Category Archives: Science

Upcoming

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I met the surgeon Friday. He ran way behind schedule, but he was collaborative and kind. My surgery is scheduled for this Friday, the 11th. I was told to find a front closure support bra that I will wear home from the surgery, which is an outpatient procedure. They will use wire localization to find the titanium piece left from the last biopsy, and then will remove tissue around that the size of a large marble. It may take 90 minutes for this, because they need to x-ray the tissue to see if they’ve gotten enough margin around the chip. If not, they’ll remove more before closing me up.

The follow up visit is set for March 18, and he told me his practice is NOT to give pathology results via phone. But he assured me that there was a 90% chance no cancer would be detected. (Though there had been an 80% chance the stereotactic biopsy wasn’t going to show a problem, but I wasn’t in that group.) He said after we get results, regardless of what they are, I should consult with an oncologist to discuss how to determine my risk and options to reduce it. He also recommended that I talk to a genetic counselor, at least to find out whether it might behoove me to get tested.

I might very well do so. My mother is a breast cancer survivor. Her mother, however, died of breast cancer when she was in her early 50s. And her mother, who lived to her 80s, had breast cancer and ovarian cancer. In fact, I think it was ovarian cancer she died of. I had dismissed my great-grandmother, because one doctor told me years ago that it’s inevitable to die of something when you get old enough, and it wasn’t indicative of a heritable condition. In light of my situation though, I’m now thinking perhaps it is. Three generations of breast cancer — regardless of the age it developed — surely has some significance, at least to me personally.

One of my sisters is worried that if I get the test done and turn out to have a mutation, that this will cause me problems getting insurance coverage later on, if I should change carriers. Fortunately, the Genetic Information Nondiscrimination Act of 2008 (GINA) was passed, which makes it illegal for health insurers and employers to discriminate on the basis of DNA information. You cannot be denied medical coverage based on DNA results. The insurance company may require additional intervention because of it (such as more frequent screenings), but it is not a pre-existing condition. Having a gene mutation does not guarantee an illness will result. So, no worries, sis!

Today

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Today I have my surgical consultation for the discovery of atypical ductal hyperplasia. I’ve been waiting two weeks for this to discuss and schedule it. Up until today I’ve carried on normally, but today I’m as tense as an overstretched rubber band.

I haven’t got more to share, although I do have another letter. Claire continues to practice cutting and was able to cut some of the triangles with assistance. I now present the letter t: tools and triangles!

tools and triangles

Results

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I got a phone call at noon on Thursday with my biopsy results. The news wasn’t the worst, but it’s not the best either. I have Atypical Ductal Hyperplasia. In simplest terms, this means there’s a spot on my breast with too many cells growing in the duct that are taking on suspiciously irregular forms. It’s not cancer, yet. But it’s one stage below Ductal Carcinoma In Situ, also known as DCIS. DCIS is also not considered dire, because it means the cancer is not yet invasive. But neither is a situation in which to sit back and do nothing.

On March 3 I meet with a surgeon, because yet another biopsy is required. This will be an excisional biopsy, I think with general anesthesia; they will remove more tissue for testing. If they find cancer cells, then we proceed from there. If they find nothing, then I will be closely monitored. I plan to ask about taking tamoxifen as a preventive measure. I also plan to seriously consider getting tested for the BRCA1 and BRCA2 gene mutations. (BRCA is a gene known as a tumor supressor. A harmful mutation greatly increases risk.) I believe that having the BRCA1 mutation also puts one at a 20-40% higher risk for ovarian cancer as well. With a family history (my maternal grandmother and my mother had breast cancer), and this condition, I feel like my breasts are a minefield. If carry BRCA1, I’d also consider an oophorectomy (removal of my ovaries).

Lots to consider. Lots of tumultuous feelings.

All That Was Missing Was Incense

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I’ve got to hand it to Palo Alto Medical Foundation. Almost every encounter I have with them is an interaction of efficiency and compassion, from the desk staff to the doctors. Today I had a stereotactic breast biopsy. That’s where you climb onto a table that’s a cross between a massage table and an auto shop lift, and your breast hangs through a hole, and they put a needle in to pull out suspicious tissue for testing. It’s not a Big Deal, but it’s not how I’d prefer to spend an afternoon, either.

But it was more pleasant than I expected. I checked in 15 minutes early as required. I was seen within 5 minutes, whisked back to a changing room, given a terrycloth robe, and told to wait in a little room chock full of magazines. Shortly I was ushered into the biopsy room.

The room was softly lit overhead (not the interrogation lighting common to such places). There was a 24×36″ photo of a sunset on the Marin Headlands to gaze at. And soft, new-agey music provided background ambiance. If there had been hot towels, aromatherapy, and chimes, I might have fallen asleep. (Not really.) The staff were caring. The physician made a point of talking to me before the procedure about what was coming and held my hand while she did so. The nurse periodically put her hand on my back. At one point I even closed my eyes. Aside from a sting when they put the local anesthesia in, and a little bit of tugging, I felt no sensation. They frequently asked how I was doing. I joked that with a three-year-old at home, it was actually a bit nice to lie still for awhile.

It was over in an hour. They were happy with the sample. They got 99% of the calcifications out and put a teeny titanium marker in the spot in case it turns out to be cancerous and they need to go back. It’s all over except for the results, which unfortunately take time. The earliest I will hear about it is next Thursday, the 17th. I’m a little sore and bruised, but it’s nothing compared to other medical interventions I’ve had.

Until then, I simply don’t have enough information, so I’m not traipsing down any “what if” paths. Yes, I’m a little tense about the unknown, but not in a way that’s ruining the present.

A Sea Change

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I wrote the following on October 20, before I got ahold of Geneen Roth’s book, Women Food and God.

I like to eat.
I like to eat sweet, salty, and calorie-dense foods.
I eat when I am not hungry.
I eat when I am bored.
I eat when I feel stressed.
I resist the idea of portion control.
I resist the idea of restricting food.
I resist the method of counting calories or WW points.
I eat whatever I want whenever I want.
I want to eat whatever I want whenever I want.
I resist exercise.
I resist sweating.
I enjoy being lazy.
——-
It feels like too much effort to move my body.
It feels like too much effort to lose weight.
It feels like too much effort to finagle my schedule to get exercise time.
——–
Before I met my husband, I exercised a lot and ate better, in part because I was unhappy and avoided being home alone. Exercise was a way of coping. And I could not afford to buy the kind of food I do now, or indulge as I do now.
——–
I ache most days in my joints. I move slowly. I have little core strength and less limb strength. My ability to balance is decreasing.
———
What does it take to get motivated? Do I get healthy for myself, for my mother, for my daughter? What level of self-loathing underlies all this behavior?
——
Reality: My body does not need a high calorie intake because of a) age and b) activity level. Yet calorie-dense foods are EVERYWHERE.

I read Roth’s book in mid-November, and it really didn’t tell me new information. (I do think it useful for someone without a lot of educational background in psychology.) However, I decided to follow her eating guidelines, as listed below:

The Eating Guidelines

  1. Eat when you are hungry.
  2. Eat sitting down in a calm environment. This does not include the car.
  3. Eat without distractions. Distractions include radio, television, newspapers, books, intense or anxiety-producing conversations or music.
  4. Eat what your body wants.
  5. Eat until you are satisfied.
  6. Eat (with the intention of being) in full view of others.
  7. Eat with enjoyment, gusto and pleasure.

I’ve also been getting on the bike nearly every day for about 30 minutes. It’s boring. I almost loathe it. But about seven minutes into the routine I hit my stride and resistance goes away (though I’m still bored), and by the end I feel really great. It gives me more energy and I feel stronger. I realized, too, that I would often eat in anticipation of future hunger. In other words, I would eat when not hungry before we left the house, because I figured we might not have time to get food while we were out, and I’m cranky when I’m hungry. And I wouldn’t think much about what I ate.

Once I began to pause and really feel what my body felt hungry for, I started choosing more vegetables and fruits and less peanut butter. Though, at times, I have to really pay attention to discern what my body wants versus what my taste buds want. Once I began to focus more on taste and texture, I began to feel satisfied sooner and my portions reduced. I eat sweets (a cookie or two, a bit of toffee) and enjoy the “just right” amount.

So what has happened in the past month? I’ve lost 11 pounds. It feels good. We’ll see if the weight continues to come off. My life feels less fraught with frustration at myself.

My Brain Hurts Sometimes

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Today Claire asked, “What is a symbol?”

I tried to answer. A symbol is a small picture that represents a thing that has a certain meaning. The letter T for the “t” sound, for example. Words are symbols. A red light is a symbol, telling people to make their car stop at it, while a yellow light means to slow down and a green one to go. A logo — like the eagle on the side of the mail truck — is a symbol for the company that is called the U.S. Postal Service. A picture of a heart means love. Candy canes are symbols for Christmas.

Then she asked, “What is the symbol for the universe?”

Wow! I told her there are many symbols — religious ones, scientific ones, artistic ones — but that the universe was sooooooo big that no one symbol can completely show what the universe is or means.

That seemed to satisfy her for that moment. More stuff for that growing brain to think about!

IMG_9497

Spirit

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Back in 2004, when my father-in-law was gravely ill, I happened across a book that I was compelled to buy: The Grace in Dying: How We Are Transformed Spiritually as We Die, by Kathleen D. Singh. I began to read it, and in the introduction the author suggested that if the reader was in the process of dying or reading this because a loved one is dying, to do the following: know that you are safe, all is well, and put the book down.

I took her advice. Four months later my father-in-law died, and I was with him for his last week nearly 24/7. It was a daunting, draining experience. I watched him take his last breath. In the process of his dying, it occurred to me that it seemed much like a labor. And having had a child since, I know it is indeed labor. But what, I wonder, is in the process of happening? Is dying just dying? The lights simply go out? What happens to the entity called “me, myself, or I”; is it really annihilated?

Or is it a transition, a birthing into something else?

I was raised religiously and have traversed a varied spiritual path. In recent years I’ve applied the term “atheist” to myself, though “agnostic” is probably more accurate. I do not need “god” as humans are able to articulate the term; I believe the universe is marvelous, and science is a way to explore it all, and isn’t that miracle enough? I am drawn to Buddhism, particularly Zen Buddhism, although I have not become a practitioner yet.

However, I did have a remarkable experience back in 1996 that at the time, I believed (as much as I could believe, which was really a process of trying to convince myself to believe) was the Holy Spirit. When I left the Christian religion (for the second time in my life), I categorized the experience as an anomaly, as an experience of self-hypnosis or psychological wish fulfillment.

I was a member of a conservative, bible-based, fundamental Christian church. The story behind the path that led me to that after years of atheism can be read here. Anyhow, one Saturday evening I remained after service. It was common for members to remain and pray with each other. This was a church where people sometimes experienced the “baptism of the Holy Spirit,” evidenced sometimes by people speaking in tongues (seeming to babble) and being filled with the Spirit, evidenced by joyous, continuous laughter. Not hysterics, not banshee laughing, just a robust laugh as one would do watching a funny show.

One evening a woman sat on the floor experiencing this laughter. I observed awhile, curious. Another woman came over and asked, “Would you like to join and be filled with the Holy Spirit?” I answered yes, but expressed a worry that it wouldn’t “take.” She said, “Just trust. Let thoughts and worries go and just be with whatever is.”

I sat next to the spirit-filled woman, put my hand on her arm, closed my eyes, and waited. To my wonder, I felt a tingling warmth from her enter my hand and flow up my right arm into my body. Whatever words I summon to describe the experience won’t do it justice, but here goes: As I was filled with this feeling, I felt light, both weightless and incandescent. I began to feel a laugh bubbling up in me. I allowed it to come forth. I sat for however long, bathed in this energy, laughing gently, feeling joy. At the same time, I also felt a part of me was still there, observing. I was not generating or creating this. Nothing was forced by me. At the same time, I did not feel “possessed” or taken over; I still felt I had agency. It was an experience unlike anything I’ve known before or since.

At some point I felt satiated, full, and decided I was done. I removed my hand from the woman’s arm and opened my eyes. I felt new. I felt connected, united with myself and with everything. As I walked, my feet connected in a way that felt like I was the earth and the earth was me. I had a feeling of well-being, life, and love. This feeling remained with me for many hours. After the night’s sleep, it had dissipated. I did not seek this encounter again, and one year later I came to terms that I did not agree with aspects of this church’s dogma and no longer wanted to pretend I did. But I remembered this experience and cherished it awhile.

Then life happened, and the incident faded. Whenever I thought about it, I lumped it in the “I’m not certain what that was but it probably wasn’t real” category. Except… it felt real, and it still resonates like an authentic experience, an encounter with the energy that makes up the universe. While I don’t believe in an anthropomorphic god, I do believe there is something that makes the universe go, something science does not explain completely yet, that it is real, we are made of it, and that we can access a connection with it. (As Carl Sagan said, “We are star stuff.”)

And now I have reopened Kathleen Singh’s book to face the question of dying, of what it’s about and what might follow. The experience I had in 1996 was a glimpse. My hunch is that this connection is possible, is accessible via meditation practice over many years, and that it is our destination at the moment the body dies. As I read her book I will process some of my reactions here.

Round Two

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Poor Claire. She has pneumonia again. This time, besides the antibiotic, we have been prescribed an Albuterol breathing treatment to give via mask every four hours until the follow-up visit on Thursday morning.

Here’s hoping it’s not asthma she is developing…

Husband is sick too with a cold. Where’s the vitamin C?? I should bathe in it.

Art Every Day Month – Day 25

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I wanted contrast and intensity. I had random scraps. This is what came together!

butte - art every day month 09 - day 25

Mesa / 2.5 x 3.5″ collage

I wasn’t sure about the difference between a butte and a mesa, so I looked it up.

A mesa is an isolated, flat-topped hill or mountain with steep sides that is smaller in area than a plateau. A butte is also a flat-topped hill with steep sides, though smaller in area than a mesa. Definitions of the surface areas of mesas and buttes vary. One source states that a mesa has a surface area of less than 4 square miles (10 square kilometers), while a butte has a surface area less than 11,250 square feet (1,000 square meters). Another source states that the surface area of a mesa is larger than 1 square mile (2.59 square kilometers); the surface area of a butte is smaller than that dimension. Some simply define a mesa as a landform that is wider than it is high and a butte as one that is higher than it is wide.

—Science Clarified

There’s your science factoid for the day.

Open The Heavens

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I’m excited. The rains are coming.

Now, you have to live in California to appreciate my enthusiasm. The weather is subtle here. When I speak of rains, I don’t mean the hair-raising, eardrum-splitting drama of a Texas thunderstorm. (Oh, how I miss those!) Even my hometown, Syracuse, is capable of stormy antics. No, the rains here are often mists or light drizzles, though it has been known to pour heavily and steadily here (spring of 2006 was an example). Rare is the thunderstorm here. About a month ago there was a thunderstorm in the middle of the night, the first in perhaps a year — nothing to write about, but still one that woke me — and it generated many comments on among my Facebook and Twitter companions. It was kind of pathetic, and therefore funny.

Here the earth receives no precipitation of substance for about six months each year during the hottest season. The ground shrivels and shrinks up like an O-cello sponge that escaped its packaging. Claire would not nap today, not even in my arms, so I took a long country ramble. As I drove through the hills, I noticed the boar-bristle landscape, the grass stiff and scratchy and looking as though it ached for rain. The stoic trees clutched their leaves, desperate for the the cleansing shower of drops. The air was a gauze curtain of dust and smog. We are parched and poised. And on Tuesday, the meteorologists say, we will be drenched and quenched.

From Weather Underground:

Heavy rain and potentially high winds expected to accompany a significant storm expected to hit late Monday into early Wednesday of next week…

A potent storm system… especially for October… will move into central and northern California beginning late Monday and continuing through Wednesday morning. This will be a very dramatic change from the typical late Summer pattern the area has been experiencing. The origins of this storm Stem from a western Pacific typhoon named Melor that hit Japan a few days ago.

Rain and increasing wind will begin in the North Bay Monday afternoon… spreading south Monday night. Tuesday and Tuesday night should see the heaviest rainfall and the strongest winds. Rainfall amounts could reach 1 to 3 inches along the coast and in the valleys. In the hills… rainfall amounts will range from 2 to 4 inches in the North Bay… with 3 to 6 inches in the Santa Cruz and northern Santa Lucia Range near Big Sur. Local amounts up to 8 to 10 inches are possible in the Santa Cruz and Santa Lucia Range. Winds Tuesday and Tuesday night will increase to 20 to 40 mph along the coast and in the hills. Gusts to 60 mph are possible in these areas. Strong southerly winds may develop in the northern Salinas valley and southern Santa Clara valleys with this storm.

Potential impacts from this storm system include:

  • possible mud and debris flows from burn scars from last Summer and this Summer. Persons living near these areas should pay close attention to updated forecasts.
  • Urban and Small Stream flooding and ponding on roadways and underpasses.
  • High winds that can down trees and thus power lines producing power outages.
  • Hazardous driving conditions due to very slippery Road conditions from a buildup of oil over the Summer and debris such as leaves accumulating on the roads.

If you want me, you’ll find me inside with my face pressed up against the window, tracking the raindrops as they wander down the window and watching the trees dance. If Claire is over her cold, you’ll probably find us outside in rain gear pouncing on puddles. The crumpled hills will soon turn emerald green. W00t!!

rain on leaves

The Joy of Discovery

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Today we took Claire to the Children’s Discovery Museum, and she had a grand time. She played with water, climbed ramps, painted, crawled, turned things over, looked in mirrors, climbed inside boxes, danced, painted her face, and generally filled her brain through all her senses. We bought a family membership, and we’ll be going frequently from now on, especially with rainy season coming.

Claire likes to play the beep-beep nose game (sometimes Mommy just needs to have her nose beeped). She’s getting more vocal about things she doesn’t want; “Mommy won’t make that noise!” She named her stuffed doggie animals (previously known as black doggy and brown doggy) “Pepper” and “Puff” respectively. Everything is mommy, daddy, and baby: buses, pieces of food, stuffed animal toys, cutlery. She needs everything to be in threes like that. She sings many songs, some of which she hasn’t heard in months (the persistence of memory!) and often is nearly on-key.

Claire is two weeks away from turning two, and it’s been an amazing journey so far. I’ll be posting more in the future about the fun projects we do and the resources and ideas I discover on the way.

at 23 months (in 4 days)

Do The Right Thing

It’s Earth Day. One of our kitchen fluorescent tube lights burned out and we have to dispose of it. After some Googling, I found this information for California:

A fluorescent light tube in your dumpster is a violation of the hazardous waste laws. Violation of these laws can result in large fines and criminal prosecution.

Fluorescent tubes contain mercury and become hazardous wastes when they no longer work. Mercury poses especially serious hazards to pregnant women and small children. Non-working tubes must be recycled by an authorized recycling firm and cannot be discarded in the trash.

Fluorescent tubes and bulbs may be managed as universal wastes under Title 22, Chapter 23 of the California Code of Regulations. This allows those who wish to discard their fluorescent tubes and lamps to do so more easily than if they were managed as hazardous wastes.

Although spent fluorescent lights can not go into the trash, there are several options for getting them to an environmentally safe and responsible recycler.

For residential disposal, you can do the following:

Find a partner in the Take-It-Back Program and drop it off (such as Orchard Supply Hardware).

Find the local Household Hazardous Waste Facility to take fluorescent tubes
and bulbs along with other universal wastes — search Earth911 or the Department of Toxic Substances Control.

This and more information for California is in this PDF.

Finally

Husband and I are about to watch the very last episode of Battlestar Galactica. I saw a headline that said it was immersion therapy for the post 9/11 world. It’s a dark series, but it has richly developed characters and is intensely interesting. I’m eager to know how they resolve all this. I’ve never been much of a sci-fi fan, but this series encompasses so much more than what people might think when they consider the genre.