One step implant procedure with Alloderm - Anyone?
Comments
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Catherine, I'm so sorry to hear about your very unexpected problems. I hope you are not in any pain. Perhaps some of the stitches failed at the base of the implant? I think Speech's explanation/ideas are on target. I suppose the good news is that it is fixable, but no one wants to do the "one step" twice! I hope that you have supportive family and friends and that your second go at the "one step" is flawless.
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Hi Okiegal!
Thanks so much for your reply! Ive started physio today and it should help -
while Im waiting for the redo of the left breast! I agree that Speeches thoughts are
right too! I'm very fortunate to have wonderful friends, family and coworkers!
I must say that it is great to hear of everyones experience - since we are
and have gone through it!
Today as I was reading some comments - I was relieved to
hear that other women have had the 'jumping/ flexing breast' ( I had thought
that it was yet again another mishap! Ha!
I'm very blessed to be cancer free and you are right - it is 'fixable'!
Thanks again! Take care and God Bless, Catherine10 -
Hello Everyone,
Catherine, I'm sorry to you have to wait for your PS to return from vacation. I hope you are comfortable and not in any pain. My PS said that that I could only be a B cup...I was a C. She instructed not to lift anything over 5 lbs for a while. I did not start to massage for a couple of months. I took it slow for a while and gave myself the time to heal. I'm happy you have the support of family and friends. I wish you the best. Please let us know how you are.
Upcreek, I have a friend who travels a frequently for work and will pass the info about the sleeve! Thanks!
Sandy105, I know someone who used Dr. Ashikari and Dr. Salzberg for nipple sparing "one step." She said nothing negative about her experience. Best Wishes!
Fortunate1, A Good MIR...peace of mind!
Carole, Glad your friend is doing well.
I continued to have problems with my ear along with a bad headache. My PC said to see a neurologist and otolaryngologists. I saw the otolaryngologists today and he cannot explain the head ache (said to see a neurologist), but a hearing test showed significant hearing loss in my left and little loss in my right ear. He prescribed Medrol (steroid) and I will go back next Friday for another hearing test. My dad was legally deaf. Keeping my fingers crossed my hearing comes back. I will be making an appointment the neurologist tomorrow.
Going to be warm tomorrow...Happy St. Patrick's Day to those who celebrate! I hope you are all well...Have a great Day!!
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Hi everyone!
I am glad that I discovered this thread. I recently have decided on having the immediate reconstruction with implants following a UMX on the left. I have heard my BS mentioned the one-step implant reconstruction which I don't know much about, but I asked my PS about the possbility of doing such a procedure. My PS is actually a DIEP expert (I initially wanted to do a DIEP, but my BS advised me to do a simpler shorter procedure because I had pulmonary embulism before), but I assumed he can also do implants and he will be seeing me tomorrow to see whether I am a good candidate for the onestep procedure.
Since I am truly a novice, could someone here please enlighten me regarding the following:
1. My cup size is B, does the small size influence whether I am a good candidate for the one-step reconstruction?
2. How long is the surgery that involves UMX, SNB, and then one-step implant reconstruction?
3. What are some of the typical problems that you have encountered during your surgery and then during your recovery?
I have read some of the postings here so I got some information. Sorry if my questions are already answered by some previous postings, but I don't know whether I can get through all 81 pages of postings. That is why I am asking the questions here.
Thanks so much for your help!
Bella
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Welcome, Bella. Your B cup breast size is in your favor in determining if you're a candidate for the one step. Your surgeon may be able to spare your nipples, saving you from the later procedures to create nipples. My one-step/nipple sparing took about 4 hours in surgery. I had problems with my incisions healing and after several weeks went back to surgery to have the left incision redone. After that, it healed quickly. One nipple was iffy for a few weeks but eventually healed.
I think my healing problems were caused by the BMX. My breasts were small and very dense. The BS said afterwards that the surgery was difficult for her. It's a delicate balance between removing all the breast tissue and not shaving the skin too thin.
The whole experience seems to have happened long ago but was actually only almost 2 yrs. ago. You'll be intensely involved in breast health for months as you go through this surgery and recovery but with time you'll put it behind you and get back to everyday life. Best of luck and please feel free to keep us updated on how you're doing.
Upcreek, about a week ago I went into the guest bedroom to store the mardi gras wreath in the closet and get out a spring wreath for the front door. I noticed a bag on the bed and discovered your lovely gift! Thank you for the book and pretty bottle of maple syrup. I wrote you an e-mail but it bounced back. Now everyone knows what a lackadaisical housekeeper I am. I still haven't changed the sheets on the guest bed! Rest assured that if we have a houseguest before we depart for the summer on our Alaska trip, I will launder the sheets!
Speaking of the Alaska trip, our cute little truck camper is very clean on the interior and ready to go except for food and clothing. I transferred cooking and eating paraphernalia from the big 5th wheel, which will sit in its shed this summer. The first weekend in April we'll take a trial trip over to Gulf Shores, AL.
Have a great St. Patrick's day. I must remember to call my youngest brother and wish him a happy birthday.
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Carole,
Thanks for your welcome and prompt reply. I doubt I will be able to get nipple sparing because my DCIS is right behind the nipple.
My further question is: does it require an experienced one-step PS to do this? I know my PS is an experienced DIEP surgeon, but I don't kow about his experience in this particular procedure. I think he will have no problem doing regular TE based implant procedure.
Best,
Bella
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Bella-YT, I would think that if your surgeon is an expert at DIEP, a "one sided" one-step should be no problem. It is a fairly simple surgery. In my case, the total surgery took about 4 hours. My BS preformed the BLMX and then my PS took over. He inserted the implant (instead of a tissue expander) and then attached (sutured) the Alloderm to keep the implant in place and closed the incision with a nice, neat stitch. I had a drain that was inserted at the outer side of each breast. Surgeons who prefer to use expanders also utilize Alloderm to keep the expander in place. With the "one-step", implant size needs to be kept at a B or below. My PS recommended it for me because I was an appropriate weight and only wanted to be a "B" (I was an almost
. He feels like the recovery is quicker and that there is less pain overall for "one step" patients. He was generous with the prescription of muscle relaxers and pain meds. You will want muscle relaxers if you go the "one step" route.Catherine, you're welcome! And yes, I had "flexy breasts" too.
Meg, I'm so alarmed! I hope you can get an answer/cure for your ear soon! Hope you are feeling better with the use of the steroids.
Carole, SOOO funny! What a nice surprise to find UpCreek's present!
Have a good day all!
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Okiegal,
Thanks so much! Your reply is very informative.
It's sunshine and close to 60 degree here in Boston.
Happy St. Patrick's Day!
Bella
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Hi Carole, Okiegal, and all,
May I ask a few more questions:
1. Did you have to do followup or revision surgeries after the one-step?
2. How long was your recovery?
3. With the Alloderm inside your breast skin, do you feel strange, does it feel hard and tight? I have not seen Alloderm but I have seen implants, and I know implant itself is soft and light but what about Alloderm?
Thanks for your help,
Bella
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Bella, my recovery was perhaps a bit slower than some, but I only stayed one night in the hospital. After I returned home, I lounged around for a few days and took it easy for a few weeks. I had help from my mom and my sister, but was going "stir crazy" within a few days and went out to eat at a restaurant within the first week (with my drains hidden under a blousey top!) I was able to drive by the third week, but overall healing took longer. Your muscles take a while to accomodate the implant and you will be sore and your pecs will be weak for a while. Your PS can give you a good estimate of what your recovery time should be.
My only "revision" came when I had my nipple reconstruction (an out patient procedure). I had my PS revise the scar a little bit. I still have not had tattooing done.
Alloderm is an "acellular matrix", basically it is tissue with everything removed except the collogen. It acts as a mesh and your tissue grows into it and I think that it is eventually absorbed, so that your breast skin ends up feeling the same everywhere. My implants are by Allergan and are the Naturelle line. They are as soft as the sample that I felt in the doctors office. I am very happy with them!
There is something weird happening with my computer or this website. Whenever I hit the apostrophe key, it returns to the bottom of the page to a search function. Wierd, but that is why my post sounds a bit stilted!
Have a good day all.
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Thanks so much, Okiegal.
How long did you have the drains before they were removed?
And how long after the MX and one-step did you have the nipple recon?
Thanks again,
Bella
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Catherine: Sorry to hear of your problems but everyone is correct in saying that it is fixable. Please keep us posted.
Bella: 81 pages to sift through? Wow, these ladies sure chat allot don't they. whoops, I guess I'm one of the guilty ones. My surgery took 4 hours, had 4 drains that were out in 10 days and healed very quickly.
Meg: Did you celebrate St. Patrick's Day? We had our usual family gathering with traditional Irish dishes (and not corn beef and cabbage--not sure where that originated from). We had Dublin Coddle, scallops and mushrooms, and colcannon. My sister made a brownie like dessert with icing like the Irish Flag. And of course, real Irish coffee! We have friends in Ireland and their celebrations are low key compared to us in North America. Meg, I hope you are feeling better.
Carole: You are very welcome for the little gift. We enjoyed our visit with the two of you so much and think of you often. I sent you an email.
Hi to Okiegal and Fortunate One and everyone else.
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Upcreek, what an interesting Irish meal. DH would love the scallops, his favorite seafood. St. Patrick's day is celebrated in New Orleans with--drum roll--parades and throws! There are some bars in the Irish Channel of New Orleans that are favorite places to gather. My youngest brother's birthday is on March 17.
Questions on drains, etc. I had two drains, one on each side. They stayed in for 10 days if my recollection is accurate. The removal was relatively painless, but I had quite a hole on each side that was sore for a few weeks.
Questions on revisions. For women desiring a perfect result, it's common to go back for revision procedures to exchange implants for larger size, to raise or lower a breast, deal with a divot, etc. My PS wanted to do a revision surgery, re re-position my right breast (BC breast) and exchange implants for larger ones, but I doubt that I will ever choose to undergo another surgery for cosmetic reasons.
Today looks beautiful outside, sunny and mild. We ran the A/C last night because we like to sleep with a light blanket and the outside air was too balmy to open a window. Spring arrived several weeks ago and along with the blossoms, we have various pollens that play havoc with the human sinuses. Funny, but I never wondered before whether the animals have any sinus problems! A famous poem (Lovesong of J Alfred Prufrock) starts with the line, "April is the cruellest month of the year." I always think of that line when spring arrives with all its beauty and hope of renewal and birth and all of its pollen!
Meg, I find your hearing issue very upsetting. I do hope that you regain your hearing. Keep us informed because we're very concerned. My worry is loss of vision because of some family history.
Well, I must go walk 3 miles before breakfast. Later I plan to go to the driving range and hit some golf balls in the hope of improving my golf game. I have been playing so badly that I find myself not enjoying myself. I guess I'm one of those people who only enjoys what I do well.
A great Saturday to all.
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Hi everyone, and Bella,
Bella, I was in the hospital two nights, then an easy recovery at home. Some pain in the hospital, very little at home. I had two drains (a unilateral) that I hated. They were taken out after ten days. That's when I felt presentable, though I think I was still wearing loose buttoned blouses.
I had a bit of skin die along the incision, which was removed in a small procedure in a small operating room at my PS's office. I also, later, had a nipple made and some fat transfered to fill a divot. My PS wants to do another fat transfer, but I don't know if I will. The alloderm did feel a bit stiff at first, but is now soft. I have a stiff spot along the scar, but I don't think it's the alloderm. The PS matched my "full B", whatever that means, pretty well. For a while I was upset about the differences. We all want to be restored to our natural look. The new side has a different, rounder, but similar shape, moves differently, flexes when I use my pec, all of which take some getting used to. But you will. In a bra, truthfully, no one would notice a thing. In this strange world of BC, the one-step is mercifully easy.
Meg, I hope your hearing issues resolve with your hearing intact. Let us know.... big hug.
We had salmon with a little dry rub, seared in a red hot cast iron skillet, champ (potatoes mashed with cabbage), asparagus, and beer. Yum. Would love to try the scallops!
We're having a lot of fun watching our local basketball team show what it can do - go San Diego State!! I did my undergraduate work there, DH just added another masters there - a fine school that doesn't always get much respect.
Carole, three miles, you are my hero. I never, ever seek out exercise, and never care about it. So, I finally have joined a gym. It has lots of classes for me to try, and maybe come to enjoy.... I hope! It's brand new, opens in April. So I only have a little time left to be my natural indolent self. Wish me luck.
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Hello Everyone,
Thanks for your concern about my hearing. Day three on the steroids and I feel flushed and have difficulty sleeping. It is now 12:40 a.m. and I am wide awake! The good news is my severe headache is now a dull headache and I do feel like my hearing in my left ear is improving. I will see the otolaryngologist again on Friday and I have an appointment with a neurologist on April 4.
Bella, My surgery took 4 ½ hours and I was in the hospital for 2 nights. My drains were in for two weeks, but it depends on how many cc of fluid drains out. I kept a chart and brought it with me to my PS appointments. I will have 3-D tattoos someday...I'm not ready yet! At first your breasts will be swollen and look larger. As you heal they will soften and drop some. Best of luck and let us know how you are.
Upcreek, We celebrated St. Patrick's Day with corn beef, cabbage and boiled potatoes. For dessert we had chocolate cake with green icing that looked like grass topped with a Leprechaun! LOL... I don't drink, but people tell me that DH makes the best Irish coffee!
Carole, We have had spring weather for 3 days now! My son is already complaining of a sore throat! Happy to hear you camper is ready!
Okiegal, I hope your computer is behaving!
Fortunate1, Enjoy the new gym! My sister takes a zumba class and says it is a lot of fun.
Take care everyone. I hope you are all well and have a good Sunday!
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Hi all,
Thanks so much for the information. I saw my PS yesterday and it seemed to him that I am not a good candidate for a one-step recon: he indicated that for the one step the person needs to have a good size breast envelope for the surgeon to close it in one-step, because I have a B cup, I may not have enough skin to close it. He said typically the one-step is down-sizing, something like from a C cup to a B.
He did say that he will see whether the one-step can be done at the moment of surgery, if not, he will most likely put the expander in. He said he would rather be conservative and safe then try the one-step which he thinks my breast skin may not take it.
So we will see.
Thanks for all the information about surgery length and number of drains, etc.
Have a good Sunday.
Bella
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Hi Bella,
I went in a C cup and came out the same.
My PS has the same approach as yours. He too warned me about the risk of the skin not taking it.
My operation was after chemo which can also affect the skin condition.
I appreciated his approach of not selling me the best case scenario. It is better to be ready to all the options.
Hope every thing turns your way. The worst that can happen is not bad because he will put the expanders.
I had a double MX with the immediate recon. I had 2 drains for almost ten days. I went back to work only a month after surgery. Took me around that time to drive.
At first, I needed help around the clock because I could not get up alone from bed.
Again good luck.
Wish a good week to all.
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MaiTai,
Thanks for sharing your experience. This is very helpful. My PS is actually a DIEP expert so he reiterated the benefit of having DIEP which is one step. He said that the implanted recon require multiple steps, the fillings and exchange surgery, etc. He said one of his patients was not happy with the implant and eventually did a DIEP. For implant recon, the breast would ripple sometimes because of the shape of silicone. But he also said that he respects my decision.
I am comfortable with my decision: UMX with immediate implant recon. The surgery time is shorter (he said 3.5 hours) and so is the recovery time. I like your attitude of getting back to work. I'd like to get rid of the BC and return to normally as soon as I can.
Thanks,
Bella
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Hi all,
Bella, your surgeon makes a good point about needing an appropriate amount of skin. I went from a slightly saggy B, to a full B. My PS did a good job of copying what I had, but I'm a bit larger overall. I recall at the appointment where he discussed the surgery that he indicated that he would try a few sizes of implants during the surgery to see what would fit properly and would try to create the size I had requested. I must have had enough skin in the end. Either way, you will have drains. Mine were for in between 10 and 13 days. The left side stayed in longer than the right and left a dimple that the PS smoothed out at the same time that he did my nipple reconstructions. I had my nipple reconstruction at about 4 months after my original surgery. I waited until the fall because I wanted to make sure that I could wear heavier clothing to conceal any buldging bandages. Plus, I was kind of anxious to opt for another procedure and wanted to be healed really well. I think I could have chosen to do it sooner.
Meg, I'm glad to hear you are following up with specialists and that your headache is going away. I continue to hope for a full recovery!
Yum, everyone's St. P's celebrations sound good!
Fortunate1, I want to take a Zumba class. Let's go check it out!
Best to UpCreek, Carole and all the rest!
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Hi to everyone. I was signed up for golf today, but called yesterday afternoon and had my name scratched off the list. I have been too much on the go lately and wanted to have a leisurely morning and get some chores done. This afternoon and tonight is my babysitting stint with my niece's 3 children. Boy, have I gained admiration for you moms who have reared children. They constantly test the boundaries, don't they? I feel sorry for my niece having to deal with 3 children of different ages, but she chose to have them. I hope the pleasure matches the stress.
My calender for the rest of March, April, and the first half of May is filled with medical apptments that I need to get in before we depart.
All the trees are that vibrant shade of spring green except for the pecan trees, which are the last to concede that winter is over. The azaleas and bridal wreath and wisteria are in bloom. Pollen count is high!
My weight is still seesawing. I go down 3 or 4 lbs, then go back up. It has been almost 2 years now since my bc dx when I was at my goal weight.
Enough dawdling. Before starting my chores I'll do a weight workout. Happy Wed. to all.
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carole- your description is beautiful!
Nice day to all.
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Good Sunday morning. the sun is shining. Had company over for dinner last night (Carole--the friends we visited in Florida) and had a great supper. Rolled a pork roast with peppers, asparagus and goat cheese, garlic roast potatoes. Was good and it was my friend's birthday.
Taking my mom shopping today for shoes. My DH is going away for business and I will join him after work tomorrow for two days and fly back with him.
Meg: I hope your ear is better. Let us know.
Fortunate 1: I bet the salmon was good. There is nnothing like those cast iron pans!
Hi to all and have a wonderful Sunday.
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Hello everyone,
I had another hearing test on Friday and there was little improvement. I have an appointment for at CT tomorrow morning. In two weeks I will have an ABR test which tests the nerves to the brain. My headache is much better. My left ear feels like it needs to pop and I have ringing in both ears, but otherwise I think I hear fine! I do not have the TV or radio blasting and I am soft spoken!
Carole, When do you leave for Alaska and how long will it take to get there? What an adventure! My weight has been up and down too, but I am eating too many sweets at times! My headache has stopped me from my daily 3 mile walk. but I'm going to walk today!
The weather is crazy in NY. Last week we had two days of snow and then rain! It has been cold with temperatures ranging from 20's and below in the evenings and 30-40 during the day.
I hope you are all well and have a great Monday!
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Hi Meg, it's good to hear from you. Glad that the headache is better. I hope the CT went well and that you have some answers.
Our weather is alternating cold and drizzly and cool early spring sunny. We have planted our tomatoes, swearing that we will take better care of them this year. We are eating the last of the oranges and are dizzy with the sweet smell of orange blossoms for next years crop. My weight is up and down too, just a couple of pounds but I swear even that little amount is giving me a little tummy bulge. Just two weeks until the gym opens for business. Nice and new, clean and sparkly. I think I need to figure out what one wears to a gym... how ignorant could I possibly be? Can I hide the jiggly parts somehow?
Hugs to all. How are you, Bella?
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Thinking of you Meg! And glad your CT is over!
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Fortunate and all,
I am doing fine, thanks for asking. My surgery is scheduled in Mid April, and I work till the day of the surgery. I am comfortable with the type of the surgery I am having, but once a while I wonder what if something goes wrong in the surgery. I am afraid that there will be too much pain if things go wrong or they wheel me back for another surgery. I had complication from a surgery two years ago, so I worry that will happen again.
Other than that, I am hanging in here and try not to think too much
Hope everyone have a wonderful day!
Bella
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Waiting is so hard, and worrying is so natural. Come here and worry "out loud" if it helps. Before you know it, you'll be out of surgery and healing. Something that several of us had in common... feeling relief to the point of elation when we woke up.
Hi Okiegal, have you planted your garden yet?
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Hi all,
The wedding shower for my niece was this Saturday. It turned out lovely, but was so much work! Also, a lot of worry about who was coming. Apparently, a majority of people don't understand that RSVP means "please call the hostesses and let them know if you will or won't be attending!" In the end, we had plenty of homemade quiche, fresh fruit salad and a variety of sweets and coffee. The weather was absolutely gorgeous, sunny and in the 70's with spring flowers just starting to bloom.
I've been busy with work and the aforementioned party and eating too much, but at least the house is clean and I'm starting back on WW again today with exercise! Fortunate1, we've planted only lettuces so far and need to replant some of the ones that didn't sprout. We have some other "starts" waiting indoors, ready to plant as soon as possible. We're going to try to grow tomatoes, squash, cucumbers, eggplant, bell peppers, jalapenoes, cilantro and basil. We always struggle with the tomatoes and squash, but hope springs eternal!
Hope everyone is doing good. Have a good week!
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Okiegal, the prospective garden sounds wonderful. Squash is very easy to grow here. Also cucumbers. They grow so fast the pests don't have time to ruin them. Tomatoes are almost impossible to grow without applying 7 dust. Lots of pests to ruin the fruit.
DH and I took a shakedown trip to Gulf Shores, AL, with the truck camper this past weekend. Everything went well. The trip to Canada and Alaska this summer will be doable with this small camper. Sleeping in the queen-sized bed was ok. Not as comfy as the king-sized bed in the big camper but by the 2nd night we slept sounder than the 1st night. Sitting at night will be the biggest loss of comfort. Our only seating is the dinette banquettes. Taking a shower is a challenge for DH, who is on the portly side. The shower is small.
The weather at Gulf Shores was delightful. Sunny with a breeze off the ocean. Cool enough at night to sleep with the windows and hatches open. We took the bicycles. On Sat. we bicycled to the beach and walked on the harder packed sand near the water. Afterwards we biked on a nice paved trail for a total of 10 miles. On Sun. we biked the trail again for a total of 12 miles. Being out of shape, my leg muscles felt the exercise.
I've been so over-scheduled lately that I've decided that something has to go, and that something will probably be bridge games. I'll continue to play on my computer.
Fortunate, how are the classes going? Meg, any more improvement in your hearing? Upcreek, is winter coming to an end? Did you do a lot of ice skating this winter?
Hi to everyone.
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Our garden problem is neglectful gardeners. We never get the soaker hoses that we use adjusted just right. Lack of water in the heat of summer = vegetable suffering. But we always have enough tomatoes for some satisfaction.
Carole and DH will see the garden this summer, I'll have to do my best.
Bad news on the teaching front. California schools aren't doing too well and I lost one of my classes yesterday to the terrible budget cuts. I'll finish out the semester and pack up my tools. The second school, that distressed me by giving my class to someone else this semester, hasn't told me anything yet. A class for me is in the schedule for next semester, but cuts are being considered.
I, on the other hand, am having a great time doing figure sculpture in clay at the second school. My friend that teaches it and lets me work is very encouraging. Artists always want more time to do their own work. Maybe this will be how I finally get mine - no teaching to distract me.
Hugs to all.
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