Things change, but they don't really

Last night I was lying in bed listening (with a tiny bit of insomnia) to the heavy rain come down and realized that I wasn't concerned that the roof might leak. This is a significant change, there were a few years where I would dread every forecasted rain storm and even make a point not to be home in case the roof did leak.

When we bought the house in early 2005, we knew we needed a new roof. We had some ice dam issues that first year which caused some ceiling damage too. We had the roof replaced in the summer of 2005. On New Year's Day 2006, I was working in my office upstairs and heard a drip. The roof was leaking in my office. We found a new roofer who would come that day and did some repairs. A few trips by the roofer and several hundred dollars later, we no longer had any drips but I had learned to hate rain. It would stress me out. What if the roof leaked again? We couldn't keep spending money on the roof, we had to pay for other things - a furnace, driveway paving, etc. I was stressed for every storm.

Last night I was not stressed by the rain and I started thinking. I knew the roof could leak at any time. This does happen sometimes. Roofs do leak - during hurricanes, or when big debris lands on them, or with ice dams, not just in regular rainstorms. But I wasn't concerned.

Last week I had my annual mammogram and physical and I wasn't stressed about cancer issues. I was stressed about other health issues on my never ending list of new medical issues. Have things changed? Not really. Just because I was not stressed about cancer cooties, doesn't mean the concern they may reappear has disappeared. It never really does.

After my first cancer diagnosis, I learned to despise the words 'but with your medical history we need to be sure...' Every little medical blip put me to the front of the cancer line. Eventually, my stress settled down and I wouldn't be as concerned about every issue. Then another cancer diagnosis, totally unrelated but very stressful, came along and I returned to the front of the cancer line for everything.

With two cancer diagnoses and three years of waiting for a clean mammogram, my stress level is finally settling down. Maybe my breast cancer is not going to come back but 'with my medical history, they always need to be sure'.

So last week, I wasn't as concerned that they might find cancer cooties related to my breast cancer as it has not been as problematic in the past year. In fact I passed last year's mammogram and with a second clean one this year, I was feeling pretty comfortable with it and wasn't freaking out that they might find something else during it.

Its the other cancer issues that cause me stress but that doctor isn't until July. I have another thyroid ultrasound in July to see if they can figure out what is the 'detectable but too small to biopsy' thing is that is hanging out where my thyroid used to be. So I think I have just deferred my stress for a different doctor appointment.

I can still stress about my mysteriously caused heart rate issues but that doesn't look like cancer. It could be caused by my thyroid levels being messed up but it doesn't look like cancer. I'll have my echocardiogram in a few weeks and learn more then. I'll save more stress for then.

So things did change, the roof didn't leak and my mammogram was clean and I wasn't stressed. I have learned that I can always find something new to stress about with my health. And with 'my medical history, they need to be sure'.

I'm cranky

I'm cranky this week. I have a lot going on and am feeling stressed. This is what is making me cranky:

1. Blogger was down for most of two days. I find this one of the most epic cases of mismanagement. Yes it is a free service we use to host our blogs but it is part of Google's money making tools (where they are trying to take over the world) but they just severely shot themselves in the foot. Apparently there were some upgrades and maintenance issues and things went wrong and the Blogger service was done for parts of Thursday and most of Friday with no real updates or explanation. I am ready to move my blog to a provider which actually runs parallel servers to ensure these issues don't happen. Its not the problems with service but the lack of communication through the issues. Just imagine if the Google search engine was down for the same amount of time. Anyway, I couldn't blog yesterday and I always blog (unless I am in a part of the world without internet) and it upset my routine and made me cranky.


2. On Wednesday I posted about my wonderful series of doctor appointments and how much fun I had with them on Tuesday (but you couldn't read it because Blogger was down). They were so much fun and then my doctor called me Wednesday night and I couldn't get hold of her to call back until Thursday morning. When doctors call you at home at night it is always stressful. Apparently my blood tests, EKG, and chest x-ray were normal (or as normal as I can be) but my PCP spoke with my endocrinologist and they want me to slightly adjust my thyroid hormone levels down to see if it impacts my heart rate and then have more blood work in six weeks. But if my thyroid level gets lower, its harder to lose weight or not gain weight and one of the things which stresses your heart is your weight. I also have an Echo cardiogram in a few weeks to see if this tells us any more information. So I am still in 'wait and see' for longer.


3. I am not looking forward to a series of shots under my knee cap. I was stupid and looked up what they do and then someone else told me how painful they were for her husband.


4. I am overscheduled. I have entirely too much to do in the next few weeks. I have personal stuff to do. I have volunteer work. I have doctor appointments. I have a lot of work to do. I have meetings. I have events for work. And it all has to be done in the next ten days.


5. I have knee pain, back pain, SI joint pain and don't feel like sucking it up and coping so I am whining.


6. I am not getting enough sleep. I wake up at night and have a very difficult time getting back to sleep. And last night just as I did get back to sleep the (stupid) cat knocked over my water glass all over the floor. He went back to sleep. I cleaned up the mess.

But otherwise I am fine and there were no cancer cooties to be found at my physical.

Is this even news?

Health care costs for American families are increasing. Is this even news any more? When health care costs go down, that will be news.

But I did pick a few nuggets out of this increase. First of all employers are pushing more of the insurance costs onto employees in an effort to control their costs. I don't see a problem with this. Your employer provides health insurance but where does it say that they have to pay for the vast majority of it? They don't. They have to pay for what they can afford.

Health insurance is a benefit that is part of an employment package. This is true whether you are a CEO for a multinational or bagging groceries. If you are offered a job at $15/hour working in a retail store. It provides two weeks vacation each year and a 401K, and no health insurance. How does that compare to a job working at a retail store for $14/hour which also provides two weeks vacation, a 401K and minimal health insurance at a cost to you of $50/week. Which job would you take? I would take the one with insurance. In looking at job compensation, never just look at the rate you are paid but everything else involved. This can also including commuting costs and distance and hours required to work - 7am-3pm or 7pm-3am - there's a big difference there.

So health insurance is one thing a company offers and the costs may change. The company may also choose to move their office to another town, or change how much they put into your 401K or change their vacation policy. That is their prerogative. If I company can't afford to keep up with the insurance increases set by their insurance provider and maybe has to cut back on benefits offered or increase co-pays and all sorts of other options but the premiums go up. You can't blame the employer, they are trying to stay financially solvent and not have layoffs.

Another point is that although health care reform is in the works and is starting to show its impact, it has only had a very limited impact on curtailing costs. Those changes are still coming.

My point (because I always have a point) is that health care costs money. There is no way around this. It is based on skilled people providing services to you to keep you healthy. This doesn't come cheap. You can't have an MRI using a several hundred thousand dollar machine, that has to be maintained, serviced, upgraded and periodically replaced without expecting to bear some of this cost. Some of the cost comes directly out of your pocket, some comes out of your pocket indirectly through lower salary from your employer, and some comes out of your pocket from government subsidies etc. You are going to pay for it.

So until health care costs go down, there is no news and we still have to pay for it. If your employer needs to increase your share of your health care instead of letting you go, which would you prefer?

That Lovely Place to Wait

I feel like I should run around quoting 'Candide', where the cast runs around wishing for the best of all possible worlds in the middle of the Spanish inquisition where its 'oh what a day for an auto-da-fe'. Basically incredible amounts of optimism in the midst of chaos and bad things.

Yesterday I had a wonderful time at the hospital. I met with my back pain doctor and we discussed my back and how it actually feels better these days due to my new drugs and my actually making it to the gym regularly. He also gave me a greatly appreciated cortisone injection in my left hip which has been full of bursitis recently. My back feels okay - meaning it doesn't give me nearly constant pain, but it is not and will never be cured so don't jump up and down with optimism for me. I don't have to see him for four months instead of the usual three.

Then I went for my mammogram and changed into a lovely gown and sat around and waited but then finally got a clean result on the first try which was very nice. I changed back into my clothes.

Then I went back to check in for my bone density scan and changed into another set of lovely pajamas. The test is quick and boring. I then changed back into my clothes again.

My last scheduled stop was at my primary care for a physical with my new doctor. We talked and decided that the biggest concern is my blood pressure/pulse/heart rate. She measured my pulse at 106 but my BP was 128/86 which isn't bad but still higher than it used to be. We talked about my eating habits, my salt intake, exercise schedule, weight gain/lost, etc. We also talked about the impact of my thyroid level (which won't settle down) on heart rate etc. Weight loss would be good as well - but I already knew that and will try some more.

Finally, this is what I know. I have tachycardia - meaning fast heart rate - which is not a good thing. After changing back into my clothes again, I was sent for an EKG (which meant another lovely gown) and I brought the tapes down to the doctor to read. She said my heart rate was normal but fast. So I guess the good news is it doesn't look like I am about to drop dead. But then I had a chest x-ray (another clothes change - at this point they recognized me in diagnostic radiology where my mammogram and bone density scan took place) as well as a full set of blood tests.

I also am scheduled to have a fasting blood test next week, an echocardiogram, and then back to see her in a month to finish my physical (we never got past the cardiac issues) and discuss the results of all my tests. Next week I will stop by and get the results of all my tests to review (and over-analyze and over-research online) in private as well

So two doctors, five tests, and five clothes changes later, I am in the lovely place to wait called 'you have something wrong with you that could be very bad but we don't know quite what it is yet or how we are going to treat it'. I hate this place. But I do like my new doctor and think we can work together on this.

It all catches up sometimes

Today is the day I haven't been looking forward to, or maybe I have been looking forward to. I will spend the morning at doctor appointments.

My first stop is my back pain doctor where I can tell him in some ways my back is better these days between my new meds and the additional exercise I have been getting at the new gym I am going to. That should be okay. I have a few areas of concerns with my back but overall I'm doing okay.

My next stop involves a heavy dose of scanxiety as it is my annual mammogram. I was stupid (I have to stop doing this to my self but since I have this lovely blog I can look up my thoughts from anytime in the past four years.) But I digress, I was stupid, I looked up my results from last year's mammogram and some calcifications were found and while the radiologist recommended follow up in six months my surgeon thought they were nothing and said I could wait a year. And that is now year is up.

My third stop is a bone density scan. This will involve another change of clothing into a lovely set of pjs and robe (why don't I just wear my own?) for a two minute bone density scan to see if my osteopenia has returned.

Finally, if I am still on schedule, I meet with my primary care physician where I get to go through all my tiny list of medical issues/problems. Its not that long a list, but its not that short. I consider them issues and I don't think she can necessarily tell me they are normal. Actually I am quite firm in my stance that I want answers and not to be told 'well that sometimes happens to people'. I want to know why things happen to me. I realize somethings occur without any significant cause but I am pretty firm that I need to know more.

I think I am taking this stance because of the idiotic Dr. B I met with who told me he was collecting cases of hypertension with a secondary cause over the years and I clearly was not one. I was just fat, lazy, ate too much prepared food and salt. It is becoming clearer now that he was wrong, I do have something going on - probably related to my thyroid - that he ignored. He did upset me and I now realize I am overreacting to the whole situation.

Anyway, that will be my morning. If I am still sane by the end of it, I will go to the gym to destress. Then I will go out to dinner with a friend and get to complain about it too.

Cancer causes PTSD for patients and family members

There are not enough rocket scientist cancer people out there who could deny this one but it took a study about parents of children with cancer and a referral to a study of stress on breast cancer patients to paint the big picture. A cancer diagnosis is stressful - well DOH! - whether its you or a family member.

I think the issue of the stress level of family members is finally getting more attention. A cancer diagnosis does a number on everyone in the family. I have seen more emotional people talking about their family member's cancer and fewer emotions from the patients themselves. A cancer diagnosis is hard to cope with - facing the unknown.

If you are the patient in treatment, you get a whole group of people to help you - doctor, nurses, social workers, etc - who are on call 24/7 for everything from the sniffles to new symptoms. You get lots of TLC. They want to make sure you stay healthy enough to continue your treatment and are not reacting to it in bad ways.

If you are a family member of a cancer patient, its close but not the same. The doctors are focusing on the patient but include you in the conversation. You may be able to see more of the big picture but that doesn't mean it is a rosy, optimistic one.

I have been on both sides of this lovely little situation so I can tell you its not easy either side. At my first cancer diagnosis, I was a kid, I didn't really cope. At my second diagnosis, I was much more proactive and said 'look, tell me the information'. Then with my husband's diagnosis, I spoke up and said to the surgeon 'I've had cancer twice so we have an idea of what to expect for treatment options'. That actually was a good idea as the surgeon opened up and talked to us more.

It should not be a surprise that the word cancer has nasty overtones (hurry up with the damn cure will you?). And the resulting level of stress can do nasty things to your sanity, brain, and body. I think talking about it as opposed to ignoring the giant elephant in the room will make a huge difference. But the stress will take a long time to go away, if ever.

Lessons from preschool - sharing is good

Medical researchers who didn't learn sharing and playing well with others need to go back to preschool to try again. There is a new study on medical studies. (Just what we need - a study on studies. What's next - a study on a study on studies?)

Anyway, it says that the proximity of people has a correlation with increased significant breakthroughs in research. I live outside Boston which is a pretty geeky city and full of medical research. It turns out more medical breakthroughs happen here than elsewhere because people are so close together. And when people share buildings there are more collaborations. And when they share floors and talk in hallways and elevators, there are even more.

Back in January, I think I blogged about the Broad Institute and how it is a new place full of collaboration in medical research. And now this study validates what they are doing there.

Sharing ideas is important. Talking to others is important. But I think researchers spend lots of time working in labs doing research, which is why they are paid to be there, but maybe they need to talk to others. So basically if you do research you should talk to people in elevators and hallways. There are lots of us out there waiting (im)patiently for more significant breakthroughs.