A Pink Glove Video

A nice upbeat video to help start tonight's festivities.

Open New Year's Eve and New Years Day

Hey all,

We will be open normal hours for New Year's Eve and New Year's Day, 10am-11pm. Got a couple new things in stock and some replenishment. New in:

-Lost Abbey Gift of the Magi
-Lost Abbey 10 Commandments
-Anchor Old Foghorn Barleywine
-Brother David's Triple
-Brother David's Double
-Green Flash Hop Head Red
-Green Flash Triple
-Port Old Viscosity
-Hitachino White Ale

Happy New Year!

Nate

PET scan

This morning I woke up extra early to get to the Cancer Institute for my PET scan. Rik walked the dog while I got ready. It was only 23 degrees outside! Thank heavens I bought that long down coat on sale a few years ago.

The prep for a PET scan is:

• No exercise for 48 hours prior to the test.
• Eat a no sugar-low carbohydrate diet the day before.
• Eat a high protein/high fat dinner the night before.
• Nothing but water after 9 PM.

Because my power port can't be used for the PET contrast, the chemo nurse started an IV line. (The PET solution tends to stick in the port, and would show as a big lighted area on the results that might mask any cancer located in the same spot as my port is placed.)

The PET tech gave me some yummy (not) barium contrast material to drink. It comes in four flavors: mocha, banana, berry and vanilla. I chose the mocha as the potentially least disgusting taste. Then I rested quietly, listening to music. I was told to be completely still, not even turning the pages of a book, so the PET radiotracer solution doesn't show a false positive in active muscles. The barium contrast gave me a bit of diarrhea, which happens in about 25% of people. Yucky but manageable.

After an hour of quiet, I went into the scan room. Lying on the narrow scanner bed with my arms overhead and my eyes covered with an eye mask, I relaxed as best I could. Twenty-five minutes later, I was done.

Rik took me to Cafe Presse, my favorite place to eat on Capitol Hill. It was almost noon at this point and I'd been fasting since 9 PM last night, so I was pretty hungry. I ordered pain et beurre, omelette avec fromage Comte, et chocolat chaud (French-style hot chocolate; basically a bittersweet chocolate bar melted into whole milk and served with a whopping dollop of whipped cream on the side). Rik had steak frites. Everything was delicious, as always here.

We came home and I took Bobka the dog for a nice walk. Now I'm off for a nap. I get the PET results on Tuesday.

Onc Visit

Yesterday I went in have my blood work done. Then while waiting to see the Onc, the trials nurse came in and said … oh don’t get up … I want to check your bp first. It was 88/66. Yikes ! that’s way too low.

We then went into the exam room where we went over the 50 odd some questions on what side effects I was experiencing this week. She informed me that my blood work indicates that my liver function had not improved from last week so we’ll just have to wait another week … off chemo of course … and I will enjoy more of my chemo vacation.

A short while later, my Onc came in … he did a quick exam that included listening to my breathing and checking the inside of my mouth with me doing the aw-test. He did a quick feel of my ankles and feet checking for swelling. Then he checked my abdomen, pressing down around my liver looking for any tender spots. There was one small spot but everything else was ok.

He then talked about my low bp saying that I should stop taking Amlodipine immediately and then if I don’t get my bp to where the top number is close to 95 within the next 4 days, I should also drop the Ramipril from 10mg to 5 a day. And of course, we’ll just crank it all back up when I get back on the Brivanib.

My blooming orchid

I bought an orchid over the summer to complement our lovely re-done bathroom. The flowers only last so long and in the past I have not had luck growing new ones. After many months of careful watering and fertilizing, I am proud to say that my orchid has bloomed again!

O Canada

We recently spent a few days in Vancouver BC and had a truly marvelous time, visiting with family and friends and eating,  drinking and shopping our way across town.

Dinner at Vij's was clearly a highlight. We'd eaten take-away from Rangoli, the less expensive sister place next door, but this was our first time at the real thing. The line outside the door starts at 5 PM for the 5:30 opening. We were the 20th-26th people in line and were seated right away after they opened the doors.

Servers offered complimentary hot chai tea and appetizers of tapioca-root "fries." Our dinner was simply amazing. Because we were six people, we were able to sample many menu items:

Jackfruit in black cardamom and cumin masala 

Samosas filled with lamb and beef sauteed in fennel, cloves and sumac

Yam, paneer and cabbage kofta in pureed lentil curry

Seared venison medallions with figs and khoa in pomegranate curry

Beef shortribs braised in yogurt, fenugreek and cumin curry

Wine marinated lamb "popsicles" in fenugreek cream curry on turmeric and spinach potatoes

Marinated and grilled salmon in coconut and green onion curry

And of course, mango-pistachio ice cream for dessert

In 2003 the New York Times called Vij's "easily among the finest Indian restaurants in the world." I concur!

We stayed at the Westin Bayshore and were upgraded to a room with a fabulous view. This hotel is very near Stanley Park and was convenient to many cafes and shops. Rik and I spent a morning strolling down Robson Street and supporting the Canadian economy with some post-Boxing Day shopping. 

At Geomania Rik purchased this charming little First People's sculpture of a champagne jade polar bear perched on a quartz iceberg eating a tiny hematite fish.

I picked up a pair of red 2010 Olympic mittens at The Bay. And we saw the most perfect dress on display at Premiere, which I simply had to have.

At the end of our three kilometer walk and shopping spree we picked up some dessert from True Confections on Denman to share later. Then it was off to ice skate. Well, Rik and the kids all skated; I drank hot coffee with my cousins and friends. Everyone was ready for a treat at that point, so we headed to Casa Gelato to taste among the 218 flavors of ice cream. I tasted fennel, fig and walnut, and ended up with fig and chocolate. (I wanted to taste the pear, balsamic and blue cheese flavor but the server was too busy.) Rik had mango-jackfruit.

After dinner at our friends' home, we enjoyed the desserts from True Confections: one slice each of Boston cream pie, chocolate cake with chocolate ganache frosting, triple berry pie and Black Forest cherry tart (with loads of whipped cream). By this point Rik and I were completely pooped, so we went back to the hotel and crashed over TV.

The next day we met up with our friends for breakfast at Scoozi's, where I enjoyed eggs benedict with smoked salmon and my annual glass of fresh grapefruit juice. Somehow we rolled into the car and made it home to Seattle, sated with good food and even better company.

Chemo Vacation Continued

Well, I’ve officially been off Brivanib one week and I thought I’d share with you how things are going. I’m feeling less lethargic and wouldn’t have been able to handle all that’s happened on chemo.

Still require tons of sleep but I’m not as chilled in bed or out.  I was in bare feet all day yesterday with no need for a blanket and heating pad. wooohooo!

My appetite is up a bit and it’s not so reactive. I now can eat a greater variety of foods, still in small portions, without having that immediate gurgling in my abdomen. And today was the first day for a regular bm and I can drink fluids without that nausea feeling coming on.

My ankles are slightly less swollen and a friend mentioned that my face wasn’t as puffy. There’s a little more interest in doing a few things now too. And getting up off the chair is less of a chore. Shortness of breath is better tho I still cough way too much.

With all the festivities going on, I sort of forgot to monitor my bp. So this morning I checked it and it’s 96/77 … a little low. So if that happens, my Onc told me to cut one of my bp meds in half.

The only thing that doesn’t seem to be resolving itself is my urine, it's still a dark golden color. I hope to drink even more fluids in the next few days to dilute that back to normal.

Visiting with Friends

Yesterday we visited with long time friends B and D. We ended up being there longer than any one of us expected. I was feeling pretty good the whole time. After a while the men got into their laptops and other toys and us girls just talked and occasionally watched the fish swim around in their huge aquarium.

B and D are such gracious hosts … always an ample supply of snacks and drinks and they even had a blanket already for me to wrap myself up in. They know me too well.

Even tho we got home at a descent time, I still ended up sleeping a solid 12 hours.

oh yeah...

I hope your Christmas was as fulfilling as mine in 1989!!

Attention Gueuze Lovers

Has Arrived to Healthy Spirits. Tiny allocation. Get it while you can.

Cheers,

Rami

A Family Visit

Well, it was another wonderful afternoon and evening spent with family. In the morning, I followed the same regimen as I did yesterday except my usual little nap was cut short because we had to leave. 

So after dinner, we all moved to the more comfortable chairs in the living room. I hogged the whole couch by putting my feet up and then my sister came by with a blanket to cover me up. Thanks sis, I’ll just close my eyes for a bit and listen to what's going on.

I wasn’t listening too well because I fell asleep and woke up an hr half later. I really do like how I can nod off practically anywhere. Then I just joined in the conversation and no one said boo.

Without these naps, I’d just power out and be too tired to enjoy what’s going on.

Children

I was corresponding back and forth in the comments section of the Elizabeth Edwards post about selfishness, having children, not having children, going to enormous effort to have them. You could call me selfish for not having children. I was always afraid they'd have asthma, I was afraid I'd run out on them in a panic, that I would be selfish and not want to pay attention to them. I realized that I think strangers who've tried very hard (hormones, in vitro, etc.) are spoiled, but when my friends and family have taken this route, I'm very sympathetic. What does this mean except that I'm judgmental? Or maybe that I'm envious of celebrities who have been able to stop the clock, the way they've been successful in doing so much else. Both Wendy Wasserstein and Elizabeth Edwards had children late and both died of cancer. Connection? I don't know. I do know that both ovarian and breast cancer have been known as "the nun's disease." My sister has three children and has never had even a cancer scare. I don't have the BRCA gene, and I would bet neither does she. My mother has never had breast or ovarian cancer. She had two children and no more. Is there a part of me that wishes that I could have gone through all the body mechanics to have a child late in life? The truth is that I like options. I always want to feel that I could take up anything, marathon-running, or art or a new language, with my middle-aged chemo-addled brain and body. And you can always find role models. Take Grandma Moses, for example. I've always wanted to experience pregnancy and childbirth. When I come across an ad for a surrogate, I read it, and it takes me a second or two to realize that yes, though I am healthy (if you ignore the breast and blood cancer and asthma), I am not 35 years old any more.

Attention, bloggers

More media queries, for current and former bloggers:
If you live and work in the Chicago area and used to blog,
but don't anymore, and want to be interviewed, please contact
Lisa Bertagnoli (www.chicagobusiness.com)
Email: query-uk5@helpareporter.com
Media Outlet: www.chicagobusiness.com
Deadline: 05:00 PM EST - 30 December
***
African-American Bloggers: How Did You Begin Blogging?
BlackWeblogAwards.com is looking for African-American bloggers to
share their stories of how they started blogging. How did you
begin blogging? Who (or what) influenced or inspired you? What
has blogging brought to your life? We want to know! All stories
will be fully attributed to you with links to your blog as well.
Photos are a plus.
Maurice Cherry (Black Weblog Awards)
query-cih@helpareporter.com
Deadline: 11:00 PM EST - 31 December

What we did on December 25th

While the rest of the world (or so it seemed) was quietly celebrating Christmas, Rik and I had a great day with friends.

I went to synagogue in the morning and got to hang with my peeps. The volunteer Shabbes Chefs had made Chinese food for lunch! Rik took the dog for a long walk and then had a nap. (See "Jewish Christmas: Why Jews eat Chinese on December 25".)

After shul we went over to friends and played Scrabble and Pictionary, ate cookies, drank tea, and shmoozed.

For dinner we went to Chiang's, our favorite Chinese restaurant. Given the huge, noisy crowd and despite the fact that we pre-ordered our dinner, everything was still slow. But delicious! Next year we go for lunch instead of dinner and we will pre-order our meal.

What we enjoyed:
Vegetarian hot and sour soup and egg flower soup
3 orders of vegetarian spare ribs
Whole tea-smoked duck
2 orders of vegetable mu shu
Spicy and garlicky green beans
Spicy and garlicky eggplant
Green onion pancake
2 orders of rice cakes with chicken and vegetables
AND
a whole flounder prepared especially for us in the salt-and-pepper style (It was so beautiful, I should have taken a photo.)

After dinner we headed back to the G's for dessert and general hanging out. We got relationship advice from the teens, shared recipes, drank coffee and relaxed.

It was a lovely day. I hope yours was at least as much fun as ours!

Visiting with Family

Yesterday D and I went over to my sister’s place for Christmas dinner. My major preoccupation is to do whatever it takes so I don’t have any stomach or bathroom issues. And make sure I’m alert enough to take part in conversation and to be sociable.

I started off yesterday with white bread for breakfast. Then I did my blog and got it ready to auto post at 11:30. Then I had shower, got dressed and organized myself. I did this all early enough to have an hr nap before we left. My sleep it still not up to par and having a good little nap, I’ll have enough energy to make it through the day.

So at my sister’s place, when it came time to sit down and eat, I chose white turkey meat, one meat ball, a small piece of ham and some mashed potatoes. I decided it was best to take two Imodium after just a couple of mouthfuls. I only ate about half of what I put on my plate because, it’s best that I quit eating as soon as I get the slightest feeling of being full. It must have been the right amount because I was able to stay out of the bathroom till this morning. After dinner, I politely said no to any drinks and just sipped on water.

Today is another dinner at my other sisters house … I plan to get ready the same way too.

Christmas day Schedule

Keeping up with our commitment to satisfy your lust for good beer, Healthy Spirits will be open today until 5 pm.

Merry Christmas,

Rami

415-255-0610

More Chemo Side Effects Report to Onc

While visiting my Onc this past Thursday, we talked about a few other side effects I was experiencing. My feet are swelling up. He and the trials nurse wanted to have a close look at my feet and I felt bad for them as they pulled my compression socks off and back on. They got a bit of a work out doing that. The Onc then said … oh this isn’t too bad … how are your shoes fitting … I said they’re not. I can only wear my runners now and even they are bruising my ankles. I guess some Boxing Week shopping is in order.

Another thing we talked about was my tender mouth and difficulty swallowing. I was thinking it was due to the fact that I had a stuffy nose, I tended to breathe more through my mouth which seemed to dry everything out. The Onc said that my tender mouth and difficulty swallowing are known side effects of Brivanib. The nurse asked if I had any sores in my mouth and I said no … it was just sensitive to things like toothpaste, pop, certain foods, and hot and cold.

I also mentioned I was hearing strange sounds in my ears but chemo brain here missed what they said about that. I’ll ask again next week.

Merry Christmas, Happy Holidays & Seasons Greetings

Merry Christmas, Happy Holidays & Seasons Greetings.

More cancer?

We saw Dr G yesterday and my tumor markers have been rising slightly for the past three checks. That might indicate that the Faslodex is working (i.e., you get a bump up in tumor markers at first) OR if it's a steady rise, it might mean that the Faslodex is not working. Hard to say. By physical exam, I am "completely stable."

Dr G and I discussed another PET/CT scan, an expensive test which apparently I haven't had since July 2008. This scan measures the cancer's activity by noting how quickly the tumors take up glucose (sugar).

If the PET/CT scan reveals much more active cancer, and it becomes apparent that the Faslodex is not working, the back up plan is for me to start another chemo, Navelbine (vinorelbine), in January.

Dr G tells me that Navelbine tends to be very mild when compared to other chemotherapies, and just as effective as anything else. For those of a medical turn of mind, here is a link to the recent Journal of Clinical Oncology which Dr G shared with me. You may find it interesting. Technical, but interesting. All others, note the abstract's final paragraph:

Conclusion The study failed to demonstrate superiority of any drug in terms of efficacy, but the vinorelbine combination had significantly fewer adverse effects and should be considered as an alternative first-line option.

Wait and see....

pain for the holidays

Since I forgot to renew my opiate prescription before I left for the holidays, and since I am subsequently curled up in the fetal position at my mom's house unable to move from excruciating pain and withdrawal symptoms (watery eyes, hot flashes & chills, MONDO headaches, excessive yawning), I thought I'd post about pain.

Chronic pain. The thing that follows after cancer, but no one seems to talk about. The thing that plagues my everyday life, but doctors can't seem to figure out. Chronic pain is eating up my life.

Now, everyone's physiology and background is different. I only speak for myself. I'm sure there are miraculous people out there that go through chemo, surgery, and radiation relatively unscathed and untouched. Cancer treatment lite, I like to call it. If you fall into this category-- lucky duck-- just scroll on down. If not, let's share our experiences with chronic pain instead of masking them, as young adults tend to do in an effort to be "normal" within their peer group. Perhaps the more dialogue is opened, the more physicians and loved ones will be able to understand and help us.

My chronic pain seems to be twofold:

I have deep somatic pain due to scar tissue in my hip, where the tumor was, and right clavicle/shoulder, where lymph nodes were plucked during the Thyca surgery. This pain is dull, aching, and absolutely unrelenting. This is my main issue and the thing that compromises my quality of life the most. When untreated by opiates, as it is now, this pain consumes me-- I can't focus on anything else. I avoid physical activity completely. It just does not let up. It's maddening, I tell you.

[Scar tissue from radiation has also caused a myriad of problems for my digestive system and bladder... but that's another painful story for another painful day]

I also have neuropathic pain all over my body, though mostly felt in my joints, presumably from 8 months of chemo toxins damaging the protective sheaths around my nerves. This pain feels sharp, stabbing, and sometimes tingly. It's rather unpredictable-- I get sparks of pain everywhere from my chin to my toes. I also experience neuropathic pain around my neck incision, where nerves have been cut & damaged. The skin there is numb to the touch, but even gentle pressure creates a sharp pain.

To combat all of this I use daily opiates, light stretching, pot, and hot baths. The opiates, obviously, are the only thing I've found that allow me to live a semi-normal, semi-pain-free existence. Unfortunately, these have all sorts of drawbacks, including increased dependency, side effects (I hate the grogginess), and nasty withdrawl symptoms. Plus, they're pricey. You need insurance. You need employment. You need a functional body to stay employed. You need opiates. Etcetera.

Until now, I had no idea just how much I rely on those little orange pills to function.

Do you have chronic pain, even years after treatment? How do your doctors respond to your concerns? Have you found anything that particulary works for you?

I’m on Chemo Vacation

Yesterday I had my nine week appointment at the clinic. The appointment usually starts with the clinical trials nurse going over any new side effects I may be experiencing. We barely started when the Onc came in, sat down and asked how I was feeling. I said that two days after starting Eltroxin for my thyroid, I was sleeping better. D noticed it too; he said he felt my sleeping was much more relaxed. We ended that bit of conversation with the nurse asking me exactly when I started taking Eltroxin.

The nurse asked me about nausea and diarrhea … I said I have it pretty well under control but then I’m not eating that much. Looks like my blood work reflected that because the Onc suggested I start taking Imodium first thing in the morning and every four hours after that. The point was I needed to get more nutrition into me.

After the nurse went over her long list of side effect questions, she went over the blood work. One liver function number is especially high, the same number that just about prevented me from getting in the clinical trial. Both the nurse and Onc said this is a known chemo side effect and is expected but it also means you need a small chemo vacation … one or two weeks off of Brivanib for your liver to recover. 

Once again they reassured me that is something to be expected, so don’t worry. She then asked me to hand over all my Brivanib pills. Now I understand why I have to bring them to every appointment.

We scheduled an appointment for next week for more blood work.

Ommegange Chocolate Indulgence

The decadent and seductive Chocolate Indulgence from Ommegang has arrived.
Also, we were blessed with a second allocation of the 2009 North Coast Old Stock Ale Cellar Reserve Bourbon Barrel.
We received Russian River Damnation, Consecration, Supplication, Redemption.

Cheers,

Rami

Website blogs

My new web site developers are trying to get me more "out there" in the internet....social networking sites etc.  The siteis still very much under construction, have patience!

They also offer a blog network attached to my site for appendix cancer patients so that we can more easily communicate with each other.  New to me, JCow. I checked it for the heck of it today, and several people have joined our blog network!!!   Surprised me, and made me feel great.  Those diagnosed with appendix cancer are supporting others diagnosed with appendix cancer via the blog network!  We all need that...communicating  with others who have been there and done that, walked in our shoes.  People who can support us in ways those who don't have our diagnosis can't.  I have some who are not candidates for surgery who are looking for others like them who they can communicate with....maybe they can join the blog network?  It's a bit like a private facebook community.

Also, for fun, I'm going to paste a link here. I grew up in a traditional church and really didn't like it...the solumness, the formality, the liturgy, the dreary hymns.  I quit going to church pretty much when I moved out at 17.  Then I discovered the more contemporary churches about 10 years ago...and loved them!  I belong to one now that is 1000 members strong, is upbeat (jeans are the normal attire), we have a great band (complete with drums and electric guitars), and informal services.  We have 5 Christmas Eve services, one tonight (good for me as we spend Christmas Eve in Illinois with my family).  But this video is a rocked out rendition of one of my favorite carols, Drummer Boy,  from last year's Christmas Eve service that I LOVED!   Maybe some of you will enjoy it?

I Have a Brivanib Buddy

About a week ago my mets friend K from Calgary sent me an email with a link to a discussion group on BC Mets where a lady posted a comment to the discussion about Brivanib. I was very interested in M’s story and decided to follow her. It’s helpful to know other people’s experiences with this drug and gives me  some piece of mind.

In the discussion group, M said about 8 weeks ago she started a phase 1 clinical trial with Xeloda and Brivanib combo. Her first issue was her bp spiked to 200/100. I had a similar experience with my bp jumping to 170/101. We both had great results on some aspects of our blood work after just three weeks on Brivanib and our tumours or tumour markers have shrunk ~30%. Our Oncs measure our cancer differently.

Where things change up a bit is that she has had to go off Brivanib for five weeks because her Onc was having difficulty getting her bp under control and other aspects her liver function quadrupled. So out of eight weeks, she has actually been taking Brivanib for only three.

Brivanib appears to be a finicky drug and I only hope that my blood work today doesn't show my already high liver function has gone too high and that I can continue chemo. I’ve been checking my bp regularly and it’s ~122 / 75 with the meds I’m on.

M and I now regularly email each other. We’re breaking new ground here and it’s sure nice to have a trials buddy to help go thru this.

The 100 greatest Jewish songs ever

This article from Tablet Magazine ranks the top 100 greatest Jewish songs ever. I gotta say, I agree with almost every choice!

Cookie creation

Although I love to cook and bake, I am hopeless at presentation. I just can never seem to manage making things look delicious.

Last week I went to a cookie exchange party. For those of you, like me, who have never baked Christmas cookies (since I don't celebrate Christmas), I had to ask what this entailed.

You bake a dozen or so of your personal favorite cookies and bring them to the party. Everyone else does the same. You all enjoy tasting each cookie, drink tea (or wine) and have a pleasant visit together. Then everyone brings home a sampling of all the cookies.

Well, there were so many cookies that I had to share them with friends. Here is the beautiful cookie platter --

I take credit for baking the (parve) chocolate crinkle cookies from The Seattle Times and the heart-shaped rosemary shortbread from The Herbfarm. The rest came from the cookie exchange (lemon bars, Russian tea cakes, pumpkin cookies, jam centers with white chocolate icing) and from a few of Rik's students ("candy canes", frosted sugar cookies, chocolate chip cookies).

We also ate a new kind of fruit salad: pomegranate seeds mixed with toasted nuts and tossed with honey. It was scrumptious, if I do say so myself!

Checklist for Clinical Trial Nurse

Today I made my list of aches and pains for the trials nurse when I see her on Thursday and I thought I’d share it with you. I’m going to say that my coughing continues … better at times and worse at others.  I did have a bad cough before I started Brivanib; funny thing tho, that it got better, much better in fact for a few weeks and now it’s back to where it started.

When you’re on chemo, some of these symptoms creep up on you ever so slowly that you don’t really know when they started but that is always a question the nurse asks … when did this or that start? Well aprox Dec 10, I developed a tender mouth and a sensitivity to hot and cold. There is tenderness around my teeth as well. Some foods are more irritating to eat and if I bit my tongue, for sure it takes longer to heal.

Food doesn’t go down smoothly anymore either and my throat feels restrictive. My nose has been stuffy since before I started Brivanib and it really stuffs up now during the night. So now I breathe through my mouth which tends to dry the whole works out.

Sometimes when I’m lying down, I hear odd sounds in my left ear … one being something like camera shutter. Another being a big over head door slamming shut. I will mention that I was sick for the very first time since starting Brivanib. Also my feet and ankles continue to swell, so much so that since Dec 15,  there's a  skin wrinkle where my shin and ankle meet.

Just fun stories!

Ham causes cancer...and so does eggnog! 

I bought some eggnog the other day....and my kids protested. We don't DO eggnog anymore!  Eggnog kind of signifies my cancer diagnosis to them.  Before I was diagnosed,I bought some eggnog. Shortly after I drank a glass I had severe stomach cramps. I had never in my life had a stomach ache or stomach cramps, and decided the eggnog was bad.  I asked if anyone else had had any, and grateful that they hadn't, I disposed of it.  I had several more episodes of severe abdominal pain after that which in the end led to my cancer diagnosis.  But to them, eggnog and cancer are related, even to this day!  One of the survivors who wrote a story for my site had the same experience after eating ham, he also misdiagnosed it as food poisoning.  I wonder if others have similar stories?  At least now I get all of the eggnog to myself!

I was recently interviewed for my newspaper,they are doing a story on my non-profit and appendiceal cancer (Yeah!  We need more awareness!).  They asked a lot of questions about my cancer.  It made me remember how devastated my youngest daughter was with my diagnosis. Sure that cancer was a death sentence, she was afraid I would die.  Once she knew I had cancer (she was ten), she went to school and told all of her friends that her mom had cancer.  That day she came home ecstatic.  I asked her why.  She told me of all of her friends who had lost relatives to colon, breast, brain and ovarian cancer.  But she said "Mom, no one knew ANYONE who ever died of appendix cancer!!".  I decided that maybe there was at least one good thing about having a rare cancer!

If I don't post again before the holiday, I want to wish everyone a VERY Merry Christmas!!

The Abyss 2010

The long awaited Abyss has arrived. Small shipment and no bottle limits. We are promised a second shipment next week, but I would not count on it. Beer of the month club members can RSVP.

Cheers,

Rami
415-255-0610

Cancer Research Saves Lives Video

Here is a five minute video put out by American Association for Cancer Research. It’s a fascinating video about the accomplishments by all cancer researchers so far.

The mission of the AACR is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research.

Just a note of caution, you may want to turn down your speakers or even shut the volume off as the music is quite loud and repetitive and there is no speaking.

North Coast Old Stock Cellar Reserve just arrived!

Hey guys,

Just received a shipment of the 2009 Old Stock Cellar Reserve aged in bourbon barrels. It's on the shelves now, with no bottle limits. We have been looking forward to this release for a while so get it while you can. Cheers!

Nate

Mother 86 Years Young

Yesterday I went through my normal morning routine, except I would not be having my early afternoon nap. It’s my mother’s 86th birthday and twelve of the family got together for lunch at a local restaurant to celebrate. As we all gathered around, I thought what a wonderful family I have. Everyone was so full of life … chatting with each other, catching up on all the news. My nieces and nephews are all couples now and have grown into fine young adults, with careers and talking about their great plans for the future. Mother just sat there glowing as she looked around the table surrounded by her children and her grandchildren … she was just so proud.

Because food is such an issue for me, I decided to look up the menu on the web the night before … thinking if there would possibly be anything I could order. In the end, D and I shared a burger and fries because that was what was popular at our end of the table. I had two bites of his burger and about four fries and it sat well with me. My thoughts now are that I can probably eat most anything as long as the portions are very very small. I even had one bite of cake to help celebrate the occasion. And everything came out ok … in the end … this morning.

As soon as we got home, I hit the sack for a nice long nap.

Well, poop.

My M-spike went up a teeny bit to 2.7. The nurse emphasized that THIS IS NOT A BIG DEAL. The rational part of my brain knows she is completely right. I've dealt with this spike for five-plus years, and I've watched it do all kinds of weird things from month to month, and I know a one-time increase of .3 IS NOT A BIG DEAL. The irrational part of my brain (which is most of my brain, I think) doesn't like it at all. Oh, well. What can I do? I guess I'll put back the slightly unbuttoned photo of Bon Jovi for starters:

By the way, I'm now on 15 mg of Revlimid to try to help my blood counts recover. So we'll see.

Two new initiatives from the CSCC

The Cancer Stem Cell Consortium (CSCC) has announced the launch of two new initiatives for 2011-2012. Information about these initiatives is available via the websites of the CSCC and Genome Canada.

The two initiatives are:

1. C4Resource: The Canada-California Collaborative Cancer Stem Cell Resource and Technology Platform Network or C4Resource, which would coordinate cancer stem cell research resources and platform technologies more efficiently and effectively to advance research and discovery and accelerate clinical translation of new findings; and,

2. Partnership with CIRM: A second funding partnership with the California Institute for Regenerative Medicine (CIRM) through the CIRM's Disease Team Therapy Development Research Awards.

Information about the CIRM Disease Team Therapy Development Research Award RFA is available at: http://www.cirm.ca.gov/RFA_10-05

Montreal-style bagels in Seattle

On Friday I ate at Seattle's new, Montreal-style bagel bakery:  Eltana. Opened by a friend from our synagogue, Eltana is on 12th Avenue near Pine Street on Seattle's Capitol Hill. The bagels are hand-formed, boiled in honey water and baked in a wood-fired oven. More hole than dough, with a soft center and chewy crust, bakers place the bagels in the oven on very long paddles and remove them the same way onto a chute and hopper, just like the bagels at Montreal's St.-Viateur bakery.

Eltana serves plain, sesame, poppy, everything, wheat, and sesame wheat bagels with a variety of spreads, salads, coffee and cold drinks, and beer and wine (it's on Capitol Hill after all). Everything is vegetarian.

I LOVED these bagels! I brought home a dozen and the resident Canadian was very impressed.

The only catch? Just like Montreal bagels, you have to eat them the day they are made or freeze them for future noshing. Otherwise they turn into hockey pucks.

It appears I'll be bringing home a dozen every week. Yum!

Keeping up with Jill

Rik said the funniest thing to my mother the other day. She called when I wasn't home, and when asked where I was, Rik said "She's feeling so good, I can barely keep up with her!"

It's true, I have been feeling exceptionally well. I'm sure most of it is due to being off chemo since October. My return to good health, not to mention hair, has given me even more energy than I expected. And of course, having enough hair to look intentionally short, keeping my reduced weight stable and being again the size I was when I met Rik 16 years ago all contribute to better mental and emotional good health. (The new clothes I had to buy didn't hurt either. Retail therapy can be very helpful.) Even my lymphedema seems to be under better control.

I will see my orthopedist this week and get his take on why I have pain in my knee. Then all the docs will "talk" and hopefully Dr G will recommend that I stay on the high dose Faslodex.

In the meantime, I enjoy feeling good!

Funny comic!

Okay, fellow Star Trek fans -- check out the Foxtrot comic from today, December 19, 2010.

(tee hee!)

A Rude Start Day

Yesterday morning I woke up feeling a little off… can’t really describe it but I was off. I got up and took my Brivanib pills with a glass of water. I then laid down for about an hour and got up and took three bp pills and sat at the kitchen table. D was making coffee at the time. A couple minutes later I said to D, wow those made me feel nauseous today. About a minute later I said get me a plastic bowl. How big of bowl would you like? NOW I said. I went from feeling fine to vomiting in no time flat.

I wanted a bowl to see which of the pills would come out so that I could replace them. I didn’t think there was time for any of them to dissolve but who knows. There was one bp pill that was still intact which I replaced when I took with my thyroid pill a half hour later. I’ll gotta tell ya, it felt so good to get that all over with so quickly. This is the first time I’ve been chemo sick since 2000 when I was on FEC.

On the bright side, my last three bm’s have been near normal. whoo hoo !! I’m still very careful of what I eat tho; no dairy and keep the portions small. I just nibble and give my stomach time to see how it likes it.

Email

If anyone has recently sent me an email I did not respond to, please resend!  I think I got all of them but may have missed one or two with the host change-over for my web site.  They did add a new contact feature to  my site so email is sent to me via a form on the site, so hopefully I won't get as much spam!  I got tons when my email address was on the site.  Filling out the form is the same as sending me an email, just more secure!

Prescribed a Thyroid Medication

On Monday I mentioned I was struggling with my sleep. I said, I’d wake up breathing real hard ... trying to get some air in me. D described it as I start breathing shallow then I take a whole bunch of deep breaths to recover. So that morning I emailed the trials nurse to see if they could prescribe something for me to give me some relief. Between days off and telephone tag, it wasn’t till late yesterday I picked up my prescription for Eltroxin (levothyroxine) … a thyroid medication. I was not expecting a thyroid medication.

According to WebMD, Eltroxin is used to treat an underactive thyroid (hypothyroidism). It replaces or provides more thyroid hormone, which is normally produced by the thyroid gland. Symptoms of low thyroid hormone levels include tiredness, muscle aches, constipation, dry skin, weight gain, slow heartbeat, or sensitivity to cold.

I’d have to say I have many of  those symptoms … especially the fatigue and feeling cold all the time. If this little pill could get rid of the chills and give me some more energy, I’d be thrilled.

I see the Onc Thursday so I’ll find out more then.

Healthy Spirits: Beer of the Month Club January 2011

Now ready for pick-up!

cheers,

dave hauslein
beer manager
415-255-0610

Huge Bouquet of Flowers for Christmas

Last Wednesday about supper time, the door bell rang. D went to see who it was … turns out it’s a delivery, I was getting flowers … a huge boutique of flowers. Not only was it huge but the whole thing was heavy too.

After putting the bouquet on the dining room table, we carefully unwrapped it from the many layers of plastic used to keep it warm as it’s carried from the heated van to the house.

Oh my … it’s a Christmas flower arrangement with fresh greens including cedars and pine bows, filled with Holly, red roses, red decorative Christmas balls and whole bunch of flowers I’m not that familiar with. And when I came back into the room with some water, I noticed that the scent from it all had filled the room, perfect for the season.

It turns out they’re from my sister in the USA. Sis, thank you so much for the lovely flowers, they look gorgeous. We set the bouquet up in the living room right in front of the fireplace. They not only lightened and brightened the room, but my spirits too. You have always been so supportive and kind.

Ralph

For a few years now, I've been hearing about The Elf on the Shelf from other mothers of small children. This December, I finally broke down and bought one. The Elf on the Shelf either strikes people as cute or creepy. I think he's kinda cute; Jay thinks the Elf is going to come to life in the night and kill us. You be the judge:


If you've never heard of The Elf on the Shelf, here's how he works: You purchase an Elf on the Shelf set, which comes with the cute/creepy elf and a storybook about him. The storybook explains that the elf watches you all day long. When you fall asleep at night, the elf flies off to the North Pole to tell Santa whether you've been naughty or nice all day. He can also relay messages to Santa about what you want for Christmas. The elf then flies back to your house, but he never ends up in the same spot as before. Every morning, he's somewhere else in your house, and you have to look for him. On Christmas Eve, he disappears, only to show up suddenly the following year on the day after Thanksgiving. (Or perhaps several days after Thanksgiving, depending on whether Mommy actually remembers that the elf is supposed to show up.)

WCK was a little bit skeptical when we first took him out of the box:

ME: He has magic powers.
WCK: This guy?
ME: Yes. He has magic powers.
WCK: This guy?
ME: Yes.
WCK: This STUFFED ANIMAL has MAGIC POWERS???!?!

But once I read her the book, WCK was totally into the elf's powers. She even dropped him with a little scream when I got to the part about the most important Elf Rule: Never touch the elf, or his magic will wear off. I wasn't aware of this rule, so this made getting the elf into his first WCK-watching position a little bit hard. I had to sort of shove him into a corner using the edge of the book.

WCK named the elf Ralph, and we have to hunt for him every morning. Ralph has never been in the same place twice. He's turned up on top of the fridge and on top of the nativity scene. He's been trapped in the entertainment center and has been found hanging from lamps and window blinds. This morning, Ralph was in the car. Ralph is a little crazy.

We have just another week left with Ralph, and I have to admit that I'll miss the little guy. At least Jay will stop hearing elf footsteps coming for him in the middle of the night.

Healthy Spirits: New Arrivals

1. He'Brew Vertical Jewbelation (blend of all 7 Jewbelation anniversary beers, 100% aged in 6 year Sazerac Rye barrels)

2. Ale Industries Fysus (Extremely Limited blended, barrel aged barleywine)

3. Uncommon Brewers Baltic Porter (16oz can)


FYI: The Abyss should be coming monday afternoon.

cheers,

dave hauslein
beer manager
415-255-0610

BC Christmas Party

Yesterday we had our Sears BC Coffee Group Christmas Party. Our original plan was to have a Christmas party in J’s hospice room on December 15th as that seemed to work best for everyone … but time was against us and J passed away on December 7th. We were all kinda thinking that we’d just forgo this year’s party but T, J’s daughter said these parties were very important to J and that she wanted us to continue with them way after she was gone. In fact she had already purchased Christmas gifts for the gift exchange back in September. So at the last minute, Irm offered up her home to have the party.

T joined us and it was so fitting to have her there to hand out J’s Christmas gifts. We shared stories and shed a few tears and looked at pics of happier times as we talked about J. After munching on some finger food, we waited anxiously to see what this year’s dessert would be. Irm is an amazing dessert maker and she wowed us once again … trays and trays of German Christmas baking. Oh my! it was amazing. I had to limit my munching because my stomach but I’m sure the other gals ooo’s and aaaah’s could be heard down the block.

After a while we moved over to the living room and sat on the comfy soft sofa and chairs with our coffees. Gradually eyeballs glanced over to the tree in the corner and we decided it was time to open the gifts. Then the cackling and laughing really got going. Time to enjoy the moment, it was so festive.

First Mets Coffee Group

On Monday afternoon, a handful of our mets group gals got together for coffee. Our support group had officially ended last week and we decided to meet casually. There were four of us, which is about half of the group were there … which is still good. As we settled in with our coffee and tea, the conversation soon shifted to cancer.

We talked a bit about whether we were in denial or not, something we didn’t talk about at the clinic. We all agreed that’s a tough one to figure out. One gal said, I don’t know if I’m in denial or not. I still feel so good but when my Onc stands right in front of me and says that I have 6 to 18 months to live … 18 months if you take treatment and 6 if you don’t, that’s really hard to wrap your head around. And then another gal says, I’ve been thinking that this is my last Christmas for 11 years now. Wow .. how different things can be.

We then talked about how bad we felt about leaving our jobs so abruptly, leaving those behind to figure out who is going to do your work. I know I left my job the same day I found out how bad my cancer was.

We ended up talking about our plans for the holidays and that sometime in the New Year we’ll email around to meet again.

Healthy Spirits: FIFTYFIFTY ECLIPSE!!!

No bottle limits, but only Beer of the Month Club members may reserve bottles. Open for shipping.

1. 2009 Vintage Elijah Craig (Very Limited)
2. 2009 Vintage Heaven Hill (Very Limited)
3. 2010 Evan Williams (Good Availability)
4. 2010 Four Roses (Limited)
5. 2010 Heaven Hill (Limited)


cheers,

dave hauslein
beer manager
415-255-0610

Physiotherapist - 6 month checkup

The clinic likes to keep tabs on my lymphedema arm and yesterday I had my physiotherapist appointment. I’ve been so fortunate not to have anything major go wrong so I only need to go twice a year. She measured up both arms to compare the two in size. My right arm has the edema and it’s only 4.5% larger than my left. Seeing how that is my dominate arm, she said that’s pretty good.

I was a bit surprised that it hadn’t really changed from my visit in June because I’ve started a new chemo since then and the edema is puffing up my ankles. I assumed my arm would follow but I guess not … yea. No change in the size of my glove or sleeve.

When I mentioned to the physiotherapist that my ankles were puffing up … she said you know what you need? And I said … some diabetic socks? No, you need some airplane knee highs. They are light compression knee highs that people like to wear when flying. I said guess what? I have a pair of those leftover from my trip last summer. 

Later on I was thinking, why didn’t I ask her the difference between the $7 flight socks and the $27 ones.

Elizabeth Edwards's Cancer

My online friend Ellen Moskowitz, who is president of the Metastatic Breast Cancer Network, had this letter to the editor published at the New York Times. Ellen gave me permission to share it on my blog.


To the Editor:


Re “Elizabeth Edwards, 1949-2010: Successes and Cruel Reversals, Played Out on a Political Stage” (obituary, front page, Dec. 8):

Elizabeth Edwards remains a hero in the metastatic community. She gave a face, her face, to metastatic breast cancer. She let the world know that she was living with a terminal diagnosis.

Mrs. Edwards lived three years and nine months with this disease. Some of us get lucky and respond well to the bag of treatments and live six, eight or, amazingly, more years; but eventually all treatments stop working for everyone with a metastatic diagnosis.

One woman dies of metastatic breast cancer every 14 minutes in the United States, and no one knows how to stop the metastatic cells from spreading once the process has begun.

While we all want a cure, what we need now is for researchers to focus on how to stop metastasis once it has begun, thus taking the fear out of a breast cancer diagnosis and making Stage 4 breast cancer a truly chronic disease.

Ellen Moskowitz
President
Metastatic Breast Cancer Network
New York, Dec. 8, 2010

Dunava!

I spent a wonderful 24 hours with Dunava in Vancouver BC this weekend. We had been invited to sing with members of the (former) band Balkan Cabaret. Although I wasn't able to rehearse with Dunava this fall, our director invited me to come along and have fun. Turns out, having fun also meant singing with the band on a few songs that I already knew.

We loaded up the cars at 1:30 PM and caravanned north to the Canadian border. In our car we sang, ate, and talked nonstop.

More than halfway there, we got a call from the other car that one of the women forgot her passport. What to do? 1) Get her boyfriend to drive up on Sunday with her passport so she could get back into the States hassle-free. 2) Hope that no one cares that she didn't have the passport. And 3) Ask the Canadian border guards what they recommend. Option 3 won, and the Canadian guards told her that not only would the USA not prevent a citizen from returning home, they would also check in the database for her passport. Whew!

Upon arrival in Vancouver, we got something hot to drink and walked to meet my friends at The Noodle Box in Kitsilano. I joined them for dinner; the Dunavites walked back to the folk dance party location for a potluck dinner. At around 7:30 we gussied up in sparkly and glittery clothes, and at 8:00 the party began.

The organizers wanted to begin by singing Christmas carols. This made me feel surprisingly uncomfortable. (I have always thought of folk dancing as completely nonreligious.) I sat down during the carols with another Jewish person and waited awkwardly until the nonsectarian music and dancing began.

I joined Dunava in some of the dozen or so songs they sang with the band. Several of the women sang solos. They also did a short a cappella set (which I did not join, since it was very tightly rehearsed). Everyone at the party seemed to love the music. I danced until my toes were numb!

At 11 PM my friends picked me up, and we sat up talking until past midnight. In the morning we ate fresh crepes with fruit, chocolate sauce, and yogurt for breakfast, along with strong cappuccino. They drove me to where the Dunavites were staying and we headed south to the border. We did manage to make time for a quick stop at the duty free store for some chocolate and liquor.

At a rest stop just south of the Canadian/USA border, we found our other car. The singer who had forgotten her passport presented her driver's license to the USA border guards, and they checked her passport registration on the computer and okayed her to re-enter the country. The two cars caravanned back to Seattle. We made silly faces at each other every time we passed.

After a quick snack with Rik and catching up on the ironing, I pooped out on the sofa and fell asleep for two hours. At 8 PM Rik gently suggested I just get into bed, and I slept soundly until 8:00 this morning. I guess I really was tired from all that singing and dancing!

3 Liter Stone Double Bastard Ale 2010

New Arrival

We just received a tiny allotment of this year's release.

Get it soon it will go fast.

Rami

Healthy Spirits

CIGNA Covers HIPEC!

I received an email from Dr.Sardi in regards to the fact that CIGNA insurance no longer considers cytoreduction surgery and HIPEC for PMP (jelly belly) experimental and will pay for the procedure now. It is a victory!  They had previously refused to cover the procedure as they deemed it experimental.

I was a bit disappointed, though, that they will only cover it for PMP (mucinous tumors), though CRS/HIPEC are used with good results for several other peritoneal surface malignancies (cancers that have spread into the abdomen), including primary peritoneal, ovarian, gastric and colon cancers.  It will not cover appendix cancer tumors that are not mucous producing. Part of why they will not cover these procedures was stated on their site.  In referring to other clinical trials, they stated:

" It was noted that patient selection criteria differed between centers and individual trials. Also each treatment center prescribed different chemotherapy regimens and varied in the amount of detail reported."

Again, we need all of the surgeons to be on the same page, to agree on a standardized treatment protocols and to use the same techniques and procedures.  Insurance companies want one standard of care to be proven effective in trials before they will provide coverage.  That is the purpose of the American Society of Peritoneal Surface Malignancies, to standardize CRS and HIPEC. 

For what it's worth, it would probably be a good thing if you are looking for a surgeon to choose one that belongs to this organization, many of the prominent HIPEC surgeons are members.  I have the list of members for the ASPSM here.  The list is international, I have my own list and I need to edit it to separate US vs. international members, but for now this is the list on the ASPSM site (note though I am not a surgeon, I am listed as a member! And proud of that! :).

Lousy Sleep Last Nite

I went to sleep last nite feeling pretty good but it didn’t last. I started waking up numerous times throughout the night. I’d wake up breathing real hard ... trying to get some air in me. D described it as I start breathing shallow then I take a whole bunch of deep breaths to recover. He says I moan a little in there too.

This waking up during the nite is becoming more and more of a problem starting last week. I'm thinking it’s when I'm in a deep sleep at night. I usually have an afternoon nap and waking up doesn't seem to be a problem. I feel well rested then too. During the day, I do have occasional shortness of breath and I am easily winded if I do something a little strenuous.

I feel a little panicky when I can't get enough air. First thing this morning, I sent an email to my trials nurse letting her know what’s going on.

Travelling for Breast Reconstruction Just Got a Lot Cheaper

Great news! Well, to be honest, it's not really "news" anymore since it happened a few of months ago but I have come across several patients that didn't know about this so I thought I'd post about it....

PRMA Plastic Surgery and several San Antonio hotels have partnered with the American Cancer Society to offset travel expenses for breast cancer patients travelling to PRMA for their breast reconstruction.

Accommodation is now provided at either significantly reduced rates or at no charge on a space-available basis. This program is for patients who are having surgery at least 50 miles from their home. One caregiver is also welcome to travel with the patient. The program only applies to lodging Monday through Thursday (so weekends are NOT included). You also need to give advanced notice... at least two weeks advance notice is usually needed (remember this is on a space-available basis).

I encourage patients living more than 50 miles from San Antonio to call the American Cancer Society directly on (877) 227-1618 for more information and to take advantage of this great opportunity. Hotels conveniently located near PRMA can be found here.

Dr C


*****

Dr Chrysopoulo is a board certified plastic surgeon specializing in breast reconstruction. On Facebook?.... Connect with other breast cancer patients in our FB Breast Cancer Reconstruction Community.

*****

Big Cancer

This is why I'm generally wary of mega huge nonprofits. They tend to lose perspective.

Really Susan G Komen foundation? No need to go all diva on us.

Susan G Komen Foundation elbows out charities over use of the word "cure"

"In addition to raising millions of dollars a year for breast cancer research, fundraising giant Susan G. Komen for the Cure has a lesser-known mission that eats up donor funds: patrolling the waters for other charities and events around the country that use any variation of "for the cure" in their names.

So far, Komen has identified and filed legal trademark oppositions against more than a hundred of these Mom and Pop charities, including Kites for a Cure, Par for The Cure, Surfing for a Cure and Cupcakes for a Cure--and many of the organizations are too small and underfunded to hold their ground..."

"Cupcakes for the countermeasure" just wouldn't fit on the banner. jerks.

I’m Starting to Swell Up

Brivanib is causing edema or swelling my feet, ankles, legs and face and must be obvious because a couple different people have mentioned my face is rounding out. Sometimes you’ll hear cancer folks refer to this as having a moon face. My ankles are now puffed out to where I need head over to the drug store and buy diabetic socks. My regular socks are now getting too tight.

This is not my first go-round with edema. Back in 2009 when I was on Taxotere, I got pretty swollen in my ankles and legs as well as my face. I also collected fluid around my lungs and in my abdomen.

To me, fluid in the abdomen is no biggy … I just need larger clothes but fluid around the lungs is way different. At times I was really short on breath and that scared me. I was breathing shallow at nite and sometimes I stopped breathing for a few seconds. Fluid around the lungs caused me to cough a lot too.

It’s only been seven weeks since I started Brivanib and I just don’t know how much fluid this chemo is gonna build. D says that I’m starting to breathe shallow at nite and that has me concerned.

Knitting Group is Done for the Year

Yesterday I went to the last knitting support group meeting of the year. I joined in January and then it shut down for July and August. Not only was this was the last meeting of the year, it’s possibly the last for a long time as the facilitators decided after ten years of volunteering with the clinic, they needed a break. It was a bit sad to think we might not see each other again; some of us have really grown close.

I enjoyed the company of group because the conversations always tended to be on a lighter side with no shortage of outright laughter. F mentioned we should collect email addresses and phone numbers so we could keep in touch. Excellent idea … around went a piece of paper to collect the info and then we made photocopies.

After the meeting, all 10 of us went over to a restaurant in the mall and had a bite to eat. I ordered dry white toast and tea, which seems to be the safest choice for me these days. We continued to chat up a storm, make jokes and one-liners.

It was now approaching three hours out and it was all catching up with me. I had started feeling a little weak after the two hour meeting and now I was really feeling weak and bit nauseous too. It was definitely time for me to head home.

Malignant Pleural Mesothelioma

Pleural mesothelioma is the most common organise of mesothelioma; around 80-90% of the cases solon in the pleural.

In pervasive, the symptoms of cancerous pleural mesothelioma which may channelize a enduring to the medico are:

    * A unrelenting symptom
    * Sweat swallowing
    * Shortness of relief or effort respiration
    * Rest disturbances
    * Upset, especially in the chest, belly or move rearwards, which doesn't respond to over-the-counter somatesthesia drug
    * Exit of appetency and coefficient failure

Ofttimes, when the diligent is examined, changeful accrual is open in the furniture structure; it can unremarkably be seen on a bureau x-ray or heard during the corporal inquiring.

How cushy it is to address pleural mesothelioma depends on the production of the malignance. The originally it is diagnosed, the author believable it is that postoperative management present lengthen being prospect, survival judge. A combining of surgery, chemotherapy and radiation, glorious as trimodality therapy has shown a endurance appraise of 45% at 2 period and 22% at 5 age.



Pleural mesothelioma is sometimes diagnosed by fortuity, before there are any symptoms, ofttimes when a routine x-ray is done. As the growth spreads over the pleura, the pleura thickens and becomes inferior stretched and many constraining. The lungs beautify less functional and huffing is progressively ambitious.

When the neoplasm spreads beyond the pleura, it invades surrounding tissue. This can contract the lungs promote and crusade solon painfulness (for information, as it invades the furniture surround or ribs.)

Cancerous pleural mesothelioma may resemble added lung-related cancers; historically, it has required advance testing of the tissue take by spotting and watch with an electron microscrope. New, notwithstanding, a slaying judge has been developed that can part to mesothelioma pretty reliably. This greatly simplifies the diagnostic transmute, and because the effort can improve analyse mesothelioma lasting before characteristic symptoms feigning up, communication can commence more earlier, when the prospect is untold meliorate.

Asbestos, Mesothelioma and other asbestos related lung disease

Loosely utterance asbestos can create two types of harm in humans: Crab e.g. mesothelioma; and tough condensation (either within the alveolar scheme of the lung, or in its pleural coating)

Asbestosis is ofttimes sensitive severally from pneumoconiosis flatbottom tho' asbestos is a rubbish - but it is a unscheduled mould of sinewy rubbish. Suchlike silicosis, asbestosis is a thoughtful statement which is incurable and can ensue in modification at an beforehand age. Still, as is the someone with more disadvantageous substances it does require a positive indrawn elvis of asbestos before there is a mensurable essay of asbestosis. Thusly, extant or employed in a structure in which asbestos has been utilised in constituent and befittingly sealed testament not prove in a drunk simulacrum shows asbestos bodies in imperfect bronchoalveolar liquid obtained finished bronchoalveolar lavage (BAL) by the author for characteristic and search purposes from a characteristic fille who had operative exposure to asbestos (line alveolar macrophage cells follower to the larger body, tightlipped to a whacking multinucleated heavyweight radiophone, spell in the bottom redress jack construction a small embody has probably been swallowed by a span of the cells). 

This photomicrograph shows an asbestos embody low higher magnification, enclosed by consonant macrophages (the phagocytic cells indweller in the alveoli). Asbestos bodies are not only asbestos fibres but are characterised by a concealing containing irons and catalyst (ferritin). Comment also the least unlighted inclusions in numerous of the macrophages - these are probably the significance of tobacco respiration.

This chest pic (conservative) shows 'benignant' disease of the pleura caused by asbestos danger. 

Asbestosis is oftentimes grouped separately from pneumoconiosis flat though asbestos is a rubbish -but it is a primary gathering of sinewy scrap. Equivalent silicosis, asbestosis is a sobering precondition which is incurable and can resultant in demise at an previous age. Withal, as is the happening with umteen malign substances it does expect a definite inhaled pane of asbestos before there is a measurable chance of asbestosis. Thusly, experience or employed in a building in which asbestos has been misused in construction and befittingly sealed leave not conclusion in a dominating: the quantity "asbestosis" is only old for one fact disease caused by asbestos and not for all its eudaimonia personalty. Other effects can allow thickening and/or calcification of the pleura. Asbestos can also grounds a specific person of the pleura called mesothelioma as excavation as bronchial sign same to that caused by evaporation.) 

Sadly, not all collection or activity is valuable and reserve. Information alone is not a jock for intelligent risk reaction strategies. Consider the attendant pic for monition. The exposure was confiscated by the author in the 1980s. You would be real dumfounded to conceptualize out where: In a Federal Eudaemonia Tableware Hospital in England! Would you canvas that advising workers not to inspire blueness asbestos is a tenable path of protecting their welfare, and preventing ill-health? 

With an cognition specified as the one exemplified by the above ikon is not astonishing that sadly fill give locomote to die of mesothelioma for decades to locomote as a legacy of the terrible passiveness in the onetime.