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Thursday, January 31, 2019
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Saturday, January 26, 2019
ENCORE #103! – Man Cancer and the Orchiectomy
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 first
appeared in December of 2011.
I’m re-posting
this today because Olympic gold medal swimmer announced a few days ago that he
is undergoing treatment for testicular cancer. Here’s a link to the current USA
Today article: https://www.usatoday.com/story/sports/olympics/2019/01/24/olympic-swimmer-nathan-adrian-diagnosed-testicular-cancer/2670220002/
So this week I got
the news that two good friends of mine have cancer. One has colon cancer and
will be undergoing a colECTOMY (ecto = Greek for “to cut out”) during the
Christmas season.
The other is
twenty-some years younger than me. He was diagnosed with testicular cancer and
had a radical orchiectomy after which…well, we don’t know because they are in
the specific diagnosis part of his New Normal. He said he’d let me know because
I pray well for biological specifics – I can see the parts of the body that are
affected – cancer, breaks, dislocations, flu. I am a great prayer for healing
of body parts as well as for restoring the heart and mind.
At any rate, some
time ago, my wife asked “Why do so many people have breast cancer?” I marshaled
statistics in this post: http://breastcancerreaper.blogspot.com/2011/06/why-do-so-many-women-have-breast-cancer.html
The research led
me to the statistics for other kinds of cancer – lung cancer, Liz’s mom died
from this; blood cancer (leukemia), the son of close family friends; brain
cancer, an old friend of mine died from this at 30; skin cancer, my sister,
brother and sister-in-law have this; there are others with other cancers that I
don’t care to enumerate at this time.
Testicular cancer
has increased by 60% in the past 25 years. Why? Right now no one knows the
answer, it just…has.
A student of mine,
after we talked about why my wife’s hair all fell out during chemo. I talked
about how the chemicals target fast-growing cancer cells – and kill the
fast-growing hair cells “accidentally”. She then went on a rave about how we
should make drugs that ONLY target cancer cells…and that got me to thinking.
Are all cancer
cells created equal? Or are they egalitarian? Is testicular cancer the same as
breast cancer? Brain cancer? Lung cancer? Skin cancer?
Questions – and
today…no answers. Just more questions that I’m going to try to answer in the
future…
Saturday, January 19, 2019
Encouragement (In Suffering, Pain, and Witnessing Both…) #5: GUY’S GOTTA TALK ABOUT…Stress
The older I get, the more suffering and
pain I’ve experienced; and the more of both I stand witness to. From my wife’s
(and many, many of our friends and coworkers) battle against breast cancer; to
my dad’s (and the parents of many of our friends and coworkers) process as he
fades away as this complex disease breaks the connections between more and more
memories, I have become not only frustrated with suffering, pain, and having to
watch both, I have been witness to the suffering and pain among the students I
serve as a school counselor. I have become angry and sometimes paralyzed. This
is my attempt to lift myself from the occasional stifling grief that darkens my
days…
So…at the moment, my
brother-in-law is sitting about a meter and a half behind me. He’s living with
us at the moment after several bouts with atrial fibrillation and other issues.
He is very weak,
walks with a cane or a walker, has atrial fibrillation and sometimes has
incontinence. Not being a stranger to ANY of those in the list (except the afib,
for which he isn’t a candidate for valve transplant (my mother wasn’t, either
after valve damage she got from some childhood disease in the 1930s or 40s). He
also sometimes hears voices and thinks he’s fine to go back home because he can
take care of himself just fine.
My dad is very
weak, walks with a cane and refuses to use a walker, has Alzheimer’s and frequently
has incontinence. Not being a stranger to ANY of those on the list (except the
Alzheimer’s, for which there is no cure and no one really has any idea why some
people get it and some people don’t). He also has extremely lucid dreams, which
he calls to ask me if I can bail out some guys he knows who are in jail
somewhere; or to tell me that my mother is talking to him in his room; or to
ask me for the third time in 20 minutes if he has a car (he hasn’t had a car
for 3 years, when I forcibly removed it from him when he and my mom moved into
assisted living. Prior to that, he had pretty much lost his sense of direction
and frequently got lost – and denied it vehemently.
At work, I had an
unexpected turn of events in that my boss asked me to do something different
than what had been planned. He shifted my position to another of the people I
worked with and asked me to do something entirely different – for which I had
little training and no desire to do. But because I was busy with the students I
was helping to graduate from high school, I agreed without any thought or
question. And now something new is coming up – I am going back into the
classroom after a 6 year hiatus. While I have no doubt that I can do it, and I
was even contemplating it myself, and EVEN valiantly volunteered to do it…when
they said, “Great. You’ll start on Wednesday!” I was stunned – and frankly a
little scared.
While my wife’s
breast cancer has shown no sign whatsoever of recurring, horror stories I ran
into in the past keep surfacing and terrifying me. I wonder if, when she has a
twinge, it’s not “a sign”.
And I’m aging –
before my very eyes, quite literally. And my wife retired last week – and many
of the other people I socialize with are retired or retiring soon…and I can’t for
another four years. I ache most of the time and I struggle to keep my weight
down to a number for which I’m just plain obese rather than morbidly obese.
My writing isn’t
going much of anywhere, and it’s 9 degrees F outside and the middle of winter,
so I can’t go out and ride my bike.
There are all
kinds of coping methods for stress. The negative ones include: overindulging in
caffeine, smoking, drinking, spending, eating, becoming antisocial, avoiding
going outside, paranoid fear, anger, overwork, oversleeping, promiscuity, and starvation.
Positive ways seem
to be abundant and are typically the mirror image of the negative ones above.
I’m fairly certain
none of those would do much to alleviate my stress, though I WILL tell you I eat
too much.
Lately, I’ve
started to go outside of myself to deal with stress, and while I’m not very
good at it yet, I’m growing into it. It all stems from the following Bible verses:
1 Peter 5:7 “…casting all your anxiety on Him, because He
cares for you.”
Matthew 11:28 “Come
to Me, all who are weary and heavy-laden, and I will give you rest.”
Isaiah 41:13 “For
I, the Lord your God, will hold your right hand, saying to you, ‘Fear not, I
will help you’”
Isaiah 46:4 “Even
to your old age, I am He, and even to gray hairs I will carry you! I have made,
and I will bear; even I will carry, and will deliver you.”
For me, right now,
these are God speaking to my stressed out body, mind, and heart.
*Whew!*
Image:
Saturday, January 12, 2019
ENCORE #102! – Metastatic Breast Cancer: Brain 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…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 first appeared in January 2014.
While I don’t
usually go to Yahoo Ask for my medical information, I decided today to START
there because the answerer is both an MD and clear:
“Interesting that
you bring this up. Primary brain malignancies have always been called brain
‘tumors’ rather than ‘cancer of the brain’. Yet many are clearly cancerous,
locally invasive, progressing malignancies. Strange the way people perceive
words. If you tell patients they have a ‘tumor, it does not seem as ominous to
them as saying they have ‘cancer’…there is confusion that many people have in
regard to this topic. A person with lung carcinoma that has spread to the brain
has lung cancer in the brain. It is not a brain cancer. It is still lung cancer
that is growing in the brain area. A person with a glioblastoma multiforme has a brain tumor - but these are usually
aggressive cancers. As for cures - that depends on the primary brain
cancer/tumor type and the stage.
Interesting
question regarding the semantics of this.”
Source(s): MD
medical oncologist - cancer specialist doctor Spreedog, 2010 http://answers.yahoo.com/question/index?qid=20091114024633AADSsIx
This is in
concordance with what I’ve already found out about bone cancer and lung cancer
– when you have had breast cancer and is spreads (which is what Metastatic
Breast Cancer is), you have breast cancer cells growing wild in the bones,
liver, lungs, brain and various other
places.
So what happens?
This seems to me to be a truly horrible kind of MBC because the brain is the
seat of Human consciousness.
The writer here expresses
this terror: “It was because of a few unusual symptoms, that several months ago
I requested a brain scan. By the time the date arrived for the scan, the
symptoms, along with my fears, had disappeared. Imagine my surprise when the
next day my oncologist called to say that they had found 2 tiny spots on my
brain. The news was devastating. While breast cancer is every woman’s
nightmare, and metastasis is the nightmare of everyone who has breast cancer,
brain metastasis is the nightmare of everyone who has metastatic disease. It
was so frightening that I couldn’t speak to anyone about it. I could barely
allow myself to think about it. None of this is news to you. You wonder how
many tears you can actually shed. You wonder if you will ever feel like your
old self again and if your friends and family will ever think of you in the same
way. You wonder if you will lose the person you are. It is the most terrifying
diagnosis anyone can have, even those of us who are used to bad news.”
What are the
symptoms? Please keep in mind that the symptoms are DIFFERENT depending on
where the cancer attacks first. Also, OTHER things can cause these symptoms. My
wife works as a classroom aide with kindergartners – she gets headaches
sometimes, as anyone would who tries to work with a room full of
five-year-olds!
Symptoms include:
“changes in the ability to think, understand and use words correctly; emotional
changes; weakness; dizziness; seeing lights, seeing double, or narrowing of
vision; problems with balance; seizures; nausea and vomiting; changes in
smelling, taste, hearing. If any of these symptoms persist (that is, stick around for a while) like a headache that is
worse in the morning, lasts for days, or recurs every day, then you’ll want to
talk to your health care authority.
Once you report to
the cancer care center or your doctor and there appears to be reason to suspect
MBC-brain cancer, an MRI (magnetic resonance imaging) is the most effective
technology for diagnosing breast cancer brain metastases. It does a better job
in distinguishing a single metastasis from multiple metastases, which is an
important factor in determining what kind of treatment a patient needs.
Unfortunately,
treatment for MBC-brain cancer is problematic still. In m0st cases, whole brain
radiation (which is exactly what it sounds like) is the first line of offense.
There is good evidence that this treatment is effective almost half of the time
in completely reversing the effects of the cancer. In MOST cases, it reduces
the symptoms significantly. It is also a shorter-term treatment than the
original chemotherapy with radiation doses given daily for 5-10 days (though
this is sometimes spread over a longer period to lessen the side-effects.
At other times,
the radiation is aimed from multiple directions at specific metastases. This
has the advantage of fewer side-effects, but there is no clear EVIDENCE yet
that this is as effective as whole brain radiation treatment.
Other, less common
treatments include brain surgery (physical removal of the cancer), chemotherapy
(not effective usually because the chemo can’t break through the barrier into
the brain through the blood (called the blood-brain barrier); and a combination
of the above.
Finally: “‘So much
depends on the aggressiveness of your individual cancer, the time to recurrence
from original diagnosis, any other metastases, and overall health—and, the
number, location and size of the brain mets (metastases), and whether they are
symptomatic or not,’ Patty observed. ‘I
was so sure that I would die within 18 months of my first diagnosis with brain
mets. I readied for the time of my
death. Now, I’ve had to revise things a few times. I wonder if I hold some kind of record for
brain MRI’s, having had them on average every two months for five years—that
would be around thirty, with bad veins! I’ve had brain mets for five years and
have been living with eight lesions for two and a half years.’”
References: http://brainmetsbc.org/
Saturday, January 5, 2019
GUY’S GOTTA TALK ABOUT…Alzheimer’s #21: Stages and Levels…
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…
The residence my
dad lives at does annual care reviews. This past month, because of changes in
his behavior and abilities, my dad was advanced from Level 1 (for which he
receives minimal care beyond what is normally provided to all of the community
(someone is always there to help him, room & board, medication delivery,
recreation and facility use, programming, nurse assessment, care conferences,
etc.) to Level 3. He’ll now receives help taking a shower, shaving, some help
dressing (mostly dressing appropriately), behavioral intervention (he has done “exit-seeking”
practically since he moved into the facility, often complaining that he feels
like a prisoner)but which as recently escalated to following a woman he thinks
is my mother and holding her hand (while the woman’s HUSBAND was sitting
there), his incontinence has increased, and he has a prescription for olanzapine:
“used to treat nervous, emotional, and mental conditions…may also be used alone
or with other medicines (lithium or valproate) to treat bipolar disorder
(manic-depressive illness) or mania that is part of bipolar disorder”, which
they use as needed when he gets agitated and really tries to “escape” the
place.
What does this
mean? Well, by now you know I prefer the 7 Stages of Alzheimer’s over the
Stage 1: No memory
problems are evident.
Stage 2: Minor
memory problems but not distinguishable from normal age related memory loss.
Stage 3: Friends
and family members begin to notice memory and cognitive problems like not being
able to find the right word during conversations, forgetting new acquaintances,
an frequently losing valuables.
Stage 4: Clear cut,
classic symptoms of Alzheimer’s disease are apparent.
Stage 5: Need help
with many day to day activities. Significant confusion, forgetting person
information like phone number but still able to bathe and toilet independently.
They also usually still know their family members and some detail about their
personal histories, especially their childhood and youth.
[Dad is probably
here-ish.]
Stage 6: Confusion
or unawareness of environment and surroundings, behavior problems, assistance
with activities of daily living, recognizes only friends and relatives, loss of
history, incontinence, wandering.
Stages 7: Lose
ability to respond to their environment or communicate, assistance with all
activities of daily living is necessary, and many lose the ability to swallow
[Dad has trouble with this already].
For me the Three
Stages of Alzheimer’s (Early, Middle, Late) seem…more open to a “shoulder shrug”
interpretation, like “Well, he has trouble coming up with the right word or
name, remembering names when introduced to new people, challenges performing
tasks in social or work settings, forgetting material that one has just read, losing
or misplacing valuables, increasing trouble with planning or organizing, so OMG!!!!
He MUST HAVE ALZHEIMER’S!!! Quick let’s get him institutionalized....” for
Early Stage Alzheimer’s.
As far as I recall,
Dad was in this stage well before we forced him and Mom to move.
With the Middle
Stage, comes forgetfulness of events or about one's own personal history, moody
or withdrawn, especially in socially or mentally challenging situations, unable
to recall their own address or telephone number or the high school or college
from which they graduated, confusion about where they are or what day it is, need
help choosing proper clothing for the season or the occasion, trouble controlling
bladder and bowels in some individuals, changes in sleep patterns, such as
sleeping during the day and becoming restless at night, an increased risk of
wandering and becoming lost, personality and behavioral changes, including
suspiciousness and delusions or compulsive, repetitive behavior like
hand-wringing or tissue shredding…
Late: Needs
round-the-clock assistance with daily activities and personal care, lose
awareness of recent experiences as well as of their surroundings, experience
changes in physical abilities, including the ability to walk, sit and,
eventually, swallow; have increasing difficulty communicating; become
vulnerable to infections, especially pneumonia.
Now, not to be
cynical or anything, but with the weed-like propagation of Memory Care facilities
(which charge exorbitant fees and seem to be a really good financial investment),
the moment a parent forgets something, with three Stages, families might throw
their arms in the air and place their parents in a Memory Care Facility when
the vague Early Stages of Alzheimer’s show their ugly head.
Dad would have
been in Late Stage for the past year or so…but with Seven Stages, when I
started this blog, Dad was between Stage 5 and 6. Most recently – like last
week – it’s clear that he’s advanced to Stage 6 with clear signs that Stage 7
is imminent. In particular, since this summer, Dad has exhibited a marked inability
to assess his environment, to wit: he called me two nights ago 23 times starting
at 1:40 am and calling for the last time at 3:42 am. He had no recollection of
that when I went to pick him up for his doctor’s appointment. He frequently has
no awareness of time of day, and lately he’s been unable to read his old watch,
becoming entirely confused when I ask him to describe… “What’s the big hand
pointing to? What’s the little hand pointing to?” I haven’t even tried to ask
him about the minute hand…
At any rate, I’ve
been working to reconcile myself with Dad’s decreasing ability…and to be
perfectly honest with you, I’m not doing really well and I find myself pulling
away.
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