Cytochromes are us

Maya and Sunny

Cytochromes are complex heme based units responsible for carrying out some chemical reactions in the body. The liver has many of these systems used in part to detoxify certain substrates. These cytochromes metabolize many of the drugs we take.
Tamoxifen can reduce recurrences in estrogen positive breast cancer (arotamase inhibitors do a better job but have more painful side effects) by 30 %. However, Tamoxifen  is not the active drug. The cytochrome CYP2D6 in the liver converts it to active species. But there are some problems here. 7-10% of people have faulty CYP2D6 systems and you can't tell them by looking at them. Also some SSRIs (antidepressants) interfere with the metabolism too so the estrogen ends up not being blocked and is free to stimulate those rogue cancer cells.
Earlier studies have shown that the recurrence rates are higher with these cytochrome deficient people but a huge study just released at the San Antonio conference contradicts that. These people's overall survival seems identical. Doesn't make sense to me. Perhaps Tamoxifen itself has some activity..but the question I forget to ask the oncologist who presented this the other week is if suppressing estrogen is so important, then why don't they measure the levels to make sure this is happening? Yeah, the whole business doesn't affect me personally as my tumor was estrogen negative but it does affect the grand majority of cancer patients.
Other cytochromes are important too. About 10 years ago, grapefruit was found to interfere with the cytochrome P450. Certain drugs did not get metabolized as expected leading to much higher blood levels of these drugs. It is important that statins get metabolized in the liver by this enzyme system. If metabolism occurs in the muscle instead, bad things happen.

The local news keeps flashing warnings of some huge snowstorm tomorrow. It was clear and sunny today but so, so cold. I wimped out and ran inside.

Last night we had a family dinner at Josh and Julia's house. Baby Maya was her most charming. It was a pleasant evening.

Harris Hill

Memories..they are fading fast. I used to be able to list all the teachers I ever had, at least in elementary school and now I am drawing a blank particularly around 5th grade. Not that that matters. But one memory still is firmly in my mind: the day I saw a plane crash on Harris Hill. Harris Hill is one of the oldest gliderports in the US. It is near Elmira NY, which is not far from Corning where I grew up. My father would take me there. He liked to photograph the gliders. But the plane that crashed was a tow plane as I heard its sputtering engine as it made a downward arc  sideways in the sky landing in some trees maybe a half mile away from me. The pilot must have reported trouble as firetrucks were already headed towards the trees. What year? I think 1958, but it could have been a year later or earlier. I was on the porch of the information center. I remember the panelling and the coke machine. I was drinking some Coke..a rare event in itself. Everything about that moment was so clear. I was young but I knew what I was witnessing was very bad and scary. I don't remember if I heard the crash though. I remember asking the next day whether the pilot died and I was told that the trees cushioned the crash but my parents weren't very upfront with me about reporting deaths. My pet turtle had died around that time. When I asked my mother where it was, she said that the turtle had told her that it was tired of living in a bowl and wanted to live somewhere outside. I wasn't aware that turtles could talk and even if they did, you didn't have to do what they say. I tried to look this accident up on the internet, and found  nada. My father is dead so he can't confirm this either.

While working out today at the Y, I ran into a former triathlon  training partner who also is a BC survivor, ten years now. When I first got BC, I thought about contacting her but I had felt guilty that I hadn't done anything for her while she was doing chemo. Our friendship had sort of sputtered out by then but still it was not a good excuse. She still had to work, had two small children and I think her POS husband had left her by then. They didn't have Neulasta in those days so she was very sick most of the time as her white blood cells were killed off by the Red Devil. Bad, bad Sue. When I first was diagnosed, it crossed my mind that this was karma for neglecting her and another woman. Of course I didn't know exactly what was going on at the time but I should have reached out. We compared notes, which was interesting. Treatment has changed quite a bit in the past ten years.

It is sunny out now..very pretty. Josh and Julia are making a belated birthday dinner for Steve. I had reminded him a few days before that his father's birthday was coming up but he said I needed to remind him on the day of. Hmmm.

My cute grandsons

They look like Siamese twins here

These were all taken by Shanna. I haven' t had the pleasure of seeing the boys myself in 2 months..Maybe at the end of February?

Thirty-one weeks

I watched Ms. Maya this morning while Naomi took her test and then worked out. She was 31 weeks yesterday..how time flies. I still haven't taken a good picture of her smiling. She smiles to greet people but doesn't smile much pass that unless you throw her up into the air.

Spent an afternoon in Ypsi..first at the excellent Vietnamese place there and then coffee at Beezy's  with a friend. Then I went to buy more baby stuff..

A winter weather advisory is in effect so I went out to run before it. Can't wait for spring!

At least....

Any attempt to assuage grief starting with the words At least should be quickly squashed.

At least it's a good cancer
At least you had those 50 years cancer-free
At least you could get pregnant
At least you had your child for x years

Now you can tell yourself all sorts of at least statements if it makes you feel better (counting your blessings would be another phrase for it) but it will never..never make anyone else feel better. What got me started on this is that my hairdresser suffered a loss recently and was told several outrageous at least statements. These did not comfort her. They either made her angry or made her sadder depending on the statement even though the intent was probably not that at all.

My hair is now carmel colored instead of white blonde with black and white roots. She managed to cut it so that I still have some waves or at least body without depending on too many hair products. If these waves go away, it will be back to the page boy pictured to the right with Steve...me before cancer. Are any of my readers old enough to remember Spoolies or Dippety-Do? Straight hair was considered a major cosmetic defect while growing up (along with being too tall and having big feet). I couldn't do much about the latter other than slouch, avoid heels, stuff my feet into too small shoes) but I could wrap my hair into spoolies, snap them shut, and sleep on these hard little nubs all over my head. The Dippety-Do made the curls last a little longer though it also made them crunchy and greasy looking. I wasn't very good at this: I would have shanks of straight hair amongst the pseudo-waves. Also I was cursed with cowlicks around my temples..those seemed to go away with chemo but give them time, maybe they will be back. Naomi has wavy hair but she will use a straightener if she has time. Julia completely wipes out all over her beautiful curls with one. Josh just has Julia cut his curls off if they start to appear. Who knows what hair Ms. Maya will have? I see straight pieces of blonde hair that in strong light seem reddish. She also has some little dark brown curls. She will be considered African-American but aside from her latte with extra milk skin, it isn't obvious that she is.

She had her 6 month check-up yesterday even though she is closer to 7 months. All is good though she had a boatload of shots, much more than any of my kids ever had. She has not continued her accelerated growth rate. According to their records, she gained less than a pound and didn't get any taller. She is now smaller than any of my kids at the same age and Daniel.( Daniel has caught up to his 18 month older brother in weight). She looks slim until you see her dimpled thunder thighs. Before the doctor visit, the public health nurse visited and tested her. She did well in her tests except one..looking for a noisy toy which she has done in the past with Naomi. The nurse is not fond of the Circle of Neglect for any amount of time but the doctor thinks it is fine for 10 minute intervals, which is about Maya's level of patience.

We went out to eat for Steve's birthday and I made him a birthday pie. He does not like cakes but he does like cherry pies.

As it was relatively warm today (24 degrees...)I ran outside before the snow was to start though the dusting already out there made things slippery around my house. We are supposed to get a inch or two. Shanna is supposed to get around a foot making her drive to the doctor's not so fun and impossible to park.

Double birthday

He turns three today

His favorite trucks: fire trucks and trucks that dig

He rarely sits still for a picture

Only one year old here. Three years ago, his grandpa got the best birthday present anyone could receive...a healthy, happy grandson.

Three years and a day ago, very early in the morning I received a phone call from Shanna saying that though she had more than 2 weeks to go before her due date, she thought she might be in labor. I told her I would be on my way within an hour. The car was already loaded with baby equipment from her sister-in-law, the GPS loaded with her address and that of the hospital, I just needed some money, some gas,  and to throw my things in a bag. That winter was very snowy but that day was sunny and the roads were clear. It was around zero outside.

According to my GPS, her apartment was 755 miles away. Could I make it in time? I really wanted to see my first grandchild be born. I hadn't slept much the night before; I finally had gone to sleep when the phone rang. I kept awake fueled by coffee and the fact I would soon see a grandchild. What would have been nice to have was an EZ pass (which I now have) as the many stops for tolls took time and I had little use of my left arm due to a fracture. I could not extend my arm and needed to cross my right arm over my body to deal with the tolls. I was also thwarted by NY, which is a very long state, whose law prohibited autofueling. I planned to multitask while getting gas but instead I needed to hold the cold metal down (zero degrees!) with no gloves.
I called every once in a while to see how the labor was progressing. Fortunately, very slowly. At one point, Shanna fell asleep, which in general means no labor. I had grabbed some Italian tapes in anticipation of my trip to Italy. These tapes had you sing key phrases. Some people can memorize songs easier than memorizing dialogs. I was hoping that this would work for me; it at least kept me awake. It was dark by the time I was driving through the snowy Berkshires. I made the trip in a record 12 hours. Fortunately I had easy border crossings, which sometimes can chew up more than an hour.I had gone through Detroit at rush hour and the sun glare had caused some accidents which delayed me somewhat. I was lucky not to have to deal with snow though high winds caused the existing snow to cover the road near Niagara Falls.

Shanna was still debating whether she was in labor when I arrived. She hadn't packed yet. Her apartment faced downtown Boston and there was a fireworks display that night which was fun to watch. It was also a Mom's dinner that night, which I had called to tell them that I was otherwise occupied. The moms all called to see how the labor was going. Around midnight, Shanna finally decided that she was in labor. She was 4 cm when we finally figured out how to get to the hospital in Cambridge (lots of no left turn signs..I thought we could ignore them with the excuse that Shanna was in labor but..). Shanna was progressing well with no pain meds. She was finally ready to push around 5 in the morning. The midwife decided to check her at the last minute and looked alarmed...she couldn't feel the top of the head! An ultrasound confirmed Oliver was breech. So I ended up missing the birth but I could hear his first cry and saw him being transferred from Shanna to a table minutes after his birth. Ramy brought him out to me when he was 10 minutes old. He clearly was a healthy little guy. I called Steve to wish him Happy Birthday and to tell him about his birthday grandson.

Fighting fire with fire

There was an article today in the WSJ on using tumor cells themselves to control the growth of cancer tumors. Although cancer is generally defined as uncontrolled growth, there is some control. The tumors send signalling chemicals apparently to distal sites to inhibit growth. Once the mother tumor is gone and therefore no longer signalling, the distal sites are free to grow. So in the study described today, the tumor cells are grown into beads and the  beads injected into the person (or in trials, animal). The tumor cells can grow within the  beads but can not escape. However their signals can escape and inhibit growth. In animal studies, this has worked in advanced prostate cancers extending lifetimes up to threefold. A small study in humans is just starting in patients with advanced prostate, pancreatic, or colon cancers.

Tumors are not the only entity sending signals. The digestive system also sends signals to the brain signalling.. feed me...feed me...feed me..... How to block this signalling? How to make the the gut feel satiety and stop asking the brain to send it more food? There are foods that take longer to digest and make people feel full earlier and longer. Food scientists are working on this.

How to deal with a friend's grief? Things not to say: I know just how you feel. He's happier in heaven. Time heals all wounds. We all go through this. You should move on.Good things come from bad. What doesn't kill you makes you stronger. You ought..you should..you need to...........


What do do? Be there and say you are sorry. Make no demands on the person. I think all above is appropriate too when a friend is diagnosed with cancer. Don't make a person feel bad for feeling grief and belittle the cause.

So my gift from cancer, curls, has faded completely now. My hair is straight and very fast growing. Today I will deal with it or rather my hair dresser. Hopefully she'll come up with a good solution.

Mastectomy versus lumpectomy

One of the many woulda, shoulda, couldas of my life was opting for a lumpectomy instead of a mastectomy. I had based my decision on the fact that I though I had a small tumor (which ended up doubling in size and number by the time surgery rolled around) and my surgeon's insistence that my survival would be absolutely the same in either case. But not long after I had the two surgeries (bad margins and lots of possible DCIS), I was reading that in the case of hormone negative BC, survival is actually better with mastectomies. If you are BRAC1, they recommend mastectomy. Most BRAC1 have TNBC but not all TNBC is BRAC1. Even though my history does not suggest BRAC1, still there must be some defect that could lead to another tumor.

Anyway at the recent San Antonio Breast Cancer conference, they announced a huge study that showed for hormone negative patients over 50 (c'est moi!) the lumpectomy ladies were 17% less likely to die than the mastectomy ladies (see http://www.webmd.com/breast-cancer/news/20101217/breast-conserving-therapy-better-than-mastectomy). Good news for me but as this contradicts earlier studies and I am so cynical, I wonder if some sort of bias is in play between the two groups. First of all, the BRAC1 ladies wouldn't be in the lumpectomy group. In general, their survival is lower (though recent studies dispute that). If there is wide spread DCIS, time for a mastectomy! So in general, it seems that the patients who are most likely to recur have the mastectomies, so of course they probably have lower survival rates.

At high school orientation, they stress the importance of student athletics saying that the grade point averages of the athletes is higher than the non-athletes. But if you have a bad GPA, you can't be on a team so that sort of biases the results right there. Another favorite statistic of mine is that breast fed babies have higher IQs that formula fed babies. But it is mainly middle to upper class ladies doing the breast feeding.....

Snow, snow..go away. It finally isn't so cold out but with 2 inches of new snow, it is slippery out, so again to the gym. We went out to eat with Josh and Julia yesterday, which was nice. Today Ms. Maya and her mom came over for a bit. I will go over there shortly so Naomi can go to class.

Foxes just want to have fun

http://www.snotr.com/video/2273

Daria is dead

Daria took photos during her last year of life of things that gave her pleasure

Another of Daria's photos

It is amazing how quickly she went. She was still blogging this Tuesday. In her honor I am posting one of her posts about her attitude she made about a month after she found out her cancer returned for the second time:

Postitive Attitude

This morning I was at the Cross Cancer at the Patient Support Group. One of the ladies from the support group had said that I had a very positive attitude. We are also in another support group and she has visited this site.

I thought about what she said. I do have a positive attitude but don't get me wrong ... I have negative thoughts. When the news of my re-occurrence came, I was 'paralyzed' with negative thoughts. I didn't know how I was going to go on but as time went on and one foot in front of the other, I was able to bring myself out of that hole and find that positive attitude.

So why the positive attitude? As I was growing up, I realized I got to choose my attitude on how I see things. The struggle has been long and hard. Outwardly, I find life goes better if you have or appear to have a positive attitude. It is like if you create it, you will be it. I believed that if I came across with a good attitude, the world would mirror it. Yes this did work most times but not always. Inwardly, my positive attitude might be more motivated by trying to avoid issues and not really deal with them. It is like creating a new reality. Even though you may think the worst or feel the worst about something, just pretend it will be O.K. and hopefully it will be.

Do I hide behind my positive attitude ... absolutely yes. It makes me feel like I am strong and in control and most importantly it keeps a lot of the emotions at bay. The emotions I'm talking about are other peoples emotions. When people show their emotions, the weight of the emotions transfer to my shoulders. I have difficultly dealing with all the drama.

I have rambled here a bit but it is something I wanted to talk about. My positive attitude has helped me cope with the struggles andtribulations of life and now this disease.

I feel I have not been clear with my thoughts. I may have to revisitthis subject once again when my thoughts are more organized.

Basketball Redux

Naomi back in the day

Naomi's senior basketball season coincided perfectly with my 16 week stint in
 chemoland. I never missed a home game but I didn't go to some of the away
 games that were more than an hour away if the roads were bad. Naomi now 
weighs 25 lbs less than she did when she was practicing for 2.5 hours a day.
.and she just had a baby. She is now  taking a gym class to help tone her up.

Last night her old team played their cross town rivals as did the boys' team. 
Don'tae's cousin plays center for the rivals so she sat with him (and Maya) in
 'enemy' territory. The cousin is 6'7" and dunks regularly. However, the River
 Rat boys were the State's runner ups last year (and they have since beaten the
 state champion) so they were hard to beat. The gym was packed for the boy's 
game which was first. I sat with a former soccer dad whose son played on
 Josh's travel team. It was fun catching up.

Half of the fans disappeared for the girls' game. Shame on them. Only one
 current player played on Naomi's team though she knew at least half of the 
other players. I caught up with some of the parents who were surprised to see
 Maya (didn't you tell her about birth control?). . The rival team however had
 many of the same players that Naomi played against. The Lady Rats prevailed
 but they aren't the strong team that Naomi played on. No defense for
 instance: Naomi's specialty. The rivals' coach was battling a rare form of 
uterine cancer when I saw her last year that had spread. Usually it is the lining
 that tumors develop in but in her case, it was in the muscular wall. She seems
 to have her own hair now and by all reports is doing fine. Two years ago, the 
two teams met and were raising money for LiveStrong, I spoke to her and 
she was very encouraging. My friends came to see the game in which 
Naomi played very well. It was a bright spot during the bleak time of
 chemoland also coinciding with my least favorite season.

You can lead a horse to water but you can't make her drink. Lectures, 
doctors' visits....all in vain. But whining about it also is counterproductive. Do
 I wish Maya didn't exist? Of course not but maybe she could have popped up
 when Naomi was much, much older.

Daria

Daria is an incredibly sweet woman from Edmonton, Alberta currently fighting for her life. Her history from her blog:

Diagnosis and Treatment

2000

 Diagnosis
•    Invasive Ductal Adenocarcinoma Breast Cancer
•    Estrogen-receptor positive
•    Grade 2
•    Stage 2

Treatment
•    Mastectomy on right side.
•    Chemotherapy (FEC - Fluorouracil, also known as 5FU, Epirubicin and Cyclophosphamide) – 6 cycles.
•    Radiation – 25 rounds.
•    Tamoxifen (Nolvadex).

2004

Diagnosis
•    Reoccurrence of cancer on center of chest.

Treatment
•    Surgery.
•    Switched from Tamoxifen (Nolvadex) to Famara (Letrozole).

2008 to present

Diagnosis
•    Reoccurrence … cancer in the lungs, liver and bones.
•    Stage 4.

Treatment
•    Taxotere (Docetaxel) & Phase III Study of IMC-1121B (Randomized, Double-Blind) - 20 cycles
•    Xeloda (Capecitabine) – 8 cycles.
•    Vinorelbine (Navelbine) - 3 cycles.
•    Phase 1 Study of BMS-582664 Brivanib alaninate (Randomized Discontinuations) versus Placebo in Subjects with Advance Tumours)

She has been on various chemotherapies for the past 2 years to shrink her liver and lung mets.Initially all of them seem to work but then they would stop working and she and her oncologist would scramble to find a clinical trial that she'd qualify for. The latest was the Brivanib. Her liver tumors started to shrink but it caused problems with her blood pressure so she had to discontinue it for a few weeks. Fluid started building up around her lung and internal organs. They were hoping that this was caused by a clogged bile duct, a nicer explanation, but maybe the liver tumors started growing again. I certainly hope not. Through it all, she has been amazingly chipper. If good attitude would cure cancer, she certainly would be cured. It wasn't until this weekend that she admitted in her blog that she was losing faith in the medical treatments and that she might not have that much time left. Her wonderful husband rushed her to the hospital this Wednesday because she was experiencing  a lot of pain. Daria blogs every single day and has many, many people reading her blog. She comments frequently on others blogs always trying to be upbeat. She has been on mine almost daily. Thursday her husband Don got on her blog to tell her many friends what was going on. Everyone is just hoping that whatever the problem is, it is fixable.But realistically, not many survive Stage 4 breast cancer. It makes me very sad.

So it is extra cold here for the next few days. Back to exercising inside though yesterday when it was a balmy 19, I went outside for 6 miles. We had a mom's night out last night spoiled somewhat by a hostess telling one of us that I had no reservation. They had crossed it off when they sat another mom but should have been on the look out for members of our party. So this mom went home.

Treatment options for breast cancer

Thwarted again. I wanted to listen to the doctor who is doing research on triple negative BC in African Americans trying to find the founder gene in Ghana. She was supposed to speak last month but her talk was rescheduled for last night. However she was replaced by another physician who spoke about treatment options for advanced breast cancer. I resisted the urge to walk out and listened to what this woman had to say. She was a good speaker.

Things that I learned.
A new estrogen blocker was recently approved to replace aromatase inhibitors for the  prevention of estrogen positive recurrences in women with non-functioning ovaries,  Faslodex. Upside: does not have the severity of bone and joint pain that the AIs have. Downside: needs to be injected monthly and the injections are painful.

Carbo and cis platins probably more effective against TNBC than the anthracyclines (such as my friend Adriamycin aka Red Devil). Aside from the cardiotoxicity, the Red Devil causes leukemia in 1% of its patients.

Herceptin: This oncologist believes this to be the wonder drug saving the 25% of BC patients who are Her2 positive. Her2 positives have excess copies of a gene that causes their cancers to grow. But doesn't all BC have this gene? Yes they do. Furthermore, there is no cut and dry line between being a Her2 positive or negative. There is a continuum. Maybe it would help patients who are not 'strongly' Her2 positive. Maybe it would help others. According to the Susan Love book, Herceptin has helped women who were initially falsely designated as positives but then when their samples were retested with the new FISH test, found to be negatives.

So it is still cold out and will be for at least a week. I am not a fan of winter.

On tap for today: If it isn't too icy, run outside and help Naomi study. Mom's night out tonight.

The Loneliness of Grief

Girl or boy? Well they both have beards so they are probably male turkeys. In the winter, they form single sex flocks. I did not know turkeys had beards. It looked like horse hair hanging from their chests. Also they are bigger than females and have this fleshy stuff on their heads that can blow up and turn blue or red depending on their mood.

The other night, we watched The Rabbit Hole (compliments of TB, thank-you!). Excellent acting and interesting take on how to deal with crushing grief. The main character (Nicole Kidman) loses her 4 year old son in an accident. Outwardly, she does not seem affected but she can not move forward. Her mother had lost her 30 year old son to a drug overdose and tries to give her unwelcome advice. She equates their losses but no, losing a 4 year old in an accident does not equal losing a drug addict. She and her husband attend a support group for parents of dead children. Many of the grieving parents turn to religion (God wanted a little angel!)which the Nicole character finds revolting. Why would a benevolent God allow an innocent child to die? As her husband had suffered the same loss, their griefs should be similar but they handle the loss in such different ways, that it threatens their once strong marriage. A teenage boy had run the little boy over when the boy suddenly darted in front of him. He struggles with guilt although no one, even the parents, blame him. He finds a way to handle his grief that Nicole finds strangely comforting.

No ones sadnesses are ever equal. Grief can be so isolating. When I had a miscarriage many years ago, I was very sad. It was not helpful to be told that my loss was small. (Good thing it was too young for you to get attached). I knew someone else who had a miscarriage and called her to see how she got through it. Of course our losses were not equal (She had an ectopic pregnancy, life-threatening, and was infertile afterwards. She could have pointed out that she suffered much more than I but I am grateful that she did not).
Steve suffered the same loss too but his strategy seemed to be for me to get pregnant again, which scared me as I didn't think I could bear another loss. I did go to a support group, once, and by comparison, my loss seemed so much smaller than what the others had experienced, it just made me sadder.

A similar situation arises in these cancer support groups especially when Stage 1 and Stage 4 people are mixed. The Stage 4 people could be thinking how lucky the Stage 1 people are. The Stage 1 people are terrified at becoming Stage 4 people.

My house guest is back in California. It was fun having her here and catching up on old times and how we are dealing with our various challenges. Another friend who had lived with us stopped by too.

It was warm enough to run outside yesterday but this morning, it had all turned to ice so back to the gym.
Later today, I will finally get to hear the researcher speak who has researched the Ghanaian connection to TNBC although that won't be the focus of her talk.

Pretty in Pink

wild turkeys

Turkeys at Kensington

chickadees and Teri

More turkeys

Her eyes have turned brown

Our weekend guest, now happily home

We saw plenty of winter birds today: chickadees, tit mice, flickers, downy woodpeckers, juncos, wild turkeys, cardinals, goldfinch. The first two groups of birds eagerly ate out of our hands. Usually the titmice are more reserved but I had pecans..yum for them. Teri had not experienced such tame birds before. It was fun. Even the turkeys approached us for some pecans. They are so beautiful.
It's been very fun having my college friend here.

My hardest journey

Route 78 heading east

Route 78 heading west. I wish I could show how steep this grade is.

No, this post won't be about my long battle against cancer or how hard it is to be a mother of challenging children but a physical challenge I undertook around 1994 biking from coastal California to the mountain town of Julian. The linear distance is only around 50-60 miles (my record in a day is 112 miles, mainly against a wind) but starting from sea level, I would climb 4280 ft. There are few hills in Ann Arbor that involve climbs of much more than a 100 feet and I whine about them (especially when I used to live perched on the crest of Broadway Hill). Added to my difficulty was that I was still recovering from Graves' Disease, which limits how much oxygen I could process at a time. I was only able to run 20 minutes at that time (as opposed to running an entire marathon). Biking generally isn't so aerobically challenging as running except when hills are involved. I started my journey during rush hour (it was in November and the sun sets especially early in CA) to get to the beautiful sounding Paseo Delicioso del Del Dios. Southern California certainly has more intriguing sounding names for its road (versus Southern Michigan, 8 Mile, 9 Mile, etc..). The Del Dios Highway hugs a reservoir while it climbs steeply east to Escondido. Since this is a good sized town and there was a lot of traffic, I skirted around the southern edge of the city to get to Highway 78, which I took for 40 miles. There is only one town on the way, Ramona, where I stopped for lunch. I was riding my brother's hybrid bike which had 24 speeds. As he is 8 inches taller than I, the bike was too large and I had to plan my stops carefully so the bike would be at an angle. At some points,I would be in 1st gear standing on the pedals with my heart pounding out of my chest. Worse, on the switchbacks, it would appear that the ground was flat. The road had mile markers every tenth of a mile. Sometimes it would take a minute just to do a tenth of a mile (like how slow I am running now!) Bikes are incredible machines but at some point on very steep inclines, one loses the advantages of it being a machine as you hauling up its weight along with your own. I made it and stayed in a cute B&B. It is a resort town. The next morning I awoke to snow! (it was November). The day before in the desert, it was 80 degrees but it is cooler at higher elevations. I waited as long as I could to ride down the mountain. It was cold and foggy. I worried that drivers could not see me. Also controlling my speed on the sharp switch backs was scary. It was a long way down off the edge. I had a west wind to battle though most of the route was downhill. Eventually it became warm and sunny again but with 20 miles to go, I had a flat in the middle of nowhere. I remembered there was a battlefield with a tourist center about 3 miles away where I could call for help (this is before cellphones). I started running with the bike but in less than a few minutes, someone offered me a ride to a bike store where I got a new inner tube and was on my way.

Sunny is gone as her humans returned from their ski trip at Boyne. Julia lived in Zurich, Switzerland for 3 years growing up and learned to be an expert skier. She also learned to speak German but somehow forgot most of it. Their family took Josh on ski trips and he learned quickly. He was able to handle the mountains in Colorado.

I am eagerly awaiting the arrival of my college housemate from CA as I type. Shoulkd be fun.

3 Mayas

From photofunia

Abruzzo

Sulmona as seen in the movie only this square was full of market stalls. The aqueduct goes from the mountains to the town's fountain

Sulmona's major industry..confetti making. These are fancy Jordan almonds wired to look like flowers

The town of Castel Ieri (Castle of yesterday) as seen from Castelvecchio. It covers the entire hill

Downtown Celano where we spent a day taking classes at the University of L'Aquila satellite site

Feast of the frog legs and gnocchi that we attended in nearby Molina

Castle in Gagliano

Narrow alley ways as featured in The American. This is in Gagliano

Also in Gagliano

So I finally watched The American which was filmed in various parts of Abruzzo, an area often overlooked by tourists. I had stayed there almost 6 weeks in the summer of 2008 taking classes. The area is very mountainous and rugged. I stayed in Gagliano Aterno, a town of 300 that was mostly built in 1200.  The nearest town was Castelvecchio that I would run down to many mornings. There was a Castelvecchio in the movie but there are at least 2 towns with that name in Abruzzo. The one I am familiar with is Castelvecchio Subequo. I thought I recognized the nearby town of Castel Ieri. Most of the movie was shot in the very pretty town of Castel del Monte which was maybe 30 miles away. We didn't go there. But the village streets looked very similar so it was fun looking at the scenery. Some scenes were shot in Sulmona which I went to twice. It probably is the biggest city in the province of L'Aquila aside from L'Aquila itself which was destroyed in the earthquake in 2009. The movie itself? I like George Clooney but the plot did not make any sense to me. He is a hitman hired by who knows who and he is getting tired of it. He tries to hide in Abruzzo as it is so far off everyone's radar but his employer tracks him down and seems to want him dead. So A+ for scenery: C for plot. The music is good though.

Celano Castle

I had entitled one of my previous posts Castelvecchio. It is now my number one hit (surpassing Donkey Stew). I hope I am referring to the correct Castelvecchio.

One part of the movie I thought was funny. George needed to keep his work quiet. He would wait for the bells to ring and do his loud work in synch with the tolls. With the bells ringing so often, he wouldn't have to wait long. The bells in Gagliano were inconveniently right outside of my window and would ring every 15 minutes. A different bell would signal how many quarters past the hour so at 12:45, the bells would ring 15 times. During a funeral procession or a Saint's procession, the bells would ring for an hour. For a small town, there seemed to be alot of funerals while we were there. Bells..bells..bells...

More slippery snow so back to the Y for me. Too many unsupervised children running around and too many newbies on the machines with no sense of gym etiquette. Hopefully they will fade away.

The Dorm Room

Naomi imagining what her dorm room would look like. She had drawn this shortly after her 10th birthday. She imagined that she'd go to the same school as Josh did, an engineering school

When Naomi was younger, she loved to draw. She used to love to draw princesses and 
castles. She loved to include all sorts of details. I always liked this picture and had it on my
 wall at work. It is a bit wrinkled and pencil does not show up well with our scanner. I like
 the disco ball and the poster of Christina Aguillera.

What the picture shows is that she had a hard time getting proportions right.

Well she never will be in a dorm room. She needed to go to school close to home and
 now she has Maya.

I left work about three years ago. I had a large office which I filled with too much stuff 
over the 31 years I had worked there. I took a large plastic bag, filled it with numerous
 folders, and threw the whole mess in a corner of our den. Today I decided to sort
 through the bag and organize what is left. This picture is what was in the bag. I've
 thrown most of the stuff away. I have a folder now of most of my publications and
 presentations.

While I was working, I did not have much spare time. Both Josh and Naomi needed
 extensive help with homework though fortunately Josh was able to be much more
 independent once he went away to school. The kids were in travel sports so that
 meant weekends away. There were lots of practices to take the kids too and I rarely
 missed any of their games. I also tried to exercise 5 times a week. I also coached
 several sports teams and was a girl scout leader for six years. Many home projects
 just did not
 get done.

So now with all this time on my hands, my house should be spotless and all these
 projects 
completed, right?

As usual, I do have my excuses..babies, weddings, and of course ...CANCER. I was
 lucky not to have as severe side effects as some do during chemo but the 7 months
 of treatments left me with little spare energy. I did absolutely no projects during that
 time. Steve spent most of the days battling the insurance companies and waiting on me.

I am taking a day off from working out. Sunny will arrive any minute so part of my 
exercise will be walking her while her owners ski.

Tiger Mothers

Recently I read an article Are Chinese Mothers Superior? based on the recently published book Battle Hymn of the Tiger Mothers by Amy Chua.(http://online.wsj.com/article/SB10001424052748704111504576059713528698754.html)
A 'tiger mother' isn't necessarily Chinese or even Asian, though stereotypically most seem to be. Rather it appears to be  a parenting technique that withholds affection or even material goods unless superior performance by the child is obtained. No treats for A minuses. No sleepovers, organized sports, dating until college, TV, computer games.... If a child has not achieved a particular skill, one harangues them and withholds food until they do. The author insisted she was brought up this way and she turned out 'fine' and is now raising her daughters similarly. My children were friends with some of these 'tiger cubs'. The tiger moms don't stop their techniques just because their cubs now are adults. Plus living in the US, the cubs are exposed to how other kids live and they identify more with their 'western peers' than their tiger moms' values. The opposite approach, the so-called Western parenting technique is to increase self-esteem of the child at every opportunity. If a child only gets an A minus, well they tried.

Obviously there has been much discussion concerning this. Some tiger cubs point out that they are now undergoing years of therapy due to their tiger mom.
What is success? Good grades? High paying job? No teenage pregnancies?
Do the cubs actually have a good  relationship with their moms?
What does a tiger mother do when a child has some sort of handicap? Unthinkable I know. What if their child can't get all As? Do they drown the child? Continually call it 'garbage'? (A term Chua calls her child when she misbehaves).
I know some tiger cubs have fled and haven't looked back.

Comfort Food

To see Posh Nosh's (my favorite show) take on comfort food see http://www.youtube.com/watch?v=scPT7n5s4nY&feature=related

I just returned from my Cooking for Wellness class. The subject: comfort food. Usually comfort food is full of fat and starch but in this class we tried to modify that. What we made: whole wheat mac and cheese made with low fat cheese, vegetarian chili, molasses oatmeal cookies and hot chocolate made with almond milk. Today in the WSJ, the non-dairy milks were compared for taste, texture, nutrition. Almond, rice, soy and coconut were compared. Almond came out the winner in almost all respects. The people in the class are either cancer survivors or supporters of a cancer survivor. We have a few regulars so it is fun to see these people once a month plus I really like the instructor who is a nutritionist and a BC survivor. I should make much more of these foods.

So it ended up snowing about 4-5 inches yesterday making the roads very slick yesterday.  Still not nearly as much as in Boston and NYC. I am now the chief snow shoveler as Steve is working.

About a year ago, I learned about the existence of Maya. It was very upsetting as I thought she (although initially she was believed to be a boy) would really make it hard for Naomi to continue her education and dig herself out of poverty. Yes Naomi will have to struggle that much more but Maya is a very beloved baby.

1/11/11

I am here not so eagerly awaiting our snowstorm though it will be only a fraction of what NYC and especially Boston will receive. Even Seattle will get snow. Some of the hills are so steep there, I would be afraid to go down them if there was any ice. I was able to run before the snow became too heavy.

Science news:
Lymphedema: Anyone who has had node removal, even if only one node was removed, is at risk for this painful condition. We are told never to have our blood pressure taken on the affected arm, have blood removed, take extended plane rides without a compression cuff, or do heavy lifting. Also we are to avoid injury to that arm because even a minor scratch can turn into an infection with our impaired lymphatic system. Anyway, recently a study was reported in which BC survivors who had node dissection were divided into 2 groups: weight lifters and non-weight-lifters. The weight lifters had less lymphedema than the non-weight-lifters. Of course there is no direct cause and effect here but at any rate, it seems that one can safely lift without worrying about lymphedema.

As for me, I just assumed that since I had only 3 nodes taken from a possible twenty or so, I should not be at risk. I have taken one round trip plane ride to Europe and 3 to the west coast trips since the node surgery without ill effects. Also my good veins are in my right arm so I have blood taken there. And I lift weights...
For about a year after surgery, I had limited mobility on the affected side and a lot of pain that seemed to be bone pain. It scared me as bone mets are always a possibility. But it seemed to be frozen shoulder caused by: radiation? nerve damage in the surgery? Taxol? Lymphedema? With careful stretching, the pain finally went away.

Blood test for cancer: There is now a test that can detect very small amount of circulating cancer cells in the blood. The test will not be commercially available for 5 years or so. Even a 1 cm tumor sheds 1 million cells a day but only an extremely small fraction of these cells develop into a tumor. A positive result would indicate you have cancer somewhere..but where? A scary investigation could result. It could be potentially more useful to those undergoing chemo against a known tumor. Still have circulating cancer cells? Better try a different chemo.

Steve is now working more hours so I am alone to amuse myself. I've been slowly decluttering. Naomi is taking a class at night so I sit Maya until Don'tae comes home from work. Poor baby has a cold right now.

The physics of triathlons

Naomi did get a few pix in before finding out that cameras were forbidden

When teaching physics to high schoolers, you have to put up with a bit of whining. When are we every going to use this stuff? Why do we need to know that? I had taught diluted physics to high math ability 10th graders back in the day (and at night, low performing adult math students..quite a contrast). I tried to give practical examples as much as possible. I had them determine their reaction times using a meter stick and the formula
 d=(1/2)gt² . We discussed relativity. You are walking to the back of the train at 2mi/hour. The train is travelling due east at 60 mi/hour. What is your actual speed? Relative to the train. Relative to the earth. Relative to a fixed point outside of earth. Relative to the ....


Back when I took physics in high school, I remember calculating the height of the WXYZ broadcasting tower that was about 3/4 of a mile away with crude surveying tools we constructed so we could get the angles from 2 different points at a known distance and a table of trig functions (we did not have calculators preloaded with these values..it certainly would have made our lives easier).


We dealt with vectors. You are paddling across a 1 mile wide river at 2 miles an hour. The current is a steady 3 mi/hour. How long does this trip take? How far did you paddle? Use d=vt and the Pythagorean theorem.


When doing triathlons, I thought about these vectors especially in the swim. Fortunately small inland lakes generally have negligible currents and usually I just had to deal with being tangled in seaweed, fuel slicks from motorboats, waves,  getting my goggles kicked off by my fellow triathletes, trying to swim in a straight line with spotty points of reference, being cold, not panicking, getting tired...One year I did the Chicago triathlon which at that time consisted of a 1500 m swim in Lake Michigan, a 25 mi bike ride, and a 10K run. To enter, you had to certify that you were capable of swimming a mile (which I had since I swam a different race by the same organizers). They mentioned though that if there was an east wind (we swam east more than any other direction), we better be capable of swimming 2 miles. Of course there was a strong east wind when we awoke that morning, which was good news for the bike leg as we were travelling north and south on Lakeshore Drive with little travel east.. A 20 mph wind doesn't turn into a 20 mph current to fight against but even if it translated to a 2 mph current I was hosed if all I was capable of was swimming 2 miles an hour. I'd be swimming in place. Cross currents would add to your time too particularly if you were slow. See Pythagorean theorem.


They said the water was 66 degrees, which maybe it was near the shore where they measured but there seemed to be pockets of ice water that made me gasp. I considered bailing unless I could get my breathing slowed down..calm down! calm down! Eventually I was able to get into a rhythm. Unlike many of the lakes I did races in, Lake Michigan is actually clear and I could see the bottom (way, way down there). I found myself swimming on top of some old sea wall that seemed to be parallel to the shore. Looking up constantly to orient cuts into one time. I did look up and found that by fellow racers had cut into the shore to finish. Ugh!


Biking against a strong wind actually is helpful to the weaker riders. Wind resistance is proportional to  the square of the speed meaning doubling the speed would quadruple the wind resistance. Attempts to reduce this resistance from tucking behind another rider (drafting) was forbidden. Riding a bike that minimized resistance was OK.
Surprisingly (to me) bike spokes are a considerable source of resistance so solid wheels  are sometimes used (tough with cross winds though). Tucking your body down as much as possible maximizes speed but hurts the back. Making sure you aren't wearing baggy clothes helps too. Toe clips maximizes the energy transmitted to the crank so none is wasted trying to keep your feet on the peddles and on the upswing part of the cycle. But you need to remember your feet are locked in if you have to suddenly stop (I forgot this once..ow!).


Wind resistance is less of a factor in running due to the lack of speed involved. It actually helps in cooling on hot days. Still on very windy days in races, I sometimes tucked behind a big man (and would feel somewhat insulted finding people behind me using me as a human shield).


When snorkeling, there were often currents to deal with. I would swim against the current to view a particular reef so that I would not be dashed against it. Also it would keep me warm as snorkeling is not as heat generating as swimming. But the sea introduces more challenges: sea creatures which is why I was snorkeling in the first place. Jelly fish though are no fun.


When visiting my in-laws off of Coney Island, sometimes I would train swimming beyond the breakers parallel to the coast. Once I became sea sick rising up and down with the waves. You adjust your breathing to the waves. I tried to avoid swimming near the breakwaters so I would not get dashed into them. When doing aerobic exercise, endorphins are released. I could overlook minor pains. Once though while swimming in the Atlantic I felt intense stinging underneath my suit. I stopped, took off my foggy goggles and found these tiny translucent baby crablike things pinching me. I have since read that there are blooms of sea lice, infant jellyfish that are capable of stinging but these things seemed to have pinchers and eyes. Suffice it to say, I cut my swim short that day.

Baby's first swim

Ms. Maya had her first swim at the Y yesterday in their 90 degree kiddie pool and enjoyed it very much. Alas this was undocumented not for a lack of cameras but the Y's firm policy of no photography around the pool. This is to discourage sexual predators somehow.

I used to swim at UM regularly. There was a viewing area outside of the pool frequented by men whose women were required to cover up all their body except for the face. This really upset my training partner (this is when I was doing triathlons) and he shooed some of them away. It seemed so hypocritical of these men to require their wives to be covered but then it was OK to drool at women doing their laps.

I haven't swam except to snorkel in more than 15 years. I used to swim quite regularly although my form was even worse than my running form. At one point, I was able to swim farther than I could run (2.5 miles). Once I had 2 kids, it was hard to find the time to swim so I switched to running. In 1984, I did my first biathlon..1 mile  open water swim and then a 5K cross-country run. Even during my first running race, I wasn't last even though I had just started running ( I did get fairly good at it but now due to numerous challenges..I am so slow but I should be grateful I can run as well as I do). I assumed there would be slower swimmers than me..wrong. There may indeed be slower swimmers than me but they don't show up to do a one mile open water swim. Slow runners may show up to races but they have the option of walking and even if they did collapse from fatigue, you'd at least find their body. Furthermore, my bad technique wasn't my biggest problem; having 20/600 vision was. I had assumed I'd just follow the crowd but after a few minutes when I looked up, I saw no one. We were to follow a path very spottily marked with gallon milk jugs. Against a white sky, they were impossible to see especially with my poor visual acuity made worse by leaky, foggy goggles. We were to raise our arm if we were in distress. I did and after a while, a row boat came over to me offering me a ride back to the start. I said I wasn't tired or injured, I just couldn't see the path. So the boat rowed beside me begging for me to come into the boat and at other times suggesting how I could improve my stroke. I was last out of the water, by a whole lot, and it had taken a whole hour. I was able to overtake some people  on the running course.

I did get much better at the swim though it still was the weakest link by far in the triathlon. In a closed course lake in which you swam 4 lengths to make a half mile, I did that in 15 minutes but that was drafting off of my fellow swimmers (one can really swim much faster in the slipstream of another swimmer) They ban drafting during the bicycle leg but it would be hard to prevent during the swim. The best I did swimming a mile in open water (no lanes) was 35 minutes. I did have contact under my goggles..no more swimming blind.

Still too slippery outside to run so back to the track.
Josh and I went over to spend part of the afternoon with Maya and Josh. Josh seems to enjoy interacting with the baby..hopefully he and Julia will get baby fever soon but I have been warned about being too greedy about acquiring grandbabies.