Recurrent Breast Cancer

Wednesday, July 18, 2018

Picture of Colon Cancer

Have you had a colonoscopy to screen for colon cancer? 
Screening should begin at age fifty. African and American Indians may consider testing at age forty-five. 
The procedure involves a video camera to collect and a biopsy tissue biopsy a biopsy for analysis and to remove polyps. 

 Diagnosing colon cancer is performed by colonoscopy to examine the inside of the colon. A scope is used to examine the inside of the colon through the rectum. 

A colonoscopy with a video camera is used to take a biopsy for analysis to remove polyps and screen for cancer. 
Staging is used to monitor the severity of cancer.  Here are the staging criteria.

Stage 1: cancer has grown through the mucosa (colon wall)  or rectum but has not spread through the mucosa or rectum.  

Stage 2 Cancer has grown into the rectum but has not spread to the lymph nodes. 

Stage 3:    Cancer has invaded nearby lymph nodes but has not affected other body parts.  

Stage 4: Cancer has spread to other organs, to include the liver or the lung. 

Treatment for colon cancer involves removing the tumor by colonoscopy under anesthesia.  There are several surgical techniques.   

1.  Endoscopic mucosal resection. This involves removing polyps by colonoscopy if the cancer is localized and completely contained with polyps in an early state. The polyps are removed during the colonoscopy.

2.  Minimally invasive surgery. Polyps that can't be removed endoscopic resection.

3.  Invasive surgery. Polyps that can't be removed during a colonoscopy. In that instance, a small incision through abdominal wall inserting several small incisions through the abdominal wall in order to insert instruments attached through cameras on video. This technique involves taking samples from lymph nodes in the area where the cancer is located. If the cancer is invasive, surgery is recommended. 

4. If cancer has grown through the colon, this may require a partial colectomy. this procedure surgeon removes part of the colon that contains cancer, along with margin normal mass of tissue on either side of cancer. The surgeon may reconnect healthy portions of the colon. When it is not possible to reconnect the colon, an ostomy is recommended. 

Another option is to surgically open the abdomen and construct an ostomy bag that is worn on the patient's lower abdomen. 
In some cases, the colostomy bag may be permanent. 

Lymph node removal is done to remove the nodes to test for cancer. In some instances, chemotherapy is recommended to destroy cancer cells.  

After surgery, if cancer has spread to the lymph nodes, then chemotherapy is administered to relieve symptoms 

Radiation therapy may be recommended to eradicate cancer cells. This is to shrink tumor cells by radiation and to cancer cells. 

Drug therapy may be included. These include Evacizumab,  (Avastin ), Cetuximab, (Erbux), and Panitumumab).  

Targeted drugs given with chemotherapy may cause side effects.
Immunotherapy may be included in the treatment plan.

Consider  Palliative care to improve quality of life  improve the quality of life may feel better and live longer. Find a support group for coping and support. Check for further information on this topic. 

Source: Mayo Clinic; Diagnosis and Screening for Colon Cancer.                                           

Friday, June 8, 2018


Traumatic Brain Injury TBI

You may imagine that TBI is an issue that concerns young adults who suffer athletic injuries and soldiers who receive blows in active duty. You don’t have to be a sportsperson to get TBI, although multiple TBI’s will manifest as classic Alzheimer’s symptoms.  In the elderly, there is a concern of TBI as a result of falls, auto accidents, penetrating wounds, and sports activities as well. Neurogenesis will be slower if you are older. The most important thing is to avoid getting a TBI again. You can be your own worst enemy  

When people have TBI the traumatic injuries don’t just go away. Long-term, if you are a younger person with TBI, you can recover fairly completely over time. If you have good relationships with people close to you, avoid alcohol, and take care of yourself through diet and exercise you will have a good improvement. People tend to isolate when they experience TBI which causes a downward spiral of depression. Having a purpose in life, many times this being work and relationships, gives you a new perspective and drive to get up in the morning.

Many accidents can result in head trauma and a concussion also known as TBI. It can have either have temporary or long term effects. Symptoms will appear immediately; other than neck and head pain, people will experience a brief loss of consciousness, nausea, dizziness, sleeplessness or oversleep, loss of balance, and a range of emotions such as anger, guilt remorse, and self-pity. More severe symptoms may be inability to awaken, clear fluids draining from nose or ears, weakness, numbness of toes, slurred speech or a coma. On the most severe end of the spectrum - suicide ideation, altered consciousness, brain death, seizures, and hydrocephalus (water on the brain).

Several alternative treatments that are not as conventional may help recovery from TBI. Smoking marijuana decreases brain inflammation according to the latest psychiatric literature. TBI causes brain inflammation and resulting cognitive issues. Other than time, good self-care combined with brain-training, perhaps sanitizing your sleep habits can prove to be the most effective way to recover from TBI. Sometimes people will go to a combination psychiatrist and neurologist for comprehensive treatment, addressing emotional, biological and physical issues at the same time. The neurologist typically conducts a sleep study. The end effect can be uninterrupted sleep with the help of a CPAP – a little rectangular box with a cord that plugs in near the bedside and headgear that slips over your head and tubes which slip into your nostrils. After some practice, in most cases you will sleep really well. You get more oxygenation, you wake up more refreshed, and these things improve cognition and recovery.

TBI in summary, is a treatable condition, even if someone shoots you in the head. People get through it. DLBGYD - Don’t let the bastards get you down, it’s an Army saying.

Wednesday, May 9, 2018

Essential Tremor (ET) is a nerve disorder in which the affected person has uncontrollable shaking, or tremors in different parts of the body. Areas affected are the hands, arms, larynx, tongue and chin. The lower body is rarely affected. The condition can be confused with Parkinson's Disease. ET is the most common movement disorder. It affects ten million people in the U.S. It often strikes for the first time during adolescence or middle age, between ages forty and fifty. 
The thalamus of the brain controls muscle activity. 

It is not a life threating condition. Most of those affected live normal lives with this disorder. Daily activities such as eating, dressing, or writing can be difficult. The true cause of ET is not understood. The tremors can be disabling if the affected person can't perform daily activities. 

The condition is due to electrical brain activity of the thalamus. It is a deep structure of the brain that coordinates muscle activity. The true cause of ET is not understood. 

Genetics is responsible for ET in half of those who have the disorder. A child born with a parent with ET will have a fifty percent chance of having the condition. gene. It is more common in the elderly. Symptoms become more pronounced with aging. It is not a part of the natural aging process. 

Common symptoms include uncontrollable shaking for brief periods of time, shaking voice, nodding head, voice tremor,  
 head, shaking voice, and tremors that worsen  during emotional distress,

The movement tremors fade with rest. In some cases there may be balance problems. Conditions that mimic it include factors or diseases, including Parkinson's Disease.  Disorders that mimic ET include thyriod disease, 
Drug treatment include Inderal, neurontin and Topamax.  
Xanax, Valium. Botox may be a treatment option.

 Treatment includes deep brain stimulation, implantation of electrical leads to the thalamus, and surgery. 

Implantation of electrical leads to the thalamus deep in the brain. high intensity MRI Ultrasound  to destroy tissue in the thalamus. Patients are awake during the surgical procedure. There is no effective medications for ET. surgery can ease the tremor  lifestyle changes may help reduce the tremors. 

Source: WebMD; The Brain and Essential Tremor.  

Wednesday, May 2, 2018

I may see if I can buy this book on my Kindle
Essential Tremor (ET), is a nervous system disorder that causes involuntary rhythmic shaking, most commonly in the hands. 
It is especially common when doing simple tasks such as drinking from a glass or tying your shoelaces. It can worsen over time. It is often confused with Parkinson's Disease. It can be severe in some people. It may occur at any age but is most common in those forty and older. 

Simple tasks, such as drinking from a glass or tying your shoelaces may be challenging.  It worsens over time and can be severe in some people. It is often confused with Parkinson's Disease. It may occur at any age, but it is most common in those ages forty or older. Symptoms begin gradually, on one side of the body.
It worsens with movement. It usually occurs in the hands, first affecting one or both hands. 

ET can be aggravated by emotional distress, fatigue, caffeine, or temperature extremes.

Many people associate ET with Parkinson's disease, which includes a stooped posture, and a slow, shuffling gate. ET is not Parkison's disease. 

Those with ET develop other neurological signs and symptoms, such as an unsteady gait (ataxia.).  It mainly involves the hands, legs, chin, and other body parts. Half of ET cases result from genetic mutation. 

Risk factors include genetic mutation. That is, if you have a parent with a genetic mutation for ET, you have a fifty percent chance of developing the disorder yourself. 

ET is more common in those ages forty or older. The condition is not life-threatening, but symptoms can worsen over time. Challenges include holding a glass without spilling, putting on makeup or shaving, difficulty with speech, and writing legibly,

For further information, log on to

Sunday, April 22, 2018

Vision Problems in Older Adults.

Let's take a look at common eye problems that are prevalent in older adults. 

Presbyopia  is loss of ability to see close objects or small print.  It is a slow process that occurs over time. You may not notice this change until age forty or older. It can be treated with reading glasses. 

Floaters are tiny spots or specks that across the field of vision. Most people notice them in well-lit rooms or outdoors on a sunny day. They are benign, though they could indicate more severe issues, such as retinal detachment. If you notice a sudden change in your vision, schedule an appointment with your optometrist.   

Dry eyes occur when tear glands cannot produce enough quality tears. The condition can be uncomfortable, causing itching or burning. Sometimes it could lead to vision loss. Those with dry eyes or can lead to tearing or irritation.  The eyes try to wash out the irritation using excess tears. Consider purchasing a humidifier in your bedroom. There are over the counter eye drops, such as Thera Tears or Refresh. Special eyedrops may be used to block the tear ducts. Purchase a humidifier.
Tearing could be triggered by wind, bright light, and temperature changes. Wear your sunglasses when outside. Sometimes the condition may be due to an obstructed tear duct or a dusty environment.  Protect your eyes with sunglasses. 

Cataracts are cloudy areas that cover the eye lens. It can cause vision impairment. They form slowly, with redness or eye tearing. If they are large or thick, they can be surgically removed. 

Glaucoma is an eye condition with increased eye pressure.  If it is not treated, it could lead to permanent vision loss. Age and race are risk factors. It may be caused by blunt trauma, infection, or blood vessel blockage. Have your eyes checked at least annually.    Prescription or over the counter eye drops can ease the discomfort. 
Laser surgery may be indicated. 

Conjunctivitis also known as "pink eye. includes inflammation and itching. It occurs in all ages, It is frequently due to smoke or dust.   

Temporal arteritis  is a condition that includes severe headache. It is worstened with chewing. It may lead to vision loss over time. 
Additional symptoms include low grade fever. It may be exacerbated by an impaired immune system.    

Source:  Cleveland Clinic. 

Sunday, April 15, 2018

Are you concerned about your weight?   Obesity takes its toll in the long term. These include snoring, insomnia, diabetes, and knee arthritis.  BMI (body mass index) is a tool for measuring weight.    

Overweight occurs when you eat more calories than you burn through daily activity. Cutting down your calory intake and increasing your activity is a solution.  A sedentary lifestyle is bad for your health. An unhealthy diet and poor eating habits will result in more body fat. Instead of a coke, drink diet coke.  Eat more fruits and vegetables and fruits. You can't change your genes.  However, genetics affect the amount of fat you store and where it is stored. Instead of a coke, get a diet coke. Include more fruits and vegetables in your diet. 

Obesity runs in families. You can't change your genes, but you can change your eating habits. Genetics affect the amount of fat you store. It is affected by family lifestyle.

If you are not physically active,  you are storing calories. Inactivity leads to lower extremity arthritis. 

Climb the steps rather than using the elevator. 

When you go to the grocery store, read the ingredients. Be calory conscience.  Read the food labels. Pay attention to the contents of fat and sugar. Practice "portion control." 

Insomnia may trigger the need for snacking between meals. However, increase your activity.  Climb the stairs rather than using the elevator. Snoring may be a sign of sleep apnea. You may want to contact your primary care physician to order an overnight sleep study.   

Obesity can lead to shame, guilt, social isolation, disability, and lower cognition.  

Walking, swimming, and bicycling, will burn calories and improve your balance and sleep quality.  Limit your snacking between meals. 

A ketogenic diet lowers brain inflammation and promotes cognition. Consider purchasing "The Ketogenic Diet Cookbook," Amanda C. Hughes. Easy, Whole Food Keto Recipes for Any Budget."   

Keep a notebook or food diary to track how often you eat and portion control. 

Weigh yourself no more than twice per week to track your progress. This will bolster your confidence and keep you on track. 

Stay with your program and keep yourself busy. Don't get discouraged. Be careful during the holidays and avoid splurging.

Famous quote:  "I found there was only one way to look thin. Hang out with obese people."  Rodney Dangerfield

Source:  Mayo Clinic.


Monday, April 9, 2018

Sundowning:  Late Day Confusion. Source:  Mayo Clinic

Sundowning:  Late-day confusion. The term "sundowning" refers to a state of confusion occurring in the late afternoon and spanning into the night. It can cause a variety of behaviors such as confusion, anxiety, aggression, or ignoring directions.  Symptoms may lead to pacing or wandering.  It is not a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer's disease.  

The exact cause of this behavior is not known. Factors that aggravate late day confusion include fatigue, low lighting, insomnia, increased shadows, disruption of the body's internal clock, difficulty separating reality from dreams, and presence of an infection such as a urinary tract infection. 

Here are tips for reducing sundowning.  Try to maintain a predictable routine for bedtime, waking, meals, and activities.  Plan for activities and exposure to light during the day to encourage nighttime sleepiness. 

 Limit daytime napping.  Limit caffeine and sugar to morning hours. Avoid eating a large meal within several hours of goint to bed.  Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.  
In the evening, try to reduce background noise and stimulating activities, including  TV viewing, which may be upsetting. 
In a strange or unfamiliar setting, bring familiar items, such as photographs, to create a relaxed, familiar setting. If you have a pet, the pet may lower your stress level and promote falling asleep.

Play gentle music in the evening or relaxing nature sounds such as the sound of ocean waves. Get a checkup with your care provider to determine if you might have an underlying condtion, such as a urinary tract condition or sleep apnea. The condition may worsen if  sundowning develops quickly. Consider Melatonin, an over the counter medicine that induces sleep. 

When sundowning occurs in a care facility, it may be due to the flurry of activity during staff shift changes or the lack of structured activities during staff shift changes.  
Source:  Mayo Clinic 

Famous quote:  "I only went out for a walk, and finally concluded to stay out till sundown. for going out, I found, was really going in.  John Muir."  

Source:  Mayo Clinic