Fatherhood, Fertility

The Olympics of Microsurgery

You know it when it’s happening. The moment you have to rise to the occasion. It’s shut up and put out time. You summon all of your faculties, as only your best will do. A performance, race, speech, interview, exam or surgery. We all have these moments. I treasure mine.

The Case of All Cases

The couple shows up from a distant land. Unable to conceive, he is found to be sterile due to a blockage in the tubing of his reproductive tract. He remembers having a painful infection “down there” in his 20’s that was treated but still managed to scar the tiny tubes inside the epididymis near the testicle. Kind of like a vasectomy that you didn’t want.

He’d been all over and had seen other docs. They all told him to “just grab some sperm” and go to IVF-ICSI. “It works great,” they said. But he, like me, likes to fix things that are broken. “There must be a way to repair this so that I can have kids at home instead of in a lab,” he said to me. Continue Reading

Aging, Anxiety, Depression

hole the shape of dadFrom Madness to Manhood: In Search of My Lost Father and Myself

“Kids have a hole in their soul in the shape of their dad. And if a father is unwilling or unable to fill that hole, it can leave a wound that is not easily healed.” Roland Warren.

I was five years old when my uncle drove me to the mental hospital. I was confused and afraid.

“Why do I have to go,” I asked Uncle Harry.

He looked at me with his round face and kind eyes. “Your father needs you.”

“What’s the matter with him?” I was beginning to cry and I clamped my throat tight to stop the tears.

I sank down into the leather seats of uncle Harry’s new Buick, a soft yellow beauty. It had four ventiports on each side of the engine that I imagined were eyes that could see into the future. The grill in front looked like an open mouth with huge teeth. I would worry that it might swallow me up if I got too close, but I felt safe inside the car. Continue Reading

Other Cancers

liquid biopsyHow Can Liquid Biopsy Influence Cancer Treatment Decision?

Noninvasive testing technology for cancer diagnosis and monitoring has advanced to include liquid biopsy for early detection. Using nothing more than a blood sample, scientists can locate DNA belonging to the tumor, referred to as circulating tumor DNA (ctDNA), and analyze it to diagnose the type of cancer present as well as identify specific characteristics of the tumor.

 

Benefits of Liquid Biopsy

Sometimes a solid tumor biopsy cannot be surgically removed. This may be due its location or because the patient’s health will not permit them to undergo an invasive procedure. Additionally, because the amount of the biopsy obtained may not be sufficient for testing, doctors can gain the necessary information regarding the tumor without the need to perform a surgical procedure using a liquid biopsy. The procedure, a blood draw, is much quicker than an operation and provides information that is exceptionally consistent with information acquired from a tissue biopsy.

The noninvasive nature of this test allows doctors to extract information on a regular basis regarding the behavior of the tumor, a practice that can be risky for patients if conducted through repeated solid tissue biopsy procedures. The ability to collect information regarding a tumor regularly can significantly influence treatment decisions for cancer patients. Additionally, liquid biopsy provides information that allows physicians to tailor a treatment plan to your specific diagnosis.

 

Tumor Behavior Evolves Over Time

Tumors can change their behavior, including how they respond to therapies, throughout the treatment period. Some cancers can even become resistant to treatments over time. Liquid biopsy can detect gene mutations that can cause cancer to stop responding to current treatments. When physicians detect behavioral changes in the tumor, they can act towards making the necessary changes to your treatment plan that can lead to an improved response.

The degree to which a tumor responds to treatment can also be monitored early in the treatment. If the tumor is not responding, your cancer care team can reevaluate your current treatment plan and discuss options for changes in your treatment plan. When lack of response to treatment is detected early on, your cancer care team can discuss alternate treatment options and monitor regularly with liquid biopsies.

 

Liquid Biopsy May Indicate Your Risk of Cancer Recurrence

For some types of cancer, liquid biopsy has been proven to diagnose recurrence as much as one year before traditional screening methods. Your doctor can use this information to outline the best post-treatment plan for your diagnosis. It is important to follow a strict schedule of regular physical examinations in addition to recommended cancer screenings to detect the recurrence of cancer as early as possible.

 

Still Have Questions About Liquid Biopsy?

If you have been diagnosed with cancer and have questions about liquid biopsy, talk to your cancer care team. Your doctor will be able to explain how this test works as well as if it may provide information that can positively impact decisions regarding your treatment plan.

 

Sources:

https://www.asco.org/about-asco/press-center/news-releases/liquid-biopsy-may-help-guide-treatment-decisions-advanced

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356857/

https://www.cancer.gov/publications/dictionaries/cancer-terms?cdrid=779095

http://meetinglibrary.asco.org/record/127581/abstract

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4190567/

https://www.sciencedaily.com/releases/2007/02/070218194439.htm

https://www.theguardian.com/society/2017/apr/26/dna-based-test-can-spot-cancer-recurrence-a-year-before-conventional-scans

https://www.cancer.gov/about-cancer/coping/survivorship/follow-up-care/follow-up-fact-sheet

Family Issues, Fatherhood, Parenting, Relationships

blended families have challengesLife in the 21st-Century Blended Family

Dear Mr. Dad: My fiancée and I are both divorced, and between the two of us, there are four children from previous marriages. Mine are 7 and 5, his are 6 and 8. When my girlfriend and I first met each other’s kids, things were great—the children hit it off really well and liked hanging out together. And the adult-child relationships seemed to be blossoming. But over the past few months, things have begun to deteriorate on all fronts—the kids are squabbling and my fiancée and I aren’t getting along as well with each other’s kids. We both had such high hopes of building a strong blended family together, but that’s looking less and less likely. What can we do?

A: You’re all—adults and kids alike—walking into an incredibly challenging situation, and, unfortunately, there’s no magic formula to make it work. That said, by far the most important thing you can do is to take a close look at your expectations—and then lower them. I know that sounds harsh, but it’s truly for the best. Imagining that the six people involved will all love each other and that you’ll come together into one big, happy blended family is setting yourself up for failure. Things might end up that way eventually. Or they might never get there. Most likely, they’ll be something in between.

Let’s start with the kids. The behavior you described is completely normal. Things started off well because the four of them are pretty similar in age and they could get together, play, and then go back to their own home. There were no territorial issues and not much pressure. But as things between you and your fiancée have gotten more serious, everything has changed. They know that when everyone moves into the same house, they’ll have to do a lot more sharing and they’ll have a lot less space of their own.

Read the rest of this article here.

Education, Growing Up, Parenting

talented kidsWhy You Shouldn’t Tell Your Children They’re Extremely Talented

Is your daughter the brightest math student in her class? Do your son’s piano skills outpace everyone in his peer group? If so, you’re likely already thinking about how fostering your child’s natural talent could lead to great accomplishments and happiness. But if future success is in store, one of the best ways to set your child up for it is to actually take the focus off their innate abilities, and shift your attention to their efforts instead.

It’s natural for us as parents to want to praise our children for their strengths. For many of us who grew up in the era of “children should be seen and not heard,” we now actively work to cultivate confidence, self-esteem, and independence in our children. But by continuously praising kids for their abilities, we may be getting in the way of them actually developing those very qualities.

Let’s take a look at the science of motivation and achievement to understand how our praise can affect our children. Continue Reading

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