THINGS ACCENTURE TAUGHT ME, REALLY

I've worked a lot at Accenture over the past 10 years (read: many overtime hours). Gave some good energy in lots of different projects that have done well. I don't know if every minute of it was worth it, but I do know that throughout the process, I've had the chance to hone my ability to communicate effectively with all kinds of people and make good decisions. I'm by no means an expert, but am definitely more aware of how to do better. Initially, I thought these abilities were only applicable to the clients and the work that we were doing. But as I started growing up (yes, I have a little!) and experiencing more things, some of the things I've been able to "practice" at work really have helped in other areas of my life.

How to Communicate Effectively
Do you understand the words that are coming out of my mouth? -Smokey, "Friday"
I've found that people are very different. (Um, duh!) Each person brings a lifetime of assumptions of what certain words mean and feelings around certain words. So, when talking to someone we need to learn to listen to the other person, even if they are not saying anything, and tailor our communication to get our point across. There are effective ways to do it and not as effective ways to do it.  It's a constant learning experience to take what I'm thinking in my brain and translate what is coming out of my mouth into something someone can understand. Words mean something. You can't just say whatever stupid stuff that comes to mind - no one will know what the heck you are saying.

How to Make the Best Decision 
We can approach every decision we are faced with methodically, whether it be about how to design a system best or what the best treatment decision is given the information that we know.
1. Be clear about what your intention is.
2. Then, start asking questions. As many as you need to to make a decision. If you have a time limit, ask 'em fast. :)
3. Throughout, stay calm and keep an open mind.
4. Identify the options.
5. Weigh the options.
6. Pick the best option.

Seems simple, no?  This works in 90% of our decisions. I made up that percentage.

What I have realized is that in the 10% of decisions that are related to those you love, you can be methodical and logical but, as you assess in step 5 and make your decision in step 6, your must let your heart in to help guide you to the best decision. The most logical decision is not always the best one.

UCSF APPOINTMENT THOUGHTS

I had my appointment on Thursday with Dr. Ewing, a breast surgeon at UCSF. She was very straightforward, informative, and positive. Smiled a lot too. Funny how different outlooks different surgeons can have.  UCSF is definitely more on the "do as little harm as possible" side within western medicine and are much more informed (or used to hearing about) options that include alternative treatments. They are, in my opinion, more responsive and relevant in terms of what the patient wants in terms of their treatment.

I have some action items to take care of before final recommendations are made, but in short, the surgeon thinks that lumpectomy is still an option since there is only one known cancerous area. Her final recommendation would also depend on results of the genetic test, hormone receptor test, and her review of my images. When I told her about wanting to try Traditional Chinese Medicine before doing anything invasive, she (very carefully) said that it is not something she recommends but if that is the treatment that I choose then they can support that approach with MRI monitoring every three months as long as my insurance covers it.  She believes it does, but I would have to confirm.  She also said that I could do this only if my hormone receptor test comes back positive (hormone sensitive), which means it it is less likely to grow agressively.

OPTIONS

The options she gave me are:
Option 1. Lumpectomy of the one known cancerous area with radiation of the left breast. I would need continue to do MRI monitoring each year.
Option 2. Mastectomy of the left breast (either nipple-sparing or non-nipple sparing) where all breast tissue is removed and no radiation is needed. Centinal node biopsy would be done to check lymph nodes.
Option 3. After discussing my desire to start with non-invasive TCM treatments first, she also gave me the option of MRI monitoring every 3 months with Tamoxifen.

Dr. Ewing said she also wants to biopsy the 6mm mass to rule out the need for mastectomy...but I don't really want to do another biopsy. I don't think it's worth the trauma on my breast tissue - it may cause more harm than good. Obviously, I don't really want to take Tamoxifen too. It's drug that prevents the growth of invasive breast cancers by interfering with estrogen. I remember when my mom took that.  Perhaps it has less side effects now.

An interesting thing Dr. Ewing shared with me about Option 1 vs. Option 2 is that in young people that have developed cancer, the most recent studies show that there is no noticable difference in recurrence rates between those choosing lumpectomy vs. mastectomy.  Did you know that recurrence rates and survival rates that doctors refer to are based on a 5-year time period? She mentioned there are studies in the 10- to 15-year range, but these are not the numbers that are most widely referenced. Additionally, it takes many cancers 5-10 years to grow to a detectable size, so what do these numbers really even mean with respect to how healthy you will be for the rest of your life?

BENEFITS OF UCSF

I asked what the difference between UCSF and UC Davis are - she said they have more experience in doing mastectomies.  Still to be confirmed.

A really good thing about UCSF is that after I get the results of the genetic test and hormone receptor test and get my images on disk, I can bring these results and images to an all day consultation at UCSF where I have access to the full UCSF team to get everything I need done all in one day. Dr. Ewing, her mammography team, and any other specialist I need would be on hand to provide whatever I needed at one time. No scheduling and returning for another appointment. How thoughtful!

NEXT STEPS

1. Get a genetic test
2. Get the estrogen/progesterone hormone receptor test
3. Go to UC Davis to get my medical films on disk
4. Call insurance company to see if MRI monitoring is covered
5. Set up an all day appointment at UCSF

And then we come back to food...

I had this beautiful meal at my friend's parents' house in SF after my appointment - homemade Vietnamese eggrolls and pho with the works. Thanks for feeding us, Vu's! 

Quick update - tomorrow I have my second opinion appointment at UCSF Medical Center. I have some of the same questions for them that I did for the UC Davis Medical Center surgeons, but I also will be asking them whether there are treatment options that provide some more flexibility to allow me to incorporate some of the traditional chinese medicine treatments into the overall plan. I'm interested to see what their treatment recommendation is and whether they can provide some flexibility and coordination of treatments. 

On the herbal front, I've sent my body vital readings (see 8/26 blog post) back to the doctor.  I discussed it with him and asked him how, from the readings, I can monitor whether my weak heart is getting stronger.  He said it has to do with how warm my hands and feet are - they should be very warm to the tips even when I'm in, say, an air conditioned environment. I know that my hands and feet - at the tips they still feel cold at times. Generally, though, my body vital readings have improved over the two weeks. These can possibly be attributed to the herbs, but can also be attributed to my diet and sleep changes.  Based on my results after 2 weeks, he prescribed a new set of herbs for me.  Unfortunately, they sent them to my CA address instead of my Atlanta address (even after two confirmations), so they overnighted some powder pills to me today.  I will take them until I get home on Friday, at which point I'll be able to make my herbal tea. 

Ok, more on how the UCSF appointment went after tomorrow!

EAT LIKE YOU'D FEED YOUR BABY

Food has always been an important part of my life growing up - many of the traditions we had as kids had to do with food, and heck, the Chinese way of asking how you are doing is asking if you've eaten! It's true, at least in my family. I was talking to Colleen the other day about my new approach to eating. I'm cutting down on the sugar intake, removing refined sugars and dairy altogether, generally remembering eating more organic, whole foods of all different colors, and lighter on the meat intake. She has a 10-month old, and with the help of Baby Cook, she is fixing whole, healthy foods for her and consciously watching what goes in. As we were talking, I noticed I'm now eating a lot more like how her baby is eating.

As we grow up, we're introduced to a slew of tasty, tasty things...that are not necessarily that good for us. We know it, but we still eat it, and then we soon forget that maybe it's not so good for us. Why should we not continue to eat consciously and healthily...as if we were babies?  Our bodies don't get better at processing foods that are bad for us.  We need the nutrients just as much as we needed them then.  I love the soft, mold-ripened cheese plates, followed by a  fatty rib-eye, finished with a beautiful dessert just as much as the next person, but over time it takes a toll on your body. Your body becomes a more acidic environment and invites disease to come in and take a seat. I'm reading all kinds of things that point to the fact that this is true. So, I'm changing it up a bit...and eating like I'd like to be fed if that choice were in someone else's hands. Except that in this case, it's in mine.

      

I now have almost a week under my belt with the Chinese herbs. I have the boiling down to about 2 hours in ATL, a little less when I'm at home because I have a super stove. :)  It smells like it should - this is what commonly wafts around in the normal air when you go to Taiwan or China! Also reminds me a bit of my childhood when my mom and dad would be making herbal teas.

Here are some pictures of what I've been doing to prepare and drink the herbal tea treatment:

The herbs and two 1/4" pieces of ginger into a stainless steel pot:

Before boiling, 12 cups of water to the herbs:

Then, I boil the 12 cups down to 4 cups, and 2 hrs and a movie later, I strain the herbs out and keep the liquid.  I drink a cup before breakfast and a cup before dinner:

So far, so good.  It's not too hard to drink...really just a cup.  Let's see how this goes. Cutting out refined sugar is not as hard as I thought it would be either. Working towards getting my internal environment more alkaline and less acidic...