Tuesday, August 31, 2010

Without ovaries we wouldn't have you to read this.

In a sea of PINK I want you to take a second and remember the ocean is in fact TEAL in color and remember that September is Ovarian Cancer Awareness month.

I have actually been thinking of what I want to say in this blog for several weeks now. I don't want to come across rude or disrespectful to brave women fighting breast cancer and winning. I have more admiration for cancer survivors than I do most, with the exception of military men and women and women who choose to breastfeed. I would also never disrespect the work on various breast cancer awareness organizations such as Susan G. Komen. It is amazing the awareness women (and men) have of breast cancer prevalence and prevention.

Unfortunately in our continued infatuation with the beauty of the female form (primarily the breast) we overlook significant details. First, the clinical and breast self exam.

There is currently no scientific evidence from randomized trials that breast self-exam (BSE) saves lives or enables women to detect breast cancer at earlier stages. In addition, there are some data that show that BSE greatly increases the number of benign lumps detected, resulting in increased anxiety, physician visits, and unnecessary biopsies. Therefore, NBCC does not support efforts to promote and teach BSE on a population-wide level in any age group of women - National Breast Cancer Coalition

This is not to say that the BSE or CBE (clinical-breast exam) does not detect cancer and should not be discussed, but research shows no difference in morbidity and mortality with the extensive push for women to perform this monthly.

Next, let's talk funding. $2,596 is appropriated by the National Cancer Institute for each new diagnosis of breast cancer followed by colon cancer ($2,361) and pancreatic cancer ($2,200).

Susan G. Komen has raised over one billion dollars to date and awarded over 180 million in monies towards research. They have also been accused of pinkwashing women and corporate sponsors. No matter what, each dollar spent towards breast cancer is amazing. Early diagnosis leads to better outcomes. Better outcomes leads to more survivors. More survivors leads to

...AT LEAST YOUR MOM DOESN'T HAVE BREAST CANCER...

I have been told this one three separate occasions. THREE. My mom has stage IIIC ovarian cancer. She was initially staged at stage IV. Last staging for women with ovarian cancer is common, it is nicknamed the SILENT KILLER after all. Why the silent killer?

Because the Ovarian Cancer National Alliance and other related organizations have not dominated the market nor received the celebrity of other "fashionable cancers". Its symptoms are vague and include...

Bloating
Feeling of fullness
Mild abdominal and pelvic pain
Changes in urination such as urgency and frequency

To compound matters, there is currently no recommended guideline for evaluating and detecting ovarian cancer in its earlier and more treatable stages. In contrast colon cancer has fecal occult blood testing and the colonoscopy, breast cancer has mammography, cervical cancer has the pap smear, and prostate cancer has the controversial PSA test.


A blood test for ovarian cancer markers has been developed and FDA-approved to little fanfare, public knowledge, or insurance coverage. A simple blood test to detect cancer earlier, you would think insurance and the media would be all over it. Sadly no.

We often overlook cancers due to a myriad of circumstances: vanity and celebrity, poor education, and poor fundraising. Few knew how deadly and painful pancreatic cancer is until Patrick Swayze fought it bravely and in the public eye.

Did you know Kathy Bates and Carol Channing are survivors of ovarian cancer? Did you know Coretta Scott King battled the disease? What about Gilda Radner? Yet, we can easily spit out names of breast cancer survivors (which is sooo amazing that we can).

This brings me back to my mom who is battling the SILENT KILLER to this very second.

At least she doesn't have breast cancer

December 7, 2006 at approximately 5 in the afternoon. My mom was first day post-op from a complete hysterectomy, lymph node dissection, partial colectomy, ablation, and removal of the omentum. She had just gotten up and walked for the first time and was laying in bed. The attending dermatologist was rounding on her as the cancer caused a skin condition which lead to massive blisters all over her body. As she was talking, she stopped and slurred "I feel funny". Her oxygen saturation plummeted to 41%, her heart rate stopped for over a minute, then raced to the 200s and she began coughing blood. As she semi-aroused the health team called a medical emergency and went into action. BILATERAL pulmonary emboli. I watched as the debated intubation, debated cardioverting her, and watched as she was wheeled away to CT scan then the ICU for two weeks. I watched as she struggled for each breath, struggled against the BiPAP, then to sit, then to stand, and then to walk 10 feet. This proud and healthy woman couldn't even walk to the toilet. I watched as she turned black and blue from daily blood gasses.

Lucky she doesn't have breast cancer

January 2007 to July 2007 I watch as my mom endures chemo after chemo. I listen to her at night vomiting continuously and crying. I watch as her once toned arms turn to flesh and bones. I watch her eyes lose their life and her face sink into pain and despair. In the hospital, out of the hospital. Faceless days and painful nights. She faked bravery and resolutely refused to give in. I watched as they punished her body time and again with 3-4 agents. Watched her turn ghostly pale and wonder if I would hear her last breath in the night. I watched as she couldn't eat. I watched each drop of TPN enter her fragile body. I watched her head bald.

Lucky she doesn't have breast cancer

August 19th, 2008 a proud grandmother undergoing tumor removal and ablation of the intestines on the 4th floor and new mom and baby on the 5th floor. My son was born August 18th, 2008 in the same hospital that my mom receives her treatment from. My mom, Beany, a new grandmother should be enjoying the first moments of her Conor's life. Instead she is under the knife for new growth. This hospital course was her best by far. She only spent 3 days in the ICU with respiratory compromise. This time pneumonia and pulmonary effusion. She did not hold him for other 6 weeks as she slowly recovered.

Lucky she doesn't have breast cancer

No cancer is better than another, and no cancer worse. They all are awful and all take emotional tolls on the family. No matter the stage, no matter the type, and no matter the treatment.

My mom's battle is far from done. Her CA-125 levels are rising again. The last time they doubled from previous. We are gearing up for another fight. This November will celebrate 4 years of continuous battle.

This September, please donate a dollar or two to the OVARIAN CANCER NATIONAL ALLIANCE or if in Charleston LOWCOUNTRY WOMEN WITH WINGS.

I want nothing more than for this world to be as TEAL as it is PINK. Then I know women are taking better care of their gynecological health and the survivorship of ovarian cancer will rise.

62% of women are diagnosed at later stages when spread has occurred. Only 28.2% make it to 5-years. Of all women diagnosed with ovarian cancer the 10-year survivor percentage is 39%

Please reduce your risks. Breastfeed your infant. Use birth control. Eat well. Exercise. And please think of my mom when you see pink. She is more than worthy of the admiration and respect any cancer survivor or fighter gets. Not the stares of condemnation and pity.

She is a cancer patient not a douche bag.


Tuesday, August 24, 2010

Stop.

I wish I could have stage IIIC ovarian cancer and not my mom. I wish my mom was happy. I hate seeing her this way. It isn't fair. I can't help her. It doesn't work.

No child should see what I have seen with my mom.

No one deserves her pain. No one deserves to see her pain.

I just want her to be my mommy. Not my mommy with cancer, fear, and sadness.

Thursday, August 5, 2010

Grumpies

Take a break for five from...

  1. Facebook rants in which one allegedly calls out "scenesters" by pointing to some inane fashion trend then proceeding to say how "cool" it was when they did it while still in diapers. No you didn't, yes you still participate in the "cool", and yes your post is simply annoying.
  2. Facebook rants about politics when it is merely one-sided vapid post of misguided thinking spurned on by above scenesters.
  3. Boycotting without resolute adherence.
  4. Facebook ranting about every little nonsensical thing wrong in the FML vain. "I was constipated today, FML". Nothing in my life has ever been so bad that I say ____ it. Nothing. Stop whining my generation, life is pretty much amazing.
  5. Ranting at the doctor's office when you make an appointment to be there. I'm not here for humor, I'm here to prevent death and disability.
  6. Realizing that my family was used over Facebook. Frustrating, angering, and humiliating
  7. The WRITING CENTER AT MUSC! They were supposed to review my paper this week. Oops they are out of the office.
Please be quiet when you don't have anything useful to say. I guess politics and the internet don't mix.

Wednesday, August 4, 2010

Helping the toast-shaped people since 2010

I totally had the "ah-ha" moment of my budding nurse practitioner career today. I have found a breast lump, sent 3 individuals to the hospital, and discovered a valid reason for resistant hypertension without referral (coarctation of the aorta, fancy). Those are all cool and exciting, but today I actually made a true difference ...

I have a gentleman who presents to clinic with his young son. His son is a metal kid, and I speak his language fluently and he loves his dad without pretense. His dad is depressed and battling chronic disease. I have initiated the conversation on seeking help for the depression to closed ears 3 times now. His depression doesn't take a clinician to recognize, it is the kind where a random stranger would offer help, a hug, or a sorrowful face and nod of understanding. Each time I leave the room in near tears, because I feel empathy and overwhelming respect for the son. He keeps his dad alive, gives him a reason to smile, and wants so badly to help him (side note, where did individuals like this disappear to?). Today I decided to focus on this beautiful dynamic, and I rallied the son to the rescue. We threw a Hail Mary pass and the play was perfect.

HE AGREED TO TRY AN ANTI-DEPRESSANT!!!!

That was my feel good moment of all my clinical experiences combined. Better than the one time CPR worked. Better than proving the CON wrong about my semi-awful luck and performance in school. I just wish now I had follow-up to see the difference I hope it will make. Maybe I will be okay when I graduate. Maybe.

In ode to my clinical experiences I present the worst/best marketing for an erectile dysfunction drug ever. I love and keep giggling when I see the sexy toast people.