Russian Roulette

Several weeks ago, following the advice of my inner voice that said, "go, go, go," I attended a symposium at Portland's Mittleman Jewish Community Center entitled, "Your Jewish Genes and Cancer." 

For some time I have known that I might be at high risk for breast cancer.  Both my mother and sister have dealt with breast cancer at different stages of their lives:  Mom at about age 73, and then, years later, my sister's cancer was discovered at age 44.   After their positive diagnoses, both had a lumpectomy, followed by a course of radiation, and both have been extremely fortunate --- with no cancer recurrence.  Then, last fall, while visiting relatives in the mid-West, I learned that a cousin there --- on my Dad's side --- had recently been diagnosed with breast cancer and undergone a mastectomy.

My family (both father and mother) are eastern European Jews called Ashkenazim, and generation after generation of these eastern Europen Jews living separately in ghettos in places like Latvia, Lithuania, Poland, Russia and Hungary, married among themselves which led to a proliferation of certain genetic mutations and a higher risk for some inherited diseases, among them, breast cancer.  At the April symposium, I learned that the risk of developing breast cancer among the general population is 1 in 400.  For Ashkenazic Jews, the risk is 1 in 40.  Quite a shocking difference! 

Admittedly, I have known of my risk for quite some time.  I am an well educated woman who as a rule, makes good decisions about my life.  Since my sister's bout with breast cancer, however, I have, you might say, been playing Russian Roulette. I read with interest what the so-called experts have to say about not needing a mammogram every year, and I go ahead and get one annually anyway, in spite of such "expert" opinions. And, every year I go feeling both unbelievably anxious and stressed.  And every year as I get older, that anxiety seems to increase.  

Reluctantly, following that persistent inner voice, I attended the April symposium at the Jewish Community Center.  Nothing could have prepared me for what I experienced that evening, walking into that room, seeing so many familiar faces!   I was in shock!  So many women, many of whom I have known for years, grown up with, worked with on various committees and boards, embraced me and  shared their stories of being diagnosed with BRCA1** and/or BRCA2**,  the genetic mutation that puts so many Jewish women at risk for breast cancer. Others were waiting for the results of genetic testing to determine if they are BRCA1 or BRCA2 carriers. If positive, this had significant implications for not just them, but their children and grandchildren as well. Apparently among my friends, this is a health topic that is not readily discussed. I continue to be amazed that so many women I know, are dealing with these same issues I have been avoiding.

I left that symposium a different person, certainly more aware that I had been hiding from the truth, and playing Russian Roulette with myself and my children. I need to assess my risk for breast cancer with an expert, a genetic counselor.  I need to find out what my health insurance will pay for, and what it won't pay for.  Most importantly, I need to begin to think about my options --- if --- such testing proves that I am a carrier of the BRCA1 or BRCA2 genes.  How will my family feel if it is determined a double mastectomy would be my best option?  What are my chances if I do nothing? What, what, what........

("The Angelina Jolie Factor:"  This famously beautiful young woman and mother, announced recently, she had undergone a double mastectomy and breast reconstruction after genetic testing proved she was a carrier of a  BRCA gene.  Breast cancer had been her mother's killer some years ago.)

My Portland Jewish lady-friends and vicariously, Angelina Jolie, are urging me toward genetic testing.  Yet, I continue to think, procrastinate, and have not yet made that call to the genetic counselor.  My husband's health and my mother's health seem to take up all my time, energy and priorities.  I keep promising myself to call that number, which even now, sits right in front of me.

                                            Me, my Mom, and my sister, c.1965

**BRCA1 and BRCA2 can also cause breast cancer in men.

Friends and Family:  Your thoughts and comments will be read and appreciated.

Back in the Bird's Nest!

Once the fog of re-entry settles after a month away, it actually seems good to be home.  It takes a while for my control-freak personality to get everything cleaned, and back in its own place.  The Bird's Nest looks better every day and a few days of sunshine have allowed Mt. Hood to appear in all her glory through the windows.  I've placed a bowl of green anthuriums on the coffee table for just that little touch of Hawaii.  They look beautiful, and I am finally feeling like I have time to sit down once again with a good book, or write a new blog post!

(Best of all, I am now able to add photos from my iphone to my blog!  After much computer/iphone frustration, it finally works and I am feeling that it will be a good thing to share photos along with thoughts.) 

As always, this year's Hawaii/Oahu quest was to stay as far away as possible from buses of  tourists and mobs crowding downtown Waikiki.  Staying away from throngs of people has become my great obsession as I get older. So, staying on the "other side" of the island is a must, and I purposefully plan days that largely take us to places the "hordes" have not yet found.  "Where can that be on Oahu?" you might ask. Well, there are quite a few locales that currently are almost untouched by tourists.

For example, take the lovely Turtle Bay area on the North Shore where photographic scenes like this abound.   A good lunch at Ola restaurant on the beach with sand in your toes and under your table is a great place to go for relaxation, and then if you are lucky, to catch a surf competition, Sunset Beach is ten minutes up the road. You might catch a wedding here, or a polo tournament nearby, or ponder the monument to those who spotted the first Japanese fighters as they approached Pearl Harbor in December, 1941.

Chinatown in Honolulu seems it would be overrun with tour buses. But it doesn't seem to be the case. During the day at the shops and markets, and into the evening, shoppers seem mostly local.  With our Honolulu friends showing us the way to good Chinese food, we also stumbled on a beautiful alter to the Quon Yin in the Cultural Plaza: a calming presence in the midst of Honolulu.

About as "away" as one can get from the tourist rabble is the Valley of the Temples Memorial Park at Ahuimanu, just north of Kaneohe.  The "Beyodo In" is an exact replica of a Buddhist Temple of the same name in Japan.  This year we rang the giant bronze bell three times in memory of my Dad, followed a roaming peacock, and sat before the giant golden Buddha offering incense and sending our thoughts and prayers to eternity.

 

Macabre as it seems, Oahu cemeteries drew me in this year.   Their appeal has a historical quality, and they encourage quiet and meditation.  Also, in Oahu, except for the Punch Bowl Memorial, cemeteries don't generally attract the tour bus crowd.  Yet they have a unique, and somber beauty.  The Japanese Buddhist Cemetery in Kaneohe is lovely, more so when the mountain mists are rolling through. 

What I most love about my travels, is encountering the unexpected: a bird, a waterfall, a unique flower, a vista that takes my breath away.  Now with my iphone, I am able to snap a photo and later, when I return home, a brief look can transport me back to that moment.  And, thanks to this miraculous technology, I can now share it with blog friends as well!

                                                                       ALOHA!