An inoperable brain tumor?? What??

You can never be sure exactly what is going on inside your body.  Well, there are the obvious things, like hunger pains and gas….   But beyond that, it is impossible to really have a clear picture of how healthy our organs are, or how our blood looks, or exactly how things are functioning.  Of course we know when they STOP functioning, but what about when things are “okay”, but may not be perfect.

For example, what if your lungs had some spots that were unhealthy because when you were younger you decided to cave to peer pressure and a smoked cigarettes for 15+years……(I am talking about a friend here….duh), or if you decided to smoke Marijuana a couple of times just to “check it out”….ummmm duh,…..a friend again……. or maybe you even might have tried something harder once…..(FRIEND……….OKAY????…..sheesh).  We can’t look into our bodies and see what kind of damage these choices may have caused.

What about the people who have illnesses due to no fault of their own, but just because it is that way for them?  What about time bombs that are just ticking away like Cancer, or heart disease, or high cholesterol, or a stroke.  Just waiting until your guard is down to strike and cause havoc in your life and loved ones.  Too bad we can’t have some sort of see through window that doctors can use to see what might happen to us and our bodies so we can prepare.

My point is  that we never know what is going on inside us.  Maybe that is a good thing, maybe not.

About 4 years ago Bluebell began having headaches.  Every day.  All day.  They were worse if she coughed, or sneezed, or bent over to tie her shoes.  I made her go to the Primary Care doctor.  They sent her to a neurologist.  He ordered an MRI.  We were called back to the Primary Care doctor.  She brought us in, and told us she did not know what was causing Bluebell’s headaches, but they had found a “Tumor” in her brain while they were doing the MRI, and Bluebell would be sent to a Neurosurgeon for evaluation.

Then the Neurosurgery appointments began.  MRI’s, Cat Scans, discussions.  This was in December of 2009.  Bluebell was diagnosed with a Meningioma (benign tumor of the meninges), which was sitting right next to her brainstem in a very bad (inoperable) spot.  She had an amazing Neurosurgeon at the Portsmouth Naval Hospital: Dr. Piccarilli.  Dr. P. is a super smart lady, and told Bluebell that it was a very small (millimeters) tumor and we were simply going to watch it for a while.  Get MRI’s annually and see what it does.

I was shocked!!!! Really??

A tumor???

In an inoperable spot right next to her brainstem???

Only Bluebell could have this kind of luck.  We often joke, that when God created her, He mixed up lots of different kinds of health issues, and tossed them into her DNA, just to see how she could handle it.  We had already been through eye surgery, cervical cancer, a radical hysterectomy, benign thyroid tumor, lymphedema from the hysterectomy, a stapedectomy to correct her deteriorating ear bone……

I mean……. really???

An inoperable brain tumor??

So we did what we assumed everyone does in that situation.

We named the tumor.

Calvin.

He became her scapegoat.  Any time she did something and we got into an argument she said “Oops, must be Calvin.”  If she forgot something she would say, “thanks a lot Calvin”.  Basically poor Calvin was blamed for all her difficulties.  I almost felt bad for the poor little millimeter of tissue……   except that he parked himself right next to Bluebell’s brainstem….which is incidentally a VITAL organ….   If he had parked himself in a more accessible spot in Bluebell’s brain I would like him MUCH better!!!!

Bluebell's looks like this only hers is a bit smaller.  Not encroaching on the brainstem
Bluebell’s looks like this only hers is a bit smaller. Not encroaching on the brain-stem

Time went on and Bluebell continued to see Dr P.  After a year, Dr P decided that Calvin had grown just a smidge, and it was time for Bluebell to see someone else about Calvin.  A neurosurgeon who specialized in a particular procedure that could help either reduce Calvin’s size, or stop him from growing.  So she sent us to see a doctor at Riverside Hospital in Newport News named Dr Lesnick.  He is a surgeon who specializes in a procedure called Gamma Knife Radiation. 

Bluebell was scheduled an we went in at 6 am for Bluebell’s procedure.  She was given a twilight anesthesia cocktail which means she wouldn’t feel anything but would be alert enough to answer questions and respond to directions.  However, she wouldn’t remember anything, so of course I took advantage of that!  🙂

For the procedure they had to put a contraption on her head called a halo.  Then they buckle this helmet thing on in the machine and use a computer to pinpoint exactly where the radiation is to go.

 

Bluebell in hospital bed with halo on.
Bluebell in hospital bed with halo on.

To hold the halo in place so it won’t move they actually screw in into your skin in 4 places.  Two on the forehead and two in the back of the scalp.  Hence the anesthesia.

left side of forehead
left side of forehead

It was pretty much an all day procedure.  We didn’t get out of there until 4:00 in the afternoon.

It all went as well as they expected, and she was scheduled for a follow up visit in 6 months to do another MRI to see if Calvin was affected by the Gamma Knife.

The follow up MRI showed that Calvin had not grown, but he had not gotten smaller either, but Dr. Lesnick was very hopeful the procedure had worked.

So now Bluebell goes in every year to have an MRI done to see how Calvin is doing.  In May it will be time for her annual visit to check on Calvin.  Since she remains asymptomatic I feel pretty confident the Gamma Knife stopped him in his tracks.

I will say that one of the most touching moments I had during this entire situation was during a visit with Dr Lesnick.  I told him how grateful I was that a doctor of his prominence made this procedure available to those of us who use government healthcare insurance (Tricare) because I know Tricare does not reimburse doctors very well.  He responded it was the least he could do to honor people who served in the military!  Brought tears to my eyes!

I guess the moral of the story is that you never know what life will throw your way, and in the big picture we just do the best we can and keep marching forward to face the challenges head on.

Literally, in Bluebell’s case.  So Calvin is here to stay because he is in a place that no surgeon can get to.  He is a part of our life, and he is going to stay right where he is.

Let’s talk about Acne

I have been working for a local dermatologist for over 8 years.  He has been the President of the  National Medical Association and was named the 2008 Practitioner of the Year by the National Medical Association.  He has been in private practice for over 27 years.

I have learned an amazing amount of information from him.  Prior to working for him as a medical assistant and Skin Care Specialist, I spent 20 years in the Navy as a corpsman, so I have over 25 years of expertise in the medical field as well.

Today I want to talk about acne, which affects 40 to 50 million Americans at any given time according to the American Academy of Dermatology (AAD).  Acne can affect people of all ages, and some women don’t develop their first case of acne until they are in their 40’s. Acne causes many people emotional distress!  They are embarrassed and upset by their skin.  Let’s be real, your face is the first thing most people look at, and we want to put our best face forward.

I can’t tell you how many times I have heard patients say, “I have NEVER had an acne bump….why am I getting them now in my 30’s..(or 40’s)…(or 50’s)???”  This is more common than you might think.  Often when an adult develops acne it is called “Rosacea” also referred to as “adult acne”.

However, let’s back up a bit and debunk a few myths about acne that most people think are true.  First of all, despite what your mother told you, (or what you are telling your kids), fried foods, soda, and how much water a person drinks has NOTHING to do with acne. Fried foods and soda do not make acne worse, so eat french fries and drink Mountain Dew to your heart’s content.  It will not make your acne worse.  It will however cause your waistline to increase, but that is not the topic for today.

Okay so now that you know what does NOT make your acne worse, let me tell you what DOES.  Hormone and stress levels are a huge factor in acne.  As a matter of fact many times I have heard from high school patients that their acne was doing really well after seeing the doctor and getting on a regimen of medication and products and procedures, but when they went off to college their acne got much worse.  Many patients come home on their first school break with their acne flaring out of control.  Let’s face it, going to school is stressful, especially if it is their first year away from home.

Many of my female patients will often tell me that their acne is worse just before their menstrual cycle.  Even if they no longer cycle due to menopause or birth control, they will notice that their acne goes through monthly cycles of better and worse.  That is because our bodies’ hormone levels still go up and down.

Acne is caused by the skin not shedding properly.  So the skin clogs the pores, thus backing up the oil in the pore causing whiteheads and blackheads (comedones) or larger “juicier” bumps also called pustules.  This is where acne medicine comes in.  For comedonal acne, (blackheads and small whiteheads) the retinoids are a great medicine to use.  These are medications such as Retin-A, Tretinoin, Tazorac, Epiduo, Differin, among others.

Topical medicines
Topical medicines

These medicines “teach” your skin to shed or slough properly so the oil can flow and not clog your pores.  They can sometimes be irritating or drying, (especially to sensitive skin), so there are a couple of “tricks of the trade” you can use to help combat the irritation.  1) Use the medicine every other night to start so your skin can get used to the medicine.  2) Mix a dab of moisturizer in with the amount of medication you are putting on your skin so the moisturizer acts as a  “buffer” it to make the medicine less irritating.  Even with all of that you may notice some peeling with these medications.  Of course if you have any concerns discuss them with your medical provider.

Comedonal acne
Comedonal acne

For the larger, “juicier” bumps, there are other things a medical provider can use.  Benzoyl Peroxide is a great medicine for larger bumps, as well as topical or oral antibiotics.  Benzoyl Peroxide can also be drying, so start that every other night also if you notice your skin being more dry than usual.

Pustular type acne
Pustular type acne

For people who have that really large acne all over their face that is painful and deep in the skin, (called cystic acne) they DEFINITELY need to seek out medical care.  I have seen many patients put on Isotretinoin (aka Accutaine, Isotret, and a few more).  This medication has many side effects and has to be monitored VERY closely by your dermatologist with monthly visits, blood tests, pregnancy tests (for females) among others.  However, I have seen this medication literally work miracles for patients.  I always think about the teenagers who went from kids with poor posture, hiding their faces behind their hair, poor self esteem before the medicine to kids who sit up straight, have improved self esteem, and smiling MUCH more.  It can make a HUGE difference, but as I said, it needs to be closely monitored by a medical professional.

Nodulocystic acne aka Cystic acne
Nodulocystic acne aka Cystic acne

There are also some great products that can be used to help with acne.  Glycolic acid cleansers are a wonderful product for people (even with sensitive skin in the right amounts) with oily, acne prone skin.  A couple of glycolic cleansers that we sell in the office that I like (they can be purchased at many dermatologist’s office or online) are:

Glyderm Gentle Cleanser
Glyderm Gentle Cleanser

Glyderm Gentle cleanser (made by Equalan Pharma) is a daily cleanser with 2% glycolic acid (also known as AHA or Alpha-hydroxy acid).  It is very gentle and can be used by most people.  The glycolic acid helps exfoliate the skin. However, it is a creamy cleanser and will NOT foam up.

Vivite daily cleanser
Vivite daily cleanser

Vivite Daily cleanser (made by Allergan) has a 12% glycolic acid compound in it, and is therefore a bit more exfoliating than the Glyderm.  It is also stronger and can irritate sensitive skin.  It is a creamy cleanser.
For those of you who LOVE to use a scrub, Vivite makes a nice one.  PLEASE stay away from scrubs with nut shells as the exfoliating ingredient….nut shells can be sharp and scratch the skin. I really like the Vivite Exfoliating cleanser.  It has a 15% Glycolic acid compound and very nice soft exfoliating beads that scrub without scratching or causing irritation.  It should be used no more than two to three times per week.

Vivite exfoliating cleanser
Vivite exfoliating cleanser

Other products to try:
We have some products made by Topix Pharmacuetical that I love.  You can also get these at many dermatologist’s office or online. One of the reasons I really like Topix products is because they use many botanical ingredients in their products.  I like botanics and more natural ingredients.

Glycolix/Topix 15% Glycolic pads
Glycolix/Topix 15% Glycolic pads

Topix 15% Glycolic pads.  I love these because they don’t make your face sticky at all.  You can use them in the morning after cleansing, or during the day if you get hot and sweaty and yucky……(love that medical term?)  I tell my clients you can out some in a baggie and carry them with you during the day or to the gym, or the beach, etc.

Topix/Glycolix 5/2 Gly/Sal pads
Topix/Glycolix 5/2 Gly/Sal pads

These are Gly/Sal 5-2 pads.  They have 5% glycolic and 2% salicylic.  They are great for acne spot treatment.

Glycolix/Topix 10/2 Gly/Sal pads
Glycolix/Topix 10/2 Gly/Sal pads

ly/Sal 10-2 are pads with 10% Glycolic and 2% Salicylic acid.  Stronger than the 5-2 pads, they are also great for acne spot treatments.

There are lots of other products out there, too many to name them all.  I shared with you just a few of my favorite acne treatment products.  Generally speaking a product with salicylic acid can help with bumps.  Glycolic acid is also a good product for skin too sensitive for Salicylic acid.

I am happy to answer any questions you all may have, and if you are local to the Hampton Roads area I do offer free skin care consultations at the doctor’s office where I work, so you can call me or email me, or comment to schedule an appointment.  🙂  Please note I do NOT get paid by any of these companies, nor do I get paid for FREE consultations……

Plump is not a 4 letter word.

I have a confession to make.

I am plump.

I am okay with it.

I work out 3-4 times EVERY week.  Without fail.  That just seems to be my routine.  Knowing that, you might think…….wow, she works out 3-4 times every week.  I bet she is svelte, thin, healthy, looks great in a swimsuit, or some other wonderful compliment…..  Well, for those of you who don’t know me, NOTHING could be further from the truth, and for those of you who do know me, it is probably a shocker that I work out so much and am still so…. (well, lets just keep it real)…….so pudgy.  I know, I know……I am a pudgy lady  Sometimes to make myself feel better I say “thick”, or “fluffy”, or “voluptuous”, but the truth is I am just plump.

fat prejusice

I read an amazing post about just this very thing this week about being a Plus Sized Princess.   It is an amazing post and a wonderful concept.  I applaud CeCe for writing this post and she really made me think!! While I don’t have PCOS, I have struggled with my weight forever it seems.

This is a battle I have been fighting my ENTIRE life.  I kid you not.  I am going to tell you my diet saga.  If any of these diets apply to you, just keep track, make a little tic on a piece of paper, we can compare notes later.  When I was a teenager I was not plump, but I wanted to be more slender.  My mother was always doing weight watchers, and she would help me plan weight watchers meals.  Anyone else ever have those oh so lovely weight watchers “tuna pizza on a english muffin”?  Or how about tuna with melba toast?  Okay, so then when I was a young adult I lived on salad and went to the gym every day for an hour. Not only did I want to be slender, but I was in the Navy and had to maintain weight standards.  And let me tell you, Navy weight standards are NOT made for girls with an hourglass shape.  They are made for girls with small hips, more of a “boyish”, or “athletic”  shape .

Me in 2003.  Plump even then.
Me in 2003.

Now don’t get me wrong, in my 20’s I was a hot mama, and turned heads, I had an hourglass figure that could stop traffic…and maintained Navy weight standards……..but at what cost?  I ate so poorly and worked out for an hour 6 days a week.  I was obsessed with weight loss.

Move on to other diets I have tried…(get your pencil and paper ready)…..cabbage soup diet, Jenny Craig, Scarsdale diet, Atkins diet (I did this one before it was “in” so the food tasted like cardboard and was very expensive), the Zone diet, the citrus fruit diet, the “eat all you want of one kind of food” diet, the Mediterranean diet, and others I have simply forgotten about.  Some of them worked, for awhile, but I got tired of always restricting and counting and being SOOOO careful!  In those years I got married, had two babies, got divorced, moved many times, had many various life changing events, and just couldn’t keep up with each diet.

Four years ago my younger brother Brian died of a massive heart attack.  He had been overweight for many years, and had high blood pressure and diabetes, and coronary heart disease.  My father died on Christmas Day 2010.  He was 70.  When he died, he was older than any other male in his family for at least 5 generations.  He had a great healthy heart, he took care of himself.  For him it was a stroke that killed him.  But because there were so many heart attacks in his family particularly with the males, he was very careful with his health, especially his cardiac health.

After Brian died, I decided it really was time to make sure my heart was healthy.  So I joined a gym and started going 3-4 times every week. I hoped I would lose weight while getting my body healthy, but alas, that was not to be. However, on the positive side, my heart is healthy.  My cholesterol is good, my blood pressure is good, and my sugar is good.  So, I may be plump, but I am a damn healthy plump woman.  I have been doing Weight Watchers for about 6 months.  I eat foods in moderation. I eat vegetables, meats, fruits, and yes sweets.

love yourself

So my point to all of this is that in my opinion it is okay to be a healthy plump person.  I would rather have a healthy heart and be plump than be skinny and have an unhealthy heart.

Thank goodness Bluebell agrees.