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Wednesday, November 19, 2014

Taking Charge of Your Treatment: A Breast Cancer Two-Timer Shares Her Experience

The diagnosis of cancer is a highly charged emotional event. It can throw us off for days before we can begin to think clearly. The inclination may be to follow whatever the person delivering the news tells you. Not always the best idea. As a nurse/medical writer who has breast cancer twice, here is what I recommend and live by:

1. Don’t accept the first treatment recommendation you receive. Get a second and a third opinion, and listen to the reasons for each one’s recommendations. One doctor may recommend less treatment than you think you need. Get as many opinions as you need to feel comfortable about your decision. You don’t have to decide today.

2. Ask other cancer patients, friends, and people in the medical profession for names of doctors for second and third opinions. Don’t use two doctors in the same practice, and make sure they are not affiliated.

3. Set up your appointments as soon as possible, and get copies of all your medical records to them in advance. Create a paper trail. You should have a complete file of any surgical or biopsy reports. They may be needed years later and be difficult to track down.

4. Do your own research-but wait until you have all the facts. It will help you ask the right questions. If you don’t have a feel for the reputable medical websites, make friends with a health professional. One of mine was upset by my diagnosis and said she needed an assignment. I asked her to research the relative risk of recurrence with and without chemotherapy for my type of cancer. When she had the information together, we sat down and made a list of questions for me to take to my appointments. I felt more in control, and she knew she had really helped me.

5. Take someone with you to the appointment or tape record it. When dealing with a highly emotional issue like cancer treatment, even nurses don’t always hear everything. A second set of ears or a tape will allow you to re-hear it in a more neutral environment. None of the doctors I saw: my surgeon, radiation oncologist, or the medical oncologists had any problem with taping our session.

6. Ask them to put chances of recurrence with various treatment options in a way that makes sense to you. For me, percentages worked. If surgery plus radiation and tamoxifen has an 85% cure rate, and chemotherapy would only add an additional 2-3%, is it worth the trauma and side effects of chemotherapy? That was my situation and I could live with a 2-3% risk. Another woman I met in radiation, a stockbroker accustomed to taking risk on a daily basis, was in the same boat. She opted for chemotherapy because she needed to feel she was doing everything possible. That’s the point. What is right for you may not be right for someone else.

7. Don’t give away the treatment decision to your doctor. It is your body. For any treatment to be effective, it must have your full mental and emotional support. Your immune system will not be fooled. Only you can decide your risk comfort level. My first oncologist had declared that I needed six months of chemotherapy in addition to the radiation and tamoxifen. I thought I would die either way. Both the second and third opinion physicians felt that chemotherapy was not even clearly indicated in my case. And because they both agreed, but for slightly different reasons, I felt comfortable going with my gut feeling that chemotherapy was not really right for me. It has been 13 years since that second diagnosis.

Sunday, November 9, 2014

Trash Collection is Site-Sensitive

Picking up trash can be fascinating, seriously! I have the blessing of living in two different places, one way up in the mountains with very little trash, and one in the heart of a major city with beaucoup trash, so plentiful it seems to come up out the ground instead of grass. So I have different approaches to my dedication for keeping my world cleaner.

In Colorado, I have a friend who is always training pack llamas, so when we do our adopt-a-road trash pickup, we take a llama along with saddlebags to hold the trash. Then we climb down and up ditches, picking up what tourists flying by have decided to jettison. They don’t live here; why should they care?

Rattling the saddlebags and stuffing trash gradually gets the llamas used to packing and we don’t have to carry all of it. Win-win. Plus, with a llama, people always slow down to look and sometimes notice we are picking up trash, which gets them to thinking about not leaving any!

My city home has a real dearth of pack animals, so I have my own mantra for that: if I see a discarded plastic bag (and who doesn’t daily in the city?) I was meant to pick it up and fill it with trash before depositing it in a proper receptacle. That basically means, every time I leave my house, I will be picking up trash, but that has a finite limit, as does the bag. Then I can continue on my way, enjoying the walk, the day and any flowers.

Imagine my surprise one day during my mountain time while sauntering down a dirt road gawking at the new snow covering on the mountains, when an empty plastic bag drifted in front of me. Here? Okay, same pledge holds, so I picked it up and started filling. Because of our paucity of trash, I walked a lot farther toting it before it was full. And my surroundings were once more pristine.

Can I invite you readers to do the same? Minus the llama, in most cases, I know, but be aware and help out our planet a little.