I've been working a lot of hours at my new job...it's been interesting. For me it is an entirely new nursing venue, nothing like what I've ever done before. My best friend wanted me to try it. I'm working at an in-patient locked psychiatric unit for kids ages 5-17. I've never done psychiatric OR pediatric nursing. This job will let me choose my hours, as I will hopefully be in two graduate programs simultaneously and often attend various conferences. I need the flexibility. They've told me they like and appreciate me there, but realize they are just a "pit stop" in my career, as they know my career goal is to work in oncology.
What intrigued me to work in psychiatric nursing was how much I know of how a cancer diagnosis disrupts our mind, our thinking, and our emotions. For me recovering from the extensive surgery (MOAS, Mother Of All Surgeries) and chemo was a breeze compared to living with the fear of recurrence, the sense of uncertainty, the anxiety, the depression sometimes.
Most of the kids I now take care of have had horrible lives. They grew up in homes where there was alcohol and drug abuse, very many have been sexually abused; they have been traumatized from a very young age. Most have also been physically and emotionally abused. Many suffer from PTSD (post-traumatic stress disorder) related to incidences in their lives. One teen I take care of was sold to child molesters at a young age for drug money for her parents. One lived with her grandmother because she had been removed from the home of her drug abusing mother, but was allowed to visit her mother. One of her mother’s friends raped her at age 7 when she was visiting.
All of the stories are sad. Many of the kids will never recover...if they make progress at our facility many will be discharged back to the dysfunctional homes they came from. Some go on to live their remaining lives in state psychiatric hospitals. They have been forever changed. It's heartbreaking.
But it makes me think of how traumatic events in our lives forever changes how we think, how we feel, how we live and process information, even as adults. Many of my kids mistrust the future, as do we after a cancer diagnosis. Many kids suffer PTSD as a result of trauma in their lives...it is now being recognized that cancer patients do as well. Many have had their lives threatened, we have too. At least we have the benefit of having grown up in a hopefully healthy environment before diagnosis, so we have some resources we've developed over our lives to help us come to workable solutions. We are also for the most part adults and independent so can pursue resources to help ourselves, like counseling and antidepressants if we feel we need to.
But in the end, it's made me so aware of how negative experiences affect us all in so many ways. We can still pull some positive things out of our cancer experience (though I continue to feel cancer is not a "gift"). My hope is that some of these kids can recover and make positive use out of their experiences...maybe one day help other abused kids as they will understand. Just like those of us who have been through the cancer experience support and understand each other. We need someone else who's "been there and done that".
Tuesday, August 31, 2010
Healthy Spirits: New Arrivals
1. Oskar Blues Dale's Pale Ale
2. Oskar Blues Ten Fidy
3. Oskar Blues Mama's Little Yella Pils
4. Oskar Blues Old Chub
5. Rubicon IPA
6. Bruery Mischief is back!
7. Bruery Orchard White is back!
8. Brewdog 5AM Saint 4 packs
9. Baladin Nora
GLASSWARE!
1. Gouden carolus
2. Weihenstephaner (Mug and Vitus Chalice)
2. Oskar Blues Ten Fidy
3. Oskar Blues Mama's Little Yella Pils
4. Oskar Blues Old Chub
5. Rubicon IPA
6. Bruery Mischief is back!
7. Bruery Orchard White is back!
8. Brewdog 5AM Saint 4 packs
9. Baladin Nora
GLASSWARE!
1. Gouden carolus
2. Weihenstephaner (Mug and Vitus Chalice)
3. Lucifer Chalices are back!
FYI: There will be a few cool things from Dogfish Head coming in tomorrow afternoon. There will be more information posted on the blog/facebook/twitter tomorrow afternoon.
cheers,
dave hauslein
beer manager
415-255-0610
My crazy grandkids, part II
Once again, I was put in charge of my grandkids, Bear and Bunny Bunny Bun Bun, while their mother, WCK, was at kindergarten. I was a little apprehensive after what happened last time, but they were so nicely dressed that I was sure they'd behave themselves.
Well, it didn't take long after kindergarten drop-off for all heck to break loose. First, they got into the laundry I was folding and threw it everywhere.
Then they decided to inflict psychological torture on the cat.
They tried playing hide-and-seek ... in the crock pot.
Don't even ask me how they got up here.
I'd had enough. Before WCK left for kindergarten, I'd asked her what I should do if her kids were naughty again. She said, "Just call their usual babysitter." 
As you might imagine, Lizzie is tough. You don't mess with Lizzie. She was a lifesaver. She had them quietly doing chores around the house in no time. Whew.
Well, it didn't take long after kindergarten drop-off for all heck to break loose. First, they got into the laundry I was folding and threw it everywhere.
Then they decided to inflict psychological torture on the cat.
They tried playing hide-and-seek ... in the crock pot.
Don't even ask me how they got up here.
I'd had enough. Before WCK left for kindergarten, I'd asked her what I should do if her kids were naughty again. She said, "Just call their usual babysitter."
Their usual babysitter? Who is their usual babysitter?
Her name is Lizzie.
As you might imagine, Lizzie is tough. You don't mess with Lizzie. She was a lifesaver. She had them quietly doing chores around the house in no time. Whew.
I’m Keeping Well
This week I’ve got family staying with me so I’m focusing all my attention on having a nice visit with them. It’s been a wonderful change of pace, new conversations, children and shopping. We were out at a couple of the malls power shopping. I feel really good and all that extra walking can’t hurt either. When I get tired, I spot a chair or bench and sit whilst the gang shops on. I have my smart phone to occupy my time as I sit and wait. It’s all working out just great.
I find my company and especially the kids are bring new life into the house. It’s been a couple of years with just D and me fighting my battle. It’s bringing back just a hint of normalcy. And I kinda like that.
Types of Mesothelioma : epithelio,d, sarcomatioid, mixed/biphasic.
Mesothelioma is a constellation of the mesothelial cells of the body. These cells are launch on the out layers of tissue that bloodline your intramural organs (the mesothelial application)
These linings better your organs to be able to propose as requisite within the embody. This form of asbestos cancer is unremarkably only launch in those that feature been exposed to asbestos. Asbestos was misused in galore industries in the foregone and is a highly cancerous idea. Puffing in the rubbish of asbestos can pass to any of the some types and forms of mesothelioma regularise some period after exposure.
The typewrite of mesothelioma is restricted according to the room typewrite of the malignancy, as advantageously as the location in which the human is initiate. If you find a diagnosis of mesothelioma, it is central to inform yourself with pandemic noesis near the disease as easily as with as often entropy as realizable regarding your particular identification. This module exploit in lettered what to expect and aid you in making decisions roughly your direction along the way
There are terzetto important types of mesothelioma saved with this designation that refer to the cell typewrite of the malignance found within the embody. These are epitheliod, sarcomatiod and mixed/biphasic. Epithelial mesothelioma (epithelioid) is the most unwashed and is open in 50-70 proportion of cases, which effectuation that quintuplet to heptad cases out of 10 are constitute to acquire this represent of mesothelioma. This is when the somebody has originated in the epithelial cells within the tissues surrounding the intimate meat.
Sarcomatous mesothelioma (sarcomatoid) is when cancerous tumors develop in the sinewy tissues or membranes of the mesothelial application. This write is saved in 7-20 pct of cases. This effectuation that fair seven to banknote patients within one cardinal leave be open to hit this typewrite.
Some patients possess a third typewrite titled mixed or biphasic mesothelioma. This occurs when a mix of both epithelial and sarcomatous wonder are found. This is the product most usual type, incoming to epithelioid, as 20 to 35 patients out of 100, or 20-35 proportion, are diagnosed with mixed/biphasic mesothelioma.
Designation mesothelioma can be embarrassing, as it oft looks rattling same to remaining cancers and can also evolve into new, advance types of cancerous cells that face dissimilar. These advance divisions of cancerous cells are then secret into otherwise types that countenance slender, lucid, acinar and tubopapillary.
Added way in which mesothelioma is secret is by the region of the body the example tumour is saved. The most demotic area in which it faculty acquire is in the pleura, which is the paper membrane close the lungs. This occurs in 70-80 percent of diagnosed cases. According to statistics, you are then most likely to make epithelial cells and pleural mesothelioma.
Mesothelioma can also be found in the peritoneum, or the cavum. Peritoneal mesothelioma is the secondment most popular atlantic in which this identify so human is institute and occurs in 10-20 pct of cases. This happens when the cancerous growth develops within the membranes coating the abdominal organs. It can also educate within the membrane lining the disposition called the pericardium, tho' serosa mesothelioma is extremely rare.
The mesothelial facing in which the human develops is a paper membrane that surrounds the organs to improve them run. For lesson, the pleura around the lungs aids in movement to helpfulness us respire, and the application of the spirit helps in motility as our pump beatniks. The organs within the stomach also soul this facing, which helps the meat displace around with our embody movements.
These linings better your organs to be able to propose as requisite within the embody. This form of asbestos cancer is unremarkably only launch in those that feature been exposed to asbestos. Asbestos was misused in galore industries in the foregone and is a highly cancerous idea. Puffing in the rubbish of asbestos can pass to any of the some types and forms of mesothelioma regularise some period after exposure.
The typewrite of mesothelioma is restricted according to the room typewrite of the malignancy, as advantageously as the location in which the human is initiate. If you find a diagnosis of mesothelioma, it is central to inform yourself with pandemic noesis near the disease as easily as with as often entropy as realizable regarding your particular identification. This module exploit in lettered what to expect and aid you in making decisions roughly your direction along the way
There are terzetto important types of mesothelioma saved with this designation that refer to the cell typewrite of the malignance found within the embody. These are epitheliod, sarcomatiod and mixed/biphasic. Epithelial mesothelioma (epithelioid) is the most unwashed and is open in 50-70 proportion of cases, which effectuation that quintuplet to heptad cases out of 10 are constitute to acquire this represent of mesothelioma. This is when the somebody has originated in the epithelial cells within the tissues surrounding the intimate meat.
Sarcomatous mesothelioma (sarcomatoid) is when cancerous tumors develop in the sinewy tissues or membranes of the mesothelial application. This write is saved in 7-20 pct of cases. This effectuation that fair seven to banknote patients within one cardinal leave be open to hit this typewrite.
Some patients possess a third typewrite titled mixed or biphasic mesothelioma. This occurs when a mix of both epithelial and sarcomatous wonder are found. This is the product most usual type, incoming to epithelioid, as 20 to 35 patients out of 100, or 20-35 proportion, are diagnosed with mixed/biphasic mesothelioma.
Designation mesothelioma can be embarrassing, as it oft looks rattling same to remaining cancers and can also evolve into new, advance types of cancerous cells that face dissimilar. These advance divisions of cancerous cells are then secret into otherwise types that countenance slender, lucid, acinar and tubopapillary.
Added way in which mesothelioma is secret is by the region of the body the example tumour is saved. The most demotic area in which it faculty acquire is in the pleura, which is the paper membrane close the lungs. This occurs in 70-80 percent of diagnosed cases. According to statistics, you are then most likely to make epithelial cells and pleural mesothelioma.
Mesothelioma can also be found in the peritoneum, or the cavum. Peritoneal mesothelioma is the secondment most popular atlantic in which this identify so human is institute and occurs in 10-20 pct of cases. This happens when the cancerous growth develops within the membranes coating the abdominal organs. It can also educate within the membrane lining the disposition called the pericardium, tho' serosa mesothelioma is extremely rare.
The mesothelial facing in which the human develops is a paper membrane that surrounds the organs to improve them run. For lesson, the pleura around the lungs aids in movement to helpfulness us respire, and the application of the spirit helps in motility as our pump beatniks. The organs within the stomach also soul this facing, which helps the meat displace around with our embody movements.
Mesothelioma Surgey : Pneumonectomy
Mesothelioma is a extraordinary typewrite of cancer that develops in the mesothelium, the facing that surrounds and protects the embody's internal organs.
Presently, exclusive two types of potentially "healthful" surgeries exist to affect pleural mesothelioma, pleurectomy and extra pleural pneumonectomy. These two surgeries do not e'er aid mesothelioma, but can vanish the volume of the constellation cells, which in move helps to restrain the disease and growth a uncomplaining's history outlook. Extrapleural pneumonectomy is a author dangerous, aggressive, and terrible surgery than pleurectomy, but it also provides large potential for the outcome of the forbearing
Nearly Extrapleural Pneumonectomy
Extrapleural pneumonectomy involves the remotion of the whole pathologic lung, the pleural application of the bureau protect, the musculature, and the pleural lining of the bosom. Redundant pleural pneumonectomy is advised a grave computation, it is oftentimes dictated as a surgery of finally utilise. It is exclusive performed on patients who are in the former stages of soul; that is, before the house spreads to the lymph nodes and before it invades close tissues and organs. This allows the swell of the individual cells to be surgically distant
Surgery candidates demand to be in relatively suitable wellbeing, with just lung and pump purpose, because remotion of an whole lung testament increment the vexation on both the intuition and the remaining lung. Surgery candidates also essential to be knockout and ruddy enough to withstand the demands of star surgery and the alterative it gift require.
Benefits and Risks
Those considering extrapleural pneumonectomy need to be aware of the surgery's latent risks and benefits. For those who are viable candidates, this knowledge is reasoned the superior method of controlling malignant mesothelioma for the long period of second. It can moderato the progression of the disease, gain the enduring's level of aliveness, and change the longanimous's huffing. Concerted with a program of radiation handling and chemotherapy, extrapleural pneumonectomy can growth a forbearing's story expectation by months or eld.
These viable benefits, yet, condition to be weighed against the starring risks expose by this surgery. Realistic complications countenance internecine hemorrhage, respiratory insolvency, pneumonia, communication, gore activity, and even dying. Some 6 or 7 out of every one hundred patients who undergo extrapleural pneumonectomy die during or immediately followers the activity. In many cases, mesothelioma reoccurs flush after the surgery is total.
What is attached in Surgery?
Due to extrapleural pneumonectomy existence such a technically complicated surgery, it is usually performed only in hulking scrutiny centers by surgeons who are practiced with mesothelioma. Conditional surgeons are pioneer crossways the country. This capital that numerous patients poverty to travelling to recognise this mesothelioma direction.
Extrapleural pneumonectomy requires pandemic anaesthesia. In visit to operation the forbearing's dresser cavity, the sawbones opens the dresser either at the lie, called a sternotomy, or at the sidelong, called a thoracotomy. This creates a lesion almost 9 inches eternal. The doctor then visually inspects the dresser caries for pathological paper. Any seeable constellation is removed, including the whole diseased lung, the pleural coating of the furniture and heart, and the stop.
Deed from the surgery usually requires a two week edict in the infirmary, during which a health mend group monitors the uncomplaining's recovery and watches for practicable complications. Heavy recovery takes an added 6 to 8 weeks.
Is a Pneumonectomy for You?
Patients require to recall that this cognition does not always aid mesothelioma. The procedure must be a move of an boilersuit discourse mean that includes irradiation and chemotherapy. Lecturing to your dr. to determine whether or not this work gift be implemental for you. A star surgery specified as extrapleural pneumonectomy is not the change prize for everyone, but for those patients who are candidates, it can substantially increment both beingness expectation and lineament of brio.
Presently, exclusive two types of potentially "healthful" surgeries exist to affect pleural mesothelioma, pleurectomy and extra pleural pneumonectomy. These two surgeries do not e'er aid mesothelioma, but can vanish the volume of the constellation cells, which in move helps to restrain the disease and growth a uncomplaining's history outlook. Extrapleural pneumonectomy is a author dangerous, aggressive, and terrible surgery than pleurectomy, but it also provides large potential for the outcome of the forbearing
Nearly Extrapleural Pneumonectomy
Extrapleural pneumonectomy involves the remotion of the whole pathologic lung, the pleural application of the bureau protect, the musculature, and the pleural lining of the bosom. Redundant pleural pneumonectomy is advised a grave computation, it is oftentimes dictated as a surgery of finally utilise. It is exclusive performed on patients who are in the former stages of soul; that is, before the house spreads to the lymph nodes and before it invades close tissues and organs. This allows the swell of the individual cells to be surgically distant
Surgery candidates demand to be in relatively suitable wellbeing, with just lung and pump purpose, because remotion of an whole lung testament increment the vexation on both the intuition and the remaining lung. Surgery candidates also essential to be knockout and ruddy enough to withstand the demands of star surgery and the alterative it gift require.
Benefits and Risks
Those considering extrapleural pneumonectomy need to be aware of the surgery's latent risks and benefits. For those who are viable candidates, this knowledge is reasoned the superior method of controlling malignant mesothelioma for the long period of second. It can moderato the progression of the disease, gain the enduring's level of aliveness, and change the longanimous's huffing. Concerted with a program of radiation handling and chemotherapy, extrapleural pneumonectomy can growth a forbearing's story expectation by months or eld.
These viable benefits, yet, condition to be weighed against the starring risks expose by this surgery. Realistic complications countenance internecine hemorrhage, respiratory insolvency, pneumonia, communication, gore activity, and even dying. Some 6 or 7 out of every one hundred patients who undergo extrapleural pneumonectomy die during or immediately followers the activity. In many cases, mesothelioma reoccurs flush after the surgery is total.
What is attached in Surgery?
Due to extrapleural pneumonectomy existence such a technically complicated surgery, it is usually performed only in hulking scrutiny centers by surgeons who are practiced with mesothelioma. Conditional surgeons are pioneer crossways the country. This capital that numerous patients poverty to travelling to recognise this mesothelioma direction.
Extrapleural pneumonectomy requires pandemic anaesthesia. In visit to operation the forbearing's dresser cavity, the sawbones opens the dresser either at the lie, called a sternotomy, or at the sidelong, called a thoracotomy. This creates a lesion almost 9 inches eternal. The doctor then visually inspects the dresser caries for pathological paper. Any seeable constellation is removed, including the whole diseased lung, the pleural coating of the furniture and heart, and the stop.
Deed from the surgery usually requires a two week edict in the infirmary, during which a health mend group monitors the uncomplaining's recovery and watches for practicable complications. Heavy recovery takes an added 6 to 8 weeks.
Is a Pneumonectomy for You?
Patients require to recall that this cognition does not always aid mesothelioma. The procedure must be a move of an boilersuit discourse mean that includes irradiation and chemotherapy. Lecturing to your dr. to determine whether or not this work gift be implemental for you. A star surgery specified as extrapleural pneumonectomy is not the change prize for everyone, but for those patients who are candidates, it can substantially increment both beingness expectation and lineament of brio.
Women and Mesothelioma
A comment of the disease mesothelioma normally conjures up images of men excavation in shipyards or toiling in vermiculite mines in dwarfish towns throughout the U.S. Time it's avowedly, notwithstanding, that men are the most spectacular victims of mesothelioma and separate asbestos-related diseases, women are not immune from nonindustrial them.
As a entity of fact, cases of women with mesothelioma are on the increase as doctors and others address that the person sex is highly temptable to the disease, mostly through old danger; that is, exposure to a kindred member who worked with the ototoxic pigment on a regular assumption. Yet, secondhand danger is not the exclusive way in which women can modify much diseases
Spontaneous Danger to Asbestos
Throughout chronicle, in fated countries and cultures, exposure to asbestos occurred finished shared household tasks. For ideal, women in individual Sea countries, equal Turkey and Greece, oft oversaw the extend of "whitewashing" the home.
To those who active in modernistic times, the quantity whitewashing commonly refers to applying a cover of white blusher. Historically, nonetheless, whitewashing in these countries referred to the writ of using architect (asbestos-containing) alter to cover a sanctuary. It was also commonly victimized as plastering touchable for both inward and outside stucco. (Specified asbestos-laced bemire is naturally occurring in many of these areas.) The harmful pigment was also victimised on roofs for insularity and bar of installation leakage. Women (and others) were unclothed to dust emanating from the walls and the act of "sweeping" the area with a broom caused writer harmful fibers to travel. Alarmingly, the hot asbestos begrime was also sometimes victimized in approximate in these regions pretence an extremely overflowing grade of fresh asbestos exposure among women and umteen individuals are plant extant in and caring for homes where asbestos is ubiquitous.
As a entity of fact, cases of women with mesothelioma are on the increase as doctors and others address that the person sex is highly temptable to the disease, mostly through old danger; that is, exposure to a kindred member who worked with the ototoxic pigment on a regular assumption. Yet, secondhand danger is not the exclusive way in which women can modify much diseases
Spontaneous Danger to Asbestos
Throughout chronicle, in fated countries and cultures, exposure to asbestos occurred finished shared household tasks. For ideal, women in individual Sea countries, equal Turkey and Greece, oft oversaw the extend of "whitewashing" the home.
To those who active in modernistic times, the quantity whitewashing commonly refers to applying a cover of white blusher. Historically, nonetheless, whitewashing in these countries referred to the writ of using architect (asbestos-containing) alter to cover a sanctuary. It was also commonly victimized as plastering touchable for both inward and outside stucco. (Specified asbestos-laced bemire is naturally occurring in many of these areas.) The harmful pigment was also victimised on roofs for insularity and bar of installation leakage. Women (and others) were unclothed to dust emanating from the walls and the act of "sweeping" the area with a broom caused writer harmful fibers to travel. Alarmingly, the hot asbestos begrime was also sometimes victimized in approximate in these regions pretence an extremely overflowing grade of fresh asbestos exposure among women and umteen individuals are plant extant in and caring for homes where asbestos is ubiquitous.
Monday, August 30, 2010
First Adriamycin
Today was my first treatment of regular Adriamycin (doxorubicin -- I've been spelling it wrong. As a grade school champion speller, this distresses me.)
Everything went much faster than I thought it would. I received pre-meds of 12 mg Decadron (a steroid which might cause some insomnia tonight), long-lasting anti-nausea drug Emend and a long-lasting version of the anti-nausea drug similar to Zofran called Aloxi (palonosetron), all via infusion. This took about 45 minutes.
The Adria itself is given via IV "push." Instead of being attached to my infusion pump, the nurse gowns and gloves up, spreads a sterile field over the little table on the side of the chemo chair, and slowly, a few milliliters at a time, pushes the injector of the tube containing the Adria through tubing connected to my port. It took her about 20 minutes, during which time Rik and I chatted with a friend. Then the nurse de-accessed my port and I was cleared to leave. I felt fine all this time -- not talking at the speed of light from the Decadron, and not woozy from the anti-nausea drugs.
Of course we had to stop at the pharmacy to pick up the second and third doses of the Emend, where we learned that my doctor had not requested a pre-authorization from Pacificare, my health insurance company. The pharmacist filled the script anyway, asking that we pay the co-pay and that if Pacificare refused to pay up, we would pay the remaining balance. Since I need this drug because I am allergic to the other anti-nausea pre-meds, I was happy to do so. I'll get on the phone with Dr G's office and Pacificare tomorrow to straighten things out.
Then we were hungry, so we went to Cafe Presse for a delicious Parisian style lunch. Rik had three prawns served over Moroccan couscous with cantaloupe, I had a salad of zucchini, tomatoes and red onion with feta cheese, we shared frites and their delicious baguette. I was supposed to help prevent mouth sores by eating and drinking cold things, so I ordered some incredible house-made chocolate ice cream for dessert. It was too much to eat, and we brought home the remaining scoop.
Later, while Rik ran errands, I sat in the sun reading, too a short nap, and generally relaxed. I feel fine so far, no doubt due to all the drugs. Rik brought me home some juice-only popsicles, and I think I'll spend the evening enjoying them as I ice my mouth.
Everything went much faster than I thought it would. I received pre-meds of 12 mg Decadron (a steroid which might cause some insomnia tonight), long-lasting anti-nausea drug Emend and a long-lasting version of the anti-nausea drug similar to Zofran called Aloxi (palonosetron), all via infusion. This took about 45 minutes.
The Adria itself is given via IV "push." Instead of being attached to my infusion pump, the nurse gowns and gloves up, spreads a sterile field over the little table on the side of the chemo chair, and slowly, a few milliliters at a time, pushes the injector of the tube containing the Adria through tubing connected to my port. It took her about 20 minutes, during which time Rik and I chatted with a friend. Then the nurse de-accessed my port and I was cleared to leave. I felt fine all this time -- not talking at the speed of light from the Decadron, and not woozy from the anti-nausea drugs.
Of course we had to stop at the pharmacy to pick up the second and third doses of the Emend, where we learned that my doctor had not requested a pre-authorization from Pacificare, my health insurance company. The pharmacist filled the script anyway, asking that we pay the co-pay and that if Pacificare refused to pay up, we would pay the remaining balance. Since I need this drug because I am allergic to the other anti-nausea pre-meds, I was happy to do so. I'll get on the phone with Dr G's office and Pacificare tomorrow to straighten things out.
Then we were hungry, so we went to Cafe Presse for a delicious Parisian style lunch. Rik had three prawns served over Moroccan couscous with cantaloupe, I had a salad of zucchini, tomatoes and red onion with feta cheese, we shared frites and their delicious baguette. I was supposed to help prevent mouth sores by eating and drinking cold things, so I ordered some incredible house-made chocolate ice cream for dessert. It was too much to eat, and we brought home the remaining scoop.
Later, while Rik ran errands, I sat in the sun reading, too a short nap, and generally relaxed. I feel fine so far, no doubt due to all the drugs. Rik brought me home some juice-only popsicles, and I think I'll spend the evening enjoying them as I ice my mouth.
Ramona Forever
When I was growing up, one of my favorite book series was the Ramona series by Beverly Cleary. I bought WCK a collection of Ramona books for her fifth birthday, hoping that she'd enjoy them as much as I had. Also, I wanted to show her that there are much better alternatives to (gag) those awful Junie B. Jones books.
My plan worked. WCK loved Ramona, and we spent the entire summer reading all eight books in the series. I looked forward to reading every night, so I could re-live the Ramona adventures I'd long forgotten about. Remember when she gets mad at her family and gets revenge by squeezing an entire tube of toothpaste into the sink? Or when she tries to be funny by cracking open a hard-boiled egg on her head ... only to realize her mom packed a raw egg in her lunch by mistake? Or when she wore her pajamas to school under her clothes? Or when Picky-Picky died? I could go on and on.
I'd never read the last book in the series, Ramona's World, because it was published in 1999, so it was fun to discover a new Ramona book together. We went to the Ramona and Beezus movie, which was actually pretty good, and not just because Aidan from Sex and the City played the dad. Although that did help.
Our Ramona reading prompted Jay to run out to the library and get the Henry Huggins books. Every night, I'd read a chapter of Ramona, and then Jay would read a chapter of Henry. Ramona makes cameo appearances in the Henry Huggins books, too.
When we got to the last chapter of Ramona's World, WCK and I actually felt a little sad. We talked about how much we'd miss Ramona, but I told her that pretty soon, she'll be reading by herself and she can read all of the Ramona books over and over again.
Our next book series? Little House! Aw, yeah! Take that, Junie B. Jones!
My plan worked. WCK loved Ramona, and we spent the entire summer reading all eight books in the series. I looked forward to reading every night, so I could re-live the Ramona adventures I'd long forgotten about. Remember when she gets mad at her family and gets revenge by squeezing an entire tube of toothpaste into the sink? Or when she tries to be funny by cracking open a hard-boiled egg on her head ... only to realize her mom packed a raw egg in her lunch by mistake? Or when she wore her pajamas to school under her clothes? Or when Picky-Picky died? I could go on and on.
I'd never read the last book in the series, Ramona's World, because it was published in 1999, so it was fun to discover a new Ramona book together. We went to the Ramona and Beezus movie, which was actually pretty good, and not just because Aidan from Sex and the City played the dad. Although that did help.
Our Ramona reading prompted Jay to run out to the library and get the Henry Huggins books. Every night, I'd read a chapter of Ramona, and then Jay would read a chapter of Henry. Ramona makes cameo appearances in the Henry Huggins books, too.
When we got to the last chapter of Ramona's World, WCK and I actually felt a little sad. We talked about how much we'd miss Ramona, but I told her that pretty soon, she'll be reading by herself and she can read all of the Ramona books over and over again.
Our next book series? Little House! Aw, yeah! Take that, Junie B. Jones!
Olivia Newton-John BC Video
Here is a four minute video with breast cancer survivor, Olivia Newton-John who shares tips for women battling breast cancer. She recalls what she learned while advocating for her health.
Sunday, August 29, 2010
My favorite household task
It's silver polishing time again. Twice a year, before Rosh Hashanah and Pesach, I take on my favorite household chore and polish the silver. (That's also when I make chopped liver, but more on that later.)
Some might laugh, but polishing the silver is like ironing: you start out with a tarnished (or wrinkled) item, and with a tiny amount of work, your item becomes bright and shiny (or crisply pressed).
When I was a child, I used to ask my mother, "Can I polish the silver? Please??" She, of course, was happy to have me take on a chore, and thus began my life-long live affair with silver polish.
This morning I went to the synagogue to polish the silver. Three of us spent an hour shining up the Torah crowns, pointers, breastplates, and other assorted items. Now I am home and about to start on our silver: trays, candlesticks, tea set, serving pieces, even a pair of earrings in need of a shine. I'll wear rubber gloves to keep the polish off my skin.
Too bad we're not hosting a holiday meal this year so I can show off my bright, shiny silver.
Some might laugh, but polishing the silver is like ironing: you start out with a tarnished (or wrinkled) item, and with a tiny amount of work, your item becomes bright and shiny (or crisply pressed).
When I was a child, I used to ask my mother, "Can I polish the silver? Please??" She, of course, was happy to have me take on a chore, and thus began my life-long live affair with silver polish.
This morning I went to the synagogue to polish the silver. Three of us spent an hour shining up the Torah crowns, pointers, breastplates, and other assorted items. Now I am home and about to start on our silver: trays, candlesticks, tea set, serving pieces, even a pair of earrings in need of a shine. I'll wear rubber gloves to keep the polish off my skin.
Too bad we're not hosting a holiday meal this year so I can show off my bright, shiny silver.
On this day of August twenty-ninth, 2010
It is with great sorrow (and a fair amount of disbelief) that I announce my second primary cancer diagnosis.
This time it is papillary thyroid carcinoma- I have surgery scheduled for this Thursday. They'll be taking out the whole gland, plus any lymph nodes that are involved. We shall go from there.
The diagnosis comes just weeks before my intended move to New York. All plans are put on hold. I'll need to stay in California for close monitoring. There go my dreams again, off to the dump. Perhaps I'll get to reclaim them later, little lost treasures, just like last time.
It is almost two years- to the day- of my Ewing's dx in 2008.
Why are my cells so goddamn uppity?
It started with a cyst. A lump on my neck, right above the clavicle, about the size of a walnut. I thought it was a swollen lymph node. Upon biopsy it was revealed that the lump is mostly old blood from cappillaries in the thyroid gland, mixed with pus and lymph fluid- my body's futile attempt at fighting back.
So here we are, a lump, a second cancer, a postponing of life once again.
As celebration, or distraction, D and I went to the carnivorous plant nursery in Sebastapol.
This time it is papillary thyroid carcinoma- I have surgery scheduled for this Thursday. They'll be taking out the whole gland, plus any lymph nodes that are involved. We shall go from there.
The diagnosis comes just weeks before my intended move to New York. All plans are put on hold. I'll need to stay in California for close monitoring. There go my dreams again, off to the dump. Perhaps I'll get to reclaim them later, little lost treasures, just like last time.
It is almost two years- to the day- of my Ewing's dx in 2008.
Why are my cells so goddamn uppity?
It started with a cyst. A lump on my neck, right above the clavicle, about the size of a walnut. I thought it was a swollen lymph node. Upon biopsy it was revealed that the lump is mostly old blood from cappillaries in the thyroid gland, mixed with pus and lymph fluid- my body's futile attempt at fighting back.
So here we are, a lump, a second cancer, a postponing of life once again.
As celebration, or distraction, D and I went to the carnivorous plant nursery in Sebastapol.
deadly beautiful things.
Upcoming Breast Cancer Conferences
Recently I’ve received info on three breast cancer conferences. Two of them are scheduled for this year and a third is in the spring of 2011. I went to this past spring’s conference in PA and loved it. It was so nice to be with other BC survivors from all over North America.
Canadian Breast Cancer Network (CBCN)
CBCN is having their 2nd conference for young women living with breast cancer, Body, Mind, Spirit 2010: National Conference for Young Women Living with Breast Cancer, on October 29 — 31, 2010, Toronto, ON, Canada. Subsidy is available. For more information please click here.
Living Beyond Breast Cancer (LBBC)
LBBC is having their annual fall conference, News You Can Use: Breast Cancer Updates for Living Well, on November 13, 2010, in Philadelphia, PA, USA. Subsidy is available. For more information, please click here.
The World Conference on Breast Cancer Foundation (WCBCF)
WCBCF is having their 6th world conference, Transcending the Breast Cancer Experience: A Global Partnership, on June 7-11 in 2011, Hamilton, ON, Canada. Subsidy unconfirmed. For more information, please click there.
Saturday, August 28, 2010
Meet my grandson, Bunny Bunny Bun Bun
Yesterday morning before school, WCK appeared in the kitchen with a doll stroller containing Bear and Bunny Bunny Bun Bun. Attached to the stroller was a camera, as well as baskets containing supplies, such as plastic food, bibs, and toys.
WCK informed me that these were her kids, and, seeing as I was their grandmother, it was my job to look after them all day while she was in school. She left strict instructions: "You can take them anywhere you want, except the desert, because they are both very scared of rattlesnakes."
My plans to explore the vast deserts of Kansas City dashed, I decided we'd spend the day hanging out around the house. Like a good grandma, I took photos to show WCK what her kids had been up to all day. First, we got out the toys she'd packed and played for a while:
We hung out with Garland:
We went outside, although we only went on the back deck, out of fear of neighbors, I mean rattlesnakes, spotting us:
We worked up big appetites hiding from rattlesnakes, so it was time to put on bibs and enjoy a healthy lunch of plastic vegetables:
And then a good nap in WCK's bed:
After their nap, I left them sitting quietly, nicely reading Bear's favorite book ...
I turned my back for a second, and ... THEY CLIMBED TO THE TOP OF THE KITCHEN CABINETS!! WHAT THE HECK? GET DOWN FROM THERE! YOU KIDS ARE BEING NAUGHTY!
Whew. I finally got them down. That was a close one. WAIT A MINUTE! NOW THEY'RE ON TOP OF THE LAMP!!! Those dang kids!
WCK found it hilarious that they'd climbed so high. Easy for her to say; she's off at luxurious kindergarten all day while I have to chase after her children. I was worn out. The time to go pick up their mother could not come soon enough.
WCK informed me that these were her kids, and, seeing as I was their grandmother, it was my job to look after them all day while she was in school. She left strict instructions: "You can take them anywhere you want, except the desert, because they are both very scared of rattlesnakes."
My plans to explore the vast deserts of Kansas City dashed, I decided we'd spend the day hanging out around the house. Like a good grandma, I took photos to show WCK what her kids had been up to all day. First, we got out the toys she'd packed and played for a while:
We hung out with Garland:
We went outside, although we only went on the back deck, out of fear of neighbors, I mean rattlesnakes, spotting us:
We worked up big appetites hiding from rattlesnakes, so it was time to put on bibs and enjoy a healthy lunch of plastic vegetables:
And then a good nap in WCK's bed:
After their nap, I left them sitting quietly, nicely reading Bear's favorite book ...
I turned my back for a second, and ... THEY CLIMBED TO THE TOP OF THE KITCHEN CABINETS!! WHAT THE HECK? GET DOWN FROM THERE! YOU KIDS ARE BEING NAUGHTY!
Whew. I finally got them down. That was a close one. WAIT A MINUTE! NOW THEY'RE ON TOP OF THE LAMP!!! Those dang kids!
WCK found it hilarious that they'd climbed so high. Easy for her to say; she's off at luxurious kindergarten all day while I have to chase after her children. I was worn out. The time to go pick up their mother could not come soon enough.
Chemo Effects are Wearing Off
I haven’t had chemo since August 6th and I’m gradually feeling better as each week goes by. I’m sleeping solid and the fatigue is lessoning. I find my mind is clearer too. I’m more alert and I just want to do more stuff. That’s all working out great because I have relatives visiting all next week.
Yesterday, I stopped in at the Clinic for my weekly PICC line re-dressing. Then I headed over to the Support Center and picked up a brochure of what classes will be running this fall. I will likely join the drop-in knitting group. There are a couple others I may consider.
My final stop was the pharmacy to pick up a small two pill prescription of teva-amoxicillin; an antibiotic. I’m seeing my dentist next week for a cleaning and exam. The routine is for me to take these pills an hour before the appointment to help me fight any potential infection caused by the cleaning.
Friday, August 27, 2010
Cancer and Supplements
Here is a four minute video titled The Scoop on Supplements. Created by the American Cancer Society, it offers helpful information about dietary supplements and addresses myths about their effectiveness at reducing cancer risk.
Thursday, August 26, 2010
More chemo
Today we saw Seattle's best oncologist and got the results of my recent ultrasound and bone scan.
The ultrasound indicated five liver lesions. This is a good baseline number for testing the chemo's effectiveness in the future. The CT scan I had in July indicated seven liver lesions. Since these two types of scans show different information, it's not possible to say for certain that two of the seven liver lesions are gone.
The bone scan revealed increased activity on my many sites of bone metastases, as compared with the last bone scan taken at this facility in 2005. There are mets in my skull, cervical spine, scapulae, humeri, forearm, thoracic spine, ribs, lumbar spine, sacrum, pelvis and femurs. (Apparently I light up like a Christmas tree.) However, there don't appear to be any new spots of disease, and Dr G would not recommend radiation at this time. He doe not think I am in danger of a fracture.
My tumor markers have consistently decreased since starting chemo in May, so something has been working.
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The current plan is to start me on Adriamycin (doxirubicin) once a week for four weeks beginning next Monday, and then re-evaluate. On this low dose regimen I am likely to experience more mucositis (mouth sores). Dr G will try to prevent that side effect with some other meds such as L-glutamine powder (also prescribed by my naturopath), calcium phosphate rinse, Neulasta, chlorhexidine gluconate rinse, vitamin E, 
Gelclair and "Magic Mouthwash" (xylocaine viscous solution, Zovirax® (alcohol-free), and Maalox® or Mylanta®). Dr G told me I should suck on ice chips while receiving treatment.
I'll also be at risk for infection due to low red and white blood cell counts and will probably experience more hair loss. Hopefully I won't have more issues with hand-foot syndrome.
Rik and I have already decided on a plan of action if the mucositis prevents me from eating. He will feed me milkshakes, smoothies, even Ensure
"lattes" -- anything to get calories into me. I dropped five pounds the last time this happened and although Dr G praised me for keeping stable weight, I don't really want to lose much more.
The ultrasound indicated five liver lesions. This is a good baseline number for testing the chemo's effectiveness in the future. The CT scan I had in July indicated seven liver lesions. Since these two types of scans show different information, it's not possible to say for certain that two of the seven liver lesions are gone.
The bone scan revealed increased activity on my many sites of bone metastases, as compared with the last bone scan taken at this facility in 2005. There are mets in my skull, cervical spine, scapulae, humeri, forearm, thoracic spine, ribs, lumbar spine, sacrum, pelvis and femurs. (Apparently I light up like a Christmas tree.) However, there don't appear to be any new spots of disease, and Dr G would not recommend radiation at this time. He doe not think I am in danger of a fracture.
My tumor markers have consistently decreased since starting chemo in May, so something has been working.
_.jpg)
The current plan is to start me on Adriamycin (doxirubicin) once a week for four weeks beginning next Monday, and then re-evaluate. On this low dose regimen I am likely to experience more mucositis (mouth sores). Dr G will try to prevent that side effect with some other meds such as L-glutamine powder (also prescribed by my naturopath), calcium phosphate rinse, Neulasta, chlorhexidine gluconate rinse, vitamin E, 
Gelclair and "Magic Mouthwash" (xylocaine viscous solution, Zovirax® (alcohol-free), and Maalox® or Mylanta®). Dr G told me I should suck on ice chips while receiving treatment. I'll also be at risk for infection due to low red and white blood cell counts and will probably experience more hair loss. Hopefully I won't have more issues with hand-foot syndrome.
Rik and I have already decided on a plan of action if the mucositis prevents me from eating. He will feed me milkshakes, smoothies, even Ensure
"lattes" -- anything to get calories into me. I dropped five pounds the last time this happened and although Dr G praised me for keeping stable weight, I don't really want to lose much more.
How Cool is That!!!!
I'm really not great at fundraising...I need to get over that as I have a non-profit now that I need to learn to raise funds for. Most of my life I have volunteered my time...working soup kitchens, delivering meals to the homebound and handicapped, providing musical entertainment to the lonely. When I get calls asking me to donate money, I always say "I donate my time but not my money, do you need my time?". Those calls usually end quickly.
But anyway, I went ahead and created a donation page under the name of my non-profit to raise funds for the Heat if To Beat It walk I will attend in Maryland in September. It's a walk to help raise awareness and research funds for our cancers. I never checked the page as I expected no response, but figured I would donate to my own Heat It to Beat it site (at least $100 as those who raise $100 get a T-shirt to commemorate the event. I'd like the T-shirt since I'll be traveling out there from Chicago and am kind of sentimental about the event. I really want the T-Shirt!).
For the heck of it I checked my "Heat it to Beat it" site, and Oh My Gosh!!, I have two donations totalling $250!!!! I was blown away!!! And those who donated left comments that made me feel SO good! "Thanks for all of your work on the website. It has helped my family greatly." and "2 year survivor signet ring appendix cancer. Go Carolyn!". Thank you so much Ginger and Emery!! I hope you read my blog so you know how grateful I am! I never expected anyone to donate to that site.
I'm working 40 hours this week, but in the nursing world, if your relief doesn't show up for the next shift, you are "mandated", you have to stay another shift or risk losing your license and job for "patient abandonment" if you go home when you were supposed to. All bets are on that I will be "mandated" this weekend, as the nurse following my Saturday shift calls off more than she shows up for work. So I've decided if I am mandated for that extra shift, I will donate the money I earn on that shift to my "Heat it to Beat It" page.
Maybe I'll donate a shift even if I don't get mandated, because now I'm inspired!
Thanks again!
But anyway, I went ahead and created a donation page under the name of my non-profit to raise funds for the Heat if To Beat It walk I will attend in Maryland in September. It's a walk to help raise awareness and research funds for our cancers. I never checked the page as I expected no response, but figured I would donate to my own Heat It to Beat it site (at least $100 as those who raise $100 get a T-shirt to commemorate the event. I'd like the T-shirt since I'll be traveling out there from Chicago and am kind of sentimental about the event. I really want the T-Shirt!).
For the heck of it I checked my "Heat it to Beat it" site, and Oh My Gosh!!, I have two donations totalling $250!!!! I was blown away!!! And those who donated left comments that made me feel SO good! "Thanks for all of your work on the website. It has helped my family greatly." and "2 year survivor signet ring appendix cancer. Go Carolyn!". Thank you so much Ginger and Emery!! I hope you read my blog so you know how grateful I am! I never expected anyone to donate to that site.
I'm working 40 hours this week, but in the nursing world, if your relief doesn't show up for the next shift, you are "mandated", you have to stay another shift or risk losing your license and job for "patient abandonment" if you go home when you were supposed to. All bets are on that I will be "mandated" this weekend, as the nurse following my Saturday shift calls off more than she shows up for work. So I've decided if I am mandated for that extra shift, I will donate the money I earn on that shift to my "Heat it to Beat It" page.
Maybe I'll donate a shift even if I don't get mandated, because now I'm inspired!
Thanks again!
Another good visit
We had another good visit with my mom this past week. It may well have been the best one ever. Mom dealt beautifully with my bald head, saying that "you still look like you." We reminisced about my dad and other family memories.
Mom read to me a love letter that my dad wrote to her two years before they were engaged or married. They must have had a tiff, because in the letter he apologizes and says that she is the only girl for him. I never knew my dad was such a romantic!
I shared a letter Dad had written to me in 1978 when I was studying in Israel for the year. It's something I had kept private from the rest of the family all this time. Mom took home my letter and will share both with my sister.
I leapt right back into meetings, appointments etc. but had a good day. Now I am off to the onc and will report in on his recommendations soon.
Mom read to me a love letter that my dad wrote to her two years before they were engaged or married. They must have had a tiff, because in the letter he apologizes and says that she is the only girl for him. I never knew my dad was such a romantic!
I shared a letter Dad had written to me in 1978 when I was studying in Israel for the year. It's something I had kept private from the rest of the family all this time. Mom took home my letter and will share both with my sister.
I leapt right back into meetings, appointments etc. but had a good day. Now I am off to the onc and will report in on his recommendations soon.
My Lunch with Lance Armstrong
Finally, my lunch with seven time Tour de France winner Lance Armstrong. How inspiring this event was for me and 1100 other people. He shared his cancer story … where in 1996, at the age of 25 he was diagnosed with stage three testicular cancer. The cancer had spread to his lungs, abdomen and brain. Today he is cancer free.
In 1997, he founded the Lance Armstrong Foundation, which supports people affected by cancer. In May 2004, Nike and his Foundation launched with the yellow silicone gel bracelet as a fundraising idea. To date 71 million yellow bracelets have been sold.
When I thought of Lance Armstrong, I thought because of his racing background that he must be a real focused, intense person and that it would show in his personality. In fact I found the opposite to be true, he seemed like a very relaxed and easy going guy. I don’t think he used any notes when he spoke.
If you are interested in seeing some pics of the event and hearing the audio of his talk, please click here.
Wednesday, August 25, 2010
New Batch of Temptation on the shelves!
Hey all,
We are happy to announce the arrival of the latest batch of Russian River Temptation in the new 375ml format. Served ice cold on a hot day like today with it's beautifully refreshing acidity, sounds like heaven right about now.
Come and get it
Nate
Clinical Trial Update
Yesterday afternoon I received a phone call from the Cross Cancer Clinic. I have an appointment on Friday, September 10th with a new oncologist to discuss my eligibility for a clinical trial. The appointment will be about 45 minutes.
In the end, I’ll head home with a consent form that will outline all the known side effects of the proposed study drug. After careful consideration and if I’m still willing to go along with this, I’ll sign and return the form.
Wow, it feels like I’ve moved into another time zone with this.
Tuesday, August 24, 2010
The Skinny on Susan
Life is a series of two steps forward and one step back. Or, in my case, two pounds forward, ten pounds back.
In my last post, I wrote about my ongoing struggle to gain weight and my visit to a nutritionist. I was alarmed today when I stepped on the scales at the City of Hope and discovered that I've gone from an underweight 112 to a skeletal 105 pounds. At this poundage, I have to be careful on the dance floor; my sharp, protruding hip bones could be lethal weapons.
Of course, this weight loss follows a week of symptoms that resembled a stomach flu. But I suspect that there's something more going on. For weeks, I've felt an uncomfortable feeling of fullness. And my body seems to have trouble absorbing nutrients A few weeks ago I learned that my Vitamin D levels were at an alarmingly low 9.5, when 30 is low normal. I'm also Vitamin C deficient, which is strange since I make a steady diet of the lemons, oranges and grapefruit from our back yard.
I know I've written before about seeing a GI specialist, and I've finally scheduled an appointment for September 7. I'm eager to get to the bottom of this. (No pun intended.)
In my last post, I wrote about my ongoing struggle to gain weight and my visit to a nutritionist. I was alarmed today when I stepped on the scales at the City of Hope and discovered that I've gone from an underweight 112 to a skeletal 105 pounds. At this poundage, I have to be careful on the dance floor; my sharp, protruding hip bones could be lethal weapons.
Of course, this weight loss follows a week of symptoms that resembled a stomach flu. But I suspect that there's something more going on. For weeks, I've felt an uncomfortable feeling of fullness. And my body seems to have trouble absorbing nutrients A few weeks ago I learned that my Vitamin D levels were at an alarmingly low 9.5, when 30 is low normal. I'm also Vitamin C deficient, which is strange since I make a steady diet of the lemons, oranges and grapefruit from our back yard.
I know I've written before about seeing a GI specialist, and I've finally scheduled an appointment for September 7. I'm eager to get to the bottom of this. (No pun intended.)
Planning Things Takes More Effort
I’ve just come to the realization I’m putting way too much effort in planning my upcoming family visit. My sister and niece and two of her grade school kids are coming to town for a visit. They are only staying for 6 days but it all can’t be restaurant food so I thought I’d whip up a couple or three big bowl casseroles and freeze them in advance. I just don’t have it in me to put together a full meal all those days in a row. Besides, I’d rather spend time with them than time in the kitchen.
Anyways, what gets me is how long I thought about this and how early I’m getting going on it to pull this off. I just don’t have the energy to bang this off in a day and half like I used to. Even tho there is only two of us, I started making a list and cleaning up the whole house last week.
I told D, when company is here, each morning he is to put the coffee on first thing because I won’t have the energy to kick off the morning. Once I get a whiff of fresh brew, I’ll be more willing to drag my hini out of bed.
I’m so happy to be seeing the family again.
Monday, August 23, 2010
Feeling good
The past few days I have felt a little better each morning. Today I noticed that my hands are almost completely healed, with no new areas of dead skin. Although I continue to take a nap every afternoon, I've also had the energy to take a long walk, shop at Costco, and enjoy my visit with my mom.
I see the oncologist later this week and will know more at that point of how effective the chemotherapy has been. Until then, I plan to take it easy, sit in the sunshine, and cuddle with my dog and husband (not necessarily in that order).
I see the oncologist later this week and will know more at that point of how effective the chemotherapy has been. Until then, I plan to take it easy, sit in the sunshine, and cuddle with my dog and husband (not necessarily in that order).
Two Open Access reviews
1) Cancer Stem Cells in Pancreatic Cancer by Qi Bao and 6 co-authors, including Karl-Walter Jauch and Christiane J Bruns, Cancers 2010(Aug 19); 2(3): 1629-41. [Full text PDF][Scribd entry][Part of the Special Issue Pancreatic Cancer]. Abstract:
Comment: Review #2 is the first paper that has been published in the special issue on Cancer Stem Cells. As of August 20, 17 more contributions to this special issue are planned. Review #1, although about CSCs, is a contribution to a separate special issue on Pancreatic Cancer.
Pancreatic cancer is an aggressive malignant solid tumor well-known by early metastasis, local invasion, resistance to standard chemo- and radiotherapy and poor prognosis. Increasing evidence indicates that pancreatic cancer is initiated and propagated by cancer stem cells (CSCs). Here we review the current research results regarding CSCs in pancreatic cancer and discuss the different markers identifying pancreatic CSCs. This review will focus on metastasis, microRNA regulation and anti-CSC therapy in pancreatic cancer.2) The Emerging Role of the Phosphatidylinositol 3-Kinase/ Akt/Mammalian Target of Rapamycin Signaling Network in Cancer Stem Cell Biology by Alberto M Martelli and 4 co-authors, including James A McCubrey, Cancers 2010(Aug 18); 2(3): 1576-96. [Part of the Special Issue Cancer Stem Cells].
Comment: Review #2 is the first paper that has been published in the special issue on Cancer Stem Cells. As of August 20, 17 more contributions to this special issue are planned. Review #1, although about CSCs, is a contribution to a separate special issue on Pancreatic Cancer.
I Have Another Wart
For most of my life, I’ve felt fortunate to never had trouble with warts. That changed when I started chemo some two years ago. Early last year I developed my first plantar wart. It hung around for about six months and eventually disappeared on its own sometime after I started Xeloda. One of the side effects of Xeloda was intense dryness in my hands and feet. I think that is what killed that wart. Back then I thought to myself, you’d think chemo would prevent these goofy things from growing but in fact the opposite is true, chemo compromises one’s immune system which invites warts to grow. Anyways, I was happy to once again be wart free.
Then last month, I developed this real itchy spot on the top of my right foot. About a week later, up pops this dark colored wart. Just great I thought … most of the time it doesn’t bother me. It’s only when I look at it. But really I wish it was gone.
So this past weekend, I was thinking, I’m in between chemos right now … I could go get some of that OTC stuff and zap it away before my new treatment starts. I jumped on the net to read up on warts. I was disappointed to find that those wart removers could take months to work. I guess I’m stuck with that little devil for now. Tho I’m gonna swear at him every day and see it that sends him packing.
Sunday, August 22, 2010
Healthy Spirits: BEER OF THE MONTH CLUB SEPTEMBER 2010
cheers,
dave hauslein
beer manager
415-255-0610
A Frank Discussion Between Two Cancer Survivors
I wanted to share with you this very frank cancer discussion between Richard Cohen and Johnathon Alter. They talk back and forth, mostly about Johnathon’s Non-Hodgkin’s lymphoma diagnosis.
Richard is a colon cancer survivor and former senior producer for CBS News and CNN ... Jonathon is a columnist and senior editor for Newsweek Magazine.
Their discussion focuses on Jonathon’s approach and challenges when he was battling cancer and some practical tips he used to fight back.
The video is a two part series titled Winning Against Cancer Pt 1 and Pt 2. Here is the link to both ...
Saturday, August 21, 2010
Scientist-Survivor Program
I have been involved with AACR's the Scientist-Survivor Program since 2008.
It is a marvelous program. Fun story of how I got involved there, a woman found my appendix cancer web site and emailed me. She was a renal cancer survivor of many years (not sure how she came upon my site?). She loved what I was doing and we developed a friendship. She was an advocate for renal cancer patients and cancer patients in general in our state government (turns out she only lived 30 miles away from me!). She had become involved in the Scientist-Survivor Program and was determined that I become involved too. She encouraged me to apply to the program, said I HAD to be a part of it. I needed a recommendation letter as part of my application, which she wrote for me.
I was accepted into the program and attended my first AACR annual meeting in 2008. I was blown away. The conference was huge, with 17,000 cancer researchers, oncologists, nurses and survivors attending. There were hundreds of presentations offered from scientists revealing cutting edge cancer research findings. I learned so much...and I love to learn.
The Scientist-Survivor Program accepts about 30 of us a year to attend the annual meetings. All of us are cancer survivors who have become advocates. As part of the program we all get to spend time together and learn from each other. It's an amazing group, I was so inspired by many cancer advocates. We learn so much at the annual meetings. We are able to share what we learn with others in the cancer community when we return. We are also treated very well. We have a Scientist-Survivor meeting room at conferences where we can all go to have meals together, there are special presentations for those in our program, we get to meet personally with some of the cancer research scientists (that's how I met one of the founders of Stand Up to Cancer).
The Scientist-Survivor Program was the brainchild of Anna Barker (see her here in a news interview), the Deputy Director of the National Cancer Institute. Via the program I have met and spent time with her...and I've come to idolize her. She is brilliant, passionate and caring. She lost all of her family to cancer and has made it her life's mission to see cancer defeated. She is now one of my heros (and I don't have many!)
I've copied the goals of the Scientist-Survivor Program from their web site below. I so encourage any survivor advocates to apply to this program, it is life-changing!
Goals of the AACR Scientist↔Survivor Program
Broaden survivor and patient advocates’ understanding of fundamental topics in cancer research and expose them to the cutting-edge science that is accelerating our progress against cancer today.
Develop an informed constituency of survivor and patient advocates who work in the larger cancer community.
Increase awareness on the part of scientists and survivor and patient advocates of the many ways in which they can collaborate to support, influence and strengthen cancer research.
Develop synergistic collaborations among scientists and advocates to increase funding of cancer research, increase participation in clinical trials, improve the design of clinical trials, increase the number of effective cancer drugs, and facilitate access to cancer information for the general public, high-risk individuals, and minority and underserved populations.
Provide laboratory and clinical scientists with the opportunity to gain a more personal understanding of the enormous impact of cancer on patients and their loved ones.
Expose scientists to the key concerns of survivor and patient advocates, which include survivorship, quality of life, science and public policy, and other important issues.
Disseminate the knowledge and new perspectives acquired through the program to a vast and diverse audience.
Create mutually beneficial and enduring partnerships among advocates and researchers.
It is a marvelous program. Fun story of how I got involved there, a woman found my appendix cancer web site and emailed me. She was a renal cancer survivor of many years (not sure how she came upon my site?). She loved what I was doing and we developed a friendship. She was an advocate for renal cancer patients and cancer patients in general in our state government (turns out she only lived 30 miles away from me!). She had become involved in the Scientist-Survivor Program and was determined that I become involved too. She encouraged me to apply to the program, said I HAD to be a part of it. I needed a recommendation letter as part of my application, which she wrote for me.
I was accepted into the program and attended my first AACR annual meeting in 2008. I was blown away. The conference was huge, with 17,000 cancer researchers, oncologists, nurses and survivors attending. There were hundreds of presentations offered from scientists revealing cutting edge cancer research findings. I learned so much...and I love to learn.
The Scientist-Survivor Program accepts about 30 of us a year to attend the annual meetings. All of us are cancer survivors who have become advocates. As part of the program we all get to spend time together and learn from each other. It's an amazing group, I was so inspired by many cancer advocates. We learn so much at the annual meetings. We are able to share what we learn with others in the cancer community when we return. We are also treated very well. We have a Scientist-Survivor meeting room at conferences where we can all go to have meals together, there are special presentations for those in our program, we get to meet personally with some of the cancer research scientists (that's how I met one of the founders of Stand Up to Cancer).
The Scientist-Survivor Program was the brainchild of Anna Barker (see her here in a news interview), the Deputy Director of the National Cancer Institute. Via the program I have met and spent time with her...and I've come to idolize her. She is brilliant, passionate and caring. She lost all of her family to cancer and has made it her life's mission to see cancer defeated. She is now one of my heros (and I don't have many!)
I've copied the goals of the Scientist-Survivor Program from their web site below. I so encourage any survivor advocates to apply to this program, it is life-changing!
Goals of the AACR Scientist↔Survivor Program
Broaden survivor and patient advocates’ understanding of fundamental topics in cancer research and expose them to the cutting-edge science that is accelerating our progress against cancer today.
Develop an informed constituency of survivor and patient advocates who work in the larger cancer community.
Increase awareness on the part of scientists and survivor and patient advocates of the many ways in which they can collaborate to support, influence and strengthen cancer research.
Develop synergistic collaborations among scientists and advocates to increase funding of cancer research, increase participation in clinical trials, improve the design of clinical trials, increase the number of effective cancer drugs, and facilitate access to cancer information for the general public, high-risk individuals, and minority and underserved populations.
Provide laboratory and clinical scientists with the opportunity to gain a more personal understanding of the enormous impact of cancer on patients and their loved ones.
Expose scientists to the key concerns of survivor and patient advocates, which include survivorship, quality of life, science and public policy, and other important issues.
Disseminate the knowledge and new perspectives acquired through the program to a vast and diverse audience.
Create mutually beneficial and enduring partnerships among advocates and researchers.
Feeling so Tired
Yesterday about mid morning my nose was running like a tap, so I decided to take a Benadryl. It didn’t take long before I became drowsy so I laid down for a two hour nap. Benadryl effects usually last four hours. A little later I got myself together for my weekly PICC line dressing change at the clinic.
I didn’t feel very energetic for the remainder of the afternoon and I started feeling super drowsy after supper. Later, D asked if I wanted to go for a walk? I said no thanks, I think I’m going to bed. This morning and 12 hours later, I woke up feeling pretty good.
So what could have caused me to be so tired? … well we’ve been experiencing poor air quality since Thursday. Maybe it was the big anniversary do with the girls combined the outing with C and the Benadryl all added together.
Friday, August 20, 2010
Have you made a big change?
O, how they want us to have had epiphanies, shifts, turnabouts, makeovers, changeovers and on and on. If you happen to be one of the people who have (has? I never remember) made a big change because of breast cancer, and you'd like to be interviewed, read on:
Breast Cancer survivors
Category: General
Email: query-j5b@helpareporter.com
Media Outlet: Book
Deadline: 07:00 PM EST - 24 August
Query:
I am a cookbook author and nationally-published essayist writing
a novel centered on themes of rebuilding life after breast
cancer, I am interested interviewing breast-cancer survivors who
were inspired to make a major life change (new career, move,
etc.) because of beating their disease. Would be most interested
in speaking with people of South Asian descent. Acknowledgment
given to interviewees in published book.
Healthy Spirits: New Arrivals
1. Dogfish Head Theobroma
2. Wandering Aengus Dry Oaked Cider
3. Wandering Aengus Wickson Crabapple Cider
4. Reel Ales Monkfish Tripel
5. Fish Tale Organic IPA
6. Anchor Humming Ale
7. Sierra Nevada Tumbler Autumn Brown Ale
8. Chimay Blue Magnums
9. Chimay/Duvel/Russian River/Chouffe glassware!
cheers,
dave hauslein
beer manager
415-255-0610
2. Wandering Aengus Dry Oaked Cider
3. Wandering Aengus Wickson Crabapple Cider
4. Reel Ales Monkfish Tripel
5. Fish Tale Organic IPA
6. Anchor Humming Ale
7. Sierra Nevada Tumbler Autumn Brown Ale
8. Chimay Blue Magnums
9. Chimay/Duvel/Russian River/Chouffe glassware!
cheers,
dave hauslein
beer manager
415-255-0610
Happy mets-iversary to me!
Eight years ago today I got the terrible news that my cancer had returned and spread to my bones. I went home on crutches, fell and broke my left femur. It was a long recovery but I am incredibly pleased to say I am still here, eight years later.
It's an odd feeling to outline mortality predictions. At the time, in 2002, 50% of women with metastatic breast cancer lived one year (I asked my oncologist). I've outlived that prediction many times now. Someone has to be on the far end of the statistics curve, and I think I should be one of those folks.
My mother arrived for a week's visit and we are holding a dinner party for our closest friends tonight. The menu, of course, includes three of my favorite foods: champagne, whipped cream and chocolate. (I couldn't figure out how to include the potato chips.) We'll have champagne to toast, challah, zucchini minestrone, ramen salad, roasted green beans with Marcona almonds, halibut in garlic-parmesan topping and conclude with homemade tiramisu.
This delicious meal, plus celebrating with family and friends, should be just the "pick-me-up" I need!
It's an odd feeling to outline mortality predictions. At the time, in 2002, 50% of women with metastatic breast cancer lived one year (I asked my oncologist). I've outlived that prediction many times now. Someone has to be on the far end of the statistics curve, and I think I should be one of those folks.
My mother arrived for a week's visit and we are holding a dinner party for our closest friends tonight. The menu, of course, includes three of my favorite foods: champagne, whipped cream and chocolate. (I couldn't figure out how to include the potato chips.) We'll have champagne to toast, challah, zucchini minestrone, ramen salad, roasted green beans with Marcona almonds, halibut in garlic-parmesan topping and conclude with homemade tiramisu.
This delicious meal, plus celebrating with family and friends, should be just the "pick-me-up" I need!
Cancer Talk over Coffee
Yesterday C, a fellow stage four cancer survivor and I went for coffee to a neat little coffee shop off Whyte Ave. Not only did it have a funky cool atmosphere but it was also a bakery, so we each had a great tasting muffin to go with our coffees. C was looking good and she said she was feeling good too. That was really nice to hear.
We chatted about what we’ve been up to since we last meet; including how we were doing mentally and physically. She said she had a burst of energy and spent the day before at the Fringe Festival with her neighbor. She said it felt so good to be out and about after being laid up this past while. I talked about some of what I’ve been up to … including the coffee group picnic yesterday.
We both felt it was important to have one little something to look forward to so that our minds stay busy and occupied. Next week C is going to the mountain resort town of Jasper and I am going to the Lance Armstrong Luncheon.
Stand Up to Cancer!
On September 10th, Stand Up to Cancer will again host a multi-network television research fundraiser. Fun thing, I was able to meet in person one of the founders of Stand Up to Cancer in 2008. He is a brilliant cancer researcher and scientist I greatly admire and personally like a lot. He is truly dedicated to finding a cure for cancer and is very inspirational. He has passion that is contagious.
Stand Up to Cancer strives to raise funds for innovative cancer research.
Seventy percent of the funds collected go to fund cancer research "Dream Teams", bringing the best research minds together to look for cancer cures. Dream Teams seek to bring some of the best scientists working together in looking for answers, combining their knowledge and resources vs. working independently in their own corners of the world.
Twenty percent of the funds raised are used to fund research that is "out of the box" and would not likely otherwise be funded by anyone.
Ten percent of the funds are used to maintain Stand Up to Cancer.
I kind of think the answer to cancer will be something "out of the box" in the end.
The telethon will air on E!, The Style Network, G4, ABC, NBC, CBS, FOX, HBO, Bio, Discovery Health, HBO Latino, MLB Network, mun2, Showtime, Smithsonian Channel, TV One and VH1 simultaneously at 8pm (7pm Central time) on September 10th.
I think just the three major networks aired it simultaneously last time. Maybe one day it will be on every TV channel simultaneously, the only thing to watch!
When the 2008 telethon aired, at one point so many donations rolled in at once that the software or whatever crashed for a bit, so some funds were lost. I don't think they expected that big a response. I'm sure this time they will be prepared for it.
Cancer has affected ALL of our lives; even those who have never been diagnosed have had someone in their life struggling with or losing a battle with cancer. We all want to see cancer defeated. It's a cause we can all be united for. Maybe Stand Up to Cancer will be the force that unites us and helps us work together to forever be rid of cancer?
Stand Up to Cancer strives to raise funds for innovative cancer research.
Seventy percent of the funds collected go to fund cancer research "Dream Teams", bringing the best research minds together to look for cancer cures. Dream Teams seek to bring some of the best scientists working together in looking for answers, combining their knowledge and resources vs. working independently in their own corners of the world.
Twenty percent of the funds raised are used to fund research that is "out of the box" and would not likely otherwise be funded by anyone.
Ten percent of the funds are used to maintain Stand Up to Cancer.
I kind of think the answer to cancer will be something "out of the box" in the end.
The telethon will air on E!, The Style Network, G4, ABC, NBC, CBS, FOX, HBO, Bio, Discovery Health, HBO Latino, MLB Network, mun2, Showtime, Smithsonian Channel, TV One and VH1 simultaneously at 8pm (7pm Central time) on September 10th.
I think just the three major networks aired it simultaneously last time. Maybe one day it will be on every TV channel simultaneously, the only thing to watch!
When the 2008 telethon aired, at one point so many donations rolled in at once that the software or whatever crashed for a bit, so some funds were lost. I don't think they expected that big a response. I'm sure this time they will be prepared for it.
Cancer has affected ALL of our lives; even those who have never been diagnosed have had someone in their life struggling with or losing a battle with cancer. We all want to see cancer defeated. It's a cause we can all be united for. Maybe Stand Up to Cancer will be the force that unites us and helps us work together to forever be rid of cancer?
Multimodal Treatment of Mesothelioma
For mesothelioma, many ways of treatment were performed by combining various methods. The most successful of these ways is “triple therapy” combination of surgical, chemotherapy and radiotherapy. In this way of treatment, the most significant element is to diagnose the disease in its early stage. Particularly, the method combination of high dose radiotherapy and chemotherapy with surgical has been most successful way of treatment for recovering patients.
An operation called as extrapleural pneumonectomy is performed in order to completely remove the tumor. Lining of the lung and entire lung affected in chest cavity (or thoracic cavity) and with diaphragm muscle and lung of the heart which touched with the lining of the lung are removed. In the last decade, reliability of operation has increased and risk of death (or mortality) after operation has dropped below 4% from about 10%. Considering that risk of death after open-heart surgery is 1-2%, the rate above-mentioned is quite high. By the end of the treatment, life expectancy of patients treated in USA increased above 2 years and it was seen a long lifetime period in a certain part of patients. In a study carried out in collaboration with Marmara University and Osmangazi University in Turkey, 4 year disease-free survival was observed in patients treated by the following protocol.
Triple therapy takes a total of six months. At first the operation is performed and after a month radiotherapy begins, which will take 2 months. After the radiotherapy, the patient rest for a month and chemotherapy is performed for 2 months. Completing all three treatment periods is essential to ensure adequate achievement against the disease.
An operation called as extrapleural pneumonectomy is performed in order to completely remove the tumor. Lining of the lung and entire lung affected in chest cavity (or thoracic cavity) and with diaphragm muscle and lung of the heart which touched with the lining of the lung are removed. In the last decade, reliability of operation has increased and risk of death (or mortality) after operation has dropped below 4% from about 10%. Considering that risk of death after open-heart surgery is 1-2%, the rate above-mentioned is quite high. By the end of the treatment, life expectancy of patients treated in USA increased above 2 years and it was seen a long lifetime period in a certain part of patients. In a study carried out in collaboration with Marmara University and Osmangazi University in Turkey, 4 year disease-free survival was observed in patients treated by the following protocol.
Triple therapy takes a total of six months. At first the operation is performed and after a month radiotherapy begins, which will take 2 months. After the radiotherapy, the patient rest for a month and chemotherapy is performed for 2 months. Completing all three treatment periods is essential to ensure adequate achievement against the disease.
Thursday, August 19, 2010
Selective targeting of neuroblastoma tumour-initiating cells
Selective targeting of neuroblastoma tumour-initiating cells by compounds identified in stem cell-based small molecule screens by Kristen M Smith and 16 co-authors, including David R Kaplan, EMBO Mol Med 2010(Aug 18) [Epub ahead of print][Full text]. Abstract:
Neuroblastoma (NB) is the most deadly extra-cranial solid tumour in children necessitating an urgent need for effective and less toxic treatments. One reason for the lack of efficacious treatments may be the inability of existing drugs to target the tumour-initiating or cancer stem cell population responsible for sustaining tumour growth, metastases and relapse. Here, we describe a strategy to identify compounds that selectively target patient-derived cancer stem cell-like tumour-initiating cells (TICs) while sparing normal paediatric stem cells (skin-derived precursors, SKPs) and characterize two therapeutic candidates. DECA-14 and rapamycin were identified as NB TIC-selective agents. Both compounds induced TIC death at nanomolar concentrations in vitro, significantly reduced NB xenograft tumour weight in vivo, and dramatically decreased self-renewal or tumour-initiation capacity in treated tumours. These results demonstrate that differential drug sensitivities between TICs and normal paediatric stem cells can be exploited to identify novel, patient-specific and potentially less toxic therapies.See also: New Twist on Drug Screening to Treat Common Childhood Cancer, ScienceDaily, August 18, 2010. Excerpt:
A study led by scientists at The Hospital for Sick Children (SickKids) reveals a new method of identifying drugs to treat children suffering from fatal cancers for which an effective treatment has not been found. Rather than developing a new drug from scratch, which is a complicated and time-consuming process, they tried a different approach: in the lab, they tested existing drugs on cancer stem cells from young patients with neuroblastoma, one of the common cancers of infants and children.A related blog post is: High-throughput cancer stem cell-based screening assay for therapeutic compounds by Alexey Bersenev, Stem Cell Assays, August 19, 2010 [FriendFeed entry].
Bone scan saga
Bone scans have been a regular part of my cancer experience since the day I broke my leg in 2002. I don't remember that one (I was sedated) but usually they go something like this:
1) Have port accessed by specially trained nurses at Swedish Cherry Hill Ambulatory Infusion Center
2) Go to bone scan location in hospital basement and receive injection of radioactive dye
3) Head back upstairs to have port de-accessed
4) Drink lots of water, get a snack and amuse myself for a couple of hours
5) Return to bone scan location
6) Use the toilet and
7) Lie on scanner bed, get strapped in and covered with warm blankie for bone scan (duration about 60 minutes)
Luckily, they always let me listen to music during the bone scan. Before the days of iPods I brought CDs; now I just set the iPod to "shuffle" and enjoy random music for the duration.
Yesterday's bone scan was at Seattle Nuclear Medicine, not at Swedish's Cherry Hill location. SNM has some fancy, new machine that can read your bone scan after less than an hour's wait.
People who don't have ports must have an intravenous line started by a technician. I wanted to use my port but never heard back from the doctor's office to see if they had arranged for the Swedish Cancer Institute (in the building next door) to access it. As I sat down in the chair for the tech to start a line, my cell phone rang: yes, I could get my port accessed.
Well, I was already at the bone scan building, and I will let anyone try to start an IV line once, so I asked to lie down for the experience. Sure enough, my vein collapsed as the tech was trying to start the IV. That was it, I told him to stop and that I wanted to have my port accessed. He was a good technician; he listened to me. I walked over to the Cancer Institute.
After a 30 minute wait, a nurse was available to access my port. She did, I headed back to SNM, and received my radioactive contrast injection. Come back in 45 minutes.
I walked back to the Cancer Institute, which was extremely busy. I suggested to the receptionist that I could return after my bone scan. I went out on the street, found a new crepe place that had been open only three days, and had a freshly-made crepe with bananas, strawberries, Nutella and (sadly) fake whipped cream. I drank a huge glass of water.
Back to SNM. I went straight back to the bone scan room, used the toilet, took off my glasses and shoes and tried to get comfy on the narrow scanner bed. I wear an eye mask for these scans, so I can't see how close my nose is to the scanner ceiling. This scanner was in the shape of a CT machine, like a donut with a hole in the center, so less claustrophobic than others.
I put in my earphones and set my iPod to shuffle. The tech strapped my arms to my sides, covered me with a warm blanket and started the scan.
I actually fell asleep for the first 20 minutes. But after what felt like an hour, I really had to pee again, my back hurt from lying on the scanner bed and I was beginning to get really uncomfortable. I called out "How much longer?" and was told three more minutes.
Those last three minutes felt like another thirty. I had to pee. I wanted to move, or at least wiggle. My back ached. I had to pee! I asked again, how much longer, and heard back "only a minute and 30 seconds." Believe me, I sweated out those last 30 seconds.
The tech released me and I ran into the bathroom. I got dressed and headed back to the Cancer Institute, where all was quiet and a nurse de-accessed my port immediately.
Of course, I got stuck in rush hour traffic on the way home. Total elapsed time, door to door? Four and a half hours. Total aggravation? Extreme. From my doctor's office not calling to tell me he had written orders to get my port accessed, to the collapsed vein, the walking back and forth between buildings and the hour-plus scan duration, this was an afternoon from hell. I was so exhausted I fell asleep for an hour on the sofa.
This is one day in my life in Cancer Land.
1) Have port accessed by specially trained nurses at Swedish Cherry Hill Ambulatory Infusion Center
2) Go to bone scan location in hospital basement and receive injection of radioactive dye
3) Head back upstairs to have port de-accessed
4) Drink lots of water, get a snack and amuse myself for a couple of hours
5) Return to bone scan location
6) Use the toilet and
7) Lie on scanner bed, get strapped in and covered with warm blankie for bone scan (duration about 60 minutes)
Luckily, they always let me listen to music during the bone scan. Before the days of iPods I brought CDs; now I just set the iPod to "shuffle" and enjoy random music for the duration.
Yesterday's bone scan was at Seattle Nuclear Medicine, not at Swedish's Cherry Hill location. SNM has some fancy, new machine that can read your bone scan after less than an hour's wait.
People who don't have ports must have an intravenous line started by a technician. I wanted to use my port but never heard back from the doctor's office to see if they had arranged for the Swedish Cancer Institute (in the building next door) to access it. As I sat down in the chair for the tech to start a line, my cell phone rang: yes, I could get my port accessed.
Well, I was already at the bone scan building, and I will let anyone try to start an IV line once, so I asked to lie down for the experience. Sure enough, my vein collapsed as the tech was trying to start the IV. That was it, I told him to stop and that I wanted to have my port accessed. He was a good technician; he listened to me. I walked over to the Cancer Institute.
After a 30 minute wait, a nurse was available to access my port. She did, I headed back to SNM, and received my radioactive contrast injection. Come back in 45 minutes.
I walked back to the Cancer Institute, which was extremely busy. I suggested to the receptionist that I could return after my bone scan. I went out on the street, found a new crepe place that had been open only three days, and had a freshly-made crepe with bananas, strawberries, Nutella and (sadly) fake whipped cream. I drank a huge glass of water.
Back to SNM. I went straight back to the bone scan room, used the toilet, took off my glasses and shoes and tried to get comfy on the narrow scanner bed. I wear an eye mask for these scans, so I can't see how close my nose is to the scanner ceiling. This scanner was in the shape of a CT machine, like a donut with a hole in the center, so less claustrophobic than others.
I put in my earphones and set my iPod to shuffle. The tech strapped my arms to my sides, covered me with a warm blanket and started the scan.
I actually fell asleep for the first 20 minutes. But after what felt like an hour, I really had to pee again, my back hurt from lying on the scanner bed and I was beginning to get really uncomfortable. I called out "How much longer?" and was told three more minutes.
Those last three minutes felt like another thirty. I had to pee. I wanted to move, or at least wiggle. My back ached. I had to pee! I asked again, how much longer, and heard back "only a minute and 30 seconds." Believe me, I sweated out those last 30 seconds.
The tech released me and I ran into the bathroom. I got dressed and headed back to the Cancer Institute, where all was quiet and a nurse de-accessed my port immediately.
Of course, I got stuck in rush hour traffic on the way home. Total elapsed time, door to door? Four and a half hours. Total aggravation? Extreme. From my doctor's office not calling to tell me he had written orders to get my port accessed, to the collapsed vein, the walking back and forth between buildings and the hour-plus scan duration, this was an afternoon from hell. I was so exhausted I fell asleep for an hour on the sofa.
This is one day in my life in Cancer Land.
more soup
Starring (in order of appearance): olive oil, onions, garlic, garam masala, chipotle powder, water, vegetable stock, brown lentils, tomatoes, yu choy sum (Chinese greens), lemon juice, ground coriander. Served with a dollop of yogurt.
Loosely based on a Lebanese lentil soup recipe from the Toronto Star. I was out of cumin so substituted the garam masala. Ditto on the chipotle powder instead of cayenne. Soup is spicy but very, very good (if I do say so myself).
Annual Coffee Group Picnic
Yesterday the breast cancer gals got together for our annual summer picnic. Instead of meeting at a dept store coffee shop, we entertained ourselves outside in J’s back yard. It was our 9th picnic in a row and we sure enjoyed it.
Each of the gals brought a little something to eat which made for a yummy combination. Spring rolls, dumplings, wraps, potato salad, pasta salad and yes once again we were honored with one of Erm’s amazing desserts. This time it was a three-layer cake filled with peaches and whipped cream. She said she worked on it till midnight … wow, thanks so much Erm. Once again it was most delicious.
J has a beautiful blooming back yard. Occasionally a squirrel or chipmunk or blue jay would make a visit to sneak one of the peanuts. There were the sounds of squirrels chirping and birds singing too. It was real pleasure to be there surrounded by nature right in middle of the city.
Ari, our mascot was feeling a bit left out, so we gave him an opportunity to romp around a bit too. He was a bit rambunctious but we loved every minute of it.
After dessert, we sat around sipping fresh perked coffee. We talked a bit about when we first met and narrowed it down to the fall of 2000. Officially, our coffee group didn’t start till January of 2001 when our support group at the clinic ended. Wow, that’s almost 10 years now. Just then J’s daughter came home. She was kind enough to take some group pictures of us and then she gave each of us a gift … a beautiful bag of seven healing stones. With these came a handmade card to describe the healing properties of each polished stone. What a thoughtful gift.
TRAM Flap vs DIEP Flap: What's the Difference?
Up until a few years ago, the TRAM flap was the gold standard in breast reconstruction after mastectomy. The TRAM has now been surpassed by the DIEP flap for that honor. For patient's researching their reconstructive options after mastectomy, it is important to understand the concept of TRAM surgery and how it has evolved into today's cutting edge DIEP procedure.
1) The Pedicled TRAM flap: this was the first operation to describe use of one of the rectus abdominus muscles (sit-up muscle) for breast reconstruction. The surgery begins with an incision from hip to hip. Then, the lower abdominal tissue below the belly button (skin, fat and one of the abdominal muscles) is tunneled under the upper abdominal skin to the chest to create a new breast.
Recovery from the surgery can be difficult and painful. Long-term, the patient has to adapt to the loss of some abdominal strength (up to 20%). As with any surgical procedure there is the possibility of complications. These include delayed healing, fat necrosis (part of the tissue turns hard due to poor blood supply), abdominal complications such as bulging and/or hernia, and loss of the reconstruction altogether (rare).
2) The Free TRAM flap: this procedure uses the same abdominal tissue as the pedicled TRAM except that the tissue ("flap") is disconnected from the patient's body, transplanted to the chest, and reconnected to the body using microsurgery. Advantages over the pedicled TRAM include: improved blood supply (and therefore less risk of healing problems and fat necrosis), and less muscle sacrifice (so the abdominal recovery is a little easier, potentially more strength is maintained long-term, and the risk of bulging and hernia formation is lower).
Since the tissue is disconnected and transplanted to the chest, there is also no tunneling under the skin as there is with the pedicled procedure and no subsequent upper abdominal bulge around the ribcage area (which is typically seen with tunneling).
3) The Muscle-Sparing Free TRAM flap: this operation is associated with all the benefits of the free TRAM but has significantly fewer abdominal complications and side-effects (pain, bulging, hernia, strength loss) because the vast majority of the abdominal muscle is spared and left behind. The amount of muscle taken is typically very small (postage-stamp size). We will opt for this version of the TRAM only in the rare event that the patient's anatomy does not allow for a DIEP or SIEA flap.
4) The DIEP flap: This is the most advanced form of breast reconstruction surgery available today. Like the muscle-sparing free TRAM, the DIEP uses the patient's own abdominal skin and fat to reconstruct a natural, soft breast after mastectomy. Unlike the TRAM however, all the abdominal muscle is preserved. Only abdominal skin and fat are removed similar to a "tummy tuck". Patients therefore experience less pain after surgery, enjoy a faster recovery and maintain their abdominal strength long-term. Since the abdominal muscles are saved, the risk of complications like abdominal bulging and hernia are also significantly lower. Please visit our gallery to view DIEP flap before and after photos.
*****
Dr Chrysopoulo is a board certified plastic surgeon specializing in the latest breast reconstruction techniques including DIEP flap surgery. He and his partners perform over 500 DIEP flap procedures per year and are In-Network for most US insurance plans. Learn more about your breast reconstruction options and connect with other breast reconstruction patients here. You can also follow Dr C on Twitter!
*****
Dr Chrysopoulo is a board certified plastic surgeon specializing in the latest breast reconstruction techniques including DIEP flap surgery. He and his partners perform over 500 DIEP flap procedures per year and are In-Network for most US insurance plans. Learn more about your breast reconstruction options and connect with other breast reconstruction patients here. You can also follow Dr C on Twitter!
*****
Wednesday, August 18, 2010
Therapeutic implications of colon CSCs
Therapeutic implications of colon cancer stem cells by Eros Fabrizi and 3 co-authors, including Lucia Ricci-Vitiani, World J Gastroenterol 2010(Aug 21); 16(31): 3871-7. OA review. [FriendFeed entry][PubMed citation]. Abstract:
Colorectal cancer is the second most common cause of cancer-related death in many industrialized countries and is characterized by a heterogenic pool of cells with distinct differentiation patterns. Recently, the concept that cancer might arise from a rare population of cells with stem cell-like properties has received support with regard to several solid tumors, including colorectal cancer. According to the cancer stem cell hypothesis, cancer can be considered a disease in which mutations either convert normal stem cells into aberrant counterparts or cause a more differentiated cell to revert toward a stem cell-like behaviour; either way these cells are thought to be responsible for tumor generation and propagation. The statement that only a subset of cells drives tumor formation has major implications for the development of new targeted therapeutic strategies aimed at eradicating the tumor stem cell population. This review will focus on the biology of normal and malignant colonic stem cells, which might contribute to our understanding of the mechanisms responsible for tumor development and resistance to therapy.
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