February 25, 2010

Biopsy results -- good news

I saw Dr. G yesterday and the results of the biopsy of the bump on my shoulder blade were benign -- it's nothing. And so, evidently, are the bumps on my head. Nothing.

For nothing, they sure feel like something, but I am not eager to have my head shaved in order to biopsy them. If Dr. Goldberg isn't worried about it, I'm not worried about it.

My CA 27-29 tumor marker came down again last week for the second month in a row. It had been climbing steadily for many months prior. Dr. G was able to show me a graph of my tumor markers and there was a clear spike beginning in June 2008 -- when I began the Megace. So Megace was not my friend and I am glad to have switched treatments.

The recent reduction in tumor markers is due to stopping the Megace. I am going to stay on the toremifene for the time being to give it a chance to work, but it remains to be seen what effect it will have on my cancer.

In the meanwhile, I feel good! What more can one ask for?

February 23, 2010

Feedback from commercial medical suppliers

I occasionally receive feedback to a post from someone representing a commercial medical supplier. In a recent post on lymphedema, someone used this forum as an opportunity to plug his company's lymphedema garments. I appreciate that "Jason Longmier" wanted to offer me relief from my lymphedema troubles, but I removed his post. The last thing I want is for another person living with cancer to think that I might endorse a particular product when I don't use it.

When I tell you that I use something, it's because because someone on my health care team has recommended it to me.

So if you are employee of a medical provider, no matter how well-intentioned, please don't troll the web looking to take advantage of cancer patients' blogs and thinking you can advertise your product or company for free. Or at least, don't do it on my blog.

February 22, 2010

More lymphedema news

My left hand seems to be responding well to the therapist's idea of wrapping the hand and wrist only at night. The edema has reduced and the tissue feels softer at the beginning of the day. However, once I remove my glove at the end of the day, the tissue is still firm, but a few minutes of massage helps.

My big concern is my inability to do anything after I bandage my hand (I'm left-handed). I have been pretty home bound at night (don't want to drive bandaged) and of course can't type, hold a pen, cook, hold or grip anything, etc. either. I have to take lorazepam to sleep and know that I will have rebound insomnia from that once I am done bandaging.

But the idea seems to be working!

Breast cancer and aspirin

You may have read or heard the news last week about how women with early stage breast cancer who were already taking aspirin regularly for another reason may have had some benefit from the aspirin on their cancer.

When my port-a-cath was originally placed, I was told to only take tylenol, not aspirin or ibuprofen, because the additional blood thinning properties of those drugs would interfere with the effectiveness of the warfarin (blood thinner) I had to take to prevent an infection in my port.

So no weekly aspirins for me. But it's a fascinating story nonetheless.

February 18, 2010

A double-duty medical day

Today I had two medical appointments scheduled back-to-back.

The first was with the lymphedema therapist, who agreed that there was something we could try to reduce the swelling in my hand and wrist. I've had increased edema there since Labor Day and was willing to try again with another therapist. For months my left hand has been so swollen with fluid that I can barely close it, much less make a fist. Today's evaluation appointment led to one recommendation. I am going to try bandaging my hand and wrist only at night. If I see softening in the tissue (the step before reduction in edema volume), then we will know it works. If nothing happens, all I've wasted is a few nights of good sleep. And if it seems to increase the edema, I will stop. I have three more appointments scheduled with this therapist.

After a ten minute break between appointments (at least the two places were close enough to walk to) I saw Dr. F for the first post-op checkup. She was adorable, calling her work on my tummy so perfect that I could wear a bikini on the French Riviera and no one would know I'd had surgery. (I should have asked her to pay for the trip or at least the bikini.)

Dr. F also did a pelvic exam. I had mentioned that I have some pain after urinating, and she thought it might be due to stitches rubbing against my bladder. The stitches will dissolve. I see Dr. F again in mid-March, six weeks after the original surgery date.

I drove home, felt so ooghy from the exam that I laid down on the sofa, took some vicodin and then some lorazepam to keep me from feeling like I was crawling out of my skin, slept a bit and now am feeling better. (Of course, I also got in my jammies at 6 PM.)

What Olympic tape-delay controversy? NBC still doesn't get it

I realize this is off-topic, but I have been so frustrated with NBC's tape-delayed west coast Olympics coverage. Vancouver BC is only a couple of hours' drive from Seattle, practically in our backyard and certainly in the same Pacific time zone. I even wanted to attend some events (but the prices were ridiculously high).

We have been following the Olympics on NBC, which tapes and delays their live coverage to the west coast. So when my mom watches the Olympics live at 8 PM in New Jersey, she can't call me to say "wasn't that wonderful?" because it's only 5 PM in Seattle and NBC won't air the coverage here for another three hours.

Yesterday's Seattle Times carried a great article by a local reporter covering the Olympics. Ron Judd has received numerous complaints from readers expressing frustration at no live coverage of the Olympics in Seattle. On their behalf, he contacted an NBC vice president of communications, Christopher McCloskey, who clearly doesn't get the problem.

Even King5, the local NBC affiliate, has had so many complaints from viewers on this subject that they said on their website, "For those concerned about the 3-hour tape delay on the West Coast, the decision to broadcast the Olympics live or on tape delay is made by NBC Sports, not KING TV."

When was the last time you heard a local affiliate of a national network disclaim the relationship?

So if you are one of the "tiny, vocal minority" that NBC thinks are the only people frustrated about watching delayed Olympics coverage happening right up the road from Seattle, feel free to contact NBC via their Olympics website for viewer response. Or send NBC an email at feedback@nbcuni.com.

You can read Judd's full Seattle Times article here.

February 16, 2010

Bumps on the head

About four weeks ago I noticed two small, round bumps on my head. They didn't itch or hurt but were slightly tender to the touch. Then a bump appeared on my left shoulder blade. Yesterday I had an appointment with Dr. G and lo and behold! A third bump had appeared on my head, overnight.

Dr. G decided to do a punch biopsy of the bump on my left shoulder blade, just in case. He says he doesn't think it's cancer but better safe, etc. He gave me plenty of lidocaine so that nothing hurt, and put a bandaid over the sutures.

Yes, it's possible to have scalp metastases. My friend Josh has several and they trouble him greatly, so much so that his docs recommended treating them with radiation.

We'll wait to see what my biopsy results are. In the meantime Dr. G asked me to re-start the toremifene.

February 14, 2010

Recovery two weeks out

I've been feeling fine recently but yesterday had more pain around my tummy than I'd expected. Vicodin took care of that but also put me to sleep for too many hours. I napped from 10-ish to 1:30 and then again in the afternoon.

Same thing this morning. I woke up feeling fine but within an hour was hurtin'. Again vicodin to the rescue but it still put me to sleep. (I guess I have to readjust to it after the week off after surgery..)

At least I got in that hour -- made waffles for breakfast with maple syrup, cut kiwis, and Greek-style yogurt for me. Neighbors going on a trip had given us some citrus, so fresh grapefruit and Jaffa orange juices were on the menu. I made Rik an Americano. (For you non-Seattleites, that's a shot of espresso with hot water added to fill the cup).

Now we're off to a shiva minyan for the father of a good friend. Then run an errand. I must be feeling better.

February 10, 2010

Vegan cupcakes take over the world

What do you do when it's your turn to bring snack and you ate the last egg for breakfast?

Bake vegan cupcakes!

A few months ago I borrowed Vegan Cupcakes Take Over The World from the library and got inspired. After all, these are the perfect treats for the kosher home: parve (i.e. made without any dairy or meat) and so can be served after either spinach-cheese quiche OR roasted chicken.

Since I had long ago returned the cookbook to the library, I used the Dairy-Free Chocolate Cake (Vegan) recipe from the 1997 Joy of Cooking (p. 932), poured the batter into cupcake liners and baked them for 20 minutes.

I then frosted the cupcakes with Joy's Chocolate Sour Cream Frosting (p. 1004), melting some cinnamon chips with the chocolate. I sprinkled the tops with chocolate nibs and extra cinnamon chips.

PS They were a big hit!

February 09, 2010

Recovery one week out

It's been just over a week since my hysterectomy and I feel about 85% recovered. I still needed pain meds yesterday, last night and this morning, but as of this moment I feel pretty good.

Monday was harder than expected, probably because I may have overdone it at the choir retreat/slumber party: walking up and down stairs, singing for hours, and generally probably moving more than I was ready for. I got very cranky at the end of the day and must have been pretty unpleasant to be around. A nap helped but didn't improve my mood. Watching the final episode of "Heroes" for the season did make a difference, but by the time it ended the time was already 10 PM and Rik had gone to bed.

Last night I put out a call for more dog walkers and J answered the call for today. I just can't quite bend over far enough to pick up the dog poop! Plus if the dogs got excited about something I think they could pull me off balance and I don't want to fall. Having a friend help walk them makes it much easier for me and gets me outside for a bit.

I did manage to bake more of the NY Times No-Knead Bread recipe (as adapted by the folks at Cook's Illustrated and Seattle Times writer Nancy Leson). It tastes so good and is so easy that I believe I will stop buying expensive bread for a while and just bake a couple of loaves each week. Why pay $6 for a loaf of artisanal bread when I can make it at home?

February 05, 2010

International Ice Cream for Breakfast Day

Tomorrow, the first Saturday in February, is International Ice Cream for Breakfast Day. Created by a American Jewish family many years ago, it's celebrated widely around the world. At our house there will be hot oatmeal, vanilla ice cream, chopped chocolate, nuts, and fruit (maple syrup for the Canadian). What a great way to start the day!

The people at Molly Moon, my favorite local ice cream place, really pay attention when their customers talk. We have been for the weekend ice cream for breakfast twice this winter and both times mentioned Ice Cream for Breakfast Day. After our last visit, the owner posted on her blog about their version, with total proceeds from Saturday's sales benefiting Haiti health care and relief support non-profit, Partners in Health. Way to go Molly Moon's -- doing good and serving a crucial need in the ice cream world at the same time!

Recovery days 3 and 4

I felt even better yesterday than the day before, so good in fact that when G came over to walk the dogs I went with her. I can walk, just am not so steady on my feet that I want to walk alone in case I should fall. And certainly can't bend over quite far enough to pick up the poop....

Taking a walk, eating a bagel and lox and visiting with a friend were clearly the highlights of the day. I took the morning and afternoon naps as usual and managed to reduce my pain meds again. Ran three loads of laundry also (not a highlight but still an achievement). By 7 PM I was aching and so took more meds in order to relax and fall asleep later. I have to figure out the timing better so that I take something at 10 PM and get into bed, instead of waking up at 3 AM needing more meds.

Today's dog walker had to cancel unexpectedly so the pooches will have to manage on their own in the back yard until Rik gets home from school. For Bob this won't be a problem but Pumpkin might have issues.

Hoping to continue to improve and wean myself off pain meds half a tablet at a time.

February 03, 2010

Hospital recap

It's day two of recovery and I spent much of it on the sofa napping. C came over to walk the dogs and L made us both lunch, but I did have both morning and afternoon snoozes.

Some highlights of my hospital stay:

In the surgery prep and waiting area there was a new touch. Instead of warm blankets, the gurneys are covered with a Bair Hugger. It looks like a down comforter made of channeled "paper" with a hose in the middle. Warm air blows into the "blanket" and the heat keeps the patient toasty, so you put energy into healing instead of into shivering. Rik and I laughed out loud when we saw it, but I LOVED it!

Rik went home to feed and walk the dogs, then came back to the hospital around 5 PM.

The anesthesiologist tried hard to access my port but was unsuccessful. He then tried to start a line in my arm -- twice -- with no success. At this point he said he wanted to give me ether to relax me and then he would start an IV in my hand. (I had warned him that my veins were crappy.) The ether worked great. I immediately relaxed and the next thing I know I was in recovery.

By the time I got upstairs to a room it was past 6 PM. Dr. F had already spoken with Rik, who then called my mom, his mom, my sister and several close friends. He sat with me until about 9:00, by which time he was asleep in a chair and I was drowsing on the bed, so he went home.

I needed assistance to get into the bathroom the first couple of times, and then I was good on my own. But I was on the toilet every hour all night long! My pain appeared well controlled; I just had to pee all the time. The good part about being a patient at Swedish is the 24-hour meal plan. I called down for a snack at 4 AM and enjoyed vanilla yogurt with Cheerios and a decaf mocha, then went back to sleep until the next time I had to pee.

The next morning they removed the IV line and I was able to take a shower. I had a second breakfast of mashed potatoes, turkey sausage, a whole wheat roll and some fresh fruit. (I saved the espresso shake as a snack before discharge.)

When Dr. F came in on her rounds, she agreed all was good. When I told her about my having to pee every hour, she checked the rate on the IV pole and it was properly set. The nurse then chimed in that they had just lowered the rate from 50 to 25. "50!" said Dr. F. "I ordered 25!" No wonder I was in the toilet all night long. I had been getting twice the recommended fluid amount.

The morning ended with an unexpectedly pleasant surprise when the room telephone rang. It was the anesthesiologist, Dr. Max Lucero. He was calling to make sure that the port site was okay, and that I had managed well with the IV in my hand.

I gotta say, I have had a number of surgical procedures over the years, and in my experience the anesthesiologist comes in a few minutes before the surgery starts, introduces himself (it's always been a him), starts a line, and I never see him again. That Dr. Lucero called to make sure I was okay is a testimony to his being a caring, concerned medical professional and to Swedish Medical Center, who hired him. Kudos to Dr. L! He can put me to sleep any time.

February 02, 2010

Home again

Just came in, greeted the excited dogs and have unpacked from my one night hospital stay. This is a quick note to say that the surgery went well and I feel fine. The pain has been easily controlled with oral pain meds, but I slept only a bit at a time due to overly ambitious hydration and so was up to pee every hour on the hour all night long.

I plan to take a big nap now and will post more details later. It feels good to be home!

February 01, 2010

Going in for surgery

I have been a little stressed about the surgery. Over the weekend Rik and I snapped at each other. He still doesn't feel well from the sinus infection and I was evidently more stressed than I realized.

However, I slept reasonably well last night and got up before the crack of dawn to make and eat breakfast so that I didn't have to fast for as long. A one-egg omelet with sauteed mushrooms, toast and two big glasses of water should stop my tummy from growling too much later on. Imagine if I had gone without eating or drinking from dinner the night before to dinner time today? It would feel like Yom Kippur.

Maybe that's why they make you fast before surgery -- to recreate the feeling of atonement? Nah, it's some medical reason. Still, it gives one cause to think.