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Tuesday, April 12, 2016

Weak, Woozy and Wet Weather

I may have overdone it by going to the market on Saturday.  I spent most of Sunday feeling weak and woozy, which was most frustrating. I did get a few things accomplished but not much. I decided on something simple for supper, so made  a chicken and avocado salad with  almond/orange dressing, using a recipe from Annabel Langbein’s cookbook.  The chicken was surprisingly tender and juicy, which was a surprise since most of the breasts we’ve cooked lately have been tough and tasteless. I’ll probably use her method of poaching chicken using mostly residual heat, from now on.

By Monday I was feeling a little more energetic and got plenty of exercise by going up and down the basement stairs to do several loads of laundry. For only two people Mr. G and I seem to have a lot of dirty laundry. Sometimes, when I view the pile of laundry that needs to be washed, I wonder if   someone isn’t sneaking in and dropping off their laundry hoping I won’t notice.  But alas, it is all ours. After getting the laundry washed, dried, folded and put away, I  decided to cook some of the shiitake mushrooms we had bought on Saturday.  I chopped about half of them, along with some white mushrooms I already had, and made a  mushroom velouté. I don't know if it was the mushrooms or just time doing its thing, but I do feel more energetic today and not nearly as fatigued as I have been feeling.

I had hoped that when my energy level improved we’d be able to get some things done in the garden, but the weather hasn’t been cooperative-  it’s been rainy, windy, cloudy and  generally not good weather for being outside, and it looks like the forecast is calling for more of the same.  There’s plenty that needs to be  one inside, so I won’t be idle- but it’s more fun  to be outside playing in the dirt!  Meanwhile, I’ll  look at  pictures of past efforts in the garden and  keep hoping I’ll be able to  get out there soon to finish  weeding and bed prepping and get on to the business of planting!  Last year, not sure  how I was going to react to the chemotherapy, I pretty much   did my gardening on the deck, in containers, which worked out well,  as  you can see from these pics, 



 
but  I’d like to get some stuff in the ground  again this year, and  rework my  little raised beds again   These pics are from 2014, and that’s what I’m aiming for, as well as having a  nice deck garden again. Except for the Squash.  I will not grow squash.  Squash vine borers and other  critters that have attacked   my squash plants every year leaving a   limp and wilted  mess rather than the nice  healthy robust plants I began with have convinced me that I am no match for them. I have tried every non-toxic remedy I could find, to no avail.  I admit defeat. I will concentrate my efforts instead on picking off the  tobacco hornworms that  seek to destroy the tomatoes every year. Organic gardening in the Deep South is a challenge.  I love a challenge- as long as it isn't TOO challenging ;-) 










Saturday, April 09, 2016

This Little Piggy Went to Market


Today was the first market of the new season at Pepper Place Farmers Market, and I was determined to go because it’s become a tradition. So, heeding the warning to avoid sun exposure while on Erbitux, I slathered on the SPF 30 sunscreen, donned long sleeves and a hat and off we went.  The long sleeves, and the turtleneck I wore turned out to be a good choice because it was   a tad on the chilly side this morning.  As we neared the market, the streets were lined with cars for blocks and people were walking.  I didn’t know if I was quite up to walking a great distance since I still felt just a little weak and wonky, but sometimes the fates smile upon us, and they did today. We lucked out, and found a spot just across the street from the market on our first pass.

The market is usually crowded on opening day, but today was as crowded as I have ever seen it. 

You could barely move.  And dogs! It seemed like every other person there had brought his or her dogs.  It would be nice if they would also bring pooper-scoopers and not let their dogs on retractable leashes  tangle  themselves around folks' legs, but. . .Some dogs were very well behaved; others   seemed to be over stimulated by the sights and scents. This guy was one of the calmer ones, waiting patiently for his folks to finish making their purchase. I could never take Agatha and Victoria- the excitement would be too much for them and they'd  most likely have conniption fits and never recover!

There were vendors with all manner of food and craft items.  The fresh veggies and strawberries were in abundance and there were two mushroom vendors. We bought some spinach, strawberries and shiitake mushrooms. We decided to grab a cup of coffee and something to eat and sit at one of the tables.  Mr. G bought some boudin sausage and I grabbed a chocolate croissant. It was nice and relaxing to sit and listen to Debbie Bond and Rick Asherson play the blues and watch the little kids grooving to the music and dancing, having a grand time. 

 


It was a fun morning, but I was   quite tired so we decided to head for home.   
Once  home I took a nice long nap. Altogether it was a pretty good Saturday, perfect weather with blue skies, a wonderful market with fresh veggies, happy little kids, and blues music for entertainment. Who could ask for more?

Thursday, April 07, 2016

Progress Report- Good News and Bad News


 Spent another long day in the oncology clinic yesterday; we got there at 8:30 AM and left just after 2 PM.  One of the oncology nurses had phoned on Monday to ask if I could get there an hour early because the doctor was changing my chemo drugs and the new combination would need to infuse at least four hours.  I figured the CT scan results from last week’s scan must not be what we had hoped for. As it turns out there was some good news and some bad news on the CT scan. The bad news is that the liver tumor has increased in size by 18%. The good news is that all the other hypodensities in the liver and pancreas have remained stable and that the stomach, small bowel, appendix and colon appear normal and the rectal mass is still unseen. Based on the growth of the liver tumor, my oncologist started me on a new chemo regimen today.  I thought at first that I would be getting FOLFIRI plus Erbitux, but I’m actually just getting the Erbitux and Camptosar (Irinotecan), both of which have some fairly nasty side effects, but have shown a lot of promise in clinical trials, especially in patients with wild type KRAS gene, which I have.  So I guess that makes me a wild child. I’m hoping I can tolerate the side effects without having to stop the treatment early. One of the side effects of the Erbitux is an acne-like rash which I hear is quite unpleasant.  The doctor said if I did get the rash to call and they would phone in a prescription for a gel to use on the rash.  I hope it doesn’t come to that.  One should not have to deal with acne in one’s seventies; I am sure there are better ways to fake a youthful appearance!

Once in the infusion room I saw that someone had already taken my favorite chair so I wasn’t as close to a plug for my Kindle. It didn’t really matter as it turns out because I kept drifting off to sleep anyway and didn’t use the Kindle much.  I took the Tylenol the nurse brought, and then she hooked me up with some benadryl and  anti-nausea drugs. After that, we got the heavy stuff.  A short while after the Erbitux began flowing I began to itch.  Furiously. On my arms, legs, abdomen, buttocks. Then welts started popping up.  I looked and felt like I had been closed up in a roomful of angry, hungry, biting mosquitoes!  The nurse stopped the Erbitux and hooked up something to stop the itching.  It worked, thank goodness!  She told me my mouth would get very dry, like it had cotton stuffed in it. Sure enough it did, but she had brought me a cup of water and a peppermint candy- they helped a lot. We were able to continue the infusion of the Erbitux, then they hooked up the Camptosar and after another hour and a half, I was unhooked  and on my way.  The best part is that I’m not on the pump any more! The doctor took me off 5-FU. Hallelujah!

Much as I dislike this whole set of circumstances, I am constantly reminded that some people are a lot worse off.  One poor elderly woman who came in for her first treatment didn’t yet have a port.  It took three nurses to try to get a vein that would work.  She kept hollering in pain telling them to take it out, she’d just come back tomorrow.  They finally gave up and   took her down to radiology, so she might be getting a combination of chemo plus radiation. I hope she gets her problem sorted out, but she has a rough road ahead, for sure.
  
When I went back to the waiting room to find Mr.G he said I looked pale as a ghost, and after looking in the mirror I have to agree with him.  I could probably try out for a part on the Walking Dead and not even need make-up! Once we were in the car, I kept dozing off and went straight to sleep once we got home.  I slept most of the afternoon, off and on and felt completely wiped out.  This morning I still look like death warmed over, but am feeling much perkier, although my face feels hot (no fever) and has a strange mottled appearance with some red blotches, grey skin  areas. To make things worse the bags under my eyes look like I’ve been packing them for a trip. This too shall pass.  At least I hope so!

Tuesday, March 29, 2016

CT Scans and Craneflies


I had a CT scan yesterday with contrast.   Since I had a nasty reaction to the barium solution I drank beforehand for the  previous CT scan,  I was told to arrive an hour or so before the scan to drink  a solution they had  at the center.  After I  registered  a nurse brought out a bottle of what appeared to be clear water.  It was Omnipaque, an iodine solution in powder form mixed with water. It actually was  nearly tasteless and much easier to get down than the barium solution.  Best of all, it caused no  nasty reactions. About an hour after I’d  finished drinking it,   a technician called me back,  took a finger prick blood test to  check kidney function and had a nurse access my port. While they were doing the preliminary positioning, test scans, etc., we discovered that the buttons on my new shirt are not plastic, as I thought, but have some metal component that  screwed up the image, so we  began over, sans shirt, and they  began pumping in the iodinated intravenous contrast. That is always such a strange sensation and I’m so glad the tech warned me about it he first time I had a scan. Within   seconds of the dye pumping in, you  feel   a lot of heat,  especially in the groin area,  and get the sensation that you  are wetting yourself.  If they had not  warned me I would have sworn I WAS actually wetting myself. It’s very strange, but passes quickly.  The table slid  into the CT doughnut,  the whirring began, a disembodied voice ordered me to " Breathe in," "Hold your breathe," "Breathe!" a couple of times and   before I knew it, the tech was telling me we were finished. Now to wait for the results and keep fingers and toes crossed that the rectal tumor and  metastasized  liver tumor have shrunk, there are no new lesions anywhere, and the existing  spots and lesions have disappeared or remained stable.

Not having had anything to eat or drink since supper the night before I was ravenous when we got home at around  1 P.M. and desperately craving  a cup of coffee. Mr. G made some coffee, and  ham and cheese sandwiches, with loose leaf lettuce from our own little crop growing on the deck.  After that I napped for a little while before going outside to do some watering in the greenhouse and weeding in my little jungle of a garden bed.  It is somewhat frustrating to get tired so very easily, but   working fifteen or twenty minutes then taking a ten or fifteen minute break DOES get the job done, albeit a bit slower than I would like. The plan was that   I would cook supper early than take a short  break before getting ready for yoga. I had told the instructor that I probably wouldn’t be there because  I’m usually so fatigued for  three or four days after I get unhooked from the pump, but this time, I had a lot more energy, so I planned to go. Problem is, I fell asleep on my “short” break and by the time I woke up  it was too late to even think about cooking supper, getting showered and going anywhere, so I missed yoga class.  We did have a nice supper, though: more recipes from Annabel Langbein: Mediterranean baked fish and a slightly tweaked version of her parsley mashed potatoes (I added sour cream), and  spinach bacon and avocado salad with raspberry vinaigrette.

Today I’ve been back outside weeding the jungle, fighting to control the  ever expanding soapwort, watching   the cedar waxwings   gobbling the berries off the holly tree, and  wondering why these two,  who I think are craneflies, were at it for well over an hour on the back door didn’t  get a room somewhere!


Sunday, March 27, 2016

More Political Ponderings


Since I  was first diagnosed  with cancer last year, my Medicare  supplemental policy insurance has been billed just over  $307,000 for the  physician care, tests, biopsies,  scans and treatments I’ve received. Because Medicare and the insurance company have been able to negotiate lower costs with the providers, they have paid only a portion of that amount, and  my total  out-of-pocket expenses are capped at $6700 per year. It’s still a hefty amount which threatens to destroy whatever meager savings we have managed to accumulate, but I am extremely grateful  to have the coverage and wish all Americans could have the security of knowing  they  can get affordable care, should they face a similar diagnosis or a catastrophic accident requiring extensive care. Which is why the idea of universal coverage as Bernie Sanders proposes appeals to me a great deal.   I like a lot of Bernie Sanders plans in theory.  But I have a lot of questions on how some of these plans would actually be implemented and question his and his campaign managers’ grasp of financial matters,  I find myself asking, "How?" to most of what Sanders says he is going to do. "How do you plan to convince Congress to increase taxes on the rich, increase wages, create jobs, extend Medicare to all as well as guarantee a free college education, etc.?" How much does Sen. Sanders actually know about how Medicare works? Does he realize how much those of us receiving Medicare have paid into it, how much our monthly premium deducted form our Social Security checks for Part B coverage is? Does he know that we have a pretty hefty out of pocket expense and that while it does provide many preventative services, Medicare does not cover most dental or eye care services, and does not cover hearing aids? What about the current  Medicare portion of the FICA payroll tax  paid by both  employers and employees to  cover Medicare premiums? Now the Medicare tax is 1.45%  for those earning under $200,000. Those earning   more than that amount also pay an additional 0.9% Medicare surtax.  Will that be increased or will the   tax be scrapped and rolled into an all inclusive payroll tax for universal healthcare? What about the unemployed?   How will their  tax be covered? Medicare is  truly a wonderful thing as is the idea of  universal healthcare is a goal we should strive for.  I believe the Affordable Care Act is a first step in the right direction toward achieving that goal, but when I look at the  Republican congressional opposition to it, the number of efforts to overturn the law and the  many Republican governors who have refused to expand Medicaid  so that their  constituents are eligible , I wonder just how realistic  many of Sanders sweeping proposals and promises are as opposed to Secretary Clinton’s more pragmatic approach and her determination to   support  down ticket Democratic candidates at  state  levels. Because   it is as the state and local level that a lot of legislative change and political  leverage  is needed

 A  question about Bernie Sanders’ free college  for all plan.   According to the summary on his site, Sanders’ plan  states that total tuition at public colleges and universities amounts to about $70 billion per year. Of that cost, under the Sanders plan the federal government  would be responsible for  67% of the cost while the states would be required to pick up the remaining 33% . But according to data from the Center on Budget and Policy Priorities, states have been cutting funding  for K-12 programs since the 2008 recession and most states have not restored those earlier levels.  In fact, in about half the states reporting, less general aid  per student is being  provided now than in 2008, and In three states, including Alabama, funding  cuts are 15% or more.

The cuts also affect higher education. While state funding for higher education has been rising slightly in the last  couple of years, there is still a large reliance on student tuition to fund higher education.  US News reports that, “ Overall, half of states now receive more financial support from tuition dollars than from state or local funding. And the reliance on tuition revenue varies widely between states, from a low of 15.1 percent in Wyoming to a high of 84.5 percent in Vermont.”

Sanders’ plan calls for  financing the federal  funding  by Imposing a Robin Hood Tax on Wall Street, a Wall Street speculation fee on investment houses, hedge funds, and other speculators of 0.5% on stock trades (50 cents for every $100 worth of stock), a 0.1% fee on bonds, and a 0.005%fee on derivatives. He estimates that this fee will raise the necessary  money with some left over, but nowhere  in the plan does he address the problem of where the already cash-strapped states are going to come up with their share, nor of what happens  if  there is another  recession or a drop in speculation, stock trades, etc.

Sen. Sanders said, “I promise at the end of my first term we won't have more people in jail than in any other country. .But according to the Bureau of Justice Statistics, of the  2.2 million Americans in prison at the end of 2013, only 215,000 inmates, less than 10% were in federal prisons. The rest were in state and local facilities. Even if he freed every prisoner in federal prisons, we would still have 2 million   people in prison.

And  back to taxes:  Many of the tax inequalities in this country are due to  state and local taxes. According to the Institute on Taxation and Economic Policy (ITEP), “On average, the poorest 20 percent of taxpayers nationwide pay more than double the effective tax rate paid by the richest 1 per cent of households (10.9 percent v. 5.4 percent). ITEP’s analysis factors in all major state and local taxes, including personal and corporate income taxes, property taxes, sales and other excise taxes.  And a lot of those taxes are state and local taxes that  affect the poor. Here  in Alabama, the poor pay more than 1½ times as much of their income on state and local taxes than the rich. Alabama also has some of the nation's highest sales tax rates, which disproportionately affects middle - and lower-income earners, and we also pay a tax on groceries.  Yet  Sen. Sanders' plan calls for adding  even more of a tax burden on the middle class.  As he noted in an October 2015 interview with George Stephanopoulos,“If you’re looking at providing paid family and medical leave – which virtually every other major country has – so that when a mom gives birth, she doesn’t have to go back to work in two weeks or if there is an illness in the family, dad or mom can stay home with the kids, that will require a small increase in the payroll tax.”  Right now there are federal  laws being proposed to deal with these issues including the Family And Medical Insurance Leave (FAMILY) Act, which would create a national paid family  and medical  leave insurance program  that would provide up to 12 weeks of partially - paid leave for reasons covered by the FMLA.  Also, more than $2.2 billion proposed in the Department of Labor’s Fiscal Year 2016 budget that would hel p states fund and implement new paid family and medical leave programs, and $35 million proposed for states to create the infrastructure needed to develop new state paid leave programs . Does Sanders propose to build on these policies or scrap them and  start from scratch? How does he  intned to get   Republican governors and state legislators on board, given the opposition they have shown to the Affordable Care Act?

I worry, with so many  Sanders supporters vowing that they  will not support  Clinton if Sanders loses the nomination,  that all the enthusiasm for the “revolution” that Senator Sanders is calling for  will  die down and that his followers will drop out rather than continue to work on passing progressive legislation and in getting  progressives elected to  local and state offices.
 So, yes,  I have a lot of misgivings about Senator Sanders’ proposals, and policies and the  way he has used the  Democratic Party he has scorned as being  part of the establishment responsible for our current   inequities and problems to further his own candidacy without supporting other progressives within the party.  Both candidates have flaws, all politicians do, and no politician is  going to be able to please 100 percent of  his or her constituency  all of the time.  What I wonder about is, do Sanders and his supporters realize that bankers and the 1%  are also part of the fabric of this country with rights and interests.   Their interests shouldn’t outweigh the interests of middle class and poor Americans as they have in the past and do now,  but in order to institute reforms and rein in   the influence of money in politics, compromises will have to be negotiated. In order to accommodate the interests of a diverse populace and best serve the needs of the country as a whole, adversaries with different ideologies will have to work together. Given that Sanders has castigated and alienated the banking industry and the rich to  a large degree, I’m not sure Sanders  is the best candidate to effect those changes, reforms and  compromises.


Friday, March 25, 2016

Look, Ma- red hands! A brand new side effect

Today was unhook day- Mr. G. unhooked me from the  5FU pump and flushed the lines this morning. I wasn't as fatigued as  I normally am and stayed awake most of the day.  I noticed that  the tips of my fingers and thumbs were sore, but didn't think too much about it.  Until I woke up from a  late-afternoon nap with   raging red palms and fingers that felt  sore and swollen- especially  the fingertips. Even soles of my feet were sore, but not  as much as my palms. Evidently I'm getting  all the side effects I've  read about with 5-FU, but thankfully not all at once.  This one is called  palmar-plantar erythrodysesthesia, or hand and foot syndrome.  Sounds  kind of like  hoof and mouth disease, doesn't it? In medical literature, the condition is described as "a cutaneous toxicity that manifests with palmar and plantar erythema, edema, and dysesthesia with varying degrees of pain, scaling, and vesiculation." There are all kinds of theories as to what causes it and who gets it, but  it is supposedly more common in women of advanced age, and I certainly fit that criteria! One of the more promising things I read in the Oncology literature was: "There actually have been some reports of PPE being correlated with improved survival, suggesting that greater exposure to the therapeutic drug, as represented by the PPE, also results in improved outcomes."  Now that would make a fair trade off on the  symptoms if  it turned out to be a strong correlation.

Anyhow, it was quite painful at first and I didn't know if I'd be able to  prepare supper, but Mr. G said he'd step in if needed   so I decided to  go ahead and try. I had already planned to cook some chicken tenders with roasted asparagus, and decided on lemony chicken francese. I think  working with the chicken, which involved a lot of hand washing, actually helped. I'd read that  one should avoid  heat with this condition, so I washed my hands  with cold water.  This is the exact opposite of  dealing with  the neuropathy I had earlier, where you avoid cold. I do think the cold water helped because the pain and  tenderness did seem to subside somewhat, although some tasks, like twisting the little tops on the salt and pepper mills, were painfully difficult. But everything went well, all things considered, and the chicken turned out  quite tender and the lemony sauce with capers was delicious.  It's now  a few hours later and while my hands  still feel a little sore and swollen they  are much improved and I'm hopeful  they'll be back to normal  soon.

So this is a most interesting journey,  quite bumpy at times, but a learning experience for sure.  Although, come  to think of it, it's not exactly the kind of learning experience I would have chosen if I'd actually had a choice.

I hope  the  whole hand  problem will be over by tomorrow.  We're supposed to have a nice day before the rain sets in on Sunday, and there are seedlings that need to be potted up, so I'm hoping to spend a few hours at the potting bench and maybe even get some more weeds pulled in  my jungle of  what was once a garden bed.

Thursday, March 24, 2016

Treatment number four of this round is now history!

Had another  morning in the infusion room yesterday. This was my fourth treatment  on this round.  I have a CT scan scheduled for Monday to see if the tumors  and other liver lesions are regressing, progressing or staying stable. My oncologist  feels pretty confident that the scan will show shrinkage based on the results of my bloodwork, vitals and  general appearance.  I hope she's right. The one glitch is that  she will be out of town all week, so I asked if  it would be possible for me to get the results before she got back.  She said she'd leave  instruction for one of the nurses to call me when the results come in.  I'm hoping she remembered to do that. She knows having to wait for results causes me anxiety and that I  have much less anxiety when I get  bad news than I do having to wait for news, good or bad. I don't know   how we'll proceed, whether there will be more chemo or what- it all depends on what the scan shows.

There was quite a bit of activity  in the chair next to me yesterday. The woman in the chair was there for her second treatment, but her port  was infected, so she needed to get her infusion directly through a vein. Her veins were in such bad shape that it took two nurses to get the infusion started.  The doc came in and told her that if she wanted to delay the treatment for a week that she had no objection, but the  woman said she wanted to go ahead and get it, if possible. The poor woman was supposed to go straight  from the infusion to hospital admitting to begin a course of antibiotics and  have the port removed but when she found out they would keep her overnight for observation she insisted she needed to go home first, which they evidently got worked out to everybody's satisfaction.. She was in pretty good spirits when I left and talking about having a PICC line in place for the next treatment.  I do hope all goes well for her and she's able to finish  her chemo regimen.

I'm doing much better so far  after this treatment, not half as fatigued as usual.  I did crash for a few hours after we got home, but  have been up most of the day today, not doing anything strenuous, but have been able to  check on the greenhouse a few times,  take some pictures of things in bloom and post them to facebook, feed the dogs, and play toss the toy with them. I may even be up to  making supper tonight. The facial flushing has begun, as usual, bu even that isn't too bad, and actually, the red face is  an improvement over the deathly grey  pallor I have n the day of treatment.

When we got home yesterday, poor Victoria went to the brass  container I keep behind the front door to hold their leashes and tried to pull hers out, indicating she wanted to go for a walk.  I felt sorry for her, but just couldn't accommodate, so I'm kind of glad it's been raining today.  She  doesn't like the rain at all, so hasn't made a move to get her leash!

Our  dogwood is almost in full bloom- it looked like a lovely bright cloud on a gray morning. I snapped this just as the rain began to drizzle down.