Coffee heat rising

Does Breast Surgery for DCIS Save Lives?

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In a word: probably.

Yesterday, NPR ran a talk-show piece that went online with a “scare” headline: “Surgery Doesn’t Help Women with Early-Stage Breast Carcinoma.” In fact, the report doesn’t say you’re going to die if you have early stage breast cancer. In fact, it discusses DCIS, which is not known to be cancer at all.

And yes, for some women, surgery makes no difference in survival rates because some cases of DCIS, which has been described as a “pre-cancer,” never progress to an invasive stage.

However, an unknown percentage of DCIS incidences do convert to invasive cancer. We do not know what that percentage is, because a true randomized study (in which X number of women are randomly assigned to have no treatment and an equivalent number get surgery) would be wildly unethical. Knowing that a substantial risk is there — possibly in the vicinity of 80% — doctors are morally obliged to recommend surgical treatment.

The story reports that survival rates are noticeably improved among women who have intermediate and high-grade DCIS:

For the women who had cells that were closer on the continuum to invasive cancer — those with intermediate- or high-grade DCIS — surgery did provide a significant benefit. After 10 years, 98.6 percent of women with intermediate-grade DCIS and who had surgery had survived breast cancer, compared to 94.6 percent of women who didn’t have surgery. And with high-grade DCIS, 98.4 percent of those who had surgery survived, compared to 90.5 percent of those who didn’t.

My DCIS did contain intermediate and high-grade areas; fortunately, there was no necrosis, which is a marker that the DCIS is about to convert to invasive cancer. So it looks like I have a 98.4% chance of living another ten years.

The problem with these survival rates is that they don’t always distinguish between women who died of breast cancer and women who died of just anything.  Some studies take the cause of death into account, and some vacuum up all mortality data. So one can find oneself with a basketful of apples and oranges and no way of knowing which is which.

Survival rates for early-stage breast cancers — I mean the real thing, not DCIS — are quite high. They’re not nearly 100%, but they’re well over 80%. Survival rates for DCIS that has been treated with lumpectomy + radiation + hormone blockers or with simple mastectomy approach 100% when causes other than metastasizing breast cancer are taken out of the equation.

To my mind, a serious problem is the  widespread insistence on lumpectomy, which is not “just as effective” as mastectomy. Radiation treatment, tamoxifen, and AI’s are not minor things. Radiation causes some very unpleasant side effects, some of them long-term, and if the idea is to preserve a semblance of your natural breast, it’s a major FAIL. Radiation causes your scar to contract, so that you can end up significantly disfigured. Tamoxifen can cause uterine cancer and blood clots (leading to stroke and deep-vein thrombosis), and both tamoxifen and aromatase inhibitors can cause painful arthralgia. Only about 40% of women stay on AI’s for the entire five years that’s recommended, and the quit rate for tamoxifen is also pretty high.

As many as 50% of DCIS incidences never convert to invasive cancer. Hence it’s reasonable to argue that removing every one of them and performing mastectomies to get rid of it is overtreatment.

But I think that assertion may be debatable. If non-conversion rates really ARE as high as 50% (we do not know and have no ethical way to find out), then it means the rate of conversion TO invasive cancer is at least 50%; it may be significantly higher, possibly as much as 80%. Would you rather go through life boobless or would you prefer to run to the hospital every year for yet another mammogram (mammography also has side effects), possibly yet another biopsy, and worry constantly about what’s growing in your chest?

Spider Gems

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Click on this!
Click on this!

When the sprinkling system came on the potted plants this morning, a delicate and almost invisible spider web caught these exquisite little gems.

Cat Wars: Reinforcing the Battlements

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tabbycatSo the carpet-tack strips I zip-tied along the tops of the cinderblock walls by way of discouraging Other Daughter’s nuisance cat from jumping into the yard, predating on the birds and geckos, and using my desert landscaping as a giant litterbox have worked middling well. I haven’t seen her atop the wall for a long time, nor have I found any of her parasite-laden little doggy treats laying around the backyard.

And so, as crackpot as this particular decorative element appears, it seems to be working to keep the damn cat out.

A year and a half later, the strips have buckled and warped under the onslaught of rain and sun. Fortunately, this was easily fixed simply by adding a another half-dozen plastic zip-ties. They’ll last a few more months before I have to take them down and replace them.

But the problem of the caps atop the cinderblock support columns remains. They present no practical way to tie down pieces of carpet-tack strips. Aluminum pans full of water, besides looking even crazier than the tack strips, breed mosquitoes and get tipped over by mockingbirds using them as watering holes.

I ended up jury-rigging some little squares of carpet tacks, which provided a couple of crossbars that could be tied to the decorative blocks abutting some, but not all of the columns. These worked to keep the cat from perching on the columns, but they can’t be tied down firmly — or, in one corner, at all — and so the buckling renders them even more bizarre-looking than the straight pieces and, where no tiedown is reasonable, essentially nonfunctional.

What to do?

Several folk sites on the Internet claim that cats dislike tinfoil. With a lifetime supply of Costco aluminum foil residing in the pantry, this would be an easy and cheap fix.

However, one crass skeptic has mounted a video in which he tests this theory. He tapes lengths of tinfoil down a short, hardwood-floored hallway and lets the camera run.

Kitty approaches the new carpeting with suspicion. She sniffs. She tests it tentatively with a paw. Then she strides over it, marches up to the camera, and rubs her furry flank across its lens.

😆 Yay, crass skeptics!

More believable is the claim that cats don’t like sticky stuff under their feet. We’re told that double-sided tape stuck atop a counter or on furniture you would like to remain un-clawed will discourage counter-roaming and sofa-ripping.

Possibly. At Amazon, reviewers of an anti-cat product designed to stick on upholstered furniture report that the cat simply removes the tape and then proceeds with its project of shredding the sofa.

However. Perching on top of something is different from clawing fabric. There actually IS a good chance that sticky stuff could repel Other Daughter’s cat from the cinderblock column caps.

However1. Sticky stuff will stay sticky about 48 hours out there. So much crap drops out of the Devil-Pod Tree and also, at this time of year, out of the paloverde tree that a sticky surface would soon be rendered nonfunctional.

This returns us to the question of how to affix tack strips to the column caps, even if temporarily.

How about using double-sided tape to hold them down? Scotch sells an exterior mounting tape that is beloved by a huge majority of Amazon reviewers. The minority who whinge about it complain that it doesn’t hold up certain objects. But as a weapon in the Cat Wars, the stuff would lay flat — it wouldn’t be called upon to stick anything to the side of a wall. Some of the product’s admirers claim that heat only makes it work better; it seems to lose effectiveness in sub-freezing temps. Those do not occur around here, at least not often.

This could be the answer. Four hundred and fifty feet of heavy-duty double-sided tape would hold down a lot 18-inch strips of cat-repellent tack sticks.

House_gecko_with_spiderIn the absence of Other Daughter’s accursed cat, life has begun to return to the backyard. The gecko population is slowly recovering.

And in the presence of geckos, the mosquito population has declined.

We still have some, but nothing like the swarms that normally harass the Funny Farm’s warm-blooded denizens at this time of  year.

The flies also seem to have declined a little. Still enough to be a nuisance, but not six or eight in the house at a time.

And I believe there are more birds out there than before.

And there’s a duck.

Yes. DUCK. A little research reveals that it takes baby ducks about 60 days to fledge. So if they hatch and if they survive, they’ll be around for most of the summer.

DUCK is not disturbed by the presence of the human in the pool. Today I do have to shock-treat, since we’re starting to get some algae. But the only time she leaves the nest to forage is around 3 to 4 in the afternoon. So I figure if I slip some chlorine into the drink early in the morning, by mid-afternoon the water should be safe for her even if she happens to go into the pool. Which she doesn’t. Not often, anyway.

M’hijto remarked that the ducklings are likely to be picked off by the neighbor’s damned cat, if not by the coyotes, the raccoons, and the resident red-tail.

Hence the project to shore up the battlements. Quack!

YoungDucksminimized

Ant Wars: The Battle of the Garage

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The Ant Queen has marshaled her troops once again. Over the weekend the little Amazons launched their forays with great élan. In fact, they did something no one would have thought possible for Ant nor Man: raided a big pot full of dishware soaking in Dawn detergent. Apparently the prize of cooking oil floating atop the toxic stew was too much to resist.

Saturday night M’hijito came over and we prepared one of our amazing feasts: an entire bag of Costco mussels, steamed in butter, garlic, and white wine. Now those were good!

musselsOf course, a large project like this creates a large pile of dirty dishes, none of which I happened to feel like scrubbing after having spent half the day eating and drinking. So I hauled the huge kettle we’d used out to the garage utility sink, dosed it mightily with Dawn, and filled it to the top with soapy water. Dropped a couple of smaller pans into it and went on about my business.

Come Sunday morning, I opened the door to the garage to drop something in the recycling basket, and HOLY maquerel! The place was a-swarm with busy ants!

Busy, biting ants.

They’re raiding the trash basket — apparently we’d dropped something nummy in there. But then I look over at the sink and find three times as many of the little gals charging the giant soup kettle as are dallying with the trash can.

WTF????  They actually were attacking a potful of Dawn detergent!

And they were brooking no competition.

Braving a barrage of bites, I charged into the breach. Dumped the water down the sink (damn! Was there that much grease in there? How clogged can a sink clog?) and blasted the Enemy’s troops with a squirt cannon loaded with Dawn.

dawn detergBugs hate Dawn. It kills them dead.

They went on the retreat. Followed them to a crack under the garage’s side door, whence they had entered my territory.

Not just any crack. It appears the Hive is actually under the slab there. They weren’t exiting through a crack along the door threshold. They were disappearing into it.

Interesting.

Sprinkled food-grade diatomaceous earth along their retreat route and all along the door’s little concrete threshold. Especially around the entry to their Castle.

Before long, the survivors had disappeared.

I suspect they’re not gone. For the nonce, though, they’re in abeyance.

Fix-up Mini-Frenzy

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How d’you like the flower that popped up in the backyard? Some kind of day-lily, I think. It picks up the colors in the Slave Labor cover, so I stuck it in FaM’s banner, for the nonce.

P1030527Welp, yesterday it was time to get to work with the little B&D “Mouse” sander I picked up at the Depot during the most recent spending spree. Ain’t he the cutest li’l guy?

You know, back in the Day when I was a young pup, I was surprisingly good with a sander. For a girl. 😉 I liked to refinish and, at one point, to build furniture. Plus we lived in a historic neighborhood, and the house needed shoring up all the time. Ex-DH was good at earning a living but not so clever with tools — as a practical matter, I think, he felt that the highest and best use for some of that wealth was hiring other people to do the work.

But my father was a putterer and a hobbyist handyman, and his cast of mind must have come down to me in the genes: I couldn’t stand it. So I would do a lot of the repairs and fix-up around the house.

Later, when we moved to a neighborhood more amenable to raising children, we lived in a somewhat newer house that had lent itself to fewer small repairs. Jobs that needed to be done called for master craftsmen, not for a girl with a screwdriver, a saw, and a hammer. Plus I didn’t much like the house and so rarely felt moved to launch elaborate projects. When I exited, I left most of my tools behind, including a very nice electric sander.

The “Mouse” gadget can’t hold a candle to that thing. It’s designed for small detail work. But the price was right, and so was the project.

Yes: the project. What we have here is a little Doobie Damage, occasioned when Ruby Doo realized she could eat the runners off the rockers that live on the westside deck:

P1030525
As usual, click on the image for finer detail…

Isn’t that charming? She chewed the back ends of all four runners on the two wicker chairs.

The chairs are real wicker, not that new weatherproof plastic stuff. I’ve had them for, oh…maybe 15 or 20 years. Bought them in the old house, dragged them over here, and happily placed them in the Leafy Bower that is the covered deck. They pose a couple of challenges: they have to be hauled indoors whenever it rains, and they really should be spray-painted once a year.

As a practical matter, I’ve painted them three times before this. So they were looking pretty tired.

Hmm... Shabby chic is one thing, but there may be a limit.
Hmm… Shabby chic is one thing, but there may be a limit.
Interesting...
Interesting…

I like these chairs. A lot. They’re comfortable. Wicker gives when you sit on it. That plastic stuff does not. I’ve looked at outdoor fake-wicker rockers at just about everyplace over the years: at Pier 1 (the home of these venerable and time-worn objects), at Cost Plus, at Home Depot, at Lowe’s, at Crate & Barrel. To a chair, they’re uncomfortable. And the price? Holy mackerel!

Pier 1 wants $161 apiece — $320+ to replace these two chairs — and they’re not as nice-looking, nor are they anything you’d want to sit in for more than about three minutes. Crate & Barrel is offering theirs on sale for $399 apiece, apparently having failed to extract $599 from their customer base. Home Depot wants $164 for a truly ugly swiveling thing that requires not one but two cushions for which you will pay extra, but they’re selling something that looks an awful lot like Pier 1’s for a mere $139. Lowe’s has a wider selection, but the only one that resembles these (whose style I happen to like) goes for $229 — almost $500 to replace the two of them!!!

So it makes the cost of six cans of Ace’s best cheap white enamel gloss and a little Black & Decker sander look like a bargain.

The sander worked pretty well to smooth off the worst of the gnaw marks. Also used it to knock down the worst of the peeling paint. I didn’t try to sand all the paint off or even to make it especially smooth — the rockers are made of some kind of soft wood, which likely won’t stand up to a lot of electric sanding. Plus I kind of like the rustic look…it has a sort of beach-house style about it.

Yeah, I know: shabby chic has had its day — mercifully, a short one.

Some spackling compound was laying around the paint cabinet. Bought that a while back by way of repairing the hole in the wall where the front door bashed the drywall.

Previous owners… Always, always inexplicably weird. You know, Satan (or one of his predecessors) installed door bumpers for every single one of the interior doors. Why do you suppose he didn’t put in one for the front door, which is the door that’s most likely to slam against a wall?

So that was quite the repair job. That idiot. Anyway, it’s always nice to have a spackling compound around the house.

Used it to fill that big crack and the little fang holes that couldn’t reasonably be sanded down without sanding off the whole damn runner. Also found, interestingly, that I could use it to mold a shape for the most badly damaged runner. While it’s not exactly the same as the others, it’s good enough for government work. And certainly not something that I feel impelled to spend $500 to replace…

More spackle than wood...
More spackle than wood…

Next: spray-paint those chairs till I was blue in the face!

Literally, no doubt. I hate working with that stuff. It brings to mind an image of the inside of a pair of lungs coated with quick-dry enamel.

And it’s wasteful. Extravagantly, ridiculously wasteful. Twice as much paint floats off into the atmosphere as gets on the object you’re trying to cover. But it’s not very practical to try to paint wicker with a brush, soo…

No matter how still the day is — and yesterday was suitably still — there’s always some prevailing air flow. When you’re downwind, you kind of have to hold your breath as you spray and then step out of the drifting cloud every minute or so to draw a breath of relatively clean air. I hate that. No. I didn’t have a mask and I’ve never found them to be very effective anyway because they knock my glasses around so I can’t see what I’m doing and they don’t fit tight on your face and when it’s 100 degrees outside (as it was yesterday) you can’t bear to keep them on. The alternative strategy: just don’t breathe.

At any rate, it took six (6!) cans of Ace’s best to coat those damn chairs, what with the chewed-up runners and the manifold places where the old paint had chipped off the wicker. By about 8 or 9 p.m., they were back on the deck to dry…

P1030535
Wet paint!

The trees in the side yard shed a phenomenal amount of debris. The paloverde is still dropping spent blossoms, and the accursed willow acacia never quits dropping junk. Right now it’s pods. Billions and billions of pods. Was going to place the chairs in the garage to dry overnight. But as I was hauling one in there, toluene-laden paint fumes rising off its wicker surface to gag me, I happened to glance at the gas water heater… Uh oh!

Carry chair and its fumes back outdoors, double-time.

Of course I couldn’t leave them in the front yard, where this paint job took place — they’d be gone well before dawn. So had to haul them into the backyard and let them sit on the deck, hoping they wouldn’t be covered with tree trash by morning.

They weren’t.

And so here they are, adorned with a couple of the new Pier 1 cushions, also acquired during said spending spree:

P1030543Not bad, I’d say, for a $300 saving.