ENCORE #151! – It’s Funny, But It’s Not – Breast Cancer and the Bombing of Hiroshima

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. 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 2018…

It’s funny, but it’s not that the whole breast cancer ordeal feels over.

It’s not over. My wife continues to live in the shadow of the aftermath. Sort of like the old move, “The Day After”.

On November 20, 1983, American television aired a movie that realistically explored what would happen if there was a real exchange of nuclear weapons between the US and the Soviet Union. It had a profound effect in that rather than focusing on the war itself – though it did show the explosion of warheads on US soil and over cities – its purpose was to explore what happened to normal people left with virtually nothing.

I watched it from Toronto, Canada and was completely creeped out. I said several times to myself and those I was watching it with. The fact that Korean Air Lines flight 007 had been shot down by the Soviet Union, killing all 269 passengers and crew aboard on September 1, 1983 (including 62 Americans and others from 16 countries) – a mere eleven weeks earlier; only made it more real.

There was drama there, as there was drama in the initial years of the breast cancer diagnosis.

But we’re now in the long-term effects of the diagnosis, treatment, and recovery.

What has Hollywood done representing the long-term effects of nuclear war? It didn’t have to do anything. Documentary film makers visited Hiroshima and Nagasaki, Japan almost immediately after the bombing while others went sixty years later and interviewed survivors.

I haven’t seen these movies, but I DID see “The Day After”. I think that my life right now, as well as that of my wife, is in the exploration of the aftermath of the destruction of our lives. She is a survivor, assuredly. I am a survivor of a sort. Maybe I need to see if there are movies about people who lived on the island of Etajima, which was an island in Hiroshima Bay, south of the main city. What were their lives that day? What are their lives like now? Are there any survivors who lived there who have been interviewed?

Has their story ever been written?

Hmmm…I also just had an idea last night about a person who collects the six flags that astronauts left on the Moon. Could I meld this into something that would reflect my thoughts about living on that island and loving a survivor of the first atomic attack in Human history – and using it to explore my thoughts about being the husband of a breast cancer survivor? We’ll see.

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

DIABETES: OTHER MEDICAL ISSUES RIGHT NOW! #1: Cortisone and Diabetes…An Unexpected Reaction…

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.

Occasionally, I've decided to highlight other kinds of things I discover…
Today: Cortisone Injections and Blood Sugar surges

“Steroids are being used effectively for the treatment of a variety of musculoskeletal disorders, including osteoarthritis, tendonitis, myofascial pain syndrome, and trigger fingers. They are especially useful for shoulder or spinal diseases, mainly for the treatment of shoulder pain caused by rotator cuff disease or adhesive capsulitis and spinal pain caused by herniated nucleus pulposus (HNP) and spinal stenosis. Steroids are useful for treating severe pain that requires surgical treatment in patients who cannot undergo surgery due to medical complications or other problems. However, steroid use is accompanied by various side effects such as fever, facial flushing, nausea, and fatigue. One typical side effect of steroid injection is an increase in blood glucose level.”

WHOA! Was this a surprise to us!

My wife’s doctor, thinking (didn’t she read my wife’s file???) that she was just giving a normal shot to a normal person to take care of a case of normal tendonitis, didn’t tell her to expect anything other than the relief of pain…

As I said, the end result has been a startling surprise to us!

Blood sugars that are normally controlled about 127 were over 500 a few hours ago after a moderate Friday Night-Pre-Blizzard-Celebration with grandkids, their mom, and her mom…(two grandmas and a grandpa)…

Whoa! For those of you who don’t know what I’m talking about, here’s a brief lesson: “When you have diabetes, your body isn’t able to get the sugar from blood into cells, or make enough, or any, insulin. This causes high levels of blood sugar, or high glucose levels. The carbohydrates in food cause blood sugar levels to go up after meals. When you eat foods that contain carbohydrates, the digestion process turns them into sugars. These sugars are released into the blood and transported to the cells. The pancreas, a small organ in the abdomen, releases a hormone called insulin to meet the sugar at the cell. Insulin acts as a ‘bridge’, allowing the sugar to go from the blood into the cell. When the cell uses the sugar for energy, blood sugar levels go down.”

So, the levels of sugar in the blood – are measured as the number of milligrams of sugar / (= “per”) deciliter of blood. If you’re fasting and before meals it should be less than110 mg/dL and less than 140 mg/dL two hours after eating a meal…my wife’s was 527 mg/dL two hours after supper…

That doesn’t sound like a big change, but consider this: “Severely high blood sugar turns your blood thick and syrupy. The excess sugar passes from your blood into your urine, which triggers a filtering process that draws tremendous amounts of fluid from your body. Left untreated, this can lead to life-threatening dehydration and a diabetic coma.”

To continue then, she brought the levels down to 400 fairly quickly, but that was only after feeling really horrible! Not sure what the night will bring, but I’ll be updating this before posting it…

To continue with the spark for this post – the cortisone shot started to affect her almost immediately in a negative way with her normal blood sugars elevated but not to a worrisome level. Throw on top of that our little party, and there was near panic in the house.

“The aim of this study was to investigate the duration of blood glucose level elevation after steroid injection in patients with type 2 DM and whether associated factors and poor blood glucose control play a role in the elevation of blood glucose levels.” The result was that it was only supposed to last for a couple of days…

But, that wasn’t so. It’s been five days now and she was having trouble getting stable blood sugars even before the party.

Postscript: After talking to the doctor’s office Physician’s Assistant – who talked to both doctors (left hand and right hand no knowing what the other was doing) and confirming that taking extra Metformin was a reasonable response in her case and after several bottles of protein drink and a night’s sleep, sugars came down. But she has to be careful…

Resources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7214140/, https://www.healthline.com/health/type-2-diabetes/understanding-glucose-levels, https://www.mayoclinic.org/diseases-conditions/diabetic-coma/symptoms-causes/syc-20371475
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ENCORE #150! – 10 Exercise TIPS for Cancer Folk (and don’t forget the significant others!)

From the first moment my wife discovered she had breast cancer in March of 2011, there was a deafening silence from the men I knew. 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 2015.

“You should just exercise! It will take away the stress! It will help you heal faster! Exercise will make you better!”

Cool.

Fine. Sign me up for the next Grandma’s Marathon! Running twenty-six miles should be good for at least one chemotherapy session, right?

Exercise…

What exactly does this mean? How do I turn “exercise is good for you” into something I can DO? Oh, and is the “exercise is good for you” mantra only for the loved one with cancer? What about me – who put on something over ten pounds during the chemo sessions and can’t seem to shake the weight now? 

The answers to these questions a literally scattered all over the internet, so I’ll try and analyze and condense them here into TEN workable breast cancer treatment and after-treatment practical exercise tips (ALWAYS TALK TO OR CALL YOUR CANCER CARE CENTER BEFORE YOU START ANY KIND OF EXERCISE TO SEE IF IT’S SAFE FOR YOU):

1) “‘You don't have to be Lance Armstrong,’ stresses Dr. Julia Rowland of the National Cancer Institute, speaking from a survivorship meeting this month that highlighted exercise research. ‘Walk the dog, play a little golf.’” Walk the dog, walk to the end of the block, walk somewhere. Several people recommended finding a neighborhood indoor mall that opens early and walk the perimeter before the stores open. Walk!

2) “Researchers think exercising together may help both partners stick with it. They also are testing whether the shared activity improves both physical functioning and eases the strain that cancer puts on the caregiver and the marriage.” Walk with a loved one (in my case, ME! I should be walking and exercising WITH my wife. WALKING. Doing DANCE FEVER to an enjoyable music routine. Life weights – or cans of soup if you don’t have weights. A little weight lifted a number of times during a day counts as exercise! Hide the weight in your work locker or in a desk drawer – or leave it out and tell people what you’re doing. You will find a remarkable amount of support.

3) “For example, Schmitz led a major study that found careful weight training can protect against lymphedema, reversing years of advice to coddle the at-risk arm…” See #2 – lift anything! (By the way, this is called resistance training – the weight “resists” being lifted.)

4) “…at-home exercises with some muscle-strengthening, plus a better diet, could slow physical decline.” There are dozens of DVD exercise programs. If you can’t buy one, check one out from your local library or ask to borrow one from a local gym, YMCA or school. Do as much as you can, then stop. (See #1 above!) Also, lifting the DVD into the player is exercise! Here’s the address for a DVD specifically for breast cancer survivors: http://www.strengthandcourage.net/

5) Arms at your side, hold a towel in both hands. Using the unaffected arm, pull the other behind the back. Alternate Pain is to be respected and the stretch should be held to the point of discomfort not pain .The stretches should be held from 5-10 seconds at first, gradually increasing the length of time. It’s better to do this several times during the day, rather than all at once. With arms bent (on either side of the head), hold a towel in both hands. Using the unaffected arm, pull the other behind the head.

6) “If lymphedema is a concern, you…should be fitted with a sleeve which is worn while exercising especially when lifting weights. Progress…slowly and start with a light weight – ONE pound is just fine.”

7) Walking and cycling are quite beneficial as are swimming, cross training, or aerobics. It is best to begin with a 5-10 minute walk to judge...if a long period is too much, multiple shorter aerobic sessions are fine. Your goal will be to gradually increase the time period engaged in aerobic exercise and to slowly increase your exercise tolerance.

8) Doing yoga can provide flexibility benefits as well as instruction in stress reduction techniques that can prove beneficial. [I know nothing about yoga, so start with a library visit or a YouTube video: http://www.youtube.com/watch?v=H3vLZqPZxZE]

9) Yep, I’m sayin’ it again: “Walking, a common fitness choice, offers the benefits of aerobic exercise without overly straining the body. According to a 2005 study in the Journal of the American Medical Association, the benefits of walking peak when a breast cancer patient or survivor walks 3 to 5 hours weekly at a pace of 2 to 3 miles per hour.”

10) Find a swimming pool and join a waterobics class; if you can’t join a class, get this CD: http://www.maryessert.com/bcr.htm This site lists the exercises and exactly how to do them!

References: http://www.msnbc.msn.com/id/37978604/ns/health-cancer/t/get-moving-cancer-survivors-urged-exercise/#.TyPj4lxAb_M, http://www.cancer.org/Cancer/BreastCancer/MoreInformation/exercises-after-breast-surgery, http://www.cdc.gov/nccdphp/dnpa/physical/pdf/PA_Intensity_table_2_1.pdf (A really, really LONG list of things you can do to exercise!), http://www.afpafitness.com/articles/articles-and-newletters/research-articles-index/womens-fitness-health-issues/fitness-tips-for-working-with-breast-cancer-survivors/
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GUY’S GOTTA TALK ABOUT…Alzheimer’s #34: Other Kinds of Dementia?

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…

Actually, I had no idea that there were so many causes of dementia. According the Wikipedia, dementia is “a set of symptoms caused some sort of brain damage, usually brought on by disease, though it can also result from injury. Over time, there is an increase in problems with memory, thinking, and behavior. These accumulate until they begin to affect the ability of a person to do what we would consider everyday activities. There are also emotional problems, difficulties with language, and decreased motivation. A person’s consciousness isn’t usually affected.[What does THAT mean??? By definition, consciousness is variously, “awareness of internal or external existence.” However, despite thousands of years of attempting to define what ‘consciousness’ is, Schneider and Velmans conclude that consciousness is ‘at once the most familiar and most mysterious aspect of our lives.’”] Dementias change a person’s usual mental functioning, and the person’s cognitive decline is faster than what we would expect in normal aging. In 2013, dementia was reclassified as a major neurocognitive disorder, with varying degrees of severity, and with all KINDS of causes.”

So then, what are these different kinds of dementia?

Vascular Dementia (second most common after Alzheimer’s): caused by a lack of blood flow to the brain. Vascular dementia can happen as you age and can be related to atherosclerotic disease or stroke. Symptoms can appear slowly or suddenly (this may have happened in my mom. She DID have congestive heart failure and absolutely did have changes in how she viewed the world and did things for herself.)

AIDS-Related Dementia: It’s also possible for those with HIV to develop cognitive impairment and dementia, especially if they’re not taking antiviral medications.

Dementia with Lewy bodies: caused by protein deposits in nerve cells. This interrupts chemical messages in the brain and causes memory loss and disorientation. There are similarities between this and both Parkinson’s and Alzheimer’s. Visual hallucinations, trouble falling asleep at night, or fall asleep unexpectedly during the day, fainting or getting lost or disoriented may also occur.

Parkinson’s Disease: This disease can cause problems with reasoning and judgment leading to trouble understanding visual information or remembering how to do simple daily tasks. They may even have confusing or frightening hallucinations, become more than normally irritable. Depression or paranoia, trouble speaking because of forgotten words, or getting lost during a conversation can also happen.

Frontotemporal dementia: This disease affects the front and side parts of the brain, which control language and behavior and may strike people as young as 45 years old. It does appear to run in families. It can cause loss of inhibitions and motivation, as well as compulsive behavior, create problems with speech, including forgetting the meaning of common words.

Creutzfeldt-Jakob disease (rarest form of dementia): Oddly enough, I came across this disease while researching for a science fiction story I wrote (currently it’s in submission). The symptoms are similar to the other dementias, but only 1 in 1 million people are diagnosed with it every year. That said, CJD progresses so quickly that victims often die within a year of diagnosis as it also affects the body as well, causing twitching and muscle stiffness.

Wernicke-Korsakoff syndrome: This disease is a one-two kick to the groin. Initially, Wernicke’s encephalopathy, is initiated by a lack of vitamin B-1, leading to bleeding in the lower sections of the brain, causing double vision and a loss of muscle coordination. If untreated, these symptoms decrease, and the signs of Korsakoff syndrome kick in. Trouble processing information, learning new skills, and remembering things. Technically, Wernicke-Korsakoff syndrome is not a dementia. However, symptoms are similar enough to dementia to warrant the classification. Also, W-K can result of malnutrition or chronic infections. However, the most common cause for this vitamin deficiency is alcoholism. In a stranger reaction, people with this dementia will make up information to fill in the gaps in their memories without realizing what they’re doing.

Mixed dementia: Very common, usually a combination of vascular dementia and Alzheimer’s. In nearly half of people diagnosed with Alzheimer’s actually have this form.

Normal pressure hydrocephalus: Typically caused by injury, bleeding, infection, or brain surgery, there’s a build-up of excess fluid in the brain’s ventricles. The ventricles are fluid-filled spaces that rely on just the right amount of fluid to work properly. When the fluid builds up excessively, it places extra pressure on the brain.

Huntington’s disease: a genetic condition that causes dementia (juvenile and adult onset) causing premature breakdown of the brain’s nerve cells, which can lead to dementia and impaired movement causing jerking, difficulty walking, and trouble swallowing, difficulty focusing on tasks, controlling impulses, trouble speaking clearly, and difficulty learning new things.

Dementia caused by Multiple Sclerosis: Sometimes happens.

Alcohol and drug abuse: Finally, these can cause brain damage not apparent immediately, rather showing up as a person ages.

So, now we know. Dementia has multiple causes that all lead to similar symptoms. Forewarned is forearmed.

Resource: https://www.healthline.com/health/types-dementia#huntingtons-disease, https://en.wikipedia.org/wiki/Consciousness
Image: https://upload.inkspire.org/uploads%2F1503370874800-Alzheimer-disease-patients.jpg

Wishing You a Happy and Blessed New Year!

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