Battling For Health

The liver is the largest internal human organ. If the liver completely shut down, we would die within 24 hours. This is because the liver has so many vital functions in human life.

Functions of the liver:

• Convert, store and release glucose as needed
• Breakdown fat and produce cholesterol
• Remove ammonia from your body
• Produce blood proteins, including clotting factors
• Detoxify drugs and alcohol
• Produce bile (the role of bile is to break down fat)
• Cleanse the body of cell debris and damaged red blood cells

The National Cancer Institute defines liver cancer as: “Primary liver cancer is cancer that forms in the tissues of the liver. Secondary liver cancer is cancer that spreads to the liver from another part of the body. ” The NCI estimates there will be 21,370 cases and 18,410 deaths from liver cancer and intrahepatic bile duct cancer in the U.S. this year.

Types of Primary Tumors of the Liver:

Hepatocellular : The most common type of liver cancer in adults. Three out of four diagnoses of liver cancer will be hepatocellular. This cancer may present as spots on the liver, a single tumor or various patterns.

Cholangiocarcinoma: This type of liver cancer starts in the bile duct and often has the same treatment plan as hepatocellular liver cancer.

Fibrolamellar carcinoma:A subtype of hepatocellular cancer, this is a rare form with a better prognosis than other types of liver cancer.

Hepatoblastoma:A very rare liver cancer found in children younger than 4, with a good prognosis if diagnosed early.

Angiosarcoma and Hemangiosarcoma: These rare forms of liver cancer begin in the blood vessels, grow quickly and have a very poor prognosis.

Symptoms of liver cancer may include:

• Lack of appetite and weight loss
• Abdominal discomfort
• Nausea and vomiting
• General weakness and fatigue
• An enlarged and tender liver
• Swollen abdomen
• Jaundice of the skin and eyes

Some of the Risk Factors Associated with Liver Cancer:

• Liver infections such as hepatitis
• Diabetes
• Cirrhosis of the liver
• Sex-Males are twice as likely to develop the disease
• Age-In the U.S and Europe the average age is 60
• Smoking tobacco
• Obesity
• Bile duct disease
• Consumption of foods contaminated with aflatoxins (a mold). This is a problem in Asia and Africa.

Diagnosis and Treatment:

• Diagnosis may include a physical exam, blood tests for liver function, CT, ultrasound, angiogram, MRI and biopsy.
• Note that people at risk may be checked routinely for early tumor development using an AFP (alpha-fetoprotein) blood test which detects a protein present in many liver cancers.
• Staging-see the Mayo Clinic site for information on staging types.
• Treatment depends on staging and the individual diagnosis and may include surgery, chemotherapy and or radiation. Ablation is a treatment used to treat tumors that cannot be removed by surgery locally. Embolization is a treatment used to cut off blood supply to the tumor. See the American Cancer Society site for detailed information on treatment options including complementary and alternative treatment.

Resources and News:

American Liver Foundation

M.D. Anderson, Adult Liver Cancer Support, includes networks, support groups and message boards.

DG Dispatch, March 12, 2008. Guidelines Support Ablation Techniques for Unresectable Liver Cancer: Presented at NCCN “Tumour ablation techniques should play a major role in treating tumours of the liver that are not suitable for resection, according to updated treatment guidelines for hepatocellular carcinoma …”

Battling Books:

100 Q&A About Liver Cancer by Ghassan K. Abou-Alfa (2005)

The Liver Book: A Comprehensive Guide to Diagnosis, Treatment and Recovery by Sanjiv Chopra ( 2001)

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When we were kids, we used to put our hands over our ears and hum loudly or say, “I can’t hear you.”  It was our way of telling the other child who was speaking that we were not interested in, and would not listen to whatever they had to say. 

Then there’s my youngest son.  He covers his face with his favorite blanket.  That’s his way of “hiding.”  He figures, if he can’t see me, then I can’t see him.

What’s the point?  I’m glad you asked.

The point is that, we adults do the very same thing. We act as if not talking about end of life issues will keep us from having to deal with them.  We put our proverbial hands over our ears or blankets over our heads as if to declare, “I can’t hear it and I can’t see it, so it must not be. ”

This is a sensitive subject for me, as neither of my parents made their wishes clear.  Neither had living wills or Advanced Directives.  So, I was forced to make some very difficult decisions in both cases.

When it hits you that you have very little time with someone you love very much, the last thing you need to layer onto that very difficult time is more questions.  Especially questions that can, at least to some degree, be handled in advance.

Making a decision now will help to keep peace.  Grief impacts everyone differently.  Some people would rather have their loved ones alive no matter what.  Others can’t bear to see them suffer. Take that burden off of them. Make your wishes known, in writing.

What is an Advanced Directive?

An advanced directive is simply giving directions (in advance) regarding end of life issues.  Thinking about the end of life BEFORE it comes.  Advanced directives can be verbal.  Certainly not the best, but it does make the decision making process a little easier if someone can remember what a person said.  A Living Will is the best.  Click here for a sample of a living will.  It’s a written, legal document that explains your wishes regarding tube feeding, dialysis, invasive procedures, living for an extended period of time on a respirator, etc.  I’ll discuss Do Not Resuscitate (DNR) orders in a seperate post.

So, whether or not you have Alzheimer’s disease, whether you are sick or healthy, do yourself and the loved ones in your life a favor.  Take your hands off your ears and the blanket from over your head.  Please, do a living will and encourage your loved ones to do it too.

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If you are among the people who read my blogs on a regular basis, then you already know how dangerous healthcare can be. Sad, because healthcare is intended to IMPROVE lives, certainly not hurt them.

In fact, healthcare can be dangerous, sometimes randomly through mistakes and missteps. It can be dangerous for what is ignored or through mere laziness. Other times it’s dangerous because of access questions — if you don’t have the right insurance, or if you are lacking insurance, you don’t have the same options as others.

I do not believe any provider or payer ever sets out to make it intentionally dangerous, but then, the road to heaven, etc etc….

Knowing how dangerous healthcare can be, a whole new “industry” has begun to build — an industry of professionals who provide tools and advice to patients to help them stay as safe as they can. That’s my world now — an advisor to those who may be unsuspecting, not even questioning whether their healthcare will help them, not understanding that in fact, it might be quite dangerous.

Among the aspects to my work is the fact that I read and research constantly. The bulk of my day is spent learning what’s going on in the world of healthcare. What’s out there that is dangerous? What new dangers have evolved? What is being done to keep patients safe? What can I recommend to patients to help them keep themselves safe?

One phenomenon I’ve witnessed in the past four years is a transition within providers themselves: from either ignoring or denying safety problems exist, to not only understanding them, but now jumping on the bandwagon to provide tools to patients to help them stay safe.

I have mixed feelings — very mixed. While I very much appreciate the fact that providers aren’t in so much denial as they used to be, and are willing to observe problems and suggest ways to alleviate them, I also feel it’s a little like asking the fox to explain to the chickens how they can keep themselves from being eaten…

And yet…. I appreciate the fact that they ARE trying to keep us patients from being ‘eaten.” I do understand that it’s not realistic to ask them to change their “diet” to begin with.

OK — so with that admission — this article arrived in my Inbox this week. From RNCentral — a website created for nurses and thos who would choose nursing as a career. The article is called 25 Tips to Protect Yourself from Medical Errors.

It’s good. There’s plenty of good advice in it. I’m very happy the link was sent to me so I can share it with you.

But I ask you — does my fox and chickens metaphor strike anyone else as appropriate too? For example, why are the professionals who are supposed to be the ones to KNOW to wash their hands to prevent infection, telling us it’s our responsibility to make sure they do?

Read it. You’ll learn from it. And yes, much of the advice is geared to patients to handle themselves when no provider is around to help, or for interface with professionals. These are patient responsibilities and have nothing to do with foxes, henhouses, or chickens….

::sigh:: I hate it when cynicism plays a role in well-intentioned advice. Welcome to my world….

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What do you rub on your joints for arthritic pain relief? I have always relied on Efficascent Oil (Methyl Salicylate Camphor + Menthol) — which could be available under different brand names in other countries.

When my knees become stiff, this home remedy efficascent oil is really a lot of help.

Have you heard of Manuka Honey? Don’t worry, I haven’t either.

Manuka Honey - a special type of honey -has powerful anti-inflammatory properties, making it a viable treatment solution for people with arthritis.

In treating arthritis and other forms of inflammation, eliminating the underlying cause and inflammation is necessary. Doctors and other medical professionals are now discovering that a particular type of honey called “Manuka Honey” has natural anti-inflammatory properties that are extremely effective in treating these conditions. In addition, Manuka Honey has the ability to diffuse into the depths of skin tissue so as to get to affected areas.

“Manuka Honey is an organic, all-natural substance that is more effective in relieving pain than most analgesic products that are available over-the-counter,” says Frank Buonanotte, CEO of Honeymark International which is a manufacturer of Manuka Honey products. “Due to its powerful anti-inflammatory properties, Manuka Honey is now being considered a viable treatment option for arthritis and other muscle and joint pain.”

Manuka Honey products are manufactured by Honeymark International.

You can purchase Honeymark’s Pain Relief Cream with Manuka Honey by calling 1-866-427-7329 or visiting www.HoneymarkProducts.com.

[Story and Photo Source]

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The arthritis drug Orencia has been approved as the treatment when all other treatments fail.

In the UK, after being ruled not cost effective The National Institute for Health and Clinical Excellence (NICE), is bad news to all the people there (who has been under treatment with Orencia) with aggressive rheumatoid arthritis.

Such a ruling went down despite appeals by The National Rheumatoid Arthritis Society (NRAS) and Bristol-Myers Squibb — maker of Orencia (abatacept).

Around 400,000 people in Britain have rheumatoid arthritis. About 10 per cent have a severe form.

They can be offered a class of drugs called anti-TNFs but around 30 per cent of patients derive no benefit.

The drug’s manufacturer, Bristol-Myers Squibb, submitted evidence to Nice showing that around 3,585 patients in Britain would be eligible for treatment with abatacept.

Ailsa Bosworth, the chief executive of NRAS, said: “We are bitterly disappointed that Nice has ignored our appeals to approve the use of abatacept for people with severe rheumatoid arthritis, a therapy that could really make a difference to their lives.

“They have condemned people with severe rheumatoid arthritis, who have already failed on other therapies, to a lifetime of misery.”
Patients traditionally receive 13 doses of the drug per year.

What now for these patients who was ‘living” on Orencia? According to reports, these patients will be condemned to a life of misery!

Is that really the case…there must be other alternative…like other drugs with the same effect as Orencia? Or patients can even get the said drug from other countries, if such a thing is possible in the UK. I’m saying…there’s gotta be a loop hole in order to get around this dilemma.

Figures from Bristol-Myers Squibb show that an average dose would cost the NHS £718 or £9,334 a year. The company has said this is similar to the cost of anti-TNF drugs.

Andrew Dillon, the chief executive of Nice, said an independent appraisal committee had found that abatacept “does not represent a good use of NHS resources”.

He added that the committee recommended that patients receiving the drug should have the option to continue therapy until they and their clinicians consider it appropriate to stop.

Orencia has been approved for moderate to severe rheumatoid arthritis.

ORENCIA works in a fundamentally different way than any other rheumatoid arthritis treatment. ORENCIA works early in the RA inflammatory process at the T-cell level and can reduce the activation of T cells, which reduces the activation of other cells in the RA inflammatory process.

Find out more about Orencia.

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From the time I was about 9 or 10 years old, my mother encouraged me to keep a journal (well, she called it a diary).  Although I always enjoyed writing, I never understood why she bugged me so much to write my thoughts.  I figured maybe she wanted to read it when I wasn’t around.  Or maybe, she recognized my desire and ability to write before I did.  She surely never realized that the practice would help me to cope with caring for her as we, together, battled Alzheimer’s disease.

As a caregiver, you have a lot going on in your heart and head and journaling is a great way to relieve stress.

Journaling also provides you with a reminder of what’s going on from day to day.  You don’t necessarily want it to become a calendar, but my to do list often starts as a brain dump in my journal and then makes it to my calendar or at least a sheet of paper as a list for the day.

Your journal won’t judge you.  Your feelings are so complicated.  Your journal isn’t going to look at you funny when you secretely wonder how much longer you can keep up caregiving.  Your journal isn’t going to tell you you are a bad son or daughter when you start to consider a long term care facility and your journal isn’t going to say your lazy when you  express that you are tired of cleaning up the bathroom or changing adult diapers or being accused of stealing money.

Finally, caregivers are often isolated and have few opportunities to share thier thoughts and feelings.  Journaling is a great way to express your feelings.  It may even help you to problem solve.  As you write, some solutions may become apparent.

I have listed just a few benefits of keeping a journal. Click on this link to see 100 reasons you should keep a journal.

Towards the end of each year, I spend time in the bookstore selecting a journal for the upcoming year.  Now, it’s really not that big of a deal.  I just happen to enjoy writing my thoughts and ideas in a nicely covered and bound book, with lined pages.  Usually, it runs me in the neighborood of $15-$20. However, any paper will do.  The key is to select something that works for YOU. 

Lines or no lines?  Some people like lines, some don’t. I used to loathe lines, they stiffeled my creativity when I was in that mode.  However, when I got to seriously putting down of my thoughts, I found that I desperately needed lines.

You may also consider using the computer. I do that, even now, when I have a lot going on in my head becasue I can type much faster than I can write.

Does Size Matter?  To me it does.  I like a journal that is smaller than 8 x 11, but larger than 5 x 7.  Not sure why, it just works for me.  But I know people who use legal pads and I know peopole who use very small notebooks, it’s a matter of personal preference.

Binding.  This is important.  Spiral type binding works well becasue pages are easily accessible, but the pages tear from the spiral part after some use.  For me, it’s just important that the book lays flat when opened. Other than that, it doesn’t really matter.

In the final analysis, it matters not if you pay for a nice “official” journal or use recycled paper from the office. What matters, is that you write, write, write.

Start now!  What do you think? Do you keep a journal?  Do you think it would be beneficial to you?  Leave a comment, let us know.

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Author Appearance!

Author Liz Holzemer will be speaking at three branches of the Colorado, Douglas County Libraries, May, 5-8-10, as part of the Author Series.

The topic is Healing with Humor.

Holzemer’s book Curveball:When Life Throws You a Brain Tumor (2007) is a Denver non-fiction bestseller about her battle with not only a brain tumor (meningioma), but also a breast tumor. She is the founder of Meningioma Mommas, an online support group that raises funds for meningioma research and advocates meningioma awareness.

A Tasty Event Coming Up in Boston!

Boston Bakes For Breast Cancer

“Boston Bakes for Breast Cancer is a sweet and delicious way to raise “dough” to battle breast cancer. More than 100 restaurants and bakeries in the Boston area will bake unique desserts the week leading up to Mother’s Day, May 5 - 11. One hundred percent of sales from a specially selected dessert will benefit breast cancer research and care at Dana-Farber Cancer Institute.”

Spread the News!

Lance Armstrong Foundation’s LIVESTRONG Day 2008, is Tuesday, May 13.

Sign the LIVESTRONG ARMY petition.

Headline Cancer News!

ScienceDaily, April 25, 2008. Coffee May Protect Against Breast Cancer, Study Shows. “Depending on which variant of a certain gene a woman has, a coffee consumption rate of at least two-three cups a day can either reduce the total risk of developing breast cancer or delay the onset of cancer.”

ScienceDaily, April 24, 2008. New Cell Targets For Preventing Growth of Breast and Other Tumors Identified. “Researchers at the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill have discovered new targets for cancer treatment aimed at blocking a key step in tumor progression.”

The Vancouver Sun, April 22, 2008. Doctors Turning Away Cancer Patients ‘Inappropriate’:Abbott. “Health minister George Abbott said he’s disappointed and concerned about an emerging trend in which family doctors are turning away new patients because they have cancer or have survived it.”

The Detroit Free Press, April 22, 2008. The Color of Cancer. Minority women find special support through Gilda’s Club.

The Boston Globe, April 21, 2008. Does Breast Feeding Protect a Woman Against Breast Cancer? Data from 98 studies on lactation and breast cancer risk says, yes.

The Chicago Sun-Times, April 21, 2008. Doctors Differ on Prostate Cancer Testing, Treatment. The “PSA test remains one of the most controversial screening tests in medicine, even though it has been around for more than 20 years. ”

The Boston Globe, April 20, 2008. Renewing the War on Cancer by Lance Armstrong. Armstrong running in the 112th Boston Marathon along with 50 LIVESTRONG members.

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What exactly is an antioxidant and what does it have to do with cancer?

Per the American Dietetic Association: “Antioxidants are dietary substances including some nutrients such as beta carotene, vitamins C and E and selenium, that can prevent damage to your body cells or repair damage that has been done.”

Basically an antioxidant is capable of counteracting the normal damaging effects of oxidation by neutralizing free radicals in the body. The balance of antioxidants to oxidants is disturbed by poor diet, smoking, disease, normal aging, x-rays and many other things. When an antioxidant neutralizes a free radical, the antioxidant becomes oxidized and the body needs to be resupplied with antioxidants.

From the U.S. Department of Agriculture: “Antioxidants such as vitamins A, C and E, help protect healthy cells from damage by free radicals. Normal body functions such as breathing or physical activity, and other lifestyle habits, such as smoking, produce substances called free radicals that weaken healthy cells. Weakened cells are more susceptible to cardiovascular disease and certain types of cancer.”

It’s important to remember that the consumption of exceptionally large amounts of antioxidants can be harmful to the body. Current studies in antioxidants are constantly reevaluating levels of antioxidants needed for optimal health and for healing. Antioxidants are found in foods we eat; however if you are interested in oral supplements consult your physician. As a report of the American Cancer Society points out, the effect of supplements on cancer tumors and interactions with medication leaves many still unanswered questions. Talk to your physician. The National Cancer Institute provides information on antioxidants under investigation in clinical trials.

Traditional antioxidants:

Vitamin C: Red pepper, yellow pepper, strawberries, oranges lemons, cantaloupes, cauliflower. Information on the connection to vitamin C and cancer is provided at the Linus Pauling Institute.

Vitamin E: Prevents the oxidation of fat and Vitamin A. It is thought to prevent prostrate and breast cancer. Sources of vitamin E include nuts, avocados, mangoes and sweet potatoes. See the National Cancer Institute site for information on the SELECT trial, (Selenium and Vitamin E trial) which studied the effect of these supplements on prostate cancer.

Beta carotene:Found naturally in foods such as cantaloupe, mangoes, papaya, pumpkin, peppers, spinach, kale, squash, sweet potatoes, and apricots. Note that the results of a clinical trial showed that beta carotene supplements should be avoided by smokers. See the National Cancer Institute for more information.

Selenium: Naturally found in seafood, beef, pork, chicken, Brazil nuts, brown rice, and whole wheat bread. Selenium studies show its importance in fighting prostate cancer, per a study by the University of Arizona Cancer Center.

Antioxidants Being Studied:

Flavonoids: Found in brewed tea. Flavonoids are also found in dark chocolate. An interesting clinical trial on dark chocolate is found on WebMD. Studies are now showing the impact on flavonoids in various types of cancer, such as prostrate and ovarian cancer as noted at ScienceDaily.

Lycopene: Found in tomatoes, watermelon and pink grapefruit. For more information on lycopene and cancer see the Mayo Clinic site or Lycopene and Health.

Phytochemicals: Found in blueberries, strawberries and cranberries, phytochemicals are now linked to a positive impact on certain cancers such as colon cancer and liver cancer. The Daily Mail, shares a recent study at Rutgers University on blueberries. NutraUSA shares a similar study with promise for liver cancer.

Recommended daily amounts of vitamins, and minerals are available from the U.S. Department of Agriculture library. They include a series of reports “on the dietary reference values for the intake of nutrients by Americans and Canadians.”

Battling Books:

The Super Antioxidant Diet and Nutrition Guide: a Health Plan for the Body, Mind and Spirit by Robin Jeep, Richard B. Couey, and Sherie Ellington Pitman (February 2008)

Antioxidants Against Cancer by Ralph W. Moss (2000)

Additional information is available in our archives:

The Relationship Between Cancer and Antioxidants

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Good health and nutrition gets trickier as people age. Throw in a measure of Alzheimer’s disease and you may have a larger challenge to face.

The recipes in this section, A Recipe for Life, are designed to nourish both those living with Alzheimer’s disease as well as their caregivers.  As food prices continue to rise on a weekly, if not daily, basis and as the need for more care demands more of your available time; my goal today, is to provide you with recipes that are healthy, quick and inexpensive.

Today’s Recipe for Life

Spinach, Basil and Tomato Pasta–Why it’s good for you

This simple, delicious and inexpensive meal is very nutritious.   The whole grain pasta has almost double the fiber and protein and nearly triple the folate of its white counterpart.  According to American Family Physician, “Garlic has long been used medicinally, most recently for its cardiovascular, anti-neoplastic, and antimicrobial properties.” Tomatoes are known be high in antioxidants and vitamins C and A.  Just ask Popeye about Spinach, it has lots of iron, folate and antioxidants. Olive Oil may well be the “miracle food” of this list.   Long touted for its nutritional properties, it’s a monounsaturated fat (good fat), its great for the heart and the colon.

Spinach, Basil and Tomato Pasta Recipe

Ingredients:

1 pound whole wheat pasta (fettuccini, linguini and penne work nicely) 

2-3 cloves garlic (chopped fine)

1 medium red onion, cut in half and sliced

1 large fresh tomato, sliced

2 pounds fresh spinach, washed and roughly chapped

4-5 sprigs fresh basil, washed and roughly chopped

1-2 sprigs fresh basil, washed and finely chopped

Approx. 3-4 Tbs. Extra virgin olive oil

Sea Salt to taste

Instructions:

1. Cook pasta according to directions on package.
2. Lightly sauté garlic and onion in olive oil about 3-5 minutes, add spinach and 4-5 roughly chopped basil sprigs, till just warmed and wilted, toss in cooked pasta. 
3. Serve topped with tomato slices and 1-2 sprigs fresh chopped basil

Now, here’s a Recipe for the rest of your life

A Recipe for Life

Start with a life

One that has a hungry heart

Add some hope

It’s a great place to start

Stir in faith

As tiny as a mustard seed

All you must do now, is just believe.

Stir in some love

It flavors all you do

A little patience

Is a good thing to add too 

But back to love

It makes the world go ‘round

Add a hearty appetite

And now you’ve found….

A Recipe for Life!

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Yummy Goodness, Without The Extra Sugar

I love granola. Toasted, crunchy, and sweet it is versatile and perfect for anytime snacking. Most home-made recipes are full of sugar, though. While I know that regular sugar is fine for most healthy diabetics in small quantities, the amount called for in most recipes would make the most lenient doctor or nutritionist go into fits.

Can’t say that I blame them. Brown sugar, white sugar, honey, and a big dose of molasses makes home-made granola a big no-no. In the following recipe, I have replaced most of those with (mostly)natural alternatives. Feel free to experiment until you find the perfect fit for you and your taste.

Diabetic Friendly Granola

*10 cups rolled oats
*1 cup wheat germ
*1 cup sunflower seeds, hulled.
*1 cup flax seeds
*1 cup each chopped almonds, peanuts, walnuts
*1 ½ cup Brown Sugar Splenda
*1 cup water
*1 cup vegetable oil
*½ cup agave nectar
*½ cup Blackstrap molasses
*1 teaspoon salt (sea salt is great)
*2 ½ teaspoons cinnamon
*3 teaspoons vanilla

Pre-heat your oven to 325 F. Mix oats, wheat germ, flax and sunflower seeds in a large bowl until evenly distributed. In a medium to large saucepan, mix the rest of the ingredients and warm over low heat until the Splenda is melted without boiling. Pour over the dry ingredients and mix until all of the dry ingredients are well coated.

Spread the mix into 13×9 baking pans. You will need 4 to 5, or make the granola in batches. Bake for approximately 30 minutes. Check the granola during baking and stir with a wooden spoon every 5 minutes or so. For a chewier granola, remove at around 20 minutes. For extra crunchy, give the mix 5 to 10 minutes longer in the oven, watching closely for a golden brown color on the oats.

Allow to cool, place in large zipper top bags and store in a cool, dry place for up to 3 months. You can also freeze the granola for longer keeping. Amount made: Approximately 20 cups.

Eat with milk for breakfast or snack on this anytime you’d like something sweet, but healthy.

* It is possible to not use Splenda. If you are familiar with Stevia, use it instead. Since Stevia is so much sweeter than sugar, you will need to adjust. You will also need to reduce the wet ingredients slightly.

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