Recurrent Breast Cancer

Saturday, December 23, 2017

Alzheimer's is not a death sentence.

If you are diagnosed with Altzheimers, daily function is crucial. Allow yourself to slow down and manage your capabilities. This is important before you flood yourself with various medications that could lead to drug interactions.

Compensatory strategies help you deal with Altzheimers. Make life easier for yourself by placing items in the same location. Make them easily visible by marking them with colorful tape. Consider using your cell phone calendar to help you remember the day of the week and the month. What about items you need at the grocery store? Do you have your or your to-do list? You can make "to do lists" for errands and appointments.

Try making "jingles" that you sing to yourself regarding groceries. Sing the list as you write the items down on an index card. Keep a small notebook in your pocket to recall important information, such as appointments. If you forgot your grocery list, sing the items to yourself.

Assess your overall health. Cognition can be affected for other reasons, such as job loss, traumatic brain injury, drug abuse, PTSD (post traumatic stress disorder ), depression, and a death in the family. These conditions mimic Altzheimers.

Insomnia disturbs sleep quality and hampers short-term memory.Consider stretching your back, shoulders, and legs before going to bed. If you awaken early, or you can't sleep, consider Melatonin, an over the counter sleep aid.

If your brain is getting tired, take a "Brain Break." Walk outside, play Sudoku, and try word puzzles.

If insomnia is keeping you awake and you can't fall asleep, take a Melatonin tablet, at bedtime.

Don't carry a grudge against someone. Apologize and let it go. Consider a tune from the
Beatles, "Listen to Words of Wisdom, Let it Be."

There is evidence that hearing aids improve cognition.They are are expensive. However, if you are a military veteran, you may be eligible to get them at no cost.

Should these strategies boost your mental function, you may notice a "dopamine rush" that will give you a "feel good" sensation.

Walking, running, and bicycling are great for exercise. Allways wear a protective helmet.Traumatic Brain Injury hampers cognition, which mimics Alzheimer's.

Consider taking Vitamin B6 and B12. Low levels of these vitamins can hamper cognition. How do you know? Try it.
Holidays can be depressing, especially if you have Alzheimer's, job loss, death in the family, and divorce. Anger and depression disrupt function, sleep, appetite, and cognition.

Depression can be managed with Tai Chi, aerobic exercise, or taking a walk in the neighborhood.
Having short term, goals and a long term purpose alleviates depression.

Sign up for volunteering, This can be something as simple as volunteering at a Veteran's Hospital, Dumb Friends League, or Food Bank.

If you angered someone, apologize promptly. Don’t allow your thoughts to ruminate. An apology diffuses depression and anxiety. If you feel guilty, frustrated, or angry with yourself, take a few deep, slow breaths to destress and recalibrate
A walk outside can calm you down and bolster your cognition. This is like pushing the reset button on your computer. Managing your emotions is beneficial. Don't shutter yourself from others, especially your family members.

Assertiveness training is a method to get what you need without causing confrontation. It allows you to bargain with others without animosity. Give it a try.


Misplaced car keys or cell phone? Methodically start searching your home starting from the bottom floor to the top. Put a red fob on your car keys and hang the keys at the entrance of your home. Consider getting a spare set of car keys and put them in a magnetic box that can be attached to the underside of your car.

A mental thealth check-up can dig deeper to see whether your are experiencing Alzheimers symptoms, or if there is another related conditon that has not be evaluated or treated.

A diagnosis of Alzheimer's does not mean that your life is over. Hopefully, you will find that these suggestions help you cope. Build a purpose inyour life, other than your Alzheimer's.
Vitamins B-6 and B-12 can improve cognition. Foods that are rich in these iinclude chickpeas, fish, potatoes, bananas, cottage cheese, and poultry

A wide variety of foods supply vitamin B-6, including chickpeas, fish, potatoes, bananas, cottage cheese, poultry and meat. B-6 plays a role in cognitive function, and it is also involved in more than 100 enzyme reactions. Along with B-12, B-6 helps control homocysteine, a substance that is linked to an increased risk of cardiovascular disease.


You get B-12 from fish, cheese, dairy, meat and eggs, as well as from fortified cereals. Vitamin B-12 plays a crucial role in energy metabolism and the production of red blood cells. Because B-12 helps your body convert carbohydrates from what you eat into fuel, low levels of the vitamin can lead to fatigue. You also need B-12 for healthy nerve function, so a deficiency may lead to nerve damage. In addition, vitamin B-12 promotes healthy neurological function and DNA production, and it's also needed for normal brain function.





Friday, December 8, 2017

Many famous people have had schizophrenia, including Vincent Van Gogh; Mary Todd Lincoln; John Nash- a brilliant mathematician; Brian Wilson, the Beach Boys; Nathanial Ayers;  and “The soloist,” a black American who was a double bassist at Julliard. Those with schizophrenia can be gifted.
 Schizophrenia symptoms include auditory hallucinations, disorganized speech, delusions, hallucinations, and catatonic behavior. Those affected are diagnosed between sixteen and thirty years of age. Symptoms include delusions, hallucinations, thought disorders, and lack of motivation. There is no specific gene that triggers the disorder. Schizophrenics are aware of their thought disorders. They have control over thoughts and behavior.
      The affected person may believe they are being persecuted. They may think they have extraordinary powers and gifts.
Symptoms include hallucinations and hearing voices (auditory hallucinations).  This may include visual images (seeing things that are not there).    When speaking, the person might jump from one subject to another for no logical reason. Speech may be muddled and difficult to understand.
         Lack of motivation is typical. The affected person loses their drive. They may give up on daily activities, such as personal hygiene, washing and cooking.   They may not respond to happy or sad events, or may react inappropriately.
        Social withdrawal is typical. When a patient with schizophrenia withdraws, it is often because they believe someone may harm them. They might not be aware of the illness. Hallucinations and delusions are real to the patient. Schizophrenics have difficulty with concentration, planning, organizing, and communication.   Treatment goals include having few or stable symptoms. Hospitalization is not recommended unless there is another medical issue that demands inpatient treatment.  Some have no family history of the disorder. It may be due to a new mutation.
A psychiatrist experienced in treating schizophrenia guides treatment.  The team may include a psychologist, social worker, psychiatric nurse and a case manager. The team approach may be available in clinics with expertise in schizophrenia treatment. Medications are the cornerstone of treatment. Antipsychotic medications are the most commonly prescribed drugs.  They control symptoms by affecting the brain neurotransmitter, dopamine.
Treatment goals include antipsychotic medications to manage signs and symptoms at the lowest dose. Medications could include antidepressants. It may take several weeks for the patient to notice improvement. 
Willingness to cooperate with treatment determines drug choice. The patient should consult with their treatment provider regarding side effects. 
Newer, second-generation medications are preferred. They have a lower risk of side effects. These include Chlorpromazine, Clozapine, Haloperidol, Fluphenazine, and Perphenezine. 
Older antipsychotic medicines could cause frequent and potential side effects, including possibility of a movement disorder (tardive dyskinesia) that may or may not be reversible. Once psychosis recedes, in addition to continuing medication, psychological and social interventions are crucial.
Psychotherapy helps normalize thought patterns.  Learning to cope with stress and identify early warning signs of relapse help with symptom management..
Socials skill training improve communication and facilitates daily activities. This provides support and education to families dealing with schizophrenia. Vocational rehabilitation can help those with schizophrenia prepare for further education and employment.
Many communities have programs to help those affected to find housing, self-help groups, and crisis intervention. With appropriate treatment, most people with schizophrenia can manage their illness. During crisis periods or times of severe symptoms, hospitalization may be necessary. If drug treatment is not effective, electroconvulsive therapy (ECT) is considered.
Coping with a mental disorder as complex as schizophrenia is challenging,  both for the person with the condition and for friends and family. Here are some ways to cope.
Learn about schizophrenia and join a support group. Education motivates the person to stick to a treatment plan. Support groups can help them reach out to others facing similar challenges.  Stay focused on goals. Managing schizophrenia is an ongoing process.
Stay motivated.  Help your loved one take responsibility for managing the illness and working toward goals.
Learn relaxation and stress management. The person with schizophrenia and loved ones may benefit from stress reduction techniques, such as meditation, yoga, or Tai Chi.
Go with your loved one to their appointments. Getting the information first hand will help you know what you're facing.
My amiable brother started hearing voices in his head at the University of Kansas in1970. I try to keep in touch with him by phone.
Manifestations of the disease process include psychotic disorders, such as delusions, hallucinations, and dysfunctional ways of thinking, called thought disorders (such as believing that” I can fly).”  Depression is common. It runs in families, even if the genes may not manifest. Auditory hallucinations could interfere with activities of daily living.
Clonazapine is a drug that may be prescribed. Social skills training is another treatment.  Treatment goals include avoiding hospitalization.  Once you get in the hospital patients tend to stay a while.  
Source: NIH www.nimh.nih.gov


Tuesday, November 28, 2017





Have you had your annual flu shot?  Influenza symptoms include a runny nose, congestion, fever, muscle aches, cough, and wheezing. The flu could progress pneumonia in the elderly.

The Centers for Disease Control recommends that everyone six months and older should receive the annual influenza vaccine. This includes those older than sixty-five, pregnant women, and those with a weakened immune system, such as AIDS.  The vaccine is available as a nasal spray.  It provides protection for two weeks after receiving the vaccine.

The annual flu vaccine prevents flu sickness.  Symptoms include muscle aches, weakness, and fever.  The vaccine cannot cause the flu. It is especially important for those with long term health conditions, such as AIDS.  The current flu vaccine is injectable.  The nasal spray vaccine is not recommended this season. 


Flu vaccination reduces the risk of hospitalization, especially in children and older adults. Those older than fifty years reduce their risk of hospitalization by fifty-seven percent. You cannot get the flu by getting the flu vaccination.

Here is a list of medical conditions that increase risk for getting the flu:  asthma, sickle cell disease, diabetes, chronic obstructive pulmonary disease, heart failure, kidney and liver disorders, those younger than nineteen years and on long-term aspirin. system, those with AIDS, cancer, adults sixty-five and older, Native Americans, and Alaska Natives. The vaccine changes annually. 
Source:  www.cdc.gov/flu.

You can call 1-800-CDC-INFO.  1-800-232-4636













Friday, October 27, 2017





There's a song about pretty much everything, including kidney stones, believe it or not. So there's something there for whatever you happen to be suffering, you know?  Sinead O' Connor

KIDNEY STONES 

Are you experiencing persistent, excruciating flank (lower back) pain? This may be a warning sign of kidney stones

TESTING

Testing to verify the diagnosis includes looking for high levels of calcium or uric acid in the urine. A twenty-four hour urine collection requires drinking a lot of fluids to try and pass the stone. Imaging verification includes x-rays or CT scans.
These may show kidney stones in the urinary tract. Additional testing may include ultrasound and an intravenous pyelogram. 

TREATMENT

Small stones that don't block the kidney can be treated by your family doctor. consider. You may want to schedule a urology visit or nephrologist. 

Sometimes the stones are gradually passed through the ureters and into the bladder. Small stones usually pass in the urine with minimal discomfort. Drinking two to three quarts of water daily will flush out the urinary tract. In most cases, over the counter medicines, such as Motrin, Advil, or Naprosyn alleviate the pain. 

Stone analysis confirms the diagnosis. Uric acid stones can be treated with allopurinol to facilitate treatment. Long-term antibiotics in small doses helps treat the Struvite stones. Cystine stones more difficult to treat. drink more fluids. Consider medication that decreases cystine in the urine. Long-term use of antibiotics in small doses. 


Ultrasound may be used to pulverize the stone. This procedure lasts fourty-five to sixty minutes. Light anesthesia can facilitate the procedure. 

In rare cases, large stones that do not pass are removed by a ureteroscope with a camera and the surgery is often successful. Drinking copious amounts of water will help flush out the urinary tract.

PREVENTION 

Taking a thiazide diuretic may help prevent further stones. You can also reduce kidney stone risk by drinking water throughout the day. A diet that has fewer oxalate-rich foods, which include rhubarb, beets, okra, spinach, nuts, potatoes, chocolate, and black pepper is helpful as well. Calcium-rich foods may also reduce risk. 
                                                
To summarize, kidney stones are not life-threatening. The pain starts with lower level pain that may intensify surprisingly quickly. It hurts like heck, similar to taking your lower lip and pulling it over your head as Bill Cosby used to say (about delivering a baby). For men and women, if you have deep pain in the lower back area away from your spine, closer to your left and right sides, your next move should be a phone call should be to a urologist or a visit to the urgency care or emergency depending on the time of day and the intensity of the pain.

Source: https//www mayo clinic.org.



  





































Tuesday, October 10, 2017

Osteoarthritis (OA) is the most common form of arthritis. Over time the joint cartilage wears down. It affects the weight bearing joints, hands, knees, hips and spine. The condition can be managed. The goal of treatment is to preserve and enhance function.    

Factors that increase symptoms include older age. Women  are more likely to have the condition than men. Obesity contributes to symptoms Weight bearing joints, such as the hips, knees are especially affected.  joint trauma, such as a fall, increases risk.

Joint tenderness and stiffness are most likely during early mornings and after prolonged sitting, such as after long plane flight. 

Joint grating sensation. bone spurs, seen on x-rays, can validate the findings. X-ray imaging can validate the findings. MRI imaging may validate the findings. 

MRI imaging can facilitate the findings. 
Symptoms can be treated without surgery in most cases. Physical therapy, anti-inflammatory medicines.  Stretching, aerobics, Tai Chi, yoga improve balance, especially in a group setting. 

Cortisone injections in the joint may relieve pain. It is recommended to limit injections to no more than three to four injections over a year. Overuse of injections over time could weaken the cartilage and joint. Hyaluronic injections to the affected joint may help.

*Physical therapy improves strength and balance.  Swimming pool therapy, and walking equally effective. 

*Occupational therapy techniques such as using large grip tooth brush. Have a bench in your shower to relieve prolonged standing.

*Tai Chi and Yoga therapy combined with stretching and deep breathing. Led by a professional instructor. prevent falling or head trauma. 
*Bone re-alignment osteotomy. may be considered in special cases. this involves surgical removal a portion of leg bone. The procedure  shifts body weight away from the painful knee. 
Worn portions of the knee removed and replaced with plastic and titanium. 
*Lifestyle changes and exercise. Exercise increases endurance, strengthens muscles and improves balance. walking in pool, stationary bike.

*Don't overdo the training. If you have pain, decrease the intensity. Try a stationary bicycle. 
Consider a visit with a dietitian. 

*Aim for gradual weight loss. 
Over the counter medicines include Flexall Tablets, Aspercreme, 
Capsaicin, may relieve pain. It may be used three or four times daily. It is a component of chili peppers. Wash your hands after 
Topricin, Biofreeze Gel, Topricin, and Trivita Joint Complex. 

 *Use heat and cold to control pain. Heat relieves stiffness.
Pain creams work best when massaged into the joints. You may want to try shoe inserts for foot comfort. 

 *Gripping tools, such as opening a jar. 
*Osteopathic Manipulation and Chiopractic treatment are helpful
Acupuncture with or without current stimulation.

OTC meds for arthritis
Image result for arthritis quotes sayings
  

Friday, September 29, 2017

Recurrent Breast Cancer is a breast cancer that recurs after initial treatment. Approximately 12.4 percent of women born in the U.S. will develop breast cancer at some time during their lives.
Signs include skin inflam......mation, nipple redness, nipple discharge, painless nodules (lymph nodes) under the skin or the chest wall. Signs and symptoms include persistent and worsening pain, such as chest or bone pain.
A distant (metastatic) recurrence can migrate to the neck or collar bone: symptoms include persistent deep pain and a lump under the arm or near the collar bone (clavicle). 
Recurrent breast cancer may occur months or years after initial treatment. The cancer could recur in the same site as the original cancer. Recurrent breast cancer is not hopeless. Treatment may eliminate local, regional or distant recurrent breast cancer.
Treatments linked to a reduced risk of breast cancer recurrence include:
Women with hormone receptor positive breast cancer may reduce their risk of recurrent breast cancer by taking hormone therapy after their initial treatment. The hormone therapy may continue for at least five years.
For women with breast cancer who have increased risk of cancer recurrence, chemotherapy may decrease the chance that cancer will recur. Those who receive chemotherapy live longer.
Women who've had a breast-sparing operation to treat breast cancer and those who had a large tumor or inflammatory breast cancer have a lower chance of the cancer recurring if they're treated with radiation therapy.
Maintaining a healthy weight can decrease the risk of recurrent breast cancer. Regular exercise may reduce your risk of breast cancer recurrence.
Factors that increase the risk of a recurrence include:
Cancer in nearby lymph nodes at the time of your original diagnosis.
Women with multiple affected lymph nodes.
Women with larger tumors.
Women who don't undergo the radiation therapy.
Younger women, particularly those under age 35 at the time of their original breast cancer diagnosis.
Women with inflammatory breast cancer.
If your breast cancer wasn't responsive to hormone therapy.
How do you diagnose it?
Your doctor is likely to ask you a number of questions.
When did you first begin experooencing symptoms again?
Has the been a change in the symptoms over time?

Do these symptoms feel different from when you were first diagnosed with cancer?

How do you eel overall?
Have yunexpected weight loss? Have you lost your appetite?
If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. Imaging tests may include a magnetic resonance imaging (MRI), computerized tomography (CT) scan, X-ray, bone scan or positron emission tomography (PET) scan. Not eveRecurrent Breast Cancer is a breast cancer that recurs after initial treatment. Approximately 12.4 percent of women born in the U.S. will develop breast cancer at some time during their lives.
 Signs include skin inflammation, nipple redness, nipple discharge, painless nodules (lymph nodes) under the skin or the chest wall. Signs and symptoms include persistent and worsening pain, such as chest or bone pain.
 A distant (metastatic) recurrence can migrate to the neck or collar bone: symptoms include persistent deep pain and a lump under the arm or near the collar bone (clavicle). 
Recurrent breast cancer may occur months or years after initial treatment. The cancer could recur in the same site as the original cancer. Recurrent breast cancer is not hopeless. Treatment may eliminate local, regional or distant recurrent breast cancer.
Treatments linked to a reduced risk of breast cancer recurrence include:

Women with hormone receptor positive breast cancer may reduce their risk of recurrent breast cancer by taking hormone therapy after their initial treatment. The hormone therapy may continue for at least five years.

For women with breast cancer who have increased risk of cancer recurrence, chemotherapy may decrease the chance that cancer will recur. Those who receive chemotherapy live longer.

Women who've had a breast-sparing operation to treat breast cancer and those who had a large tumor or inflammatory breast cancer have a lower chance of the cancer recurring if they're treated with radiation therapy.

Maintaining a healthy weight can decrease the risk of recurrent breast cancer. Regular exercise may reduce your risk of breast cancer recurrence.

Factors that increase the risk of a recurrence include:

Cancer in nearby lymph nodes at the time of your original diagnosis.
Women with multiple affected lymph nodes.

Women with larger tumors.

Women who don't undergo the radiation therapy.

Younger women, particularly those under age 35 at the time of their original breast cancer diagnosis.
 Women with inflammatory breast cancer.
 If your breast cancer wasn't responsive to hormone therapy.
 How do you diagnose it?
 Your doctor is likely to ask you a number of questions.
 When did you first begin experiencing symptoms again?
Has there been a change in the symptoms over time?
Do these symptoms feel different from when you were first diagnosed with cancer?
How do you feel overall?
Have you had any unexpected weight loss? Have you lost your appetite?

If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. Imaging tests may include a magnetic resonance imaging (MRI), computerized tomography (CT) scan, X-ray, bone scan or positron emission tomography (PET) scan. Not every person needs every test.
Your doctor may recommend a biopsy procedure to collect suspicious cells for testing. Working in a laboratory, a pathologist examines the cells and determines the types of cells involved. A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. Tests also show whether the cancer is sensitive to hormone treatment or targeted therapy.
 Treatment for a local recurrence may include radiation if you haven't had it before. Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. If you didn't have radiation therapy for your first breast cancer, your doctor may recommend it. Chemotherapy and hormone therapy may also be recommended. Treatment options depend on the extent of the disease, its hormone receptor status, type of treatment you received for your first breast cancer and overall health.
 If your first cancer was treated with a lumpectomy, your doctor may recommend a mastectomy to remove all of your breast tissue. If your first breast cancer was treated with a mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the new cancer along with a margin of normal tissue.
 Hormone therapy. Medications that block the growth-promoting effects of the hormones estrogen and progesterone may be recommended if your cancer is hormone receptor positive. For women whose cancer makes extra HER2 protein, the drug trastuzumab (Herceptin) can decrease the chance of the cancer recurring.
 Treatments exist for metastatic breast cancer. Options will depend on where your cancer has spread. If cancer has spread to your bones, your doctor may recommend a bone-building drug to reduce your risk of broken bones or reduce bone pain you may experience. Treatment may allow you to live longer and help relieve symptoms.
 No alternative medicine treatments exist for breast cancer. Complementary and alternative medicine therapies may help cope with side effects of treatment when combined with your doctor's care. They can also help you cope with distress. They include:

Art therapy
Dance or movement therapy
Exercise
Meditation
Music therapy
Relaxation exercises
Yoga
 Your doctor can refer you to professionals who can help you learn about and try these alternative treatments.

Keep friends and family close. Keeping your close relationships strong will help you deal with your recurrent breast cancer. Friends and family can provide the practical support you will need, such as helping take care of your house if you are in the hospital. They can serve as emotional support when you feel overwhelmed by cancer.
 The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful. Ask your doctor about support groups in the area such as the National Cancer Institute or the American Cancer Society.

Sources:  NIH Breast Cancer Institute (https://www.nih.gov/)  
Breast Cancer in American Women (https://www.cancer.gov/types/breast/risk-fact-sheet)
National Cancer Institute (https://www.cancer.gov/types/breastry person needs every test.
Your doctor may recommend a biopsy procedure to collect suspicious cells for testing. Working in a laboratory, a pathologist examines the cells and determines the types of cells involved. A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. Tests also show whether the cancer is sensitive to hormone treatment or targeted therapy.
Treatment for a local recurrence may include radiation if you haven't had it before. Radiation therapy uses high-energy beams, such as X-rays, tokill cancer cells. If you didn't have radiation therapy for your first breast cancer, your doctor may recommend it. Chemotherapy and hormone therapy may also be recommended. Treatment options depend on the extent of the disease, its hormone receptor status, type of treatment you received for your first breast cancer and overall health.
If your first cancer was treated with a lumpectomy, your doctor may recommend a mastectomy to remove all of your breast tissue. If your first breast cancer was treated with a mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the new cancer along with a margin of normal tissue.
Hormone therapy. Medications that block the growth-promoting effects of the hormones estrogen and progesterone may be recommended if your cancer is hormone receptor positive. For women whose cancer makes extra HER2 protein, the drug trastuzumab (Herceptin) can decrease the chance of the cancer recurring.
Treatments exist for metastatic breast cancer. Options will depend on where your cancer has spread. If cancer has spread to your bones, your doctor may recommend a bone-building drug to reduce your risk of broken bones or reduce bone pain you may experience. Treatment may allow you to live longer and help relieve symptoms.
No alternative medicine treatments exist for breast cancer. Complementary and alternative medicine therapies may help cope with side effects of treatment when combined with your doctor's care. They can also help you cope with distress. They include:
Art therapy
Dance or movement therapy
Exercise
Meditation
Music therapy
Relaxation exercises
Yoga
Your doctor can refer you to professionals who can help you learn about and try these alternative treatments.
Keep friends and family close. Keeping your close relationships strong will help you deal with your recurrent breast cancer. Friends and family can provide the practical support you will need, such as helping take care of your house if you are in the hospital. They can serve as emotional support when you feel overwhelmed by cancer.
The concern and understanding of a counselor, medical social worker, clergy member or cancer support group also may be helpful. Ask your doctor about support groups in the area such as the National Cancer Institute or the American Cancer Society.

Sources:

NIH Breast Cancer Institute (https://www.nih.gov/)  
Breast Cancer in American Women (https://www.cancer.gov/types/breast/risk-fact-sheet)
National Cancer Institute (https://www.cancer.gov/types/breast