Wednesday, February 25, 2015

Super Toe to become Surgery Toe

Sorry, no pictures, just information. 

Superficial Malignant Melanoma. 

It's still hard to say that. I have skin cancer.  I've gone to calling it "toe cancer".  Post about Super Toe update.   Post about Super Toe & original biopsy. 

Friday (20th) I ended up having my appt/consultation with the general surgeon, thanks to the GI, a week earlier than planned.  

I was suppose to have my Remicade on the 17th.  My Gastro acted like he had never heard of my calling in about the Melanoma. He was going to call a Mayo doc he had worked with at a different hospital to ask about my condition, medicine, then my PCP and the general surgeon. 

He didn't want to  me to have my Remicade and said we'd schedule that later, if again.  He said, contrary to what the CCFA said, that there  was no way to prove that Remicade causes melanoma. Given his behavior and such, I wonder if it was a CYA statement.   Really.   Especially with the 'we may not give it to you again'.   Not that I'd have it again once the Melanoma/toe issue was resolved, but that "we may not give it to you again'.

The danger is if a person who regularly is given Remicade goes off the medication, that, when the patient is given Remicade in the future, the person would have a 30% chance of having a negative reaction. I've never asked how they'd treat a "negative reaction" since the medicine would be in one's body for at least eight weeks.  

Ever the optimistic person, I read that as there is a 70% chance I can go back on it. Alas, the medical world doesn't see it that way. 

My mind was prepared to have an appt with the general surgeon for the 27th, not the 20th.  I wasn't all that happy that the Gastro had to suddenly make sure this appointment was ASAP.  More so that The Mike had taken the 27th off from work in order to be with at this appointment. Now it meant that I'd be going to the surgeon's office on my own. Yes, I'm a big girl. Yes, I should be able to do this on my own. No, I don't want to. (pout).  Plus, I want more people who are on my side and can remember what is being said--even though I take notes--than what little information the doctor ends up putting in his medical notes.  The Mike had a conflict at work and could not be at my appointment. 

Adding to my frustration for the day, the Gastro told me not to eat before the appointment in case the surgeon did the biopsy that day in the office--seriously? without a driver for me? My PCP told me that a large area of skin would be removed by the surgeon, so I had a hard time believing he'd do this in office.  Once I found out that the appointment was at 11:30am I said there was no way I wasn't eating. So I had breakfast, of course it was after the headache set in for not eating. :-( 

Surgeon: Great guy. Nice, personable. Is a runner. First, he threw me off by asking if I've been feeling okay lately. I said, "well, compared to how I've felt for the last four years that no one is able to tell me why, yes". So I explained the tired, the fatigue, the lack of energy, the bruising, the feeling of running 10 miles after running 3 miles, that I've increased my magnesium and feel a lot better.   His reply?   Have you seen a rheumatologist?  A rheumatologist could probably help you with these symptoms. Really?  Why would my PCP and GI never suggest such a thing!

The surgeon also always refers all cancer patients to the oncologist for a discussion/talk through. Wow.  This stuff is getting real (mom would be proud to know I didn't type my "favorite" word). Not only do I need a biopsy for the Melanoma (gulp, again, reminding myself I have cancer). I have to also see the oncologist (gulp, gulp). 

Surgery will be in the hospital because the location will be tricky to get to, and there is a nerve that runs up that toe.   light bulb moment. Ah, this is why the toe has been so very sensitive in this location!  

Basically he'll cut out the area more fully, then sew it up. The nerve will probably be cut, which means I'll have a lack of feeling in the toe forever then.  If it's not fully cut, it could  mean I'll have the 'drunk tingly skin' feeling as after the knee surgery. It took about five years for that to go away completely. The cut/removal will basically look like an eye. 

Draw an eye on a piece of paper, iris, pupil, open eye lids.  The tiny iris would be the melanoma, the pupil (1 cm diameter) skin removal for cell removal, and then the open eye lid are is the basic cut where he would draw the skin (tight) and close it in a straight line.  The end of the cut on the top of the foot would be about half an inch and then about the same on the underfoot as well.  Go ahead, look at your toes. How much skin do you have there to take a 1cm out for this.  My mind is saying OWIE and the surgery hasn't even happened!  

I will also have a lymph node biopsy performed.  My melanoma was .5mm and if it was .76mm it'd be an automatic biopsy, but since mine is smaller, it's just an option for me, which we'll take.  It was .5mm at the time I caught it, who knows at surgery time.  

Oncologist. Nice woman.  Met with her yesterday.  She said if the spot was 4mm or larger, then there would be drug involvement, but at .5mm, there won't be--on her end.  Also, told me that Remicade doesn't necessary "cause" melanoma, but that in addition to suppressing the immune system that would want to fight my colitis, it also suppresses the immune system that helps protect against cancer.  So much information to absorb!  

As of now, the surgery to remove the melanoma fully is April 9, which works with the surgeon's, The Mike's, and my schedule. After that, no running for at least 3 weeks, minimum, per the surgeon. He said no way, no how would I be running before at least three weeks from the surgery date. My mind said "Darn" but also is happy he can say that honestly up front. I'd hate to be told that I could be doing something a week out and then not. 

Snagged this from the CCFA facebook page
  

Friday, February 20, 2015

Pork chops and rice. . .what to do?


Thursday night I only knew we were having porkchops and brown rice.  The porkchops because that is what I had gotten at the grocer on Tuesday, and I had brined them Thursday morning with a tablespoon of salt, a tsp of sugar, and filled the container with water. Brining helps keep the pork tender. We learned of this from Alton Brown on his turkey brine recipe, but also on America's Test Kitchen.   The rice, because I was cleaning out the pantry and had a cup and a half of brown rice left, for over a year or so.  I always pass it up to cook because it takes 45 minutes to cook. YIKES. No way to do quick meals with that time restriction! 

Thanks to Pinterest, I found this recipe by Southern Krazed. It looked fabulous and just what I was looking for since it contained 1. porkchops and 2. rice. 

Her ingredient list: 
  • 4 Small Boneless Pork Chops (approximately 1 lbs.)
  • 1 Can Chicken Broth (15 oz.)
  • 1 Cup White Rice (not instant)
  • 2 Cups Chunky Salsa (your favorite brand and heat level)
  • 1 Can Black Beans, drained and rinsed
  • 1 Can or 2 Cups Frozen Corn
  • 1 Cup Shredded Cheddar Jack Cheese
  • 1 Tbsp. Oil
  • Salt and Pepper
Well, I already had cooked the rice, plus I didn't have all the ingredients. Now, some might freak out at that and I said, "well, I'm making my own thing here with hers as an inspiration!".  

My supplies:

*two cups of red salsa (Mad Butcher if you're around Iowa, or you can order on line). 
*one can of refried black beans 
*3/4 cup of frozen corn
*no cheese since we're eliminating it from the house
*two butterfly pork chops ---which really means four small porkchops. 
*already cooked rice

I also had: 

*half a can of diced jalapenos
*Trader Joe taco seasoning
*Avocados
*Green salsa

I also had a couple containers of Newman's Pineapple salsa, but somehow I didn't think I'd actually like that in the meal tonight.  

I ended up cooking the pork chops by heating a Tablespoon of olive oil in the pan, and tossing the drained and dried pork chops in the pan to sear on both sides.  Then I added about a half tablespoon of taco seasoning to the pan with some water, covered and let simmer/cook.

In a skillet I added the frozen corn, the rice, the half can of jalapenos, and a cup of red salsa which I then stirred and heated through. I didn't want to use all the red salsa in case The Mike wanted more on his plate--'cause I'm caring that way. 

The black beans I heated up in the microwave. 

For plating, I completely forgot about the avocados, even though there are five in the fruit basket right on the counter where I plate the meals!  
Spanish rice flare with seasoned porkchops, side of black beans and green salsa.  

No cheese and it was fabulous.  Hubby gets this for leftovers today while I'll have the tuna noodle from Wednesday or sardines.  

I ended up mixing my beans and rice together, but, of course, that doesn't make a pretty photo.  

I never use to be one for salsa, and have come to realize I don't really care for red "normal" salsa, but love the different ones like the green salsa and the Pineapple salsa--which is great with tortilla chips and (gulp) sometimes on an omelet.  (There was a time, pre-The Mike, where I'd never have put salsa on my eggs.  


Health, Clots and listening to your body

Gluten Dude​ raises excellent points in his Facebook post/article yesterday regarding this article's reason for Jerome Kersey's death (former basketball player):  

1. be aware of something being "off" in your body;
2. pay attention, and;
3. keep after doctors if they repeatedly refuse you.

After my ACL surgery about ten years ago, I had to wear thigh high compression stalkings to bed, and for the first two weeks after the surgery for the whole day as well--minus a couple hours to let the legs breathe. Oh, how The Mike misses giving himself a black eye (slight exaggeration), struggling to put the compression stalkings in his hands to tug them on his wife.  They were very tight, much more so than the compression calf sleeves or socks that athletes wear these days.  [hmmm, maybe men should be required to put pantyhose on their wives at least once. . . mom always said to be sure the husband knows how to dress the wife (and vice versa) before it becomes necessary to do so---something she reiterated after her stroke.]

In 2011 I would run my first marathon in October, but before I did that, in June I had my seventh half marathon to run.  I did a lot of driving and ran my first Hospital Hill Run​.

-Four and a half hours in the car.  Stop and get my race packet.
-Drive for two more hours to Emporia for The Mike's Dirty Kanza event.
-Get up early the next morning, drive two more hours to KC, MO.
-Race in the hot, humid air (even more unusual than the normal June humidity of summer). Eat (while sitting in a restaurant--best GF pizza at Minsky's though, with GF cake!).
-Then drive two more hours to Emporia. Where I "relaxed" while waiting for The Mike to finish his race that night.  By relax, I mean freaking out about the really weird storm clouds, the storm warnings for the areas around Emporia, the dark sky, and knowing we're in flipping Kansas where tornadoes are not that unusual!
-Then six hours in the car in the next day driving home.

Later that week I had a pain in the outside of my left calf, about two to three inches above my ankle. I thought maybe I had turned my ankle in heels at work, or done something in the race. Then I had problems even maintaining a 4mph run on the treadmill. I called my doctor's office at this point and was told by the nurse "you're just over training."

I called in a few more weeks and was told the same thing.  I *knew* something wasn't right, but ignored it because the doctor's nurse kept telling me it wasn't serious.

I perfected the run 30 seconds walk a minute run because I couldn't breathe to keep up a running pace.  [This is NOT something you want to perfect if you're in good health]

Then, on a Friday in July (just before the Quad-City Times Bix 7 which​ I had intended to run), I went out on my morning run and had a HUGE 'blast' feeling from the inside to outside of my chest. Freaked me out, came home, called hubby, drove myself to the ER (which you should never do if you're having cardiac issues!!).  The best description was being punched in the chest from the inside out.  This description perplexed the medical personnel. Maybe they'd never had someone explain it like that before.  HUGE tests run. One of the techs asked what my bracelet was. Road Id. I explained and said everyone needs one and all medical personnel should know what it is.  The tech was a runner and said she needed to get one of those. I believe EVERYONE should have a Road ID, even if just to say your name, blood type, emergency contact name & number.

ER doc said that I didn't have a heart attack, but that I had had a small clot that had broken free and blasted through the veins/arteries and that I was darn lucky. Extremely lucky.  Know how lucky?  My mom had a blood clot in her left arm at the beginning of May, just a few months before (after heart surgery) which may have resulted in her massive stroke a scant fifteen days later.  I should have pursued the issue with the doctor--insisted on an appointment--but I didn't want to 'waste' time off from work when I might need it for other things, like more immediate visits to my parents.  

As a result of this "small" blood clot, I always wear my compression sleeves in the car if we're on a long car ride/drive--something over three hours, or take a baby aspirin before the long driving event. No need to tempt the fates any more than necessary.

Which leads me where I am today and having Super Toe looked at more closely because I knew a freckle --with rings like the planet Saturn --was not normal.

Pay attention to your body. Act if something is not right. If doctor's naysay you. Keep after the doctor, rephrase what you're experiencing (maybe it's just they're not understanding your wording), or find a new one who will listen.

Monday, February 16, 2015

Olive bread --Feb 6

I was wanting something different for bread one evening, when I was making chicken breasts seasoned with thyme.  I decided to go for rosemary-thyme-olive chebe. 

These would be the first Chebe I'd make since we decided to cut back on a lot of our cheese intake. (gasp, gasp). I know, it's a shocker, especially for the dairy farmer's daughter!  
Next step: olives.  I had to choose between Kalamata olives and black and green.  I decided to go with the black and green, adding about 3/4 of a cup of mixed sliced olives. 
While I usually use the food processor to mix Chebe, I didn't want the olives to become diced or minced, and so used a fork in order to keep the olives in their shape.
After shaping, I baked on a parchment paper covered pizza stone. 350 20 minutes. 

Tongue in cheek funny platter----it has a stalk of golden ripe wheat on it.
Still a gorgeous sight to this Quirky farm raised gal.
Fresh out of the oven

Plated up for dinner 

I shared this with Chebe and they were so fabulous and kind in that they posted the recipe to the web page's recipe section!  

Friday, February 13, 2015

Super Toe update

Super toe, so named from the cape during the biopsy procedure, needs to make a reappearance.  

I downgraded the "fingertip" bandaid to a regular bandaid.  . . but I ordered more of the fingertip ones from Amazon to get just those (since I dislike the knuckle ones with the four tabs of adhesive). 

I even managed to get toe socks on with the regular bandaid:  

WOOT! toe socks return to the foot
I was feeling pretty good. The toe area still is sensitive to pulling on the skin. I haven't run on it yet. I had the biopsy on Monday and on Thursday I did yoga. The doc said I'd be able to go on Tuesday morning, but I kept waking up in the night and bumping it, so that was a no-go.  I have worked up to 7 miles walking on the treadmill and it tingles/throbs after about an hour.  
The white area is the biopsy section. I've kept it covered with Neosporin and bandaids.  

Wednesday --fifteen days after the procedure--we decided it was healed enough I could go without bandaids. This is what it looks like now.   That little spot of color at about the 1o'clock position? Yeah, it needs to come off, as well as more skin. 

A week after the biopsy I called the doc's office expecting to have had the results the Thursday or Friday before.  No results.  I called again last Thursday, the 5th, and they said the results were sent to Mayo. Hmmm. Didn't tell me why though. 

My doctor called me on Saturday --thought it was about the biopsy. Nope, it was to tell me my measles tiger test was showing the vaccine was still working.  --yeah, my doctor herself called to tell me that--on a weekend to boot! 

Tuesday of this week, the 10th, I had a message from my doctor to call her back.  EEEK!  That's never good news.  

I called back. said I was returning a call to her. She came on the line quickly, so I hope she was at the nurse's station and not in with a patient.  


The long and short. I have Melanoma. Probably from my immune-suppression medication for my colitis which can cause it--as I referenced in my earlier post about Super Toe.    

Wow. (gulp) I have skin cancer. 

Superficial Malignant Melanoma 

Apparently it was only 1/2 millimeter deep, considered small, and just "removing it should be the cure" for this, per my doc.  

The bad:   I have to get a "wide margin" of skin removed to ensure that all the melanoma cells are removed. Doc said they'll go in at least once, and probably twice more, to remove skin. 

My response:  Glad I haven't registered for any races this year (laughed). 
Dr. reply:  Oh, you can run. (cheerleader doctor). You can do this. Your race is in May?  


LOL.  I want to do a race at the end of March, plus one in May, plus one in June, and every month, but I have to be able to run without too much pain to do the training! 

So much information is available at skincancer.org

The most dangerous form of skin cancer, these cancerous growths develop when unrepaired DNA damage to skin cells (most often caused by ultraviolet radiation from sunshine or tanning beds) triggers mutations (genetic defects) that lead the skin cells to multiply rapidly and form malignant tumors.

Melanoma is a type of skin cancer. Anyone can get melanoma. When found early and treated, the cure rate is nearly 100%. 
Family/medical history:  

  • Melanoma runs in the family (parent, child, sibling, cousin, aunt, uncle had melanoma).
  • You had another skin cancer, but most especially another melanoma.
  • A weakened immune system.
Now, my "saturn" shaped spot just appeared, as far as I know. I last had a pedicure in June and nothing was said then. I've painted my nails since then and don't remember seeing any spot there. I probably hadn't done a nail job since October.

My symptom:  an itch of the toe which felt like a hangnail rubbing the other toe.  I scratched and scratched then yanked the foot up to inspect--saw the spot and was quite happy that I already had an appt with the doctor three days later for my sinus infection.  

From my dermatologist's office: "While melanoma is the least common type of skin cancer, it is by far the most dangerous."   

The Mike and I were already trying to figure out which dermatologist to head to for full body checks based on our age and what we've always heard for that.  We picked the doctor and will have our full body exams the morning of my toe excision.  

Source

More to come in March on the Super Toe saga.

Thursday, January 29, 2015

Chicken stir fry

In terms of workout today, I had a hard day at yoga bootcamp this morning!   Our regular instructor was out with a broken arm ---the hazards of ice biking!--and we had a sub, whom we've had before. However, today every third move was a Chaturanga.  Mix that in with the biopsy toe that is still hurting and moving from downdog to chaturanga to mountain pose to chaturanga. . . . okay, there were some other moves in there as well!   While I knock it, it was a fabulous workout today. I just had to stop at one point and put my Fox River sock back on so my bandaid would rub off where it was on the sole of my foot. 

Earlier this week I planned out some meals. By that I mean, I took a post it note and said, "Tonight is Pizza, Wednesday is stir fry, Thursday is Mexican Lasagna, and  Friday is soup".  Of that, the stir fry happened Thursday instead of Wednesday and the soup isn't happening tomorrow.  

While I wanted to make a stir fry, I didn't really have a recipe. I had a few things purchased in mind for it, and tonight I used google to find a couple recipes I used for inspiration. This one and that one

Obviously I couldn't use both completely, since I can't do fermented black beans (found out they're actually soybeans), nor did I have the specific noodles or napa cabbage for the other. 

Ah well, that's where inspiration comes into play!  We had left over rice from Monday night, which makes having stir fry perfect this week! 
Food prep
I love my food processor, but don't often use all the attachment blades, finding it easier to just cut up an onion by hand if that's the only thing that needs cut.  Tonight, I played with my Kitchenaid toy. I used the Julienne blade for the carrots, doing up a lot figuring they'd be used in a soup or salads later on. Then I sliced the shrooms in it, and watched as the last one just jumped and whirled over the blade---it was too much fun to watch, so I didn't use the push down tool.. After the 'shrooms came the onion--- 1 1/2 medium sized ones, though I didn't put all of it in the cooked mixture. Then a bell pepper as well.  A can of diced chestnuts (I don't like the sliced ones--too much at once), sliced bamboo, coconut aminos instead of soy sauce, and the Just Bare chicken breasts.  

I was soooo proud of myself, then I looked again at the inspiration recipes and saw that I'm suppose to marinate the meat in the soy oil. UGH.    Okay then---quick--thin slice the chicken!   Add to a mixing bowl with about 1/4 cup of soy sauce and, hey let's add about a tablespoon of garlic to that and 1 tsp of corn starch. Stir and let sit. Phew. That's accomplished!  

I cooked the mushrooms in a separate pan, not knowing if The Mike would want some added in his stirfry. I love the fungi, he sometimes feel like a fungi and sometime he doesn't, although I think he's a fun-guy all the time. 

I started with heating up the pan with a splash of olive oil and cooked the onions for a few minutes, then added in a half tablespoon of minced garlic--the more the merrier!   After the onion was cooked a bit longer I added in the red bell peppers and carrots, as well as 1/2 tsp of dried ginger and a small pinch--sort of--of red pepper flakes. I have a shaker on those and I just shook some into the pan.  As that was cooking and I was stirring, I decided that it didn't smell spicy enough, so I added another 1/2 tsp of dried ginger and another few shakes of the red pepper flake canister.  When it was all melded together, I put into a microwave heated bowl, so it wouldn't cool down.  While I was prepping to cook the other items, The Mike had some and said, 'WHOA That's SPICY'.  So then I had to try some. Eyes water, throat on fire. Yes, spicy, but I was hopeful that adding in the other items (rice, chicken, sauce, bamboo, chestnuts) would calm down and share the spices. 
Rice and veggie mixture
Once the pan was again empty, I turned up the heat and added another splash of olive oil and added in all the chicken and broth.  Afterwards, I noticed that I probably should have cooked it in two batches, but what was done was done. The pan wasn't too crowded, it was just not wasn't all that loose either.  Chicken was cooked and I added about 1/2 cup of chicken broth in order to create a bit of gravy---is it called gravy in stir fry? 

Then it was time to finish plating and serve. Well, we used a bowl. 
Finished meal, tossed with forks to blend
Once the items were all placed together, the spices weren't too much at all.  The Mike went back for seconds and said, "This is like HuHot!".  LOL.   His second bowl was rice, raw onion, cooked veggies, and chicken mixture. 

Recipe: 
1 package of Just Bare chicken
1 tsp corn starch 
1/4 cup Coconut Aminos (and more for serving if you'd like)
1 T of minced garlic---if using fresh, use half--for marinade
1 sliced onion
1/2 T minced garlic for the veggies 
1 tsp of ground ginger
1 to 2 julienne cut carrots
1 bell pepper (color of your choice) 
Pinch of red pepper flakes
1/2 cup chicken broth 
As many mushrooms as you love
1 can diced water chestnuts
1 can sliced bamboo 
2 scallions/green onions diced for topping

Slice everything to start, so you are all ready to go with the quick cooking when it's time. 
Marinate thinly sliced chicken in coconut aminos (or soy sauce), garlic and corn starch. Stir well. Let marinate for 15 minutes. 

In hot skillet with a quick splash (half tablespoon) of olive oil, add onions, stir for a few minutes, add garlic, ginger and red pepper flakes, and stir for just a couple minutes. Then add the carrots and bell pepper and allow to cook until they just soften. Then move the veggies to a bowl for holding.  

Heat up the skillet again, and add a bit more olive oil. When hot, add in the chicken mixture.   You'll want to do this in two batches.  Cook half the chicken, put it in with the veggies. Then cook the other half of the chicken. Once cooked, add half a cup of chicken broth. Skootch--that's a technical word--the chicken to the side and add in the chestnuts and bamboo in order to heat them in the broth/juices. 

Add all to the mixing/serving bowl and serve on top of rice or rice noodles and top with the diced scallions.  

Wednesday, January 28, 2015

Official test? Do you or don't you?

Do you or don't you?     I'm talking about THIS article regarding whether or not one needs to be tested for celiac disease.

It takes--on average--a decade to get checked for celiac in the United States. Source cited

After my sibling was diagnosed, I asked my GI to test me in 2006.  I've known since 1993 that I could/would get another autoimmune disease. When I was discharged from the hospital, my sibling who was with me took me to the college library a few days later and brought me any books that referenced my type of colitis.  GASP, I thought, I have a 33% change of having another autoimmune disease ---and there are literally hundreds of them.  Have I looked up that stat since 1993?  No. But it's always stuck in my mind.   Since I have another autoimmune disease, plus strong family history of celiac disease (sibling, paternal family), I wanted to find out if I had celiac. Instead, when I asked to be checked,  I was told "you have colitis, you don't have celiac".  They didn't like my response of "I could have both".

My PCP ended up doing the blood test, which was negative.   I wasn't surprised.  First off, a negative blood test for celiac doesn't mean you don't have it. It just means that the blood --for whatever reason--isn't showing you have celiac.  If you have a positive blood sample for celiac, then you have celiac, but a negative sample doesn't matter much, though most doctors look at it and say, "You don't have it".   Since I'm on an immunosuppressant, my blood doesn't work well with tests like this. I didn't show a reaction to anything on a food allergy panel, not even to the control to which "everyone" reacts.

The Mike suggested I go gluten free. OMG I felt sooo much better, and I haven't  look back.   Some people say I'm not celiac then, because I didn't have the biopsy. Well, it's not known if I'm celiac, but I believe I am.  I am at least gluten intolerant, but with the strong family history, I'd say I'm celiac.  I do not knowingly 'cheat' on the gluten free lifestyle plan. I eat gluten free 100% :-)   In order to be tested for celiac now, I either have to have the DNA test, which only shows if I carry the gene, not if it's been activated, or I have to eat gluten for at least three months (according to the University of Iowa Hospitals and Clinics).

Most people who have celiac, have been gluten free, can't go a few days eating gluten, let alone three months, and still function in society.  This is because once you eliminate your intolerant food, then you've also eliminated any--for lack of a better word--tolerance to the intolerant.  Your body completely sees this food as the enemy and attacks because of it.

Gluten free and proud of it.