Wednesday, January 28, 2009

Risk Factors for Breast Cancer

Just had chemo today and Geoff and I brought my oncologist our worries about chemo being so easy last time and is it really doing what it's supposed to do? The doc showed me my blood counts from the first time I did chemo with him without the 10% reduction and reassured me that I had literally no immune system after that. When he reduced it by 10%, my immune system was still low. He also checked me and told me he notices a difference and said I should check in with the surgeon next week - just to touch base and see if he wants to do surgery before I continue on with the next 3 or 4 rounds of chemo. (That appointment's on Monday morning.) He also reassured us that chemo is supposed to be this way - easy. Geoff joked about how we were expecting chemo to be horrendous and were disappointed when it didn't meet our expectations!

Over the last couple of days I communicated with 2 people who needed to hear my story. It's a story I've been reluctant to go into just because I feel so guilty about not catching this sooner had I gotten a mammogram or thermogram earlier. (I'm still in the "if only's.) But it's something I need to eventually write about here because I know it will help so many people. I hate to say this but if/when I do die from this, G-d forbid, I want this carepages to be a source of healing - something good that came out of this disease.

For today though, I'll just give you the Risk Factors for Breast Cancer and tell you where I fall in those factors. I got this list from the book put out by Johns Hopkins and given to me by my mother-in-law's dear friend, Jo Ann. It's called, "Choices in Breast Cancer Treatment - Medical Specialists and Cancer Survivors Tell You What You Need to Know," edited by Kenneth D. Miller, M.D.

The Risk Factors:
*Age over 30 (I'm 49)
*No children or first child after age 30 (I had my first at age 35)
*Benign breast disease - fibrocystic disease (I've had this since I was in high school and it went away for about 7 years with a supplement I was taking and came back when I stopped the supplement - so that's probably one reason why I ignored it for too long - along with denial and fear.)
*Obesity/high fat diet (I've been overweight, I don't know if I'd be considered obese but maybe. For sure my fav foods are pasta or bread & butter and cheese. Especially since I can't do sugar at all or I catch a cold.)
*Family history of cancer, especially a mother or sister with breast cancer. (My mother had uterine cancer and DCIS which is a form of pre-cancer that was caught early with a mammogram. I've had skin cancer - basal cell. My aunt on mom's mother's side, my grandma's sister, died of colon cancer.)
*Early onset of menses. (I had a normal onset of menses but not menopause. I started skipping periods on the earliest side of "normal" - around age 45/46 which is why I thought stopping that supplement may be a good idea - of course, now, I think I was wrong to stop it, but who knows - according to the rabbi, this was all meant to be and for a good reason that we may not know right away.)

The last and in addition to early onset of menses, the only risk factor that I would probably not be considered to have is lower socioeconomic status.

There's another risk factor that wasn't mentioned in this book, but when I went to see every oncologist, they asked me this: Is your ancestry Askenazi Jew? It is. But I got tested for the BRC gene and don't have it but you don't have to be Jewish to have the gene.

So, not to make this soooooo long you don't want to read it but here are some other risk factors that were not listed in this book but are out there in the new age, psychology and alternative medicine field. These risk factors are not totally researched or validated but I did read a book that did show some studies validating some of it (Imagery In Healing - Shamanism and Modern Medicine by Jeanne Achterberg) - a book that my dear friend Liz loaned me that she got from her friend who died of this disease perhaps due to not following all of the traditional medical model's instructions because she was so into the alternatives). The list I've compiled below has caused me lots of guilt and pain and one of them contributed to the choices I made as far as not getting myself checked:
*unresolved anger
*unsupportive spouse - or believing that the spouse is unsupportive
*negative thoughts
*radiation from mammograms
*being wimpy and not standing up for yourself in life and not taking care of yourself

I'm still emailing the rabbi back and forth and asking more questions. So I will let you eventually read my entire story of what transpired between the time I stopped the supplement and started feeling a lump and the time I finally got diagnosed - at such a late stage when they just rarely see that anymore now that so many women are getting their regular mammograms.

On to another easy week of chemo where if it goes the same as last time, I'll start to feel body pain on Thursday night and then want to be in bed just sleeping and watching TV until Monday and maybe have one day of nausea where I actually need to take something for it. Easy. Hope you all have a great week.

Monday, January 26, 2009

The Rabbi's Answer

I asked my rabbi to look at my post from last week: "Enjoying Life" and to please give me the Jewish answer to the question of where G-d's plan ends and my will begins. For example, is this disease my fault? And if it was G-d's plan, then what does "Tract gut vet zein gut" (think good and it will be good) have to do with my being able to control outcomes when G-d's controlling everything?

This is what he wrote me back to answer my questions (through email):

Rabbi Yochanan Friedman
to me

Hi allison,

Sorry for the delayed response.

In any case, here are my thoughts.

You know the joke about the fellow who is caught in a flood but refuses all the help that comes by saying, “G-d will help.” He dies in the flood and comes before G-d with a complaint. “Why didn’t you save me? I believed in you!” And G-d says, “I sent you three boats and a helicopter! Why didn’t you take them?”

An oldie but goodie and it's even relevant to this discussion.

So, here are my $0.02.

For starters, there are two words that are never appropriate in this discussion. They are “if only”.

If only I had had better thoughts…. If only I had gone to a different doctor…. If only I had been more religious… These two words are inappropriate because they are completely untrue, almost blasphemous. And this is where the joke is just a joke.

“If only” means that I think G-d may have intended for there to be a different outcome but I ruined His plans with my mistakes. That’s not possible. That’s taking far too much credit. “But how do I know it’s not my fault”? Well, you can repent for any poor choices you may have made. But that doesn’t change the fact that what was is exactly what was meant to be. Any pain that I had – provided it is in the past – was certainly meant to be.

The better question is what about the future? Can I influence the outcome from here on?

It is true that all that happens is G-d’s will. Nothing can happen outside of His plan. It is also true, as you write, that “tracht gut vet zein gut” – positive thought creates positive outcome. How do the two work in harmony?

You see, the “Tracht gut” method is no different than, say, going to a doctor or taking a vitamin. In G-d’s plan there are many ‘conduits’ for health. Good health can come through exercise or through the right supplements. Good health can also come through surgery or other more painful means. In much the same way, health can come in the merit of giving charity or through the blessing of a Tzaddik – or, by creating that health in your mind.

Different situations demand different actions to solve particular problems. Which action – or what combination of actions – will be the right solution for my particular circumstance? And how is that determined? The answer to that is, that’s where we defer to Divine providence. That is indeed predetermined.

In other words, whether you’ll be saved by the boat or the helicopter is not in your hands. You have to take the solution that Divine providence has set for you. How do you know which one it is destined to be? Well, you don’t. You just try your best and give every responsible option a try.

So, bottom line: Have a good doctor, eat well, take your vitamins and “Tracht gut” – and then “vet zein gut.” Why? Because any one of those could be the ‘vehicle’ through which G-d intends to deliver your good results.

I would expect that all this creates three questions for every one answered. But that’s the Jewish way. Let’s keep studying, and enjoy the journey as much as we hope to enjoy the destination.

I look forward to your feedback.

Best wishes and Zei gezunt!


Next Chemo - Wednesday

Hi Everyone,

Just letting you know that I'm still doing fine...though I should probably go back on my vegan diet. Darn. My tummy needs me to go really slow with introducing the old diet back but I really have a hard time eating different food than the rest of my family! We've had some delicious meals from friends but maybe it's all been too much for me: Italian pasta with tomato sauce and cheese and chicken enchiladas! So good! Breads...I even made a challah for Shabbos for the first time in months. But I can tell I've been going a bit too fast in that direction. Oh well, I'm not in the hospital, right? I have to count my blessings. And one of them is that the chemo treatment was so easy last time.

So one more of the A & C and then in 3 weeks I'm on to the T. The T is a 4 hour drip. That's why this time, (my last of the 2 hour drips) seems like a piece of cake, so I haven't asked anyone to visit. Sharol told me she wants to come visit though. So of course, I won't refuse that but won't ask anyone else since I will be saving my favors for the long 4 hour drip next time!

It has been really nice that each time I've sat for my chemo, I've had a friend come and visit me. And when I was in the hospital, my friend Stefanie showed up unexpectedly right in time for my blood transfusion. That was a horrendously scary experience for me and I was going to go through it alone, but Stefanie ended up walking in and made it so much better for me. I was focused on the blood of people I didn't know flooding my body and instead, she helped me focus on all the incredibly kind people who gave their blood for me.

So my friends have been a truly great support to me through this difficult time. Thanks to all of you. And because my chemo has been so easy, I was able to set a time for my parents to visit again. They were here for my very first chemo and the night after they left, I ended up in the hospital, so I've been holding them off for awhile though my dad asks me almost every day to let them know when they can visit again. My dad has been sending me lots of Harry & David gifts and so when I got sent the 3rd turkey on Thanksgiving when we had a huge one cooking in the oven, I came up with another plan for him. I gave him a list of places to get gift cards for me. (Thanks to Stef-it was her idea.) So now I've got some gift cards to New Leaf and Trader Joes! Lucky me. I got Aimee a new thermos (from New Leaf) to take her lunch to school (she hates sandwiches), along with some supplements I needed and organic beans and rice (food I need to be going back to). Thanks Dad!

Next chemo: this Wednesday at 9:30am.