I simply wasn’t able to do it, even if I wanted to. And I had no desire to toe the line. Self restraint came easy at first, and for the bulk of the first two weeks, as I walked about slowly and protectively, I rendered my left arm off-limits, keeping it quiet at my side, hand in pocket, and avoiding all temptation.

Later on, after my pec muscle had started to stop its twitching, it became harder to not want to resume my usual activity and get full mobility back—but I knew it would take an achingly long time. There was still ample discomfort to provide swift warning not to lift my fat cat, a pile of books, or a shopping bag loaded with groceries, or get on my bike and fly over the hills without a care. The repercussions were swift and furious.

Less than a week out of my last surgery, my new girl a mere five days old, I am already wondering how I’m going to make it through the next four weeks without totally screwing up. Dr. Pitts gave me plenty of warning—do anything rigorous, lift anything over five pounds with either side, stretch your arms overhead in the first two weeks, wear a bra, for god’s sake, and risk messing with the implant, which could move, change position, and assume the very lopsidedness that I was so desperately trying to avoid.

I’ve already put in a lot of jail time, and I have no desire to blow it. How would I ever forgive myself?

I’ve realized I need help in leaving this frustration behind, and staying the course.

For several days leading up to my last surgery, I saw turtles, it seems, everywhere. One morning, as I was pulling out of our driveway one morning, a huge turtle appeared on the road before me, about to make her way down the grassy slope towards the stream that runs on the edge of our property. We get a lot of visiting turtles in the springtime—usually snappers, but sometimes the more elusive wood turtle, now designated as a species-of-interest with a limited habitat (including, it seems, our specially-mapped wetlands) in the state. This one was attracting a lot of attention, and we made sure she made her way to safety.

One afternoon, the boys and I went on a long walk one day to the outer reaches of River Road and Pisgah, where the road turns rough and the trees start to fill in along the river. The tiniest of baby painted turtles—the size of a quarter—lay on the road, where it seemed to have been caught under a tire. Dominick scooped it up and cooed to it, hoping to revive it. Its little tail moving ever so slightly, we placed it gingerly in the tufted grass on the side of the road and wished it well, knowing that if we attempted to bring him home and valiantly nurse him back to health, he’d surely die by the time we got to the end of the road.

A few days later, we discovered a large painted turtle hanging out in our side garden, about to make her way under our deck. She was beautiful—the distinct orange and black markings stunningly artistic, her belly an unexpected orange. We ran inside to get our turtle book, but when we had returned, she was gone. We experienced much disappointment at not being able to spend more time with her: a missed opportunity.

The next evening, I was driving to Dominick’s baseball game in Northfield, and suddenly realized that the small gray thing plugging along the side of the road was a turtle, moving with much determination and focus, each stride deliberate, and, fortunately, just within the narrow shoulder. I slowed down to see it more closely—boxy, strong, motoring, it could be a snapper, looking to lay her eggs. I instantly feared for her life. A car could have easily squashed it. And who knows where she was headed—to the local market for a turkey sandwich? She’d have to cross the road. To the library to return some overdue books? (At least the library was on the same side of the road.)

So many turtles, so little time.

But if I listen, I can learn from these turtles that move ever so slowly through life, as if they know they’ve got all the time in the world--and they do. Don’t we all?

Turtles have long been associated with many things in many cultures—as a native symbol for Mother Earth, turtles can represent longevity, the female, an awakening to heightened sensitivities. The thirteen markings on its shell provided inspiration for the lunar calendar. Turtles have been thought to be the keepers of the doorways to the Faerie Realm, where the mysteries of the stirring of the senses take full flight. That's where we find our peace, after all.

Turtles, it seems, don’t have to work very hard to move with purpose and deliberation, each intentional step forward echoing their strong sense of groundedness within life, their feet solidly connected to earth. Perhaps I need to trust the catch and flow of the ground beneath me, immersing myself into this thing called life.

The wise old turtle carries its shell on its back, and when need be, when there’s trouble afoot, or when life becomes too much, he can retreat, pulling his head into the safety of his shell, and ponder things until all is clear. Perhaps there will be times when I need to go inside my shell, coming out only when my ideas are ready to be expressed.

Life gets busy, and the hectic pace quickly reaches a crescendo of disequilibrium if left unchecked. Things get topsy-turvy. We fly by the seat of our pants. We turn a blind eye to the opportunities around us. We miss out on the chances to tap into ourselves, restore our awareness, and reach for the abundance that is waiting. We lose sight of who we are—that primal, animal center of energy and connection to the natural world that lies, pulsating and awaiting release and renewal, within all of us, often neglected, forgotten, dismissed, diminished, belittled.

Perhaps the turtle can teach me some things about getting through the next four weeks—and the next forty years. Perhaps the turtle can teach all of us.

When life becomes too hectic, slow down. When you can no longer see the forest for the trees, sit back and open your eyes again to your surroundings. Take time to notice the little things—they matter. When your world upends itself, use your head and knowledge to right yourself. All that you need to know is within you. Let the natural flow work for you. Take your time. Revisit your own perceptions about time. Is your relationship to time a healthy one—or does it control you, spinning things out of control and away from the harmony that soothes our souls? Don’t expect to take giant steps; too much, too soon will only upset the balance. Pay attention, or you’ll miss our on opportunities. And when you need to, ask yourself: are you not hearing or seeing what you should? Are you or those around you not using discrimination? Are your senses awake, tingling, searching, keeping you grounded in this present moment?

The turtle reminds us that Mother Earth generously offers all that we need—but we need to be able to open ourselves up to it and in order to do that, we need to slow our pace, awaken our senses, and realize that we have all the time in the world. We can wait to pick up the cat, reach for the pot hanging from the ceiling, or stretch those arms overhead. We don’t have to figure out the big stuff all at once. Not just yet. There’ll be plenty of time for all that later.

I am grateful for the animal totems that frequently enter my world—and bring me back to a place inside that feels safe, true, and pure. There is peace in this place, an all-out sensory experience that instantly transports me back to being a child, visiting my great grandparent’s farm, and losing myself in the smell of hay, the rush of wind against the waves of grass, the stark quiet of place; searching for salamanders with friends during recess, when we’d focus all our attention on where they might be—with ears, eyes, hands, noses all tuned in, becoming a part of their world as we left ours, that wretched blacktop playground, behind; and holing up in a rocky crevice at my father’s beach for the afternoon, tasting the salt in the air, watching the sea birds spiraling and dodging currents and tides, and hunting for treasures amongst the tide pools: sea glass, crabs, star fish, sponges, periwinkles, and the perfectly smooth banded stones, wave worn and full of magic.

It’s the magic I’m after. But finding those doors to the Faerie Realm requires some serious work—quiet, reverent listening, noticing the little things, and maybe a little luck. I’ve got time. We all do.

Those who contemplate the beauty of the earth find reserves of strength that will endure as long as life lasts. ~ Rachel Carson

It’s a Girl! The Great Reveal and Other Detox Delights.

The path of life is the present.

I wake up with a mission: to jump-start the long, critical process of detoxing my body, regain my sense of balance, stop hallucinating, empty my bladder fully, restore functionality to my digestive system, get rid of the chemical taste in my mouth so I can actually enjoy food again, and get acquainted with my new girl.

First task: Get rid of the patch! After breakfast, I take off the transdermal scopolamine patch that’s been sitting behind my right ear since pre-op, when the anesthesia doc, in between hooking me up to the IV and running through my anesthesia history, carefully stuck it on, promising that it would minimize any residual feelings of nausea I might have post-op from the anesthesia. As much as I know it was a necessary piece of the surgery and my initial recovery, especially given how pitifully sensitive my stomach is to any kind of motion sickness (especially the drug-induced, midway ride, or whale watch kinds), it feels good to peel the patch off and throw it away. Those patches pack a lot of power in a very small space. Shaped like a small, circular band aid that you might use to cover a shaving nick on your leg, the patch feels like a bug crawling up my neck, or a deer tick burrowing in for some dinner, and time and time again, I’d scratch it away, only to realize too late, of course, that it was just the damn patch, and I’d have to rush off to wash my hands.

Apparently, whatever makes it so effective can also rub off on your fingers, and if your fingers come into contact with your eyes, it can do strange things, dilating your pupils and blurring your vision. In addition, there’s a host of other most excellent side effects, including drowsiness, disorientation, dry mouth, blurred vision, dilated pupils, confusion, hallucinations, difficulty urinating, and rash, that are associated with use of the scopolamine patch. Funny, but I’ve had all those symptoms since surgery on Tuesday, and as glad as I am to have a reason for them, it’s also a little frightening to think of how strong the medication must be in order to wreak such havoc on your system. Add in all the other meds—the touradol, the anti-nausea drugs, the anesthesia gas, the vicodin, the antibiotic, etc—and you’ve got yourself a pretty potent little brew. Hence, my mission.

When I finally do rid myself of the patch, it takes me a short while to regain my land legs, and initially, I find myself pitching about as if I were on a boat rollicking on the high seas. Jim wore a patch during the week we were traveling around the Galápagos Islands two summers ago; I think it worked brilliantly for him. If he was hallucinating, I wasn’t aware of it (actually, he thought he saw blue-footed boobies, but they were actually just pigeons, haha). The rest of us were downing Dramamine at dinner time, when the table would pitch back and forth in synch with the rough seas outside, and we’d have to steady the dishes from sliding across to the other side. By the time Mauricio, our guide, worked his way through his presentation as to what our schedule would be the next day, we’d be lost in a drowsy Dramamine haze, eyes drooping, head dropping and then snapping into alternating bursts of slumber and wakefulness. Whaddya say? More blue-footed boobies tomorrow?

Task two: Unwrap the bandages for the Great Reveal. I had taken a few sneaky peeks yesterday, trying to see what was making me itch so badly (maybe the patch, maybe the adhesive tape), but couldn’t see much, just the edge of the incision on the left side. I am eager to meet my new girl, to see what she looks like after all this time, and to see if I indeed have a matching pair. There was some relief in knowing that Dr. Pitts deemed the lift to my right breast unnecessary; my right girl would be intact, my left finally in tune with the right, party- porn girl Pamela Anderson evicted, and a new tenant—quiet, responsible, low-key—moved in. But hovering around me is a bit of anxiety, an annoying fly that I can’t quite swat away. What will she look like? Will she be bruised? Discolored? Will there be any other surprises—places where the adhesive tape has ripped off my skin, Dr. Pitts’ sharpie marks, any discharge leaking from the incision? Ewww...

I stand before the wide mirror in the upstairs bathroom. The wrapping is thick and tight. I start with the outermost layer, slowly unraveling it to its end. I stop to roll it up, taking my time, knowing that once it’s done, I’ll have to unwrap the rest. Thick surgical pads sit under the next layer of gauze. They are free of blood, and I think: this is a good sign. I don’t want to have to revisit the bruising and bleeding of my post-mastectomy girl, who truly needed all those pads for comfort and protection, and for crying her drain out.

I unwrap the rest and there she is: my new left girl, stunningly awesome, a perfect match for my right girl, in size and shape and droop and wiggle. Bravo, Dr. Pitts! Gone is the stiff rigidity of the expander, and in its place, lies a softer, more natural looking and feeling breast. Of course, they’ve been wrapped up so tightly for so long that they look slightly squashed, and as I check them out, I am at once struck with the hilarity of how small they really are, and I laugh out loud. It’s good to have my girls back. However small they are, they’re mine—and, they’re cancer-free. Bonus.

Task three: Take my first shower, hurrah! There is no bruising, no discoloration, just some dried blood along the incision. There is no pain, just some soreness that comes and goes to remind me to take it easy for a while. I don’t rush but I don’t linger, either. I wash my hair, easily reaching the top regions of scalp and pate, and I am happy for the lack of tenderness in my chest that made it so difficult to do much of anything after my last surgery. As I soap up around my chest, I give my new girl a little push, and she jiggles. I give my old girl a little push, and she, too, jiggles. Perfect.

Out of the shower, I’m wondering how long it will take for my girls to spring back to life after being strapped down for so long. I’m not allowed to wear a bra for another four weeks, so, I’ll have to make do with layering with tank tops, and somehow disguising the fact that I still only have one nipple. There are paste-on nipples you can buy for just such an occasion—when you’ve only got one, and you don’t want people staring at your chest, trying to make sense of what they’re seeing. But I don’t think I’ll bother with those; I figure, most women have subtle differences in their breasts and nipples that go unnoticed each and every day. And at a certain age, when you really start to feel like a Used Bagge, you just don’t give a hoot what people might think. For years, I never wore a bra, and even back then, I didn’t really care if my nipples were showing through or not. But when people know that you’ve had breast cancer and reconstruction surgery, their eyes will invariably travel to your right side and then your left, wondering, just what does a reconstructed breast look like?

My left girl is still a girl in progress, after all. In another two months, I’ll be able to get my nipple, and I won’t have to worry about whether anyone is wondering why my left girl looks so smooth and nipple-less, while my right girl is clearly saying hello!. And two months after that, I’ll get tattooed—color for the nipple and an instant areola, and maybe, if I can convince the tattoo artist, a lovely little lizard, too. Unlike the past two surgeries, the nipple construction will take place in Dr. Pitt’s office, not at NWH, under local anesthesia, not general. Here’s a horrible image: long ago, many male plastic surgeons used to take tissue from a woman’s labia (yes, labia, and if you don’t know where or what that is, you should refer to your old anatomy book and make a date to acquaint yourself with your vagina, or, as my family likes to call it, your pookie) to construct her nipple. Can you imagine? Doesn’t that make you want to grab your crotch and never let go? Ouch!! In recent years, docs have used skin grafting techniques, taking skin from the inner thigh to create a new nipple. Dr. Pitts has said that skin from the inner thigh just doesn’t feel or look enough like the real thing, and that she prefers using skin from the breast itself to form the nipple. Makes good sense to me. Just as long as it’s not my labia!

Task four: Pick more strawberries. Get out in the sunshine. Breathe in some fresh air. Expel gunk from lungs. My mother, Luke, Dominick and I take our time filling our boxes with berries. The picking is exceptionally good this year, and it’s easy to overflow a quart container without having to move an inch down the row. It’s the perfect activity: calming, meditative, delicious, leisurely, and fun. We run into friends and get caught up while the kids start to stain their lips and finger tips and shirts with berry juice. A reporter from the local paper shows up to ask us questions: how long have we been picking at Upinngil? (ever since we can remember) What is our favorite variety? (the non-rotten kind) What do we do with the ones we pick? (throw them at annoying reporters) Yadda, yadda. A photographer shows up to snap away while we’re gleaning the rows. I almost tell him to take a picture of my new girl. First photo-op! Or not. I forget myself. No one cares about your girl, I tell myself, and frankly, we’re all getting sick and tired of hearing about it all the time, so shuddup already! It’s about the strawberries, after all. We’ve picked twenty one pounds. We grab some shortcake biscuits from the Honey House on the way out, and plan on a veritable strawberry feast at dinner time.

My cousin Susan arrives for an unexpected visit in the early afternoon. It’s so great to see her. As we sit and talk and laugh, I am acutely aware of the how much healing power resides in simply being with people you love and who make you laugh, pulling you outside yourself for just a few moments, to air out your worries, and help you remember that you will feel better tomorrow, and even better the day after.

Task five: Move that blocked chi along! My mother drops me off at my acupuncturist’s office in the afternoon. Dan’s a quiet, unassuming, kind man who makes me feel like a chatterbox, prattling on and on about my new girl, about my bloated belly, the hallucinations, my sluggish system. I take to the quiet of the table and welcome the rush of the needles as they find and release stagnant pools of energy. I count ten needles in all. Ah, I have some work to do. I close my eyes and the faces appear around me. They are unrecognizable, looming over me, morphing into other faces. Are they left over from the masked faces that surrounded me in the OR? My spirit guides come to tell me something? I breathe deeply, and focus on the street sounds spilling into the room from outside. Within minutes, I am falling into a deeper level of consciousness. One by one, the sounds peel away, baring the quiet and stillness of my soul. The faces are gone. It’s just me now, feeling the tug and flow of energy up and down the currents that crackle and rage with life force. Time slips away…

Dan comes back into the room to remove the needles, recheck my pulses; I am ushered back into body and room, where the sounds reappear, and I am once again here. My mother waits for me in the lobby. I can feel things starting to move again. We head home to round up dinner, and get the strawberries ready for the shortcake. It’s really the only thing to do on this day. The promise of Friday's Summer Solstice suffuses the night sky with an excess of light, the orange sun taking its time to drop over the horizon. The sky is so beautiful with clouds and colors and light that I hope someone, somewhere, is painting it.

Task six: Sleep. Heal. Dream. Ask the faces what they want. Then ask them to please leave me alone. Sleep through the dog's barking, the boys coming into the house after spending another night in the tent, the roar of trucks pulling up over the hill, the birdsongs filling the skies. Wake up and feel better, knowing that everything is going to be okay. Believe it. Trust it. Surrender to it. Embrace it. Leave the fear behind.

You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. ~ Eleanor Roosevelt

Always laugh when you can, it's cheaper than medicine.

It’s Monday afternoon. My mother and I arrive at the Newton Marriott, same hotel as before, but a decidedly different room. I instantly feel the associative energy from being there the night before my mastectomy. Dread. Anticipation. Loneliness. Courage.

There is no view of the river this time, just the empty end of the parking lot, where a lone cop, his car parked under the trees, sleeps off his recent donut binge. There will be no lovely white swan coming over to greet us this time, just a small clumsy bird careening into the broad window outside of our room before flying off, apparently unharmed. What am I supposed to take from that?

We picnic in our room and watch some silly TV before retiring to bed with our books. I think I’m ready to sleep, but as soon as the light goes off, my head starts to whirl. Maybe I’m missing my blue light, or the comfort of my own bed, or perhaps all my anxieties leading up to this next surgery have finally found me, nestled in a quiet moment of repose, and have sprung their malevolent gossip on me.

It’s early Tuesday morning. I’ve woken with the sun that shines through the curtains to bathe the room and spring me from my eerie dreams. I doze off until about 5:45 to take my Tamoxifen and drink a good spat of water. I have slept only in snatches, here and there, struggling at first to quiet my quickening pulse and deepen my breathing, and later, to find some semblance of comfort in the overly warm bundle of bedding that bunches around me in a sort of suffocation. I slide back under the uppermost layers of sleep, and dream I am nursing Dominick, and then Luke, both toddlers again. And they’ve been cranky and sad and afraid, and when I put each of them to my breast, left side of course, the troubled look in their eyes vanish, and I suddenly realize why they’ve been so out of sorts. But of course!, I tell myself, I’ve been forgetting to nurse them.

That’s the trick of parenting, isn’t it? Knowing how to “nurse” your children long after they’ve stopped nursing? There’s an art to knowing how to calm their fears, soothe their anger and frustrations, stay connected, and show them how much you love them each and every day, no matter what’s going on or how crazy they’re making you feel. It was so much easier when I could just snuggle with them on my lap, attach them to a nipple, and watch their worries disappear. If only it could be that simple now! I am aware that the dream is processing this next phase of finality—of losing my breast, of teetering on the edge of having to watch my kids grow up and go, Luke pushing away only to pull back again, those tethers tenuous at best, the letting go paramoun to the inevitable loss. It's just so painful sometimes.

Overnight, I’ve felt the pinch of guilt—or perhaps it’s regret—and I’ve been wanting to go back and be kinder to the expander that’s helped me grow my new girl. Like one of those ugly, modular, temporary classroom buildings they often erect until the new, more-fabulous, permanent one can be constructed, the expander has done its job, after all, stretching the skin and pectoral muscle to create a pocket of space for the new implant, with a little extra skin for the natural droop and softness of comport that will help my new girl look more like a real breast, and not some freakishly hard, overstuffed artificial entity.

I suppose I didn’t want to sound ungrateful, because I am, and as much as I’ve complained about her, I know she’s been necessary, a real critical part of this reconstruction process, and for all her hard work—I salute her.

Ok, now she can go.

We’ve arrived at the Surgical Center at NWH. I’m always amazed at what I don’t remember from the last time: the route we take from the Marriott to NWH looks totally unfamiliar, and I realize how so many things slip away and off your radar when you’re focused on something else. I sit only long enough to read a bit about Paul Pierce in the newspaper, and then am hustled into the pre-op area, where I don the usual: hideous johnnie gown, gray no-slip socks, and sexy blue shower cap. The first nurse tries to get the IV set up in a vein on my right hand, but gives up after only one or two tries, declares my veins “delicate,” and leaves it to the anesthesiologist nurse to figure out. Delicate? Me? Can you have a pelvis like a mach truck and still be delicate?

Dr. Pitts arrives with her black sharpie in hand. She encircles the old incision, and points out the tiny bump, a slight puckering of the skin on the upper edge of the scar left over from the mastectomy, that she’ll smooth out during today’s surgery, thereby erasing all traces of the skin-stretching that took place over these past two and a half months. She makes a crescent moon-shaped sliver around the top part of my areola on my right breast where she will perform the lift—but explains that she’ll only do it if absolutely necessary; if the girls are well enough matched, then it won’t be worth the scar to have the lift done. I tell her that I will leave it up to her best judgment. I’ve realized that there are far more important things to think about. I refuse to get hung up on something so trivial. Lift or no lift, it really doesn’t matter that much to me.

The anesthesiologist arrives—an older man, and a Brit, judging from his accent. He is kind, wraps a warm towel around up my right arm to plump up my veins. A short while later, his assistant comes in and successfully gets the IV started, dispelling all rumors about my so-called delicate veins. She tells me I have big, juicy veins. Could have been a junkie (though I’m awfully glad I’m not). The nurse herself is a recent breast cancer survivor, and we share a few tales while she’s needling my veins. It’s always reassuring to meet other women who have beaten back the breast cancer beast, and are living their lives cancer-free and on their own terms.

When the OR opens up, things move quickly. I say good-bye to my mother, whose eyes have filled with tears, and the nurses wrap my lower legs with the pulsating squeeze action to pump blood throughout my body, lessening the risk of blood clots forming and working any mischief. They start the drip, drip of the sedative, and I try to keep the conversation going, but more likely, I am merely spouting gobbledygook, and they are rolling their eyes.

Suddenly, I am coming to. Big lights swing overhead; I am still in the OR. I feel them scrubbing my left side. “I think I woke up too early,” I say. “Don’t worry about it. We’re pretty much done here.” I feel like a floppy doll as they lift my head and torso off the table and wrap me up tightly. There is a sense of hustle and bustle. They are not rough, but they are not gentle, either. Efficiency has taken over. The oxygen mask rounds down on me, filling my system with an intense chemical smell that fries my lungs. Amidst all the shower caps and surgical masks, I see eyes only. People are talking around me and about me but not to me. They lift me from operating room table to a gurney, and I am wheeled to the first recovery area.

I think the clock says 12:30, but my eyes are pretty shot. I don’t remember much about being in the first recovery area, other than that my voice is husky with all the meds and I keep having to repeat myself. I start to feel some pain on my left side; despite my best efforts to ask for something less sinister, they administer some fast-acting morphine. This loss of control inherent in my best-laid recovery plan reminds me of the first birthing plan I concocted before Luke was born—full of the very best intentions to keep the labor as healthy and natural as possible—and how once labor set in, and I found myself hooked up to the monitors, reeling with Pitocin, and begging for something to help take the edge off, the birthing plan was suddenly blown to smithereens. After the morphine, Toradol, a liquid form of motrin, flows through the IV. Slowly, I claw my way to the outer reaches of awareness.

Once I’ve been moved to the outer edge of the recovery circle, where I sit in a recliner and try to navigate through the fog in my head, they offer me something to drink. My whiskey voice is weak. Cranberry juice, please, I croak. Pitiful. They bring me some saltines that glom and stick in my dry Morphine mouth. They bring over Vicodin, another glass of water. My mother arrives, carrying some pink roses from my father, who is visiting a friend but will stop in later. I ask for my hair brush—my hair, wet when I arrived, has dried in a tangled mess of curls. It feels good to brush it out and feel a little more dignified. You quickly learn that it’s the little things that matter—and dignity ranks high on the list when you’re sporting disposable underpants under an ugly johnnie gown, and you’re looking—and feeling—a little bit like a truck has quite run you over, and somehow, you’ve peeled yourself up and off the asphalt and are sitting there, wondering what to do next.

My mother reports that Dr. Pitts decided not to give my right girl a lift, that the expander—and now the implant—was positioned so well that she thought it just wouldn’t be worth having the scar around the right areola. I appreciate her decision for respecting who I am and anticipating what would feel best for me. That doesn’t always happen in the medical world. I’m also relieved, because it means my girls will get along without having to force the issue, and that my right girl may still be girlish enough to keep up with the left. And the more I talk with women, it seems that most of us aren’t perfectly symmetrical anyway, that nursing our babies, who invariably favor a side, creates an imbalance that often stays with us for the rest of our lives. And then there’s gravity! Imperfect, asymmetrical breasts are just one more of those well-earned vestiges of life experience, along with our scars and wrinkles, which I think most of us would never want to part with.

My father arrives just as the nurses are starting to crank out the paperwork. I walk to the bathroom, gingerly, with the help of a nurse, who carries my IV bag and makes sure I don’t caterwaul through the hallway. As I attempt to empty my bladder, I am reminded, again, of how much all my systems have slowed, and how much time it will take for the body to restore functionality and rebound fully. I change out of my hospital garb into more comfortable clothes, sign a few papers, and climb into a wheelchair. Eviction complete, it’s time to go.

I brace myself for the long ride home. I have not been looking forward to this, but the pain meds have done their job, and I feel okay. We drive through bubbles of stop and go traffic early along Route 2, but for the most part, it is smooth enough for me to write a little in my notebook, before breaching the wall of some strange kind of sleep to doze the rest of the way.

At home, I am glad for hugs from the boys and big wet sloppy kisses from Daisy, but I feel exhausted, a little nauseated, despite the Scopalmine patch behind my ear, and head-trippy. All I want to do is retreat to my room, find some quiet within. I’m tapping into a strange sensation of hovering between layers of wakefulness and some other level of consciousness that borders on hallucination and total flip city. I can’t sleep--my head instantly fills with imagery that makes me think I’ve gone totally insane. I can’t watch TV or a movie—it seems overly chaotic and loud, and only adds to the over-stimulation that courses through my veins. And I can’t read—the words are jumping all over the page, and my eyes can’t seem to still them long enough to actually understand what they are saying. On my bed, I lie on my back, knees up, eyes closed, but the effect is so strange that I get up and head outside to sit on the porch, trying to find some kind of center. The clouds have cleared out, and a light breeze sings through the trees, their tops ablaze with afternoon sun. I am content to just sit and feel the sun, and listen to the wind and the birds settling in for the night. It’s nice not to have to do anything at all.

At bedtime, I go to sleep reluctantly, my body screaming at me to give it rest and sleep, my heart urging me to stay up late to watch the Celtics game, my head playing broker to the two. My head, of course, wins out, its logic prevailing over the longing of my heart, to see the awesome Celtics crush the Lakers. I sleep fairly well, waking up at some point to down another blasted Vicodin, and resisting the temptation to turn on the TV and see who won.

This morning, I am subdued, trying to shake the hangover off and find some enjoyment in the day. I am moving slowly, but am feeling so much stronger than I did after my last surgery that I have convinced myself that this will be a much speedier recovery. There is much relief in knowing that my bandages do not have to be changed today, and that when I do remove them tomorrow, I will not have to deal with the shock of having lost my breast, only the joy of greeting a new girl. Both Dr. Pitt’s office and the NWH nurses have called, checking in to see how I’m feeling. Just fine, thanks, just a little constipated, bleary-eyed and nauseated. Nothing I can’t handle. I haven’t taken any more pain meds today, intent as I am to clear all the meds out of my system as fast as I can. My eyes are still funky, my lungs gunked up, my legs a bit unsteady, my throat sore and sticky from the breathing tube and anesthesia drugs. My Morphine mouth comes and goes, and my voice sounds like I was sucking down Thai gin-tinis and Tequila in my IV bag at some all night party. But it’s all good.

I’ve received several gifts today—emails from people I haven’t heard from in a long while, who wrote to add their good Juju to the mix, giving me a much-needed lift, urging me on. The best tonic of all was hearing how the Celtics demolished the Lakers last night in the final game of the championships. I have watched highlights. The sheer genius of Paul Pierce, the return of the shooters, the great defense that stymied the Laker’s usual prowess on the court. And the best part? The post-game jumping hug circle, of course. Ah, the power of Ubuntu!

This week and next, I will have to restrain from reaching for the pots and pans above my head, picking up the cat, or chasing a Frisbee down. For another four weeks, I’ll have to stay off my bike, resist the urge to play tennis, and sleep on my right side only. But tomorrow I see my acupuncturist again, and I’ll continue with PT as soon as I am up to it. I’m confident that I won’t have to take any more Vicodin, that my systems will clean out and re-energize with rest and good food, and that I’ll be feeling much more like myself in just a few days. Things take time, if you’ve got it to spare. Paul Pierce waited all those years for a championship. I can wait a little longer for my trophy. One step at a time. I'll worry about the What's Next later. For now, that means watching the thunder clouds roll in while I try to catch a little nap.

Be well, and remember: Anything is possible ~ Kevin Garnett

Ara Mi Le--My Whole Self is Well, There is Nothing Wrong with ME.

It's Monday morning, the day before my next surgery. Jim has gone to work, another day, another day. The boys and I are scavenging breakfast, getting ready to head next door to pick a load of strawberries to freeze for color and sustenance during the bleak winter months. Somehow, amidst continuing our homeschooling projects, picking, washing, and hulling fourteen pounds of strawberries for the freezer, and arranging my physical space for a comfortable re-entry on Wednesday, I must try to quell my rising anxieties about surgery tomorrow, put my head to the right tilt, and get ready.

As I prepare for my voyage to the suburban sprawl of Route 128 and Newton-Wellesley Hospital later this afternoon, I've been trying to decide

1. what to pack
2. what to worry about
3. what not to worry about.

The packing is easy--Tamoxifen, Vicodin, Cephalexin, Milk of Magnesia, tank tops (my beautiful new bras, unfortunately, have to stay locked up for another four weeks), comfortable pants and loose-fitting tops, tampax (yes, it seems the stars are aligned for my cycle to be in perfect tune with that of the moon and the surgeon's schedule), my current can't-put-down Jodi Picoult book, a few tokens of Juju spirit, love and friendship, and the usual assortment of personal care products that will not help me in any way look less bruised and exhausted after the surgery, but which I will bring with me nonetheless because it's okay to pretend, after all, that you don't look like hell when you really do.

The worries are there, and though I've put them on the back burner, they seem to percolate every now and then, nudging and prodding for attention when I am trying not to give them any. I don't even care to talk about them now. I'm doing my best not to give them the spotlight.

There's plenty to not worry about. I am in good hands. I am healthy. I will heal quickly. I am strong. I will have matching girls soon. I will be fine. After all, my doc is the best, and NWH is clean, comfortable, state of the art, completely prepared to set my old girl free and exchange her for a new girl, with a more winsome personality and perky appearance, without incident or accident or any sort of "dent" at all. The procedure will go swimmingly, and Dr. Pitts will marvel over how perfectly the surgery goes--on schedule, easy out, easy in, new implant in place on the left and gentle lift to the right, and all things symmetrical. Not perfection, but something akin to it. It's all anyone can hope for.

I suppose I'd like not to worry, about waking up from anesthesia (going to sleep is the easy part), hearing the guy next to me snoring, trying to focus my eyes and remember where I am, wondering why I feel like I've been sucking down tequila from shot glasses all night. But I do worry about all that. A little. Sometimes a lot, but usually not so much. Just enough to keep my stomach aflutter, and my breath aware of the need to expand outward and inward, deeper, deeper.


I'd like to ask the nurses to fill my IV bags with Thai Gin-tinis from Hope & Olive, but I'm sure they'd look at me funny, and I'd be forced to spend the remainder of my pre-op session trying to convince them that I wasn't a lush, after all, just a girl (ok, woman) filled with a yearning for simpler days.


Ironically, at Hope & Olive last night, where we enjoyed a delicious father's day dinner, the featured drink was tequila with grapefruit soda. I was tempted, I will admit, but thought my stomach would lurch at the all-too familiar heavy sweetness of the agave, the tongue-numbing, throat-burning sting of the final nip sips, the blessed, blissed out spin of the head towards the end of WWRFC occifer's meetings. Well, if only...(are johnnie gowns actually made of cotton?). I will not worry about it. Thai Gin-tinis on the other hand...

My friend Sonja, a fellow Used Bagge, sent me the above card after my last surgery. I'm sure she knew I would enjoy it, and I did. I stopped drinking when I was about 26, partly because I found out that I am allergic to alcohol (an epiphany that explained the hives that started to show up my freshman year after particularly rabid nights of imbibing, which I justified by telling myself that I was only allergic to beer at first, and then, when the hives reappeared after sharing a bottle of some cheap red wine, maybe beer and wine, and then gin, the beloved tequila, the slippery nipples, the little nips of warming peppermint schnapps that I kept in my long, striped rugby socks when playing fullback on the cold, hard pitch, waiting for someone to tackle, or for the ball to come my way, all crossed off my list, until pathetically, I was down to drinking Kamikazes, and then, nothing, and just the glow of sobriety about me for about six months--of heading out to the parties, enjoying myself sans drinks, and chuckling the next day when I would run into someone who would regale me with stories of how "wasted" I had been the night before. Uh-huh, sure I was.) and partly because it seemed like the right thing to do, given a blazing trail of alcoholism on both sides of the family that, as an inherited trait or predisposition, was starting to make itself known. In the last fifteen years, I've probably had about a half a dozen drinks, mostly gin and tonics, once a summer, or a Thai gin-tini from the lovely bar at Hope & Olive, and I've enjoyed them all, and while I have not suffered through any more hives, I am acutely aware of its power, and, like an untrustworthy old friend trying to get back into my life, I keep it at an arm's length, a comfortable distance.

My friend Clinton said that he imagined that "the cancer-survival experience must be a bit like the getting sober experience - there's a before and an after, and the two are really nothing alike. Nothing has changed, but everything has changed." I think he's right. We all have our befores and afters, those times in our lives when we've had to take a big leap forward, traverse the rapids, walk the spindly ladder bridge across the chasm, admonish our excesses, the deprivations, and neglect, and turn a corner in a search for answers, change, peace.

If I can keep my head up, perhaps I'll discover the remnants of a life lived without regrets, excesses, mistakes, and all. As Clinton reminded me (via this Lloyd-George quote), "You can't cross a chasm in two small jumps." And this, strangely, from the "Father of the hydrogen bomb, "When you come to the end of all the light you know, and it's time to step into the darkness of the unknown, faith is knowing that one of two things shall happen: Either you will be given something solid to stand on or you will be taught to fly."

I'm still finding my courage...one of these days...

Astrologically speaking, the time is ripe, of course, with the energy of Wednesday's Full Moon, Thursday morning's shift by Mercury into direct motion, and Friday's Summer Solistice, when the center of the solar system (the Sun) and the outer regions of our celestial home (Pluto) form their annual polarity, all convening to create a fiery, emotional time laden with opportunities, for leaving behind all that is no longer working, and adopting new patterns of growth and change.

“Right now you're the chrysalis breaking free of your old cocoon. You're feeling the winds of change blowing, but on the surface it may not look like much is happening. This is a delicate stage in your process of transformation. The chrysalis must sit and allow its wings to dry just the right amount of time so strength and success on its beautiful butterfly journey will be assured.”

It's interesting to me that my surgery--when this uncomfortable expander, that has clearly over-stayed its welcome, will be replaced by a new girl--is landing on a day when these extreme energy-fields in the cosmos are encouraging me to lose the old and move forward into the new, with open heart and mind. I am eager for this to be over and done with. I am eager to receive the energy of the after. My left side has been talking to me a lot in the past few days, the strange numbness in my shoulder and under-arm area intensifying the awkwardness of the expander's edge, that seems to dig ever deeper into ribs, over-stretching my skin, escalating into a feeling of just wanting to get it out. Time to go. Sayonara. Ciao, baby.

Just the other day, I received an email from a woman who had heard about my blog from a friend of hers who knew my mother; she herself had just been diagnosed with breast cancer in April, and has been reading the Flip Side for about a month. It means a lot to me that anyone reads the blog, these often-hastily scribbled brain drains and ruminations of the heart, and it means more when people respond to something I've written, because it lets me know that I am not, after all, alone, that someone out there is listening. So, when I heard from this kind woman, I realized that if I've been able to alleviate the fears of even one person going through this, then I've done something right. Her words came at a time when I was starting to lose my breath, feeling as if I was going under again, wondering where to find some light, a land line, a hand to hold. And her words offered me just that, uplifting me, and giving me courage, and I am grateful. "I wanted to tell you two things, " she wrote. "One, your words have helped me have the courage to accept all that is happening to me. Two, I want to wish you all the best for your surgery on Tuesday. You are not alone and my thoughts will be with you." Thank you, Maribeth. You have no idea just how much that means to me.

It's time for me to go pack my toothbrush, change out of my strawberry-picking shorts, and say good bye to the boys. I'll be in touch as soon as I can. My mother is arriving any minute to drive me to Newton, where we'll spend the night at the Marriott just a few miles from the hospital, wake up early, and head over to pre-op, to change into the lovely hospital garb, the johnnies, no-slip socks and voluminous blue hair net, volley the endless questions about name, birth date, and which side they'll be working their magic on, summon my inner warrior once again to face the demons of doubt and fear head on, and finally, relax into the pulse of good Juju flowing my way (thanks in advance for any you can muster!) and the drip, drip, drip of the sedative starting to flow through my veins. After surgery, which should take a couple of hours, and recovery, which should take a few more, I should be free to go, as long as everything is working as it should be (hence, the Milk of Magnesia), and return home, a long, bumpy two hour drive along route 2 that I could typically drive using just my knees--but that tomorrow, I will leave to my mother and her trusty Honda civic hybrid. I hope to be home by nightfall, to kiss the boys good night before slipping into a Vicodin-induced slumber. All good.

Everyone keeps telling me to laugh, laugh! to speed up the healing process and feel better sooner. In that spirit, I'd like to share a few links to some hilarity and creativity that we've been enjoying today: I will Survive! http://www.youtube.com/watch?v=fN1dPtEph2U

Hit me, hit me, with a little chick pea: http://www.youtube.com/watch?v=nIybz6axr1Q&feature=bzb302

New animation by Blu…Harold and the Purple Crayon for the older set: http://www.youtube.com/watch?v=uuGaqLT-gO4

And finally, http://www.youtube.com/watch?v=qo1d6ttbAq8&feature=related

I leave you with words that Maribeth sent my way. They came to her via her djembe drum teacher: "Ara Mi Le" - My whole self is well, there is nothing wrong with ME.

With love,

Liz

Always Hold a Used Bagge by the Bottom

My poor chemical-laden dog Daisy is sleeping off her nasty meds in the shade; she's suffering, slightly, at least until a ball or frisbee appears, through her latest application of Advantix, that cursed, blessed combination of toxic gunk that keeps the fleas and ticks away but leaves her wondering why she feels like hell. I know how she feels. I have been aware that my next surgery, when I'll trade in expander for implant on the left, and refurbish the right with a slight lift, is fast approaching, and that soon I too will be trying to sleep off the nasty meds in the shade, and wondering why I feel like hell.

I have not wanted to think too much about it, because when I do, all I can see is the night nurse coming in to catheterize me, the endless parade of nurses and doctors, asking me my name and taking my vitals over and over again, filling me up with meds, disguised in drip bags and brightly colored pills...and those first impressions of my scar--the alien ugliness and strange, alarming beauty of the violent bursts of color on my chest, spiraling through the bruise cycle--that still haunt me in the mirror.


I have buzzed through my week, making preparations, running errands, and trying to organize things in a pathetic attempt to exert some kind of control over the images that haunt my waking steps and infiltrate my better dreams. It's a futile exercise, but somehow, it lends an illusion of control to make these days leading up to Tuesday infinitely more do-able. Otherwise, I'd be entrenched in my anxiety--about what's to come, about what I don't know, about what I do know, about what I've experienced before, and don't necessarily want to experience again. Part of it is not wanting to relinquish even the illusion of control come the 17th, when I must surrender to the Anesthesia gods and fantasize about filling the drip bag with tequila. And this, from an ex-party girl who stopped sucking down bottles of Jose' years and years ago! But wouldn't it be nice?

Just this morning, the buzz intensified. It was the kind of day that made me wonder how I got through it without stealing sips from a nip tucked away in a pocket. (Pathetic! I've never done that! Well--only when I used to get cold playing fullback for the WWRFC). After speed-picking several quarts of fat juicy strawberries with Dominick to start the day off just right (though it would have been better if we could have lingered), we took Luke to his doctor's appointment at 9:15, where he was finally able to remove the splint he's been wearing for the past six weeks to repair a ruptured ligament (basketball injury). Just an hour later, we had already hightailed it to the local food co-op, where we cashed in some coupons for free stuff (it's a bit like getting free gas these days) and marveled at the kindness of strangers (a nice lady offered Luke a quarter when the meter maid came by to evict him from the parked car and make him pay up), dropped off camp forms at the pediatrician's office, made a deposit at the bank, and finally, went to the library, where we returned some books that were wretchedly late (and again, kindness shone forth, as the librarian waived all fines, hurrah!) and picked out a bunch of new ones before heading home for lunch, more reading, and working on their ancient civ projects. At the end, I should have been hanging together by mere threads, my typical evening unraveling, but somehow, the hustle and bustle of the day worked, to quell the spasms of anxiety about not being organized, to dispel the inner strife around balance and free will and creativity, and compel me to cook a big dinner, and dessert to boot. Where did all this energy come from? Of course, it could very well be an illusion--and I'm actually exhausted, and am indeed unraveling as we speak, but just don't know it yet, and won't until Tuesday, when I'll welcome the sedative into my system like an old friend and slip into neverland, hand in hand, to worship the Anesthesia gods. I'll probably do that anyway, exhausted or energized. I have learned never to say no to a little, ah, rest.

There are signs that this current buzz will soon spin to a halt. Luke takes the SSATs tomorrow, signaling the end of a long spring of preparation and hard work. Dominick's baseball season has officially wound down; the only thing left to do is to scrub the grass stains out of the knees and return the uniform. We're eating salad greens and kale and chard and herbs out of our garden, and there are more vegetables announcing themselves each day. And the boys are fully entrenched in summer reading mode--I can't get their noses out of their books for much, except, perhaps, some frisbee on the lawn or fresh-out-of-the-oven strawberry rhubarb crisp. It's a wonderful thing, when they move from book to book (Dominick has three going right now), series to series, devouring page after page, always ready and eager for more, and seemingly blind to the vast number of distractions that could wreak instant havoc on their best-laid summer reading plans (for instance, a new PS2 game, the latest Celtics-Lakers UBUNTU! fest, or the season finale of Top Chef...). They read in the car, in the waiting room, during breakfast (yes, we all read at the table sometimes), on the couch, at the picnic table, under the tree, on the porch, in bed...

I wish I could join them. Soon enough...

It seems the hardest part is giving up being able to do whatever I have wanted to do--physically--for another four weeks post-op. After working hard to gain some strength and stamina back since my last surgery, I worry about losing it all over again. I started PT last week, and have made strides in easing the chronic hip, back, and knee pain that was nudging me towards early retirement from all contact sports (it was my future boxing career that I believed was most in peril). I even played squash last weekend, when Jim, the boys and I spent Saturday in Williamstown with my mother, eating far too much Indian food at Spice Root, crashing the class of '88's reunion, and yes, donning the dorky protective eye wear and hitting the crap out of the little blue ball in the white walled, red striped court that always makes me feel a little boxed in and happily insane (it's a good sport). My but-tocks were sore as heck from all that bending and reaching and kicking some 13-year old butt (it does feel good to still be able to beat Luke at something), but it was a good kind of sore, emanating from the depths of my hips and nates and speaking to me in a kindly way, Hey Liz! Yeah, we're a little out of shape, but thanks for taking us out for a spin! Of course, we only hear what we want to hear. They could very well have been saying, Liz, you fat shit! What the hell are you trying to do, kill us? Yadda-yadda. Whatever. They've recovered, and have stopped whining, and no matter what they were telling me, it felt good, and my girls, good girls that they are, didn't complain at all.

I was glad to squeeze some squash in, amidst the bicycling and frisbee and general running amok we've been doing, and survive it. And more than that, I was thrilled to see some old friends at Williams that weekend, and to reconnect with the spirit of our time there, when the most I worried about my girls was whether my strapless dress would stay up during the Homecoming dance. Most especially, I enjoyed seeing a healthy cache of my old Dennett House charges and fellow Used Bagges from the WWRFC, who still, after all these years, continue to lighten my load, brighten my gloomier days, and put a smile back on my face. In their honor, I wore an old rugby shirt to my PT appointment last week. The receptionist chuckled, "Oh, I love your shirt. Always hold a Used Bagg-ie by the bottom. " Baggie? I didn't have the heart to tell her that the Bagge was simply pronounced bag. I figured it didn't matter a bit. I headed into the PT room, where Laura, my therapist, started to work on my squash-tight butt muscles, digging her elbow into the side of my bottom, where the pain seared, spread, and then dissipated as I screamed silently into the pillow. Used Bagge indeed.

In addition to PT, I've also started to see an acupuncturist, and had my first session yesterday. After slipping into a deep relaxation for about twenty-five minutes, seven needles stuck in various points in my body, dislodging all that stuck, cranky chi so that it could flow freely throughout my body, I was finally able to see what all the fuss is about. I could easily become a needle-addict. All that blissed out serenity! Geez, where have I been? I could get used to that.

Tonight, we're enjoying the first strawberry rhubarb crisp of the season, our own little slice of rapturous delight. Needles? Who needs needles? Dominick has just asked me if I'd like some "Napoleon" on it. Napoleon? With his dirty little war-torn feet? No, but I'll take a scoop of Neapolitan, thank you.

Little by little, we are savoring the best of the season, jogging the memory, re-igniting the senses, and reminding ourselves of just why we live here. This time of year, the succulence of the strawberries is just the beginning. Just this week, we were treated to the whip of new air that filled and refreshed the house after a wicked, awesome thunderstorm that lit up the skies, still thick with the rumble and release of heat and humidity that had stuck to us like melted chocolate for three days. We've stained the tips of our fingers pink with the juice of the new strawberry season. We've swum in Laurel Lake, caught newts in a bottle, and brought enough sand home in our shoes to create our own beach. I even tried a bathing suit on--actually, I tried on all of my bathing suits--but none of them worked, at all--so decided instead to swim in my bra, surf shirt and shorts. I was a little overdressed, but at least my left girl wasn't shouting out Look at me! Look how much bigger I am than that one! Oy.

Thanks to the encouragement of friends, I have decided to go ahead with the lift on the right side--it's my best bet for not having to worry about having mis-matched girls. After all, I'm done with the invincible thing. And this Used Bagge needs to be held by the bottom--and the top, too, apparently, so my girls don't spill out and cause a ruckus. I'll leave all that to the younger set. As Dominick said the other day, "Actually, they sent me down from outer space to hypnotize you with my belly dancing." It explained a lot, actually.