Wednesday, November 25, 2009

Cancer and the Holidays. . . How Do You Deal??

The holidays are always a crazy time of year and sometimes they can bring out the worst in people.  That was true for those around me.  So when I was going through my chemo treatments back in 2001 I wondered how I would handle holiday craziness while I felt exhausted, sick, and depressed.  I was not looking forward to Thanksgiving meal not even the stuffing which was always my favorite.  Nothing tasted good to me because of chemo.  I seriously considered grilled cheese for dinner as it was the only thing I enjoyed eating that didn't really taste like metal.  

What was harder to figure out though was how I would handle my family and put myself first.  Putting myself ahead of others was not something that came easily to me.  But cancer certainly gave me the ability to see things more clearly.  I had to figure out a game plan that would allow me to get through the holiday with as little stress as possible.  I spent some time thinking about what I wanted to do.  How did I want to spend the day.  And what I came up with was not as appealing to my mom as it was to me.  I wanted to make a lasagna and eat it with my brother and his girlfriend at my place.  Not everyone in my family got along but I knew the 3 of us would.  I promised my mom that we would all go to her house for dessert.  She reluctantly agreed.  It was alot of work to cook but I was pleased that I could do what I wanted for once in my life.  I didn't eat much but I enjoyed the quiet dinner with my brother and his girlfriend.  After the meal we headed over to see my mom and grandma for dessert and it was short and comfortable. 

I got through the day with minimal craziness and was proud of myself for expressing my needs to those around me.   It was not easy however the benefits far outweighed the risks so to speak.  Going through cancer treatment is so very difficult and it changes you.  The experience also can change those around you good or bad.  I think it is important to draw boundaries at times like these and make your needs known.  Think about what you want.  Think about what would make you happy for the holiday.  And try your hardest to make that happen.  Drawing those boundaries is important and doesn't have to be reserved for the holidays although for me it is when those around me are all caught up in the craziness.  It is what I try to arm myself with in order to not loose myself.  I tried to focus on what I was thankful for that day.  And that was feeling thankful for still being alive.

How do you handle the holidays?  If you are currently going through treatment have you had to be more expressive with your needs especially during the holidays?  How have those around you responded?  Has having cancer made you say or do things that you normally would not?

Friday, November 20, 2009

Breast Cancer Screening Guidelines . . . What Do You Think??

As a young breast cancer survivor I am sure I will be in the minority when I say this but I am not alarmed by the new mammography guidelines released by the USPSTF. The recommended change is to increase the age from 40 to 50 for mammograms in otherwise healthy women. This debate has become so heated that even a well respected clinician like
Dr. Susan Love is getting alot of flack for her support of the recommendations. She addresses these issues on her blog. A great organization called Breast Cancer Action (BCA) includes their take on this issue via a statement on their website. They are one of the few in support of it as well.

I am an 8 year breast cancer survivor diagnosed at 31 years old. I was not at the age to get mammograms and did not have a significant family history of the disease. It was not something I thought about at all. That is until I found a lump in my breast. I went to the doctor who recommended a mammogram. No tumor was evident however the results came back revealing subtle architechtural distortion of the breast tissue therefore a biopsy was recommended. The diagnosis was Stage II breast cancer. I had a mastectomy, reconstruction and chemo. These days I go annually for mammograms as part of my post cancer followup. Mammography has been known to not be a good screening tool for young women because of the dense breast tissue. I have actually been told by a radiologist that my mammo's are almost impossible to read for that reason which leads me to question why I am having them done. Breast MRI is known to have a high false positive rate which is why it is not recommended for use in otherwise healthy women. I have had breast MRI resulting in a false positive which lead to an unnecessary biopsy. There is also the concern about radiation exposure from tests such as these causing cancer as the young age group is more suseptible to this than the older population. I have to admit this concerns me as well.

This change in recommendations does not address the lack of an effective screening tool for young women. Young women are in the same boat they were before as are most young adults. I think right now the most important thing women in our age group can do is be familiar with your breasts, know your risk factors, and if you find something abnormal get to the doctor and have it checked out. Kairol Rosenthal is the author of "Everything Changes: The Insider's Guide to Cancer in Your 20's and 30's". She is also in support of these guidelines and today has written a blog post more specific to the Breast Self Exam (BSE) aspect of those recommendations. I have shared my opinion with Kairol on that topic. Check it out here.

I think there needs to be less anger driven debates and more direction towards how we can reduce mortality rates in young women starting with finding a more effective screening tool for this population. I think that using an ineffective tool for lack of something better gives a false sense of security to the many women fearful of getting this disease.

How do you feel about the new guidelines? Do you think the debate has become too heated? Do you think people's reactions are fear driven? Where do you think the focus should be? As a young women what issue is most important to you regarding breast cancer screening?

Monday, November 16, 2009

Can Good Nutrition Prevent Cancer??

When I was diagnosed with cancer I was hoping for the cookbook recipe to ensure I would survive.  If I do this type of surgery, this type of chemo, take this medication then I will be ok.  There were alot of decisions to make under the advice of my doctors but what none of them could tell me with 100% certainty is how long I would live if I survived.  

When treatment was over the fear of recurrence set in.  I felt like all I was going to do was wait for cancer to strike again unless I became proactive about my life.  So part as part of my quest I began to look for alternative ways to maintain my health and improve my lifestyle.

Nutrition was a good place for me to start.  As I looked back on my life and the things I ate it became no surprise to me why I was sick so much.  I never drank water, never ate veggies and barely at fruit.  I can't even tell you what I was eating although I can promise  you it's nutritional value was barely existent.  Over the years since I finished my treatment I have made many improvements to my diet.  I even began juicing.  But what I did notice though is I tend to become obsessed with it all.  And I am well aware that this obsession stems from fear.  

And then I think about people in my family that never had cancer.  Like my Grandma who lived to the ripe old age of 85 and smoked since she was 16, ate white bread with every meal, drank coffee daily, enjoyed pizza, nitrite laden cold cuts, and even KFC.  She was never sick until 2 years before she died and was diagnosed with emphysema.  I also remember how often she prayed.  And how positive she tried to be.  She always gave up her worries to something bigger than herself.  And she always advised me to do the same.  Now that is the part of haven't had much success with.  It is what I struggle with the most.  I have an easier time controlling what I eat than the crazy thoughts that swim through my mind most of the time.  

So, do I think that good nutrition can prevent cancer?  I am not sure to tell you the truth although I do believe it can help.  I tend to believe it is not one specific thing.  I think it is about balance.  A delicate balance the body and the mind.  I believe that the thoughts you put in your head can affect your health just as much as the food you put in your mouth.  

Tonite I will be a guest on the Stupid Cancer Show.  This is the topic up for discussion.  So join me to listen in and hang in the chatroom with other young survivors!  It is sure to be an interesting show!  Check it out here

Do you think that what you eat can affect your health?  Since your cancer diagnosis have you made changes to your lifestyle and/or diet in an effort to stay well?  If so what prompted this change in you?

Wednesday, November 11, 2009

The Impatient Patient

One would think that after 8 years I would have built up a stronger wall. But once I am in that orange striped gown open to the front I am instantly a half naked fearful patient. As scared as I am though I have much less patience for stupidity.

Yesterday I had my annual checkup with my oncologist. I have passed the 5 year mark which means that I only have mammo's each year but no more bloodwork. So it should have been an easy appointment. Then again, what about cancer is ever easy.

As I paced back and forth waiting for the doc I was startled when someone new walked through the door. She introduced herself as a Fellow and looked as if she were in her early 30's. She informed me that my doctor would be in soon. Hoping she didn't see me roll my eyes I thought about how I was not in the mood to be a lab rat again. I suppose that is par for the course when you go to a teaching hospital, a major cancer center. Still I would have appreciated more preparedness on her part. One of her first questions was about why I decided to not take Tamoxifen. All I thought was "here we go..." As I explained my reasons while she stood there debating them I wanted to ask her why this was even coming up now as I had this discussion 7 years ago with my doctor. She continued on asking tons of questions like what kind of surgery I had...all of which she could have found out had she thoroughly reviewed my chart.

As my patience began to wane I was quite startled at what came next. She stepped in front of me and opened my gown to do a breast exam. As soon as she saw my boobs her eyes bugged out and her mouth LITERALLY dropped open in amazement. At that moment I as a person ceased to exist. All that she was interested in was me from the neck down. It went something like this...

"OMG....that is amazing. Did you have a TRAM flap?" she said while still staring at my boobs with wide doe eyes.

"Yes" I replied wondering why she didn't read that in my chart.

"Wow! That is the best one I have seen....unbelieveable! Who did your surgery?"

When I told her who did it all I could think about was how bad I felt. I thought about how when I looked in the mirror I did not think it looked amazing. When I look in the mirror I am reminded of what I lost. I am reminded of how lopsided I look and how I can no longer feel anything on that side. Which lead to her next question...

"What does it feel like?" she asked with her eyes finally glancing up to meet mine.

"It feels numb all over." I said as I began to feel like something that should be working a side show.

What she didn't realize was how quickly she separated me into parts. It felt as though she was more interested in my reconstructed boob and not in the person it was attached to. Her bug eyed reaction to my boobs will be on my long list of inappropriate responses by medical staff. It made me feel uncomfortable. I only wish I had the guts to tell her so. She may have gotten all A's in med school but I would score her bedside manner a big fat F.

Has a doctor ever made you feel uncomfortable either through words or actions? How did you handle it? Have you ever been an impatient patient? Ever disagreed with your doc? How did he/she react?

Thursday, November 5, 2009

Do You Remember Your First Kiss??

It was a very hot summer nite in August of '86.  I had just turned 16.  I could smell his Drakkar cologne mixed in with the exhaust fumes from his father's maroon Chevette.  As we quickly rounded the corner I heard the squeak of the breaks.  I didn't want to look up.  I didn't want the ride to end.  

Janet Jackson's When I Think Of You  was blaring from the radio speakers.   The windows were rolled down.  I felt the warm humid breeze blowing through my hair as I turned to glance over at him.  He gently touched my hand with his.  His hand was big and strong overpowering mine.  I wanted his big arms wrapped around me.  I could feel goosebumps riding up my spine.  As  his  hand lightly squeeze mine I felt very warm and tingly.  It was the first time a boy ever held my  hand.  I was too shy to look in his eyes but I could almost feel his smile.  The moonlight coming through the car window showered light on our hands.  The moment seemed never ending.  I wanted time to stop.

I felt his hand gently pull mine closer to him as if to lead me into his arms.  The other hand touched my face.  I was afraid he could hear the sound of my knees shaking.  And just like that I felt his lips quickly touch mine.  It was a soft, wet kiss that brought the goosebumps back again.  

So unsure of what to say or do I said goodbye and practically jumped out of the car.  I could feel my smile getting bigger as I approached my house.   I turned to look back at him and heard the whirring of the engine getting louder.  I was just about to wave when I heard " that you?"  in my mom's concerned voice billowing out of the kitchen window.  Rolling my eyes with a sigh escaping my breath I clicked the latch on the door.  I walked inside, headed straight for the stairs and up to my room.  As I felt myself bounce on my bed belly flop style I licked my lips.  I touched them as if something big had just happened.  I tried to remember the feeling, the softness of his mouth.  All of the other sounds in the house were quickly drowned out by the song playing in my head.   I began to replay that moment.  A thousand times would never be enough.  I could only hope it would happen again.

Little did I know at the time but I had just shared my first kiss with the man I would someday marry...

Do you remember your first kiss?  How old were you?  Is it a fond memory or something you would rather forget?  

Tuesday, November 3, 2009

News Segment On Self Breast Exams Featuring Bare Boobs. . . Necessary Or Not??

I have no doubt that doing self exams helps to save lives.  I was 31 years old when I found a lump in my breast that turned out to be cancer.  Although I was never vigilant about doing self exams I found the lump while in the shower one morning doing what I named the "poke around".  I was soaping myself up and was just being lazy I guess not using the proper clinical techniques but I found it nonetheless.  I think I first learned how to do the exam via an article in a women's magazine.  There were written instructions and diagrams.  Then when I began going to the gynecologist in my early twenties I was instructed in the proper techniques.  I believe there is enough information out there that putting a commercial segment on TV showing a woman doing a breast exam nude is just not necessary.  

A recent article on CBS discusses this issue about an ABC affiliate station in D.C. that aired a segment showing a woman doing a self breast exam and did not blur out the boobs. Check out the video here.   It also noted in the article that the station was airing the segments during fall sweeps week.  I found that interesting and couldn't help but wonder as many others whether the station is airing the segments for shock value to enhance ratings.  Of course they say that is not true.  What they do say is that the motivation behind the segment stemmed from learning through research that the majority of women don't know how to do these exams.  But I personally question that as there are so many other ways for women to gain knowledge about doing self exams without showing a young woman's bare boobs during the 5 o'clock news.

Have you heard about this segment?  What do you think?  Do you wonder if it is a ratings stunt?  When did you first learn how to do your breast self exams?