Back to School

"The dream begins, most of the time, with a teacher who believes in you, who tugs and pushes and leads you on to the next plateau, sometimes poking you with a sharp stick called the truth" - Dan Rather

One of my recently graduated seniors - passing along motivation for me as I return to work :)

I started teaching again - hesitantly. I get these pain spikes that are almost seizure like and crippling. It's hard to predict them, and my walking was still very weak when I first returned to work.

Luckily, the physical aspects of teaching (including standing for 40 min at a time) have really helped to reverse some of the atrophy in my quads, and some days, my walking is as fluid and seamless as a flowing stream. Other days, I'm shaky and clumsy ... there really isn't any rhyme or reason to it.

The first week of school, I told my students about my general health status. I basically said, "I want to stop the rumor mill before it starts, and as my students I'm going to share something with you that I believe you have a right to know. I have an illness that causes me pain sometimes, and I may start shaking in class. You may see me walking down the halls, and I may look like I'm really hurting. Do not worry or be afraid, I am fine. I am not dying - I'm not leaving you. I assure you, the pain is not as bad as it looks and my Carcinoid cancer is under control. If you want to talk more about this privately, I'm happy to do so."

I teach the honors English courses for juniors and seniors, and my kids are amazing; they totally get it and have adjusted accordingly. For example, sometimes my writing is too shaky because of the palsy like tremors in my hands, and a kid will take over at the chalkboard.  If I need to sit (which I can only do for a few minutes at a time because of my animated teaching style), they become eerily quiet so that I don't need to raise my voice beyond a normal speaking tone.

I was having great days the first couple weeks of school, and even better lessons... until I got a pain wave last week after 1st period. When these waves hit, it feels like my entire body is in a trash compactor and my bones are being broken. I had to be driven home by a friend, and then Mike and Rob drove my car to my apartment later that night.

I was embarrassed, and almost didn't want to return to school... I started questioning whether or not it was fair to my students to continue teaching given my illness; I felt guilty that the pain prevents me from preforming at my absolute best, and I am uncomfortable with the fact that there will be days I have to miss because of the unpredictability of my symptoms.

I returned to school two days later to find a beautiful card from my 3rd period, and had every kid rushing up to me to ask me if I was alright.  Many of the teachers (including the librarian) said that my students were really worried, and kept asking them if they knew anything about my condition ... one teacher even remarked, "I can't believe how attached they are, and how much they love you after only a couple of weeks!"

Card from my Current Juniors 2012

My kids' reactions, along with the overwhelming, genuine concern and compassion of my colleagues, made me realize that I had the support system to continue, and my students are better off with me (even if I'm not 100%) than without me.

As long as I can stand, talk, and breath - you can find me in room 126, discussing Beowulf, Ramayana or life choices... challenging kids to think about their identity, and pushing them to understand that they must create their own opportunities in life. Below are just a few pictures from the end of the summer / start of school... I am grateful that I am able to live my passion every single day.

Pictures: After my students graduate, I allow them to "follow me" on Instagram, and give some of them my number in case they need anything.

(Instagram Photo) One of my students (at Rutgers) showing me that she is writing in the journal I gave her for graduation

(Instagram Photo) College Send Off Lunch 2012: love these boys and their constant shenanigans (never in my class of course)

(top left - email from one of my students from last year who won the Gates Scholarship... love the subject line; top right - taking two of my recent grads out to lunch... these two are super special because I taught them both Jr and Sr year - and they're awesome of course; bottom - email from parent following last week's Back to School night -- I taught her daughter (North Eastern) as a senior 2 yrs ago ... this year I have her son.

It's texts like these that make me smile....

When I returned to my classroom after being sick for two days, I found a zebra sitting on this photo of a grad whom I still mentor on a weekly basis. My current students must have put it there! (Zebras = symbol for Carcinoid cancer).. on the right is a recent trip to Annamaria's home so I could visit with "momma"

This comment (on a recent Instgram photo my sister took of me) is from one of my students whom I had for Jr and Sr year... he and his best friend Kalyn recently told me, "we miss you like a child misses his mother" - such wonderful kids

Day at Balboa Park

Artist studio at Balboa Park in San Diego

Whenever I don't write a blog for a while, I always want to start out like a 13-year-old girl who has neglected her bubble-gum pink puffy-vinyl covered diary for too long (ok - like a 1980s 13-year-old):

Dear Diary,
Sorry I haven't written for so long diary. A lot has happened. 

Truth is, a lot HAS happened... not the least of which was that I finished out the rest of my wonderful vacation with my mom. One of my favorite days was the one we spent together in Babloa Park - where we ate calamari fries, meditated at the Japanese tea gardens, marveled at the Spanish colonial architecture, and took a trip to the world famous San Diego Zoo (where I got some GREAT shots of my favorite zebra pals).

Since I've been back in Jersey, I've been able to see two movies (Pina and The Artist), throw a surprise birthday party for my boyfriend, and had my yearly teaching review.

And I got sick.

So I guess all I can say is - I'm back modern-blogger-diary, and I'll try to write more often in the future.

Japanese Tea Garden at Balboa Park

One of the Many Amazing Buildings at Balboa Park

Think Different...

Gary had a wonderful idea of using Apple's slogan "Think Different" to promote NET cancer awareness and advocacy. The above picture is my first attempt at incorporating the two campaigns.

Additionally, some of my students are going to try to adapt the "Think Different" video below for NET Cancer Awareness Day (Nov. 10th).

While Steve Jobs decided to downplay his cancer diagnosis, the sad fact is that he had (and most likely died from) a pancreatic NET cancer... perhaps his determination to look at the world differently - as a world full of endless possibilities - will help encourage medical professionals to broaden their purview when faced with NET symptoms, especially since the average NET cancer patient waits 5-7 years before receiving the proper diagnosis.

The NET / Carcinoid community has been challenging the medical world to "think differently" about NET cancers for years. Below is an explanation from the Carcinoid Cancer Texas Survivors (CCTS) website about why zebra stripes are the chosen pin "color" for NET cancers.

Why the Zebra?

When medical students are going through their training they inevitably hear the phrase: "When you hear hoof beats, think horses, not zebras."Basically this helps to illustrate the strategy of initially diagnosing the more usual diseases or problems when a patient presents with symptoms.

An all-too-common scenario for many patients with Carcinoid, however, is one where a proper diagnoses is not made for a period of time . . . very often those with Carcinoid Syndrome are diagnosed with IBS or Crohn's Disease or perhaps even allergies or heart disease, before finally the correct diagnoses is made.

Some of our expert physicians have been heard to state therefore that in the case of Carcinoid, the patients ARE the Zebras . . . the more unusual . . . and NOT the horses! One of our more colorful Carcinoid Expert Physicians is well known for telling Carcinoid patients not only are we the Zebras, but we have pink stripes with purple spots!

And so we proudly embrace our ZEBRA STRIPES!!

Think Different * NET Cancers

Virtual Stamp Collection: Featuring Zebras

Prologue: I wrote this on Monday - while doing my bowel prep... and going on an internet stamp hunt turned out to be a great diversion.

For the past 2.5 hours, I've been drinking 8 ounces of my blue-colored, mucus-flavored bowel-prep concoction every 10 minutes, as directed.


In between gagging down this terrible elixir, I decided to write a letter to my sister to take my mind off of things; not an email or facebook message - a real, honest to goodness, pen-to-paper, letter.

After I was finished, I thought about how perfect it would be if I had a zebra stamp to stick on it. (Carcinoid ribbon color is zebra striped). There is something so romantic about stamps - especially ones that have a faded, foreign postmark, smothering them, as they cling to the right hand corner of a yellowed, hand addressed envelope.

Then I thought - well, hey... there have to be countries that feature zebras on their postage... and how cool would it be to start a stamp collection? While I probably write more letters than most, I too am guilty of indulging in the immediacy of virtual messaging on a daily basis - so I found it sweetly ironic (and immediately gratifying) to create a virtual collection of zebra postage stamps from around the world.

From time to time, I'm going to add to my virtual collection, and maybe someday I'll affix my own foreign stamp to a postcard telling of some adventure I'm having - a miniature zebra winking from behind a smudged ink-ring - symbolic evidence of my triumphant return from the land of cancer.

Congo (1993)

Rwanda (1984)

Rwanda (1967)

Cuba (1970)

Guinea (1975)

USSR (1968)

This is a collage of stamps that I created through a program called Smilebox, which includes stamps from the following countries:

left column: Kenya (1966); United Nations (1984), Rwanda (1984); center column: Angola (1953), Portugese colony of Mozambique Companhia (1937), Belgian Congo (1942); right column: Vietnam (1982), Dependency of Ajman, Manama (1969), Zimbabwe (1980), Republic of Guinea Bissau (1988), Arab Democratic Republic of Western Sahara (1996), Nigeria (2001)

If you happen upon any zebra stamps out there in your travels - please send me a picture :)

Stamp Entry 7/23: Submitted by My Friend Jean in NJ

Chasing Zebras: The Unofficial Guide to House, M.D.

"I look for zebras because other doctors have ruled out all the horses." Gregory House, M.D.

Last May, I wrote a blog post chronicling appearances of "carcinoid" on the popular show House, M.D. (one of my mom's favorite shows). Recently, I came across this "insider's guide" to House - with a title too good not to include in my blog.

BOOK EXCERPT:

“It is an axiom of medicine: 'when you hear hoofbeats, you think horses, not zebras.' Dr. Gregory House and his elite team of diagnostic fellows chase medicine’s “zebras” — the anomalies, the odd presentations, the diseases so rare that most doctors would not have encountered them in a normal medical practice.

House, M.D. is, itself, a zebra in a herd of horses. It is a rare find of a show blessed with consistently sharp, intelligent writing: densely packed and multifaceted. It features one of the most complex characters ever to have been written for the small screen, Dr. Gregory House, brought to life through Hugh Laurie’s brilliant and nuanced performance."

Title: Chasing Zebras: The Unofficial Guide to House, M.D.
Author: Barbara Barnett
Genre: Television Nonfiction
Paperback: 352 pages
Publisher: Ecw Press (September 1, 2010)
Available on Amazon

Zebra Cover: Smithsonian Magazine

A friend of mine texted me the Smithsonian Magazine cover for March 2011. Pretty neat!

After reading the magazine's featured article about the 20,000 plains zebras that wander through Botswana’s Makgadikgadi Pans - I'm even more convinced that the zebra is the PERFECT mascot for carcinoid survivors, because we share many of the same qualities ...

* Spirited: zebras have a wild spirit that makes them nearly impossible to tame or domesticate;

* Unique: like a human fingerprint, each zebra stripe pattern is identifiably different;

* Resilient: zebras "walk 34-mile round trips every two to four days to get from water to food, to water again, on an endless journey between thirst and hunger"; it's estimated that they travel more than 2,300 miles a year.

To Read the full article in the Smithsonian Magazine: "Nothing Can Stop the Zebra" click HERE.

iphone picture 6/1/11

A few weeks ago, I chaperoned the senior class trip to Six Flags Great Adventure and escaped the 94 degree heat for a while by partaking in the largest drive-thru safari outside of Africa. The 350-acre wildlife preserve has more than 1,200 exotic animals - including zebras of course!

But the Smithsonian article has me thinking - maybe I should take a trip to Africa to see these magnificent creatures, that hold so much meaning for me now, in the wild.

Managing an "Orphan Disease"

"Carcinoid cancer and carcinoid syndrome are orphan diseases that do not garner as much attention as more common diseases, but we are trying to change that" - Dr. Richard Warner



There are about 11,000 to 12,000 people diagnosed with a carcinoid tumor each year in the United States. About two-thirds of all carcinoid tumors are in the gastrointestinal system. Specifically, appendiceal carcinoids account for about 26% of all carcinoid tumors, and out of these - only about 5% of appendiceal carcinoid tumors are greater than 2 cm.

Bottom Line (approximatly): less than 156 people are diagnosed with an appendiceal carcinoid tumor greater than 2 cm every year in the United States; I am one of them.

My friend Christine jokes that I won the very elusive "unlucky lottery" - and when you consider that 1,600 new lottery millionaires are created every year...she makes a darn good point.

If it wasn't enough to have a rare cancer, I also have a laundry list of very unusual symptoms:

* constipation after a right hemicolectomy (Dr. Nash teasingly pointed out during my last visit that this symptom has been conspicuously missing from my previous blogs... touche doctor). Usually, people without half a colon have the "opposite" problem with their bowels. Again, leave it to me to be the odd duck. It's rare, but sometimes the nerves in the colon negatively respond to surgery and the colon doesn't work as well afterward. Dr. Nash said he only sees this reaction in a few patients a year, and I'm on a daily dose of Colace (perhaps permanently).

* a heart rate that drops as my exercise intensity increases

* weakening muscle strength and increased joint pain

* exhaustion to the point of tears

* fevers and nausea

The most frustrating issue is that I'm getting progressively worse with each month - sometimes it's even hard to walk now. Is it related to the carcinoid? Since the MRI didn't show signs of the carcinoid metastasizing in the liver - probably not... but it's such a rare disease, how can we be sure? In search of answers, Dr. Nash and I have mapped out the following plan (including my annual colonoscopy since mid-gut carcinoid increases my risk of colon cancer):

Future Schedule

May 5th: cardiology appointment - Dr. Avendano (Cardiovascular Interventionalists)
June: rheumatology appointment (Hospital for Special Surgery in NYC)
July: colonoscopy - Dr. Maloney Patel (Robert Wood Johnson Hospital, CINJ)
October 7th: follow-up appointment - Dr. Nash (Sloan Kettering)

Thanks everyone for your continued support, love and prayers; I couldn't have gotten this far without you.

Carcinoid Cancer Awareness

Zebra stripes are used to symbolize rare or “camouflaged” conditions. The Carcinoid community wants med students to flip the old adage, and think: “When you hear hoof beats don't assume it's a horse, it might be a zebra.”







Wearing a zebra pin or a zebra-striped bracelet or ribbon shows your support to promote awareness and to fund the education and research needs related to carcinoid cancer.

TWO GOOD WEBSITES:
www.caringforcarcinoid.org
www.carcinoid.org