Sunday, January 27, 2013

Surrounded by Death

I heard about the deaths of elderly people as a result of the flu in the news, but this past week it hit closer to home.  One of my work colleagues lost his 81-year-old father.  He was hospitalized for the flu but the hospital released him with a 102 degree fever because they didn't have enough rooms to accommodate the ill. The next day he was found dead in his bed.

My former mother-in-law, who was 87 years old, got phemonia that resulted from complications of the flu and she died last Thursday. Then another friend's mother got the flu,  fell unconscious and passed away in hospice. That makes three deaths due to this flu virus in one week.

It shook me up enough to get a flu shot yesterday. I figure if I managed to survive breast cancer, I'll be damned if the flu is going to do me in.  I remember many years ago when a cold front hit, my grandfather had a massive heart attack that killed him. Winter does that to old people. I have seen it time and again.

I suppose I could just blame the weather, but it also has to do with getting older. My friends ex-husband, who has been battling colon cancer for years, decided to throw the towel in by stopping dialysis and checking into a hospice. It almost seems like he's committing suicide.  For many years my friend and her ex-husband were the best friends of me and my ex-husband. We were just like Lucy, Ricky, Ethel and Fred. But now the possibility of us ever getting together just to reminisce will never happen.

It's sort of like when everyone wanted The Beatles to reunite. Once John Lennon died, all our hopes were dashed. That's what happens when the people you know start to die. You can't help but reminisce. I think about Stephen, the one in hospice now, in his better days. I think of all the fun the four of us had. The New Year's Eves toasting champagne classes in Atlantic City. All of us gambling the night away. But now Stephen is just laying in a bed, waiting to die. So sad.

If having cancer did nothing else to me, it made me honor my body more.  Now I pop vitamins and get plenty of sleep. I try to work out. I try to eat healthy. If death is going to knock on my door, I don't want it to stand on my doorstep because I abused my body.  I don't want to be like my father, who literally died with a cigarette hanging from his mouth.

I don't want an empty bottle of whisky laying next to my lifeless body. I don't want drugs strewn across my beside table as witness to my corpse.  Like anyone, I would prefer to die peacefully. If that doesn't happen,  hopefully I will die quickly.

It would be nice if we all had a choice. But unless you take your own life, there aren't options. So I guess the best I can do for now it take care of my health.

Beyond that, death is a certain.

Monday, January 21, 2013

Birthday Blues

When I was a little girl, my birthday was a big deal. It was actually a day that I looked forward to. However, with each passing year, that has changed. The older I get, the more I dread the big B-day. In my 40s and even when I turned 50 I tried to be gracious about this whole aging thing.

But now that I'm on the closer side to 60 than I am to 50, I can't be that nonchalant about birthdays. In fact, I'm mad about getting old and I'm not going to hide my outrage over the inevitable any longer.

In the midst of this pissed-off feeling over turning 56,  I have started to stoop low. Last Saturday night while listening to a live band, this guy said: Well you and I are about the same age--in our late '40s--that's why we like this kind of music. In the past, I would have proclaimed my age proudly and then ask: How old are you? But I just couldn't bring myself to do that. Instead, I  silently nodded and smiled. After all, I wasn't lying, and what he didn't know wouldn't hurt him.

So this is how it starts. I have become that dreaded woman who won't reveal her age. I always honored Oprah's disdain for this kind behavior. Oprah says your age is just a number. Got that right. It's a number on your driver's license, your passport and your birth certificate that announces to the world how over-the-hill you are getting. No one wants to be perceived as old. That's why it gets harder to throw that number out there.

A lot of it has to do with vanity. But it also has to do with the incongruence between how you think and how you look. My mom once told me: In my mind, I am still 21. At the time she said this, it scared me a bit. But now I totally get it. Last Saturday night, I still felt like the 20-year-old who would dance the night away under a mirrored disco ball. Never mind that I was huffing and puffing after two straight dance sets.

It's tough when your head and body no longer match up. Which is why I defend my decision to pretend that I am 48 years old this year instead of 56. When it comes to birthdays, denial can be a good thing.

Thursday, January 17, 2013

Genes and Tamoxifen

Genes Linked to Effectiveness of Tamoxifen for Breast Cancer

December 28, 2012 Courtesy Health Day
BREAST Genes Linked to Effectiveness of Tamoxifen for Breast Cancer
FRIDAY, Dec. 28 (HealthDay News) For breast cancer patients prescribed tamoxifen to treat their disease, genetic traits affecting an enzyme in the liver are major players in determining the impact of the hormone therapy, new research suggests.
There’s been debate in the scientific world for years over the role of genetic differences in the enzyme, known as CYP2D6. An estimated 5 percent to 7 percent of European and North American women have a trait that prevents the enzyme from working properly.
“Our findings confirm that, in early breast cancer treated with tamoxifen, genetic alterations in CYP2D6 lead to a higher likelihood of recurrence and death,” Dr. Matthew Goetz, a Mayo Clinic oncologist and lead author of the study that reported the findings, said in a Mayo Clinic news release.
The researchers tracked two groups of women: postmenopausal women with primary estrogen receptor-positive breast cancer who received tamoxifen for five years, and those took got the drug for two years followed by another drug, anastrozole, for three years.
Among those who took tamoxifen for five years, those whose genetic makeup prevented the enzyme from being able to process things were 2.5 times more likely to die or have their cancer return than those whose enzymes worked normally, the investigators found.
However, genetic traits involving the enzyme didn’t seem to influence the fates of the women who switched to anastrozole, an aromatase inhibitor, after two years of tamoxifen, the study found.
“Switching from tamoxifen to an aromatase inhibitor may be one reason for the discrepant studies surrounding CYP2D6 and tamoxifen — as information about whether a patient took an aromatase inhibitor after tamoxifen was not available in most of the prior studies,” senior author Dr. James Ingle, of the Mayo Clinic, said in the news release.
Goezt thinks the study findings confirm that women should switch from tamoxifen to an aromatase inhibitor, or avoid tamoxifen altogether, if tests show they have the genetic trait that limits the metabolizing process.
The study was released online in advance of publication in an upcoming print issue of the journal Clinical Cancer Research.
More information
For more about breast cancer, visit the U.S. National Library of Medicine.
HEALTHDAY Web XSmall Genes Linked to Effectiveness of Tamoxifen for Breast Cancer

Tuesday, January 15, 2013

Relevance of Five-Year Cancer Survival

A few days ago I realized this coming March will mark five years since I was first diagnosed with breast cancer.  My mother is really excited about this.  That's because she believes once I pass this five-year milestone, I will be free from the clutches of cancer for the rest of my life.

I try to explain to her that is simply not true. I met one woman at an exercise class that went 10 years without her breast cancer returning until she felt a pea-sized bump one day in the shower. Then she had to go through the surgery, chemo and radiation all over again. 

Yes, studies do suggest chances of survival increase five years after a cancer diagnosis. But that is not a guarantee you will suddenly become completely immune to the disease.  Cancer is crazy unpredictable and doesn't abide by any timelines.

Melissa, who valiantly battled lung cancer, died five years and one month after her initial diagnosis. My oncologist tells me that estrogen-positive breast cancer can rear its ugly head eight, 10 or 15 years after the first diagnosis. I appreciate his honesty. I don't want to be under some delusion that once I get through March 2013 I can kiss all my cancer fears goodbye.

If my mother wants to believe that, so be it. Not me. I prefer to stay grounded in reality.

Monday, January 7, 2013

Best Movie of The Year

Silver Linings Playbook: One of the best movies I have seen in years! Go see it!

Review courtesy of Eric Eisenberg

Every single one of us is at least a little fucked up mentally. Obviously some people have worse conditions than others, but deep down there’s something tweaked within all of us – it’s part of the human experience.  And that’s what makes Silver Linings Playbook, the new movie from writer-director David O. Russell based on the novel by Matthew Quick, such an impressive piece of filmmaking: the lead character is described is an undiagnosed bipolar locked up after a violent attack, but his recovery and the sometimes cockeyed support he gets from his loved ones only exposes the fact that none of us are anything close to what could be described as “normal.”

The film has a main story – a former teacher named Pat Solitano (Bradley Cooper) is released from a mental hospital after an eight month stay and tries to win back the affection of his cheating ex-wife (Brea Bee) – but that simple-though-entertaining plot almost fades away in your mind as you watch the fascinating characters who come in and out of Pat's life. Tiffany (Jennifer Lawrence), who meets our hero after he moves back home, is a recently widowed young woman who coped with her distress by having sex with every person in her office. Pat Sr. (Robert De Niro), Pat’s father, is not just an obsessive Philadelphia Eagles fan, but also a compulsive gambler with OCD tendencies in his extreme superstitiousness. Ronnie (John Ortiz) is Pat’s best friend who is stuck in a marriage with a woman (Julia Stiles) who bosses him around and has completely shredded his confidence. And not only are these characters beautifully illustrated and crafted with depth and personality, Russell utilizes them to their greatest extent, not only fitting them into the larger story seamlessly, but also providing each of them with a full arc to play with.

The entire movie is impeccably cast. While Cooper is the film’s greatest surprise – evincing his character’s manic episodes with just the proper amount of panic, fear and stress without ever overplaying his hand – and De Niro is fantastic, it’s Lawrence’s turn that you’ll be talking about as you exit the theater. Tiffany is almost as screwed up as Pat, and the young actress plays her with an engaging aggressiveness that lets her dominate every scene she’s in, whether she’s wildly charging out of the side of the screen while Pat is on a run or shutting down Pat Sr. when he suggests that she is “bad juju” for the Eagles. She’s the fourth grade bully who punches you in the arm and tells you to stop being such a wimp, and though you may bruise and have your feelings hurt you still can’t help the overwhelming crush you have on her.

Russell does it with more than his pen, as his direction perfectly reflects the film’s themes and tones. Throughout the film he makes a point of having the camera come rushing up to actors until its right in their faces. It’s sometimes disorienting, but it creates an atmosphere for the movie and makes you feel as though you’re watching the story through the eyes of the characters. As he has in previous films like The Fighter and Three Kings he mixes tones brilliantly, able to orchestrate emotions with soft and jagged camera movement – and without ever alienating the audience.

There’s a thin line to walk in crafting a comedy about mental illness. Going about it in the wrong way could not only result in something insensitive, but also foolish and overdone, with characters waving their arms in the air and running down the street with their pants around their ankles. But Russell is simply too good a filmmaker to let that happen. Thanks to his workSilver Linings Playbook isn’t just a great piece of entertainment filled with appealing, fun characters, but also a film that gets how fucked up we all really are.

Reviewed By: Eric Eisenberg
movie reviewed rating

Saturday, January 5, 2013

Maintaining Your Mental Health

During my down time between Christmas and New Year's Day, I filled out this online questionnaire that determines what your real age is based on your current health. The test was divided into four parts that covered stress levels, sleep patterns, diet and exercise, and emotional well-being.

The last part had questions such as: How many friends do you have? How many times do you call them to get together? Are you a member of any social organizations? Do you have pets? 

After I finished the test, I found out my real age was actually 1.5 years younger than my current age. I would have liked a better score, but erring on the younger side of the scale is definitely better than living in a body that's older than your real age.

I was surprised at how much human connection factored into the test. Apparently, the more socially connected a person is in the world, the longer they will likely live.

I realize the value of social connection every time I go through a difficult time. When I had some issues many years ago, I found help through group therapy.

When I was going through breast cancer I was immediately ushered into a breast cancer support group at the Norma Pfriem Breast Cancer Center by my doctors. As cliche as it sounds, it really did make going through treatment easier.

Perhaps that's why I instinctively reached out for help when I started sinking into a depression a year ago. It took a couple of months to find the right doctors that would prescribe medication and find a therapist that was a good fit.

When I finally did, that made all the difference. The outer circumstances of my life haven't changed much. However, the way I react to those circumstances have changed a lot. 

As this new year kicks-off, most everyone vows to lose weight, stop smoking or lay-off the booze. But what about your mental health? Isn't that an important part of your well-being, too?

In light of what happened in Newtown, Connecticut just three weeks ago, it is something to think about.

Tuesday, January 1, 2013


Vegas, baby!
My Grandma and Grandpa Bruch
Christmas 2000 with my nephews
My brother reading to Davis, Alex and Matt on Christmas Eve

Luna and her baby, my beloved Mac
Still miss him. Macavity--1987-2000
There will never be another cat like Mac
Marcy and Joe Christmas 2007

My mom at 20 years old