Go Lead Idaho – Get in the Game

This past week I attended another great Go Lead Idaho event – A Legacy of Leading. Go Lead Idaho helps women build leadership skills and helps women engage in politics, public advocacy, and public planning. The speakers this week, Marilyn Monroe Fordham and Rose Bowman, are two veterans of being “first”. Sometimes it’s easy to forget just how recently and severely women’s work and political options were limited to a small subset of opportunities.

Both speakers talked about being strongly discouraged in the 70s and 80s from choosing challenging, non-secretarial type degrees in college and from applying for jobs that were at the time typically reserved for men. Marilyn talked about staying in a banking job for years trying to break through the glass ceiling of “no women can be bank officers”. She eventually left to start her own business as promotion after promotion passed her by. They didn’t even hide why they wouldn’t consider her – they flatly stated it was because she was a woman. The powers that be also talked about the possibility that she might someday get pregnant as a roadblock to many roles – those were the days when women were expected to quit working as soon as they “showed” their pregnancy. While today few people would come out and say so, and many may think they’re being totally fair when evaluating people, there are countless subtle perceptions and reactions that still keep women from being completely successful.

This doesn’t mean we give up or sit around complaining – we need to stand up for ourselves. Don’t get discouraged, keep things positive, and stay focused on the goal. How other people perceive you matters – but don’t let it define you. And don’t try to do it alone. Ask for help and give help to others. Step up to help with projects – you will learn a lot, make new contacts, and show people what you can do. Even if you’re volunteering or doing something outside the scope of your core job you’re still showing people your skills and giving them a reason to remember you the next time an opportunity arises. Always be ready to help others, especially women who may be looking for a female based network. Help others feel confident and build their own circles.

When you are choosing new projects and opportunities challenge yourself. Don’t compare yourself to others and what they could do with the job, project, or role – think of what you can contribute and be creative about it. Others don’t really know more about how to do it than you do – and what you do know how to do could be exactly what is needed whether it’s typical or not. Stretch yourself and don’t focus at first on the practicalities. Figure out what needs to be done then come up with a plan that combines your needs with the needs of the job or project. Many times the schedules and specifics are much more flexible than they seem at first – ask for what you need.

Sometimes the best way to solve a problem is to redefine it. Marilyn recounted how she sat on boards with a mix of men and women and there were often 1-2 people who tried to “win” and dominate discussions. However, as she joined boards that were composed of all women she saw a lot more of a focus on solving the problem and collaborating. Over the years the boards she was on became more efficient as they spent less time “playing golf” and instead focused on getting the work done sooner so they could get back to their responsibilities such as families and full time jobs. This wasn’t because of the inherent gender differences but because the women had different goals in mind and focused on them. They stated their needs, got things done, and made the job better.

When Rose ran for US Senate in Idaho in 1972 she was the first woman to do so. People were less likely to give money to a woman and she was running in the primary against the husbands of friends. She got out, made contacts, networked, but still lost the primary. But she was out there, she showed everyone that a woman could run, and she leveraged the contacts she made into appointments to multiple statewide offices. She made a difference. So what was next – what women have run for US Senate since then in Idaho? None. Women haven’t stepped up. We all have our excuses – we’re too busy, we don’t feel we have the skills, or it just seems like too much work. But really – why hasn’t any woman run again in the last 40 years?

You don’t have to start out with a national political office – but start somewhere. Do something new, extend your comfort zone, grow  your network, and get in the game – any game! Go lead Idaho!

The Princess and the Cancer Pea

The Princess's backyard
The Princess’s backyard

Once upon a time there was a princess in Boise, ID. We know she is a princess because she has so many advantages. She works for a Fortune 50 company that provides excellent health care and whose culture encourages strong support of employees as they go through hard times. She owns a nice house in the foothills that is way bigger than she needs and is great for parties – and since she works from home she feels she can justify the extra space. She has wonderful, extremely supportive friends around the world who will do (have done!) just about anything for her. She gets to speak her mind freely and does often freely share her opinions. She has shoes and bicycles and rafts and coats and boots and clothes and friends for just about any specific activity she likes to do. And when she wants to go on an adventure or buy something nice she just does it. She lives in a city often ranked top 10 for outdoor activities and adventures and can walk or ride into the foothills or along the Boise River a very short distance from her house. The princess is writing this blog on her patio as she looks out on her gorgeous, tree-covered hillside of a backyard. This princess lives a wonderful, charmed life.

So what could go wrong in this perfect, Camelot world?

That little cancer pea…. And thank goodness it was only pea size when they found it! Because this princess has great health care she didn’t hesitate to ask for an MRI and go to the High Risk Breast Clinic after the initial two sets of mammograms plus an ultrasound said that the shadow on the first mammogram wasn’t really anything to worry about. Because the princess knew her insurance would cover just about any reasonable health care advised by a doctor she asked for the expensive genetic testing and spent three hours at the High Risk Breast Clinic talking to a genetic counselor, a surgeon, and an oncologist about her lifetime risk of breast cancer and how her mom’s two breast cancers (the 2nd one was terminal) affected the princess’s own risk. They told her to lose 10 pounds, exercise more, get screened twice a year, and take Tamoxifen. The princess not only lives in a country that can offer the best health care in the world if you can afford it, she is also lucky enough to have a job that gives her the insurance that means she can get that excellent care when she needs it. Because of that high quality of care and her great health care insurance the princess had breast cancer surgery and she is now cured. She won’t even have much scarring and her breast doesn’t really look any different than it did before. How great is that?!

Cancer sizes compared to produce - this princess had a pea sized tumor
Cancer sizes compared to produce – this princess had a pea sized tumor

Because of that great health care plan, when the surgeon suggested that maybe another ultrasound was needed and maybe they should just go ahead and do a biopsy guided by that ultrasound she didn’t hesitate – she had no fear of the testing costs or any difficult decisions based on whether she could afford any suggested future care. And that may have saved her life. At the very least it made the whole cancer thing less scary. If the princess had no insurance or had insurance that was more costly or she couldn’t afford even minor copays and deductibles like so many people in this country they might not have found the cancer until next year’s mammogram. Statistically the tumor might have doubled in size twice in the next year – from .9cm to 3-4cm. It might have gone from totally non-aggressive and incapable of spreading to other parts of her body to something that was about to or already had escaped into her lymph nodes or blood stream. She might have not just breast cancer but also bone cancer or something else hard to cure and painful. But this princess had great health care and she is cured and that is wonderful for her!

Ultrasound images
Ultrasound images

But for many in this country, with the type of insurance so many people in the United States have (or don’t have), they might never have had the 2nd mammogram and biopsy this year and might not have their next mammogram on the advised schedule. So that tumor might have doubled in size again and again and again…. Once you are considered high risk (and the princess was given an estimated 36% lifetime risk of breast cancer – almost triple the norm) you are often put on a schedule to have an MRI then six months later a mammogram then six months later an MRI – rinse and repeat. After her cancer diagnosis this is now a forever-more schedule for the rest of her life unless she decides to have a preventative double mastectomy. But not all insurance will cover that screening MRI. It’s expensive and some insurance carriers will refuse to cover it, especially if you’re only borderline high risk or had a mastectomy (the princess had a lumpectomy). The princess heard that some high risk women save up so they can get an MRI every 3-4 years, paying totally out of their own pocket, and they just can’t afford to get the once a year MRI that their doctor recommends.

While the Affordable Care Act (ACA aka ObamaCare) takes great strides forward because it requires that a screening/preventative mammogram be covered by your insurance for free, it doesn’t require subsequent follow-up care such as a 2nd mammogram in the same year to be free. In her case the princess had to pay several hundred dollars for the 2nd mammogram/first ultrasound and doesn’t yet know the total costs for the second ultrasound, ultrasound-guided biopsy, nurse navigator, surgery, pathology reports, radiation, and follow-up care. But since her maximum out of pocket for any given year is small she has probably already paid every health care expense she will have to pay this year. And how wonderful is that? But how many people in this country have that luxury?

Stand Up for Women's HealthThe Affordable Care Act also means that the princess is guaranteed that her past breast cancer won’t keep her from getting health insurance if she changes jobs in the future. Pre-existing conditions can no longer be used as an excuse for insurance companies to avoid covering the people who may need the insurance the most. There are also state and national laws that prevent health insurance companies and employers from using the results of genetic testing to discriminate against the princess and other Americans in health insurance and employment decisions – but they don’t prevent life insurance discrimination.

For most people health care insurance in general will be cheaper and more comprehensive with the new health care exchanges ObamaCare has created. In some states that really care about their inhabitants Medicaid expansion also covers and subsidizes even more people. So if you don’t have insurance or need better insurance now is the time to do your research and get covered! If you still can’t afford breast cancer screenings and treatment go to your local Planned Parenthood clinic for help. They provide funding for screenings and health care of all kinds for men, women, and children. As a proud board member of Planned Parenthood Votes Northwest I encourage you to support women and women’s health care (and men’s too!) by supporting Planned Parenthood!

The princess wants you to think long and hard about your health, your health care, your friends, and your insurance. Fight like a girl at all times! Think about all the wonderful things ObamaCare is doing and will continue to do to improve the overall health of Americans. Make your mammogram appointments and keep them! Encourage your friends to do the same. Get to know your own breasts, how they look and feel at various times of the month, and tell your doctor if anything changes. Think about what your own health and life are worth and be willing to pay for care when needed. Speak up and ask lots of questions – challenge health care providers and insurance companies if needed. Be supportive of your friends and ask them for help when you need it. Don’t fall for pink-washed products and research any charities before you donate to them. Take charge of your life so you too can have a wonderful, charmed life like the princess!Fight Like A Girl - Sister Wives

Read more about the princess on http://www.caringbridge.org/visit/cindygross and http://befriendingdragons.com. She also tweets as CindyGross and SQLCindy.

No Coffee? Just Because of Surgery? Geez.

Friday I had a fun filled day starting with NO COFFEE. Oh, and a lot of poking and prodding and a little surgery. Less than a month after getting my breast cancer diagnosis I had a 1.3 cm lump (about the size of the tip of my index finger) removed from my left breast. I really appreciate all of my extremely supportive friends who have been helping me stay upbeat and positive throughout this whole process! Just a bit of daily radiation starting in a month or so and then this pesky cancer thing is all gone!

I was on vacation all of last week so having to get up for the alarm on Friday was a bit rough. But not having any coffee was the hardest part. Nothing to eat or drink after midnight – just like a Gremlin.

Sean and Rich dropped me off at St. Luke’s for a morning of appointments – I didn’t see the point in anyone hanging around when they couldn’t go in with me anywhere so I requested that no one show up before the surgery itself.

I went through admitting and they took me through the back corridors to the breast cancer center. There I waited well past my scheduled appointment time because the patient ahead of me was running late. Eventually they got me into the ultrasound waiting room where Bri, the same tech who did the ultrasound for my biopsy, was waiting. She gave me a hospital gown to change into but let me keep my yoga pants on for the morning’s appointments. She found the tumor and the metal clip they had inserted during the biopsy with the ultrasound and a new radiologist came in – she just moved to Boise from Seattle. WP_20130906_007Bri told her how I had watched the needle go in for the biopsy and watched every step of the biopsy needle sucking out the tissue. The radiologist used the ultrasound images to mark the desired spot (see the big black area in the images) then she inserted a thin wire down to where the clip is – this shows the surgeon where to cut.

WP_20130906_010They showed me on the ultrasound image how the wire was different “colors” every centimeter to help the surgeon judge the size and get all of the tumor. Each surgeon apparently has a favorite out of the hundreds of types of possible wires and this is the type that my surgeon Dr. Szentes prefers. The nurse measured twice to verify that the wire was sticking out by 14 cm, another double check that they had the wire inserted correctly in the right place. They coiled the end of the wire up and taped it down with gauze.

Next I went across the hall and had a couple of mammograms taken to verify that the wire was indeed in the right place. They handed me a copy of the films, told me I wouldn’t remember the next time they took mammograms right after the surgery, and sent me back to the ultrasound room. There they cleaned me up, put on more secure wrappings over the wire, and sent me to the next appointment.

Finding the sentinel nodes with nuclear medicine was the next step which took about an hour. I wrote about that in Nuclear Blue. Because they had scheduled two hours just in case I needed it and it took less than an hour at this point I was almost back on schedule –maybe 15-20 minutes late.

They sent me over to pre-op to wait. On the way to my bed the nurse grabbed me a warm blanket from the heater (130 degrees) and had me cover up as soon as I changed into the surgical gown. A few minutes later she replaced it with another, freshly warmed blanket.

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Next a nurse came in and put a catheter in my arm – no needle yet. WP_20130906_036

At this point they said I could have visitors. Linda came in first. Then Krista came in and stayed while they had me sign consent forms and the surgeon put his initials on my breast to make sure he cut into the correct one. I asked him if he could take any gory pictures for my blog and he agreed to get me a copy of the tumor picture. If any of the sentinel nodes were especially odd he would have a pic taken of that as well.

Then they gave me the happy meds. Apparently Carol came in after that but I don’t remember this and have no idea why I stuck my tongue out….

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The next thing I remember is the recovery nurse talking to me and Kate standing next to my bed. I immediately asked for coffee. After all, it was getting late in the day and I hadn’t had any yet! I was also hungry and had vanilla pudding (much better than chocolate!) and graham crackers. They also gave me a Vicodin and checked my vital signs. Dr. Szentes came in with a great gift – a very high quality glossy picture of the tumor! Oh, and the news that everything looked fine. They can’t say anything for sure until the final pathology report is back on Tuesday but the preliminary results look great. They got the whole thing with “clear margins” and the lymph nodes appear healthy. Because the lymph nodes (he took 2) looked so normal he didn’t take a picture of them.WP_20130906_039

It wasn’t very long before they let me get up and get dressed. I felt perfectly fine – not at all dizzy or light headed. But for some reason I couldn’t walk in a straight line. The nurse said that a lack of balance was normal after anesthesia. They wheeled me down to the main entrance and I got into Kate’s car with no problems. We drove through the pharmacy and picked up more Vicodin then headed to Starbucks – the hospital coffee just wasn’t sufficient. I ordered a heavenly pumpkin spice latte and we headed home. I was now walking in a straight line and felt great. Linda brought me soup and Carol, Emily, Kate, Linda, and Lucy stayed to play cards while we ate cheese and crackers.

While everyone left fairly early so I could rest (Sean and Rich stayed overnight in case I needed anything) I couldn’t sleep until after 2a. Emily loaned me a copy of The Immortal Life of Henrietta Lacks so I got a really good start on reading that (I finished it Sunday night) and surfed the inter-webs. Saturday Terry and Linda took me on an excursion to Art in the Park where I bought too many earrings and ate roasted corn on the cob. When I got home it had been 24 hours since surgery so I was able to remove the outer dressing (only steri-strips are left and they stay on for two weeks) and take a shower. I went to bed early Saturday and slept 11 hours! Sunday I took it easy. Kate took me to breakfast and there was a short excursion with Carol involving a wheel barrow…. While I took Vicodin Saturday I was down to Tylenol on Sunday and expect to be pain-killer free Monday.

I figure if my biggest concerns were waiting all day for my first coffee and not being able to take a shower the next morning then things must be going pretty darn good! I look forward to healing up and getting back to a normal life. I am sending out a huge THANK YOU to all of my friends – I really appreciate your support!

Study: Quality of life for breast cancer survivors similar to that of women who never had the disease

Read more: http://medcitynews.com/2013/09/study-quality-of-life-for-breast-cancer-survivors-similar-to-that-of-women-who-never-had-the-disease/#ixzz2eNO04SQp

Nuclear Blue

Friday as part of my lumpectomy they took out two lymph nodes to check for any spread of the cancer. They are called “sentinel nodes” and are found via radiation. After they inserted a “localization” wire in my left breast to guide the surgeon to the tumor they took a couple of mammogram pictures, put me in a wheelchair with the images in hand, and pushed me down to Nuclear Medicine room #1. Rick took over once I was in that room and thoroughly explained each step that would be happening. He started with warning me yet again that I would be peeing Bronco blue for a day or so. The radioactive dye is tinted blue and it works its way out as blue urine – because Boise State is such a big deal in Boise everyone gleefully tells me I’ll pee BSU Bronco Blue as if I’m a Bronco fan (I’m a Boomer Sooner!) and somehow that will make it more normal.

WP_20130906_012Rick commented on how pleasant it is to have a patient that is positive and upbeat. He totally understands why so many people come through upset and tense but he enjoyed having me in there asking questions and looking forward to the future. I imagine it must be pretty bleak dealing all day every day with people who are facing uncertain or negative futures but Rick said he really liked his job and enjoyed learning new things all the time as the technology grew and changed.

The radiologist, Dr. Leymaster, came in and again warned me about the blue pee. I guess it must have freaked someone out at one point. Everyone along the way warned me – nurses, technicians, admissions people, doctors. Maybe they just enjoy talking about it. Then they had me lay down on the machine and the radiologist injected Lidocaine then the radioactive material – less than I will get when I fly to Seattle this week.

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The radiologist left the room and the technician Rick pushed me under the imaging part of the machine. Since I was so interested in what was going on he made sure I could see the screen during the procedure and explained what was going on. The two big spots on the screen are the two injection spots just above and below my areola. Because this picture is so soon after the shots most of the radioactive material is still in the injection sites but will eventually work its way through my lymph system and out of my body – as blue pee of course. WP_20130906_031 The point though is to find the “first” lymph node or two that my breast drains to. The nurse explained that lymph nodes are like a pearl necklace – when you lay a string down in a clump it’s hard to tell where the “beginning” is. That “pearl necklace” is what is in the average armpit – a big mixed up mass of lymph nodes with no easily found beginning. The lymph fluid drains in a specific order, they are all connected with a single channel. The radioactive dye drains from the breasts in the same order as lymph fluid so where ever it goes first is where any cancer would go first. They can remove just the first couple of “sentinel” nodes and biopsy them – if they are free of cancer then the rest of the lymph nodes should be cancer free as well. After about 10 minutes Rick pointed out for me the small clump of radiation “above” the injection sites that indicated the fluid was clumping in a node – the first sentinel node. He then “drew” an outline of my body on the screen.

The radiologist came back in and used the Geiger counter along with the pictures to mark a spot in my armpit for the surgeon to remove the sentinel nodes. Rick had told me the machine would sound like R2D2 and in a way it did – as the machine got closer to the node with the dye it did beep and gurgle.

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We finished up by looking at the higher resolution computer image and Rick showed me all the cool colors he could add to make the output more readable. We settled on green (of course!) for my pictures. The two biggest spots are still the injection spots and the spot just to the right and above is the node. The other dot further above is just an artifact of the process of drawing the outline of my arm – it is not a drainage spot. The line on the right is where he “drew” outside my rib cage and up under my armpit.

SentinelNodeEdited

By the time of my surgery the dye had spread out a bit more but they already knew where the first node was. We won’t know for sure until the pathology results are back on Tuesday but the preliminary indications are that there is no cancer in the lymph nodes and I will be fine. And yes, I did pee blue the day after surgery….

Curing Cancer with Donations

It’s natural to want to donate to something, to offer to help “fix things” when someone is sick or injured. But how do you pick who gets your time or money? Do you give to a local charity? One of the big names? Something directly related to and as specific as possible to the illness? Something general? I don’t think there’s any one good answer. Before you donate to anything, check them out on an independent site like Charity Navigator or Charity Watch. Make sure you search on the exact name as there are many look-a-like groups and some of them are completely bogus or donate just a tiny fraction of what they raise to their supposed cause.

KeepCalmAndFightCancer

Since my breast cancer diagnosis a few weeks ago I have relied heavily on a handful of sites. The big medical ones are the Mayo Clinic, American Cancer Society, and the National Cancer Institute. The first two do accept donations. I also got some great BRCA information from FORCE aka Facing Our Risk of Cancer Empowered. Another organization that has been incredibly helpful is Caring Bridge. They allow me to keep everyone updated from a central location. They rely on donations to help power the servers and run their website. From my past political experience (and as a Planned Parenthood Votes Northwest board member) I can highly recommend Planned Parenthood as a group to support in the fight against breast cancer. They provide funding for many women who otherwise wouldn’t be able to get a mammogram or other health screenings. Idaho is dead last in breast cancer screenings so that is clearly an area for improvement here. Again, Planned Parenthood of the Great Northwest can help as they offer funding for Idaho women who need screening.

One group I do NOT directly support is Susan G. Komen. Not only did they recently falsely claim a long disproven link between abortion and breast cancer but they have some questionable practices related to prosecuting other groups that use “for the Cure” in their own fundraising efforts. They did quickly restore their funding to Planned Parenthood but the damage they did with their misinformation is long lasting.

There are other groups out there that aren’t doing research or treatment but that add a lot to the lives of those fighting cancer. For example, there are groups that provide free house cleaning for people going through chemo or other debilitating treatments, free scarves, hats, or wigs for people with hair loss from chemo, and low cost or free get-aways like weekends at a cabin or fishing trips. Many of these groups are too small to be rated by the charity rating organizations so find something local and ask around.

I won’t tell you who to donate to, but I do suggest you do your research and choose something you really care about. It seems likely you’ll have more impact with a donation to a smaller organization. Right now I’m thinking I may be donating more to the groups that provide screening and offer support during and after diagnosis and treatment. You may also want to think about a random act of kindness to someone in need.

Serenity for Surgery

Surgery. The word seems to terrify a lot of people but I’m fascinated, kind of like River Tam reading Shepherd Book’s book. I tried to get them to agree to take pictures during the procedure but haven’t had any luck with that so far. I asked if I could stay awake and watch but that is apparently not an option either. They tell me there are a mix of privacy, lawsuit, and infection concerns plus they don’t want to distract the surgeon. Sigh. I bet Dr. Simon Tam would take pics during surgery if I asked… at least if I looked like Kaylee or Inara.

Serenity

Friday I am having a lumpectomy, also known as breast conservation surgery. From a clinical perspective they are simply removing what is estimated to be a 1.3cm tumor and 1-2 lymph nodes through a small incision (maybe two incisions) that is expected to heal with little scarring. I expect Dr. Szentes to have the mad piloting skills of Wash and the brash, confident command of Captain Mal as he operates. Or even better, the mechanical skills of Kaylee. It’s outpatient surgery and I will go home within a few hours of the end of surgery. In about 3-5 days I get pathology results back to confirm that they got the entire tumor and that it doesn’t appear to have spread like Jayne on a drunken spree with Vera. Given the early detection, low grade, and small size of the tumor they are pretty confident it hasn’t spread. The bigger concern is whether I get another in the future. My mom had breast cancer twice and the second one killed her. However, treatment in the 1990s when she got sick and treatment and screening now are very different. they will prescribe Tamoxifen and I may take other steps to reduce my estrogen exposure. No matter how my BRCA results turn out (genetic testing is due back around September 13) I will be on an every 6 months screening schedule, alternating MRIs and mammograms, for the foreseeable future. With that level of “enhanced screening” my survival rate from breast cancer is actually higher than the general population, certainly higher than if I ran into a bunch of Reavers. So ladies (and high risk men!) don’t put off your mammograms and get to know your own boobs!

Engineered by Firefly

Everyone else seems more concerned about this surgery than I am. I look at it as an inconvenience that will make me uncomfortable for a few days. I’m grateful they caught the cancer early, it’s non-aggressive, and I have a clear, relatively easy treatment plan. The advances they’ve made in surgery (they take only a small margin around the tumor in most non-aggressive cases) and radiation (very targeted and much less troublesome than chemo) are remarkable. I’ve asked a ton of questions and explored all sorts of options such as new types of genetic testing on tumors (EXON 7 testing for example is too new and unproven and other genetic markers in the tumor would prove the same thing) and bio-preserving my tumor for research (Boise has a bio research facility and it looks likely I will be able to participate). I am very lucky to have a nurse navigator assigned by St. Luke’s to help answer all my questions, track down providers, and help me through any sort of concerns I have. She’s very no-nonsense like Zoe and helpful like Shepherd Book.

In the meantime I am enjoying my birthday (it’s today but I had a fun costume party at my house Sunday night with many great friends) and my vacation (tubing the Boise River, multiple movies, friends visiting from Phoenix, walking the greenbelt, great food and wine). I wish I could visit Jaynestown too but that will have to wait a few hundred years. I’ll take a couple of days off after the surgery; more to make sure I’m relaxed and caught up on personal things than because I expect to truly need it for recovery. It will be about a month or so before I start radiation, then we’ll be on to the enhanced screening and I’ll continue to get on with my life. This surgery and the cancer is just a small bump in the road and I’m looking forward to moving on past it so I can live long and prosper. The future is looking Shiny because no power in the ‘verse can stop me! And I definitely aim to misbehave because you can’t take the sky from me!

A Boobtastic MRI Experience

Today I had my first ever MRI – in this case a boobtastic MRI. They’re using the MRI to look for blood supplies in both of my breasts. Cancers need a lot of blood to grow and thrive so that’s why MRIs are used in cancer screening – they look for unexpected blood supplies. However, many other things can also cause out of the ordinary blood supplies and many of these are in no way dangerous. This means there’s a high chance of false positives that lead to additional screening such as ultrasounds that focus in on the area with the extra blood supplies. Today’s MRI will help them better estimate the size of the tumor in my left breast to increase the chance they take the optimal amount of tissue during the lumpectomy. They aim to get “clear margins” meaning they remove a bit of non-tumorous tissue around the tumor without missing any of the tumor or taking more tissue than needed. The MRI could also identify other potential “excessive” blood supplies that might need further investigation before surgery. I’m looking at a future screening schedule that includes an MRI every 12 months for the rest of my life since I’m a high risk patient. That will alternate with mammograms so that I have some sort of screening every 6 months. This “enhanced screening” greatly increases survival rates in high risk patients to the point that high risk patients are actually more likely to survive a cancer than someone in the general population who may or may not get screened regularly. So gals – get screened as often as your doctor recommends and get familiar with your own boobs!

Originally my MRI was scheduled for 430p at the downtown Boise St. Luke’s very near my house. However, I got a call around 1130a saying that there were some emergencies that needed the MRI and they could not get me into the Boise location today. Would I be able to arrive at their Meridian hospital by 1230 because they had an opening there? I quickly checked with my chauffeur, Linda Crozier, and verified that yes, this would work. She ditched her husband and their planned movie and picked me up immediately. We were “all the way in Meridian” (those of you in Boise will understand that to mean “almost in a foreign country”) by 1215p. I popped my prescribed anti-anxiety pill as we pulled into the parking lot. If they offer you an anti-anxiety pill when they’re scheduling the appointment then take the pill – why not? They quickly checked us in and I was back in the MRI waiting room within a few minutes. Linda opted to wait in the main waiting room as they wouldn’t let her observe the actual MRI any way.

They let me keep on my metal-free yoga pants and thick, warm socks but had me put on scrubs for a top. They verified yet again that I was wearing no metal, had never had an accident involving metal in my eyes (!), and that the only metal embedded in me was the plate in my left arm (per the tech that isn’t ferrous and can’t cause harm in an MRI) and the clip they inserted in my breast to mark the tumor.

Boob MRI for breast cancer screening
Boob MRI for breast cancer screening

Within a few more minutes I was in the MRI room. That’s when I first saw the pink contraption pictured here. I guess they figure anything breast related must be pink because all women just love pastels and pink in particular… right…. NOT! They had me sit on the side of the table while they inserted a catheter in my arm so they could add some dye later in the process. Then they had me get as comfortable as possible on the boob contraption. The boobs themselves just hung in two holes (labeled conveniently as left boob and right boob in the picture). My head fit in a massage-table-like head rest. My arms were stretched out in front of me. Then they figured out the right combination of blankets and pillows under my rib cage, legs, and feet to make me comfortable enough that I wasn’t likely to squirm and added a blanket on top to keep me warm. If you move during the 20-45 minute MRI they have to redo pictures and stay even longer so comfort is key. They hooked up a line to the catheter in my arm, put some big headphones on me (with music piped in from my iPod), put a call button in my hand (they can’t hear me call out over the loud noises the machine makes), and pushed me back into the MRI machine.

The machine had been making clunking noises of various sorts the whole time, but now the noises became more consistent and louder, though the specific sounds changed quite a bit. The machine is taking many, many pictures, each one of a different 3mm slice of my breasts. I just concentrated on breathing deeply and listening to my music. They had placed a double mirror under the headrest so I could see out the end of the tunnel. I watched that for a while but it was not very interesting – a very narrow view of the room between my fingers. So I closed my eyes and relaxed. After about 10 minutes I heard a voice over the headphones saying they were injecting the dye and I could feel a cold spot in my arm for a few seconds. I have a vague memory of hearing an extra loud noise and jerking at some point. I think the memory was vague because I was asleep…. The tech’s voice came over the headphones saying I had moved so they would have to redo a couple of the pics. I was very relaxed at that point and may have gone back to sleep – it seemed to be over very quickly.

They came in and pushed me out of the tube. They had me sit up and they removed the catheter then said I could leave. I asked if I could grab my phone from the waiting room and take a picture. They said sure. I couldn’t take the phone inside the room but was able to take the pic from the doorway. I said I needed it for my blog and the tech said, yes, people do that all the time. Who knew so many of us thought other people would care about our MRI experiences!

After changing back into my street clothes I collected Linda and we headed back to Boise for a coffee fix at Starbucks. They already have Pumpkin Spice available! We relaxed in the Starbucks for a while then Linda dropped me off and headed out to get back to her day.

It generally takes 24-48 hours for a mammo-radiologist to review and report on the results. I really hope they get to it before the end of the day Friday because they aren’t working on Monday due to the Labor Day holiday. I would really like to have confirmation that the MRI has no surprises so I can plan for a Sept 6 lumpectomy. If the Sept 6 surgery date doesn’t work out we may be back to the original Sept 25 surgery I was hoping for when I was thinking I wanted to wait for my BRCA results (I’ll cover that in a separate blog).

I hope you found my boob’s boobtastic journey through the MRI entertaining and/or educational. 🙂 For anyone trying to calm your nerves before having your own MRI – it was easy! Just make sure you are comfortable, ask tons of questions ahead of time and as they are prepping you for the MRI, and relax.

Climbing the Tree of Life

Tree of LifeThis week I got news that most will take as bad. But there are some very good things about it. I may have cancer, but it’s a very non-aggressive, easily treatable type. We caught it early and have a solid treatment plan that should completely remove it. There are a few test results we’re waiting on but all-in-all my prognosis is good. What do I do with this new found kick in the pants? Cancer is supposed to be a life changing event that makes you re-evaluate everything and choose new directions. What direction do I want to take? How radical of a change? In what part(s) of my life? Is all this re-evaluating even the right thing to do? It does make me question a lot of things but honestly the biggest thing I want to rush out and do is some of the traveling I’ve been putting off. I want to go to Greece – visit the ancient ruins, sit on the beach, and just relax. I want to start crossing off the remaining US states that I haven’t yet been to – less than half are left but a few I’ve only been to for work or as a kid and I would like to have a “fun” memory of each. I would like to visit most of the continents: Antarctica might just be too cold but the rest all have many interesting possibilities. I want to keep having fun, always learn more, and contribute what I can to society. I am realizing that the details may not matter so much – I just need to keep climbing the tree of life.

Don’t Be Sorry

Don’t be sorry.TinyDragonOnFingers

There are so many ways to look at that. Don’t be sorry you did something yourself. Don’t feel sorry for someone else. Don’t dwell on the negative…. Right now I just want you to avoid telling me you’re sorry. I want to hear “hey – it’s going to be alright” or “you’re lucky”. Why, you ask?

Well, I was diagnosed on August 19 with breast cancer. We caught it early, it’s non-aggressive, it’s small, and it’s considered very treatable. Don’t feel sorry for me and don’t say you’re sorry. If I’m going to have cancer this is about as good as it gets. Think positive, help me plan for the future, and treat me like normal. And of course indulge my every whim and let me win every argument…. Just kidding. Mostly. Many of you want to help and I do appreciate that. Let me put your offers on hold as I am told help is most needed a few months into the treatment plan.

Thank you for your caring and for your support!

I’ll update my medical details regularly here: http://www.caringbridge.org/visit/cindygross

Follow me at https://twitter.com/cindygross.

Big Data Twitter Demo

Real-time. Social Sentiment Analysis. Twitter. Cloud. Insights. We have your Big Data buzzwords here!

Everyone seems to want to incorporate social sentiment into their business analysis. Well we have the demo for you! Use it for a quick demonstration of what can be done and when the excitement goes through the roof, use it to inspire your own design!

Real-Time Processing – Instant Insights!

First, use Event Driven Processing (EDP) to show the data on a dashboard. In the demo you’ll use StreamInsight, also referred to as Complex Event Processing (CEP), though you may want to use Microsoft Open Technologies’s RX / Reactive Extensions in your own project. Use the dashboard to make real-time decisions and take immediate action. For example, configure your EDP to “pop” only on terms related to your company and your marketing analyst can watch how the volume of tweets and the sentiment (measured positive/neutral/negative in this example) change in response to your Super Bowl ad or a mention of your company on a the news show. She can respond instantly with changes to your website, your own tweets, sales/promotions, or whatever is appropriate to your business.

Data Storage – Enable Insights!

EDP reads the data as it is pushed through a query, there is no inherent storage involved. You could just discard the data and never store it. In this example we chose to store the data for later trending and historical analysis. We take the tweet id, the date/time the tweet was captured, the sentiment score calculated during the real-time processing, and the keyword that caught our attention and store it in SQL Azure. This data is available to other applications that need to join it with existing data and requires fast responses to individual queries. The remaining data including the raw tweet, any geographic data the tweeter chose to share, and other data is dropped in an Azure Blob Store.

Trends, Patterns, and Historical Insights!

Now point HDInsight (Hadoop) to the Azure Blob Storage using HDInsight’s ASV extension to HDFS. You can spin up a Hadoop cluster in Azure, pay for as many nodes as you need for as long as you need them then spin them down to save money. The data remains in the blob store – available for future Hadoop clusters, other applications, archival, or whatever you need it for. Add structure to the JSON data with Hive and now you have rows and columns that can be accessed by BI tools!

Visualization for Powerful Insights!

Now create a PowerPivot tabular model (self-service BI / client side) or an Analysis Service tabular model (corporate BI) to store the relevant data in a highly compressed, in-memory format for fast access. Add in a few Power View visualizations mashing up data from multiple structured and unstructured sources and you can show your business decision makers easily digestible and understandable data in a format they just get and love! Make some decisions, take some actions, and you’ve just shown how to turn free Twitter data into a valuable resource that can have a direct impact on your company!

How to Get These Insights

Follow the instructions on the CodePlex site for the Big Data Twitter Demo project. Set it up, run through the demo, get excited, and go improve your business!

Demo Created By:

Vu Le

Andrew Moll

Aviad Ezra @aviade_pro

Brad Sarsfield @Bradoop

Later Additions By:

Lara Rubbelke @SQLGal | http://sqlblog.com/blogs/lara_rubbelke/

Robert Bruckner http://blogs.msdn.com/b/robertbruckner/

Cindy Gross @SQLCindy | http://blogs.msdn.com/cindygross

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