On Monday, I had a chemo follow up which was just to check in on blood work and how I’ve been feeling overall since my first AC treatment. In reality, I’ve been feeling well and only had a few issues in the first 3 days after chemo with some nausea and fatigue which I expected and did manage pretty well. Hydration is key, my friends.
What I did not expect was that my white blood counts came back “critically low” because otherwise I’d been feeling almost back to normal. It sounds like my counts weren’t able to come back up after my udenyca shot last week as they should have, maybe because we chose to administer a lower dose. I’ve been advised to stay home so I don’t catch any bugs (or God forbid, COVID), and my oncologist put me on a short course of preventative antibiotics just in case.
A quick note on COVID – cases are rising everywhere as we ease up on social distancing guidelines. PLEASE, please, please wear your masks. It’s a quick selfless way to take care of your neighbor, friends, and families. My anxiety is sky high with my immune system running so low, so do it for me or for anyone else you know with a compromised immune system!
Since I’m home, I filmed a little Pilates video for those of you who are also at home and might need a quick workout! Bear with me – I’m still working on a few things too (like video editing….how do I remove the background noise?!). But I hope this gets you moving and connecting with your body today!
Enjoy!
Hoping Justin & I can sneak out for a little drive around the island or walk later this afternoon. I’m scheduled for my next chemo on Thursday next week – please say a few prayers that my white counts have come up by then so there is no delay ❤
I’ve been feeling much better the last few days and was able to work a little bit over the weekend. I’ve been lucky to keep working my “COVID” job (giving good news to patients who’ve tested negative), and I can’t say enough how grateful I am to work with such a supportive rehab team, COVID team, and organization!
Yesterday, I went for a walk around the neighborhood by myself. It feels so good to get outside and have some time to process everything. I’ve been using the Calm Apprecently, and I used their mindful walking exercise yesterday which was soothing. It helped me stay more conscious in the moment, rather than letting my overactive brain run wild.
I also used one of my favorite apps called Charity Miles. This app tracks your distance using GPS, and their sponsors donate so many cents per mile walked/ran/biked to a charity of your choice. It may be a small way to give back, but I am grateful I can have even a little bit of impact just by taking my daily walks. I hope you’ll try it, too!
Workout with a view!
As a physical therapist, I have seen how significant the impact of regular exercise can be for anyone, let alone someone going through cancer treatments. There are some general guidelines that are good for everyone, but for those with cancer, the exercise type and intensity may need to be monitored more closely.
For example, for people undergoing chemotherapy, it’s important not to overexert themselves during exerce in order to protect the heart! It is equally important not to be a couch potato in order to keep the heart strong. During chemo, the American College of Sports Medicine (ACSM) recommends 150 minutes per week of moderate intensity aerobic exercise like walking, biking, or swimming. That’s about 30-60 minutes, 3-5 days per week – not so bad, huh?
Interestingly enough, these are the exact same guidelines they recommend for a “regular” person too! Aerobic exercise is a great way to improve cardiovascular health, aid sleep, and boost the immune system along with many, many other things!
Personally, I am trying to stay at about 30-40% of my maximum heart rate to avoid too much strain on my heart (normally I would walk at about 40-60% of my max heart rate), which is why I’ll likely stick with walking and light hiking for aerobic exercise over the next few months. I’ll miss you spin class (*sobs*)!
I also had my husband help me perform a baseline treadmill test so I could know where I started from, and I plan to repeat this test mid-chemo as well as after treatments, so I can be sure to catch any significant deconditioning as early as possible.
Strength, or resistance, training is also part of my routine, but usually only 2-3 times per week. I prefer Pilates, yoga, or bodyweight training. Resistance training improves mood, helps build lean muscle and reduces body fat, but it also becomes extremely important for helping to balance blood glucose & insulin levels (here I go again, I know…). Also, doesn’t it just feel gooddd when you can lift heavy things?!
Exercise (especially during cancer treatment or for an injury) should always be tailored to a person’s individual preferences and goals. Working with a physical therapist can be extremely helpful to prevent cancer-related fatigue, muscle atrophy, and functional decline, and if you need help finding a provider in your area, reach out to me or check out this handy tool through the American Physical Therapy Association!
*I would highly recommend any patient undergoing active care for cancer to have a physical therapist or exercise physiologist follow them throughout treatment to keep you as safe, strong and active as possible. ALWAYS check with you doctor before beginning a new exercise program.*
I had my first dose dense AC treatment on Tuesday, and so far it has gone better than anticipated. So far I’ve had a little nausea which I was able to manage well with some meds at home and I pretty much fall asleep any time I sit down on the couch, but all-in-all I’ve felt pretty good. Coming out of the fog a little bit today.
I also went in for my udenyca shot yesterday which helps to boost my white blood cell count. My oncologist actually gave me a slightly lower dose of this since, typically, younger people are more “robust” (as she put it) and can upregulate white blood cell count more easily. So far no significant side effects like bone pain, so I’m very thankful.
Round 1 – DONE!
I also haven’t had a chance to mention that I received my genetics results last week and I do not have a BRCA 1/2 mutation. This means that I’ll likely be able to choose a less aggressive surgery (lumpectomy v. mastectomy). It also means I have less chance of recurrence in my breasts or ovaries and it also means that my family members don’t have an increased risk of breast or ovarian cancer. Yay!
Just wanted to say thanks to everyone who’s reached out and who have sent very thoughtful gifts and prayers. I couldn’t get through any of this without you!
Especially a big thank you to my husband who is now head chef (ok, he always was), home pharmacist and water-bringer extraordinaire. So grateful for you, Justin ❤
Not the worst view from my chemo chair….
Hope you’re all doing well – will continue to update as much as I can. I’m hoping to get into work a few days next week if I’m feeling well enough.
This blog post is going to open up a whole can of worms for me. I feel so passionately about nutrition and I have soooo much to say so I’ve delayed writing this post because I wanted to do more research before I put just any old information out there.
Before I dive in, I want to give you a little history about my diet and health pre-cancer. I’ve been vegetarian (…well, “flexitarian”) since 2010. I chose this out of personal preference but also because there’s some decent history of heart disease in my family and I (always) like to be proactive.
“An ounce of prevention is worth a pound of cure.”
Benjamin Franklin
Last February, I also went off my birth control pill which I had been on for 12 years (OMG, I know!). I have always suspected that I had polycystic ovarian syndrome, or PCOS (symptoms can include irregular menstrual cycles, infertility, acne, excessive hair growth on the face/chest/back, and weight gain), since high school and the pill helped me to manage most of those symptoms for a long time. PCOS also goes hand in hand with insulin resistance as it is primarily a condition of hormonal imbalance.
This is where it gets juicy, guys. Insulin is a hormone that lowers our blood sugar and helps us to use those delicious carbs that we eat as fuel. If a person has insulin resistance, their body has difficulty using blood glucose for energy/metabolism and blood glucose levels stay elevated or we begin to store it as fat. When blood sugar keeps increasing, the body produces more insulin, and on and on we go….
It sort of works like this: If I eat a donut, or a bowl of pasta, my blood sugar increases. Then, my insulin levels go up to try to reduce my blood glucose. If my body has a limited number of insulin receptors in certain cells, the blood insulin level stays high and, in the long term, can increase my risk for developing diabetes (if I don’t already have it) or obesity.
Borrowed from: renewedvitalitymd.com
There have been many studies about the link between insulin resistance, especially in people with diabetes or metabolic syndrome (yes, we’re talking about the same insulin), and cancer. As it turns out, those with high blood insulin levels are at an increased risk for tumor development and for more rapid tumor growth.
Here’s the funny thing, though – this doesn’t only happen when we eat carbohydrates (FYI all “sugars” are carbohydrates). It can also occur when we eat animal products like meat, dairy, or eggs because those foods have something called insulin-like growth factors which are similar to insulin in that they have some ability to lower blood glucose, but they primarily promote cell growth.
Now, for someone with cancer, their tumor/s, just like every other normal cell in their body, also have insulin receptors (IR) and insulin-like growth factor receptors (IGFR). It seems that for those with insulin resistance, the IR and IGFR are more sensitive, and the tumor can grow more quickly dependent on what we eat!
If I haven’t bored you to death already, then you may be starting to understand why Justin and I have chosen to be very strict about diet during my cancer treatments. We are eating primarily vegan (no dairy, no eggs, no meat, no poultry), limiting the “bad fats,” and eliminating alcohol and processed sugars. We are far from perfect at this, and I do occasionally sneak a dark chocolate peanut butter cup from Trader Joe’s, but if I am going to kick cancer’s butt, then I need to make my body the most inhospitable place for it to live!
I’ve also been doing intermittent fasting (I fast for 16 hours, then eat all my usual daily calories in the remaining 8 hours) to help regulate my blood sugar and metabolism. I’ll save you and write about the benefits of intermittent fasting in another post!
We’ve been working with a local MD who specializes in nutrition and has recently moved his practice toward working mostly with patients with cancer. Check him (& his delicious cookbooks) out here: http://www.drshintani.com/
I’ll let you digest this totally fascinating information, but before I do, I just want to mention one more time how important it is to know your own body! Be curious, ask your doctors questions, and if something doesn’t seem right check with your doctor – your life could depend on it!
Just a quick update today – It was a busy weekend with having my chemo port placed on Friday and my egg retrieval procedure today. Both went as well as possible and I’m so thankful the recovery has been really smooth.
I’ve been finding myself needing to take more “mindful minutes” to myself in the past week since starting chemo next week has me a bit anxious. In this video, I’ll teach you my favorite mindful breathing exercise to stimulate the parasympathetic nervous system when you only have a minute or two during your busy day.
Feel free to add in your own affirmation with each breath or you could even do some EFT tapping as well! Some of my favorite affirmations are:
I am grounded & safe.
I am loved and cared for deeply.
I choose to live with joy and love.
I am enough.
I can heal my body.
P.S. June 1st means it’s time to do your monthly breast self-exam!! For more info on how and why to do a self-exam, check out my earlier post here. #EarlyDetectionSavesLives
On Thursday morning, I had my “chemo teach” with the oncology APRN. Basically, this is just education on the nitty gritty details of the chemo regimen I’ll be going through.
Since I saw my oncologist on May 5, she changed her mind regarding the best course of treatment, and is now recommending that I start with the more “aggressive” chemo medications first. This combo of adriamycin and cytoxan, a.k.a. the “red devil” (because of the color of the infusion), will be given every other week for 4 rounds (8 weeks). I won’t bore you with the major side effects, but this medication will lower my immune system significantly so the infusion is followed up with a shot of udenyca (formerly known as neulasta) which will stimulate my bone marrow to increase white blood cell production.
This was a hard pill to swallow for me since I’d thought we’d be doing the “less intense” chemo first and that I’d maybe get to skip the other if my scans all came back clear. This actually is the typical protocol so it shouldn’t have come as so much of a surprise, but I’d been preparing mentally for the taxol treatment so I got a bit rattled. It’s simply a reminder for me that triple negative breast cancer is aggressive and although I am stage I, it doesn’t mean I get to skip any steps.
While I’m ready to get the ball rolling and begin treatment, I am feeling a bit of resentment at the whole COVID situation at this point since I won’t be able to have anyone sit with me during my infusions, and Justin will only be able to drop me off and pick me up from my port surgery on Friday.
I’m also unsure how I’ll respond to the treatment and that anxiety comes in waves. I’ve been very aware of my mindset around treatment and there are definitely times when I have to remind myself that chemo is just medicineand that I’m fortunate that there is something that can heal me even if it could have some nasty side effects.
In other news, I started my hormone injections for the egg retrieval and it’s going well. I should be able to have that procedure done next week between Monday and Wednesday.
I’ve been trying to get outside and enjoy the sun and the beach as much as I can. I made one of my favorite vegetarian/vegan meals this week (here‘s the recipe!), and Justin’s been making sourdough bread which makes me very happy! I was able to go for a short hike after work yesterday with my old coworker, Erin, and I was really thankful to have time out in nature with once of my most supportive friends.
Tonight, we had dinner for our friend Jimmy’s birthday – it’s nice to be able to get together to celebrate something. I felt very touched that everyone offered to pray over me and we had a really great dinner. If any of you need some really delicious spices, check out our friend Kai’s spices here. ❤
I hope everyone’s having a nice Memorial Day weekend and that you’re all staying safe & healthy!
On Monday, my CT, bone scans, and ECG/EKG came back all clear! This means I am a true stage I, and you just can’t ask for better news than that.
But Tuesday….I honestly barely have any words for how well my coworkers held me up yesterday. Over the past few weeks they’d put together a (vegan) lunch and the most thoughtful gift basket for me…complete with shower curtain hugs (!) and my very own new pelvis model (*AMAZING*).
I knew I lucked out getting a job at Queen’s (Ann Frost, if you’re reading this, I owe you BIG time!), but they continue to prove to me over and over that they are the true definition of good people.
Ryan – thank you, especially, for this prayer…
******************************** Ka Pule No Ka Malumalu ~ Ka Pule Lokahi The Prayer of Protection The Unity Prayer
Ka Malamalama O Ke Akua E Ho’opuni Mai ia Kakou The Light of God surrounds us. Ke Aloha O Ke Akua E Kipuni Mai ia Kakou The Love of God enfolds us. Ka Mana O Ke Akua E Ho’opakele Mai ia Kakou The Power of God protects us. Ke Alo O Ke Akua E Malama Mai ia Kakou The Presence of God watches over us. Ma Kahi A Kakou, E Hele Aku Ai He Akua No. Where we are, God is. In your name we pray, Amen. ❤
If I have seen further, it is by standing on the shoulders of giants.
Sir Isaac Newton
To my Queen’s Rehab ‘Ohana, You really know how to make a girl feel special. I am so honored to know and work with you.
I know it’s not the weekend yet, but I’m off tomorrow so I can do about 8 million scans (jk, kinda), so it’s my weekend!
This week has been rather uneventful, thank goodness! I did have a consultation with a genetic counselor on Monday and just received my “spit test” in the mail today. I should get that back in about three-ish weeks. This tiny little saliva sample may seem small in the scheme of things, but in reality, the results will have a significant impact on my treatment course so if everyone could just take a quick sec and pray that I’m BRCA negative, that would be much appreciated!
I also just received two HUGE boxes full of hormones and needles. I’m actually pretty sure my security guard was pissed that the boxes were taking up so much space in his tiny office…but he better just be glad he doesn’t have to get all emotional and hormonal next week!
The hormones are actually part of the egg retrieval process that should begin next week sometime. The process is 10 days of injections, and then egg retrieval two days later after my ovaries have produced approximately 20 beautiful future hapa baby eggs. I sincerely apologize in advance to everyone in case I can’t stop crying for no reason next week…
Tomorrow, I’ll have a CT scan and bone scan to make sure the cancer is only in my left boob and a baseline EKG/ECG to check my heart function before I start treatment.
I’ll have a chemo consultation next week to learn about what I may experience during my next 12 weeks of infusions. Tentatively, I’ll have my chemo port placed on May 29, unless bumped by my egg retrieval which depends completely on my (usually undependable) menstrual cycle.
As I said before, my life does not only revolve around cancer…. I’m still going to work every day, but for the past several months I’ve been relocated from our PT office to a “manpower” job that has me calling back patients with negative COVID results. I feel like this has been a cool role to play in this pandemic in that I get to give a lot of good news! I also get to work with some really fun nurses and fellow PTs.
Today, the Hawaii Air National Guard did a fly over for most of the major hospitals on the islands. Truly, the doctors, nurses, respiratory therapists, PT/OT/SLPs, housekeepers (and the list goes on…) who have been tasked with caring for these patients on the front lines deserve all the praise in the world and this was an awesome way to pay respect to them!
#MahaloHealthHeroes
Today, I also taught a Zoom Pilates session with a friend/coworker from my previous job. I enrolled in a Pilates teacher training in February and being able to complete that and do all of the mat work at home during these “quarantine” times has been a real life-saver!
Unfortunately, Justin and I had to cancel our 2nd anniversary trip to Yosemite and Sonoma in September which is a huge, huge bummer. My chemo won’t end until sometime around October so we figured we better just reschedule. So much for getting off the rock this year…. I guess I will just have to Pinterest plan my dream vacation in the meantime!
Yosemite Dreamin’
Hope you are all having a great week – take care of yourselves!
One of the things I hear the most from people when I tell them that I have cancer is “I’m sorry.” I’ve been reflecting on that statement a lot, and I had a really great conversation about this with my priest, Fr. Russell, a few weeks ago.
I get that cancer isn’t exactly the type of diagnosis that anyone wants in their whole lifetime, let alone just after they turned 30. While it is very scary news, and while many things about my diagnosis are uncertain, I’ve decided to take Fr. Russell’s (always excellent) advice and “struggle well.”
He told me that in Russia, instead of saying I’m sorry, people will tell someone with a new cancer diagnosis “thank you.” Thank you for struggling well. Thank you for fighting so that we can have more days with you. More experiences. More life.
Now, I’m not Russian, and I’ve never been to Russia, so I can’t verify that this is true, but I am certain that I don’t want anyone to feel sorry for me. Up to this point, I’ve had a really excellent life and still do! I can only see one way through this, and that’s to be alive & well at the end of it!
I plan to wake up each day and choose to be optimistic and proactive. I plan to learn as much as I can so that in the end, I’ll be a better wife, daughter, friend, and practitioner. I plan to let myself feel crappy when I feel crappy, but to go out and enjoy the sun or good food when I feel good. I plan to nurture my relationships with others and my relationship with myself.
My goal is to motivate anyone reading this post to take a moment to look at your life in perspective. To nourish those things that are truly important to you whether that be your relationships, your career, your spirituality, whatever.
I hope that you’ll prioritize your health above many things. If we don’t have our health, then all the rest suffers too. Be proactive, not reactive! Eat delicious, whole foods. Move your body daily – go for a walk, lift weights, dance! De-stress with journaling, meditating, going out in nature, getting a massage. Get some sun. Practice gratitude. There’s always, always something to be grateful for.
If you have concerns about your health, don’t be afraid to speak up! Talk to your doctors, nurses, physical therapists (we are great listeners!) and ask them about anything that may seem off or that makes you worry. You know your body best and shouldn’t wait around for answers to come to you!
I wanted to thank everyone for such kind words, cards, gifts, and love sent my way! I am truly honored to walk this Earth with all of you ❤
Since I have your attention, I want to let you know that doing a monthly breast self-exam is really important. This is how I found my cancer and how you might find yours too. Imagine if I hadn’t done my self-exam and just didn’t see my doctor until December again! I would not be in the same boat as I’m in now. Early detection is KEY!
To do your self-exam at home, follow these 5 steps:
Look at your breasts in the mirror. Check for:
Dimpling, puckering, or bulging of the skin
Change or inversion of the nipple
Redness, soreness, rash or swelling
Raise your arms overhead and check for the same things.
Look for any fluid leaking from the nipple.
Lie down and feel for lumps. Apply gentle, but firm pressure from your collar bone to your abdomen and from your breastbone to your armpit. Try moving your hand in small circles or up and down.
Now stand up and check for lumps in the same way as #4.1
If you’re not afraid of boobs – watch this video…
Ideally, you should do your self-exam at the same time during your menstrual cycle each month. If you’re not cycling you can pick a day each month that you do your check!
The better you know your body, the more you’ll be able to detect a change. It could save your life. Have the “breast” day, friends! ❤
Bri D. PT. 