Quote for October

A Prayer for the Ephesians Eph. 3:14-21

For this reason I kneel before the Father, from whom His whole family in heaven derives its name. I pray that out of His glorious riches He may strengthen you with power through His Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you being rooted and established in love, may have power, together with all the saints, to grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge--that you may be filled to the measure of all the fullness of God.


Now to Him who is able to do immeasurably more than all we ask or imagine, according to His power that is at work within us, to Him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen!


Friday, November 11, 2011

Welcome to This Heart of Mine

Hi,

This is a song I discovered a couple years ago when I heard Shaun Groves perform at a Christian Music Festival in Del Mar, California. The festival is called Spirit West Coast. It is the only song I have ever found that is similar to what I experienced when I gave my whole heart over to God in 2007.

I had accepted Christ as my Savior, been filled with the Holy Spirit, and had been baptised in the Holy Spirit years ago. However, I had never let go of wanting to control my own life, instead of handing it over to God. One day I finally let go of wanting to hang on to my health, my daughter, and my Dad. I had been afraid that God would take those things away from me, if I let Him have them. My Dad and my daughter are still here. My health is worse, but I benefit from being in God's will for my life, rather than trying to figure out everything for myself.

This song by Shaun Groves speaks about letting God into all the corners and closets of our life. It can be found on UTube with Shaun singing the lyrics.


Welcome Home
By Shaun Groves c 2001 New Spring Publishing Inc./ASCAP
 
Take me, make me
All You want me to be
That’s all I’m asking, all I’m asking.

Welcome to this heart of mine
I’ve buried under prideful vines
Grown to hide the mess I’ve made
Inside of me. Come decorate, Lord.
Open up the creaking door
And walk upon the dusty floor
Scrape away the guilty stains
Until no sin or shame remain.
Spread your love upon the walls
And occupy the empty halls
Until the man I am has faded.
No more doors are barricaded.

Chorus: Come inside this heart of mine
It’s not my own. Make it home.
Come and take this heart and make it all Your own
Welcome home.

Take a seat, pull up a chair.
Forgive me for the disrepair
And the souvenirs from floor to ceiling
Gathered in my search for meaning.
Ev’ry closet’s filled with clutter
Messes yet to be discovered.
I’m overwhelmed, I understand
I can’t make this place all that You can.
I took the space you placed in me
Redecorated in shades of greed
And I made sure every door stayed locked
Every window blocked and still You knocked.

Take me, make me
All you want me to be
That’s all I’m asking,
All I’m asking.

Sunday, November 6, 2011

PRRT Peptide Receptor Radionuclide Therapy

PRRT is a therapy to treat neuroendocrine tumors that has been used for several years (possibly a decade) in Europe. It uses radioactive elements attached to Octreotide to shrink the tumors. This treatment works because most neuroendocrine tumors have receptors that bind the naturally occurring chemical somatostatin. Octreotide is simply a synthetic version of somatostatin, so Octreotide goes straight to NETs just like somatostatin would.

Somatostatin is a naturally calming compound. When it goes to the cell membrane of a carcinoid cell, it attaches to its receptors on the cell membrane. Then it makes the cell slow down and not produce so much of the neurotransmittors, peptides, or hormones that the tumor usually makes. Therefore, somatostatin is part of a feedback mechanism that tells cells that their secretions are not necessary, so the cells decrease making the secretions that incidentally make carcinoid patients sick.
Since it is a somatostatin analog, Octreotide goes naturally to carcinoid cells, and when a radionuclide is attached to Octreotide then the radiation affects the carcinoid tumor. There are three different radionuclides that have been used in PRRT: Indium-111, Yttrium-90, and Lutetium-177. One of the reasons to use one of the radionuclides versus another is that they have different ranges of penetration.

The doctors use the radionuclide that will penetrate the tumor, but not destroy normal tissue that is around the tumor. Indium-111 has the shortest range of penetration; Lutetium-177 has a range of 2mm; and Yttrium-90 has a range of 12mm. There is more information about PRRT on the Caring for Carcinoid Foundation website at www.caringforcarcinoid.org/PRRT.


The use of Gallium-68 DOTATE PET/CT and PRRT is so new that scientists just had their first conference June 23-26, 2011 at Bad Berka, Germany. Patients are considered for PRRT if their scans show an inoperable tumor(s) that can be measured on the scans, or if their symptoms are not well managed by Sandostatin or Octreotide therapy. This website contains information for patients who want to have PRRT at Bad Berka, Germany: http://www.prrtinfo.org/.

PRRT requires a series of treatments. Reading the accounts of patients (on Cancer Compass) who went to Rotterdam for PRRT reported that they would go for one week at a time, and stay at a local hotel. The treatment would take place at a medical center to which they returned several days in a row. The patients would have to stay over the weekend to make sure they were well enough to travel, then fly home on Monday. A couple years ago people were writing that they would return home for a couple months before returning for treatments two through four. Results were usually very good, with tumors shrinking and symptoms being reduced.

However, I have learned this year that PRRT can have side effects that include leukemia and bone marrow toxicity. The leukemia was written as an effect that can show up later in life, but a woman suffering from bone marrow toxicity had it happen immediately after her PRRT treatment. Her bone marrow was not making the proper amount of platelets and red blood cells, but she was being treated for the condition and was recovering. This just reminds us that every treatment has side effects, so we need to know what they are and how to fight them.

There isn't much data in the USA, yet, on PRRT. However, this weekend (11-11-11) there is a conference at MD Anderson Medical Center in Houston, Texas, under the leadership of a Dr. Lao, about the progress they have made on doing PRRT in this country. Possibly, next week I can report on a date for PRRT to be available to us without a flight across the ocean.

Update: Well, there is no date for PRRT in the US. There are still hoops for the doctors and universities to jump through before the therapy is available in the USA. If you would like to see a synopsis of what happened at the conference at MD Anderson Medical Center, see this blog www.lucysnoidblog.blogspot.com . Lucy was at the conference and she has a great account of how PRRT works and why it is not available here.

Praying for the best possible result,
Sharon

Wednesday, October 26, 2011

What's Happening in This Blog

I enjoy looking at the statistics for the blog to see what people are reading, and what countries they are from. The USA is the leading county most weeks, but sometimes I will have had several readers from Russia, Germany or Romania, so those countries will have the most views on certain days. I always have some viewers from Canada, but not very often from the UK this year. These are not all the countries, but they include Slovenia, Hungary, Macedonia, India, Brazil, Mexico, Italy Australia, Austria, and China.

Some of you look at the blog right away after I write something new, and I try to see where you are. Sometimes those people are in Russia, Germany or the USA. Thank you for your loyalty. The three followers on "Journey to Joy" are my cousin, Debbi, and my sisters. Thank you ladies for your love.

What are people reading? The most commonly read post is the one about Welchol from 2010. Last year and earlier this year, the most common post was the one about "What happens during an Octreoscan?" I think there are more doctors talking about Welchol as a way to combat diarrhea, so patients go online to find out information. Some patients have concerns about Welchol; they ask if it affects their cognitive skills, and if if it affects their heart rate, etc.

I have not had any ill effects that I can put down as being caused by Welchol. At the time I was taking it every day in November 2010, I was in desperate need of stopping diarrhea, so I didn't notice side effects. Now I use Welchol once or twice a week, and don't notice any problems. It does seem to work one hour after I take it, and usually stops all action for 24-30 hours. Once recently, it only held for 10 hours, but that was long enough for me to do what I needed to do that day.

Lately, I have joined the email list for ACOR carcinoid. It's going to help me get more information about other types of scans and treatments. There are not too many new things around, but Vanderbilt Neuroendocrine Center in Nashville, Tennessee has the new scan: 68-Gallium PET/CT. It was the first US facility to get FDA approval to use 68-Gallium to diagnose neuroendocrine tumors. The Gallium scan is also at the University of Iowa.


Next week I am going to be doing more research on the Gallium scan and on PRRT. PRRT is the Peptide Receptor Radionuclide Therapy that is not FDA approved yet. It has been in Europe for a decade. People write about going to Rotterdam or Bad Berka for treatment and getting much better. It has been tested in Houston, Texas for about 2 years. Vanderbilt wants to add it to their Neuroendocrine Center. I am holding on waiting for these procedures to be approved, and hoping they will be approved by time I need them. I am not there yet, but I trust the PRRT will be in the US in two more years. Since I have the tiny tumors that do not show up in Octreoscans, in one more year, I may be ready to go wherever there is a 68-Gallium scan available. Particularly, if my symptoms keep increasing, and no one has seen my tumor since November 2008. Four years would be a long time to go without knowing where the enemy is, and how many of them there are.


The scans are not yet available to the public at Vanderbilt University or Iowa State. It has to do with being approved by the FDA and figuring out costs. During the experimental stage, the expense of doing the scan is paid for by the state or the entity that is paying for the research.


Update 11-14-11 on Gallium-68 Availability:The FDA has 100% approved the Ga 68 scan at both sites, but they would have to give it away. The universities hope the application to the FDA for "cost recovery" will be in place soon, but it is doubtful that will happen soon because of the money involved. When Dr. Woltering asked for cost recovery for treating 135 patients with PRRT at LSU the FDA never allowed it. This is a major problem for individuals trying to do drug development in the USA.



Also, there is a limit to what tumors the Gallium scan can detect. Patients from Australia and Europe are finding that the new scans still don't detect the tumors that are the size of a match head or a pinhead. The smallest tumor a Gallium-68 scan can show is 3mm to 5mm. So my tumors may not show up on those scans, anyway. It doesn't sound like I need to plan a trip across the country any time soon.


So it looks like sometime in 2012 we may get the 68-Gallium PET/CT. I know there are people sicker than I am who need the scans done first. Some people don't know where their primary tumor was; that can impact the type of treatment they get. I hope I don't find out that I have tiny tumors scattered like salt across my liver. That last statement doesn't sound like great faith. Hmm, I think I need some scripture here.



Be anxious for nothing, but in everything by prayer and supplication with thanksgiving make your requests be made known to God. And the peace of God, which surpasses all comprehension, shall guard your minds and your hearts in Christ Jesus...And my God shall supply all your needs according to His riches in glory in Jesus Christ. Now to our God and Father be glory forever and ever. Amen. Philippians 4: 6-7, 19-20.

Sunday, October 16, 2011

This is Different

I returned to having the Octreotide LAR two days ago, having finished my Octreoscan. I got a 40mg injection, which is the higher dose of Octreotide that I have gotten since July 27.
For the last two nights I have fallen asleep suddenly with my clothes on, face unwashed and teeth unbrushed. Friday night I slept about 10 hours from 11 until 9. Then Saturday night I slept from 7:30 until 6:15.
I don't know what my tumor is dumping into my bloodstream, but I would sure like to know. This morning I just wanted to lie down and let my eyes roll back into my head. However, I knew I would be better with prayer, so I went to church.
NOTE WELL: What was happening here was an overdose of Octreotide. I had to go through this extreme weakness twice before I was at the oncologist at the same time it was happening. He realized that the overdose symptoms of Octreotide are almost the same as the disease itself. The difference is the extreme weakness caused by the drug. I adjusted my dose to one injection of 20mg every two weeks. That is suggested by Dr. Eugene Woltering of LSU, It works well for me.
 I walked into church leaning on my cane and moving my feet about 10 inches at a time. Luckily, I get to park right at the front door because I bring two 80-year-old women to church. I made it to my seat and back out again. I did get some help getting to my chair.
The stuff that carcinoid does is so random. This morning I was much sicker than the 82-year-old lady that rides with me. Then about 4:00 pm I went outside and gardened for 40 minutes. I had to move very carefully, but I wanted to do something to help my daffodils bloom. Then about 9:20 tonight, I could feel the darkness closing in (so to speak). Since 7:00 pm I have been in my nightgown so I could sleep in nightclothes for the first time in 3 days.
This morning I wore my Carcinoid Awareness baseball shirt to church because I felt so bad. I did that on purpose to raise some awareness, but almost no one looks at the shirt. I guess they don't want to look at my chest. At least I pointed it out to three people who asked what was wrong. If I've got to die of this, I'll be one d*** angry dead lady if I can't get at least 100 people to know what it is.

(www.zazzle.com is the place to get shirts and caps printed for most any cause. They offer several things for carcinoid. I got 2 styles of shirts, and a little tote bag. The tote bag is not really strong enough to hold a Bible, but it can hold something smaller.)


Tuesday, September 27, 2011

Scans are Done

Hi,


"You know the Lord's got his hand on you." my friend Raquel, after finding out I've had a tumor in my liver for three years.

I have been through a new round of Octreoscans in the last week. In two days I get the results. This time the Nuclear Medicine Dept. used a new Gamma Camera that is in the new Douglas Hospital at UCI Medical Center in Orange, California. The staff is very pleased with the quality of the images produced by the camera, and hoped it would point out my tiny carcinoid tumors.


Since my symptoms have doubled in the last few months, I hope the tumors are more visible now. It would be good to know where they are located in my liver, rather than just assuming that they remain there. If I could see the tumors are concentrated in a spot on the top of my liver, I would relax, instead of wondering if they have spread out far and wide.

9/29/2011 Today I saw my surgeon about the results of the Octreoscan. The scan was the same as the last three; there is no evidence of any abnormal absorption of the radioactive Octreotide. In other words, the radiologist cannot tell where the tumor(s) is located. It's still very small, so it doesn't absorb enough of the radioactive chemical to be seen. The Octreotide in my regular medication makes the tumor(s) shrink, and then they can't be seen in the scans. I asked the surgeon about the tumors spreading while unseen. He assured me that if they were spreading, we could see them. So, I guess I shouldn't complain.

I did have a higher Chromagranin A level in my blood on the day the scans were done. For scanning, I have to go off of my daily shots of Octreotide (200mcg 3x daily). I stopped the shots Sunday night and had to stay off of them until the scans finished Friday afternoon. On Monday, I was incredibly sleepy all day. I woke up because our dog wanted to eat, but couldn't stay up, so I stayed in bed until noon, sleeping much of the time. I was sleepy and suffering from "brain fog" in the morning all week. About one o'clock in the afternoon it gets better, but I'm still sleepy a week later.

Therefore, while I was on campus waiting for the nuclear medicine scan to be done, I called my oncologist's nurse. She got me a lab slip for Chromogranin A, and I had my blood drawn. It was 107 on a scale that has the high level beginning at 95. The level in August was 67, and Sept.was 107. Being on a regular dose of Octreotide Acetate, definitely works for me.

I pray the you all will feel better today. Some relief from your symptoms courtesy of your Heavenly Father.

God bless you,
Sharon

Thursday, September 8, 2011

Current Chromogranin A Numbers

Hi,

My oncologist's nurse mailed me the results from my CgA check on 8/24/2011. The test was done after I had already eaten breakfast, but my blood glucose was only 91, so it wasn't very much breakfast.

Chromogranin A result 67.
Reference range: 0 to 95 ng.mL
Method: Cisboi Chromoa(TM)EIA

So that was a normal number that is believable.

The results from 7/28/2011. Also done after eating breakfast.

Chromogranin A result 96.
This was done the day after I had gotten my first injection of 40mg of Octreotide. The CgA was high, but I think it was higher before the injection. It was a time when I had feelings of intense heat in my back. Now I am not as hot, but I still heat up and perspire easily.

It's curious to me that last year I began having symptoms from Carcinoid that involved lots of diarrhea from about August 25-November 5. Then I had a nice break and was doing great at my birthday in January. Then since May 1, I have been more and more dizzy. It is more frequent and bothersome than just a month ago, and I keep forgetting to mention it. In May I began to get the really hot sweats. I have diarrhea about once a week. So the symptoms occur in cycles. Curious.

Best regards,
Sharon

Tuesday, August 30, 2011

The Voice of Truth by Casting Crowns

There is inspiration in music to help us keep going. I love this song!


 "Voice of Truth" lyrics and music by Mark Hall and Steven Curtis Chapman. It was recorded by Casting Crowns. It is based on 2 Corinthians 12:7-10 and 1 Corinthians 1:20-24.

In the middle of the song it says:

"Oh what I would do to have
The kind of strength it takes to stand before a giant
With just a sling and a stone
Surrounded by the sound of a thousand warriors
Shaking in their armor
Wishing they'd have had the strength to stand

But the giant's calling out my name and he laughs at me
Reminding me of all the times before I've tried before and failed.
The giant keeps on telling me
Time and time again, 'Boy you'll never win!'
'You'll never win!'

But the stone was just the right size
To put the giant on the ground
And the waves they don't seem so high
On the top of them lookin' down
I will soar with the wings of eagles
When I stop and listen to the sound of Jesus
Singing over me.

I will choose to listen and believe the voice of truth."

I had not listened to this cd [ Casting Crowns 2003] for months, but it spoke to me this afternoon, especially the lines that say the giant laughs at me.

Then I am reminded in the chorus, " But the voice of truth tells me a different story
The voice of truth says, 'Do not be afraid!'
And the voice of truth says, 'This is for my glory!'
Out of all the voices calling out to me,
I will choose to listen and believe the voice of truth."

May God richly bless you,
Sharon

Wednesday, August 24, 2011

New Octreoscan Coming and Chromogranin A Changes

Hello,

Just wanted to make a health note here because I learned something when I saw my oncologist at UC Irvine Medical Center today. A month ago I had gone in to see the surgeon who did the resection of my duodenum and removed the original tumors. I had not seen him for almost two years! It didn't seem that long.

I used to go to see the surgeon after I had an Octreoscan done. Last year I got to feeling MUCH better in November after the Octreoscan was done, so I never got over to the surgeon. However, now I have not felt very well since May, so I wanted to get this doctor's opinion. I told him about the increased heat and flushing of my face and back, plus the earlier diarrhea, and he decided I should have another Octreoscan. Plus, he wanted an Chromogranin A done that day in the lab at the Cancer Center.

Now that is where it gets interesting. As the surgeon suggested, I had the Chromogranin A test in the lab at UC Irvine in Orange, California. I used to do that, but for a year I have been having my blood drawn at a Quest lab near my home. However, the Quest lab keeps sending lab results with CgA levels that are lower than normal. Also, Quest Labs use a different scale to decide if the Chromogranin is too high. My oncologist said it was like comparing apples and oranges. Today I found out that the Chromogranin A drawn at the Cancer Center was borderline high. And, as my oncologist pointed out, that CgA was drawn the day after I just had the 40mg Octreotide LAR. I should have had very low CgA because I had just gotten a big dose of my medication.

Therefore, I am going to go back to getting my Chromogranin A levels checked at the Chao Family Cancer Center. I will go in an hour early before I get my Octreotide LAR injection and get my blood drawn when my Chromogranin A level should be at its highest. This way we should be able to get reliable numbers with respect to my Chromogranin levels.

Wednesday, August 10, 2011

The Crumbs that Fall from God's Table

The Faith of the Canaanite Woman/ Matthew 15:21-28

Leaving that place, Jesus withdrew to the region of Tyre and Sidon. A Canaanite woman from that vicinity came to Him, crying out, "Lord, Son of David, have mercy on me! My daughter is suffering terribly from demon-possession."

Jesus did not utter a word. So his disciples came to Him and urged Him, "Send her away, for she keeps crying out after us."

He answered, "I was sent only to the lost sheep of Israel."

The woman came and knelt before Him, "Lord, help me!" she said.

He replied, "It is not right to take the children's bread and toss it to their dogs."

"Yes, Lord," she said, "but even the dogs eat the crumbs that fall from their master's table."

Then Jesus answered, "Woman,you have great faith! Your request is granted." And her daughter was healed from that very hour.

As you can imagine, the crumbs that fall from God's table must be tremendous. I am writing this to remind myself that I may not get all I want from God, but what I get is pretty amazing. I just had a breast biopsy today. I asked some friends for prayer, and I went through the biopsy with a feeling of great peace: lying there feeling like nothing was going to bother me. I actually felt quite cozy; I think that is the best word. The biopsy was done because a lump showed up in my mammogram. I have no symptoms. The surgeon cannot feel any mass, and the mass does not show up in an ultrasound, increasing the chance that it is benign.

In the past I have asked God for healing of complete conditions and I have asked for relief from symptoms. I have Sjogren's Syndrome, and I've had it at least 25 years. It's an autoimmune condition that begins with dryness in the eyes and mouth because the glands are being attacked. I began with dryness in my eyes that gradually led to a lump (pinguicula) on my left eye. My eye would water in bright light, and if I walked outside without sunglasses, I would grab my eye because of the strong pain that shot through my eye. Finally, the growth spread to my cornea (a pterygium), and my eye surgeon said we had to remove it.

Several weeks before the surgery, during a Bible study, I asked for healing in my left eye. The pain and watering were so bad, I had to pull off the road on the way home from work because I could not see the road. My friends prayed, and I was healed! I remember my friend saying, "She's healed," as the Lord spoke to her. After that day, my eye was moist and the pain and watering stopped. I considered cancelling the surgery, but the lump on my eye was a callus caused by the dryness that had been in my eye. It had not disappeared, and it interfered with the proper closing of my eyelid. That made my eye even drier, and my eye would not be perfect with the lump there.

My eye doctor is also an eye surgeon. I remember that he became more cautious as the surgery date approached. Sometimes a pterygium will come back after being removed, and the doctor told me that it can come back in just a few months. I wasn't worried because I knew my eye was healed. After the surgery, for the first six months, every time the surgeon checked my eye, he said, "We couldn't have asked for a better result." I knew that. God healed my eye.

There are more examples of how God relieved some more symptoms of Sjogren's Syndrome so that I could continue teaching. I do not know why He does not heal me, but He allowed me to keep teaching.

Five or six years ago, my mouth was getting drier and my throat would hurt every day. I was hoarse, also. I did get a wireless microphone to use in my classroom after going to a special therapist. She was not a speech therapist, but a voice therapist, I guess. My rheumatologist referred me to her. She found that I could talk 2.5 times as long when I spoke quietly, compared to using the normal volume of my voice to talk across a room. So using the microphone relieved the pain and it helped me to be able to speak to my students in a pleasant tone of voice and still be heard in the back of the room.

At this time I was drinking 4 bottles of water per day in my classroom to keep my mouth from being too dry. If my mouth was dry, my throat would get irritated, and I would cough repeatedly. That would end the lesson. Also, my feet burned from the neuropathy that Sjogren's causes.

I was being prayed for often during this time. I had a friend Gerri who would pray that I would be healed from the top of my head to the tips of my toes. One night I asked God for relief from the symptoms of Sjogren's Syndrome. This was a few years after the surgery on my eye, and my eyes were better, but it was difficult to teach. We were asking God to heal me completely, but if that was not His plan, I would be happy to simply feel better.

Since the night I prayed, the burning in my feet is much less. I don't notice most days. I do tend to wear sandals to keep my feet cooler, but the burning is inside my feet. The Lord reduced my thirst. I went down to drinking 3 bottles of water per day and my throat hurt less. God gave me the ability to keep teaching until my school district offered an early retirement incentive, and I could retire.

I was fortunate to be able to read from Matthew Henry's Commentary on the Bible at my father's house on August 13th. I found the comments on the passage of scripture about the Canaanite woman to be fascinating. I had wondered why Christ said things to her that seemed so off-putting. In other instances Christ had asked supplicants, "What do you want of Me?" Why did He make Himself so unavailable to this particular woman?

Of course, she was not Jewish, but neither was the Samaritan woman at the well. Jesus spoke to the Samaritan first. What was so different about the Canaanite lady? The difference was that man looks on the outward appearance, but God looks on the heart. Christ could see her heart.

Jesus Christ could see that she was a woman of great faith. He knew that if he presented obstacles to her, that her faith would grow. Each time he ignored her or verbally pushed her away, she came closer. She was not offended that He compared her people to dogs. She became even more humble, instead of arguing or being offended. When Christ said the food for the children shouldn't be given to their dogs, this lady was willing to eat the crumbs.

At that point Jesus answered her petition. He commended her faith, and healed her daughter.

As I read the pages in Matthew Henry regarding this passage in Matthew, I gained increasing clarity about my situation. I have known since 2007 that God was drawing me closer to Him. Now I know He also recognized that my faith was strong, and He knew it could grow stronger. He had confidence in me. Thank you Father for Your confidence in me! I love You.

Sharon