GUY’S GOTTA TALK ABOUT…DIABETES #4: PART 2 - What Does It Mean To “Eat Right”???

For the first times since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!

Balancing proteins and carbohydrates (which, if you didn’t know, get turned INTO sugars in your body; proteins do NOT get turned into sugars because they’re not made that way); seemed to make sense, and seemed to be something I could do…but here’s the kicker: ANY diet I submit to will be for the remainder of my life. I WILL NOT say I get this whole thing of living with my diabetes yet. I need to substitute FRUITS and vegetables for sauces and rice. Make better menu choices that EMPHASIZE meat and vegetables rather than rice and nacho cheese. I’m working on it…I’m not preaching at you, I’m trying to figure out how to live longer with my diabetes!

So, what do I do when I get a craving for Dairy Queen or a Whopper or a candy bar?

OK…I go get a DQ – HOWEVER, I’d usually rather have a Culver’s Flavor Of The Month. But what I’m finally beginning to learn is the secret of substitution…

I’m going to compare two of my big weaknesses: Frozen DQ/Wendy’s/Culver’s/Whatever.

First: the one that’s closest to our house and changes often: Culver’s.

Let’s look at an “impartial” source:

In the interest of being entirely transparent: I often get the 2 Scoop Carmel Cashew Sundae. Lots of numbers, but for me as a diabetic (there, I WROTE IT! Another step forward…) 52 g of fat; 121 g of carbohydrates (I fool myself by saying, “carbs”); 85 g of sugar (mostly likely standard issue sucrose (table sugar); and finally 16 g of protein. “See! THERE’S PROTEIN THERE!”

There is. But the stuff that insulin has to work on outweighs the protein 258 to 16 (or more scientifically 16:1). What do I suppose is going to happen? My pancreas will flood my bloodstream with insulin so I can take that VASTLY overwhelming amount of sugar, burn (=metabolize) a TEENSY bit of it as I sit on my chair at home, watching PIRATES OF THE CARIBBEAN: Dead Man’s Chest to keep me sitting upright, chewing, breathing, and otherwise existing, then store the excess (about 16 times the amount it uses from the protein) in FAT CELLS… Of course, to store all that non-protein, the pancreas has to pump out MORE insulin…and, well you see the problem.

How about I get one of my OTHER favorites, a DQ Peanut Buster Parfait? I KNOW that must be OK, cause it has peanuts! Let’s take a look at what DQ posts out there:

Again, let’s look at the pertinent data: Fat = 31 g Carbohydrate = 95 g Sugar = 68 g Protein = 17 g. Summed up as I did for that gloriously tasty Carmel Cashew two scoop sundae: 194 g (the stuff insulin has to work on), protein 17 g or 194 to 17, or (again) more scientifically, 11:1.

Culver’s 2 scoop, caramel cashew sundae: 16:1
Dairy Queen Peanut Buster Parfait: 11:1

OK – let’s say I’m a really good boy and order ONLY a Culver’s Grilled Chicken and cashew salad with Ranch dressing? Raw data: 

Fat = 19 + 24 = 62 grams + 15 g carbohydrates + 4 g sugar = 81 grams of stuff insulin HAS to take care of. Protein = 47 grams.

Scientifically speaking: 81 g to 47 grams = 1.7:1 (rounding UP) gives me a 2:1 ratio.

Culver’s 2 scoop, caramel cashew sundae: 16:1
Dairy Queen Peanut Buster Parfait: 11:1
Cashew Chicken Salad: 2:1

I’m NOT going to ever love the Culver’s Chicken Salad as much as Culver’s 2 scoop caramel cashew sundae BUT, I need to keep stuff like this in mind FOR THE REST OF MY LIFE…

Seeing this MIGHT slow me down. If I want to live longer, it’s going to HAVE TO slow me down to make choices…

Resources: https://www.culvers.com/menu-and-nutrition/nutrition-grid
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

GUY’S GOTTA TALK ABOUT…DIABETES #4: PART 1 - What Does It Mean To “Eat Right”?

For the first time since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1 diabetes.

Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome (???) to join me!

Until a couple months ago, to “eat right” just meant that I couldn’t pig out on candy bars and sugared cereal…

When I was diagnosed as diabetic, that didn’t only suddenly change – I mean, REALLY change; it changed the way I see the world.

When I have ice cream or birthday cake with the grandkids, or cookies, or sugary drinks, or use sugar in my coffee, I’m not only damaging my body in a sort of “academic” way. I’m damaging it in a real way.

Right now, neither of us are insulin dependent. We’re both what used to be called “insulin resistant”, but now goes by the name of “…impaired insulin sensitivity, [It means that I] have built up a tolerance to insulin, making the hormone less effective. As a result, more insulin is needed to persuade fat and muscle cells to take up glucose and the liver to continues to store it [rather than use it].

“Just why a person fails to respond properly to insulin is still a mystery. But there are ways to make the body more receptive to insulin, which can help prevent or delay type 2 diabetes—or help someone with type 1 diabetes manage their blood glucose (blood sugar).

“In response to the body's insulin resistance, the pancreas deploys greater amounts of the hormone to keep cells energized and blood glucose levels under control. This is why people with type 2 diabetes tend to have elevated levels of circulating insulin. The ability of the pancreas to increase insulin production means that insulin resistance alone won't have any symptoms at first. Over time, though, insulin resistance tends to get worse, and the pancreatic beta cells that make insulin can wear out. Eventually, the pancreas no longer produces enough insulin to overcome the cells' resistance. The result is higher blood glucose levels, and ultimately prediabetes or type 2 diabetes.”

So what do I do? Sure, I’ll change my diet – but HOW? Sure I should exercise, but I DO – I bicycle from fifteen to twenty miles a week on park trails. I’m not only adjusting tension or changes gears on a stationary ‘cycle.

OK – that’s probably good, and most likely saved my life up to this point as I’ve been riding for the past fifty years…what about DIET though.

My mind rebels at the word! I need to retrain myself to think in terms of diet being WHAT I EAT, rather than WHAT I CAN’T EAT…

I need to get out of this whole “deprivation mode” and get into a “survival mode”. I mean, when I was a certified nursing assistant, I had to care for a husband and wife who lived in the nursing home. He was elderly, but his mind and sense of humor were intact. His wife however, had lost both her legs below the knee to diabetes! “Well, we’re not primitive anymore! We have drugs that will keep us safe!”

Hmmm… “Yyyyyessss, that’s true.” But, going out and getting a double scoop of Culver’s frozen custard Flavor of the Month, or a Dairy Queen medium M&M Blizzard is no longer a WISE choice! (Was it EVER??? Probably not!)

So, what does my diet mean now?

I’m a sort of basic kind of guy (as well as being named Guy!) Reading, reading, reading seems to have brought me to a point that, while I lost weight doing the ATKINS diet, which primarily reduced carbohydrates while doing away with sugar and replacing it with Sucralose® is STILL not the best diet for me. One bit of reading I found came from an elderly book called THE INSULIN RESISTANT DIET. (https://m.media-amazon.com/images/I/519peAFXcML._SY291_BO1,204,203,200_QL40_FMwebp_.jpg)

 Its essential premise is that I should be BALANCING carbohydrates/sugars with protein.

THAT I can handle, and as a retired science teacher (science teachers, in addition to taking English, PE, Music, Social Studies, and other general classes, also have to take a HEAVY dose of science: biology (of course), chemistry and physics next, then math up through two semesters of Algebra-based Calculus, history of science classes, then sciences specific to your degree. I was going to be a Middle School Science Teacher. I needed two geology classes (physical and historical), meteorology, soil science, astronomy, and then electives. For me genetics, immunology, animal physiology…you probably get the boring picture!

Balancing proteins and carbohydrates (which, if you didn’t know, get turned INTO sugars in your body; proteins do NOT get turned into sugars because they’re not made that way); seemed to make sense, and seemed to be something I could do…but here’s the kicker: FOR THE REST OF MY LIFE!!!

ANY diet I submit to will be for the remainder of my life. I WILL NOT say I get this whole thing of living with my diabetes yet. I’ve had Culver’s and Dairy Queen treats. I don’t live in a monastery on a mountain top! But I need to control them. I need to substitute FRUITS and vegetables for sauces and rice. Make better menu choices that EMPHASIZE meat and vegetables rather than rice and nacho cheese…(we’re going out tonight, Mexican!)

Like I said, I’m not good at this yet. But I’m working on it. It’s just I have to remind myself that I CAN’T dawdle anymore. This I important. I’ve damaged my body with 65 or so bad habits…

In case you were wondering? This isn’t the last you’ve heard me on the subject of “diet” – and I’m not preaching at you. I’m trying to figure out how to live longer with my diabetes!

For MORE details: https://www.cdc.gov/diabetes/managing/eat-well.html
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

DIABETES RESEARCH RIGHT NOW! #1: DIABETES RESEARCH RIGHT NOW!

From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE  “club” that has been rapidly expanding since t stopped being a death sentence in the early 20^th Century. Currently, there are about HALF A BILLION PEOPLE who have Type 2 Diabetes. For the past 3500 years – dating back to Ancient Egypt – people have suffered from diabetes. Well, I’m one of them now… Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Diabetes 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:

Oddly, a study out of the Technical University of Munich, this month on the ScienceDaily website connects both Diabetes and Alzheimer’s…

In Alzheimer's disease, the degeneration of brain cells is linked to formation of toxic protein aggregates and deposits known as amyloid plaques. Similar processes play an important role also in type 2 diabetes. A research team has now developed 'mini-proteins', so-called peptides, which are able to bind the proteins that form amyloids and prevent their aggregation into cytotoxic amyloids.”

What’s that mean in plain English?

 I’ve written about plaques and tangles in the past in Alzheimer’s posts (for example, here: https://breastcancerreaper.blogspot.com/2021/11/alzheimers-research-right-now-16-cause.html). Research is ongoing to discover how this incredibly complex organ we call “the brain” is affected by Alzheimer’s. Plaques are weird clusters of broken protein pieces. They get stuck between nerve cells which slows down how quickly – or even WHETHER – nerve cells can communicate with each other. If they can’t communicate, the person loses memories, the ability to know what to do in certain situations, sometimes even the ability to walk, drink, or even feed themselves. Disconnected from each other, the nerve cells eventually start to die. Dead and dying nerve cells contain tangles, which are made up of twisted strands of another protein. Quite simply, the brain slowly becomes a train wreck of broken pieces of proteins that cut off and clog communication between the cells.

 Now it appears that the formations of these same proteins mess with our bodies and interfere with the use and transport of insulin – the molecule that takes the simple sugar that comes from your body breaking down stuff like hamburgers, potato chips, and mini-donuts into the tiny, tiny sugar called glucose – the simplest sugar that you can have and still call it “sugar”. It also happens to be the ONLY sugar your body can use to run itself.

 So – HOW do these plaques and tangles that gum up the brain’s ability to think and remember wreck our body’s ability to use insulin properly? Insulin is supposed to allow the cells of the body to take glucose from the blood.

SO?

 “Insulin controls the breakdown of carbs, fat, and protein by boosting glucose from the blood into liver, fat. and muscle cells. The glucose is changed into either glycogen or fat. The liver actually does both. Both glycogen and fat store energy this way. The liver won’t make glucose or release it into the blood when there’re too much insulin in the blood. The same insulin also messes with making protein ALL OVER THE BODY. Low levels of insulin have the opposite effect – it makes the body STOP making glucose. And glucose is what makes your body work – muscles, blood cells, antibody cells, brain cells, nerve cells…so insulin HAS to be balanced or else it screws up the functions of the body.”

 Now you have the background to read WHAT this means for Type 2 Diabetics AND Alzheimer’s patients. Before I go any farther, let me point out that these plaques and tangles, once they begin to clump and form “blobs”, kill individual cells – it’s called being cyto (cell) toxic (deadly), or cytotoxic.

 “The team invented artificial peptides (which are like, “building blocks” of everything your body is made of.) These artificial peptides STOP the clumping of plaques and tangles. Dr. Kapurniotu notes, ‘The designed peptides look very similar to harmful clumps and tangles, but don’t have the cytotoxic effects! In fact, white blood cells go after them even MORE that the ones what make up the plaques and tangles!’”

 There’s no “magic bullet” right now to cure diabetes (or Alzheimer’s), but it seems that based on this research, that there MIGHT be something that can manage both diseases…and that will help an incredible number of people…

A Concise History of Diabetes: https://www.everydayhealth.com/diabetes/understanding/diabetes-mellitus-through-time.aspx

Resources: https://www.sciencedaily.com/releases/2022/11/221109085759.htm

Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

GUY’S GOTTA TALK ABOUT…DIABETES #3: What Is Blood Sugar and What Does It RESPOND To??? PART 1

For the first times since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!

I was going to do something different, but I think I’m going to go after something incredibly perplexing to me…

So, after my visit with a Diabetes Educator, I got my monitor and have embarked on the diabetic adventure of poking myself with a sharp needle, bleeding and then “taking my blood sugar” at least once a day. Below, you’ll see a picture of the results:



Since I started doing the finger prick thing, I’ve gotten readings that range from 110 to 218. I know what the number MEANS (it’s bad because it’s lit up red on the monitor. It’s good if it’s green…) but apparently it depends also on the time of day, what you’ve eaten, and how much you’ve moved. So, I’m going to dig into it here, starting with the foundation and I’m personalizing it so my HEAD gets it:

“Insulin is a key player in developing type 2 diabetes…it regulates glucose in my body…Here are the high points:

The food I eat is broken down into glucose that enters my bloodstream. That happens in everyone all the time. That tells the pancreas to release insulin, which enters cells commanding them to use the glucose. Insulin signals the liver to store glucose. As the level of glucose in my blood goes down, the amount of insulin goes down, too. When the insulin levels go too far down, it alerts the liver to release stored glucose, so even if I haven’t eaten for a while, I don’t pass out from my cells starving. That’s when everything works smoothly.

My body is…I’d like to use a stronger expletive, but I’m trying to keep my blog G-Rated, so I’ll say…messed up. So, I go to the Minnesota State Fair and do what I’ve always done: “It’s fine! I only do this once a year! I’m walking a lot today! I’ll be fine!” Lots of glucose enters my bloodstream. My pancreas pumps out more insulin to get glucose into cells. After a while, my cells stop sucking in glucose. My pancreas releases MORE insulin, trying to force my cells to pick up more glucose. My pancreas can’t keep up, and the levels of glucose in my blood keep rising. The insulin is ALSO telling my liver and muscles to store glucose. When they’re stuffed full, my liver sends the glucose to FAT cells to be stored as (to be frank) FLAB. I’ve become insulin resistant, the new term is that I have impaired insulin sensitivity.

So, there’s glucose in my blood that should be going into my muscle cells, which gets shunted to FAT cells.

I got it.

Next, how much glucose is supposed to be in my blood? Well a fairly intensive search on the internet only cleared THAT question up enough to say, “It all depends”… There are a number of charts that show me what the “right amount of glucose in my blood should be”. I’m going to reference this one until/unless my doctor directs me to another one:

https://assets-global.website-files.com/622154d5a1d5c02e596f4511/62f2bee4de0117f1ec10c745_BloodGlucoseChart.jpeg

This might be old (2019), but it’s a really good summary of what I SHOULD be doing. I’ll dive into it in my next post: https://diabetes.org/sites/default/files/2019-10/ADV_2019_Consumer_Nutrition_One%20Pager.pdf

So, farewell for the next two weeks. I’ll be posting again on November 27 – appropriately three days after Thanksgiving!

Resource: https://diabetes.org/, (for a MUCH deeper look at several studies that used constant glucose monitoring to track data, go here: https://www.levelshealth.com/blog/what-should-my-glucose-levels-be-ultimate-guide#:~:text=Summary%20Of%20Normal%20Glucose%20Ranges&text=Glucose%20levels%20between%2070%2D120,of%2081%2D102%20mg%2Fdl), “Nutrition Therapy” sounds fancy, but in the end, it means “eating right” https://diabetesjournals.org/care/article/42/5/731/40480/Nutrition-Therapy-for-Adults-With-Diabetes-or

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

GUY’S GOTTA TALK ABOUT…DIABETES #2: Actually UNDERSTANDING Diabetes and What It Means for Me…

For the first time since I started this column eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1 diabetes. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome (???) to join me!

The hardest thing for me is the new routines…

Take your blood sugars. Take your pills (only one of which is currently for diabetes – the METFORMIN). Watch your diet…my past efforts to watch my diet were (more or less) to watch the fork lift the food to my mouth or aim whatever hand food I was eating into my mouth (something of a challenge when we’re at the Minnesota State Fair as most of the hand food is eaten while walking through huge crowds of people doing what you’re doing…eating!)

Even things like counting calories, which ISN’T as important in diabetes as is counting carbs, but it’s a hard shift.

The main reason? I’m not used to CARING about what I eat, how I exercise, and if my body is working correctly…OK – that’s not entirely true, I care. BUT, I haven’t cared enough. So, I do care – but I DON’T UNDERSTAND THINGS RIGHT NOW!

For example, I’ve got my finger-pricker, the blood sugar reader gizmo, and the sterile lances. I know, more or less what it’s reading: 185 mg/dL literally means 189 milligrams of sugar per deciliter of blood. As a science teacher, I can actually envision a deciliter – but it’s not easy. We used ml (or milliliters) when I was in the lab for most of my 45 years of going to college and teaching science classes. This might help you visualize it:

https://o.quizlet.com/Jj2S4QGmAClR-hUZGa1ZGg_b.png

So, now I have a better idea of what I’m measuring. My blood sugar has been between 110-209 (at various times of day – I STILL don’t understand that. That low was after I fasted from about 9pm to 5pm (I was going to Red Robin with a buddy of mine and KNEW I was going to be eating French fries!) But at 10pm after I was done eating, my blood sugars were 115, 101, and 110. How is that? The following morning, it was 175 at 8:15 am. One morning, it was 152 at 12:40 am and the device said that was GOOD…CLEARLY a subject for my next post!)

You can tell I have a lot of reading to do. I can’t work at controlling my blood sugars unless I understand my blood sugars! And I don’t mean saying, “Doctor, doctor, whatever shall I do???”

I am me, and I need to UNDERSTAND what’s going on in my body. I have a bunch of books – TYPE 2 Diabetes BASICS; THE FIRST YEAR: TYPE 2 DIABETES; REVERSING DIABETES, and a whole bunch of other ones my wife bought when she was first diagnosed. Right now, I’m basically in the dark, the tips of my fingers hurt (why do I have to prick the TIPS of my fingers? Why not my ankle? Why not my elbow? Why not my butt cheek? I DON’T KNOW!

And THAT’S what I’m doing here. I’m exploring this whole thing and writing about it – only this time, instead of my WIFE’S breast cancer or DAD’S Alzheimer’s, I’m looking at MY OWN diabetes.

Humbling. That’s what it is. Humbling…

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg; https://thumbs.dreamstime.com/z/glucose-levels-blood-diagram-hyperglycemia-hypoglycemia-diabetes-142482790.jpg

GUY’S GOTTA TALK ABOUT…DIABETES #1 The Diagnosis

For the first time since I started this column eleven years ago, it’s going to be about me. 

I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1 diabetes. Since then, I haven’t WANTED to talk about diabetes at all.

But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome (???) to join me!

When I sat down with the Diabetes Education counselor, it was no surprise that I was there.

I’ve been pre-diabetic for a few years. I knew I could change my diagnosis if I just followed a few simple steps. I needed to lose weight, exercise more, and eat right. My response to that knowledge was, “Yeah, yeah, yeah, I’ll get to it! Besides I eat pretty good. I ride my bike! I sometimes lose weight!”

Well, the jig is up. I’ve been caught with my proverbial pants down (sorta like the scene in SPIDER-MAN: A Long Way From Home. Nothing evil going down, but he got caught getting ready to put on the black suit that ultimately inspired Ned to call him Night Monkey.) I’m now officially diabetic.

What’s that mean? (TOTALLY UN)Funny you should ask!

I now have a blood sugar monitor kit of my very own. I used it for the first time this morning. My blood sugar level was 173, which my phone tells me is “high”.

And that means, what? Yeah, here’s where the educating myself well enough to understand comes in, plus a little bit of Translating the Doctors.

First a BRIEF history of diabetes (HIGHLY condensed from the Wikipedia article: Diabetes was one of the first diseases described by Human medicine. The term “diabetes” or “to pass through” was first used in 230 BCE by the Greek Apollonius of Memphis

Two types of diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 CE with one type being associated with youth and another type with being overweight. It took a long time to create an effective treatment. The early part of the 20th century for Canadians Banting and Best who finally isolated and purified insulin. We’ve known for a fact what causes diabetes FOR A HUNDRED YEARS…

What is blood sugar? It’s pretty simple: “Blood sugar, or glucose, is the main sugar found in your blood. It comes from the food you eat, and is your body's main source of energy. Your blood carries glucose to all of your body's cells to use for energy.”

And what does that have to do with diabetes? “Diabetes is a disease in which your blood sugar levels are too high. Over time, having too much glucose in your blood can cause serious problems…Himsworth published research that differentiated between type 1 and type 2 diabetes. He theorized that many people had insulin resistance rather than insulin deficiency. Insulin resistance is one factor that leads to type 2 diabetes. When a person has insulin resistance, their body cells lose their sensitivity to insulin and are not able to take in glucose. In response, the pancreas increases its output of insulin.”

What’s a NORMAL blood sugar? “Fasting normal blood sugar for a person without diabetes: 70–99 mg/dl (This is what my monitor shows. The funny letters after mean “milligrams per deciliter” or how much glucose (in milligrams – like what most of you antibiotics and Tylenol/Advil/Aleve is measured in) there is in a deciliter (which is one tenth of a liter or about the bottom of a two liter bottle of pop).” Official ADA recommendation for someone with diabetes: 80–130 mg/dl (4.4–7.2 mmol/L) when you get up in the morning (fasting level) and less than 180 mg/dl after you’ve had a meal.”

What KIND of serious problems can insulin resistance (Type 2 diabetes) cause? “stresses the pancreas (where insulin is made) damaging it. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Diabetes and kidney disease due to diabetes caused an estimated 2 million deaths.

And WHAT THE @#$&!* can I do about it? A healthy diet, regular physical activity, maintaining a normal body weight and avoiding tobacco use are ways to prevent or delay the onset of type 2 diabetes. How much am I SUPPOSED to weigh? (If you want to know about yourself, click here, supply the numbers and it will tell you! ( https://www.medicalnewstoday.com/articles/323446#body-mass-index-bmi ) I weigh 255 pounds. I should be between 136-172 pounds. So…to be safe, I need to lose 150 pounds…

“Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications.”

No other sentence I have ever typed sounded so incredibly SIMPLE and terrifyingly DIFFICULT...I have my work cut out for me and it’s (finally) time to get serious.

Sources: https://en.wikipedia.org/wiki/Diabetes, https://www.medicalnewstoday.com/articles/317484#non-insulin-treatment, https://www.who.int/news-room/fact-sheets/detail/diabetes,
For MORE details: https://en.wikipedia.org/wiki/History_of_diabetes
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Guy's Gotta Talk...For the Last Time

I started this blog eleven years ago, a few weeks after my wife was diagnosed with breast cancer.

I started it because I couldn't find any other man willing to talk about their experience. So, being me, I started a blog, talking into the wide universe and hoping someone would talk back.

No one ever did, really. I didn't have any kind of celebrity status, no book to sell, and no hospital endorsement...

I got an occasional reply or observation or comment. And that was good enough for me, because something even more important happened: I learned about breast cancer and Alzheimer's -- and I hope others did as well. But after more than a decade, nearly six hundred posts, and over 100,000 views, I'm hanging it up. I'll leave the blog here for a while; eventually close it -- or let it die a natural death.

Why? Well, the first month I wrote, I got (if the Status chart is accurate!) about 60 views. Last month, I got...a hair over a hundred and fifty last month.

At the height of the blog, which was November 2018, I was sharing my thoughts about both breast cancer and Alzheimer's and something like 2700 people stopped by the site each month, long enough to be counted -- or long enough to read what they were interested in.

Dad's diagnosis of Alzheimer's several years before he started to show obvious signs of AD launched me into a new line of research, and I found those people willing to talk about AD about as chatty as the ones who had thoughts about breast cancer.

But as the months and years have passed, so has FaceBook and EBlogger. Shorter, more interactive sites -- TikTok, Instagram, YouTube (my grandson expects NOT to have to go to college as he will be a popular YouTuber... 8-/ ) have taken over and can give fast, less-thoughtful answers than my blog. The service I provided -- like Translating The Doctors; AD and BC Research RIGHT NOW!; Encouragement; and recently, ancillary issues related to both AD and BC -- don't appear to be needed anymore as time has become more and more of the essence, and people don't really WANT to talk about BC or Alzheimer's.

So -- explore the site, and for a while the features that are RIGHT NOW! should remain fairly pertinent. But, as time passes, they'll grow out of date, and eventually, EBlogger itself will wither, die, and vanish.

I've thought of printing everything off, but that wouldn't be helpful to anyone -- except maybe Posterity. My grandkids might be interested in reading the posts, but that seems unlikely -- I rarely look at pictures of my parents any more and can't imagine the science will hold up well in another eleven years...2033?

WHOA! In the meantime, I hope my brief time here was helpful to you --whether as a comfort, a resource, or just simply to read and know that treatments and the horror of Breast Cancer and Alzheimer's have come a long way...

Thanks for reading -- some of you through the YEARS...farewell.

Image: https://thumbs.dreamstime.com/b/farewell-written-sand-fading-flood-78677870.jpg

ENCORE #186! – Lumps. Bumps. Divots. Scars.

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 March of 2015…

I have a divot in my forehead.

My wife has a divot in her side. Both sides, actually.

Breast cancer – skin cancer in my own experience – is all about divots.

Define divot (plural divots)
1.A torn up piece of turf (e.g. by a golf club in making a stroke or by a horse's hoof).
2.A disruption in an otherwise smooth contour.

It’s the second definition that concerns me here.

After discovery and confirmation four years ago this week, the breast cancer specialists we were working with looked at several options. One of them, used in cases where the cancer was discovered early and was small, is called a “lumpectomy”. In this procedure (I was just struck this MOMENT by the sterility of this word. It sounds so clean and simple. Like when I did “cookbook labs” as a science teacher. It involved steps students would follow to achieve a very specific result. For lots of kids, it involved reading and rereading the procedure, their finger under the step they were following so they could get it “right”. Lumpectomies are nowhere NEAR this simple and involve invasive methods that deform the breast...) “Lumpectomy is the removal of the breast tumor (the "lump") and some of the normal tissue that surrounds it.

Lumpectomy is a form of “breast-conserving” or "breast preservation" surgery. There are several names used for breast-conserving surgery: biopsy, lumpectomy, partial mastectomy, re-excision, quadrantectomy, or wedge resection. Technically, a lumpectomy is a partial mastectomy, because part of the breast tissue is removed. But the amount of tissue removed can vary greatly. Quadrantectomy, for example, means that roughly a quarter of your breast will be removed. Make sure you have a clear understanding from your surgeon about how much of your breast may be gone after surgery and what kind of scar you will have.”

While this makes an attempt at realism, nothing can quite convey the results but a person who experienced it.

My wife had a double mastectomy which is the most extreme form of breast cancer surgery possible.

I can NEVER know what that’s like. I can only imagine it.

Since my own skin cancer surgery, I’ve had a tiny, non-life-threatening taste of what it might possibly feel like to have a lumpectomy. One of the cancers on my face was on my forehead. Using the Mohs procedure (described here: http://breastcancerreaper.blogspot.com/2014/11/guys-gotta-talk-about-9face-and-breast.html) layers of tissue that have cancer cells are removed, tested, then the incision is either closed or another layer of cells are removed and tested. The end result, after healing and recovery, has been a “divot” in my forehead. Touching it right now, I can ASSURE you that it is gigantic and I’m positive everyone sees it but out of politeness, ignores it.

Right. I work in a high school. Politeness is something we work on in our kids every day because about half of them have never experienced it at home. If anyone noticed a divot in my forehead, they’d tell me. Ergo: it’s not noticeable.

My wife had me look at a small lump on her left side, asking, “Is this one of the places that the drains went in?” A matched spot above it confirmed that it is, indeed, the place where one of the drains exited the surgical field four years ago. She also has a scar where the port was placed in order to do chemotherapy.

Lumps. Bumps. Divots. Scars.

These are clearly the legacy of breast cancer – of any kind of cancer. I’m sure plastic surgery could clear up many of them, yet I feel no compulsion at all to GET the surgery. I wonder why...

Sorry for the rambling commentary. But that’s where I’m at today...

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

RELATED MEDICAL ISSUES RIGHT NOW! #8: Racial Disparities in Alzheimer’s and Breast Cancer Treatments

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…

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…

The immediate crises that were Breast Cancer and Alzheimer’s have passed. There are, however ancillary issues like testing and treatments that may not be directly related to BC or A but intersect with them. Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: Racial Disparities in Alzheimer’s and Breast Cancer Treatments (See also: https://breastcancerreaper.blogspot.com/2022/01/related-medical-issues-right-now-4.html)

There are countless resources, news reports, and investigative pieces that clearly and concisely delineate the problem – if you are any race but white and have anything but comprehensive health insurance, your treatment for a breast cancer diagnosis or one of Alzheimer’s Disease will be far, far, far away LESS effective and virtually unaffordable.

I placed sources sources below, all of them CURRENT (2022). So, let’s just not argue. The facts speak for themselves. If you disagree, don’t bother trying to justify or argue, just leave peaceably. If you leave a stupid comment, I won’t bother reading it, delete it, and you won’t bug me AT ALL.

I have nothing to say to fools.

So, what’s being done to address this monstrous inequity?

Some things ARE being done!

Breast Cancer: “Sisters Network Inc. is committed to increasing local and national attention to the devastating impact that breast cancer has in the African American community.” They host events, an important one? STOP THE SILENCE Walk, https://www.stopthesilencewalk.org/. Held annually in Houston, Texas; this event is a major fund raiser for Sisters Network Inc. As well, “In 1999, Sisters’ broke new ground by hosting the nation’s first national Breast Cancer Conference to specifically address the impact of breast cancer among African American women. Now in its 12th year, the conference, which attracts more than 600 participants, including nationally recognized medical experts, has been held in metropolitan cities such as Houston, Atlanta, Detroit, Richmond Virginia and Chicago.” They also have a specific outreach program: “Sisters’ national branding campaign, "STOP THE SILENCE®," speaks directly to the nations, African American communities, long-standing history of not discussing cancer and other life-threatening health concerns.”

Evidence shows that the precipitous drop of breast cancer screenings hit ALL women, but was especially devastating among lower socioeconomic groups: “The COVID-19 pandemic has disrupted…cancer screening…in the United States and Europe have shown that cancer screening dropped dramatically during the pandemic…a modeling study estimated that delayed and missed screenings would likely increase breast cancer deaths…by 7.9% to 9.6%...This adverse impact…may differ among sociodemographic groups, given the disproportionate impact the pandemic has had on underserved racial and ethnic groups and other vulnerable population groups.”

Alzheimer detection and treatment among lower socioeconomic groups was low to begin with, “Alzheimer’s…the most frequent cause of dementia, is a progressive degenerative brain disorder affecting approximately 5.5 million people in the US, 24 million people worldwide…The average post-diagnosis AD survival rate is typically 5 to 8 years. However, this tends to vary among patients due to other factors such as age, gender, ethnicity, socioeconomic status, and additional health complications…”

The study concludes, “…socio-economic disparities exist worldwide between countries, influencing the validity of results in cross-cultural research. These disparities are reflected in the variability of educational levels and the quality of education. A universal socio-economic and educational assessment approach would improve reliability in comparing AD risk and progression in diverse groups, between and within countries.” A UNIVERSAL APPROACH??? How would that even be possible? It boggles the mind – and most of all, who would possibly pay for it? Insurance companies? Most likely not because there would be no profit in it – though that might NOT be true…

Lastly, the study below also points out that there are multiple issues even defining who and what they are looking for. How can you equitably screen a white, wealthy, Harvard graduate and a black, poor Haitian for Alzheimer’s symptoms – separated by 2400 kilometers? It boggles my mind to even consider DEVELOPING a tool, let alone using it…

There is so much here, I may write a science fiction story about it. It seems like that might be the only place this could be solved.

Resources:
https://www.sistersnetworkinc.org/index.html, https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780067, https://link.springer.com/article/10.1007/s13311-022-01193-z
Image: https://cdn.mos.cms.futurecdn.net/zsbWK9QgLFjUJwawbWaYnW-970-80.jpg.webp

ENCORE #185! – NO Benadryl Redux!

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 June of 2017…

When my wife began her chemotherapy in 2014, we knew she was going in for the most aggressive treatment. The first day, we checked in, and after the nurses “hooked her up”, they added a Benadryl drip.

We all know that Benadryl is supposed to dampen an allergic reaction, but what was it supposed to do during chemo? Here’s what I found: “Diphenhydramine works by blocking the action of histamine, a substance in the body that causes allergy-type symptoms. It has also been found to be slightly effective against the nausea and vomiting that can be caused by chemotherapy and/or help prevent side effects from other anti-nausea medications.”

So, in order to reduce nausea, they gave her Benadryl. Cool.

The effect in HER, however overshadowed any possible lessening of the nausea. Her legs began to wildly spasm – a sort of “SUPER-restless-leg-syndrome” (Which see here: http://breastcancerreaper.blogspot.com/2017/03/encore-58-dealing-with-restless-limb.html).

So what does this (thankfully!) long-past reaction have to do with today?

Rashes. She’s discovered that she gets hives on her head and chest. It’s a reaction that actually has a name: Sun Allergy (http://www.health.harvard.edu/allergies/sun-allergy-photosensitivity)

Chemo drugs – in fact ANY drug – can cause some form of photosensitivity. “Photosensitivity is an enhanced skin response to ultraviolet radiation (sunlight). There are three types of photosensitivity reactions phototoxic, photoallergic and UV recall reaction. Phototoxic reactions are common photosensitivity reactions and can be produced in most individuals given a high enough dose of drug and sufficient light exposure. These photosensitivity reactions are usually evident within 5-20 hours of exposure and resembles an exaggerated sunburn (redness, swelling, blistering, weeping and peeling). The rash is confined to areas exposed to light. Drugs associated with these photosensitivity reactions are dacarbazine, fluorouracil, methotrexate and vinblastine. Photoallergic reactions are less common than phototoxic reactions. A photoallergic reaction is similar to a phototoxic reaction but the reaction may spread beyond area's exposed to light. A drug that may have this photosensitivity reaction is flutamide.”

Do we KNOW this is what happened? No. Does it seem possible? Yes. Maybe we can move forward from here, eh – that is, “Just one MORE thing to think about post-cancer!”

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

ALZHEIMER’S RESEARCH RIGHT NOW! #18: FDA Approves First In Vitro Test for Early Alzheimer’s Disease!!!

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: In VITRO test for Alzheimer’s markers in Cerebrospinal Fluid!

Up until recently, the only way researchers could detect biomarkers that indicated the accumulation of proteins that are likely the primary cause of Alzheimer’s Disease was to via a spinal tap – or examine the brain tissue after a patient had died. (Such a clinical way to state it…my father passed away three-and-a-half years ago from Alzheimer’s complications from a head injury he got falling off his bed…)

They could also shoot radiation at their heads as well, using Positron Emission Tomography (a PET scan). That’s not the number one choice of doctors and patients everywhere.

So now, the procedure known by the extremely clumsy name Fujirebio Diagnostics’ Lumipulse G β-Amyloid Ratio (1-42/1-40) Test. I’d call it the FDL Test…

But it doesn’t matter what it’s called as long as it does what it’s supposed to do. In this case: “Alzheimer’s is marked by the presence of plaques, or tangles, of beta-amyloid protein in the brain. We can test for them, but until now, the only way to do it was using a PET scan. The new test will do that as well, but requires a spinal tap (which involves inserting a long, thin needle into the lower back, and sucking up a sample of the fluid that’s in the sack around the spine.)

If there’s a strong suspicion of Alzheimer’s in a patient, the doctor can order the test. “The test measures two forms of the protein, referred to as beta-amyloid 42 and beta-amyloid 40. By comparing the amount of each kind, they get a ratio of the two forms of the beta-amyloid. Doing some calculations then can give an idea of whether a person is likely to have amyloid plaques. According to the FDA, using the new test gives results similar to what would be seen in a PET scan.”

Your average PET/CT scanner cost runs between 1.7 million and 2.5 million dollar. Needless to say, your average hospital in Mexico City isn’t going to have one; and if it does, it’s doubtful that the grandmother of a middle-income family would be able to afford it. The new test is much more affordable and will also be more portable.

So, you find out that the patient is likely to have Alzheimer’s. Then what?

“The importance of early diagnosis is essential to effective treatment. But there’s never been an approved biomarker test anyone could use. With it, more efficient clinical trials for new therapies might be developed, and patients, families, and their doctors might take action much earlier in the disease process.”

It’s not widely available yet, but that’s just a matter of time. The efficacy? Hmmm. If you have a spouse, sibling, parent, or grandparent suffering the early stages of Alzheimer’s, you’ll be holding your breath to see if this new test helps!

Resources: https://pharmaphorum.com/news/fda-approves-first-in-vitro-test-for-early-alzheimers-disease/, https://alzheimersnewstoday.com/2022/05/16/alzheimers-diagnostic-test-lumipulse-given-fda-marketing-permission/
Image: https://i.insider.com/605cf658106eb50019d05b11?width=1000&format=jpeg&auto=webp

ENCORE #184! – Chemo Killed Colds…and Other Weird Thoughts

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 2012 – almost a decade ago…

My wife’s down with a coughing, miserable, fever-full something-or-other, most likely the most recent form of the noravirus...

Working in an elementary school, she’s usually immune to whatever plague is making its way through the general population. But when something smacks into the school and it’s new, and the kids are staying home in droves…well, the staff usually gets it and it wipes them out, too.

So she’s down for the last day before Christmas Vacation.

It wasn’t like that during chemo. We’ve talked about it before. All of the normal illnesses seemed to give way in front of the onslaught of Taxotere (http://breastcancerreaper.blogspot.com/2011/10/whats-it-do.html), Adriamycin (http://breastcancerreaper.blogspot.com/2011/10/adriamycin-whats-it-do.html), and Cytoxan (http://breastcancerreaper.blogspot.com/2011/11/cytoxan-whats-it-do.html), grouped with Neulasta (http://breastcancerreaper.blogspot.com/2011/11/neulasta-whats-it-do.html).

But was that truth or only appearance?

Appearance, I guess (http://www.cdc.gov/cancer/preventinfections/patients.htm); though the FACT was that my wife got sick with garden-variety colds and infections less often while she was taking chemo and a reasonable conclusion would be that her blood would be highly toxic to anything else that got into her.

BUT…what about neulasta (the brand name of a compound called PEG-filgrastim)? If white blood cells fight off disease and neulasta BOOSTS the white blood cell count…

I did a lengthy search, but can find virtually NOTHING regarding people who have taken neulasta without having some sort of disease. While one of the side effects of using neulasta is a decrease in mineral bone density, there don’t seem to be any other consistent and wide-spread reactions (of course, there are isolated incidences of nausea, etc. One person even reacted by getting horrible pocks of dead and dying flesh (called Sweets Syndrome)).

It would be interesting to find out if there have been instances of people who took neulasta without having any sort of illness. Would they have a super-immune system? Would they sail through life without illness? Don’t know. The intent of neulasta injections coupled with chemotherapy is to boost the immune system’s response in order to ward of infections during the treatment. That’s what it did for my wife.

The question I have is that if it did that during chemotherapy when the immune system was weak; what would it do for a HEALTHY immune system?

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

GUY’S GOTTA TALK ABOUT BREAST CANCER #51…After Explant and Slow Going

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…

While the surgery is “long past”, and the two post-operation meetings went well; and the two drains were removed, recovery continues apace…if that pace was from the Ice Age.

We NEVER expected “instant recovery”. That’s what my mom expected when she had her hip replaced when she was 68…and it was so! She worked hard, did all the exercises, and was soon back to dancing across the stage of her beloved Wastebasket Review. She had it replaced a second time when she was 80-something. She was EXPECTING a quick recovery, but that never happened. She was in a huge amount of pain, she couldn’t handle MORE pain that came with doing the rehabilitative exercises, and she gave up. That was a contributing factor in her rapid decline…

So, my wife NEVER expected “instant recovery”.

What she got was surprises during recovery.

The FIRST surprise came when they told her “You won’t be able to do anything 

‘normally’ for another six months.”

WTH???? The doctor clarified that she’d be unable to lift large objects for that period of time. That the “large objects” included our almost-three-year-old-grandson was not what we expected. Fortunately he’s of the “always running at high speed until he conks out for a nap” kind of kiddo! He doesn’t USUALLY let us carry him anymore.

The second surprise was that she couldn’t life ANYTHING for the first two weeks; and she COULD NOT UNDER ANY CIRCUMSTANCES reach for anything over her head for some time – an indeterminate number that depended on several factors – rate of wound healing, condition of the skin as the wound healed, and “pain indicators”, ie, “If it hurts, don’t do it!”

Why?

Well, it involved, in my wife, after the removal of the implant and the scar-tissue capsule that had formed around it, “The muscle is often times sewn back down after an explanation. As long as the capsule is removed the muscle will scar and stick back down. There is raw tissue on both sides that the body will heal together.”

But, like all major surgery, it doesn’t happen FAST. Unlike the external incisions which form scabs to protect the healing injury, internal healing takes more time. It’s also the reason “drains” are placed under the skin to drain away any serous fluid that gathers post-surgery. Sometimes there is a small amount of blood as well. My wife’s physician’s assistant took out the tubes. The procedure was simple: a couple of stitches that held the tubes in place were snipped and the tubes pulled out without any real discomfort. My wife was fine with it at the time. She’s still experiencing some pain as she heals, but the doctor assured us that that is normal.

We’re not teenagers anymore! Not even in our fifties anymore. ALL injuries take longer to heal. My wife sometimes tries to do too much (I know, SHOCKING!), then has to back off an rest. Considering it’s been a GRAND total of nineteen DAYS since she was under anesthesia for three-and-a-half HOURS!!!!, I think she’s doing pretty good. She just wants to do MORE!

The doctor was pleased with the result, and now, like all good things, it will take some time to be back up to full speed!

[While there ARE YouTubes regarding explant surgery, I didn’t watch them myself as I don’t have the background to judge whether what they say is true or deals with explant surgery realistically. Feel free to Google them and judge for yourselves!]

Resource: https://www.realself.com/question/chico-ca-muscle-repair-explanting
(Answers the question: “How is muscle repair done when explanting?”); https://www.realself.com/question/new-york-new-york-drains-after-breast-implant-removal-collect-fluids-tissue (Answers the question:
Do drains placed in the chest after explant collect fluids and tissue?)
Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #183! – 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…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 2012.

Here again, just in time for the season!

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.”

*blink 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...if you live in Minnesota, WHAT THE HECK DO YOU DO!?!?!?!?!?

Deep breath.

Now you can be prepared for summer camping. As prepared as you can be!

Reference: http://www.lymphnet.org/lymphedemaFAQs/riskReduction/summerTips.htm

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

GUY’S GOTTA TALK ABOUT BREAST CANCER #50…Drain Pains, and Chest Wraps, and Pain Meds, OH MY!

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…

Well, it’s over.

The surgery, anyway. Now we’re coming up on the end of the first week, post-operative. It’s funny, the routine is so similar to the radical mastectomy, and the implant surgery, that it feels like no time has passed at all; almost like we’re replaying a milder version of the whole experience like a movie; and back at the beginning.

But 11 years ago, I was only 54 and had a lot more energy than I do now. OTOH, the kids were 19 and 23 when my wife was first diagnosed, they’re 34 and 31 now with spouses and kids of their own. Everything the doctors told us that would happen was mere speculation; a dream (or nightmare if, you will); and not truly comprehensible. We’d nothing to compare it to…

The implant surgery two years later, was also not truly comprehensible, but it lacked the raw terror of the diagnosis and demand for instant-if-not-sooner from the hospital and her doctor of the diagnosis and headlong rush to stop the monster from eating my wife; their mother, sister, sister-in-law, daughter-in-law, friend, neighbor....

During those days, we measured the time from the morning we checked into the hospital for the double mastectomy surgery to the end result as a matter of a few hundreds of hours. Then there was the benevolent abuse of chemotherapy, as hair vanished and weariness was the order of the day. Breast reconstruction two years later lacked the terror and seemed to be a good thing.

We find ourselves 11 years later, wondering what happened, and the images of my wife with chest drains and on pain meds (all the while worry that if she takes too many she’ll become an ADDICT!!!), chest wrapped in an ace bandage, and a visual inspection of the end result and being impressed by the neatness of the stitches; glad that it’s over…again. Those same intentional, healing wounds inspiring a shortness of breath in me and tears and countless phone calls from our kids, kids-in-law, and foster-kids.

And yet…and yet…when the doctor made the incision to remove the implants and their scar capsules, there was a faint fear that she would come out and say, “I’m sorry, but we found more cancer.”

But that’s NOT what she said. She said, “The surgery went very smoothly and we’re done a bit before we estimated we’d be done. She’s doing very well.” Those were the only words we needed to hear and so today I write from a place where my wife is steadily healing and growing stronger every day!

For those of you who are Christians, please join me in thanking God…He is worthy…please sing along with congregation of Christians in giving praise to Him: https://www.youtube.com/watch?v=fs7Kah6wnY8

Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

GUY’S GOTTA TALK ABOUT BREAST CANCER #49…Almost the Day For the Explant

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…

So, tomorrow, we report to the hospital for the explant surgery, aka implant removal surgery.

My heart still skips a beat, not because I’m ACTUALLY afraid, rather because of a vague sense of anxiety for the future.

After the original mastectomy, which was essentially an emergency once the breast cancer diagnosis was verified – medical care was reduced to countless visits to hospitals and clinics for pre-op, post-op, then chemotherapy consults, followed by weeks of chemo administered at a clinic across town, then the OTHER clinic visits for Neulasta to control what the chemo did to the did to my wife’s immune system, followed by more pre-sessions…

Two years later, we did another round because the breast cancer appeared to be gone…then my wife jammed her finger against a wall, a doctor said, “Don’t worry.” And then she had full scale lymphedema (which at the time wasn’t considered the business of the breast cancer community on any level, and was “just bad luck, oh well, thank you very much for your concern, *slam!*”).

And so today, after a revolution within the breast cancer community declared that lymphedema was real, but there was no cure for it and very little help…we’ve just learned to deal with it and learned to navigate the things we need to do.

Then the breast implant surgery, followed by ten years of pain…and now here we are. To say that the past eleven years have been a roller coaster begs me to point out that it was an amusement park roller coaster – it was a roller coaster IN AGONIZINGLY SLOW MOTION.

Tomorrow morning, we hope to enter the absolutely final step of this expedition Explant Surgery. What is Explant Surgery? “Explant Surgery and En Bloc Capsulectomy/Implant removal (or explant surgery) is an option for patients who are having problems with their breast implants, or who now simply prefer to be implant-free.

“The procedure removes the implant, usually along with part or all of the surrounding scar capsule. ‘En bloc’ capsulectomy involves removal of the implant and [scar tissue] capsule as one specimen... When performed alone, explant surgery is usually an outpatient procedure. The incision used to remove the implant is usually based on the patient's prior surgical history. The amount of capsule that needs to be removed in conjunction with explant surgery is [also] influenced by several factors (…diagnosis, surgical plan, patient preferences, etc), and is determined on a case-by-case basis.)”

As well, because there were two methods of doing the implant surgery – either UNDER the chest muscle or ON TO OF the chest muscle – hers will be removal from under the muscles. That requires the repair of the chest muscles and necessitates two weeks of extremely restricted movement, followed by two more weeks of limited lifting.

Two weeks from today, I’ll have more to say. As for now, “anticipatory stress” is all I have to deal with. And my wife is doing very well – she’s been baking, cleaning, preparing for the month of inaction, so she’s got things in a good perspective.

I’ll let you know more later!

Resource: https://www.bustle.com/wellness/explant-surgery-breast-implant-removal-experts, https://www.breastimplantcancer.org/treatment/#:~:text=What%20Is%20an%20Explant%3F,response%20to%20a%20foreign%20object.
Image: http://wrex.images.worldnow.com/images/23784252_SA.jpg

ENCORE #182! – When Are You Back Up To Full Speed?

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 October of 2012…

Working full-time as a classroom aide for a kindergarten class is a draining experience even for the young and able-bodied! The classroom teacher is a young woman with loads of energy, enthusiasm and ideas – and SHE is often worn out at the end of the day! How could my wife possibly expect to keep up with her – as well as chasing after 25 five-going-on-six little kids, and closely monitoring and recording data on one child in the class who needs LOTS of supervision?

She works at the elementary school in the district with THE highest level of poverty. The neighborhood her school is in is primarily made up of apartments, has an airport, several vacant lots, one partially burned out gas station, suburban row houses all built within weeks of each other in 1956 and beginning to look their age. The environment is dilapidated, the school is dilapidated, the charter school next door to her school siphons off the best and the brightest leaving her school with more than its fair share of challenges.

She comes home exhausted every day and wonders when she’s going to feel better. Lymphedema is a concern still – nah, it’s downright worrisome. Yesterday she broke out in hives because she didn’t rinse out her compression sleeve well enough – because she was tired. Her feet are sore. Her knees and joints are sore (though that has gotten better since she’s gone gluten free) and she doesn’t remember feeling this crappy BEFORE the surgery, chemo and recovery.

So when WILL she feel like she used to?

In a transcript of a panel discussion on “Life After Breast Cancer” posted at http://secondopinion-tv.org/episode/life-after-breast-cancer, one of the panelists notes, “It's not possible to ‘flip a switch’ and immediately go back to a former life at full throttle. The body is in repair mode and women have to pace themselves. In fact, it may take a year or more to regain a sufficient level of energy and sense of well-being.”

Debbie Woodbury, commenting on a question at Talk About Health (http://talkabouthealth.com/how-long-did-it-take-for-you-to-feel-normal-again-after-breast-cancer-or-do-you-ever-feel-normal-again) points out: “Emotionally, it took even longer [than a year] to heal, but I will never be the same as I was before the cancer...no cancer survivor I've ever talked to...has ever told me that they were able to return to the normal life they had before they were diagnosed. It just doesn't happen. Cancer redefines normal.”

What exactly is a repair mode? Technically “recovery” has to do with the initial surgical recovery, but, “After your cancer treatment, as a cancer survivor you're eager to return to good health. But beyond your initial recovery, there are ways to improve your long-term health so that you can enjoy the years ahead as a cancer survivor. The recommendations for cancer survivors are no different from the recommendations for anyone who wants to improve his or her health: Exercise, eat a balanced diet, maintain a healthy weight, avoid tobacco and limit the amount of alcohol you drink. But for cancer survivors, these strategies have added benefits. These simple steps can improve your quality of life, smoothing your transition into survivorship.”

This is recovery.

“But doctor, will I ever be able to play the violin again?”
“Of course!”
“That’s amazing! I never played it before the surgery!”

Ba dum bum. Everything people have blogged leads me to believe that the repair mode of post-cancer recovery is long and difficult. Of COURSE you feel better than you did immediately after surgery. It seems like things are getting better fast. But that’s different. Cancer is invasive and if you’ve undergone a prolonged chemo or radiation therapy, then your entire body has been weakened – from head to toe.

“You may have permanent scars on your body, or you may not be able to do some things you once did easily. Or you may even have emotional scars from going through so much. You may find that others think of you differently now - or you may view yourself in a different way…”, “...those who have gone through cancer treatment describe the first few months as a time of change...finding out what's normal for you now. People often say that life has new meaning or that they look at things differently now. You can also expect things to keep changing as you begin your recovery. Your new ‘normal may include making changes in the way you eat, the things you do, and your sources of support...follow-up care. Should I tell the doctor about symptoms that worry me? Which doctors should I see after treatment? How often should I see my doctor? What tests do I need? What can be done to relieve pain, fatigue, or other problems after treatment? How long will it take for me to recover and feel more like myself? Is there anything I can or should be doing to keep cancer from coming back?”

All of this – and MORE – are things to factor into recovery.

The answer to the ultimate question, “So when WILL she feel like she used to?” may not have a clear or solid answer. I suppose the best response might be, “e) All of the above”...

Resources: http://www.cancer.gov/cancertopics/coping/life-after-treatment/page1/AllPages