Wednesday, December 15, 2010

Oh what a pain

Hi Everyone

We are up in Canada now, going to Williams Lake to spend a few days with my parents.

We are then going to look at a few communities that need doctors. Chase and Clearwater.

It is great to have a lot to chose from, since there are so many variables that enter into the decision of which job and which town do we want to go to. In British Columbia they have made an effort to define the level of isolation and from that they have determined income levels as well as benefits etc.

The distance from which the nearest specialist, how far north, population of town, number of doctors in each town, are all factors that play into the division. It seems as though we totally have our choice of living anywhere in the province we want, as there are jobs for doctors everywhere. It is so much the opposite from the situation in Oregon, where it seems that Bandon was the only place we could work. Ken is doing urgent care clinics now, but does not see that as a long term career, as the shifts are very long and he has to see a lot of patients in that time, never really getting to know anyone. Most of these jobs in BC would involve hospital privilages, something else that we can not get in Oregon. The physicians who practice in more isolated communities are compensated with special stipends and those who move there have their moving expenses covered.

In deciding where to go we have made a list of criteria. We do not want to be more than a couple of hours from a major medical center, which in BC are Kelowna, Kamloops and Vancouver. My reason for this is that should the bleeding ever become a major problem, OR if I ever have a bowel obstruction, which they told me I have a 35% chance of, I want to be in a larger hospital. Any kind of abdominal surgery on someone who has had radiation to the abdomen would be high risk surgery.

We want to be in a gardening zone 5 or higher, since this is the zone that Eliot Coleman grows throughout the winter in in Maine.

We want to be somewhere we can eventually be able to afford a small acreage, which rules out any urban areas.

We do not want to be on too much ER call, which rules out very small towns.

So you can see we are sort of going around in circles.

Some of our wish list things are mutually exclusive. So you see what happens when you have too much choice. We ARE doing our interviews on Wednesday and Thursday of this week. Obviously compromizes are going to be required.

I really feel that I am starting to get a handle on my radiation injury issues.

The sucralfate seems to keep the bleeding to a minimum most days. Some days I bleed a lot, but then I have to remind myself that there has been no bleeding for several days.

I saw a new primary care doctor a few weeks ago. The gastroenterologist suggested her...... I think he was tired of me trying to find a solution for a problem he had none for. The sucralfate enemas were my idea. Anyways, it was really an incredible visit. First of all, she had experience with radiation bowel issues.

I explained to her that I am starting to find ways to deal with my problems and explained as I have here about the low dose percoset. To my surprize she said that that is exactley what she would do if in my situation. Rather than limit oneself to an extremely unhealthy diet to control the pain........

She said that she had other women who, like me, had had gynecological cancers and subsequently developed radiation enteritis. She said that what I needed to accept was that there were no “cures” and that to a certain extent, I would just find ways to “control” the problem. She said there would be times when it is bad and times when it is better. She said that there are a number of things to try, in an attempt to control it..

First off she asked if I had tried a lactose free diet, I said that I had not, but had contemplated it. There really IS something about something being suggested by a doctor. :)

Radiation, as it causes injury to the bowels, can also damage the cells that secrete lactase, the enzyme that breaks down lactose. If the lactase is not secreted, then when you drink milk or eat milk products, the protein lastose (from milk) does not get broken down, and in essence it just rots in the gut, causing gas, diarhea and abdominal bloating. Her suggestion was to try for a week to go with no milk products and then to gradually reintroduce them to determine my tolerance level.

Although this did not help my pain, it did seem to help the continuous gas, and I do feel better without the milk. I went back to my Barbara Kingsolver book (animal vegetable miracle) and she explains (as a lactose intoleree herself) that while milk icecream and yoghurt are the worst, as you get into the cheeses you will find less and less lactose as the cheeses get older or harder.

Apparently all asians are lactose intolerant as well as 50% of african americans, and also people in general become more intolerant with age.

Most people are “relative” lactose intolerant in that they can tolerate small amounts. I gather than that is likely me in that the entire part of the bowel that secretes lactase is not likely affected, more likely a portion of it. She also explains that the softer cheeses are also the hardest ones to tolerate. Apparently the fermentation process is what breaks down a lot of the lactose during the process of cheese making. However in the manufactoring of the soft cheeses, to speed up the process, they actually illiminate the fermentation process and just add the acid(the other part of the process).

So soft cheeses purchased from the large manufacturors are often not tolerated HOWEVER, I have just bought all the stuff required to make my own mozzerella cheese and plan to attempt to make my own, and use the fermentation process.

To go with my morning latte I have been experimenting with all of the alternatives to milk, soy, rice milk, and more recently HEMP MILK.... it was terrible.

Well this brings me to Wednesday morning and we are heading off from Williams Lake to Clearwater this morning.

I will keep you posted.

much love

Janet Bates

jankenb @

Tuesday, November 30, 2010

radio show tonite

Hi everyone
Ken and Mark and I are playing live on a radio show tonite at 8 pm
Here is the link, the show is streaming.


Thursday, November 25, 2010

and them bones...

Well while I am at it, I might as well explain the rest.
A week ago I was up at OHSU at the osteoporosis clinic. A year ago it was suggested that I go on treatment for osteoporosis because my left hip was osteoporotic (or .1 points away from it).
I did not go on treatments because that was around the same time that all of my gastrointestinal problems began. I have taken calcium and Vit d though.
My other hip and the other bones tested were fine. I truly feel that this was a result of radiation, because I have been a long distance runner for years, I have done all the right things...... well that does not always work. Irregardless, I do not wish to have a broken hip before I turn 60, so will do the treatment.
At the clinic he said I had a 5 percent risk of a pathologic fracture in the next 10 years. He also suggested that he would not suggest I receive the oral form of treatment with all the problems I have had. There is a new treatment that is given once a year intravenously, and that is likely what I will do. The really important thing with this treatment is to have your Vitamin d blood levels normal. I had a test of my vit d levels and it was low. Hard to believe since I have been taking supplements for a year. He said it was extremely common in Oregon, I guess because of the lack of sunshine. I do feel I "partook" in as much sunshine as I could last summer.
The other thing I learned from him, is that since I am on a medication that changes the PH of the stomach (ie makes it less acidic) regular calcium (calcium carbonate)
was not well absorbed.
He said though that for people who are on any meds that change the ph of the stomach, that they should be on calcium "citrate". It is much better absorbed in any ph. It can be found at any pharmacy.
So I am not on Vit D 2000 units to raise my levels prior to the infusion. Many people are fearful of the osteonecrosis of the jaw, which has occurred on these meds.
I have recently been listening to medical lectures on CDs and it was explained that this only occurred in people who had had a dental extraction.
So it is likely a good idea to have your teeth checked prior to starting treatment to make sure you are not going to need a tooth extracted.
We have sub freezing weather now here in Eugene and my "hoop house" or "high tunnel" is keep cozy and warm..... well 34 degrees or higher, with no other form of heat.
The day before the big freeze I went out and cut off all my pepper plants at the base of the stem, cut off all the leaves and I have all the peppers in vases, ripening on the plants.
Apparently they will ripen faster if they are kept above 60 degrees, and slower at 50-60.
Below that nothing will happen and above 60-70 they will dry out.
So I have one vase in the garage, one in the back bedroom and one in the greenhouse, all different temperatures, so that they will ripen at different times. Apparently it works best if they are still on the plant. I had no idea how many peppers I had, until I "harvested" them.

One thing I have learned this year about tomatoes and peppers. In the spring, planting the seedlings I had grown in the greenhouse, the tomatoes were much more hardy.
The weather really had to be warm before the pepper seedlings would survive. However it seems as though the fall is the entire opposite. The tomato plants really started to suffer a month ago, whereas the pepper plants almost seemed to get stronger with the cooler weather.
We are still eating out of the garden, I harvested all of my carrots a few days ago and we had carrot soup, there was a very small crop of carrots.
Today we are having pumpkin cake for dessert, I had taken all our pumpkins and roasted them and pureed the pulp and froze it, and make a cake with it yesterday. The last of our potatoes we will also have today, did not get lot of potatoes this year either.
We still have tons of tomatoes ripening in boxes etc, but not sure how long that is going to last, I will have to go back on this blog to see when we started eating tomatoes, but it would be nice to be able to say we ate fresh tomatoes from our garden for 6 months.
Happy Thanksgiving to all, despite all my grumbling, we do have much to be thankful for, and we will remember that today
jankenb @

Wednesday, November 24, 2010

home is where the garden is

Hi Everyone
I have not posted for awhile, hard to summarize all that is going on. We have this little poster in our bathroom that lists lifes little instructions, and one of them is "don't expect life to be fair".
Some days we just feel that everything is just going against us.

Owning 2 homes is an extremely expensive endeavor and clearly a mistake we made while I was on radiation. With me unable to work, and Ken options limited right now as well, we are heading further and further in debt. We have had a little more interest in our Bandon house, but clearly no offers. In fact building that house was clearly a mistake given the market. It will never sell for even a fraction of what it cost us. AND then we bought a house in Eugene.
I am sure that there are many people in much worse situations, but this is not at all how we had planned it.
On top of it all, I have just found out that I cannot get malpractice because I did not take out tail insurance when I gave up my insurance in feb 2009. I had not seen a patient out side the hospital in about a year, and the hospital insurance covered me there, and neither Ken nor I had any idea what tail insurance was.
In Canada malpractice insurance covers you for the period you pay for it, so if you are covered on june 1999 and in 2005 you get a lawsuit against you, you are covered because you had insurance then.
In the US, turns out that you are only covered as long as you continue to pay for insurance. Feb 2009 I was diagnosed with cancer and did not understand any of this, so cancelled my insurance for outside the hospital. Ken had done the same when he started at hospital
Well it turns out that insurance companies will not cover you if you have had a break in your insurance.
The work we have been doing has been covered under other people, ie Ken is covered at the university and is considered a locum at the urgent care clinic, but this is quite limited (he is only allowed to work 30 shifts a year)
Ken would likely be insurable because for him it has been over 5 years since he worked private practice.
Anyways, we are in this dreadful financial situation that really requires us both to work, and so we are looking elsewhere for work, and in fact looking north. (our medical insurance for the two of us is 1250 a month)
We also both have aging parents whom we want to spend more time with, as well as children whom we (for some ODD reason) find we really miss and wish to be closer to.
That all combined with the thoughts that we just could not stomach another election with Sarah Palin...... as well as many other reasons...
We are looking for work in Canada. British Columbia to be exact.
They are very short of doctors, and it seems like that is pretty much everywhere.
They are very short of primary care doctors in the US as well....

SO of course when you soul search and make a decision like this OF COURSE SOMETHING happens. After a day talking to recruiters last week, Ken came home and said that at the urgent care clinic he works at, they thought that they would look at hiring me to work there as well.
THAT FIGURES. So I met with them yesterday.. we will see.

Medically, a lot has happened. The hyperbarics only really worked for awhile and within a week I was bleeding as much as before, so of course I went back to the books.
The truth of the matter is that there is no one treatment for radiation proctitis that has been studied enough to recommend clearly.
So all these other treatments, hyperbarics, argon plasma treatments, etc are all treatments that have shown promise, but they need a really big study to be able to say that they work!
One fairly inexpensive treatment, with no side effects if the use of sucralfate enemas. I got the gastroenterologist to order them, he made sure to tell me he had never done it.
The enemas have to be prepared at a compounding pharmacy, because sucralfate exists as an oral formulation in the US, but not in an enema form.
Sucralfate is currently used when a person has a bleeding ulcer, they take it orally. It is felt to provide protection to open wounds, in fact it is being used also to treat chronic skin wounds.
So it makes sense for my kind of wounds, only mine are on the inside, hence the enemas.
It is 20ccs given twice a day, and I actually purchased the studies( which were all done in other countries) to get the details of how to do this. They suggest to lie on the left side for up to 30 minutes following each treatment.

The really great thing is that after only 2-3 days on treatments the bleeding was appreciably better, and after a week, it is still improving. I will continue for a month and then reassess the situation.
I am very hopeful about this new treatment, and feel that it is largely ignored in the US. I have read everything about it at pubmed which is where published articles are kept, and can find no downside, and only upsides. I just do not understand why it has not be adopted in the US. I do feel it is just wrong to ignore this problem, from everything I have read it only gets worse.

In case anyone is interested, I use 20 mls of a 10 % solution twice daily for a month. After a month if there is still bleeding it is suggested to do it for another month. Some people take up to 3 months, but the studies showed that up to 3 years later there was no signs of the bleeding returning.

I have just had a ct scan of chest abdomen and pelvis and it was essentially normal, the mass is still there in the pelvis, but it has not changed at all. A recent CA 125 was 8, which is great.

The other really great thing is that I have been doing really well with running. I have been running every second day for about 2.5 miles, for the past 8 days. So I have a great start on returning to that.
Well for the first time in 13 years, we are looking forward to celebrating thanksgiving. If nothing else we feel that we have options, and many people do not.
One of the girls on the hystersister cancer forum died yesterday (I have followed this forum for the past year and a half). Truly is sad what this cancer does to the lives of so many people.

Bye for now

jankenb @

Friday, November 5, 2010


Hi Everyone

On our way to Bandon for the hair appointment I made 6 months ago, really my first hair cut in almost 2 years. I have cut my bangs a few times.

Not to brag or anything, but it is extremely thick, so thick it is really hard to do anything with, so am looking forward to some thinning. A life of wishing I had curly hair has left me somewhat dissappointed now that I have it.

Who would have known that the curls would not go the way you want them to go???

I guess it is one of those grass is always greener things.

Halloween came and went and for the first time in 25 years, I gave out candy.

For the previous 24 we have lived in places too remote for children to wander down our driveways.

I have to say I felt badly stuffing such junk in those tiny buckets. My only defence would be that they have years to get their cholesteral and weight issues sorted out. (unlike me)

A friend was horrified when I announced that I did not believe in Halloween. Blasphemous !!!!

My arguments are that first of all, like every other holiday people go out and buy a bunch of costumes made of non biodegradable fabrics, use once, then throw away.

The amount of plastics that go into all the yard decorations is appalling. The exposing small children to high doses of high fructose corn syrup is shameful as well. BUT the biggest think is the waste of all them pumpkins. Chopped up and left to rot. ..... and what about the children in biafra (to use one of my mothers comments when I did not eat my veggies)

Pumpkins are supposed to be one of those great for you foods, with supposed anti cancer properties.

I had lunch yesterday with a few people who are interested in my becoming a medical director for possibly a couple of nursing homes, so am hopeful that I might just have a job.

Today went to see Gastroenterologist basically in follow up of the gastroscopy I had in September. I was happy to report that changing the meds to Protonix totally cleared up my reflux symptoms ( I had been on omeprazole and ranitidine) I guess I really did not think that the meds were that different.

I also had to report that the bleeding is back as heavy as it was before, and that I was interested in perhaps having the argon laser treatments. He was much more cautious this time than previously. He said that unless I was having symptoms from the blood loss, such as tiredness or shortness of breath, that to do procedure would/ could be high risk of causing new problems.

Despite the fact that ongoing rectal bleeding is troubling, that it would be more troubling to have a complication of the procedure. I guess this is where I was at before in many ways. So will wait and see.

I am due for followup CT scan of the area behind the rectum where there is a mass, so will first of all see what this shows.

I will be seeing my gyne/oncology on thursday, I was due for my 4 monthly exam, and I have developed a vaginal discharge. Well it is more just water.

In the mornings, I have basic water draining from vagina. Not the rest of the day.

Of course as is per usual, I have gone to the books to see what this could be. Although I will first see doctor, the thing I am worried that this can be is a vesicovaginal fistula, or a urethrovaginal fistula.

What that means is an opening between two organs, in this case, the bladder and the vagina, or the urethra (the tube that goes between the bladder to the outside).

Usually these problems form after a hysterectomy when the bladder gets accidently cut, a tract forms so that the urine goes directly from the bladder through vagina. The form that goes from the urethra to the bladder, is also caused from the surgery.

In developing countries these problems are usually caused during childbirth, because csections are more rare, and women are more likely to have long contracted labours, and the pressure from the head on the urethra or the bladder causes lack of blood supply to the area trapped, and an opening forms. In developed countries the more likely cause is from hysterectomy, and usually occurs within a few days of the surgery.

Radiation to the pelvis is another cause of this problem, and can occur anywheres from a few months to many years after radiation.

The bladder sits in front of the uterus after a hysterectomy, and if the opening is from the bladder to the vagina, depending on size of fistula (or opening), the women can either experience a continuous flow of urine from the bladder to the vagina, if it is the urethra, it is more “positional”.

I guess I am wondering if perhaps the reason i am only having this in the mornings is that during the night the bladder being on top of the vagina, it tends to drain that way, but in the day more the normal way.

One of the ways they diagnose this is by injected methylene blue into the bladder and then on vag exam looking to see if there is anything blue there.

I have no idea if this is what is causing my problem, but thought it was kind of interesting, and for those who read this for the medical stuff.... there you have it.

OK so I did not finish the blog ( did not have internet coverage)
So now am back in Eugene, have had hair do and saw my gyne oncologist yesterday.
She did not think it looked like a cancer had returned, and did not think it looked like urine was leaking into the vagina.
She said that the vagina was extremely inflamed though, and that perhaps the discharge was what we call in medicine, a transudate. That is when an area is very inflamed like perhaps a burn and it "leaks" watery fluid. There is no sign of any infection.
So she suggested that I take some pyridium ( a medication used as a bladder analgesic in patients with painful bladder infections), but pyridium also turns urine bright orange.
She suggested I take pyridium, and put tampon in vagina, and once the urine turns orange, remove the tampon and see what colour the discharge is then.
Well I did this..... and had so much pain putting it in, and then had to take a pain killer to take it out , it was excruciating to get it out. However the discharge did not turn orange like the urine, so despite the pain, I WAS able to show that it was not urine, and so the discharge was definitely coming from the inflamed tissues.
She said that she did not know what was causing and did not know how to treat it...period!

Bear in mind that she has no experience with hyperbarics, in fact, there is much that is not known about hyperbarics. SOOOOO my take on this is that the entire vagina is totally scarred down from the radiation. Radiation causes damage to the tissues by interrupting the blood supply.
Hyperbarics encourage the growth of new blood vessels in areas of inadequate blood supply, so my guess is that this is all a result of hyperbarics.. The question remains is whether it is good or bad. Is it attempting to heal the vaginal walls?????
I guess I do not know. So I have to figure out what to do next, will likely just wait and see for awhile to see if perhaps it might heal on its own.

BTW I ran 2 miles last week, and it went really well, so am going to try to get that going again.
jankenb @

Friday, October 29, 2010

my winter garden

Hi everyone
I finished my hyperbaric treatments on Monday of this week, and am doing pretty well.
The bleeding is still present but much less that before, from approx 1/4 cup a day down to about a teaspoon. Sorry, somewhat graphic.....
I am pretty much back to almost a normal diet. I just have to limit the amounts of certain things.... other wise I have more pain.
The testing that was done for Lynch Syndrome was negative, ie my cancer tissue did not show signs of lack of mismatch repair. I did end up doing a lot of reading about Lynch syndrome and they say that only 5% of families likely to have this genetic predisposition for cancer, have been diagnosed. So if you have any family members with an early colon cancer, (ie under 50 years old) OR an early endometrial cancer (under 50), you may want to look into this, it clearly could be life saving for some.
From the photos you can see how my winter garden is coming along. About 6 weeks ago I started several veggies in the greenhouse in flats, mustard greens, spinach, Kale, broccoli, cabbage...
Ken recently finished the high tunnel, and this week we got the plastic in the mail to cover it with, so I have planted all my seedlings in the high tunnel.
For colder weather it will essentially have two layers of plastic (ie when the temp drops down below freezing), and when it is above freezing it will only be one layer.
From the pics you can see that the entire thing is covered with plastic, and then we have also covered the raised beds with plastic, and I will keep the plastic off the raised beds unless it gets really cold. (we figure that this high tunnel cost about 150 bucks to build)
The plants all seem to be doing well inside, despite the plants outside starting the frump now.
I chose the 10 best basil plants and transplanted them into pots and have them in the greenhouse. I also have moved some of my tomato plants that were in pots into the greenhouse. The other 70 plants I have harvested the green tomatoes and they are in boxes in the dark, ....ripening.... I hope.
I have harvested all the pumpkins and made pumpkin puree and dried the seeds. I have made fruit leather from the puree. I have read that pumpkin has anti prostate properties. Not that I have a prostate, but there is one in the house.....

I am seeing the gastroenterologist next week, I had hoped to tell him that bleeding was stopped, because he was so doubtful of the hyperbarics, but not so.
I am so fed up with all of this, I am contemplating getting the laser treatments to stop the bleeding completely if this does not go away.
Anyways, have a great day...
jankenb @

Saturday, October 16, 2010

6 more treatments to go

Hi Everyone
Have completed 3 weeks of hyperbarics and it has been very hectic, as for the last while I have been driving back and forth each day. I have 6 more treatments and I have to say that I do believe they are doing something. There is this fear of saying they are working for fear of jinxing the whole thing, but the bleeding has been MUCH less for the past week.
PLUS I have been walking long distances and it does not seem to have had an effect on the bleeding.
I am pretty much healed up from my surgery, the left breast is still quite sore, but surgeon said it would likely take longer to heal as the surgery had been much more intensive getting the ruptured implant out.
I just found out yesterday that though peace health had decided to hire me, but it was based on me getting hospital privileges, and though the credentials committee voted in favour of that, the medical executive committee would not allow me to apply for privileges.(because of my board certification status)
So was quite disappointed, however at a conference Ken and I were at last weekend, at least 4 different "entities" expressed an interest in me working for them. From a hospice director in Portland to a doctor asking me about joining his group, 2 nursing homes.... so I do have some options.

The genetic counsellor has requested that the pathologist reexamine my cancer tissues for evidence of "mismatch repair" MMR, which is the first step in determining whether I have the gene (or rather LACK OF) which causes Lynch Syndrome. I should be getting the results of that back on Monday and from there if that were positive, I would go on to genetic testing.
There are 4 subtypes of the mutation and so the first person in a family tested, they determine which subtype it is, and then offer testing the remainder of the family, for just that subtype.
So I will keep you posted.
I have canned about 30 jars of tomato sauce (got the recipe from the Barbara Kingsolver book "animal vegetable miracle"), as well as about 20 jars of other things.
I hope to can another 10 jars tomorrow of the tomatoes.
By for now
jankenb @

Wednesday, September 29, 2010

hyperbaric 2.5

Hi there

I have completed 3 of my “new” hyperbaric treatments. They are at 2.5 atmospheres and as such are about 15 minutes longer than the previous ones, for 2 reasons.

It takes longer to get to the higher pressure and down from it, and there is that 10 minute break where you breath air from a mask, this is 10 minutes in the chamber that does not count towards your 90 minutes. Because I am looking at possibly starting work again, I decided to listen to medical education tapes instead of movies, today I watched a movie. I think I might like the tapes better.

Since the treatments are in Portland we are having to do some “commuting”. Ken was off the first 3 days of this week, so we have been there together, and are driving back to Eugene now and I will drive back alone for treatment tomorrow afternoon, stay overnight and have a treatment early Friday and drive back to Eugene.

Ken and I are having a great time with long walks etc. Very odd thing happened on Monday afternoon we took dogs for a walk and I was wearing hiking boots I have had for years (they were away in a box, I just found whilst moving). We got about a mile down the road and all of a sudden one boot just litteraly fell apart, weirdest thing I have ever seen the rubber just seemed to all of a sudden disintigrate. So we turned around and headed back to the van and half way there the other shoe fell apart. So it was off to the shoe store as I only took one pair.
Yesterday we climbed up to the top of the multnomah falls, quite a hike. Then we went to Mcmennamins Edgemont winery where they were just crushing the first grapes of the season (merlot grapes in fact). They really were stomping them down. We tried all their wines and loved them all.

This Mcmennamins is a very large property that was once “the poor house”. I have to say in seeing it, that they really were nicer to “the poor” than they are now.

Althought I gather that the winery and the brewery and the distillary were not there then, it still is extremely lovely. They have rooms to rent, european style, with the bathroom down the hall. There are many different restaurants, and the rooms start at 50 dollars a night. So I am going to stay there on Thursday night rather than camping in the van. I am a little less comfortable camping on my own, than with Ken there.

I am including pictures of the hyperbaric unit as most people do not really have a sense for what they look like, heck I did not have a clue until I started.

Looks like I am ready for blast off....



jankenb @

Saturday, September 25, 2010

High tunnels

Hi there
We have had a busy week, gastroscopy on Wednesday and trip to hyperbaric unit in Portland on Thursday. Gastroscopy showed I had NERD, I guess it is a new term for computer savvy people who develop heartburn..... NOT
It stands for Non Erosive Reflux disease. I gather that they have made this distinction from erosive reflux disease, because erosive reflux disease needs to be followed more closely.
You see people with reflux who have erosive signs at their lower esophagus, can develop a precursor to cancer called barretts esophagus. These people need to be followed more closely and biopsied to ensure that there are no signs of cancer.
Anyways mine looked great and he has suggested a different proton pump inhibitor, Protonix, instead of Prilosec.
Onwards to Portland on Thursday to see the doctor at the hyperbaric unit. That went GREAT, in fact they even had me scheduled for a treatment Thursday and Friday, but Dylan, our son was on his way to spend a few days with us in Eugene, so we decided to wait until Monday.

It was quite reassuring to meet with a doctor at the unit who clearly knew a lot about radiation injuries. She talked about many different types of injuries that she had seen benefit from the hyperbarics. It was interesting how she came to the same conclusion that I had about the bleeding I have now. You see this bleeding started the second to last week of my hyperbarics in the spring. She said it was likely that the hyperbarics HAD worked and started healing via angioneogenesis (new blood vessel growth), but it had only just started. So likely needed a few more weeks....
She said it was always hard to tell who would benefit, but she felt certain that I would and that I would likely also see improvement with the vaginal scarring that is now starting to bleed all the time as well. I will be treated with 2.5 atmospheres. Since this is a higher dose it does run a higher risk of seizures (because the oxygen level is so high, the seizures are from oxygen toxicity), you have to have an air breathing break half way through the treatments. Since the chamber is 100 percent oxygen, you breath regular air (usually about 21% oxygen) for 10 minutes half way through your treatment to decrease your risk of seizures.
Ken is not working too much this next month, so he will be able to come up with me for much of the month. They are quite flexible with the scheduling right now, so we will likely go up one day and have a late appt, and then an early appt the next day and home that day etc etc.

Well my peppers FINALLy started turning red. Well one of them did. The rest are actually looking pretty healthy, so hopefully the next few weeks will see some action. I have been researching "high tunnels" for the past several months as a way to extend my gardening year. Ken and I decided that the cattle panels we have been using would make for a very good support system, so I have included some pictures of the tunnel under construction.
I am going to drag all of my tomatoes and peppers that are in pots into this structure so we can have them longer into the fall, I have also started peas, cabbage, broccoli, beets and mustard, as fall crops, some of which will be also grown in the tunnel. I have started them all in the greenhouse to give them a head start, because this is a little late for starting fall crops.
bye for now love janet

Tuesday, September 21, 2010

4 sisters

Hi everyone
Sorry to be such a whiner, after getting my cholesterol the other day I was down it just seemed TOO MUCH...for me. However over the past few days I have decided just to pick myself up by my boot straps and just do what I have to do.
They say to follow low fat diet.... which I have for years, however since last christmas I have likely done more poorly at that. They say to eat less animal products and I have been basically vegetarian for years, but over the past 2 months I have started eating meat because of all the bleeding I have had. They say I should have more fiber, but when I got this radiation enteritis, they said to eat minimal fiber. They say to maintain a BMI of under 25 and I am a bit over 25.
This is a BMI calculator They say to exercise more, and I have stopped exercising over the past few months because it seemed to make the bleeding worse, and so I need to increase exercising as well. (in moderation)
SOOO I just need to lose 10 lbs, increase my fiber despite the cramps (that should help the bleeding too)... and stop eating so much cheese or else find a low fat cheese that tastes reasonable. Get out for a long walk every day... AND then in 3 months get it checked again.

I will hopefully start the hyperbarics in the next week or so and solve THAT problem. I saw my doc yesterday and now have a referral to go to the osteoporosis clinic at OHSU to talk to a specialist to see if I really have osteoporosis if it is only in the bones that were radiated, and if so what treatment would they suggest.
Some days it just seems like everything is going against you.... but all you gotta do is to sit back and figure out how you are going to solve each of those problems and then do it.
Two days out hunting for mushrooms always helps my psyche.

My latest preserving feat has been making fruit leather. I had about 8 cups of applesauce in fridge and needed to do SOMETHING with it, so I went out and picked blackberries, put the through the strainer (not necessary) and then spread the mixture out on parchment paper and put in the dehydrator 6-8 hours .... presto ...fruit leather...
THEN on Saturday I decided to do the same thing with the pumpkin. I cut open the pumpkin took the seeds out and baked the pieces. I then peeled them and put the "meat" into the food processor along with agave syrup, nutmeg, cinnamon , yoghurt and some apple sauce and dehydrated them and man are they good. Pumpkin is just SOOO good for you too, why waste something as healthy as pumpkins by cutting them all up into faces.

So now my next thing is eggplant. I grew them from seed in the greenhouse and have watched them in the garden all summer pretty much doing nothing, and suddenly they are producing by the ton....
Really not what I expected, I thought I was going to have to write off eggplants as something I can grow. I do seem to have a failure though. I have many many pepper plants, and they are all "red bell peppers" and there are many many green peppers on the plants, but none seem to make it to the red stage, they all just seem to rot. There is no way either Ken nor me can eat green peppers. So will have to do something different next year.

I have included a picture of me with my 3 sisters, drinking a bottle of wine Angies daughter brought back from Australia called "4 sisters"
Bye for now
jankenb @

Saturday, September 18, 2010

Lynch syndrome

Hi everyone
Well there just always seems to be something ELSE..... I am SOO frustrated, I went into all of this as a healthy person, an extremely healthy person. ...... well except for the cancer part. I get sooo upset that I seem to be getting further and further away from being healthy, yet I feel I have no right to complain, knowing that so many others have died of the cancer.
I had a very down day yesterday, Ken and I went to a cardiology conference (great conference by the way). Part of the program is that they have a cholesterol panel testing before the conference starts for any interested docs. Since I have not had that checked since before my surgery (at that time the anaesthetist commented that I had "an enviable cholesterol panel". Well not anymore. Despite following a low fat, low cholesterol, mostly vegetarian diet for 30 years (since my mother had a heart attack at the age of 52), my LDL is substantially elevated.
I am going to have to look into my mothers records, but she had a familial form of cholesterol problem, her father died when she was a teenager of a heart attack as did his father, (her grandfather). I guess I will need to be looking further into this. The suggestion at the conference was to follow a low fat diet, eat less animal products and lose weight.

That all being said, there may be yet another familial disorder I have inherited that may have caused my cancer. It seemed odd when my cancer was diagnosed, that my sister (3 years younger) had just had a hysterectomy for complex atypical hyperplasia, which is the precurser to the cancer that I had. I was sent for genetic counselling because my mother and grandmother both had breast cancer. Since both breast cancers occurred at an elderly age, and endometrial cancer is only weakly linked to breast cancer, no testing was done.
There is another syndrome called the lynch syndrome in which a family tends to have endometrial cancer AND colon cancers. The counsellor did not think there was enough of a tie here either.
I have a first cousin who died last year at the age of 43 of colon cancer. He was diagnosed around the age of 40. From the reading I have done (I learned a lot about lynch syndrome from the hystersister forum where several of the girls there have lynch syndrome as part of their endometrial cancer) I have found out that if a family has one member who develops colon cancer or endo cancer at a young age (under the age of 50), and there are two other cases in the same family who are siblings then this family could be a lynch syndrome family.
I guess the thing that got me looking into this, is that I only just found out this year that the colonoscopy I had in Bandon last year, a certain kind of polyp was found that is also linked to this familial syndrome. It was a villous adenoma, which is a precancer and of the type that tends to occur with lynch syndrome. I guess the thing I only just found out recently (my family never tells me anything), my sister Denise, the same one who had the endometrial precancer, had a colonoscopy earlier this year and they removed a precancerous polyp.
I guess I was just blown away that Denise and I both had precancer/cancer of the endometrium, and we both had precancer of the colon.
The other cancers associated with this syndrome are ovarian, upper urologic tract, gastric, small bowel, biliary/pancreatic, skin (sebaceous adenomas and carcinomas and keratoacanthomas), and brain cancers.
As in most other familial cancer syndromes, early age of onset and multiplicity of cancers have been considered hallmarks of Lynch syndrome. In registry-based Lynch syndrome series, the mean age at initial colorectal cancer diagnosis is about 45 years, compared to around age 65 for sporadic colorectal cancer, and some Lynch syndrome patients present with colorectal cancer in their twenties. Similarly, the mean age of uterine cancer in Lynch syndrome is about 50 years, which is about 10 years younger than the average age of sporadic uterine cancer.
My endometrial cancer was diagnosed when I was 52, but I had clearly had it for some time. My doctor felt it was a very young age to develop endometrial cancer, and my sister would have been approx 49 when she was diagnosed. Neither of us had any risk factors for it either.

Although it has been years since I have done genetics, this syndrome is inherited as an autosomal dominant, which I believe means that 50% of a carrier's offspring would inherit lynch syndrome, and of those 80% would develop cancer, most likely endometrial, or colon cancer.
I contacted my uncle (the father of my cousin Steve) to find out if he knew anymore about other family members with cancer. Turns out 2 of my female cousins, for two different families died of small cell cancer of the lung last year, but they were heavy smokers and this cancer is associated with that. Also one of my fathers Aunts died of cancer of the stomach, or something like that. The other thing I found out was that with Lynch syndrome the cancers/polyps of the colon tend to be more proximal, which means further up. My cousins cancer was pretty much as high as you can get in the colon, and my polyp and my sisters were also high up. The types of polyps that are more likely to be associated with Lynch syndrome are villous adenomas and dysplastic adenomas. (Mine was villous, and my sisters was dysplastic)
Anyways I thought this might be of interest in case any readers have family members with colon cancer at a young age.

Other news, I am scheduled for gastroscopy Tuesday morning. I have had stomach pain and heartburn for 2 months now, despite taking a double dose of two different OTC stomach meds, omeprazole and quiting caffeine. I did have a gastroscopy a year ago in Bandon, but that test was not documented well, and from it, it is hard to tell where any of the biopsies came from as the notes say they were taken from the esophagus, but the pathology describes them as gastric tissue. So my gastroenterologist wanted to see what is going on now ( a two week course of one med regular dose SHOULD clear up any gastritis, esophagus problems)
Then on Thursday we are going to Portland to meet with the hyperbaric doctor hopefully to begin the hyperbarics at the higher pressure ASAP. I have been bleeding much more extensively and though my hemoglobin is still in normal range, it is dropping with each reading and my red blood cells have been below normal for awhile and are also dropping with each test.
The gastroenterologist really wanted to start treating my bleeding with laser this wednesday, (he said it would likely take several treatments to treat the large area involved), but I really want to hold out to see if I can get a cure with the hyperbarics. I am very anxious to begin treatments, because I am very anxious to see if it is going to work. The gastroenterologist said the
I guess the other reason I am looking at going to portland instead of waiting until the unit opens here in Eugene, is that while they are checking my credentials for this job I am waiting to find out, I might as well get treated, rather than start treatment at the time they may just want me to begin work.

On top of all of this, I was diagnosed with osteoporosis last november, and it was suggested I go on medications for that, with all that has happened with my stomach etc, I was afraid to, so I will likely get that looked at again, and try to find a better way to treat it, if I do actually have it.

I am SOOO Looking forward to being healthy again. Perhaps I am asking too much

by for now
jankenb @

Thursday, September 16, 2010

family pictures

Things are starting to settle, yesterdays post was written several days earlier.
We have canned 8 quarts of dill pickles one of dill beans, I have harvested all of my black turtle beans and they are just sitting getting that last bit of drying before I put them away for a cold winter nights black bean soup (perhaps AFTER I have done my hyperbarics).
I have made zucchini cookies, zucchini muffins and zucchini loaves as well as a huge pan of zucchini lasagna. The whole summer it has been ME AGAINST THE ZUCCHINIS.... every now and then they started creeping up on me and starting to get ahead, then I went into a flurry of activity to use them all up, and this time having been gone 10 days I was REALLY behind. But last night I used up 4 very small zucchinis on our pizza and right now "I have no zucchinis" in other words, I am winning!!!!
I have 8 cups of applesauce in the fridge that ken has been nagging at me that we have to so something about, however I have just won over the zucchinis, I need a few days to figure out how to deal with the last of the apples. (we dried all the rest) Perhaps I will try apple leather.

I never expected it but I also now have a large crop of eggplants, they took forever to start to grow, those cute little eggplants, so that will be my next thing.
We have had pesto every day for ages, I made a huge batch of pesto and froze it before we left cutting the plants back quite aways. Well they are back with a vengeance. The other night I told ken, do you might if we have pesto AGAIN........
Oddly enough he went on to tell me this story about a guy (in texas of course) who had just killed his wife and family in a rage.... that apparently started when she served him cold eggs for breakfast(not sure if he was trying to tell me something) (OK no pesto tonite)
I am sure you are all wondering about the tomatoes. Well I have been keeping up with them as well, making tomato sauce, we have about 8 pints of tomato sauce, I just cooked the tomatoes up and then put them through this very cool strainer that came as an attachment with my mixmaster and then cook it down until half the liquid is gone.
This weeks tomatoes, I am going to make actual sauce with basil and peppers in it. I have a lot to do this week.

I am really liking having very small breasts. I remember years ago looking at other women in public places and felt that I was pretty much the smallest one out there. The other day at IKEA I was looking around and once again felt the same. However major difference, back then it bothered me being different from everyone else, and now I relish in it. I think my days of activism changed me. It was very hard to get used to being one of a very small number who were willing to speak out directly against the war (in 2003) It was very new to me to be holding views that were held by only a very small group of people(perhaps I had always been like that, but never put it to the test)
So rather than hide my flat chest, or make it look larger artificially, I plan to flaunt it, cuz its "unique" :)
While up in Canada we spent a week in Kamloops for a family reunion, before the surgery, so thought I would include some pictures from there
Pictures of my whole family, ie sisters, and parents, pictures of Dylan Sara( his girlfriend) and Josh, and well the other pictures...
What can I say,.... I went to a rodeo with a camera....... (Dylans girlfriend is into horses etc)

By for now
jankenb @

Tuesday, September 14, 2010

a week post op

Hi Everyone

Ken and I are almost back to Eugene. AND I am so excited to see my garden, I have been dreaming about it.

All and all I think I have done well post operatively. The first day I was pretty sore, but I have done pretty well since then. I woke up from the surgery with an ace wrap (in Canadian :tensor bandage) around my chest, and two drains.

The way it was explained to me, he removed each of the implants and the capsules around them, leaving the entire area of raw tissue, and the purpose of the wrap is to keep the two sides of this raw tissue together with the hopes that they will heal together and not leave a space. The purpose of the drains is to make sure that all the bleeding and drainage gets removed, otherwize the fluid would get in between the two surfaces, preventing them from healing together. These fluid collections are called “seromas” and it sounds like they can be a real problem in healing.

So the drains are basically tubing about the size of IV tubing with multiple holes in them, placed in the operative site, and then stitched to the skin. At the outside end of the drain is a ball that collects the fluid and you can drain the fluid from this ball. (I guess it is a bit like a turkey baster, you squeeze it and it sucks the fluid up)

Anyways, they leave the drains in until the drainage becomes minimal. I saw the doctor again yesterday and he removed the drains.

He seemed to think that everything looked pretty good. To me it is hard to tell, lots of swelling and bruising, so time will tell what it will look like. I have decided that I think I like this new “flat” look. Seems like much lower maintenance

I think that this is going to create a huge gap in my closet.

I went through this phase 10 years ago when I had them put it, and I bought all kinds of low cut tops etc, but the funny thing, for the most part, it took me years to become comfortable enough to even wear a tighter fitting top, let alone something very low cut. So now there will really be no reason to wear any of this stuff.

It has been kind of interesting since I “came out of my closet”,......

Several people have commented about why do women in our society feel the need to do this sort of thing. I guess I have never seen it like that. I always saw it as much the same as I would dying my hair, or having peirced ears, or even wearing a different type of clothing. It is always “ I wonder what I would look like in that”. I have to say I only did it for me, for no one else but me. In defence of my actions, I would have to say that there are many things we do in life to alter our appearances. I for one have almost never worn makeup. I guess I just so much wanted to have breasts, and though looking back, I can see it was a mistake, at least I know now that like so many things in life.......... “That as they got closer were not what we visioned at all”

Now as I write this I realize that one of my songs describes this much better than I can here. So I will enclude a link to that song.

ilver dollars

Written by: janet bates

Silver dollar Janet Bates 2007.…..
How many times have we chased silver dollars
That slipped through our fingers like slow flowing water (does)

How many dreams have we seen in the distance
That as we got closer they were not what we visioned at all

How many plans have we changed by the time
They got close to fruition, our plans then are different

So many times have I thought of what might have been
Looked at was has been, glad of the life that I lead

Ads I'd seen
in magazines,
thought that could be me
It's only now I can see

So many things that I thought that I wanted
I found what I wanted only, what I already had REPEAT

You cannot learn too soon
If you reach for the moon
Even though its what you wanted
It won't fit in your pocket

Stars may seem bright
As you gaze out at night
In the light of the day
They just all go away

….And when you dream
Just of pastures of green
They will all turn to brown
When autumn comes around open the "for all of his wealth" album and scroll down to silver dolllars
there is a downloadable form there.

love Janet jankenb @

Wednesday, September 8, 2010

post op 3 hours

just a quik note to let y"all know i had surgery today, i am fine, and "nurse kenny" has come out of retirement to give me top notch care

I am going to try something unique for me, and I am just going to lay here until tomorrow and do absolutlely nothing, which is what the doctor said to do.

Doctor had some trouble getting the ruptured implant out, as there were "issues", but as you know....... I will give you ALL the details tomorrow or the next day.
Love to all of you and thank you so much for all the wonderful notes I have received.

jankenb @

Friday, September 3, 2010

What a difference a year makes

Ken and I took the same trip this year as last, and thought we would stop at the same little place beside Duffy Lake to take the same picture again.
What a difference a year has made........
Well somethings do not seem to change that much at all. I think that Ken looks like he just changed his shirt for the second picture.
AND the weather changed a bit too.
Just thought I would share the photos
jankenb @

Thursday, September 2, 2010

back in ca na da

Hi Everyone
Ken and I (and the dogs) are on our way to Whistler, from Vancouver. I met with the surgeon today and the surgery is planned for next Wednesday. I feel so much better that I have waited to have the surgery with this doctor. He even showed me a little video that he has on his phone (that he uses when he lectures) on how the implant is removed without anything being left behind.
He specializes in reconstructive surgery after mastectomy. He seems to think it will just look fine once he is done. The first surgeon basically told me how horrible it was going to look and STRONGLY encouraged me to just replace the implant with another one.
I am so glad I decided not to go with him.

I am also booked to be starting back in the hyperbaric unit, (the new one that will be opening at Riverbend hospital) in November. I will be one of the first patients in this new unit. This unit goes up to 3 atmospheres (however I will be treated with 2.4 atmospheres.
I finally heard back from my oncologist about my PET scan and he said that the increased take up of the dye in the base of the tongue was most likely because I was talking between when the injection was given. Active muscles take up the dye in greater concentrations. Can you imagine me talking too much?????
The tech at the PET scan place was telling me that that is why whey have this little room that you basically sit in the dark after the injection. He said he had a guy once that brought in a computer game and sure enough all his arm muscles “lit up” on the scan.

I have had an incredibly exciting week for an extremely “unexpected” reason.
I got a call from the physician recruiter from Peace Health to ask if I would be interested in a position as hospitalist at the old Sacred Heart hospital (which is now called the University District hospital)
I was totally shocked, and said that I never would have expected that they would ask me to work, being as Peace Health has a bylaw against hiring non board certified docs.

Well I guess Peace Health ( which is a large non profit organization that owns several facilities) They have two “campuses” in Eugene, one at Riverbend (RB) which is the new hospital and the other at the old Sacred Heart (University District)(UD).

All the hospitalists rotate through both facilities, but since the unit at UD is only about 35 beds and Riverbend (RB) is much larger, none of them spend much time over there at UD. The unit is mostly geriatrics, with a high percentage of Alzheimers patients and all the unique problems that they get.
They have been thinking of having one or two physicians JUST work over at UD They noted on my resume the 9 years I cared for all the patients in the locked Alzheimers unit at Heritage Place, combined with the 3 years I worked as a hospitalist in Bandon and thought I would be perfect for the job. So I spent all day Monday being “interviewed”, and then a dinner to meet me and Ken at one of the doctors house.
It is not totally straight forward but they have found out that there is in certain circumstances a way around the bylaws if a physician came along with the kind of experience I seem to have.
They are also short of physicians in the hospitalist group, as a few of them have recently left. I am pretty excited about this as from all I can see this job could be my “dream job”, the one I left in Bandon, without the politics.........

If it does not work out, that will be OK, I STILL have my 73 tomato plants......

It was extremely hard to leave my garden, and in my “notes to self” book that I need to write about this years successes and failures, a few paragraphs will definately be devoted to “when NOT to leave the garden”.
I would say that the first 2 weeks of September would qualify. I have canned 9 pints of tomato sauce, 5 pints of dilly beans, and 5 of dill pickles. We have dried many bags of sliced apple and one bag of dried mushroom. I picked every tomato that had even the faintest red colour to it, to bring with us on this trip.
It may not have been the greatest time for surgery, but
Ken and I have this idea that perhaps getting this done AND the hyperbarics in November, perhaps by Christmas I will be perfectly healthy.

Maybe I can start running again then
jankenb @ .

Wednesday, August 25, 2010

another operation

Hi there everyone
This blog is one that I have tormented over for a very long time, ie whether or not to write it.
However since I have always seen this blog as both an accurate update on my medical situation as well as a means of explaining medical issues as they arise, to further the readers medical understanding, I feel compelled to also share my current situation with my readers. I will be having an operation in about 2 weeks for a problem I can only describe as "self induced". I am sharing this only with the hopes that I might spare someone else needless procedures and pain.
It is a very personal situation, but I feel I have shared a lot of stuff thus far, why not this?

Part of the reason for my trip to Canada next week is to have surgery to remove breast implants, one of which has ruptured and is leaking silicone. I was advised over a year ago that this needed to be removed, but with being on chemo, and also having a low blood count, I opted to delay this until now.

I am telling this with the hopes that someone might read this and perhaps opt NOT to do this.
10 years ago, whilst training to do that Boston marathon ( this is a marathon that you have to qualify for, which means you have to have achieved a certain time in another marathon), I subsequently lost a lot of weight. In doing so lost what small breasts I had (or so I saw it).
At the time, being inundated with Victoria Secrets catalogues etc I decided I wanted to look like those models, well at least be able to fill out the clothing. ( I should add here that I have long believed that Victoria Secrets is likely responsible for MUCH of the whole breast augmentation craze)(just a thought)
I found out that having a breast augmentation (breast implants) was not a huge procedure. I went and saw a surgeon and he also agreed that I could have the procedure done under local anaesthesia (not how it is usually done, but hey, I did not want to risk my life with an anaesthetic). I had saline implants put in and immediately developed capsular contraction of the worst kind.
AN EXPLANATION: When a foreign object of any kind is inserted into the body, the body forms a capsule around it. Capsular contraction is when this capsule shrinks and forms a tight constrictive wall around the implant, making it as hard as a rock and quite painful.
Now I should have learned at this point that perhaps I was not meant to have implants, however I felt still that I wanted to have breasts....
So I found a surgeon in Portland who would repair this, and since I had had capsular contraction, I would qualify for silicone implants.
Again I had the surgery under local anaesthetic. He removed the capsule around the implant and the implant and put in silicone implants. I should add here that this is all placed under the muscle of the chest wall. True breasts sit on the outside of the chest wall muscle, but to get a better effect, often breast implants are placed UNDER the pectoral muscle.
Well things went well for 9 years and I really had no problems..

Last June amidst chemo and the fears of this cancer, I went to see a surgeon about having a bilateral prophylactic mastectomy, (my mother AND my grandmother had breast cancer and I was NOT wishing to go through this cancer thing again) I was quite emotional at the time.
The surgeon said that at that point, I was more likely to succumb to the endometrial cancer than breast cancer, so she would not consider the surgery until at least a year after my treatments. She did order an MRI because she felt a lump.
The MRI showed that the breast implant was ruptured, but that it was still contained in the capsule.
I was in the middle of chemo and radiation at the time, so nothing I could do about it.
I did see a plastic surgeon in the fall about removing it. He advised removing them and replacing them. I found that he was quite dishonest about the whole situation and decided not to have the surgery. He had described the surgery he was going to perform, and I signed the consent. I later went for my presurgery appointment and in reading the consent in detail, I found that the surgery he had described to me was NOT the surgery he had put on the consent.

This was around the time that my radiation problems began so I did not do anything about it. I DID start reading though.
I found that the ONLY way to totally get rid of the silicone was to remove the implant AND the capsule enbloc which means to remove the whole thing as one. This not at all what the surgeon here had planned.
To make a long story short, the closest plastic surgeon that removes the implant AND capsule as one is up in Vancouver BC, and that is why I am going there for the procedure.

I thought I would also outline some of the things I have learned about breast implants that I think more people should learn.
Over 50% of women who have breast augmentation (breast implant insertion) require another operation. Bear in mind that the surgery is expensive and many women save up for the operation and cannot afford to have surgery to repair whatever the problem is. The other situation that often comes up is that while someone might be able to pay for the surgery, when the time comes that they need it repaired, they are in a different financial situation..... ie retired.
Of asymptomatic women (women with no symptoms), at 10 years 50% of breast implants have ruptured. (saline implants deflate immediately when they rupture, but silicone implants remain as a gel inside the capsule) So my situation is not unusual.
Once ruptured the silicone can leak out to various parts of the body.
The studies done years ago disproved that breast implants have anything to do with rheumatological problems, HOWEVER women with ruptured implants were never studied, so it is unclear what happens once they rupture.
After you have had breast implants for a long time the shape of your chest changes somewhat in that having them removed you will be much smaller appearing than you were to begin with.

You cannot get private health insurance if you have breast implants. I was refused because of mine. I have long said that the reason I was refused was because of the vaginal bleeding, but what happened was that the vaginal bleeding made the insurance company look closer at my files, and the fact that I had breast implants made me uninsurable. Fortunately being in Oregon they have a plan for those refused insurance for a medical problem.
Most states do not have this.
SO there it is.... I have revealed all.
I hope that in reading this someone else can pass on this info. I will more than likely add other info about this as I remember it.

The cheapest way to deal with all of this is to throw out all the Victoria's secret catalogues. Kind of funny, after my sons became teens, somehow the VS catalogues just disappeared on their own.