No more mammagrams for women age 40?

It's been all over the news, the recent recommendation that women between the ages of 40 and 50 no longer need to have a mammogram, and women over 50 can have one every other year instead of every year. Plus there is now a recommendation that women no longer need to perform monthly breast self-exams (BSE). It's too stressful.

Oy.

I had a baseline mammogram at age 35 just in case (on my doctor's recommendation). At age 39 I found a tumor through BSE. It was confirmed by mammography and needle biopsy to be malignant and I entered the world of breast cancer.

Was I nervous about the baseline mammo? Yes. And about the tumor I could feel, about the follow up mammogram, the needle biopsy, and the three-day wait for results.

Was I glad to have had the testing anyway? You bet! Because I wasn't even old enough at 39 to begin having mammograms. But I got cancer anyway.

Several of my younger friends who were diagnosed with breast cancer had difficulty getting their doctors to believe that they had found a lump, or a suspicious rash, and needed follow up diagnosis and care. Many of them are now dead, because breast cancer in younger women can be more aggressive than in older women.

So here are my feelings about these recommendations:

1. I hope that the insurance companies don't view this as a reason to no longer fund mammography in women who fall outside the age criteria.

2. I still recommend to my mother, my sister and my friends that they have annual mammograms. Because mammography catches breast cancer earlier, when it is more easily treatable.

3. Let's not allow this to keep our country from health care reform either.

4. For anyone who doesn't know what to do, I say: Talk to your doctor. Ask her what she recommends. Discuss the new guidelines in detail with him. And make a health care decision based on your medical needs, not the potential stress that other women might feel.

It could keep you alive.

Rainy Seattle days

It's a typical Seattle November -- cool if not outright cold, rainy, grey, overcast, windy. It's hard to go outdoors when the weather is so miserable, so I have been trying to focus on in-home tasks since my family left on Monday. (Of course, the fact that I was a little pooped from the birthday party and everyone's visit may have something to do with not wanting to run around!)

I have gone through all the party photos, ordered prints from Costco, rearranged the scrapbook. Stacked up the ironing but haven't actually done it yet -- maybe later today. Swept the leaves and outdoor yuck from the floors. (I swear, the dogs bring in more every day.) Did a load of dishes and laundry.

I have a good book to cuddle up with, but I also have a meeting to attend later this morning. At least by the time I get to the book the dogs will have dried off from their morning walk (Pumpkin got soaked). It's much more pleasant to cuddle with dry dogs than wet, stinky ones.

And that's my plan for today. The best part about living with cancer can be the freedom to do nothing if it so moves me.

Happy birthday to me! (part two)

The second part of the big 50th birthday celebration was an (adults only) birthday party. A catered dinner, a special cocktail, the closest of friends and family all combined to make for a memorable evening.

Rik greeted everyone at the door and offered a glass of something festive - beer, wine, sparkling water or a special pomegranate martini. The caterers passed hot onion tartlets and olive tapenade on baguettes. A. handed me a tiara to wear, complete with sparkly purple rhinestones. People had the opportunity to write a favorite lyric from a musical into a special scrapbook to which I will add photos from the party.

We enjoyed a fabulous dinner catered by the Madison Park Cafe:
Spinach salad with goat cheese and pears
Marinated salmon on skewers
Green beans
Farro with sauteed vegetables
Sliced baguette and butter

Music by Balkanarama set the mood for a festive evening.

I think the highlight of the program was the singing of Ladarke with friends from Balkanarama, Radost and Dunava. What a rush! We haven't sung it together in years. And the kazoos were a nice substitute for a tamburitsa orchestra.

Of course, another highlight was the video slide show Rik created. And the toasts by my mother, sister and husband. And the roasting from dear friends C and D. Who could choose?

Dessert was prepared by good friends and featured lots of vitamin CH (chocolate).

We ended the evening with more dancing, carrying on and happy talk. All in all it was the perfect birthday party, just the way I imagined it, down to the last detail.

Happy birthday to me! (part one)

As part of the great 50th birthday celebration, I asked for an aliyah, to be called to the Torah at Shabbat morning services. The rabbi made a special blessing for my continued good health and leadership to our synagogue community. Later on I led the congregation in the musaf service. It was so wonderful to have my mother, sister and brother in law, and Rik's parents there to celebrate with us. I felt sneakily good about saving a whole row of seats and then being able to say, "My whole family is coming."

After shul we all came back to the house for coffee and cake and a chance to shmooze a bit. Once everyone had left I tried to nap but it just didn't happen. I must be so keyed up that my family is here that I simply couldn't sleep!

For dinner we went to Rover's, a wonderful French restaurant that I have wanted to try for years. When he was at Washington MIddle School, Rik taught the children of "the chef in the hat," Thierry Ratureau. We were greeted warmly by the staff and offered champagne, compliments of the chef and his wife. It was a lovely start to a perfectly exquisite meal. (And clearly it paid to mention the WMS connection when making the reservation!)

Here is what we ate, a special tasting menu in honor of Julia Child:

Amuse Bouche of fennel soup, sardines with harissa and fromage de tete (which is not cheese but made from meat pieces from the head of a calf, in aspic and seasoned carefully. I ate it but neglected to ask what animal it came from. It was delicious.)
Salade Lyonnaise with frisee lettuce, poached egg, bacon, garlic crouton and red wine vinaigrette (I asked for mine to be served without the bacon.)
Soupe a l'Oignon with baguette and comte cheese
Boeuf Bourguignon (beef stew) with red wine, pearl onion, carrot and mushroom
Souffle au Chocolate served with rum creme anglaise

It was a wonderfully decadent meal, served professionally and spiced with lively conversation. We were seated in a private area and felt that we had the undivided attention of the staff. I can heartily recommend Rover's for your next special occasion.

Friday haiku

A Facebook friend challenged me to write a Friday haiku. Here is mine:

Birthday coming up
Celebrate with ev'ryone
It's the big 5 - 0

Birthday musings

In a few days I am going to turn 50 years old. After my mets diagnosis, this is an age I wasn't sure I would I would see, much less get to celebrate with family and friends.

Originally after my mets diagnosis I just wanted to outlive the predictions, which said half the women diagnosed with mets lived one year. That was seven years ago, and I confess I am glad to have outlived the prediction from that time and no longer even want to know what the current data suggest. Every day after that first year has been a gift. That's why I celebrate my "metsiversary" every year.

It also was never a goal of mine to reach the age of 50. I did have goals at first: to dance at my niece's bat mitzvah; to travel to places old and new in other parts of the world; to buy a house and make it a home. (I also had a goal to raise children, but the cancer prevented that from happening.) I am glad to have achieved all of these goals. I am glad to have been well enough to achieve all of them. And I am even happier that I continue to feel well enough to set new goals.

For now, it's enough to spend time with family and enjoy the celebration. I am going to be 50, despite the cancer I have no grey hair, and I look and feel pretty terrific. As we say on Passover -- dayenu -- it will be enough.

Thought for the day

To quote a friend from my online support group:

Choose to be happy.

What else is there to say?

Update from the oncologist

Yesterday I had my monthly appointment with Dr. G. He still says it's time to change therapies as my tumor marker CA 27.29 continues to rise. But the newish breast tumors have shrunk slightly and I am not symptomatic of anything else. So we are planning a bone scan to see if there is any other cancer activity in my body.

I managed to persuade him to consider trying Femara (letrozole) again, the first estrogen inhibitor I used, which I took for three years with good results. In the meanwhile he will do some more research on Avastin (bevacizumab). We both agree that we should put off chemo as long as possible, given my body's hyper-sensitive reactions last spring to the 5FU.

Until next month's visit, I stay on the Megace.

Some lymphedema improvement

My hand continues to improve somewhat. I have been sleeping without bandaging for about a week. Today I have been able to be without the glove until now, about 3 PM. I also saw the oncologist hits morning and he asked about the lymphedema. He thinks that the improvement in the lymphedema is my cancer not being as active. Huh.

I called the compression garment provider, Mary Catherine's and Daughters, to see if they had a second over-the-counter glove for me. (In May, they forgot to tell me the second glove had arrived and the owner brought it to me while I was in the hospital.) It turns out that they only order a certain number of garments in any given week, and so my sleeves and second glove will likely not arrive until the end of the week of Thanksgiving. I don't know why they have this policy, especially since my insurance company has already authorized payment for the garments. So I have another few weeks to wear the old sleeves and hope they are giving me enough compression. At least they told me they have already ordered the garments. Granted, the sleeves are custom made in Germany, so I knew it would take a few weeks, but the glove? It's an OTC item.

If I hadn't already given them my business, I might be tempted to go to another provider. But at this point it would be more effort to cancel the authorization request and get a new one for a different provider. But I am not impressed with this kind of customer service.

Lymphedema back and forth

I think my hand may be beginning to improve. If you remember, I slept without the bandaging one night last week(?) and then felt I hadn't gotten enough support without the wrapping. Last night after a long day and a hard choir rehearsal, I felt I needed to get some fresh air on my skin so decided not to bandage before bed. This morning my hand seems okay. I am actually not wearing the glove yet and it's already 11 AM.

Could this be an indicator that things are beginning to return to normal? If I can alternate sleeping bandaged and unwrapped, if I don't have to wear the glove all day long but only most or even part of the day, if the new sleeves arrive quickly, maybe my hand and arm will be on the way to normal. The old normal, not a new normal, I hope.

Of course, every time I sleep unwrapped I don't take any ativan and then I get a little rebound insomnia, but what can you do? It's still more comfortable to lie awake in bed unwrapped than to bandage and try to sleep uncomfortably on drugs.