Monday, May 14, 2012

YOUR VOTES AND YOUR E-SIGNATURE ASAP

It's May 14th.  Tomorrow is the final voting day for the Pink Well Challenge.  The day after that, I'll have to fill the space above the posts with a plea for something else.  I need something upon which to focus.  This challenge has been my cause since I realized we had the power to use our voices to get funds for METAvivor.  Vote today.  Vote tomorrow.  Vote three times today and three times tomorrow.  Send the link to everyone you know.  Let's get a BIG push for LOTS of last minutes votes.  It's important.

Above the plea for votes is The Clock.  It's Deadline 2020.  It's the initiative of the NBCC, the National Breast Cancer Coalition.  I returned home from the 2012 Advocacy Summit last Tuesday night.  I vowed to make noise wherever I could. This blog is a pretty noisy place for me.  I need some help.  Your Help.

First of all, each state was challenged to produce a number of signatures on The Petition to the President.  If you have NOT signed the petition, I encourage you to do so.  You can submit your signature electronically.  NBCC will see to it that your name is included.  If you happen to be at ANY event where you might have a captive audience, why not consider printing out the petition form.  Several signatures can go on one paper.  Mingle with the crowd.  Is there anyone among us who does NOT want to see the complete demise of breast cancer.  Honestly.  It's become pandemic and I don't really care whether or not it truly fits the medical definition of pandemic.  It's pandemic.  Because I said so.  So sign the damn petition.

Step two.  We need to get signatures on the Accelerating the End of Breast Cancer Act.  That would be the signatures of ALL congressional representatives.  Is your representative on this list?  Clearly, if your state isn't on the list, it's a fair assumption that your rep didn't sign the thing.  After lobbying on the hill (that sounds so damn important, now doesn't it?????), I can safely say that NO representative wants to be seen as "anti-woman," and there is no disease that screams WOMAN better, louder, pinker than breast cancer.  It's highly likely your representative isn't aware the bill is out there and that his/her signature is absolutely essential.  It's up to YOU to tell him/her.  (We DO need to come up with a metrosexual word as this his/her, him/her, s/he, wo(men) is getting annoying.... it distracts me when I'm writing.... Just sharin' ....)

Back to those signatures, IF your state is on the list and you are not sure about YOUR representative, NBCC makes it very simple.  Fill in the blanks.  The message will be transmitted through that page to the proper representative.  You will see the name of your representative as soon as you complete the form.  I'm going to play Let's Make A Deal.  If it turns out that YOUR rep didn't sign this yet, leave their name in the comments section.  I'll happily find them on twitter, I'll start a "twit storm" and soon the entire state will know that a Serious Woman's Health Issue is being ignored by Representative So and So from the Great State of Such and Such.

We will get the signatures.  I got your back.  One of my workshops last weekend was all about using social media to get the message out.  You think it can't be done?  There's a global breast cancer organization still dealing with fallout.  That demise was a direct result of places like Twitter and Facebook (and the blogs, too!) keeping the story alive.  Social media made sure the story had legs and SM was the big machine moving those legs like a hamster in a wheel.  And then, there's Kony 2012.  You can read about it but thanks to Social Media, in a 25 day span from when the video was released in March, the thing was viewed more than 86 MILLION times on You Tube.  All because ONE person posted the video and knew how to engage an audience and compel that audience to keep it going.

My fellow New Yorkers:  We have only one representative whose name is NOT on that bill.  Jose Serrano from the South Bronx.  Missing.  I'm already on it.  The twit storm has begun.  I'll be more than happy to continue the twit brigade. Send.Me.Your.Inkless.Your.Unsigned.Your.Clueless.  It's an election year.  Trust me.  The politicos need to pander to us. We are not a "special interest" group.  We are women. Women have breasts.  The number one risk factor for developing breast cancer?  You are a WOMAN.  Red or blue, ultra liberal or uber conservative and everywhere in between, putting a deadline on breast cancer it something that crosses all.

Your assignment for the next couple of days.....
1-METAvivor votes today and tomorrow.
2-Sign the presidential petition (and print out a few pages to haul around with you if you are so inclined).
3-Make sure your congressional representative has signed the Accelerating the End of Breast Cancer bill. If not, WHY NOT????

Demand answers.  They have jobs thanks to our votes.  They are OUR voice.  They should be representing the concerns of their constituents.  If they can't, come November, be sure to tell them to take a hike.  That's how the system works and it's always a good idea to play nice.  And if you can't get cooperation, you can always work towards satisfaction.  Vote 'em out......

Saturday, May 12, 2012

HAPPY MOTHER'S DAY TO ALL-MOST ESPECIALLY TO MY MOM

This is an anomaly.  I don't normally write anything on the weekend.  If you happen upon this post on Saturday and see that it's still up on Monday, that should tell you something.  The story is compelling.  It involves a mom and her two daughters, twins......I'm sure you can guess where it's going, but it's a MUST READ.  We need to keep retelling the stories. The REAL LIFE stories, over and over AND OVER again.  We need to share the stories.

I'm with Nancy, who is both the author and has a co-starring role, Nancy, who tells us that we must "Join together to be the generation that puts an end to this disease."  Thanks, Nancy Wyatt, an Army of Women volunteer from Los Angeles for taking the time to write about your experiences and thanks, Army of Women for allowing me to share the story on this blog.

I just want to wish everyone a very Happy Mother's Day and I also want to say, I Love You, Mom.

And now, Nancy gets the last words......


This Mother’s Day, I Want to End Breast Cancer

To Every Mother, Daughter, and Sister:

As a mother of two beautiful daughters and now grandmother to a pack of joyful and spirited grandchildren, I have made a simple wish for this Mother’s Day. I’m not looking for bouquets of flowers and bountiful gifts. This Mother’s Day, I want to end breast cancer and my wish is that we join together to be the generation that puts an end to this disease. Together, we can create a world for future mothers, daughters, and sisters without breast cancer.

When the “oldest” of my twin daughters found a lump in her breast at 32 years of age, we were all devastated. I was so scared for my daughter. This dreaded disease was an unwelcomed visitor in our family history, as my paternal grandmother had also been diagnosed with breast cancer. Sure enough, after a mammogram, ultrasound, needle aspiration, and finally a lumpectomy her lumps were found to be malignant. Her surgery was followed by a long year of chemotherapy and 8 weeks of radiation treatments.

Things seemed to be going well and we all thought she was doing just fine, when she discovered another lump in her scar tissue. She underwent a second lumpectomy and four days later, what the surgeon originally proposed as additional scar tissue, came back as cancerous. They recommended chemo again but my very tough, “I can handle anything” daughter broke down in tears, as she just couldn’t go through it again. After much thought and lots of prayer, she decided to forego chemotherapy a second time. She ended treatment in 1995 and today I’m happy to say that she’s healthy and still enjoying life to the fullest.

Unfortunately, this was just the beginning for me and my girls. Eleven years after my daughter’s initial diagnosis, her twin sister, who was 40 years old, had just delivered her 5th baby. While nursing the baby she felt a pain in her breast. Much to her chagrin, she discovered a lump in her breast. Sure enough, this lump turned out to be malignant, too. She, too, went through a year of chemotherapy. Again, I feel so fortunate to report that all is well and this busy mom of five is running around like crazy with all her kids and loving every minute of it.

We are thankful for every new day and try to put the ugly days behind us. But three years ago, we learned that breast cancer was not done with us just yet–when I myself was diagnosed. I, like my twin daughters, underwent a lumpectomy, followed by chemotherapy and radiation. Although science has made much progress with treatment options, we still don’t know how to PREVENT breast cancer.

I, too am now doing fine, but as the days go by and I see my granddaughters grow up I worry about what lies in their future. Successes and triumphs, relationships and heartbreaks are sure to come, but if I could be a part of eliminating one thing from their future…it would be breast cancer.

My daughters and I support the Dr. Susan Love Research Foundation’s Love/Avon Army of Women Program because its working to eradicate breast cancer and improve the quality of women’s health through innovative research, education, and advocacy. What sets the Dr. Susan Love Research Foundation apart from all other breast cancer organizations is its mission to move breast cancer beyond a cure by understanding the causes and ways to prevent it. They are conducting research that is focused on getting to the root of the disease and ending it once and for all. It is their firm belief that at the core of effective research is a need for scientists, women and funders to work together.

Talk to your friends and spread the word. Get everyone you know to sign up for the Army of Women, be a volunteer and help eradicate breast cancer! This Mother’s Day, give a gift to your daughters, their daughters, and their daughters to follow. To support our work, donate today.
Help build a world without breast cancer!

Sincerely,
Nancy Wyatt
Army of Women member, Los Angeles, California

Friday, May 11, 2012

#FEARLESS_FRIENDS

This is somewhat loosely tied to yesterday's post.  One week ago, I left for Washington DC to attend the NBCC Annual Advocate Summit.  I am still poring through the material and information I received during my four days in DC.  Much to share from the brilliant minds who spoke at the workshops in which I participated, those who sat on the plenary panels, the congressional representatives who stopped in to speak to the group and those we visited on lobby day, and finally, the presentation to which I was invited by the Cancer Support Community.

There is much MORE to share about the relationships that were rooted in a virtual world and suddenly spilled into real hugs and school-girl squeals of delight.  New friendships were forged from across the country, across the globe and from around the block.  I had to go to DC to meet some of the most wonderful women who've been working tirelessly beside NBCC since it's inception and one person with whom I'd been trying to connect for several months.  Those were the around-the-blockers.

I literally, bumped into a woman from NYC while I was at the Army of Women table in the reception hall as she was introducing herself to the girl at the table.  I looked up after hearing her name.  I didn't know she would be there.  An unexpected surprise.  I had face to face meetings with the other Army of Women volunteers and staff for the first time. Bumped into some of the blog/twitter crowd.  The last person I met was a young woman from South Africa.  I was winding down in the hotel lobby before heading to the airport.  She has a story to tell and it will be on the blog in the upcoming days.  Let's just say I've been assigned the job of seeing if she can get a copy of Pink Ribbons Inc.  Suffice to say, there was no winding down.  I was getting amp'd up.  For now, I'll leave that right there.  I better.  Or there will be a rant.

I would be sharing a room with someone whom I never met, had only spoken to once and with whom I did lots of tweeting and messaging.  I arrived first and when Lori knocked on the door, it was a moment of pure pandemonium.  Within about five minutes, it was clear we will be lifelong friends.  We shared stories and traded wisecracks and there are at least 100 unfinished conversations.  Lori is brilliant.  Lori is a mets patient.  Lori is my friend and we will be friends forever.  And I intend to make sure I do whatever I must to ensure our "forever" means a good long time.

The following morning, we met CJ from METAvivor.  I fell in love.  CJ may be the sweetest and kindest person I have every met.  Bar none.  Another instant connect.  Warm and pure.  And then Debbi, my California counterpart in the Army of Women.  I guess we anchor the coasts.  Debbi and I have some rather uncanny similarities in our stories including our enrollment in the initial group of just over 1000 wo(men) in The Breast Cancer M.A.P. Project.  Stay tuned.  I connected the dots backwards on that one but it's quite blog worthy and it's an initiative of the Cancer Support Community.

Things are starting to get a bit odd.... I'm not going to get all Poltergeist or go Zen.  I'm just sayin....  Deb and I BOTH in DC, both of us included in the initial results of the MAP Project which was published in October, an invitation to the luncheon from that very same Cancer Support Community.  Things were about to get a bit odder.  (Yes, a "bit more odd" reads better, but odder is a word and I just felt like being odd.)

That first day, I was primarily with Lori and CJ and I believe I sent a tweet that went along the lines of:  "Sitting between Lori and CJ. It doesn't get much better than this."  I was being what we, in this corner of the blog world, have come to refer to as a #FearlessFriend.  I didn't feel like a fearless anything.  I just felt like I was sitting between two spectacular women and I wanted to know what I could do to assist either of them individually or as a collective group.  I was perfectly positioned.  I just wanted to listen.  I didn't want to ask what I could do.  I just wanted to listen.  Formulate my own thoughts and then open up a conversation with an idea rather than a question.  It's a better starting point.  There will be much much much more on that in the coming weeks.

Wait... didn't I say things were about to get odder.  CJ left for the evening.  Lori and I went back to the room to figure out what to do about dinner.  I flipped open my iPad and opened up my browser and had to blink a couple of times.  I called Lori.  Maybe we were looking at the page before we left the room?  I've been known to lose entire pieces of conversation or chunks of an "episode" ......  Lori simply shook her head.  No, neither of us touched that iPad.  The two of us just stood there staring at the screen and staring at each other.

It was a post written exactly one year ago today, May 11, 2011.  It was written by Rachel.  Right after she attended NBCC. All about her meeting with the other mets patients.  Rachel's meeting in 2011 seemed to go a bit better than Lori's did in 2012 (but Lori wasn't a mets patient in 2011, either...... Lori had her life turned upside down just months ago).  She talked about how she and Susan were the youngest in the room.  She talked about the need for those of us who are well enough to step up because those with mets are generally not in the greatest shape to advocate for themselves.  Rachel is gone. Susan died the same day.

I don't know why Rachel's blog, THIS entry most especially, bounced up to greet me as I flipped over the iPad cover.  I'll stay out of the twilight zone and claim that it's one of those chunks of time that I dropped out of my mind.  Or not.  I'll say it was Rachel, reminding me that her words will live on forever, reminding me we can use those words as a roadmap for how to be #FearlessFriends, reminding me that there are people for whom the pink bell tolls, reminding me to stare right down the barrel of the gun if that is what it takes to push change, to be fearless in apologizing to someone whose very actions were those she used her own words to criticize, to be fearless in the face of pinkpocrisy, to just BE.

Go ahead, click the link  and then, bookmark the blog.  Many of you knew Rachel but if you didn't, visit her blog.  Say hi to Anthony.  Give Newman a shout out.  Wish her family and friends well.  Make sure she is never forgotten.  That Susan is never forgotten.  That we push for the research to FIRST help those who need it the most.  Those whose lives are in the balance.  Too late for Rachel, too late for Susan, but it doesn't have to continue.  We need to make it clear.  Deadline 2020 IS a priority.  Sign the petition to the president.  Most importantly, we simply must find a way to save 300,000 lives between today and the goal.  They count.  They count the most.  They count more than anything else.  They are counting on US.  Are you with us?  Be a #FearlessFriend.  First.

Thursday, May 10, 2012

A MOST PROFOUND APOLOGY

Yesterday morning, a comment was left on my May 3rd blog entry.  It was left in response to a comment I made on another blog.  What follows below is a public apology.  And hopefully an explanation that can help heal any wounds that may have been inflicted by words.


Dear Coli,


I am SO sorry for the pain you feel, SO SORRY that your sister's life was taken by this dread disease, so very sorry if my words caused even the slightest of pain.  There are times that words are simply inadequate to express feelings.  This is one of those times.  I am glad you took the time to come to this blog and share your feelings.  If my comment was taken as an attack on Heather rather than an attack on the way I have come to feel about being held up as a "brand" to add to someone's bottom line, I am deeply apologetic.


I am resentful of the billions raised (and wasted) and decades of what amounts to truly meaningless research.  If we weren't so accepting of the status quo (breast cancer is a "good cancer" and "early detection is a cure"), perhaps the right research might have been funded.  Secondarily, there is a lack of public awareness of how misguided and downright unscrupulous some people (organizations) have become.  Slapping a pink ribbon on anything and sending little or no money at ANY charity surely appears to be the rule rather than the exception.  Having the recipient charities fund what amounts to stupidity rather than actually use the funds to help wo(men) in need or direct money toward research when research is the only way things will ever change is deplorable.


Yes, we must be careful with our words and using the story of any one individual to bring attention to what I have come to call pinkpocrisy without knowing anything about the individual's life, can be exceptionally hurtful.  I would imagine that it was incredibly painful to be blindsided by an article that appears to taint Heather's legacy just as you marked the one year anniversary of her death.  To see such an article for the first time, I understand your outrage.  I do.  I can't say I blame you, either.  Heather wasn't anyone's cause.  Heather was your sister.  Your 27 year old sister who only lived about 14 months after she was diagnosed.


Please know, from the bottom of my heart....those of us who are determined to make lots of noise are doing so in memory of all of those who have been taken from us and in honor of those who are living with metastatic disease.  Including Heather.  Especially Heather.  I am hoping to make a difference, to change the conversation, to see my friends with mets live long lives and die of ANYTHING except breast cancer.


I have a "family cluster" of disease and a daughter who is the driving force behind my efforts.  The fact that my mom and I had identical treatment despite the nineteen year gap between our diagnoses drives me.  My mom's FIRST round of breast cancer was in 1987.  Heather was likely just a baby.  Her second bout of breast cancer was after I completed my primary treatment.  Heather was diagnosed around the same time as my younger sister.   


Seeing a journalist say "everyone knows breast cancer, if detected early enough, is curable," drives me because not only is that an inaccurate statement, in some ways it lays blame at the feet of those like Heather, whose disease progressed quickly and aggressively.  Seeing a journalist say "in the battle against cancer one is a survivor if you survive the first night after being told you have the disease" drives me as that too is an inaccurate statement.  Those who are metastatic patients do not refer to themselves as survivors. They are terminal cancer patients.  The vast majority of them will not survive the disease.  The vast majority of them will die of breast cancer.  


The misrepresentation of the words survive and cure drive me to raise a deeper awareness and understanding.  Words like cure, prevent, early detection guarantee, survivor (and others) have no place in the same sentence as breast cancer YET. The sea of pink is, in my most humble and delicately stated opinion, our biggest obstacle toward meaningful change.   Like you are, and like Heather was, intimately aware of the ways in which this disease steals lives, the rest of the world must be made aware. Heather was not a pink ribbon.  Heather was a BEAUTIFUL young woman with a bright future whose life was stolen.  There are few people in the world who have stood in your shoes, Coli.  You remained at your sister's side and saw first hand what most in this world refuse to acknowledge.


So did Anthony Moro.  It was his wife, Rachel, who left the first comment on the blog where Heather's story appeared.  Her blog, The Cancer Culture Chronicles is filled with information about the misuse of funds, meaningless research.  Rachel's comments are scattered all over this blog and they are my most cherished comments.  She kicked and screamed about the pinkpocrisy because she knew Heather's life should not end at the tender age of 27.  Rachel died in February.  Rachel's life should not have ended at the age of 41.  That's far too young, too.  My friend died just days before Rachel.  She was 39. Her daughter is 8. 


Again, I am deeply and profoundly sorry if my words upset you in even the slightest way.  It most certainly was not my intent.  My intent is to make sure all the Heathers and Rachels of the world are not forgotten.  My intent is to stand shoulder to shoulder with my dear friends who are living with metastatic disease.  I want them around for a long, long time.  My intent is to do everything I can to protect my daughter.  I've said this a number of times throughout this blog.  I don't ever want to be in my mom's shoes.  She stood beside me when the doctor told me I had cancer.


I hope my words here have brought some measure of comfort and perhaps a slightly clearer understanding that my actions and my motivation come from a place of pure love.  And dogged determination.


In my thoughts,


AnneMarie



Friday, May 4, 2012

VISIBLE INK

There is a ten minute video below that is well worth watching.  I'm going to go out on a limb here and make some presumptions.  If you are reading this, you may also blog which means you enjoy writing.  Or, you may be a breast cancer patient or a caregiver to someone in the throes of an illness.  Perhaps you know I like to rant and you want to laugh at me, laugh with me or join in my ranting.  Maybe you remember I can find myself in some silly situations or envision myself in places like a hyperbaric chamber because there was some obscure (and likely ridiculous) study I stumbled upon that connected cognitive improvement with the oxygen enriched air inside one of those contraptions.

In recent weeks, I've gotten somewhat preachy and the crux of my preachiness has been all about donating directly to things that speak to your heart and soul.  Cut out the middle man and put the money right into the hands of the people who are going to USE the money.  This is a great example of what I mean when I say "donate directly."  And this is what it looks like when volunteers are devoted and dedicated and donor dollars are used wisely.

I am a participant in the Visible Ink program at Memorial Sloan Kettering.  I will let the video explain the program as it is SO MUCH more than just a writing program.  Rather than waste time gushing about the program, the folks who produced the video catch every single thing about Visible Ink that makes it so incredibly special, so powerful, so healing.  What I WILL gush about is the genius of the woman whose brilliant mind crafted this idea and then brought it to fruition.

Judith Kelman launched the program in 2008.  I know I mentioned in a very early entry that I was poised to participate when Visible Ink was unveiled.  I still have my first email correspondence with Judith in a saved box in Outlook.  Then bottom fell out of my world and there was no time for me.  In 2011, three years and many problems later.... I MADE the time.  It truly changed my life.

Judith has turned this writing program into a work of art.  Literally.  You can see for yourself.  And yes, this is a completely shameless plug.  I have a bit part in the video.  So yes, it's compulsory viewing.  And yes, if you are so inclined, their are high hopes to expand this program beyond the walls of the MSK Community.........

I can't begin to express my gratitude to Judith for her vision and to Anna who continues to cheer me on and helps me cut things to size and clean up the choppies.  This is a nice way to end the week.... And, as I head to Washington DC to make some noise, I am struck by this:  All of my activities today began as a result of VI......  It is because of VI that I realized I had to pay it forward by getting involved.... first with the hospital and then with Army of Women and now as a member of NBCC and Breast Cancer Action.  Visible Ink changed me and now it's my turn to change the world.  I'm dreaming big.  Join me, won't you?




Thursday, May 3, 2012

AWARENESS....NOTHING IS MORE IMPORTANT

If you happen to be one of the people who actually reads this blog and you know a bit about who I am,  I would imagine you might be scratching your head right now.  The other day, I had a post with a title about our "ability to prevent breast cancer."  Thankfully, there are a few people who do email me and that post has me a bit worried.  I hope anyone who saw that title and bypassed the post will go back and read it.

There is a line from a medical oncologist explaining what women might attempt to do to "prevent" breast cancer.  She wasn't being serious with her suggestions, she was trying to make a point.  The statements are so ludicrous, they made me laugh.  And breast cancer is not anything that I laugh about.  EVER.  But, it was a clever way to grab my attention.  I read the entire article.  It's logical.  

I do agree with her thoughts about primary care physicians being trained to identify "at risk women." I agree with her thoughts about having our primary care physicians (or our gynecologists) discuss the potential benefit of taking a drug like tamoxifen or an aromitase inhibitor if we are in an "at risk" category.  All people with high cholesterol are not sent to a cardiologist.  Ditto those patients with high blood pressure.  They are monitored and medications are prescribed, for the most part, by their primary care doctors.  Those who do not respond to medications are the ones who are referred for specialty care.  I might have benefitted from "preventative" tamoxifen.  I doubt I would have taken it, but it MAY have cut off the estrogen supply to the rogue cells and perhaps I might have been spared the cancer diagnosis.

That's the skinny on the post that insinuates "prevention" as a possibility.  A sound bite.  I'm becoming a sound biter.  And I'm using the buzz words that I've come to despise.  First "prevent" and now this???  AWARENESS????  Surely I've moved to the dark side.  Or should I say, the pink haze....  NAH.  This awareness has zero zip zilch to do with cancer or illness or really anything... this is a story of what the hell happened last night that made me miss my monthly Patient Volunteer meeting at MSK and it was a great meeting.  (I phoned in but it was NOT the same.......)

I had my swimming pool uncovered on Monday and as I was running out for yoga, the young man from the pool company was pulling up to vacuum the leaves now that the water was clear enough to see the bottom.  Today, they will throw salt into the water and for the rest of the summer, the pool basically takes care of itself.  It's NOT a salt water pool but we have this great salt filtration system.  It makes natural chlorine and I save a bundle on chemicals.

When I got back from yoga, I went to put my yoga mat into my "basement"  ....  It's only under half of the house and the basement is only half underground.  One of the windows is eye level with the ground and I have a great view of the pool from this window.  I walked over to the window to see what was going on with the water.  Frequently, the window is open. It was open yesterday afternoon as I was glancing at the pool.

Right beside that window are the meters for the electric and the gas along with the box for the phone line and the cable modem.  My nostrils were invaded with what I thought was a slight odor of gas.  I called my daughter and asked her if she could smell anything.  Initially she said she didn't smell anything and then she thought she did.  I went outside to the meter and again, it seemed like there was an odor.  I was outdoors so there was a small element of my logical brain in play........"Hey, jerk... you are in OPEN air where this stuff would be dissipating if it were nothing."

I HATE sounding the damn alarm and "I smell gas" is pretty high on the alarm scale.  It's an eleven.  Call the gas company? Or wait?  Or call?  Or check again in an hour?  In an hour?????  I grabbed the phone and called The Special Phone Number. There are no prompts to press one for this or two for that.  The phone is answered with the same swiftness as a 911 call. And they don't take kindly to people jamming that number with stupid questions like, "I have no hot water" or "why is there a service charge on my bill?"  The greeting, "What is your gas emergency?"  I don't have an emergency.... and I try to tell the girl I'm not sure if it's an emergency or not, but I THINK I may smell gas.

She asked me a couple of quick questions and as I was elaborating she was entering a mayday request.  "Stay on the line with me until I get a confirmation that they accepted the order."  Huh???  Who accepted WHAT order?????  It's a procedural thing.  No ball dropping when someone calls in and implies even the hint of a gas leak.  This shit is serious.  I hung up the phone and I said to my daughter, "Just watch this."  She was looking at me like I was nuts.  I told her to check the time because there would be someone at the door within minutes.  Turned out, twenty minutes to be exact.

I felt like a complete idiot when the guy got to the door.  I just shook my head and took him to the gas meter, told him I felt like a giant ass but I thought I could smell gas.  Ten minutes later, he was at my door again to inform me that YES, the valve was leaking and YES, there was a fairly significant leak and YES, he replaced that value and he needed to check all the pilot lights in the house.  Water heater, boiler, cooktop......

The fact that the meter was right outside my open window meant the gas would be leaking into the basement and once it reached a saturation point, one of those flames to the boiler or the hot water heater?  BOOM.  It coulda been a real issue. The key point here?  It's a damn good thing I am AWARE how dangerous a gas leak can be...... Because I'm pretty sure I would have been completely UNAWARE if  the house had blown to smithereens.  I would have just been collateral damage. Without ever even knowing what the hell happened.  Yes, Awareness.  Nothing is more important.     

Wednesday, May 2, 2012

MAYDAY MAYDAY MAYDAY

May Day.

Yes Ter Day.  Per Se.

And why is MayDay a distress call?  I already did the wiki detour.  Not important.  Just curious.  It's French, per se.

This is going to be a rambling mess of swirling thoughts.  Yesterday, I was invited to a presentation given by The Ohio State University Comprehensive Cancer Center: The James.  They are an NCCN Member Cancer Center.  They are also an NCI designated Comprehensive  Cancer Center.  Of the 41 NCI centers, they are one of only seven centers funded by the NCI to conduct phase I and phase II clinical trials.

Sidebar:  The NCCN is comprised of 21 major cancer centers throughout the US.  They write and continually update the guidelines for the treatment of any and all cancers.  The guidelines are a series of flowcharts that are available for anyone to read.  Why do I know this?  I have a binder filled with the "doctor version" of the breast cancer treatment guidelines as they existed in 2006 when I was diagnosed.  When my friend's 20 something year old son was diagnosed with a germ cell testicular cancer, he was being treated at the local oncologist's office.  Oncologist happened to be a friend but the night before what I calculated should have been a chemo treatment (if said friend oncologist was following the recommended guidelines), I sent my girlfriend a text message asking if the following day was going to be "Poison son with toxin A and toxin B"   ......   I recall the immediate reply:  "How do you know that and HOW the hell do you know the names of the drugs??"  I simply forwarded her the PDF that I downloaded from the NCCN site.  And I was confident in the kid's doctor.

Second sidebar:  Phase I and phase II clinical trials.... there is a semi written post about the importance of clinical trials which I will finish writing.  The post had more to do with explaining the difference between a research study and a drug trial to coerce more women to enroll in the Army of Women database.  Then I realized that clinical trials SAVE LIVES and it required a bit more digging to provide good links to easy to navigate sites.  Which explains why THAT post remains in the "semi-written" state.

There are many people to thank for that invitation and there are many things to share but for now, the only thing I want to mention is that I already KNEW OSU was On The Edge.  Stick with me here for a few moments.  In one of my very first posts, I mentioned my very dearest friend.  She's been by my side, literally, from the DAY the first radiologist told me he would prepare my films so I could have them reviewed by a breast surgeon.  I remember him holding my hand ever so gently.  I remember his voice, calm and steady.  I remember him looking into my eyes hoping to reassure me. "AnneMarie, I am sure they are going to want to remove those things to make sure they aren't cancer."  I don't remember leaving his office (which I apparently did without incident).

I do remember being in my car in the parking lot in hysterics on the phone with my husband, "You don't understand.  THEY KNOW what they are looking at.  THIS IS NOT GOOD."  I don't remember the ten minute drive home until I was about thirty seconds from my driveway.  I remember he called me to make sure I got home safely (I was about ninety seconds from home when my cell phone rang) and I remember telling him, "No, I only called Linda."  I'm guessing he must have asked if I called anyone (like my mom, which I didn't, until weeks later and only after much coercion).  And I remember being at my kitchen table for no more than ten minutes when my front door flew open.  It was Linda.  Sashaying through my hallway and into the kitchen in her very best Jackie O strut, announcing as she approached, "Don't you DARE think you are stealing my thunder.  I'm the cancer patient, NOT YOU."

The scar on Linda's neck was still visible.  It went from one ear to the other.  Her thyroid was removed two months prior. Medullary thyroid cancer.  As it happened, MTC was mentioned yesterday at the presentation but this is relevant to this post because I already knew they were ON THE EDGE at The Ohio State CCC, The James.  When Linda was diagnosed with this extremely rare cancer for which there was no option besides surgery, I refused to accept the words of her doctor.  "We will monitor your calcitonin levels.  When they go up, we will scan you.  We will locate where the cancer is growing and Dr. Excellent Surgeon will remove the cancer.  When Dr. ES tells me he can't cut anymore, we will throw you into a clinical trial."

Linda is a patient at MSK and I'm 1000% certain that is not the way the doctor said that to us (and yes, I was at her side for that visit and many others), but that's the way I heard it.  And I began to research.  And Linda and I were making a field trip to Ohio.  There was ONE doctor in the entire country (that I was able to find) who was doing some sort of a clinical trial on medullary thyroid cancer.  The print-out is probably still in a file in my office.  I knew, in March of 2006, long before I became so intimate with cancer, the good folks at OSUCCC were OUR Lady Gaga On The Edge (LG was still Stephanie and she was still in school and unknown so she was On The Edge, too).  NO Matter.

Yesterday, their presentation reminded me of what I've known for six years.  If I was impressed in 2006 reading about one doctor's research, I was that much MORE IMPRESSED yesterday to see how they work in collaboration across many disciplines to advance the research toward the goal of preventing cancer.  No one is working in a vacuum.  There was a cohesiveness, an effortless transition from one aspect to the next, a sense of teamwork and one shared common goal.  Fix this mess and attack it from all sides.  The details of the presentation will have to follow in another post but I left the luncheon with a renewed sense of hope.  We CAN do this.  They will lead by example, an example I hope others will soon follow.

That was far more than I expected to say, but I suppose OSUCCC has held a very special place in my heart for all of these years.  The memories began to flood in when I saw the words Medullary Thyroid Cancer on the screen.  Oddly enough, MTC was mentioned during the genetic presentation which is only odd because we had a conversation on Monday evening on twitter about hereditary breast and ovarian cancers and I did take a bit of exception with some of the statements that were being used during our weekly chat.  Words like "true negative" have no place in a conversation about genetics when the science is still in its infancy so I was very interested to hear what they had to say about the genome.  Again... off topic... but I'm not really on a topic.... 

I'm supposed to be rambling... so here goes with the rambles.....

It was pouring as I was driving into the city.  Rather than listen to music, I turned on the local radio news station.  The purpose of the radio was to monitor the traffic because one can never have too much information when driving on a rainy day where one needs to arrive somewhere by a specified time.  The car was monitoring traffic via the nav, my iPhone was monitoring traffic via the sucky AT&T cell network and the radio was monitoring the traffic via the air waves to my ears. In the process, via that radio,  I learned a whole bunch of other "stuff."

It was likely, thanks to May Day May Day that #Occupy Wall Street would be causing traffic disruptions in and around the city because that's just what protesters should be doing to make their point.  Piss off everyone who is trying to get to and fro in an already insanely crowded area, on a rainy day.  I'm pretty sure those cabbies are NOT in the 1% so why?  I get it. You need to make a point.  But JEEEZZZZ, you guys were pissing off the 99.  Just sayin'

Mitt Romney was expected to be in town at some point.  That's not a political statement.  That's just another traffic inconvenience.  It's not an Obama inconvenience with street closures and frozen zones but still, an issue.  A traffic issue. On a rainy day.  With protesters in the mix.  And Mitt. 

Then, I got the feel good story as I was headed for Columbus Circle to the venue for the luncheon.  I drive distracted so I tend to not pay much attention to the radio unless it's pertinent to the purpose.  The rain, the traffic, Occupy, Mitt and I hear something about best restaurants and I only heard, "two of them are in NYC: blah blah blah and Per Se."  I can't rewind the radio like I can back up the TV so I had to wait until I got home to google the story.  Per Se is the restaurant where the presentation and the luncheon was held.  It's not even fair to call it a restaurant.  It's an "experience."  And, it's on the list of The 50 Best Restaurants IN THE WORLD.  It's number six.  In the world.  And I was an invited guest.  Actually, in looking at the list, it's the first restaurant on the list from the USA.

And to close out the day, I was thinking about this weekend in Washington DC.  The Avon Walk ends on Sunday.  The NBCC ends on Tuesday.  There are going to be tons of women with breast cancer  passing through Reagan National Airport in a 48 hour period.  I was thinking someone should alert the TSA.  Lighten up with the pat downs in the body scanners.  Really. We should get some sort of designated area or something..... and Bam!  Fat chance.  There goes that breaking news music.....  "Wait!  What???"      "heightened security...."       "no credible threats but....."

Well, ladies, not only can we expect pat downs, I'm thinking they may be doing "scar checks" to make sure we are all healed.  As the story goes, we are now on an alert for "terrorists with bombs surgically implanted inside their bodies."

Geez, ya don't suppose I planted that thought in anyone's head......... 

Tuesday, May 1, 2012

ONLY **YOU** CAN PREVENT BREAST CANCER.

Well.... it turns out we really CAN prevent breast cancer..... If you read this blog, you know that my tongue is so firmly planted inside my cheek....... or, my teeth have left marks on my tongue from biting it.  Generally, I'm not one to bite my tongue.  In another life, I was a big tongue biter.  No more.  That person is gone and now, I just call it like I see it.  And, I don't care if people get upset.  Change the channel.  Tune me out and tune in elsewhere.  Freedom of speech and all that jazz.  Feel free to share information.  Use the proper caveats.  Are you expressing an opinion?  Then do not frame it as a medical fact.  It insults my intelligence.  I feel like Al Pacino handing that glass to Carlo before he meets his fate in that last scene of The Godfather.  Me and Al.  We don't like having our intelligence insulted.  That's a grammatical mess but frankly, I don't really care about that at this moment, either.

This appeared in an article back in November and I like this point of view.  I know the link to the original Medscape article is likely not going to work unless you set up an account with a login and a password.  The words below were spoken by Dr. Kathy Miller from Indiana University.  There are video blogs on the Medscape site.  She is an oncologist whose advice, if followed, as she says, will put her "blissfully out of business."

The point of the article and the video is to explain how primary care physicians should be doing more to incorporate breast cancer risk reducing conversations into their practices.  I'm sure many do but I'm sure many more do not.  She compares this to cardiology.  Your primary doctor will do blood work and test your lipids (cholesterol, triglycerides).  They check your blood pressure.  Issues with either of those things can be controlled once a person is made aware they may be at risk for heart disease or stroke.  We all know what constitutes high cholesterol or high blood pressure.  If our doctors find we are prone to either, they will discuss ways in which we can attempt to change our diet and incorporate exercise and stress reducing activities into our lives.  They may prescribe medications.  These situations, unless the numbers are off the charts, do not set off the "you need to see a cardiologist" bell. 

Are our primary care physicians discussing things we can do to reduce our risk of developing breast cancer?  I'm trying to think back to those years I was "blissfully NOT in this club."  I had two excellent gynecologists. Aside from a breast exam and a prescription for a mammography, I'm not sure we ever discussed the importance of exercise, a healthy diet, maintaining proper weight, alcohol intake.... that list.  The list of things we can do to give ourselves the best possible edge and then, it does, and is, and for the time being shall remain: a crap shoot.  But..... there are things.

According to Dr. Miller, the PCP's "simply don't think this is their job."  It is not said in a deragatory fashion.  It's a simple observation and perhaps a suggestion for ways in which to incorporate more whole body health into the hands of our internists, our primary care physicians.  She goes on to say they are not equipped or well trained..... they are not comfortable discussing oncology drugs.  Considering the damn toxicity of most oncology drugs, I can't say I blame those PCP's ONE iota!

The thing is this.  If I understand her correctly, statins would need to be prescribed to 275-325 patients in order to prevent ONE heart attack or ONE stroke.  These drugs are being prescribed by the PCP. Interestingly enough, in order to prevent just ONE breast cancer, SERM's or AI's (like tamoxifen or femara) would need to be prescribed to the same 275-325 patients.  Dr. Miller's point is well taken.  Why aren't our PCP's provided with guidelines to follow so they might perform the necessary tests to determine which women might benefit from tamoxifen or an aromitase inhibitor?

Her point is valid.  I was a high risk patient.  Then I was a breast cancer patient.  Might I have benefitted from tamoxifen? Maybe I was one of the 275-325 patients in the group that fit the guidelines.  If I were in that group, maybe the tamoxifen would have done its job before those cells went rogue.  I know me and I would have wanted better odds than one in 300 to deal with the risks associated with tamoxifen but that's a whole other issue.  The thing is.... the option was never even on the table for discussion.  I like her train of thought.  It makes sense.

As for the word prevent...... I make no apologies for the sour taste that word leaves in my mouth.  Too many of us feel could have, should have done something... that the cancer was somehow our fault.  This is the way Dr. Miller explains we CAN prevent breast cancer.......

"I was talking about breast cancer prevention and screening in our Department of Medicine grand rounds today. In reality, we could prevent breast cancer today.


Here is what we would need to do: Mandate that every woman has her first child, the first of at least 7 or 8, at about age 15, with a prophylactic mastectomy after delivery of that last child, and absolutely mandatory breastfeeding, for at least a year per child, with a prophylactic mastectomy after the last child is weaned. Everybody has to do an hour of exercise daily and follow a diet with a maximum of 20% of calories from fat.


Obesity is outlawed, or at least taxed, particularly postmenopausal weight gain. We would return to Prohibition -- so no more cocktail hour, no more wine with dinner. Prempro® would be absolutely removed from every pharmacy. Think about selling selective estrogen receptor modulator (SERM) or aromatase inhibitor (AI)-fortified foods (particularly for women) in health food stores. If you do all of these things, I am blissfully out of business."


(Me again... obviously, she was finished with the 1984 Orwellian rant and I do love a woman with a good rant.......But she went on to further explain.......)


"I know we are not going to do these things."


But there is something we could do, which is take a lesson from our cardiology colleagues. Cardiologists have made preventive cardiology internal medicine's bread and butter. In reality, we treat hypertension primarily to prevent heart disease and strokes, and also to prevent kidney disease, but primarily to prevent heart disease and strokes. We also treat hypercholesterolemia to prevent heart disease and strokes. When was the last time your internist said, "Oh, my dear, your cholesterol is 250. That puts you at risk for heart disease, so I'm going to send you to a cardiologist." Cardiologists have made primary prevention a primary care priority. We have not done that.
We have kept preventive oncology in the realm of oncology. That means that primary care physicians simply don't think this is their job. They don't feel equipped and well trained. They are not comfortable with our medicines. In their minds, the benefits of a SERM or an AI for prevention are too small to justify prescribing it.
If you look at the number of patients you need to treat with a statin to prevent 1 heart attack or 1 stroke, depending on which study and which statin you look at, you come up with a number-needed-to-treat of somewhere between 275 and 325 people. That is identical to the number of patients needed to treat with a SERM or the number of patients needed to treat with an AI to prevent 1 case of breast cancer.
So here is my plea: Make primary oncology prevention an internal medicine primary care issue. There is no reason not to, and if it takes off, we could be a lot less busy.


I love a woman with a brain.... and I love a woman who isn't afraid to use that brain.... and I most especially love a woman who isn't afraid to open her mouth when something makes sense.  It's time for us to start being more sensible, don't you think?  I know this isn't going to change a damn thing and really, what I do want is meaningful change....... but having spent yesterday in a building where each of the ten floors is devoted to one specific cancer specialty..... and getting stuck on the elevator that, of course, stopped on every single floor..... I looked into the eyes of the woman who was using those calming breathing techniques, I watched the brother and sister who were about my age talking to their dad about the need for him to get stronger before they could even entertain any of the options laid before them by the doctor, I listened to the woman in the waiting room who was a bit louder than necessary telling the person on the other end of the phone that her drains were removed but no, she can't drive just yet and her flight was expected to land by 4PM...... 


If just one of the many people who I encountered might be spared jumping on the cancer bus because of this change, I'll take it.  It's not nearly enough but if you happen to be that one person, it's surely MORE than enough. 

Monday, April 30, 2012

THE CLOCK IS TICKING ........ THE TIME IS NOW

This Friday, I will be on a plane, albeit one a bit smaller than I prefer, bound for Washington DC to participate in the National Breast Cancer Coalition advocacy summit.  That big clock above the blog posts?  Deadline 2020?  That's the genius of the National Breast Cancer Coalition.

These are the people who are trying desperately to change the conversation.  And with good reason, don't you agree?  We are insane with the breast cancer thing.  I've learned that insanity is when you keep doing the same thing over and over again and expect a different result.  Some might argue.  Some will say we've made progress.  Some will say we are saving more lives and I won't disagree.  We have made progress.

Early detection is saving and will continue to save lives but we've known THAT for many years.  We've found ways to minimize the side effects of chemotherapy.  I don't know who exactly perpetrates this factoid but for me, that seems like an urban myth.  I double dare you to wait near a chemotherapy suite and ask one of the women who is either entering or exiting how they feel in the days immediately following their chemotherapy.

Plastic surgery techniques have come far.  This is NOT an urban myth.  The plastics guys seem to have made the most progress.  They have come up with some ingenious methods to reconstruct us once we've taken the big plunge.  They are moving fat around, reconnecting blood supplies, using implants, taking muscle from other parts of our bodies to create the illusion of breasts.  Still.  Let's make no mistake here.  They are not breasts.  It's slight of hand and an illusion.  And make no additional mistake.  Some women are severely and seriously compromised after surgery.  But it looks good.  Forget about how it feels.  Billy Crystal...... You Look Mahvelous.......Absolutely Mahvelous.

None of this takes away from my "we are insane" position.  We're barking up the wrong tree.  We're moving in the wrong direction.  We are doing little more than marking time.  Meaningful progress matters.   The progress we have made stopped being meaningful about twenty years ago.  This week I will gear up to add my voice to the hundreds of others who will be in Washington DC demanding better.

Coincidentally, the DC Avon Walk is this weekend, too.  I don't think I'll arrive in time to help greet the walkers if Army of Women has a sign up table at the walk registration but Army of Women will have a table at the advocacy summit.  And I will be at that table lending a hand whenever I can.  If you are in the DC area, come see me at the Hyatt Crystal City.  If you are attending NBCC, time to start planning for the meet ups!

Are you going?  Roll Call........  Kindly sign the attendance sheet.    


Friday, April 27, 2012

LET'S HEAR IT FOR THE BOYS......

This is going to be short and sweet.  I have plenty to say.  With a capital P but there are too many loose ends I have to tie up and they are clogging my brain's ability to put together anything that resembles a cohesive sentence.

Life has a funny way of twisting and turning.  I started out blogging with one thought in mind.  Chemobrain, which is NOT funny, until you force it to BE funny, was going to be the heart of this blog.  I suppose on some level it is.  After all, isn't the hallmark of chemobrain doing the mental zig zag?  I don't even want to tell you how many email responses I found on this laptop.  Unsent.  Unfinished because I was distracted by something external.  The UPS guy with my shoes.  Or internal. I really wanted those Louboutin's so let's do the internet hunt.

I want to close out the week by thanking two men.  I'm singling out only these two because they are tied directly to this blog.  And they both had my back when I went on two recent rants.  They deserve recognition and my most sincere thanks.

Close to a month ago, I got irritated with that Pink Speed Dating Event.  The one where they are charging $2500.00 to only eighteen different hand picked Pink Profiteers so those lucky chosen ones can pitch their pink products to I don't know who. I'm still a little confused about that part of the event.  It says they will be pitching their products to "the media" and I'm trying to understand exactly what that means.  For advertising space?  Or are they pitching to some other group of people for a spot on the shelves of some store?  No matter.  The whole thing is a farce.  And guess what?  Registration is closed and they got their eighteen products all lined up.  Maybe someone at NBCC will know something about this.  The event is the day after I get home.  In NYC.

My anonymous "friend" left a comment that I did not appreciate when I tried to expose that event as the epitome of what I believe to be disgraceful cause marketing.  I felt like I was being berated by said anonymous friend.  I shut up and I didn't even reply to my buddies who commented on that blog entry.  I chose to stay out of the fray.  It's not like me to let the responses go without acknowledging them.  When someone leaves a comment, I don't know about blog etiquette, but my human being etiquette says, "If someone took their precious time to leave a comment, it's proper for me to acknowledge the comment."  I'm grateful when I see comments and I want to share my gratitude.  Maybe a "real blogger" isn't supposed to do that.... and if that's the case, so be it.  I'm sticking to my values and my beliefs.  I'm not about to start molding myself to fit any prearranged notion.

Because the comments are always open and unmoderated and because I've allowed anyone to post (even "anonymously") there could have been a war of words between me and the person who chose to have some pretty strong opinions but not the backbone to man up and identify him or herself.  Some very close blog buddies jumped to my defense.  Weeks went by and I noticed another comment pop up on that particular post.  It was from a man.  And it was a man who has breast cancer.  We happen to have a family friend who is a male breast cancer patient so I am quite conscious of the fact that men DO get breast cancer.  Oftentimes, when I'm writing and I type "women," I am thinking (and men, too) but by and large breast cancer in men is what you might call an orphan disease.  I'm thinking I may start typing wo(men) as a reminder to anyone reading that we wo(men) do not own the rights of exclusivity to the disease that is Breast Cancer.

Huge digression.  Ultimately, I DID respond to his comment on that post.  It takes guts (just my opinion) for a man to comment on what is primarily a bitch blog and walk right into the midst of what might have turned into a cat fight and it is especially gutsy when the comment begins with the words, "as one of the few men with breast cancer......"  Not only was I exceptionally touched by his willingness to share some of his experiences, he signed his name.  His full name.  His parting words were to anonymous:  GFY.  The man has my back on that one.  I am so appreciative.  It was unexpected.  And it deserves a public thank you.  Charles, a true gentleman.  And yes, gentlemen can, do and SHOULD feel free to use the "F" word, particularly when jumping to the defense of a woman.

The other man I want to thank also had my back when I got pissed off.  He jumped in when I was sharing my blog about those two french guys who started that Boobstagram thing.  I was having a twitter conversation with another woman.  She had a link to the pink PORN bus.  We were trading stories about pinkverts.  Does that require a definition?  You know I like to make up words.  I can't claim that as my own.  I read it somewhere.  Pinkvert=Pervert who finds a way to use breast cancer because sex sells.  The pinkverts are to the sex end of this gig what the pink cap wearing volunterrorists are to the cause marketing side of the gig.  Can't claim THAT word either.  They are both pretty witty words, don't you think?

The twitter exchange between a new woman friend and I was picked up by a man who, in 140 characters, managed to share that he was somewhat stunned at the stupidity of the boobstagram thing.  The next morning, I was copied in on a tweet with a link to a blog.  This is GENIUS and I want to thank HIM for not only stepping out about HIS testicular cancer but for taking that cancer and doing a side by side ..... never mind.. you simply have to read it for yourself.  And I have to say thank you because he took the time to quote some of the things I said in my rant.  And I LOVE his rant.  It's a great companion piece.  Definitely another ballsy maneuver.  So thank you, Jeff Fecke for reminding us it's not about saving body parts but it's about saving PEOPLE.  Saving LIVES.  And thank you for having my back.

Thursday, April 26, 2012

THE WEIGHT OF THE WAIT

It's been 48 hours.

I gave my oncologist a hug and got the big kiss off.

Purchased several pairs of shoes.

Had a day of volunteer activities yesterday.

Able to go pick up one pair of shoes today.

Two other pairs?  One shipped, and, of course, the one I HOPE to wear on Saturday night, still processing.  Must wait.

Today....... mom's at the oncologist.  And so..... again. I. wait.

I.hate.to.wait.

I.hate.THE.wait.

I Love You, mom.

xoxoxox


 

Wednesday, April 25, 2012

THE BIG KISS OFF

I don't know even know where to begin.  I'm not one to be at a loss for words but the support I felt yesterday was simply breathtaking.

First, if you aren't a twitter person, I'm FREE!  I am officially on annual follow ups with the oncologist.  Technically, I'm being put in the "survivorship" program.  In other words, once a year and in still other words, I likely won't even see the oncologist.  It will be the nurse practitioner.  Naturally, if something isn't right, he's still my doctor, but for now, I got the big kiss off.

I will be on femara for another five years but I already expected that would be the case.  I got that heads up at one of the seminars I attended.  We discussed the new Choosing Wisely guidelines with the blood tests for the tumor markers.  I love my doc.  He explained, for now, MSKCC is continuing to do the tests but they are reviewing the guidelines and will make a formal decision some time in the near future.  It seems likely they will stop doing this test.

I guess that means I honestly have morphed into A Flying Wallenda.  No Net.  (Did your eyes read that as "not yet" because mine did, every single time I did a read through...just curious??)  Like I said the other day.  It starts on a runaway train and now I simply must take that first step on to the wire.  I just saw a piece about the Wallendas on television and I was struck by that very statement.  Something about the hard part being while they are on the ledge, anticipating the walk to the other side... and once they took that first step, they just had to focus and concentrate on moving forward.  Balance. Reaching the other side.

I have no net.  The safety of the tests and the scans is on the ledge behind me.  Now, I move forward.  If I must stop and recenter, it doesn't mean I'm going to fall.  It simply means I need to use that balance stick (or whatever the hell you call that thing) to get my footing back.  The net makes it too easy to just toss it in when the going gets a little tough.  The safety of the net is really stopping forward progress.  The safety of the net can possibly get me to believe hurling myself off a building might not be such a bad idea---after all, I got that net.  And now, No Net.

I am embracing NED.  I know that recurrence thing will still creep up in some dark moments and I know, too, when that happens, I will be held up by the same group of amazing people who sent me tweets while I was waiting for the doctor yesterday...... and the very same group who were sending me tweets to share my joy hours later as I found myself in a celebratory shoe shopping spree.  I consider myself most fortunate to have found my voice and in doing so, to have found myself surrounded by brilliant, caring and  loving friends.  I don't know how to say thank you for yesterday, except to say that I hope to be in a  position to do for each and every one of you as you did for me.

Now.... a few random thoughts.  Someone who reads this blog and has communicated with me via email needs some extra special thoughts sent his way today.  His wife is likely in surgery as this is on your screen.  Another good friend is getting results from her latest round of treatment.... Someone else has an oncology follow up within the next couple of days.  My new friend DID make her appointment and she will need to know she's not alone, either.

And, today.... mom is where I was on Monday.  She goes to see our oncologist for her follow up tomorrow.  There is something so unnatural for a mom and a daughter to "share" the same oncologist.  It's part of what drives me.  And it's part of what scares me, too. She was NED for twenty years.  And then, she wasn't.  Hers was a local recurrence. Fortunately, local.  We are survivors.  Together.  I'm officially at five years now.  She will be there in about four months.

To everyone who is staring into the abyss:  You are not alone.  You are NOT alone.

And, having nothing whatsoever to do with this.....blogger has a new interface.  I have yet to figure it out.  I THINK it's been around for a LONG time but I refused to use it.  Suddenly, I'm seeing a daily tweet about "My thoughts" with a link to this blog.  I'm not big on self promotion so if you found yourself here from the twitter link....... welcome.  Sooner or later, I will find the setting that will disconnect this auto tweet feature......

And SOONER or later, I will remember that the "schedule" calendar is formatted with Monday as the first day, meaning, what looks like it SHOULD be Wednesday on the little box is really Thursday... and this post should have been up already HOURS ago....... Sing it loud, sing it proud.... chemobrain.... attention to those details that in another life was my thing. Poof.  Gone.  It's the minutiae, not the ability.  And yet, even knowing that, I need a mini me minutiae checker.......

One more AND.... and it's a biggee.....  I want to thank Rann Patterson for featuring this blog (and by association, me) on Bella Online.  Rann is the editor of the Cancer section of the magazine.  She wrote a very powerful article and I am honored that she chose to share this blog with her readers.  The article was posted yesterday.  Seeing that was certainly a nice way to start what was, at the time, a scary day.  Ended with lots of new shoes, but at the start......fear.  Followed by celebration, followed by retail therapy gone completely amok.

Three stores, EIGHT pairs of shoes, five pairs already here, two being shipped because they didn't have my size, one has to be picked up on Thursday.  Pre-sale.  What the hell is that all about anyway?  Pre-sale pre-selling.....  If it weren't about a great pair of black pumps that I am getting for a great price, I'm pretty sure I'd be on a rant.  But, there will be no ranting about shoes.  I'm following the wise words of Marilyn Monroe and conquering the world.... "Give a girl the right shoes......." Well, I now have a decent selection of right shoes.  And left ones, too.



Tuesday, April 24, 2012

ENTERING THE FOG, SCISSORS IN HAND

So... six years ago today, I was so convinced the envelope containing this was insignificant it was tossed aside for at least three hours before I finally decided to open it.  I didn't have chemobrain in 2006.  No clue what I was thinking. Really, I was thinking.... "This is no big deal.  At All.  I get these letters every year."  I was an accomplished pro at The Letter.  The only thing that was different?  Year prior, this stuff would come on an index card.  Enter HIPAA.  The sealed envelopes, which in the past might have invoked terror? Not so much.  My privacy matters.  Unless, of course, I'm printing an image of the letter on a blog for anyone who stumbles this way to see.  I'm invading my own privacy.
Highway to Hell

Little did I know, or little could I have realized I was very lucky to get this letter on a Monday.  WTF?  Seriously??  THAT mattered??  YES, It did.  For whatever reason, both the radiologist and the gynecologist had late hours on Mondays.  I was able to jump into action.  Place the necessary phone calls.  Set up the appointments.  Get prescriptions faxed.  I'm great in a crisis.  Organizing my shit.  That could not have taken more than fifteen minutes.  Like I said.  Pre Chemobrain.... I was pretty fabulous at springing into action and getting immediate results.  Concrete and quick.

Good thing, too.  Once those appointments were in place and after being assured by every person I spoke to in little more than fifteen minutes, "Just being cautious, this is nothing," and... I am talking at least six people including both doctors and the staff I had to take out in a defensive tackle to get those doctors on the phone.......  IMMEDIATELY upon having my plans in place, I did what any normal person might do.  I sat all by myself.  At the kitchen table.  And I cried for two solid hours before my husband walked in the door.  Suffice to say, by the time he walked in, well, you know what you look like after tears have been spilling for two straight hours.

One hundred thirty five minutes earlier I ripped open the envelope, and very cavalierly, I tossed it aside.  I can still see it floating, almost featherlike, from my hand, through the air on its way to the counter.  Mid air, my eyes caught the words "calcium spots."  In that very moment, life would NEVER be the same again.  I'm doing what Steve Jobs described so perfectly when he beautifully explained the concept of connecting the dots backwards.  And how you can only connect the dots backwards.

On April 24, 2006 at approximately 6PM, I became a passenger on what I like to call "The Runaway Train" and that letter was my ticket to board the train.  Simultaneously, it was also my first step on The Highway To Hell.  Who knew?  Me...... I was just being a drama queen.  I was making a mountain out of a sentence.  Pulling out the phrases that had maximum impact and turning them into an epic disaster.  D.R.A.M.A. --- Q.U.E.E.N.

If I was on a Runaway Train six years ago.  On this very day.  Today, in 2012, on this very day, I am Flying Without A Net. One of those odd coincidences.  I have my six month oncology follow up today.  Precisely six years To The Day.  Five years post chemo.  With an excellent prognosis.  And Scanxiety.  Even though I don't get scans.  I just get bloodwork.  Maybe. See prior posts.  Not so sure WHAT will happen today.  Only certainty... my only guarantee?  Count on a full report.  Hell. Maybe I'll video the whole damn thing and just roll tape.

There is a message in this.  It's an important message.  It's one worth repeating.  Once you jump on The Cancer Train, as so many of my blogger buddies and twitter pals and fellow travelers can share:  We are FOREVER changed.

I designated myself as the guest of honor at the #bcsm tweet chat last night.  The topic was living with fear of recurrence. I guess, once again, I am LUCKY my doctor appointment is today.  And I'm lucky the topic for the chat was exactly what the doctor ordered.  Last night, I was held up by the support of more people than I can possible thank.  Those lonely hours the night before oncology follow ups are awful. I had global support.  I don't know how to begin to say thank you to all of you.

For the record.  My logic brain knows I know I'm STILL being a d.r.a.m.a.---q.u.e.e.n.  Chemobrain trumps logic brain every. single. time.  Paper covers rock and scissors cuts paper.  In that little analogy-my physical brain is the rock. Paper is logic and those scissors?  I'm AnneMarie ScissorBrain.  Hell, if Johnny Depp had Edward's Scissorhands, I can claim a scissor brain.  And, my message?  It doesn't really ever get EASY.  This follow up crap.... once bitten and all that jazz... nope... It never gets easy.  It just may get easIER.

And this would be a big PS to the tweep who used the #bcsm bat signal on Sunday night to mention she was six months late in scheduling her six month oncology follow up.  I promise, I got your back.  We all got your back.  No words.  Just pure global support and love.  I hope you made your appointment.

And, a further PS to there rest of us...... as long as I had to do my normal wiki, IMDB, google detour to get some foundation for the Scissorhands reference...... a quote from the movie that some of us may appreciate....

"You can't touch anything without destroying it! Who the hell do you think you are hanging around here, huh?
Get the hell outta here! Go you freak! "

Monday, April 23, 2012

EVALUATE FIRST, POISON AND BURN AFTER

Last Friday, we were provided with still more proof that we are not losing are minds.  We've already lost them.  Tomorrow morning, when I'm in the oncologist's office for my six month check up, in addition to haunting him about:
  • The constant lower back pain that seems to begin about ten days prior to each oncology follow up and goes away within 48 hours of seeing the doctor.
  • The shooting pain that penetrates my temple...... time frame for this?  See above.  Pretty much identical to the back pain.
  • The funky looking brownish dot.  Eraser size.  On the inside of my right wrist.  No, it's not from a watch.  No, it's not from banging it because despite my clumsiness being a 12 on a scale of one to ten, there is no way for me to contort my arm to bruise it in that spot.  Besides, The Big C is four episodes in.  Who doesn't want to share the melanoma journey with Laura Linney?  Is this some kind of a joke??
  • What's up with the Choosing Wisely stuff?  Will we continue to do these tumor marker blood tests?? I feel better having them done to be quite honest.  I don't like the idea of being a cancer patient with NO follow up screening whatsoever.  Seems irresponsible.  If I DIDN'T have cancer, I'd be going for an annual mammography.  Now I HAVE cancer, NED, but yes, I HAVE cancer and NO screening?  Yeah... that's not working for me......  That's going to be a big conversation.
  • Then, we can talk about his patient..... the one I talked to..... the one who specifically asked about chemobrain..... the one who was advised by three oncologists that chemo was indicated in her case.  And yes, it was a total coincidence that I spoke to her and yes, it was totally unknown to both of us that we had the same oncologist until we were well into our conversation.  One of those odd coincidences.
  • Finally, we can talk about The Giants!  He has season seats.  We have season seats, too.  Possibly we'll be divvying up the tickets if we can't get our act together (back story) but technically, one of those seats IS mine.   
Apparently, I will also bring him the interview, MY interview, that was published in the March 15 edition of ASCO Post.  You didn't see it? Well... Here You Go

I made an observation in that interview piece and once again.... VALIDATION!  On April 20, Science Daily printed a column titled:  Cancer Therapies Affect Cognitive Functioning Among Breast Cancer Survivors.  This is most definitely NOT breaking news.  It's just more proof that we really have lost our minds.  Or, our brains are playing some kind of twisted hide and seek game.  And, I've always known "chemobrain" isn't exactly the most accurate description.  The research presented in this article from seems to point to the fact that those of us who received chemotherapy performed similarly as those who received radiation and WE all performed subpar to the control group of women who were matched by age and zip code and better luck.

I have chemobrain.  You might have radsbrain.  Doesn't have that same, nice melodic ring-radsbrain.  The thing is, the study which was done at Moffitt Cancer Center in collaboration with researchers at the University of South Florida and the University of Kentucky seems to point to what WE already know.  Basically, our brains have exited the building along with Elvis.  What I especially like in this article?  The lead author's take away.  His suggestion?

"Since patients report cognitive problems that interfere with their daily activities, early workups should include tests to determine cognitive functioning prior to treatment."

I LOVE that suggestion......  Ya know why?  In October, when I was talking the the Jo Cavallo at ASCO Post,  this is what I had to say....

"Had I known developing chemobrain was a possibility, I would have insisted on a neuropsychological evaluation before starting any treatment so I could compare the difference in my cognition before and after therapy."

I feel like being a 6 year old whiny wise ass.  Na Na NA NA NA....... Ha Ha.... Said it first.  Beat you to it.  Really, I'm boasting right now and I'm pretty damn proud of myself.  I know, I KNOW... it's one of those Seven Sin Things.  I'm so thrilled I was able to make this observation with my chemobrain and have a brilliant researcher with a Ph D come to the same exact conclusion after studying hundreds of women over several years. I think I earned the right:  Be Proud.  ARMY Proud.  That's what pops into my head.... and guess what.... There's even a RIBBON for THAT....


In case you are a geek like me and need the "official version" rather than magazine version, this is what the abstract says.......  

Abstract

BACKGROUND:

This study examined the influence of prior treatment on the course of cognitive functioning in breast cancer survivors. Changes in cognitive functioning over time were compared in breast cancer survivors treated with chemotherapy plus radiotherapy, breast cancer survivors treated with radiotherapy only, and women with no history of cancer.

METHODS:

Stage 0-II breast cancer patients treated with chemotherapy plus radiotherapy (CT group; n = 62) or radiotherapy only (RT group; n = 67) completed neuropsychological assessments 6 months after completing treatment and again 36 months later. Women with no history of cancer (NC group; n = 184) were assessed over a similar interval.

RESULTS:

A significant group × time effect was found for processing speed (P = .009) that reflected a tendency for the NC group but not the RT and CT groups to improve over time. There was also a significant group effect for executive functioning (P = .006) that reflected the NC group performing better than the CT and RT groups. Additional analyses found the administration of hormonal therapy was not associated with change over time in cognitive performance.

CONCLUSIONS:

Findings provide limited support for the view that changes in cognitive functioning in cancer survivors are attributable to chemotherapy administration and illustrate the importance of including a radiotherapy comparison group. Future research should seek to examine possible mechanisms that could explain the apparent prolonged impact of both chemotherapy and radiotherapy on cognitive functioning in breast cancer survivors. Cancer 2012;. © 2011 American Cancer Society.