A few years back I was diagnosed with breast cancer, two different kinds in both breasts. I had chemotherapy followed by surgery then radiation on one side. I did a great deal of research into the subjects and opted for a double mastectomy without reconstruction.
Refusing reconstruction is not the most popular choice women make. Often it is not presented to them as an option. When I saw the plastic surgeon I had done my research and I had questions. He had told me he could make me one beautiful breast and one that they could fix surgically a year later. The need for radiation on the one side post surgery would like cause deformity in the one breasts. Hmmm. Breasts seem to come in even numbers: zero or two. I wasn't excited about one normal, one iffy. "The metal expanders you put in, will those remain in during radiation?" I asked. The reply was yes. It was the next question that stumped him. "So do the expanders deflect any of the radiation or warp the radiation field in any way?" Silence. He didn't know. Two phone calls later to radiation oncologists, the response was, "We can work around that."
Shaken by what I felt was a questionable response to a reasonable question, I went home, did more research, and opted not to have reconstruction. It required too many surgeries for my taste. The plastic surgeon told me statistically I would be happier if I had the reconstruction, and I do remember asking my surgeon to give me the "pretty" stitches as I was not intending on any reconstruction. She laughed and told me that all of her stitches were the pretty kind.
Three months post surgery I did finally attempt prosthetic for a couple of months. The sales person kept telling me I would mess up my back if I didn't wear them and I owed it to myself to wear them. Silicone is the standard and I found it hot in the summer, cold in the winter and very heavy although I had chosen only B cups. They pressed on my scar tissue and the band around the bra gave me lymphedema. After three months I stopped wearing them.
Breasts did appear to define who was as a woman and I was not about to endure pain for the look of breasts. It has been 5 years and I am still sans breasts. I don't think about it often and in the right cut of clothing I believe I simply appear flat chested. I even found the love of my life sans breasts; he loves me for who I am without them.
While turning down reconstruction may not be for everyone, I have seen a growing population of women out there on the internet that have done the same. It isn't a matter of doing what we are told, or even doing what statistics say we will make us happier. It is really about knowing yourself and making the decision that is right for you.
Sunday, February 12, 2017
Things We Are Good At Doing
My best friend and I were talking on the phone when I heard her say, "I am only good at two things. Only two things fill me up, walking and helping others." This was when I knew my friend was in a kind of crisis and she didn't realize it. Having been friends for 35 years, we have been through many ups and downs together. It saddened me to hear that my very best friend thought she was only really good at two things. She used to be so confident which had me wondered where all that confidence had gone. As a tribute to my best friend, who is so much more than a walker and helper, I want her to know a couple of things that I alone have found her to be good at doing for which she is not giving herself any credit.
1. Telling jokes. She is the best at remembering and telling jokes.
2. She has this lovely singing quality to her voice, the tone of which is cheerful and soothing.
3. Loving with all of her heart. She selflessly loves her children, her grandchildren, her animals, friends and husband.
4. Entertaining. She is the queen of hostessing. Everyone feels at home, she creates a lively atmosphere. People's food preferences are always considered. She even makes more food so everyone can take some home.
5. She is an awesome grandmother caring both for the emotional and physical welfare of her two grandgirls. She travels with them, hikes with them and exposes them to all kinds of education events.
6. She is the kind of friend that will show up on your doorstep when you need her most. She is keeping friendships and knowing when to let them go.
7. She is a great listener and conversationalist. She puts everyone at ease and is able to laugh at herself.
8. She is a good wife to her husband. She takes care of her family's emotional and physical wants and needs.
9. She plays well with others and has never met a stranger. People just like her.
10. She is uber creative. Her home looks like it came out of a magazine and she did it all herself. She has a super decorating and organizational instinct. Best of all she can make the place look like a palace without spending exorbitant amounts of money.
11. The woman is adventurous. Whether it be traveling across Europe or hiking up an active volcano, she is there.
12. She is extremely giving of herself. She does a great deal of volunteering for the Alzheimer's Association.
13. She rocks at being a health care advocate for people. She is not intimidated by medical professionals in the least. She boldy asks for explanations and clarification.
14. She is a painter. She paints walls, ceilings, front doors. She paints landscapes and flowers. And she is good at it.
15. She is quite the cook and her family all loves her cooking.
16. She is very observant and aware of the people in her immediate circle. She senses when they are feeling unwell often before they know it themselves.
17. Tribal. Well that's what I call it. She has these moments of insight and wisdom that are so right on and deep that it can take a while before you can wrap your mind around them.
18. A classy dresser. She always looks put together and stylish. I love it when she is my personal shopper. I tend to dress on the frumpy side and she does what she can to interviene which I appreciate.
19. Extremely patient with the infirmed and elderly.
20. Smart as a whip and catches onto things really quickly.
Perhaps we should tell people more often about their qualities that we appreciate. Maybe we should do it now before they feel they are only good at two things.
1. Telling jokes. She is the best at remembering and telling jokes.
2. She has this lovely singing quality to her voice, the tone of which is cheerful and soothing.
3. Loving with all of her heart. She selflessly loves her children, her grandchildren, her animals, friends and husband.
4. Entertaining. She is the queen of hostessing. Everyone feels at home, she creates a lively atmosphere. People's food preferences are always considered. She even makes more food so everyone can take some home.
5. She is an awesome grandmother caring both for the emotional and physical welfare of her two grandgirls. She travels with them, hikes with them and exposes them to all kinds of education events.
6. She is the kind of friend that will show up on your doorstep when you need her most. She is keeping friendships and knowing when to let them go.
7. She is a great listener and conversationalist. She puts everyone at ease and is able to laugh at herself.
8. She is a good wife to her husband. She takes care of her family's emotional and physical wants and needs.
9. She plays well with others and has never met a stranger. People just like her.
10. She is uber creative. Her home looks like it came out of a magazine and she did it all herself. She has a super decorating and organizational instinct. Best of all she can make the place look like a palace without spending exorbitant amounts of money.
11. The woman is adventurous. Whether it be traveling across Europe or hiking up an active volcano, she is there.
12. She is extremely giving of herself. She does a great deal of volunteering for the Alzheimer's Association.
13. She rocks at being a health care advocate for people. She is not intimidated by medical professionals in the least. She boldy asks for explanations and clarification.
14. She is a painter. She paints walls, ceilings, front doors. She paints landscapes and flowers. And she is good at it.
15. She is quite the cook and her family all loves her cooking.
16. She is very observant and aware of the people in her immediate circle. She senses when they are feeling unwell often before they know it themselves.
17. Tribal. Well that's what I call it. She has these moments of insight and wisdom that are so right on and deep that it can take a while before you can wrap your mind around them.
18. A classy dresser. She always looks put together and stylish. I love it when she is my personal shopper. I tend to dress on the frumpy side and she does what she can to interviene which I appreciate.
19. Extremely patient with the infirmed and elderly.
20. Smart as a whip and catches onto things really quickly.
Perhaps we should tell people more often about their qualities that we appreciate. Maybe we should do it now before they feel they are only good at two things.
Saturday, February 11, 2017
The Hostile Work Environment
The last few years I have been working in a highly toxic work situation, I mean a seriously hostile work environment. The person I worked with had the trifecta of disease which translated into her inability to play well with others. She had a very unstable bipolar disorder, was a long term alcoholic and had one of the worst cases of narcissistic personality disorder I have every experienced. She flung about wild, delusional accusations all of which my boss believed. She had gross gaps in her memory and frequently was unable to recall recent conversations. Everyone was her servant in her mind.
Previously she had been found in her office by the custodial staff one evening with an empty wine bottle on her desk, passed out on the floor. She had hit her head on the corner of the desk and was lying in a pool of her own blood. Naked. Yet she kept her job. Fear of a law suite because of the Disabilities Act, maybe.
The three of us would have meeting after meeting in my boss' office. The post mortem on the meetings went somewhat like, "Why can't you get along with her?" "Get along? The only way to make her happy is to do her work for her. " "Then why don't you?" he suggested. I tried explaining to him that I already had a full time job. If he wanted me to do her work for her then he should draw up the contract and make me an offer for overtime at which point he threw up his hands in exasperation and stormed out, (he was prone to tantrums and yelling himself.)
One lovely meeting the woman had a classic psychotic break right then and there. My boss had tried to explain to her that she could not "boss" me around as she was not my supervisor. She lost it. Her voice changed into some state of demonic possession and I had scenes flash in my mind from the movie The Exorcist. "You are not the boss of me......you need a boss....I don't need bossing, no one can boss me, no one can control me, I don't need CONTROLLNG!" It was spooky. I assumed we would be calling an ambulance and she would be on a 72 hour hold with evaluation. I turned to look at my boss. Equally disconcerting was my boss sitting there, legs crossed, looking and acting as though nothing unusual had just happened. I could only think what a horror his home life must be for him to sit there as if this was normal.
I have questioned myself often as to why I did not file a hostile work environment complaint. Obviously I am lacking litigious sensibilities. I truly thought it would make things even worse for me which was probably true. I was ever so tired on the inside of fighting the ridiculous nonsensical battles. Taking on yet another battle didn't make sense at the time.
She finally resigned. Oddly, there has been some fall out from my work environment returning more to normalcy. I am still on hyper alert, just waiting for the next unfounded, false accusation. I dread seeing my boss as I've come to realize he is a very broken human being and the tantrums he has are ugly. I still dread going to work. I have unexpected bouts of anxiety. While the poisoning has ceased, the effects of its toxicity are fading slowly. It's going to take some time to heal.
Wednesday, February 8, 2017
Multi Drug Resistant Gene (MDR1) and Collies
The Collie breed
along with a few other breeds, are carriers of a genetic mutation in the MDR1
gene. This protein made from this gene
is responsible for transporting drugs across the blood-brain barrier. A mutation
in this gene enables some drugs to accumulate in the brain in abnormally high
amounts possibly resulting in an overdose and death of the dog. The following link lists breeds known to have
MDR1 mutations and includes the frequency of the mutation https://www.vgl.ucdavis.edu/cghg/mdr1b.php About 75% of all Collies are affected in
some way either being carriers of the mutation or pure mutants. Dogs with two copies of the mutation (25% of Collies)
are highly susceptible to overdosing from some drugs.
A classic saying
taught to veterinarians during their schooling is, “white feet, don’t
treat”. The sentence typically refers to
the use of Ivermectin. The number of
drugs found to be affected by the MDR1 mutation has expanded past Ivermectin ( vcpl.vetmed.wsu.edu/problems-drugs
). Included in the list are many de-wormers
and anti parasitics (Ivermectin, Flagyl), Loperimide (Imodium® - anti-diarrhea),
Morphine, Buprenorphine, Fentanyl and Acepromizine (pain
killers and pre-anesthetics), as well as many chemotherapy agents.
Recently I had an
encounter with a newly graduated veterinarian.
She quoted to me the, “white feet, don’t treat” saying and also told the
pup, “No Ivermectin for you.” As I was
casually mentioned that many other drugs were now included on the list, she was
about to give the pup a dose of de-wormer (we had forgotten to bring in a poop
sample). I stopped her and asked her
what were the active ingredients in that wormer and she didn’t know. Not
knowing the MDR1 status of my pup and having my handy list of drugs known to
cause problems in MDR1 mutants with me, I stopped her until I had an answer.
In summary, it
may not only be useful, it may be life saving for our dogs, for us to know the
dog’s MDR1 status of our Collies and familiarize ourselves with the list of
harmful drugs if our dogs have the mutation.
We should not rely on our veterinarians to be encyclopedias of all
breeds and drugs and we should be able to have discussions with our
veterinarians about their drug choices for our dogs.
Below are links for
MDR1 Testing. Testing is as simple as mailing in a cheek swab. At
this writing the last link had the best pricing. Two out of my three
Collies are carriers and one tested to be a mutant. The mutant happens to be the pup mentioned
above in the de-worming example.
MDR1 Testing
The drugs listed below put your MDR1 dog at risk.
Class A
Do NOT use these drugs with the MDR1 gene defect:
Ivermectine substances "Anti parasites": (Diapec®,
Ecomectin®, Equimax®, Eqvalan®, Ivomec®, Noromectin®, Paramectin®, Qualimec®,
Sumex®, Virbamec®)
Doramectine substances "Anti parasites": (Dectomax®
)
Loperamide substances "ant diarrheal ": (Imodium®)
Moxidectine substances "Anti Parasites"
(Cydectin®, Equest®) (Flagyl )
Class B
Use only under close supervision of Veternarian:
Cytostatics "Chemotherapy": (Vinblastine,
Vincristine, Doxorubicine, Paclitaxel, Docetaxel, Methotrexat, Vincristine)
Immunosuppressive: (Cyclosporine A)
Heart glycosides: (Digoxine, Methyldigoxine)
Opioids: (Morphium) Antiarrhythmics: (Verapamil,
Diltiazem, Chinidine)
Antiemetics (Ondansetron, Domperidon, Metoclopramide
)
Antibiotics (Sparfloxacin, Grepafloxacin,
Erythromycin)
Antihistamin (Ebastin) Glucocorticoid (Dexamethason)
Acepromazine (tranquilizer and pre-anesthetic agent)
*
Butorphanol "analgesic and pre-anesthetic
agent" *
Other drugs: Etoposide, Mitoxantrone, Ondansetron,
Paclitaxel, Rifampicin
Class C
Can be used only in the permitted application form and dose:
Selamectin (Stronghold®), Milbemax® and
Advocate®
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