Make over from my AWESOME family.....

July 31st, today has been a busy day. Doctors appointments for Mark and I on our knee's (the yearly checkup). Dr. Hickman said my knee's looked good, straight and no sign of anything like cancer in the bone. He also said the chemo won't affect my new knee's, yeah. Next was an appointment for Austin and then I met some of my sisters and my mom at h2Blow in Foothill Village for a makeover.

My nephews wife Tiffany got the idea and my family ran with it. So I got a hair wash/conditioner, scalp treatment then a style. After the styling I then had my makeup done. The gal that did my hair style ended up being a friend of my son Parker, in highschool. Before the makeover I wasn't really sure if I wanted to have it done but I knew my family was trying to be gracious and do something nice for me. So, I decided I had better do it and be happy about it. It wasn't that I didn't want it done...it was more not wanting to have all the attention on me. I have to tell tell you - that as I was getting it done it felt really nice! I was able to relax a little, have fun with my sisters and mom, it was fun. We went to my sister-in-laws home to do the pictures. They have the most beautiful yard & home. Deb & Rick worked really hard to have the yard looking nice for the pictures and it showed. My photographer was great - she kept saying there were so many area's to pick from. By this point when it came time to take pictures I had decided I was really having a good time. I even made some sassy faces, and some silly faces. I just basically had fun. It's not always you really get to act like a model so I said what the heck enjoy it, have fun, I did. Now we'll have to see if it shows that in the pictures. We then went to dinner and got to visit and talk. I can't begin to thank my awesome family for this treat it was really fun even though I was hesitant at first. THANK YOU!!! It will be a highlight for me to enjoy while going through everything this next little while. My family has been and will always be an awesome support system for me! I LOVE YOU!!  (The pictures are skiwampus but you get the idea)

July 27th..."Bitter or Better"...Lemonade...Alex Boye...song....

I need to give credit for the quote from Alex Boye. He has a new song called "Lemonade" that is awesome! Here's the link to the music video on you tube: Lemonade

  Church was awesome today lots of stories on faith. Here is the quote that was on the program:

"Strengthen yourselves by seeking the source of true strength--the Savior. Come unto him. He loves you.He desires your happiness and exults in your desires for righteousness. Make him your strength, your daily companion, your rod & your staff. Let him comfort you. There is no burden we need bear alone. His grace compensates for our deficiencies."

Chieko Okazaki (Strength in the Savior, Conference talk, 1993)

July 25th...foot, Pioneer Day, CAM research

Well my foot has been absolutely killing me! So with talking to the doctors office a couple of times, I now have to be totally off of it either resting, on crutches or a scooter. What a pain... so I of course complied. The pain has been on the inside of my left foot most all the time. Now there is some bruising on the left/outside of my left foot. I've kinda stopped using the scooter because it hurts my knee from that surgery last year. so I used both crutches but have worked down to using just one crutch and the boot. It finally seems to be calming down a little.

Last night we had our annual BBQ on the rocks. It's so fun but a lot of work. Chris had a friend from work who was from India here visiting for two weeks so he brought him over. He played the guitar and sang and brought an Indian treat. Chris described it like a combination of eating tree bark, insulation and cotton candy, it was good but very interesting. He also gave us this banner thing you hang in your house that has a dragon on it that's bright red and gold. We sat and visited and then went out front to do fireworks like we always do. It was a great show.

I was doing a lot of research on CAM therapies (complementary and alternative medicine). I had heard some good things as far as treating seizures with Cannabis (marijuana) which one of my sons has. I had also heard that oncologists were getting on board using it as well so my interest was sparked to find out more. Here are a few excepts from research I've found;

General Information (NCI-National Cancer Institute)

• Cannabis , also known as marijuana, originated in Central Asia but is grown worldwide today. 
• In the United States, it is a controlled substance and is classified as a Schedule I agent (a drug with increased potential for abuse and no known medical use). 
• The Cannabis plant produces a resin containing psychoactive compounds called cannabinoids. The highest concentration of cannabinoids is found in the female flowers of the plant. 
• Clinical trials conducted on medicinal Cannabis are limited. The U.S. Food and Drug Administration (FDA) has not approved the use of Cannabis as a treatment for any medical condition. To conduct clinical drug research in the United States, researchers must file an Investigational New Drug (IND) application with the FDA.
• The potential benefits of medicinal Cannabis for people living with cancer include: antiemetic effects, appetite stimulation, pain relief, and improved sleep. 
• Although few relevant surveys of practice patterns exist, it appears that physicians caring for cancer patients in the United States who recommend medicinal Cannabis predominantly do so for symptom management.

Cannabis and Cannabinoids

Because cannabinoid receptors, unlike opioid receptors, are not located in the brainstem areas controlling respiration, lethal overdoses from Cannabis and cannabinoids do not occur. However, cannabinoid receptors are present in other tissues throughout the body, not just in the central nervous system, and adverse effects include: tachycardia, hypotension, conjunctival injection, bronchodilation, muscle relaxation, and decreased gastrointestinal motility.

Although cannabinoids are considered by some to be addictive drugs, their addictive potential is considerably lower than that of other prescribed agents or substances of abuse. The brain develops a tolerance to cannabinoids.

Withdrawal symptoms: such as irritability, insomnia with sleep electroencephalogram disturbance, restlessness, hot flashes, and, rarely, nausea and cramping have been observed. However, these symptoms appear to be mild compared with withdrawal symptoms associated with opiates or benzodiazepines, and the symptoms usually dissipate after a few days.

Unlike other commonly used drugs, cannabinoids are stored in adipose tissue and excreted at a low rate (half-life 1–3 days), so even abrupt cessation of cannabinoid intake is not associated with rapid declines in plasma concentrations that would precipitate severe or abrupt withdrawal symptoms or drug cravings.

Cannabis has been shown to kill cancer cells in the laboratory and to affect the immune system. However, there is no evidence that Cannabis' effects on the immune system help the body fight cancer

July 13th....Wigs....who knew

In everything I have researched it's better to get your wig before you start losing your hair so it looks closer to your natural color. Today I started looking at places to go. I also found additional information that I didn't know before. Here are a few excerpts:

"wig basics - different types of construction and hair, different weights. Consider what kind of weather you will be coping with during treatment - cool or hot weather? Your wig should fit not only your head, but also your lifestyle and your circumstances".

"Get measured for a wig, so you'll know what size you need. Try on several wigs, and if you have a friend along, have photos taken so you can study them later. Try a wig that is a little lighter than your natural shade (chemo can lower your red blood counts and that makes you pale). Find a style that matches your current hairstyle, or a coiffure that you've always wanted to try. This is a time to start inventing your Super Twin - the person within you that is super strong and plans on surviving! Consider a change of color if you like. A word to the wise: short and medium length wigs are easiest to care for and weigh less."

Most (insurance companies) will require a prescription from your oncologist. You should buy a wig before your first chemotherapy appointment ,because hair loss can start two weeks after your first infusion. It's a gradual process for many of us, but having a wig ready to go can ease the transition greatly.

I guess I'd better get on the band wagon and get me a wig...ummm what color should I try? I already have a lime green one from Halloween. Mark always wanted to marry a brunette. Then he decided when 'Titanic' came out he thought I should become a redhead. Maybe I'll start a collection. For those of you who don't know me I have long hair...so now it's time to start thinking about a shorter hairstyle so I will be a little prepared for the shock of no hair...

Straight, with bangs they say works better, so short though...

Brunette--what do you think...medium length is a little better maybe not quite of a shock for me.

 I found out the my insurance company doesn't cover the cost of a wig...but with a prescription and then appealing my insurance, they might grant it. If they do then they would reimburse me the cost of the wig. They run anywhere from about $100-$400. The ones I have been looking at are around $125. Maybe that "collection" will have to wait...

Thursday July 10th...Bear Lake, cancer research

Every once in a while I get thinking about it and I get kinda concerned but mostly it’s like-what are you going to do its going to happen anyway so it’s basically your attitude on how you deal with it. For me I think I don’t know what to expect so why worry about it until it happens. I’m sure I will feel differently then. For me I talk about wigs, scarfs, losing my hair, diarrhea, mouth sores and even though I talk about it I don’t think I really comprehend the real scope of things. Sometimes Mark and I will lie in bed at night and talk and we just wonder what the future will hold.

Last night we came up to our annual Bear Lake trip with the Woodbadge group up at Paul and Pat Streifs cabin. Mark has so much work he could stay home but I told him I wanted him to come because we needed this break before my surgery, chemo etc. So we've played cards, visited, played on the lake. It’s been relaxing, it was a good choice.

......A beautiful Bear Lake Sunset.......

I spend a lot of my time researching everything on ovarian cancer since they treat fallopian tube cancer the same way. Everything from the procedures (with pictures), treatments; chemo, cannabis, immunization theory, wigs, you name it I have looked it up or am still looking it up.  Thanks to those who have given me info to look up in addition to my own research.

Thursday July 3rd...Dr. Dodson (6)...Risk Factors

Risk Factors

I asked the doctor about the risk factor with my sisters and he said the ones that are at risk are families that have multiple members having breast or ovarian cancer, males and females. He said I didn’t have enough family history to be affected. He said it’s the environment and how our bodies react to it.

The most important risk factor for ovarian cancer is a family history of a first-degree relative (e.g., mother, daughter, or sister) with the disease. The highest risk appears in women who have two or more first-degree relatives with ovarian cancer. The risk is somewhat less for women who have one first-degree and one second-degree relative (grandmother or aunt) with ovarian cancer.

           
One thing I asked the doctor was is it normal to feel normal? I don’t feel sick just a few aches and pains from the previous surgeries. I’m still getting my energy back and my foot bugs me but really I feel pretty normal. I sometimes wonder why everyone says I’m very sick because I don’t feel like it. I’m sure it will get worse later. I just don’t know what to expect… So for now I'm enjoying everything I can!

Thursday July 3rd...Dr. Dodson (5)...info, stoma, chemo

In some cases surgeons have to remove part of the bowel. They will usually only have to do this if the cancer has spread there and is blocking the bowel. They may have to create an opening (stoma) on the outside of the abdomen for bowel movements to come out into a bag. This is called a colostomy. This is often only temporary. The surgeon can do another smaller operation to close the stoma up again once everything has settled down from your first operation.  Below is a diagram showing a colostomy with a bag.

After you have recovered from surgery, you will have chemotherapy. If the surgeon was able to remove all your cancer, the aim of chemotherapy is to reduce the risk of the cancer coming back. If the surgeon could not take out all the cancer, then the aim of chemotherapy is to shrink the cancer that has been left behind. Some women may then have further surgery.

Chemotherapy is the use of drugs to kill cancer cells. Usually chemotherapy for ovarian cancer is given intravenously (injected into a vein). You may be treated in the doctor’s office or the outpatient part of a hospital. The drugs travel through the bloodstream to reach all parts of the body. This is why chemotherapy can be effective in treating ovarian cancer that has spread beyond the ovaries. However, the same drugs that kill cancer cells may also damage healthy cells. Chemotherapy is usually given in cycles. Periods of chemotherapy treatment are alternated with rest periods when no chemotherapy is given. Most women with ovarian cancer receive chemotherapy for about 6 months following their surgery. 

Thursday July 3rd...Dr. Dodson (4)...Grading and Staging Cancer...

Grading ovarian cancer

Doctors may also assign a grade to the disease. The appearance of the cells gives doctors an idea of how quickly or slowly the cancer is likely to grow. As a normal cell grows and matures, it becomes specialized for its role and place in the body. This is called differentiation. A tumor’s grade uses the letter “G” and a number. It describes how closely the cancer cells resemble normal tissue under a microscope. Cells that look like healthy cells are low grade, and those that look like cancer cells are high grade. In general, the lower the grade, the better the prognosis is. There are 3 grades of ovarian cancer

·         GX: The tumor grade cannot be identified.

·         G1: Describes cells that look more like normal cells (well differentiated/low grade).

·         G2: The cells are somewhat different (moderately differentiated).

·         G3: The tumor cells barely resemble normal cells (poorly differentiated).

·         G4: The cells do not look like normal cells or are underdeveloped are (undifferentiated/high grade).

Staging ovarian cancer

The staging of a cancer tells the doctor how far it has grown and if it has spread. It is important because your specialist will decide on your treatment according to the stage of your cancer.

Doctors use a simple 1 to 4 staging system for ovarian cancer. It is called the FIGO system after its authors - the International Federation of Gynecological Oncologists. Advanced ovarian cancer means cancer from stages 2 to 4. It has spread away from the ovary to other parts of the body. Cancer that has spread to another part of the body is called secondary cancer or metastases. If the doctor finds cancer in the lymph nodes then it automatically becomes stage 3. I then qualify for clinical trials.

Stage 1- ovarian cancer means the cancer is only in the ovaries.

It is divided into 3 groups

·         Stage 1a - the cancer is completely inside one ovary

·         Stage 1b - the cancer is completely inside both ovaries\

·         Stage 1c - as well as cancer in one or both ovaries, there is some cancer on the surface of an ovary or there are cancer cells in fluid taken from inside your abdomen during

surgery or the ovary ruptures (bursts) before or during surgery

Stage 2- means the cancer has grown outside the ovary or ovaries and is growing within the area circled by your hip bones (the pelvis). There may also be cancer cells in the abdomen.  

So stage 2 cancer can be:

·         2a - the cancer has grown into the fallopian tubes or the womb

·         2b - the cancer has grown into other tissues in the pelvis, for example the bladder or rectum

·         2c - the cancer has grown into other tissues in the pelvis (this is the stage where the doctor says I’m at right now) and there are cancer cells in fluid taken from inside your abdomen (I don’t know if there is cancer cells in my fluid though).

Stage 3- cancer of the ovary means the cancer has spread outside the area surrounded by your hip bones (the pelvis) into the abdominal cavity. Your cancer is also stage 3 if cancer is found in the lymph nodes in your upper abdomen (tummy), groin or behind the womb.

So stage 3 cancer can be:

·         3a - using a microscope, cancer growths can be seen in tissue taken from the lining of the abdomen

·         3b - there are visible tumor growths on the lining of the abdomen that are 2cm across or smaller

·         3c - there are tumor growths larger than 2cm on the lining of the abdomen, or cancer in lymph nodes in the upper abdomen, groin or behind the womb, or both

 Stage 4- ovarian cancer means the cancer has spread to other body organs some distance from the ovaries, such as the liver or lungs. But if ovarian cancer is only found on the surface of the liver and not within the liver itself, then the cancer is still stage 3.

Thursday July 3rd...Dr. Dodson (3)...Surgery for advanced ovarian cancer....

Surgery for advanced ovarian cancer

If the cancer has spread to other areas in your pelvis or abdomen, your surgeon will aim to remove as much of the cancer as possible. This is called debulking. The less cancer there is after surgery, the easier it is for chemotherapy to kill off any cells left behind.

Dr. Dodson will do the surgery laparascopically if he can get to everything he needs to, in checking things he won’t have to open me up. If that’s the case it is an outpatient surgery and I am able to start chemo in 2-3 days after, no heavy lifting for 6 weeks and no submerging for 2 weeks. If he can’t get to everything he needs to he will have to open me up giving me an incision from my pubic line up around my belly button and up to my breast bone. If he does that then I will be in the hospital 4-5 days, my recovery time is 8 weeks. My risk of infection is 50/50 due to my big belly because fat doesn’t have any vascular blood supply to help it heal. If he goes in and finds something in or on my colon he might have to do a bowel resection which is explained below. If that’s the case then I will be in the hospital 7-10 days. I will have to heal at that point before they would start the chemo. With taking out some lymph nodes for biopsies those areas won’t have a place to filter things out so I might get some swelling in my legs and my pelvis.

Thursday July 3rd...Dr. Dodson (2)...treatment options, surgery for early ovarian cancer

Treatment options:

The doctor said I had (3) options;

1.      Do nothing- (he said if I were 80 years old then this would be ok but it wasn’t an option for me because I was to young)

2.      Just do Chemo-which might not take care of all the cancer. If a piece of cancer gets left about the size of the middle of a sharpie he would give me 23 months. That’s big enough to make it have a vascular source giving it the ability to grow.

3.    Surgery & Chemo.

When ovarian cancer is diagnosed, it is vital to determine if the cancer has spread beyond the ovaries. If your surgeon thinks it is possible to remove all or most of your cancer, you will have surgery before your chemotherapy.

Most women with ovarian cancer will have surgery to remove

·         Both ovaries and fallopian tubes

·         The womb (uterus), including the cervix

This operation is called a total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO).

Surgery for early ovarian cancer

·         During the surgery to remove your ovaries and womb (my uterus/fallopian tubes/cervix were already done), my doctor will take biopsies from several areas within the abdomen and pelvis to find out if the cancer has spread. This is so that they can fully stage the cancer. This helps the doctor decide if you need treatment after surgery. The doctor said he takes the biopsies from where gravity falls. When you sit the cells settle there, when you lay back they can spread.

·         My doctor will remove a layer of fatty tissue that is close to the ovaries, called the omentum.  This is important as ovarian cancer can spread there.  Removing the omentum is called an omentectomy. 

                                                    [Organs in the abdomen (above)]

                                                    [Cutting away of the Omentum]

[an actual Omentum]

·         My doctor will put some sterile fluid inside my abdomen and then remove it. They then send this to the laboratory to see if it contains cancer cells. This is called peritoneal or abdominal washings.

My doctor also will:

·         Remove some lymph nodes (pelvic and para-aortic lymph nodes) for biopsies.

·         In addition my doctor said he would be checking my liver,

·         Look at the underside of my diaphragm and do a biopsy.

·         He will also be taking out my appendix. He says they usually have to go back in and take it out so they just take it out to begin with.

My upcoming surgery is on August 4^th; the doctor will be doing all of the above.

Thursday July 3rd...Dr. Dodson (1)...1st appt....

Well it’s been while since I’ve written, for many reasons. I’m feeling better so I’m doing more things. Dr. Dodson’s office called and said they had a cancellation so I jumped at it. I wasn’t sure if Mark would be able to come but he ended up being able to. The doctor drew pictures on a paper as he explained things to us. The following is an email I am sending to my family explaining things but mostly for me to remember everything the doctor said.

             Mark and I met with Dr. Mark Dodson today. He took a history and did a bi-vaginal exam, using the speculum and then feeling with his fingers inside by where my cervix used to be as well as a finger up my rectum-weird… Then he had me get dressed and he came back in to talk with us.

I have included some additional information and pictures to help people understand better. Everything in blue is my understanding from the doctor’s appointment.

·         Cancer occurs when cells in an area of the body grow abnormally.

·         Ovarian cancer is the seventh most common cancer among women.

·         Epithelial ovarian cancer is the most common and accounts for 85 percent to 89 percent of ovarian cancers.

Epithelial ovarian cancer means the cancer started in the surface layer covering the ovary. There are various types of epithelial cancers of the ovary; (The doctor said it was like different makes of vehicles)

·         Serous

·         Endometrioid

·         Clear cell

·         Mucinous

·         Undifferentiated or unclassifiable

Serous epithelial ovarian cancer is the most common type, making up about two thirds of the cases diagnosed. Doctors now think that most high grade serous ovarian cancers actually start in cells at the far end of the fallopian tube, rather than the surface of the ovary. These early cancer cells then spread to the ovary and grow. This is the type the doctor said I had “High grade serous carcinoma”

Ovarian cancer usually spreads via local shedding into the peritoneal cavity followed by implantation on the peritoneum and via local invasion of bowel and bladder. The pelvic nodes were involved as often as the para-aortic nodes. Tumor cells may also block diaphragmatic (diaphragm) lymphatics. The resulting impairment of lymphatic drainage of the peritoneum is thought to play a role in development of ascites (fluid) in ovarian cancer.