Wednesday, August 3, 2011

an intro to the new blog

Hello
as promised I have started a new blog that is called janet and ken's next adventure
and it is at
http://janetandken.blogspot.com/2011/08/janet-and-ken-bates-first-blog.html

When we were in Oregon, so many friends expressed an interest in keeping up with what we were up to so I thought I had to start a new blog.
TOday being my birthday seemed like a good day to start

much love
Janet

Sunday, June 19, 2011

the end of the journey




Hi Everyone
Well perhaps not so much the end of the journey, but I guess I am feeling more and more confident that I left the endometrial cancer behind a long time ago. With all the superstitions etc, I feel it hard to say cure, because in medicine, you never say never and never say always, and I am fine to look at it from a relative perspective. I am relatively certain I no longer have endometrial cancer.
Has the CT scan a few weeks ago and it was normal and had the CA 125 done this last week and it was 5, almost 2.5 years after my surgery, that is pretty darn reassuring for me.
I am not going to post on this blog anymore, but will begin a new one for those friends from the US who I think just wonder how we are doing. I think I will call it Ken and Janets great adventures, because we DO have some great adventures.

My other problems are still there, and still a problem, but I cannot imagine them being of any interest to anyone anymore.

This has been quite a week for us, on Tuesday the funds came through on our sale of the Eugene house and our Williams Lake house (we have owned the house my parents lived in for the past 22 years) (My mother has gone into a care facility and my father has moved into a mobile home park across from my mother's facility)
We are out of debt for the first time in many many years, and if we do not go too crazy, should have enough to build this house without going into debt again.

We are living in an RV next to where our house is being built and I am sitting here viewing my incredible garden, in total silence, except for the occasional bird........ oh and Rex's occasional bark, remember REX?
Things are not going quite as well as we wanted at work YET, but then again, you have a little more leeway when you are out of debt. Hopefully they will be just fine in a month or so.
We only want to work half time each, making one full time.
We really feel that we are living on the best place on earth. The North side of the Shuswap only has one main road leading to it and it goes all the way up to Seymour Arm, which is about 2 hours north of here.
When you come around the north side of the lake, you cross this one way bridge, and then you are in Scotch Creek, and there is something about crossing that bridge that to me feels like I am home. I never like crossing it going the other way. I really feel home.

Last night we celebrated our older son Dylan's 24th birthday, and had friends of his over. It was so special to be so close to our kids and have a chance to be more involved with their lives.
Last weekend Dylan plumbed our entire house, which was a very special day. I was so proud. He was so methodical about getting all the lines in and out.
Very special situation to be able to see your grown children's work first hand. He is being pretty darn tolerant of my "change of minding".... I decided to add a prep sink, at the last minute.
Although we really thought that having a small house we would never do the house concert thing again, somehow it has turned out that we figure the house WILL be big enough for house concerts. Just how it turned out, so looking forward to getting back into that.




I have dropped back to 2 days a week recently, and feel that that might be perfect for me. I have been working 3 days a week and sometimes I either have a lot of pain, OR am nauseated. I feel that I can get through one day in a row like that, but not 2.
So I will ultimately be working tuesdays and thursdays.

We are leaving for Oregon on July 6th. I have an appt with the cancer agency in Kelowna in the afternoon there, and we will head south that night.
We are performing at the Oregon country Fair, on July 8th 9th and 10th, so if you are there, please come and say hello.
We are then going to Bandon on the 11th, or 12th, and performing at Bullards Beach amphitheater on July the 13th at 6:30, and then at brewed awakenings in Bandon on July 15th, at 6:30 (I think)...or maybe it was 6..? Perhaps check with them

I will post here to let you know what the new blog will be, but for now this will be my last blog.
I have to say that it has meant so much to have someone interested enough in what was going on with me to read my blog. I realize that over the past year or so my blog has little to do with the cancer, but it seemed a way, after we moved away from Bandon, to keep people apprised of our whereabouts.
Now I feel I need to call it something else

Once again thank you and do not hesitate to call me if you have any questions, I will post here to say where the new blog will be, much love

Janet

jankenb @ gmail.com


Wednesday, May 4, 2011

the house comes up





Well Ken and I are doing well, we have made some changes to our schedules and it is getting a little bit better. We have been overwhelmed by the work. The town has not had regular doctors )(except one) for some time now and we have been really pressured to see a lot of patients, and we just cannot do that, as we can only work as fast as we can work and when we get behind we are spending the entire evenings working on charts. That is no fun. We realize with this new job we do not have the responsibilities we had when we were running our own clinics, however we also have lost a lot of autonomy, in that we cannot make all the decisions about our work like we did before. There are clearly pros and cons to this employee thing.

We might not last at it, and might end up going out on our own, but we will see.


Our house is going well, and we continue to love where we have bought. Just off the back of the property are miles of trails and I have gotten back to running 3 times a week. Up to 6 miles now.


I have been having a lot more pain lately with almost everything, and so will be having a CT scan in the next few weeks. The oncologist left it up to me, he said that even if we found something (a metastasis) there was nothing we could do about it, so why do the testing. I guess this makes some sense to me, but I guess I feel if I am going to be going out on my own with a clinic, there will be some commitment there and I would like to make sure that all this pain is not from the cancer.

I guess I also wonder if at all possible if this radiation enteritis only affected a small part of the small bowel, if it were to get really bad, if some day I could get it resected. Also not sure if that is possible, but I feel it would be nice to look forward to SOMETHING for this pain ??

The routine is for the first 3 years to get CT scan every 6 months or sooner if there were new symptoms. My last CA 125 was nice and low.


We are currently on our way to Seattle to take Josh to catch his flight to Prague on Sunday morning.

I am quite nervous about this, but also quite excited for him as it is going to be such an experience. He is going on an anthropology course 1 month, studying the gypsies. He then writes a paper on it,. There are 17 of them going. He is doing his paper on the influence of television on the gypsies. I guess even though many of them do not have any modern amenities, they ALL have satellite televisions. Sounds like it could be very interesting. So they watch all the very stupid things people in north america do with their money and lose all persective on reality..... at least their reality.


Last Sunday night one of my “cancer buddies” died. I believe she was 38. She had ovarian cancer. It was diagnosed in 2005 and she had a remission for 4 years, a recurrence in 2009 and then intermittant chemo since then. We became online friends... She was also a musician and I sent her my most recent CD and she was so inspired by me having done a cd (while on chemo), she recorded a CD last summer. (at this time she knew that she was not going to be cured from her disease) She had the most incredible voice, she had 2 small children and wrote a blog almost right until the end. Her husband wrote it right up until the end. They had both prayed that when the time came it would be fast, and she would not suffer, and it did all happen pretty quickly and she had time to spend at home with her children, and if a death could be beautiful, hers was. It was a family experience with the children and her husband reading to her and just spending time. She went into a coma about 4 days before she died.


Another cancer patient, and a musician I know from my house concert series, Anne Feeney, was just diagnosed with brain metastasis. She was diagnosed last summer with small cell cancer of the lung, and underwent chemo and radiation. SHe had opted at the time not to do a form of radiation to the brain that was a low dose form. I guess since so many of those with small cell cancer of the lung, get mets to the brain they do some form of generalized radiation to kill off any cancer cells in the brain. She is now undergoing gamma knife radiation treatments to the tumour in the brain, which are high dose treatments to a very specific area, in fact like surgery without the scalpel. She seems to be doing well as the last I heard, she was off in Oakland , California at a conference, so here’s hoping that the Gamma knife was successful.


Our family has been absolutely devastated this week by an accident our neice has been in in Australia. It was a head on accident in which she seems to have bore most ot the brunt.

She was treated at the scene by a helicopter ambulance crew, with blood transfusions and chest tubes. (apparently she and the other lady injured at the site were the very first patients to revieve blood at the scene, via air ambulance) In the past they have brought blood to the scene, but they have just started carrying blood in the ambulance.

She sustained a serious head injury, and a fracture of the sternum, which caused her lungs to collapse (which is why they put in chest tubes at the scene) She also had internal injuries, fractures of her lower spine, and her femur. My sister and her husband caught a flight on Sunday night midnite to fly to Australia.

It is truly amazing that she survived this accident, but it seems as though she was in the best possible place, she was airlifted to a trauma center that specializes in head injuries. She was placed in a drug induced coma right at the accident scene and they began breathing for her right away.

Since this blog is taking me so long to write (2 weeks thus far), my neice is definately getting better, she had a second surgery 2 days ago to repair a fractured femur and elbow, and though there have been a few concerns post op, she seems to be doing well.

She has an enormous amount of challenges ahead of her, including a few more operations to repair broken bones.


An interesting tidbit about Australia health care. I do not know a lot about their system, but my sister tells me that they have this system whereby all drivers have to renew their licences annually, and the money from this goes towards paying for the costs of motor vehicle accident injuries. So all of her care is paid for, despite that it might be a very long rehab etc. Interesting.


We have just heard that we have been selected for a stage at the ORegon Country Fair.

We will be playing on the Shady Grove Stage at noon on Saturday the 9th of July.

We have been planning this trip since we left, and we will also be performing at Brewed Awakenings on the 15th of July at 6:30 pm, in Bandon. I have been trying to get ahold of Bulllards Beach campground as well, but since our cell phones have changes, we have likely gotten off of their list. (we have been playing there for 4 years now)



Our land is a 1.67 acre lot and it is pie shaped with the small part opening onto a cul de sac.
The large part opens onto the forest at the back.
We have to build the house up front because there is an archaeological covenant preventing us from building at the back. The place the house is sitting is basically on the edge of an ancient creek. (Our street address is Ancient Creek lane.... cool eh?)

so the back part of the house where I am standing to take this photo is almost directly west, and also opens towards the forest.

Well I have been writing this for way too long
Bye for now
Love
Janet
jankenb @ gmail.com

Sunday, April 10, 2011

a garden interupted

Hi everyone.
We are out on our property now, we purchased a Park Model home, which are RVs made more for semipermanent parking. It is an older model 1998, and we got it for less than more RVs cost. It is 36 feet long with 2 slide outs. (These slide outs are the old fashioned kind that you have to slide out by hand, it took Ken and I a day to get them out)
We just came back from my first official run since being in Canada. We just headed off the backside of our property onto a trail that made a 2.5 mile loop, which for me is........ priceless.
Our property is at the end of a culdesac that then goes into a big forest, and I am essentially 2 blocks from the tiny clinic I work at in Scotch Creek. (more on that one later)
I will try to post some pictures later when we get back to Chase.
We still have the rental house in Chase, until the end of May, but we JUST LOVE IT OUT HERE!!!!
I cannot wait until our friends Mark (our drummer) and Linda come to visit us with their dog, we will just be able to head off the back with dogs and NO LEASHES.... priceless.
After the Bandon house sold and we got the money, the US dollar had dropped so far that we were only able to purchase the land, and really have nothing left to build. So we will have to borrow from the bank, just to start the foundation
HOWEVER, anyone who knows my music, the first song on the first cd......... we have a home, we have a garden AND we have a place in the woods...
Guess we do not need much else. I wish I could remember the name of the song, I guess I did not put the first cd on the website......
HERE IN YOUR ARMS on the CD a time has come.....

Gardening, I have found this blog quite useful to go back and find out what I did wrong gardening last summer. I have JUST as many tomato plants maybe more, but I have not yet planted any of them, in fact I have not planted anything in the ground yet. I have a makeshift greenhouse with big lawn chairs and plastic draped over them.
I have already lost most of my basil seedlings, but they had been started too early anyways, so have restarted them.
I have pepper plants and tomato plants up to 4-5 inches spinach, arugula, asparagus, endive.
The area I am in has about an average last frost day about 2 weeks later than Eugene.

Our property is 1.6 acreas and we are on a street that all the other lots are 1 acre. We have one house on our left and another on our right that seem to have owners that are TOTALLY obsessed with mowing their lawns, as well as all the OTHER things that people do with lawns t his time of year, between the two of them there has been a mower going almost all weekend and the guy on the left is just heading out with a gas can.
I am certain we are going to be a big disappointment to the neighborhood. CHAOS!
Our vegetable garden is going to be out by the road, likely bringing down the whole neighborhood.
The guy on the left has already offered to loan us his bobcat (I gather to get our yard in shape to look just like his)
The little clinic I work at, it seems that everyone who comes in is a gardener. One patient I was just showing out of my office one day and in the hallway, he was asking if there are any plants I would like, I said, it would be great to get some Rhubarb starts, if someone is dividing their plants and all of a sudden three people said "I can get you rhubarb", the nurse, someone in the waiting room and the patient I was seeing.
So I have offers of strawberries, raspberries, chives, rhubarb, and a guy down the road has offered us all the apples we want in the fall (he has about 50 trees and nothing to do with them all), have I said how much I love it here????
There is this one thing about the neighborhood I really do not like, one of the guys on the cul de sac has two large flags in his yard and Canadian and American
Ken and I will get our peace flag out there

I HAVE HEALTH CARE INSURANCE! as of April 1st, it is SOO reassuring to know that if something happens we are not going to be destroyed financially. Between my biopsy and my visit to the cancer center, I have spent 800 dollars in the past 2 months. In Canada the amount they charge non residents is exorbitant. At the cancer center they were going to charge me 1050 dollars just to see the doctor, until I showed them my passport, and proof that I was on waiting list to get bc health insurance. Then they charged me 400. I think that if I would have had insurance they would have billed the insurance 200. I believe this is done to discourage americans from coming to Canada for their cancer treatments. I found the whole debacle kind of embarrassing, that a cancer center would be like that......in Canada.

I am doing well, I believe I have been losing weight, as the foods I can eat are so limited, and so I tend to snack less because I just end up getting pain and nausea half an hour later. (it took me a year to "get it") The rectal bleeding is always there too, but I don't worry about it anymore because I know it does not affect my blood count too much. (I guess this also took me a year to "get it")
So I am 2 years and 1.5 months post surgery, and it is looking more and more like I " beat the dragon".... I really do not think about it much, and almost never worry about it anymore.

Bye for now
Love
Janet

jankenb @ gmail.com




Sunday, March 27, 2011

nursing homes

Hi Everyone

I just got home from Williams Lake, my mother was admitted to a long term care facility this weekend and my sister and I went up to be there for this very difficult time. In Canada there is a shortage of long term care beds and so there is a waiting list,

so approx one year ago her name was put on a list for long term care. We thought it would be approx a 2 year wait for her to get in, and while we did not think the time was right when we applied, we felt that the time might well be right when 2 years came around.

I should also point out here that the waiting list are for the totally government sponsored beds. Someone with the funds can go into facility right away.

My father has been the primary caregiver for 4 years now, my mother had a stroke in Feb 2007, while having an angiogram. The angiogram was part of the work up for open heart surgery to replace her aortic valve. She went through 6 months of rehab and went home with a walker. We purchased a modular home that was set up for a person with handicaps, so that she could sit to work in the kitchen and we felt that she could be much more independent. In August of that year, the time came for her aortic valve surgery, and since she was getting very short of breath (due to Aortic stenosis) she decided that she still wanted to have the surgery. BUT.... a week before she was to have surgery she fell and broke her hip. She was flown to Victoria and both the hip surgery and the open heart surgery were performed within a few days of each other.

She did well after the heart surgery, but that she had had open heart surgery, she could not do the normal rehab that a hip fracture patient would undergo. (when the chest is split open with open heart surgery, the sternum takes a good 6 weeks to heal and you cannot put weight on your arms)

So she in essence ended up in wheelchair.

Last September my father admitted he was burning out from this, and we had a family meeting to find out how we could help and from this, she was started on a once a month week of respite care as well as twice weekly caregivers in the home to help with bathing. Then a few weeks her name came up, and we were in the position of either taking the bed, OR going back to the bottom of the list. (another possible 2 year wait)

So the decision was made to take the bed now.


My mother has some memory problems, but does seem to know what is going on right now and is seeming devastated and extremely sad. As one might expect, this has been an extremely difficult weekend for my family. We are all extremely sad to see her so sad.

In the two weeks or so of planning for this trip I have been trying to figure out a way to somehow make this all better. I have a certain amount of guilt for having been gone from Canada for so long, and only having seen my parents once a year or so. Now in coming back I wanted to try to make it up somehow and had hoped to be able to take her for periods of time to add to the respite and to make it easier for Dad to be able to care for her at home. BUT the bed came up before I was physically able to do any of that. So the decision now is not whether I can care for her for a week a month, but can I care for her full time?

We ARE hoping to break ground in building our home here in the next few weeks, and the plans we purchased we chose with the plan in mind that Mom would be coming for weeks at a time, so with mainfloor bedroom and wheelchair bathroom.

Ken and I spoke before I went up and have agreed that we CAN take her on full time with hiring care aids to look after her when I am working etc.

Although it is a very big step to take, I presented this plan to my family this weekend, and the consensus was to see how she does for the first few months. This will allow us time to get the house set up and ready for her. It is just breaking my heart though to know she is there and she does not want to be there, and when she asks, will I have to stay here forever?? I really do not know what to say.

I have told her about our house and that she is going to be coming for a visit and I guess we will start there.

This is clearly not something that every family has to deal with, as many people live out their lives without ever needing long term care. Several years ago my parents were visiting us in Bandon, and I took my father to the Wellness center to show him a bench I wanted him to copy for my yard. We had to go right through the Alzheimer's unit and my usual confident father was visibly terrified. He said on leaving to "shoot me if I ever get like this", implying he would never want to go into a place like this. I guess its just something most people hope to somehow bypass. I would say having worked on the other side of this issue for years that it is never easy and never straightforward.


I have to include another interesting tidbit I found out this weekend. I stayed the weekend at my parents house, I stayed in the van.

Looking for a book to read, I noticed a very plain book on the bookshelf titled “1906 fruit growers report”, which caught my interest.

Somewhere in reading about my mothers family a few years ago I read that my great grandfather, (my mothers paternal grandfather) has been commissioned by the BC government at the turn of the century to go into the Okanagan to determine the feasibility of growing fruit there.

(any Canadians reading this will know that the Okanagan has been one of the main areas that fruit has been grown in western Canada, but in more recent years, grapes.....)

I guess I was unsure of the validity of the statement until I started reading this book tonite. The book was essentially a meeting of the fruit growers of the "dominion of Canada", in Ottawa. He was a delegate from BC. There were several Canadian government officials who attended including the minister of agriculture, “the minister of Militia” and the governor general of Canada.

What is even more fascinating about this book is that a one of the primary objectives of this meeting was to address the “adulteration of foods”

There is a good deal of discussion of the impurities that were being added to the foods, such as preservatives, colour dyes and glucose. The minister of agriculture was essentially saying that we have preserved food without these substances for many years, safely why allow these substances now. (in 1906)

I have really only skimmed the book, but was extremely proud to read my great grandfathers comments. I guess I always knew that my love for gardening was so strong it MUST be genetic. I certainly will write more about it.

On my last CD the song I wrote, “with this seed” was actually about this, knowing my grandfather was a farmer, and my grandfather was a horticulturist.


Love

Janet

jankenb @ gmail.com

Tuesday, March 22, 2011

life carries on

Hi there
We have now been in Canada for almost 2 months, and we are adjusting. Somehow it just seems as though if we could just get through the.......... then everything is going to be fine. We keep thinking that anytime now, our lives are going to settle down and the stressors are going to go away. Sometimes I wonder if I just have this unreal expectation that there is such a thing as a life without stress.
We just today received the funds from out Bandon house, it was due on March 1st, and we had made offer on land here, so a very stressful month.
So everything going through today, yesterday we found out that Ken's dad had a heart attack last weekend.....
my mother is going into nursing home on Friday. Big step in my life..... sooooo hard to deal with. I had hoped in moving to Canada to be able to be more involved in my mother's care.

So my sister and I are driving up to Williams Lake to be there when my mother goes to the facility and Ken is going in the other direction to be there with his parents. His father is almost 90 now.
We have had multiple trips to Kamloops and Kelowna trying to get our vehicles "inspected" so that they can be licensed in Canada.
I think if we were to do it over again we might have just sold our vehicles prior to the move, for all it has cost and the time involved. I think that moving to another country is not for the light hearted.... and to do it twice is NUTZ. EVERYTHING has to be changed when you change countries.....my next big step is that April 1st, I will officially have health care in Canada. There is a 3 month wait once you arrive.
All of my medical misadventures have definitely aided in our medical knowledge, in that between us we have diagnosed 4 people with radiation proctitis, patients whom had been treated unsuccessfully for what was felt to be hemorrhoids etc. So perhaps others might benefit.
The land we have ....purchased is 2 blocks from the clinic I will be working at in Scotch Creek, it is 1.67 acres and flat and perfect for gardening/farming. I have hundreds of little seedlings growing in our rental house, just vying for a bit of light. (we do have undercabinet flourescent lighting in the kitchen) So I just have to keep everything growing for another week or so until we can put the seedlings out on our new property.
We have found a house plan online that includes photographs of the house fully built.
It IS smaller than the Bandon house, but all we really need.


We will make the downstairs bathroom wheelchair accessible so my mother can come and stay.

Lots of Love
Janet
jankenb @ gmail.com



Saturday, March 5, 2011

BC cancer agency

Hi Everyone
I have had my first visit with the cancer center in BC in Kelowna, yesterday.
It went very well and I even learned a few things.
The doctor I saw was a radiation oncologist and he had reviewed my records and was pretty amazed that a patient who had had radiation for gyne cancer would have the problems I am having. Through it all he concluded that I must just be one of those people who are extremely sensitive to radiation.
He had never seen someone with my kind of radiation develop proctitis, the enteritis OR the skin breakdown that I experienced at the end of radiation, the open wound that took 3 months to heal after radiation.
I quite liked him, he was pretty darn blunt.

He did have an explanation for how it was that I got these small bowel problems though.
I have explained some of this stuff a long time ago, but I am going to explain it again here with the newer information.
After a hysterectomy the pelvis is essentially empty, leaving lots of room for the small bowel to move down into the pelvis. The small bowel is more susceptible to damage from radiation, but since it moves around so much, one specific area does not get hit by the full 25 treatmentes of radiation. The Large bowel does not move around, as it is fixed to certain structures in the abdomen/pelvis, so it gets the dose the same for the 25 treatments. The large bowel is not as susceptible to the effects of radiation though. So this is why I have the proctitis, , the rectal area gets hit by each and every treatment. What I learned yesterday is that IF the small bowel is in any way "tethered" to anything in the pelvis, (such as when a person is post op and has adhesions, or scars HOLDING the bowel to perhaps a sidewall in the pelvis) then that area of small bowel will get the same dose every day for perhaps the entire 25 treatments. And being more susceptable to the effects, tends to sustain damage.

He was blunt about the follow up in describing the futility. So if the DO find a recurrence in the vagina, unlikely they could do much to treat it, because I could not be radiation any more PLUS surgery in that area would not heal.

The lesion that we removed 2 weeks ago thought it was very small, is not healing at all, it really does not do anything, so i am afraid I am back to that situation again, trying to get somethiung to heal in an area that does not heal well.

Things are going well, I am more thrilled every day to be here, we are spending more time with family all the time and it just feels right.
I starting in right away as a rabble rouser at the clinic.

There is this one policy they have that has the doctor who is on call for the ER going back and forth all day between the office and the ER. I laid out a plan and made a proposal to change all that and lo and behold, I DID get it changed and afterwards, everyone is saying "now why DID we do it that way" NO ONE liked it the old way, not the nurses, not the doctors and of course not the patients....and no one knew why we were doing it that way.
So all my years of training as a rabble rouser in the US, will definitely not go to waste.
We really like the other doctor we are working with, he is from Sri Lanka. He is extremely easy going and VERY easy to work with.
We also have a nurse practitioner whoe we work with and she is great too. The nurses in the ER are great too, in fact one of them was in the class behind me in nursing school back in 1977.

I really am starting to come to terms with my radiation stuff. I guess its like Kubler Ross's stages of grief and greiving. (She wrote all those years ago on death and dying, describing several steps a person goes through with any sort of loss) I am sure I have talked about this before, but mention it now, just in that I really can see that I have been through several steps of acceptance.
Kubler Ross's steps are : and note that this is actually on death and dying, but it has been found that people go through similar steps with any sort of loss

"The progression of states is:[2]

  1. Denial—"I feel fine."; "This can't be happening, not to me."
    Denial is usually only a temporary defense for the individual. This feeling is generally replaced with heightened awareness of positions and individuals that will be left behind after death.
  2. Anger—"Why me? It's not fair!"; "How can this happen to me?"; "Who is to blame?"
    Once in the second stage, the individual recognizes that denial cannot continue. Because of anger, the person is very difficult to care for due to misplaced feelings of rage and envy. Any individual that symbolizes life or energy is subject to projected resentment and jealousy.
  3. Bargaining—"Just let me live to see my children graduate."; "I'll do anything for a few more years."; "I will give my life savings if..."
    The third stage involves the hope that the individual can somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle. Psychologically, the individual is saying, "I understand I will die, but if I could just have more time..."
  4. Depression—"I'm so sad, why bother with anything?"; "I'm going to die... What's the point?"; "I miss my loved one, why go on?"
    During the fourth stage, the dying person begins to understand the certainty of death. Because of this, the individual may become silent, refuse visitors and spend much of the time crying and grieving. This process allows the dying person to disconnect from things of love and affection. It is not recommended to attempt to cheer up an individual who is in this stage. It is an important time for grieving that must be processed.
  5. Acceptance—"It's going to be okay."; "I can't fight it, I may as well prepare for it."
    In this last stage, the individual begins to come to terms with his mortality or that of his loved one.

K├╝bler-Ross originally applied these stages to people suffering from terminal illness, later to any form of catastrophic personal loss (job, income, freedom). This may also include significant life events such as the death of a loved one, divorce, drug addiction, the onset of a disease or chronic illness, an infertility diagnosis, as well many tragedies anddisasters."


Looking back I have really struggled with this "condition" working so hard to just make it go away. I realize now that it is not going to go away and I guess really what I wanted from the doctor is just someone who can recognize that it is a difficult problem, who is willing to help me when I need it. This doctor I saw yesterday, once I explained to him that I HAVE accepted that this will likely be a chronic illness, and my biggest fear/concern at this point is not having a doctor to help me with the symptoms.
There are times when I need pain meds, and antinausea and there may come a time that I need to have a procedure for the bleeding. I guess I just feel so much better knowing that I have a doctor for now who knows that this is a painful disease and is willing to help out where he can.

I have just had the most terrible night, had pizza for dinner last night, and bought come dark chocolate to have with dinner and was sick all night. So not sure if it was the cheese on the pizza, the chocolate, or if it was some of the veggies on the pizza, and we went over to Kelowna and I did not bring any of my nausea meds with me.

So lesson from that, I likely CANNOT eat chocolate at all, I need to take my meds wherever I go! AND it just seems to work better just to eat at home where I can cook all my own meals. Once I have my garden up and running that should not be a concern.
All my bedding plants that are all over my kitchen are about 2 inches high now, and I am really looking forward to having our acreage so I can plant them
I may need to get rid of the snow, to find a place to plant them, but doggonit, I may just do that.

OH and I just cannot say how much I love that I have been given another chance to be a doctor, I am just loving being a doctor, there was a time back at Eugene that I thought given the situation there that I might never get to practice medicine again, so I have been given another chance on SO MANY levels.
Life is great.

Lots of love to all.
Janet

jankenb @ gmail.com



Saturday, February 26, 2011

My second anniversary

I have to say that it has been years since I really looked forward to christmas, or my birthday etc etc. However I really do could the days to my anniversaries from my surgery. So I am now 2 years cancer free. It was quite timely how the results of my biopsy came back yesterday, just in time to add to the celebrations. My biopsy was benign!
So on wards.
Celebrated by getting a crown done on one of my molars which in itself was pretty exciting, since this was the first dental work I have had done in the past 14 years (and I have had lots root canals etc) that I was actually numb. So seem to have found myself a very good dentist.

May have created my own monster, in that the area that we biopsied is showing no signs of healing at all, however we will take out stitches today since stitches themselves left in can be a source of infection. But that is nothing I haven't already dealt with so no biggie there.

Bye for now, looking towards a hopefully warmer March.
Love
Janet
jankenb @ gmail.com

Thursday, February 24, 2011

first day in ER

Hi Everyone.
Almost 2 weeks down at new job and things are setting down.
I had my first day in the ER yesterday in about 12 years. It went well. I have to admit I have been somewhat indoctrinated into the american way of looking at the Canadian health care system (only very slightly, and even what I had preconceived is wrong)
I had a patient with what appeared to be a strain, I took an xray and it was non conclusive and speaking immediately with the radiologist, he suggested a CT scan (with my preconception of the Canadian system, I said "how long is THAT going to take?), and he said, just fax over a req, and send her over (over to Kamloops). SHe was back to Chase in 2 hours of so.

With one payer, everyone is working on the same page, and for a common goal, and that is the patient care. So it seems to save a lot of money just having everyone working for the same payer, so it cuts out a set of management in every dept.
Also this little "hospital" well its not really a hospital, it has an ER, lab, home care, xray, diabetes teaching, etc etc. No actual beds to spend the night.
The xray and lab are similar to bandon, except they only have techs and no managers, instead there is a manager for the whole building instead of a manager for each dept. (since it is small).

The charting is less onerous since we are only charting for record keeping for the patient, as opposed to the US where your charting is doing to defend your billing to medicare, (or other insurance companies)
What can I say, I just love it.

We DID purchase the acreage we were looking at, and the whole deal is more or less depending on us getting the money from the house in Bandon. SO I have started about 10 large flats with seeds all around the kitchen and bathroom to get all my seeds going, as when the snow is gone, I will have somewhere to put them in the ground.

Everything is going very well, except one ....little thing..
I had Ken remove a lesion that had formed on my vulva over the past few weeks, it is about 3 -4 mm, and very hard and seemed to have been altering the anatomy there.
We have sent it for pathology and are anxiously awaiting the results.
OF COURSE I spent a whole day reading about vulvar cancer and the good thing is that they did not mention any that were from recurring endometrial cancer. So if anything this would be a totally new cancer...which is better than a recurring one.
BUT I will try NOT to get too far ahead of myself and try to be patient waiting for the results.
But I did want to mention for anyone to report any changes spots etc on their vulva (the flappy lips on the outside of the vagina), it is not a really common cancer, but it is not unheard of either.. YOu can get malignant melanonas there as well as basal cell carcinomas, but most are more specific to the vulva.
They often present with itching, or irritation to the area. They can get mistaken for yeast infections. So anyone with chronic problems down there, need to get looked at with regards to the possibility of something else going on. There are many skin conditions that occur in the area including psoriasis.

Not sure if 2 days is too early to be looking for results, but I will head down and search out my results.

It certainly would not be the first time I panicked over nothing, and likely not the last

Love
Janet
jankenb @ gmail.com

Tuesday, February 15, 2011

happy valentine's day


Hi Everyone
Well yesterday was our first day of work. I just loved it, it was such a joy to be practicing medicine again. Ken, not so much. Ken was, if you can believe it..... grouchy....no say it isn't so.....
The big thing is that they have computerized charts here. Ken has worked with them at the job at the university and at the urgent care clinic. I have NOT worked with them.
I guess the program at the urgent care clinic is a much better program, and for me, I am easy to please because I have never worked with computer programs.
Ken is not grouchy today though, so all is well.

Met many wonderful patients who were all so appreciative that we are in Chase, and right off the bat sending women off for endometrial biopsies. NOT going to let one endometrial cancer get past me..... not on my watch....
The wonderful trumpeter swans posed for me just out our front window, they are amazing creatures. With several of them out there they basically sound like the horn section of an orchestra "warming up".
Not all is perfect though, and I am having more and more pain, which really has me worried. I have pain after I eat almost anything now. I often have nausea. SO OF COURSE I am worried about recurrences, like a broken record, it just comes around every 3-4 months.
Just when all of the stressors of the past several years have disappeared it just seems as though SOMETHING is bound to go wrong now. I guess that is where my twisted mind goes.
I do not think I am alone, I am sure that all cancer patients go through phases like this.
I did just get a call from the cancer agency, saying, not sure if you have been told about your appointment.....
YEA.... NO NOONE told me about an appointment.
So I am seeing the radiation oncologist on March the 4th in Kelowna and I am thrilled. It is a bit scary not having a doctor yet. So I have an "in".
Rex is all better, but Chewy DID figure out a way to get the rice and chicken, he too started with the diarrhea.
We did find out what caused it. Rex's stool cultures came back as "Clostridium Difficile",
better known as "c diff"
This is the bug that shuts down nursing homes etc......
It is an opportunistic bug which means that it is very common, but only infects when given an advantage. We see it most often in patients in the hospital who have been treated with antibiotics. The antibiotics kill off the good bacteria in the bowel, allowing C difficile to take over.
It is also seen in the elderly with decreased immunity.
Presents with diarrhea often bloody.

So today I am off and Ken is working ( I have half time position)
much love
janet

jankenb @ gmail.com

Thursday, February 10, 2011

Wasn't it a party?































































Well Rex is better.


We are finding that the two hardest things to get sorted our have been getting the mini cooper into the country and me getting into the cancer agency.

If we were to put together all the time Ken has spent on the phone trying to get the mini cooper into the country, I would said it would likely add up to about at least 8 hours.

For some reason BMW, the makers of the mini) have created this incredible complicated system such that we will have to pay 2000 dollars to change over our car to Canadian standards. The running lights (in Canada it is law that all vehicles after a certain date must have headlights that are on all the time for safety) We actually had the car set up this way after we bought it 9 years ago. Somehow to make it officially changed over alters all of the electronics and warning lights,so the whole cluster has to be replaced. Then we need proof from the company that there are no recalls on the car. The Mini company has told us that there are no recalls, however they will not put it in writing, and in order to get a “no recalls” letter will cost us 500 dollars. So we have been going around and around with this.

The other thing is getting me into the BC cancer agency for my followups. They have all of my records showing my cancer, pathology, and all the treatments, and I have copies of all the films. They said that they needed a letter of consult from my Eugene doctor. She sent a letter that only said that I have all my records. I am not sure what her issue is and why she would not send a consult letter.

So I called the cancer agency back and asked exactly what they wanted in the letter and they said the letter has to say what she wants them to do, but I said is this not standard...?

THen I asked, perhaps I have something confused here, “do you DO followup here” they assured me that yes they DO followup of cancers.....

So I asked if I could get a letter from my primary care doctor and they said yes and she faxed letter and they said that they did not get it. So then I asked if my husband could write a letter and they said yes....

SO I figure WHAT GIVES?? If my husband can write the letter, this is obviously a formality, and apparently has nothing to do with insurance.

I guess I HAD my hopes up that things would be diferent up here, but.....

I have explained that I DO have insurance....


I guess it has always seemed that a clinic that cares for cancer patients should be compassionate to the difficulties that cancer patients go through and I really would feel SOO much better right now to at least know I have somewhere to go if I have a problem. Since I still have a lot of bleeding and pain, I just would feel better to know I have a doctor here.

So me and the mini seem to be out in the cold for now...


I have been to the dentist though...


Rex, we thought perhaps was not going to make it, with his age, and the amount of diarhea and blood that he passed it just seemed he is so frail anyways.

But we took him to vet and in the vets office he had another bloody diarhea all over the office, seemed like it was just exploding.

She was certainly impressed.

She was great, and did a full exam, we did samples of the stool and she gave us syringes and needles (we still had bags of IV fluids from when I was on Chemo) So we drew up 60 cc of fluid and injected it into the subcutaneous tissued in the neck. We actually only did this twice because he seemed to be be starting to get his appetite back by this time and gradually he has been eating and drinking.

So he seems to be fine now.

I guess it was food poisoning.


Likely all those dead fish on the beach, not sure if I mentioned that this lake is connected to the adams river which is the site of the largest salmon run in north american. They all go there to spawn in October and this past year was the largest salmon run in 100 years. and ......... they all ....died and floated down the river and the Shuswap and Little Shuswap are completely lined with dead salmon.

Since it is cold, they are frozen but the vet said that though “salmon poisoning” is not common in this area, they may carry many other infections.

So Rex is eating rice and chicken and Chewy is very jealous, and trying to figure out how HE TOO can poop out bloody diarhea so he can get some rice and chicken too.


We are expecting to get the funds from our house at the end of the month, and have been looking for an acreage out at Scotch Creek which is a small town on the Shuswap.

(Chase is on a smaller lake called the “little Shuswap”)


It is 1.6 acres on a very flat area, and backs onto a wilderness area. Would be great for gardening. It is hard to envision land, when it is covered with snow.

Anyways I will get this blog posted as I have included many of the photos from our last party. ...... of many of the wonderful people who have touched our lives in the past several years.

Just going through the pictures, they "cross section" many aspects of our lives in Bandon...... great party.

Also one shot of the "high tunnel" to show how productive it was despite freezing temperatures, the spinach and mustard greens were growing like crazy.

Today Ken and I are going into the clinic to learn the computer system and on monday we begin work....YEA>>>>

Love Janet

jankenb @ gmail.com




Thursday, February 3, 2011

we have arrived!

Well we have made it to Chase, and life is good.
We have a rented furnished house to live in until July 1st. It overlooks the "Little Shuswap" lake and we watched the trumpeter swans out our front window on the lake http://en.wikipedia.org/wiki/Trumpeter_Swan
Just as an aside, about the swans, they were hunted to near extinction at the beginning of the 20th century. Out in the Chilcotin (an area west of where I grew up in BC), a man named Ralph Edwards is credited for saving the Trumpeter Swans by hauling grain up to Lonesome Lake in the 1920s and 30s. A book was written about him by Leland Stowe, called "the Crusoe of Lonesome Lake".
They only come in the winter.
Well it is now the 4th and every day is getting better and just now realizing what a very difficult time the past while has been. I said to Ken I just could not believe how much better I felt yesterday than the day before, and today I just cannot believe how much better I feel.

Our malpractice and privileges have pretty much gone through, and so essentially all the things that were issues in our working in Eugene, have been solved here. We have left two beautiful homes behind, and it is always hard, HOWEVER... the house we are renting is so incredibly bright it seems to make up for some of the shortcomings. I guess all the snow helps the brightness, I had forgotten how much light the snow brings into the house.
I am so happy to be back in the same country as my children, and how badly I feel for having been gone for so long from my parents. Looking back I am trying to remember why we went to the US.
We went because we wanted to be by the ocean. Having a bit of a wild older son, the very best days our family had together were days on the beach. So we wanted to be by a beach. Most people are unaware of this but there is very little ocean front that is habitable on the west coast of Canada, and what is available is some of the most expensive property in Canada, Vancouver, and Victoria.
At the time we left, the BC government was limiting "billing numbers", the one thing you need to posses as a physician in order to be paid. The govt at the time thought that there were too many doctors in the province and that that was why health care costs were so high.
We wanted to move to a place called Sechelt, and it would have cost us 600 thousand for a half time practice (so a quarter time each), since the way the system worked. Rather than end up in debt just for the right to practice we looked south.
A flyer was frequently delivered to a friend from the OHSU, the med school in Oregon advertising positions for doctors in rural areas, and we saw jobs on the Oregon coast, and eventually took one. It took over a year to get our green cards.
Recently preparing for this move, I went back over our annual taxes for the past 17 years or so as I was curious if we really DID make more money in the US and many had accused us as moving there for that reason. I found that of the 14 years we have been in the US, only one year did we make more than we had in Canada, and many of the years we made less than a half than we had made in Canada.

Anyways, I digress again. It is now Monday and we are on our way to Kamloops with a very sick dog, poor Rex has had diarrhea for the past 2 days, and was basically up all night, and most recently has been passing just blood.
We are not sure if this is perhaps his end, but it may just be an infection.
We will see.
We are otherwise doing very well up here and I will post this now, with the hopes to have some time in the next few days to post a few pictures. We have very minimal internet where we are.

Love
Janet
jankenb @ gmail.com

Sunday, January 30, 2011

moving day

Well I am leaving in the morning.
I feel that I have been moving for months now, even years. We are not sure we ever really moved into the Bandon house. We built it, lived in an RV while it was being built, our 2 sons lived in smaller RVs next to ours, and we had a year of living in our own private RV park.
We moved in when it was finished, but somehow we never really moved in. Your whole perspective changes after living in an RV for a year.
You no longer have an affinity for souvenirs and trinkets, they are the first things to go when you are downsizing.
The really depressing part is that I really thought we had downsized a lot as we have gotten rid of a lot of stuff, and children (so to speak).
When you move to another country, you have to itemize everything you own, so you can provide a list to the customs person when you move. The way we have done this (now we are about to do IT for a second time) is that we have a book that we list everything that is in the boxes. Each cardboard box is assigned a number and the number goes in the book and the book lists what is in the box. Heaven help us should we lose the book. We are now making copies of the book so the moving company has a copy.
The last time we spent weeks packing and making note of everything and when we got to the border, the moving van had already crossed with out stuff and they seemed TOTALLY uninterested in our book.
(hard to pump yourself up once again to "itemize" everything you own)
However we have done that, and looking back, when we were at box 50, Ken was smug, saying that we have had over 200 boxes when we moved to the US ( as it we have so much less now)
Now we are well over 200 b0xes.
In 2003, we planned on moving back to Canada. We had taken a strong public stance against the war and had been "publicly" reminded we were Canadians and to mind our own affairs..
so to speak.
There were letters to the editor about us, we received what I would consider hate mail, and one day I felt extremely alone, I wrote a song called "Time to go". The

I feel it whenever the wind blows

I feel it deep in my soul

I feel it when the night is upon me

it's time for me to go

CHORUS

I Feel so far from home

I feel I don't belong

I feel like a stranger here

it's time for me to go


the tide will only get higher

the waves will start crashing in

my life will only get harder to bear

it's time for me to go


voices constantly calling

they question why I am here

they say whenever the wind blows

they say it's time to go


I yearn to be where the sun shines

my heart longs to be free

my heart will go where the wind goes

and I will go away


The song has always been one of my most popular songs and has been on two of my CDs. It has always been my families favourite song as well. For some odd reason there were several people who considered it an assisted suicide song, being written in Oregon, me being a doctor...

However it was an interesting journey into the realm of music, and all that goes on there.

It did feel odd playing the song after my diagnosis with the cancer though.

Today we did a video in our back yard, and if it is not at the end of this blog, it will be on one soon.


My health is... stable. My "twin" has just been diagnosed with possible recurrence of her cancer in the lymph nodes around the heart and lungs. When I say twin, .. she is someone who had exactly the same grade and stage or cancer and she received exactly the same treatments as me. Only thing is that she was 6 months ahead of me. I guess we were both thinking that we were out of the woods.

I am looking forward to "establishing" with the BC cancer agency for my follow up. I have more pain with time, and though it has been established that the pain is related to the radiation damage, it is hard some times, not to worry about the cancer..... but I don't... too often.


Well NOW it is moving day, I had a very rough night with nausea and pain, so I have opted to wait for Ken and drive up with him after the moving van leaves. We have to be at border before 3:30 to get the cars "imported".


The van is here...sooo

gotta go

love Janet

janken b @ gmail.com