This will be the final post

At 2:00am on October 2nd, 2016 Naomi Beth Sichler died peacefully at home surrounded by her family.

We were both always floored at the effect this little public notepad could have on others, and have been overwhelmed with the support we received over the years. We always wondered why people were so interested in the way we lived our lives together, when to us, we were just trying to enjoy each other.

I have so many thank you’s to deliver due to the expansive amount of help and love we have received, that I am bound to miss a few, but know that we could not have loved each other and lived so richly had it not been for the help of so many. Naomi always reminded me that people seemed to run towards us, not away, when they found out about her diagnosis. In this way we were lucky, unfortunately, this is not always the case.

First off, thank you to Skirball Hospice for providing some of the finest care imaginable during this time. Your professionalism and compassion instilled confidence and peace. The constant calls and texts from nurses not even on duty, shows how much you all truly care. Your presence during our time of need allowed, and even made possible, a beautiful end to Naomi’s journey with us.

Thank you Compassion & Choices for being such strong advocates for the terminally ill. Although Naomi chose not to take the aid-in-dying medication, the relief it brought her to know it was an option is something all terminally ill patients should be able to feel.

Thank you to our team at UCLA. Despite Naomi being a USC Trojan, she didn’t trust anyone else with her care. Dr. Nghiemphu, Nanette, Tom, and Cheryl, you all made us feel that you cared about us as people, not just patients.

Thank you to everyone who came out of the woodwork to show us support in the form of cards, flowers, clothes and blankets, rides to doctor’s appointments, food deliveries, and apartments to stay in for family members from out of town. This list is larger than the internet, but thank you all.

To my family – Thank you for accepting Naomi as a daughter and sister. She got unfathomable joy from knowing her family had doubled. Thank you for helping us enjoy the small moments in life through cards, books, and many other actions that let us know you were thinking of us. Thank you for instilling my sense of family, compassion, humility, and caring that helped me provide Naomi with strength when it was needed.

Thank you to Naomi’s family. Eleanor, John, and Tim my heart goes out to you. You were the fortunate ones who knew Naomi the longest. Thank you for raising and supporting the most authentic, strong, loving and thoughtful woman I ever met. Eleanor – Thank you from every inch of my soul for putting your life on hold on numerous occasions to help us maneuver our way through this disease. Thank you for your positivity. Thank you for supporting me as well over all these years. The expansiveness of your love knows no bounds. John – Thank you for being such a steady presence at all times. I know Naomi’s calmness in the face of adversity came from you. Tim – Thank you for your unflinching loyalty, friendship, and comfort to not only Naomi but to me. You and Naomi were always looking out for each other and shared a relationship that she treasured like none other. I am truly blessed to have you all in my life. Knowing that Naomi’s blood runs through you brings me much needed solace.

Thank you to our friends. Vast barely describes this list and the amount of thank you’s to include here so I’ll keep things general. Your words and actions have left me astonished, and floored as to how we could be so lucky to have such amazing people in our lives. Thank you all for helping us have a good life worth living. We are forever thankful for your generosity, loyalty, shoulders to cry on, hands to hold, firm hugs, smiles shared, heartbreaks comforted, and celebrations together. I have no doubt we will carry on Naomi’s legacy together.

Lastly, thank you Naomi, for pouring your soul into this blog and into our relationship. Your openness and authenticity shined through in all that you did. Thank you for getting the broom out and helping me sweep up the pieces of my shattered life. Thank you for taking a chance with me and milking every ounce of love out of our all-too-brief time together. Thank you for pushing me to be a better person; the best version of me. Thank you for being fearless and honest. You have made an irreversible impression on my being. Every step I take in this life will be made with you. I am left with a void the size of the universe in my heart, but I thank you for bringing such amazing people into my life to help me grow around that void. Thank you for bringing me way more than net-joy. I love you.

We are all Naomi’s brain,

Mike

Memorial Service Details

Anyone who has been impacted by Naomi’s journey is welcome to attend a memorial service celebrating her life.

Date: October 30, 2016

Time: 12-3pm

Location: Ahmenson Senior Center at Expo Park

Parking: There is limited free parking on S. Park Dr, but many available lot and metered spots on the streets surrounding the center (Bill Robertson Ln and Martin Luther King Jr. Blvd).

Donations: If you would like to send a gift or condolences, here are two organizations that provided us guidance and information that was paramount in our navigation of this disease.

Simms/Mann Center for Integrated Oncology

Cancer Support Community – Benjamin Center

Permission to Feel

As some of you know, I pitched a version of this essay to The New York Times’ Modern Love editors, but they unfortunately passed. I couldn’t think of a better day than today – Mike’s and my second (and final) wedding anniversary – to share this piece of my heart with you all. Not everyone is fortunate enough to find true love during their time on this earth. We are two of the lucky ones who did. And this is our story.

Permission to Feel

This moment — this one right here

Thank you thank you thank you for the outpouring of love and support over the past few weeks. I am blown away by the number of people who have reached out to let us know they’ve been touched in some way by my blog/our story. It’s particularly meaningful to hear from friends, acquaintances, and even total strangers about the specific and personal ways in which witnessing and reading about our experiences has made a difference to them, whether it be vowing to spend more time with family, saying “f—it; let’s get that second dog,” seizing opportunities for adventure/travel, or simply being present and appreciating how special and valuable each moment with their loved ones is.

For a little while, I’d been struggling to understand why following my blog has been so impactful to so many people because, to me, it’s simply my unglamorous, messy, ordinary life. One comment in particular, though, helped me understand why so many people relate to our situation. Davida, my former boss’s wife, put into words very clearly how the blog has touched her. Her words capture so well what I hope my legacy (such as it is) will be: “You have helped me to appreciate the importance of this moment — this one right here,” she wrote, “as it unfolds and regardless of what it contains — by showing how it’s done and by writing about your process and your experiences with such delicate sensibility and brilliant specificity.” So thanks again to Davida and to many others for making me feel like the difficult work of being open and vulnerable throughout this experience has made a difference to you. Knowing that my cancer diagnosis brought Mike into my life makes the terrible parts of this worthwhile, and the knowledge that sharing my experiences honestly has had a positive impact on others is the icing on the cake. 

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Our friend Amanda made and hand-delivered this stunning flower arrangement. Thank you SO much, Amanda! Check out her lovely creations on Instagram @bloomthereitis.

Special thanks also to members of the Northeastern University Physical Therapy class of 2009. This wonderful group of Mike’s classmates reached out to ask if they could make a charitable contribution that would help other people experiencing a cancer diagnosis. They’ve generously raised $2,500, to be split between the Cancer Support Community-Benjamin Center and the Simms/Mann Center for Integrative Oncology, two organizations that have provided immeasurable help, resources and support for us over the past 6 years. In a particularly touching and meaningful gesture, John Tran, a member of this class, has also offered to contribute the funds needed to keep iamnaomisbrain.com up and running in perpetuity. We are deeply grateful.

We continue to fill our days with the little things: reading together, listening to records in our little sitting room, watching a few TV shows and movies, going on walks together and with friends and family. We’ve had quite a few appointments this week and last with members of my new hospice team and have basked in the company of and laughter with friends, after all the medical talk.

status update 7/6/16

Lots of people have been asking how I’m doing since my Avastin infusion last week. I’m hanging in there. I don’t really feel any differently since the infusion but haven’t been sleeping well so have been pretty fatigued. Today is my last day on the 4mg dose of steroids. Hoping the reduction to 2mg tomorrow will make a big difference in my sleep and other side effects. The swelling and water weight I’m carrying around with me are getting really uncomfortable, another reason I’m very eager to start the process of tapering the steroids. 

Mike estimates based on his look at the MRI that my tumor grew by about third since my scan six weeks ago, so things are progressing fairly rapidly. My left-arm weakness is significantly worse. Typing and writing have become very difficult. Looks like Siri and I are going to become better friends. I am still working hard on keeping up my strength. I’m doing a series of exercises every day for my legs and back and have recently added arm and hand exercises under Mike’s guidance. I got a Fitbit a couple weeks ago as well, which is helping keep me motivated to move around the house and take my daily walks. I’m pretty sure I am actually getting more steps/activity than when I was working; and it’s a good challenge to find creative ways to stay off the couch. 

I’ve also begun preliminary work for an essay series I plan to develop addressing the patient and family experience within the modern American healthcare system. In the coming weeks, I plan to interview folks who have had cancer or another chronic/terminal illness about their experiences from diagnosis through end-of-life care. This project is the result of a series of conversations with my healthcare providers, Mike, my mom, friends, and others in this regard.

I’ve begun to read some of the literature/consume other media on this topic, including When Breath Becomes Air by Paul Kalanithi, Being Mortal by Atul Gawunde and this fabulous TED talk by BJ Miller, senior director and advocate at Zen Hospice Project, in San Francisco. These physicians are contributing in tremendous ways to the conversation about how the healthcare system needs to and can be transformed to place the patient at the center. I feel that the voices of the patients and families themselves are, in large part, missing from the conversation taking place in the public sphere, however. I hope that through this series I can help shed additional light from this important perspective. 

If you or anyone you know has experienced cancer or another chronic or terminal illness — or is a family member of someone who passed away after receiving care within the healthcare system — please let me know if you would be interested in speaking with me for this project. 

Even as I embark on this project, we’re still trying to squeeze in as many adventures as possible. Our friends Ted and Sara are back from Europe and were in town over the past few days, including the holiday weekend. Huge thanks to Ted for driving me to my various doctor appointments last week. It was great to be able to spend that time together. We also had so much fun with the two of them and our friends Jeff and Ana listening to the sounds of one of our favorite bands, The Dustbowl Revival, at the beautiful Levitt Pavilion in Pasadena this weekend. And we enjoyed a spectacular view of the Rose Bowl fireworks from Ted’s parents’ house in Pasadena. #netjoy

post-MRI status update 6/29/16

Given the increased weakness in my left arm leading up to today’s MRI, Mike and I went into today’s appointment prepared to hear that my tumor is continuing to grow, which is indeed the case. It’s growing fairly slowly, but growing nonetheless. Inflammation seems to be pretty well under control at this point. 

We used today’s appointment to talk extensively about the risks and benefits of Avastin. The serious potential negative incidents such as stroke, brain bleed and gut bleed seem to be even more rare than we initially understood and are more common among older patients who are otherwise in much worse health than I am. That being said, there are intrinsic risks that simply cannot be avoided. Our conversation did assure both Mike and me that the Avastin is the best course of action at this time. It will allow me to taper off the steroids, further improving my quality of life in the coming months. 

We also spoke with the care team, including Dr. Nghiemphu and both my wonderful social workers, about the End-of-Life Option Act. Dr. Nghiemphu does not feel she can state with confidence that I have less than six months to live at this point (good news, right?!), so that process will have to be initiated further down the road. 

We are in very good spirits, and I’ll proceed with my first infusion of Avastin tomorrow at 11am. 

Thank you to Mike for being a stalwart source of love, support and laughter. You make everything better. And a big thanks to Ted for a great lunch and the ride today. I look forward to more time together tomorrow!

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Congratulations, Cheryl, on your retirement. You will be missed. I cannot thank you enough for your support and advocacy on my behalf over the past 5.5 years. You and Tom are simply the best!

learning to dance in the rain

Last summer, my dear friend Chelsea made me a paper chain — with one link for each day of radiation treatment. More than just a creative way to mark my progress through treatment, on each piece of the chain Chelsea wrote a meaningful quote by some of her — and my — favorite authors, poets and philosophers. I’ve been revisiting the stack of quotes recently and have found many to be timely and relevant to my present situation.

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The three pictured below, in particular, help capture the peace that found me during our staycation weekend at the Merendino/Williams pad in Pasadena. I find that it’s easy to breeze glibly by quotes like these unless I am intentional about pausing and thinking and allowing them to really reach me.

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I took the time today to sit with each of these three quotes and think about why it felt meaningful to me in the context of this special weekend. Here goes:

It’s not about waiting for the storm to pass. It’s about learning to dance in the rain. 

In the most literal sense, I was hoping for a warm, cloudless weekend that would allow us to take advantage of the pool at the Pasadena house. While the clouds did burn off in the afternoons, it was mostly pretty overcast and chilly. On Sunday morning, when Mike and I paid our friends Eileen and Ned a visit at their new house (affectionately dubbed “The Hobbit Hole”) in La Crescenta, it was actually raining. The misty rain, however, along with hot tea, coffee and oh-so-flaky pastries we picked up at Gio’s in Montrose, were the perfect backdrop against which to be introduced to Eileen and Ned’s quaint mountain cabin. The clouds also provided the perfect weather for sleeping in, napping, and just generally relaxing — something Mike, Tim, Jen and I took full advantage of during the entire weekend.

We must let go of the life we have planned, so we can accept the one that is waiting for us. — Joseph Campbell

Joseph Campbell has been a spirit guide throughout my entire journey with cancer, and these words have resonated with me for many years. This weekend was just another example of the gifts that are waiting when we are able to let go in the struggle to hold on to our hopes and dreams and accept what life is offering instead. In the case of this weekend, it was precious time with Tim and Jen, whom we don’t get to see nearly often enough. Interesting conversations about healthcare and food policy, hilarious stories about the antics, trials and tribulations of Jen’s fourth-grade students, and laughter over our fumbling attempts to deliver prompts in a game of Taboo.

We do not remember the days. We remember the moments.

Here are a few of the moments I’ll remember and treasure from this weekend:

  • Sitting with Mike, Eileen and Ned in The Hobbit Hole eating a crumbly, not-too-sweet, coffee-cake muffin, drinking a ginger hot tea and petting the kitty, Ginger.
  • Taking a sunset walk with Mike on a peaceful dirt path lined by mature trees.
  • Looking out toward the mountains from the patio with Mike and Tim sitting close by.
  • Gazing at Van Gogh’s Portrait of a Peasant during our visit to the Norton Simon Museum.
  • Enjoying a late-night donut meet-up in Eagle Rock with our friends Jeff and Ana.
  • Preparing a simple-but-satisfying meal of grilled kabobs and rice with Mike, Tim and Jen.
  • Lying in bed reading in the late afternoon sun and waking up an hour and a half later from a delicious nap.

We are SO grateful to our friend, Ted, and his parents, Gari and Ellen, for making this little staycation possible for us. It was the perfect location — not too far from home to make the drive uncomfortable for me, but far enough to make it feel like a real holiday-weekend getaway. I’ve loved the Merendino/Williams Pasadena home ever since Ted first introduced me to it in college, and it made for the just the change of scenery I needed to escape from purgatory for the weekend.

walking the walk

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there are three reasons i’m eating this pinkberry while waiting for my lunch to arrive: a) trying to make myself feel better after finding out the cyst on my left ovary is twice as big as it was two months ago and might need to be surgically removed (like I really need one more thing to think about apart from all this cancer stuff); b) following my own advice about eating dessert first. life is uncertain, right?; and c) i LOVE pinkberry!

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