Saturday, September 29, 2012

Edmonton family events

My youngest sister is moving to England tomorrow. She's been planning this move for a long, long time and the day has finally come. I'm very excited for her because moving to England has been a dream of hers for years and years and I'm thrilled that she's realizing this dream. Of course I'm sad, too, because this is such a big change and I don't think I like big changes.

Selfishly, I'm sad because it's a big change and I don't like changes so I'd love for her to stay in Canada, but I want her to be the happiest she can be so my selfish wants have to take a backseat here. Besides, I know that she'll come back to visit - in fact, I think we're going to co-ordinate a Christmas visit - and I'll be able to go and visit her.

Because I wanted to see my sister before she left, I was in Edmonton last weekend. I didn't tell anyone other than my family that I was going there because I wanted to focus on spending time with my sisters. To my friends: we'll get together next time I'm in Edmonton.

I was there for four days and saw both my sisters as much as possible on each of those days. I had the best time I've ever had with my sisters over those four days and my sisters said they had the best time ever, too. We really connected and didn't fight and had the biggest giggles ever :)

One of the things we did was look over old photos that each sister had scanned or developed from slides and negatives. We saw parts of our childhood that we hadn't seen before as well as parts of our parent's and grandparent's lives that were eye-opening to us. It was fun to look back and ourselves and see how beautiful we really were and how great those pictures were... and the silly things that some of us may have done to our hair.

I love my sisters so much and I love that we had such a great time and were so comfortable together. I'm sending good thoughts to my youngest sister that she'll have safe travels and that she'll love it there more than she thinks she will. Have a great time, seester! I love you.

Thursday, September 20, 2012

Gozer's visit to the doctor

Gozer has gained quite a bit of weight quite quickly: over the last four months she's gone from 9.3kg (20.5lbs) to 11.8kg (26.0lb), an increase of more than 25%. When anyone - human or dog - adds 25% to their weight in only a four months, it's cause for some concern. Gozer's walk time has decreased by a third to half of the pre-summer levels due to the hot weather so it's likely that her weight gain is related to her decreased activity. The vet also thinks that Gozer might be a bit older than we had thought - closer to four years old rather than two - because that's when dogs naturally gain weight

The vet thinks that Gozer is a bit chubby but isn't obese and says that Gozer does need to lose weight - but not too quickly. She's going to draw up a chart showing how many calories Gozer needs each day and from there we'll figure out how much to feed her and how much exercise to give her.

While I was there I inadvertently became part of an issue they're having. Way back when, Gozer was given flea medication that we'll need to start giving to her again in December (she's on Trifexis for the summer to protect against other parasites). Unfortunately, the medication expired in August of this year and there's no way that I'll give her expired medication in December. When I took Gozer in for her grooming a couple of weeks ago, I brought the package to the office. They checked and all of this medication was expired; since they had to order more, I took my package home.

After Gozer and I left the groomers, one of the groomers came running out with a new package of medication. When I got home I noticed that the medication was for larger dogs. Gozer is chubby but she's not that big! I brought both packages in with me today and explained what had happened. The vet was very upset because whoever set up the box just reprinted the label and didn't get the vet's signature, meaning the vet didn't know that this had happened - a major violation of protocol. This didn't cause any problems for me or for Gozer but if the staff is doing this kind of thing at other times, some pet could get hurt and that's not good.

We'll get Gozer's ideal calorie intake next week and then we'll be going back to the vet in a couple of months to see how much weight Gozer loses. We'll also need to pick up her flea medication - one that the vet has signed off on!

Monday, September 17, 2012

My skin thing has a name

The changes to the skin on my left breast are definitely morphea, a type of scleroderma. The biopsy sample was good: it was 0.5cm by 0.4cm and went down into the fatty tissue below the derma, or skin layer. There were areas of sclerosis in the derma that went all the way down into the fat so the changes are quite extensive.

No one really knows what causes morphea. It's thought to be an autoimmune disease and it shows up as a long-term side effect of radiation. The cases I've seen have shown up much sooner than 11 years after radiation like mine did. I can imagine a scenario where my immune system was wonky because of the cancer and sarcoidosis and the denosumab just added enough strain to my already-weird system for the morphea to take hold.

There aren't really any treatments for morphea; pretty much everything is done off-label on an experimental basis because nothing really works. The best treatment is a systemic one - I think it's cyclophosphamide, a type of chemotherapy, and it works by suppressing the immune system - but my system is fragile enough that we don't want to introduce a new systemic treatment until or unless we have to do it.

There's another topical treatment I could do but I'd need to see him every two weeks and there's no guarantee it will work. I don't think he thinks it's worth trying, partly because I'd have to travel so far. If I lived in Oakville, things would be different. Before I make a decision one way or another on whether to try this treatment, he wants me to talk to my oncologist and family doctor to get their thoughts. So we'll see. I'm not convinced that it's worth trying to get rid of it, especially since it's not life-threatening or anything. Besides, if chemotherapy clears this thing up, it'll get cleared up when I'm the "lucky" recipient of chemotherapy for the cancer - whenever that happens (which hopefully won't be for quite some time yet).

Oh, and the dermatologist thinks that the incision is healing up quite well. He told me that sometimes infection will take hold and be tough to get rid of so if there are any signs that the infection is returning, I need to get to the ER right away. I'll definitely do that: I don't want to wind up in the hospital with IV antibiotics.

Sunday, September 16, 2012

Healing but tired

I think the anitbiotic is working. There's still some fluid draining from the holes where the stitches were but it's lessening and looking less infectiony. The redness is also fading and the swelling is going down so the area doesn't look quite as angry and swollen as before. I'm happy that it's getting better and that I don't need to go back to the hospital for IV antibiotics.

I am finding that I'm extremely tired since I started the antibiotics. I feel like I'm so tired all the time and the slightest activity leaves me exhausted. I assume that the antibiotic is forcing my body to heal and that's what is making me so, so, so tired.

Tomorrow afternoon I see my dermatologist and hopefully he'll agree that the biopsy site is healing well. I also hope that he'll have meaningful pathology results so that we know what's going on with my skin. I'm not looking forward to the drive tomorrow but I'll sleep in, load up on caffeine, and take it easy so that I'm not too tired. I don't know what we'll do about supper, exactly, but I'll deal with that tomorrow.

Thursday, September 13, 2012

Adventures in (non)healing

For the last few days my left arm, underarm, and breast have all felt heavy, achy, and sore and I was having a hard time lifting my hand up high because it hurt in my underarm. I figured that the biopsy and my previous surgery taking out lymph nodes caused a buildup of lymph fluid in those areas so I massaged them. I'd been taught how to do the use massage to move the lymph fluid and get it flowing better way back when I had the lymphedema in my arm. I'd noticed that the area around the stitches was a bit warm and a bit red but I figured that this was related to the swelling and buildup of lymph fluid.

Imagine my surprise when I was having a bath and I noticed that the area around the stitches was bright red and there was that particular yellow crust around the stitches that signifies infection. My dermatologist had told me to call if anything looked strange and so I called right away. He would have liked it if I could have gone to see him this afternoon but he was leaving in an hour and it would have taken at least an hour and a half to get there because Ian had the car.

He told me that in this case, I should go to the emergency room and have them look at it since he couldn't prescribe something over the phone. I asked if I could go to a walk-in clinic and he reluctantly said yes but preferred the emergency room.

I called Ian right away, told him what was going on, and he came home to take me to the emergency room. I was worried that I'd end up there for at least six hours... and I almost did. The main treatment area was not moving at all and was really backed up. They were able to get me into the minor treatment area where I was seen by a nurse practitioner. She took out the stitches, gave me a prescription for Keflex, and we were on our way in just over two hours.

If the Keflex doesn't work I need to go back to the ER and they'll put me on IV antibiotics. That's one outcome I'd like to avoid but if it does come to that, it's actually a good thing that I went to this ER - the one associated with the cancer center. As much as I'd wanted to go to a walk-in clinic, going to this ER meant that they had more information about me and my cancer treatment. Ian was right to make me go to the ER even though I was whining about having to be there for six hours.

I see the dermatologist on Monday. He expects that the infection will be cleared up and I hope he's right.

Tuesday, September 11, 2012

Streams and rivers and frogs, oh my!

The person who cleans our house had to bring her kids with her today. They're 10 and 7 and both boys and I offered to take them and Gozer for a walk. We ended up out there for about two hours.

Mostly the walk went well: we went through the woods and down by the river... and by a stream and through the stream and beside the stream. The boys decided that they wanted to look for frogs so that's what we did. Unfortunately, all of us got our feet wet... including Gozer. She was doing ok walking through the streams - it was when she stepped into much up to her chest that things were bad for her. She became a little panicky after that because she wanted out of that area right that second.

When Ian found out that Gozer smelled like fish and was absolutely filthy, he gave me a choice: keep her outside until he got home, or give her a bath myself. It turns out that I can bathe her all by myself. I thought I did a good job but I detected the faintest scent of fish when she came in from her short evening walk so I think I'll have to bathe her again tomorrow.

I don't think my cleaner was too, too upset that both her boys came back with filthy, wet socks and shoes (and two frogs). If there's a next time for this, we're not going for nearly as long and we're going to go frog-hunting closer to home. Preferably without actually stepping into a stream.

Sunday, September 09, 2012

A whole lot of work

With my cholesterol higher than it should be I know that I need to make some changes. Diet-wise, we're looking more carefully at what we're eating and making healthier choices that involve more fruits and vegetables. However, changing my diet isn't enough: I need to exercise more.

With it being so hot this summer I haven't been walking Gozer during the day and I haven't been getting much other exercise. Weeding is some exercise but it isn't cardiovascular exercise so it isn't helping my heart at all. Somehow it does seem to be increasing my flexibility, however: for the first time ever I can bend at my hips, keep my legs straight, and put my hands flat on the ground. I used to have to strain to touch my fingertips to the ground.

Today I got more exercise than I'd bargained for because we decided to seed some of the bare patches on our front lawn and the top of the back lawn and overseed the rest of those lawns. We - by which I mean I - de-thatched these areas first which was a LOT of work. Using the rake doesn't just involve my arms but my upper- and mid- back, core, shoulders, and legs. Fortunately, by using my core and upper back, my lower back didn't hurt while I was working and it's still feeling good..

I haven't done that much work since I was paddling! Unfortunately, because I haven't done much exercise lately, I wasn't able to quite finish de-thatching everything and Ian had to finish. Even though he only worked for an extra 20 minutes or so after I stopped, I knew that if I hadn't stopped I would have crossed the line into overdoing it and I would have paid for it for the next week. I'm proud of what I accomplished today. Afterwards I had a lovely long, hot bath to soak my muscles.

It's going to be nice this week so I plan to take Gozer out for an afternoon walk. It'll be good for her chubby bum as well as mine. And maybe next weekend I'll be able to do some physical work in the yard again - after fully recovering from this weekend, I expect (ok, I hope) to have more stamina.

Wednesday, September 05, 2012

Everyone gets a new diet in our house

For the last couple of months we've known that Gozer had gained weight. We were feeding her the recommended amount and she still gets two walks per day but for some reason her weight has been increasing.

How much has it increased? She went from just under 20 pounds in the spring to 25.8(!) today. In other words, she's increased her body weight by over 25% in just a few months. That's a huge weight gain for a person, let alone a dog. I knew she was bigger but I didn't know that she was that much bigger. I don't think she's obese because I can see her waist from the side although I can't see it from above and I can't feel her ribs without pressing hard into her sidess.

Gozer is going to be groomed on Friday and because she's over 25 pounds I think she'll be considered a medium instead of a small dog as 25 pounds is the cutoff. Of course it costs more to groom a medium-sized dog because they require more handling.

Tomorrow I'm also going to call and make an appointment for Gozer to see the vet. Clearly she's going to need to reduce her weight and I need to get some hints for that. I also need to be sure that she doesn't have some condition that's causing her to gain weight. She's gained the weight so fast for no real reason that I can see that I'm a bit concerned.

Tuesday, September 04, 2012

Doctor's appointments

Today we got to visit some doctors.

Both Ian and I were called in to see our family doctor about our cholesterol results. Fortunately, the rest of both our bloodwork was fine but he has issues with the cholesterol levels. My HDL (good cholesterol) was 1.92, my LDL (bad cholesterol) was 4.81, and the ratio of my total cholesterol over HDL is 3.7. Because my dad had a heart attack at 39 and died after surgery to correct serious vascular issues in his legs I'm considered to be at high risk for heart problems and a ratio of 3.7 is getting to be too high. I think that the ratio should be under 4.0 - which mine is - but it's gone up since the last time I had the cholesterol tested.

Ian has different numbers and other factors and his cholesterol has to come down, too. Our family doctor gave Ian some new medication but he doesn't want to give me yet another medication. Therefore, we have to make some dietary changes: more fruits and vegetables, no more ice cream (including Blizzards and McFlurries), no more high-fat foods, no more fries and chicken fingers for dinner.

We'll be getting our cholesterol checked again in about six weeks to see if the steps we're taking are having an effect. I hope that the change in diet works that quickly.

After seeing our family doctor I had a biopsy done on the the skin on my breast. A new spot has actually shown up at the end of my collarbone on the left side; he looked at it but he decided to focus on the breast skin. As he was looking at the area to figure out where to do the biopsy, he asked if I had any kind of implant. Ummm, no - if I did, I'd have made that breast bigger to be more like the other one instead of walking around with one normal boob and one mini-boob. Apparently the changes to the skin have somehow made the breast feel like I've got implants.

The doctor was really good especially when it came to dealing with me. I'd been nervous all day and when I laid on the thingy I started to get a very woogly back and had trouble staying still. Mostly it was the thought of feeling him do the biopsy and put in the stitches that was making my back all woogly so I tried to do some breathing and focusing on other senses. It mostly worked and I was able to stay more still. I did not think about beetles crawling on my skin, as Ian suggested afterwards, because that's kind of what the woogly feeling is like.

The doctor put in two stitches which will come out in two weeks when I go back for the pathology results. If the results are inconclusive then he'll do another biopsy. I don't exactly know what kind of biopsy he did but he was worried about puncturing an implant (hence the question about implants above) so I think he took a fairly large sample.