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

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

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

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

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