We are pleased to announce that five Passport Health Colorado locations are offering the H1N1 vaccine for the general public. Anyone 6 months of age and older is now eligible to receive the 2009 H1N1 vaccine.  All vaccines are first come, first served and while supplies last.

Our current clinic listings are:

Boulder: Saturday, December 12th walk-in clinic (no appointment needed) between 10a – 2p. Saturday, December 19th by appointment only between 10a – 2p. Weekdays by appointment only.
Lakewood: Saturday, December 12th walk-in clinic (no appointment needed) between 10a – 2p. Weekdays by appointment only.
Centennial: Weekdays by appointment only.
Cherry Creek: Saturday, December 19th by appointment only between 9a – 12p or walk-in (no appointment needed) between 12p – 4p. Weekdays by appointment only.
Colorado Springs: Weekdays by appointment only.

We also still have Seasonal Flu vaccines available for anyone who would like it.

Please call us at (303) 442-8728, (719) 387-5528 or (970) 484-2148 to schedule an appointment or for directions to any of our offices.

Stress has a funny way of bringing out the worst in a person. Being hassled, harried; being everywhere all the time but never really being there; being too busy to attend to your own wants eventually leads to a loss of interest in things or life, and depression.

Now before you totally lose it, here are a couple of ways you can reduce your stress levels to avoid being overwhelmed:

• Have a good and long breathing exercise.

How a person breathes actually contributes to the feeling of anxiety. So take one good long deep breathe from your belly and slowly exhale. Think of a peaceful scene. Do a couple more of these until you feel your heart beat slow down.

• Relax your muscles.

Doing a little stretching exercise actually releases tight muscles, helping you relax your body in times of stress.

• Soothe yourself with music.

If music player is at hand, listen to slow songs. Studies show that the tempo of a song actually contributes to how we feel upon hearing it.

• Eat right. Exercise.

Maintaining a healthy diet and exercise actually helps a person deal with stress. Proper nutrition gives a person more energy and energy helps a person maintain a positive outlook.

• Find a hobby.

Most people would suggest gardening, yoga, or getting a pet. By doing so you will have less time to focus on what is stressing you out and how much it is stressing you out.

• Have an anti-stress mantra.

Mumbling or talking to yourself during a moment of anxiety or angst is not as crazy as it may seem to some. Having an anti-stress mantra actually helps a person cope with the demands of life.

• And lastly, Relax.

If you can find a place to cuddle and take a nap, please do. When a person lacks sleep, he is more prone to be stressed out.

Passport Health Colorado now has doses of 2009 H1N1 influenza vaccine available in our Boulder, Lakewood, Cherry Creek, and Colorado Springs offices (nasal spray and injectable shot versions), and are expecting to receive doses H1N1 influenza vaccine in our other offices soon. Keep watching our website for upcoming H1N1 clinic date and times in our 6 offices.

• Boulder: During the week (Monday through Friday) by appointment only or Saturday, December 12th, 10:00 am – 2:00 pm, walk-in clinic (no appointment needed)
• Lakewood: During the week (Monday through Friday) by appointment only or Saturday, December 12th, 10:00 am – 2:00 pm, walk-in clinic (no appointment needed)
• Cherry Creek: During the week (Monday through Friday) by appointment only
• Colorado Springs: During the week (Monday through Friday) by appointment only

The H1N1 vaccine is currently reserved for clients in one of five risk categories:

1. Pregnant Women
2. Caregivers or household contacts of infants under 6 months of age
3. Children and students aged 6 months through 24 years
4. Healthcare workers
5. Adults over 24 years of age with underlying health conditions. Examples of those conditions include chronic pulmonary (asthma, COPD, lung disease), cardiovascular (congestive heart failure), hepatic (hepatitis, cirrhosis), hematological (leukemia), neurologic (epilepsy, Parkinsons), neuromuscular (MS), metabolic (diabetes), or immunosuppressive disorders (cancer, AIDS, HIV, steroid medications).

The price for all H1N1 shots are FREE, however there is a $15.00 vaccine administration fee per dose.

Seasonal flu vaccine is also now available on a first come, first served basis. We have limited doses of both injectable (ages 6 months and up) and FluMist nasal spray vaccine (ages 2-49 years and healthy).

For an appointment in any of our locations, please call (303) 442-8728 or (719) 387-5528 or (970) 484-2148

Waist 53.5

Chest 44

Right Leg 29

Left Leg 28.5

Right Arm 15

Left Arm 15.5

Neck 17

A quick status update of my health after 2 weeks.

• Joint pain is slowly going away (exercise and green tea) No more (mild) pain killer for me every day.
• Weight is at 250.5 , so there has been a little improvement.
• Not so winded when I walk, endurance is up.
• Stress is down a bit.
• Self Esteem is going up.  4 days in a row fixing my hair and putting on makeup for work. Which I NEVER do.

All is good.

First I did chemo, that is pretty standard with ibc. I was on Taxol with Avastin as well as Zometa on a four week schedule.

• Week 1 – all three
• Week 2 – Taxol only
• Week 3 – Taxol and Avastin
• Week 4 – off

This was a schedule proposed by the oncologist I saw at IU in late May, she actually did the clinical trials of Taxol with Avastin. She explained that since the cancer had spread a mastectomy would be up to me but probably wouldn’t be necessary unless I wanted to. The idea behind having surgery is to keep it from spreading and it had already done that.  She also explained that their goal as doctors when you are stage IV, is to keep you alive as long as possible, as comfortably as possible – no timelines. Which is good because the only statistic that matters to me is mine.

I had scans at the end of June that were really good, everything had responded and was smaller! YEAH!

Continued treatment – had lost my hair by the beginning of June, my Mom had gotten me two really great wigs and lots of hats, my sister contributed to the hats as well. I had lost some weight but was holding steady at about 130.

In August I started developing some neuropathy, numbness and tingling in my toes mostly but a little in my fingers and by mid September had also developed skin sensitivity on the front of my shins and thighs and on my lower back. Mostly just sensation, not pain really. For example if my son wanted to sit on my lap I could pick him up and set him on my lap and take a deep breath or two and it would be gone but if he was fidgety or tried to climb up then it was more bothersome. Laying down in bed at night and rolling over or when I crouched down while wearing long pants and they tightened over my thighs are the other times I really noticed it.

I also started developing problems with my fingernails in September. That was more difficult than the hair thing for me. They can loosen in their nail beds due to the chemo and my middle, ring and pinky fingers on both hands as well as the toenails on my big toes were effected too. I ended up not losing any of them but it was close and I did get infections under two nails.

Despite that being tougher for me my mantra is… I can do whatever I need to do to stay with my babies. I’ll be bald and without fingernails forever if I stay with my kids.

End of September – next set of scans… LUNG – declared clear, LYMPH nodes – almost resolved themselves, BONE – stable to mildly improved, LIVER – additional mild response, BREAST – additional mild response. Not near as dramatic as the results in June but still, everything improving, not getting worse. Time to look at changes to treatment, we had “Maximum response for the amount of toxicity” I was getting.

Stopped Avastin September 30th, stopped Taxol October 16th, still go once a month approximately for the Zometa.

Had ovaries and fallopian tubes removed (oophorectomy) November 5th, laproscopic and am doing great. Next is a mastectomy. It turns out there have been some studies that show longer survival times and lower recurrance rates when you remove the original source of the cancer. Have had the BRCA testing done and am positive for BRCA 2. Sort of stinks but it is info I can do something with. Right now I am scheduled to have the mastectomy on December 8th but there is a snafu with my insurance and I may have to wait until the beginning of 2010. We’ll see but for now, I am on an estrogen inhibitor (the cancer in my body is positive for estrogen which is why we removed my ovaries – take out the estrogen factories) that I take once a day. My nails are recovering, I’m getting some hair back (eyelashes and eyebrows will be welcomed back!), the neuropathy is subsiding and I’m getting back some energy.

That has you pretty well up to date on what the long version of the story is. I’m sure other bits and pieces will be discussed as we move forward but there is the bulk of it.

Monday and my mom’s friend has said she’ll see me that day. I go pick up my husband and off we go. News is still – inflammatory sucks – aggressive and nasty and will start with chemo on Thursday regardless of what the scans say. She keeps the scans that are scheduled and adds a port placement and MUGA scan. Dr. Bechhold and her nurse Deanna are really good to me, they give me lots of information including a really good list of places to get hair prosthesis (wigs). I leave still scared to death but feeling a little better because I feel like we are starting to fight it.

So my week is shaping up as…

• Monday – meet oncologist
• Tuesday- CT scan and bone scan
• Wednesday – port placement for easier admin of chemo and other drugs
• Thursday – start chemo
• Friday  – MUGA scan (Heart because chemo can be tough on your heart)

So we realize the family is going to be around a lot and there is going to be a lot happening so it is time to tell my daughter. She is 6 1/2. So not fair that she should have to hear this. We sit her down on Monday night and tell her, at least the basics, Mommy has breast cancer, she’s going to take strong medicine that will make her lose her hair and will probably have surgery at some point to take off the breast that is sick. I take her to school the next day and fill in her teacher, the principal and the school counselor. I had also heard that her teacher was going to move to the next grade with them so I asked them to keep her with the same teacher (and I am so grateful they did).

It was my daughter’s sharing day that day so she tells her class that her Mommy has cancer, she is going to have her breast cut off and lose her hair. Not how I would have phrased it but she is reasonably accurate.  She understood what we told her. So I get a call from the guidance counselor giving me a heads up about this which is fairly entertaining now but I was pretty concerned at the time. So the word is about to spread…

Have scans, praying the entire time. Have port placement, not too bad and while it was twilight sedation I’d bet I fell asleep given that I hadn’t really slept in days at that point. Go for chemo and to get scan results. They aren’t what we want. The bone scan shows mets to my right hip, two on my spine, one on my right shoulder and one on my skull. The CT shows mets to my right lung and my liver.  I start chemo – Taxol, Avastin (keeps new blood vessels from growing towards the cancer and giving it that fuel) and Zometa (to rebuild my bones as we kill the bad cells). I also get scheduled for a brain scan the following Tuesday.

MUGA scan on Friday goes well – now to wait and see if it is in my brain. I go for my next chemo on Wednesday.

I spend the weekend as a mess, if it is in my brain I’m in trouble. Not that things are going to be easy as they stand  but brain mets are scary. To add to it, one of the other parents on my daughter’s soccer team had been diagnosed the previous November with lung cancer that had metastasized to his brain – at age 35. Healthy, young, wonderful guy. We lost him four months later, he left a beautiful wife, 7 year old daughter, 4 year old son, was his mother’s only child and she adores him still and a ton of other friends and family. Brain mets terrify me.

Spend a tearful morning at church, praying that my brain is cancer free. Go for the brain scan, still praying. Go to get chemo and scan results the next day. MUGA was good, needed that mostly as a baseline. Brain scan results aren’t back quite yet. I tell my doctor that I can’t handle waiting – can she find out for me. That is when she realizes how scared I am and expains that “I don’t expect to find any in your brain, I just need a clear brain scan for the Avastin”. OMG. I am so relieved, she comes back 20 minutes later and says “Yes there is a brain, No there is no cancer in it” – the shelling has stopped as my husband phrases it.

Now to calm down and look at a second opinion and figure out what is happening.

Dr. Beckes tells me I need a CT and a bone scan ASAP to determine if it has spread and I need to get to an oncologist, like, yesterday and she gives me recommendations. I call my Mom and my Husband and somehow am managing to stay in control. At least I think I did.

I call Dr. Grannan who tells me the same thing and gives me recommendations for an oncologist as well as someone to do my port as he is going out of town. I call my general practictioner and talk to the doctor I had seen on Tuesday who tells me the same thing and gives me some names.

I call the oncologist whose name popped up twice and of course he was double booked for the following week but they could get me in to see his associate on Thursday morning – keep in mind this is Friday afternoon and I’m in a panic. I agree and explain that I have had three doctors tell me I need a bone scan and a ct, could we get those scheduled so we can hit the ground running on Thursday. I don’t know how old this girl was but I’m not sure she’d be my first line to deal with oncology patients. Anyway she says she’ll check, calls me back in about 30 minutes and says the doctor okayed it, when was I available…. “My schedule just got clear. You tell me where and when to be.” – SERIOUSLY! She calls back again, I have them scheduled for Tuesday at Anderson Mercy. Beautiful.

Now to wait and tell the people who love me. This sucks.

Not going to tell my kids until I know what I am dealing with. May 8th is my sister’s birthday… do I tell her? My Dad’s Mother died of breast cancer when he was 5, I can’t tell him on the phone, I have to go see him. Then there are my friends, and of course it is Mother’s Day weekend.

My Mom convinces me to tell my Sister. I’d want to know if it was her even if it was my birthday, and I asked her to come over the next day to go tell Dad with me.

Then I make my big mistake. I start looking online. Not only could I not eat because my stomach was a mess but looking at the numbers regarding ibc – the rarest and nastiest version of breast cancer, and numbers regarding stage IV cancer, then looking at all there is about your diet and cancer. I was afraid to eat. Every time I put something in my mouth I was thinking “Is this feeding it? Is it starving it?” Complete mess. I call my doctor Saturday because I’m nauseous and everything I eat goes straight through me. I get an operator who says that the nurses don’t usually take calls on Saturday. I explain what is going on and it turns out she is a survivor – in treatment – and she’ll get a message to my doctor who calls in a prescription for me. Wow. That was fortunate.

Saturday my Sister comes over and we go to my Dad’s. I have tried to call a couple times and give my Stepmom a heads up but Dad answers the phone every time I call. My son was with us and as we walk in I send my Brother to go get Dad and quickly stun my Stepmother with the news. Dad comes down. ‘How do I tell him? I can’t do this. God I don’t want this to be happening.’ Dad sits, I tell him, he manages to find a reason to leave the table and my Sister follows him and we all cry.

I go to church and tell my Sunday School class, they are amazing and most of them have known me since I was a kid – seriously, like 2. I used to play with their kids. I spend the day scared to death that I’m going to die and trying to enjoy what I’m afraid could be my last Mother’s Day. I haven’t had enough of them yet! How am I going to wait until Thursday?

Monday – my Mom calls in the morning. She called her friend Becky, an oncologist that she knows, and explained that she needed the name of an oncologist who specialized in breast cancer that she would go to or that she would send her daughter to and explains why. Becky tells my Mom “I specialize in breast cancer and I’ll see her this afternoon”. God is putting the right people in my way.

When one lives in their own body, things are normal to them.  All my ailment are completely normal to me.  It’s not until one begins to list them and sees them complied that the list it become real.  That some of these ailments are probably related.  For example, it’s easier to think that you have knee pain because you have “bad knees” than to think it’s part of a larger picture, like the excess weight you carry.  Excess weight on a person can become such a normal feeling that it can be hard to remember what it is like to be of a more healthier weight.  This weight IS normal to me.  It’s something I can easily ignore until I look in the mirror.

Let me start my list…

Back pain
Knee pain
Foot pain
Snoring
Depression
Anxiety
Stress
Asthma
Diabetes Insipidus
Hypothyroidism
Irregular mentrual cycle
Fatigue

Well, I am sure there are more, but like I said, they become such a routine part of life that it’s easy to forget you even have an ailment.  I hope to track these ailments and report any improvements of symptoms as I journey to better health.  I will need to push through them, not let them stand in my way.  Not make excuses for them.  They will not go away by themselves. 

Only I can make the changes to my body.

Noah is out of surgery and is resting. Thank you so much for your prayers and support. I’ll update more later. (I’m smushed in a hospital bed because he whispered that he wanted to snuggle; I have no blood in my body from the waist down but it’s worth it!

With love -
Amber

Sent from my Super amazing iPhone

Hello all -

We need powerful prayers for Noah. Today he is undergoing another brain surgery to insert a shunt from his brain to his abdomen. Not only is the surgery frightening enough, they are telling me that the cancer cells could travel down the shunt, into his belly and “seed”. They are also inserting a double “port” into his chest, under his skin to administer chemotherapy. He is also having another spinal tap to see if the cells are spreading more. This week is critical.

Thank you for your love and support.
Amber, Dennis, Landin & Noah

The oophorectomy was Thursday. It’s Sunday now. Doing okay. I got home from the hospital sooner than expected. Surgery was scheduled for 7:30am and we were at Good Sam at 5! I was home by lunch, I evidently woke up more quickly than expected, I took the percoset for the first 24 hours but didn’t like it so I’ve just been taking 4 Motrin at a time. Seems to be working to take the edge off so far. The left side incision is a little bigger but both will allow me to wear a bikini (not that I have much the last few years). The left one is also bruising some and is the more painful of the three, especially if I try to roll over at night. Don’t feel the one in the bellybutton at all.

Took the kids to church and hit the grocery store, need to go to bed. But I’ve been thinking…

My cousins walked in a walk to raise money for Pancreatic cansur research this weekend. We lost their mother, my aunt (Daddy’s sister) to this several years ago. cansir sucks. I did one (with a bunch of people who love me) for breast cansur here in Cincinnati, there are leukemia walks, lung cansir walks and on and on. With all the walks and all the people impacted by this disease I’m left wondering… when will we find a cure, for any of them, will we find a cure and why haven’t we yet? It seems like we would have to but each type of this disease has so many versions, and it is such an industry now, will there be multiple cures, different ones for different kinds and then for the subtypes within each. As an example, breast canser is tested for estrogen receptors, progesterone receptors and Her2nu. All things from which it can get fuel. The version I have is inflammatory and is estrogen positive, but negative for the other two. My friend Diane also has inflammatory but it is triple negative. A more common type for example is invasive ductal but it can also have any combination of the three. There are even those who are triple positive, do we all need a different cure or is one going to get all the breast cansirs, or even better will one just get rid of all cansir? That would certainly be a miracle drug wouldn’t it.

Okay, and a little off topic, do people who smoke while they are on these walks see the contradiction in what they are doing? Seriously, you are surrounded by people who either have cansir or love someone who does, at what point does smoking seem like a good idea in this setting? And then to get offended when someone calls you on it (seriously I watched this scenario play out). Yes, we are outside but when you are blowing smoke two feet in front of someone, outside doesn’t matter unless the wind is howling through. Don’t get me wrong, some of the people I love smoke, I wish they didn’t, I don’t get it and I don’t love them any less but regardless, I don’t want them smoking around me either and they don’t. How about helping us keep our list of challenges as small as possible.

Click Here for more Information

Click Here for information on antibiotics and when they work!

News from the Department of Health:

Health Secretary Francisco T. Duque III personally checking the health conditions of evacuees devastated by Typhoon Ondoy.

Health Secretary Francisco T. Duque III personally checking the health conditions of evacuees devastated by Typhoon Ondoy. In order to prevent diseases in evacuation centers, Duque urges everyone to practice good personal hygiene like boiling water use for cooking and drinking, washing hands with soap and water before and after eating and after using the toilet, using toilet facilities/portalets for one’s personal needs, using protective clothing to avoid dengue, and to breastfeed every child because mother’s milk provides complete nutrition and that water in evacuation sites is usually unsafe. (5 October 2009, Taguig City)

Intravene offers vaccination and immunization programs for schools, businesses and those traveling abroad.  They will be here at JMU for the flu and H1N1 vaccinations.  Click here for more information.

We have received this question many times, mostly from people assuming that the vaccine is a brand new vaccine that is being catapulted through the testing and approval process. It is important to note that the 2009 H1N1 (Swine Flu) vaccine is not a “new” or experimental vaccine; it’s simply a new strain of the influenza virus, which is turned into a vaccine using the same process that seasonal flu vaccine goes through each year in production. The response to the 2009 H1N1 (Swine Flu) vaccine should be similar to seasonal flu vaccine. Here is the CDC’s response to this question:

“We expect the 2009 H1N1 influenza vaccine to have a similar safety profile as seasonal flu vaccines, which have a very good safety track record. Over the years, hundreds of millions of Americans have received seasonal flu vaccines. The most common side effects following flu vaccinations are mild, such as soreness, redness, tenderness or swelling where the shot was given. The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) will be closely monitoring for any signs that the vaccine is causing unexpected adverse events and we will work with state and local health officials to investigate any unusual events.”

If you experience abnormal side effects after receiving the novel H1N1 (Swine Flu) vaccine, always report your symptoms to the doctor or health care professional that administered the vaccine. This will enable a report to be submitted to a nationwide database that allows tracking of trends for side effects.

For more information on 2009 H1N1 (Swine Flu) vaccine safety, please visit the CDC safety website.

Written by: Holly Brown, Office Manager for Passport Health Colorado

There are updates available for those who would like to check on the progress of Father Ron Clemmer.   Read the latest update and show your support at: http://www.caringbridge.org/visit/fatherron

There is now a limited supply of seasonal flu vaccine. Call Passport Health Colorado to be put on our waiting list and we will be providing seasonal flu vaccine based on the waiting list as we receive vaccine.

Prices for Seasonal Flu Vaccine fr September 2009 – May 2010 are as follows:

• Adult Flu Shot (Adult 18+ years) = $25
• Pediatric Thimerasol-free Flu Shot = $40
• FluMist – Thimerasol-free (ages 2-49 only, intra-nasal spray) = $40

Receipt provided upon request. Passport Health IS NOT a Medicare/Medicaid provider and WILL NOT submit claims.

Policy for Vaccinating Children: Minimum of 6 months of age. For the first year of immunization the child will require 2 doses, 30 days apart. Children under the age of 18 years must be accompanied by an adult. Administration of vaccine is first come, first served.

All flu vaccines are by appointment only, please call 303-442-8728; 719-387-5528 or 970-484-2148 to be put on a waiting list.

Here’s the latest new as of September 9, 2009. In the state of Colorado, H1N1 “Swine Flu” vaccine will only be available through county health departments in October-December to high-risk groups. Private providers, like Passport Health Colorado, will be able to provide H1N1 vaccine to the general public as of January 1, 2010.

On a national level, Passport Health is working closely with the CDC to be a provider for the H1N1 vaccine nation-wide. Here at Passport Health Colorado, we are working closely with our colleagues at the health departments to get doses for our clients. Last week, I attended a meeting with all of the Denver metro county health departments to get an update on what they are planning for H1N1 vaccine delivery.

The first doses of H1N1 vaccine are expected to ship sometime in October. For all of November and December, the health departments will be running community clinics and focusing on high priority clients only (pregnant women, school children and young adults up to age 24, caregivers of infants, healthcare workers, adults with chronic medical conditions ONLY). The general message from all counties is that H1N1 doses for all non-priority clients will not be made available to community vaccinators (such as Passport Health Colorado) until after January 1, 2010.

Once doses are available, we will be scheduling walk-in clinics in our offices as well as corporate H1N1 clinics. Prior to January, our clients in the priority risk groups should receive the vaccine through community channels. Please continue to check our website and this blog for more updates. We will post community clinic dates as information becomes available.

Written by: Rebecca Sundhagen, RN, BSN; Nurse Manager for Passport Health Colorado

Bill's house looked kind of like this after the recent makeover.

As some of you already know, Bill’s out of the hospital: hooray! Here’s the story in his own inimitable words:

My stem cell transplantation was a great success. I got out a week early, didn’t have near the side effects that most other people have, fell in love with 15 cute nurses, gagged down 42 hospital meals (finally talked them into frying bacon but they wouldn’t go for the beer), and only exposed my rear end once while walking the halls in my gown.

He’d love to see people, but he also has to be very careful about infection. Here’s what he says about it:

It’s very okay to visit me or bring food, as long as you have no symptoms of any kind of illness. Get a flu shot this fall, though, if you want to continue to be my freind. I have hand sanitizer and face mask here for you. The masks make everyone look like Mr. Ed.

Basically, the same guidelines apply as for hospital visiting, below. But, just as with the hospital, don’t let that scare you away. Bill wants and needs visitors – that’s part of his recovery. And apparently, along with his immune system, he suffered some loss of social skills and is insisting on being called King Bubba again. Visitors will help keep him humble.

Some of us Bill’s Buddies got together with his family 2 weekends ago and did a thorough makeover of his house, to make sure it was both nice, and a clean environment. It looks great. We filmed the whole thing, and it will be airing soon as part of the new show, “Neat Eye for the Messy Guy.” By the way, some of your contributions went towards buying him an excellent quality HEPA air purifier so his new immune system doesn’t have to work quite so hard: thanks again to all who donated.