Tag: Cowden’s Syndrome

Friends…

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It was hard to believe it had been so many years since we were all together.  It was even harder to imagine it was over 15 years since we all shared space, time, and our souls in SUNY New Paltz.  It was a far cry from most of our late nights at P & Gs.

As a matter of fact , as we sat across from each other at The Cheesecake Factory in New Jersey, two of them pregnant and all of us chatting about our children, and old times -often in the same breath- you never would have imagined the amount of time that passed since we last spoke – face to face.

But the food was decent, and the conversation refreshing, and I found myself wishing it could happen more often – or last a lot longer.  It hardly seemed right to get up when only a few hours had passed.  But each of our lives called us away.  To children, and husbands, and lives that needed tending to.

As we hugged each other, and I watched my two friends ‘baby bumps” bang into each other, I was reminded of the reality that real friendships truly do last forever.  We picked up with each other as though graduation had been last week, and although there was so much more to say, there wasn’t a moment that lacked conversation.

Facebook has been a blessing for us.  A way to keep tabs on each other, and keep track of the major happenings.  These ladies used Facebook as a means of support for me over the last six months, when some days it seemed the sky was falling.  They reached out to me – as if we were still next door neighbors in New Paltz.  Facebook arranged our meeting last night.  As a simple group message “Hey can we pull this off?” – and I am so grateful we did.

See in order to stay sane, life has to be about more than Cowden’s Syndrome.  It has to be about more than knee pain that wakes my girl up in the middle of the night after only 4 days without her Celebrex.  (At least we tried!)

Life has to be about more than infections that scare me half to death, viruses that take hold way too fast, and doctors that want to fix it all but don’t know how.

It can’t always be about tumors, and, “Are they growing or not?”

It can’t always be about the tests and the screenings, like tomorrow’s colonoscopy.

The recovery room at tomorrow’s colonoscopy site!

Those things are always going to be part of our lives – forever.  They aren’t going away.  That is the reality of Cowden’s Syndrome.

But the real reality, in the world where we know too well that “Everyone has Something,” is that it is necessary to make time to hug old friends.  It is helpful to the soul, to relive old times, and to sometimes sit and have dinner with people who stood beside you years ago, and who have made it clear they are prepared to do the same now.

Biting through the cage

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My dog Lucky is a bit neurotic.  She just is.  So when I came home today to find she had chewed through half her metal crate – literally lifted the bar off at one point, I wasn’t all that surprised.

Lucky (the black one) and Allie, playing together.

It got me to thinking though.  No one, or thing – really likes to be caged.  The “girls” get plenty of time to roam free when we are home, and when we are not, but we have to make the best decision for them each time. 

What struck me thought tonight, when I saw a piece of the metal crate literally bent off, is exactly how much she doesn’t like the crate, and how much she wants out.

We feel like that sometimes here – about PTEN, and Cowden’s Syndrome.  We feel like we are stuck, in a locked crate.  We want to run free, but the daunting tasks that lie ahead make it seem like an “Escape from Alcatraz” might be necessary.

Meghan’s fevers this weekend scared me.  I know her immune system deficiency may stand alone from Cowden’s, but that doesn’t make it any easier to process.  And, I swear if they were not related before, they feed off each other now.

The fever was gone Sunday night.  It made another showing of about 102 and then that was it.  She stayed home Monday with our friend Patty, and was treated like the princess she is.  By the time I came home Monday she looked so much more like herself.

We went to the pediatrician Monday night.  He wants me to contact her oncologist and get a referral to a neurologist to address the intermittent headaches she has been having.  Her oncologist who Emails quickly, got a set of all the recent labs and the recent brain MRI.  She is going to get back to me.  I have no idea where we will fit one more doctor in – but we will figure it out.

So this morning, we woke up feeling ready to go.  She responds so well to antibiotics, that we were seriously on the mend.

After she brushed her teeth she complained her gums were bothering her.  I didn’t see much. 

Tonight she said it was much worse.  There is a growth on her tongue.  Right on the edge.  It grew today.  During the day.  No idea why.  No clue what to do about it.  I don’t know but it reeks of Cowden’s and its NASTY overgrowth – of everything.

I guess I will deal with it tomorrow, right after I call on the throat culture and find out if we need to see the ENT.

Someone told me today I looked tired.  Not me.

If you need me, I will be biting my way through the crate, getting rid of one bar at a time.  Maybe Lucky las the right idea.

Stay tuned…

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I learned a few things as I set up my classroom this week.  Many of them I will not say here, because Mom always says, “If you don’t have anything nice to say, don’t say anything at all!”  Well at least that’s what she used to say when we were young…  but I digress.

I have been without my own classroom for a few years now.  I have been a traveling math cluster, and then last year shared a room with a colleague.  This year I was given my own 3rd floor room. It is harder to have a room, but change is good – so I was ready and excited to try it out.  And grateful for the opportunity. 

See last spring my colleague and I were told we were to share the 3rd floor room.  So, in the heat of June we brought everything we could (using LOTS of kids to help) up to that room.  The rest of my personal belongings (from the first 10 years in the classroom) were stored in a nearby storage closet.

Sometime over the summer I got an Email that the schedule had changed.  The third floor room would be mine alone, and the 1st floor room would belong to my colleague.  So I set about the business of buying all the things you need for a room.

I brought my things in on August 22nd, but I couldn’t stay to set up.  Meghan had an appointment.  As a matter of fact I couldn’t come in the next day either because of two of my appointments -so I first got in to get settled yesterday.

Much to my surprise, the storage closet where all my personal things were had a new lock.  I didn’t have a key so I took that as my clue to vacate. 

Now, prior to the Mastectomy, I was pretty strong.  I helped my husband renovate the house.  I know how to move heavy things.  Prior to the hysterectomy and the mastectomy – just a few short months apart, and just 6 months ago… I felt like this.

Now, after moving boxes for 3 hours yesterday. up and down the stairs, even with the help of a few well intentioned friends, I feel more like this.

I am sore in places I had no idea it was OK to be sore.  This was either an eye opener to my age, my body’s fatigue, or the fact that it is time for some serious exercise.

But, after 2 days my classroom went from this:

To a lot closer to this:

Which is a good thing, because I just don’t do clutter well at all.

So when I left a little more relaxed it was time to get a confusing phone call from the doctor.

Meghan’s blood panel appears normal, but I have to compare the thyroid numbers off the last one when I see it.  That was OK, and then he said the MRI had an “ODD” finding – shocker!

The “anterior pituitary tissue is seen though it is diminutive in size for age.”

Still actively trying to figure out what that means, especially because we were scanning for a pituitary tumor to try to find the cause of the early puberty. Now, clearly the pituitary is TOO SMALL?  Really?  I just can’t figure this out.

Grateful there is no tumor, I asked the doctor if it was insignificant.  To which he replied, “Everything means something.  I have never seen this before but I will be asking a lot of questions.”

So, fourth grade for my big girl tomorrow.  One day at a time, this is all we can do…

One of a kind…

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It probably started in the spring.  Meghan’s class had been working on a fundraiser for Alex’s Lemonade Stand. (alexslemonade.org)  The entire third grade was raising money for childhood cancer, and she took her fundraising work very seriously.

Meghan decided to make a bookmark, with a picture of my cousin Meghan – Angel Meghan as we speak of her – who died from Leukemia in 1991.  She wanted to make her connection to the fundraising personal.  As we prepared baskets of bookmarks to leave with people we knew, Meghan decided we should sell ribbons too.

So, I asked her what color?  She wasn’t sure what I meant, but I really didn’t know if there was a color ribbon for childhood cancer.  So, she took out her iPad and a quick search found us gold.  The gold ribbon was the color for childhood cancer.

 So we headed to Michael’s and bought up as much gold ribbon as we could find. We bought lots of safety pins.  We set to work cutting and pinning.

We dropped baskets off with my Uncle Chris and cousin Katie (“Angel Meghan’s” Dad and sister.)  They were eager to help, and passed baskets off to friends of theirs.  Before we knew it we were making more ribbons, and more bookmarks.

Meghan was so absolutely thrilled to raise over $500 for the project.  It was such a huge success and we were so proud.

That project raised her awareness of her ability to do for others, and helped her confidence so much.  It also made her aware, acutely aware, of cause ribbons.  She would identify the ones she knew, like the pink ribbon for breast cancer, and she would look up ones she didn’t know.  She learned about the puzzle piece for autism, and even yellow ribbons being used when soldiers are away from home.  I think that is the project that truly got her using a search engine too.  (Thanks Mrs. Azzarello!)

It seemed only natural, that months later, having watched me receive pink ribbons after my breast cancer surgery, and after countless surgeries and appointments of her own, that she would ask what “our” ribbon was.  Not sure of course exactly what she meant, I had her clarify.  “What is the ribbon for genetic diseases?”

So back to the search engines we went.  We tried a few other places. but eventually decided that this was the one.

It made sense.  The Global Genes Project had a logo that reflected her cause.  This was the ribbon for Rare Diseases – genetic disorders like our Cowden’s Syndrome.  It Made sense, their saying, “Hope – It’s in our genes” was catchy enough, and it left you thinking about the connection between genes, and jeans – the denim ribbon.

The next question should have had a simple answer – but it didn’t.  She said, “Can I have one?”

Once she clarified that she needed something, something to represent her, and all she has gone through, I understood.  She needed a symbol, something to wear that would make it easier to talk to people, that would help her feel proud, and strong, like it all mattered.

Sure, I thought.  We will get you something.

Well I looked, and I looked, and I looked.  There was nothing.  Beyond the sticker I had gotten as a thank you when I sent a contribution to The Global Genes Project, I could find NOTHING for her to own or wear, no jewelry or clothes with this “denim” ribbon.

Well sometimes the best ideas are born out of lunchtime conversation.  So, as I sat with some teacher friends the next day, I recanted Meghan’s desire to have her own cause ribbon.  One friend, the pure hearted Mom of an autistic son, who was wearing a beautiful diamond puzzle piece around her neck, “got it” on so many levels.  And, her husband happens to be a jeweler.

She said, “give me what you have, let’s see what we can do.”

Well I think we all thought it would be easier than it was.  But after weeks of searching her husband determined that there was nothing, anywhere like what we were looking for.  If we wanted it, we could have it, but they would have to make the mold.

Fortunate to have good and generous people in our lives, we paid only for the cost of the creation of the piece.  My friends husband generously donated his time, because he too “gets it.”  Their goal was only to make my girl happy.  And for that I am so grateful.

After anxious months of waiting, the piece arrived last Friday.  She treats it like a rare gem.

It is RARE, a one of a kind beauty – just like my girl.  But, never staying focused on herself for too long, she thought – wouldn’t it be nice if we could do a fundraiser, and sell these so that we could raise money for The Global Genes Project?

Well, last Friday we sent them an Email with several pictures.  It is a crazy time of year, but we are anxious to hear from them, and hoping that Meghan’s idea, can benefit many others.  It would be fitting.  That’s just the kind of kid she is.

For now though, the necklace is “one of a kind,” just like her!

Bookends

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So my little girl took some of the influence of her Dad and has taken a liking to comic books.  She has been reading them on her Ipad, and although I might not admit it to either one of them, I kind of like the idea.  I like Superheroes, and their “Good beats evil” message.  I know it doesn’t always work out that way, but she is 9…

I sat in the MRI room with Meghan tonight – again.  And even though it is a wonder I could think of anything over the banging of the machine, and the remnants of this migraine I have been fighting for days, I kept thinking of bookends.

Yep, bookends.  See, back in June, on the first day after school was out for the summer we went for an MRI of her knee.  It was a Thursday, the Thursday before July 4th.  So, how ironic I thought, when earlier I was sitting in another MRI, this one of her brain, on the Thursday before Labor Day.

Bookends.  Our summer ends the way it began, waiting for test results.  Although I am starting to get the feeling that this testing and waiting will transcend all seasons.  I will just notice it more in the summer – the season where I have one full time job (Mom to Meghan,) rather than two (Mom to Meghan AND teacher.)

And I am reminded of the image of the dog digging up the street that Meghan found for me a few weeks ago.  This is what we do.

We do not accept anything less than an answer that makes Mommy comfortable.  When the doctors tell me that puberty is just starting earlier these days, I buy it – to a point.  When they tell me to consider all the hormones in the milk, and the chicken, I raise an eyebrow.  My girl who has been dairy free since she was 15 months old, and has almost never consumed a piece of nonorganic chicken, who is at or below the weight for her height, and who has a mom who went through puberty LATE, should be one of the early ones… I just don’t buy it.  So when the hormone tests don’t match, and I get doctors refusing to answer me, I push harder.  That is what the MRI was today.  My fault.  I needed to have them rule out a pituitary tumor.  We have Cowden’s Syndrome.  We grow things.  Someone should check.  Just sayin… Then, when the results are clean in a few days I will breathe deeply and accept that this just IS.

And the recurrent strep… well lo and behold, the ENT said there is regrowth of the tonsil tissue.  He wants to see her the next time she has strep.  He shouldn’t have to wait too long.  He also told me the right lobe of her thyroid was quite enlarged.

So we wait for the thyroid panel, and wonder if it has changed drastically.  And, we think of those nodules on her thyroid and the doctor who told me they will turn… not if – but when.

Bookends.

We started the summer at the doctor.  We spent most of the summer at the doctor.  Scan this, check that.  It will never happen like this again if I can control it, but it was necessary this time.

And in between the bookends of MRIs, we fit in some fun stuff.  There were some great play dates. a day trip to the beach, some swims in the pool. a FABULOUS trip to Disney, a week of Vacation Bible School – (although not our “favorite”one.)  There were some lazy days, and lots of just being together time.  We can get a lot of talking in on all those trips to the doctor.

I guess the summer wasn’t a total loss, and yet still somehow I feel sad.  Cheated.  I stress at the thought of the scheduling complications being back at work brings.  Holding up the appointments of a regular kid (eyes, orthodontist, swim class, PT, dance…) is tough enough.  Complicate it with Cowden’s x2 and it gets hairy.

Maybe I feel like this every summer.  Maybe I just love my girl too much.  Time marches on.  School next week ready or not!

My beautiful 9 year old!

“The Velveteen Rabbit”

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by Margery Williams

“Real isn’t how you are made,” said the Skin Horse.  “It’s a thing that happens to you….

…”It doesn’t happen all at once,” said the Skin Horse.  “You become.  It takes a long time.  That’s why it doesn’t happen often to people who break easily, or have sharp edges, or who have to be carefully kept.”  Generally, by the time you are Real, most of your hair has been loved off. and your eyes drop out, and you get loose in the joints, and very shabby.  But all those things don’t matter at all because once you are Real you can’t be ugly, except to people who don’t understand…”

I spoke to the oncologist today, about my MRI.  She had really no better or clearer information than the nurse I spoke to Friday.  The harmatomas are large.  There are several.  They might be able to stay, they might not.  She requested the sonogram from April to see if it is worth a comparison.  I will get the CD and the reports and send them along.  I will let the doctors again analyze the same few articles on Cowden’s Syndrome that exist.  I won’t tell them that I have likely read all of them myself too.  I will let them tell me if the spleen stays or goes.

I think it is that conversation, combined with the one I had with Meghan that brought the story of The Velveteen Rabbit to my mind tonight.  As we are buying clothes for school and trying to keep her quickly developing body comfortable and appropriate, she asks about my scars.  There are quite a few, the lipoma in my neck, the partial thyroidectomy, the C-Section, the hysterectomy, but she focuses on the mastectomy. and the scars from the reconstruction.  She asks sometimes to see them even as they are covered.  She asks if she will get to decide when to have that surgery.  “IF” I stress, “IF!”  You don’t know…  But she knows.  She is preparing already for the day it is her turn.  It twists my stomach in a knot.

We have had between us more than 25 surgeries, large and small.  We have scars of all sizes – inside and out.  But we are “Real.”  In a deep, important sense, we are “real” to each other.

I am in limbo… waiting.  But it is ok.  I live in a house where I have become “real.”  And, even on my darkest days, “…once you are Real you can’t be ugly, except to people who don’t understand.”

“It’s not fair!”

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“It’s NOT fair Daddy!”  Came the screech from the basement.  I held my breath. 

“You can’t do that Daddy!  It’s NOT fair!”

When I heard my husband return the challenge with an “Oh yeah? Watch this!”  I knew all was well.  The giggling that followed sealed the deal.

I couldn’t help but find it a bit ironic that of all the things that have gone on in her life, she chooses a helicopter game in the basement with her Dad, to shout the words,”IT’S NOT FAIR!”

She didn’t use those words once, all summer, when we spent what I equate to an OBSCENE amount of hours in doctor’s offices and waiting rooms.  She didn’t utter those words as she was poked and prodded and asked the same questions over and over. “They never find the answers anyway, Mommy.”

She didn’t tell me it wasn’t fair, when instead of planning playdates, or camp experiences we were trekking back and forth to Manhattan, for her, or for me.  She simply wiggled in the play time when there was room.

This morning, when I sprung on her the idea that she needed bloodwork, after the bank, and before the orthodontist, she could have EASILY told me. “It’s not fair!”  And I would have understood.  I know very few people who have given up more blood than she has.  And when the lab was full, and we had to come back later, so she could think about it all day, she definitely could have told me, “It’s not fair!”  But she didn’t.

This morning when we learned that her braces are imminent, and that she is going to need to contend with them in addition to her new grade and ever changing body – I expected a yell.  Nope.  “Won’t it be great to have them off before most of my friends even get theirs on?”

So as I scheduled one more MRI this week.  This one for her, to make sure the pituitary is its proper size with no extra features… I thought it would be a big foot stamping, “It’s not fair!”  Nothing.  Just the typical, “Can you stay, and will I need a needle?”  Followed by, “I hope I can watch a movie this time because I don’t like having my head done.”  How disturbing that this will be her third brain MRI.

This has been one hell of a summer, following one seriously wild spring.  I have lost count of the appointments, and it is probably better.  They aren’t going anywhere and we will continue to have to roll with it.  As the last week of summer vacation comes to a close, and I lament the lack of relaxation, the cleaning that never happened, the day trips that never came to pass, I want to shout, “IT”S NOT FAIR!”

But then I look at my 9 year old.  Wise beyond her years.  Content to live in this house where she is so loved and appreciated.  We have had many talks about the suffering of others through the years, and especially this year.  She knows she is not alone in having a tough path to travel.  She also knows it could be worse.

Maybe that contributes to the poise and grace under pressure.  Maybe that is why she is so insanely mature.  Or maybe, in the midst of the chaos that is Cowden’s Syndrome, we – her father and I – are just the luckiest parents in the world.

But God is good – all the time!

“I plan, God laughs.”

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I really should listen to my Mom…

My Mom says this… a lot.  And she is usually right.  I am a planner by nature.  Mom, although sometimes reluctant to admit it, is a planner too.  The difference is that the wisdom of her years have helped her tone down the level of planning so it is a bit less obvious, and she has also – wisely- learned to keep many of the plans she does make – to herself.

I like to organize everything, and quite simply put – Cowden’s Syndrome is chaos.  At least right now.

I mean eventually maybe it will fall into a neat little schedule of screenings, and routine visits, but right now – not so much.  If you saw the legal size yellow pad on my desk you would chuckle.  I have appointments planned until February of 2013.  And, at first glance to list doesn’t look too bad.  I was proud.  I got to these appointments early.  They are all routine.  They will all happen after school or on vacation days.  My terms.  But then we get to the unscheduled ones… and the follow ups… and the new visits.  That’s when things start getting hairy.

I called the oncologist‘s office today to get the results of my MRI.  The oncologist is away until Tuesday, but a very kind nurse called me back in about an hour.  She said, “Everything is benign.”  I wasn’t sure to be relived, or panicked.  What “everything?”  So she started with telling me my liver is just fine.  (Well thank goodness, because I hadn’t even THOUGHT to worry about my liver.)  She then proceeded to tell me there was a “small cyst” on my kidney, but that was probably no big deal. (And probably not a worry unless you live in a subgroup of people that have a 33% lifetime incidence of renal cell carcinoma.) She continued by telling me my spleen was “a bit more involved.” Hmmm… never have those words started a positive conversation.

The last two times I have had abdominal sonograms, both have very matter of factly stated that there is one 3.5 cm harmatoma on my spleen.  Ok, I had decided all by myself… if it stays 3.5 cm and behaves, we will just leave it there.

Well, apparently there is a “vascular lesion” that is a “significant” size, and “several” small harmatomas on the spleen.

So I said, “what does this all mean?”  That is when she said we would have to wait until the oncologist returned to determine the necessary next steps.

“Can I have a copy of the report?”

“I would rather not send it to you until you speak to the doctor.  I just wanted to reassure you there were no malignancies.  She may want you to come in.”

Which is where I did laugh out loud.  Come in – to hear a summary of what I was just told?  No thanks.  Just tell me what I need to do next and I will get it done.

I looked at my nice yellow pad, where September  previously had no appointments, and I see the colonoscopy written in for the 18th.

I have to say I was pretty sure 2 major surgeries for me, meant I was done for the year.  There goes that planning again.  Maybe I will keep my spleen and its harmatomas forever.  Maybe they will make me have it out.  Truth is I have no idea.  And I can’t plan for it at all.

School starts in a week or so.  My life apparently doesn’t always jive with the school calendar.  I will have to roll with it.

More importantly, Pop’s birthday is tomorrow.  He is 93, and a true inspiration.  My family will gather at my house to celebrate him.  I couldn’t be more excited.

I really think I am OK with this concept, but we all need a reminder sometimes!

I will get my results Tuesday, and life will go on.  It will all work itself out, as it has for… well forever.  I will try to keep the planning in check.  I really do try.

The only thing I am planning tonight is how many chairs I need for Pop’s birthday celebration!

Whose afraid on an MRI? Not me – practice makes perfect!

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MRI

So as I was positioned to be rolled into the MRI tube today, I realized my heart wasn’t even racing.  Not that I ENJOY an MRI, it’s just they have become so familiar that they no longer provoke the anxiety they used to.  I have held onto Meghan‘s shoulder through countless knee MRIs, and this past year have had quite a few of my own.

Today it was an abdominal MRI.  Now if you have been following the story at all you know my abdomen is missing a few things.  You may or may not know that there is also the issue of a harmatoma (basically a fatty tumor) on my spleen from this PTEN harmatoma tumor syndrome.  Yep, that’s the other big fancy name for Cowden’s Syndrome – or more technically it is the umbrella term that covers Cowden’s and several other syndromes.

So, why the MRI?  Well among the other neat cancers that seem to come with this genetic mutation, is renal cell carcinoma.  A recent study, the same one that put the lifetime breast cancer risk at 85%, placed the risk of renal cell carcinoma in Cowden’s patients at 33% Yep, quiet old kidney cancer – hiding there until it causes you a problem.  So, they like to screen for it – twice a year with an abdominal MRI.

http://www.ncbi.nlm.nih.gov/pubmed/22252256

Part of me wishes they could just do the kidney.  You see I have this theory about taking the used car to the mechanic…  You just sometimes find out more than you wanted to know.

OK Used Cars

 I really am not in the mood to lose any more organs.  I think I have reached my quota for the year.  And I have to tell you, this is one hell of a way to lose a few pounds.

So, somtime tomorrow or Monday the oncologist will call me.  She will tell me that the kidneys look great.  She will tell me that the harmatoma on the spleen hasn’t grown, and it can stay right where it is.  She will also tell me that the stones they saw on ultrasound in my gallbladder a few months ago are no problem at all.  She will tell me all that because that is what I need to hear.  And hopefully it will all be true.

I need it to be true.  Because I will be busy.  An appointment right before the MRI with a new GI set me up for the “necessary” screening endoscopy/colonoscopy on September 18th. The risk of colon cancer is a meager 9%, up only a few % points from the general population, but no point leaving any stone unturned I guess!

Some days I wait for the break.  The time when we will be without doctors.  Then I realize this is all so new.  They are all so scared and confused they are doing all they can when they scan this, study that…  Hey, it worked for me when they saved my life with the breast cancer.  And, it will work to keep my girl safe as we scan her thyroid religiously.

I am tired.  I would be lying if I said anything else.  I am TIRED of doctors.  But, as I said before… I will keep going, necause there is no choice.  Plus, “Everybody has SOMETHING!” https://beatingcowdens.wordpress.com/wp-admin/post.php?post=693&action=edit

At least I am not afraid of the MRI tube anymore!