Tuesday, November 30, 2010

Vitamin D

Maya in her hospital gown. She kept grabbing at the clowns trying to pick them off. She will be 5 months old tomorrow. This weekend, she learned how to flip over.

A report came out today recommending that Americans and Canadians triple their Vitamin D intake to 600 IU. As there have been recent studies linking breast cancer to low Vitamin D levels, my onc had been telling me to take 2x500 IU/day in divided doses as she felt the body can only utilize so much at a time. Who knows what my Vit D blood levels were? Who knows what they are now? The divided dose business is a pain because the Vit D comes with calcium which in the past has bound up my thyroid medication rendering it useless and putting me into a severe hypothyroid state. Not fun. So I take the thyroid medication as soon as I get up and don't take the Vit D until noon. If I'm lucky, I'll remember to take the 2nd dose at night.

Exposure to sunlight is key to making the Vit D usable. I am out there, winter or not, daily so I think lack of sun exposure is not an issue for me. The panel's main impetus for its recommendations is preventing osteoporosis. Its deficiency is also linked to higher levels of heart disease, stroke, diabetes, various cancers including my favorite, and cognitive decline. So do people in the South have less of these conditions?
Can you take too much Vitamin D? Yes, around 10,000 IU, one is at risk for kidney stones and heart disease.

In other science news, there is a strong link between second hand smoke and hearing loss. Hmmm. Steve was exposed constantly growing up and he has moderate hearing loss. Could this be why?

It was in the 50s this morning. I ran in shorts. I feel so good running and especially after I finish. I'd go crazy if I couldn't run.

Tonight we will have dinner with Shanna's family. They are coming back from Canada as I type.

Monday, November 29, 2010

Historical Postcards

Postmarked 1908. My father graduated from here 1944. Later it became the Frieze building, part of UM. I took Anthropology 101 in it. About 5 years ago, the university ripped it down to build a dorm. Only the doorway remains.
Eastern HS, Detroit Postcard dated 1918. My maternal grandfather attended here

Ford Rotunda postmarked 1944. Every year Ford would have an elaborate X-mas display within that we attended even though we lived in NY at the time. When I found out that I was moving to Michigan, I was excited because I would be then able to go to the Rotunda all the time but alas, it burned down the same year I moved here.
From 1909. Most of the older postcards are drawings but this is a doctored photo.

Madison Square Garden and the Met Life Bldg which at that time (1910) was the tallest structure in the world at 48 stories

I was digging through one of the closets today looking for manuscripts that my paternal grandmother and grandfather had written. They are in sealed wooden boxes and I have never opened them. The search continues for them. Instead I came across a box of postcards that were from my mother's family. A lot of them are from fairly local places, Brighton Water works, Jackson firehouse, Henry Ford Hospital (1943) but there are some from Germany too before WWI.

I also came across some genealogy papers of both my paternal grandfather's and  my daughter's ex-fiance. My grandfather had traced us back to Scotland. The papers are quite complicated. One entry was quite sad for a woman, who as near as I can tell was the great aunt of my paternal grandfather.
Twins: born and died 1832
Triplets : born and died 2-27-1839
Twins: born and died 8-30, 1840
There was a surviving boy born before the triplets who died at 13. So this lady buried 8 kids, at least.
According to the Weather Channel, the meteorological winter begins tomorrow. But it was sunny and calm today, good for a long run.

Up in Canada, Ramy's procedure went smoothly. We'll have one last dinner with them tomorrow.

Sunday, November 28, 2010

Neoadjuvant chemotherapy

The usual order of treatment in the cancerland triathlon  is Slash!Poison!Burn!. However, if the tumor is especially large or if distal mets have already occurred, they might do chemo first. This has two advantages: it may shrink the tumor to the point that a lumpectomy could be performed instead of a mastectomy and the sensitivity to a particular regime can be identified. If a particular chemo completely wipes out a tumor, they call it a CPR (complete pathological response) and this bodes well for the patient. If it killed the primary, it probably killed the mets.

This is assuming the mets are the same as the primary tumor. In blogsphere, Kim (of I'm just a little Batty) found herself at the ripe age of 25 at Stage 4. Could you imagine? The tumor was large. They treated her with neoadjuvant chemo and her liver mets shrunk to nothing. Her breast tumor was still there. The primary was Her2- and the mets Her2+. Fortunately for her, the situation was not reversed. She is now about to turn 32 and became pregnant while undergoing treatment. There is not a huge number of babies conceived while the mom   was being treated with Herceptin. Fortunately the baby was fine and is now 13 months.

My gut feeling was get rid of this tumor NOW! before it spreads any further.Since my tumor initially appeared small, neoadjuvant chemo was not even on the table. But then in those 3 weeks, the tumor apparently doubled. I wish they had measured it right before the surgery and maybe I would not have needed a second surgery. According to the Merck Manual, even a 1 cm tumor sheds around a million cells a day into the lymphatic and blood systems. Most of these cells die but all you need is for one to take hold somewhere. But in Susan Love's book, she brings up another scary cancer factoid. It turns out that there seems to a signalling system between the the primary and the distal mets. The primary apparently signals for the mets not to grow so much. But if the primary is removed, these signals stop and the mets blossom. Ugh!

Cold but sunny today. Shanna and the babies came this morning before her and Ramy's trip to Toronto for the medical procedure tomorrow morning. Two nights without babies! A luxury for Shanna.
Later Sunny, Josh and I went for a long walk. Lots of squirrels for Sunny to pursue but not catch. Josh and  Julia had gone to their 10th high school reunion last night. He filled me in on what the kids I knew were up to . Fun.

Turkey matzoh ball soup is on the menu tonight. That will be the last of Turkeyfest.

Saturday, November 27, 2010

Alopecia

Past and present alopecia victims. A year ago, Daniel was similarly hair challenged as Ms. Maya. I don't think she's actually lost hair, it's just that her head grew so the same amount of hairs have to cover a greater area.
Maya's shirt reads I am as cute as my aunt.

Al-low-PEESH-a. What a pretty name, assuming you didn't know what it meant. Some medical conditions sound as disgusting as their names: smegma, rhinorrhea, carbuncle........but alopecia sounds almost nice.

Once in a support group, I was relating my trials with  alopecia when the moderator asked if I found my hair loss the hardest aspect of Cancerland.

No, not even close. The strong possibility of early, painful death trumps temporary hair loss anytime.


But what alopecia uncovered for me was a black spot the size of a dime on the side of my head. Melanoma? I asked my onc.She suggested a dermatology consult.
It was very windy walking from the parking lot to the office. My wig threatened becoming airborn. It was probably askew when I showed up immediately suggesting I was wearing a wig. Many times people complimented on my new hair not knowing it was a wig.

So you are here for your alopecia?

Um, no. I think I know why I have alopecia (Thank-you, Red Devil). It's this black spot that concerns me...
The upshot was that the black spot was biopsied and was found to be 'nothing' but several 'precancerous lesions' were found on my forehead. These were frozen off. Now they are back. Another thing to take care of.

No babies today as there are too many places the Bostonians need to be. Tomorrow they leave for Toronto for a medical procedure not approved yet  in the US for Ramy. It will be expensive as their insurance does not cover Canadian treatments but it is necessary according to the experts.

Just as I was finishing my run this morning, I was stopped to give directions. The woman thanked me telling me I was a good, good person.
Well at least someone thinks so.

Friday, November 26, 2010

Dude, where's my hair?

Black Friday

The family at Thanksgiving Dinner yesterday

Dinner was very nice yesterday. I love it when the kids are all together though Dontae was not there. Too many relatives to visit.  The babies all seemed to be in good moods. Oliver worked on his puzzle for most of the dinner. For someone who hasn't even turned three yet, he is quite adept.

For those of you outside the US, Black Friday is the recently coined term for the Friday after Thanksgiving in which the X-mas shopping season officially starts. Each year the stores open earlier and earlier. We usually sit this one out. I'm not a big fan of malls especially crowded ones.

I instead spent part of this morning running off some of the dinner. The first snowflakes that I saw at least, fell as I ran with the windchill around 10 deg F. I tried to minimize running west directly into the wind. Still it felt good to be moving. Yesterday I was too busy slicing and dicing and basting to exercise.

The Bostonians are coming for dinner. I will try to find a tasty way to serve leftovers.

Thursday, November 25, 2010

Tradition

This will be the first time in 4 years that all the kids will be here for Thanksgiving. Before 2006, Shanna lived in CA after she graduated but returned to MI for  not quite a year before moving to Boston. I make the same things every Thanksgiving. The few times I had decided to change things, I was faced with angry kids. This is not a time when my inventiveness is appreciated. Almost every Thanksgiving, we had included my (now ex) life long friend who pleaded for a less boring menu. She will not return to our table. It makes me sad that 57 years of friendship are over but what can one do. It can not be fixed.

The Menu:

Turkey with celery-onion dressing, gravy
Ambrosia (orange, pineapple, coconut, sour cream marshmallow mix aka 5 cup salad)
A green salad of some sort
Rolls
Sweet potato casserole supplied by my DIL
Green bean casserole aka 3 can casserole though I don't use canned green beans
 Apple crisp

In the past, the friend supplied the pumpkin pie. I also have had cranberry relish too but no one eats it

The kids have other places to be today so we have to co-ordinate schedules. Josh and Julia will go to DC for X-mas where Julia's parents live but I have them for today.

Happy Thanksgiving all!!

Wednesday, November 24, 2010

Gratitude

Science day in the WSJ was fairly skimpy yesterday. There was an article about some virus now believed to be associated with chronic fatigue syndrome possibly contaminating the blood supply and one on how grateful people in general are happier campers. It suggested keeping a 'gratitude' diary. So in the spirit of Thanksgiving, here is what I am most thankful for.

My family: I am thankful that my children still want to hang out with me and are healthy, happy adults. Shanna and her family safely made the long journey last night and we saw them briefly.

I am thankful for my grandchildren even though all were not planned, they are blessings. Ms. Maya had her 'popping' joints checked out today at UM by the orthopedic specialist. Although they too hear the 'pop', the ultrasounds show all is fine. My grandsons needed this done too as they were both breech babies, which is hard on the hips.

I am thankful that so far my breast cancer seems to not have come back. Last night I thought I felt rib pain (bone mets? Oh no!) but it since has faded. I am grateful that I can run for more than an hour without stopping even though now I am so, so slow.

I am thankful for my friends both away and here who have supported me so much.

I am thankful that even though the economy is so hard right now here and we have had a very bad year financially, we will do all right. Steve had an interview this week to work again to deal with some of these unexpected expenses. Upside: he can work when he wants to. Downside: it pays a fraction of what we used to earn.

Tuesday, November 23, 2010

Positives vs Negatives

Recently a good review of Triple Negative Breast Cancer was published http://forum.tnbcfoundation.org/new-england-journal-of-medicine-article-on-tnbc_topic7460.html It summarizes all that is known about the disease and where treatment stands. Somewhere between 12 to 17% of BC is characterized as TNBC. Patients are generally much younger (less than 40) and more likely to be African-American or Hispanic. Women with BRAC1 or BRAC2 gene mutations are also more likely to have TNBC. As I am not under 40, African-American or have a history of BRAC mutations, I am an outlier.

In this paper, they distinguish between TNBC with so called basal markers and TNBC without these markers. In which category I fit is unknown because if they tested me for this, it wasn't shared with me. Unfortunately the yellow line for TNBC negative markers didn't show up well here but you have to take my word that overall survival at ten years is 75% vs 70%. I have yet to get hard numbers on 'old' TNBC patients but I feel and hope that survival is higher, in part as young patients aren't even looking for BC so it is found at a later stage. Also for all my her2+ friends, even though this is a very recent publication, the data does not reflect that now early stage her2+ BC is treated with Herceptin so survival  should be much better than the 55-60% shown here.

If you compare the survival curves of TNBC vs ER+ above, you'll see at about 5 years  or so, it flattens out for TNBC but keeps on dropping for ER+. Another way of looking at this is the hazard ratio for distal recurrences.
(sorry about the crookedness). At I year, the chances of having a distal recurrence for TNBC is .125 vs .025 for ER+ or 5 times as high. At ten years though, the risk remains the same for ER+ but is none for TNBC.

Where do distal recurrences occur first?
          TNBC                    ER+
Brain  30%                       10%
Lung  40%                       20%
Liver  20%                       30%
Bone  10%                       40%

So the most common site for recurrences to happen for ER+ is in the bones. This is rarely deadly in itself (though painful and awful). From there though, it will spread elsewhere though it takes time.
TNBC spreads to the deadly spots first, thus the quicker time to death.

With all the new treatments on the horizon, I am hoping that graphs in the future don't look so dismal.

So much for BC.

Shanna and her family will begin the long drive here tonight for Thanksgiving. Think good thoughts to ensure that the ride goes smoothly. They do the drive at night as the boys are more likely to be asleep.If she becomes too tired, they will stop. I look forward to seeing them.
Tomorrow Maya goes in to check out what her hip 'pops'.

There was a high wind advisory this morning with a note that they mean it this time (so many warnings failed to materialize). I got out as soon as I could to face the wind, which was not bad. It had completely died down by the time I stopped but now I see it has returned.

Monday, November 22, 2010

The Red Devil

The Red Devil is familiar and feared in Cancerland. Its generic name is doxorubicin but in the US at least, it is known as Adriamycin, its former generic name and now trade name. The current standard of care for TNBC is summarized in the following initials: 4xAC DD;4xT; 2 week cycles.
A=adriamycin
C=cytoxan
T=taxol
DD=dose dense
How it works is interfering with the DNA synthesis of fast growing cells. However it is not specific for cancer cells. Other fast growing cells get killed too such as hair, the inside of the digestive tract, lining of the mouth, and worse, it can sometimes cause heart failure. The solution of it is bright red thus the name.

The Red Devil is also the name of a novel I recently read detailing Katherine Russell Rich's BC battle. She had at least 3 recurrences. It took 2 years for the BC to recur beyond the breast making her Stage 4. There is no Stage 5. As the book was published 11 years ago, I thought there was little chance that she could have survived all that. But as of May 2010, she is thriving!!

Bad news in Cancerland. A BC survivor needed to remove her prosthesis in public to get through airport security.
Last week I looked at my mammogram. I have at least 8 metal staples left over from the 2 surgeries. Will I get through security?

I now have a complete set of states according to Stat counter. Someone in Rapid City,SD visited this morning.

The weekend was quiet. I went to the Moms. Two of the moms just got back from various travels and brought back souvenirs for those of us stuck here. So I have pottery from Turkey, soap from Greece and a spice garland from Grenada. We went out to brunch in Josh's small town yesterday. All his friends were in town for the big Wisconsin game. . Not pretty for UM.

Sunday, November 21, 2010

Random

Josh as a senior in HS. His 10th reunion is next weekend. I like this picture because it shows his curls, which he cuts off now as soon as they appear

The Orange Crush, a team I coached when Naomi was in 1st grade. She is in the front row with the baseball hat. Also in picture is Spud, Josh and Julio. Josh and Julio were responsible for teaching the skills.

Shanna's wedding party. Julia and Naomi are bridesmaids

Steve and his brother probably in 1982 or1983. They really do look alike.

Where is South Dakota?

Looks like the moon
We were in S. Dakota (1988-Badlands with Steve, Shanna 9, and Josh 6.)

According to my stat counter, my 20,000 visitor logged on in the middle of last night. Either it was someone from Sydney, Australia interested in Alzheimer's Disease or someone from Chelmsford, MA wanting to know about donkey stew. Donkey stew seems to be the number one non-cancer related page visited. No I don't have a recipe for donkey stew, sorry folks! It was on the menu in a restaurant in Stresa, Italy specializing in Piedmont cuisine. In the same post, I wrote about the horse baby food (that is food made from horses for human babies) on the shelf in the local store. When traveling, I try to compare and contrast cultures, this is what I find interesting about life.

Aside from the  stat counter, I have a flag counter that only shows where a hit is from, no other information. According to that, I have had  visitors from 85 different countries, 50 states, and 11 Canadian provinces. I kept track of countries on paper before I installed that app so my total is close to 130.

So which state hasn't visited me? (Washington DC is considered a state for these purposes and I have several readers from there)
 South Dakota!
Wyoming, Alaska, Hawaii, and Delaware finally had found me in the last few months. In 1988, our family spent most of a week there on our way to Yellowstone. We followed the trail of Laura Ingalls Wilder from the Little House on the... a series that Shanna enjoyed at the time. We visited the Corn Palace in Mitchell. A day and night was spent in the Badlands.To escape the oppressive heat, I got up as the sun was rising to run through that beautiful, stark landscape. We then spent a couple days in the Black Hills visiting Mount Rushmore, Wind Cave, Hot Springs, and Custer State Park.

As for Canada, I am missing Prince Edward Island and that First Nation land..Nunavit?. I have had visitors from the Yukon and the Northwest territories. (The term "native Americans" isn't used in Canada)

And blogger has installed its own stats which analyzes stats differently from the other two. According to it, Stat counter isn't picking up some of my hits. And I got a hit today that wasn't on any of the counters but I know it's there.

Saturday, November 20, 2010

The trouble with screening

A math problem:

There exists a deadly condition that arises sporadically affecting 1% of the population. There exists a blood test for it that is 95% accurate i.e. 5% false positives and 5% false negatives (rarely are these numbers the same: more false negatives for pregnancy tests than false positives, for example). You have recently tested positive for this condition. How scared should you be? What are the chances you really have this condition?

100%
95%
50%
15%

Answer:
The last number.


Explanation:
You have 1000 random people. Only 10 of them truly have the disease. Of the 990 people who don't have the disease, 49 test positive falsely. Altogether, about 60/1000 test positive. Your chances of being a true positive therefore is around 1 in 6.

Of course we are assuming no bias meaning you are not in subgroup more at risk for this condition. We also have to assume that early detection will influence the course of the disease otherwise there is no point in screening.

Ups and downs


Upside: Thanksgiving with the entire family
Downside: No Christmas with them

Friday, November 19, 2010

La Piazza



Maya today

During the fall 2 years ago (while just beginning treatment for BC), I attended an Italian film series at WSU centered around the concept of la piazza, the town square. The movies were from various sections of Italy; some were comedies and some tragedies but the theme  was that what laws that should to be enforced were decided by the gossips sitting around the town square more so than the justice system.

My favorite was Divorce, Italian Style. A man is married to a very clingy, obnoxious woman. He really wishes he were rid of her and has a suitable replacement in mind. Divorce was illegal however in the early 60s. He is made aware of a possible loophole: if you catch your wife in the act with another man and  you kill her, the penalty was significantly lighter. In especially egregious cases, the judge could give you less than a year in jail. Since the judge had to live in the town with the people, he was mindful of what the town thought he should rule. But how to entice his wife into having an affair especially when she is so obsessively devoted to him? He hilariously manages to. He bides his time into exacting revenge. He pretends to be upset that he is cuckolded  though secretly, he is delighted. People are gossiping away on the piazza how if he were really a man, he'd kill the wife. He knows the longer he waits, the less his sentence will be influenced directly by the piazza.  But of course complications arise....


Marcello Mastroianni is just great in this movie. The movie and he won all sorts of awards. See it if possible.

One hand gesture we learned in Italy, more insulting that a raised middle finger, was 'fare del cornuto' which looks identical to  the Hook'em Longhorns gesture. There, it could get you killed as being cuckolded is not respected and the gesture implies that that is what is going on.

But no piazza here. We have comments on the on-line version of what our newspaper has morphed into second guessing judges, assuming the worst in people, suggesting possible punishments for situations they know little about. Most of these comments are anonymous and rarely well thought out. There were two cases today as fodder for our modern day piazza.
Case 1
This has made national news. A high school teacher in solidarity with some gay students, wears a pro-Gay t-shirt. A student  in his class says something to the effect that he hates gays. The teacher kicks him of the classroom. When the teacher is asked by this same student, what about his rights to free speech, the teacher says there is no right to free speech in his classroom. Although the teacher is seen by some as a national hero, he is suspended by the school system.

The discussion in the piazza:
Students have a right to free speech. Since when? When a teacher requests silence so he could teach or kids could concentrate on a test, is this invalidating constitutional rights? Do kids have the same rights as adults? How to maintain order in the classroom? If a kid says he hates Blacks in a classroom with Blacks, can he be censured? Yes, but gays are not a race, they are a life choice. Since when?


Case 2
 This also concerns a local high school (as in my childrens' school) teacher. This teacher has been on leave for a few months for something that is not disclosed in the article. He is very popular with both students and parents who rallied at a school board meeting for his support last night. Both parents and students gave examples of miracles he has performed.

The discussion in the piazza: 
We as tax payers have a right to know details of the suspension! If he is accused of something, he must be guilty (that's my favorite). Why publish this story at all, when not all the facts are in?
It doesn't matter what a person is 99.9% percent of the time, it matters what happened in that 0.1%. (interesting: there was a variation of this in that movie about a nun finding goodness on death row, only I guess that would be the inverse) More examples of miracles he performs from various teachers and students. The paper chimes in that they gave the teacher a chance to tell his side in the paper but he declined. Well gee, why wouldn't he want the personal details of his life for all the world to see? He must be guilty of something awful!

On for tonight: Mom's group. Sorry about the lack of a homemade dessert ladies, I will make up for it.

Thursday, November 18, 2010

..Tempus Fu-ge-aboutit!



Baby tricks performed by Ms. Maya at the ripe old age of 20 weeks:


Can chortle.


Can reach for things but usually she misses the mark. If she is successful in grabbing an object, it goes to her mouth.


Can support her upper body with her forearms.


Tracks people at a distance with her eyes.


Smiles at strangers


Coos and pretends to talk

Fairness

While going to the UM, I lived in the co-ops. With my limited budget, they were affordable in part because the residents were supposed to put in so many hours of work to make the place run. The organization had just a few paid employees. My life there was an eye opener in many respects. We discussed the ethics of many things. What was fair? Is it fair to eat beef when each  pound of beef took 5 lbs of grain to produce when there are starving people around the world? We tackled racism, homophobia, many issues. In general, there seemed to be a shared mission to try to make things fair. Initially, I agreed to be a treasurer. How hard could it be? Very difficult as it turned out preparing trial balances etc. I had no experience with accounting but I quickly learned. I eventually decided that I could be president of the house; certainly that should be less hassle.

In this organization, there were two types of houses. Big ones that contained commercial kitchens making it legal to prepare food for groups of people and small houses lacking these kitchens. Residents of the small houses were required to eat (and of course help prepare) their meals in the big houses. Overall, there were more people living in big houses than small houses and thus they had more representation. Was this fair? From my stint as an accountant, I noticed that the big houses charged an outrageous part of their fixed charges (maintenance, etc) over to the residents of the small houses justifying that since  the small residents spent part of their time there, they should be charged something. The upshot was that the small house residents paid significantly more in rent total. As president, I was to represent my small house at policy making meetings with the other co-op presidents. I had checked the rents at the other small houses. Yes they too were much higher. At the first meeting I attended, I entered a motion that our rents become more equal; a fairness rule so to speak. Another small house seconded my motion. There was some discussion. One big house president said that if I didn't like the situation, I should just move into a big house myself. Ah..that sounds fair doesn't it? Well the motion was defeated. We small houses didn't have the numbers to defend ourselves. I went back to my house and had a meeting. I wanted to have a rent strike to force this organization who claims to be so fair, actually be fair to its underrepresented minority. They could not evict all of us. Surprisingly, my motion passed. I sent a letter to the board  president saying our house was no longer going to pay rent until this situation is fixed. It got fixed.

Later I was contacted by one of the female permanent employees who wanted me to study pay equity between male and female employees. Market forces are not 'fair' as it turned out.

Eventually I had too many other responsibilities to attend all these meetings. I agreed to be the head chef for 2 meals and finish out my time obligations as a dinner clean-up supervisor.

Cooking for 70 people was an experience in itself.  We relied heavily on the cookbook Cooking for Fifty multiplying everything by 1.5. Another staple was Diet for a Small Planet in which we learned how to get our complete protein from non-animal sources.

All and all, my life in the co-ops made me grow up and learn in ways I could not have imagined. When in CA a few months back, my friend from the co-op had some pictures of us back in the day. We looked so impossibly young. We so much wanted to do the right things; not just for us but the planet, for the down trodden, etc. The idealism of youth! I learned Roberts Rules of Order, double entry accounting, compromise, what amino acids are in what foods, what is tofu and turbot, how to get co-operation from kids who came from privileged  backgrounds and unused to chores, how to maintain a 100 year old house (which burned to the ground about 5 years ago)etc. I feel badly that my children did not have a similar experience.

I also learned that principles and practices can be miles apart.

Wednesday, November 17, 2010

Alzheimer's Disease

Yesterday's WSJ contained a quarter page ad that was mainly blank entitled Picture of an Alzheimer's Disease Survivor. Underneath the blank picture, there is a statement that there are no survivors yet Alzheimer's Disease (AD) receives only 6% of the funds that cancer research receives. I am not sure how they came up with that number as I know private industry is furiously looking for treatment. In my past life, I was personally on several projects to potentially treat AD. Most were focused on determining how AD brain chemistry differed from normal and correcting that. Effort right now seems to be focused on preventing the plaque formation that seems to cause  neuronal death. This is a much more difficult problem than cancer. Cancer is not a single disease but many different ones having in common 'uncontrolled growth' that leads to death. Some cancers are treatable; many are not.

When I first faced my diagnosis, I thought darkly Well at least I won't have to worry about Alzheimer's (and no more worrying about my sketchy 401K either). There is a strong genetic component to AD. My mother died from it but she seems to be the only one in her large family to have had it. Her sister at 90, for instance, is sharp as a tack. It is a dreadful disease that destroys your identity slowly: The Long Goodbye. It is said to be childhood in reverse. Instead of gaining skills as you age, you lose them. At the end, she lost the reflex to swallow, a skill a 7 month old fetus has. A movie that particularly irritates me is The Notebook in which the patient as played by Gena Rowlands (her earlier self played by Rachel McAdams: no physical resemblance there) has AD but is perfectly groomed and articulate. The only sign of the disease is that she has crabby moods occasionally and she does not recognize any of her family members. Her loving husband tries to jog her memory by retelling their love story. And for a golden moment, it does: Love conquers dying neurons! She dies in her husbands arms though she seemed to not have any  other underlying disease.

AN ALZHEIMER'S PATIENT TIMELINE
Late 1990s: Mom is convinced something is wrong with her (beyond the BC she had had in 1991). She goes from doctor to doctor trying to inarticulately explain herself. Every sniffle must mean something. Her conversations with others are a list of her complaints. Verdict: Physically healthy; probable dementia.

2001: She is forgetting words. When trying to explain my father's kidney failure, she says: His kidnuts are gone! My father reports she can no longer do a simple math problem and is behaving erratically. His solution: Threaten her with a nursing home if she doesn't clean up her act. Her response: The day I go to a nursing home is the day I kill myself. I was surprised by this as she never makes emotional statements. Her weight drops from 140 to below 100. She is no longer permitted to drive but still expected to do errands that involve crossing a very busy road and walking a mile.

 Fall 2003: Her formerly very neat handwriting morphs into a childish scrawl. She struggles to remember the order of words; both spoken and written. Her fastidiously kept checkbook no longer contains balance updates. In a few months time, her handwriting is completely illegible. She now weighs only 90 lbs. She forgets to wash her hair, do routine grooming, or wear a bra. She forgets she hates chocolate. In late fall, she moves in with me when my father was hospitalized. Although she knows my name, she refers to Steve as That nice man who lives here and Naomi as She. Josh pops in at one point and she recoils in terror. She has no idea who he is.
She formerly loved to put 1000+ piece jigsaw puzzles together. I get out a toddler's ten piece puzzle. She says that she can't do that. She remains very polite, thanking people for everything. She can recognize some letters of the alphabet and like to read them off signs as I drive. There's an A; I can read that!!Look, there's a B. I draw a bath for her. She no longer has any idea how to clean herself so I wash her. She regards me as a 6 month infant would. She roots through my drawers amazed at what's in them. I ask her not to to. She says, OK but 5 minutes later, she is ripping things apart. She likes to tear paper into little pieces. Her vocabulary is that of a 4 year old. She can still tie her shoes though, which is a 6 year old's skill. She starts to wet the bed. She can not be out of my sight for a minute but I need to work and I try to arrange a placement in a nursing home. My father does not want to pay and is sure that I am exaggerating everything.. She gets up and wanders around in the middle of the night. I tell her she needs to go back to bed. OK. Finally he agrees to permit her to go to a home at the end of September. After  I settle her in, she asks if I am going to leave her there. Yes but I'll visit you every other day. OK and she shrugs.


Oct 2003 to November 2003: When I come, she's very excited telling everyone in earshot that My mother's here! My mother's here! She no longer knows my name. Soon My mother's here! morphs to My!


November 2003: Mom slips on something on the floor and breaks her hip.Her bones are very brittle and she has a sizeable hump on her back. Her sisters and brother who are much older now than she is here have great posture. As I was the person admitting her, I am contacted instead of my dad. He is furious and wants to sue. For what? I ask. She has a titanium rod inserted to stabilize the hip. Fifty percent of nursing home residents who break their hip are dead within a year. She loves to move however and paces incessantly and recovers.

Early winter 2003-2004: Upon admission, she was placed in a general unit as she was ambulatory and co-operative. The big question was whether she was a 'flight risk'. If so, she would need to be placed in the much more expensive locked down part. To my knowledge she never tried to escape. Services to remind her to go to meals were purchased. Initially she seems happy to be there and not under the thumb of her husband. She starts to become combative and knocks cigarettes out of the mouths of people in the smoking lounge telling them that they are bad.

February 2004: Mom becomes violent even though she never has been before in her life. She attacks her frail roommate and tears up everything she can find. She punctures her special air mattress needed for her sore hip. The nursing home kicks her out and she spends a month in a psychiatric unit where they try her out on different combinations of drugs to calm her down. She pleads to get out of there. I go to a 'family' meeting with the psychiatrist to see what underlying issues she might have that could be mistaken for AD. I find it annoying as it doesn't matter who she was, she is not that person anymore. The psychiatrist goes over a long list of meds and their side effects with my father and I. Since this is my line of work, I am familiar with them all but my father is shocked. But there is no choice. This is the last conversation I had with him in person. We talk once on the phone a few weeks later and he hangs up on me. When I see him in the hospital a month later, he is in a deep sleep.

April 2004: She now is in her own room in a locked Alzheimer's unit in a different home that costs twice as much. She recognizes me still and is happy to see me. She can speak 3 word sentences. We spend our visit walking back and forth. She loves to move. I bring her special snacks. She will eat an entire bag of cookies in one sitting if I don't carefully mete them out. She is gaining weight from the drugs. My father dies at the end of the month. I tell her: Oh, no one told me. Well I am telling you now. He was old, wasn't he?
My brother and I go to court to become her legal guardians and conservators. My father leaves behind the estate from hell.


Fall 2004: She is only able to say one word now. Yes. She still recognizes me, loves her treats and her walks. She also likes to set off alarms, cause floods, take apart toilets. I get many phone calls complaining of her behavior. She now needs adult briefs all the time. Over the next year, she is briefly hospitalized for possible strokes and infections. At one point, her sister visits and gets too close to her. My mother attacks her. Why does she hate me so much?my aunt asks. She has no idea who you are.

Fall 2005 to  Fall 2007: She develops congestive heart disease. Her feet swell to twice their normal size and are purple. She does not respond to cardiac medication. She is accepted to hospice care but Medicare only pays if it could be proven you will die within 6 months. She looks to be on death's door at the intake interview but rallies over and over for the next 2 years so it is a struggle to get her re certified. She forgets how to walk and how to use utensils. She eats with her hands. Beyond 2006, I never see her smile. She no longer recognizes me. She still can say the word yes but uses it inappropriately. She can recognize questions from ones tone of voice and the answer always is yes. There is a cat in the facility. I bring it up to her so that she could pet it. Instead she tries to strangle the cat. She has forgotten how to walk and is provided a wheelchair which she uses  for 2 years. She does not know how to make it move with her hands but she kicks off. Since she gets into trouble so quickly, they box her in with chairs. There is some question whether this is a restraint. She still loves to move so I take her outside where she can kick the chair into motion to her heart's content. At one point, I show her a X-mas display. She takes her arm and knocks everything down. For 2 years, there is not much change in her status.

The end: I visit her on a warm Friday afternoon and she is vigorously kicking the chair around per usual. I worry that I am letting her become overheated but when I touch her arm, it is cold to the touch. Strange I think. On Sunday night, I get a call saying that she has stopped eating and that hospice has been informed.
Tuesday the hospice nurse said that my mom's body was cold and she did not swallow if food was placed in her mouth. I visit her and she reaches out to  me with a look of abject misery. I demand that hospice medicate her so she will not feel a thing. She is dead within 36 hours.

In the beginning, she is prescribed various Alzheimer's medications. There is no improvement in her ability but the drugs were approved only for mild to moderate AD. She has severe AD. Mainly she is given drugs to control her agitation. There is little left of my old mom by the time she dies. When she dies, I am relieved as this was no way to live, wanting to move but not being able.

Tuesday, November 16, 2010

Gli uomini come lei se li mangia a colazione*

In Europe, or at least in Spain, France, and Italy, breakfast seems to consist of a cup of coffee(only one: a tiny cup) and a roll of some sort.. Not much for this chowhound.

My routine, while living in the monastery in Italy, would be to get up as soon as the sun rose which was around 6 am. Flies landing on me would prod me into action. I would drink some water and eat a bit of starch of some sort and hit the road running. I would be back around 7 before the shower hogs were up so I could have a chance of getting clean before the showers  flooded. Breakfast was at 8 (colazione: love that word. Part of the expression *she eats men like you for breakfast). Titziana would ask if we would want latte freddo o caldo emphasizing that caldo = hot, not cold as it sounds. The starch selections would consist of toast or packaged junk food. One of the selections was called Plumcake, not a translation even though there is no 'k' in the Italian alphabet (or j, y, or x). There were no plums in it. It seemed to be a Twinkie. There was Nutella and really good cherry jam for the toast. I would always have 2 cups of my caffe latte (in Italy, if you ask for a latte, you get milk). There was no fruit or juice. Two hours after my run, I was hungry and I was left unsatisfied.

But this is typical for those countries. Conventional wisdom here (probably spread by the cereal industry) is that a hearty breakfast is associated with thinness and good health. But these scanty breakfast eaters, particularly in France and Spain, are much thinner than their American counterparts. What is my point? I think I will start eating like a European and maybe their thinness will wear off on me. When I wake up, I am not especially hungry. I take my thyroid replacement as soon as I get up. Food, especially that containing calcium, interferes with its bioavailability. I do crave coffee, with half and half and sugar in it. I drink some juice for hydration and glucose and I am out running. I get hungry around lunch. We'll see if this causes some weight loss.

Monday, November 15, 2010

Ignorance is Bliss?

One of my blogging friends subscribes to The Daily Prompt in which you are sent a subject to blog on. Last week's prompts seemed to be colors: I would have written about PINK of those suggested. Another week a while ago concerned adages: My favorite would be : You can lead a horse to water but you can't make it drink!
But in Cancerland, is ignorance bliss?

This ran through my head repeatedly right after I was diagnosed. If only I hadn't shown up to my appointment, I wouldn't have found this out and I wouldn't be so upset! Of course sooner or later, this type of thinking would cause my death. But no, I tried to learn everything about my situation as quickly as possible. Immediately I came across the words poor prognosis, quick metastases to soft tissues, no targeted treatment, etc. Did I need to read this?

Initially no one said anything about my specific odds. On the Susan Love website, they have an odds calculator. I plugged in my numbers and my odds coming out were very scary. I said something about them to my surgeon who thought they were not correct. She plugged the numbers into the commercial, just for doctors site and came up with better ones. Later the oncology asst gave me more dismal ones from the same site. She had plugged in that my tumor was 3-5 cm whereas the other doctor said it was 2-3 cm. I complained. She said I was focusing on the wrong numbers: she wanted me to see how much better my odds were IF I did chemo. In various support groups, it seemed that no else knew their odds and I certainly wasn't going to ask as I can't imagine a more personal question. Some of the ladies had no idea what chemo they were on: I show up, hope they know what they are doing, and hope I'm alive at the end of it seemed to be a common sentiment.

But I have to know everything.

The odds though can't be correct as the database is constantly changing for the better. Still it is hard to confront your mortality way before you thought you would have to.

This has not been a fun week.A Kafka-esque situation has arisen which we are handling. I've been running alot to relieve stress.
Every weekend Josh or his friends throw a UM football party though I don't think anyone in their crowd actually went there (I did). Josh always invites Naomi, which I am happy that he includes her and exposes her to other life styles. Maya seems to like the attention too.

Friday, November 12, 2010

If your man tests positive for pregnancy.......

Then he could have testicular cancer.

HCG, the same hormone the placenta produces, is a biomarker for testicular cancer. When Lance Armstrong battled testicular cancer, his blood levels were higher than any pregnant lady's. By monitoring the levels, it could be quickly assessed whether his treatment was working, which luckily for him, it was.

Only some breast cancers produce markers that could be measured; TNBC usually does not.
Ovarian cancer produces a CA-125 antigen. Measuring this antigen in asymptomatic women is not a useful screening tool as there are too many false positives. However, in women who already had ovarian cancer, it is very reliable in detecting metastases. A recent study concluded that this was a mixed blessing. They found no difference in overall survival between women who were treated at the first sign of an elevated CA-125 and women who waited for actual symptoms to appear. If this is indeed true, then why bother with the CA-125? It would be hard to do 'nothing', when you have reason to believe a tumor is reforming.

There was this sweet woman in my LiveStrong class. On the last day, she told me she was resuming chemo as her CA-125 levels were rising. She did not know where the mets were, though she had been thoroughly scanned, but assumed they were somewhere. Despite the chemo, they must have reared their ugly heads at some point as I read her obit less than a year later.

I was reading someones Stage 4 BC blog the other day. She took issue with the word 'survivor' to describe early stage breast cancer patients that did not succumb to their disease. She says the word somehow implies that these women did something beyond merely endure treatment that the Stage 4 ladies did not, a variation of blaming the victim. I don't think I agree with her but she is in a world that I fortunately am not. Previous to getting cancer, I would have thought telling the newly diagnosed that they would be OK would not be insulting but once there in Cancerland, it bugged the hell out of me as it seemed to belittle my concerns. I COULD DIE!!!! Oh don't be silly, so and so survived it.

The other day in our group, a lady announced that she had bursitis of the trochanter, a painful condition. Another lady enthusiastically said that was good news.
Good news!?! She can barely walk! I was puzzled.
Well it isn't cancer, the good news lady said. It turns out that her BC returned 10 years after initial treatment to her outer trochanter, part of the femur under the hip and the woman with the bursitis thought she might be experiencing the same thing. Anything but cancer.

It is close to 70 out. It probably won't be this warm again until March. I had a nice run. Naomi and Maya are here resting. Maya is becoming much more interactive; smiling and cooing following us with her eyes. She still doesn't do the baby tricks some kids her age do such as roll over but she's a big girl, almost 2 lbs more than her mother was at the same age. Today I was to help Naomi figure out her next step but she wants to put that off a little longer.

Thursday, November 11, 2010

All quiet on the medical front

Naomi received an A on her final. She graduates from her mini-program tonight. Now she just needs to take the state test...

Both she and Maya had a doctor's appt today. I was puzzled why Naomi had to be seen but to be considered this physician's patient, she needed a baseline physical. Ms. Maya received 3 shots plus an oral dose of the Hib vaccine so she will probably be grumpy tonight. She is 16#14.4 oz and 27 " tall putting her at 96% for weight and off the charts for height. She does all the age appropiate baby tricks. She will need an ultrasound of her hip because in certain positions, the hip socket pops.

I needed to take Naomi when she was the same age for the same problem to a pediatric orthopedic specialist. It was my week of doctors. One day at the pediatric urologist as a follow-up for Shanna's surgery, another day with the same guy and all the tests for Naomi as she could have inheritied the same problem (she didn't) and I couldn't persuade them to take both girls on the same day..no, that would just be too convenient. Then the day at the orthopedic clinic. Shanna's doctor also felt that she should spend some time with an orthopedic consult for her knock knees. She inherited them from her father who was able to do marathons at a good clip. Clearly knock-knees can be functional. I notice that Daniel sits the same way as she does: in between her legs folded to the side. I couldn't ever sit that way.
To mix it up, another day was spent in the burbs with my mom's oncologist weighing her options for her BC. My mom refused to make a decision: she told me to make it for her. They were just starting to do lumpectomies plus radiation instead of mastectomies. At that point of time, they had data only for 5 years out that the outcomes were identical. So Ma, do you still want your breasts and are you willing to drive here every day for 6 weeks?
We went with the lumpdectomy, radiation, and tamoxifen. She was told to stop the Premarin. Chemo was reserved for mets. She died of Alzheimer's 16 years later.

It is very pretty out today. Time for a walk. I already worked on my muscles at the Y. Not many were there.

Wednesday, November 10, 2010

Test anxiety

Today my test anxiety did not concern results from mammograms but hoping that Naomi is prepared for tonight's final. I worry more about her taking tests than I ever did for tests I took myself. There is also a state test she'll have to take soon to be become licensed.

I quizzed her on everything to be covered all afternoon. She has already passed all the clinical procedures  and the pre-tests to get into the clinical program.

My day off from exercise yesterday made my morning's run that much easier though I ran through drizzle instead of the beautiful weather we had yesterday.

This evening I went to the monthly Cooking for Wellness for cancer survivors. Tonight's topic: flaxseed which presumably is full of cancer fighting substances. I really like the instructor, a 2 time BC survivor, and most of the usual crowd. I've made some of the recipes at home but I should cook much more healthily. Yesterday the other TNBC left in the waiting room asked me what steps I've made to ensure it doesn't come back. Ummmmm..trying to eat more fruit? She asked if I ever read what was in body creams: various forms of formaldehyde. So no skin products for her, no dairy, no hormone infested meat. My grandsons drink whole milk as opposed to the skim milk Steve and Naomi, when she's over, drink. Most of a gallon was left over to I made a huge batch of Arab style rice pudding with it. This would have horrified my waiting room companion, concentrated dairy. Worse, I took it over to Naomi today to eat.

Tuesday, November 9, 2010

Scan Anxiety Redux

The waiting room for the mammograms was completely filled this morning. By the time I was finished with my half hour series of scans and rescans, half were gone. I was told that this will be my last 'diagnostic scan; no more high magnifications' but now I don't know how true that is. Slowly all the other patients disappeared until only two of us remained. The other lady was BRAC2 and had had triple negative BC also, very rare to meet them in the flesh aside from my neighbor diagnosed at the same time as I. Five years later, she developed estrogen positive BC in her lymph node. This was not considered a recurrence but a new primary. Finally even she disappeared (with a clean bill of health) and it was just me thinking unhappy thoughts. For one thing, I was already late for the radiation oncology meeting. (They did tell me later I should have reminded them of that, that perhaps I would have been dealt with quicker but past experience has been there is no speeding up anything there). Finally I was called into a room with the radiologist, a bad sign right there as usually these people just sign a letter of good news and are never seen. She said that she would need to ultrasound my 'mass'. Instantly I felt my world crumbling and started to panic. Almost 2 hours later, I still feel sick to my stomach. I must have looked terrified. She told me not to panic, that although there have been changes since last year, it was probably nothing. So after the ultrasound in which I held my breath choking back tears, the radiologist said what happened is that I had a hemotoma after the surgeries but now, 2 years later, it is solidifying. On the mammogram, it looks like a tumor but the ultrasound shows it as fluid with small lumps of fibrous stuff forming so it is not a tumor.

On to the radiation oncologist, which was anticlimatic. I wanted her to confirm what the radiologists had said but she said she was not a radiologist (which is what I thought a radiation oncologist was). Until next summer, I am supposed to be seen every 3 months. The two years of intensive surveillance starts when you finish treatment, not when you are diagnosed.

All in all, I was gone nearly 4 hours.

It is beautiful outside. Maybe I'll go for a walk and calm myself down.

And now, no X-mas with all the grandkids. Shanna and her family are coming around Thanksgiving instead. Her husband has a medical condition that could only be treated in Canada. Go figure. This is according to his Harvard based specialist. It is not a fatal condition but one that seriously impacts his quality of life. Originially everything was set up in Toronto but now they are seeing if the procedure could be done closer to us as in Windsor.

Monday, November 8, 2010

Marathon


Once upon a time.......Look at all my arm muscles
If you had run a marathon before, it was put on your bib for  seeding purposes. The time was from my first,  the Detroit marathon in 1984 when I had a 2 year old and 5 year old at home.

I was watching the NYC Marathon yesterday with longing. Steve and I ran it 25 years ago, a year after we ran our first one in Detroit. We had to enter a lottery to get accepted but we both were. Unfortunately that day was unseasonably warm (80 degrees and I do best when it is less than 60).
The run began in Staten Island and we were seeded by time theoretically but some how, we were way back. I think our first mile time was over 25 minutes, 10 minutes alone to get to the starting line. We immediately climbed 250 feet on the top level of the Verrazano Bridge, which vibrated from the combined forces of 20000  pounding feet. Almost half of the run alone was in Brooklyn. Here we benefitted from a tailwind. We went through numerous neighborhoods of different ethnic groups. I would ask Steve what neighborhood were we in now (he grew up in Brooklyn). After a while, he was too tired to answer. Over the Pulanski Bridge into Queens, Long Island City, which looked drab at the time but now is 'up and coming'. Around the 16 mile mark, we took the Queensboro Bridge into Manhattan on what they called The World's Longest Carpet, laid down to protect our sore feet from the metal grating. Well it was long, but very narrow and we were in the middle of the pack, so no room for us on the magic carpet. On the downhill side, Steve asked if we couldn't slow down. Ha! I have to gloat here. It is very hard for me to run with someone, particularly Steve, as we have our own paces. On training runs, he would say that if he ran at my 'slow' pace, he could run forever. Also, I don't speed up going down hills as I am trying to protect my knees whereas he does speed up so I was surprised when he told me to slow down. Second Avenue was lined with cheerers. Lots of energy! Went through the pricy Upper East Side into Spanish Harlam over the bridge for a mile or so in the Bronx. Somehwere in the Bronx, Steve told me he was going to walk. Now I am not against walking in a marathon. I do it for a few seconds while drinking water but if I do it for more than a minute, the short acting endorphins fade and then I am in big trouble. So we parted ways at the 20 mile mark. Some people say that although mathematically 20 miles is more than 75% of the marathon, in effort it is only half of it. The last 10K is especially brutal and no amount of telling yourself, you're almost done..less than an hour, can erase that. This seems especially true for men. Yep they have the bigger muscles and a more favorable lean mass to fat ratio but it seems to take much more training to get the same level of endurance as a woman. I found this especially true in long distance biking. I would start rides with muscular men struggling to keep up with their superior speed but after an hour, my job would become easier and easier.

My name was on my chest and women runners were relatively rarer so I got lots of cheers, especially in the Bronx. Into Manhattan and Harlem. I tried to admire the architecture but the late fall setting sun's in the south glare blinded me. I stopped at one point to stretch my cramping legs and immediately I am swarmed by on-lookers wondering if I am OK. Yes, just need to stretch. Into Central Park. As it is warmer there than in Michigan, no fall colors. It is amazingly hilly or maybe my fatigue just makes it seem so. Also the roads are very narrow and all those once speedier men are fading into slow-moving zombies blocking my way  annoying me as I don't want to run any extra distance trying to get around them. We leave the park briefly to run on 59th St  and then re-enter at Columbus Circle. Now I know that I will be done in less than 4 minutes and I am re-energized.  The route to the finish is wider and loud music is playing. I try to sprint the last 100 feet. I am not sure if I ever got a picture of me finishing. There were so many more runners here. My time was a disappointing 4:10  but if corrected for that really bad 1st mile, was well under 3:50. Pictured above, the true time (after being held up 4 minutes at the start, was 3:48). I look like a drowned rat as I throw the water I can't drink on to my head to cool myself. It is hard to look pretty running a marathon, not that I cared. Right after I finish, I have stand for quite some time in a finish chute to make sure of our running order. They cover each one of us with a mylar blanket. However, especially after exercising, I faint unless I move. I start to faint and workers hold me up. I think I was put briefly in a medical tent, I really can't remember. I know I was worried about Steve and how he would find me. He finished 10 minutes later, must have done alot of walking We take the subway back to Brooklyn to his parent's apartment where the kids were staying.
We are tired beyond belief.

Yesterday runners included the Chilean miner. He didn't want to be trapped in a mine for 60days plus to interfere with his training schedule so he made himself some sort of harness so he could run in place against a force. This is a dedicated runner despite not having the build (he is very squat). He was clearly living his dream.

If I somehow could lose all this excess, I would like to run another marathon. Running so much while large is putting me at risk for injury. As it is, I think I have a stress fracture in my toe and the pain of it was leaking through the cloud of endorphins yesterday. And I am now so impossibly slow. Age? Weight? Really bad form?

But I am out there, slowly pounding the pavement, preferably the hard packed clay kind, absurdly swinging my arms (which I try to correct if I think I am being watched). It doesn't seem to be making much of a dent into my now ( compared to early years) huge waist. I do have legs of a younger woman though and great circulation. I look healthy. Hopefully tomorrow, I won't find something to  dispute that.

Sunday, November 7, 2010

Comfort Zone

Now it is time for me to be petty. What is stuck in my craw today? Drivers waiting at lights who insist on having one to two car lengths of space in front of them. Did they confuse the driver's ed rule about having a car length between you and the next guy for every 10 mph you are going? Well if you are going 0 mph, you therefore should have 0 carlengths in front of you. It would be OK if there were just a few of these people out there but no, at any light, you'll see almost 50% of people doing this. Why would I care? Well let's say I want to turn right on Green going west. The right turn car lane is about 6 cars deep but sometimes as little as 3 selfish cars manage to block the access to it as they insist on having their comfort zone. Obstruction anyone? Waste of gas? If you recognize yourself here, please inch up to the car in front of you once you are past the danger of being rear ended (the only reason I could see for this).

This does not happen in NYC or Boston (home of the particularly impatient driver known as the "Masshole"). This would not be tolerated. Space on the road is precious there although the main reason  they idle so close to the next car is to prevent anyone from cutting in front of them, which massholes are known to do. I am an honorary masshole. Too impatient for Michigan driving.

In NYC, locals were frustrated with slow moving tourists blocking the sidewalk and painted a line in the middle of the sidewalk: one side for tourists dawdling and the other for the fast moving locals. This was a joke in NYC but in London, they are doing it for real on Oxford Street, which must have the most congested sidewalks in the world. We were on them briefly until claustaphobia got the better of me.

It was in the mid 20s  but beautiful when I went for a run out in the sticks this morning but dry. Soon I won't be able to run on the scenic beauty road as dirt roads remain icy much longer than the paved.

I went out for BBQ with Josh at lunch. It's been a long time since it was just the 2 of us. I do enjoy Julia but I feel we can have better talks when it is just us.

What's up this week? My cancer check-up. I managed to skip the last one 3 months ago. I have no signs of recurrence and they do no tests. This week's visit includes the  dreaded mammograms. As my tumor was impossible to feel, the mammogram is the only way any local recurrence can be detected in my case. The most likely area is chock full of scar tissue and is quite lumpy. But they are the same lumps.

Saturday, November 6, 2010

Sue, sui generis

Sue is generous?
Suey, suey, suey.
Why is this girl different from all the rest?
Sue, sui generis.

Picture this 45 to 50 years ago.

Sunday school: A girl 2 standard deviations from the norm in height and weight,  awkward Baby Huey amongst the cute little chicks, struggles to understand this day's lesson. She seems to be the only one paying attention per usual. Either her classmates are secure in the knowledge that Jesus loves them or they really don't give a damn. Either way, they seem to know something she doesn't know.

To atone for her sporadic attendance, something she has absolutely no control over, she is to recite a Bible verse.

The Lord is my Shepherd, I shall not want...

Immediately she is confused. Is the writer (David she was told) rejecting the Lord?

In public school, she usually gets the right answers. In Sunday school, she always misses the point.
If she were Eve, she certainly would have eaten that apple chosing knowledge over blind obedience.
If she were Abraham, she would not have gone through the motions of killing her only son to prove obedience.
When God throws misfortunes in Job's way to prove a point to Satan, she wonders why Job's children needed to be killed (along with all his wives, servants and livestock). When Job's friends reject him assuming Job must be on the wrong side of God, they are punished for assuming the obvious.

On and on. However no thanks to Jesus, God becomes more reasonable in the New Testament although the logic of having ones Son tortured and killed seems to escape her. The parables are even harder to decipher.
The prodigal son. she saw the non-prodigal son's point: it is unfair. (We like to reenact this parable in our own family).
Then the tale of the 10 brides awaiting their groom. Five were wise; five were not. The unwise wasted their oil so they were not able to receive their groom. At the last minute, they plead to the wise ones to share their oil, they were rebuffed (aren't they supposed to share?see The Prodigal Son). The point shewas told, was that you had to be ready to receive the Lord.

Not only did she go to Sunday School, she sang in the choir (The Crusaders before anyone knew that was a pejorative word). She had a reasonable voice before hitting puberty reduced her range  to half an octave.  Due to her excessive height, she was always in the back row.

However she thought God did not like her. She had many questions. Sheseemed to be entirely alone in this. She actually scheduled an appointment with the minister to voice her concerns. Sadly she could not articulate them very well and he gave her the standard You are too young to fully understand this.

Even though he was nice about it, she felt he was very condescending.
She never showed up in that church again.

You're nothing but a pack of cards!"Alice
Alice in Wonderland.

Friday, November 5, 2010

What is a pit bull?


Putative pitbull?
Pit from web, compliments of jp who sent me lots of cute dog pix today
I had already posted this but somehow, the entire post disappeared into cyberspace.

Recently a local township  enacted an ordinance requiring all pit owners to sterilize their animals. This was spurred by the local HS, which is not even in that particular township, who reports that most of their intake consists of pit bulls who are rarely adopted. The HS will sterilize the township's pitbulls for free. This is assuming that this township is responsible for all the  excess pitbulls.

I have several questions. First of all: enforcement? Will there be funds to have someone go door-to-door to ensure that there are no unsterilized pit bulls inside? Will they just wait for people to complain that they suspect a pit bull is in their neighborhood? What is a pit bull anyway?

I have had some experience with mistaken identity. I had taken my little black pug pup, Zoe pictured above, to Naomi's daycare. Immediately a worker chastised me for having 'that sort of dog' when I had a young child. I specifically had selected a pug because of their friendliness but she didn't have the fawn coloring associated with pugs such as Spud  (black is a dominant trait: her mother was a fawn but daddy must have been black) so people often did not know what breed she was. The worker thought she was a pit.

About 8 years ago, a police officer knocked on my door wondering whether I could tell him who was the owner of a pit bull he had in his car picked up near my house?

Um..that's not a pitbull. That is a boxer.

So why would he knock on my door? Well I had complained of vicious pits living next door (that awful rental!) who escaped regularly and had torn apart a bloodhound that was walked on a leash recently. And it turned out that they weren't pits but instead American bulldogs who are also bred for fighting but are even larger. He had responded when people had called the attack in. It took five bystanders to pull off the dogs. But for some reason, the bloodhound owner did not press charges. The bulldog owners had to make changes to ensure the dogs would not escape (but the dogs did escape). People complained, but since the dogs never attacked a person, they were allowed to exist. Meanwhile walking Spud became a challenge as I needed to see where those dogs were before taking him out.Other people walked their dogs carrying large sticks to beat off the dogs if they appeared. Fortunately, a few months later the owners and dogs disappeared leaving all the dog paraphernalia behind.

So with so much public confusion on what a pit bull is, who will decide if a given dog is a pit bull? What percentage does a dog have to be to be considered one? Turns out that a HS official would make a decision (lots of power they seem to have). But an owner could get a DNA test to prove his dog's innocence. This is where the owner would win.

Recently a WSJ reporter whose rescue dog looked very much like the 2nd picture above though without the leaves, for a story had his dog's DNA tested. According to the results, the dog was a mix of several breeds but pit bull was not one of them. How could this be? Just look at his face! Turns out that pit bull DNA was not in this particular lab's database.

My granddog Sunny who I frequently dogsit, is clearly not a pit bull but is mistaken often for a 'vicious dog'. People will cross the street when I walk her sometimes and I overhear such comments. She is a very friendly German Shepherd. Yep there are some very unfriendly German Shepherds as shown in the media (not including Rin Tin Tin).

There is this attitude that ones virility is tied to the virility of ones dog. Although I like to think of that as a 'redneck' way of thinking, I am surprised to find it among 'educated' people. For the record, all the animals I ever had have been neutered or spayed. Animals in heat aren't pleasant and walking an unneutered male insisting on marking every vertical object is not fun either. And yes there are too many dogs that end up put to sleep though locally, many of the dogs up for adoption seem to be imported from other parts of the country. There are too many irresponsible people who don't consider the consequences of their inactions.

I am curious to see how this all works out. It seems to give a certain organization too much power which I have first hand knowledge that they abuse.

Thursday, November 4, 2010

J'accuse!


Random images from the web that appealed to me

Nothing is more upsetting than being falsely accused of something. Aside from the whole Dakotagate fiasco, there have been other times this has happened.

First memory: I am 5 playing with my girlfriend Michelle in New York. Her younger brother yanks on her hair hard and she starts screaming and crying. Her grandmother rushes in to see what the problem is and Michelle between sobs gets out that her hair was pulled but is too inarticulate to say who did it. Grandma immediately assumes I was the culprit and pulls my hair hard.
See what it feels like!! 
Eventually she figured out I am innocent and offered a cookie.
Of course, these days Grandma would get into big trouble physically disciplining someone else's child.

At work, I signed on as a guinea pig to test the bioavailability of various drugs. I would select which ones very carefully. For their studies, it was often important that we fast before taking the drug. To ensure that we did indeed fast, they would check our  blood glucose levels. One morning, the director called me into her office. Generally she was very friendly towards me but on this day, she looked very annoyed.
You did fast, didn't you?
Yes I did.
Well your glucose levels were very high. Either you have developed diabetes in the past week (unlikely) or you didn't fast.
She then went on to see if I just didn't accidentally consume sugar such as breath mints. I suggested that there was a lab mistake. She didn't buy that either.
What I had done was run 3 or 4 miles before coming there. I would think that this would decrease my blood sugar but perhaps my liver was releasing glycogen and converting it to glucose. She said no more running while I am being dosed. The blood sugar shouldn't interfere with their studies, assuming I hadn't eaten but if they then noticed that the drug wasn't being metabolized as fast as the other subjects, then they could conclude I was a liar.
They didn't kick me out so I guess they figured I was telling the truth.
They kicked Steve off a study for testing positive for opiates. At the time, the company got these bagels very heavily encrusted with poppy seeds, which Steve liked to eat daily. They admitted that was probably the reason he tested positive, but still he was off the study. A few years later, the megacompany that bought our company out had a penchant for random drug testing even though it is illegal to do it without cause in many states including the sites that they have the most employees in and have their corporate headquarters. They claimed that poppy seeds would NOT cause a positive reaction. Each drug test cost the company a minimum of $200. I would love to see the cost benefit analysis of that edict.This does not include the cost of employee disengagement when undergoing such a humiliating exercise (someone had to listen to you pee, you couldn't flush, you had to stand there while they did various tests on the pee to ensure it was fresh pee, etc).

One of my favorite false accusations was that my whole family has eating disorders with the implication that this was all my fault. My ex-friend and I were visiting my college friend out-of-state that just happened to be a psychiatrist. Out of no where, the ex-friend piped in that every single person in my immediate family has some sort of eating disorder, wasn't that interesting and what does the psychiatrist think of that? I was flabbergasted. This was wrong on so many levels! Of course the college friend gave me the WTF? look and immediately changed the subject. He had no intention of practicing off-hours on an unwilling participant. And we ALL have eating disorders just because Shanna and Steve were thin? FYI, thinness is 'normal'; not every thin person has anorexia.

I ran in the cold drizzle out in the country; a good run. Then I rescued all my tuberous begonias so that they may produce next year. I am also trying to preserve some of my many geraniums out of the soil. They will presumably go into some kind of hibernation mode. Sticking cutting directly into the soil was about 75% successful in producing new plants with roots. I do better sticking cuttings into pots. All that is left in bloom and alive are my snapdragons, my black eyed Susan vine (unrelated to black-eyed Susans I think), some of the petunias, some California poppies, some pinks, some lobelia, marigolds, zinnias, some nemesia; all else dead.

Naomi is doing well with her patients. She has just one more week in her program.

Wednesday, November 3, 2010

Maya trying to speak

video

Back to Boston

Although there is a fringe of brown hair at the nape of her neck, her new hair coming in looks reddish



Shanna and the boys are on the plane to Boston. We will see them at X-mas. Now the glass knick knacks can be put back in their places and the level of chaos will go down.

Shanna and I did get some just mom and daughter time today which I treasure; a trip to Canton where the cheap eye brow threading is done, a steak lunch, and homemade Indian cardamom ice cream (they were out of anjeer or fig, my favorite).

Steve didn't get home until close to midnight. The number of ballots tallied did not equal the number of voters so no one went home until that was settled. Almost an 18 h day for him with just one break.
So now back to normal here. While Steve was at the airport, I had Maya duty. She is becoming so much more interactive. I will try to load a video in which she speaks or at least tries to.

Followers

Blog Archive