November 28, 2010

The perfect Thanksgiving day

I think we have finally hit upon the perfect Thanksgiving celebration.

Before everyone comes over, watch the Macy's Parade from New York City, with special emphasis on the Broadway shows. (It's especially important to sigh over never growing tall enough to dance with the Radio City Rockettes.)

In the afternoon get together with closest family and friends. Everyone pitches in to make the meal. Our menu for fifteen, including six teenagers and four vegetarians:
Green salad 
Pickled green tomatoes 
Roast turkey 
Gravy (turkey & vegetarian) 
Cranberry-sour cherry chutney
Brussel sprouts 
Salmon & mushroom-leek filo packets
Sparkling juices and wine
We asked everyone to suggest something to toast: good health, joy in friendship, delicious food, you name it.

Then go to see a movie together. This requires selecting a movie that everyone will enjoy (or at least tolerate) and choosing the theatre and screening time in advance so people can purchase tickets. We went to the newest Harry Potter film, which almost everyone was eager to see.

Come back to the house for snack and dessert. Because we keep kosher, and also because it had been several hours since we'd eaten meat, we could have a dairy snack: 
Four different cheeses with crackers and sliced apples
Apple and pumpkin pies
Apple cake
Vanilla ice cream
Coffee and tea

Last, play games. We played a rousing rendition of Celebrity and Apples to Apples.

It was a wonderful day that lasted well into the evening and perhaps one of the best Thanksgiving celebrations ever.

November 26, 2010

Travel tips for breast cancer survivors

My online friend Chemobabe posted a notice on Facebook from the Komen Foundation, warning breast cancer survivors on how to travel by air during the holidays.

If you’re a breast cancer survivor traveling by air during the holidays…

…you may be concerned about what to expect from the Transportation Security Administration (TSA) screening guidelines at U.S. airports beginning this week.

TSA is now using full-body scanners at 68 U.S. airports that can detect surgical clips, prostheses and implants. If these devices are detected, breast cancer survivors may be subjected to a more thorough and personal secondary screening by TSA agents.

The secondary screening has been controversial: One breast cancer survivor says she was told to remove her prosthesis; another told us that she was in pain for days from pressure to her chemo port, and others say they felt invaded and distressed.

Susan G. Komen for the Cure® has written to Homeland Security Secretary Janet Napolitano to offer Komen for the Cure’s expertise into the special issues around the nation’s 2.5 million breast cancer survivors. We’re not national security experts, of course. But we can do our part to ensure that survivors are treated with respect and dignity.

As we do so, here are some steps you can take as you head to the airport this holiday season:

• Komen is recommending that breast cancer survivors arrive earlier than usual at the airport, with ample time to go through the new secondary screening if necessary
• If you are concerned about going through the body scanner for any reason, you may request a private pat-down screening
• If you choose, or are selected for, a pat-down screening, you may request a private screening away from public areas
• You should advise the TSA agents of any chemotherapy ports or other medical devices.
• You should not be asked to remove your prosthetic device
• Most airlines strongly recommend that customers use carry-ons, rather than checked luggage, to carry medicines or prosthetic devices

Here is more information from TSA’s website that may be helpful as you plan your travel: 
We don’t at this point have reliable data on the potential impact of these new screening procedures on breast cancer survivors. We want to hear from our survivors about their experience at the airport – good or bad. Please send an e-mail to

Please know that we are watching this situation as it develops, and are more than happy to work with TSA to ensure that the issues of breast cancer survivors are heard.

November 24, 2010

Still practically snowed in

Seattle continues to be snowed in today.

On Tuesday Rik was off and we enjoyed a walk with the dog in the bright sunshine, cuddled, took naps (well, I did the ironing), and generally just hung out. The schools announced a closure at 5 PM, so Rik is off again today.

Rik did go to the airport last night to pick up my mom, who will spend the weekend with us. The main roads were clear, but there was a wait to drive the one mile from the highway exit to the airport with heavy traffic.

Today we have heavy clouds, which means the temperature is a little milder and it's not as windy. We are going to attempt a trip to the grocery store to pick up the last few items for Thanksgiving dinner. I've been in touch with all our guests and everyone has been out at least once in the past few days, so it appears that we will have our feast with family and friends.

I foresee more cuddling, naps and just hanging out in our future -- with plenty of hot tea, coffee or cocoa and a warm dog butt snuggled up next to us.

November 22, 2010

Snowy Seattle

I woke up this morning to two inches of snow on the ground -- most unusual for Seattle -- and a prediction for six more inches to come. 

Not trusting the other drivers (who mostly don't know how to drive in the snow), I stayed home and installed the new modem, made cranberry sauce for Thanksgiving, did some chores and am about to read a book. That, plus hot coffee, makes for a perfect snow day.

 Thank goodness I went to the grocery store yesterday!

November 18, 2010

Seattle Magazine's The Best of Everything

Seattle Magazine has again listed it's Top 10 everything, and Dr G is on the list for medical oncology!

The guy who fixed my legs, Dr Daniel Flugstad, is on the list for orthopedic surgery.

Dr Martin Siegel, who saved my life by diagnosing toxic shock syndrome after my original breast surgery, is on the list for infectious disease.

Someone I've consulted with in the past, psychiatrist Dr John Wynn, is on the list.

And Dr. Mark Freeman, the endodontist who made even root canal comfortable, is on the list.

Do I have a great care team or what?!

November 17, 2010

No change in treatment

I saw Dr G today and he decided, after careful reading of Dr Ellis's note, that I could stay on the high dose Faslodex for the time being. As per Dr Ellis, I will be carefully monitored, starting with another chest/abdomen/pelvis CT, to determine how the liver mets respond to this treatment. The high dose Faslodex is so popular that his practice is having trouble keeping the medicine in stock!

Dr G also told me that the FDA just approved another drug (Halaven - eribulin mesylate) today for the treatment of metastatic breast cancer. As he says, there is so much happening in this field that one has to stay alive for the next new thing to come down the pike.

So for the time being, I will get two shots in the butt every month -- which is way better than being on chemotherapy!

November 16, 2010

A joke from a friend

Coffee, chocolate, men... some things are just better rich.
-- Unknown 

In Italy, espresso is considered so essential to daily life that the price is regulated by the government.

Coffee Pain (the joke)

Linda and Jill were chatting over coffee.

Said Linda, "I've been experiencing a strange and painful side effect from coffee. I'm fine when I drink it black, but if I use cream, or sugar, or both, I get a stabbing pain in one eye."

Linda took a sip of her coffee. "Oww!" she cried. "There it goes again!"

Said Jill, "Take the spoon out of the cup."

Birthday reflections

Since last year's big 5-0, I've had a new port placed, had a hysterectomy, dislocated my elbow, underwent three kinds of chemo, and learned my mets had spread to my liver. 

Despite the health challenges, I feel well enough to dance and sing; learned to feed myself with my non-dominant hand while the elbow was healing; enjoy the love of husband, family and friends; and take my daily dose of vitamin CH (chocolate).

On Wednesday I see the onc and get the news on what to do next. I've enjoyed the month off chemo while on Faslodex, don't really know what Dr G will offer but imagine it will include Xeloda. The breast tumor I can palpate has definitely gotten smaller in this past month on Faslodex, but the scalp mets feel unchanged and I think there is a new one.

I ate chocolate and drank sparkling wine with friends last night and we toasted to everyone's continued good health and long life. What else is there to wish for?

November 15, 2010

Happy birthday to me!

Today is my 51st birthday (on the way to 120, as we say in Hebrew). It's been a quiet day after a very busy weekend. I am looking forward to a nap but wanted to post first.

This summer I got in touch with a good friend from graduate school days, who I haven't seen in 27 years! We had a lovely visit together this weekend. On Friday we wandered through the Pike Place market and bought the fixings for a delicious dinner (white wild king salmon; cauliflower roasted with olive oil, capers, and dried cherries; sauteed chanterelle mushrooms; fresh whole wheat-rye bread; Beecher's flagship cheddar, Stilton with dried apricots and chocolate truffles from My Divine Chocolate).

On Saturday Rik and I had been invited to a bar mitzvah, so all three of us went to synagogue. Saturday night Rik went to the family and friends party while my friend and I went out for Greek food and live music from Balkanarama.

Sunday we went to Jai Thai for Mieng Kham, the world's best appetizer: toasted coconut, red onion, ginger, lime, peanut, green chili and palm sugar rolled in lalop leaves. (Delicious!) We also enjoyed tom yum soup, pumpkin curry, rice noodles with vegetables and tofu and brown rice. After this feast we went for the tour of Theo Chocolate and all the chocolate tasting anyone could possibly want! Rik and I brought home a chocolate/almond/cherry bar, an 84% single origin bar from the Dominican Republic, and roasted cacao nibs. I ground some nibs to add to my morning espresso today.

So today I am taking it easy. I did a little grocery shopping, walked the dog, and am glad to be enjoying my birthday. Kudos to Dr G for helping me get through another year!

November 11, 2010

Miss Manners And the Big C

Christopher Hitchens wrote this great article in the December 2010 issue of Vanity Fair magazine. Newly diagnosed with stage IV esophageal cancer, he comments on people's etiquette (or lack thereof) when speaking with someone who has cancer.

If you don't have cancer, I recommend you read it. And if you do (and if so, I am sorry to hear it), you may find yourself sympathetically nodding along.

Veteran's Day

This is by way of a love note to my father, who served in the Army Corps of Engineers during World War II, when he was just 19 years old. 

And I tip my hat to my Canadian-born husband and all Canadians who remember their country's losses from WWI  every year by wearing red poppy pins in their lapels.

In Flanders Fields 
By: Lieutenant Colonel John McCrae, MD (1872-1918)
Canadian Army

In Flanders Fields the poppies blow
Between the crosses row on row,
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.

McCrae's "In Flanders Fields" remains to this day one of the most memorable war poems ever written. It is a lasting legacy of the terrible battle in the Ypres salient in the spring of 1915. Here is the story of the making of that poem:

Although he had been a doctor for years and had served in the South African War, it was impossible to get used to the suffering, the screams, and the blood here, and Major John McCrae had seen and heard enough in his dressing station to last him a lifetime.

As a surgeon attached to the 1st Field Artillery Brigade, Major McCrae, who had joined the McGill faculty in 1900 after graduating from the University of Toronto, had spent seventeen days treating injured men -- Canadians, British, Indians, French, and Germans -- in the Ypres salient.

It had been an ordeal that he had hardly thought possible. McCrae later wrote of it:

"I wish I could embody on paper some of the varied sensations of that seventeen days... Seventeen days of Hades! At the end of the first day if anyone had told us we had to spend seventeen days there, we would have folded our hands and said it could not have been done."

One death particularly affected McCrae. A young friend and former student, Lieut. Alexis Helmer of Ottawa, had been killed by a shell burst on 2 May 1915. Lieutenant Helmer was buried later that day in the little cemetery outside McCrae's dressing station, and McCrae had performed the funeral ceremony in the absence of the chaplain.

The next day, sitting on the back of an ambulance parked near the dressing station beside the Canal de l'Yser, just a few hundred yards north of Ypres, McCrae vented his anguish by composing a poem. The major was no stranger to writing, having authored several medical texts besides dabbling in poetry.

In the nearby cemetery, McCrae could see the wild poppies that sprang up in the ditches in that part of Europe, and he spent twenty minutes of precious rest time scribbling fifteen lines of verse in a notebook.

A young soldier watched him write it. Cyril Allinson, a twenty-two year old sergeant-major, was delivering mail that day when he spotted McCrae. The major looked up as Allinson approached, then went on writing while the sergeant-major stood there quietly. "His face was very tired but calm as we wrote," Allinson recalled. "He looked around from time to time, his eyes straying to Helmer's grave."

When McCrae finished five minutes later, he took his mail from Allinson and, without saying a word, handed his pad to the young NCO. Allinson was moved by what he read:

"The poem was exactly an exact description of the scene in front of us both. He used the word blow in that line because the poppies actually were being blown that morning by a gentle east wind. It never occurred to me at that time that it would ever be published. It seemed to me just an exact description of the scene."

In fact, it was very nearly not published. Dissatisfied with it, McCrae tossed the poem away, but a fellow officer retrieved it and sent it to newspapers in England. The Spectator, in London, rejected it, but Punch published it on 8 December 1915.

November 10, 2010

A little more hair

I took this photo earlier today to show off my new hair growth. Soon I will have actual bangs again and will no longer resemble my middle-aged, balding brother (if I had one).

I wondered recently if strangers have trouble telling if I am male or female from just looking at my face. I decided that no one only looks at your face: we use all the visual clues available. So in my case, the fact that I wear a pink coat or earrings might be the giveaway.

November 06, 2010

Cradle CRAP

My head has been rather itchy lately, and the wispy new hairs needed a trim, so I went to see Cherie at Essence Salon yesterday afternoon, and she told me I have "cradle cap" (!)

Evidently babies are prone to this and yes, even cancer patients with new hair growth can get it. Cherie picked at my scalp with a lice comb to remove some dead skin (very yucky) and told me to brush with a natural bristle brush twice daily and wash with a sensitive-skin shampoo.

I've also heard about using a paste of baking soda and water; A&D ointment (eew!); Mustela Hydra BeBe; baby or olive oil. With all these products, you rub it in and then let it sit for about 20  minutes, wash several times, then condition.

I guess even though I have never raised a baby, I will be trying some new stuff. And reporting this to Dr G.

November 02, 2010

A second opinion

Yesterday I met Dr Georgiana Ellis, a hematologist / oncologist at Seattle Cancer Care Alliance who Dr G highly respects. She reviewed my history and made some recommendations for future treatment. I don't know yet what Dr G will think is best, but it was very interesting to get another perspective on my situation.

From my notes:
- Liver mets tend to grow faster than bone mets, so the first step should be to get them under control with chemo, then look to an anti-hormonal drug for maintenance.
- Repeat CT and bone scans to get the most up to date information on the cancer's activity. Consider a brain MRI to see if cancer might cause the vertigo I've experienced recently.
- Test tumor markers CA 27.29 and CEA.
- There are no clinical trials open now for which I'd be a candidate.
- Consider low dose Xeloda (oral chemotherapy), two weeks on and one week off, perhaps in combination with Navelbine. At a lower dose of Xeloda, Dr Ellis doesn't think I will be bothered too much by hand-foot syndrome (which was the original reason I didn't want to try Xeloda last year). In her experience, her patients with lymphedema do not report hand-foot syndrome negatively affecting their edema.
- If we choose to stay with high dose Faslodex now, Dr Ellis recommends careful monitoring to be sure my disease remains under control.
- Regarding estrogen therapy, Dr Ellis has used a lower dose of 2 mg three times a day, which had fewer complications and the same efficacy as higher dose estrogen.

I learned a lot from Dr Ellis and imagine that Dr G will share his recommendations with me the next time I see him, in a few weeks.