Month: June 2024

20 June 2024

Last night was movie night with Chris and Tucker. We saw The Hundred Foot Journey, starring Helen Mirren, Om Puri, Manish Dayal and Charlotte Le Bon. It’s a great story set in an idyllic village in France (the scenery is gorgeous) and can be considered food porn. It’s got it all if you like either French cuisine or Indian cuisine – and I like both. It’s about chasing Michelin stars, young love and older love.

Years ago, a group of us decided to have a Julia Child party where each of us would prepare a dish from Mastering the Art of French Cooking. I decided to boeuf bourguignon. I even roasted bones in the oven to get the deep flavor as per Julia Child. It took two days to make. Everyone went all out and we assembled at Nancy and Michel’s and sat down to glorious food. We were all sick the next day because we were not use to (1) that rich of food and (2) the large portions we ate. We forgot French don’t serve giant size portions.

Probably the most amazing food film I’ve ever seen was Babette’s Feast. It’s about a woman who shows up on the coast of Denmark and begins to serve as a cook to two old women whose deceased father established a religious sect. As part of the sect’s charity, the two women fed the disabled and poor of the sect until Babette shows up and begins to cook. To say there’s a difference in the meals is an understatement. Later, Babette is notified she has won the French lottery. She spends the entire amount on a feast for the two women and their friends/long lost lovers. It’s food porn at its finest. I saw the film at an art showing with my friend Adam and after we left the theater, we did our own food porn at a restaurant in Coral Gables. Our meal went on for hours!

It’s a dreary, rainy, windy day. My energy level seems to continue to drop. I’m not sure if that’s because I’m not doing enough physical activity or if it’s due to the reduced left ventricle ejection fraction. It’s easy enough to talk myself into the latter.

In any case, I canceled physical therapy with Shannon this afternoon. Tomorrow I meet with my surgeon, Dr. Burgers. I’ll ask her advice on my quandary with Herceptin and heart failure. Hopefully she will give me some insight. In any case, on Tuesday of next week I’m scheduled to talk with Dr. Velez. Monday I have the bone density scan. I’ve never had one but Chris gets one every two years and says it’s about the easiest procedure you can do.

It’s mango season is South Florida and my neighbor’s tree was a bust this year. Chris brought me two large mangos from a neighbor of hers. When she pulled them out of the bag, they were so large I thought they were papaya. These are truly large mangos. The ones on my neighbor’s tree are about half the size.

I’d never eaten mangos before I moved down here. They now rank among one of my favorite fruits. The only problem with them is the large seed. It reminds me of the film Oh God! starring John Denver and George Burns. John is conversing with God aka George Burns and asks if God has ever made a mistake. God thinks for a moment and says avocado. “I made the seed too big.” Ditto mangos.

Stay tuned!

19 June 2024

It’s been a very busy day. First up was the MUGA scan at 10 am. Of course, I had to be there at 9:30. Felipe took me back and he was the one who set me up for the first scan back in October 23 (I’ve only had one MUGA scan before, 3 echocardiograms). The last time Felipe had a lot of trouble finding a vein. Not this time. He’s become a little more assured.

Danielle, the same one who put me in the machine last time did it again. The only uncomfortable thing (other than freezing temperatures) is you have to hold your arms above your head during the scan. My left shoulder started to ache. Danielle kindly switched gears and did scan 3 out of sequence so I could rest my arms down by my side.

From there I headed to Starbucks located inside Holy Cross Hospital. I have the app and thought I ordered my cappuccino. Apparently, the app was still stuck on Broward General’s Starbucks. I wasted some money but someone at Broward General got a free coffee.

After getting the right hospital for Starbucks and getting my cappuccino, I headed to Whole Foods to replenish my food stocks. I bought mostly fruit and cheese. I could live off that if it wasn’t for my cholesterol.

I left Whole Foods for Walgreens to pick up my antidepressant medication and then made it back home in time to grab a banana for lunch and head out to Wilton Manors to get a massage from Tom. I made it home around 5 pm and either the traffic is lighter or I beat it. Maybe the snowbirds have returned to Capistrano.

The bad news is I got the reading on the MUGA scan. It is 40% for the left ventricle ejection fraction so there has been no improvement since the last echocardiogram. Looks like next Tuesday’s meeting with my oncologist will be very interesting.

Tonight is movie night with Chris and Tucker.

Stay tuned!

18 June 2024

Yesterday, Barbra braved the Davie Blvd. 5 pm traffic to pick me up to go to Tap42 with Joel and Keith. Barb and I arrived first and luckily found a parking place and then Joel and Keith walked in. Mondays are Prohibition Burger days where the burger is 1/2 off. Even so, I hesitate to order an $8 burger much less a $16 burger.

Tap 42 is probably for a much younger crowd than us. The music can be very loud, particularly if you sit inside. We opted for the patio and the patio still makes conversation a little difficult. Insert your thoughts about fuddy duddy here.

I managed to eat half my burger and less than half of my sweet potato fries. I will admit the service was quite attentive and efficient. The problem is meat has lost its appeal to me. Every time I make a meat dish at home, I find the next time I make it, I go vegetarian and enjoy it better.

Tap42 has something akin to Astroturf installed on the patio and of course, I almost tripped on those artificial blades of grass. As a consequence, when Barb drove me home, she got out and walked me to the door. I guess I’m still unsteady of my feet.

I’m debating whether or not to go to physical therapy today. I feel drained of energy. I didn’t even walk this morning. I haven’t felt well in quite a while. Whether it is psychosomatic in association with the Herceptin problem or simply fatigue from the cumulative effects of the Herceptin treatments, or some underlying medical condition, I don’t know.

The sun is out at the moment and it’s still breezy but we have rain predicted for eight of the next nine days. Part of that is due to the tropical system off the coast of Florida. There is some strengthening predicted but very little chance to develop into a tropical storm. It’ll mostly be a rain event. Pretty soon the ground will be saturated and the probability of flooding will increase. And, we haven’t even got into the busy part of hurricane season (August and September).

I managed to find another dentist yesterday. It’s a little out of the way from my house but they take AARP Delta Dental PPO. It’s a practice with three dentists and I went with the one with more experience. She is a co-owner of the practice. I’m scheduled for the 19th of August. I need to have the old dentist email the x-rays over to the new dentist.

Stay tuned!

17 June 2024

June seems to be flying by. We have two tropical depressions (Gulf of Mexico and east coast of Florida) but at least the sun has come out the last few days – for short periods of time.

I started my walk about 7:15 this morning and not paying attention, I didn’t notice the overcast skies. As I got a few feet down the sidewalk it started sprinkling. I debated whether to go back for the umbrella and figured I was waterproof and kept walking. It finally quit sprinkling about half way through the walk but as I write this and look out the window to check the weather, it’s overcast again and windy.

Yesterday, I was a popular boy. I started my 3 pm conversation with Jimmie and almost immediately, my friend Wade in San Francisco called. I sent him to voice mail. Then it was Joel – again voice mail. Next was a text from Barbara about going to Tap42 for hamburger specials, and lastly, Jennie, former secretary from Broward College. – to voice mail.

After hanging up with Jimmie, I was busy calling all the missed calls and texting Barbara. I can go long periods of time, weeks even, without a single phone call but like peeing, once you’ve broken the seal, as my friend Holley says, you are going to keep going. That’s like phone calls for me.

Other than phone calls and texts yesterday, it was a dead day for me. I pretty much spent the rest of the time reading and catching up with Brokenwood Mysteries on Acorn TV. I just finished re-watching the entire series of The Crown. Let’s face it, we’re in the dry season for new episodes and series on TV.

When everyone calls to check on me, like yesterday, they always ask how I feel. I feel OK. I don’t feel well but I’m OK. I’m readjusting to the blood pressure medicine and Jardiance. I’m a little lightheaded and unsteady on my feet but I put that down to the new medications. If I do a morning walk (0.9 miles today) it tires me out for quite a while. I peed on my first ketose strip yesterday and it was negative.

Dr. Jellinger wanted to do a NT PROBNP test on me. That stands for N-terminal pro-B type natriuretic peptide. It’s used to make NBP hormone. When there are large amounts of NT PROBNP in the blood stream, it means your heart is having to work harder. Normal amounts are 450 picograms/milliLiter or less. I came in at 36. So, at this point, I don’t have congestive heart failure.

Wednesday will tell more of the tale when I undergo a MUGA scan on the heart with a radioactive tracer. No caffeine for me on Wednesday. I’ll be grouchy until the first cup of coffee afterwards. Luckily, there’s a Starbucks in Holy Cross Hospital.

Stay tuned!

16 June 2024

Happy Fathers Day to all you Dads!

I really, really, really didn’t want to do my morning walk this morning. Finally around 7 I got out of bed and put on my clothes and boots and headed out to Riverland Road. Riverland is aptly named. It historically gets under water with a heavy dew. There are 3 or 4 places the water gets over a foot deep after a heavy rain. The temporary pond comes up over the swale, the sidewalk and into peoples’ yards.

Fortunately, the water has abated and the sun actually popped out this morning. It was pleasant albeit humid conditions for a walk.

Since the echocardiograms have shown decreased output in my left ventricle, all the doctors ask if I have a shortness of breath. Apparently, that clues them in to heart problems. The only time I could confirm that was a walk last week where I was huffing and puffing a little.

As I walked Riverland this morning, I realized I had defaulted to my hiking-up-a-mountain breathing pattern. I find I have more energy when hiking uphill if I take two shallow inhales and two shallow exhales per breath. It was a little startling to me to shift automatically into that pattern on flat terrain.

In any event, I made 1.4 miles today even though I was dragging by the time I got back to the house.

I’ve written before that I am now on a continuous glucose monitor. The device which attaches to your upper arm lasts for 14 days and then you have to detach it and then put on a new one. That’s the theory. The reality is these things come off on their own. Not easily. Usually it’s when I bump into a door jam. In one case, the monitor simply quit working well before the 14 days. I have now requested 3 new monitors from Abbott labs to replace the one defective and the two I knocked off. They’ve been very good about getting a replacement to me. There adhesive needs a little work. However, they were probably not designed for clumsy oafs like me.

For some reason, I’ve gotten into the baked sweet potato routine for dinner. I roast them in the peel in the oven for around an hour or hour and a half based on the size. Usually, after eating one, I’m not hungry for anything else.

There are two types of people in the sweet potato world. There are those that don’t eat the peel and those weirdos that do eat the peel. Yes, I know that’s where the nutrition is mostly contained but no self respecting Mississippian would eat the peel of a sweet potato. We leave that to the Alabamians.

Maybe I’ll try peeling them first, quarter them long ways and roast them in the oven. Maybe a sprinkle of brown sugar and cinnamon.

Stay tuned!

15 June 2024

For some reason, I had no energy yesterday. My afternoon nap ran to 3 hours! I got the pool filter cleaned (unbelievably dirty) but that was it and that was after the nap. I knew I wouldn’t be able to get to sleep last night so I took a sleeping pill for the first time in quite a while. I got out of bed around 7:30 and put on the coffee.

I feel a little better today but again have no energy. Changing linen on the bed this morning had me out of breath. I had to sit down and rest and drink a glass of water. I did manage to get my now usual, reduced cleaning routine done. I haven’t really done a good cleaning in months. Don’t go looking for dust bunnies under the beds because you will find a plethora of them. When I get my home equity line of credit paid off, I may entertain a cleaning service for the house. I’ve resisted so far. Maybe I can have them clean things I can’t get to and I can still do what I think needs me to clean.

One bit of good news is I’m now 3-0 on Signatera tests. This is the blood test that looks for breast cancer cells in your blood stream. The Florida panthers and I are doing great! I suspect I’ll be doing this test for the rest of my life.

I mentioned I canceled PT yesterday but I got a phone call a little later telling me they canceled it anyway because they lost electricity. I don’t know if that was due to the flood or if some work crews did something they shouldn’t have.

This was a very busy week. I had something scheduled for every weekday. Next week starts off easy. Tuesday I have PT, Wednesday is the MUGA scan and my monthly massage, Thursday is PT again and then on Friday I have my 6 month checkup with Dr. Burgers, my surgeon. I try to schedule only one event per day but Dr. Velez, the oncologist, scheduled the MUGA scan due to my reaction to Herceptin.

My auto insurance with State Farm went up by $241. I had read where insurance rates for autos was going up. It’s now $1760 for 6 months. Pretty soon I’m gonna have to take out a home loan to pay car insurance – either that or go back to work. I suspect my home insurance will also go up at least 10% (like every year). That’s if they let me keep my policy with Citizens – the insurer of last resort. I can see why some people who have paid off their homes stop their home owner’s insurance.

As you might guess, we’ve been blessed with a little more rain. At least we are not going through the deluges of the past 4 days. While the ground can still soak up most of the water, we will soon saturate it and then with a hurricane that’s heavy with rain, we could see some real flooding.

Stay tuned!

14 June 2024

I forced myself out of bed this morning about 6:20 and started my morning walk with overcast skies. I decided discretion was the better part of valor and instead of my trusty walking stick, I took an umbrella.

About 0.1 mile into my walk it started sprinkling. By the time I hit 0.2 miles, it started to rain and I was glad for my umbrella. I turned around and it continued to rain. I made it back to the house and it’s only stopped raining for the last few minutes. It’s 9:12 now so we’ve had about 2 hours of rain and drizzle.

Broward County reported some places got 20 inches in 24 hours. Hallandale and Hollywood were the most affected. One real problem was people driving through the water and sending wakes that would go into the homes along the road.

As you might guess, I messed up the order of sandwiches to the cancer center. There were two orders and the first order was delivered OK. The second order came to my house. I had to send the poor driver all the way across town to Holy Cross. Kathy, the Nurse Navigator called to profusely thank me. It was the least I could do for all they have done for me this year.

Since I’m getting some conflicting signals from several sources about the Herceptin treatment, I made the mistake of trying to get educated on the subject and I Googled “Herceptin and ejection fraction.” I read a couple of scientific papers on the subject. I then tried to find the original paper on the Dana Farber study about 17 or 18 treatments of Herceptin every three weeks apart. That’s pretty much a year of treatment. I couldn’t find the paper.

What I didn’t anticipate was how aggressive my cancer was. The HER2+ transmembrane protein is what the virus attaches to. Herceptin is like a blocker to the protein so the virus cannot attach. However, the HER2+transmembrane protein is found everywhere in the body, and, as you might guess, in the heart. That protein is necessary for the proper functioning of the heart so when you block it, it can lead to heart problems. They most often mention heart failure.

There are some studies out of the UK that suggest less than 17 treatments is OK and there are studies of the US that say that’s dangerous not to do the 17 treatments. Both are backed by data and methodology. What it boils down to is no one knows for sure if my missing 4 treatments will cause my cancer to return.

In any case, on the 19th I have a MUGA scan and on the 25th I have a Herceptin treatment scheduled with a meeting with Dr. Velez before the treatment. I find myself between a rock and a hard place in trying to make a decision. Another way of putting it is do I die of cancer or do I die of heart failure. Of course, neither event may occur but that’s kind of how the literature puts it.

The one bit of good news on that front is that I am also progesterone receptor and estrogen receptor positive. That means even though I had an aggressive form of cancer, it was slow growing.

Either my research depressed me or the weather is affecting me but I don’t have any energy today. I managed to drag the yard waste bin and garbage bin back from the curb and into their places in the side yard. I canceled physical therapy for today. I just couldn’t face that.

Farah, Dr. Jellinger’s assistant (endocrinology) faxed the bone density prescription over to Holy Cross. I should get a call from scheduling today sometime.

The Jardiance Dr. Jellinger put me on comes with all kinds of precautions. If my glucose level drops, dial back the insulin pen. I’ll pee a lot for the first two weeks and I need to pee onto the ketose strips to make sure I’m not losing too much sugar. It’s complicated to be on this drug.

I know I worry some of you with my dour and muddled look at things but I’m really OK. Like anyone going through this, I have good days and bad days. The good news is the good days do return.

The one thing that did startle me was in conversation with Dr. Jellinger about the effects of Herceptin and what Jardiance can and can not do, I mentioned I didn’t care as long as I could still hike. He looked at me, then away and didn’t respond. Maybe I’ll get a motorized wheel chair with tracks instead of wheels. Then I could go over any terrain.

Stay tuned!

13 June 2024

Yesterday’s rain was significant. Last year when I flooded, we received 22 inches of rain in 24 hours. Yesterday and the day before we received 22 inches in 48 hours. Fortunately, my area drained pretty quickly. The papers said Fort Lauderdale got 8 inches in a very short period of time. More is expected today. Monday of next week is the only day we are not predicted to have rain.

There was a time yesterday where there was a very heavy downpour and then it stopped all of a sudden. That harkened me back to those days in Mississippi where you thought tornado when that occurred. There were some tornados that touched down north of Palm Beach County.

This morning I met Chris and Tucker on our walk. We didn’t do movie night last night. Chris and Tucker would had to arrive by boat. She sent me a photo of Tucker after the afternoon walk in the rain and he looked like a drowned rat.

Just before I met Chris on the walk, I noticed my neighbor’s wax apple in bloom.

This is in the myrtle family of plants and is native to the Malay Peninsula. Technically, the fruit is edible.

The liquid to flesh ratio is similar to watermelon. Wikipedia suggests it tastes like a snow pear but I have no idea what that tastes like.

What I do know is the flowers had an unusual aroma – very much like just a hint of vanilla. It must have been very attractive to the bees.

Today is my only “off” day and with the skies clouding up, I suspect I’m headed back to bed with a book in my hand. I made chocolate cookies the other day so I have plenty to snack on.

Tomorrow is physical therapy with Shannon.

Instacart will deliver my sandwich orders from Publix to the cancer center today – if they are not flooded out.

Stay tuned!

12 June 2024

And the rains came. We had around 3 inches yesterday and they are predicting anywhere from 8-10 inches by the end of the week. So far, I’ve had no flooding. I turned my lawn sprinklers off for the duration of the rainy season.

I’m back to my getting out of bed by 6:30 and doing a morning walk. I managed 1.2 miles today. The temperature was 77°F but the humidity was 94%. I was damp and not by rain by the time I got back to the house.

You’ve read about my favorite yard on my walks. It’s like a miniature botanical garden. Here’s what the sidewalk looks like as you head north.

It’s like a tunnel of plant growth. You almost feel like you are in a tropical rain forest.

3:51 pm
All the streets are flooded in the neighborhood except my street. I can still see the top of the street. My trip back from the endocrinologist was exciting with people driving like insane people during flooded streets.

I had a long talk with my endocrinologist. My scheduled time in was 1:30 and he walked in around 1:40. I walked out at 10 till 3. He reviewed my echocardiograms and he suggested I discuss with the oncologist if the effects of Herceptin on the heart are permanent or if they are reversible and to what degree. He also suggested the oncologist contact my cardiologist and discuss the situation with him.

He put me back on Jardiance (10 mg 1x) which is for my A1c3 but also because it has proven to be effective in reducing heart failure. He just got back from a conference that Jardiance was the topic of discussion. That means I will be monitoring my urination (will increase) and my sugar levels in the urine by the ketone strips. Believe it or not, it’s kinda tough to pee on a tiny strip like that. One time before I did it the stream of urine knocked the strip out of my hand and into the toilet.

I have to watch out for dehydration. I have to look out for shortness of breath. I’m on another drug. Life is good.

The good news is my cholesterol is down as well as my LDL. He was pleased with that. He’s also doing a blood test that will determine if I have heart failure. Apparently, the atrium produces a hormone that is easily detected when stressed. He’s also asked me to get a bone density test. I’ve been on statin drugs for over 30 years and statin drugs can severely reduce bone density. He thought my chipped fibula could be due to that. I’ve got a prescription for that so I’ll go to Holy Cross for a blood draw some day soon.

Stay tuned.

11 June 2024

I had a major breakthrough yesterday! Not only did I trim my fingernails, but for the first time in about 10 months, I managed to trim my toenails! One step forward….

It started raining about 4 am this morning and has pretty much been a downpour, steady rain, or simply a drizzle all day today.

Here’s the 5 pm weather map. Florida is under there somewhere. Fort Lauderdale has had 2.03 inches and Hialeah has had 4.97. That’s just today. It’s still raining. The rest of the week is 80-90% chance of rain.

I called the director of nurses at the cancer center today and asked if I could send some Publix sandwiches to the staff and nurses at the infusion center. She was very appreciative. I have them ordered for delivery for Thursday from 10am to noon. I included a fruit plate and a carrot cake.

I did the same for the ground floor which are mostly nurses and physicians. I wanted to do something to say thank you for all the help they’ve been for the year’s time of treatment. Everyone has been great and I will miss them if I don’t have any more treatments.

I got a call from Holy Cross to schedule a MUGA scan. I didn’t think that was going to happen so I need to converse with Dr. Velez about why if we are not doing any more Herceptin treatments.

Today was physical therapy day. I wore my new boot which took a little getting use to. Shannon put me through a full workout but was mindful of my left ankle.

I was going to take the PT people some homemade chocolate cookies but I didn’t bake them long enough and they were too soft. I like them that way but they don’t transport well. I still have some dough so I make try again for Friday. Nothing like giving health care people practicing a healthy life style cookies with too much sugar, butter, and gluten.

Stay tuned!