Saturday, October 28, 2017

GUY’S GOTTA TALK ABOUT…Alzheimer’s #11: Time Traveling With My Dad, part 2

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

I’m a STAR TREK nerd and I have been since my dad introduced me to the TV series in 1968 or 1969. I was pre-adolescent, and desperate to have something in common with his. I’d failed miserably in “sports” and long ceded that domain to my brothers and sister. I’d pretty much given up ever having any connection with Dad. Until Gene Roddenberry and Lucille Ball conspired to bring my dad and me together. The fact is that for me, STAR TREK is inextricably linked to my relationship with my father, and I am a writer today because of that connection.

STAR TREK has also dealt with time travel since what is called The Original  Series, beginning with “Tomorrow Is Yesterday” in 1967 and a time travel incident that was used to reboot the entire franchise in 2009, creating a skew from the timeline of all of the TV series as well as the first ten movies…as well as a temporal incident in this real world. During the premier of that movie, my father, myself, and my own son went to the movie along with an old, old friend of mine…

Anyways, in all, STAR TREK has dealt with time travel issues in 50 of the 741 television episodes and thirteen movies.

When I talk to dad these days, I’m dealing with time travel issues all the time.

I’m pretty sure Alzheimer’s messing with Dad’s memories would have been stranger for me if I hadn’t actually messed around with time travel and alternate futures in my own head.

Most of the people who’ve heard me deal with Dad’s wanderings through the past and present are amazed at how calm and soft-spoken I am. Truthfully, the leaps and bounds he makes don’t bother me. I just go with the flow of the conversation – oh, I forgot to mention that Dad ALSO deals with alternate timelines as well. Like the one where Mom is still alive and is divorcing him…

Alzheimer’s has given me a new appreciation for the philosophical concept of “being in the now”. Jesus said it, “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” (Matthew 6:34, NIV)

Buddha said it, ““The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly.” (Motivating Thoughts of Gautama Buddha, Mahesh Dut Sharma)

Ekhart Tolle said it, “All negativity is caused by an accumulation of psychological time and denial of the present. Unease, anxiety, tension, stress, worry - all forms of fear - are caused by too much future, and not enough presence. Guilt, regret, resentment, grievances, sadness, bitterness, and all forms of non-forgiveness are caused by too much past, and not enough presence.” (The Power of Now: A Guide to Spiritual Enlightenment)

Must be right, eh? (I’d put a smiley emoticon here if I could…)

For Dad, “now” is a fluid concept. Lately he’s been vividly dreaming, calling me to whisper that because I won’t believe him, I HAVE to come to his apartment, because Mom’s there and they’re talking; or insisting that he has an entire wardrobe at “that place I was before” he has to get to; or declaring that “the guys I bum around with” had just dropped him off and he was wondering when he would get paid for doing the job they did. But when I press for details (no, I don’t grill him!), the illusion begins to fall apart and he’ll say, “I don’t know where I am or what I’m going to do next…”

That’s the default mode. Something in him senses that the timelines aren’t lining up. He called last night to ask if I had Mom’s phone number, followed saying in the next breath, “Oh, Mom’s dead.” He’ll breathe one more time, then ask, “But does she have a phone where she’s at?”

When I’m feeling strong and in a good mood, I can joke about it, “Dad, you know where Mom is, right?”

“Oh, that’s right, she’s dead.”

“And you know how creepy that would be for you to try and talk to her in her coffin, right?”

He laughs, and then we move on to whatever the next point of conversation is, sometimes in the past, sometimes “I’m just bored here…”

I’ll talk about boredom some other time. For now, these are all my thoughts on time traveling with Dad. If you’re interested in my previous ruminations where I’ve done research into the medical “why” this is happening, you can go here: http://breastcancerreaper.blogspot.com/2017/09/guys-gotta-talk-aboutalzheimers-10-time.html

For now, that’s it.


Saturday, October 21, 2017

ENCORE #73! – Metastatic Breast Cancer: BRAIN CANCER

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry first appeared in January of 2012.

The first question that comes to mind is, “Is a brain tumor the same as brain cancer?”

While I don’t usually go to Yahoo Ask for my medical information, I decided today to START there because the answerer is both an MD and clear:

“Interesting that you bring this up. Primary brain malignancies have always been called brain ‘tumors’ rather than ‘cancer of the brain’. Yet many are clearly cancerous, locally invasive, progressing malignancies. Strange the way people perceive words. If you tell patients they have a ‘tumor, it does not seem as ominous to them as saying they have ‘cancer’…there is confusion that many people have in regard to this topic. A person with lung carcinoma that has spread to the brain has lung cancer in the brain. It is not a brain cancer. It is still lung cancer that is growing in the brain area. A person with a glioblastoma multiforme has a brain tumor - but these are usually aggressive cancers. As for cures - that depends on the primary brain cancer/tumor type and the stage.
Interesting question regarding the semantics of this.”

Source(s): MD medical oncologist - cancer specialist doctor Spreedog, 2010 http://answers.yahoo.com/question/index?qid=20091114024633AADSsIx

This is in concordance with what I’ve already found out about bone cancer and lung cancer – when you have had breast cancer and is spreads (which is what Metastatic Breast Cancer is), you have breast cancer cells growing wild in the bones, liver, lungs, brain and various  other places.

So what happens? This seems to me to be a truly horrible kind of MBC because the brain is the seat of Human consciousness.

The writer here expresses this terror: “It was because of a few unusual symptoms, that several months ago I requested a brain scan. By the time the date arrived for the scan, the symptoms, along with my fears, had disappeared. Imagine my surprise when the next day my oncologist called to say that they had found 2 tiny spots on my brain. The news was devastating. While breast cancer is every woman’s nightmare, and metastasis is the nightmare of everyone who has breast cancer, brain metastasis is the nightmare of everyone who has metastatic disease. It was so frightening that I couldn’t speak to anyone about it. I could barely allow myself to think about it. None of this is news to you. You wonder how many tears you can actually shed. You wonder if you will ever feel like your old self again and if your friends and family will ever think of you in the same way. You wonder if you will lose the person you are. It is the most terrifying diagnosis anyone can have, even those of us who are used to bad news.”

What are the symptoms? Please keep in mind that the symptoms are DIFFERENT depending on where the cancer attacks first. Also, OTHER things can cause these symptoms. My wife works as a classroom aide with kindergartners – she gets headaches sometimes, as anyone would who tries to work with a room full of five-year-olds!

Symptoms include: “changes in the ability to think, understand and use words correctly; emotional changes; weakness; dizziness; seeing lights, seeing double, or narrowing of vision; problems with balance; seizures; nausea and vomiting; changes in smelling, taste, hearing. If any of these symptoms persist (that is, stick around for a while) like a headache that is worse in the morning, lasts for days, or recurs every day, then you’ll want to talk to your health care authority.

Once you report to the cancer care center or your doctor and there appears to be reason to suspect MBC-brain cancer, an MRI (magnetic resonance imaging) is the most effective technology for diagnosing breast cancer brain metastases. It does a better job in distinguishing a single metastasis from multiple metastases, which is an important factor in determining what kind of treatment a patient needs.

Unfortunately, treatment for MBC-brain cancer is problematic still. In m0st cases, whole brain radiation (which is exactly what it sounds like) is the first line of offense. There is good evidence that this treatment is effective almost half of the time in completely reversing the effects of the cancer. In MOST cases, it reduces the symptoms significantly. It is also a shorter-term treatment than the original chemotherapy with radiation doses given daily for 5-10 days (though this is sometimes spread over a longer period to lessen the side-effects.

At other times, the radiation is aimed from multiple directions at specific metastases. This has the advantage of fewer side-effects, but there is no clear EVIDENCE yet that this is as effective as whole brain radiation treatment.

Other, less common treatments include brain surgery (physical removal of the cancer), chemotherapy (not effective usually because the chemo can’t break through the barrier into the brain through the blood (called the blood-brain barrier); and a combination of the above.

Finally: “‘So much depends on the aggressiveness of your individual cancer, the time to recurrence from original diagnosis, any other metastases, and overall health—and, the number, location and size of the brain mets (metastases), and whether they are symptomatic or not,’  Patty observed. ‘I was so sure that I would die within 18 months of my first diagnosis with brain mets.  I readied for the time of my death. Now, I’ve had to revise things a few times.  I wonder if I hold some kind of record for brain MRI’s, having had them on average every two months for five years—that would be around thirty, with bad veins! I’ve had brain mets for five years and have been living with eight lesions for two and a half years.’”


Saturday, October 14, 2017

GUY’S GOTTA TALK ABOUT …#38: When There’s Nothing To Talk About Is There Nothing To Talk About?

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…

Like the title says…I don’t know what to say right now, so I’m going to direct you to a post by a very old friend of mine. I met Bruce Bethke before my wife and I married. I was looking for a science fiction writers group to join and stumbled across a notecard at UNCLE HUGO’S SCIENCE FICTION BOOKSTORE (http://www.unclehugo.com/prod/index.shtml).

Bruce, Phillip C. Jennings, and Geri Balter started meeting, then sort of drifted apart. Bruce and I didn’t talk much (it was at the advent of the Internet, so contact was via paper or face-t0-face). Several years later, at a MinniCon, I heard him speak, re-introduced myself, and as it was now the Age of the Internet, we renewed our friendship. Older and wiser, we found we had more things in common.

This his wife was diagnosed with breast cancer.

A few months later, my wife was diagnosed with breast cancer.

We became actual friends.

He’s a science fiction award-winning author; he’s a man who has survived some very difficult life experiences, and now he’s the executive editor of an on-line speculative fiction magazine.

A few days ago, he shared about their most recent experience with breast cancer.

I’ll leave you to ruminate with him as he looks at jackalopes and cancer…

http://stupefyingstories.com/

Scroll down to the Thursday, October 12, 2017 entry...

Saturday, October 7, 2017

ENCORE #72! – Metastatic Breast Cancer: Liver Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared in December 2011.

This is not a cancer you hear about frequently, though it is third worldwide after lung and stomach in the number of deaths each year. It is uncommon in the United States with three fourths of all cases diagnosed in Southeast Asia, Mozambique and South Africa.

It is one of the least common of the metastatic breast cancers with bone cancer being 70% of the metastases and brain cancer being 10%. The remaining 20% are distributed between liver, lung and non-specific systemic diseases.

Metastatic breast cancer-caused liver cancer can show up as a significant weight loss, jaundice (getting yellow skin – this condition is sometimes seen in newborns (our son was jaundiced at birth)), and elevated liver enzymes (Inflamed or injured liver cells leak higher than normal amounts of Alanine transaminase (ALT) [This enzyme causes certain reactions to happen in the body that provide for cell energy and brain signal transmission] and Aspartate transaminase (AST) [which helps in the formation of the amino acids used to make several different body proteins such as hemoglobin], into the bloodstream). Other symptoms of MBC are abdominal pain, loss of appetite, fevers, nausea, sweats and vomiting. In some cases, there are no symptoms.

Tests that may be done to diagnose liver metastases include a CT (Computer Assisted Tomography) scan of the abdomen, liver function tests (to check for the elevated enzymes mentioned above), MRI (Magnetic Resonance Imaging) of the abdomen, PET (Positron Emission Tomography) scans or ultrasound of the liver

Pain from this kind of liver cancer responds to chemotherapy and analgesia. Doctors can also try radiation therapy to relieve pain and shrink the cancers.

How well you do depends on the location of the original cancer and how much it has spread to the liver. As recently as January of 2011, doctors have added a new treatment to the arsenal: Resection (removing parts of the liver affected by the cancer) of breast cancer liver metastases paid off in a survival benefit in patients with chemotherapy-responsive, estrogen receptor (ER)-positive primary tumors, according to data from a retrospective chart review.

“Although the cases were small in number, they are relevant in the context of changing views about cancer that metastasizes to the liver…I think there has been a [dramatic change in thinking] over the past 10 years or so, where it has been realized that this surgery can lead to long-term survival…I don't think that was recognized previously…I think there has been something of a nihilistic attitude toward breast cancer metastasis to other organs in the past…Generally incurable, most liver metastases from breast cancer are treated with chemotherapy or hormonal therapy,” said Daniel E. Abbott, MD, of the University of Texas MD Anderson Cancer Center in Houston. “I think this information is most valuable when people are willing to counsel patients and make the tougher decisions about who should and should not have surgery and then let patients make informed decisions.”

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

Saturday, September 30, 2017

BREAST CANCER RESEARCH RIGHT NOW! #56: Andes Mountains Plant Extract Inhibits Growth and Spread of Cancer Stem Cells!

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: Damsin inhibits the growth and spread of cancer stem cells…

Environmental scientists say all the time that “cutting down the rain forests could easily destroy the next cure for cancer…”

The plant is related to a plant we have lots of here, asters – you know, the tiny, “daisy” looking plant? Found on the Great Plains in it its natural state and in most garden stores in the spring, it’s common here in the US. THIS plant, with no name but its scientific one, Ambrosia arborescens, is found in the Andes mountains from Columbia down to Bolivia. The local peoples use it as an aspirin, a Tylenol, and an antiseptic, so it wasn’t like it was unknown.

Turned out that used against breast cancer, it stops the growth of these things called cancer stem cells. Cancer stem cells are highly resistant to chemotherapy because they are, in a way, not true cancer cells – it’s more like they’re FUTURE cancer cells.

In a way, these stem cells remind me of viruses. Viruses aren’t technically alive – specifically, they can’t make baby viruses without the help of another cell. Making babies is one of the BASIC definitions of living things (of course not ALL living things make babies! Within a species females can’t make babies without males; but given a viable egg and a sperm cell, Humans reproduce.) Viruses don’t make new viruses unless they invade a normal cell and take over its normal job, forcing it to make more viruses. THAT’S why “antibiotics” can’t kill viruses – because a virus isn’t alive, it can’t be killed. You might think of viruses as microscopic zombies…

Stem cells aren’t any specific kind of cancer cell – they’re a “generic” cancer cell – so chemotherapy designed to take out breast cancer cells doesn’t work, slides off the stem cells, which then go to a new place in the body (metastasizes) and turn into a breast cancer cell and begins to reproduce. This is where metastasized bone, lung, brain, and liver come from.

At any rate, the chemical that comes from the Ambrosia arborescens is called damsin (it can be made by Humans, too. When its artificial, it’s called ambrosin), and when used against cancer cells – at least in recent tests – both damsin and ambrosin “inhibit the division and mobility of the cancer cells. This means that the tumour becomes smaller as cell proliferation [cells dividing and growing] decreases.”

The research is only at the very beginning stages, BUT…if it continues to perform in animals and Humans the way it performs in the lab, this could lead to a new and better way to treat breast cancer!


Saturday, September 23, 2017

ENCORE #71! – Metastatic Breast Cancer -- Lung Cancer

From the first moment my wife discovered she had breast cancer, there was a deafening silence from the men I know. Even ones whose wives, mothers or girlfriends had breast cancer seemed to have received a gag order from some Central Cancer Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this blog…That was four years ago – as time passed, people searching for answers stumbled across my blog and checked out what I had to say. The following entry appeared on Christmas Eve in 2011.

Some fifteen years ago, my wife’s mother passed away from lung cancer.

A child of her times, she smoked often and heavily for a number of years while raising four children, then quit – long before I met her.

Diagnose with lung cancer in 1994, she took chemotherapy, went into remission and finally succumbed to the disease in (I think – and my wife will correct me!) 1997.

Her disease was DIFFERENT than the type of lung cancer that can flare up after a woman (or rarely a man) is treated initially for breast cancer. Lung cancer after breast cancer is most often caused by BREAST CANCER cells that have invaded other organs and therefore are called metastatic breast cancer. The word “metastatic” was used in the 1570s and comes from the Greek metastasis which means "transference, removal, change.” The roots are meta which means "over, across" plus the word histanai which means "to place, cause to stand.” The medical use for "shift of disease from one part of the body to another" dates from 1660s in English.

“Metastatic cancer to the lungs is the spread of cancer from another region of the body to the lungs. The place where cancer begins is called the primary cancer. For example, if breast cancer spreads to the lungs, it would be called breast cancer with metastasis (spread) to the lungs. In this case, breast cancer would be considered the ‘primary’ cancer.”

Symptoms that would lead doctors to believe that the breast cancer had metastasized to the lungs are similar to those of “regular” lung cancer and would be warning signs that a person would need to see their doctor as soon as possible. They include: a cough that persists over time, or does not go away with treatment; coughing up blood, difficulty breathing (due to decreased airflow by a tumor obstructing the large airways or spread through the lungs); wheezing (caused by the interference of airflow through an airway obstructed by a tumor); pain in the chest, back, shoulder, or arm (when a lung tumor presses on nerves around the lungs); repeated lung infections such as pneumonia or bronchitis; hoarseness; and lastly, lung cancer CAN have no apparent symptoms and only appear  when a chest x-ray is done for another reason.

As well, “general symptoms” of lung cancer can sometimes present with vague concerns such as fatigue, weight loss, loss of appetite, and even depression can be a symptom of lung cancer as well as many other conditions.

Treatment for cancer metastatic to the lungs is usually determined by the primary cancer, or origin of the cancer. Systemic therapy (chemotherapy, biological therapy, targeted therapy, hormonal therapy), local therapy – which might include surgery or radiation therapy), or a combination of these treatments. The choice of treatment generally depends on the size, location, and number of metastatic tumors; the patient’s age and general health; and the types of treatment the patient has had in the past.

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

Saturday, September 16, 2017

GUY’S GOTTA TALK ABOUT…Alzheimer’s #10: Time Traveling With My Dad

Dad’s diagnosis of Alzheimer’s stayed hidden from everyone until I took over the medical administration of my parents in 2015. Once I found out, there was a deafening silence from most of the people I know even though virtually all of them would add, “My _____ had Alzheimer’s…” But there was little help, little beyond people sadly shaking heads. Or horror stories. Lots of those. Even the ones who knew about the disease seemed to have received a gag order from some Central Alzheimer’s Command and did little more than mumble about the experience. Not one to shut up for any known reason, I started this part of my blog…

I love the concept of time travel.

My favorite set of movies are the BACK TO THE FUTURE Trilogy.

My wife and I just spent the past week binge-watching Series 5 of DR. WHO.

STAR TREK (all of the series!) have great fun playing with time travel – doing some of the most impressive episodes of all time and introducing the entire Mirror Universe…

I LOVE TIME TRAVEL!!!!

However. Captain Kathryn Janeway in the Star Trek series, VOYAGER, had one of the most succinct criticisms of time travel I’ve ever heard. In the episode “Future’s End”, she says, “Time travel - from my first day on the job as captain, I swore that I would never let myself get caught up in one of these God-forsaken paradoxes. The future is the past, the past is the future...it all gives me a headache.”

I used to laugh at that, but since Dad starting sliding from Stage Four firmly into Stage Five of Alzheimer’s, her complaint has suddenly struck close to home.

Talking to Dad, I get headaches petty regularly these days. Dad’s mind slides from sometime in 1941 when he was just ten years old, to the present. There are moments when he forgets that my mom passed away (14 months ago now) only to remember that she did almost before the words leave his mouth.

He’ll call and ask where mom is…and after talking to him for a few minutes, I realize he’s talking about HIS mother. She died in 1954. Dad was only 23 and on leave from the Air Force because she was ill. His own father had died when he was sixteen.

In the previous 100 words, starting with “Talking to Dad…” you went from 2017 to 1941, back to 2017, then the middle of 2016 and onto 1954. That’s 70 years + 70 years + 1 year + 63 years, for a grand total of time travel years of 204 years.  

I’ll never know exactly how Dad felt either of those days because he just goes into a factual explanation about how his dad was napping while he was on the phone with some girl. After a while, Dad noticed that his father had stopped breathing. He gets even more factual and brief after that, ending with, “June took care of most of it.” June was my aunt. She was all of 29 when her mother died.

At any rate. The disease has made my father into a time traveler – a lost time traveler at that. While I’m still firmly rooted here, for him, he’s not unsure of what day or time it is, he has no real perception even of what year it is.

“For example, the perception of an ocean sunset combines a multitude of visual impressions; a vast color palette with numerous shapes (a round red sun, the line of the horizon, purple clouds of all shapes and sizes, etc.). But the experience is more than just visual. The sound of the waves and the gulls flying overhead. The smell and the taste of the salt water and the way the warm breeze feels against your face. You may be enjoying the moment with friends, and this also becomes a part of the overall experience, and of the memory.

“It is the hippocampus that sorts and compares these impressions (like the sunset) and creates a memory. Memories at this stage are short-term memories. The hippocampus then decides if a particular memory will be committed to long-term memory.

“So it is not surprising that forgetting a recent event (short-term memory) is one of the very first symptoms of this disease.”

OK – short term is scrambled so he forgets what happened yesterday. What about the skipping around?

“Patients with Alzheimer's disease…received tests of recall and recognition, word-completion priming, and incomplete-picture priming. [They] had impaired recall and recognition…[and] impaired word-completion priming. [They also] had intact incomplete-picture priming, a form of priming shown to be perceptual in normal subjects. These results provide…evidence for a dissociation between two components of repetition priming, perceptual priming…and nonperceptual priming... Preserverd perceptual priming in AD may be mediated by the occipital regions that are relatively spared in AD; compromised nonperceptual priming may be mediated by temporal regions that show dense neuropathological changes early in AD.”

In English? How about this: Based on tests that looked at , Alzheimer’s people have trouble remembering and recognizing things like pictures, words, and common sentences (Like, “See Jane run,” or pictures of places, people, or things). People can usually recognize words that are made up of words they already know – “airplane” for example, “air” and “plane”. They have more trouble with words they’re unfamiliar with, for example “Alzheimer’s”.

They also have trouble repeating actions unless they’re used to them. Another problem they run into is that there’s a weak connection with what’s happening “now” to Dad and what happened in the past. He’s experienced past events more often, so he remembers them. Current events aren’t attached to anything – except past events – Dad knows what it’s like for someone close to you to die. He remembers HIS mother dying. But not Mom dying and mentioning the current event sparks the past event. Ideas, language, and how he responds to various people in various situations – are damaged early on in Alzheimer’s.

So – Dad’s memories skip all over the place whenever something that’s happening “now” recalls something that happened “then”.

I still love time travel – I just hate watching my dad travel in time. It recalls to mind a STAR TREK: Deep Space 9 episode in which Captain Sisco’s son ages while the captain stays the same age and is snapped into his son’s life at different times. We’ll talk more about “The Visitor” next time and how it feels like what’s happening to Dad.