ENCORE #128! – The Reconstruction Era – Part 6

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 September of 2013.

“It appears that the next event is breast reconstruction!”

What has amazed me is how INTERESTED people are.

As my wife has had “fills” [Define: “Tissue expansion is a relatively straightforward procedure that enables the body to ‘grow’ extra skin for use in reconstructing almost any part of the body. A silicone balloon expander is inserted under the skin near the area to be repaired and then gradually filled with salt water over time, causing the skin to stretch and grow. It is most commonly used for breast reconstruction following breast removal...”] the size of the expander has increased, creating a place for the actual implant to go once the fills are done.

Couple other things here, one of which is the new name, the other what they “look” like. First the name. My wife has wisely insisted that the surgery is creating “boobs”. These are NOT breasts. Breasts are natural organs that God or evolution designed to feed newborn infants. The “boobs” are cosmetic reconstructions designed to look like breasts and to create the appearance of breasts – and to deflect sympathy and strange looks. They allow a post-mastectomy woman to feel like the other half of the Human race. One plus of the reconstruction – my wife will NEVER HAVE TO WEAR A BRA AGAIN! The boobs are designed to stay exactly where the doctor put them.

Which segues into my second observation regarding what they LOOK like. A few intimate friends of my wife have asked to see them and have marveled at how strange they look. They are, in fact rather like the alien called Odo on the old Star Trek television Deep Space Nine. This alien’s natural form is nothing like Human, so to make everyone around “him” feel more comfortable, “he” has taken on the form of a Human male. “His” face, while recognizable Human has none of the FINE features of a Human face. Odo has eyes, nose, mouth and ears, but only in smooth, featureless outline.

The boobs my wife has are smooth, featureless outlines of real breasts. There is no nipple – though when the surgery is done, the nipples will be added. However, we were informed early on that the areola itself – the dark skin surrounding the nipple – will NOT be recreated. She has to go in…FOR TATTOOS!!!!!!!!!!!!!!!!!! Which are not, of course, covered by insurance as in fact, no tattoos are, being as they are an art form.

“You have GOT to be kidding!” you quip.

I kid you not. I shudder to think what it would be like to go to the nearest certified tattoo artist, walk up to the desk or the multiply-pierced and tattooed associate and say, “Excuse me, I’d like to get an estimate for how much it would cost to get areolas tattooed on my new boobs.”

Resources: http://www.plasticsurgery.org/reconstructive-procedures/tissue-expansion.html

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

ALZHEIMER’S RESEARCH RIGHT NOW! #6: A Dementia VACCINE!?!?!?! (Part 1)

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Alzheimer’s 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: https://www.extremetech.com/extreme/304009-a-new-alzheimers-vaccine-could-be-headed-for-human-trials (This is an online summary of the actual study below).

Too late for Dad, but in time for us?

So, I emailed my doctor about some of the things I’ve written about in this blog, in particular, this post:  “What do these four things have in common: LSDs, Eye Tests, a Video Game, and Blood Tests?” https://breastcancerreaper.blogspot.com/2019/08/alzheimers-research-right-now-3-what-do.html

Here's what I wrote along with his response:

"Dear Dr. Holton:

           "My name is Guy Stewart, and I have some concerns about myself and Alzheimer's. My father died about a year ago from complications resulting from an initial Alzheimer's diagnosis four years earlier. He and my mom eventually moved to assisted living in Maple Grove; and when my mom went on hospice, we used the opportunity to move both into Memory Care. Mom passed, and Dad stayed. I am a writer and science teacher and did much research on dementias. I would like to see if qualify for some early screening advances in the field. The link here is to an essay I wrote regarding some developing research. If you would take the time to skim the links, I'd appreciate it as I would like to see what I can do BEFORE I begin to develop symptoms and it's too late. DON'T rely on the essay -- read the links at the bottom. Thank you." https://breastcancerreaper.blogspot.com/2019/08/alzheimers-research-right-now-3-what-do.html

"Guy,

         "Thanks for the information.  It is very difficult to watch a parent slowly decline from Alzheimer's dementia.  It is a very painful disease process. If you are noting short-term memory lapses, more so than others your age, recommend getting a MoCA test (stands for Montreal Cognitive Assessment).  Our nurses do that at the clinic at Brooklyn Center.  Can just make an appointment with the RN for the MoCA test.  This is quite sensitive and specific for early Alzheimer's type dementia.  Suggest follow-up appointment with me immediately afterwards to discuss the results."

The Health Partners Neuroscience Center in Saint Paul is presently doing several research projects for Alzheimer's type dementia.  I recommend you contact them regarding the most recent research in early detection.  They have the most up-to-date stuff, and perhaps you or family members could be enrolled in their studies.  Good luck and best wishes.”

So, I signed up to be alerted if they are interested in doing Neuroscience studies, in particular, research into stopping Alzheimer’s Disease. (I’ve participated in several studies already! ARIC (Atherosclerosis In Communities); D2D (The effect of vitamin D2 on pre-Diabetes (which earned me a kidney stone…ouch…)); and a couple of other minor ones.

Next time, I’ll talk about the vaccine and its progress. Also, I’ll make an appointment after I retire, to take the MoCA – and I’ll actually report on that test later, in GGTA…Alzheimer’s!

Resources: https://alzres.biomedcentral.com/articles/10.1186/s13195-019-0556-2#Abs1

Image: https://www.meduniwien.ac.at/web/fileadmin/_processed_/e/1/csm_shutterstock_142671010_4683b6bf13.jpg

ENCORE #127! – The Reconstruction Era, Part 5

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 July of 2013.

What I have discovered is that “reconstruction” is an ongoing process. Like The South after the Civil  War, which took many years to recover, my wife is slowly recovering from the surgery, chemotherapy – and now the initial surgery to put in the spacers.

As I’ve documented before, THAT surgery necessitated a few nights of sheer agony, followed by several weeks of rebuilding strength and then regular injections of saline solution in order to stretch the skin so that the ACTUAL implants could be placed some time in November or December.

We are now at some two years and four months after the initial double mastectomy.

Reconstruction in The South took anywhere from twelve to fourteen to “it’s not done yet”…

How long will breast reconstruction last?

Not forever, that’s for certain! There are already signs that things are proceeding apace. After a “triple fill” of saline in the expanders, the increase in size is noticeable and while there’s quite a bit of soreness and tenderness and an obvious sense of stretching involved, there is also a sense of “completion” that I’ve noticed as well.

While we never stopped “winking and butt tweaking” during this time, the winking is now proceeding to raising eyebrows. There’s a sense of a return to normalcy. While doctor visits will be something that will last “forever” as blood tests and other tests will be a part of the new normal, dealing with the after effects of breast cancer have become integrated into life rather than something that happens in panic mode or has to be considered carefully.

While I loathe the path we’ve had to take to get here, I love the fact that we are NOW here!

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

BREAST CANCER RESEARCH RIGHT NOW! #71: “Promising Blood Test Could Help to Predict Breast Cancer Recurrence”: My Realistic Re-Write of a Hyperbolic Headline

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: https://www.hindawi.com/journals/jo/2020/8132507/

I first came across the TIME Magazine article referenced below, with the startling headline, “Promising Blood Test Could Help to Predict Breast Cancer Recurrence”.

As is usual with journalists, the facts are far less likely to get a page turn or site click. In fact, the headline seems to me to be intentionally misleading.

From a more recent article than the one TIME authors chose to base their headline on, the authors point out: “…in principle, tTDS [tagged, targeted deep sequencing, altered to Targeted Digital Sequencing then creatively dubbed TARDIS] is a promising technique for the detection of MRD [minimal residual disease] in BC [breast cancer]. Further studies should assess its use after target design optimization and by increasing the quantity of plasma to be used for ctDNA [circulating tumor DNA] detection. Ultimately, the goal of applying tTDS in early BC is, however, to demonstrate not only its clinical validity, but rather its medical utility. This latter task may lead to effective strategies aimed at altering the course of relapsed disease when detected earlier than clinical progression, and studies directed to this purpose are strongly needed.”

“With the recent possibility of designing custom tTDS panels, which include the most frequently mutated genes in BC, such as TP53, CDH1, GATA3, and PIK3CA hotspots, the use of this method may lead to an effective way to monitor the presence of MRD in a significant proportion of early BC patients.”

“In conclusion, our work showed that, in principle, tTDS is a promising technique for the detection of MRD in BC. Further studies should assess its use after target design optimization and by increasing the quantity of plasma to be used for ctDNA detection. Ultimately, the goal of applying tTDS in early BC is, however, to demonstrate not only its clinical validity, but rather its medical utility. This latter task may lead to effective strategies aimed at altering the course of relapsed disease when detected earlier than clinical progression, and studies directed to this purpose are strongly needed.”

In case you haven’t gathered as much, I am deeply suspicious of a media that intentionally writes at an sixth grade level (based on the Kincaid-Fleishman Scale “…Time magazine scores about 52, an average grade six student's written assignment (age of 12) has a readability index of 60–70 (and a reading grade level of six to seven), and the Harvard Law Review has a general readability score in the low 30s. The highest (easiest) readability score possible is 121.22, but only if every sentence consists of only one one-syllable word. "The cat sat on the mat." scores 116. The score does not have a theoretical lower bound; therefore, it is possible to make the score as low as wanted by arbitrarily including words with many syllables. The sentence “This sentence, taken as a reading passage unto itself, is being used to prove a point." has a readability of 69. The sentence, “The Australian platypus is seemingly a hybrid of a mammal and reptilian creature." scores 37.5 as it has 24 syllables and 13 words. While Amazon calculates “…the text of Moby Dick [is] 57.9, one particularly long sentence about sharks in chapter 64 has a readability score of −146.77. One sentence in the beginning of Swann's Way, by Marcel Proust, has a score of −515.1. The U.S. Department of Defense uses the reading ease test as the standard test of readability for its documents and forms.” (https://en.wikipedia.org/wiki/Flesch%E2%80%93Kincaid_readability_tests

I understand the mission of news documents is to create a reading experience for the public that is approachable to the widest possible audience. But something as important as research into breast cancer treatment…in order to be clear, sometimes it seems that some publishers resort not only to hyperbole, but they allow their reporting to edge into “fake news”.

Based on the academic paper (I admit it’s dense, but I also have a bachelor’s degree in biology and I’m pretty sure most of their writers DON’T) linked below, the researchers say, “…in principle, tTDS is a promising technique for the detection of MRD in BC. Further studies should assess its use after target design optimization and by increasing the quantity of plasma to be used for ctDNA detection. Ultimately, the goal of applying tTDS in early BC is, however, to demonstrate not only its clinical validity, but rather its medical utility. This latter task may lead to effective strategies aimed at altering the course of relapsed disease when detected earlier than clinical progression, and studies directed to this purpose are strongly needed.”

What I would have translated that into is this:

 “Right now, all we’re saying is that TARDIS is a promising way to find tiny pieces of breast cancer DNA in a patient’s blood. We still have lots of testing to do to make it as accurate as possible in finding those pieces. We want to create something that not only works in the lab, but be able to use it as a true test of the chance of a breast cancer coming back – before we find tumors growing in the patient’s body.”

The far less dramatic headline would have accurately read, “Scientists Testing a Way to Find Evidence of Breast Cancer Return BEFORE Tumors Appear” or if you insist, “Promising Research Might Warn Doctors of Return of Breast Cancer”.

Resources: https://time.com/5646791/breast-cancer-blood-test/, https://www.forbes.com/sites/victoriaforster/2019/07/12/blood-test-may-be-able-to-predict-breast-cancer-relapse/#5c243e8b7064 https://www.hindawi.com/journals/jo/2020/8132507/,

Image: https://thumbor.forbes.com/thumbor/960x0/https%3A%2F%2Fspecials-images.forbesimg.com%2Fdam%2Fimageserve%2F514347547%2F960x0.jpg%3Ffit%3Dscale