Breast Cancer - Dense breasts complicate diagnosis

In July, I referred to an article about dense breasts.  Now: 

More sensitive (and expensive) tests increasingly tapped for breast cancer screening     By Jaimy Lee  | December 10, 2014 

This more recent article on modernhealthcare.com sounds like more help is in the works for those of us who have dense breasts.

First, I need to contact the hospital to see if they have documented my dense breasts.

My oncologist has recommended I have my next December diagnostic screening (all cancer survivors in this area have 2 years of "diagnostic" mammos instead of "screening.") somewhere new.  The place he recommended has 3-D screening.

The next question is money.  The article I reference above seems to hint at more likelihood that those of us with dense breasts and high risk may this year even find Medicare willing to pay for 3D screening.

Monday I'll try to call the "new" screening place to see if they know anything about Medicare payment for 3D.  Or maybe I'll wait to see if there is more news later from the med sites on Medicare $$

So far I haven't finished looking to see if the hospital actually documented my dense breasts.

Meantime, you might want to read the article all the way through.

I wish you health.

Save $ on medicine

Be aware of cost savings available to every patient

DIANE SCHEB, RN | MEDS | FEBRUARY 11, 2015

www.kevinmd.com/b

Tamoxifen feet-vein-artery Diary

This Tamoxifen foot pain-and-swelling thing involves more than walking!

Thursday. Last visit to Dr. Neville, for report on the vascular test. Asks me if I've ever been sent to a heart specialist.  (NO)  He says there's a vascular problem--not enough blood to the balls of my feet.  Everyone else is telling me to elevate my swollen feet and get the blood back to the heart.  So is it an arterial problem?  He says:  I want you to walk!

Corie puts a tiny metatarsal pad in my right shoe; gives me a discount card for NewBalance store.  Tells me to see manager.

Friday.  I go on my longest walk for ages, wearing my clogs.  Friday night 2 Gabapentin, but almost impossible to sleep.  Random pains in places I've never had pains.  Is this Tamoxifen or the unaccustomed exercise?  Took Tylenol in the middle of the night.

Saturday.  Woke  hungry and, of course, tired.  Was it partly hunger that kept me awake?

Sunday.   Swollen feet.  What's new?  Got my clogs on, went off to meet a friend and did some walking around the shopping center where I often go to Starbucks.

Monday.   NewBalance Manager will not be in, Walked around the neighborhood - more than a thousand steps, again wearing my old slide-sandal Clarks'.

Tuesday.  Manager doesn't have any walking shoe for me without very lumpy soles that will cause me to break my neck.  I agreed to e-mail him a link on some NewBalance walking shoes I saw online from LLBean.  Sent him the link.  Heavy laundry and kitchen chores.

Wednesday.  Usual foot pain and swelling.  Wore my ancient, sturdy Clark's sandals around the house.  Took a Tylenol, put on clogs, and walked through big department store shoe area - no luck.

Physical Therapy outpatient called me--I have a new assessment tomorrow!

Breast Cancer Survivors-Tamoxifen, sore feet, and our veins. Tennis or ...

Rare craving for ice cream today after studying Medical statistics made easy.  I finally got a Snickers ice cream bar and a quiet moment on the sidewalk to wonder if my sweats had really shrunk (maybe) and why my waist is in danger of disappearing beside my ever-growing abdomen.

Then along comes Dr. Katz and his article that I actually read.

Inactivity kills more than obesity: Let’s go beyond the headline
DAVID L. KATZ, MD | CONDITIONS | JANUARY 29, 2015  in Kevin, MD

 Fat around the waist was mentioned in the article.  Discussed, even.  So was the fact that more activity could mean less fat.  I guess taking heavy pots and bowls out of the dishwasher 2 or 3 times a day and climbing the library stairs isn't enough moderate exercise,

Then there's the foot-pain doctor:

My activity has been way down since my feet started hurting a lot.  The podiatrist, who knows about Tamoxifen, has found a potentially dangerous vascular problem.  I don't want to develop a clot.  His verdict:

WALK.

Yes, that's also what the spine surgeon preaches.  Yes, I'm the one who urged you to read "Cancer Survivors Rest in Peace." *  (The one about exercise to live.) 

Bottom line:  Even though my feet are very swollen when I wake up (not unknown with Tamoxifen) and they're often much smaller in the afternoon or by supper, I have to find some really good shoes that allow me to walk more.  Much more.  Morning and afternoon.

Foot doctor's orthotics specialist gave me a tiny metatarsal pad for my right foot in my everyday shoes. We considered a bonfire for my rainy-day-puddle shoes) after he literally rolled one up in a ball.   Gave me a "prescription" for a discount on some tougher, healthy shoes.  He also showed me some healthy shoes that will not shout "old crip."  And ones without the cute lugs on the bottom that make me fall on my face.

So Monday it's serious shopping for tough, supporting, seriously padded rain-or-shine shoes.  Hopefully I'll be able to walk in the mornings, and then compensate with padded socks as the swelling goes down. And walk some more.  (Need instructions for woman with lumbar fusion changing socks and retying shoes in Starbucks bathroom.)  Anything to make those foot veins healthy.

In short, I might have improved my life expectancy if I'd pushed, fought, for the right podiatrist some time ago, instead of curling up with too many books.

I wish  you health. 

* from Sunrise Rounds  http://sunriserounds.com

Breast Cancer patients and survivors - one doctor understands

This morning, Sunrise Rounds has a post  (scroll to Cancer Care--The Secret Change) about how we feel when a cancer is "cured."  How hard it is to forget that ghost whisper:  It could come back.  That phantom pain that says: Is it back?  Dr. Salwitz shares the words of a survivor and cancer treatment professional who seems shocked at how cancer acts and feels when we're the patient.

Since breast cancer especially has been found to be ever lurking, his post really struck me.

He talks about the parts of us - body and mind - that aren't quite what they were before radiation, before whatever science has done to us as well as to the disease.  And how we feel about those alterations and losses.  

About all this he says one thing that made me feel a deep kinship with other survivors, "The clincher?  None of this is obvious to anyone else." 

Our families, spouses, friends have heaved a sigh of relief for us.  We rang the bell!

And yet... 

I wish you health.

Tamoxifen? or spine nerves? causing foot pain

More and more often recently, I'd been skipping my walks because of foot pain and morning swelling.  A podiatrist had told me months ago that something in my legs could make my feet burn.  I do take Gabapentin at night for painful leg nerves that the spine fusion didn't cure.

My primary doctor sent me to another podiatrist for the foot pain. My regular physical therapist and a retired nurse friend definitely approved of her choice.

New-patient podiatrist visit

We had a long discussion starting with my worsening foot pain and the new development--swollen feet, also nerves, especially to my upper thighs, that were not healed by the spine fusion.  Showed him my home-made salvation, metatarsal pads.  As if that weren't enough, I assured him I can't tell when Tamoxifen is causing daily pains.

He will order a custom compounded cream for my feet.

One week later at his PhTherapy dept:

I showed up.  First I sat  in a firm chair dangling my feet that did not reach the bottom of the foot bath.  Pain.

Then off to the therapist's painful chair.  Pillow under legs did not help pressure on sore thighs. Massage with cream, measurements, electro-stimulation, ultra-sound.  Way too long in chair.  Pain.

Finally, en route to my car my  feet were starting to feel a little cold.

At home, my feet felt as if I were standing in snow.  After four hours of "freeze," and leaving messages, talked with nurses or aides who said the doctor called my snowy feet "a little flare-up."   Little it wasn't.  They told me to elevate my feet--done already.  We made an appointment for the next day.  I pretty much spent the evening sitting too long, reading a murder mystery, trying to ignore my legs and feet.

Next day: Learned that the physical therapist had used their cream called some kind of "...freeze..:"   He apologized profusely. I asked for warning about strong side effects, but Dr. said they don't warn because they're not common.  "Call the office and tell us."  I mentioned there wasn't a live person on the phone to tell.  Finally he gave me a hug! kissed my cheek, and went out.

His nurse told me what I tell other people, but don't practice sometimes:  Tell the PT you can't sit long, that you have to get up and move around, that he mustn't leave you on your own, that he must check on you every few minutes.  Good idea.  It's not the PT's job to guess.

Bottom line so far:

I never know what Tamoxifen is causing.
I don't know why nerves are hurting more.
The first PT didn't do much for the pain and swelling.

Next post - the $$$ RX cream

Breast Cancer - Early stage: Lumpectomy - New: device may avoid repeat lumpectomy

Internet Medicine .com has posted this article from PRnews.com, a press release circulating company.  The post is titled SOURCE.

New Technology To Detect Lingering Cancer Cells During Breast Surgery

Posted by admin+ / January 5, 2015

"The Division of Breast Surgery at NYU Langone was the first in New York City to utilize MarginProbe(r) for early stage breast cancer."  

According to the post, the medical device uses " non-destructive radio-frequency spectroscopy technology . . . "  This technology searches for random cancer cells on the margins of the first specimen removed (or even during removal).  So if necessary, the surgeon can excise a bigger sample with clear margins before closing.

I realize that non-destructive is not quite the same as harmless, but I'm impressed by the possibility of avoiding second and third lumpectomy surgery.  Surgery is never completely without risk.

To read the post, go to Internet Medicine.com, select category medical devices, type in lumpectomy and hit search.

Since I know more than one person whose first lumpectomy did not have clear margins, I was very interested in this article.

I wish you health.