Update

Hello to anyone out there who is still following my blog.  I hope there are some of you out there still.  I am doing well.  As far as my physical health goes, I continue to see my surgical oncologist on a monthly basis.  I continue to have normal exams, but unfortunately my CA125 blood test continues to rise.  My pain that started most of this work-up is almost completely gone.  Not sure if that is due to decreasing my intake of nuts (almonds) but could be linked.  I have another blood test and exam next week.
I have been offered a 20 hour position in Fremont Kaiser which means I will soon have benefits.  The job is the same as I'm doing now but will now be guaranteed hours and the very nice benefit package to go along with it.  Very reassuring for me to soon have that in place.
Oliver and I are making pet therapy visits a few times/month and getting more relaxed with it.
I am speaking this Saturday at St Joseph's Treat-meant for You day for people diagnosed with cancer in the past year or currently in treatment.  I will be speaking on forgiveness.  Oliver will also be there with me for Pet Therapy.  It will be a wonderfully rewarding day.
All in the family are well.  Rileigh will be coming home soon for the summer.  Robert is going to Peru at the end of the month for a vacation.  Dana and Bobby are working hard to pay for Rileigh's college and have found a good balance of playing hard too when they have a day off together.  They are taking a trip to Vegas at the end of the month to celebrate their 25th wedding anniversary.  Dad is playing softball again.  Mom is keeping busy on the house and taking classes to further her spiritual growth.
I was dedicated enough to finally write out my goals for the year with action plans on how to achieve them all.  One goal is to continue to do this blog every 3-4 weeks if not on a more consistent basis.  I hope all of you will keep me on track with that goal.
Please be well and keep in touch,
Denise

Tax Season and Mind/Body/Spirit Presentations

Many of you, I'm sure, dread doing your tax work like I do.  Even though I don't enjoy it, it is not usually something I procrastinate.  Most years I have my taxes done by mid Feb.  This year has been different.  I have put it off and put it off and put if off.  A few nights ago, I finally was able to make myself sit down and work on some of it.  I soon realized why I had such a procrastination block.  Obviously, I have significant health bills, receipts, miles to track and such for my 2011 year of treatment.  As I was going through receipt and receipt after receipt of all of my visits I began to cry.  By looking at all those receipts, I was reliving the year of feeling so awful and it wasn't so pleasant.  My procrastination had a real reason behind it.  My taxes are still not done, in fact I'm suppose to be working on them now.  So, as you can see, I continue to procrastinate a bit with it.  But now I allow myself some of the delay because I better understand what's behind it.  

On a brighter note, I had the opportunity to give a presentation on Mind/Body/Spirit yesterday to a local Women's Shelter.  It was great.  I spent a good deal of time over the past 10 days working on the presentation and it was very well received.  My mom was kind enough to go with me and video the presentation so I can use it as a critiquing tool to see how I can make it better.  My next presentation will be in April at the St. Joseph's Treatment for You Day which is a "spa day" for anyone diagnosed with cancer in the past year.  If you know anyone who has been diagnosed in the past year and lives in this area, let me know and we will get them signed up.  

And for those of you who aren't on Facebook and don't already know: Oliver and I became certified as a Pet Therapy Dog Team.  We are waiting for our national certification to come in the mail, but once it does we can officially make visits on our own.  We are currently scheduled to appear at the Treatment for You day that I mentioned above.  Yea!  We have a graduation picture that I'm hoping to get through email and then I'll post it here for everyone to see. 

Love to you all

Denise

Perspective and Appreciation

Good February day to all.
Just wanted to say a few words about gratitude for the small things that can sometimes be overlooked.  I recently was sick with the flu.  After being sick for a few days I decided to attempt a short walk with Oliver.  About half way through the walk (and in the back of the orchard) I felt very tired and was ready to be done.  I immediately turned to negative self-talk and said I shouldn't have gone so far.  But, I'm happy to say I quickly corrected myself and said...remember when you could only walk to the neighbors house, or only down the street, or needed help with a person on each side holding my arms to get through a walk.  Then I realized all of that was only a year ago.  It brought a smile to my face.  In a years time how far I've come.  This is the perspective in which I want to see things and live my life.  Thank you for the opportunity to choose to walk ON MY OWN.  Thank you for the beautiful almond blossoms on the trees that provide a surreal scenery in which to walk, aroma and all.

To give you update on the other things going on....

I am changing jobs to Kaiser Walnut Creek.  I will still be working Perioperative medicine but this job is a 20 hour position so will have benefits.  YEA!!!  My days of paying Cobra are soon to end.  I have a very good feel about the environment and the people I will be working with.

I am also becoming more involved in St Joseph's cancer program.  Jim Linderman is the head of the cancer center and him and I have had several discussions about my vision of a wellness center.  He has offered me 3 different opportunities to help move me in that direction.  I will be presenting as one of the breakout sessions at St Joseph's Treat-ment for You Day.  This is a day of pampering for people diagnosed with cancer in the past year or two  They offer help with diagnoses, massages, manicures, and good fun energy with others with cancer.  I will also be presenting a 90minute workshop/class at St Josephs in the spring.  And just today he asked if I would make a 30 min presentation and one of the Women's shelter in the area in March.  All of this is extremely anxiety provoking but also the direction I would like to take so I'm pushing myself beyond the fear.

As far as my health.  I continue to feel good.  The left lower quadrant pain comes/goes.  I had yet another visit with my surgical oncologist.  My exam remains normal, other than the left sided pain. But my Ca-125 values continue to creep up.  My level is now 30.  So I've gone from 6 (post chemo) to 30 two weeks ago.  I decided to continue and wait so we will repeat another blood test and exam in 4 weeks (March 15th).  I continue to juice twice daily, green smoothie once daily, exercise, and eat mostly raw/whole foods.  I attended a Women's Wellness nutritional conference put on by David Wolfe's Longevity Now for 4 days in Costa Mesa which was wonderful.

I hope you are all doing well.  Thank you for your support,
Denise

Update Thursday, Jan 19th

It has come time to give all of you an update on my health.  On Saturday, December 17th I began having some left sided lower pain.  It persisted over the next 2 days.  On the following Monday I called in to my Gyn Oncologist's office. My physician was out for the week for the holiday but her nurse advised me to have my Ca125 (tumor marker test) done earlier than planned.  Unfortunately, the test showed an elevation compared to my numbers over the last year.  I had been running 6 throughout the year. I went up just a tad to 8 in September and the test on Dec 22nd was 17.  This is still in normal range but a definite change from what I had been trending.  My physician called me once she was back in the office and advised a CAT scan and an exam with her.  I was already scheduled to see her on Jan 19th for my routine 3 month check.  I did the CAT scan on Dec 28.  It unfortunately has added to the confusion, rather than helping.  It didn't show anything on the lower left side where I was feeling the pain, but there is a small nodule just below my belly button area.  Unfortunately, no one knows what this nodule is or its significance.  Dr. Chen called me a bit frustrated herself.  We decided to repeat another Ca125 before coming to see her on the 19th.
So today is the 19th and I did have an exan by Dr. Chen which was normal.  Unfortunately, my Ca125 continues to creep up and is now 24.  Dr. Chen would like to believe that my pain and the increase in my blood test is from Diverticulosis, but cannot know for sure.  We discussed jumping into a variety of treatments including: chemo, PET scan, and Laparoscopic Surgery with colonoscopy, or waiting.  I chose to wait.
The plan is to continue to follow Ca 125 values and exams over the next few weeks and see what the trend is.  Dr. Chen again wonders if all my wonderful healthy eating of raw foods/roughage/juicing is creating a diverticulosis but was quick to say continue doing what you're doing.
I would like to be confident with all the good changes I've made, how good I feel overall, and everything I've been working on to improve my health that there is no cancer developing in my body again.  But the stress and fear of the unknown still remain in the back of my head.
I was trying to keep all of this quiet from all of you until I knew something definite and could reassure you and just let you know what I HAD been going through. BUT I continue to not have answers.  You all know I'm pretty much a "writing on the walls kind of gal" and it's hard for me to say all is good and I'm feeling great when any of you are asking how's it going.  Sooo, at this point I prefer to be completely honest and let you know what is happening even though I don't have solid answers.
I appreciate any support, prayers, positive thoughts, healthy guided visualizations you can do on my behalf. I deeply hope to be writing to you soon letting you know there is a decrease in my Ca125 value.  Until then, I will continue with massage therapy, acupuncture, neuro reflex therapy, electro lymphatic drainage, supplementation, detoxing, juicing, exercising, walking/loving on Oliver, meditation, and learning/reading all I can on living a balanced/healthy diet in mind, body, and spirit.

Article in St. Joseph's Cancer Quarterly

I wanted to share an article I was asked to write for the Cancer Quarterly Newsletter put out by St. Joseph's hospital in Stockton.  I have participated in several of their activities over the past year and the head of the cancer center (Jim Linderman) asked if I would contribute to their latest newsletter.  I hoped to put a link to the entire newsletter in this blog, but my technical abilities or inabilities are preventing me from doing so.  Anyway, here is the written words of the article without all the glory of the actual newsletter.  Hope you enjoy!


Embracing My
Cancer Diagnosis
By Denise Southwick
My diagnosis of stage 3C Fallopian
Tube Cancer came in November of
2010. It was quite a challenge for me to
play the part of the patient, because I’ve
been a nurse practitioner for 14 years.
I was happy being the one in the white
coat providing support, treatment, and
education to patients. I wasn’t supposed
to be the bald one on the exam table.
Well, our journeys are not always as we
planned.
As long as I can remember, I’ve tried
to live my life from a positive perspective,
believing that there is a higher power out
there working with me. I welcome the
lesson in every experience, despite the
perception of it being positive or negative.
Fortunately, I maintained this attitude
with my cancer diagnosis. I knew I had
been struggling with stagnation in my life

and felt I could be doing more to aspire to
happiness. So when the diagnosis came,
I accepted that this was my opportunity
to shake things up and take my life to a
whole new level. Easier said than done!
I found that I embraced my cancer
diagnosis and all that I could learn.
Unfortunately, I was not so enthused
about the chemotherapy. My energy and
ability to be positive were zapped and all

I could focus on was how to get through
the next few minutes, hours, and that
particular day.
When opportunities arose that
seemed to me to be baby steps towards
getting back to living a purposeful
life, I tried to push myself to partake. I
agreed to have a foot rub by my massage
therapist. And agreed to attend a
KMBS workshop at St. Joseph’s about
meditation. And, reluctantly I agreed to
participate in the Treat-Meant for You
Day. I’m the first to admit I really didn’t
want to go. I didn’t want to be around
“sick” people, because I was already
struggling with trying to maintain a
healthy frame of mind.
What if you could be in an
environment where the person with a
full head of hair was more of the anomaly
than your own bald head? And most of
the people around you truly understood
what you were going through – not
showing sympathy but ALSO walking
that same cancer path. What if this
environment also provided services that
helped you feel like a whole person again;
provided insight on how to heal in every
way with laughter, giving, and relaxation?
When I arrived and saw all the people
with head dressings such as wigs, hats,
scarves, and a few brave bald ones, I
thought to myself, this is going to be so
depressing. Boy was I wrong.
I thoroughly enjoyed interacting with
“my people” who understood just what
I was feeling. Those providing services
wanted to help and wanted, so much,
for this to be a positive and healing
experience for all involved. I encourage
any of you newly diagnosed, to embrace
what the Treat-Meant for You day has to
offer. Along with Treat-Meant for You I
found many modalities including support
groups, acupuncture, massage therapy,
meditation, and nutritional supplements
that are helping me heal my mind, body,
and soul. My focus now is in helping
others who are called to walk a path
similar to mine.
denisesouthwick@gmail.com

Happy New Year

I hope you are all having a safe and joyous night tonight.  My family and I are headed to Kathy's (soccer mom) house to play LCR.  It's a silly game that somehow becomes fun when mixed with a lot of people.
I wanted to say thank you for all of your support over the past year.  I appreciate each and every one of you.  I will write more soon, but wanted to send out a Happy New Year's wish.
Here's to a wonderfully exciting and HEALTHY 2012.

Guest "Lecturer" at Stanford Medical School 11/29/2011

Stanford was my dream school to attend for undergrad.  I did not make it there, but last week had the opportunity to be a guest "lecturer" to 2nd year medical students during their Gynecology Oncology rotation. The California Ovarian Cancer Coalition has a program called STS (Survivors Teaching Students).  The leader of my ovarian cancer support group is heavily involved in the STS program.  I, along with 2 other survivors spoke to a group of 60 or so students during their pathology class.  We spoke about our cancer journey and what we thought future doctors should know about diagnosis and treating ovarian cancer.  The professor came up to me after our platform and asked if I was a professional speaker.  YEA!! She said we were the best panal they have ever had.  It was such a great experience and hopefully puts a face to this disease and helps those students diagnosis Ovarian/Fallopian Tube/Peritoneal Cancers in the future.
I've included here my speech just for mere interest to all of you and to help increase the awareness of this group of cancers. 
Enjoy!  As always, I am open to hearing back from anyone who wants to share their thoughts. 

Good Morning.  My name is Denise.  I bring a few unique perspectives to my cancer diagnosis.  1) I am a Nurse Practitioner and had been working in Women’s Health for 14 years at the time of my diagnosis; 2) is that my official diagnosis was Fallopian Tube cancer; 3) is that I was diagnosed at the age of 38 years old.  

More and more research is coming about that shows the majority of ovarian or primary peritoneal cancers probably start in the Fallopian tubes.  The challenge with diagnosing it as so is due to the late diagnosis and simply that most pathologist aren’t aware to be looking for the fallopian tubes as the primary site. 

It is difficult for me to say exactly when my symptoms started, but I believe it was some time in March or April of 2010.   I remember having a week of lower abdominal pain mixed with bowel pressure, and diarrhea.  I attributed it to something I ate.  About a month later I had similar symptoms and thought that was odd because I could not think of anything I ate to cause the symptoms.  When the symptoms hit the third month, I realized it was at the time of my ovulation.  I never really had any history of painful ovulation prior to this so I thought this was also odd.  I waited another month to see if indeed the symptoms occurred again at ovulation and they did. 

At that time I contacted a NP friend and asked for some lab work and an ultrasound and made an appointment to be seen.  This was August 2010 and at this point I was having a descent amount of lower abdominal pain/pressure, pressure and urgency to urinate, and pressure and frequent BM’s.  What I also thought was odd was I was having severe back pain.  U/a and STD screening were done and came back normal.  My exam on that day was also normal; the NP referred me to GI while we were waiting for the u/s results.

The ultrasound results are still a mystery to this day.  Because I knew the tech and knew how ultrasounds worked, the tech was open in talking to me about the findings.  The tech said he saw a 5 x 6 cm solid mass on my left side.  He made it clear that it was not attached to my ovary or uterus, but that it was displacing my bladder, uterus and lower intestine.  He said I would most likely need a CT scan. BUT MY ULTRASOUND WAS ULTIMATELY READ AS NORMAL.

The GI specialist I saw, luckily, ordered a CT to r/o diverticulosis/diverticulitis due to the bowel changes I was experiencing.

I next saw an OB/Gyn physician, who also reported a normal pelvic exam.  She preferred to wait for the CT results before any further action.

My CT showed multiple soft tissue nodular densities in left lower quadrant. The impression on the CT was endometriosis or neoplasm. 

The ob/gyn physician then ordered tumor markers: CA 125, CA 19-9, and CEA. She made a point to tell me she was concerned because endometriosis does not show up on CT scans so she did not feel the implants were endometriosis.

My Ca 125 was slightly elevated at 50 (normal range 1-35).  She gave me three treatment options at this point: 1) diagnostic laparoscopy, 2) Lupron assuming it is endometriosis or 3) wait.  I admit I really didn’t like any of the options. I was in the frame of mind that I wanted to know what we were dealing with before I agreed to having surgery. I had never had surgery in my life up to this point so was quite reluctant to do so. 

I requested an Gyn Oncologist to review my case.  The Gyn Onc stated “at most” a diagnostic lap could be done by the regular gyn doctor. He said due to my age,

subtle findings on CT and what he considered a normal CA 125 since it is not an accurate test in a pre-menopausal women that he assumed benign findings at the most.  I bring up this point, not as a complaint, against those physicians but as an important aspect for all of you. That even with a CT suspicious for cancer the thought pattern of this being cancer still wasn’t there.  My symptoms were pretty classic for ovarian/fallopian tube cancer so if they ONLY took into account my symptoms, that was reason enough to take me into surgery, but with the CT and slightly elevated CA125 it should have been a slam dunk.

Instead I was put on the routine surgery schedule and booked for surgery 2 ½ months later. 

In the following couple of months my symptoms progressively worsened with continuous abdominal pain, bloating, bowel and bladder pressure and urgency. I also developed referred Right shoulder pain. 

I ultimately had surgery in mid Nov by a friend/colleague of mine.

When he came out of surgery he said my entire pelvic region was one huge solid mass and had severe adhesions attached to the bowel/bladder, and pelvic walls. He explained that I would need a hysterectomy regardless of the test results.

A week later he notified me I had ovarian cancer that was at least a stage 3C because the biopsies were not even taken from the ovaries due to not being able to identify them on surgical exam.

After being referred to a different Gyn Onc, another CT was performed which showed full involvement of my ovaries and mesenteric nodes. I was taken into surgery on Dec 3^rd of last year for a complete hysterectomy, debulking cancer surgery and had an 8” bowl resection due to the metastasis. My tumor mass totaled about 19cm.

I started chemo while inpatient on post-op day 6.  Two weeks later I had a chest and intraperitoneal port placed.  I received my first two rounds of chemo in both ports.  With

intraperitoneal chemo they basically pump 2 liters of fluid in your abdomen (1 liter of chemo and 1 liter of saline) and then have you rotate every 15 mins for 2 hours like you’re a pig roasting.  The side effects of the intraperitoneal chemo were too severe for me to handle and I ultimately finished my next 4 rounds of chemo through the chest port. 

I finished chemo at the end of April and since have had a clear CT, pelvic exams, and Ca125’s.

I emphasize to you to listen to your patients’ symptoms and look at the whole picture.  Even with all the modern testing my diagnosis was delayed.  Had I been taken into surgery in Aug/Sept it is possible my diagnosis could have been a late stage 2/early stage 3, and my ovaries and uterus could have been saved.