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

where we are going

I have sat down to write now several times, but something seems to keep getting in the way.

So I will start all over.

The moving van is coming a week tomorrow to load our things and I will likely leave that day for Canada. Ken likely the day after.

I cancelled my health insurance for the end of January (what was I thinking)(it WAS a big deal though). I do have interim private health insurance in Canada, until the regular government insurance kicks in.(there is a 3 month waiting period)

Interesting though that the private insurance there costs less than a quarter of the monthly premiums we are paying here.

It was hard saying goodbye to everyone last weekend, such wonderful friends. The term "end of an era" was brought up about our leaving and I echoed the term in my comments of leaving. The wonderful people of the peace movement there really kept us there ......... perhaps longer than we should have stayed. We feel that all the conflict at the hospital really did me in.

However it was a time that I will always hold as a very special part of my life. To put it into a sentence.... It was the time I realized that even when all those around you disagree with you, you are not necessarily wrong.

I did truly love the hospital work as well, funny how a few bad apples can ruin the whole box.

Ken and I have decided that we are leaving SO MUCH behind, that at this point it is best we just look forward, lest we go crazy.

We ...kind of, sort of like, maybe have an offer on our house.. well you know how it goes.

AND we have had lots of interest in our Eugene house. It is all very painful, especially seeing the Bandon house go for what it is going for. Its like we spent 3 full years paying for the half of the house that someone is getting for free. Just isn't fair.

Looking forward. We have a furnished house to rent the first of February, in Chase. I am hoping to start work the first week of February. Joshes car is still registered, and insured in the US because he is a student and in looking into it, we cannot take it officially into Canada, so will have to drive it back into Washington and just sell it to a car dealer in Bellingham. (surely we are not going to come out on top of that deal) His car is a Kia and the year it was made 2006, it did not meet the standards required to be licensed in Canada.

Our Van will cost us a lot to take over as well.

Since we have lived in the US all these years we can bring our vehicles over "duty free", up to 10,000 and the rest we have to pay duty and tax on.

The Mini cooper will be fine, and it has winter tires on it, how cool is that?

We will be working at a clinic in Chase which has
View Larger Map

a satellite clinic over in scotch creek which you can see on this map where the two are, just zoom out and you will see Scotch creek on the north side of the bigger lake

We are looking at an older house on 3 acres half way between the two. I wish I was better with google earth and I would show you in more detail where we were going to be.

Well back to packing, will keep you updated. Love Janet

move date january 31

Hi there

Well Ken and I are definitely on the move. We have a moving date of January 31st and theoretically starting work in Chase BC on Feb 14th.

I might possibly begin before that date.

The Chase clinic is in a small town 2500 people on the little Shuswap Lake, which is right next to the Shuswap lake, which is huge. A real summer destination spot.

Chase itself is not so much of a destination as the points beyond Chase. We are looking at working in Chase and possibly eventually living at a place called Scotch Creek, which is a very small spot along the north Shuswap lake, as there are many small acreages up above the lake.

Moving and starting up this month will prevent us from sinking too much further into debt (whilst waiting for house to sell)

Ken has this (clever) ad running in the Bandon paper this week, advertising a half price sale on our house, with the price being about half of what it cost us to build.

We are trying to focus on being very unemotional about it all, after all its just money and we have our health.

Giving up the Eugene house is also very hard for us after all of our dreams of this little hobby farm. ( we have planted SO many fruit trees in the past and just left them). I worked SO hard last summer on this garden. However I am very thankful that I had such a great gardening summer and hope that soon we can have another garden.

So we try to keep looking forward instead of back and being up in Canada makes that easier. I just got back from yet another trip up to Canada yesterday. I went up to look for a house for us to rent to begin with.

Snowed the whole time I was there it seems. The mayor of Chase found us a house to rent that is fully furnished (the owners come just for the summers so we will have to be out by end of June) We figure we will have a better idea of where we want to live by then, and hopefully our properties down here will have sold by then and we can afford to buy up there.

Ken and I will work in a clinic that is next to a medical center. The medical center has lab, xray, and an emergency dept. The emergency dept is only open from 9 am until 3 pm each day.

There is a clinic in Scotch Creek that is sort of a satelite of the chase clinic.

Currently no doctors are going out to Scotch Creek clinic, there is a nurse practitioner that goes every 2 weeks. I am hoping to start going weekly to get that clinic going again. (there are 5000 full time residents on the north side of the lake and this would be their nearest medical clinic)

Ken and I have both signed a contract with Ken working full time and me working .5 time (half time)

Our two sons live in Kamloops (40 mins away)(as well as my sister)

My parents live about 3.5 hours away and Kens are about the same in the other direction.

We are having a big "leaving" party at our Bandon house on January 15th for anyone who wants to come, it may well be the last time we are in Bandon for a long while.

It will be a potluck dinner and I am encouraging people to bring lawn chairs (our couch and kitchen chairs are still there, so there is some seating.

So thats what we are up to, though leaving is very hard, we are trying to only look ahead.

Love Janet

jankenb @ gmail.com

Oh what a pain

Hi Everyone

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I will keep you posted.

much love

Janet Bates

jankenb @ gmail.com

radio show tonite

Hi everyone

Ken and Mark and I are playing live on a radio show tonite at 8 pm

Here is the link, the show is streaming.

http://www.krvm.org/listen/listen.html

Love

Janet

and them bones...

Well while I am at it, I might as well explain the rest.

A week ago I was up at OHSU at the osteoporosis clinic. A year ago it was suggested that I go on treatment for osteoporosis because my left hip was osteoporotic (or .1 points away from it).

I did not go on treatments because that was around the same time that all of my gastrointestinal problems began. I have taken calcium and Vit d though.

My other hip and the other bones tested were fine. I truly feel that this was a result of radiation, because I have been a long distance runner for years, I have done all the right things...... well that does not always work. Irregardless, I do not wish to have a broken hip before I turn 60, so will do the treatment.

At the clinic he said I had a 5 percent risk of a pathologic fracture in the next 10 years. He also suggested that he would not suggest I receive the oral form of treatment with all the problems I have had. There is a new treatment that is given once a year intravenously, and that is likely what I will do. The really important thing with this treatment is to have your Vitamin d blood levels normal. I had a test of my vit d levels and it was low. Hard to believe since I have been taking supplements for a year. He said it was extremely common in Oregon, I guess because of the lack of sunshine. I do feel I "partook" in as much sunshine as I could last summer.

The other thing I learned from him, is that since I am on a medication that changes the PH of the stomach (ie makes it less acidic) regular calcium (calcium carbonate)

was not well absorbed.

He said though that for people who are on any meds that change the ph of the stomach, that they should be on calcium "citrate". It is much better absorbed in any ph. It can be found at any pharmacy.

So I am not on Vit D 2000 units to raise my levels prior to the infusion. Many people are fearful of the osteonecrosis of the jaw, which has occurred on these meds.

I have recently been listening to medical lectures on CDs and it was explained that this only occurred in people who had had a dental extraction.

So it is likely a good idea to have your teeth checked prior to starting treatment to make sure you are not going to need a tooth extracted.

We have sub freezing weather now here in Eugene and my "hoop house" or "high tunnel" is keep cozy and warm..... well 34 degrees or higher, with no other form of heat.

The day before the big freeze I went out and cut off all my pepper plants at the base of the stem, cut off all the leaves and I have all the peppers in vases, ripening on the plants.

Apparently they will ripen faster if they are kept above 60 degrees, and slower at 50-60.

Below that nothing will happen and above 60-70 they will dry out.

So I have one vase in the garage, one in the back bedroom and one in the greenhouse, all different temperatures, so that they will ripen at different times. Apparently it works best if they are still on the plant. I had no idea how many peppers I had, until I "harvested" them.

One thing I have learned this year about tomatoes and peppers. In the spring, planting the seedlings I had grown in the greenhouse, the tomatoes were much more hardy.

The weather really had to be warm before the pepper seedlings would survive. However it seems as though the fall is the entire opposite. The tomato plants really started to suffer a month ago, whereas the pepper plants almost seemed to get stronger with the cooler weather.

We are still eating out of the garden, I harvested all of my carrots a few days ago and we had carrot soup, there was a very small crop of carrots.

Today we are having pumpkin cake for dessert, I had taken all our pumpkins and roasted them and pureed the pulp and froze it, and make a cake with it yesterday. The last of our potatoes we will also have today, did not get lot of potatoes this year either.

We still have tons of tomatoes ripening in boxes etc, but not sure how long that is going to last, I will have to go back on this blog to see when we started eating tomatoes, but it would be nice to be able to say we ate fresh tomatoes from our garden for 6 months.

Happy Thanksgiving to all, despite all my grumbling, we do have much to be thankful for, and we will remember that today

love

Janet

jankenb @ gmail.com

home is where the garden is

Hi Everyone

I have not posted for awhile, hard to summarize all that is going on. We have this little poster in our bathroom that lists lifes little instructions, and one of them is "don't expect life to be fair".

Some days we just feel that everything is just going against us.

Owning 2 homes is an extremely expensive endeavor and clearly a mistake we made while I was on radiation. With me unable to work, and Ken options limited right now as well, we are heading further and further in debt. We have had a little more interest in our Bandon house, but clearly no offers. In fact building that house was clearly a mistake given the market. It will never sell for even a fraction of what it cost us. AND then we bought a house in Eugene.

I am sure that there are many people in much worse situations, but this is not at all how we had planned it.

On top of it all, I have just found out that I cannot get malpractice because I did not take out tail insurance when I gave up my insurance in feb 2009. I had not seen a patient out side the hospital in about a year, and the hospital insurance covered me there, and neither Ken nor I had any idea what tail insurance was.

In Canada malpractice insurance covers you for the period you pay for it, so if you are covered on june 1999 and in 2005 you get a lawsuit against you, you are covered because you had insurance then.

In the US, turns out that you are only covered as long as you continue to pay for insurance. Feb 2009 I was diagnosed with cancer and did not understand any of this, so cancelled my insurance for outside the hospital. Ken had done the same when he started at hospital

Well it turns out that insurance companies will not cover you if you have had a break in your insurance.

The work we have been doing has been covered under other people, ie Ken is covered at the university and is considered a locum at the urgent care clinic, but this is quite limited (he is only allowed to work 30 shifts a year)

Ken would likely be insurable because for him it has been over 5 years since he worked private practice.

Anyways, we are in this dreadful financial situation that really requires us both to work, and so we are looking elsewhere for work, and in fact looking north. (our medical insurance for the two of us is 1250 a month)

We also both have aging parents whom we want to spend more time with, as well as children whom we (for some ODD reason) find we really miss and wish to be closer to.

That all combined with the thoughts that we just could not stomach another election with Sarah Palin...... as well as many other reasons...

We are looking for work in Canada. British Columbia to be exact.

They are very short of doctors, and it seems like that is pretty much everywhere.

They are very short of primary care doctors in the US as well....

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

THAT FIGURES. So I met with them yesterday.. we will see.

Medically, a lot has happened. The hyperbarics only really worked for awhile and within a week I was bleeding as much as before, so of course I went back to the books.

The truth of the matter is that there is no one treatment for radiation proctitis that has been studied enough to recommend clearly.

So all these other treatments, hyperbarics, argon plasma treatments, etc are all treatments that have shown promise, but they need a really big study to be able to say that they work!

One fairly inexpensive treatment, with no side effects if the use of sucralfate enemas. I got the gastroenterologist to order them, he made sure to tell me he had never done it.

The enemas have to be prepared at a compounding pharmacy, because sucralfate exists as an oral formulation in the US, but not in an enema form.

Sucralfate is currently used when a person has a bleeding ulcer, they take it orally. It is felt to provide protection to open wounds, in fact it is being used also to treat chronic skin wounds.

So it makes sense for my kind of wounds, only mine are on the inside, hence the enemas.

It is 20ccs given twice a day, and I actually purchased the studies( which were all done in other countries) to get the details of how to do this. They suggest to lie on the left side for up to 30 minutes following each treatment.

The really great thing is that after only 2-3 days on treatments the bleeding was appreciably better, and after a week, it is still improving. I will continue for a month and then reassess the situation.

I am very hopeful about this new treatment, and feel that it is largely ignored in the US. I have read everything about it at pubmed which is where published articles are kept, and can find no downside, and only upsides. I just do not understand why it has not be adopted in the US. I do feel it is just wrong to ignore this problem, from everything I have read it only gets worse.

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

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

The other really great thing is that I have been doing really well with running. I have been running every second day for about 2.5 miles, for the past 8 days. So I have a great start on returning to that.

Well for the first time in 13 years, we are looking forward to celebrating thanksgiving. If nothing else we feel that we have options, and many people do not.

One of the girls on the hystersister cancer forum died yesterday (I have followed this forum for the past year and a half). Truly is sad what this cancer does to the lives of so many people.

Bye for now

Love

Janet

jankenb @ gmail.com