March 30, 2009

More cancer dreams

Last night I had a dream, very similar to an earlier cancer dream.

I was on the phone with an important business call when a couple of people in the room started to talk louder and louder. I asked them to move into another room, to lower their voices, but they just got noisier and noisier. Finally, one of the pair of noisy talkers took the phone from my hand and unplugged the cord. Imagine my frustration that I couldn't finish my conversation! I chased the talkers from the room, threatened to call the police, and tried to get my call back, all at the same time.

I think this is my chemo metaphor. I always said to the mets that if they misbehaved, I'd have to call in the big guns to zap them back into silence. Now it seems I feel they are taunting me. So I am going to take them seriously and bring out the first of the big guns -- the first chemo I've had since my original diagnosis in 1999.

Yes, I'm scared of moving from these relatively benign anti-estrogenic drugs that put me into early menopause, gave me hot flashes, and caused me to gain weight. In exchange, the side effects will be diarrhea and mouth sores, maybe some hair thinning. I'll be on a short tether to the infusion center (as well as potentially to the toilet). But I aim to bring all my cancer back to a quiescent state.

March 29, 2009

Just say....

A friend shared this comment on a recent post, and I thought I must share it with everyone:

"All I can say is: "Just say FU to cancer!"

Now that's a positive attitude I can get behind.

March 26, 2009

A new (old) drug -- 5-F U

I took 5-FU in the adjuvant setting, when I was originally diagnosed in 1999. This time it will be given intravenously once a week for six weeks, along with leucovorin, a form of folic acid, that helps the 5 FU work more effectively. I'll also take vitamin B6 (pyridoxine) to help manage any hand-foot syndrome, although the risk is smaller than for xeloda. The main side effects are diarrhea, mouth sores, even some hand-foot syndrome.

After six weeks, we will evaluate while I take a two week break from treatment. I may have more scans to determine how well the 5-FU is working.

I'll be calling my naturopath to see what he might recommend to supplement my health while on chemo.

It's my first chemo since 1999, and I don't mind saying I'm a little apprehensive. Still, I did take this drug once before and tolerated it pretty well. Maybe the same thing will happen again with this weekly dose. One can always hope.... and it's so like me to find the silver lining even in this cloud.

Change in treatment

After some conversation, Dr. G and I have decided to start me on intravenous 5-FU (Fluorouracil). Here's why.

Xeloda (capecitabine) would have been the chemo of choice. It's more than an oral form of 5-FU, and thought to be more effective because of the way it bonds to an enzyme that affects the cancer cells. But 60% of the people taking it develop some form of hand-foot syndrome (Palmar-Plantar Erythrodysesthesia) as a side effect. The hands and feet turn red and itchy, crack and are tender.

Given my lymphedema flare up that still hasn't subsided, the thought of a greater than 1 in 2 chance of developing something that would trigger even more edema was hard to bear. I can imagine all too clearly what it would be like to wear a compression glove over such sensitive skin. I wouldn't be able to, and that would trigger more edema, and the vicious cycle of not being able to do for myself would start.

Also, given my recent hospital stay to treat a staph infection, the risk of getting another infection from a virus or bacteria that entered via a crack in my cuticles seemed like an even greater risk.

Living with mets is all about QOL -- quality of life. And if my QOL goes down too far, it's a short slide from "why bother?" to giving up. Which I am nowhere near ready to do.

MRI results

Good news: the report on last week's MRI of the thoracic spine does NOT indicate new metastases. Instead everything which appears seems to have been treated already. No risk of spinal cord compression or fractures.

Bone scans show only bone activity. If I'd broken a bone as a child, it would still show up on a bone scan. Likewise old, treated mets show up on bone scans as well as new mets.

It's possible that the MRI did not cover the same places as the bone scan, although I am sure the thoracic spine is the thoracic spine. I did not see the bone scan report but the MRI report is very thorough.

Dr. G cleared me to dance (a little). We discussed a new treatment; more on that later while I do some research.

March 24, 2009

Medical paperwork

I got two items in the mail yesterday. My insurance company sent me a notice that they paid a bill for a doctor I don't recognize and for whom I owe a copay. The hospital sent me an invoice for "recurring outpatient" with no dates of service or other details.

I ask you, how is a person supposed to deal with this?

It means getting on the phone with the insurance company and the hospital, taking copious notes, making sure I get the names of the people I speak with and dating my notes so that when it happens again, I have concrete information to back myself up.

Isn't it enough that I have metastatic cancer? Do I also have to spend hours of my precious time dealing with medical paperwork?

The short answer is Yes.

Why can't the companies do things right the first time?

March 20, 2009

Thoracic spine MRI today

Today I went for an MRI of the thoracic spine, where I have new mets. My ears may have heard MRI, my eyes saw my hand write it in my calendar, but clearly my brain didn't register it.

Normally for an MRI I bring my own eye mask and ear plugs and take some lorazepam so I don't get too stressed from the claustrophobia of being in the MRI tube. But since my brain didn't register MRI as MRI, I was not prepared. Luckily I carry meds with me and was able to take both some lorazepam and some hydrocodone in case I had pain from lying still on my back for 30+minutes.

The technician provided a wash cloth, which we draped over my eyes. She gave me ear plugs and pads over each ear to close down even more sound. (MRIs are notoriously noisy. The patient is subjected to with all kinds of clanging sounds.) They gave me a panic button to hold I and practiced my yoga breathing during the scan. Best of all, the doctor decided not to have a scan with contrast, so I didn't have to have a vein accessed.

I get the results next week. We already know from the bone scan that I have more mets. The MRI results should give a better idea of how serious they are by pinpointing the location(s) close to the spine.

"How are you"

Sometimes when people ask, "How are you?" I answer "Fine" and I mean just that -- things are right in my world.

But sometimes when people ask how I'm doing, "Fine" means this --

F = freaked out
I = insecure
N = neurotic
E = emotional

I learned this at a support group I used to attend and it's always been relevant. Even more so when you're living with cancer.

March 19, 2009

Dunava spring concert


Dunava will sing in two concerts this spring --

Saturday, April 11
Full Moon Concert Series
Shoreline Universalist Unitarian Church
14724 1st Ave NE, Shoreline, WA 98155
7:30 p.m.
Special Guest: Croatian dance music by Ruze Dalmatinke!
Tickets: $15
Contact me if you want to buy a ticket in advance!

Saturday, May 2
An evening with Dunava
Cafe Babel
126 NW Canal Street, Suite 100, Seattle, WA 98107
7:30 p.m.
$5 cover charge at the door
A casual evening of a cappella music from the Balkans

March 17, 2009

More tests

Dr. Goldberg wants me to have an MRI of the thoracic spine before changing my treatment. That will be this Friday. He'll get the report in 2-3 business days and his wonderful office staff have squeezed me in next Thursday to see him and get the results.

No word yet on whether the dasatinib trial is a go. I hope to hear more next week.

No news yet

I'm still waiting to hear about the clinical trial. In the meantime I have scheduled an MRI of the thoracic spine to see more clearly what's cooking there.

March 13, 2009

The Cancerland Carousel


I frequently use this image: If being diagnosed with breast cancer the first time was like being on a roller coaster, living with metastatic disease is like being on a carousel or merry-go-round.

Sometimes I'm sitting on the bench, enjoying a quiet ride.

Other times I'm going up and down on a pony.

That's what it feels like now.

March 11, 2009

New mets

I saw the oncologist today and the results of my recent bone scan indicate new metastases in the thoracic spine (around the shoulder blades) and right rib. My tumor marker has climbed as well from the December low of 17 to a current value of just over 80. It appears that the Arimidex is not working as well as we had hoped.

We discussed a clinical trial, Xeloda, and estrogen therapies. Dr. G's staff is going to find out if I qualify for the dasatinib trial. If I do qualify, this is the treatment plan of choice. No doubt it will include more scans and tests, to help determine the disease's current activity more completely.

As far as estrogen therapy goes, Dr. G discussed my case with Dr. Hannah Linden, an oncologist at Seattle Cancer Care Alliance, who thought it might be a good fit for me when they start running this protocol. Dr. G wisely says that there's no point in trying to replicate the study results without a protocol. He remains concerned that any benefit from estrogen would be very short-term (like the drop after stopping tamoxifen and starting Arimidex, which lasted about a month). And of course, with such a highly estrogen-sensitive cancer as mine, giving me more estrogen could simply mean feeding the cancer.

As my cousin the oncologist pointed out, I can always take Xeloda if I don't qualify for the clinical trial or the dasatinib doesn't work.

Stay tuned for more.

Sharsheret teleconference update

Here is some feedback from the Sharsheret nationwide teleconference “Take It From Me: My Words In My Own Way”.
The teleconference was a true success and attendees benefited from your shared experience. The discussion about Journaling, Blogging and Writing your Living Story will be shared with hundreds of Jewish women, their families, and health care professionals across the country via a written transcript posted on our website.

We would like to share with you some of the positive feedback we received about the “Take It From Me” teleconference from attendees:

“I've got some beautiful stuff from my kids (cards they've made thru the years, emails to me)and now I know how to leave them to my kids in a meaningful way.”
“I certainly learned a lot. “
“I received the encouragement to write.”
“The speakers validated my experiences to date using writing as a healing tool.”
“It was most interesting.”

Over 50 participants nationwide, appreciated the thoughtful insights you shared on the teleconference. Thank you for your contributions to our meaningful event. We look forward to sharing news of Sharsheret’s growth with you in the years ahead.

Sharsheret
(866) 474-2774
Linking Young Jewish Women In Their Fight Against Breast Cancer

March 09, 2009

The cookie holiday

Tonight begins the Jewish holiday of Purim, otherwise known in our house as the cookie holiday. I am convinced that the reason we give each other sweets on this holiday is to use up the flour before Passover.

This is truly the holiday about which we say, "They tried to kill us, God saved us, let's eat," even though there is no mention of God in the book of Esther. It's the Jewish equivalent of Mardi Gras, when we dress in costumes, drink to excess and generally carry on until we can't tell the difference between bless Mordechai and curse Haman.

I baked 52 hamentashen this year, using the recipe from Joan Nathan's Jewish Holiday Kitchen as adapted by my friend D, who adds 3 tablespoons of milk and some nutmeg to the dough. I filled some with cooked apples, some with mini chocolate chips (the American version) and some with fig jam and dried cherries. Of course I had to taste one of each...

I had a minor oven incident when taking out the last tray and gave myself a little burn on one arm despite wearing the long oven mitts! Some aloe vera did the trick to take away the sting.

March 08, 2009

Dunava rocks!

Dunava sang today as guests of the Columbia Choirs. It was our first performance at Town Hall, Seattle's community culture center located in the historic First Hill neighborhood. The acoustics are marvelous for choral singing.

I think Dunava was a surprise for the audience, which seemed to be composed mainly of family and friends of the Columbia Choirs. Most of these groups, and the other guest choirs, performed highly arranged choral music from church and classical traditions. Dunava, by contrast, sang our rough and beautiful Balkan village harmonies.

We sang for about 15 minutes featuring songs from Croatia, Albania, and Bulgaria. (I had a short duet!) One of our newest members plays the accordion and she and another Dunavite, playing drum, accompanied a new Albanian piece.

It's safe to say the audience loved us and would have been delighted to hear an encore if the timing permitted. They were still applauding loudly after we left the stage!

Attitude improvement

Things are certainly looking up since I stopped bandaging my arm. Although my hand and wrist are still somewhat swollen, my attitude has shifted dramatically. Three nights of comfortable sleep without wrapping helped me feel more in control of my life. Although I did have some rebound insomnia from stopping the Ativan, that's easily remedied by an afternoon nap. (Not that I've had time for one...)

Of course it didn't hurt to have a little sunshine, a good dinner with friends, kisses from my husband and cuddly dogs.

March 05, 2009

Midnight meltdown

Last night I hit the max. I was tired (got up at 6:30 AM in order to be at the bone scan by 9:00); my arm was still acting up (bandaged since 5 PM); my port was accessed (so I could get the Zometa today and only have one stick).

By the time I got into bed I was a bundle of aches and frustrations. No matter how I tried, I couldn't get comfortable. Taking the nightly 0.5 mg dose of Ativan didn't help, so I took another half-milligram. I tried yoga breathing but couldn't stop twitching. Songs from the choir rehearsal earlier in the evening were stuck in my brain. Even a third half-milligram of Ativan couldn't relax me.

After tossing and turning for more than two hours, I was on the verge of tears when I finally figured it out. I can't take it any more. The combined stress of lymphedema flare ups, new cancer worries, and a sense that I have over-committed myself on too many fronts collided. I tore off the bandaging as fast as I could, thrashing around the whole time.

It's a wonder RIk got any sleep at all. It was about 2 AM by the time I had my epiphany. Eventually I fell asleep too.

Today I had my annual physical exam with my primary care doctor. She reinforced that I need to take a break from dealing with the lymphedema flare up and just go back to my usual coping for a while. So I will try the sleeve/glove during the day and nothing at night and see how things go. I cancelled my remaining physical therapy appointments and can always reschedule if needed. In a week or two I'll order new garments that hopefully will fit better.

I may have to adjust to another "new normal" with the lymphedema and learn to accept a larger hand and arm. I'm not quite ready to do that yet. Taking a break may help me adjust.

March 04, 2009

Sharsheret teleconference

Last night I was one of three presenters at a teleconference on writing as a means for self-expression for cancer patients sponsored by Sharsheret, the organization for young Jewish women with breast cancer. It turns out that I was the only amateur (the other two presenters are professional, published writers). I was a little overwhelmed at being in such company, but was glad to participate. Sharsheret also recently launched a blog, and was gracious enough to link from their blog to mine.

Here's what I said in the teleconference, which about 60 women had signed up for --
Why do I blog about cancer?

Thank you to Sharsheret for including me in this conversation. First a little bit about me: My name is Jill Cohen and I have been living with breast cancer for ten years. My original diagnosis at age 39 in 1999 was at stage II. I had a lumpectomy, CMF chemotherapy and radiation. I was also diagnosed with lymphedema a few weeks after my surgery. In 2002, my cancer returned with extensive metastases to more than 20 bones in my skull, sternum, spine, humerii and femurs. A few months ago I was diagnosed with three new primary tumors in both breasts. All of these cancers have been highly ER/PR+ and I have been mostly stable on anti-estrogen drugs and occasional rounds of radiation for the past six and a half years.

I started to write an ethical will, which our first speaker Linda spoke about, while recovering from a broken leg that coincided with my mets diagnosis. Every day I wrote and wrote and cried and cried. But I found I liked writing for 15 minutes every day as a way to express myself. And after my ethical will was complete, I missed the daily writing.

I should point out that I have no published credentials as a writer. Blogging is my first public effort to write outside of the workplace setting. I’m really an amateur.

So why do I blog?

1. I got tired of repeating the same conversation with different people every time I had news to share. When I was first diagnosed with breast cancer, we stayed in touch with family and friends via telephone and email throughout the months of my treatment. A few years later, when my husband had open-heart surgery, we did the same. Then when my mets were diagnosed in 2002, we started sending these mass emails again.

2. Sending email to dozens, maybe a hundred people soon became too time-consuming. I had to segment the large list of email addresses into sections because of the size limitations on the email system. Each post had to be sent several times. Pretty soon we were overwhelmed with people’s desire for up-to-date information and inundated with replies to every email we sent.

3. So I decided to start a blog. Readers can see my blog any time they choose. Most family and friends seem to check my blog several times a week. I feel some pressure to write daily but as I seem to have a lot to say, I can usually keep up with my self-imposed schedule. Unless a lymphedema flareup interferes with my ability to type….

By blogging, I am able to write both short notes and longer posts about whatever part of living with cancer is on my mind that day. I can rant about my frustration with the medical system. I can bemoan my frustrations with lymphedema. I disclose how I manage pain, talk about new symptoms (new tumors!) and deal with new drugs and their side effects. I actually find that getting the cancer stuff off my chest every day helps me live the rest of my life without dwelling on cancer. Best of all, I don’t have to repeat myself several times a day, every day, to different people. I also blog about holiday celebrations, cooking, living a Jewish life, gardening, my dogs, and spirituality, as well as living with cancer and grief, death and dying.

When I have very important news to share, such as test results, I do call my immediate family to tell them what’s going on. So in a way I am still repeating a few conversations. But most of the people I know were willing to check my blog at their own convenience rather than expecting an occasional email from me.

4. In addition to being a great way to stay in touch with family and friends, blogging also gave me an opportunity to educate members of the public who find my blog about the realities of living with metastatic cancer. Since metastatic disease is not frequently mentioned in the press, I think I also fill a need. I am always surprised when random people find my blog. Most of the time I enjoy reading comments from people I’ve never met. Occasionally I receive comments that I do not welcome, and I am able to delete those comments from public view.

My blog is called Dancing With Cancer: Living With Mets, A “New Normal.” It was rated 9.4 out of 10 total points and number 2 of all blogs on metastatic cancer by Blogged.com, an independent rating site reviewed by real people. I was surprised but proud to receive this recognition. It has apparently led others to read what I have to say.

Why did I call my blog dancing with cancer? I’ve been a dancer all my life and this image spoke to me. Sometimes the cancer leads the dance and I follow, and sometimes I am in the lead.

I didn’t learn quite enough about how to blog before I started blogging, so the name of my blog is not the same as the URL. You can read my blog at www.jillscancerjourney.blogspot.com.

I was thrilled to be asked three questions afterwards. The first was on how to deal with people who give you, the patient, unsolicited advice. Here I quoted another woman living with metastatic breast cancer, The Assertive Cancer Patient, who, when she blogs about new treatments, writes that she does not want medical advice from anyone. Her ability to set boundaries is a great example.

The second question had to do with Twitter, which I am unfamiliar with. You should have seen me, trying to access Twitter's web site while simultaneously answering the question.

The third question was a technical one about the ease of blogging. I said that I might be more computer-savvy than some, so it was easy for me to do the research on blog hosts, choose one, and set myself up. My only regret here is that I didn't come up with the name for the blog (Dancing With Cancer) until after I had set up the URL. So they're not the same, which might make it one step harder to find my blog online.

However, I just Googled the words "dancing with cancer" and my blog was the second hit, after a book by a cancer survivor and before Patrick Swayze. How's that for results?

Today's bone scan

I continue to be very glad that I have medical care through Swedish Medical Center's Cherry Hill campus, where every staff person, from the guy pulling the linen crate in the hallway to the infusion nurses and the nuclear medicine tech, greeted me with a smile today.

The scan was a breeze. After getting my port accessed and receiving the radioactive dye injection, the tech told me to take a break, have lunch and come back in two hours. Well, that was at 10 AM so I had more of a second breakfast at Cafe Stellina.

For $11 I enjoyed a fresh roll with sweet butter, a puff pastry tart filled with scrambled eggs, cheese and scallions (cooked to order, with the scallions substituting for pancetta, which I don't eat, it being pork), green salad and a decaf mocha. I was the only patron in the restaurant at that hour but the chef and waiter took excellent care of me. The food was delicious! I will definitely return for breakfast or lunch, since I believe they are only open until 5 PM.

After my yummy second breakfast (the hobbits would have loved it: "What?! No second breakfast?") I returned to the hospital for the actual scan. I set my iPod to shuffle, placed an eye mask over my face, and was tucked into a warm blanket for the hour-long scan. I actually think I fell asleep, because soft snoring kept waking me. If only MRI's were this easy!

I ran into Dr. Goldberg, Seattle's best oncologist, crossing the hospital's main admission area, and he too greeted me warmly and asked why I was in the hospital (for the bone scan he had ordered, but he can't be expected to know my schedule). Dr. G told me on the fly that he spoke with a colleague at UW Medical Center and she recommends he follow the treatment idea I had first brought to his attention -- estrogen followed by aromatase inhibitors. This concept was announced at the recent San Antonio Breast Cancer Symposium and appears to be a new spin on an old treatment. To learn more, read this article from Artemis, the e-zine of the Johns Hopkins Breast Centers.

I imagine that after Dr. G receives the bone scan report, and depending on the results of tomorrow's blood test, we may look at a potential change in treatment.

March 03, 2009

Bone scan coming up

Tomorrow I have a bone scan, the one that usually happens every six or so months. This time it will be an F-18 bone tomogram, which involves an injection of radioactive dye into the blood.

To do this the nurses in the Ambulatory Infusion Center will access my port. After I receive the dye injection, we allow time for the dye to spread throughout the body (a wait of usually more than one hour, so I'd better bring a good book). Lastly the scan itself, which for me means lying on my back on a scanner bed with an eye mask over my eyes so I can relax and practice my yoga breathing. The technicians usually let me bring my own CDs, so I subject everyone to Broadway show tunes and try not to tap my toes while in the scanner bed. The scan itself takes about an hour but the whole procedure takes up most of the day.

I was smart and scheduled the bone scan for the day before I am supposed to get my monthly Zometa. When the AIC nurses access my port tomorrow, they will be able to leave it accessed for the drug the next day so I only have to get stuck once. I am so in favor of only being stuck once!

Talking about blogging

Sharsheret , the organization for young Jewish women with breast cancer, asked me to participate in a teleconference called “Take It From Me: My Experience in My Own Words.” The three presenters will talk about three different recording methods addressing the varying needs and interests of women with breast cancer. The teleconference will end with a Q&A session.

Living Stories: Writing or Recording Your Life Stories

Journaling Through Breast Cancer: A Means of Self-Awareness and Self-Expression

Why Do I Blog? Tired of Repetition, Convenience, and Education (that's me!)


I'll post on how it went!

March 02, 2009

Hear Dunava sing

My 9-voice Balkan women's choir Dunava will participate in a Friendship Concert sponsored by Columbia Choirs of Metropolitan Seattle on Sunday, March 8, 2009 at 1:30pm at Seattle's Town Hall, 1119 8th Avenue.

As Dunava's director said, "We're one of six choirs, but I'm sure we're nothing like any of the others."

From the press materials:
Music from around the world sung by award-winning Seattle area choirs

Invited Guests
Snohomish Children’s Choir
Seattle Youth Chorus
Dunava Women’s Choir

Columbia Choirs
Columbia Children’s Choirs
Columbia Vocal Ensemble
Con Brio Women’s Choir

Tickets at the door
$10 – adults
$7 – seniors
$5 – children under 18

March 01, 2009

Chestita Baba Marta!


"All over the world people meet spring with joy and new hope but it is only in Bulgaria where it is saved as an ancient custom.

If you are walking along the streets in Bulgaria on the 1st of March you will witness many smiling faces. But first of all your eyes will be captured by martenitsas. Everyone has decorated their clothes with them. Moreover, you can see decorated dogs and cats. In the small villages in the mountains people decorate their domestic animals: lambs, kids, young horses. Houses have their own martenitsa, as well.

Maybe you are wondering what this decoration looks like. The classical "martenitsa" is made out of red and white weaved threads. Sometimes it ends are made into tassels from the same yarn. Usually the tassels are decorated with blue beads, small golden coins or colorful threads.

In ancient times "matenitsa" was accepted as a ritual sign - an amulet for protection from evil spirits. Nowadays, almost all these functions are forgotten and it symbolises the coming of the spring. But even now Bulgarians believe that they will be healthy during the whole year if they wear "martenitsa" in March. There is an ancient saying that "If you don't wear your martenitsa, Baba Marta will bring evil things to you".

The mythical character of Baba Marta personifies the spring, the sun that can easily burn the fair skin of people's faces. According to the national belief Baba Marta is an old lady. She is an old lady and she is limp. That's why she carries an iron stick to learn on. The national beliefes define the temperament of Baba Marta as very unstable. When she was smiling the sun was shining; when she was mad st somebody cold weather was firming the ground. The majority of the rituals aim to make her happy and merciful.

People believe also that Baba Marta would visit only a very clean and tidy house. That's why people clean their houses thoroughly at the end of February. Symbolically this is a spring cleaning from all bad, old and unfertile stuff from the past year.

Baba Marta had specific requirements to the people she was going to meet the very first day in March. The old people didn't go out early in the morning because they could get her mad. She liked to meet young girls and women on the first of March which meant that the weather would be warm and nice.

Baba Marta was very favorable towards the people that wear martenitsa. Usually they were made from wool, silk and cotton yarn by women. The basic colors used were red and white. The threads are woven together. Traditional martenitsa can include other elements such as silver coins, beads, garlic, snail's shells, horse's tail hairs, etc. Together they formed an amulet.

On the first of March everybody should wear martenitsa, especially young children, just married couples or newly born domestic animals. Some of the fruit trees, the handles of the door, the vineyard also have their own martenitsa. There are special places where you can put martenitsa: on the wrists, on your neck as a necklace or on your left side of your dress. In some regions of Bulgaria there are special amulets according to people's social status. Young unmarried girls wear their martenitsa on the left side of their dress whereas young unmarried lads wear them on their left hand small finger, married men put martenitsa in their right sock.

People wear martenitsa for a certain period of time. Usually the end of the period is connected with the first signs of the coming spring - blossomed trees, meeting of the first spring birds like storks, swallows or cranes. Then people remove their martenitsa and tie them to a blossomed fruit tree.
In different regions of Bulgaria the process of taking off the martenitsa was connected with forecasting practices. In Southern Bulgaria people believed that martenitsa fastened to the wrists should be taken away when you see a flying stork. If the stork wasn't flying that was a symbol for a very lazy summer. People take off the martenitsa from their neck when they see a swallow which symbolizes the neck to be graceful and long as of the bird. Unmarried girls put their martenitsas under a big stone and then they would make a prognosis for their future wedding.

When the martenitsa is taken off according to all rituals its special spiritual purposes are over. This marks an important transition - the end of the winter and a tansfer to positive changes. This widespread practice of wearing of Martenitsa and its exclusive stability in the Bulgarian folk culture is explained with the believed magical power of the red colour. Along with the garlic, the metal coin, the blue beads, and wolf's or snake's tooth, the red woolen thread is believed to have the magic power to chase away the evil spirit, the demons and the illneses.

Bulgarians don't practise all these rituals nowadays. The necessity of most of these preventive measures has dropped off. The essencials of this rich ritual have been reshaped according to the modern holiday aspects. The kids are the most enthused when practicing this traditional holiday. They accept Baba Marta as well as they accepted Santa Clause two months before, but they receive Martenitsas instead of presents. There are many songs to Baba Marta also, that are kept from the ancient times and are still sung nowadays. All them are joyful and merry like Marta's character.

The Martenitsa... this magical amulet inherited by our predecessors is the first sign of the coming spring. That's why each Bulgarian wears martenitsa on the first of March, symbolizing ones faith that hereon everything will be better. People will smile because they believe they have won the benevolence of Baba Marta."

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