MAD AS HELL-- DCIS - Did Radiation take away my future chances?

If DCIS ever comes back , a chance I didn't know existed has already been taken from me!  I could possibly have had a second lumpectomy, avoided major surgery, been home the next day. But instead, with the firsts DCIS, I got a month of radiation, mostly on the entire breast. The news in this article not only blew me away, it made me furious about a possible lost chance.

Can Women Get More Than One Lumpectomy?  

 Dana-Farber  June 15, 2015  Cancer research

Like you, or your mom or your grandmother, I am over 70.  

Did no one in my area know about this when I was diagnosed?  Were one or two doctors dead set against using this information? Was everyone afraid to go outside of what has recently been the "standard of care?:Is this all brand new information?   The surgeon had assured me that the radiation oncologist would not give me radiation if I didn't need it. He didn't say how much.

True, my DCIS was perhaps not eligible, but decisions offered were limited - radiation or go home.

If you are or your mom is over 70, read the fourth paragraph.  Read it again. I was over 70, and no one, mentioned any of those possibilities.

 In fact, read it all.

 "Women who are diagnosed for the first time with breast cancer

 in multiple spots traditionally have had a mastectomy. 

However, a new trial at Dana-Farber/Harvard Cancer Center 

offers these patients multiple lumpectomies followed by radiation, 

rather than removing the entire breast."

From INSIGHT Dana-Farber publication


I wish you health.

ANTI-INFLAMMATORY DIET + PRE-DIABETIC DIET - Losing weight

What I don't eat any more

As my doctor says: avoid processed sugar and

 processed flour (you know, like white flour)

BTW The diet sheet doesn't seem to know who
 gets inflammation from dairy, wheat, eggs, and who doesn't

Whole wheat muffin from usual mkt - has sugar
Whipped sweet potato from same mkt has sugar
My favorite almond milk that has sugar
The skin on the supermarket whole-chicken-to-go (sugar)
My beloved Starbucks butter croissant and Starbucks butter croissant egg sandwich
White rice
Instant oatmeal pkgs.  (Even the "original" has sugar!)  Here I am, cooking oatmeal.


How an over-65-er gets that extra protein we need

Avocado - highest fruit protein I can find
Peas - also high protein, but not recommended every day by one writer on type 2
Heaping 2 teaspoon of 0% yoghurt (read the label:  even "plain" yoghurt has sugars like milk sugar plus 1 heaping tsp of vanilla latte yoghurt from my market


What I hate about avoiding red meat:

How in the world do I eat so much chicken and avoid getting sick and tired of it?
 I'm already getting tired of tuna (needs lots of Lemonaise)  and can't afford fresh salmon.
And the in-house roasted turkey at the market is a bit boring.  Quite a bit boring.
Some clown, er, manufacturer,  put sugar in the chicken broth I bought!!!!!!
And did I mention I'm also supposed to be on the anti-Gerd diet, which is the opposite of all this?


What saves me - and helped kiss a few pounds goodbye

I always liked crisp head lettuce and cucumber - puts water in my system and fills me up
Turbinado sugar or other unprocessed sugar in almost invisible amounts
Lara bars - The fiber from the nuts balances (so far)  the dates in the bar + no soy
Unsweetened almond milk (does have tapioca starch in microscopic amt.)
O'Jai Cook Lemonaise - has fat and eggs in it, but I need the biotin and flavor
Starbucks usually has bananas
Limited cheese
I still drink coffee

Also, son-in-law made awesome onion torte with anchovy and olive (crust has all health grains, no white flour)

Wild experiments

Purple and other weird carrots - ugh, tough
Sweet potato strips, not fries, from mkt.  Recipes, but I can just boil a few to help survive the monotony.


What I think I need and might get

Both diets forget what pregnant women have known for centuries - something dry can settle your stomach.  A nearby restaurant says I can go in at breakfast and get whole wheat toast.  We'll see.

PS I'm really on my feet today, so may allow myself a little more Vanilla/Latte yoghurt (insert smile)

I wish you health.

MUST READ: Metatstatic Breast Cancer - A Patient is doing the research?!

A researcher is willing to mention patients!  And (gasp) insist that patients must be involved  in research. Okay, there is some small print here - Harvard may not be calling you and other patients you know just yet.  But her story is amazing.

http://bcsmcommunity.org/all-hands-on-deck-the-metastatic-breast-cancer-project/

Corrie Painter, PhD on work at Broad Institute of MIT and Harvard--

"My personal experiences with an exceedingly rare breast malignancy called angiosarcoma allowed me to peer through a window that included a lumpectomy, a mastectomy and chemotherapy, with none of the research or support that is poured into breast cancer awareness. "

What blew me away is that Broad advertised for a "professional patient."  

Please follow the link and read this for maybe a little hope.  Or Google BCSM - the article is in their headline today.  And if you like, check out her "boss" research head Nikhil Wagle, MD, on Twitter.

I wish you health.

BACK ON TAMOXIFEN - Cutting down to half dose

I had some blood work, and went in to see my oncologist for 30-days-off- Tamox appointment. The big question: Will I go back on Tamoxifen?

The first thing he asks is: Are your feet any better?  And I sheepishly say, Not much.

What isn't said is that I've had the feeling I'm "more intelligent" without Tamox.  Just a feeling the last week or 2 of the month off, as I watched myself react to things and how I've been able to plan or make a choice without that little white pill. I don't ask: Is there enough "brain difference" to stay off it forever?

Then he surprises me: tells me he thinks all the changes and new diets are good for me, waking me up--that he can see it in my face.  Hmmmm.  Nobody else mentioned a difference, but maybe I need another look in the mirror.  I was thinking the changes, tests, and diets were just tiring me out.

He asks if I have any Tamoxifen at home.  Yes.  "Break them in half and take half every day.  (They make a half strength one, 20 mg.)  Then come back and see me in three months."

No problem!  I have a pill splitter.  And I trust him.

Yes, I still have unanswered questions:  I've lost weight during my new anti-inflamatory and prediabetes diets while I was off Tamoxifen.  What caused what?  Will I stop losing weight now that I'm back on Tamoxifen?  No answers.

No crystal ball.  Just a great doctor who keeps track of me and comes up with good plans.  And fingers crossed.

I wish you health.

"YOU HAVE PRE-DIABETES" Yeah...I was afraid of that

You know you're in trouble when you're checking in to the oncologist's blood lab and the phone rings with a call from your other doctor's assistant:  You've got Pre-Diabetes.

But I'd suspected trouble. About a month ago they ordered a second blood test--blood sugar was a bit high.  (The assistant on the phone had used the word diabetes.)  I put off the second test for more than a week.  Between the thunder storms, endless paperwork about moving, and the oncologist giving me a month off tamoxifen, I had enough for one week.

Out in the car, I listened to the phone message:  "avoid processed sugars and avoid processed flour."  That was a good, simple way to get me started.  But my head thought... Freely translated:  lotsa luck on ever eating or drinking your favorites."

Climbed the library stairs (my regular workout).  They had a new book, about type 2 diabetes.  Nothing on Pre-diabetes.  (Of course, I'd already been all over the web, especially Mayo Clinic, after the first test.)

It was just to hot to go to the market, so I went home and read a lot of the Type 2 book.

   The lists and recipes seemed to allow a lot of exceptions to his rules.  He's pushing more meat (I need the protein,) more eggs (I need the biotin* and B12.) and endless non-starchy vegetables.  (I'd only seen three of them in my life. )  

The big motivator in the book was learning

 what high sugar may already be doing to mess up my eyes.

Bottom line, meat and salad and rivers of olive oil.  (Gee, I could get glamourous like the pretty women in the detective novels - dressing on the side just to look at, not to eat .) So no Greek yoghurt dressing?

Exercised.  Took some actions about regular mealtime.

Believe it or not, I woke up this morning feeling kinda happy.  It's a relief to know that Pre-diabetes is real.  It's not just another of the endless "maybes"  since I started the search for the right Texas doctors. Hoping the new diet will prove (slowly)  which fatigue and other symptoms are not Tamoxifen.

Into the kitchen, pour my beloved almond milk down the drain. My favorite yoghurt will probably be next.   Make some plain instant oats and throw in a dab of honey and some berries.  Make the coffee, save it to drink with a bit of half n half after the cereal (as the book insists.)

Coming soon:  grocery shopping and blood sugar

I wish you health.

TAMOXIFEN - A Month off?

My health was not marvelous before DCIS.  I came to Texas with a background of ailments, 10 weeks after lumbar fusion.  Before I felt “over” the spine issues, I got that mammogram and fell onto the “down escalator” of Do This, Do That.  No one said I could “wait and see.”

After the successful lumpectomy, the surgeon said, “You don’t have to do anything.”  But he gave me some names of two people he thought I should meet: The Radiation Oncologist gave me a hard sell, and I had looked at an interactive decision aid on line. I had radiation.

Afterward, the Medical Oncologist said, “You’re cured.  But we have…”  I told him I was interested in Tamoxifen.  I quickly got far LESS interested, despite his encouragements.

Recently, after about a year, I told him I just wasn’t doing well.  He asked me to tell him all about it (making him one in a million Drs.)  He talked to me for a while, then suggested I try going without it for a month. I smiled.  I hoped the month would settle whether Tamoxifen was causing my mood, fatigue, aches and pains, my sleep problems, and my swollen and painful feet that kept me from all the walking I’m supposed to do to stay alive.   

What is not better after 2 1/2 weeks' off Tamoxifen?  My feet still hurt at random times and when I wake.  I still have some aches and pains despite months of PTh for strength.  I still have headaches and occasionally wake during the night from muscle pains that Gabapentin hasn’t masked.  I still often have amazing fatigue, some of which may be caused by complications such as planning to move and getting a call about slightly high blood sugar from my GPs office. I often just don’t want to do anything. Depression?

What is better after 2 ½ weeks"vacation?"  I feel more intelligent (go ahead and laugh.)  Sometimes easier to remember where I put things, make plans, adapt.  Not so many pains.  My feet are less swollen, and I even forgot my home-made metatarsal pads for two or three days.   

The Tamoxifen-free month will end on my birthday, the date of our next Onco appointment.  By then I will have the results of my blood sugar test and of the labs ordered by my oncologist. It's hard not to think about them...

Right now I guess I’ll probably vote to go back on those little white pills.  But being a web addict, I still look for info on blood sugar and tamox.

I wish you health.

 Coming soon:  conflicting articles on Tamoxifen and diabetes

Please read this article, and plan to stand up for yourself.

On MEDPAGETODAY, Harlan Krumholz, MD, gives us his take on how our rights are neglected when we get that last-minute yellow paper to sign for the "informed" consent process.

"'Patients need permission to make a choice and

 to know that the choice is not pre-ordained.'" (Red edit mine.)

The article is short and easy.  My opinion is that until the system is fixed, we patients need to insist on info far in advance:

"What will I be signing and what are my other choices, 

and what if I don't sign when I find surprises in the form?"

http://www.medpagetoday.com/MedPageTodayat10/LessIsMore/51785?isalert=1&uun=g745835d4062R5912758u&xid=NL_breakingnews_2015-05-29

I wish you health.

Next post: a vacation from Tamoxifn