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…

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.”

*blinks 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 – camping next week to celebrate 25 years of marriage and now we’ll be prepared. As prepared as we can be!

Reference: http://www.lymphnet.org/lymphedemaFAQs/riskReduction/summerTips.htm
Image: http://rlv.zcache.com/minnesota_state_bird_the_mosquito_tshirt-p235392594519424546z89ss_400.jpg

What’s the Difference Between Metastatic Liver Cancer and non-Metastatic 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…

A few weeks ago a friend of mine was diagnosed with liver cancer.

I’d talked about metastatic breast cancer of the liver (http://breastcancerreaper.blogspot.com/2011/12/metastatic-breast-cancer-liver-cancer.html), but with this grim diagnosis, I wanted to look more closely at the differences – if any.

In brief, metastatic breast cancer in the liver (MBC:L) comes from the transfer of breast cells to the liver and then the growth of tumors there. Most often treated with hormone, chemo and radiation therapies, there are newer choices as well, including liver resection.

With the diagnosis of non-MBC liver cancer, my friend also has complications. Regarding these complications, it has been “...shown that cancer is…common…for [this  kind of complication]. The authors attributed this to overlooked symptoms, such as blood in the urine or stool, and delayed treatment because of complications…The most common cancer...is hepatocellular carcinoma, a type of liver cancer.”

Hepatocellular carcinoma, also called HCC, develops like any other cancer by a mutation to the cellular machinery that makes the cell divide faster than normal and/or gives the cell a sort of “immortality” by keeping itself from ever dying. This wild growth of cells form tumors and the tumors ruin the normal balance of chemistry in the liver. This leads to many different symptoms: abdominal pain, jaundice, bloating, loss of appetite, nausea and proteins in the blood that aren’t supposed to be there.

The short answer to the question above is that there isn't any real difference between MBC:L and HCC. Both are mutated cells run wild. In MBC, the cells running wild originated in breast tissue. In HCC, the cells running wild originated in the liver.

There are many treatments available for both MBC:L and HCC and while there is a constant search for new methodology, in the long run, whether the cancer originated in metastatic breast cells or in the liver itself, the prognosis continues to depend on how much the cancer has spread and how quickly it is treated. The main difference is that MBC:L cells can also be treated with tamoxifen (which affects estrogen levels) the same as any other breast cancer cells. HCC is not treated that way.

Resources: http://en.wikipedia.org/wiki/Hepatocellular_carcinoma
Images: http://upload.wikimedia.org/wikipedia/commons/thumb/2/2f/Hepatocellular_carcinoma_intermed_mag.jpg/220px-Hepatocellular_carcinoma_intermed_mag.jpg

Men Caring For Wives With Breast Cancer ARE SICK, TOO!

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…

I refuse to use this as an excuse for gaining about 15 pounds the last year.

I DID need to explain to myself why, after hovering around 240 for decades I slid up to 260 where I’ve been for months now.

I was vaguely aware that I wasn’t doing what I SHOULD have been doing: eating reasonably, doing SOME exercise and watching the carbs. But there didn’t seem to be any hard reason to watch myself.

Then I stumbled across this: “‘Caregivers are called hidden patients because when they go in for appointments with their spouses, very few people ask how the caregiver is doing,’ study author Sharla Wells-Di Gregorio, an assistant professor of psychiatry and psychology, said in the news release. ‘These men are experiencing significant distress and physical complaints, but often do not seek medical care for themselves due to their focus on their wives' illness.’”

Again, I don’t WANT to use this as an excuse for packing on the poundage. I need to understand myself as I continue walking alongside my wife.

Oh, then there’s the guilt about the GUILT: I feel horrible that she suffered through the hell of chemo. I ate to make myself feel better (and assuage my guilt) and packed on weight – and then felt guilty that I was getting fat because I wouldn’t be able to help my wife as much ‘cause I was feeling crappy with the weight gain…

Circular reasoning.

Now what?

I understand better now and so I resolve a couple things:

1) I will stop gorging to make myself feel better. It WON’T make me feel better in the long run. (The extra pounds have hurt my knees. I need to drop that 15 to get back to the relatively low knee pain I experienced before the weight gain.)

2) I will eat with greater attention to food VALUE (fewer empty calories, more reasonable proportions.)

3) I will NEVER eat at a buffet again. (I know from my training as an Elijah House counselor that vows are NOT good, so if I can morph that into a promise to myself, I will. Right now it’s too strong of a feeling for anything less than a vow). What I saw the night before last made me extremely sad.

4) I will work toward exercising more often. I LOVE my new bike. We need to get better acquainted!

5) I will surrender my life more fully to Jesus Christ. It has never been His intention that I take the gift of living in this country and make a pig of myself...

I’ve written about this before (http://breastcancerreaper.blogspot.com/2011/05/husbanding-bigger-middle.html), but I understand what was going on better, now.

If this makes sense to anyone who reads this, let me know!

Resource: http://health.usnews.com/health-news/news/articles/2012/04/23/wifes-breast-cancer-can-hurt-husbands-health-too-study
Image: http://martinisatthebluemax.files.wordpress.com/2011/07/996047012_ec26700659_o.jpg?w=640

Lymphedema -- Again...

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…

I wrote about lymphedema for the first time last February (http://breastcancerreaper.blogspot.com/2012/02/lymphedema-another-for-rest-of-your.html), which was really the first time we had to think about it. Being that it was only a few short months after chemo was over and my wife’s hair had only just started to grow back to a “normal” length, lymphedema didn’t really surface as an issue.

Five months later, it’s still not an ISSUE. But it’s become something of an irritation.

See, we have a couple of grandchildren and we’re do-it-yourselfers when it comes to things around the house.

What do those two things have to do with each other?

If you didn’t go back and read the article I wrote in February, the definition of lymphedema could be simply stated: “when lymph fluid builds up in the body's tissues instead of returning to the circulatory system. This causes abnormal swelling in affected areas of the body.” Some of the symptoms of lymphedema are: “Swelling (of the arm); tightness and stiffness; heaviness, aching, pain, puffiness, feeling of "bursting"; numbness or tingling, hardness or firmness; skin color or texture changes”. This can be helped by “lymph tissue massage to stimulate lymph flow and redirect fluid to functioning nodes; modifying your activities…”

How does lymphedema intersect the fact that we have grandchildren and like to do things like grout new ceramic tile, pick up and hold and infant and a toddler, throw going-away parties for daughters headed for New Zealand, keep up a house, go grocery shopping and refinish chairs?
Hopefully you see that life-after-chemo has to undergo a bit of restructuring in light of rebuilding life-as-we-knew-it!

And so it has. Recently, I started the lymph tissue massage. My wife lays on the bed shortly before we turn in and holds the lymph node deprived arm in the air. I lotion up my hands and GENTLY slide them from fingers to armpit, pushing the lymph back into circulation. Not difficult. Not intrusive.

But it ISN’T something we’d ever had to do before March 2011. It’s part of the New Normal. And you know what? That’s OK with me today.

Resource: http://www.communitymemorial.com/services/rehab/lympedema.cfm
Image: http://oakworksblog.massagetables.com/wp-content/uploads/2012/04/massage-arm.jpg

Road Signs

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...

I was travelling yesterday and had to cross the border between Minnesota and Wisconsin.

Having been born and bred Minnesotan – as well as learning to drive here – I know that there are certain road signs that are the same everywhere and there is some variation between states. The example above is one that’s obvious.

What I didn’t realize until yesterday was that the PHILOSOPHY of signage is different between the two states. Not on the Interstate – they keep that uniform for a reason! – but it becomes apparent when you cross over.

Minnesota’s signs are concerned with where you are going. Your destination is the information communicated on the signs with frequent reports of “Duluth 96 mi” and “Next Rest Stop 44 miles”.
Wisconsin signs are concerned with where you are.

I pulled on to US 53 northbound and drove with no idea of how far I was from my destination – but quite clear that the intersection I was passing through at that moment was Black Dog Road. The next one, when I arrived was Lone Oak Lane...

There is something to learn on this continuing breast cancer event – which surfaced again after I returned home and my wife noticed that after several hours of house work, her right arm seemed swollen. I did an exercise that, while it’s not a CURE for lymphedema, can help return slight swelling back to more normal levels.

After the initial diagnosis of breast cancer, it seemed like everyone was intently focused on the destination: cancer freedom. Like my native Minnesotans, we were regularly and constantly informed that we were well on our way to the destination.

After a year of surgery and chemo and endless doctor visits and the apparent arrival at the destination, it seems someone has switched philosophies on us without saying anything. Like my Wisconsin fiends, we are now focused on where we are.

Now that I finally have the signs right, I’m pretty sure I can get over my confusion – and pass on the philosophy!

Image: http://addins.whig.com/blogs/ihavealottoshare/wp-content/uploads/2010/11/deer_crossing.png, http://rvingwithpleasureland.com/wp-content/uploads/2011/10/Deer_xing_thumb_640.jpg

Equal Rights For ALL Women! (Even ones we want to be INVISIBLE!)

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.

 Earlier this week my wife, who is also a cancer survivor and who had a double mastectomy, told me about a woman who had also survived breast cancer and who requested permission to swim at a Seattle, WA pool topless. (http://www.vancouversun.com/health/Double+mastectomy+cancer+survivor+gets+swim+topless/6830468/story.html)

At first the city turned her down, citing a pool rule. When she explained her situation – they made an exception, but only for her. Any other woman who had survived cancer and a double mastectomy, and who would want to swim topless in order to be comfortable while exercising, would have to go beg for the permission of Seattle Parks and Recreation Superintendent Christopher Williams. (Boy could I say something about THAT…) I am quite sure that my wife would be too shy to do that and would put up with the pain that accompanies wearing virtually ANY clothing over healed mastectomy incisions!

I find it ironic and irritating that in a society that openly promotes, celebrates, encourages and markets the ritualized exposing of women’s breasts (just not the nipple – but any other part of the gland is completely and enthusiastically endorse by the judicial system of the land (which, I could point out, is heavily male…)) would hassle this cancer survivor in ANY way!

Maybe this is just part of the Post-Cancer Crash, but maybe it’s not. Maybe it’s righteous indignation that our society is set up for the “well” and while happy to make “exceptions” (for veterans, women, people with physical and mental handicaps, and small children), would just as soon carry on business as usual, excluding those who do not meet the requirements of the Real Competitors and who may have suffered in any way that would leave them (in the opinion of the Real Competitors) weak and unworthy and who have been FORCED to make concessions…

Ugh.

This whole incident leaves me feeling violated and disgusted – because, if you must know the truth, I am one of the Real Competitors and have been all my life. (Well, maybe not a REAL Real Competitors, I am, after all, only a teacher and not in Business (omar, sharif. omar, sharif.)) This past year has continually opened my eyes, challenge my preconceptions and prejudices, and forced me to reconstruct basic assumptions I’ve made all my life.

Image: http://sphotos.xx.fbcdn.net/hphotos-snc6/c48.0.403.403/p403x403/168563_10150917738404091_1179796902_n.jpg

THE POST-CANCER CRASH

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…

Right after the literal and economic “boom” of WWI, came the Roaring Twenties. Life was good, coming together as Americans during The War Against The Kaiser had been followed by the heady rush of becoming a World Power, and it looked like the future was going to be bright, indeed.

Right after WWII came the Fabulous Fifties when America could do no wrong and we invented everything from hula hoops to the H-bomb and Elvis Presley.

The Great Depression came crashing down on the heels of the Roaring Twenties and the Fabulous Fifties were followed by the riots and assassinations of the Tumultuous Sixties.

For me, the bravery, positive outlook, and grand support of the Diagnosis, Surgery and Treatment year has come crashing down around my ears as the Post-Cancer Crash. Chemo is done, regular “How’s your wife doing this week?”s have dwindled to the occasional, off-hand query usually briefly answered.

My pink shoelaces are frayed and my wristband is dirty and faded. I am, quite frankly, left feeling depressed. No one’s fault but my own as there appears to be no more battle to fight. There’s no more heart-stopping terror to overcome. And really? My wife is alive and hasn’t felt better in YEARS!

So what’s up with me? I should be dancing on streets of gold, lolling about in Paradise, praising God from the rooftops, the skyscraper tops. Instead, I’m feeling quietly contemplative and a bit sad.

Ecclesiastes 3:1-9 talks about the fact that there are times in a person’s life that are given over to various things. Perhaps the past year was “a time to kill (cancer)...weep...be silent...war (on cancer)...hate (cancer)”.

In the same way – and in a NOT BAD way, perhaps now is “a time to heal...build up…a time for peace.” Perhaps now is the time to start growing again as well.

Perhaps now is a time to come back to life again. Perhaps now is “a time to throw away” the bitterness, anger and fear I’ve lived with for the past 18 months.

Take a deep breath. Hold it. Now release. Repeat.

There’s a faint smile on my face right now, so this must be the right thing to do...

Image: http://iselfcreate.files.wordpress.com/2010/11/man-breathing.jpg