Beeswax and Helping

If you want to be a good friend during a medical crisis, ask how you can help. Don't say, 'how can I help?' Ask 'Do you need anything from the grocery store? I'm going later today.' Mow their lawn. Pick up their kids from school. All those things. Anything you can do.

However, its 'none of your beeswax' on what exactly their health issues are so:

1. Do not interrogate them daily on what's the latest from their doctor 
2. Do not tell the world every little detail you interrogated out of them. Its not your story to tell.
3. Do not tell them your cousin's hairdresser's uncle's neighbor's son had the same thing and their treatment was what your friend has and they died in the end. Or conversely, their treatment was different and must be better because they lived another two years.

So remember, do not interrogate, its not your beeswax to share, and any other treatment anyone else had is irrelevant.

But go mow their lawn.....

Stop Comparing

When I was diagnosed with breast cancer, I quickly learned every person's cancer is different - even if they have the same diagnosis. (This is why it is so hard to treat.) I learned not to compare myself to anyone else. In every support group, even if we had the same diagnosis, we learned how different all are.

I get this. We are all different. We can't compare our cancers to each other.

But.... why do I keep comparing my rheumatoid arthritis to others? I have to stop comparing myself. My mother has had RA since 1989 and a friend (exact same age as me) has had RA since the early 2000's. Their differences are striking. My mother was diagnosed when they only treated RA when it became symptomatic so she has many of the deformities and issues common among patients treated according to the old standards. But her health is much more stable than mine. My friend has had RA and has very few problems. Until she retired (for non-health reasons), she worked full time including much business travel and long days.

Me? I struggle with fatigue, pain, and more fatigue and more pain. How did I get to be so special? I try not to compare myself with my friend but I do.

As medical diagnoses go, everyone is unique. It doesn't matter if three people have the exact same diagnosis but because of their genetic make up, medical history, and other issues, each is unique. No two are alike (boy am I glad I am not a doctor trying to cure people). And everyone interprets everything different. Some people might be distressed by a little nausea and others may not think it significant.

The lesson that I need to better learn is that I need to stop comparing myself to anyone else's medical stuff. I am unique and so is everyone else. I just need to focus on this life lesson. I think I will stop whining as much if I did. Everyone else will appreciate that part.

Stand by your patient

Nothing rips apart a relationship like an icky medical diagnosis. First you have to deal with your so called 'friends' who head for the hills at the first sign of anything yucky, especially the word 'cancer'. They are not your friends. Forget about them.

Then you have friends and family who obsess about your ailment and call and email constantly for the latest worst of wisdom imparted by your medical team. They often offer their 'advice' in return saying things like 'I can't understand why your doctor hasn't given you [insert the name of the treatment given to their neighbor's dog walker's cousin's hair dresser when they had a completely different diagnosis fifteen years ago]. They also want to know every time you have the least minor issue so they can be 'informed' about how you are doing. You have no idea why they need to know so much and what they are doing with all this information but feel invaded by their constant barrage of inquiries. Again, they are not really your friend either.

The people who are your friends are the ones who stop by and visit, call and just listen, and treat you like a human being, while you are trying not to lose your lunch after your latest infusion. Hang out with these people.

Finally, you have the person closest to you: your spouse/partner/best friend. Too many people find themselves suddenly single after a cancer diagnosis, in particular. I know we had our ups and downs with my breast cancer diagnosis. But I can't tell you how many friends have spoken of their spouse's lack of support, or even departure.

My husband has been wonderful. For the last three years, he has given me my weekly injections for Rheumatoid Arthritis, because I cannot deal with the idea of giving myself a shot. He accompanied me to most of my doctor appointments after my breast cancer diagnosis, where he was allowed to see everything other than my weight and any pelvic exams. He came with me to every chemo infusion where we played scrabble during the infusions (and he would delight in winning when the drugs kicked in and I could only form two letter words). He only stopped going with me when I insisted he couldn't keep missing work for weekly infusions. Now he will go with me to any medical appointment I request him to.

Unfortunately I have friends who are forced to go to difficult appointments alone or are forced to find rides for infusions or other times when they are not in shape to drive. Their partners find excuses as to why they can't help out. Or have left them completely to cope alone with bad medical news and the accompanying job loss and reduced income.

All I can say if you have a friend or partner coping with a medical disaster, don't walk away from them. If you have problems emotionally coping with their medical problems, please do not leave but try to face your concerns and become a better you. Its you who has the problem not them.

That 'Here We Go Again' Feeling

As a professional patient, at some point when faced with a diagnosis instead of panicking, you get that 'here we go again' feeling. You skip the whole stress and panic stuff and go straight to the 'how the hell are we going to fix this now'?

Honestly I do get stressed about bad medical news but I skip the panic crap and go to the 'here we go again' level. Its sort of like you become deadened to the stress of more medical crap. And it quickly is only crap.

Its sort of becoming brain dead or numbed to yet another medical disaster. They just seem to lose their impact.

Sometimes I feel like I only realize the real impact of what the doctor said to me when someone says to me 'that must really suck' or something to that effect. This is why I have therapists and other support people to help me digest all the medical crap.

I mean how much more can a person take? You told me I had cancer twice, two chronic incurable ailments, and one body falling apart syndrome that can't be cured. What else could there be? I will remain calm..... As long as I can.

The Big Gap in Treatment for All

Someone said something the other day that hit a nerve for me. 'How well do you think the emotional needs of patients are met?' And I started thinking.

When I was diagnosed with thyroid cancer, my emotional needs were not mentioned. At all. When I first destroyed my knee skiing, no mention was made of the changes I faced in my life. That was when I first needed to give up some of my favorite sports - skiing was never the same again. When I had hysterectomy, I was given the advice by friends to go to hystersisters.com to answer a lot of emotional questions and the long term impact of the surgery. I do not think my doctor gave me any advice. I mean I may have been given a pamphlet but that was it.

When I was diagnosed with breast cancer, I was definitely given a folder of information on resources - support groups, lymphedema, hair loss, Look Good, Feel Better programs. But I was the one who said I am going to a support group, asked for a therapist, and all that. My emotional needs were sometimes asked about but I felt I was the one raising the issue of how I was coping.

When I was diagnosed with fibromyalgia and rheumatoid arthritis, my emotional needs were not mentioned. these diagnoses are not minor, they are pretty much life changing. And doctors didn't think my emotions were an issue.

No matter what the doctor tells you, how often do they stop and ask you how you are doing emotionally? Somethings are minor - you get the flu, sprain your wrist, etc - you will heal and go back to normal. But after a diagnosis of RA, MS, fibromyalgia, heart attack, stroke, or anything else with a significant long term impact on your health that will change you forever, shouldn't the doctor and the rest of your medical team consider your emotional health as much as your physical health?

Being a complainer

There is a difference between complaining and being a complainer. I complain sometimes, we all complain. And we should. We should speak our minds and make our wishes known. But if we complain too often we can become complainers where we are either Chicken Little or the Boy who cried Wolf so that when we have real complaints, they get lost or overlooked.

Here is a tale of a complainer who complained so often that her complaints became overlooked and she ended up diagnosed with stage IV thyroid cancer and died from it which lead to a malpractice suit.

I think there are a couple issues in this story. The patient complained so much and spent so much time talking about other issues that it became difficult to discern real medical issues from other issues. Of course her doctor could have done more to figure out the cause of her symptoms but he and a specialist could not find anything that significant and attributed the diagnosis of acid reflux  as the cause, which is very common.

When I am the patient, I come in prepared for my appointment with a list of questions to make sure they were all addressed. I would have also kept the list from one appointment to another to make sure something is being done to find out what is wrong with me. And if it dragged on to too many times I was back in for the same thing with no change or resolution, I would get pushier and want more options.

With my medical background, I know you are never too young, too old, or too anything for a diagnosis.

I also know all medical personnel are busy and need to be told a story about a complaint. Don't say 'I have a pain', say 'I have a pain when I do this or eat this', etc. We need to make it easy for my doctors to get to the bottom of the problem. We don't need to share pictures with them or tell them about the rest of our lives. We need to give the  medical professionals as much information relating to our health problems to help them help us.

We should not be complainers but we should tell about our complaints so we do not end up like the patient in the story.

I'm so smart I could diagnose myself

Yesterday will probably go down as one of the not so greatest days in my life. Why? Because I pretended I was a healthy person. And it didn't end up so well.

Allow me to provide some of the story. We had to dig up a lot of the plants in our garden because our retaining walls are collapsing and we have to pay big bucks to a mason to fix them. It has been very hot and dry here for the past few weeks. 90s for the last few days even - which rarely happens in Boston. My poor plants which should be in the ground and in the shade are in pots in the back yard in the hot sun.

I noticed yesterday that some of them were very dry and wanted to water them. The spigot in the back yard was put up by giants and I have to stand on something to reach it. I pulled out my usual little 12" high little table to stand on. As I reached up, the table collapsed and I felt my knee bend sideways. That was a very bad moment. No one was home but the mason's assistant but he came to help me get back to the front door and inside. I could hobble.

But because of my extensive medical background, I knew exactly what to do. I went to the freezer and got an ice pack. Then I picked up the phone and called my doctor's office. I knew I needed an x-ray and possibly more. They suggested I go to the walk in clinic last evening but I declined and asked for an appointment today instead. But as I sat with my knee elevated it really started to hurt (even through all my RA/fibromyalgia meds) and I asked my husband to take me to the walk in clinic.

I saw a doctor and got an x-ray as I expected. The bones look fine (as I expected) but the doctor thinks there is ligament/muscle damage (as I also thought) and referred me to an orthopedic doctor. This is exactly as I assumed would happen. I need to call today if I do not hear from them by noon to get to see a knee doctor. (Maybe I should have just called my knee doctor first -  yes I have a knee doctor, and an ankle doctor, and many other specialists.)

They did send me home with a knee immobilizer, a totally worthless piece of equipment as it forces me to overwork my hip (and my bursitis) and causes more pain than is in my knee. They also recommended crutches or a cane, both of which I declined. But I did ask my husband to find one of the crutches in the basement as it turns out I need it for stability and weight bearing.

So one moment of pretending I was healthy allowed me to sprawl on the backyard in pain. The good side? I really need a positive here. I have a reason to sit around on my butt all day (except going to the dr and possibly getting my nails done) with an ice pack on my knee during this 90 degree weather. I am not discussing the downside at this point because I am pretending it doesn't exist. Denial? Yes. But I did know what to do and what I needed medically right away. 

Diagnosis and Being A Patient

I am going to write a series of posts on diagnosis, over diagnosis, and then over treatment. This is the first one. I plan to write the others soon but make no promises on how soon.

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When you go to the doctor with a symptom, to my non-medical school educated brain, they start by asking a few questions and then proceeding with weeding out the most frequent and most possible and eventually get to a diagnosis.

A sore throat - is it from coughing, allergies, strep, acid reflux, several other options, and finally possible cancer? Probably not cancer so we shouldn't think it is at first even with a history of cancer. Cancer people get the same ailments as other people.  It takes a bit to get through the process of elimination to get from the first to last. And a medical professional will give advice on what to do to get better.And we need to do our part in cooperating and not demanding extra tests and treatments.

Right now, for example, we have problems with antibiotic resistant germs because antibiotics were over-prescribed. As patients we need to do our part and not demand medications and tests we do not need. A sore throat may not be strep and can be determined as that through a visual exam. Antibiotics do not help viruses so don't request them. We need to believe our medical professionals when they tell us what is wrong with us and follow their instructions if we hope to get better quickly.

If we don't follow their instructions, we won't get better. Here's an example: Someone I know had a sore upper arm that wouldn't go away for months. He went to the doctor for his annual physical and the doctor said some kind of strain, go to PT. The next year he went back to the doctor for his next physical and the doctor asked about his arm, which still hurt. Then he finally did agree to go to PT and his arm stopped hurting.

But if we do follow their instructions and do not get better that becomes another story. This is when the diagnosis process can take more investigation and lead to a more serious diagnosis.

In addition, we need to be mindful of medical expenses and costs - just because we do not pay for something because it is covered by our insurance, the cost is still felt - maybe by higher premiums later on. If a doctor tells us what is wrong, we usually do not need to question them. There is no need to doubt them, unless we have a reason.

As patients, we need to work with, not against, our medical team. Take their advice and work with it. Accept their diagnosis and go with their treatment. Unless there has been a problem in the past, in which case that's another story.

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So to my non-medical school brain, this is the basics of diagnosis. I will write more on over-diagnosis soon.

Medical adventures continue

My life is a series of medical adventures. Somehow there is a giant gap in my calendar for the month of December (but don't tell anyone because I might jinx myself here).  But I am sure that will change before then.

Yesterday I went to one of my newer doctors for a conversation, not an exam, to discuss treatment options. I was given a choice of two courses of treatment. One was for a milder program which could take a few months to get going but has fewer long term side effects. The other choice would kick in sooner but had the potential for more side effects. I opted for option one with some steroids to start feeling better sooner.

That was a BAD choice. One of the potential side effects of the steroids is they 'may' cause sleeping problems. Yes they do. We went out last night (and saw Weird Al Yankovic - if you haven't seen him, I recommend him as it was a great show). We didn't get into bed until after 11. I was exhausted and couldn't sleep. I finally did sleep but badly. Guess what? I won't be taking the steroids again and will call my doctor on Monday.

Then I also go back to my back pain doctor for more conversations on Monday. I was supposed to wait another few weeks to see him but he actually had a cancellation for Monday. So that will be two doctor conversations on Monday.

My life really is a series of medical adventures. My calendar is dominated by doctor appointments.

Celebrating?

Tomorrow is my blog's fifth birthday. Five years ago I started this little means of communication. Who knew that over 1800 posts later, I would still be writing it? And still going to the (damn) doctor all the time.

It also means its been five years since my breast cancer diagnosis. I'm not celebrating. Some people jump up and down and say five years and have a party or some other celebration. I don't feel the need.

For some reason, cancer statistics always include five year survival rates. That doesn't mean squat. Its a number that was selected and used but cancer can still recur later. I did some research on this (which means I asked Dr. Google) and found that the Mayo Clinic provides some insight. (The Mayo Clinic is a bit smarter than Dr. Google so I will believe them.)

First it gives some back ground on what a survival rate is:

"One of the questions many people ask when first diagnosed with cancer is about their prognosis. You might want to know whether your cancer is relatively easy or more difficult to cure. Your doctor can't predict the future, but an estimate is possible based on the experiences of other people with the same cancer."

"Cancer survival rates are based on research that comes from information gathered on hundreds or thousands of people with a specific cancer. An overall survival rate includes people of all ages and health conditions who have been diagnosed with your cancer, including those diagnosed very early and those diagnosed very late."

This means based on other people with the same diagnosis, this is what you can expect. If a five year survival rate is 90% it means, that 10% of the people with the same diagnosis didn't make it five years while 90% did. The cup half full says 90% is the number to focus on. Its a statistic so when you focus on these you become a statistic.

Also, as I said, they don't mean squat:

"Cancer survival rates often use a five-year survival rate. But that doesn't mean that cancer can't recur beyond five years. Cancer can recur many years after successful treatment. Discuss your risk of a cancer recurrence with your doctor"

So in other words, they are statistics and you need to talk to your doctor about your particular case. This is your standard lawyer sanitized, Dr Google medical speak, CYA language to say they are merely numbers and don't really mean anything.

So no I'm not celebrating. Not yet, I'm waiting until they find a cure.

The rest of the medical adventures to skip - Part 2

More from choosingwisely.org on medical adventures to skip:

American College of Radiology:
- No imaging for uncomplicated headaches - just take a damn aspirin will you.
- No imaging for suspected pulmonary embolism without moderate or pre-test probability
- No preop or preadmission chest x-rays for ambulatory patients without history
- No CTs for evaluation in appendicitis until an ultrasound has been considered.
- No follow up imaging for inconsequential cysts unless over 1 cm

American Gastroenterological Association
- Translator needed for this one but I believe it means don't over medicate for GERD: For pharmacological treatment of patients with gastroesophageal reflux disease (GERD), long-term acid suppression therapy (proton pump inhibitors or histamine2 receptor antagonists) should be titrated to the lowest effective dose needed to achieve therapeutic goals.
- Colonoscopies only once every ten years if clean
- Colonoscopies not repeated for at least five years who have small polyps that were removed during a colonoscopy.
- Do not repeat endocscopy for at least 3 years with Barretts esophagus patients without cellular changes.
- CT scans do not need to be repeated for abdominal pain unless clinical findings or symptoms

American Association of Nephrology
- Skip routine cancer screenings for dialysis patients with limited life expectancies who are asymptomatic
- No ESAs to reach normal hemoglobin levels in chronic kidney disease patients
- No NSAIDs to patients with hypertension, heart failure or CKD.
- No PICC lines in Stage III-V CKD patients without consulting a nephrologist.
- Consult patients, families and physicians before starting chronic dialysis - a group decision

American Society of Nuclear Cardiology
- No stress tests or coronary angiography on patients without cardiac symptoms unless high risk markers are present
- no cardiac imaging for patients who are at low risk
- No radionuclide imaging as part of routine follow up in asymptomatic patients.
- No preoperative cardiac imaging as preoperative assessment in patients before  low or medium risk non cardiac surgery
- Reduce radiation exposure in cardiac imaging tests including not performing tests when limited benefits are  likely

After having read all these (and written them down) my thoughts are I am happy to see these recommendations. If there is no need, why are they running the tests? Just because a new test comes along and it shows some benefit, if over time, the becomes proven that there is no real benefit, why do we keep running it? If a patient has no symptoms why do they need a test?  We have all been trained by our doctors to expect test after test or magic pill after magic pill. But maybe just go take an aspirin and wait a few days. And a headache doesn't mean its a brain tumor.

Juggling the patient's peace of mind vs. costs vs. over diagnosis can be difficult but if in the long run there is no real benefit, feel free to skip my tests, thank you.

More pictures!

Are more pictures better? Back in the days of black and white cameras on tripods, a professional photographer would come and take a single posed shot of serious looking people dressed in black. After being hand developed a single picture was produced with no copies to send out to friends a relatives. Then personal cameras came into play and little towers of flash cubes were added on. Film was sent out to be developed and you crossed your fingers until they came back to hope that everything was in focus. You might take a couple to double your luck but still a lot was left up to chance. Then digital cameras came along and we clicked away like mad - shared them everywhere. Focus and aim become less important as quantity increases your odds for a good shot. All of our foibles in living color are available worldwide in this digital age.

In the world of medicine, photography, a/k/a imaging, has grown by leaps and bounds. Do you remember going to the hospital and you were offered an xray to see inside you before surgery? Now a single xray is replaced by ultrasounds, CT scans, PET scans, MRIs and more.  Is this better or not?

Recent studies (yes we needed more medical studies) showed that in the early 1990s approximately 5% of women had two or more imaging sessions prior to breast cancer surgery. In 2005, more than 20% had two or more imaging sessions. TThere have been significant advancements in medical technology since 1992 so there are many more pictures available. The theory is the more testing that is done the better the doctor is able to determine the course of treatment - whether for breast cancer or other ailments. But these additional tests come at a cost - both emotional and financial. Every trip back to the hospital for more tests is another emotional roller coaster and another dip into the financial hole.

Are they worth it? It seems the jury is still out on that one. They need another study to tell the doctors if the additional tests are worth while. The numbers have been analyzed on the quantity of tests but not on the outcomes. The current advice is that if your doctor sends you off for pictures, can the trips be combined so only have to take one trip and not two or more. Well that's a big help (not). I think they have plenty of pictures of my insides and outsides but somehow they always seem to want more.

The importance of knowledge

Why should you be an educated patient? Everyone tells you to go find out about your ailment. They tell you to look on line (but not too much and beware of Dr. Google) and find out what you have so you can ask your doctor the right questions. And where does that get you? Often on information overload to say the least, or with a queasy feeling in the put of your stomach as you try to figure out what it all means.

But what if you didn't look things up and do you own research and blindly listened to your doctors, ignoring your gut? Most of the time, you are fine because the doctors are smart, educated, went to medical school, and your ailment isn't that complicated.

But those times where you have a complicate ailment with a difficult diagnosis and poor prognosis? How important is your knowledge then? It can be very important. It can lead you to ask the better questions, bring more information to your doctor, and could even save your life.

Here is the story of Marci who died of brain cancer. But she was proactive and listened to her gut and found a better doctor who gave her the right diagnosis and therefore the right treatment. She also then did what she wanted to do in the remaining years of her life. This is what knowledge can do for you and why it can be so important.

Yesterday was a bad day so apparently I am crabby

I had a bad day yesterday. It was long, eventful, stressful, and tiring. My husband keeps telling the cat to avoid me because I am being crabby - even though I fed the cat and made lunch for my husband.

Yesterday morning I woke up starving, wanting breakfast, and couldn't eat, even have coffee because I had a fasting blood test before my 830 doctor appointment. I got up, fed the cat and made lunch for my husband, and was starving. I finally took a shower before getting dressed. My big toe on my left foot has been bugging me for a few days so I took a look at it after getting out of the shower. It was infected. I mean there was (yucky) pus next to my toe nail. I don't consider that something one wants to see. Crap.

I went to the hospital for my blood test and grabbed coffee and a banana (as a crabbiness reduction attempt) and called my doctor's office to be seen the same day. I got a 915 am appointment which fit nicely after my previously scheduled 830 appointment. At my 830 appointment my meds therapist wanted to know why I didn't want to increase the dose of one of my meds. I said I prefer to take fewer instead of more medications and if I am doing fine at one dose then why change it? She thought I should increase it, I disagreed. Then I realized there were refills available at the original low dose that she had ordered previously. Call me cranky but I don't want more drugs.

Then I went off to see the doctor about my toe. Its infected - now that's news (I saw it). But she said I had gotten it before it went wild. So I have to soak it twice a day in warm water, keep it covered with bacitracin or something and a bandaid and take an antibiotic for the next 7 days. If its not better in a week, call back for a follow up with a podiatrist and he can cut away at my toe. Oh joy! That sounds like some much (not) fun!

On my way home from the hospital, I stopped at medical records to (stupidly) pick up my test results from all the tests I have had recently. They did have the results of my fasting blood test from that morning which was good. This is what I found out. My mammogram was fine - but I already knew that. My bone density scan shows that I am once again back in osteopenia land after successfully leaving it two years ago. I have lots of good cholesterol and only a little of bad cholesterol. I have my EKG but haven't deciphered it yet but my doctor said it was fine but fast. I want to figure out the notes from when they compared it to my last one.

Once I got home I realized that I had not received my full blood count test results. But since I have another appointment today I can stop by and get it - and then it showed up in the mail. That was full of all sorts of nice news such as my blood counts are finally returning to the pre-chemo levels. My thyroid levels are back into low normal but we are still adjusting them.

Then I worked from home, met a friend for coffee, stood in a giant line picking up three prescriptions and rushed to PT. After that I came home did more work and had a conference call for volunteer work for an hour when all I wanted to do was go to bed early.

So the result of yesterday is I have another prescription to take, 2 new issues - infected toe and osteopenia, and have a bruise from this week's blood test growing on top of the bruise from last week's blood test.

Maybe because it has now rained for 6 days in a row is why I am cranky. But I also would prefer to get healthy.

Skeptical on being overdiagnosed

Or should I say on being a skeptic. Here's another book to read 'Overdiagnosed: Making People Sick in the Pursuit of Health'. I think for normal people, there is the risk of being over diagnosed in today's medical system. If you are like me have cancer or something else that is icky, you can skip this part. We are part of the group 'with your medical history, we have to be sure, blah, blah, blah'.

I think normal people run the risk of being over diagnosed. Take the annual screening tests like mammograms, blood tests, etc. If you are abnormal, do you get prescriptions and other visits and more fun 'procedures' to take care of what might be wrong with you?

For instance, if you go to the doctor for your annual physical and your blood pressure is off the charts, what next? A stress test? A visit to a cardiologist? A new prescription? What if the doctor just says 'since its only today, let's check it again in 3 months'? Are you comfortable with that or do you ask for an immediate follow up? Where is your comfort zone?

Then if you are part of the group 'with your medical history, blah, blah, blah' how easy is it for you to say let's wait and see? Last Friday I went to my back doctor and my blood pressure, which is normally 120/80 or 115/78 was 150/94, 147/88 and 155/90 (or something like that - I can't remember three minutes ago, never mind 3 days ago). The third test was on a different machine after a 15 minute wait. The nurse said to me that I should make sure I mention it to the doctor and maybe he would want me to go to my primary care physician for follow up. I did mention it to him, and he did not think it was significant.

I went home and researched it and asked questions and found that our blood pressure can have its ups and downs and I shouldn't worry. (What? Me worry?) I have opted with this to do nothing for now. I don't care that I am in the 'with your medical history, blah, blah, blah' group at this point. I am not jumping to any conclusions. I have another appointment in a month with another doctor and if it is still high, I will worry about it then.

The nurse was right in deferring to the doctor as that is her role. The doctor was right in not over reacting and rushing me to a cardiologist. I am right in not over reacting and rushing to my primary care. This is a little blip in my medical history and totally out of line for me. But do you see how easy it could be to rush to the over diagnosis? Keeping a healthy dose of skepticism in your medical appointments might keep your blood pressure down.

Finally more news - good and bad

I have invasive ductal breast cancer and it is basically the most average common kind of breast cancer there is. The good news is that the tumor was 1.3 cm and was clearly removed - clean margins is the term. The bad news is the one node removed tested positive and means I need to have more surgery to take out the rest of the lymph nodes under my left arm. This is already scheduled for Thursday July 5. Apparently no one wants to have surgery next week so they could fit me in quickly.

After this surgery, I will have a drain to deal with for about 10 days and then when I go back in for follow up we will find out the next stages for chemo/radiation.

Also, I have to leave the rest of the damn steri strips on until next Tuesday!!!!! Grrr...

Here's a new game to play!

So the big thing with a cancer diagnosis is, has it SPREAD? As I sit here and wait for the results, I can tell you every ache and pain in my body is surely the result of a vast network of tumors waiting for full diagnosis. Yesterday in the Boston Globe, there was an article on ovarian cancer, the "silent killer". Of course, I decided I must have symptoms of this and started to play the game.

The way to play is go to the American Cancer Society website www.cancer.org and select Learn About Cancer/Choose a Cancer Topic. Then pick a type of cancer and see if you can self diagnosis yourself! Who needs a medical degree when you can do it all online! There are a few cancers in there I can safely say I don't have: Male Breast Cancer, Penile Cancer, Prostate Cancer, Childhood Cancers, but there are still many on the list to go through! What a great stress reliever! NOT!

Also I said I recently went to the Marble Museum in VT. Well it turns out I missed the best part of the museum as noted here:

"The Vermont Marble Museum is one of five finalists in the sixth annual contest to be declared as hosting America's Best Restroom.

It's fitting that a museum devoted to the local marble quarrying industry would feature what contest sponsor Cintas, a Cincinnati-based company that supplies and maintains corporate restrooms, calls restrooms "made entirely of marble."

Marble restrooms aren't all that uncommon, but Cintas says it also was impressed with the "bright flowers and lace curtains to soften the smooth lines."

The competition is stiff."

I didn't use the bathroom I was there. Now I have to go back. To find out more about this google 'restroom marble museum'.