I have watched 2 TV shows this week and they have both left me confused. The first was Monday night with House. House showcased Long QT Syndrome as the opening diagnosis for the show. They wanted to test for it by using something called a scare test. In all the years that I have lived with the LQTS diagnosis, I have never heard the scare test mentioned either by a physician or on the internet. LQTS is diagnosed with a 12 lead ECG, a stress test, and genetic testing called the Familion Test. It is easy to get this information on the web, so it makes me wonder if the writers of house were having server problems when they wrote this show.
On Tuesday I watched the second episode of Biggest Loser. Bob and Jillian seem to be given the golden contestants this year. None of them were whining or refusing to exercise. But that didn't seem to please the trainers. I was shocked at the brutality of the exercise segments. It seemed as if they were trying to kill the contestants. It seemed to me that the already tough love work outs that I'd seen in other seasons have been put on steroid for this season. This would have me worried, but since I haven't heard already that someone has been taken off the ranch as deceased, I'm assuming that we won't be seeing it this year. Surely the show are already pre-taped.
Wednesday, September 29, 2010
Tuesday, September 28, 2010
Grand Rounds is up!
Welcome to my blog. I'm not sure how so many of you have made your way to my humble blog over the past few days, but I'm glad you stopped by. If you would like a veritable smorgasbord of quality blog reads go over to Dr. Grumpy's place. He just put Grand Rounds up today and it is chock full of well written rants. Thanks for stopping in.
Monday, September 27, 2010
Benefit Plan Elections
I just came out of the 2011 Benefit Plan Election meeting for the corporation that I work for. The meeting focused mainly on mandated plan changes. The good news is that I'm not going to have to jump through hoops to keep my daughter covered until she's 26. The better news is that the corporation that I work for has extended that coverage to vision, dental and life insurance as well as medical. This is really a great company to work with. There will be higher cost to some ancillary coverages, but the medical plans stay the same as they were last year. The sweeping changes they made last year were a boon for me, so I was very happy to be keeping the benefit package. We all went in expecting a blood bath and walked out with good news. The most astounding thing about the meeting was at the end there were people who were actually asking questions. How many questions can you have to "no change"?
Thursday, September 23, 2010
Season 10
I have been addicted to the reality TV show "The Biggest Loser" for years. I think it's because they are really trying to do something useful rather than just sitting in a house and trying to rat each other out. This week the season opener aired and if you watch TV at all, I'm sure that you heard something about it. I was surprised that a breast cancer survivor with less than a year from treatment was trying to get on the show. Actually, I was concerned that she would get on, and she still may. I totally understand her motivation. Once you've beat something like the cancer she had you want to do more than just survive it, you want to kick it's butt. I did it myself by walking the 3-Day in October 2006. But the experience of walking the 3-Day was what had me deeply concerned that this woman was actually trying to compete on the show.
The first thing is that she is still recovering from her cancer treatments. I was told when I started chemo to expect recovery to take 2 months for every month of treatment, including all treatments. My chemo, surgery and radiation took 8 months, (a shorter time due to having dose dense chemo) so my recover time was expected to be 16 months. It took every bit of it and more. I was back at work and into my routine, but I was not 100% and had to push myself quite a bit during that time. She would have a tough time keeping up with the physical demands of exercising for hours and the competitions she would need to endure to be a contestant on that show.
Another consideration would be the risk of lymphedema the exercises would place on her. Since a study came out in August 2008 that moderate exercise helps relieve lymphedema, women are no longer being told not to engage in vigorous exercise. And I have seen an improvement with my lymphedema since I have been working out. But I started slowly, gradually built up the weight that I use, always wear a compression garment and quit or modify any exercise that puts undue strain on my arm. I'm not sure that Bob and Jillian would give her that consideration. In order to keep up with the weight loss expectations of that show she would have to exercise vigorously.
And still another concern that I have is that this woman stated that she'd been told that if she didn't lose the weight her cancer would come back. I have no idea if this is what she as actually told or if this is just what she heard. The problem is that the concept is flawed. The studies show that obesity does increase risk for recurrent cancer in postmenopausal women with er/pr+ breast cancer. The thought is that fat cells store estrogen and estrogen feeds cancer cells. The evidence that weight loss decreases a woman's chance of recurrence is less reliable, the studies have just not been that conclusive. I doubt that this woman, at 38, was postmenopausal at the time of her diagnosis. Also, she stated that her cancer was very aggressive, which lends to the idea that it may have been either er/pr- or triple negative. I'm only guessing here, but the most aggressive tumors are the negative ones. So, she's been given a wake up call and needs to get healthy. Most lifestyle modification plans ask for a weight loss of 10-20% of body mass done averaging 1-2 pounds per week. This is obtained by a healthy diet and moderate exercise of up to 1 hour a day. This show seems to be very good with the diet portion of it. It teaches a diet that includes lean proteins, vegetables, fruits, whole grains and good fats measured for portion control. But the exercise portion of it is way beyond normal. And the contestants on the show lose wild amounts of weight. Most often in the double digits a week at the beginning of the show. I wonder how that is healthy? I'm amazed that it's possible.
The last concern that I have is about the chemo. Chemo stays in your body for a while and I wonder if losing that amount of weight would cause chemo that is in her body to be released into her system? Really, I don't know but it would be a concern for me. Adriamycin is a very common therapy given to breast cancer patients. It is not being given to everyone like it was when I was treated, but still a majority of survivors had danced with the red demon. And it is the gift that keeps on giving. One of the way the drug works is to disrupt carbohydrate metabolism and does cause hyperinsulinemia in people who have taken it. Insulin is a growth hormone and thus is thought to explain why most women gain weight during chemotherapy for breast cancer. In fact losing weight during treatment is thought to be a negative prognostic indicator. Some studies (done on dogs, not people) seem to indicate that carbohydrate metabolism does not return to normal after treatment is discontinued. It is also thought that chemotherapy for breast cancer decreases muscle mass that is not remedial after treatment. So, treatment for breast cancer makes you fat and you will have a harder time dealing with it after treatment is over. And this woman wanted to go up against people who would have a metabolic advantage over her.
The way the show was set up this season, she had to compete for a place on the show by running a mile with two other contestants. Because she was the last to finish the mile she did not make it on the show. I really felt sorry for her because I would like to see her win this, but I didn't hold out much hope that she could so soon after treatment. It is possible that they will be bringing her back on the show at a later time. And because she has generated so much media attention, I think that it is a real good bet that it will happen. I hope she is successful in losing weight in a healthy manner, and goes on to be NED for a long life to come. I really do wish her the best.
The first thing is that she is still recovering from her cancer treatments. I was told when I started chemo to expect recovery to take 2 months for every month of treatment, including all treatments. My chemo, surgery and radiation took 8 months, (a shorter time due to having dose dense chemo) so my recover time was expected to be 16 months. It took every bit of it and more. I was back at work and into my routine, but I was not 100% and had to push myself quite a bit during that time. She would have a tough time keeping up with the physical demands of exercising for hours and the competitions she would need to endure to be a contestant on that show.
Another consideration would be the risk of lymphedema the exercises would place on her. Since a study came out in August 2008 that moderate exercise helps relieve lymphedema, women are no longer being told not to engage in vigorous exercise. And I have seen an improvement with my lymphedema since I have been working out. But I started slowly, gradually built up the weight that I use, always wear a compression garment and quit or modify any exercise that puts undue strain on my arm. I'm not sure that Bob and Jillian would give her that consideration. In order to keep up with the weight loss expectations of that show she would have to exercise vigorously.
And still another concern that I have is that this woman stated that she'd been told that if she didn't lose the weight her cancer would come back. I have no idea if this is what she as actually told or if this is just what she heard. The problem is that the concept is flawed. The studies show that obesity does increase risk for recurrent cancer in postmenopausal women with er/pr+ breast cancer. The thought is that fat cells store estrogen and estrogen feeds cancer cells. The evidence that weight loss decreases a woman's chance of recurrence is less reliable, the studies have just not been that conclusive. I doubt that this woman, at 38, was postmenopausal at the time of her diagnosis. Also, she stated that her cancer was very aggressive, which lends to the idea that it may have been either er/pr- or triple negative. I'm only guessing here, but the most aggressive tumors are the negative ones. So, she's been given a wake up call and needs to get healthy. Most lifestyle modification plans ask for a weight loss of 10-20% of body mass done averaging 1-2 pounds per week. This is obtained by a healthy diet and moderate exercise of up to 1 hour a day. This show seems to be very good with the diet portion of it. It teaches a diet that includes lean proteins, vegetables, fruits, whole grains and good fats measured for portion control. But the exercise portion of it is way beyond normal. And the contestants on the show lose wild amounts of weight. Most often in the double digits a week at the beginning of the show. I wonder how that is healthy? I'm amazed that it's possible.
The last concern that I have is about the chemo. Chemo stays in your body for a while and I wonder if losing that amount of weight would cause chemo that is in her body to be released into her system? Really, I don't know but it would be a concern for me. Adriamycin is a very common therapy given to breast cancer patients. It is not being given to everyone like it was when I was treated, but still a majority of survivors had danced with the red demon. And it is the gift that keeps on giving. One of the way the drug works is to disrupt carbohydrate metabolism and does cause hyperinsulinemia in people who have taken it. Insulin is a growth hormone and thus is thought to explain why most women gain weight during chemotherapy for breast cancer. In fact losing weight during treatment is thought to be a negative prognostic indicator. Some studies (done on dogs, not people) seem to indicate that carbohydrate metabolism does not return to normal after treatment is discontinued. It is also thought that chemotherapy for breast cancer decreases muscle mass that is not remedial after treatment. So, treatment for breast cancer makes you fat and you will have a harder time dealing with it after treatment is over. And this woman wanted to go up against people who would have a metabolic advantage over her.
The way the show was set up this season, she had to compete for a place on the show by running a mile with two other contestants. Because she was the last to finish the mile she did not make it on the show. I really felt sorry for her because I would like to see her win this, but I didn't hold out much hope that she could so soon after treatment. It is possible that they will be bringing her back on the show at a later time. And because she has generated so much media attention, I think that it is a real good bet that it will happen. I hope she is successful in losing weight in a healthy manner, and goes on to be NED for a long life to come. I really do wish her the best.
Tuesday, September 21, 2010
Grumpy
Dr. Grumpy's blog cracks me up. I love reading it and do so almost every morning. He's hosting a grumpfest for Grand Rounds on Tuesday and wants to know what medical things make me grumpy. With six years between me and cancer, I've had plenty to grump about and do so quite often.
One of the medical things that makes me grumpy is being treated like I'm an uninformed idiot. It happens all the time when I have to deal with new medical people and it makes me down right irate. It's the EMT that when I told him that I have lymphedema in my left arm insisted that he needed to use that arm for blood pressures and to start an IV. His reasoning was that the ambulance was set up to use the left arm. Seriously? Pretend that there isn't an arm there and do what you'd do to work around that, because you can't use the left arm. He isn't the only one who has argued with me about that. The nurse in my former PCP's office pretended she couldn't get a blood pressure reading from my right arm and argued with me to use the left arm, every time I went in. She's one of the many reason that PCP has "former" in front of her title. It's the partner of another former PCP who when I had to go in after being in the hospital for a week didn't even bother to look at my chart. He asked me why I'd been in the hospital and I told him that my potassium level had gotten so low that I was in pain and was experiencing a lot of anxiety and I would like to figure out why my electrolytes keep becoming so imbalanced. He looked at me like I said that I'd just dropped in from Mars and would like the warts removed from my tentacles. He came just short of patting me on the head and told me I had chronic fatigue syndrome and a viral syndrome. It was another two years before a very smart PCP finally sent me to a nephrologist to find out that I have hyperaldosteronism and that is why I dump potassium. If you don't know the answer and don't want to take the time to find out just say "I don't know and I don't really care." "Viral syndrome" tells me that you think I'm too stupid to know that you just made something up. I quit going to that primary care office because every time I needed an appointment he was the only doctor available. No thank you. It's the cardiologist who did my angiogram and called all of the doctors and nurses in the room over to take a look at my unusual heart. When I asked him what he saw, he acted like he didn't even hear me speaking. I got really upset about that, so another person in the room actually did pat my arm and said "It's nothing to worry about. Your heart has always been that way." No kidding, so tell me what it is.
But the medical thing that makes me grumpiest are all the doctors and nurses who want to ignore the fact that I have Long QT Syndrome. They will lie to me and say that they don't see the QTc of 550 and the inverted T waves. They will tell me that a medication isn't on the list when they haven't even checked the list. One even told me that beta blockers aren't the appropriate treatment for LQTS. I understand that treating someone with LQTS is a pain. There are whole categories of medications that get taken off the plate and inevitably the medication that you prescribe to everyone that walks in the door just happens to be on the Arizona CERTS list. But in my reality, my grandfather, father and brother all just dropped dead from LQTS, and I have it too. I take this seriously even if you don't. No, I can't take an antidepressant for tension headaches. And yes, I have taken Bactrim before and didn't die from it, but it doesn't mean that I won't next time I take it. I want you to take something that I could die from seriously.
These are just a few of the things that make me grumpy, and I didn't even mention the scheduler at my oncologist office who can't figure out that I do have a scheduled appointment, or the surgeon who routinely cancels my appointment, can't reschedule until at least 3 months away and then fusses at me for missing my mammogram. Lord, I could go on for years with this grumpfest.
Oh, but one more thing that makes me grumpy, that Dr. Grumpy isn't my neurologist.
One of the medical things that makes me grumpy is being treated like I'm an uninformed idiot. It happens all the time when I have to deal with new medical people and it makes me down right irate. It's the EMT that when I told him that I have lymphedema in my left arm insisted that he needed to use that arm for blood pressures and to start an IV. His reasoning was that the ambulance was set up to use the left arm. Seriously? Pretend that there isn't an arm there and do what you'd do to work around that, because you can't use the left arm. He isn't the only one who has argued with me about that. The nurse in my former PCP's office pretended she couldn't get a blood pressure reading from my right arm and argued with me to use the left arm, every time I went in. She's one of the many reason that PCP has "former" in front of her title. It's the partner of another former PCP who when I had to go in after being in the hospital for a week didn't even bother to look at my chart. He asked me why I'd been in the hospital and I told him that my potassium level had gotten so low that I was in pain and was experiencing a lot of anxiety and I would like to figure out why my electrolytes keep becoming so imbalanced. He looked at me like I said that I'd just dropped in from Mars and would like the warts removed from my tentacles. He came just short of patting me on the head and told me I had chronic fatigue syndrome and a viral syndrome. It was another two years before a very smart PCP finally sent me to a nephrologist to find out that I have hyperaldosteronism and that is why I dump potassium. If you don't know the answer and don't want to take the time to find out just say "I don't know and I don't really care." "Viral syndrome" tells me that you think I'm too stupid to know that you just made something up. I quit going to that primary care office because every time I needed an appointment he was the only doctor available. No thank you. It's the cardiologist who did my angiogram and called all of the doctors and nurses in the room over to take a look at my unusual heart. When I asked him what he saw, he acted like he didn't even hear me speaking. I got really upset about that, so another person in the room actually did pat my arm and said "It's nothing to worry about. Your heart has always been that way." No kidding, so tell me what it is.
But the medical thing that makes me grumpiest are all the doctors and nurses who want to ignore the fact that I have Long QT Syndrome. They will lie to me and say that they don't see the QTc of 550 and the inverted T waves. They will tell me that a medication isn't on the list when they haven't even checked the list. One even told me that beta blockers aren't the appropriate treatment for LQTS. I understand that treating someone with LQTS is a pain. There are whole categories of medications that get taken off the plate and inevitably the medication that you prescribe to everyone that walks in the door just happens to be on the Arizona CERTS list. But in my reality, my grandfather, father and brother all just dropped dead from LQTS, and I have it too. I take this seriously even if you don't. No, I can't take an antidepressant for tension headaches. And yes, I have taken Bactrim before and didn't die from it, but it doesn't mean that I won't next time I take it. I want you to take something that I could die from seriously.
These are just a few of the things that make me grumpy, and I didn't even mention the scheduler at my oncologist office who can't figure out that I do have a scheduled appointment, or the surgeon who routinely cancels my appointment, can't reschedule until at least 3 months away and then fusses at me for missing my mammogram. Lord, I could go on for years with this grumpfest.
Oh, but one more thing that makes me grumpy, that Dr. Grumpy isn't my neurologist.
Wednesday, September 15, 2010
Exchange That Made Me Sad
Nini tony cut another tooth will be glad when all eye teeth are in so that he goes back to his quiet calm self
21 hours ago · Comment ·UnlikeLike
- Sonja I-teeth. Incisors. ;)
21 hours ago · LikeUnlike
Nini well i thought it was eye teeth oh well i am dumb
21 hours ago · LikeUnlike
Sonja no you're not. just letting you know ♥
21 hours ago · LikeUnlike
Matthew well he will have most of his teeth before i get back i guess so i think a trip out for icecream will be a great idea
13 hours ago · LikeUnlike
Nini yeah it would be nice... maybe frozen yougart... i like that better.
5 hours ago · LikeUnlike
Matthew well i hope theres a tcby around our area then... im sure the boys wouldn't know the difference.
54 minutes ago · LikeUnlike
Nini lol i dont care as long as we are together
50 minutes ago · LikeUnlike
Matthew we will be. and i think it will be awesome to watch the boys interacting for a change... you know i am tired of seeing them grow up over the computer id much rather be there to see it all.
This Facebook exchange made me a little sad. I'm glad that he's looking forward to coming home and joining his family again, but sad that he's missed so much of his childrens life.
Monday, September 6, 2010
Facebook Message From My Son to His Wife
"hey babe, you should so let me come by next month for a visit."?
My comment...."Like like like like like like!!!!!!"
Thursday, September 2, 2010
Facebook comment between my two sons
"it has been hectic out here and i have to get going again cause i am so definitely not doing combative operations"....
Mr. President, when are you going to stop lying to the American people?
Mr. President, when are you going to stop lying to the American people?
Wednesday, September 1, 2010
Celebrate Freedom this weekend
I'm going to Celebrate Freedom on Saturday. It is a massive party that one of the local Christian radio stations throws every year. Switchfoot will be there along with dozens of other bands. It's going to be hot and sunny, so I'm going to have to take plenty of frozen bottles of water and sun screen. Virgin Mobile finally activated my phone, so I will be able to blog and tweet from there. Looking forward to a fun day.
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Sent from my Virgin Mobile.
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Sent from my Virgin Mobile.
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