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.

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.

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!

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....

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!

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!)

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!

Branding and charities

Check out this article in the Wall Street Journal. Can you believe Komen wants to own the phrase "for the cure?" And they're not the only ones....

Charity Brawl: Nonprofits Aren't So Generous When a Name's at Stake

This article says it all

Read this if you still wonder why "pinking" everything related to breast cancer does a disservice to women who actually have it. And die from it.

In light of Elizabeth Edwards's recent death from metastatic breast cancer, this November 2010 New York Times Magazine article, Think About Pink, is timely again.

Elizabeth Edwards z'l

I was sad to hear last night of Elizabeth Edwards's death. My list serv of women with metastatic breast cancer was abuzz with the news of her turn for the worse. Her death brought to the forefront fears and concerns for these women from their families and spouses.

The common thread of shared concerns goes something like this:

Even though I knew it was inevitable, when I learned of Elizabeth Edwards's death, I felt as though I had been punched.

She handled herself with dignity and grace. 

Why did she have to go?  

Why did she have to suffer so much in the last few years of her life?

Every time we lose another mets sister, it gets closer and closer to home. 

I'm scared.

Things moved very quickly, as is often the case with advanced cancer. Death can take place weeks or even days after stopping treatment.

What I admire most about Elizabeth Edwards was her commitment to living her life fully, even with the diagnosis of metastatic cancer.

"We didn't try to prettify that in any way. This is the way it is," Edwards told ABC News in 2007 of the conversation she had with her children about her cancer. "But we also said, at the same time, you know, everybody who's sitting at this table who's not going to die, raise your hand. And they realized that we're all going to die. But we are also extraordinarily honest with them because there will come a day when they're going to have to accept that cancer has, at some point, taken me."


Zichrono l'vracha, may Elizabeth Edwards's memory be for a blessing to all who knew her.

Last night of Chanukah

A last night of Chanukah joke for you all:

A woman goes to the post office to buy stamps for her Hanukah cards.

She says to the clerk, "May I have 50 Hanukah stamps?"

The clerk says, "What denomination?"

"Oh my God," the woman says, "has it come to this? Give me 16 Orthodox, 22 Conservative, and 12 Reform."

Elizabeth Edwards gravely ill with cancer

I just learned that Elizabeth Edwards' cancer has become much more active. It appears she has liver metastases which no longer respond to treatment.

Having been faced with liver mets for the first time this summer, I can understand the seriousness of her condition. I am thankful that my liver mets are stable now and hopefully will respond to the high dose Faslodex.

I believe Mrs. Edwards is entitled to privacy about her illness, and hope that the news media will respect that as they continue to report on her situation.

In the meantime, she is in my thoughts.

CT results and follow up

On Thursday I saw Dr G and got the results of my latest CT scan. He was satisfied that the overall results are positive! One liver metastasis has decreased by more than 1 cm. Another is negligibly larger, which may be due to interpretation of the scan and at any rate is not statistically significant.

However, I complained last weekend about pain in my right knee, just to the outside of the kneecap. I had an xray before my visit with Dr G, which showed a met but not in the knee. So we reviewed my past two bone scans and neither specifically indicated a metastasis in this location. To be safe, I will see Dr Eulau, the radiation oncologist, and get his opinion.

Dr G pointed out that it's possible the pain I experienced in my knee is "flare" associated with the effectiveness of the Faslodex. If so, the pain is a sign that the Faslodex is working. Dr Eulau will take all this into consideration and give an opinion if radiation therapy might be indicated.

First night of Chanukah

Tonight is the first night of Chanukah. It's not the most important Jewish holiday, but it sure is the most well-known, probably because of the proximity to Christmas.

Like most Jewish holidays, we eat special food during Chanukah. Donuts are popular in Israel -- I hear the "season" extends now from after Simchat Torah to some time in January. Around the world, Sephardic Jews eat bimueolos and Ashkenazic Jews eat latkes. You gotta love a holiday that celebrates fried food!

My father used to stand at the stove and fry the potato latkes. He never sat down to eat, just kept them coming for my mother, my sister and me. Of course I like his version the best: potatoes and onions grated on the small, round holes of the box grater, with a little skin from the knuckles maybe mixed in. No long, shredded potatoes for me!

I've modernized by shredding the potatoes in the food processor, then changing blades and pulsing the potatoes until they're finely chopped. I scoop them out, place in a strainer over a bowl, and finely chop the onions the same way. Add an egg, some salt and pepper, and a little matza meal or flour, and stir together. Drop by large tablespoons into hot oil. Keep draining the rest of the mixture while frying the latkes. Serve with applesauce on every occasion and sour cream (if it's a dairy meal).

Delicious! I never met a fried potato I didn't like.

Oh! You want the proportions? To serve four people I use:

4 small Yukon Gold potatoes

1 large onion

1 egg

1-2 teaspoons salt (to taste)

fresh grated black pepper

plenty of olive oil for frying