October is Breast Cancer Awareness Month
Think Pink A local resources guide for early detection, education, self-care, support services and more
When cancer strikes the family
By Heather Bailey
Page 3: We all have to “Think Pink” to make a difference in women’s health Page 4: The importance of annual exams Page 5: Foundation grants for mammograms Page 5: Breast self exams Page 7: Cancer support groups Page 7: Breast density and screening Q&A Page 8: Breast cancer risks Page 9: Barb Recchia and the legacy of Barb’s Race Page 12: Dr. Cynthia Bailey: Moving from surviving to thriving Page 14: The value of philanthropy in supporting health care close to home
or some, the low point would have been the moment I found myself giving my sister a shot in the butt, crammed in the front seat of the car, on top of a parking garage in Santa Clara with strangers streaming past.
But not for me. In my memories, that was one of the high points, because it was one of the few moments I didn’t feel completely helpless and felt like I was doing something useful. My baby sister Holly was 32 when she found out she had breast cancer. When she told me, my first emotion was disbelief. Some people describe this moment as a punch in the gut. I thought I had simply misheard. When she repeated the dreaded C-word I figured she must not know for sure. I thought, “Oh, she must just be getting a lump tested, and it won’t be cancer.” When she said it a third time, I experienced the sensation of a total absence of oxygen, not just that there wasn’t any, rather that I could no longer take it in, even if it existed. I didn’t cry. Perhaps that’s strange, but I tend to be the “Hold it together and fall apart later” type. What I did know, most clearly even from the first moment, was that my world had just changed forever. I come from a close-knit family. My parents, Vicki and Steve, have been married nearly 50 years, and I’m the
See Family page 10
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The Healdsburg Tribune
Heather Bailey (right) and her sisters Holly (lower left) and Laurel.
The Windsor Times
When we all ‘Think Pink’ it makes a difference The single most important driver in reducing breast cancer deaths has been individual women’s motivation to undertake early screening, lifestyle changes and general education. By Rollie Atkinson
ampaigns like Think Pink and the annual Breast Cancer Awareness Month every October continue to make big differences in the mortality rates for what is the country’s most prevalent form of cancer.
A quarter-million U.S. women are expected to be diagnosed with breast cancer this year (400 in Sonoma County) and 16 percent of that national total (40,450) are expected to be fatal. Some 85 breast cancer deaths are expected in Sonoma County for the same time period. Not long ago the nation’s breast cancer mortality was almost triple today’s rate. And, while there have been advances in medicine and treatment, the bulk of improvement has been due to expanded awareness, more screenings and changes in lifestyle habits such as reduced smoking. In Sonoma County there is a full network of resources available to women and their families with access to information about diagnostic tests, clinicbased and alternative treatments, and programs for emotional and survivor support. Access to screenings, exams, mammograms and suitable levels of treatment also have improved locally, including several sources of “scholarships” and financial aid. Sonoma County has a nonprofit Women’s Cancer Awareness Group, with a goal of “raising awareness,
one conversation at a time.” Major medical centers including Kaiser, Sutter and St. Joseph’s all operate speciality women’s cancer or breast cancer programs. These programs provide sliding scale counseling, education, meal preparation, lymphedema resources, insurance assistance, nutrition information, and fitness centers offering free memberships for cancer patients, according to an overview included in the Women’s Cancer Awareness Group Resources Guide. Sutter Pacific Medical Foundation operates the Women’s Health Resource Center, located on Steele Lane in Santa Rosa, just east of Highway 101 near the entrance to the Sonoma County Administration Center. The center offers diagnostic procedures and referrals to oncologists, breast surgeons and genetic counseling services. But the single most important driver in reducing breast cancer deaths has been individual women’s motivation to undertake early screening, lifestyle changes and general education. This has resulted in a 89.7 percent 5-year survival rate, according the American Cancer Society. What women and their families have learned from recent years of education and awareness campaigns is that
breast cancer is not a single question with a single answer. There are different kinds of breast cancer that require different kinds of treatment. Newly diagnosed breast cancer patients will be tested to determine if their tumors are responsive to two hormones, progesterone and estrogen, and to the human epidural growth factor 2, or HER2. Scientists have developed targeted treatments for each. Patients should also find out if they have ductile or lobular cancer. Ductile begins in the milk ducts, which carry breast milk to the nipple. Lobular begins in the lobules, or milk-producing glands of the breast. The lobules are connected to the ducts. Some screening now includes genetic testing, as research has found more evidence about linking family cancer histories that also include potential increased risks for ovarian cancer in women and prostate cancer in men. A cancer diagnosis is just the beginning of life with cancer and becoming a survivor. More than half of Sonoma County’s women’s health services are dedicated to support and counseling for posttreatment or surgery.
The American Cancer Society offers the following tips to approach a breast cancer diagnosis
Strength in Numbers: The news of a cancer diagnosis can be overwhelming to patients and their loved ones. Make the most of the first few doctor appointments by bringing a friend outside of the immediate family to ensure the information is being absorbed and the right questions are being asked.
Build a Support Team: In addition to family and friends, it’s important to have a strong health care and surrounding support team. Seek out nurse navigators, local breast support groups and financial assistance to ensure you’re properly informed and have all the resources you need. Do not hesitate to consider a second opinion until you feel 100 percent confident in your health care team and treatment plan.
Think Pink is published by SONOMA WEST PUBLISHERS, INC. as a supplement to the Oct. 6, 2016 issues of The Healdsburg Tribune, The Windsor Times, Sonoma West Times & News and the Cloverdale Reveille
Understand Your Diagnosis: Learning about your specific type of breast cancer is essential because the unique biology of your tumor can directly impact your breast cancer journey. Knowing the four S’s – stage, size, status and subtype – of your tumor can help you better understand your diagnosis and the treatment options available to you.
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Ask Questions, Then Ask More: Consider asking your doctor the following questions: Are you eligible for clinical trials? Are there special treatments geared toward your specific type of breast cancer? Do I need surgery? Does surgery have to be the first step? Being actively involved can help ensure each patient receives the best treatment option for them.
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Community health centers stress importance of annual exams
aria Rangel-Anguiano, a 59year-old Hispanic woman (at right), came to Alliance Medical Center for her annual woman’s exam. Taking a break from her job at a bakery in Cloverdale, she believed it would be a routine check-up, a minor interruption to her busy schedule. Little did she know that she’d be diagnosed with breast cancer. “When I first found out I was very depressed. I was not prepared for the news,” said Maria. There was no history of breast cancer in Maria’s family and she was in good health, did not smoke and did not drink alcohol. Women between the ages of 50-75 are encouraged to get a breast exam and a screening mammogram every year for early detection of breast cancer. Maria received an exam from one of Alliance’s medical providers, who ordered a mammogram that same day for her at one of Alliance’s medical partners, Healdsburg District Hospital. She was then referred to the Redwood Regional Breast Cancer Center for a biopsy. A week later, Maria was diagnosed with Grade II/III inflammatory ductal cancer of the right breast. Maria knew she was in for a tough fight navigating the treatment. “I received support from family and friends. Alliance Medical Center gave me clinical support through programs and
counseling.” Maria received a wealth of information about treatments and breast cancer, including a new patient’s binder and the California-mandated “Treatment of Breast Cancer” booklet in Spanish. Spanish support group information was also given as well as the Spanish lymphedema prevention class information. Maria was not only struggling with the physical pains of treatment, but also
the financial burden. the support of her husband and friends, “Alliance Medical Center also pro- as well as the surgeon and doctors who vided me assistance in receiving insur- treated her. ance for my treatment. I didn’t have to Maria is now fully recovered and had pay for the surgery or advice for women everythe radiation.” where – “Go for annual Mammograms are exexams for early detecI had faith in God tion of any problem. If pensive if not covered by insurance. Only 43.7 you are diagnosed get and in science. It percent of uninsured treatment as soon as Sonoma County women possible.” was a team effort over the age of 40 reBreast cancer is the from doctors, the ported having had a most common cancer dimammogram in the last agnosed in women in clinic at Alliance, two years, compared to the United States. The and other women 76.8 percent of the highest concentration of county’s insured women. breast cancer in the who offered their Furthermore, 16.1 perUnited States is found cent of uninsured in the San Francisco support. women had never had a Bay Area. Nearly 400 mammogram, compared Sonoma County women to only 6.1 percent of insured women. will be diagnosed with breast cancer Sonoma County’s Hispanic women this year and around 85 Sonoma are even less likely to have had a mam- County women will die of breast cancer mogram: Only 27.2 percent reported this year. having one, compared to 59 percent of There are many community health white non-Hispanics. centers in Sonoma County. To make an Maria received three months of radi- appointment for an annual exam at Alation therapy and surgery. “I had faith liance Medical Center or to receive inin God and in science,” said Maria. “It formation on insurance call 433-5494. was a team effort from doctors, the In Cloverdale, call Alexander Valley clinic at Alliance, and other women who Healthcare at 894-4229. In west county, offered their support.” Though she felt contact West County Health Centers (Oca loss of hope at the beginning of her di- cidental, Guerneville and Sebastopol locaagnosis, she was able to find strength in tions.) at 824-9999 or 869-2849.
Brad Drexler, M.D. Obstetrics, Gynecology & Infertility Comprehensive Women’s Healthcare in Healdsburg for more than 20 years
e are dedicated to providing exceptional patient care in a comfortable environment, and believe in the power of patient education and prevention to promote good health. Dr. Drexler will take the time to listen to your concerns and involve you in your care decisions.
• Family Centered OB • Infertility
• Advanced Laparoscopy Surgery • Treatment of All Bladder Issues
When you are at our office, we want you to feel comfortable and cared for, and to know that your care is personal and the best that is available.
(707) 431-8843 • www.braddrexlermd.com 431 March Ave., Healdsburg • Se habla español
Foundation grant covers free mammograms to north county residents
ctober may be considered Breast Cancer Awareness, however it is important to know that breast cancer can be detected at any time during the year. Working with a grant provided by Healthcare Foundation of Northern Sonoma County, Healdsburg District Hospital (HDH) provides free mammogram screening to women either living or working within the North Sonoma County Healthcare District. Several prerequisites are required to be eligible for a free screening, including being a resident or being employed within the district. Participants must not have had a mammogram in the past 12 months, and be either uninsured, underinsured or have a high deductible, making it unaffordable to pay for a mammogram. Women 40 years and older are also eligible and urged to take advantage of the screening. Contact the Womenâ€™s Health Clinic with Healdsburg Physician Group (HPG) at 473-4400 to schedule a mammogram screening. The Healdsburg Physician Group provides yearround womenâ€™s health services, which include routine physicals and wellness exams, coordinated care with medical specialists, comprehensive patient screening, birth control consultation and provisions, hormone replacement therapy, and treatment of menopause-related symptoms. For additional information, go to www.healdsburgdistricthospital.org.
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Personal account: moving from surviving to thriving By Dr. Cynthia Bailey
s far back as I can remember, I’ve always been fundamentally and wholly afraid of getting breast cancer. My family tells the story of my paternal great grandmother who died tragically of it at 32, leaving a ranch family with six kids to fend for themselves without a mother to do what mothers do. Despite my awareness, fears and good medical care, I got breast cancer anyway – and shockingly, breast cancer changed my life for the better. It did, and I still can’t believe that I just typed those words. Would I do it again given the choice? Well, I’m not going to ask myself that question, it’s pointless. It happened to me and “The Breast Cancer Year” often felt like an avalanche of lemons burring me, bad news after bad news hitting me because I ended up having much more than just breast cancer, which I will explain later – and somehow, life made lemonade out of this abundance of lemons. I was so afraid of breast cancer that I can’t believe I could get lemonade out of a lemon like this, but it happened. And, it wasn’t intentional. It just happened as I navigated the process. Looking back is what’s brilliant because it shows me the challenges and choices that turned this into a positive. A diagnosis like this can be a wholly horrible experience, like I expected it to be, or it can be something else. For anyone about to go through a health crisis such as breast cancer, I tell you, I wish I knew some of this when I started into the journey. It would have saved me a boatload of suffering and the need to live on Ativan for the first few months. It also would have gotten me to that lemonade a whole lot faster. Telling my story is worth my time if it can help even just one person get there faster. I can’t speak for any other woman, only for myself, but as I look back on what I call “The Breast Cancer Year,” I marvel, actually. I think I intuitively knew I could get breast cancer and throughout my live I’ve done everything I could to never get that diagnosis. With magical thinking and a ton of optimism I planned (hoped) I’d dodge the bullet in spite of the frightening
Cynthia Bailey — during breast cancer treatment, with wig and makeup, and without.
statistic that one in eight women will get breast cancer and, in spite of the fact that I have a family riddled with cancer, including breast cancer. Breast cancer is the one that really scared me the most. Any time I’d start to worry, I’d soothe my fears with an inventory of my risk reducing factors: my really healthy lifestyle, having kids relatively young and breast feeding them, exercising regularly, eating really well, avoiding hormones of any sort because I had a hunch they were bad for my personal breast cancer risk. But, in August 2013 I became “that one” in the eight of us that we all don’t want to be. It started when I found the small hard lump in my left breast while doing my breast self-exam. (That breast exam probably saved my life – please girls and boys, do yours every month, really). I scheduled a mammogram, which I was due for but not behind on. I was lucky and got an appointment quickly. In fact, all my cancer appointments went quickly, probably because it was midsummer, which I know to be a medical slow season when most potential patients are too busy with vacation to go to the doctor (except for me in this case). I went for my mammogram thinking this would be just another false alarm and a quick in and out. For the past 30 years I’ve had many breast cancer false alarms because of my cystic and dense breasts. I actually started to fear the annual mammo less as I’ve aged, silly
me. Like always, as the tech checked my films to be sure they weren’t blurry I looked over her shoulder. The place where the little lump was looked bad, and I knew it. My doctor was in the building so she called him and he came down. I tried to dance around the impending disaster when I saw the serious look in his eyes. I said “But I can’t have cancer, I just bought four really pretty bras this summer in Italy on my 30th wedding anniversary trip, and I’m planning on enjoying them.” I swear I saw a tear in the corner of his eyes. From there, time is a blur but what isn’t is the way the final news hit me, and left me a complete, emotional train wreck. Even with the lead up, I wasn’t prepared. Things in my life were going so well at almost 55. Like many people, I’ve had phases in my life that were filled with stress, where I lived on an adrenaline edge always looking out for the next drama. But, this was not one of those times, and the bad news blindsided me. And, it kept getting worse. It was cancer, then it was the dreaded and very aggressive high grade triple negative cancer, then it was one in each breast meaning my prognosis and statistics were doubly bad (note that the second cancer did not show up on the mammogram, just remember that), then it was having the BRCA gene mutation and needing to worry about cancer in my ovaries too. It was an avalanche of bad news; the lemon ava-
lanche was burying me. As if all that wasn’t traumatic enough, the treatment news became yet another avalanche of lemons – what my doctors were telling me was frightening and one of my worst nightmares. I needed four months of really strong chemo with really toxic and old fashioned drugs. These were drugs that I had used on patients way back in the 80s. They were dangerous, damaging and they make patients really sick. They were not recommending new fancy miracle drugs that are like pharmaceutical smart bombs. No, apparently the cancer type I had is resistant to the smart bomb drugs and only responds to high doses of the old fashioned nuclear bomb type drugs. I was facing one of my worst fears. My really amazing and experienced breast cancer surgeon said to me: “Chemo is your only hope with this kind of cancer. I’m going to be honest with you, this is really bad cancer. If it comes back we can’t cure it, which means it’s a matter of time before it kills. Most people only last at most five years if it comes back. I’m going to be honest with you again, don’t take this wrong, but you’re stupid if you don’t do chemo; surgery alone won’t beat this one.” And after that, he said I also needed a double mastectomy. Taking my breasts off was what was needed to see how the chemo worked and if I needed more. Plus with the BRCA gene, my breasts were cancer minefields and needed to get off of my body before they blew up in cancer again. With BRCA1 mutation, I had an almost 90 percent chance of breast cancer in my life and that can mean more cancer after these two. My mom had two at different times. My surgeon said he also needed to take lymph nodes on both sides of my arms, meaning that my arms would always be at higher risk for serious infection for the rest of my life. He continued, “If there is still cancer in your breasts or lymph nodes when we remove them then you will need radiation and more chemo and your prognosis will be pretty dire.” He went on to explain that after he was done treating the breast cancer, we would need to tackle my ovaries. If there was cancer there, we would need to see a gynecologic oncology specialist
Continued next page
With magical thinking and a ton of optimism I planned (hoped) I’d dodge the bullet in spite of the frightening statistic that one in eight women will get breast cancer and, in spite of the fact that I have a family riddled with cancer, including breast cancer. Think Pink
Continued from previous page for more surgery and I would need more chemo. He said we wouldnâ€™t know what my future looked like until we were done with all this but that I needed to plan on a minimum of a year if all goes well. My head was swirling. I have two kids and this nightmare is hereditary â€“ I could have given my nightmare to them too. Thatâ€™s even worse. I was buried. It was an avalanche of bad news â€“ an avalanche of lemons upon lemons. I was absolutely devastated, and it happened so fast ... but so did the lemonade. When it comes to the lemons-tolemonade opportunity that I was buried under, Iâ€™ve always had a deep spiritual belief that there is a reason behind what happens in life. As I mentioned before, I questioned: Did this happen in my life for a reason? Is there something Iâ€™m supposed to do or change? Is there a message in this for me that I should try to hear? Whether itâ€™s Godâ€™s will, a guardian angel, the law of karma or whatever, I canâ€™t say I know for sure, I just know deep down that there is a reason for something like this. So, I started to look for the reason, and it changed how I felt about my situation and that changed the situation. Regardless of the outcome, I realized that this was where I was supposed to be in my life right now. I quit worrying about the future and regretting things from the past. I became fully present in this moment, which started feeling like slow motion. I focused on how I could cope with the treatments and support my health while I underwent this process, I started looking for ways to make lemonade out of this abundance of lemons. Good things started happening, they are the fond memories from â€œThe Breast Cancer Year,â€? and they are the sweet lemonade that came from the abundance of lemons. As I celebrate joining the many Breast Cancer Survivors this Breast Cancer Awareness Month, Iâ€™ll share
Regardless of the outcome, I realized that this was where I was supposed to be in my life right now. I quit worrying about the future and regretting things from the past. I became fully present in this moment, which started feeling like slow motion.
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some of my experiences during my Cancer Year and what Iâ€™ve learned from it all. Iâ€™ll share with you how I moved from becoming an emotional train wreck to a full-on thriver in the midst of it all. Iâ€™ll tell you how I got my â€œanchorâ€? so that I could move forward positively, feeling tranquil in the midst of an uncertain future and treatments that frightened me, hurt me and made me ill. My story is about how my avalanche of lemons became an opportunity for an abundance of lemonade. I hope that sharing it may help even just one person, who like me is about to start a similar overwhelming journey. Dr. Cynthia Baileyâ€™s story continues on her blog, which can be found at: www.drbaileyskincare.com/ info/blog/category/breast-cancer.
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Know the numbers: your breast cancer risks
hat is the average American womanâ€™s risk of developing breast cancer during her life-
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time? According to the National Cancer Institute (NCI), based on current incidence rates based on statistics for the years between 2007 and 2009, 12.4 percent of women born in the United States today will develop breast cancer at some time during their lives. This estimate means that, if the current incidence rate stays the same, a woman born today has about a one in eight chance of being diagnosed with breast cancer at some time during her life.
On the other hand, the chance that she will never have breast cancer is 87.6 percent, or about seven in eight. These probabilities are averages for the whole population. An individual womanâ€™s breast cancer risk may be higher or lower depending on a number of known factors and on factors that are not yet fully understood. To calculate an individual womanâ€™s estimated risk, health professionals can use the Breast Cancer Risk Assessment Tool available at www.cancer.gov/bcrisktool. â€“ Healdsburg District Hospital
According to a current National Cancer Institute report, the risk that a woman will be diagnosed with breast cancer during the next 10 years, starting at the following ages, is as follows: Age 30 ...... 0.44 percent (1 in 227) Age 40 ...... 1.47 percent (1 in 68) Age 50 ...... 2.38 percent (1 in 42) Age 60 ...... 3.56 percent (1 in 28) Age 70 ...... 3.82 percent (1 in 26)
Who is at risk for developing breast cancer?
esides female sex, advancing age is the biggest risk factor for breast cancer. Reproductive factors that increase exposure to endogenous estrogen, such as early menarche and late menopause, increase risk, as does the use of combination estrogen-progesterone hormones after menopause. Nulliparity (women without children) and alcohol consumption also are associated with increased risk.
Women with a family history or personal history of invasive breast cancer, ductal carcinoma in situ or lobular carcinoma in situ, or a history of breast biopsies that show benign proliferative disease have an increased risk of breast cancer. Increased breast density is associated with increased risk. It is often a heritable trait but is also seen more frequently in nulliparous women, women whose first
pregnancy occurs late in life, and women who use postmenopausal hormones and alcohol. Exposure to ionizing radiation, especially during puberty or young adulthood, and the inheritance of detrimental genetic mutations increase breast cancer risk. Information provided by National Cancer Institute. â€“ Healdsburg District Hospital
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MindStream Company teaches small groups and organizations how to thrive through stress, anxiety and the dis-ease of the body. As seen on 60 Minutes and Oprah, taught at Google, LinkedIn, the military, and schools nationwide. Now in our town of Healdsburg, under HMG (Healdsburg Mindfulness Group) learn the oďŹƒcial Mindfulness Based Stress Reduction (MBSR) meditation skills that can measurably enhance your performance and life at work and home.
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Free course consult for your company or non-proďŹ t organization, contact Gina (instructor) at Gina@GinaJackson.org or call direct at 415-272-4160. MindStream is offering 25% off the MBSR/mindful schools course; just mention the ad when inquiring. Gina is an education ambassador for BrightPink.org and class proceeds are donated to this cause Gina herself just completed cancer therapies, she and her mother are cancer thrivers!
Healdsburg’s Barbara Recchia continues the good fight By Greg Clementi
or much of the past two decades Healdsburg resident Barbara Recchia has championed a cause that has touched thousands of lives, promoting women’s fitness and well being while providing a beacon of hope and inspiration to countless others. Recchia, a two-time cancer survivor, served as co-founder, race volunteer and matriarch of Barb’s Race, the only all-women’s half triathlon distance contested in the world before the rights to the race were sold to Ironman last October. Run in conjunction with the Vineman Triathon each July, Barb’s Race raised nearly $1 million for local cancer support groups. Roughly two-thirds of the money went to Sutter's Institute for Health and Healing (previously Integrative Health & Healing Services) that offers physical, emotional and spiritual care and comfort for cancer patients to relieve the effects of their treatment. “It's not just the money that we've raised that made Barb's Race such a success in my eyes,” Recchia reflected. “It's the women who raced who had the chance to face a physical challenge while at the same time giving them the opportunity to celebrate their own cancer survival, or honor or memorialize loved ones who have faced a cancer di-
agnosis.” As part of the Sutter Institute for Health and Healing, patients from any medical provider in the community received a Barb’s Race grant to use towards integrative medicine clinical services to relieve the effects of their cancer treatments, and contributions have expanded to organizations that support people with all types of cancer. Through it all, Recchia continued her selfless work behind the scenes, humbled and proud that so many women have benefited from the program. “Barb's Race exceeded my expectations and I never imagined that with the money raised we could make such a difference for so many diagnosed with cancer,” she said. “By doing so, the money touched the lives of so many others to give them physical as well as emotional comfort and care while being treated for cancer. We have all been touched by cancer and it’s so gratifying to know that we are able to provide some support on a local level,” she added. Following the sale of the Vineman brand last year, Barb’s Race was dealt a crushing blow when Ironman announced it had no plans to reschedule the event. “When I knew Barb's Race was coming to an end it was very sad for me and it definitely left a void,” Recchia said. “Not being able to sup-
Barbara Recchia on race day
port the organizations that were providing support to cancer patients was very difficult for me.” Help as it turned out, was just around the corner, as the Healdsburg Running Club (HRC) joined forces with Scena Performance to resurrect the race in a new form and location. Recchia, along with Race Director Adam Ray and Skip Brand of the HRC, recently announced the creation of Barb’s Tri, an all-women’s triathlon which will make its debut in Healdsburg on July 22, 2017. “We’ve had great support so far from the community, and I’ve received dozens of emails thanking us for bringing the race back,” Ray noted. “People realize what an important event it is.” Barb’s Tri will offer female athletes a variety of triathlon race distances, including an Olympic distance race (.93 mile swim, 27.9 mile bike, 6.2 mile run), and a Sprint distance (.5 mile swim, 14 mile bike, 3.1 mile run). The event will also include a Duathlon (27.9 mile bike, 6.2 mile run), and an Aqua Bike (.93 mile swim, 27.9 mile bike). Each race will start and finish at Memorial Beach in Healdsburg. Like Barb’s Race, Barb’s Tri will also include a minimum fundraising requirement for each participating athlete, roughly equal to the registration fee.
Here’s the good news. We stuck together as a family, despite all the unpleasantness, because that’s what we do. Holly has had good response to her treatment and surgery, and signs look positive for a good long-term prognosis. Family From page one
oldest of three girls. I’m a lot older, eight and 10 years older, to be exact. We do an insane amount of stuff together – vacations, holidays, text chains … you name it, we do it as a group. “I was stunned,” my mother Vicki said. “It took me until that evening to take in that it was the aggressive one and that evening Holly and I just held each other and cried. And she kept saying ‘I’m not afraid, I’m not afraid’ and I knew she was. And I was terrified. It was like a bomb went off. It was hard to believe. It still is. “I remember when Holly was born, she was jaundiced and she had to stay in the hospital several extra days,” Mom continued. “I can remember when we brought her home, I held her really close to me and I said, ‘I’m not going to let anything ever happen to you.’ And I couldn’t prevent this. It’s the worst thing a parent feels, because you would do anything. And there was nothing any of us could do but be with her and
support her. We couldn’t take it away. Unfortunately, it was hers to do.” It turned out the world expert in her particular kind of cancer was at Stanford Medical Center, so that’s where we went after fruitless visits locally. We soon discovered Stanford is just far away enough and just close enough to be annoying – it’s only about 100 miles, but the vagaries of Bay Area traffic made us constantly do the scheduling dance. Often that meant leaving at the crack of dawn, spending the night, or hanging out until after rush hour (which is how I came to be giving her that injection in a parking garage – she had a very specific schedule she was supposed to follow, and when it was time, it was time). What we soon came to learn is that half of having cancer is navigating the cancer bureaucracy. Figuring out where you’re going to get treatment, what kind of health system you’re going to utilize, getting multiple opinions on what you have and how you should treat it, and filling out the forms. The forms. The endless, endless forms. Highlights from our experience in-
clude: a woman who was supposed to be our “treatment facilitator” who told my sister she would be “attached at the hip” whom we never heard from again and who managed to completely screw up the two appointments she did set; one medical facility sending medical records to the wrong medical facility, twice; and it taking endless trips to the same offices to get a single, necessary form completed. But the hardest part was the constant disagreement. One doctor or nurse would say one thing, only to have it completely contradicted by someone else few days or even hours later. It started to make you feel crazy; like you had lost the ability to comprehend human speech. We ended up with notebooks full of notes as we started to doubt our own memories. By the end my sister was carrying two backpacks to every appointment, filled with her notebooks. “What surprised me most was just how chaotic the medical system is and how difficult to maneuver,” Mom said. “We’re not stupid people and navigating it was like going down the Colorado with no oars, it was so difficult. And it
didn’t matter what facility. Stanford’s got this great reputation and it was just as bad there as any other place. You felt like you had to fight for everything, which is just ridiculous. That was the worst surprise and I never imagined that it would be like this.” My father, who has his own health issues, spent months the color of an old sheet. He couldn’t speak of it without stammering and stuttering before leaving the room. He still can’t. My mother would cry with little provocation and ask me constantly if I thought it was going to be OK. Our other sister, Laurel, cried a lot too. She said she learned which bathrooms at work were best for a midday cry. But Holly, first and foremost, was angry. Angry that she was sick, angry that it was interfering with her life and her career (she had just landed her dream job when she was diagnosed – ultimately, blessedly, they held it for her), angry that she was young, healthy, and fit, and it didn’t help her not get cancer.
Continued next page
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Continued from previous page “I think we all spend a lot of time mitigating, ‘Oh if I do this, that won’t happen to me,’” Mom said. “That got blown up. She did everything right and it didn’t matter. There’s a lot of stories we tell ourselves and it’s mostly superstitious, I think. If you exercise enough, or drive your car carefully, or keep your weight down, it won’t happen to you, and that’s just untrue.” I suppose I was waiting for that “movie moment” – you know the one where the horrible (insert one here: illness, tragedy, breakup) ends up being an amazing life-changing, life-affirming epiphany? Yeah, that didn’t happen. Interestingly, while my sister was angry, she was not bitter. “I never really thought ‘Why me?’ because bad stuff happens to people all the time,” Holly said. “It doesn’t even matter if they’re a great person or not and I know I’m not the only one to ever have this happen.” Still, in her rage at her illness, she lashed out. A lot. At us. At strangers who cut in line at the grocery story. At slow drivers on the freeway. At the medical people who couldn’t get their stories straight. We all lived in fear of the next moment or meltdown. I’d hear a doctor or nurse start to contradict previous information and my brain would go, “Explosion in 5-4-3-2 ...” And, what do you say? I certainly couldn’t tell her not to be angry, because of course she had been dealt a seriously bad hand. It wasn’t fair, it wasn’t OK and of course she was mad. “You know, for all the anger was often misdirected, I’m not sure it didn’t also help her get through it,” Mom said. “She’s always been steely. Anger can work for you and I’m not sure that it didn’t help her in an odd way. At some point she kicked in to ‘This is not going to defeat me,’ even though she was in total resistance. She’s always had that inner toughness, and anybody would be angry.” And there were complications that made it worse – she had a very bad reaction to tamoxifen when a doctor made a mistake in how he prescribed it. She got a clot from her picc line port
Sisters — Left to right: Laurel, Holly and Heather on a “sister trip” getaway during Holly’s cancer treatment.
that was potentially life threatening (or was it? Because one doctor said it needed to be removed immediately and another said it was no big deal and should just be left alone). Every extra challenge felt like a body blow. And of course, chemo was terrible. Despite some light moments while contemplating wig choice, the thought of hair loss was crushing to Holly, a moment of harsh realism the she couldn’t prepare herself for. She wasn’t one for scarves or just letting herself be bald – she wanted realism and to pretend, at least outwardly, that this wasn’t happening. We each had a lesson to learn through this process – at least that’s the one positive outlook I could manage to glean from this experience. Speaking for myself, it was about embracing helplessness, which I realize doesn’t sound positive at all. What I mean is this: I’m a doer, a researcher, a fixer. I’ll read everything about a topic I can get my hands on. I’ll
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try to acquire expertise, and I’ll learn to do stuff and jump right in and be hands on. But here’s the thing – that might have worked well if I’d had cancer. But I’m not the one who had it. Nothing I was going to do or learn was going to change what my sister was experiencing and how she was experiencing it. Ultimately, I was utterly helpless to change anything about her situation and how she was choosing to deal with it. That’s why giving her that shot was such a great moment for me – it was one of the few times I felt like I was making anything resembling a concrete contribution to the process. And I won’t lie, it was one of the few moments we started laughing and couldn’t stop. You know, that big, halfcrazed laugh that is one step from crying that leaves you gasping for breath and thrilled? We’ve always been fans of absurdity. I do know on some level that control is always an illusion. Car accidents,
aneurysms, diseases and accidents can happen to anyone at anytime, but until it happens to you (our your family) you can happily convince yourself you have more control than you actually do. My lesson was making peace with that. Here’s the good news. We stuck together as a family, despite all the unpleasantness, because that’s what we do. Holly has had good response to her treatment and surgery, and signs look positive for a good long-term prognosis. But I won’t ever be the same. Like the victim of a crime, I don’t feel quite as safe as I used to and I can't see the world in quite the same way. None of us will. Cancer stole that from us. Because I can no longer believe in a guaranteed tomorrow. Because I can never take another “abnormal test” as probably nothing. Because I know I have no control and no say. Because doing everything right will be forever meaningless to me. Because my sister got cancer.
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Breast Density and Breast Cancer Screening Q & A What is breast density? Breasts are made up of fibrous, glandular and fatty tissue. Dense breasts have a lot of fibrous or glandular tissue and less fatty tissue. Breast density may change over time and is not related to how hard or soft breasts feel during a physical exam. Why is breast density important? Dense breasts are more difficult to screen with a mammogram. Dense breast tissue appears white on mammograms (see images below) but so do many lumps, both cancerous and benign. This means abnormalities can “hide” within the image of the tissue. Some research shows that women with dense breast tissue may have a higher chance of getting breast cancer. How do I know if I have dense breasts? A radiologist reviewing your mammogram will assign a breast density score from 1 to 4. Your mammogram results will say if you have dense breasts. Score 1: Mostly fatty Score 2: Scattered fibroglandular density Score 3: Dense in some areas Score 4: Extremely dense If I have dense breasts, do I still need a mammogram? Yes. A mammogram is the only medical imaging screening proven to reduce deaths from breast cancer. Most cancers are seen on mammograms, including in women with dense breasts. Nine in 10 women with early stage breast cancer can be cured with proper treatment. Regardless of breast density, Sutter Health recommends all women age 40 and older discuss with their doctor when they should start having routine mammograms. Are there other tests besides a mammogram to check for cancer? Several other tests may help find cancers that are not seen on mammograms: ultrasound, breast magnetic resonance imaging (MRI) and tomosynthesis. For women who have risk factors for breast cancer in addition to dense breasts, any of these three tests may be useful. Additional imaging beyond mammography has not been proven to find cancers at an earlier stage or to prevent breast cancer deaths. Women with additional risk factors for breast cancer may benefit from additional imaging studies. Talk with your doctor about your risks and the next steps that are right for you. What should I do? Regardless of breast density, Sutter Health recommends all women age 40 and older should discuss with their doctor when to start having routine mammograms, and then follow those recommendations. Women with additional risk factors or concerns should talk with their doctor. Together, you can determine if other screening tests are right for you. Availability of tests may vary. How can I lower my chances of getting breast cancer? Do — exercise regularly, eat a healthy diet and maintain a normal weight Don’t — smoke or drink more than one alcoholic beverage each day (on average) — This question and answer patient information was created and approved by the Sutter Health Diagnostic Imaging Oversight Committee
North Bay Cancer Support Groups The following groups and organizations are open to all cancer patients, unless otherwise noted. All phone numbers have a 707 area code. Healdsburg District Hospital Women’s Health Center, 1540 Healdsburg Avenue, 473-4400. The center offers free mammogram screenings for uninsured and underinsured women who live or work in the North Sonoma County Healthcare District (Windsor, Healdsburg, Geyserville, Cloverdale and surrounding areas). Women must be 40 years or older and have not had a mammogram within the past 12 months and are uninsured, underinsured, have a high deductible, or are unable to afford a mammogram. Alliance Medical Center, 1381 University Avenue Healdsburg 433-5494; Windsor Clinic, 8465 Old Redwood Highway, Suite 320. 687-2498. Alexander Valley Healthcare, 6 Tarman Drive, Cloverdale, 894-4229. West County Health Centers (Occidental, Guerneville and Sebastopol locations.) 824-9999, 874-2444 or 869-2849. Sonoma West Medical Center (formerly Palm Drive Hospital.) 823-8511. Newly Diagnosed Breast Cancer Support Group – 521-7785 — sutterpacific.org. For those who have been newly diagnosed with breast cancer. Meets the first and third Wednesday of each month, from 3:30 to 4:30 p.m at 2449 Summerfield Road, Santa Rosa. Breast Cancer Peer Facilitated Support Group – 528-9783 — Contact: Kathleen Cook. Meets the first and third Wednesday of each month, from 5 – 6 p.m., 521 Mendocino Avenue, Santa Rosa. Disability services conference room. Newly diagnosed, in treatment, post treatment. Breast & Gynecological Cancer Support Group – 521-7785 — sutterpacific.org. For those who have breast or gynecological cancer. Meets the first and third Wednesday of each month from 4:30 p.m. – 6 p.m., at 2449 Summerfield Road, Santa Rosa, main entrance, second floor. Call before coming the first time. Kaiser Permanente Breast Cancer Support Group – 393-4167 — 571-3970. Meets first and third Tuesday of each month from 5:30 to 7 p.m. at the Santa Rosa Kaiser office, 401 Bicentennial Way in Santa Rosa. This group is for women at any stage of their breast cancer treatment or after treatment. Call for specific room location. Women’s Cancer Support Group – 521-7785 — sutterpacific.org. For women who have any type and any stage of cancer. Meets the second and fourth Wednesday of each month, 4:30 p.m. – 6 p.m. at 2449 Summerfield Road in Santa Rosa, main entrance, second floor. Call before coming for the first time. Young Women’s Cancer Support Group – 521-7785 — sutterpacific.org. Educational and emotional support for women 45 and under with any type and any stage of cancer. Meets on the second and fourth Tuesday of each month from 12:30 p.m. – 1:30 p.m. at 2449 Summerfield Road, Santa Rosa, main entrance, 2nd Floor. Call before coming for the first time.
The importance of philanthropy in local healthcare
ine, Women, Healthcare – what’s the connection? Lots of people know about the Wine, Women and Shoes event hosted by the Healthcare Foundation Northern Sonoma County. It is great fun, enjoyed by hundreds of women – and raises much needed money for healthcare in northern Sonoma County. Yet, people might not be aware of the importance of investments made by the foundation in providing healthcare for women and families. From wine, fashion, shoes, dinners, movies and other fun events for women, to purchasing a CT scanner and now, new MRI equipment for our local hospital, the Healthcare Foundation Northern Sonoma County is all about helping women and families get quality healthcare services needed – close to home. The foundation provides funding for critically needed technology purchases, and invests in grants to medical and dental services for women and families of all income levels. Formed in 2001, as a supporting organization to save Healdsburg General Hospital (now Healdsburg District Hospital), the foundation’s mission has evolved over the years and now takes a much broader role in convening important conversations, planning and funding healthcare needs in northern Sonoma County. The Healthcare Foundation serves as the bridge to bring together donors and community members who have a philanthropic vision centered around healthcare. Through the support of generous donors who believe that every person deserves access to good health
Generous — Barbara Grasseschi and Tony Crabb are among local philanthropists who support Healthcare Foundation Northern Sonoma County.
care – right here, close to home – the foundation has raised and invested more than $17 million since its inception. These investments have been made in continual technology improvements for Healdsburg District Hospital, such as equipment purchases and capital campaigns to renovate aging facilities, as well as the
current campaign underway to build an MRI Suite. In addition, recently expanded investments have provided large grants for direct services provided by Alliance Medical Center, Alexander Valley Healthcare, PDI Surgery Center and others. The Healthcare Foundation also has provided scholarships to nurse practitioners at Sonoma State University and a created a speaker series on health topics. The prestigious Wetzel Community Leadership Award and Spirit of Wetzel Awards are offered by the Healthcare Foundation each year to recognize leading community philanthropists who are making an impact in our community. The Healthcare Foundation’s goal is to engage the community in making a significant individual, foundation, or corporate gifts to support innovation and technology, programs and services to ensure the delivery of quality healthcare in northern Sonoma County. Get involved with us and join the thousands of donors who’ve come to trust the Healthcare Foundation as a wise investment in the future of healthcare here at home. Help the Healthcare Foundation finish the campaign to have a permanent MRI Suite at the Healdsburg District Hospital. You can make a real difference as we are only $70,000 away from completing the $3 million Kalmanovitz Challenge and we need your donation to reach the goal by year end. If you’d like to learn more about the Healthcare Foundation, or to make an investment, contact Debbie Mason at 473-0583 or dmason@healthcarefoun dation.net or visit www.healthcarefoundation.net. – Healthcare Foundation Northern Sonoma County
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Breast Cancer. Let’s Fight It. Together. We need your help — we are only $70,000 away from providing a permanent MRI Suite at Healdsburg District Hospital. Healdsburg District Hospital anchors our network of care and is the first stop for residents, tourists and workers in northern Sonoma County. Thanks to you and the Kalmanovitz Foundation, we have already purchased a CT scanner, C-arm surgical x-ray, portable digital x-ray, fluoroscopy equipment and digital x-ray unit. Our next technology upgrade is an MRI machine. MRI technology is important for providing diagnostic information to detect and build treatment plans to tackle breast cancer, as well as tissue diagnostic scanning for heart, spinal cord, brain and other injuries. With your help we can continue to improve the quality of healthcare available close to home.
Be a part of investing in a MRI for our community! DONATE NOW and YOUR GIFT WILL BE DOUBLED I want to keep quality healthcare close to home! I will help with a donation: $ $
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Please clip and return coupon to: Healthcare Foundation P.O. Box 1025 | Healdsburg, CA 95448 To donate online go to: healthcarefoundation.net
If you’d like to learn more about the Healthcare Foundation, or to make an investment with us, please contact Debbie Mason at 707.473.0583, or firstname.lastname@example.org, or visit our website at healthcarefoundation.net.
The Healthcare Foundation proudly hosts Wine Women & Shoes a premier event raising funds to keep quality healthcare close to home. healthcarefoundation.net | email@example.com | 707.473.0583
Early Detection Saves Lives Make an appointment today!
Alliance Medical Center 707-433-5494 www.alliancemed.org 1381 University Avenue, Healdsburg 8465 Old Redwood Highway, Windsor
Breast Cancer Awareness Month Think Pink
A local resources guide for early detection, education, self-care, support services and more