Living With Crohn’s

By Karri Wick Stagman

When Tyler was born in 1997, everything was normal. Ten fingers, 10 toes, one miraculous little cherub. Somehow, amazingly, she was a part of me. I was in awe; every part of me wanted to protect this tiny being. Young and idealistic, her father and I decided to give her strong name, so that she would always be regarded as such.

I had no idea how strong she would have to be.

It wasn’t until Tyler was in fourth grade that she began to show serious symptoms. No matter how hard she worked, she couldn’t keep up with the girls on the basketball court. She complained about the pain in her joints when she ran, which her doctors attributed to growing pains. She tried not to get discouraged, but her coach was increasingly hard on her. It was difficult to watch.

It was during this year that she got an infection, which progressed into pneumonia. By her third round of antibiotics, I was getting worried. Countless frustrating trips to the doctor, tests, X-rays and blood draws gave us no diagnosis.

Tyler eventually couldn’t keep food down. Between vomiting and diarrhea, she endured abdominal pain like I’ve never seen. From February to June in 2007, she lost 18 pounds and weighed in at a mere 78 pounds. She was wasting away.

Tyler and I had moved from Florida, where she was born, when she was just 2. Eight years later, I was a single mom working on commission in a new job I loved and struggling to support my small family with little to no help from her father. It became difficult to focus at work. I stayed home when she really needed me, but as a single parent I had to keep working.

My mom used all of her vacation and sick leave helping me care for Tyler. I alternated between feelings of helplessness, guilt and stress. Little did I know that both Tyler and I were learning valuable lessons: I learned how to be an advocate for my child. Tyler learned, at the tender age of 9, how to live up to her name.

In late May 2007, we were finally referred to Seattle Children’s Hospital, though we had to wait for weeks to get in. By this time Tyler, an intelligent, clever child, took another turn for the worse: On May 31, I saw a toilet full of blood without the presence of stool, and Tyler experienced pain that dropped her frail little body to the floor. We called Seattle Children’s and they said she needed to be seen immediately. Mercifully, it was the day her health insurance became effective.

After a colonoscopy and an upper GI, the diagnosis was Crohn’s Disease.

The disease was present in 11 areas the doctors could see, from her esophagus to her colon.

There is no known cause or cure for Crohn’s. It is a chronic condition, with some cases much more severe than others. Crohn’s is an autoimmune disease that acts as an opportunist: when the body’s immune system is weakened it attacks the digestive tract. In Tyler’s case, she had an infection, then pneumonia. Her Crohn’s had been there for years, but very mild, as evidenced by her joint pain and stomach troubles. When her immune system was compromised, her body could no longer fight it off.

Since that first trip, Tyler has also been diagnosed with Ulcerative Colitis (UC), which is closely related to Crohn’s, as well as Arthralgia, which is joint pain. Crohn’s and UC fall under the classification of Inflammatory Bowel Disease (IBD).

The diagnosis, however, brought little relief. There are myriad ways to treat Crohn’s, including special diets and a battery of medications, but the side effects can be brutal. We simply had to try each one and figure out which worked. Tyler’s youth complicates matters, since many medications aren’t even approved for use in children.

Finally, in December, after 11 months on the job with a chronically ill child, I had to leave work. The pressure was unbelievable. By that time Tyler needed full-time care. I took care of her during the day, and my mom would sit with her at night so I could take a part-time job. For most of her sixth-grade year, I home-schooled Tyler, because more often than not she could not attend classes. At that time, I was giving her weekly Methotrexate injections (which are also used to treat some forms of cancer).

The side effects made her miserably ill, and after several months she absolutely refused treatment. After stopping the Methotrexate injections, she was able to go back to school, though she missed about 40 percent of her classes.

Crohn’s is such a frustrating disease because it is isolating. The symptoms aren’t discussed in polite society. Our joke is that it’s not “dinner conversation.” Tyler was depressed in a way I couldn’t comprehend. She couldn’t understand why this had happened to her, and couldn’t find escape from the constant pain. Depression is very common in Crohn’s patients — I can see why.

In order to manage and treat Tyler’s Crohn’s, there were several things that had to be addressed. In order to stop the bleeding, we would have to control the inflammation, and give her intestines a chance to rest and heal. Since treatments vary, we have tried countless medications in various combinations, and her medications change based on her symptoms. With each medication there are factors to weigh, kind of a cost vs. benefit analysis. How sick is it going to make her? Can she stand it? There were pitfalls during treatment that we didn’t expect: Two years ago while receiving her seventh Remicade infusion at Seattle Children’s, she went into anaphylactic shock.

Tyler is currently taking injections of Humira, which is prescribed for patients with severe Crohn’s who do not respond to any other treatments. Tyler also has a restricted diet, has to get substantial rest and is supposed to avoid stress, which exacerbates her condition. That last one always makes me laugh — the irony!

After 41 months, she is doing much better and has learned to deal with her condition. She is still symptomatic every single day — some days much worse than others. She now only misses about 20 percent of school, which is a great improvement.

As her mother, I have seen her go through unspeakable pain. But I have seen the frailty of a 9-year-old replaced by the strength and sharp new wit of a 13-year-old who has been through more than most adults. She has a new determination that I never had.

I have also witnessed grace. The first time she had to receive a Remicade infusion in Seattle Children’s oncology unit, Tyler realized it could be worse. Following that treatment, I heard her singing a song she wrote about how beautiful all of the children were, though they looked different on the outside. I cried as I secretly listened outside the bathroom door. Her strength and compassion continually amaze me.

No Nuts, Please!

By Scott Klepach, Jr.

Parents have an endless list of things to worry about when it comes to their children, perhaps none more worrisome than food allergies.

Some skeptics say the increase in food allergies is an illusion fueled by parents’ worst fears and the media, but many doctors agree the rise in food allergies is a real problem, even if the reasons remain unclear.

“No one has any real understanding why there is such an increase,” said Dr. Nola Attaway, a pediatric allergist with Northwest Asthma and Allergy Center in Yakima. “In the countries that are industrialized, it’s moreso.”

“I see a lot of kids with food allergies,” said Dr. Heidi Robel, naturopathic physician and licensed acupuncturist in Yakima. “The question is, are we (simply) noticing it more? Yes, but it’s also increasing.”

A variety of foods will cause different symptoms. Robel said dairy, wheat and corn allergies typically produce eczema, chronic ear infection, worsened seasonal allergies, diaper rashes and even attention deficit hyperactivity disorder (ADHD). Nausea, vomiting, rashes and hives are other common symptoms. But other food allergies — those to peanuts, tree nuts and shellfish, especially — can be fatal.

“The body has made an antibody against a peanut,” said Attaway, adding that’s why symptoms can be so extreme.

One clear-cut and potentially fatal reaction is anaphylaxis, which can result from severe food allergies (to peanuts and other foods), bee stings or medication. Symptoms of anaphylactic shock might swelling of the lips and throat and difficulty breathing.

Attaway said it is important for parents of children with severe food allergies to have an anaphylaxis plan so they are fully prepared in the event a child goes into anaphylactic shock. This plan should cover mild and severe reactions. A few hives around the mouth with no other accompanying signs of shock — such as swelling of lips, trouble breathing, and fainting — can be treated first with an appropriate dose of Benadryl.

But symptoms can escalate quickly, and parents should have an EpiPen or similar auto-injector device always nearby. An EpiPen contains a dose of epinephrine, and when injected, the hormone can relieve a victim’s symptoms of anaphylactic shock — and ultimately become a lifesaver — until he or she can be taken to the emergency room.

Parents are advised to have their child tested if they are concerned about a food allergy, but doctors warn that individual tests may produce a false positive or false negative result.

“Someone may have a positive skin test, and be sensitive, but a skin test alone does not tell you they are allergic,” said Attaway.

Instead, a child might take both the skin-prick test and a blood test, but other factors are also considered, such as a record of suspected reactions and a look at any family history of various allergies.

“A lot of it depends on genetics. If dad has asthma and mom has seasonal hay fever, children have increased risk for food allergy,” Attaway said. “And if parents have some children who are allergic, that’s the biggest predictor of another sibling having a food allergy.”

Robel said diets today are not as clean as they used to be — foods are more refined and contain red and blue dyes, pesticides, hormones and antibiotics — which might cause more allergies. She recommends holding off introducing various foods to children until they reach a certain age.

“The immune system gets developed by two years of age,” said Robel. “Wait six months before introducing foods, and introduce fruits and vegetables first.”

Dairy, wheat and eggs should be introduced after six months, but Robel recommends waiting longer if there are allergies in the family.

Attaway said reading labels becomes essential for someone with a food allergy to avoid coming in contact with potentially fatal ingredients.

“Read the labels. If it says it may contain peanuts, avoid those,” Attaway said. “I’ve had patients come in who ate a blueberry muffin made on machinery exposed to peanuts. Those children who have a true, bona fide allergy should not eat those (foods).”

In fact, even the most unlikely foods could contain traces of peanuts: sauces, glazes, salad dressing, cookies, candy, pudding, specialty pizzas, some Asian and Mexican dishes, and pet food, according to the Food Allergy and Anaphylaxis Network (FAAN).

Attaway said many schools and day cares in the nation have gone nut-free, but she recommends that parents of children with food allergies pack a special goody bag of food and snacks so their kids don’t come in contact with other possibly problematic foods. Parents should also check with their child’s school about its policy regarding food allergies.

Attaway said there is a good chance children will outgrow certain food allergies, but most will continue to be prone to peanut, tree nut and shellfish allergies.

“They say up to 20 (percent) to 25 percent of children with (a) true peanut allergy can outgrow it, which is more than they used to believe,” she said. “But there’s no way of knowing which child can, and which child can’t.”

Children allergic to milk, wheat, egg and soy, however, have an 85 percent chance of outgrowing the allergy by age 8, and many of them show signs of outgrowing them by 3.

Jaclynn Bell’s children are living examples of how some people can outgrow a peanut allergy, even if their case is somewhat rare. All three of Bell’s children developed the allergy, but two of them outgrew it by age 4. Her second child, who is 2, still struggles with the allergy.

“The most difficult part of having a child with a food allergy is trying to explain the situation to someone who has never experienced or been around food allergies,” Bell said. “Having a peanut allergy can be one of the most dangerous allergies, and so many people don’t understand the severity of it. I have learned to read labels very well.”
Food Allergy or Food Intolerance?

Kids can react to foods in different ways, and it’s important not to assume they have food allergies.

“A lot of parents want to find a reason for it. Maybe it is an allergy, but there has been a lot of changes in food, with hormones and antibiotics,” said Dr. Judith Harvey of Yakima’s Family Medicine.

These changes could be contributing to the rise in adverse reactions in children, but Harvey advises parents to understand the difference between food allergies and food intolerance. She said while six percent of children suffer from some type of food allergy, up to one third of children experience food intolerance.

“Allergy and intolerance aren’t the same thing,” she said. “Diarrhea from cherries isn’t an allergy.”

Resources

Here are some great resources for parents of children with food allergies:

Mayo Clinic. The website lists the eight most common food allergies and their symptoms. These food allergies are milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. The site also provides tips on reading labels properly and how to allergy-proof your house. mayoclinic.com/health/food-allergies/AA00057

Food Allergy and Anaphylaxis Network (FAAN). “This is the best resource for parents,” said Dr. Attaway. The website offers a wealth of information on all major food allergies and includes a link to a useful pamphlet called “The Peanut Answer Book.” Attaway noted that a toll free number is available any time of day or night if parents need to call to ask questions. foodallergy.org

Kids With Food Allergies. A non-profit organization that promotes and develops plans for children with food allergies to live nutritious and healthy lives. The group focuses on educating the public about food allergies and providing networking to those with food allergies. kidswithfoodallergies.org

Sunbutter is an alternative to peanut butter, and the company states it is peanut-free, tree nut-free, and gluten-free. The website also offers a variety of recipes to make the most out of the product as well as other safe ingredients. sunbutter.com

Is my baby’s head normal?

By Laura Reed

Physical therapists at Children’s Village see up to six new babies every month who are sent by their doctor because they have flat heads. It is estimated that one out of every 50 babies will experience this condition, called plagiocephaly.

Although there are many reasons why a baby’s head may become flat, many cases are preventable. In all cases, it’s important to seek treatment because plagiocephaly can negatively affect your baby’s developing vision, hearing and movement.

Why is my baby’s head flat?
There are many reasons why a baby’s head becomes flat. Twins or triplets are more at risk due to the limited space they have to change position in utero. Premature birth, low muscle tone or birth complications may place a baby at higher risk. Sometimes babies have medical or skeletal issues that have caused this.

Unfortunately, some of the things that give us convenience are also to blame for many cases of plagiocephaly. Babies now spend much of their time in infant carriers, baby swings and bouncy seats. You can imagine how a baby rests the back or side of his head when sitting in one of these devices. Prolonged pressure quickly causes a baby’s head shape to change; skull bones not yet fused together actually shift, causing his head to become flat.

What are the symptoms of this condition?
By the time a baby begins physical therapy at 6 to 12 weeks of age, the flatness often is very noticeable and the baby also has uneven eyes, ears, nose cheeks, forehead and jaw.

Muscles in the baby’s neck may also become tight, making it hard for her to turn her head one way, a condition called torticollis. The combination of these conditions makes it difficult for your baby to look to both directions, reach with both arms, and roll to both directions. It makes it difficult for your baby to raise his or her head when on his or her tummy.

If untreated, a baby could experience a “head tilt” posture that does not go away. Alignment of the eyes, ears and jaw may be affected as well as the shape of the skull. Vision and hearing also may be impacted, as well as motor coordination and balance.

How can I keep my baby from getting a flat head?
Prevention is the easiest treatment. It’s really pretty simple!

First, to decrease the risk of SIDS, always, always have your baby sleep on his back. And, always have your baby secure in his car seat when riding in a vehicle. However, when the baby is not sleeping or riding in a vehicle, here’s what you can do:

• Give your baby lots of time on her tummy when you can closely supervise her. Place your baby on her tummy, helping her to prop on her elbows several times a day, for short periods of time.
• Use a front pack or baby sling for baby-wearing, versus a bouncy seat, swing or infant carrier. Limit time spent in car seats to only those times when your baby is riding in a vehicle.
• Change the way your baby’s head is positioned when sleeping. For one nap, turn his head toward the left. For the next nap, position his head in the middle. For the next nap, to the right.
• Encourage your baby to look to the right and the left by giving her lots of things to watch with her eyes.

What should I do if my baby’s head seems flat?
You should talk to your doctor immediately if you notice that your baby’s head is flat, or if she prefers to turn her head one way more than the other.

Your baby will be evaluated for any tightness of neck muscles, limitations of movement and abnormalities of the skull.  The therapist will provide you with stretching and positioning exercises to perform several times each day.

Depending on the severity of your baby’s torticollis and plagiocephaly, weekly therapy may be recommended. In addition, some babies will need to wear a helmet to re-shape their head.

Laura Reed is a pediatric physical therapist at Children’s Village in Yakima.

Last day of chemo

Here’s a message Michelle posted on Facebook on Sunday:

“I’m totally celebrating the fact that tomorrow is my last chemotherapy treatment – I MADE IT! The 7 weeks of radiation that I’ll do next will seem like a cakewalk compared to chemo. Thanks to everyone praying for me and sending me good vibes – it is really working because I feel stronger than ever, and I still have my … eyebrows! Plus, I’m totally chemolicious, baby!!!”

Thoughts on the mammogram debate

In case you didn’t see Michelle’s letter to the editor in Sunday’s Yakima Herald-Republic:

To the editor — Re: The Nov. 17 Associated Press article about new guidelines for screening mammograms.

Apparently, the federal Preventive Services Task Force under the Obama administration knows more than the American Cancer Society when it comes to screening women for breast cancer! Is it just me, or is this statement outrageous? According to the Associated Press, under the new guidelines recommended by this task force, women do not need mammograms in their 40s and should not even bother with performing self-breast exams.

Oh, really? Never mind that a self-exam and mammogram found my cancer at age 39 (and I was not in a high-risk category); it seems that the new guidelines are nothing more than a cost-saving measure to pay for universal health care! If thousands of women between ages 40 and 50 die due to these new guidelines, then that’s a sacrifice we need to make for universal health care? No way! Thanks, but I’ll still be following the guidelines of the American Cancer Society and not some politically motivated task force.

It’s sad that after a decade of gains being made by women taught to perform self-exams and get recommended mammograms that we now have government saying, “It doesn’t matter.” Well, it will always matter to me!

MICHELLE BERTHON

Yakima

Kids can learn yoga, too

Parents and children ages 4-8 can learn basic yoga principles and enjoy exercise in a non-competitive atmosphere at Yakima Yoga’s Saturday classes for kids.

These drop-in classes led by Gina Ord integrate basic yoga poses, music and relaxation. Handouts will be provided each session so kids can practice at home.

Kids’ Class meets from 10-10:45 a.m. select Saturdays: Nov. 14, Dec. 12, Jan. 2, Feb. 20 and March 13. Cost is $12 per family for each session, or purchase a six-class punch card for $60. Arrive 10 minutes early for your first session to register. Wear comfortable clothes and bring your own water and mat (or you can borrow a mat).

Yakima Yoga is located at 25 N. Front St., Yakima; enter through Carousel restaurant. For more information, visit yakimayoga.com or call 910-1151.

Half-way through!

Here’s a little update from Michelle’s Facebook page on Tuesday:

Had chemo on Monday morning, Gut Busters at the YMCA later that night, and yoga tonight. See, a little chemotherapy will not keep me down, and as of yesterday, I’m half-way to the finish line!

She’s had three of six treatments so far. Aside from feeling tired from the chemo — and being absolutely tired of cancer taking over her life — she’s kept up a great attitude and has been able to avoid getting sick so far.

— Sara Bristol

Chemo, second round

Hi all, it’s Sara here. I got an update from Michelle this morning, so I thought I’d share with you all that she’s doing really well so far. She received her second dose of chemotherapy on Monday and was able to go work out at the Y that evening!

After the first round of chemo in September, she felt just fine for about five days. On the sixth day, she felt like she’d been clobbered by a ton of bricks. Guess we’ll know soon enough whether that pattern’s going to repeat itself. In the meantime, here’s what Michelle’s been doing this week:

“Chemo on Monday, ‘Gut Busters’ at the YMCA on Monday night, a white blood cell booster shot on Tuesday (plus yoga on Tues. night), a trip to Northstar and the Wellness House on Wednesday (plus Target to buy Alexandre’s cowboy costume), then home in time to do 2 loads of laundry!  Okay – so now I’m tired, but I cannot seem to ‘become accepting’ of a messy house. Tomorrow (Thursday), I’m doing Pilates in the AM (a healthy body goes hand in hand with healing!), yet more lab work in the afternoon, and yoga in the PM.”

Whew! Just reading that schedule is wearing me out…  I’ll let you know when I get another update.

— Sara Bristol

‘It happened to me’: Three Yakima-area moms share their breast cancer stories

If you think breast cancer only concerns women your mother’s age, think again. If you’re a woman, this story is for you.

It’s the story of three mothers from the Yakima area who each battled breast cancer before she turned 40. Rare, right? Not exactly.

Let’s crunch some numbers: According to the American Cancer Society, one in eight women in the U.S. will be diagnosed with breast cancer in her lifetime. Of that number, 95 percent involve women age 40 and over.

So — whew! — only 5 percent involve women under 40. That means mothers in their 20s and 30s can put that concern on the back burner and get back to making dinner, right? Because that’s just, um, let’s see… about 1 in 165 women who will be diagnosed with breast cancer before age 40.

Bet you know 165 women. Start with your friends and family. Then there’s the ladies at church and work. Mothers at MOPS or the PTA. Hey, don’t forget to include yourself.

So far, medical experts can’t predict who’s going to get breast cancer. More than 70 percent of the women who get it do not have a family history of the disease.

Unfortunately, the most significant risk factors for breast cancer are just being female and getting older. So it’s more likely to occur as we age, but breast cancer is the leading cause of cancer death in women ages 15 to 54.

Thankfully, there’s a little good news: The five-year survival rate, when breast cancer is caught early before it spreads beyond the breast, is 98 percent.

That’s why we see a lot of pink in October. The official color of National Breast Cancer Awareness Month, pink now rivals pumpkin orange as the month’s predominant color: Pink ribbons, pink M&M candies, pink “Save the Ta-Tas” T-shirts. It’s all about raising money for breast cancer research and reminding women to take care of themselves with monthly breast self-exams, regular visits to the doctor and, beginning at age 40, an annual mammogram.

Just don’t be fooled into thinking you can ignore this one until the big Four-Oh lights up your birthday cake. The moms in this story each will tell you that a self-exam saved her life.

Katherine Anderson, diagnosed at 32

She was young and healthy, with no family history of cancer, when this Selah mom felt a lump during a breast self-exam in June 2007. The lump was fairly small but felt different, so Katherine went to her doctor to have it checked out — just to be sure.

“I was told that it was nothing the first time I went in,” Katherine recalls. “By November, it was really painful where my lump was, which is not normal.”

She went back to the doctor, who suspected a cyst and ordered a mammogram. After seeing the images, the doctor requested a biopsy.

“At that point, I knew I had breast cancer before they even biopsied it,” says Katherine.

As they went in to get the results of the biopsy, Katherine’s husband Chad assured her everything would be okay.

“He was like, you can’t have it. People your age don’t get breast cancer.”

Katherine’s tumor was 5 centimeters in diameter at the time she was diagnosed with Stage III breast cancer, which had already spread into some of her lymph nodes.

Katherine underwent chemotherapy followed by surgery to remove the tumor, known as a lumpectomy, then radiation. One of the hardest parts, Katherine says, was seeing how her illness affected her kids, Alyssa and Evan, now 9 and 7. Alyssa slept in Katherine’s bedroom and Evan, then a kindergartner, would sometimes ask his mom if she was going to die.

“It just rips your heart out,” Katherine says.

Now in remission for over a year, Katherine, 34, is a preschool teacher for the Toppenish School District.

“Early detection is so important,” she says. “Doing the self-exams and getting a second opinion and trusting yourself that you know your body. That’s what I’ve learned from all of this.

“You think about it (cancer) every day, but you just try to make the most of each day. It’s forever changed me.”

Carole Jevons, diagnosed at 27

Today, she’s a busy West Valley mom to three daughters. Carole doesn’t think about breast cancer too much anymore. And that kind of surprises her, actually. There were so many days she thought she’d never forget.

Step back 15 years: Carole’s grandmother was a breast cancer survivor, but Carole wasn’t worried about it for herself. After all, she was just 27, married with no children yet. Breast cancer was something that happened to older women — like her grandmother.

Health-conscious, Carole did the perfunctory breast self-exams anyway, not expecting to find anything. However, one day, she felt an unusual lump: “Rock hard, like a marble, but it didn’t hurt,” Carole recalls.

“I just figured that it was nothing, How could it be anything? I was 27.”

She was young, healthy and fit. She felt great. But after a mammography and biopsy, Carole learned she had Stage II breast cancer. Even the doctor couldn’t believe it; he sent the tissue sample twice to the lab to confirm.

Carole had a lumpectomy, followed by six months of chemotherapy and six weeks of radiation. When the treatments ended, she was ready to start a family.

Three years later, Carole got the go-ahead from her doctor. She and husband Enrique started a new chapter in their lives with the birth of their daughter Nicole.

Then, when the baby was just 6 months old, a mammogram — now a regular part of Carole’s follow-up routine — detected a new primary tumor in her other breast.

This time, Carole opted for a bilateral mastectomy, determined to kick breast cancer for good.

“And then I got it again.”

Her daughter was 4 when Carole found a third lump on her chest near the scar where her breast tissue had been removed. “How could it be? There’s nothing left,” she wondered.

After a lumpectomy, she went through chemotherapy a second time.

Today, Carole has been cancer-free for eight years. In addition to Nicole, now 12, Carole and Enrique have 3-year-old twins, Natalie and Lauren. The couple own and operate Mad Science of Yakima County.

In the 15 years since her first battle with breast cancer, Carole’s mother and an aunt have also been diagnosed with breast cancer. However, doctors haven’t been able to link the women to any known cancer gene or explain why Carole had cancer at such a young age.

“I’ve met a lot of people (other survivors) who were so young. I was surprised,” she says. At the time, “I thought I was the only one.”

“I’ve heard some women who are scared and say they don’t want to do it (get a mammogram) because it hurts. But I’m telling you, it’s just a minute or two of hurting that can save your life.”

Michelle Berthon, diagnosed at 39

Just this summer, the last week of June, Michelle and husband Todd celebrated their 11th wedding anniversary with a cruise to Alaska.

“It was the best vacation we’ve ever had,” Michelle says, enthusiastically ticking off a list off the couple’s adventures: Rock climbing, sea kayaking, riding a zip line.

Aboard the ship, Michelle also performed a breast self-exam, a precautionary task she’d been through roughly once a month for years. This time, she felt a lump.

“I was not nervous or worried,” recalls Michelle, who’d had two benign fibroadenomas removed in the past. Still, the stay-at-home mom to Alex, 5, and Madeleine, 3, arranged for a mammogram as soon as she got back to Yakima.

When she was called back for a biopsy, Michelle still wasn’t worried about cancer. After all, she reasoned, she eats well and works out at least four times a week. “I feel great.”

So, it caught Michelle by surprise when she learned in July that she had a Stage II Invasive Ductal Carcinoma in her right breast. The tumor was fast-growing, but Michelle found it early, before it had spread into her lymph nodes or other tissues.

Nine days after her diagnosis, and just three weeks after she found the lump, Michelle had surgery to remove the tumor. A month later, she had a second surgery so doctors could make sure they’d removed all of the cancerous cells; test results indicated the surgeries were a success.

Dreading the sickness and hair loss caused by the cancer-fighting drugs, Michelle began chemotherapy in mid-September. She remains confident that early detection, aggressive treatment and prayers of support will help her win this battle.

“I have no doubt I’ll make it to the five-year mark,” Michelle says. “I’ve never had any doubt.”

According to the Young Survival Coalition, many young women and their doctors are unaware that they are at risk for breast cancer. Young women are often diagnosed at a later stage than their older counterparts.

The YSC encourages young women to become advocates for their own health and become educated about breast cancer. Learn more at youngsurvival.org.

— Sara Bristol

Just getting started

So, the idea behind this blog is to give Michelle’s friends, as well as Playdate’s readers, an opportunity to follow her progress as she battles breast cancer. Some posts will be written by Michelle, while others will be written by me (Sara Bristol, the coordinator of Playdate) and some posts may be written by other folks who are close to Michelle or have expertise with cancer, etc. That’s one of the advantages of blogs, I suppose. They’re an open forum, a work in progress. So, we’ll just start writing and posting and see where this takes us.

First, I want to get you caught up on what’s been going on in Michelle’s life this past week. She started chemotherapy on Monday, Sept. 21 at her doctor’s office here in Yakima. Chemotherapy is a process of treating disease with chemicals that kill cells (both good an bad). Chemo, as it’s commonly called, is effective in fighting cancer because it kills cells that divide quickly (one of the key properties of cancer cells). However, there are plenty of “good” cells that also divide quickly and are harmed in the process, such as hair follicles and cells in the digestive tract. So that’s why chemotherapy patients eventually lose their hair and become sick from the treatments.

However, the sickness and hair loss typically doesn’t happen right away. Michelle’s doctors have told her she’ll start to experience more of these nasty side effects as the chemo drugs begin to build up in her system, probably after her second or third treatment.

So, let’s back up a minute: Michelle had her first treatment last Monday. It was a five-hour process that basically involved her staying in one place while the drugs were delivered intravenously. She’ll receive treatments every three weeks. (I’m not sure how many treatments she’s expecting to receive, so we’ll have to answer that question later.)

Michelle’s mother Diana was able to come from Port Angeles for the week to support her and help with the kids. Michelle was tired last week, but she was able to work out (at a slower pace) and do some yoga, which was helping her feel more “normal.” (She typically works out at least four times a week.)

I got to see Michelle in Bellevue for a few minutes on Friday. I happened to be in town visiting a friend; she was there for an appointment at Anton’s Hair Company. Rather than wait for her hair to fall out, Michelle decided to keep it. She had a custom wig made from her own hair.

It was a bold move: Michelle watched in the mirror as Anton shaved her head completely bald. She had a feeling of “detatched acceptance,” Michelle told me later. Just one of many tough decisions she’s had to make — and this fight’s just getting started.

— Sara Bristol

Meet Michelle

Editor’s Note: The following is an excerpt from an article that appeared in the Oct/Nov 2009 issue of Playdate Magazine featuring three Yakima-area moms who had been diagnosed with breast cancer before age 40. While the other two mothers are in remission, Michelle Berthon’s battle with cancer is ongoing. This blog is designed to keep you updated on her story. To start, please meet Michelle:

Michelle Berthon, diagnosed at 39

Just this summer, the last week of June, Michelle and husband Todd celebrated their 11th wedding anniversary with a cruise to Alaska.

“It was the best vacation we’ve ever had,” Michelle says, enthusiastically ticking off a list off the couple’s adventures: Rock climbing, sea kayaking, riding a zip line.

Aboard the ship, Michelle also performed a breast self-exam, a precautionary task she’d been through roughly once a month for years. This time, she felt a lump.

“I was not nervous or worried,” recalls Michelle, who’d had two benign fibroadenomas removed in the past. Still, the stay-at-home mom to Alex, 5, and Madeleine, 3, arranged for a mammogram as soon as she got back to Yakima.

When she was called back for a biopsy, Michelle still wasn’t worried about cancer. After all, she reasoned, she eats well and works out at least four times a week. “I feel great.”

So, it caught Michelle by surprise when she learned in July that she had a Stage II Invasive Ductal Carcinoma in her right breast. The tumor was fast-growing, but Michelle found it early, before it had spread into her lymph nodes or other tissues.

Nine days after her diagnosis, and just three weeks after she found the lump, Michelle had surgery to remove the tumor. A month later, she had a second surgery so doctors could make sure they’d removed all of the cancerous cells; test results indicated the surgeries were a success.

Dreading the sickness and hair loss caused by the cancer-fighting drugs, Michelle began chemotherapy in mid-September. She remains confident that early detection, aggressive treatment and prayers of support will help her win this battle.

“I have no doubt I’ll make it to the five-year mark,” Michelle says. “I’ve never had any doubt.”

– Sara Bristol

Safe Kids: Helmets essential for safe bike riding

By Kurt Tyrrell
For the Yakima Herald-Republic

Spring is here, which means many families are preparing to enjoy the outdoors on their bikes. Before you head out, there is a little work to be done.

It begins with finding the bikes in the garage, and rearranging “stuff” so you can wheel them out. That’s the hard part. Next, be sure to check tire pressure, patch any mysterious holes, and maybe add a little lubricant to the chains.

Then make sure the brakes work, and that seats are properly adjusted to the ever-growing children.

Check, check and check! You’re ready to roll, right?

Not quite. There is one other thing that needs to be checked for every rider, and that is the bike helmet. Adults and kids alike need to have them, and if your little one is like most, last year’s helmet may no longer fit.

May is Helmet Safety Month, making spring the perfect time to ensure that all of your loved ones (including yourself) will be safe as you wheel about. Since no one ever plans to have an accident, it’s important to teach children — and to model — that helmets must be worn each and every time a person rides a bike, or any wheeled toy.

Sometimes children mistakenly believe that they don’t need to wear helmets when they’re riding near home, yet 53 percent of vehicle-related bike deaths to children happen on minor roads and residential streets.

It’s unfortunate, but each year approx-imately 135 children die from bicycle-related injuries, and another 267,000 nonfatal bicycle injuries occur. Helmets can reduce the risk of severe brain injuries by 88 percent; however, only 15 percent to 25 percent of children 14 and under usually wear them.

It’s a parent’s responsibility to instill the importance of wearing a helmet every time a child rides. In our house, if you don’t want to wear it, you don’t get to go.

Safe Kids Yakima County suggests you follow these simple tips for making sure that your biking adventures roll along smoothly:

* Make sure the helmet fits and your child knows how to put it on correctly. A helmet should sit on top of the head in a level position, and should not rock forward and backward or side to side. The helmet straps must always be buckled, but not too tightly. Safe Kids recommends the “Eyes, Ears and Mouth” test:

EYES: Position the helmet on your head. Look up and you should see the bottom rim of the helmet. The rim should be one to two finger-widths above the eyebrows.

EARS: Make sure the straps of the helmet form a “V” under your ears when buckled. The strap should be snug, but comfortable.

MOUTH: Open your mouth as wide as you can. Do you feel the helmet hug your head? If not, tighten those straps and make sure the buckle is flat against your skin.

* Make sure the bike is the right size for the child. There should be about one inch of clearance between the bike frame and the child’s groin when the child’s feet are flat on the ground. Also, make sure the bike is in good repair — reflectors are secure, brakes work properly, gears shift smoothly, and tires are tightly secured and properly inflated.

* Check for the CPSC label. A helmet should be labeled to indicate that it meets the standards set by the U.S. Consumer Product Safety Commission.

* Remember, bike helmets are for biking. Kids should not wear bike helmets on the playground (where the straps can get caught on equipment and cause injury) or for activities that require specialized helmets (such as skiing or football).

* Model and teach proper bicyclist behavior. Ride on the right side of the road, with traffic, not against it. Stay as far to the right as possible. Use appropriate hand signals and respect traffic signals, stopping at all stop signs and stop lights. Children should not ride without supervision until they have demonstrated that they always follow the rules.

* When in doubt, get help. The sales staff at any bicycle shop or outdoor recreation store should be able to provide expert advice on fitting and adjusting bikes and helmets.

OK. Bikes tuned up? Check! Seats all adjusted? Check! Everyone have a bike helmet on? Check!

Now you’re ready to head out and explore our wonderful Yakima Valley. Happy cycling!

Memorial Hospital’s Community Education Department located at 2506 W. Nob Hill Blvd. sells bike helmets at a reduced price of $10. With the purchase of a helmet, you will receive a free personal fitting.

* Kurt Tyrrell is the Passport to Health program Coordinator for Yakima Valley Memorial Hospital and a member of Safe Kids Yakima County. He is a Certified Health Education Specialist and a Certified Child Passenger Safety Technician. His column is produced in cooperation with Safe Kids Yakima County, a local consortium of organizations, agencies and individuals actively promoting child safety.

Colic FAQs

WHAT IS COLIC? Look for the rule of threes: A pattern of intense and inconsolable crying lasting at least three hours, at least three days a week for three or more weeks. The crying generally occurs at the same time each day, often in the evening.

Colic affects as many as one in four babies. The crying typically begins when babies are a few weeks old and often subsides by 3 months. In 90 percent of babies, colic ends by 9 months.

Read the Caro family’s colic story here.

WHY DOES IT OCCUR? Despite much research, there’s still no answer to this question. Colic equally affects boys and girls, bottle-fed and breast-fed babies. A baby’s birth order is not necessarily an indicator of whether they will have colic.

There’s some evidence that babies have a higher risk of developing colic if their mother or father was a colicky infant. A family history of allergies or exposure to smoke also increase the likelihood of colic.

WHAT SHOULD I DO IF I THINK MY BABY HAS COLIC? Contact your pediatrician at the first suspected signs of colic. The doctor will need to rule out several other causes of sudden-onset screaming in a newborn, as well as help you decide the best treatment for your baby. Always check with your doctor before trying a new treatment (even those homeopathic remedies that Great Aunt Ethel swears by).

Create a support group! It’s important to remember that you are not alone in dealing with this stressful time in your baby’s life. Remind yourself that it will pass, but in the meantime, let your family and friends know what is going on. Don’t feel guilty leaving your baby with someone trusted for an hour or two to get a breather! There are many online support groups that deal with colic as well. Remember, it takes a village to raise a child – especially one with colic.

Source: mayoclinic.com

What are the benefits of probiotics during pregnancy?

What are the benefits of probiotics during pregnancy?

ASK THE DOCTORS If you have a health question, we’ll find the answer. Write to the doctors at talkback@playdateyakima.com.

Dr. Robel says: Probiotics, or friendly bacteria that reside in our gut, may increase fertility and reduce early miscarriage as well as help prevent eczema and allergies in infants, according to several recent studies.

Probiotics are found in yogurt and other fermented foods. They serve to protect us from infection and help prevent a wide range of health problems including constipation, diarrhea, colitis, irritable bowel syndrome, allergies and various skin problems.

New research is finding that probiotics may also be beneficial to women trying to conceive. In a study done in Belgium, supplementing with a probiotic while women underwent in vitro fertilization increased the rate of conception compared to women not taking the supplement. Likewise, several studies have found that women given a probiotic at the onset of pregnancy have lower rates of spontaneous miscarriage in the first trimester.

Besides the benefits to mom, there are benefits to your infant. Taking a probiotic supplement for the last three to four weeks of pregnancy may reduce rates of eczema and allergies by as much as 50 percent, according to a study published in The Journal of Allergy and Clinical Immunology.

Probiotics can be obtained by eating yogurt labeled as containing “live and active cultures.” Also, there are various supplements that can be taken.

Always speak with your health care provider before taking any supplements, including a probiotic, to decide if it is right for you. Also, not all supplements are created equal so it’s important to get a recommendation to ensure you are getting what your body needs.

— Heidi Robel, ND, is a naturopathic physician and acupuncturist in private practice in Yakima.
She’s expecting her first little one in August.

Will thumb-sucking harm my child’s teeth?

SECOND OPINION
by Ashley Tercero, DDS

Will thumb-sucking harm my child’s teeth?

ASK THE DOCTORS If you have a health question, we’ll find the answer. Write to the doctors at talkback@playdateyakima.com.

Dr. Tercero says: Non-nutritive sucking habits (finger or pacifier sucking) are normal in infants and toddlers. These habits help address a child’s need to feel secure.

Although normal and harmless for young children, non-nutritive sucking can result in long-term problems if persistent. Prolonged finger or pacifier sucking can lead to a permanent open bite and other dental and jaw deformities.

In order to prevent these problems, the habit must stop by age 5. However, the difficulty of ceasing this habit increases with age, so it’s best to stop the habit before age 3. If the habit persists beyond the age of 3, it’s recommended to see a dentist for professional evaluation.

— Ashley Tercero, DDS, is a children’s dentist at Yakima Pediatric Dentistry.
Her 7-month-old daughter, Kya, doesn’t have any teeth.

What is postpartum depression?

SECOND OPINION
by Ryan Moultray, D.O.

What is postpartum depression?

ASK THE DOCTORS If you have a health question, we’ll find the answer. Write to the doctors at talkback@playdateyakima.com.

You’ve just had a baby. You’re not sleeping, your hormones are completely confused, your body hurts and there is this constant crying noise in your ear. Who wouldn’t be a little depressed?

The “baby blues” are common, and usually develop within the first few days after birth. You might experience mood swings, anxiety, sadness and insomnia. This is a transient phenomenon and usually resolves without treatment within two weeks.

Postpartum depression is also common, developing in up to 10 percent of mothers, but often goes unrecognized. The symptoms can be nonspecific, including fatigue, sadness and crying, insomnia, feeling guilty or inadequate, being overwhelmed, poor concentration, decreased libido, anxiety and not wanting to do usually enjoyable activities. In rare and extreme cases, a woman can develop psychosis (a loss of contact with reality).

Treatment usually involves a combination of counseling, medication, exercise and spiritual or emotional support. Some women are more prone to developing PPD, so if you have a previous history of depression or other mental health issues, you may want to talk to your doctor before the baby arrives. Usually, a mother doesn’t have a follow up appointment with her doctor until six weeks after delivery. It’s important to seek help sooner if there are any concerns for PPD.

— Ryan Moultray, DO, is an osteopath at Selah Family Medicine. Will and Owen call him Dad.

Help the medicine go down

Many children balk at swallowing pills or dislike the taste of liquid medicines. If that sounds like your kid, the pharmacists at Yakima’s Apothecary Compounding Solutions have a few tricks that might be able to help.

Compounding pharmacists Bob Murdock, R.Ph., and Marc Murdock, D.Ph., specialize in working with doctors and patients to customize medications. For kids, that can mean medicated lollipops, gummies, topical creams or a special medication-dosing baby bottle.

For folks with allergies or other special needs, the apothecaries can avoid dyes, fillers and preservatives found in traditional prescription medicines. Their shop, located in the Creekside Business Park at 40th and Washington avenues, also stocks a limited line of over-the-counter drugs as well as children’s vitamins that aren’t loaded with aspartame or high-fructose corn syrup.

For more information, call the pharmacy at 248-9065 or visit apothecarycs.com.

Shoot down the flu

Winter is the greatest ally to one of our least favorite respiratory diseases: The flu.

The American Academy of Pediatrics recommends parents help youngsters defend themselves against this nasty airborne illness with an annual flu vaccine. The vaccine is encouraged for kids between 6 months and 5 years old.

“There’s not a vaccine that’s recommended for kiddos younger than 6 months,” says Dr. Ryan Moultray, an osteopath with Selah Family Medicine.

However, he adds, the flu vaccine — offered as a shot or, for kids over 2, a nasal spray — is suggested for older children with chronic illnesses, including asthma and diabetes.

“Over age 5, in a healthy kid, it’s optional,” he says. “You can get it, but it’s not formally recommended.”

The vaccines are designed to target the most common and most vicious strains of influenza, a viral infection with symptoms including severe cough, muscle aches, headache, fever, shortness of breath and sore throat. It’s definitely not a “stomach bug.”

For more information about whether a flu vaccine is right for your child, or to find out where you can get the vaccine, call your child’s doctor.

— Sara Bristol

Caught the cold?

This time of year, it’s hard to know how to comfort little ones when they’re coughing and suffering from a cold.

The FDA last year issued a report warning parents against giving over-the-counter cold medicine to young children, particularly infants and tots under age 2. So, what’s a parent to do?

“There are some simple steps you can take to alleviate your child’s discomfort,” says Dr. Duane Teerink, a father and osteopathic physician at Pacific Crest Family Medicine.

• Use a humidifier.
• Get rid of postnasal drip with a bulb syringe.
• Never give medicine intended for adults to a child.
• Do not use antihistamine products to make a child sleepy.

Dr. Teerink says cough medicine should not be given to a child under 4 years old without your doctor’s specific recommendation.

“Coughs can be hard to treat sometimes,” he says. “If simple measures don’t alleviate the cough, call your family doctor or pediatrician.”

— Debra Yergen

Avoid a haunted mouth

You can’t hide from candy at Halloween, so children’s dentist Dr. Ashley Tercero has a trick to prevent your kids’ sweet tooth from haunting their mouths:

Eating a handful of candy at one sitting is better for your teeth than snacking piece-by-piece throughout the day, says Tercero, owner of Yakima Pediatric Dentistry.

“When parents want to limit the amount of junk food kids have, they tend to ration it out,” she says. “From an oral health perspective, that’s probably the worst thing you could do.”

The explanation: Each time you eat a piece of candy, it coats the teeth with sugar. Bacteria living in the mouth then feed on the sugar, resulting in the production of acids that eat away at teeth and cause cavities. Saliva will naturally clean the sugar off your teeth in about 30 minutes, but the process starts over each time you eat another piece of candy.

Also, saliva production decreases while we’re sleeping, allowing bacteria to wreak more havoc if we go to bed with dirty mouths.

So, Tercero advises parents: “The most important brushing is the nighttime brushing, and make sure it’s after the kids have eaten their last meal.”

— Sara Bristol

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