The Reconstruction Era – Part 1

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…

It appears that the next event is breast reconstruction!

It’s been two years now since the double mastectomy and shortly, it will be two years since chemotherapy began. My wife now has an appointment to begin the next phase: breast reconstruction.

As is my wont, I am going to ONLY cover the medical side of reconstruction. I WILL tell you that the ultimate choice is your own. We discussed for nearly a year the different types of reconstruction, we researched, my wife talked to dozens of people both online and face-to-face. We consulted half a dozen doctors, changed clinics and changed clinics then went back to the second clinic again. Breast reconstruction is not a decision to be made lightly nor is it to be made quickly. There are ramifications, risks, and considerations; soul-searching and God-seeking. All of these should be part of the decision to yes or no as well as the decision of which or what.

So…I am not endorsing or advising any of the methods I will write on here. I will translate the doctors – as I’ve tried to do all along. This week: Implant-based reconstruction, step one.

First, a clear definition: “Breast reconstruction is a surgical procedure that restores shape to your breast after mastectomy (surgery that removes [one or both] breast[s] to treat or prevent breast cancer).”

The first step after the mastectomy – which may also happen during the mastectomy itself or years later – is that the surgeon lays down a device called a tissue expander.

http://www.allergan.com/assets/images/US/products/tissue_expanders.jpg

The expander is basically a balloon that the clinic will fill with salt water a little bit at a time. The surgeon puts it under BOTH the skin and the muscle and leaves it there. After the surgery to put it in, the person visits the doctor for an appointment where some salt water is injected into it and then left there. It stretches the skin and muscle a little bit. Then the person waits while until the next appointment. Obviously, there will be feelings of the skin being stretched; I IMAGINE that the feeling would be similar to what happens when you get a sting of some sort and your knuckle swells a bit.

In my wife’s case, the surgeon will add something fairly new to support the expander – a “donated human skin scaffold” which will go along the bottom side of the expander.

“Lab-made skin and soft tissue substitutes (in this case) is made from donated skin but it has all the living cells taken out. What’s left is collagen – the same stuff that makes up tendons, ligaments, cartilage, bone, and intervertebral discs (as in “I slipped a disc!”)…Tissue-engineered skin...can be used as either temporary or permanent wound coverings. Other situations in which bio-engineered skin products might substitute for living skin grafts include certain post-surgical states such as breast reconstruction…”

“AlloDerm is a soft-tissue implant fabricated by a proprietary method...”

The surgery to place the expanders and the AlloDerm will take two to four hours and includes new drains to reduce uncontrolled swelling.

In the interest of keeping the posts readably short, I’m going to stop for now and continue next week!

Resources: http://www.mayoclinic.com/health/breast-reconstruction/MY00207,
https://securews.bsneny.com/web/content/dam/BSNENY/Provider/Protocols/B/prov_prot_701113.pdf, http://emedicine.medscape.com/article/879007-overview
Image: http://www.conlab.org/acl/images/secondbank/1942_reconstruction.jpg

BREAST CANCER RESEARCH RIGHT NOW! 9: Chances of SURVIVING Breast Cancer Are Better Than Ever!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…

Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: http://www.sciencedaily.com/releases/2013/03/130327132535.htm

I thought I’d share some GOOD news for once!

“...breast cancer has made tremendous strides as well, with five-year survival rising from 75 percent in 1975 to almost 89 percent in 2012...women with breast cancer account for 22 percent of survivors [of all types of cancer]...”

I’m not sure that there’s much more to say!

While men still don’t TALK about Breast Cancer – and I get almost NO replies to the blog here; and I’ve NEVER had a reply from a male – people are reading my blog in slowly increasing numbers and my hope is that there are a few men who stumble across the blog and get a measure of help or hope. (If any of you EVER wanted to write to me – DO!)

“The report, published in the AACR's journal Cancer Epidemiology, Biomarkers & Prevention, shows that as of January 2012, there were approximately 13.7 million cancer survivors in the United States, a number that is expected to rise by 31 percent to 18 million by 2022.”

Just out of curiosity, I found a list of currently identified cancers in the US:

Most Common: bladder, breast, colorectal, endometrial, kidney, leukemia, lung, melanoma, non-Hodgkin lymphoma, pancreatic, prostate, thyroid. (These made up 1,323,000 people.)

Less Common: adrenocortical, Kaposi sarcoma, anal, appendix, astrocytoma, atypical teratoid/rhaboid, basal cell, bile duct, bone, brain stem, brain, cardio, cervical, craniopharyngeal, esophageal, esthesioneuroblastoma, Ewing’s, eye, gallbladder, gastrointestinal, germ cell (testicular, ovarian, etc), gestational trophoblastic, head and neck, heart, liver, Hodgkin, hypopharyngeal, intraocular, laryngeal, mouth, myeloma, nasopharyngeal, neuroblastoma, oral, papillomatosis, penile, pituitary, plasma cell neoplasm, salivary gland, skin, small intestine, soft tissue sarcoma, throat, urethral, and uterine. Many of these have subdivisions of types, several have pediatric forms that differ from the adult form. (Based on the above figures, these make up 12.4 million cases of cancer and cancer survivors.)

With a US population of 313,914,000 and 13,700,000 million cancer survivors, that means that 1 person out of every 23 have experienced the horror of a cancer diagnosis, some sort of treatment AND HAVE LIVED TO CELEBRATE THEIR SURVIVAL!

Resources: http://www.cancer.gov/cancertopics/types/alphalist/y
Image: http://media.miamiherald.com/smedia/2010/10/05/00/8177892.standalone.prod_affiliate.56.JPG

Easter Saturday Reflections of Nearly Two Years Since I Started This

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…

One hundred and five posts, one hundred and four weeks.

Good Friday was last night.

Why do they call it good? Strangely enough, the best explanation I have ever heard or seen popped up on Friday on my niece’s FaceBook post in the form of a comic strip drawn by legendary artist, Johnny Hart, creator of the strip “B.C.” and co-creator of the strip, “The Wizard of Id”:

This is the only reason such a day, such a celebration could be called “good”.

My daughter and I were talking about Good Friday on the way to the service and back a year ago. She observed that this the only specifically Christian Holy Day that the secular world has been unable to co-op. We decided that there’s no way that such an event could be made cute or represented by cuddly animals, people in costumes or from which candy companies might not spin adorable commercials or bunnies laying chocolate eggs. Any attempt to “cute-i-fy” Good Friday is doomed to failure by the nature of the day.

It’s grim. Gruesome. Dark.

It’s all about torture and execution.

Outsiders – those who don’t know of, believe or otherwise acknowledge Christianity find it offensive and inexplicable; perhaps even insane. “Why would you possibly want to remember the horrific execution of your rabbi and teacher?”

That night I realized for the first time that the events leading up to the execution of the Christ are NOT about the failure of God to accomplish His mission on Earth. The crucifixion was NOT a backup plan for the enlightnement of Humanity (and a bad one at that).

The events prior to Good Friday were an exhibit.

An exhibit of everything that is rotten in Humanity and a display of ample proportions of exactly why it needed forgiveness and saving.

The infant Jesus was born a slave to an empire both global and cruel. His birth sparked the slaughter of hundreds of other innocent newborns by decree. His life exposed the tedious, unremarkableness of thirty years of growing old in an ancient world and the loss of his father during adolescence; his three years of ministry exposed him to corrupt government, avarice and greed, ridicule by the intelligentsia, betrayal and abandonment by friends, public adulation turned mockery, lies, a corrupted justice system that did not represent slaves, gambling and drug abuse.

What does this have to do with my wife’s breast cancer? A year ago, I was shamed by His suffering because I have for some time now begged and challenged Him to explain, “Why have you made me suffer so?”

He hadn’t answered my plea until that night when He said, “I can’t explain that, Guy. But I can say that I have been with you in that suffering because I understand suffering. I understand despair. I get you. That’s why I haven’t cast a lightning bolt in your direction for your impertinence. I understand, as few others can, your suffering, and I’ll stand by you and answer what questions I can. Look at your blog – lots of answers there. Not ‘the answer’, that won’t come until we can talk face-to-face; but you got a lot of them. See you later, bud.”

I know this isn’t about breast cancer exactly; I suppose I pulled a Johnny Hart on you all. Be that as it may, my prayer is that you might find some answers to your suffering. If you can’t find answers, then I’d be happy to talk with you. Just leave me a comment and I’ll reply…

image: http://images.tcj.com/2012/03/Hart-6.jpg

BRAIN CANCER!!!!!!!!!!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…











One of the biggest draws on this blog has been this entry: http://breastcancerreaper.blogspot.com/2012/01/metastatic-breast-cancer-brain-cancer.html

Why is that? What is it with brain cancer -- breast cancer related or not? How many people HAVE brain cancer and how many people THINK they have brain cancer? After re-reading the article, come back here and we’ll continue our discussion!

First some facts: brain cancer accounts for “less than 1 percent of all cancers, 2.4 percent of all cancer deaths, and 20–25 percent of pediatric cancers. Ultimately, it is estimated there are 13,000 deaths per year in the United States alone as a result of brain tumors…”

OK – so hardly anyone gets brain cancer, even when it arises as a metastatic form of breast, lung or skin cancer. It JUST DOESN’T HAPPEN VERY OFTEN. So why do people type it into their search engine so often?

How many of you remember the old, old movie, KINDERGARTEN COP? An old Schwarzenegger comedy, IMDb describes it this way, “A tough cop is given his most difficult assignment: masquerade as a kindergarten teacher in order to find a drug dealer.”

The only lines I remember from the whole movie (and I’m one of those people who can quote swaths of my favorites) are these:

“Detective John Kimble: I have a headache.
Lowell: It might be a tumor.
Detective John Kimble: It's not a tumor! It's not a tumor. At all!”

While I couldn’t find actual numbers, it seems like lots of people who get headaches run a quick GOOGLE search to see if they have brain cancer: “Do not google your symptoms! Anxiety about a possible brain tumor is a common reason for a neurological consultation in my office when patients experience a new or a different type of headache. Yet, headaches are rarely the first symptom of a tumor.”

In fact, recent studies have shown that while many people believe that unusual headaches are a sure sign of a brain tumor or brain cancer, the fact is that “Each year, doctors in the United States diagnose approximately 17,000 new primary brain tumors and 100,000 new secondary brain tumors.”

Now let’s do the math.

Current population of the USA = 314,000,000
% of people who will be diagnosed with a primary brain tumor = .00005% (in talking numbers that would be five hundred thousandths of a percent)
% of people who will be diagnosed with ANY brain tumor = .0004% (in talking numbers that would be four ten thousandths of a percent)

Of course, there are the fund raisers who will make the problem worse by pumping the numbers, so let’s figure it based on THEIR numbers, “In 2012, an estimated 66,290 new primary brain tumor diagnoses will be made in the U.S…” I’ll be rounding that to 67,000 for ease of calculations:

Current population of the USA = 314,000,000
% of people who will be diagnosed with a primary brain tumor = .0002% (in talking numbers that would be two ten thousandths of a percent)
% of people who will be diagnosed with ANY brain tumor = they don’t say

There are YOUR chances and MY chances of being diagnosed with a brain tumor or brain cancer.

The Mayo Clinic has had so many of these types of visits that they note on their website: “Symptoms of Hypochondria / Health Anxiety vary widely from person to person. Some examples of common obsessions seen in Hypochondria / Health Anxiety are: thinking that a headache is indicative of a brain tumor; believing that a cough must be sign of lung cancer; assuming that a minor chest pain is a heart attack; thinking that a minor sore is a sign of AIDS…”

“First, 50%-60% of all people with brain tumors don't have headaches at all, Barnett says.”

So, the next time you have a headache and rush to the computer to GOOGLE brain cancer – and I hope you stop here, relax, have a cuppa (something, preferably non-alcoholic), take two aspirin (or acetaminophen, ibuprofen, or naproxene hydrochloride) and then call someone sensible in the morning.

But realize that for all practical purposes: it’s not a tumor.

Resources: http://en.wikipedia.org/wiki/Brain_tumor, http://www.theibta.org/uploads/file/Statistics.htm, http://www.rosenkilde.com/Brain-Tumor.html, http://www.anxietyguru.net/brain-tumor-anxiety-overblown/, http://usatoday30.usatoday.com/news/health/story/2012-06-05/benign-brain-tumors/55407486/1, http://www.cnn.com/2011/HEALTH/04/07/ep.headache.brain.tumor/index.html, http://www.dana.org/news/brainhealth/detail.aspx?id=9792, http://www.braintumor.org/news/press-kit/brain-tumor-facts.html
Image: http://media1.break.com/breakstudios/2011/8/15/teachers_kindergarten-cop.jpg

A Fantastic Cancer Voyage Chapter 1 V

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…

One of my fondest memories as a kid is watching the movie FANTASTIC VOYAGE. In it, a group of scientists and their ultra-futuristic laser-packing “submarine” are reduced to cell size and injected into the blood vessels of a world diplomat in order to destroy a blood clot in his brain.

What would a FANTASTIC VOYAGE: Breast Cancer look like? I’m going to write a novel here, short chapter by short chapter and I’m going to include the latest research and I’m going to imagine the entire story here for your delectation. Likely it WON’T be once a month…

Dr. Olubunmi Nwagbara – Ohloo to her close friends, Dr. O to those who wouldn’t try her last name for fear of offending her – stood up from the uncomfortable hospital chair at the foot of Kim Lin Anzan’s bed. Though the woman on the diagnostic bed had been hailed as the incarnation of the Buddha; or an avatar of Jesus; or the last, best hope of stemming all-out war between the world’s two super powers, India and China; to Ohloo, she was...

“What are you?” she asked abruptly.

Kim Lin Anzan smiled and said softly, “Just a woman trying to extract a promise from another woman.”

Ohloo couldn’t entirely suppress the smile until she said, “With an offer like that, you leave me absolutely no choice but to say, ‘Where do I sign’?”

The Last Hope For World Peace grinned back from her bed. For an instant, the rest of Earth’s nine billion inhabitants didn’t matter. The only thing in the world was the forge on which a new friendship was abruptly hammered into shape. “I will sign whatever release forms you need to me to sign, Dr. Nwagbara.”

Ohloo nodded and said, “As I’m going to be living inside your bloodstream – and possibly even in your brain, I think we can drop formality entirely. When it’s technically just the two of this, please call me Ohloo.”

Kim Lin Anzan nodded and said, “I love that you recognize that subtle difference. When we’re technically alone, please call me Lily. It was my mother’s pet name for me and a lot less pretentious than what everyone else finds it necessary to call me.”

Ohloo nodded and said, “Ohloo and Lily,” she shook her head. “Such humble names for such a grand endeavor.”

“Bodes well for our success, doesn’t it?”

Ohloo nodded and closed down her tablet computer projection. “It does, indeed. I need to get to the lab. You need to rest.”

“When is the big day?”

Ohloo pursed her lips, tapped the T-comp and finally said, “I think I’ll schedule for Monday. I don’t think Mondays are holy days for any faith and there’s no holy-day that my computer search can find that coincides with it.”

Lily frowned. “Why would that be important?”

“I don’t want our success to be marred with claims by philosophical, patriotic, religious or a-religious societies that their observance of whatever days are responsible for our success. Your recovery is going to involve you and I working together, but the research, facilities and ingenuity of thousands – not a single one of whom we could do without – are the only way we can accomplish this surgery.”

Lily nodded then said, “And what I asked of you?”

Ohloo paused. “What about it?”

“I will be most interested in discussing with you the implementation of breast cancer diagnosis for the masses. I’ll also be interested in your ideas of what we can do with that information once we have it.”

“I’m just one doctor...”

“...and I’m just one philosopher. Yet look where we are today.” She sat up slowly, leaning toward Ohloo. “This work  has the possibility of having a deep impact on this planetary family.”

Ohloo nodded, adding, “And if I fail and you die while we’re doing this, the end result may have the same deep impact as a comet strike.”

Image: http://medgadget.com/wp-content/uploads/2006/11/Fantastic-Voyage-200x290.jpg

BREAST CANCER RESEARCH RIGHT NOW! 8: Soldiering and Breast Cancer Create the SAME Post Traumatic Stress Disorder!

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…Every month, I’ll be highlighting breast cancer research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: http://www.sciencedaily.com/releases/2013/02/130228124030.htm

Post-Traumatic Stress Disorder is something we associate with The War On Terror; the War In Afghanistan; the War In Iraq; drive-by shootings; school shootings; disaster relief and emergency medical personnel – it’s certainly not something the cancer care doctors told us about two years ago.

What is Post-Traumatic Stress Disorder (also known as PTSD)?

“The cause of PTSD is unknown. Psychological, genetic, physical, and social factors are involved. PTSD changes the body's response to stress. It affects the stress hormones and chemicals that carry information between the nerves (neurotransmitters).”

Some of the symptoms of PTSD might be:

Symptoms of intrusive memories:

a) Flashbacks, or reliving the traumatic event for minutes or even days at a time

b) Upsetting dreams about the traumatic event


Symptoms of avoidance and emotional numbing may include:

a) Trying to avoid thinking or talking about the traumatic event

b) Feeling emotionally numb

c) Avoiding activities you once enjoyed

d) Hopelessness about the future

e) Memory problems


Trouble concentrating

Difficulty maintaining close relationships


Symptoms of anxiety and increased emotional arousal may include

a) Irritability or anger

b) Overwhelming guilt or shame

c) Self-destructive behavior, such as drinking too much

d) Trouble sleeping

e) Being easily startled or frightened

f) Hearing or seeing things that aren't there


Post-traumatic stress disorder symptoms can come and go. You may have more post-traumatic stress disorder symptoms when things are stressful in general, or when you run into reminders of what you went through.

Someone asked me recently if a double mastectomy was an amputation. I looked up the definition of amputate:

“verb (used with object), am•pu•tat•ed, am•pu•tat•ing; 1. to cut off (all or part of a limb or digit of the body), as by surgery; 2. to prune, lop off, or remove; 3. Obsolete . to prune, as branches of trees.”

I would say that a double mastectomy is by definition (though not by custom…how much would you like to bet that the people that resist defining a mastectomy as an amputation are male or women who have not had mastectomies…) an amputation.

So – if you experience the symptoms of PTSD, then talk to your doctor. If you need proof of what you are experiencing, then go to the link above, print out the article and help your caregiver move into the 21st Century.

Resources: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001923/,
http://en.wikipedia.org/wiki/Posttraumatic_stress_disorder, http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246/DSECTION=symptoms
Image: http://www.theredheadriter.com/wp-content/uploads/2012/04/2012-04-05-ptsd1.png

Raising Hope

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…

The subject of today’s blog was chosen by my wife. It is now nearly two years since the initial cancer diagnosis and the subject is Hope.

What is hope?

Funny, I think of a “dude” thing when I think of hope. As a kid, I remember hearing all kinds of war stories about how POWs who had hope could survive anything. When they lost hope; when they gave up hope of rescue; when they no longer had anything to hang on to…they died.

This of course (for any of you other, especially OLDER dudes out there) brings to mind the movie, BRIDGE ON THE RIVER KWAI. If you don’t know what that movie was, rent it, NetFlix it, Hulu it, or whatever. The most important scene is the last one. After defying their Japanese jailers, the men whistle this song:

http://www.youtube.com/watch?v=83bmsluWHZc

THAT is my definition of HOPE. At least, that’s one of them.

I also happen to be a Christian person, so I include the Bible’s definition of hope, too. It’s sort of spread out, so I’ll take the pertinent bits and pieces:

“Is not…the integrity of your ways your hope?” Job 4:6

“And now, Lord, for what do I wait? My hope is in You.” Psalm 39:7

“[The] Lord, the hope of Israel…” Jeremiah 17:13

“For I know the plans that I have for you,’ declares the Lord, ‘to give you…hope.” Jeremiah 29:11

“I have hope: the Lord’s lovingkindnesses indeed never cease, for His compassion never fails.” Lamentations 3:21-22

“And not only this, but we also exult in our tribulations, knowing that tribulation brings about perseverance; and perseverance, proven character; and proven character, hope; and hope does not disappoint, because the love of God has been poured out within our hearts through the Holy Spirit who was given to us.” Romans 5:3-5

“…through perseverance and the encouragement of the Scriptures we might have hope.” Romans 15:4

“Now may our Lord Jesus Christ Himself and God our Father, who has loved us and given us eternal comfort and good hope by grace…” 2 Thessalonians 2: 16

“…His great mercy has caused us to be born again to a living hope through the resurrection of Jesus Christ…” I Peter 1:3

That bit from the letter from the apostle Paul to the little church in Rome has a great deal of meaning to those who have suffered under the pain and horror of breast cancer. It seems to imply that hope comes through suffering.

It also seems to say that hope and love are connected. The love comes through God to give us HOPE in the same God. And THERE’S something to ponder…

And the picture today? I know it’s a comedy TV show with a rather absurd premise, but the implications of what this family is doing with this little girl, Hope, is actually, factually tightly related to that letter to Rome, which ties in unusually well with the movie BRIDGE ON THE RIVER KWAI...

Image: https://si0.twimg.com/profile_images/3177290266/2d1e188397a452796f48424335495cf6.png