Sunday, June 27, 2010

magnificent morning



Hi Everyone
I thought I would share a few photos of my garden today, and since a few things are not behaving very photogenic today, I will likely share a few more when the GET more photogenic (ie...grow)
This morning, I got up, picked myself a bowl of strawberries, raspberries and picked a few cherries off the tree. I am limiting myself to 4 cherries a day because they have such a thick skin, and the tree is only ripening about 10 a day and that leaves 6 for Ken.
I seem to be doing well with the strawberries and raspberries.....yea!!!!!
There were strawberries growing all over the place here, on the ground in areas they were not getting the best light, so I have been gradually digging them up and planting them in a cocophany of containers, many of which I was going to get rid of.....old garbage bins, unused plastic containers etc. (if you click on the photo you can see a bigger version of it)
I have then stacked them all on this lovely bench that Ken made for our greenhouse in Bandon.
So it is fun to just pick the strawberries standing up PLUS the snails have further to climb to get them.

The potatoes in the first bin look almost ready to harvest, the second bin has a month to go, I figured I would harvest the potatoes and then replant the barrel with a new set.
SO we can have early potatoes now and leave the rest for the fall.

You can see from the photo at the top, how much fun Ken is having with the cattle panels. This particular "invention" is for growing the grapes, to trellis them along. WHen we got home yesterday, there was someone in front of the house taking pictures of it. yea ken

I will try to get better pictures of the 70 tomato plants later when I can ask Ken how to change the settings on the camera. (Ken is working in Bandon today and coming back tonite)

Well I got the CT scan report when I was in Bandon, and it turns out that the doctor who gave the verbal was not the one who did the final read.
The one who did the final read has described a nodular density behind the rectum, that is 2 cm by 2 cm. He says it was also there in January and a bit larger then. He is suggesting a PET scan.
The only problem with this is that the doc who read the scan in January said it was normal.
So when I went the gynecologist in January, and the gastroenterologist they were under the impression it was normal.
I really do not know if there is any significance to this. I THINK my first colonoscopy had a polyp removed in that area that was considered precancerous, but the colonoscopy this time did not show anything. In my thoughts, I am wondering if perhaps I might have bled behind where he took the biopsy and there could be a hematoma there now. ( a hematoma is essentially a blood clot that forms in the tissues and once there it stays there, it just very gradually gets smaller and harder)
I have not heard from Dr Cook about the scan, he IS the one who ordered it. So will see whether he decides to go ahead with the PET or not.
A PET scan is a test that really just is intended to pick up a cancer recurrence early. They infuse a radioactive labeled glucose molecule and it concentrates in areas where cancers are, as cancer cells require more glucose.
I am a bit concerned about this because I am bleeding more all the time, rectally.
I AM seeing the gastroenterologist on Thursday up at OHSU, so the timing could not be better.


I am looking at my options with regards to work here, and there are not any, and that is pretty much OK with me, however I would like to work just a little. This past few weeks Ken hurt his back really badly. He actually had to call in sick to work at the university because he just could not move. He is much better now, but it did scare me a bit because right now we are totally dependent on Ken being able to work. Our health premiums alone are 1100 a month, not to mention our loan payments. We are just fine as long as Ken can work some. (everything will be fine when our house sells in Bandon)
So I am thinking I am going to join Dr Gail McClave with her clinic and do just one day a month, seeing her patients out at the "nursing homes", Heritage place, and Harmony estates. (they are not really nursing homes, but everyone calls them that)
This is actually what I have done for years, and it would be great for me to do it in conjunction with Gail, she is unable to get out to see people at the facilities and many of these people cannot get to her office to see her.
Well back to gardening today. We are going to be in Eugene now for the next several weeks.

Really looking forward to the Oregon Country Fair http://www.oregoncountryfair.org/quick_visitor_guide.php
We are performing there on Saturday and Sunday.

Bye for now
love
janet
jankenb @ gmail.com




Tuesday, June 22, 2010

Normal CT scan

Hi Everyone
Just wanted to let you know the preliminary results on my CTscan.... YEA
There was no evidence of cancer. Some non specific soft tissue changes in the rectum, which I presume is the colitis/proctitis that is causing the bleeding.
On these surveilance scans they check the chest, abdomen and pelvis....
So I am quite relieved. I will likely have the ca 125 done in one month to see which direction it is going and if is still going up, I will likely go and see my gynecologist/oncologist.

I managed to run 13.3 miles on Sunday, which is a half marathon. It is quite different running long distance and clearly takes organizing, as I am only able to drink small amounts of water at a time with out the cramping, so it was good it was not a hot day, in which case I would have to drink more than my stomach can handle. Over the years when I get beyond 10 miles I eat power bars, but even a small part of one immediately sent my stomach into cramps, so will have to get the "gu"........ which is a thick pudding like energy alternative for long distance runners.
I used to use it years ago and got so sick of it I switched over to powerbars and have always been able to eat them whilst running.
We are playing at BREWED AWAKENINGS on Friday night at 6:30
Ken and Mark and I, and we are being joined by Jaime Sterling and Rick Franke.

We had our first zuchinni from our garden two nights ago..... likely the first of "too many"

Love
Janet
jankenb @ gmail.com

Saturday, June 19, 2010

stolen compost

Well life in Eugene is going great. We decide on a few errands we have to run and then get on our bikes and try to get them done. Yesterday we had to pick up some wine that did not get delivered at our house (because we were doing errands), at UPS. From the map it looked like it was at the university, or in the area. Once there we realized it was quite a bit further south, so our errand bike ride took us about 20 miles. On the way back, I fell off my bike. (this is not unusual, in fact quite a regular occurance. We used to have tandem bikes and the boys used to fight over who had to ride with me). Anyways at the time Ken was a bit ahead of me and a guy came running to my aid. I was not hurt, just a skinned knee, but when the bike fell, the contents of my pannier poured out on the sidewalk. There is a place down by the Knickerbocker bridge that I have found that has great composted oak leaves, which I have heard are good for blueberries, so one of my "errands" was to load my pannier with "compost". In effect stealing compost.....
I think that the guy must have thought it rather odd to have a pannier full of dirt. I guess I got caught red handed.... or red kneed...... with my pilfered compost.
So you can imagine then why I run, instead of cycle, you just let your mind wander for a minute and WHAMO you become "one with the pavement"
Likely the most painful part of it all was that, since the bike ride was so long, I got hungry and ate a couple of power bars and was sick the rest of the evening....(they had nuts and raisins and oatmeal in them)
My abdominal pain has gotten worse lately and I have been taking low doses of pain killers.
I take a half of the lowest dose of percocet at least once a day now. It just settles the burning lower abdominal pain that seems to be there a lot of the time now.
I have also started bleeding rectally more, passing blood several times a day now.
It has become a cycle, the bleeding is worse when my bms are hard, so I try to increase my fiber and I get more abdominal pain, but when I do get more fiber in, I have less bleeding.
I have this feeling that all of this got better when I was on the hyperbaric treatments, but gradually came back and now I feel it is worse than before.
I am seeing doctor at OHSU on the first of July, and am quite apprehensive about that hoping
he at least is interested in trying to help.
The last gastroenterologist basically really had nothing to offer for the upper abdominal problems and he said if the bleeding got bad enough to require a blood transfusion he could go in with heat argon and essentially cauterize??
I guess I am quite fearful of this treatment, is because it seems as though burning an area that is bleeding (bleeding because it does not have enough blood supply) just seems wrong. The tissues are bleeding bacause they do not have the blood supply to heal, and you cause another injury.........? I have read about the side effects, .... rectal ulcers, which basically cause chronic pain....... and if a hole is made in the bowel, then you get peritonitis, infection throughout the whole abdomen.
I guess what I am hoping for is another trial at hyperbarics, but with the proper dose. The EUgene one only goes to 2 atmospheres and the ones in portland go to 2.4
But we will see what he says.

I did have a breast MRI last week and it was normal, which is a huge relief, I have worried about that for quite awhile. My mother and grandmother had breast cancer.
I did get ahold of Dr Cook and have a CT scan booked for monday, of the chest abdomen and pelvis, with IV and oral contrast. He does one every 6 months looking for early recurrences.
This one is 2 weeks early, I thought that my visit in Portland would be more useful if this was done before my visit there. Also in a bit of a panic about the rising CA 125, so hoping the CT will provide some reassurance.

On the garden front, we have 70 tomato plants, and I can find 10 baby tomatoes. In Barbara Kingsolvers book (animal vegetable miracle) she had 50 and grew .3 of a ton of tomatoes.
I guess I have been dreaming of doing what she did for a few years and this is so exciting for me this year to see my dream come to fruition. Ken and I bought a set of about 30 antique canning bottles at an antique auction 15 year ago, and have just found out we can use these for canning and have found a store here that sells the rubber rings.
They have glass tops on them. Of course we will need MANY more, if all goes well. My neighbours think I am nuts, but I feel I have waited for at least 20 years to have a garden such as this.
Things just did not grow well in Bandon, and it was not for lack of trying. Even here, I am having trouble getting the pepper plants to survive outside the greenhouse, it is a cooler year than typical. But I really really am having fun with the garden. And there is ALWAYS something that needs doing in the garden. So far all we have been eating from the garden is the spinach and mesclun. I have one zuchinni that is little right now, and lots a lots of kale that may soon be ready to harvest.
Our garlic, which we planted last October, will soon be ready to harvest and I am replacing them with various winter squashes for the long lastedness of their fruits.
So good fun all and all. Last summer when I was sick, I dreamed of doing this and at times wondered if I would ever get a chance, so now I have the chance, I am doing it.

Love
Janet
jankenb @ gmail.com

Wednesday, June 9, 2010

Dolly Parton

Hi Everyone
No this is not going to be a blog about my tomatoes..... well actually I DO have 6 teensy tomatoes now. I have noticed that looking at them several times a day does NOT make them grow any faster.
I had said I would post our video from the North west folk life festival we played at May 31 up in SEattle. We played on two stages, one called the ALKI stage and the other was a Dolly Parton Tribute stage.
We had our choice of Dolly Parton songs we could choose to play. The one I selected was called " the cowgirl and the dandy". The song is about a cowgirl in an airport on a night when all the planes had been grounded due to stormy weather. She meets up with a "dandy", "the grandest man that she had ever seen". The point of the song is that two very different people got together for a night of stormy weather. The song was written by Bobby Goldsboro and recorded by John Denver as well as Brenda Lee.
Ken and I met in an airport on a night when all the planes were grounded due to snowstorms, but that is about where the parallels end. I was NOT wearing rhinestone studded suit and Ken was not wearing a derby. However here is the video that Ken's sister Pat recorded for us.
Unfortunately, there was a sound issue and so you can not hear Ken and Mark's instruments as well as I would have liked, but this is how things often go at festivals.


video

I have my appt in Portland with Gastroenterologist on July 1st, and with the pain I have been having I have been thinking of going back to Dr Cooks plan.
He had said he wanted a ct of chest abdomen and pelvis approx every 6 months. (which would be early July)
I had thought I would hold off until I saw the gastroenterologist in case he suggested something different. I was also concerned about MORE radiation.
I guess now I am thinking that I should have the test before I see him. I guess something else has come up, in that my tumour markers have gone up.
The CA 125 went from 6 - 9 in the past 2 months, and they say that a 15% rise can indicate a recurrence and this is a 30 % rise. Of course I just got the results back yesterday and have been trying all week to get ahold of Cook.
To anyone who has had a ca 125, these numbers sound very low, but when you have had a radical hysterectomy, they tend to run extremely low, being there is no tissue left to produce it.

So today I have to say I am more scared than I have been in months. It is hard to say what this radiation enteritis does to the CA 125, but I know bowel cancer CAN raise it, so I wonder if bowel diseases can also raise it.......
Anyways will see what this week holds
bye for now
love
Janet
jankenb @ gmail.com

Friday, June 4, 2010

drug interactions

Over the course of this blog, as one might expect given the numbers, other people have developed cancer. People who had been following my blog. So now I have had a chance to see it all from the other side. ...... wondering on some days when I have not heard, if something really bad has happened and just a constant thought about these people.

About 5 years ago a group called the ROP organized a march between Salem and Portland that many of us from Bandon participated in. It was a 7 day event and though some of the people came for only a day or two, there were probrably about 50 of us that did the entire trip. We camped along the way, and though there were many messages of peace we marched for, I think most of our group marched to bring an end to war. (in particular the one in Iraq)

The rather disturbing thing about that march is that to my knowledge now 3 women have come down with advanced gynecological cancers, Mariem died a year ago of ovarian cancer, I was diagnosed with the endometrial cancer a year and a bit ago, and the main organizer of the march, Marcy Westerling, was recently diagnosed with

Stage 4 Ovarian cancer. She too is quite healthy, She has just recently started chemotherapy.

Not sure about you, but that seems like a lot for such a small group, it is just coincindence, or did we march through a nuclear wasteland??


One person who has followed my blog closely and whom was the source of support for me, is now in the situation of caring for her husband who is going through chemo and radiation right now.

He started off doing extremely poorly, and the thought is always.....perhaps the cancer has spread further and is affecting other body parts. He was unable to eat, the food just seemed to get stuck at his stomach and go no further.

So I did a review of his medications. He had been on some meds before all this began and then of course he was put on several new meds, and when I ran a comparison on them, there were many that were apparently interacting, and he improved partially by just stopping one of the meds.

I got to wondering how often this happens. You take one group of doctors, those who really know the chemo drugs and ALL of the side effects really well, but not so much about all the other meds a person brings to the table when they start something like this.


In the work I have done for many years in geriatrics, they teach you to think , when a person comes in with a new complaint, just think drugs, drugs, drugs, and once you have ruled them out as a cause, then move on the other possiblilities based on symptoms.

This extends way beyond geriatrics though, really anyone who is on two drugs. For instance, if you are on an ace inhibitor (bp drugs that usually have a “pril” on the end of the word), and also take an NSAID (aspirin like drugs, usually called antiinflamatories), there is a much increased risk of this combo doing damage to your kidneys, and if you throw in a diuretic (water pill) the chances go even higher.

Other examples are the antidepressants, SSRIs, such as Paxil, Zoloft, Celexa, Lexapro etc etc. While these drugs are fairly safe if taken alone, if combined with other certain drugs, they can cause seratonin syndrome, which actually can be life threatening.

Some of the “other” drugs can be herbs. One of the main symptoms of seratonin syndrome is fever and shakes, without other signs of infection.

Here is a listing of meds that interact

http://en.wikipedia.org/wiki/Serotonin_syndrome

I had lunch yesterday with a few friends in Bandon and they sheepishly each had medical questions to ask me, I told them I was thrilled to have their questions, it made me still feel like a doctor. There is no greater feeling that to solve someone else’s problem.

I guess I was not clear on the “qualifications” part of my last blog.

Ken and I had pretty much the same medical training, exept that he graduated in 1980 and I graduated in 1990. In Canada at the time, most docs were GPs, general practitioners. Specialists did residency trainingm and GPs did rotating internships.

There came a time when they decided that GPs should also become specialists ...”family practitioner”.

They had a residency training and exams as well.

Ken was able to write the family practice exam because he was grandfathered in and even though he had not done a residency because he graduated in 1980 he could do that, and the US accepted his Family practice specialty on par.

To be licenced in Oregon, one only needs to be a GP, which is why we have been able to work all these years in Bandon.

Places like Eugene have policies against doctors who are not board certified, partly because it is a more desirable place to live....I guess and so they have no shortages.

I believe myself to be a very good doctor despite my lack of board certification, but there is really nothing I can do in Eugene. Ken and I do well when we work together, and so it is hard for me seeing him work and me not being able to.

In fact between the two of us, Ken would have gladly quit medicine years ago, it has always been me that still enjoyed it.

Because of my “qualifications” or lack of them, i was extremely fortunate to have been able to work as a hospitalist in Bandon, I loved the job more than any I have ever had. I will hold that time as a very special part of my “work life”. As one can easily imagine too being in a position like that the administration clearly has something “over you”. So I was in a very vulnerable position.

Society has been taught that board certification is essential, and I am sure that the administrator will be glad to advertize now that all the doctors at the hospital are board certified. (I am just like a dinasoar that has been caught between time)


Often in small communities doctors are called upon to take greater responsibilities, and I feel that Ken and I both did just that, and we did it well.

We also truly loved the staff at the hospital, we had the most awesome working relationship with the nurses. It was truly like a real team, complete with mutual respect.

I had to go back to sign some charts yesterday and stopped only briefly at nurses station, lest I break into tears.


I will continue to be the director of the coumadin clinic, (in Bandon) and I did hear that there was a lovely picture of me in the paper. (perhaps if anyone HAS the paper they could save me one)

Ken has a job filling in at the university, and is still going to be doing some ER shifts in Bandon. We are planning on getting Mushroom licences in the fall, and perhaps trying to make money at it (it is one “job” we can do together). We LOVE picking mushrooms, but can never eat them all when they are fresh. Some we cannot eat at all. So that should be fun, plus we get to take the dogs as well.


I am currently thinking of working a couple of days a month (geriatric days) at Gail McClaves office, OR seeing her patients at heritage place a few days a month.


I am starting to get quite nervous about my CT scans I will be having in early July, but I guess that is par for the course.

Bye for now

Love

Janet Bates

jankenb @ gmail.com

Tuesday, June 1, 2010

memorial day

Ken and I are on our way out of Seattle, after a great Folk life festival.
We performed on two stages there yesterday and it went great.
I have a friend who has been watching the costs of the war, wondering if it will get to a trillion on Memorial day, and as a test, he monitored how far the costs would go while he played a recording of my song "american soldier", he then posted it on you tube http://www.youtube.com/watch?v=LNFC3yldUN8
While my song played, the cost of the war went up a million dollars.
So we played it at the festival yesterday, and hope to post the live performance to youtube soon.

It was quite fun, in that the second stage was a Dolly Parton tribute stage and several of the performers has been asked to cover a Dolly Parton song. We chose "the cowgirl and the dandy", a story of a cowgirl and a dandy coming together in an airport when the planes had all been grounded due to poor weather. The reason we chose this song is that Ken and I met in an airport during a storm that had grounded all the planes. He was NOT dressed in a Dandy suit and I was not dressed in a rhinestone studded suit with cowgirl high heel boots.
But we did get a great video of that show, so hope to get it posted here.

We met with our sisters at the casino at Tulalip. I made a hundred and twenty bucks and so bought two of the lovely house coats that they had in the room (rather than stealing them :) )

We are heading back to Eugene to start a life there. We intend to go to Bandon often to perform both at the Bulllards beach amphitheatre and at the brewed awakenings.
One of the problems with this move is that I will be unable to work as a doctor in Eugene due to my qualifications. Ken has the same training as me but was able to be grandfathered in to family practice certification (we were both trained as GPs, which was what most docs in Canada did that that time)
So I am in a position now in that my departure from Bandon will also be my departure from medicine...... unless we go back to Canada. If we go back to Canada my qualifications will be fine.
For my health, I am going to try a life without medicine, and focus on the garden and the music, and we will see how that goes. I do truly miss it though. Perhaps we can go back to Canada for the summers ????
Anyways a whole new life. We have such a wonderful group of friends in Bandon, who have been SOOOOO supportive to me through all of this cancer stuff, I really hope to maintain a relationship with Bandon, so as to keep up with these people.

Love
Janet Bates
jankenb @ gmail.com