Mable is still my friend!

I saw my oncologist last week.  No changes in my liver tumors!  Still friends with miss Mable.  I had two interesting things on my scan though. The First was a sub-acute right rib fracture of the eight rib. Now I know where that pain was coming from!  I know when I did it too but not why it fractured.  I bent over to move bucket of water and something "popped" in my ribs.  It hurt like hell and still does. I thought that perhaps I popped a muscle.  My oncologist didn't even mention it.  I saw it when I asked to read the report.  Then I asked him.  It was the very first comment.  I think he only reads the conclusion at the end...  When I did say something, then he asked me if I fell.  I was like "no".  He said it didn't have bearing on my cancer so???

The other interesting (funny) thing of note was a "new globular soft tissue density in the left buttock subcutaneous tissues.  Hahaha.  It could be a Sando shot that didn't go deep enough into the muscle (what a waste of money).  If it get bigger (it's 1.6 cm) then we will know if it is or not.  I did mention my heart palpitations.  He said nothing about the EKG I had.  He seemed clueless unconcerned about that even though carcinoid can cause them.  It really makes me miss my old oncologist.  I'm debating on whether or not to switch centers so I can go back to him.

Not my ribs!  8th rib is the one I fractured!

The next day I had an appointment with my GP (she's an internist) for a prescription refill (I hate having to go into the doctor just to get a refill but some meds require a yearly visit I guess).  I told her about the heart palps, the rib fracture and she was concerned. She was going to pull up my old Holter monitor results and echo cardiogram from 2012.  She wanted me to do the Holter monitor but when I told her I had and how big a pain it was she said she'd "see".  She also said fracturing my rib that way is NOT normal.  Wants me to have a DEXA scan to check my bone density.  I'm getting that on Wednesday.  Hope my bones are ok.

Oh, forgot.  When I got my Sandostatin shot, the needle clogged.  Not once, but twice!  She has to stick me 3 times!!!  I've never, ever had a needle clog.

All-in-all, good news.  Me and Mable will hang out for as long as we can!

4 Years...

I just passed my four year cancer diagnosis.  It kind of just went by without much thought until now.  It's hard to believe its been four years.  I'm feeling pretty good.  I have more pain from my neck than anything.  It is probably time for another injection.  I have been having some rib-area pain that is pretty steady.  It isn't super sharp but it's not a dull pain either.  It's hard to know if this is from the liver surgery or something else.  I was told that some people have pain forever after that type of surgery.  It does come and go and is definitely worse when I sit for long periods of time.

My first surgery was July 2nd, 2012.  Right-hemicolectomy via laporoscopic surgery.  My recovery went well and I was in the hospital for 4-5 days.  I can't remember.  My second surgery was the following February and was a liver resection.  They removed about ten tumors (which left me with about ten small ones).  My remaining rumors have remained fairly stable since.

Next up:  scan on July 20th and i meet with my Oncologist the following week to get results.  He didn't order any blood work but they'll do the basics before i see him.

I will let you know how that goes!

NET Cancer Day is November 10th!

and I get my butt dart!  I mean, my Sandostatin shot.  On NET Cancer Day.  Yeah.  It isn't really a butt dart anymore.  With the new formula, it is a little less painful although I have had more pain after the shot than I was having before.  I don't really think it is the formula though.  I think it is just how it is.  Sometimes it hurts and sometimes it doesn't.

Sorry I have not posted.  I've had "technical" difficulties and have not been able to access this blog.  I'm not sure how I got in tonight.  I just kept trying and it finally popped up.  Weird.

Soooo,  with NET Cancer Day approaching.  I do want to give a shout-out to raising awareness for NET/Carcinoid Cancer.  I really want to start being more or an advocate for us Zebras and help raise awareness of this rare cancer.  I am going to try and do much better with the blogging...

Please check out the Carcinoid Cancer Foundation www.carcinoid.org and if you are on Facebook, they have a zebra striped background that you can overlay onto your profile picture.  It is very cool. I did mine.

I wanted to add that one of my concerns about being "open" about advocating for NET cancer is that my work does not know about my diagnosis.  There are a few people who do but not my boss or the directors that I support.  I also work for an insurance company so it can be a little awkward.  I figured I wouldn't ever say anything until I had to get additional treatment.  I may "come out" but I haven't decided when.

My next scheduled blood work isn't until the first part of January. I have a scan scheduled for the end of January and then meet with my new oncologist the first week in February.

Changing of the Guard

I met with my current oncologist for possibly the last time last week.  He's moving to another center and will be there by next spring (taking some time off apparently).  I have had mixed feelings about him leaving me (not really me but the practice).  I feel somewhat abandoned!  He's the only oncologist I've seen since being diagnosed three years ago.  He sees most of the carcinoid patients in Utah and is very knowledgeable about it.  He's been easy to talk to, supportive, and I don't usually wait very long to see him.  At our last visit, he did tell me that he would be more than happy to see me at his new place, which it Huntsman Cancer Institute.  Recently designated as a Center of Excellence (and it really is). Why wouldn't I want to go there?

The main reason I don't want to go to Huntsman is convenience.  I know that is not a very good reason but with my current work location, I am minutes away from my current cancer clinic.  I can go in after work to get my shot.  I rarely have to leave work early or take time off to go in.  If I were to move my care to Huntsman, I may not have to leave early to go get my shot but the drive home afterwards could be brutal.  It's right by the main Hospital and campus of the University of Utah so you get a lot of traffic after 5pm  One day, I was at the hospital for a work meeting, which ended at 5pm.  It took me TWO hours to get home!  Also, no one at works knows about my cancer (there are a couple of people but not my supervisor) so I don't want to start taking a lot of time off.

What my oncologist and I decided was to wait and see.  Where have we all heard that before!  I told him I'd try another oncologist and see how it went.  I'm going to see the onc. who the president of our support group sees.  I've heard he's good but he gets waaaaaaaaay behind in seeing patients because he spends so much time with each (which can be a good thing).  My first appointment will be in February at 11:30am.  I think I'll take the entire day off just in case!

We also discussed my next scan.  I was surprised to hear him (my onc) say that he is now leaning more towards MRI's for the liver than CT Scans.  WHAT?  Now you say that?  I believe it was last year when I asked about an MRI over CTs.  He said, oh well it's much harder to read an MRI and since you've had CTs, it would be like comparing apples to oranges.  Well yes but they are better for imaging the liver!  One of the things I've always liked about him is that he's willing to let me decide. I decided to go with a CT scan for now.  Since I'll be seeing a new oncologist, we'll have something to compare.  I am getting a triple phase CT.  usually, I just get normal ones (whatever that may be).  I'm planning on asking for MRIs going forward.

If I decide to go to Huntsman, I'll go in August.  He'll have had time to settle in a bit.  I've also said that if I have progression, I would go up there anyway.  They are a research facility and would have more possible clinical trials that I could try to get into.

My blood work was all good!  I don't think my pancreastatin is back yet.  My CgA was 4 (0-5 range). Last time it was 3 so up a point but that is not a big deal.  Normal is normal.

3 years...

I wasn't sure I was going to write anything about my 3 year "Cancerversary."  Yes, I'm happy that I am still here.  I'm not "celebrating" getting a cancer diagnosis although I doubt anyone does.  It is more of a time to pause and reflect on the past 3 years; acknowldge that I am still here and have few issues... 

Part of me can't believe it's been 3 years already!  Where does the time go?  At other times, it seems like I've lived with this ROCK over my head forever. 

Why a Rock? 

We've lost several fellow ZEBRAS recently.  It seems like they are doing well, then have a few issues that quickly accelorate and then they die.  It's like a rock slide.  Everything is smooth sailing hiking and then BAM!  Rock-slide and you are in deep shit doo-doo. 



Here's to 3 more!

Scan results--sort of...

I called my cancer clinic Wednesday to see if they had my scan results. I got a call back a couple of hours later. The twat  twit that returned my call wasn't even the nurse! I think it was one of the front desk girls. While I appreciated the prompt return call, I was taken aback by her inability to tell me much. I am frustrated because she said they didn't compare this scan to my last scan because it was done at a different hospital (did I change insurance?) duh… OK, why couldn't they get my scan when they had NO problem comparing my past mammograms from said hospital? I had my last diagnostic mammo at this same hospital that I had my recent scan. I had my past mammo’s at the hospital I had my last scan (a year ago). It makes no sense to me. Probably not to you now either!

So, getting to the results. it sounds like I actually had “lesions” in my liver disappear! Great news so why am I not happy? This twat twit asked me if a millimeter was bigger than a centimeter! Pre-cancer I wouldn't have known either. I asked her how big are these remaining “lesions?” The only one she commented on was 9 mm, which is pretty small. Last scan they were 1.2 cm or smaller. I had around 10 but even my oncologist said we couldn't be sure what they were. Hmmm, I've had a surgeons hands on/in my liver cutting out what he could, ablating some and leaving the rest so I think we know what they are! Anyhoo, she did say she would put the report on my oncologists desk as he wasn't in the office. OK. I seriously doubt I will hear from him, which is fine. I’m good. I’ll get the report one of these days on MyChart. She did mention that I have a fibroid. Argh. I had one removed a year and a half ago (or so) when I went it for a uterine ablation due to continued/heavy bleeding. It hadn't shown up on my scan nor did it show on ultrasound but my OBGYN said it was about the size of my uterus and most likely causing the bleeding. After removing the fibroid, she tried to do the ablation but couldn't because my uterus was done! It said, “nope, no more hands or machines in there.” It did stop my bleeding so I was ok with that. The twat twit told me I should follow-up with my OBGYN. She said it was near in or on my right ovary. Can a fibroid grow on your ovaries? I thought they were just in your uterus. Guess I’ll Dr Google that one. I’m sad I can’t go back to the OBGYN who did my last procedure (due to job and insurance changing).  She was awesome and I really liked her. I felt more compassion and concern from her than I do from any of my other doctors! I haven’t found another one yet. I’ll just wait and see what the report really says.

A long story for what is basically good news! I’m still not happy.

Now it is Friday. I haven't heard from my oncologist and the report it still not in MyChart. I think I will call the hospital today and ask to get a copy of my scan and the report!

An update:  

A quick update on my scan results. Since I am an impatient patient person, I called the hospital and asked if I could get a copy of my scan and the report. They told me it wouldn't be available until Monday so I canned my cancer clinic and asked them if I could swing by and pick up a copy of the written report. It's closer anyway. I just wasn't feeling very confident after talking to the twat twit from their office regarding said results.

Doesn't sound like any of my "lesions" have disappeared! I still have "multiple, small lesions through all lobes of the liver." They measured 3 of them (she made it sound like I only had 3 and didn't give me the correct measurements either). My last scan said they were all 1.2 centimeters or smaller. The biggest now measure 1.4 x 1.6 centimeters, which is not much growth. The other two mentioned are just shy of a centimeter. Nothing to be worried about with Carcinoid like mine, which is slow growing. I do feel better since reading the results "with my own eyes."

I hope everyone has a lovely 3 day weekend (if you are in the States).

Proposed FDA Regulations of 'Lab Developed Tests': Could Cause Harm to Patients

I received this information in another post from a fellow blogger: Cancer....an unexpected journey

Please, click on the link and sign the petition. Change.org

I don't want to plagiarize Luna's post but I want to say that most NET Cancer patients receive very specialized blood tests that are not "standardized" tests and could potentially not be covered by insurance if this proposed regulation goes into effect.  I receive one that it not considered a "standard" blood test that gets sent to a specialized lab in California (ISI) and there are several more that I could get as well (a few I have had once but have not repeated them yet)...

If you are so inclined, please contact your Congressional Representative and your Senators to let them know that these proposed regulatory measures should not be passed.  You can even email them!
To find your Senators:

http://www.senate.gov/general/contact_information/senators_cfm.cfm

Find your Representative:

http://www.house.gov/representatives/find/

Email President Obama/the White House:

http://www.whitehouse.gov/contact/submit-questions-and-comments

This can affect those with all types of cancer and rare diseases for which standardized testing may not be available.

Speaking of blood tests...

I had my 6 month  tests.  Everything is normal.  My CgA is the same but my pancreastatin has gone up.  It's now at the very top of normal.  (0-135 is the range and mine is 135).  That's a small increase but I'm sure nothing to worry about.

I meet with my oncologist tomorrow.  I have to find out if they really are on my employee's health plan now.  If so, I will switch.  It'll save me some money-I think.  Not much but a little.

Patient Advocates

I received a "tweet" that said I was listed on Listly's list of 300+ patient advocates.

http://list.ly/list/4V0-300-plus-patient-advocates-on-twitter#item_970146?

I'm not really familiar with this list but I'm going to check it out.  I'm #316!  You can follow me on Twitter through the link on that site.  I'll try and add a "twitter" button on my blog too.  I don't tweet much--I'm hardly online anymore after working hours.  I spend most of my day on a computer and the last thing I really want to do at night it spend more time on it!  Of course with smart phones and iPads it not easy to get away from our online "life".

So what is a patient advocate?

Patient advocacy is an area of lay specialization in health care concerned with advocacy for patients, survivors and carers. Typical advocacy activities are: patient rights, matters of privacy, confidentiality or informed consent, patient representation, awareness building, and support and education of patients, survivors and their carers. Patient advocates give a voice to patients, survivors and their carers on health-care related (public) fora, informing the public, the political and regulatory world, health-care providers (hospitals, insurers, pharmaceutical companies etc.), organisations of health-care professionals, the educational world and last but not least the medical and pharmaceutical research communities.

Patient advocacy in its current form finds its origins in the early days of cancer research and treatment, in the 1950s. It's part of the notion of Total Care, a term coined by Sidney Farber, a Harvard physician and cancer researcher, referring to the treatment of children suffering from leukemia where "the cancer clinician treated the family as a whole".[1] The concept of Total Care subordinated clinical investigation to patient welfare ... "clinical investigation in the field of cancer may be carried out only as part of the total care of the patient" (Farber et al.,1956).[2] Cancer patients are usually not in a position to take an assertive stance, and even less so in the 50s; clinicians recruited patients for tests and suspicion reigned at the NIH as researchers had to convince doctors and patients they weren't experimenting on people. In order to properly represent the patients in this medico-legal and ethical discussion patient advocacy came into being as a way to make the voice of the patient heard.[3] http://en.wikipedia.org/wiki/Patient_advocacy

I'm not sure I consider myself a "patient advocate".  I started my blog to keep my friends and family informed on my medical issues and treatment.  Of course, I think most personal cancer blogs start out that way.  I do want to share what I learn along the way and help others.  I'd like to do more but with working full-time, I just don't have the "time" or energy to keep up with everything.

To me, a Patient Advocate is someone who "stands for the patient". Helps them navigate this world we call "cancer".  Lends moral support, medical information and shares treatment experiences.

What is a Patient Advocate to you?

 

Happy New Year!

Happy 2015!

I had one goal for 2014.  I'm not calling it a "resolution" because I had little control over it.  My goal? No major surgery!  Yup.  I made it.  Nothing major in 2014.  Only one minor procedure completely unrelated to cancer.  I'm not sure if I should set any goals for 2015.  I could keep with the same theme and probably be safe.

A few personal milestones in 2014.

• I was laid-off from my job of 3 years after a cancer diagnosis and two surgeries.  This was after my boss told me they would do whatever necessary to support me.  Right.  Lay me off me and take my insurance away unless you sign this "release" that states you won't sue us! Blackmail?  You bet!  Stress?  Nah.  No stress there.
• I got a job after 2 months.  It's a great job.  I like it a lot.  I actually work for an insurance company now.  Ironic?  I think so.  Oh, I also make more money than I did before (but my insurance costs me more and I had to switch around some doctors but not my oncologist).
• Remained stable according to my blood work (last scan was in February, 2014 a few days after I was laid-off my job).  I have not had a scan since. 
• Attended my first Dressage show with my horse Abbie.  We got a second place.  It was a really small show but I was proud of how well she handle the "show" atmosphere.  It was her second show ever.  

Up in 2015: What's next?

• Bloodwork scheduled for next week.  I'm not expecting any changes.  I still feel good with no carcinoid syndrome symptoms.  I do have a lot of headaches but this could be from the Sandostatin or it may be my sinus's.  I'm calling a doctor tomorrow.
• Schedule a scan before July 1st since that's when my insurance deductible kicks in again.  since I've met my deductible, I'd like to get it before I have to reach it again.  I have not (for the first time since diagnosis) met my maximum out-of-pocket.
• Switch insurance to my employee health plan.  My oncologists clinic is now part of our network.  I have no reason not to switch.  I'm very, very excited as this will save me some $$$.
• I'd really like to go to another couple of Dressage shows.  I'm not sure if I can afford it but I'm going to try.
• Go on a sister's trip.  Its been too long!  Even if we keep it domestic.  

Check out the TOP TEN Highlights of the Year for Carcinoid-Neuroendocrine Cancer
from The Carcinoid Foundation website:  https://carcinoid.wordpress.com/2014/12/18/10-highlights-of-the-year-2014-for-the-carcinoid-and-neuroendocrine-tumor-community/

1) Gallium 68 Clinical Studies
2) PRRT Clinical Trials
3) FDA Approves Lanreotide for Gastroenteropancreatic Neuroendocrine Tumors
4) Immunotherapy for NETs
5) Global NET Patient Survey (yes, I took part in this)
6) NET Conferences
7) NET Cancer Day
8) ONCLive Features Series on pancreatic Neuroendocrine Tumors
9) Warner Advocacy Award
10) NETs in the News and on Television (link to the BYU men's basketball coach here in Utah w/PNET.


Here's to a safe and healthy 2015!

Merry Christmas!

I've been trying to write  blog post for the past week but never seem to have the time or energy (or enthusiasm) to do it.  It's not that I don't want to, I just don't feel like getting on a computer at the end of the day after work.  I'm actually typing this today while at work!  Bad...

I wanted to wish everyone a very Merry Christmas!

I have a blood draw in early January to check my CgA and pancreastatin.  It's been six months. Depending on those results, we'll decide whether to do a scan or not.  I don't expect my levels to have changed, or if they have, not by much.  I have no symptoms to speak of.  My one concern is that we know these tumors don't usually spew out their hormones that show up in these tests until it's in your liver (usually, depending on the primary tumor site--lung & ovarian tumors are a few of the exceptions) but what if I have tumors outside my liver?  Do we just not worry about those?  I think not but that's the feeling I get (sometimes) from my oncologist.  He did say once that anything else that shows up is going to be so small so what would you do about it?  Cut it out!

These are just the thoughts that stumble go through my mind.  I meet with him in February.

This isn't turning out to be a very positive Christmas post...

I had a moment.  I wanted to add this fantastic post on CURE magazine by one of my favorite bloggers, Tori Tomalia.  A young mother of 3 with Stage IV lung cancer.

http://www.curetoday.com/community/tori-tomalia/2014/12/recipe-for-living-with-metastatic-cancer


It's the best "recipe" ever!  Thanks Tori!

Blessings all!

2nd "Cancerversary"!

Well, today its been two years since I heard the life-altering news, "you have cancer"!  Wow.  What a ride...

I wasn't even going to post anything more about it. I'm just feeling "blah".  Not really into it nor do I feel like it's a time to celebrate.  I'll never be "cancer-free" again.  I don't know how long I have.  Hopefully years before progression necessitates any intervention.  I've been stable since my liver surgery in Feb. 2013.  16 months.  That is GREAT!  (See, I'm trying to be positive.)

So many have died recently.  One young man, 6 months after diagnosis.  Another 5 years. Another 8 1/2.  Lindsey 3 years.  You just don't know how long you've got.  No one does but we're standing in the middle of the road waiting for that bus to hit.  All I hope for is better treatment options by the time I need something!

Here's to another 2 years with the good quality of life that I have right now!  Here's a "toast" to all those making this journey with me!

Almost Two Years!

Approaching my two year "Cancerversary"...

I can't believe its almost been two years since I was diagnosed with NET cancer (neuroendocrine carcinoma)! My thoughts have been going back to that time and it's funny interesting how everything is "before" diagnosis or "after."  Before surgery #1 or after.  Between Surgery #1 and #2...  you get my drift?

During a very long drive home from my sisters in Southern Utah (fighting the wind all the way), I was thinking about that day, the day after my colonoscopy, when I was walking out of the CT scan room and when ignorance really was "bliss".  I wonder what the technician was thinking?  Was he feeling sorry for me?  I know he saw all the tumors in my liver!  Was he thinking "oh, she's a dead woman walking?"  I probably would have though it had I known then.  I'm sure that most people, with that many tumors, don't have a very good prognosis.  I haven't been back to that particular hospital since that first scan or I would ask him.  He was very nice.  An old "hippie" looking guy (probably not that old).  I remember his kindness, his easy "banter" when he took me back to the room and got me all set- up.  I don't remember being nervous or even worried.  I'd had a CT scan before so I remembered the "wet" feeling when they inject the contrast.  I'd sat in the waiting room for about two hours drinking the iodine contrast and had to pee so bad (I couldn't remember if I was supposed to go), and when he asked if I need to use the restroom before we got started I was like, YES!!!

I just went back and read my very first blog post, which describes that first CT Scan. Made me laugh (a little).  Who knew where I'd be almost two years later... hear I am, still, and grateful to be alive and doing so well.  (I'd still like to know what he was thinking as he walked me out.)

So I'm trying hard to rediscover my "bliss". Maybe not the ignorance part--I'd rather be informed of what is going on but I need some "bliss" to come back in my life.  I keep saying I'm going to start exercising again and I really think it's time to get off the couch and just start doing it!  Yes I am tired, I have no energy but perhaps if I can just get started with something I will feel better!

It'll be two years since "the call that changed my life" on June 18th.  Two years since my first surgery on July 2nd and 16 months since liver surgery on June 21st.  Back in January I stated that my "goal" for 2014 was NO surgery for the year!  So far, so good.

Nurse reveals the top 5 regrets people make on their deathbed -

Karenstan.net recently posted an article (written by a nurse!) that’s resonating with readers everywhere…and especially with me!  I feel I'm one of the lucky ones who have been given some time to find what is most important to me. I think everyone should read this and really think about what is important (to them) in life and what would you regret?  These blew me away!  

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.
This was the most common regret of all. When people realize that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.

2. I wish I didn’t work so hard.
This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings.
Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Manydeveloped illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way,you win.

4. I wish I had stayed in touch with my friends.
Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.
This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again. When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness

- See more at: http://www.karenstan.net/2013/11/11/nurse-reveals-top-5-regrets-people-make-deathbed/#sthash.qhWPOj9s.dpuf

So tired...

I don't know what is going on... I know that most cancer patients deal with fatigue--mainly from chemo and radiation treatment (which I do not get nor have I gotten), but I have been so very tired these past two weeks.  It's almost as bad as when I was on Metropolol for my heart palps (which I quit taking do to the level of fatigue I was experiencing)!  Its almost as bad but I don't feel like my head is in a fish bowl.  Just super fatigued.  It's just a feeling of total exhaustion!

I don't have any scheduled blood draws until July.  I think that if I don't feel any better, I'll call my oncologist's office before my next Sandostatin shot and see if they will check my blood when I come in.  I don't know what else to do. I did tell the nurse at my last visit, how tired I was.  She always asks but doesn't DO anything about it or try too!  I sometimes feel that us "NOIDS" are not taken that seriously.  Someone stated that we're just a "speck" on their calendar!

I am "between" doctors for anything else since my COBRA insurance ran out and my new insurance kicked in but I haven't found a new GP yet.  I'm not going to try and get into someone new for just fatigue (except I did forget about my thyroid and will run out of pills in two more months--sigh).

I do worry that this is my "cancer" growing.  I've read on other blogs that that was the first sign of recurrence or progression--extreme fatigue!  I don't have any other symptoms though.  No new ones anyway!

Compassionate Allowance Info.

If you are diagnosed with Carcinoid Cancer with distant metastases or are inoperable/unresectable or recurrent, you can file for disability.  This site will list the conditions allowed under the CAL (compassionate allowances).

http://www.socialsecurity.gov/compassionateallowances/

Social Security has an obligation to provide benefits quickly to applicants whose medical conditions are so serious that their conditions obviously meet disability standards.

Compassionate Allowances (CAL) are a way of quickly identifying diseases and other medical conditions that invariably qualify under the Listing of Impairments based on minimal objective medical information. Compassionate Allowances allow Social Security to target the most obviously disabled individuals for allowances based on objective medical information that we can obtain quickly. Compassionate Allowances is not a separate program from the Social Security Disability Insurance or Supplemental Security Income programs.
I found my carcinoid cancer listed under the Small Intestinal Cancer.

Small Intestine Cancer - with distant metastases or inoperable, unresectable or recurrent

http://www.ssa.gov/compassionateallowances/conditions.htm

From another blogger:

"I keep copies of all my medical records and took the entire packet to the social security office. This is not required and social security will request all your records. However, I have found that things go much quicker when I do this. I also found the Social Security website very user friendly and the application not very difficult to complete".

I have not filed for disability.  Sometimes I wish I had when I was first diagnosed.  However, I am well enough to continue working and I plan to for as long as I can.  I know that one day I will probably have to file for disability so I try to keep up with the latest info. on how to get it approved quickly.  No one wants to wait months and months to get approved!  I also don't think there is any reason to hire an attorney to do it for you UNLESS you are denied and need to file an appeal!

Just trying to spread the word.  If anyone knows of any other helpful ideas to file and be approved quickly, let me know!  Also, if you know I am mistaken on any of the above, please let me know that too!  I don't want to be giving false information.

Checking in.

Another fellow blogger posted this quote from Atticus about courage:

"knowing you're licked before you begin but you begin anyway and you see it through no matter what. You rarely win, but sometimes you do."

It brings up some serious questions and emotions. My sister was telling me about a co-workers brother-in-law who was diagnosed with stage IV colon cancer and flew to MD Anderson in Houston for some pretty intensive treatment. She was like, why bother? He's going to die anyway. Why put yourself through that? Well, my response to that was (and is) "you don't know what you would do until you are faced with certain death". It really made me pause and wonder... what length will I go to when things get bad? What am I willing to put my body through? Right now, I'd say ANYTHING I have to. I probably won't win but I'm going to do whatever I can to beat this cancer down for as long as I can. Of course, with my cancer, things are not as dire as with most stage IV cancers. Carcinoid/NET Cancer is usually slow growing but it is often diagnosed so late that things can move quickly. Walking with Jane, an excellent website, is one example. Jane died four months after being diagnosed. She had symptoms for 30 years! Sometimes, Carcinoid/NET Cancer is very aggressive and moves quickly. So many different variables that it's hard to explain to people. When they ask me how I am, I say "stable". No growth. Good blood work. I don't think, even then, that they really "get it". Not unless you are a fellow cancer survivor or caregiver.

I do know that I don't want to become a burden to my family. I don't have kids, I don't have a husband. All I have are my two sisters. I don't think it's really fair to expect them to take care of me in my final years/months/days. I don't know where this path is going to lead me. Of course, I could get hit by that proverbial bus next week. Any of us could. I don't live day-to-day. I don't live in-the moment. I try but I just can't. I dream. I hope and pray for good things to come my way. I think that ten years from now there will be better treatments. More successful treatments. I don't pray for a cure. I don't think that will happen anytime soon. I do know that better treatment options for many types of cancer are coming.

On another note, I have a major decision I need to make about my health insurance. I'm now thinking that maybe I should switch to a different carrier. It would require me to see a different oncologist and a different cancer center. An excellent center that does a lot of research and clinical trails, however, they don't have anything specifically for carcinoid/net cancer. There just aren't that many of us. This is the problem. Raising funds for a rare cancer when the more well-known insidious cancers such as breast and colon get more money. Of course, when thousands die each year it creates more awareness than the rare cancers which claim a couple hundred or thousand each year. I've seen one mention of 33 Carcinoid/NET cancer patients die each day. A little over 12,000 a year. Sounds like a lot to me but when you put it with breast or colon, it is a much smaller number. Another under-funded cancer is lung. It's one of the biggest killers and doesn't get the funds because of the stigma associated with it. I'm a huge proponent for lung cancer research. No one deserves cancer--not even if you smoke or smoked. My mom had lung cancer. She smoked but had quit years and years before her diagnosis. She had surgery and treatment. She was a survivor (of the lung cancer but died from metastatic gastrointestinal cancer). Too many are not (survivor's). Too many young people are diagnosed with lung cancer that have never smoked or were casual smokers (again, not that it matters).  So if you wonder why I post about lung cancer, this is why!

I think I have decided to switch my insurance to my employer.  It'll be weird being covered by my own employer but I know the claims processors rarely look at the name.. we're just a number!  I still think they might notice when a $17,000 claim comes in!  Yikes.  Oh well.  They can't discriminate, right?  Hahaha.  I already know how that works.  Sigh.

One month and counting down...

One month until my CT scan!  Seems weird to be counting down to a scan!  I am somewhat regretting my decision to wait 7 months between scans instead of the usual 6 months!  I've said before that this is the longest I've gone between scans since my diagnosis.  Most have been no more than 4 months apart. That was, in part, due to liver surgery and the issue I had after.   See my post from 4/5/2013.

My scan is scheduled for the end of Feb. with my Oncologist appointment the following week.  I have always seen my reports before my doctor (except for my very first scan--I didn't know I could get the written report online).  I've never really felt Scanxiety before but I am feeling it now.  Even though I tell myself that nothing will have changed, this is a slow-growing cancer, I still have that anxiety of all the "what if".  What if they've grown?  What if there are new tumors in my liver? What if they've taken over my liver? What if they are now popping up everywhere?  I know that this is very unlikely.  I will genuinely be surprised if I am not still dancing with Stable Mable!  Even with that said, I am still going to worry.

I will be getting my blood work done next week so if anything is truly amiss, it should show up there.  I don't have to wait long for most of my test results.  Only that damn pancreastatin that takes 3 weeks to get back! That is why I'm getting it so early.  I want the results to be back before I see my doc!

Now I'm throwing another wrench into the "plan".  There is a clinical trial at NIH (National Institute of Health) in Bethesda, MD for the Gallaim 68 Dotatate Pet/CT Scan.  I am not sure that getting the Gallium scan right now would be that helpful (unless there is new stuff going on) but you go back every year for five years for a follow-up scan and this could be VERY helpful.  The Gallium scan is so much better at "seeing" NET tumors than either CT, MRI, or Octreotide Scans are.  It is not approved by the FDA yet so most patients end up paying the costs themselves to get this scan (anywhere from $4,000-$6,000.  This trial is free!  The only thing I would have to pay for is my first flight out and back.  Returning flights are reimbursed. I can stay in-patient and not pay for room or board.

Clinical Trial at NIH

If I'm accepted into the trial, depending on when they would want me there, I will have to have an octreotide scan, CT scan and then the Gallium scan (unless my last octreotide and CT scan is within six weeks and it's been 20 months since my O-scan and you know how long since my CT scan).  That would be a lot of scans and radiation in a very short amount of time.  I think you stay for 3 or 4 days.

I'm gathering my info. to send in to see if they will accept me.  I am not sure I would be able to participate though since I have no money to pay for the initial flight out and back. It's looking like between $500-$1,000 for a round trip ticket. Argh.  I just figure I'll worry about that hurdle after I get accepted.  I don't know if I should talk to my doc about it.  I'm sure he'd be 100% for it since it would save the insurance co. money on my next scan!  I could skip my Feb. scan if they wanted me out there before that -- they will send him all results.  I just honestly don't know what to do.  I would be going alone and that just sounds crappy.  I mean, I wouldn't want to make someone sit around for four days being bored to death while I'm getting scanned. I am the only one who can stay in the hospital.  You can't have anyone stay with you.  It just sounds so lonely though.  Of course, my ex lives nearby so I could always ask him if he wanted to come and see me.  Show me the sites. You can leave the hospital.  You don't have to stay 24 hours a day.

The only thing I don't have is my surgery notes.  I think I can get them from my oncologist.  I know they have EVERYTHING in my file...  I'm going to ask when I go in for my blood draw and shot.  I'll keep you posted.

Vitamin D Toxicity--Question for the Doctor?

I was going to call this post title "Update that really isn't" but then decided to just stick with an interesting question that I had come up today.

I went in yesterday for my butt dart  Sandostatin shot.  This is #19 (but who;s counting, right)?  I had to wait a while for them to call my insurance and get it approved!  I guess they have to do this every year.  At first I was a tad bit miffed.  I thought, why can't they do this BEFORE I come in?  Of course, the main reason would be that  they don't have my chart in front of them until I get there and did I really care if I had to wait a few extra minutes?  Well, NO, I didn't.  I was waiting for the front desk girl to get my scan scheduled anyway so I really was in no hurry.  I had no doubt it would be approved as this is pretty much the only STANDARD OF CARE for Carcinoid Cancer.  The nurse came by and said, we got the OK so I'll mix it up now.  It shouldn't be more than five minutes.  Hmmm.  Isn't is supposed to sit for 15 minutes no matter what???  She came back and got me about five minutes later.  When I was following her back she told me that she had learned a new "trick" on getting it to mix up better/faster.  She said if she breaks up the powder before adding the liquid it mixes more quickly.  OK then.  Guess we'll see.  It was actually a pretty painless shot and I'm not even very sore today.   Maybe it was her new mixing technique or maybe it is just luck.

Other than my blood pressure being high, everything else was ok.  They only weigh me, take my blood pressure and check O2 levels when I go in for my shots.  No blood work is done.

I did ask the nurse to ask Dr. W. about my 3 month tumor marker tests since he did not give me orders for them at our last appointment.  She said that they didn't need any orders.  They could just do whatever I normally have done the next time I come in for my shot.  Hmm. Cool.  The only problem is I am supposed to FAST for one of the blood tests and I usually go in for my shots late in the day.  That was easy to remedy. I rescheduled my shot for 8:30am and they will draw my blood at that time.  I had to run back and ask sweet Evelyn, the MA (medical assistant), to make sure she had a z-tube for me.  She said she'd have to order one (she came and got my chart while I was still waiting for my shot so I know she did follow through).  My biggest concern is that when I get there, they will not know what blood test to do!  I know i can tell them but I'm guessing they would actually need orders from the doctor.  We will see (that seems to be a theme running in today's post).

Getting back to the title of my post today, Vitamin D and possible toxicity?  I read an article today on Livestrong titled 9 Ways to Help Avoid Vitamin D Deficiency:  http://www.livestrong.com/slideshow/1009221-15-ways-vitamin-d-winter/?utm_source=newsletter&utm_medium=email&utm_campaign=0108#slide=10

I have read that Carcinoid patients are often Vit. D deficient.  I believe the causes are from Sandostatin, which can cause malabsorbsion, and from the intestinal surgery and cancer itself.  I've been taking a Vitamin D3 supplement since after my first surgery back in July 2012.  What caught my attention was the slide #10 about supplements.

While vitamin D consumed through food isn't known to cause toxicity, going overboard on supplemental vitamin D can lead to serious complications, such as heart, arterial and kidney problems.

This gave me pause because for the last year my creatinine clearance has steadily declined.  I did ask my oncologist if I should be concerned as he had never mentioned it.  He seemed surprised that is was below normal and thought it would be higher.  He explained how they determine that number (which is an estimate) and said he wasn't worried about it.  I thought I had mentioned this in an earlier post but I couldn't find it so perhaps I didn't.  If I did, sorry for the repeat!  When I read the article and the part about too much vitamin D causing possible kidney problems it made me wonder...  could I be taking too much?  The only way to find out is by a blood test called 25-hydroxy vitamin D test.  I think I am going to request this test.  I have my yearly appointment with my OBGYN tomorrow and she should have me get a thyroid test so I might as well do this one too.  I'm pretty sure she'll be on board with it.  I may ask for the serotonin to be done again too (she did my last one--my oncologist does not test this).

A week ago I got bucked off my horse.  I have not come off a horse in at least 6 years (I can't even remember the last time).  She has never bucked with me like she did this day.  I pretty much decided to bail off because I felt it was only going to get worse.  Luckily, no one else was in the arena and the dirt is fairly deep (but not so soft).  I landed on my right hip and back.  I wasn't hurt (except for my pride) and nothing was broken!  I did end up with a very sore mid-back and hip.  It has been getting better except I am now sore to the touch around my ribs in my back.  I think I probably bruised them.  I'm just glad I didn't break anything and that I didn't hurt my neck!  In fact, it hasn't hurt at all, which is pretty amazing considering how bad it is (degenerative disk disease).

Letter to Veteran's!

On this Veteran's Day, I would like to say "thank you" to all Veterans and their families.  Those who have served and those who are currently serving.  The sacrifices you have made and are currently making for our freedom and safety is appreciated and not forgotten.

I love this country and am proud to be an American!

Thank you,

Sharon Larsen

Name change/blood tests

I don't know if this matters but I changed the name of my blog to: mylifewithcarcinoidcancer.blogspot.com  

I didn't like just having my name up there...  

I had blood work done last Friday.  The cancer clinic actually had my Z-tube for the Pancreastatin test so they did it right there and will send that one out. The only thing I don't like about them doing it is I don't get my results as quickly.  When the hospital lab does it, the results are online usually within a day (for the regular blood work like my liver function tests, CBC, etc.).   When the clinic does it, it may NOT get posted to my personal health record (online with them) for days and days.  I know the tumor marker tests take longer (CgA about a week and Pancreastatin about two weeks), but really, can't you get my other test results up there a little sooner?

I am curious what my WBC (white blood count) and Granulocytes are this time.  WBC was high and granulocytes was low.  My doc did not say anything about it at the time.  If they are still high/low when I see him in November, I'm going to ask...  

Here's wishing/hoping for my markers to remain low!  I'm not sure when I'll get my next scan.  Probably January or February.  This will be the longest I've gone between scans since my diagnosis in June 2012 (my first blog post).