Woo Cannot Fail, It Can Only Be Failed

Yesterday, the alternative health universe lost one of its stars, a charismatic Australian woman named Jess Ainscough, better known as the "Wellness Warrior". She died at the young age of thirty after seven years of trying to cure her very rare form of cancer by eschewing traditional cancer treatments and opting for alternative therapies, such as Gerson therapy which requires lovely things such as coffee enemas every four hours.

Jessica's death upset me. Dying at thirty before having kids, before marrying her honey, and before realizing so many dreams is a human tragedy. Also though, I am pissed off that she was both a victim and a perpetrator of a set of beliefs that pressures sick people to choose between traditional (western) medicine and alternative therapies (woo). Since being diagnosed with PSC I have felt this pressure in many subtle and not-so-subtle ways.

I will not lie, I love me some woo.

I have a meditation altar set up in my bedroom, complete with my healing crystals, a sellinite candle, and pieces of beach glass.

Franck said to me recently when he came upstairs to find me meditating in front of my lit candle (to purify cosmic energies), "all you're missing is an eagle feather."

"I know. I totally need one," I said.

I am a big fan of vision boards (on Pinterest) and live in the hope that the universe will manifest my wishes of a New York Times Bestseller, a TED speaking engagement, and a trip to Sanibel island with my mom to go beachcombing. I am a devoted patient of reflexology and a Reiki-type energy massage. I believe that acupuncture can be helpful in many situations, same for yoga and visualizations. I have even done a past life regression that took me back to not one, but three past lives. Fascinating stuff.

Most days I down a monster smoothie packed with kale, probiotics, hemp, and chia seeds. It tastes like stagnating pond scum, but I know it is good for me. Maybe my smoothie is more about nutrition than woo but the line between the two in the alternative health world is often very fine indeed.

Still, nothing annoys me more since being diagnosed with PSC than people (often people I barely know) suggesting that I go on a liver cleanse to heal myself or just think positively. The implication is, of course, that I could heal myself if I followed their suggestions and believed in it enough. If it didn't work, it would clearly be my fault because I didn't do it right.

I religiously did acupuncture and Chinese herbs for a year and a half after being diagnosed with PSC, with the full consent and knowledge of my hepatologist.

I became increasingly uncomfortable, though, with my Chinese Medicine Doctor. First of all, I could discern no positive effects of her treatment besides temporary relief of some symptoms like itching. My blood results were getting worse and I was clearly getting sicker. I was bothered that she kept blaming this on my traditional doctors, even though they were not treating me with anything at that time (the only available treatment for PSC is an eventual liver transplant which tends to be a one-shot deal).

When I started to move closer to transplant and decided to discontinue the herb portion of the C.T.M. treatment because it could eliminate me from transplant eligibility, she never let an appointment go by without telling me how she had cured other liver patients with herbs or how she regretted my decision to stop them. I was being pushed to choose between traditional medicine and alternative medicine and I resented it.

Despite my lifelong love of crystals and the occult I never, not for a moment, considered abandoning western medicine in favour of woo for my PSC. It would not be my reflexologist who would be performing life-saving transplant surgery, after all. I sought out the best care I could find, which means for me flying to Calgary on a regular basis to meet with a hepatologist who has the fourth largest PSC practice in the world and is a leader in the field, and being assessed by the world-renowned liver transplant clinic in Toronto.

I do not think my PSC is a "gift" from the universe or was sent to me for me to learn some cosmic lesson. I make a conscious choice to give my experience meaning (I'm a big fan of  Vicktor Frankl) but I see PSC for what it is - a nasty, cruel disease that strikes indiscriminately, just like cancer and ALS and heart defects and all the myriad ways a human body can break down.

Traditional medicine is by no means perfect. I have been subjected to skilled but inhumane doctors who really shouldn't be allowed to talk to patients or, in fact, other human beings. At all. Under any circumstances. Things are misdiagnosed or diagnosed too late, treatments can be brutal and sometimes fatal. Sometimes, even though both doctor and patient have tried their best, people die. When this happens I remind myself that we are all headed to The Terminal on this bus of life, it is only a question of how and when.

I have seen fellow PSCers die. They have thought positively and fought until the bitter end and done everything "right". Most often their deaths can only be blamed on one thing -  this cruel disease. Often life or death boils down to the one thing that few want to accept - sheer dumb luck.

I have also, though, seen many lives saved by Western medicine. People who go from deathly ill to thriving after a liver transplant, or who recover from bile duct or liver cancer with the correct protocol. There are a lot of these miracles in our community.

So while I love my woo, I refuse to buy into the belief that woo alone will heal me, or that western medicine is evil. People who damn western medicine and promote woo will say that it is precisely because I don't believe that woo will not heal me. This, to me, is the crux of my problem with woo.

Woo cannot fail you, you can only fail the woo.

If chemo and surgery don't work, nobody is going to blame you - they are just going to blame your disease for being so goddamn unforgiving. If you opt for woo to the exclusion of traditional medicine for a serious disease and you die anyway, like Jess Ainscough, many people whose theories she championed (like those Gershon folks) will probably say that somehow she didn't do things right, or thoroughly enough, or her beliefs were too flimsy. That is bullshit. Who needs more guilt in their life, especially when struggling with a serious illness?

We can do our best to positively influence our lifespan and our quality of life, but the truth is we cannot control death.

We can do our best - trying to eat well, doing things that make us feel fulfilled and happy, meditating, yoga-ing, praying to our crystals, consulting the best specialists we can find and undergoing recommended treatments. We can do all of this and still die. Hopefully though somewhere along the way it will sink in, as it has done for me (finally!), that improving the enjoyment of my day to day life is even more important than trying in vain to stage-manage its longevity.

We cannot know how our stories will end. We cannot control the uncontrollable. Anyone who tells you different is trying to sell you something. Sadly, Jess Ainscough was not only a victim of this nefarious sales pitch, but in time ended up inflicting it on countless others struggling with life-threatening disease.

Stay open. Stay skeptical. Remember this - a closed mind is a dangerous mind.

Badass Surrender

Last Monday I was sitting in a doctor's office at the Liver Transplant Clinic in Toronto, listening to the hepatologist tell me that although a transplant would probably be in my future and was still the best case scenario for me, I was still "far too healthy for a transplant yet."

My first instinct was to argue my case.

I had ample ammunition to do so. My recent MRI showed that my PSC is progressing fast and that my bile ducts are sick, sick, sick. I have cirrhosis. I have a fibroscan score of 22 which means my liver has the pliability of a crusty, deflated football. I have to take antibiotics every day to ensure that the cholangitis infection that has now taken permanent residence in my bile ducts is kept  at bay, and a different type of antibiotic to control the suicidal itching. Most of all, my PSC guru in Calgary told me in his peppy Australian accent when I saw him at the end of November, "Well Laura! I think it's time to get you a new livah!".

Since my PSC diagnosis in 2012 I have had to fight, fight, and then fight some more to access the best care. PSC, like other "orphan" diseases, is so stupidly rare that most doctors I come across in Victoria have only experienced a couple of other PSCers at best.

Funnily enough, the third book in my "Grape" series which I am writing right now (entitled MY GRAPE YEAR) is about breaking rules. The thematic resonance with my present battles are unmistakable.

Contrary to what many people seem to believe, I did not get to Toronto by luck or by the benevolence of a medical fairy godmother / concierge service.  Rather, I accessed Toronto by offending doctors, becoming that pain-in-the-ass patient that makes medical assistants and nurses roll their eyes, refusing to take no for an answer, and nagging, pushing, and trodding (repeatedly) on the toes of the medical establishment. When the full extent of the parlous state of hepatology in British Columbia finally sunk in about six months after I was diagnosed, I made a conscious decision to discard my upbringing of being polite and not offending anyone. My survival trumped the need to be "nice" by a long shot.

I became a put-yer-dukes-up PSC badass. I did my research as though my life depended on it, and it actually (scarily) did on several occasions. I learned that Toronto was a world leader in living donor liver transplants, that they did the biggest volume of this very specialized type of surgery in North America, and depending on who I consulted, perhaps the world. I discovered that in over 700 surgeries they had never lost a donor and that doctors from all over the world flew in to learn how to duplicate the success of their program. Unfortunately nobody has a crystal ball to see into the future, but I felt with Toronto I was getting my best chance of getting through to the other side of this whole PSC thing.

Yet, after all that, at my first doctor's appointment in Toronto here was the hepatologist telling me that maybe it wasn't time for a transplant after all? Whiskey Tango Foxtrot?!?!?

My first instinct was to do what I had been doing for the past twenty-four months, to fight back. Yet about half way through that appointment, when the hepatologist was explaining the risks associated with transplant which, make no mistake about it, are substantial, it dawned on me that his arguments against transplant right now were not without merit.

Throughout that intense week I lost count of the doctors and specialists I consulted (not to mention the vials of blood drawn from my veins). The Toronto specialists were, without fail, kind and incredibly competent. Some felt I was ready for transplant right now whereas others thought it could maybe wait a while longer.

The upshot was that all the people I saw were going to meet with all my test results and make a collective decision about my case. My knee jerk reaction was to feel frustrated and impatient with this difference of opinion.

Then, I thought about it some more.

Having my case debated by so many experienced doctors in one room was exactly what I had been fighting for. They were all world leaders, their collective knowledge and expertise was mind-blowing. They were going to try to make the best decision for me and the fact that there was a difference in opinion meant that my case would be looked at in detail.

Surrender seemed like the most unnatural thing for me to do, but as it turned out surrender was the most badass choice I could make right then.

You do everything you can humanly do and then you have to do the hardest thing of all - relinquish control to the experts you have gathered in your corner and, even more importantly, to what I have come to think of as "The Great Mysterious."

So this week here I am, back in Victoria (where it is not -19 C, hooray!), practicing badass surrender to the best of my ability. While I wait for the decision to be made in Toronto I am feeling a very curious and unfamiliar feeling of peace. I have no idea how long this astonishing (for me) state of zenitude is going to last, but it has made me realize that I must become better acquainted with this whole badass surrender thing. It may just have the potential to be one of the most powerful weapons in my repertoire.

The Flotilla of Doubt

This has been the oddest New Year for me. I have never in all my life been poised to embark on such a vast sea of uncertainty.

I have absolutely no idea where I will be when Dec 31, 2015 rolls around. Very ill? Very healthy? Somewhere in between? With a new liver? With my same, sick liver? Dead? These are all distinct possibilities.

I incorporated a New Years ritual suggested to me by one of my favorite fellow PSCers into one of my regular beachcombing excursions at the dawn of 2015. I wrote down all the things I was worried about on little pieces of paper (biodegradable paper, of course) and sorted them into two piles:  1) Things I Can Control, and 2) Things I Cannot Control.

The Thing I Can Control pile contained precisely three pieces of paper.

The Things I Cannot Control Pile was a mini Everest.

I filled my pockets with Things I Cannot Control and walked down to the beach. When I got to one of my favorite outcropping of rocks I read each one out loud, crumpled it up, and threw it in the emerald-green waves. Here is a random sample:

That they will find liver / bile duct cancer that would mean I am not eligible for transplant.

That some other health issue will crop up that will mean I am no longer eligible for transplant.

That I will fail the psychological component of the transplant testing and they will take my incapacity for denial and dark humour as signs that I am, in fact, clinically insane (and therefore, no longer eligible for transplant).

That I will die during the transplant surgery (my doctor took great pains to drive home the point that 10-12% of people do not make it through the actual surgery itself).

That if I survive the transplant surgery my body will try to reject the new liver.

And so on and so forth...

Soon, there was a flotilla of Thing I Cannot Control papers bobbing around in the water. I began to climb towards the next beach but, when I looked over my shoulder, I saw that instead of floating out to sea the Things I Cannot Control were hugging close to shore, following me like an attacking fleet from the Napoleonic wars. I grabbed a nearby piece of driftwood to splash them away.

"Go away!" I shouted. "Shoo!" Sweat broke out on my forehead. These Things I Cannot Control were stalking me. I wanted them GONE.

I scrambled across the rock, hopped down onto the next beach, and found a bigger piece of driftwood. I lay in wait for the flotilla to come around the curve of the rock.

I waited there, with my driftwood weapon poised for battle, for several minutes before I started to feel like a complete dork. The flotilla still did not round the corner of the rock as expected. Where had it gone?

I hopped up back on the rock where I had thrown the papers to get a better vantage point. My eyes scanned the green waves but the Flotilla had simply vanished.

Where had they gone? Had they sunk? Had they floated off in another direction? One thing was certain, they had disappeared.

And then, on the top of that rock at my favorite beach I experienced an overwhelming wave of peace. I was going to be okay. I didn't know how, or what path would take me to okay, but I knew I was going to be okay.

Now, while Dread and me are childhood friends, I have just met Faith in passing. I would describe her as a "recent acquaintance".

My knee jerk reaction was to doubt my moment of grace, to try to explain it, to shoo it away just like my paper flotilla of uncertainty. As much as the Things I Cannot Control were scary, daring to have faith in the unknown was weirdly even scarier.

I know, deep in my soul, that learning to have faith - even when all signs point to the contrary - is one of the lessons I am supposed to learn in this lifetime. To have faith when there is no proof to support it. To have faith that all is unfolding as it is should. To have faith that everything makes sense on some higher plane that my human brain is simply not equipped to comprehend.

Yet Faith still scares the bejesus out of me.

Still, I thanked the ocean for taking care of my Things I Cannot Control for me. I wouldn't say my Flotilla of Doubt had transformed into a Flotilla of Faith yet, but it was a start.

I'll Take A Personality Transplant, Please...

Every morning since being diagnosed with PSC two and a half years ago I wake up thinking, "I totally cannot handle this. Life gave this disease to the wrong person."

I often joke that what I need even more than a liver transplant is a personality transplant. Like most jokes it contains an uncomfortable dose of The Truth.

It's not that I would wish this shitty auto-immune disease on anybody else, or because I harbour some sense of superiority that makes me think I deserve better. It's not even because of the exquisite irony that I manage four vacation rentals in the french vineyards and am the wife of a Burgundian and can no longer touch a drop of wine (but somebody up there certainly does have a twisted sense of humour). Rather, I yearn for a personality transplant because most of the time - especially on days like today when I have medical stuff looming on the horizon and am frankly not in a felicitous mental state - I feel woefully ill-equipped to deal with this disease.

Through the PSC community I have come into contact with people who possess a deep, unshakeable faith that they will be fine in the end. I'm always amazed by this. Have they always had this certainty? Where on earth does it come from? More importantly, I'd like to order some of that please.

I've also come into contact with people who are brave...like, superhero brave. They endure painful treatments and what would for me be torturous uncertainty with a kind of nonchalance that an olympic skier would feel going down the bunny hill. They say they never feel scared and, stranger still, I suspect they are actually telling the truth. I'd like a piece of that too.

There are also the people who just "carry-on" in the best of the British tradition and decide that they are not even going to really consider themselves as being sick at all, even when diagnosed with things like liver cancer. They just think "Crikey. That's a spot of bother." Wow. Yes, I'll also take one of those. 

Then there are those lucky, lucky souls who seem to have been born without the worrier gene. When I ask if they worry about cancer, post-transplant rejection, etc. they answer, in all honesty "no". When I ask how...why...how the hell they DO that, they say, "I decided there was no point to worrying, so I just don't." What!? You can actually turn off that switch in your head!?

So there's the zen buddhas, the biblical matyrs, the superheros, and then...there's me.

I am such a hypochondriac that Franck actually had to ban me from watching medical dramas like ER, House, and even Gray's Anatomy a decade ago. My suggestible imagination meant that any illness I saw on-screen would manifest itself immediately in my body as symptoms, which usually culminated in a deeply humiliating ER visit within a few hours. When I was diagnosed with PSC one of my first reactions was "Goddamit! I forgot to imagine that disease. That's why I got it!" Clearly, I also have a bit of magic-thinking craziness going on in this head of mine.

I worry and I ruminate. My mind gets stuck in painful thought patterns. I am vigilant about each symptom and fret about new ones. I wish beyond anything that I could just turn off that worry switch, but I have tried and tried and tried but mine appears to be welded in the "ON" position.

I get scared. Like really, really curled-up-on-the-bed-in-a-foetal-positon scared. When I'm like this, my mind projects terrifying films for my own personal viewing pleasure on a continuous loop.

I don't speak the language of denial. I can't pretend that I am not going through this. If I could, I would, but my powers of denial are puny.

There are so many people so much better equipped to deal with PSC than me - pretty much everybody, actually.

However, I have discovered a few arrows that I use again and again to help me fight the mental and physical impact of PSC.

One is my dark sense of humour that I share with Franck. There isn't much we can't joke about, especially if it is in bad taste. When the grim things get too threatening, we deflate them with our laughter.

Another is my need to create - write, paint, glue beach glass on wreathes...whatever takes me out of my own head for long enough to be able to take a breath again and re-engages me in life.

My defiance is one of my strongest arrows. I fall, often and badly, but there is something in me (what I call "my little spark of fuck you") that forces me to pick myself up again.

Another arrow that I have found shoots straight and true is my need to connect with others, to listen to their stories and journeys and to share mine in all its rawness. This creates a net of support that makes me feel supported and I hope makes others feel supported as well.

It's the same with parenting - I am good about reading with my kids, but lamentable at keeping track of the various lunch forms, soccer try-outs, and teacher's gifts that come with their busy lives. I love doing crafts with them but am doing a far from stellar job of protecting them from swear words and age inappropriate movies.

With my writing, I appear allergic to plotting and formatting, but I have always had an ear for dialogue and an instinct for how to end a chapter.

I guess the hard lesson I'm learning is that going through life most of us feel ill-equipped. Bemoaning our shortcomings is a waste of time better spent on cultivating our strengths, even if they seem like meagre offerings.

This is far less messy than a personality transplant. Besides, if we had a different set of arrows in our quivers, we wouldn't be ourselves anymore. That, I know, would be a terrible shame.

Us Broken Shells

 

I beachcomb several times a week on what my bevy calls "our" beach at the end of Oliver Street. It is part meditation, part therapy, and part religion. My main focus is beach glass but I pick up other pieces of intriguing flotsam and jetsam like bits of driftwood and shells.

Last week I was beachcombing with Clem. We climbed up a rock that the seagulls and crows had been using to crack shells to eat the yummy little sea creatures inside. I picked up a few and showed my handful of shells to Clem.

"Why do you only pick up the broken ones?" she asked me.

There were many intact shells scattered at our feet - ones that the birds hadn't managed to break. Clem was right though, I never pick up whole shells to take home.

"I don't know." I shrugged. "I just do."

A few days later as I arranged my new finds on half a whitewashed oyster shell, I found myself contemplating unbroken and broken shells.

Whole shells may be pristine but they have no secrets. One is more or less interchangeable with any other. The broken ones, however, are endlessly unique.

One that I picked up is broken on the top so that I can peer down its inside and see the spiral helix that disappears into the most extraordinary deep purple colour. Another, sheered in half, shows a perfect cross-section of the interior architecture of the shell and the variety of other-worldly hues contained inside.

If there is a word to describe how I have been feeling in the past few days it is Broken.

Broken by the weight of uncertainty of the next year. Will I be approved for a transplant? Will I find a donor? If so, how the hell am I going to move to Toronto for several months to make this happen?

Broken by the thought of my upcoming appointment with my PSC specialist and memories of how the last one left me so emotionally shattered that it took me over a month to pick up the pieces.

Broken by having to repeat my tumour-marker blood test in a few weeks.

Broken that I can't seem to conjur up the faith that seems to come to others so easily.

Broken by feeling myself get sicker and less able to cope with it all.

Broken by the chronic lack of organ donors and the knowledge that people like me die needlessly waiting in vain for one to come available.

Broken by the constant itching and nausea and feeling like I have the flu every day.

Broken at just wanting to set down this burden but knowing that I can't.

Since sharing my story in my keynote speech at SIWC and here on my blog I have had many people contact me and tell me about how they too are broken. Life can break us in a myriad of ways; the death of a loved one, a critical health challenge, parenting a challenging child, a painful separation, mental illness, heartache, loneliness...I am beginning to think that getting broken is an unavoidable part of the human journey.

Even though I have been struggling too much with my own broken state to get back to even half of the incredible people who have shared their stories with me (mea culpa), I am moved by each and every one.

I wish they could see how beautiful I find them. They open up and show me their strength and faith and tenacity and hope and empathy and generosity and grace. They are like my broken shells, sublime in their broken-ness, with a lustre that would be invisible if they had remained intact.

It is often difficult to see the beauty in our own broken state, or to realize that the majority of people around us are also broken or have been broken in the past. I too am seduced by the images of perfection we are constantly served up by magazines (I mean you, Real Simple) and carefully curated websites and public profiles. I find myself thinking, my life should be like that.

Ultimately though, accepting our broken-ness and sharing it is far more compelling than a flawless exterior.

I was stuck on how to end this blog post until yesterday, when I received a message from a high school friend that I haven't seen in over twenty years:

"I wanted you to know that you have inspired me to do something that is out of my comfort zone. I am donating a kidney on Thursday to a father in Max's class. Keep promoting organ donation because your words are working miracles."

Celebrating our broken-ness leads to interconnectedness, and interconnectedness leads to miracles. So if you too are a broken shell, know that you are beautiful and brave. Also, know that your glow reaches farther than you could ever realize.

Good Night, Laura. Good Work. Sleep Well. I'll Most Likely Kill You in the Morning...

Fear and I have been getting rather hot and heavy since my wonderful few days at the Surrey International Writer's Conference at the end of October.

When I introduced Clementine to the wonders of the movie The Princess Bride a few nights ago, it struck me that the past two and a half years living with my auto-immune bile duct & liver disease has been a lot like the years after Westley was captured by the Dread Pirate Roberts.

If any of you didn't spend years memorizing every line in The Princess Bride (and if not, what is wrong with you?) The Dread Pirate Roberts captured Westley on the high seas, but let him stay alive and put him to work on the pirate ship. The Dread Pirate Roberts would always bid Westley good-night in the same manner, "Good night, Westley. Good work. Sleep well. I'll most likely kill you in the morning.".

My liver disease bears an uncanny resemblance to the Dread Pirate Roberts. The thing with PSC is that it greatly increases one's risk of liver cancer and bile duct cancer. Now there are cancers and there are cancers. Bile duct and liver cancers belong in the latter category.

When I asked my PSC specialist what could be done if they found bile duct cancer in me he said, as dispassionately as a waiter reciting the specials of the day, "Usually not much. Generally all we can offer is palliative care. Death usually comes within eight months."

"Can I do anything to prevent it?" I asked.

"No."

Right then. I'll just curl up into a ball, rock back and forth, and suck my thumb.

The same specialist emailed me a letter to include in my (obscenely large) medical file in which he wrote that I am at a "tremendous" risk for bile cut cancer.

Being a writer I leapt on the significance of this word. "Tremendous," I wrote in the email I fired back immediately. "Now that is a strong word. How exactly did you mean tremendous in this context?"

He wrote back. "Your large duct PSC and the chirrotic charge of your liver mean that you are at significant, aka "tremendous," risk for bile duct cancer."

Alrighty then.

About 35% of PSCers develop bile duct or liver cancers, so I try to remind myself that I have more chance NOT to get it than to get it. Also, there are many, many other ways PSC can kill me besides cancer (which doctors have kindly spelled out in detail on numerous memorable occassions) but my mind has latched on to this fear in particular. I did the same thing when my girls were toddlers. I was paranoid about them choking on things but wasn't unnerved one jot by the idea of dropping them, parking lots, or electrocution. Minds (especially mine) + fear = weird like that.

So, part of living with PSC means that I am fearful about my PSC morphing into cancer pretty much ALL THE TIME. It is one of my first thoughts on regaining consciousness every morning, and it is that asshole of a thought that always (dressed in black and wearing a mask) who comes back to taunt me regularly throughout every day.

Every morning, after I am fed up of laying in bed feeling scared, I get up, reminding myself of something Winston Churchill said (and say what you will about the British Bulldog, he was a guy who knew a thing or two about writing and struggle and perseverance), "when you are going through hell, keep going."

Prodded by Winston's invisible cane, I make my way downstairs. I spend my days looking after my kids the best I can. I give Franck a kiss. I go for a walk with a friend. I deal with all the ridiculous administration of illness. I laugh and watch soccer games and enjoy every sip of my coffee. I write. I write. I write.

Like all PSCers, I am monitored for cancer often. I have tumor marker blood tests every six months, MRI's of my liver and bile ducts every six months and extra tests every time I am hospitalized with cholangitis. I knew I was coming up for a set of my cancer marker blood tests after Surrey. I went in to Lifelabs on Halloween Day (may as well concentrate all the spookiness in a 24 hour period, right?) and since then the Dread Pirate PSC perched on my shoulder and taunted me with lots of grim films of the future. His currency is high drama and he somehow always manages to get my attention.

I got my bloodwork back on Wednesday and my tumour marker score was actually the second lowest it's ever been (it was 102 and it has gone up to 148 before). I was pretty pleased. My specialist, however, was not as pleased and wants me to repeat it in a month. Good night, Laura, Good work. Sleep well. I'll most likely kill you in the morning...

I have survived far worse scares. In September 2013 I had an invasive exam called an ERCP where they push a scope into the bile ducts in my liver to take brushings and biopsies to specifically rule out bile duct cancer (they were that worried about it). I had to wait an ENTIRE MONTH to get the results. The Dread Pirate PSC was omnipresent during that entire month. To be frank, he was a complete douchebag.

This July my PSC had been progressing rapidly and landed me in the hospital with cholangitis for several weeks. I had to get three MRIs within a week to rule out bile duct cancer. Right after Christmas I will have to go in and get more MRIs...it is basically never-ending. Like Westley, I live with a Dread Pirate taunting me with my death every day and every night.

Still, in The Princess Bride Fire Swamp scene, Westley talks about his years with the Dread Pirate Roberts as "a wonderful time."

During these years in the face of fear Westley gained the strength to scale the Cliffs of Insanity, the resistance to withstand torture in the Pit of Despair, the ingenuity to figure out plan to storm the castle and rescue Buttercup, and most rad of all, the swordfighting skill to best Inigo Montoya. I rather suspect it was the constant threat of death that added an urgency, appreciation, and an almost superhuman focus to his days.

My fear isn't teaching me swordfighting (maybe one day, fingers crossed...), but it has pushed me to write and publish three books and get me well on my way on my fourth. Who knows? It may drive me all the way to the New York Times Bestseller List. Even if it doesn't it will make me appreciate each sip of coffee, kiss, sunset, writing session, and book launch party along the way.