Took a walk early this morning and ran into some neighbors. When they asked how I was doing (they know the circumstances), I broke down. I said that physically, on the outside, I am doing just great! Pyschologically, I can't seem to believe that the medical test results tell such a different story on the inside. It's all a bit confusing, emotionally speaking. They comforted me saying not to drive myself crazy looking for answers as to why I came up with cancer and that someday I will return to the activities I love so much but for now I must rest. They know somewhat of what they speak for they lost a daughter to pancreatic cancer just 3 years ago. They solace meant much to me and had the ring of truth yet I know that I will continue, at least, to pursue my research in a search for answers.
My focus today was two-pronged: research and planning. As for researching, thank goodness for the internet! Thank goodness for search engines! What little I read while browsing the net was frightening and hopeful. Without a doubt, high testosterone is a marker for (breast) cancer. The adrenal gland's function plays right into it as well. I found websites that suggested foods to eat and vitamins to take. Melatonin came up more than once. It helps the body relax for sleep. I remembered the handouts that my BHRT gave me. Melatonin was one of the substances. My general rule of thumb is that if some piece of information pops up more than once from two entirely different sources, I take that seriously as a probable direction to follow in my total Health Recovery Plan.
I found a couple more great websites. (See following pages.) It's all fascinating stuff! At Diagnose-Me.com, I found an invaluable tool. They offer:
"Knowing how difficult it is to weed out misinformation and piece together countless facts in order to see the 'big picture,' we now provide simple online access to The Analyst. Used by doctors and patients alike, The Analyst is a computerized diagnostic tool that sits on a vast accumulation of knowledge and research. By combining thousands of connections between signs, symptoms, risk factors, conditions and treatments, The Analyst will help to build an accurate picture of your current health status, the risks you are running and courses of action (including appropriate lab testing) that should be considered."
Diagnose-Me.com cautions:
Please note that it is extremely important to obtain an accurate diagnosis before trying to find a cure. Many diseases and conditions share common symptoms. If you treat yourself for the wrong illness or a specific symptom of a complex disease, you may delay legitimate treatment of a serious underlying problem. In other words, the greatest danger in self-treatment may be self-diagnosis. If you do not know what you really have, you cannot treat it!
Thursday, January 31, 2008
May 3: Wednesday - "Interrupted Season"
What is the difference between a 'high energy' person and a 'highly stressed' person? I cannot see myself slowing down much; neither does Rex. He doesn't see me as highly stressed or high strung and doubts / questions the saliva test results. However, our daughter Lisa put it most succinctly: “Mom, you don't know how to slow down enough to stop once in a while and 'smell the roses.'
Most of this day, I spent in a quiet mood, full of a silent fury, vacillating between depression and futility. Just when I'm doing good to mentally prepare myself for the six-week separation from my idyllic mountain home, another worry of seemingly huge proportion comes along. Just once, I wish the surprise from a medical test would be good news!
While Rex went to a meeting tonight, I began to read, "Living Through Breast Cancer." My neighbor, Jerry Winkle, had given me this book some time ago. It kept 'calling' to me so I thought reading what this Harvard doctor had to say about radiation would be helpful. (This is in preparation for the Radiation Class that Rex and I will be attending on Thursday, May 5th.)
I really like her style; it's hard to put the book down. This doctor who was also a breast cancer surgeon went through breast cancer herself in 2005... I thought that if I ever were to write a book about my personal experience, I would call it, "Interrupted Season."
Most of this day, I spent in a quiet mood, full of a silent fury, vacillating between depression and futility. Just when I'm doing good to mentally prepare myself for the six-week separation from my idyllic mountain home, another worry of seemingly huge proportion comes along. Just once, I wish the surprise from a medical test would be good news!
While Rex went to a meeting tonight, I began to read, "Living Through Breast Cancer." My neighbor, Jerry Winkle, had given me this book some time ago. It kept 'calling' to me so I thought reading what this Harvard doctor had to say about radiation would be helpful. (This is in preparation for the Radiation Class that Rex and I will be attending on Thursday, May 5th.)
I really like her style; it's hard to put the book down. This doctor who was also a breast cancer surgeon went through breast cancer herself in 2005... I thought that if I ever were to write a book about my personal experience, I would call it, "Interrupted Season."
May 2: Tuesday – Adrenal Fatigue Protocol
On a visit with my BHRT, she gave me a handout concerning adrenal fatigue and how to overcome it:
Adrenal Fatigue Protocol
The adrenals are two glands that sit on top of each kidney. Cumulative stress (emotional, financial, jobs, kids, trauma, illness, etc.) over many years causes adrenal fatigue. This program is designed to help your adrenal glands repair and function better which in turn will give you more energy and should help with weight loss, libido and general well being.
It can take 6 months to 2 years for adrenals to fully recover. You may feel better in a few days or weeks. However, judicious effort on your part is needed for the adrenals to fully 'recharge' and recover from stress. It is essential to modify your lifestyle to reduce stress to help the adrenals recover. Taking short breaks from herbs will keep your body sensitized to them. Use herbs for 2-3 months and then take a 1 week break.
1) Take a good multivitamin. (She agreed that Reliv fits that category.)
2) Exercise 30 minutes of walking 5 days per week. Don't over exercise.
3) Rest. The best time for sleep when you have adrenal fatigue is between 7 - 9 AM
----Sleep in whenever possible. Take short naps if you are able.
4) Cortico B5 B6. Supports healthy adrenal hormone production and regulation.
----Important for cellular energy. Take morning and afternoon.
OR - Vitamin B5 (pantothenic acid) 500 mg & Vitamin B6 (pyridoxine) 100 mg
5) Rhodiola. Maximizes energy, fights the effects of stress and aging, aids memory and concentration, eases anxiety and depression, helps balance hormones, improves sexual function, enhances physical performance and helps metabolize fat.
----Caution with manic depression as it may exacerbate mania. Take morning and afternoon.
6) Vitamin C with bioflavinoids (2:1 ratio) 1000-3000 mg 3 times a day. Take morning, noon and evening.
----Vitamin C is water soluble and nontoxic. Reduce dose by 500 mg if diarrhea occurs. Vitamin C increases adrenal function and also stimulates the immune system and is the most important vitamin for the adrenals.
----When your body adapts to a high dose of vitamin C, you can have symptoms of scurvy if you reduce too fast.
----When you taper off adrenal protocol, reduce by 500 mg every 2-3 days to avoid problems.
7) Seriphos (phosphorylated serine). 100 mg 2-4 times a day. For me, take morning and afternoon.
----This is a phospholipid and amino acid complex. It is one of the key building blocks in your brain and is present in all cells in your body. It reduces the stress hormone cortisol and helps to improve learning, concentration and work skills.
----Used to reduce anxiety, depression and stress. There are no known side effects.
Recommended reading: "Adrenal Fatigue: The 21st Century Stress Syndrome" by James Wilson or visit the website, www.adrenalfatigue.org
Adrenal Fatigue Protocol
The adrenals are two glands that sit on top of each kidney. Cumulative stress (emotional, financial, jobs, kids, trauma, illness, etc.) over many years causes adrenal fatigue. This program is designed to help your adrenal glands repair and function better which in turn will give you more energy and should help with weight loss, libido and general well being.
It can take 6 months to 2 years for adrenals to fully recover. You may feel better in a few days or weeks. However, judicious effort on your part is needed for the adrenals to fully 'recharge' and recover from stress. It is essential to modify your lifestyle to reduce stress to help the adrenals recover. Taking short breaks from herbs will keep your body sensitized to them. Use herbs for 2-3 months and then take a 1 week break.
1) Take a good multivitamin. (She agreed that Reliv fits that category.)
2) Exercise 30 minutes of walking 5 days per week. Don't over exercise.
3) Rest. The best time for sleep when you have adrenal fatigue is between 7 - 9 AM
----Sleep in whenever possible. Take short naps if you are able.
4) Cortico B5 B6. Supports healthy adrenal hormone production and regulation.
----Important for cellular energy. Take morning and afternoon.
OR - Vitamin B5 (pantothenic acid) 500 mg & Vitamin B6 (pyridoxine) 100 mg
5) Rhodiola. Maximizes energy, fights the effects of stress and aging, aids memory and concentration, eases anxiety and depression, helps balance hormones, improves sexual function, enhances physical performance and helps metabolize fat.
----Caution with manic depression as it may exacerbate mania. Take morning and afternoon.
6) Vitamin C with bioflavinoids (2:1 ratio) 1000-3000 mg 3 times a day. Take morning, noon and evening.
----Vitamin C is water soluble and nontoxic. Reduce dose by 500 mg if diarrhea occurs. Vitamin C increases adrenal function and also stimulates the immune system and is the most important vitamin for the adrenals.
----When your body adapts to a high dose of vitamin C, you can have symptoms of scurvy if you reduce too fast.
----When you taper off adrenal protocol, reduce by 500 mg every 2-3 days to avoid problems.
7) Seriphos (phosphorylated serine). 100 mg 2-4 times a day. For me, take morning and afternoon.
----This is a phospholipid and amino acid complex. It is one of the key building blocks in your brain and is present in all cells in your body. It reduces the stress hormone cortisol and helps to improve learning, concentration and work skills.
----Used to reduce anxiety, depression and stress. There are no known side effects.
Recommended reading: "Adrenal Fatigue: The 21st Century Stress Syndrome" by James Wilson or visit the website, www.adrenalfatigue.org
May 2: Tuesday - Saliva Test Results
Hormone Test / In Range / Out of Range / Units pg:ml / Range
Estradiol (saliva) / Out of Range: 1.7 High / Normal Range: 1.0-1.5 post-menopausal
Progesterone (saliva) / Out of Range: 128 high / Normal Range: 25-100 postmenopausal
Ratio: Pg/E2 / In Range: 75 / Normal Range: 50 - 200 optimal /
---- Progesterone therapy: 200-1000
Estriol (saliva) / In Range: 3.4 / Normal Range: 3-7 pre-& postmenopausal
Estrone (saliva) / In Range: 4.8 / Normal Range: 2-10 pre-& postmenopausal
Testosterone (saliva) / Out of Range: 255 high / Normal Range: 20 - 50
DHEAS (saliva) / Out of Range: < 2.5 low / Normal Range: 3-10
Cortisol (morning saliva) / Out of Range: 11.4 high / Normal Range: 3-8
The report also made these comments:
Estradiol is higher than expected for a postmenopausal woman not using estrogen replacement therapy (ERT).
Endogenous estrogen production (via ovaries, adrenals) aromatization (conversion) of androgens (testosterone and/or DHEAS) into estrogens in adipose tissue... likely contribute to higher estradiol. If symptoms of estrogen dominance are problematic (such as breast cancer?), it would be worthwhile to consider lowering estrogens by supplementing with natural progesterone, herbs, high fiber diet, and/or nutritional supplements such as cruciferous vegetable extracts that help accelerate estrogen clearance.
High testosterone and low DHEAS is an unusual profile that is usually caused either by testosterone supplementation (none indicated) or excess conversion of DHEAS to testosterone (via enzymes that commonly are elevated with inflammatory conditions.) (Author's note: I had serious kidney inflammation 6 months before being diagnosed with breast cancer.) Chronic exposure to high levels of testosterone or other androgens is usually associated with symptoms such as loss of scalp hair, increased facial/body hair, and acne. If these symptoms are not apparent, then the high testosterone is likely due to an acute testosterone exposure (either from supplementation or exposure to a partner using topical testosterone) or co-exposure to other hormones such as high cortisol which blocks the side effects high testosterone at the cellular level.
Cortisol is higher than the expected range in the morning. This likely contributes to bone loss, which is self-reported as moderate/severe. High cortisol is usually caused by some form of adrenal gland stressor, the most common of which include: mental/emotional stress, physical insults 9i.e. pain, diseases), chemical exposure (environmental pollutants, excessive medications) and blood sugar imbalance. Acute situational stressors (work or poor dietary choices) can also raise cortisol levels, which is a normal response to the stressor.
High cortisol production is known to contribute to accelerated bone loss. Because a high cortisol is strongly associated with bone loss, means to lower cortisol should be considered. In addition, consider more extensive cortisol testing throughout the day to assess overall adrenal function and cortisol output. For additional information about stragegies for supporting adrenal health and reducing stressors that raise cortisol levels, the following books are worth reading:
"Adrenal Fatigue" by James L. Wilso, N.D., D.C., Ph.D
"The Cortisol Connection: by Shawn Talbott, Ph.D
"The End of Stress As We Know It" by Bruce McEwen
"Awakening Athena" by Kenna Stephenson, MD.
Estradiol (saliva) / Out of Range: 1.7 High / Normal Range: 1.0-1.5 post-menopausal
Progesterone (saliva) / Out of Range: 128 high / Normal Range: 25-100 postmenopausal
Ratio: Pg/E2 / In Range: 75 / Normal Range: 50 - 200 optimal /
---- Progesterone therapy: 200-1000
Estriol (saliva) / In Range: 3.4 / Normal Range: 3-7 pre-& postmenopausal
Estrone (saliva) / In Range: 4.8 / Normal Range: 2-10 pre-& postmenopausal
Testosterone (saliva) / Out of Range: 255 high / Normal Range: 20 - 50
DHEAS (saliva) / Out of Range: < 2.5 low / Normal Range: 3-10
Cortisol (morning saliva) / Out of Range: 11.4 high / Normal Range: 3-8
The report also made these comments:
Estradiol is higher than expected for a postmenopausal woman not using estrogen replacement therapy (ERT).
Endogenous estrogen production (via ovaries, adrenals) aromatization (conversion) of androgens (testosterone and/or DHEAS) into estrogens in adipose tissue... likely contribute to higher estradiol. If symptoms of estrogen dominance are problematic (such as breast cancer?), it would be worthwhile to consider lowering estrogens by supplementing with natural progesterone, herbs, high fiber diet, and/or nutritional supplements such as cruciferous vegetable extracts that help accelerate estrogen clearance.
High testosterone and low DHEAS is an unusual profile that is usually caused either by testosterone supplementation (none indicated) or excess conversion of DHEAS to testosterone (via enzymes that commonly are elevated with inflammatory conditions.) (Author's note: I had serious kidney inflammation 6 months before being diagnosed with breast cancer.) Chronic exposure to high levels of testosterone or other androgens is usually associated with symptoms such as loss of scalp hair, increased facial/body hair, and acne. If these symptoms are not apparent, then the high testosterone is likely due to an acute testosterone exposure (either from supplementation or exposure to a partner using topical testosterone) or co-exposure to other hormones such as high cortisol which blocks the side effects high testosterone at the cellular level.
Cortisol is higher than the expected range in the morning. This likely contributes to bone loss, which is self-reported as moderate/severe. High cortisol is usually caused by some form of adrenal gland stressor, the most common of which include: mental/emotional stress, physical insults 9i.e. pain, diseases), chemical exposure (environmental pollutants, excessive medications) and blood sugar imbalance. Acute situational stressors (work or poor dietary choices) can also raise cortisol levels, which is a normal response to the stressor.
High cortisol production is known to contribute to accelerated bone loss. Because a high cortisol is strongly associated with bone loss, means to lower cortisol should be considered. In addition, consider more extensive cortisol testing throughout the day to assess overall adrenal function and cortisol output. For additional information about stragegies for supporting adrenal health and reducing stressors that raise cortisol levels, the following books are worth reading:
"Adrenal Fatigue" by James L. Wilso, N.D., D.C., Ph.D
"The Cortisol Connection: by Shawn Talbott, Ph.D
"The End of Stress As We Know It" by Bruce McEwen
"Awakening Athena" by Kenna Stephenson, MD.
Tuesday, January 29, 2008
May 2: Tuesday - Lymphedema
"Living Through Breast Cancer," by Dr. Carolyn M. Kaelin. She was (is?) Director of the Comprehensive Breast Health Center at Brigham and Women's Hospital. This is one of one of Harvard Medical School's main teaching hospitals. She has been a breast cancer surgeon and as of 2005, a breast cancer patient as well.
Dr. Kaelin's 350-page book is just great. It is most comprehensive. While it is written from a conventional medicine standpoint, it does mention complementary practices occasionally. ("Vitamin E may help scarring; one study found black cohosh to be somewhat effective in treating hot flashes....") She includes information in her book that I've not read anywhere else in all my research to date. (“A growing number of research trials show that... exercising may help improve long-term survival (and) decrease the chance of breast cancer relapse...”)
This is how she explains lymphedema:
"Lymph vessels carry lymph, a protein-rich fluid containing water, fat, bacteria, and fragments of old blood cells from the arm to larger channels in the underarm and ultimately, to the main circulatory system. When surgery or radiation alters these channels, there may not be enough remaining channels to drain all the lymph fluid from the arm. Those remaining around the shoulder will dilate due to increased lymphatic pressure as they take over the work of those channels lost to surgery. Sometimes, this doesn't work well. Fluid then backs up and accumulates in the arm.
The result is lymphedema, a swelling of the arm and hand that affects 10 to 25 percent of women after an axiliary dissection. It rangers from barely noticeable to a very obvious, uncomfortable enlargement that may disable the arm. Lymphedema may appear soon after breast surgery or even months or years later. While it can be short-lived, more commonly it is a permanent condition that may wax and wane somewhat. Repeated, severe episodes during which swelling overwhelms the arm and hand may cause tissue inflammation, produce rough, leathery, thickened skin, and harden underlying fat tissue. The greater the number of lymph nodes excised and underarm radiation therapy given, the greater the risk of lymphedema. (p. 70-71)
Typically, the risk of lymphedema is minimal after sentinel node biopsy so most surgeons do not suggest restricting the use of the arm.... If you have had an axillary dissection, the following steps may help prevent lymphedema:
Stretching and strengthening exercises are important after breast cancer surgery** but must be done especially judiciously... vigorous exercise and arm movements that increase blood flow and lymph production may overwhelm remaining lymph channels, creating fluid backup and starting the lymphedema cycle... Wear a full arm and hand compression sleeve during arm strength training, exercises where the arm is used in a repetitive movement (such as swimming, rowing or racket sports), or more rigorous physical activities that may place stress on the arm such as raking leaves or scrubbing a large floor.
Avoid having blood drawn or an IV or injections in that arm. Use the unaffected arm for blood pressure measurements. (p.71)
Wearing a bra that fits well is essential for comfort and may even help ward off lymphedema. A bra that is too tight or one that has narrow shoulder straps can obstruct the flow of lymph fluid along the remaining channels, potentially triggering troublesome swelling... (p. 143)
Shaving underarms with a razor should be avoided, particularly if you have lost sensation there due to surgery or radiation. An altered underarm lymphatic network combined with nicks and cuts may make lymphedema more likely. Consider using an electric razor." (p. 219)
** Update: To my regret, I didn't remember this advice. It was a month after radiation treatments finished - not after the surgery! - I began to feel a tightening in the muscles under my left arm. Though I began to stretch and exercise them then, I never did gain back the full range of mobility I once had.
Dr. Kaelin's 350-page book is just great. It is most comprehensive. While it is written from a conventional medicine standpoint, it does mention complementary practices occasionally. ("Vitamin E may help scarring; one study found black cohosh to be somewhat effective in treating hot flashes....") She includes information in her book that I've not read anywhere else in all my research to date. (“A growing number of research trials show that... exercising may help improve long-term survival (and) decrease the chance of breast cancer relapse...”)
This is how she explains lymphedema:
"Lymph vessels carry lymph, a protein-rich fluid containing water, fat, bacteria, and fragments of old blood cells from the arm to larger channels in the underarm and ultimately, to the main circulatory system. When surgery or radiation alters these channels, there may not be enough remaining channels to drain all the lymph fluid from the arm. Those remaining around the shoulder will dilate due to increased lymphatic pressure as they take over the work of those channels lost to surgery. Sometimes, this doesn't work well. Fluid then backs up and accumulates in the arm.
The result is lymphedema, a swelling of the arm and hand that affects 10 to 25 percent of women after an axiliary dissection. It rangers from barely noticeable to a very obvious, uncomfortable enlargement that may disable the arm. Lymphedema may appear soon after breast surgery or even months or years later. While it can be short-lived, more commonly it is a permanent condition that may wax and wane somewhat. Repeated, severe episodes during which swelling overwhelms the arm and hand may cause tissue inflammation, produce rough, leathery, thickened skin, and harden underlying fat tissue. The greater the number of lymph nodes excised and underarm radiation therapy given, the greater the risk of lymphedema. (p. 70-71)
Typically, the risk of lymphedema is minimal after sentinel node biopsy so most surgeons do not suggest restricting the use of the arm.... If you have had an axillary dissection, the following steps may help prevent lymphedema:
Stretching and strengthening exercises are important after breast cancer surgery** but must be done especially judiciously... vigorous exercise and arm movements that increase blood flow and lymph production may overwhelm remaining lymph channels, creating fluid backup and starting the lymphedema cycle... Wear a full arm and hand compression sleeve during arm strength training, exercises where the arm is used in a repetitive movement (such as swimming, rowing or racket sports), or more rigorous physical activities that may place stress on the arm such as raking leaves or scrubbing a large floor.
Avoid having blood drawn or an IV or injections in that arm. Use the unaffected arm for blood pressure measurements. (p.71)
Wearing a bra that fits well is essential for comfort and may even help ward off lymphedema. A bra that is too tight or one that has narrow shoulder straps can obstruct the flow of lymph fluid along the remaining channels, potentially triggering troublesome swelling... (p. 143)
Shaving underarms with a razor should be avoided, particularly if you have lost sensation there due to surgery or radiation. An altered underarm lymphatic network combined with nicks and cuts may make lymphedema more likely. Consider using an electric razor." (p. 219)
** Update: To my regret, I didn't remember this advice. It was a month after radiation treatments finished - not after the surgery! - I began to feel a tightening in the muscles under my left arm. Though I began to stretch and exercise them then, I never did gain back the full range of mobility I once had.
May 2: Tuesday – Visit with Debbie, my BioIdentical Hormone Replacement Therapist (BHRT)
Rex and I took a cholesterol test at Central District Health Center early this morning. At the CDHC, our blood pressure is taken before blood is drawn. The pleasant, little old nurse, Ruth, greeted us and prepared to take my blood pressure by slipping the cup up my left arm as usual. Without explaining, I gently switched it to my right arm. (No questions were asked.) The reason I did this is because the lymph node(s) removal during breast cancer surgery necessitates caution ever afterward re: the drawing blood or blood pressure readings. It may put undue stress and cause lymphedema. (See next entry for details of why.)
I was pleased that my blood pressure: was only 96/60. That's the lowest it's ever been! I thought that a good sign until I talked with Debbie and found out that low blood pressure is a not-so-good sign of adrenal gland fatigue.
My BHRT was anxious to see me. About the first words Debbie said were, "Your saliva test results came in. I don't think that I can treat you. The results show excessively high testosterone and a negative level for DHEAS. I've never dealt with that; it's out of my expertise and frankly, I don't have the time to research it for you. But here's where we are and here's what information I did collect for you."
She presented me with the results of my saliva test plus graphs she’d collected from a BHRT symposium in Salt Lake City in Sept. 2005: "The Hormone Link to Breast Cancer and Prevention Strategies" presented by David Zava, Ph.D. of the ZRT Laboratory in Beaverton, OR. These graphs charted hormone structure as they, the hormones, relate to adrenal fatigue and breast cancer initiation.
Debbie explained as best she could in the space of our appointment time some of the logistics of having breast cancer and what is needed to combat it with particular emphasis on reducing it where it initiates. The graphs (slides) were schematics of
---- Slide 1) how hormones are made
---- Slide 2) how hormones (human and from toxins) work together to produce PCOS and ovarian dysfunction, Insulin resistance (precursor to diabetes), and immune system dysfunction (precursor to breast cancer, etc.)
---- Slide 3) how the 3 estrogens work together, sometimes to our detriment.
The first slide was fairly understandable as a lot of the terms were familiar to me from my recent research.
The second slide was all ‘greek’ to me. Some terms were familiar but this one will be have to be studied in depth!
The third slide she showed me, she suggested I research COMT and SAMe. You'll see how they cascade down to cancer.
Although Debbie couldn't confidently advise me in relation to excessive testosterone + low DHEAS, she did give me several handouts she'd run off of the internet website, "Natural Medicines" (Naturaldatabase.com) re: herbs, etc. that could possibly help:
Melatonin People Use This For: (among other things; a long list) chronic fatigue syndrome, fibromyalgia, osteoporosis, breast cancer, help with certain types of chemotherapy-related side effects, and for birth control.
Turmeric People Use This For: (among other things; a shorter list) colds, cancer, kidney inflammation, infected wounds.
Bromelain People Use This For: (among other things; a short list) inhibition of blood platelet aggregation, cancer, burn debridement, anti-inflammatory action, smooth muscle relaxation.
Indole-3-Carbinol People Use This For: (among other things; a very short list) fibromyalgia, systemic lupus erythematosus, detoxifies the intestines and liver, supports the immune system.
Selenium People Use This For: (among other things; a short list) AIDS, cardiovascular disease, macular degeneration, infertility, gray hair, certain types of cancer.
Green Tea Possibly Effective For: (among other things) preventing breast cancer, decreasing high levels of fat in the blood, preventing high blood pressure.
As far as the results for estradiol and progesterone, she suggested using a recommended progesterone cream (1 teaspoon a day, 20-30 mg), 27 days a month.
For the elevated cortisol levels, she recommended an Adrenal Fatigue Protocol to bring down the stress levels. (See my entry: "May 2: Adrenal Fatigue Protocol")
In the end, we agreed that another saliva test would be taken in two months after radiation therapy had been completed.
I was pleased that my blood pressure: was only 96/60. That's the lowest it's ever been! I thought that a good sign until I talked with Debbie and found out that low blood pressure is a not-so-good sign of adrenal gland fatigue.
My BHRT was anxious to see me. About the first words Debbie said were, "Your saliva test results came in. I don't think that I can treat you. The results show excessively high testosterone and a negative level for DHEAS. I've never dealt with that; it's out of my expertise and frankly, I don't have the time to research it for you. But here's where we are and here's what information I did collect for you."
She presented me with the results of my saliva test plus graphs she’d collected from a BHRT symposium in Salt Lake City in Sept. 2005: "The Hormone Link to Breast Cancer and Prevention Strategies" presented by David Zava, Ph.D. of the ZRT Laboratory in Beaverton, OR. These graphs charted hormone structure as they, the hormones, relate to adrenal fatigue and breast cancer initiation.
Debbie explained as best she could in the space of our appointment time some of the logistics of having breast cancer and what is needed to combat it with particular emphasis on reducing it where it initiates. The graphs (slides) were schematics of
---- Slide 1) how hormones are made
---- Slide 2) how hormones (human and from toxins) work together to produce PCOS and ovarian dysfunction, Insulin resistance (precursor to diabetes), and immune system dysfunction (precursor to breast cancer, etc.)
---- Slide 3) how the 3 estrogens work together, sometimes to our detriment.
The first slide was fairly understandable as a lot of the terms were familiar to me from my recent research.
The second slide was all ‘greek’ to me. Some terms were familiar but this one will be have to be studied in depth!
The third slide she showed me, she suggested I research COMT and SAMe. You'll see how they cascade down to cancer.
Although Debbie couldn't confidently advise me in relation to excessive testosterone + low DHEAS, she did give me several handouts she'd run off of the internet website, "Natural Medicines" (Naturaldatabase.com) re: herbs, etc. that could possibly help:
Melatonin People Use This For: (among other things; a long list) chronic fatigue syndrome, fibromyalgia, osteoporosis, breast cancer, help with certain types of chemotherapy-related side effects, and for birth control.
Turmeric People Use This For: (among other things; a shorter list) colds, cancer, kidney inflammation, infected wounds.
Bromelain People Use This For: (among other things; a short list) inhibition of blood platelet aggregation, cancer, burn debridement, anti-inflammatory action, smooth muscle relaxation.
Indole-3-Carbinol People Use This For: (among other things; a very short list) fibromyalgia, systemic lupus erythematosus, detoxifies the intestines and liver, supports the immune system.
Selenium People Use This For: (among other things; a short list) AIDS, cardiovascular disease, macular degeneration, infertility, gray hair, certain types of cancer.
Green Tea Possibly Effective For: (among other things) preventing breast cancer, decreasing high levels of fat in the blood, preventing high blood pressure.
As far as the results for estradiol and progesterone, she suggested using a recommended progesterone cream (1 teaspoon a day, 20-30 mg), 27 days a month.
For the elevated cortisol levels, she recommended an Adrenal Fatigue Protocol to bring down the stress levels. (See my entry: "May 2: Adrenal Fatigue Protocol")
In the end, we agreed that another saliva test would be taken in two months after radiation therapy had been completed.
May 1: Monday: - For Better, Not Worse; In Sickness and In Health
Yesterday, I determined to resume the attitude that I began this 'season' with - to see it as a blessing from the first, last and during. The motto I adopted was For Better, Not Worse. I shall view my overall well-being (psychological, spiritual, emotional and physical) as improved for having weathered this whole experience. Some days, that is easier said than done.
Rex and I had previously discussed what kind of accommodations I'd have while staying in Boise for treatment. My choice was to have a small, studio apartment. (The hospital provided us with a list of participating hotels as it subsidizes some of the cost, thank goodness.) We checked out the apartment complex and eventually reserved one for later in the month when radiation treatment will begin. It has the bedroom on the second level with a small kitchen and adequate living area on the first. The apartment complex is set in an older part of Boise in a quiet, tranquil area about half a mile from the hospital. When ambitious, I'll be able to walk to treatments - if it's not too hot, being it's summer in the city!
My emotions ran high and close to the surface today. With the whole reality of cancer 'in my face' as it were, my heart was in my throat. Looked at from the least offensive view, it was a little like a child sent away from home to boarding school for a school semester. Looking at it from the worst, it was a little like being banished for contemporary medical reasons, only the dreaded disease of the day is cancer, not leprosy...
Thinking more positively, I mentally plan and prepare myself for the daytime but nighttime is another story. I don't sleep well without Rex. We’ve talked and I've asked him to drive down and be with me perhaps one or two days out of the five I need to be in treatment. I do this because as the apartment is a relatively small place, I can just imagine how stir-crazy he'd go without his projects to do! During the day, however, I know I'll be fine for I’ll take long walks, read a few good books, spend much time researching and writing on the computer, knit as I watch TV in the evening, go to the temple, lunch with friends, and/or visit grandchildren. When looked at from this 'side of the fence,' it will be a vacation!
Rex and I had previously discussed what kind of accommodations I'd have while staying in Boise for treatment. My choice was to have a small, studio apartment. (The hospital provided us with a list of participating hotels as it subsidizes some of the cost, thank goodness.) We checked out the apartment complex and eventually reserved one for later in the month when radiation treatment will begin. It has the bedroom on the second level with a small kitchen and adequate living area on the first. The apartment complex is set in an older part of Boise in a quiet, tranquil area about half a mile from the hospital. When ambitious, I'll be able to walk to treatments - if it's not too hot, being it's summer in the city!
My emotions ran high and close to the surface today. With the whole reality of cancer 'in my face' as it were, my heart was in my throat. Looked at from the least offensive view, it was a little like a child sent away from home to boarding school for a school semester. Looking at it from the worst, it was a little like being banished for contemporary medical reasons, only the dreaded disease of the day is cancer, not leprosy...
Thinking more positively, I mentally plan and prepare myself for the daytime but nighttime is another story. I don't sleep well without Rex. We’ve talked and I've asked him to drive down and be with me perhaps one or two days out of the five I need to be in treatment. I do this because as the apartment is a relatively small place, I can just imagine how stir-crazy he'd go without his projects to do! During the day, however, I know I'll be fine for I’ll take long walks, read a few good books, spend much time researching and writing on the computer, knit as I watch TV in the evening, go to the temple, lunch with friends, and/or visit grandchildren. When looked at from this 'side of the fence,' it will be a vacation!
April 27: Thursday: - Radiation Simulation
This day, Rex & I traveled down to Boise. We'd been advised that the visit would be a long one with Rex in the waiting room as he would not be allowed in the Radiation Simulation room.
The radiation therapist that took me back to the room was a chirpy, energetic little thing full of jokes about the 'wonderful accommodations' re: the clothing (the non-descript, worn-out smocks) and the 'bed' (hard radiation table). I would have appreciated her good humor had this not been another impactful, psychological 'in your face' experience. It's not an easy thing to literally bare your chest to strangers when you've learned how sacred your body is, your 'temple' as we believe in my LDS faith. To make matters worse, however, it was at the end of the day and the attendants seemed rushed in getting through the procedures: not particularly gentle, slow or sensitive. When I asked questions, I got either partial answers or "I'll tell you when we're finished." I sincerely hoped that she would not be the radiation therapist that would attend me each day of treatment! (Update: She was not.)
Valuable information
Still, it was this therapist who gave me some valuable advice that I tucked away for 'when that time came.' She advised that when I go home treatment, take off both blouse and bra. Wear a loose T-shirt (sweatshirt) and sit in front of the air-conditioner for a while. This will help cool down the area and prevent sweating under the folds of skin below the breast which then in turn causes itching and worse. She suggested that an under-wire bra not be worn as this also irritates the sensitive skin under the breast.
Radiation Simulation
The large, oblong room is full of huge machines. The “2100” (which will treat me) is a gigantic radial arm shaped like a capital C. It holds a recessed x-ray panel on the inside of the arm. It can go over as well as under the hard, thin, black slab I'll be laying on today and every treatment days.
I'm already in a drab hospital gown, opened to the back. As I am instructed to lie on the table, the gown is slipped down to my waist. My neck is positioned in a 'neck rest' that is anything but comfortable and cushy. It is a hard, plexiglass mold designed to keep my neck from moving during the session. Even though it is not molded with a dip in the headpiece to turn even a fraction of an inch either to the left or right, I'm told to turn my face slightly to the right. (Uncomfortable.)
The table is raised to about 5 feet into the air. (On treatment days, this will allow the 2100's radial arm to pass underneath it and shoot x-rays from back to front.) I'm instructed to raise my arms above my head maybe six inches and flat on the table. I am to grip handles that are imbedded at the top of the table. My feet, likewise, are bound together at the toes to ensure steadiness. The only concession to comfort - and this is unintentional - is a pillow inserted under my knees so that my spine may remain flat to the table. The message is absolutely clear: DO NOT MOVE!
Each wall has a recessed 'light' out of which a thin red stream of light is beamed. (It reminds me of a garage door beam.) Where these four intersect is supposed to line up to a spot on my breast. As an additional measure to insure accuracy, a canister holding another red light from the ceiling is supposed to line up in the perfect center with the intersection of the first four. My skin is tattooed with four permanent dots to be a further guide to these red beams. I am told that they are permanent for the 'just in case' scenario of a breast cancer recurrence in the other breast. Hardly reassuring!
All kinds of measurements, photos of the perimeter of the breast (as outlined by colored markers on the skin) and x-rays (for information only) are taken for the purpose of planning the exact radiation 'fields' during treatment. (Think of your lawn sprinkler system and the areas that each zone covers.) That's what a 'field' is. Every 9th or 10th day, the fields will be changed slightly in order to avoid either hot or cold spots. A ‘hot spot’ is where the fields (think of your lawn sprinklers!) overlap. This can set you up to receive burns from the xray doses. A ‘cold spot’ is where the fields don't overlap. This can set up a small space that doesn't get the benefit of radiation. The danger is that possible cancer cells may be left untreated.
Four doses of radiation will be administered each treatment: right/top of breast; left/underside of affected breast (yes, through the table and everything); left/top of breast, right/underside of affected breast.
For a good 30 minutes or more, I'm on this table. Then I'm transferred to another to have a CT scan although I'm not really told why. (Incomplete explanation.) All I know is that the CT scan procedure will not be a regular part of treatment in any way or at any time.
After about 45 minutes, I'm through. Thank goodness!
The radiation therapist that took me back to the room was a chirpy, energetic little thing full of jokes about the 'wonderful accommodations' re: the clothing (the non-descript, worn-out smocks) and the 'bed' (hard radiation table). I would have appreciated her good humor had this not been another impactful, psychological 'in your face' experience. It's not an easy thing to literally bare your chest to strangers when you've learned how sacred your body is, your 'temple' as we believe in my LDS faith. To make matters worse, however, it was at the end of the day and the attendants seemed rushed in getting through the procedures: not particularly gentle, slow or sensitive. When I asked questions, I got either partial answers or "I'll tell you when we're finished." I sincerely hoped that she would not be the radiation therapist that would attend me each day of treatment! (Update: She was not.)
Valuable information
Still, it was this therapist who gave me some valuable advice that I tucked away for 'when that time came.' She advised that when I go home treatment, take off both blouse and bra. Wear a loose T-shirt (sweatshirt) and sit in front of the air-conditioner for a while. This will help cool down the area and prevent sweating under the folds of skin below the breast which then in turn causes itching and worse. She suggested that an under-wire bra not be worn as this also irritates the sensitive skin under the breast.
Radiation Simulation
The large, oblong room is full of huge machines. The “2100” (which will treat me) is a gigantic radial arm shaped like a capital C. It holds a recessed x-ray panel on the inside of the arm. It can go over as well as under the hard, thin, black slab I'll be laying on today and every treatment days.
I'm already in a drab hospital gown, opened to the back. As I am instructed to lie on the table, the gown is slipped down to my waist. My neck is positioned in a 'neck rest' that is anything but comfortable and cushy. It is a hard, plexiglass mold designed to keep my neck from moving during the session. Even though it is not molded with a dip in the headpiece to turn even a fraction of an inch either to the left or right, I'm told to turn my face slightly to the right. (Uncomfortable.)
The table is raised to about 5 feet into the air. (On treatment days, this will allow the 2100's radial arm to pass underneath it and shoot x-rays from back to front.) I'm instructed to raise my arms above my head maybe six inches and flat on the table. I am to grip handles that are imbedded at the top of the table. My feet, likewise, are bound together at the toes to ensure steadiness. The only concession to comfort - and this is unintentional - is a pillow inserted under my knees so that my spine may remain flat to the table. The message is absolutely clear: DO NOT MOVE!
Each wall has a recessed 'light' out of which a thin red stream of light is beamed. (It reminds me of a garage door beam.) Where these four intersect is supposed to line up to a spot on my breast. As an additional measure to insure accuracy, a canister holding another red light from the ceiling is supposed to line up in the perfect center with the intersection of the first four. My skin is tattooed with four permanent dots to be a further guide to these red beams. I am told that they are permanent for the 'just in case' scenario of a breast cancer recurrence in the other breast. Hardly reassuring!
All kinds of measurements, photos of the perimeter of the breast (as outlined by colored markers on the skin) and x-rays (for information only) are taken for the purpose of planning the exact radiation 'fields' during treatment. (Think of your lawn sprinkler system and the areas that each zone covers.) That's what a 'field' is. Every 9th or 10th day, the fields will be changed slightly in order to avoid either hot or cold spots. A ‘hot spot’ is where the fields (think of your lawn sprinklers!) overlap. This can set you up to receive burns from the xray doses. A ‘cold spot’ is where the fields don't overlap. This can set up a small space that doesn't get the benefit of radiation. The danger is that possible cancer cells may be left untreated.
Four doses of radiation will be administered each treatment: right/top of breast; left/underside of affected breast (yes, through the table and everything); left/top of breast, right/underside of affected breast.
For a good 30 minutes or more, I'm on this table. Then I'm transferred to another to have a CT scan although I'm not really told why. (Incomplete explanation.) All I know is that the CT scan procedure will not be a regular part of treatment in any way or at any time.
After about 45 minutes, I'm through. Thank goodness!
Friday, January 25, 2008
April 16 - Meaningful Gifts
Meaningful Gifts to Give Your Friend with Breast Cancer
If you can possibly at all visit with your relative or friend often, do so! When you can't, here's a few suggestions:
Above all else, a listening ear and a compassionate heart are the greatest gifts you can extend to a friend / loved one.
--- Sometimes we have an obsessive, incessant need to talk about what we're going through. Sometimes we just need to hear a friend's warm voice when our doubts and fears assail us. Sometimes we need a piece of information you might have via your experiences with healing from a spiritual, intellectual or physical challenge and we didn't know what it was until you called to talk with us. So, call whenever you feel the urge! Hearing your voice is a great comfort and blessing.
When you care enough to send the very best, send a (Hallmark) card, a plant or flowers. Cards can put into words sentiments that you've not been able to say or not known just how to phrase. And what woman doesn't love to receive flowers? Interestingly enough, I found that those who sent cards with a personal note were those who'd had breast cancer.
Give a gift that keeps on giving:
Buy a book, a music cd or send articles that inspired you during your 'hard times.' You know your friend. Would she/he appreciate an inspirational book? Would they benefit from an informative work?
A personal, hand-crafted gift will remind her of your enduring empathy for her challenge. My friends gave me:
--- Maureen gave me a wooden plaque that read:
--- Maureen also gave me a collection of her personally favorite inspiring songs, such as Cristofori's Dream, Chariots of Fire, Believe, and Life Means So Much.
--- Anna gave me a lap blanket made specifically of my favorite colors. This was to keep me wrapped in warmth and love when I felt the need for it.
--- Anna also fashioned a humorous card that read: "May the dove of peace find refuge in your heart and speak words of comfort (wrap your quilt around your shoulders) to your soul and whisper to your spirit what treasures your friendship is to me. Be of good courage, you are fighting a mighty battle but the Lord is on your side. (Joshua 1:9) Love, Anna" The words 'dove' and 'treasures' were 'punctuated' by actual pieces of chocolate candy of the same names!
Practical gifts:
--- Buy your friend a set of beautiful "Thank You" cards so that over time, she may send them out to people.
--- Sew a set of wash cloths made from soft flannel-type material. These can be used in washing sensitive areas that have been made even more sensitive due to radiation, etc. Later during treatment, they may be used for Domeboro soaks to affected radiation burn areas that have opened up (like a regular sunburn that blisters, etc.)
If you have suggestions to add to this list, please let me hear from you!
If you can possibly at all visit with your relative or friend often, do so! When you can't, here's a few suggestions:
Above all else, a listening ear and a compassionate heart are the greatest gifts you can extend to a friend / loved one.
--- Sometimes we have an obsessive, incessant need to talk about what we're going through. Sometimes we just need to hear a friend's warm voice when our doubts and fears assail us. Sometimes we need a piece of information you might have via your experiences with healing from a spiritual, intellectual or physical challenge and we didn't know what it was until you called to talk with us. So, call whenever you feel the urge! Hearing your voice is a great comfort and blessing.
When you care enough to send the very best, send a (Hallmark) card, a plant or flowers. Cards can put into words sentiments that you've not been able to say or not known just how to phrase. And what woman doesn't love to receive flowers? Interestingly enough, I found that those who sent cards with a personal note were those who'd had breast cancer.
Give a gift that keeps on giving:
Buy a book, a music cd or send articles that inspired you during your 'hard times.' You know your friend. Would she/he appreciate an inspirational book? Would they benefit from an informative work?
A personal, hand-crafted gift will remind her of your enduring empathy for her challenge. My friends gave me:
--- Maureen gave me a wooden plaque that read:
--- Maureen also gave me a collection of her personally favorite inspiring songs, such as Cristofori's Dream, Chariots of Fire, Believe, and Life Means So Much.
--- Anna gave me a lap blanket made specifically of my favorite colors. This was to keep me wrapped in warmth and love when I felt the need for it.
--- Anna also fashioned a humorous card that read: "May the dove of peace find refuge in your heart and speak words of comfort (wrap your quilt around your shoulders) to your soul and whisper to your spirit what treasures your friendship is to me. Be of good courage, you are fighting a mighty battle but the Lord is on your side. (Joshua 1:9) Love, Anna" The words 'dove' and 'treasures' were 'punctuated' by actual pieces of chocolate candy of the same names!
Practical gifts:
--- Buy your friend a set of beautiful "Thank You" cards so that over time, she may send them out to people.
--- Sew a set of wash cloths made from soft flannel-type material. These can be used in washing sensitive areas that have been made even more sensitive due to radiation, etc. Later during treatment, they may be used for Domeboro soaks to affected radiation burn areas that have opened up (like a regular sunburn that blisters, etc.)
If you have suggestions to add to this list, please let me hear from you!
April 16 - Inside the Mind of a Cancer Victim
The 'word' about my condition has begun to spread throughout our small community. (Inevitable and to be expected.) People have made what they believe are encouraging, comforting, caring remarks. They want to 'connect.' Their remarks often have the opposite effect because they've not walked a similar path. Simply put, they are not familiar with the frame of mind a new cancer patient has because they've not 'been there or done that.' As one neighbor who'd gone through a double mastectomy more than twenty years ago put it: "When the doctor would tell me I had an 80% chance of making it through this, my mind would reverse that information. I'd think immediately, 'I've got a 20% chance of dying.’ People diagnosed with cancer also instantly recall all the people they've known who have lost their lives to this disease, sometimes even a close relative such as a parent, sibling, aunt/uncle, grandparent. In their mind, it's as if they themselves have suddenly placed on 'death row.'
Put yourself in their (my) place as you hear these typical remarks:
"I know what it can be like. My girlfriend's mother just went through breast cancer - twice. It was awful. Please let me know if there's anything I can do for you." (As your face goes white, you inwardly think, "Thanks! I really needed to hear right now!")
"There was a woman at work who just went through that. Had chemotherapy, radiation and the whole bit. She was incredible! She never missed a day of work." (Your heart sinks within you because you're just plain frightened of the future. It’s unknown right now. It looms like a monstrous lot of time, effort and energy to overcome it and even then you have no guarantee. So you think, "That does sound incredible! I don't know if I can possibly measure up to that. I don't know if I would even want to try. Doesn’t that sound cowardly?? Gee, I really wonder if I will make it after all.")
"Oh! You caught your cancer early! That's great because this type of cancer is one of the most curable." (Their voice carries the same level of conviction – and comfort - as if they were talking about a gall bladder operation or an appendix having been taken out! You restrain the urge to lash out and say, “You have absolutely no clue how devastating this thing is." )
"I know somebody who just went through radiation. He sailed right through it. He was able to drive himself down to treatment - a 2 hour drive each way - every day." (You're thinking, "I wonder if she has the whole story? That just sounds (ridiculously) crazy for a prostate patient to be driving 4 hours a day.")
So what would one say?
Try this: "I'd be devastated if I just got that news. Whenever you need to talk, just call." or "You must be devastated. What can I do to help at this time?"
More than anything else you could do, follow up with doing something. (See this blog’s next entry, "Meaningful Gifts.")
Put yourself in their (my) place as you hear these typical remarks:
"I know what it can be like. My girlfriend's mother just went through breast cancer - twice. It was awful. Please let me know if there's anything I can do for you." (As your face goes white, you inwardly think, "Thanks! I really needed to hear right now!")
"There was a woman at work who just went through that. Had chemotherapy, radiation and the whole bit. She was incredible! She never missed a day of work." (Your heart sinks within you because you're just plain frightened of the future. It’s unknown right now. It looms like a monstrous lot of time, effort and energy to overcome it and even then you have no guarantee. So you think, "That does sound incredible! I don't know if I can possibly measure up to that. I don't know if I would even want to try. Doesn’t that sound cowardly?? Gee, I really wonder if I will make it after all.")
"Oh! You caught your cancer early! That's great because this type of cancer is one of the most curable." (Their voice carries the same level of conviction – and comfort - as if they were talking about a gall bladder operation or an appendix having been taken out! You restrain the urge to lash out and say, “You have absolutely no clue how devastating this thing is." )
"I know somebody who just went through radiation. He sailed right through it. He was able to drive himself down to treatment - a 2 hour drive each way - every day." (You're thinking, "I wonder if she has the whole story? That just sounds (ridiculously) crazy for a prostate patient to be driving 4 hours a day.")
So what would one say?
Try this: "I'd be devastated if I just got that news. Whenever you need to talk, just call." or "You must be devastated. What can I do to help at this time?"
More than anything else you could do, follow up with doing something. (See this blog’s next entry, "Meaningful Gifts.")
Thursday, January 24, 2008
April 11: Tuesday - Saliva Test for Hormone Screening
I chose the ZRT Laboratory in Beaverton, OR. It is a CLIA Certified hormone testing laboratory established in 1998. It is independently owned by David T. Zava, Ph. D., a biochemist and breast cancer researcher. Dr. Zava's name would be familiar to any who have read, "What Your Doctor May Not Tell You About Breast Cancer." While Dr. John R. Lee, MD, is the principle author, Dr. Zava is the contributing. Much of this is information from ZRT's website, www.salivatest.com.
Why test saliva?
Hormones play a vital role in the maintenance of health. Knowledge of an imbalance can help illuminate causes of health problems and provide a rational basis for correcting the imbalance through diet, exercise, or hormone supplementation.
When glands manufacture hormones, they are transported into the bloodstream with proteins as their 'carriers.' (This is called being 'bound.' Think of hormones piggy-backing on proteins.) Only a small fraction of a given amount of hormone breaks loose from its carrier (1 - 5 %). When it does, it is free to enter target tissues such as the breast, uterus, brain, and skin. A free or unbound hormone is what is measured since it is active (or 'bioavailable). The amount of hormone that enters the saliva is representative of the fraction of steroids (steriods is another word for hormones) in the bloodstream that are bioavailable to other tissues in the body.
Your doctor may take blood tests to monitor your health. However, saliva hormone testing allows you to take more control over your own health. It may help you gain insight into health problems before you see your doctor. The advantages of testing saliva vs. blood serum are:
1. You can easily do it at home vs. having to have blood drawn at a doctor's office
2. It's less expensive and yes, it's covered by insurance (most of the time, all of the time?)
3. Saliva collection is exceptionally stable. Samples can be stored at room temps for a week without loss of activity. Blood, on the other hand, must be kept cool on ice packs, increasing costs and likelihood of error.
Depending on the specific hormones involved, certain symptoms or groups of symptoms are usually present when hormonal imbalance exists. For example, depression can be caused by an imbalance between estrogens and progesterone, low androgens like DHEA and testosterone, or high cortisol. (Genetics, dietary factors or other environmental factors may also cause this imbalance.) Accordingly, depression might be reversed by supplementation with appropriate hormones. Hormone testing can be used to guide this therapy. If hormone balance is restored but symptoms persist, then one has to look elsewhere for the cause.
The saliva test can help evaluate if estrogens are well balanced with progesterone. Too much estrogen, relative to progesterone, leads to excessive tissue proliferation (a precursor to the building of tumors). Saliva hormone testing can be vital for rational disease prevention and anti-aging programs. Testosterone in both sexes is important for the maintenance of cardiovascular and bone health (osteoporosis).
What the ZRT Laboratory's website has to offer
(This is me talking now.)
How do you know what kind of saliva testing you need done? After all, if you knew what hormones were out of whack in your body, you wouldn't have to have a saliva test done! The ZRT website presents 3 tests whereby you check off what your symptoms are. From that, you can order kits for individual hormones to be tested or a package of several hormones to be tested at the same time. (You fill one tube with saliva for the kit in all but one case.) Here's an example:
Check which of these symptoms are troublesome and persist overtime. Two or more symptoms are an indication that testing Cortisol ( C ) for adrenal imbalance is recommended:
Fatigue
Weight gain - waist
Decreased muscle mass
Thinning skin
Elevated triglycerides
Sleep disturbances
Anxious
Depression
Heart palpitations
Headaches
Decreased libido
Hair loss
Increased facial hair
Increased body hair
Increased joint pain
Acne
Sugar craving
Allergies
Chemical sensitivity
Stress
Cold body temperature
Aches and pains
Memory lapse
Irritable
A lot of those symptoms are indicative of imbalance of other hormones, etc. However, some are unique. For instance, in testing for the estrogen known as estradiol and the hormone progesterone, these questions also appear on the form:
Night sweats
Hot flashes
Tender breasts
Cystic ovaries
Water retention
Incontinence
Foggy thinking
Bone loss
My BHRT, Debbie P., had me fill out an extensive questionnaire and from that, ordered the Hormone Profile #1 test for me. It contains 5 tests for the hormones of the estradiol, progesterone, testosterone, DHEAs, and morning cortisol. An individual test of one hormone costs $30 (if you pay upfront; $45 if insurance company pays). Hormone Profile #1 costs $150.00. That gives you an idea of the expense.
BEFORE YOU DECIDE --
You can get more information by listening to taped messages (via phone)
or downloading a topic to your computer. There are 45 topics in the ZRT library. This is a 24 hour Hotline. The telephone number is 503-466-9166. Then select the topic you want to know more about. Here's a sampling:
627 All About Hormones
628 Menopause
631 What is Estrogen and Estrogen Dominance?
634 Progesterone and Why We Need It
636 Cortisol, Stress and Adrenal Health
638 Hormone Imbalance and Osteoporosis
639 Hormone Imbalance, Insulin Resistance and Polycystic Ovaries
644 Hormone Imbalance and PMS
646 Hormone Imbalance and Breast Cancer
Why test saliva?
Hormones play a vital role in the maintenance of health. Knowledge of an imbalance can help illuminate causes of health problems and provide a rational basis for correcting the imbalance through diet, exercise, or hormone supplementation.
When glands manufacture hormones, they are transported into the bloodstream with proteins as their 'carriers.' (This is called being 'bound.' Think of hormones piggy-backing on proteins.) Only a small fraction of a given amount of hormone breaks loose from its carrier (1 - 5 %). When it does, it is free to enter target tissues such as the breast, uterus, brain, and skin. A free or unbound hormone is what is measured since it is active (or 'bioavailable). The amount of hormone that enters the saliva is representative of the fraction of steroids (steriods is another word for hormones) in the bloodstream that are bioavailable to other tissues in the body.
Your doctor may take blood tests to monitor your health. However, saliva hormone testing allows you to take more control over your own health. It may help you gain insight into health problems before you see your doctor. The advantages of testing saliva vs. blood serum are:
1. You can easily do it at home vs. having to have blood drawn at a doctor's office
2. It's less expensive and yes, it's covered by insurance (most of the time, all of the time?)
3. Saliva collection is exceptionally stable. Samples can be stored at room temps for a week without loss of activity. Blood, on the other hand, must be kept cool on ice packs, increasing costs and likelihood of error.
Depending on the specific hormones involved, certain symptoms or groups of symptoms are usually present when hormonal imbalance exists. For example, depression can be caused by an imbalance between estrogens and progesterone, low androgens like DHEA and testosterone, or high cortisol. (Genetics, dietary factors or other environmental factors may also cause this imbalance.) Accordingly, depression might be reversed by supplementation with appropriate hormones. Hormone testing can be used to guide this therapy. If hormone balance is restored but symptoms persist, then one has to look elsewhere for the cause.
The saliva test can help evaluate if estrogens are well balanced with progesterone. Too much estrogen, relative to progesterone, leads to excessive tissue proliferation (a precursor to the building of tumors). Saliva hormone testing can be vital for rational disease prevention and anti-aging programs. Testosterone in both sexes is important for the maintenance of cardiovascular and bone health (osteoporosis).
What the ZRT Laboratory's website has to offer
(This is me talking now.)
How do you know what kind of saliva testing you need done? After all, if you knew what hormones were out of whack in your body, you wouldn't have to have a saliva test done! The ZRT website presents 3 tests whereby you check off what your symptoms are. From that, you can order kits for individual hormones to be tested or a package of several hormones to be tested at the same time. (You fill one tube with saliva for the kit in all but one case.) Here's an example:
Check which of these symptoms are troublesome and persist overtime. Two or more symptoms are an indication that testing Cortisol ( C ) for adrenal imbalance is recommended:
Fatigue
Weight gain - waist
Decreased muscle mass
Thinning skin
Elevated triglycerides
Sleep disturbances
Anxious
Depression
Heart palpitations
Headaches
Decreased libido
Hair loss
Increased facial hair
Increased body hair
Increased joint pain
Acne
Sugar craving
Allergies
Chemical sensitivity
Stress
Cold body temperature
Aches and pains
Memory lapse
Irritable
A lot of those symptoms are indicative of imbalance of other hormones, etc. However, some are unique. For instance, in testing for the estrogen known as estradiol and the hormone progesterone, these questions also appear on the form:
Night sweats
Hot flashes
Tender breasts
Cystic ovaries
Water retention
Incontinence
Foggy thinking
Bone loss
My BHRT, Debbie P., had me fill out an extensive questionnaire and from that, ordered the Hormone Profile #1 test for me. It contains 5 tests for the hormones of the estradiol, progesterone, testosterone, DHEAs, and morning cortisol. An individual test of one hormone costs $30 (if you pay upfront; $45 if insurance company pays). Hormone Profile #1 costs $150.00. That gives you an idea of the expense.
BEFORE YOU DECIDE --
You can get more information by listening to taped messages (via phone)
or downloading a topic to your computer. There are 45 topics in the ZRT library. This is a 24 hour Hotline. The telephone number is 503-466-9166. Then select the topic you want to know more about. Here's a sampling:
627 All About Hormones
628 Menopause
631 What is Estrogen and Estrogen Dominance?
634 Progesterone and Why We Need It
636 Cortisol, Stress and Adrenal Health
638 Hormone Imbalance and Osteoporosis
639 Hormone Imbalance, Insulin Resistance and Polycystic Ovaries
644 Hormone Imbalance and PMS
646 Hormone Imbalance and Breast Cancer
April 11: Tuesday - Hormones and Their Roles
This is a dictionary of terms specific to the body's hormones. Sources for this page are:
www.Diagnose-Me.com
www.womentowomen.com
www.project-aware.org
www.Lef.org (Life Extension)
Hormone - Hormone(s) are chemical substances secreted by a variety of body organs that are carried into the bloodstream. They usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. Examples include adrenal hormones such as corticosteroids (cortisol) and aldosterone; testosterone, estrogens, progesterone, and DHEA.
______________________________________________________________________________________________
Adrenal glands - The adrenals are walnut-sized glands located on top of each kidney and are important control centers for many of the body's hormones. The outer layer of the gland, called the adrenal cortex, produces hormones including cortisol, DHEA, estrogen, and testosterone. (Note: not exclusively! Hormones can be produced in other places and ways.) The centers of the glands produce adrenaline, the hormone named after them. The basic task of your adrenal glands is to rush all your body's resources into 'fight or flight' mode by increasing production of adrenaline and other hormones. When healthy, your adrenals can instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion, and sharpen your senses. A healthy stress response takes priority over all other metabolic functions but wasn't designed to last very long.
Cholesterol - This vital substance that is synthesized by the liver and other bodily tissues. The body uses cholesterol as a building block for, among other things, steroid hormones. One clinical study proposes that healthy hormone production is representative (a reflection of) healthy cholesterol levels.
Cortisol - This is hormone secreted by the adrenal gland. In its normal function, cortisol helps us meet the challenges of stress by converting proteins into energy, releasing glycogen and counteracting inflammation.
Estrogen - female sex hormones. There are many types of estrogen: human, animal, plant, (toxic) environmental. Human estrogen in females is responsible at puberty for the development and maintenance of female sex organs. Secondary sex characteristics are the development of breasts as well as for menstrual cycles and pregnancy. A primary role of estrogen is to control the growth and function of the uterus: Specifically, estrogens create the blood-rich lining of the uterus that prepares a woman for pregnancy each month. As a general rule, estrogen promotes cell growth, primarily of the tissues responsible for reproduction. There are 3 estrogens in humans. Used all 3 together (triest), they are part of what is called NHRT or natural hormone replacement therapy. Two used together are called biest and is composed of just E2 & E3).
---- Estrone (E1) - In postmenopausal women, the body produces this human estrogen in relatively large quantities which tends to increase their fat mass while decreasing their lean body mass. This estrogen is produced in the adrenal glands and fat cells. It converts to estradiol in the liver.
---- Estradiol (E2) - This human estrogen is the most potent. It is the main estrogen influencing the menstrual cycle and its levels fluctuate tremendously. It is produced mostly by the liver. It spurs cell growth in the breast, uterus, and other tissues.
---- Estriol (E3) - This is the weakest of the three human estrogens. It has the least estrogenic effect on the body.
DHEA - Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. It may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEAs. One form is converted into the other as needed.
Progesterone - This hormone is produced in the corpus luteum of the ovaries of menstruating women. It is also found in the adrenals and is stored in fat tissue. Its primary responsibility is to prepare the uterus for egg implantation, maintain pregnancy, and prevent further ovulation during pregnancy. It helps to balance estrogen. Secondarily, it also reduces anxiety and increases sleepiness; helps build and maintain bone; slows the digestive process; promotes appetite and fat storage.
Testosterone - The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In women, it is produced primarily by the ovaries and adrenal glands. It has a direct affect on blood sugar levels and the function of the reproductive system, the nervous system, the cardiovascular system, the skeletal system, and other tissues.
www.Diagnose-Me.com
www.womentowomen.com
www.project-aware.org
www.Lef.org (Life Extension)
Hormone - Hormone(s) are chemical substances secreted by a variety of body organs that are carried into the bloodstream. They usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. Examples include adrenal hormones such as corticosteroids (cortisol) and aldosterone; testosterone, estrogens, progesterone, and DHEA.
______________________________________________________________________________________________
Adrenal glands - The adrenals are walnut-sized glands located on top of each kidney and are important control centers for many of the body's hormones. The outer layer of the gland, called the adrenal cortex, produces hormones including cortisol, DHEA, estrogen, and testosterone. (Note: not exclusively! Hormones can be produced in other places and ways.) The centers of the glands produce adrenaline, the hormone named after them. The basic task of your adrenal glands is to rush all your body's resources into 'fight or flight' mode by increasing production of adrenaline and other hormones. When healthy, your adrenals can instantly increase your heart rate and blood pressure, release your energy stores for immediate use, slow your digestion, and sharpen your senses. A healthy stress response takes priority over all other metabolic functions but wasn't designed to last very long.
Cholesterol - This vital substance that is synthesized by the liver and other bodily tissues. The body uses cholesterol as a building block for, among other things, steroid hormones. One clinical study proposes that healthy hormone production is representative (a reflection of) healthy cholesterol levels.
Cortisol - This is hormone secreted by the adrenal gland. In its normal function, cortisol helps us meet the challenges of stress by converting proteins into energy, releasing glycogen and counteracting inflammation.
Estrogen - female sex hormones. There are many types of estrogen: human, animal, plant, (toxic) environmental. Human estrogen in females is responsible at puberty for the development and maintenance of female sex organs. Secondary sex characteristics are the development of breasts as well as for menstrual cycles and pregnancy. A primary role of estrogen is to control the growth and function of the uterus: Specifically, estrogens create the blood-rich lining of the uterus that prepares a woman for pregnancy each month. As a general rule, estrogen promotes cell growth, primarily of the tissues responsible for reproduction. There are 3 estrogens in humans. Used all 3 together (triest), they are part of what is called NHRT or natural hormone replacement therapy. Two used together are called biest and is composed of just E2 & E3).
---- Estrone (E1) - In postmenopausal women, the body produces this human estrogen in relatively large quantities which tends to increase their fat mass while decreasing their lean body mass. This estrogen is produced in the adrenal glands and fat cells. It converts to estradiol in the liver.
---- Estradiol (E2) - This human estrogen is the most potent. It is the main estrogen influencing the menstrual cycle and its levels fluctuate tremendously. It is produced mostly by the liver. It spurs cell growth in the breast, uterus, and other tissues.
---- Estriol (E3) - This is the weakest of the three human estrogens. It has the least estrogenic effect on the body.
DHEA - Dehydroepiandrosterone (DHEA) is a steroid produced by the adrenal glands and is the most abundant one found in humans. It may be transformed into testosterone, estrogen or other steroids. It is found in the body as DHEA or in the sulfated form known as DHEAs. One form is converted into the other as needed.
Progesterone - This hormone is produced in the corpus luteum of the ovaries of menstruating women. It is also found in the adrenals and is stored in fat tissue. Its primary responsibility is to prepare the uterus for egg implantation, maintain pregnancy, and prevent further ovulation during pregnancy. It helps to balance estrogen. Secondarily, it also reduces anxiety and increases sleepiness; helps build and maintain bone; slows the digestive process; promotes appetite and fat storage.
Testosterone - The principal male sex hormone that induces and maintains the changes that take place in males at puberty. In women, it is produced primarily by the ovaries and adrenal glands. It has a direct affect on blood sugar levels and the function of the reproductive system, the nervous system, the cardiovascular system, the skeletal system, and other tissues.
April 11: Tuesday - Hormone Balancing
Hormone balancing is known as BioIdentical Hormone Replacement Therapy. In short, the medical community is slowly turning its 'face' from traditional HRT drugs (such as Premarin, Prempro and Provera) towards a new approach using bioidentical hormones. Traditional HRT prescribed estrogen to a woman undergoing the symptoms of menopause. It sought to replace the decreasing estrogen a woman's body made. In most cases, these drugs were prescribed without regard to how other female sex hormones fared. When a marked increase in uterine cancers among women taking HRT began to show up, drug companies developed medicines that were estrogen and progestin based compounds. When these began to be connected with breast cancer, many physicians withdrew prescribing HRT altogether. (Today, when a woman is discovered to have breast cancer, one of the first questions she’s asked is, “Did you take Hormone Replacement Therapy drugs?”
The following two references support this decision:
From the website, www.WomenToWomen.com:
(website: www.WomentoWomen.com) a group of women doctors with 21 years of clinical experience:
The pendulum has swung so far that today, very few doctors will prescribe any type of HRT - synthetical or bioidentical - for women who have had breast cancer or even a family history of breast cancer. In fact, many such women are given anti-estrogen drugs. Dr. Mills has breast cancer patients who, like Suzanne Somers, use low-dose bioidentical hormones by choice. These women have researched the issues, discussed them with their doctor, and made a well-informed decision for themselves.
From “What Your Doctor May Not Tell You About Breast Cancer,” by Dr. John R. Lee, p.212:
In January, 2000, the conservative Journal of the American Medical Association (JAMA) published a huge National Cancer Institute study that examined more than 46,000 women, and showed that the conventional medical HRT regimen using estrogen and synthetic progestins confers a higher risk of breast cancer than estrogen alone. The study received a lot of media attention, most of it shamefully misleading because the term progesterone was used to describe the progestins used in the study. Compared to no hormone use, the risk of breast cancer in women who use estrogen alone (ERT) is increased by 1 percent per year of use, whereas the risk in women using both estrogen and a progestin (HRT) is increased by 8 percent per year. This means that a woman who's on conventional HRT for 5 years has a 40% higher risk of breast cancer than a woman not using HRT. This is a huge increase and yet there were still articles following the publication of this study suggesting that the benefits of HRT for heart disease and osteoporosis outweighed its risks. Not only have the benefits of HRT for heart disease and osteoporosis been exaggerated, both are almost entirely preventable with a healthy lifestyle.
This study was certainly not the first to show this strong a connection between HRT and breast cancer, but it was the first one so large and so statistically significant that it couldn't be ignored.
---------------
What are bioidentical hormones? From Women to Women:
Bioidential hormones are manufactured to have the same molecular structure as the hormones made by your own body. By contrast, synthetic hormones are intentially different. Drug companies can't patent a bioidentical structure, so they invent synthetic hormones that are patentable (Premarin, etc.)
In our practice, we have had the greatest success with an individualized approach. We begin with laboratory tests of hormone levels (probably saliva tests). We then prescribe a precise dosage of bioidentical estrogen, testosterone or DHEA that is made up at a compounding pharmacy. Each patient is then monitored carefully through regular follow-up hormone panels to ensure we get symptom relief at the lowest possible dosage. In the initial stages, we will do a hormone panel every three months. Once balance is restored, we'll do one panel a year at the time of the annual exam.
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Why balance your hormones? Again, from Women to Women:
When estrogen levels are high in relation to our progesterone, we experience many severe symptoms, among them: anxiety, breast tenderness, cyclical headaches or migraines, depression, digestive issues, fuzzy thinking, palpitations, food cravings, irregular bleeding, water retention, weight gain and more.
If estrogen levels stay unopposed, women may develop infertility, endometriosis, amenorrhea (skipped periods), hypermenorrhea (heavy bleeding), fibroids, uterine cancer, stroke, and decreased cognitive ability, among other conditions.
There have been studies and speculation for example about the connection between high levels of estrogen and breast cancer. We think many unanswered questions remain about this link....
The following two references support this decision:
From the website, www.WomenToWomen.com:
(website: www.WomentoWomen.com) a group of women doctors with 21 years of clinical experience:
The pendulum has swung so far that today, very few doctors will prescribe any type of HRT - synthetical or bioidentical - for women who have had breast cancer or even a family history of breast cancer. In fact, many such women are given anti-estrogen drugs. Dr. Mills has breast cancer patients who, like Suzanne Somers, use low-dose bioidentical hormones by choice. These women have researched the issues, discussed them with their doctor, and made a well-informed decision for themselves.
From “What Your Doctor May Not Tell You About Breast Cancer,” by Dr. John R. Lee, p.212:
In January, 2000, the conservative Journal of the American Medical Association (JAMA) published a huge National Cancer Institute study that examined more than 46,000 women, and showed that the conventional medical HRT regimen using estrogen and synthetic progestins confers a higher risk of breast cancer than estrogen alone. The study received a lot of media attention, most of it shamefully misleading because the term progesterone was used to describe the progestins used in the study. Compared to no hormone use, the risk of breast cancer in women who use estrogen alone (ERT) is increased by 1 percent per year of use, whereas the risk in women using both estrogen and a progestin (HRT) is increased by 8 percent per year. This means that a woman who's on conventional HRT for 5 years has a 40% higher risk of breast cancer than a woman not using HRT. This is a huge increase and yet there were still articles following the publication of this study suggesting that the benefits of HRT for heart disease and osteoporosis outweighed its risks. Not only have the benefits of HRT for heart disease and osteoporosis been exaggerated, both are almost entirely preventable with a healthy lifestyle.
This study was certainly not the first to show this strong a connection between HRT and breast cancer, but it was the first one so large and so statistically significant that it couldn't be ignored.
---------------
What are bioidentical hormones? From Women to Women:
Bioidential hormones are manufactured to have the same molecular structure as the hormones made by your own body. By contrast, synthetic hormones are intentially different. Drug companies can't patent a bioidentical structure, so they invent synthetic hormones that are patentable (Premarin, etc.)
In our practice, we have had the greatest success with an individualized approach. We begin with laboratory tests of hormone levels (probably saliva tests). We then prescribe a precise dosage of bioidentical estrogen, testosterone or DHEA that is made up at a compounding pharmacy. Each patient is then monitored carefully through regular follow-up hormone panels to ensure we get symptom relief at the lowest possible dosage. In the initial stages, we will do a hormone panel every three months. Once balance is restored, we'll do one panel a year at the time of the annual exam.
-----------------------------------------------------------------
Why balance your hormones? Again, from Women to Women:
When estrogen levels are high in relation to our progesterone, we experience many severe symptoms, among them: anxiety, breast tenderness, cyclical headaches or migraines, depression, digestive issues, fuzzy thinking, palpitations, food cravings, irregular bleeding, water retention, weight gain and more.
If estrogen levels stay unopposed, women may develop infertility, endometriosis, amenorrhea (skipped periods), hypermenorrhea (heavy bleeding), fibroids, uterine cancer, stroke, and decreased cognitive ability, among other conditions.
There have been studies and speculation for example about the connection between high levels of estrogen and breast cancer. We think many unanswered questions remain about this link....
April 10-11 : When TIME was ‘King’
April 10, Monday
In prayer, I asked Heavenly Father to help me learn just how to destress. Perhaps a signal for when I'd completed a task (or a portion of it) for that day? I don't ever want to return to a list-driven life where TIME is 'King'. I want to be able to sense when the time is right to move on from one task to another rather than determine that by a clock.
I have decided that from this day forward, I will live my life as if the chapter on cancer is closed. Yes, I will be vigilant in changing those things in my life that were not healthy. But I refuse to entertain the fear that comes with the feeling of 'looking over one's shoulder' for the next possible attack.
April 11, Tuesday
We spent the night at Steve’s. The children wanted me to jump on the trampoline with them. (I quickly found that this was not the best idea for it hasn't been even two weeks yet since the surgery.) While jumping, however, 6 year old Lauren said, "Grandma, I like your sweater. The color is pretty." (It's a teal blue cardigan that buttons down all the way down the front.)
In an effort to follow his sister's good example, 4 year old Garet said, "Grandma, I like your buttons."
Oh, how I laughed (inside). Children are precious! Later, we fed a pair of ducks that had wandered into their back yard looking for something to eat.
Sweet memories.
During the day, I had an appointment with a BHRT (BioIdentical Hormone Replacement Therapist). The first step in hormone balancing is to take a saliva test. (More on this kind of test on the next page.) When the results come in, then a strategy will be planned.
No looking back now!
In prayer, I asked Heavenly Father to help me learn just how to destress. Perhaps a signal for when I'd completed a task (or a portion of it) for that day? I don't ever want to return to a list-driven life where TIME is 'King'. I want to be able to sense when the time is right to move on from one task to another rather than determine that by a clock.
I have decided that from this day forward, I will live my life as if the chapter on cancer is closed. Yes, I will be vigilant in changing those things in my life that were not healthy. But I refuse to entertain the fear that comes with the feeling of 'looking over one's shoulder' for the next possible attack.
April 11, Tuesday
We spent the night at Steve’s. The children wanted me to jump on the trampoline with them. (I quickly found that this was not the best idea for it hasn't been even two weeks yet since the surgery.) While jumping, however, 6 year old Lauren said, "Grandma, I like your sweater. The color is pretty." (It's a teal blue cardigan that buttons down all the way down the front.)
In an effort to follow his sister's good example, 4 year old Garet said, "Grandma, I like your buttons."
Oh, how I laughed (inside). Children are precious! Later, we fed a pair of ducks that had wandered into their back yard looking for something to eat.
Sweet memories.
During the day, I had an appointment with a BHRT (BioIdentical Hormone Replacement Therapist). The first step in hormone balancing is to take a saliva test. (More on this kind of test on the next page.) When the results come in, then a strategy will be planned.
No looking back now!
April 8: Saturday: What is Reality?
This morning Rex said, "This all seems so surreal. You don't look sick; you don't act sick. How can it be that you really are sick?" He was having a hard time believing my diagnosis of cancer because he hasn't seen any physical proof of the tumor itself. It's been very real to me since the day the ultrasound was taken. However, he wasn't shown any of the results or pictures, etc. Realizing this, I suggested that he be the one to coat the scars from the operation with vitamin E each morning. I hope that will bring it 'home' to him. (So far, the incision and removal of the tumor has not produced any visible change in the shape of the breast. This is because it's swollen.)
I talked with Lisa tonight. I wondered why I hadn't heard from her since being told of the micrometastasis in the lymph node. I asked her what she was thinking and feeling. Her reply was that she was so angry about the news (as my reaction had been), she could hardly talk for 24 hours. When the anger wore off, a 'down' feeling persisted. Her perspective was, "Why call and talk when we're both feeling down? What would be the benefit of that?"
Lisa also asked another question, rather tentatively (for her). She said that her mother-in-law had a lumpectomy last year and no one in her own immediate family knew anything about it until after it was all over. She held some admiration for Marla who had 'gone it alone' (been reflective within) instead of involving so many others: family and friends. Why hadn't I?
I know my daughter well enough to interpret her questions as really saying, "Why weren't you strong like that?" On the face of it, some people might see that kind of an approach as 'strong' while viewing the approach I've taken as 'weak.' Certainly we know now that keeping the news of cancer to oneself is representative of a breast cancer personality. (See entry for March 26: Psychological Profile.) The 'need to be self-contained' means that it almost goes against your very nature to have to rely on others, especially when you're the one who's been taking 'care of everyone else but' yourself.
Taking the opposite point of view, is it a sign of a weakness to withhold the news your predicament with family and friends because you just hate the idea of others serving you? I know others who've kept their surgery private (even from their own grown children). One is a good friend and I don't see her as 'weak.' So, is one approach strong and the other weak? In my opinion, neither. As I've said before, cancer is a very individual experience.
I did what I could to explain this more fully to Lisa. In my case, the blessings I'd been given suggested that I would receive much valuable information from family and friends. When friends, family and neighbors found out about the cancer, their calls (and acts) of empathy lifted me up emotionally. Just as importantly, they'd say something in passing that the spirit would witness was an important truth in my path to health and recovery. I reminded her that in the early days of this experience, her own advice to me was, "Mom, you've got to start eating different foods. You eat the same thing day in and day out. That can't be good for you." Her comment has not left my mind: I knew than and now that it is true. This approach was the right path, the best path for me.
Lisa's soft answer showed that she understood.
I talked with Lisa tonight. I wondered why I hadn't heard from her since being told of the micrometastasis in the lymph node. I asked her what she was thinking and feeling. Her reply was that she was so angry about the news (as my reaction had been), she could hardly talk for 24 hours. When the anger wore off, a 'down' feeling persisted. Her perspective was, "Why call and talk when we're both feeling down? What would be the benefit of that?"
Lisa also asked another question, rather tentatively (for her). She said that her mother-in-law had a lumpectomy last year and no one in her own immediate family knew anything about it until after it was all over. She held some admiration for Marla who had 'gone it alone' (been reflective within) instead of involving so many others: family and friends. Why hadn't I?
I know my daughter well enough to interpret her questions as really saying, "Why weren't you strong like that?" On the face of it, some people might see that kind of an approach as 'strong' while viewing the approach I've taken as 'weak.' Certainly we know now that keeping the news of cancer to oneself is representative of a breast cancer personality. (See entry for March 26: Psychological Profile.) The 'need to be self-contained' means that it almost goes against your very nature to have to rely on others, especially when you're the one who's been taking 'care of everyone else but' yourself.
Taking the opposite point of view, is it a sign of a weakness to withhold the news your predicament with family and friends because you just hate the idea of others serving you? I know others who've kept their surgery private (even from their own grown children). One is a good friend and I don't see her as 'weak.' So, is one approach strong and the other weak? In my opinion, neither. As I've said before, cancer is a very individual experience.
I did what I could to explain this more fully to Lisa. In my case, the blessings I'd been given suggested that I would receive much valuable information from family and friends. When friends, family and neighbors found out about the cancer, their calls (and acts) of empathy lifted me up emotionally. Just as importantly, they'd say something in passing that the spirit would witness was an important truth in my path to health and recovery. I reminded her that in the early days of this experience, her own advice to me was, "Mom, you've got to start eating different foods. You eat the same thing day in and day out. That can't be good for you." Her comment has not left my mind: I knew than and now that it is true. This approach was the right path, the best path for me.
Lisa's soft answer showed that she understood.
Tuesday, January 15, 2008
April 7: Friday: Decision time re: Radiation, chemotherapy, and hormonal therapy
Last night, as we ate supper, we cast our individual vote secretly for what we felt was the best treatment plan. Then we compared the two. It was amazing in that our two plans completely matched on every point. That rarely happens with us! It gave us a sense of welcome relief and satisfaction.
What we both wrote down was:
--- Surgical removal of the second and third lymph node layers.
--- ‘No’ to chemotherapy. ‘Yes’ to radiation therapy.
--- Follow-up hormonal therapy was to be accomplished through hormone balancing and other natural alternatives.
That was last night but --
Almost as soon as we shared our visions, I began to be disturbed about the prospect of the extra surgery… When I awoke this morning, I closely examined all the entries in this blog. I made careful notes with special reference to the promises contained in the blessings, the inspirations received in the temple, the impressions that had come with reading the scriptures and the answers that had come through prayer. It was revealing what I learned when I put these elements all together.
I realized that the way my journey had unfolded was what needed to happen. Heavenly Father had known all along! Originally, I wasn’t in the least open to radiation and yet I now see that it is the right choice for me. If that lymph node hadn’t tested (minimally) positive, I would never even have considered radiation. Tough as the news was to receive, I believe now it was all part of what the March 12th blessing had referred to as the ‘test of faith.’
What about the promised blessing that the procedures would be ‘minimally intrusive’ and our feeling that we should now go ahead and have me opened up again to remove the other lymph nodes? I considered that we didn’t need the extra information (re: more cancer?) that surgically removing the lymph nodes would give us. We already knew. We’d been told in these blessings. That’s what they meant when they said that my body would be rid of the cancer when blessed just before the operation. “Minimal intrusion” had occurred for both places of cancer had, unknown to us at the time of surgery, been removed.
In other words, it was not necessary to remove the lymph nodes through surgery.
In fact, I had the distinct feeling that Heavenly Father was leaving that decision up to us but if we did remove the lymph nodes surgically, I would pay a price the rest of my life. The ‘consequence’ wouldn’t be life threatening, etc. but it would be uncomfortable or limit me in some unforeseen way. (Possibly lymphadema?)
How does Reliv and hormone balancing fit in? I believe it answers the inspiration that the body can be healed and course-corrected through the natural things of the earth.
What about the inspiration received Feb. 21st? Could this new course be seen as unconventional? Somehow, it seems even more so now - each step of my Health Recovery Plan. How perfectly this course also answers the part of my ‘Prayer to Heavenly Father’ when I asked for “harmony to be between all types of therapies.”
Rex and I took a long walk and talked about all of this. I felt a great peace. He wasn’t so sure about radiating the lymph nodes but he felt ‘good’ about my decision. He felt ‘very good’ about the radiation therapy. He felt ‘comfortable’ about hormone balancing vs. hormone therapy with drugs.
In the evening, we knelt down and offered a formal prayer to know. I can’t say that either of us had a burning ‘yes’ answer but we did feel that it was right. Additionally, I sensed that the hormone balancing vs. hormone therapy is on an equal footing as regards the ‘best knowledge available at the present time.’
The ‘cure’ has not been found or perfected; this is as good as it gets right now.
What we both wrote down was:
--- Surgical removal of the second and third lymph node layers.
--- ‘No’ to chemotherapy. ‘Yes’ to radiation therapy.
--- Follow-up hormonal therapy was to be accomplished through hormone balancing and other natural alternatives.
That was last night but --
Almost as soon as we shared our visions, I began to be disturbed about the prospect of the extra surgery… When I awoke this morning, I closely examined all the entries in this blog. I made careful notes with special reference to the promises contained in the blessings, the inspirations received in the temple, the impressions that had come with reading the scriptures and the answers that had come through prayer. It was revealing what I learned when I put these elements all together.
I realized that the way my journey had unfolded was what needed to happen. Heavenly Father had known all along! Originally, I wasn’t in the least open to radiation and yet I now see that it is the right choice for me. If that lymph node hadn’t tested (minimally) positive, I would never even have considered radiation. Tough as the news was to receive, I believe now it was all part of what the March 12th blessing had referred to as the ‘test of faith.’
What about the promised blessing that the procedures would be ‘minimally intrusive’ and our feeling that we should now go ahead and have me opened up again to remove the other lymph nodes? I considered that we didn’t need the extra information (re: more cancer?) that surgically removing the lymph nodes would give us. We already knew. We’d been told in these blessings. That’s what they meant when they said that my body would be rid of the cancer when blessed just before the operation. “Minimal intrusion” had occurred for both places of cancer had, unknown to us at the time of surgery, been removed.
In other words, it was not necessary to remove the lymph nodes through surgery.
In fact, I had the distinct feeling that Heavenly Father was leaving that decision up to us but if we did remove the lymph nodes surgically, I would pay a price the rest of my life. The ‘consequence’ wouldn’t be life threatening, etc. but it would be uncomfortable or limit me in some unforeseen way. (Possibly lymphadema?)
How does Reliv and hormone balancing fit in? I believe it answers the inspiration that the body can be healed and course-corrected through the natural things of the earth.
What about the inspiration received Feb. 21st? Could this new course be seen as unconventional? Somehow, it seems even more so now - each step of my Health Recovery Plan. How perfectly this course also answers the part of my ‘Prayer to Heavenly Father’ when I asked for “harmony to be between all types of therapies.”
Rex and I took a long walk and talked about all of this. I felt a great peace. He wasn’t so sure about radiating the lymph nodes but he felt ‘good’ about my decision. He felt ‘very good’ about the radiation therapy. He felt ‘comfortable’ about hormone balancing vs. hormone therapy with drugs.
In the evening, we knelt down and offered a formal prayer to know. I can’t say that either of us had a burning ‘yes’ answer but we did feel that it was right. Additionally, I sensed that the hormone balancing vs. hormone therapy is on an equal footing as regards the ‘best knowledge available at the present time.’
The ‘cure’ has not been found or perfected; this is as good as it gets right now.
April 6th, 2006: Thursday: Localization Oncologist - Radiation Therapy
We were very fortunate to see Dr. K.., the radiation oncologist, rather immediately after visiting with Dr. H.., the chemotherapy and hormonal oncologist. Strange how a person can ‘warm’ to some doctors and not to others! This doctor was straightforward. He presented facts and answered directly the questions we directly asked. He did not attempt to influence our decision one way or the other. (His nurse, however, was a different story!) We appreciated his frankness. He inspired confidence. We both liked him and instinctively trusted him.
Our main question was: How to deal with the lymph nodes - remove surgically or radiate?
If we decided to surgically remove the second and third layers of lymph nodes (those directly behind where the sentinel lymph node lay), we could know without a doubt if there was more cancer there or not. We could then determine if chemotherapy would be needed. Surgically removing these lymph nodes meant another operation and that they would be gone forever (obviously!). On the downside, there was a slightly higher risk of contracting lymphadema with surgical removal.
We learned that because the micrometastasis found in the sentinel lymph node was so small, the chances were highly unlikely that there was cancer in the lymph nodes beyond it. However, there was the infinitesimal chance that a cancer cell could have escaped through the lymph nodes. If it did, this would mean major problems in the future: cancerous tumors appearing in the liver, lungs, brain, or bones. The upside of having the lymph nodes radiated was that they would be scarred and their functionality would be impaired but they would not be completely destroyed. If the course chosen was to radiate the lymph nodes, then having chemotherapy would become a moot point.
At our askance, Dr. K.. provided us with some statistics.
-- A woman who has a lumpectomy and whose lymph nodes tested positive for cancer and doesn’t have radiation has a 47% chance of cancer recurring in the next 5 to 8 years.
-- A woman who has a lumpectomy and whose sentinel lymph node(s) was clean but who doesn’t have radiation has a 30% chance of cancer recurrence in the following 5 – 8 years.
-- A woman who has a lumpectomy and who has radiation has a 95% chance of not having cancer recurrence in the following 5 – 8 year period.
In other words, what chemotherapy and hormone therapy do for you is to cover that other 5 – 8 % chance of recurrence. Personally speaking, that’s a pretty high price to pay in terms of risk/ reward benefits. Dr. K.. concurred saying that the more cancer you have in your lymph nodes, the more effective chemotherapy is and vice versa. Its effectiveness is minimal if there is little to no cancer present in the lymph nodes and therefore, it doesn’t exist throughout your body any more than is normal.
I asked Dr. K.. what happens when a person goes off the after-care treatment hormonal therapy drugs. He said - quite candidly - that the incidence of breast cancer recurrence rates begins to rise again. (For those with breast cancer, the chances are 1 in 6 of a cancer recurrence elsewhere in the body vs. 1 in 9 for the first-timers in the normal population.)
What I understood from information is that the hormonal therapy drugs are really a ‘patch’ that may be the solution or may not. It’s like getting a ‘guarantee’ that you’ll be alive for five years (if the chemotherapy drugs don’t kill you!). At the 5-year milestone, the medical establishment then declares that you are a cancer survivor - whether or not you contract the disease again in the future.
We thanked Dr. K.. for his time and left without coming to a conclusion as to what our next step would be. It did seem most prudent, though, to have the lymph nodes surgically removed.
Our main question was: How to deal with the lymph nodes - remove surgically or radiate?
If we decided to surgically remove the second and third layers of lymph nodes (those directly behind where the sentinel lymph node lay), we could know without a doubt if there was more cancer there or not. We could then determine if chemotherapy would be needed. Surgically removing these lymph nodes meant another operation and that they would be gone forever (obviously!). On the downside, there was a slightly higher risk of contracting lymphadema with surgical removal.
We learned that because the micrometastasis found in the sentinel lymph node was so small, the chances were highly unlikely that there was cancer in the lymph nodes beyond it. However, there was the infinitesimal chance that a cancer cell could have escaped through the lymph nodes. If it did, this would mean major problems in the future: cancerous tumors appearing in the liver, lungs, brain, or bones. The upside of having the lymph nodes radiated was that they would be scarred and their functionality would be impaired but they would not be completely destroyed. If the course chosen was to radiate the lymph nodes, then having chemotherapy would become a moot point.
At our askance, Dr. K.. provided us with some statistics.
-- A woman who has a lumpectomy and whose lymph nodes tested positive for cancer and doesn’t have radiation has a 47% chance of cancer recurring in the next 5 to 8 years.
-- A woman who has a lumpectomy and whose sentinel lymph node(s) was clean but who doesn’t have radiation has a 30% chance of cancer recurrence in the following 5 – 8 years.
-- A woman who has a lumpectomy and who has radiation has a 95% chance of not having cancer recurrence in the following 5 – 8 year period.
In other words, what chemotherapy and hormone therapy do for you is to cover that other 5 – 8 % chance of recurrence. Personally speaking, that’s a pretty high price to pay in terms of risk/ reward benefits. Dr. K.. concurred saying that the more cancer you have in your lymph nodes, the more effective chemotherapy is and vice versa. Its effectiveness is minimal if there is little to no cancer present in the lymph nodes and therefore, it doesn’t exist throughout your body any more than is normal.
I asked Dr. K.. what happens when a person goes off the after-care treatment hormonal therapy drugs. He said - quite candidly - that the incidence of breast cancer recurrence rates begins to rise again. (For those with breast cancer, the chances are 1 in 6 of a cancer recurrence elsewhere in the body vs. 1 in 9 for the first-timers in the normal population.)
What I understood from information is that the hormonal therapy drugs are really a ‘patch’ that may be the solution or may not. It’s like getting a ‘guarantee’ that you’ll be alive for five years (if the chemotherapy drugs don’t kill you!). At the 5-year milestone, the medical establishment then declares that you are a cancer survivor - whether or not you contract the disease again in the future.
We thanked Dr. K.. for his time and left without coming to a conclusion as to what our next step would be. It did seem most prudent, though, to have the lymph nodes surgically removed.
April 6, 2006: Thursday: Systemic Oncologist - Chemotherapy and Hormonal Therapy
Rex and I drove to Boise and went to the temple before keeping the appointment with Dr. H…. (Dr. H… is the systemic oncologist who coordinates plans with the two other oncologists responsible for my treatment.) In the temple, I prayed again that we would understand what she explained to us. I also felt impressed to pray that Rex and I would have a clearer picture of what course of treatment to follow. At present, the several options that we have could be arranged in several different ways. It was overwhelming to even think about it.
This time, when Dr. H…. came into the examining room, she was in a great hurry. This visit was nothing like the initial one. Now she had no time to patiently explain the different options and all our questions. The first visit had been for about 2 hours! Now she only had 20 min. In effect, she asked that we give her some idea of what we were thinking about for my course of treatment, so she wasn’t wasting her time explaining things I wasn’t going to accept anyway. I respected that and told her truthfully I was open to hearing what she had to say about chemotherapy, radiation, and hormone therapy.
She sensed my sincerity and honestly explained the situation, including options. To our great relief, Rex and I did understand them. We did wish we had had more time, but we got enough information to begin formulating a course. It was suggested that we see the radiation oncologist. Another blessing on this day was that he was able to squeeze a consultation in with us immediately.
We learned that whereas a radiation oncologist’s treatment expertise is called ‘localization’ or treatment of the affected area, Dr. H…’s area was ‘systemic’ therapy or of the whole body. Specifically, what that means is that she prescribes the chemotherapy and the after-treatment care that is hormonal therapy. Practically the first thing she said was that while the pathologist results reported a micrometastasis in the sentinel lymph node of .15 cm, the amount was so minimal as to be regarded by many oncologists as ‘negative’ for cancer.
The implication of what she was saying was a HUGE relief to us with one small caveat. Because the sentinel lymph node did show some sign of cancer, it was suggested that the next layer or two of lymph nodes be neutralized. This could be done in one of two ways: either through radiation or through surgery. As this was not her field of expertise, she simply presented those options and went on to explain what her role as a systemic oncologist might entail.
She said that in my case, chemotherapy was not especially necessary because in effect, my diagnosis could be described as Stage 1. This produced another big, BIG sigh of relief. She did recommend it, though, if we wanted to cover ‘all the bases’ and give me the absolute best prognosis. She explained how it worked. Then she went on to talk about hormonal therapy that is administered after all other treatments and continues for 5 years afterwards. In the end, she said that if I was going to forego one of the systemic treatments, she recommended it be the chemotherapy and to do the hormonal therapy.
Hormonal therapy is accomplished through drugs whose objective it is to block or inhibit the hormone receptors on the cancer cells that remain after all else has been done (chemotherapy and radiation). When a breast cancer is estrogen-positive that means that the cancer cells will continue to multiply and divide without any of the normal checks and balances, in other words, those cells would not die a natural death. If the signal to multiply is blocked, these cells won’t multiply and will (eventually) clump together to form another tumor at another site.
I knew that Tamoxifen had the potential for some pretty severe side effects. She said that she’d be prescribing Arimidex for me. I asked her how long that drug had been on the market and been used for treatments in cases similar to mine. She said that it had been on the market for a long time but had only been used in cases similar to mine for the past 3-4 years. (I remembered reading in Dr. Lee’s book that it was not usually the case that women with Stage 1 cancer – that is, not in the lymph nodes – were treated with hormone therapy. This, I take it, is what she meant by only recently was Arimidex being used for Stage 1 cancers.)
Arimidex is not known to have any lasting, serious side effects at this time. However, she said that in the short term, (like the 5 years it’s supposed to be taken?), it can have some pretty uncomfortable side effects and that she’s even had to take some women off of it.
I certainly appreciated her honesty and thought as how, when you are open with a person, they tend to be more open and honest with you.
I asked her what happens after 5 years to these cells that have been inhibited. What do they do then when you’re not taking the drug to block the receptors? She said that at this point, they don’t really know. The hope is that during the prescribed 5 years, the cell would have somehow been destroyed.
In other words, the conventional medical establishment is still experimenting – on you!
This time, when Dr. H…. came into the examining room, she was in a great hurry. This visit was nothing like the initial one. Now she had no time to patiently explain the different options and all our questions. The first visit had been for about 2 hours! Now she only had 20 min. In effect, she asked that we give her some idea of what we were thinking about for my course of treatment, so she wasn’t wasting her time explaining things I wasn’t going to accept anyway. I respected that and told her truthfully I was open to hearing what she had to say about chemotherapy, radiation, and hormone therapy.
She sensed my sincerity and honestly explained the situation, including options. To our great relief, Rex and I did understand them. We did wish we had had more time, but we got enough information to begin formulating a course. It was suggested that we see the radiation oncologist. Another blessing on this day was that he was able to squeeze a consultation in with us immediately.
We learned that whereas a radiation oncologist’s treatment expertise is called ‘localization’ or treatment of the affected area, Dr. H…’s area was ‘systemic’ therapy or of the whole body. Specifically, what that means is that she prescribes the chemotherapy and the after-treatment care that is hormonal therapy. Practically the first thing she said was that while the pathologist results reported a micrometastasis in the sentinel lymph node of .15 cm, the amount was so minimal as to be regarded by many oncologists as ‘negative’ for cancer.
The implication of what she was saying was a HUGE relief to us with one small caveat. Because the sentinel lymph node did show some sign of cancer, it was suggested that the next layer or two of lymph nodes be neutralized. This could be done in one of two ways: either through radiation or through surgery. As this was not her field of expertise, she simply presented those options and went on to explain what her role as a systemic oncologist might entail.
She said that in my case, chemotherapy was not especially necessary because in effect, my diagnosis could be described as Stage 1. This produced another big, BIG sigh of relief. She did recommend it, though, if we wanted to cover ‘all the bases’ and give me the absolute best prognosis. She explained how it worked. Then she went on to talk about hormonal therapy that is administered after all other treatments and continues for 5 years afterwards. In the end, she said that if I was going to forego one of the systemic treatments, she recommended it be the chemotherapy and to do the hormonal therapy.
Hormonal therapy is accomplished through drugs whose objective it is to block or inhibit the hormone receptors on the cancer cells that remain after all else has been done (chemotherapy and radiation). When a breast cancer is estrogen-positive that means that the cancer cells will continue to multiply and divide without any of the normal checks and balances, in other words, those cells would not die a natural death. If the signal to multiply is blocked, these cells won’t multiply and will (eventually) clump together to form another tumor at another site.
I knew that Tamoxifen had the potential for some pretty severe side effects. She said that she’d be prescribing Arimidex for me. I asked her how long that drug had been on the market and been used for treatments in cases similar to mine. She said that it had been on the market for a long time but had only been used in cases similar to mine for the past 3-4 years. (I remembered reading in Dr. Lee’s book that it was not usually the case that women with Stage 1 cancer – that is, not in the lymph nodes – were treated with hormone therapy. This, I take it, is what she meant by only recently was Arimidex being used for Stage 1 cancers.)
Arimidex is not known to have any lasting, serious side effects at this time. However, she said that in the short term, (like the 5 years it’s supposed to be taken?), it can have some pretty uncomfortable side effects and that she’s even had to take some women off of it.
I certainly appreciated her honesty and thought as how, when you are open with a person, they tend to be more open and honest with you.
I asked her what happens after 5 years to these cells that have been inhibited. What do they do then when you’re not taking the drug to block the receptors? She said that at this point, they don’t really know. The hope is that during the prescribed 5 years, the cell would have somehow been destroyed.
In other words, the conventional medical establishment is still experimenting – on you!
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