ENCORE #63! – Ripples

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…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in September of 2011.

While my daughter doesn’t often blog on her 20: A Journey of Hope, she does on her other site (http://think.o-my-soul.net/). Currently on the right hand side is her twitterfeed regarding a car accident she and I witnessed.

An elderly woman was driving her very nice car south on Washington Ave, parallel to Interstate 94 at about 4:30 PM. I’d picked my daughter up from Augsburg College where she’d just spent eight hours of attending classes in biopsychology and research methods. Traffic was light. We were chatting.

Many people use Washington to skip the heavy traffic feeding on to the interstate directly from the downtown Minneapolis area. They take it for a short jaunt through the fascinating businesses in the old Warehouse District, then enter the ramp at 22^nd by crossing a usually light southbound lane of traffic.

I think she missed the ramp, got on to the next stretch that runs between 26^th and Lowry and then, thinking the ramp was there, simply veered into oncoming traffic, looking for the ramp. She said to another bystander that she thought it was the turn on to Lowry she was making (and the Washington was a one way?). At any rate, what we saw was the woman’s car swerve deliberately into two oncoming cars.

My daughter says we experienced vicarious dissonance, “a type of vicarious discomfort resulting from imagining oneself in the speaker’s position, leading
to efforts to restore consonance”. In other words, we couldn’t believe that the woman was driving that way because we KNEW that that kind of driving couldn’t happen. We KNEW she should be in the northbound lane.

The resulting head-on collisions destroyed both her car and the badly damaged the other two. I was “first on the scene” and called 911, reported what I saw to police officer in charge after the arrival of two squad cars and a fire truck and my daughter and I moved on to home, deeply shaken.

As I drove, I thought about the accident and the effects it would have. Aside from burning itself into my daughter’s mind – she just got her license a bit over a week ago – and my own, the lives of the people in those cars will be irrevocably affected as well. The young Asian man whose older  model car doubtless carries only collision insurance is now car-less and likely will get piddly cash from the insurance company after endless wrangling over whether he caused the accident or not. The woman in the Volkswagen Beetle will experience the same thing, though by the newness of the car, it likely has more insurance.

And the elderly woman? Will she ever drive again? Will lawsuits (most likely formed by lawyerly vultures wishing to sue everyone in sight and retained by the elderly woman’s wealthy friends, cause the blame to fall on everyone but the woman) be brought, fought and bought? Who brought all of them home? Did the go to the hospital or just go home because their insurance doesn’t pay for something as minor as a non-lethal car accident?

Ripples.

What does a car accident on a Thursday afternoon have to do with breast cancer? Those of you who are THERE can easily guess. Those of you who are not, might consider this: the girlfriend of a good college friend of my daughter; has a mother who was just diagnosed with stage 4 breast cancer.

Ripples, ripples, ripples…

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

BREAST CANCER RESEARCH RIGHT NOW! #54: Surgical Solutions for Lymphedema

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…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today:

I wrote about vascularized lymph node transfer about a year ago here:

I found this website today – it has a short video you might want to watch if this is a subject that interests you, if you are considering having the procedure done, or if you’ve never heard of it: http://www.cancercenter.com/video/treatments-technology/vascularized-lymph-node-transfer/

However, when I first began to look into this subject, I realized that what I REALLY wanted to see is something I discovered today – lymphaticovenular bypass surgery.

Here’s a brief video that shows how it’s done: http://www.cancercenter.com/video/treatments-technology/lymphaticovenular-bypass-surgery/

Clearly research is moving forward as technology advances and techniques are developed. Today, I found this: “minimally invasive free vascularized omental lymphatic flap”. According to the abstract (here: https://www.ncbi.nlm.nih.gov/pubmed/27439587), there is an 83% success rate and a 22% decrease in the size of the affected limb.

So what does this mean? First: “omental”. The omentum is a large piece of tissue attached to the lower part of the stomach. It has blood vessels as well as several lymph nodes. A section of this tissue is removed by a surgeon using a microscope and moved to the place where the original lymph nodes were taken when breast cancer was first discovered. The tissue is attached and the incision is closed up after all of the blood vessels and lymph vessels are reconnected. It would look very similar to the first video.

That’s all I can find at this time, but I’ll be on this in the future as well.

Image:

http://brightcove04.o.brightcove.com/635680383001/635680383001_4395553289001_VLNT-thumb.jpg?pubId=635680383001

ENCORE #62! – Equal Rights For ALL Women! (Even ones we want to be INVISIBLE!)

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…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in February of 2016.

Earlier this week my wife, who is also a cancer survivor and who had a double mastectomy, told me about a woman who had also survived breast cancer and who requested permission to swim at a Seattle, WA pool topless. (

http://www.vancouversun.com/health/Double+mastectomy+cancer+survivor+gets+swim+topless/6830468/story.html)

At first the city turned her down, citing a pool rule. When she explained her situation – they made an exception, but only for her. Any other woman who had survived cancer and a double mastectomy, and who would want to swim topless in order to be comfortable while exercising, would have to go beg for the permission of Seattle Parks and Recreation Superintendent Christopher Williams. (Boy could I say something about THAT…) I am quite sure that my wife would be too shy to do that and would put up with the pain that accompanies wearing virtually ANY clothing over healed mastectomy incisions!

I find it ironic and irritating that in a society that openly promotes, celebrates, encourages and markets the ritualized exposing of women’s breasts (just not the nipple – but any other part of the gland is completely and enthusiastically endorse by the judicial system of the land (which, I could point out, is heavily male…)) would hassle this cancer survivor in ANY way!

Maybe this is just part of the Post-Cancer Crash, but maybe it’s not. Maybe it’s righteous indignation that our society is set up for the “well” and while happy to make “exceptions” (for veterans, women, people with physical and mental handicaps, and small children), would just as soon carry on business as usual, excluding those who do not meet the requirements of the Real Competitors and who may have suffered in any way that would leave them (in the opinion of the Real Competitors) weak and unworthy and who have been FORCED to make concessions…

Ugh.

This whole incident leaves me feeling violated and disgusted – because, if you must know the truth, I am one of the Real Competitors and have been all my life. (Well, maybe not a REAL Real Competitors, I am, after all, only a teacher and not in Business (omar, sharif. omar, sharif.)) This past year has continually opened my eyes, challenge my preconceptions and prejudices, and forced me to reconstruct basic assumptions I’ve made all my life.

Image: https://c2.staticflickr.com/6/5527/10893068965_1d328e8f71_b.jpg

GUY’S GOTTA TALK ABOUT…Alzheimer’s #7: The Science of Sundowning – Part 1

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

Dad’s sundowning is getting worse.

Last night he called me several times, confused in many ways. Once he insisted he wasn’t at the care facility where he has lived for the past two years. Another time he called asking me about a battery being charged. A third time he called worried about how he’d get to work tonight – and when I asked a bit for details he stumbled about somehow know BOTH that he’d been retired since 1993 and that he needed to get to work. When I wondered what he did there, he said, “Oh, whatever needs to be done.”

The last call was for me to come and get him and take him home – yet when I asked where, he said, “To the place I’m supposed to be.” We talked for some time, until I finally got him to agree that he’d stay there for the night and we’d talk in the morning…

As I often did when exploring my wife’s breast cancer, I pulled up a recent journal article and I’ll interpret what it says, “Neuropsychiatric symptoms (NPSs) are characterized by a marked interindividual variability. Their prevalence and severity change over the course of the disease. Moreover, multiple interacting variables and pathophysiological mechanisms may influence their occurrence and phenotypic expression. These aspects have been frequently hindering the application of standardized clinical and analytic approaches to NPS, as well as the identification of targeted pharmacological interventions.”

In essence, the authors are telling me that there are so many things that go into how an Alzheimer’s patient experiences sundowning, that there IS no standard treatment – because there is no “normal” expression of the disease. Because it’s so highly individualistic, “…the sundown syndrome has so far drawn limited clinical and scientific interest compared to other specific NPS and behavioral disturbances occurring in dementias (e.g., apathy, depression, psychotic symptoms). As a proof, the available data concerning its prevalence (mostly obtained in institutional/residential settings) are scarce and markedly discordant in the literature. Moreover, no randomized controlled trial (RCT) specifically investigating the effectiveness of pharmacological and non-pharmacological strategies in managing this condition among demented patients has been yet conducted. Several aspects may account for this low attention, such as the lack of commonly agreed definitions, the absence of specific screening and assessment tools and the multiplicity of factors that may trigger or affect its occurrence…the sundown syndrome does not appear in the recent fifth revision of the Diagnostic and Statistical Manual of Mental Disorders.”

To be perfectly frank with y’all, because there’s no target for a drug, no doctor or pharmaceutical company is going to pay for research because there’s no pot of gold at the end of Alzheimer’s rainbow. With nothing apparent to show a “dramatic recovery” when a patient gets a shot or pops a pill, no one is going to see if there’s anything to be done.

This attitude toward sundowning also reminds me of the state of education – there’s no clear definition of WHAT education is. There are very vague and woo-woo sounding ones, like this from Wikipedia: “Education is the process of facilitating learning, or the acquisition of knowledge, skills, values, beliefs, and habits….[it] frequently takes place under the guidance of educators, but learners may also educate themselves. Education can take place in formal or informal settings and any experience that has a formative effect on the way one thinks, feels, or acts may be considered educational.” Now if that isn’t vague, contradictory, and completely unhelpful, imagine what it’s like to try to justify what you do to your friends, community, and congressional bodies!

This appears to be that same for sundowning.

I’m going to stop now and continue with this discussion in future Alzheimer’s posts.

Later.

Resource: http://journal.frontiersin.org/article/10.3389/fmed.2016.00073/full

Image:  http://az616578.vo.msecnd.net/files/2016/06/25/6360242025150255191939281878_Alzheimer-disease-patients.jpg