Eating

We do know the principle for computers 'garbage in, garbage out'. But it also applies to people. If you eat bad food, you are not treating your body like the temple it should be. And you will pay the price. I was brought up eating right. I usually try to eat right. I skip the junk food but sometimes succumb to popcorn based snacks - Smartfood or Cracker Jack (still has prizes but they are pretty lame these days compared to what I got as a child - temporary tattoos and stickers are nowhere near as cool as a little car or doll). Lots of fruit and vegetables. Sometimes I even spring for organic. I smuggle vegetables into my husband's diet regularly to the point that he accuses me of being unable to make something unhealthy. He tells me I always make whole wheat, vegetables, and nothing decadent. I even exercise five days a week. (I'm not saying that just because I do all this you should to and you will be healthy - I mean look at my medical history just to negate the whole point I am trying to make.)

There are countless books out on how to eat healthy and live a healthy life. But really the point is, society can't afford to keep patching up the damage people do to their bodies by eating badly. But the point is we all need to try to eat right and exercise. Mrs. Obama wouldn't need to target the issue of childhood obesity if this wasn't a problem. So eat your veggies and get moving.

I'm done orating for the day. I am very tired. My back doesn't like me. I have had a lot of pain for the last few days and didn't sleep well. This may lead to an appearance of my inner b*tch. But since we are getting a big snow storm today, I am going to work this morning and then will go to the gym and take a nap - the most productive thing to do when the choice is being crabby.

Difficult patients - surely they aren't talking about me

Now, I know I am perfect and could never be annoying! Ha! We are all guilty of this from time to time. I know I was a cranky b*tch at a recent doctor visit, when I attempted to eat lunch after my appointment. I do feel guilt about this as well. There is no reason to be cranky (hence one of the reasons I should try to destress my life) but we all know even the calmest person can lose it once in a while. This is because we are normal human beings (I know, there is no such thing as normal but bear with me here).

Yesterday I read this article that is titled 'When Doctors Find Patients Difficult' (I am constantly amazed by the number of medical studies going on out there). Then I thought, 'surely they aren't talking about me!'. They do accurately point out that there are two sides to every discussion. On the patient's side, you go to the doctor for lots of reasons: a check up, because you are not feeling well, for a follow up to a surgery/procedure/test, etc. If your reason is stressful (which can be any of the above), you may be a bit tense and short tempered understandably. Your doctor attempts to be patient and reasonable and have a normal discussion. After the appointment, they go on to the next appointment where they go through the same thing again and again. Is this stressful? I think so.

So what if the doctor isn't having a good day? They are human beings as well - they could have a sleepless night, fight with spouse, a flat tire, whatever. Add to that numerous patients in a row that are cranky, and you get burn out, high blood pressure, crankiness and all sorts of normal human reactions over time.

In reading the article, one of their pet peeves is patients who ask to be prescribed an unnecessary medication. Who is the doctor here? Just because your friend takes something or you saw it advertised on TV, doesn't mean its right for you. Let the doctor make the decisions. I see no problem asking if there is something else they can give you that might help your situation but to demand a specific medication? No.

The article also discusses the fact that older doctors are better at handling the stress and burn out. Is handling a difficult patient an acquired skill? Possibly but that doesn't mean we should take advantage of or take out our frustrations on our younger doctors.

So let's all be nice together and let the doctors be doctors and the patients be patients and attempt to work out things without causing stress on either side.

I really am working on this stress reduction thing

Yesterday was the first day of my planned stress reduction life style. I did some cooking in the late morning and then went for a walk. I spent the afternoon on the couch watching TV and went to bed early because I was tired. I remembered to take all my pills and found a balance board that I can use to strengthen my ankle that I am going to pick up today.

Okay, now here's the real story. I did some cooking because I had vegetables (sweet potatoes and butternut squash) that were about to go bad so I cooked them up and threw them in the freezer to be used over the next few weeks. I also roasted some red peppers for pizza topping and another batch of hummus that I'll make this morning.

Then my day went down hill. I conned Walter into going for a little walk with me. He turned back after a little bit and I continued with the intention of walking through the nearby conservation land as I haven't been back there for a few weeks. Well, there was some ice. And some melting. Meaning water on the ice. So there was a little slip and fall. Again. I'm fine. But I did spend the afternoon lying on the couch with an ice pack on my ankle and I took a pain pill. And I took a second one before bed.

I am relaxed this morning because of the pills which resulted in a good night's sleep. I also don't seem to have too many fall related aches and pains. But I promise not to walk on ice today. Yesterday my husband said to me 'promise me you won't fall today'. I'll try to stick with that one today.

Call me slow but I will reduce stress

Today I am launching my reduce stress in my life campaign. I did mention it recently and have started a little bit but now I really need to focus on what is going on with me. I did a little google research (which isn't always the brightest thing to do because who knows the credibility of what is on the Internet) and found some reasonably intelligent reports showing that there are not clear links between stress and cancer but there are clear links showing that stress does nasty things to your body and makes you more susceptible to other ailments. Okay, so maybe stress wont give me more cancer but I would be happy to get rid of other medical ailments as well so I am formulating my plan.

1. Exercise more. I was getting a little wimpy about my exercise plan and frankly 30 minutes on the treadmill (with the latest copies of US, People, etc) is good, I think I need a little more. So I am going to walk more outside - because I go for a good hour. (I am also all caught up on Jen and Brad and Angelina etc - but am very convused. Did Brad and Angelina split up? Will Jen take him back or is she happy being single? And what will happen to the Brangelina children - they can't exactly send them back?) I will alternate walking outside with going to the gym where I will add tiny amounts of weight training to help my upper body. There are three machines that I can use that don't cause back pain - which is my signal to stop all activity.

2. I will take better care of me mentally. I may go back to my weekly support group for a bit (and because I missed my monthly group this week because of the wake I went to). I am also attempting to get back into my therapist before another month goes by. I will also try to do more of the things I enjoy - I have been so busy recently that I have books sitting around for weeks before I get past page 3 - me the bookworm to end all bookworms and I don't have time to read! I will also spend more time with the people I enjoy - something I haven't had time for.

3. I will not deal with stressful situations. I did a little research on this on coping with stress. The basic pieces of advice are to avoid the stressful situation, don't stress over things beyond your control (the weather), and work on coping techniques. My rules for not dealing with stressful situations means I will avoid nasty people and situations. I am not going to stress about things beyond my control - including other people's problems. And my coping techniques are covered in 1 and 2 above.

4. I am going to focus on feeling better. I am going to get a balance board so I can get serious about working with my ankle to avoid potential surgery. I am also going to work on my back issues. I am waiting for another few weeks for my new meds to see how they are working and then call the doctor. I also don't have many doctor appointments for the next few months. Late April/early May is when they all seem to be bunched. (This doesn't mean I won't be at the doctor between then - I have an ultrasound, dentist, and therapists in the interim.)

5. I will attempt to eat better. My eating habits have gone to hell in a handbasket recently. Currently my husband is not allowed to eat any fruits and vegetables. So of course, I am not eating much either. Salad, salad, salad. I will also make hummus again this week - nothing like hummus on pita bread with some lettuce and a slice of red onion. I need more veggies. So far today I did have toast with PB and an orange. And three pieces of bacon that were left - but now there is no more so NO MORE BACON. Yesterday I admit to having a tiny bowl of ice cream for breakfast because it was National Ice Cream for Breakfast Day but no more ice cream either!

So now this means I need to get started on this. In other words, I need to get out of bed and start moving and be (more) productive than playing online. Once it warms up for a bit, I will go for a walk to get some fresh air and exercise. Then I need to get caught up on a weeks worth of cooking shows on the DVR before the Superbowl this afternoon.

Another reason why we need changes to health care insurance

But first, I would like to say today is Ice Cream For Breakfast Day. Skip the oatmeal, eggs, wheaties or whatever and open your freezer and grab a bowl.

Did you know health insurance companies deny one out of every 14 claims? Does that seem a bit excessive? Anecdotally I have also been told that some insurance companies routinely deny a huge number of claims. What is wrong with this picture? Now as a good insurance premium payer you must do your part before you expect them to pay. If your policy says they don't pay for certain things, don't expect them to. Read your policy before you agree to it and read it again every year. Assume that bad things might happen to you - which is why you have insurance in the first place. Then read everything the insurance company sends you. Ask questions where you are treated. Is this covered under my insurance? Who got preapproval? What do I need to do to get preapproval? Don't assume.

If you are denied, get to work. Don't sit there and assume the insurance fairy will fly through your life and fix things for you. Start gathering information to determine if you were fairly or unfairly denied and be prepared to fight. This example is a good start. If you are faced with a big medical bill, call your provider and ask about options in repayment or renegotiate the amount.

I hear more stories about people cashing in their life savings because they were uninsured or underinsured or grossly under estimated the potential out of pocket costs for their medical expenses. Its not just about what is covered but what you might potentially spend.

All of these are examples as to why health care reform is needed at some level. Why do insurance executives make so many millions while millions of Americans are forced into bankruptcy over medical bills?

Now I am going to eat my ice cream.

Belated World Cancer Day

Yesterday was World Cancer Day. It was also probably also save the penguins day and eat broccoli day. I'm just slow sometimes. I do know today is national wear red day to raise awareness for heart disease. I'll wear a red sweater if I have one that's clean... I'm not a big fan of these awareness things because I am not sure how much they really do. But I did find the article I saw yesterday that 40% of cancers worldwide are preventable through behaviors. Reduce sun exposure, drink less alcohol and stop tobacco use are the three key steps. So why me? I never was a sun person, I don't drink tons, and I never smoked a lot. They don't know what causes all cancers. They are saying this to focus on the causes they know.

Today I am launching the reduce my stress level campaign. Allow me to summarize my week: friend died, another friend's husband has stage IV cancer, awful work situation, fell and jolted back and wrist and knee, etc, facing possible ankle surgery, husband not healing well and facing additional procedure in a few weeks, father fell and broke his leg, and its only Friday so I am not prepared for much more. I resolved the stressful job situation by leaving it as I have tried for several weeks to resolve it with no success. I don't need to have the level of stress in my life so I chose not to work there any more.

My stress level is off the charts with everything I have going on and I am looking to reduce it as much as possible. There is no reason other's problems need to be mine. Except when others medical issues loom.

My husband just asked me to promise not to fall again today. I will try. By the way, the doctor wasn't surprised with my ankle that I did fall a few times recently. So off I go for a day of work today. I will try not to fall and hope I can destress a bit.

So its not just me

I was beginning to think it was a big conspiracy and it was only me but it turns out Walter has the same problem - doctors with bad script writers. I went back to my ankle doctor yesterday expecting a recommendation along the lines of more PT/less pain, etc. No instead, it turns out she said 'my ankle is bordering on chronic' in its current state - meaning it may not get any better. In side my ankle is a harmless cyst (something common with gymnasts and ballet dancers and figure skaters), a chip of floating cartilage, and a partially torn ligament.

She recommends waiting for another three months and then seeing how it is. She also said to skip the exercises that have been causing any pain and focus on the balance exercises. (I was honest and told her I fell twice recently and she said she wasn't surprised because of balance issues caused by my ankle.) I may see some more improvement over that time and the warming weather may help as well. My options at that time will be: 1. live with it in whatever state it is in; 2. reattach ligament surgery which means six weeks in a cast, six weeks in a boot, and then rehab; 3. clean out cartilage which means two weeks in a boot, and then rehab; or 4. both options two and three together. I need a new script writer here. This is not what I wanted to hear. My ankle still hurts all the time. So what was my response: the very mature pouting phase that simply makes me feel better.

From there, I went and got Walter for his surgical follow up. He has been having some problems and wasn't feeling that great. The doctor took another look and said he needs to go back in and deal with some scar tissue issues. But he wants to wait another two to three weeks to allow for more healing before that. In the meantime, Walter has to live on a low fiber diet which means (and I quote) 'you can eat pizza and ice cream but no fruits and vegetables'. Well at least that was a nice thing to hear. But the additional procedure - which doesn't involve surgery or cutting but does involve sedation - is scheduled for three weeks from now. The part about waiting another three weeks and having to have anything else done were not part of the script we wanted to hear.

I ended my day by going to a wake. Which is worse - the wake or the funeral? I am going to the funeral today as well before work. Its going to be awful. She was too young.

What would you tell your insurance company?

Now technically, an insurance company is not supposed to know what is wrong with you. You don't need to call them up and say "I have cancer". I do strong suspect they can tell what is wrong with you by what kinds of tests/procedures/surgeries you have. But its not their business what the results of any of these are. They don't get pathology reports. They just get the bill. They are not supposed to discriminate against you.

However I am sure we have all heard the horror stories of people being dropped by their insurance after a cancer diagnosis, or refusal to renew a policy. I live in Massachusetts which has some very strong consumer protection laws against discrimination due to pre-existing conditions but still, I'm not telling my insurance company anything. They can infer all they want from my multitudinous trips to the doctor but I'm keeping my mouth shut.

Last year, they called me and offered a nurse to help me with any questions I may have. I was a little reluctant to talk to her but did in the end - mostly because I really didn't have any issues to discuss with her. I do know the insurance company has nurses on staff that will answer questions if needed.

This year my insurance company, Blue Cross, announced a new program called 'Blue Health Assessment'. They want me to go online and register and fill in all of my medical information so they can help me manage all my medical issues in one place. No, thanks.

Let me tell you why I am not going to fill this out anytime soon:

1. It would take me days to complete my medical history. I have probably had over 150 doctor visits in the past three years. Plus the previous twenty five years of my life with a few other medical misadventures. I don't have this kind of time.
2. Isn't this like giving secrets to the enemy? I mean they aren't supposed to discriminate and its not their business what is wrong with me so why should I tell them?
3. I'm lazy - see #1.
4. Am I getting paranoid about Big Brother - see #2?

Also, I think I do a pretty good job of keeping track of what is wrong with me myself. I have calendars and spread sheets and can look up and tell you when I had what done when. This is clearly outside my comfort zone so I'm not telling.

Profound thought for the day: Cancer sucks

Yesterday was further reinforcement of how cancer really is a sucky disease. A friend of mine died yesterday from breast cancer. She is the one I visited a few weeks ago. She has a seven year old and is a few years younger than me. She had triple negative breast cancer four years ago and a recurrence two years ago and has been on chemo ever since. She was in pain and on oxygen when I saw her. But perky and appreciated the take out Thai food we brought. I called her last week and we spoke briefly and I hoped to get over and see her this week. I am going to her funeral instead.

Also yesterday a friend emailed me who I have been out of touch with since before the holidays because of Walter's medical issues. Her husband has what looks like late stage colon cancer. They don't have a final diagnosis yet and no surgery so far. But things aren't looking so good.

To top it off, crabby co-workers that are unreasonable to deal with just need to grow up and get over it and get with the program. Hint: The world does not revolve around you and other people (i.e. our boss) makes decisions and changes things in rational manners to which you just need to adapt. Anyway, life is too short to deal with stupid people so my solution is to change my work schedule so I will not have my schedule overlap with hers. So mature I know but maturity levels have a tendency to slip in the face of stupidity.

Walter also isn't feeling so well. He actually called the doctor and got his appointment moved up to tomorrow afternoon.

So ended a relatively horrible day. This morning I am up early so I can go to work for a few hours. Then off to my therapist - which I might need after yesterday. Back home for a few hours and then to my support group that I haven't been to in months and then a hair cut. Finally back home for dinner. I might even get to go for a walk somewhere in there.

But things are different with cancer

So why did I list all my stupid medication side effects yesterday? Well, here's the difference. When you don't have cancer, if you have a headache, a little dizziness, aches and pains, feeling tired, you don't think anything of it. You were on your computer too long, maybe are dehydrated, overdid it at the gym, didn't get enough sleep, etc. Unless its a migraine, you fall over from being dizzy, are in excruciating pain, or fall asleep at the office, you don't think anything of it. You may take some OTC medication and just ignore things for a few days. No big deal.

But when you add a cancer diagnosis (or two) to the mix, its not a headache, its a brain tumor. Its not dizziness, its a new weird cancer infiltrating your ear drums or another incurable ailment that will deprive you of your right to drive a car and go to work. Its not aches and pains, its your cancer has spread to your bones. Its not just being tired, its leukemia and anemia causing fatigue. Your mind travels down that road to hell which is filled with all sorts of dire thoughts which usually start with, 'I'm gonna die' thoughts. Not to be morbid or anything but cancer changes everything.

Living with a cancer diagnosis means learning to balance all these evil thoughts with a 'normal' life. (If you can define normal, please feel free to let me know. We are all weird in our own way.) You wonder why cancer people are more prone to depression and go to all those support groups and talk to other cancer people to keep our sanity.

Doctors and medical professionals don't help. Well, I mean they do help because they treat you and make you better and kill off cancer cooties. But they don't help when they say 'its probably nothing but with your medical history, we need to be sure. Blah, blah, blah.' Sometimes I feel if one more doctor says that to me, I'll scream. Nothing like getting that nice little slip of paper from the doctor to head for blood tests and a chest x-ray after your annual physical (does everyone else get an annual chest x-ray?) which says 'history of thyroid carcinoma' across the bottom. Its also printed on lots of the test results I get. In case I forgot. Thank you for that reminder. I wonder why they haven't updated it to say 'history of thyroid carcinoma and breast cancer'. (Actually I think they upgraded their computer system and are removing these helpful little reminders from their print outs.)

Cancer changes everything. Well isn't that a trite little statement. I prefer to think of it as 'cancer, the gift that keeps on giving'. Anyway, I don't need any reminders on my medical history. The little voices in my head keep reminding me of it. It is dizziness as a side effect. It is a normal head ache. The aches and pains are just part of my back issues. And being tired is the result of not sleeping due to back pains.

How am I supposed to feel?

I am not sure. I am reading the side effects on my prescriptions:

Daily med #1: just has directions - take in morning and take on an empty stomach.
Daily med #2: that I take at the same time as med #1 also just has directions. Do not take this medicine if you are pregnant or plan to become pregnant. Take this medicine with a full glass of water. Take or use this medicine daily as directed. Do not skip doses or discontinue unless directed by your doctor. Take this medicine with a snack or small meal if stomach upset occurs.

Wait... so I can take them together but one on an empty stomach and one with a snack? Do I need to split these up?

Daily med #3: Do not drink alcoholic beverages while taking this medicine. May cause drowsiness, alcohol may intensive this affect. Use care when operating a car or dangerous machinery.
Daily med #4: May cause drowsiness or dizziness. Take this medicine with a snack or small meal if stomach upset occurs. Take this medicine with a full glass of water.
Daily med #5: May cause drowsiness. Alcohol may intensify this effect. Use care when operating a car or dangerous machinery. Do not take other medicines without checking with your pharmacist.

I get it. Don't drink alcohol. Drink lots of water. And now I have something to blame for my inability to parallel park. (12 back and forths yesterday to fit in a tiny little space. Sigh. Someday I will learn.) Also, I had to get special permission from my doctor to take all three of these together. Can you imagine my life if I had to take everything an hour apart? I would be a pill popping mad woman.

In addition, I have more meds. I take these in case of pain, stress, or generally crabbiness.
As needed med #1: May cause drowsiness. Taking this medicine alone or with alcohol may lessen your ability to drive or perform hazardous tasks.
As needed med #2: May cause drowsiness. Alcohol may intensive this effect. Use care when operating a car or dangerous machinery. May cause dizziness. Taking more of this medication than recommended may cause serious breathing problems. Obtain medical advice before taking nonprescription drugs. Some may affect the action of this medication.
As needed med #3: May cause drowsiness. Alcohol may intensify this effect. Use care when operating a car or dangerous machinery. May cause dizziness.

Okay, okay. No alcohol. If I am dizzy, I know why.

Then the doctor prescribed a new med but didn't tell me if I am supposed to take it instead of or in addition to what I am already taking. I have a call into the doctors office to find out what the deal is but it: May cause drowsiness or dizziness. Take this medicine with a snack or small meal if stomach upset occurs. Take this medicine with a full glass of water. But it just means drink more water and be dizzy.

So when I have all these potential causes of dizziness in me, should I feel concerned if I feel dizzy or is it just all the side effects? What about if my stomach is feeling a bit cranky? Did I skip a needed snack or take something not on an empty stomach or need another glass of water or is it really having problems? The drowsy one is easy. I just take a nap or go to bed early. I am perfectly happy to have an excuse for the parallel parking thing but what about the other issues? If I ask a doctor, they just blame one of the meds. Grr.

I think I'll just put all the bottles back on my bedside table and read the Sunday paper instead. But wait, its time to take some more meds first.

Is taking a day off from blogging

And that's all she wrote...

Prescription madness

A day of prescription madness. First stop at the meds therapist for a check on my sanity level and prescription analysis. She put directly into the computer two prescriptions for me. I did explain to her the last time I saw her the prescription wasn't there when I went to pick it up - but it was New Year's Eve, my husband and brother were waiting for me, there was a huge line at the pharmacy (and I had just fallen in the parking lot but I didn't tell her that). I figured it was a computer glitch or insurance being cranky or something and figured I would call her if I ran out before I saw her again. Well last night I went to pick up my new prescriptions, and only one was there. I explained my story to the pharmacy, they said the other prescription was actually in there but the second prescription from yesterday was not.

Then my back pain doctor called in a new prescription for me. I was all excited thinking I am getting off Lyrica - which I don't really like. But apparently when I picked it up, it was another anti-inflammatory. I need to call and find out if this is in addition to or instead of my other anti-inflammatory and refill my Lyrica prescription. I am so confused.

But I have had three doctors follow their scripts recently: my radiation oncologist says she doesn't want to seem me for six months and I look like I am doing well; my meds therapist thinks I am doing okay and I don't have to see her for two months; and my endocrinologist sent me a letter saying all my blood work came back fine. I still have an ultrasound coming up and I think I go back in six months.

Today I will call the pharmacy and two doctors to see if I can straighten out my prescriptions. But first, we need to take the fasting cat to the vet. I can't wait. He is soooo annoying and wants food. And he's begging. And he's pleading. And he's generally annoying. He hasn't had food since 7pm last night when we took it all away. I am sure I will be good and aggravated after dealing with the cat in the car before I get to spend time on the phone.

The value of pets

And I don't mean the medical kind. Apparently it took a study to realize that people grow closer to their pets during an illness. I know during chemo, the cat spent hours sitting with me as I zoned out in front of the TV, cuddling up. At the time, I thought it was just nice of him. But in reality, he was waiting to be fed.

Over the past few years, we have endured his medical ups and downs. He had diabetes and has now reverted for some unknown reason and is off insulin. But his weight keeps dropping. He is down to 13 lbs from a start of 19. He should be about 15-16 lbs. You may think this is fat for a cat but he is very tall and used to be able to reach his paws up to the kitchen counter from the floor. Currently his preference is to drink water out of the bathtub while it is running (but he wishes there was a way to do this and not get his feet wet).

Tomorrow, we have to take him to the vet for a fasting blood test. This means we do not expect much sleep tonight. He is used to having food around at all times. If the blood test results are inconclusive, he will need an ultrasound to look for a mass or something in his pancreas. We know what the word 'mass' means. Cats aren't supposed to go on the cancer roller coaster too. I may be jumping ahead but he keeps losing weight and is some what of a medical mystery to the vet. Sigh. I hate medical mysteries.

Needles and more needles

I don't like needles. Well, I am okay with the sewing kind but not the kind they stick into you. Its not like I will pass out on the floor but I just can't see them or look at them or see them going into me or anyone else (why do they always show that on TV? - ICKY!) or... well you get the picture. Me and needles are not BFFs. When I arrive at the blood lab for tests, I always say 'don't show me the needles'.

So yesterday it was with great interest I read this article that coughing can ease the pain of a needle going into you. Well, I think this is a big fat lie. When you cough, you react and move. What if when you cough, you move and they miss? OUCH! I'm not trying it.

Then there was a second article which is somewhat upsetting. They are recalling needles used for port injections because they are making little slivers of silicone which can get into the port or the patient. These needles were manufactured between Jan 2007 and August 2009. I had my port from September 2007 to March 2008 (or somewhere around there). I am not reassured by this at all. Do I have little slivers circulating around inside me? Well, I guess they might be better than cancer cooties but still a port was supposed to be helpful not potentially dangerous. And they don't tell you really what the risks of little slivers is. Thank you for the (lack of) reassurance.