Saturday, July 28, 2012

Lymph Node Excision, Mosquito Bites and “A Return To ‘Normal’”

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

After my wife came home from a lymphedema expert at the hospital, I asked her how it had gone. The answer was that the swelling is receding slowly and that the pressure sleeve would be here soon.

She asked how often she would have to wear it, the doctor replied, “Forever.” She added, “Oh, and don’t ever get a mosquito bite. That’s one of the worst things in the world.”

*blinks in startlement*

I don’t know about where you all live, perhaps someone lives in Arizona or New Zealand or Hawaii where mosquitoes aren’t a big deal. But in Minnesota, we (somewhat facetiously; but only SOMEWHAT…) call the mosquito our “state bird”. They are everywhere.

Granted, susceptibility to mosquito bites ranges from, say, me to say, my wife…

I get bitten, make no mistake. But my wife? Let me illustrate: we went to a recent fireworks fest celebrating one or another of some small town’s heritages. Great times! We sat in camp chairs set up in the middle of the street. The next morning, she showed me a pair of fist-sized welts, one on each side of her back that had been “exposed” (even though they were covered by T-shirt material!) where NUMEROUS mosquitoes had bitten her!

Take this little tidbit and add it to the doctor’s admonition and you get a recipe for me *blinking in startlement*.

So what’s the problem with mosquito bites?

First of all, let’s review the lymph nodes, which I talked about in depth here: http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html.

Excision means to remove or cut out. When the breast cancer was initially diagnosed in my wife, the doctors were very, very interested in how far it had spread. If it remained only in the breast, it was “less dangerous”. But if it had spread to the lymph nodes in the armpit (usually), the diagnosis was more terrifying and led to identifying the stage of the cancer. For a complete explanation, try this site: http://www.breastcancer.org/symptoms/diagnosis/staging.jsp They found cancer cells in the node and bumped the diagnosis from 0 to IIIB. This required them to removed lymph nodes – 21 in all and eventually the news that lymphedema would be a FOREVER concern.

Now to mosquito bites. Why are they such a concern? “...some insect bites probably are inevitable...treat them...to lessen the histamine effect, which can cause increased swelling in that area. Benadryl or hydrocortisone creams are two treatment options for insect bites. An ointment with aluminum sulfate as the active ingredient can also help decrease the effects of bites and stings...Treat an insect bite like any break in the skin on your limb at risk. Wash and dry the area completely and apply antibiotic cream to the area...take along a specialized first aid kit. The kit should include alcohol wipes to clean off any skin break, antibiotic cream for application on the skin, and bandages to protect the area…An insect repellent is a good idea...natural repellents, usually with citronella as the active ingredient, and these can be less detrimental to your skin...avoid putting insect repellent on your skin and then wearing a compression garment over it...”

So – camping next week to celebrate 25 years of marriage and now we’ll be prepared. As prepared as we can be!

Reference: http://www.lymphnet.org/lymphedemaFAQs/riskReduction/summerTips.htm
Image: http://rlv.zcache.com/minnesota_state_bird_the_mosquito_tshirt-p235392594519424546z89ss_400.jpg


Saturday, July 21, 2012

What’s the Difference Between Metastatic Liver Cancer and non-Metastatic Liver Cancer?

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

A few weeks ago a friend of mine was diagnosed with liver cancer.

I’d talked about metastatic breast cancer of the liver (http://breastcancerreaper.blogspot.com/2011/12/metastatic-breast-cancer-liver-cancer.html), but with this grim diagnosis, I wanted to look more closely at the differences – if any.

In brief, metastatic breast cancer in the liver (MBC:L) comes from the transfer of breast cells to the liver and then the growth of tumors there. Most often treated with hormone, chemo and radiation therapies, there are newer choices as well, including liver resection.

With the diagnosis of non-MBC liver cancer, my friend also has complications. Regarding these complications, it has been “...shown that cancer is…common…for [this  kind of complication]. The authors attributed this to overlooked symptoms, such as blood in the urine or stool, and delayed treatment because of complications…The most common cancer...is hepatocellular carcinoma, a type of liver cancer.”

Hepatocellular carcinoma, also called HCC, develops like any other cancer by a mutation to the cellular machinery that makes the cell divide faster than normal and/or gives the cell a sort of “immortality” by keeping itself from ever dying. This wild growth of cells form tumors and the tumors ruin the normal balance of chemistry in the liver. This leads to many different symptoms: abdominal pain, jaundice, bloating, loss of appetite, nausea and proteins in the blood that aren’t supposed to be there.

The short answer to the question above is that there isn't any real difference between MBC:L and HCC. Both are mutated cells run wild. In MBC, the cells running wild originated in breast tissue. In HCC, the cells running wild originated in the liver.

There are many treatments available for both MBC:L and HCC and while there is a constant search for new methodology, in the long run, whether the cancer originated in metastatic breast cells or in the liver itself, the prognosis continues to depend on how much the cancer has spread and how quickly it is treated. The main difference is that MBC:L cells can also be treated with tamoxifen (which affects estrogen levels) the same as any other breast cancer cells. HCC is not treated that way.

Resources: http://en.wikipedia.org/wiki/Hepatocellular_carcinoma
Images: http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Hepatocellular_carcinoma_intermed_mag.jpg/220px-Hepatocellular_carcinoma_intermed_mag.jpg


Saturday, July 14, 2012

Men Caring For Wives With Breast Cancer ARE SICK, TOO!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

I refuse to use this as an excuse for gaining about 15 pounds the last year.

I DID need to explain to myself why, after hovering around 240 for decades I slid up to 260 where I’ve been for months now.

I was vaguely aware that I wasn’t doing what I SHOULD have been doing: eating reasonably, doing SOME exercise and watching the carbs. But there didn’t seem to be any hard reason to watch myself.

Then I stumbled across this: “‘Caregivers are called hidden patients because when they go in for appointments with their spouses, very few people ask how the caregiver is doing,’ study author Sharla Wells-Di Gregorio, an assistant professor of psychiatry and psychology, said in the news release. ‘These men are experiencing significant distress and physical complaints, but often do not seek medical care for themselves due to their focus on their wives' illness.’”

Again, I don’t WANT to use this as an excuse for packing on the poundage. I need to understand myself as I continue walking alongside my wife.

Oh, then there’s the guilt about the GUILT: I feel horrible that she suffered through the hell of chemo. I ate to make myself feel better (and assuage my guilt) and packed on weight – and then felt guilty that I was getting fat because I wouldn’t be able to help my wife as much ‘cause I was feeling crappy with the weight gain…

Circular reasoning.

Now what?

I understand better now and so I resolve a couple things:

1) I will stop gorging to make myself feel better. It WON’T make me feel better in the long run. (The extra pounds have hurt my knees. I need to drop that 15 to get back to the relatively low knee pain I experienced before the weight gain.)

2) I will eat with greater attention to food VALUE (fewer empty calories, more reasonable proportions.)

3) I will NEVER eat at a buffet again. (I know from my training as an Elijah House counselor that vows are NOT good, so if I can morph that into a promise to myself, I will. Right now it’s too strong of a feeling for anything less than a vow). What I saw the night before last made me extremely sad.

4) I will work toward exercising more often. I LOVE my new bike. We need to get better acquainted!

5) I will surrender my life more fully to Jesus Christ. It has never been His intention that I take the gift of living in this country and make a pig of myself...
I’ve written about this before (http://breastcancerreaper.blogspot.com/2011/05/husbanding-bigger-middle.html), but I understand what was going on better, now.

If this makes sense to anyone who reads this, let me know!

Resource: http://health.usnews.com/health-news/news/articles/2012/04/23/wifes-breast-cancer-can-hurt-husbands-health-too-study
Image: http://martinisatthebluemax.files.wordpress.com/2011/07/996047012_ec26700659_o.jpg?w=640


Saturday, July 7, 2012

Lymphedema -- Again...

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

I wrote about lymphedema for the first time last February (http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html), which was really the first time we had to think about it. Being that it was only a few short months after chemo was over and my wife’s hair had only just started to grow back to a “normal” length, lymphedema didn’t really surface as an issue.

Five months later, it’s still not an ISSUE. But it’s become something of an irritation.

See, we have a couple of grandchildren and we’re do-it-yourselfers when it comes to things around the house.

What do those two things have to do with each other?

If you didn’t go back and read the article I wrote in February, the definition of lymphedema could be simply stated: “when lymph fluid builds up in the body's tissues instead of returning to the circulatory system. This causes abnormal swelling in affected areas of the body.” Some of the symptoms of lymphedema are: “Swelling (of the arm); tightness and stiffness; heaviness, aching, pain, puffiness, feeling of "bursting"; numbness or tingling, hardness or firmness; skin color or texture changes”. This can be helped by “lymph tissue massage to stimulate lymph flow and redirect fluid to functioning nodes; modifying your activities…”

How does lymphedema intersect the fact that we have grandchildren and like to do things like grout new ceramic tile, pick up and hold and infant and a toddler, throw going-away parties for daughters headed for New Zealand, keep up a house, go grocery shopping and refinish chairs?
Hopefully you see that life-after-chemo has to undergo a bit of restructuring in light of rebuilding life-as-we-knew-it!

And so it has. Recently, I started the lymph tissue massage. My wife lays on the bed shortly before we turn in and holds the lymph node deprived arm in the air. I lotion up my hands and GENTLY slide them from fingers to armpit, pushing the lymph back into circulation. Not difficult. Not intrusive.

But it ISN’T something we’d ever had to do before March 2011. It’s part of the New Normal. And you know what? That’s OK with me today.

Resource: http://www.communitymemorial.com/services/rehab/lympedema.cfm
Image: http://oakworksblog.massagetables.com/wp-content/uploads/2012/04/massage-arm.jpg