BCAM is BACK!

BCAM is BACK!

I know I’ve been terrible at keeping y’all up to date on my life lately, but that’s because I’m just busy living right now. When I look back on my life one year ago, I still have a hard time believing any of this actually happened. Cancer treatments consume your life for nearly a year (or more for some), and then you’re just done? When chatting with other survivors, we all seem to comment on how none of it seems real. We were in survival mode for so long, and when the dust finally settled, we had to come to terms with the fact that, yes, indeed, we did have cancer. What a trip!

Every day gets easier, but some days all the feels creep up and you don’t know whether to be sad or angry or go hide in the corner until it passes. I try not to take anything for granted, but I’m just human, too, and I often get sucked back into the usual work, sleep, eat, repeat. With that said, I’ve been making a concerted effort to go for walks by the beach, do yoga, hit up weekly farmer’s markets, and get together with friends when I can. Those things help. A lot. Make time to do things that bring you joy.

On Monday, I had my annual MRI – just a follow up scan to keep a close eye on things. Thankfully, all looks clear. There is a small area of enhancement in the same area where I mentioned I needed a biopsy back in July which already came back benign so here’s hoping I don’t need another biopsy! In my professional opinion, I’m right in the middle of tissue healing from radiation therapy, and there’s a lot of scar tissue forming right now. With that comes a lot of tightness and discomfort in my left chest wall, and I think that friction is creating a small cyst in that region.

Again, the survivorship game is not all sunshine and rainbows. While everything is technically “all good” now, sometimes it isn’t. There are a lot of things that I still need to work through, but I just choose to take it one day at a time.

October is Breast Cancer Awareness Month

This brings me to the main point of this post which is that Breast Cancer Awareness Month is back! I personally choose to refer to BCAM as “Breast Cancer ACTION Month” as I think it’s a great time to donate to breast cancer research, reach out to family/friends you know going through cancer and offer your support, and speak up to lawmakers and organizations with power to make change in medical care for cancer patients.

October is a time of pink ribbons and shameless promotion of products that support breast cancer. Breast cancer thrivers have coined this “pinkwashing” and want to remind you to be mindful of any products you purchase this year. Any major company that claims to put proceeds to support breast cancer better be donating at least 20% of their profits to organizations that fund breast cancer research. And, if you choose to make a donation to breast cancer organizations, choose one or two that fund research primarily or that you know directly supports thrivers with care packages, financial support, or practical support (like providing free wigs, offering transportation or house cleaning, or fertility preservation assistance).

Here are a few of my favorite breast cancer organizations to support:

My BCAM Action Plan

This October, I’ll be focusing on holding the American Cancer Society accountable for their recent change in recommendations to delay annual mammogram screening for those age 45 and older. This is a recent change in recommendations and adds insult to injury to prior recs that both breast self-exams (BSE’s) and clinical breast examinations are not indicated for early detection of breast cancer. These recommendations are based off a study out of Shanghai in 2018 that indicated that more benign lesions were found on BSE’s than malignant ones, and therefore led to unnecessary procedures like imaging and biopsies. In case you can’t guess who benefits from these recommendations, let me spell it out for you…INSURANCE COMPANIES.

For adolescent and young adult (AYA) cancer thrivers (ages 15-39) who are ineligible for annual mammograms, the only way for us to detect cancer early is through BSE’s. The more frequently we do these screenings, the earlier we can seek care for any abnormal findings, and the better our prognosis if we should be very unlucky to find a malignancy. I found my lump on a BSE and it saved my life. I will advocate for BSE’s until my lungs give out. Should you feel so inclined to support this cause with me, please reach out to the American Cancer Society via phone/chat or social media to let them know how you feel about this!

I’ll also be sharing a bit on social media about how PT can be helpful before, during, and after cancer treatment because October is also National Physical Therapy Month. Follow me on Instagram for more – @bri.d.pt!

Beyond that, October is my favorite month, so I’m going to get some Halloween decorations out and get ready for Spooky Season! Maybe I’ll pull out the old purple wig for Halloween this year, too! Stay well, friends!

Aloha ❤

365

365

It’s been one whole trip around the sun since we read the dreaded pathology report… “consistent with invasive ductal carcinoma.” And in these last 365 days, I feel like I’ve lived 100 different lifetimes. Newly diagnosed. Fertility planner. Chemo baldie. Breast conservation surgery advocate. Radiation breath-holding champion. Student. Educator. Survivor.

Now, the scars are fading. My irradiated skin is healed (although a little pale if you ask me). My energy is slowly returning. Life is going back to “normal,” whatever that is these days. I’ve been a little silent on the blog and on social media because a lot of my energy is going toward trying to remember what I told myself when I was first diagnosed…

YOU ARE NOT YOUR DIAGNOSIS.

Some days it’s difficult to remember who I was before cancer. Honestly, sometimes I come across an old photo and I don’t even recognize that girl! So I’m setting out to reinvent myself a bit. I’m prioritizing adventure, travel, learning new things, letting in old things that bring me joy, and not wasting one single second doing something I don’t feel passionate about…at least trying anyway.

I learned in the past year that I am fearless. I can do anything I put my mind to, but the one thing that scares me is missing out on doing the things I love and crave with the people I care about the most because of things I “should” be doing. Nothing is more important to me in this lifetime. From here on out, if it’s not a whole-hearted “yes!” for me, I’m not doing it.

You’ll likely be seeing a lot of different content from me in the future as I plan to continue the blog to share information about physical therapy, pelvic health, oncology, and other things that I feel everyone should know about. At heart, I am most passionate about teaching, sharing knowledge, and educating myself, so if you’d like to keep learning with me, I’m happy to share this space with you.

In the meantime, please keep me in your prayers as I have my “new baseline” mammogram today. As it usually works with true divine intervention, my scans are scheduled exactly on my 1 year anniversary of my diagnosis. While I feel deep down that everything’s going to look great, there’s always that tiny voice in the back of my mind saying “what if…” Honestly, I’m not sure if it will ever get easier to repeat imaging, but I’m choosing to see it as a privilege that I get to have these scans at all. God must want me here for something!

As my friend Kate says, “If you’re very lucky, life goes on.”

I hope you’ll do something that makes you feel wildly, beautifully alive today. Do it for all those we’ve loved and lost. I’m incredibly grateful for all of you.

Aloha ❤

It’s Going…

It’s Going…

**Full disclosure – this post contains affiliate links. I may earn a small commission when you purchase from certain companies at no additional cost to you. You can read my full disclaimer here. Mahalo!

Hi, friends. It’s been a minute! I just wanted to share that today I am officially 5 months out of chemo! That sounds super gangster, right?!

Many things have changed since October, and I feel like there’s a bit more “normalcy” happening. I’ve gone back to work part-time and have had wonderful patients. I almost forgot how much I love patient care. I got vaccinated for COVID. I even got my first post-chemo haircut… What more can a girl ask for?

1st post-chemo cut!

I’m still having to remind myself that I’m only about six weeks out of radiation because some days I get so frustrated by the level of fatigue I feel after only a 6-hour work day. Cancer fatigue does not equal regular fatigue, y’all. It’s a level of physical and emotional exhaustion that I would not wish on anyone. Even a full night of sleep doesn’t quite seem to be enough to fully recharge. I’m not telling you this to complain, but just to remind you to be gentle with your friends and family who’ve had cancer. The long-term effects are not always visible, but they are very, very real.

I can’t remember if I’ve said this, but being officially “cancer free” and completing treatment has not been easy. Over the past year, I was 100% in survival mode, jumping through all the hoops to get this obnoxious little invader out of my body. Then treatment ended, and honestly nothing could’ve prepared me for the emotional tsunami I’ve experienced.

Don’t get me wrong, I am overwhelmingly grateful to have had treatment work so well for me. I know that I am lucky to have caught it early and that a cure was an option. Most days, I can find the joy in knowing I’ve survived and that my body is healing, but there are many days where I feel the very real fear of recurrence or a deep sadness that my life will never quite be as carefree as it was before. There are a lot of tears. I know that this will all get better with time and I’m learning to give myself grace, but the struggle is real, you know?

For now, I’m just taking it one day, one hour, one breath at a time and learning to find peace among the challenges. I’m thankful for all of you reading this. Don’t forget to send a little love to those you love today.

If you’re feeling extra generous, TNBC awareness month is still going strong until March 31! Right now, your donation to the Triple Negative Breast Cancer Foundation will be tripled thanks to some generous sponsors!

Curious what current TNBC research focus is on?

  • Anti-androgen hormonal therapy options
  • Immunotherapy options (targeted treatments) for TNBC with specific basal-like tumors
  • PARP-inhibitors for TNBC patients with BRCA genetic mutations
  • Development of a TNBC vaccine (How cool! I love preventative medicine!)


DONATE HERE or make a purchase from Paris Laundry (a clean living site owned by a fellow #breastie who is donating 10% of all purchases to TNBC research this month) to help us advance TNBC research and find more treatment options for my fellow TNBC warriors!

Aloha ❤

And Just Like That…

And Just Like That…

Today, February 10, 2021, is my last day of radiation therapy and my LAST DAY OF ACTIVE TREATMENT for triple negative breast cancer (*breathes huge sigh of relief*)!! It has been the most rollercoaster-y 10 months of my life and I am ready to close this chapter of pokes and stitches and breath holds forever! Or at least until my follow up scans in April….

Triple negative breast cancer is a scary diagnosis. The recurrence and mortality rates are much higher than for other breast cancers, especially in the first three years of remission. After five years, however, the average recurrence rate drops quite a bit. As part of my follow up care, my wonderful breast surgeon and I have agreed to do an annual mammogram (coming up in April) and also an annual MRI (planning for October) so that I’ll have some type of surveillance scan every 6 months for the near future. Because TNBC has a high grade (cells multiply rapidly), it’s important for me to continue self-monitoring by doing a monthly breast self-exam. Should anything return between scans, I’ll be able to catch it earlier (again, #KnowThyself).

I’m planning to transition back to work in the next few weeks. I’ll likely start out seeing patients part-time and slowly ramp back up to a full time schedule. I am also transitioning to our women’s health center from our regular outpatient PT department where I’ll get to work with more pelvic floor and oncology patients (this is really where my passion lies so this is exciting for me)! As daunting as it may be, I’m very much looking forward to getting back to patient care. I feel like I am living my best life when I’m helping people live theirs so I’m thankful to have an occupation where I get to do that every single day.

Taken on my regular walk down Mahalo St. – Mahalo means “thank you” in the Hawaiian language! Fitting for today’s post…

As much as I didn’t want to get all sentimental in this post, it’s impossible to reflect back on the past 10 months and not feel completely overwhelmed with gratitude. I’m overflowing with thanks for those of you who prayed for me, who supported me financially or by sending gifts and cards, who called or texted just to check in and talk with me about anything (especially anything that didn’t have to do with cancer).

I’m amazed by my excellent medical team – they are smart, smart cookies and always made sure I was well taken care of, not to mention the whole “saving my life” thing. I’ve met many women recently who weren’t as lucky as I was with their medical teams and were told things like “you’re too young to have cancer” or “let’s just watch it closely over the next several months.” Honestly, best practice should be to just refer for the dang imaging. I could go on a long rant about how insurance companies should NOT dictate what practices and procedures are recommended by doctors (who are the actual experts on medical things, by the way), but I’ll spare you. Instead, I’ll just continue to urge you to stand up for yourself and refuse to settle for a “wait and see” approach to your health.

I’m also incredibly grateful for my body for carrying me through all this treatment. It was hard, you guys, and it was hard for my husband to watch me go through it. But, now I know just how strong I am – how strong I can be – in case I ever forget. I’m really proud of myself for seeking care when I knew something was wrong, for taking the time to research integrative treatments to support my body during treatment and recovery, and for making exercise and stress relief a priority the whole time. It’s been a privilege for me to take time off work while recovering and also to have so many knowledgeable people (healthcare providers and other cancer thrivers/survivors) around me pointing me in the right direction.

Lastly, I just have to shout out my husband one more time. Truly, I could not have done this without him. He is the best guy around, and every day I’m lucky enough to spend with him is an absolute blessing. Looking forward to many more (less scary, more exciting) experiences with you, Justin ❤

Love this guy…

Don’t forget to find the joy in the simple things today. We all have our own struggles, but it’s important to look for the blessings in each day. Sending my love to you!

Aloha ❤

5 Things I Learned from A Naturopath

5 Things I Learned from A Naturopath

It’s no secret that I am freakishly in-tune with my body and that I also value knowing exactly what’s happening behind the scenes of my symptoms. Even before I was diagnosed with breast cancer, I knew something was off with my body, and I’d started to research root causes and naturopathic/functional medicine approaches to help me with some things I’d been experiencing. Then, cancer came into my life and between the 85 million appointments (not exaggerating…), I decided to hold off on seeing yet another practitioner.

Now that I’m approaching the end of active cancer treatment, I decided it’s time to get some additional support and testing done. A few things I was concerned about include the health of my digestive system, support for my thyroid, and restoring equilibrium for my female hormones. I chose to see a naturopath (ND) based on recommendations from friends and based on her experience level and social media content (never underestimate the power of social media!). Here’s a few things I’ve learned after my initial consultation and lab work:

Get that Good Gut Health

Chemo is designed to destroy cancer cells which are typically rapidly dividing and multiplying in our bodies. Well – guess what else rapidly divides and multiplies? Healthy cells in our digestive tracts! Side effects from chemotherapy tend to hit the GI tract hard and can include mouth sores, nausea/vomiting, heartburn, and diarrhea or constipation. Seeing as I had several of these symptoms during my 16 rounds of chemo, I knew my gut was going to need support and healing.

First of all, the GI tract is full of trillions of happy, healthy bacteria typically referred to as the gut microbiome. These bacteria help us to digest food and maintain a strong immune system. It’s all a bit complex honestly, but a lack in diversity of these bacteria can lead to a whole host of health issues, including mental health concerns.

My ND recommended a few important things to get me started: a good probiotic to promote microbiome diversity and a drink called GI Revive which supports the intestinal lining and promotes regularity. It’s also crucial to eat a diverse, supportive diet that includes plenty of fiber, vegetables and whole grains, and fermented foods.
*Side note – if I’d known GI Revive existed, I would have started it during chemotherapy. However at that time, I did use L-glutamine supplements which helped me prevent issues in my mouth and lower GI tract.

Altogether, I feel like things are coming back around to normal after chemotherapy with this added support. I imagine that the more my gut heals, the more I’ll see my immune system improve and I’ll be able to maintain low levels of inflammation in my body.

Clarity on Chemopause

I started chemo on June 9, 2020, and that was also the first day I received a Zoladex injection. Zoladex is a hormonal therapy designed to stop the ovaries from creating follicles which release estrogen. The ovaries have a high rate of cell turnover like the GI tract, so chemotherapy can lead to infertility if not protected by hormonal therapy. Modern medicine is truly incredible, and I’m grateful that as a 30-year-old woman going through chemo, I had the option to try to save my fertility in this way.

Joke’s on me though, because after 6 months of this hormonal therapy, I am officially in chemopause (a medically-induced menopause), and I have all the symptoms to show for it. I specifically asked my ND for post-chemo baseline labs for my estrogen, progesterone, and testosterone levels. No surprise here, but my labs confirm I’m in a menopausal state and that explains the hot flashes, joint pain, dyspareunia (learn more here), and amenorrhea…

Now, true menopause means a woman has had no menstrual cycle for >12 months. Being only two months out from my last Zoladex injection, I’d say there’s still hope for my ovaries to bounce back. Most women who’ve been on this type of treatment have seen their menstrual cycles return after 5-6 months on average. In the meantime, I need to be supportive of my body! I attempt to exercise 3-5 times per week (walking, resistance training, and stretching) to relieve joint pain and both my ND and OB/GYN have recommended vaginal moisturizers to prevent vaginal atrophy until my estrogen levels improve. (If this is TMI for my family & friends reading this – sorry, but it’s just #RealTalk!)

I’ll continue to monitor my labs every few months to be sure things are trending in the right direction. Chemopause isn’t necessarily permanent, so here’s hoping my body can pull through!

The Thyroid Needs to Thrive

About seven years ago, while I was deep in PT school, I began having unnatural fatigue. I ended up being diagnosed with an underactive thyroid gland (hypothyroidism). The thyroid gland produces hormones which help regulate our metabolism, and if the thyroid isn’t functioning optimally, you can have symptoms like fatigue, dry skin, hair loss, weight gain, constipation, or feeling like you’re always cold. Every body system relies on the thyroid so it’s a priority to take care of it!

Trying to find the root cause of my thyroid dysfunction has always been something I was curious about before my cancer diagnosis, and after treatment I wanted to know if there was: a) any additional support needed for my thyroid after chemo, and b) if there was an underlying cause for my hypothyroidism. After running a full thyroid panel, my ND diagnosed me with Hashimoto’s thyroiditis, an autoimmune condition in which my own immune system is attacking my thyroid. She educated me that Hashimoto’s is actually the most common cause of hypothyroidism and affects about 5 in 100 people.1 It seems that Hashimoto’s is a combination of genetic factors and environmental factors such as food sensitivities or heavy metals toxicity.

My next step is to try to determine what may have triggered this autoimmune condition. The more I know about my condition, the better I can treat it or avoid any sensitivities that may make my condition worse. It might seem like I am seeking out more health problems, but my intent is really to understand my own body and how I can best support it to remain healthy and cancer-free. I will likely always have to be on thyroid medication, but I’d like to try to prevent the condition from progressing as much as I can (I plan on living a long life, you know?!).

Sometimes You Just Have to Supplement

In all honesty, I’ve never been a fan of supplements because I just can’t remember to take them every day! I now understand, however, that there are certain vitamins and minerals that I’m unable to get enough of through a vegan/vegetarian diet (like vitamin B12 which is only found in animal products), and also, based on my recent lab work, we found that some others (like my vitamin D and zinc levels) were significantly depleted for me during chemotherapy.

There are certain supplements I need to be cautious taking during radiation therapy as high levels of antioxidants (like those in vitamins A, C, and E) can interfere with the treatment itself. For now, I am supplementing with:

  • B vitamin complex to improve my energy levels and cognitive functioning
  • Vitamin D3 which promotes bone health and has been shown to reduce the risk of cancer metastasis
  • Omega-3 which helps to reduce inflammation and supports brain and heart function
  • Zinc which supports the immune system
  • A probiotic and the GI drink I mentioned earlier for gut health

It sounds like a lot, but I’m currently finding it very worthwhile. Some of the brain fog that started during chemo has lifted since I started supplementing more regularly, my GI system is more settled, and my hair is growing back much faster than I anticipated! Maybe eventually I won’t need so much supplementation, but I feel now is the time to be very supportive of my body and it’s healing.

The Cost of Collaborative Care is: Priceless.

I know what you’re all thinking – this all sounds expensive! And it is to some extent. Supplements can be pricey & aren’t covered by insurance like most pharmaceuticals. When providers don’t contract with insurance companies, the costs can add up. I don’t need to explain myself, but I just want to let you all in on my thought process at this point.

Seeing an ND and using supplements and acupuncture to support my healing have brought me immense benefits and peace of mind both before and after my cancer diagnosis. I personally feel that seeing a fee-for-service provider is excellent because they are not held to unreasonable standards that insurance companies often dictate. These providers can spend more 1:1 time with their patients, can recommend tests and treatments that can be run through insurance companies, and can provide a more holistic approach to your care. I personally feel it worth every penny to have this kind of care.

If you don’t have your health, you have nothing. This year my body has been through the ringer and besides feeling physically unwell, I saw my mental health and my relationships challenged. I was hardly able to concentrate on anything besides getting through treatment and managing my symptoms. My husband became a “caregiver” and most of our life revolved around what I could and couldn’t do with friends during a pandemic when you’re immunocompromised. I haven’t been able to treat patients for almost a year and so my sense of purpose got a little muddy at times.

Now is the time for me to heal from all of that. I am beyond grateful for good health insurance that got me through treatment without any debt, family and friends who contributed to my GoFundMe so I can seek out alternative care options as I continue to heal, and for my super-supportive coworkers who’ve donated time off and kept me in the loop at work so I don’t feel like a complete outsider. These things may seem small, but they can mean the world to someone living with a complex illness.

Again, my purpose here is to share my journey in case someone else going through this can benefit from what I’ve learned. Much of this info is very personal, and I choose to be open about this. I’ve said this before, but just because someone is considered “cancer-free” doesn’t mean they’re not still experiencing some of the long-term effects of treatment. We use fire to fight fires in cancer care and there are often side effects of side effects!

Please be kind! If you know someone in treatment (or if you know someone who may just need a little extra help), reach out today and see how you can support them – we’ve all got to have each other’s backs.

Aloha ❤

*This post is not intended to provide medical advice or recommendations. I am simply stating what has worked or been recommended to me on my personal journey. For more information, read my full disclaimer here.

Radiation & Reflections

Radiation & Reflections

It feels like it’s been a bit since I gave an update so here we go! I had my radiation simulation on January 5 which is basically a practice run for the actual radiation treatment. The radiation oncologist and radiation technicians set up the treatment table and placed stickers on my chest to help them line up the radiation beams during treatment. I was able to practice with the deep inspiration breath hold (DIBH) technique which is meant to draw the heart away from the chest wall as I inhale to minimize radiation exposure to the heart for people with left-sided breast cancer. It’s actually very fun – like a video game! They give you goggles, and as you inhale a bar rises up into a green box. The goal is to keep the bar in the middle of the box for about 30-45 seconds during treatment.

I started the actual treatment on Thursday, and it has gone well so far. The first session took about 45 minutes for the alignment and set up to be confirmed. The second treatment was much quicker (about 15 minutes) as the correct table settings were already known, and I just had to lie down and get treatment. The treatment uses 2 beams (one goes right to left across my left breast, and one goes from back to front in my left armpit), done separately, so that the whole breast receives treatment and no rogue cancer cells are left behind. I use the DIBH with each blast of radiation to protect my heart. The plan for me is to go daily (Monday through Friday) for 20 sessions (16 whole breast radiation, 4 boost to the tumor bed itself).

Learning about the process of radiation therapy has been fascinating to me! There is so much complexity and nuance from the set up, dosing, and treatment delivery. I have a lot respect for my providers and feel that I am in very good hands. How incredible is it to have these kind of treatments that are literally life-saving for so many people?!

As with any treatment, there are risks. The radiation can affect the heart and/or lungs which could cause some tissue fibrosis and the physicians/technicians do all they can to minimize this during their planning so there are no long-term effects on those vital organs. Skin irritation/breakdown is also a consideration so I am on a very strict moisturizing schedule using MyGirls Radiation Burn Cream every 3-4 hours and Aquaphor (with or without pure aloe vera mixed in) nightly. I can expect to see discoloration of my skin (tanning or redness) as treatment progresses. Other side effects can include fatigue and/or swelling of the treatment area.

Some other ways that I am supporting my body throughout radiation is to drink green tea 1 hour prior to each treatment. EGCG, which is a compound in relatively high concentration in green tea, has been shown to reduce damage to the body’s healthy cells during radiation. I am also continuing supplementation of vitamin D, a vitamin B complex, fish oils, and a few others that my physician ok’d.
**Disclaimer: Always check with your doctor about any medications or supplements you’re taking during cancer treatments as some supplements can reduce the effectiveness of chemotherapy or radiation.

Otherwise, I was able to start part-time work again on transitional duty. My department has some old paperwork that needs to be scanned into our electronic medical records system, and I couldn’t be more thankful to have an option to work outside of patient care as I finish treatment. I am trying to be very mindful about balancing my return to work with taking care of myself. The old me would have jumped in head first, but I feel a deep need to let me body guide my choices these days and it’s telling me to take it slow.

Justin & I are in the process of selling our condo and buying a new place! It seems like the right time for a change in scenery and a fresh start for us. Wish us luck in this process! When COVID settles, we’ll be taking applications for visitors…

I’ve also been reflecting a lot about getting cancer as a 30-year-old, “healthy” person, and I have two points to make about this right now. For one, I am a big believer in root cause medicine. I may never know 100% why I got breast cancer without any genetic factors or significant family history. However, I am working with a naturopath to determine if there is an underlying factor that heightened my risk for cancer in the first place. My ND is testing me for things like Hashimoto’s thyroiditis (an autoimmune thyroid condition…I have a history of hypothyroidism and a family history of Hashimoto’s), celiac’s disease/gluten sensitivity, heavy metals toxicity, and food allergies/sensitivities. This will likely be a long process of exploration, but I’ll try to update as I know more. I am a big proponent of integrative medicine and I will always strive to incorporate both natural and conventional principles into my care. I believe strongly that there is an important place for both in cancer care and recovery.

Secondly, I have been looking at cancer not as a detour in my life, but as a brand new path I’m setting out on. I realized that I feel this pressure to “get back on track,” but I prefer to see it as carving a new path for my life. It’s a scary feeling to know that I am not on the same “timeline” that I envisioned for my life before cancer, and yet I feel a sense of freedom knowing there is unlimited potential in this redirection. I am trusting God that this is the true path I was meant to tread, and that this is not the first or the last time I’ll be redirected to serve His purpose for me. I choose humility and I release control of my journey.

I hope you all have a wonderful weekend. I’m going to take some time off social media and get a bit more introspective for a bit so I’ll catch ya on the flip side!

Aloha ❤

Stronger than Cancer

Stronger than Cancer

According to the National Cancer Institute, as of January 2019, the United States had 16.9 million cancer survivors and estimates that number will increase to 22.2 million by the year 2030.1 Although I’m still technically in active treatment until I complete radiation therapy, I’m now considered NED (no evidence of disease) a.k.a. “cancer free,” a survivor. While it would seem that being a survivor is just one big party, I’ve found myself seeing from a perspective that people who haven’t gone through cancer may not consider. Today, I have a few thoughts on survivorship that I wanted to share – it’s a long one, but an important one so get comfy…

Survivor or Thriver?

In the true sense of the word, a survivor is someone who’s overcome hardship or who copes well with the challenges they’ve been given. For some of us who’ve lived or are living through cancer, surviving doesn’t quite describe what it’s like to take on a complex illness and somehow maintain a semi-normal life. That’s why many in the cancer community now prefer the term “thriver” because they choose to continue to not only survive, but thrive through and beyond a cancer diagnosis. It’s not about getting through it without complications, but rather just living as normally as possible during treatment. Being a thriver means rolling with the punches, accepting what you have to do to get through it all, and getting to live how you want despite your diagnosis.

Being a thriver takes on a whole new meaning, though, for someone with metastatic/stage IV cancer. As of now, there’s no true cure for Stage IV cancer and treatment continues until the cancer doesn’t respond anymore. However, many people live for years on palliative treatment since research and treatments continue to advance all the time (#StageIVNeedsMore). In the meantime, there is always normal life running parallel to someone’s diagnosis. The world doesn’t just stop turning. I bring this up only to remind you that everyone’s diagnosis is different – not everyone can be cured, and it seems unfair to put “surviving” on a pedestal when, honestly, what it takes to thrive after a cancer diagnosis is so much more honorable.

If you’re interested in donating to support Stage IV breast cancer reseach, click here.

Mental Health after Cancer

Despite much stigma around mental illness in the past, I think the narrative about mental health issues is gradually (thankfully) starting to change. Many of us experience some degree of mental health concerns throughout our lifetime, but there are a few specific things that someone with cancer may go through after diagnosis and especially in the years after someone may be considered NED.

Scanxiety is the term used by cancer thrivers to convey anxiety around pending imaging (mammogram, CT/PET scans, etc.) or about the results of them. Imaging is the first stop on the cancer diagnosis train and so repeating this process every six months to a year can bring up a lot of emotions, even if it’s expected the scan results will all be normal. It’s important to recognize these feelings are normal and expected (especially in those first 5 years after diagnosis when the likelihood of recurrence is highest), and this would be a good time to throw your toxic positivity out the window. Here are a few ways to be there for someone preparing for follow up scans:

Don’t say….

“Everything will be fine…”

“You have nothing to worry about…”

“It’s just an MRI/CT/mammogram…”

“Stay positive – negative thoughts only lead to disease…”

Instead try….

“I know you’re worried about your tests/results, do you want to talk about it?”

“It’s ok to feel [insert emotion here] after all you’ve been through.”

“Do you want to go for a walk/coffee/other activity to take your mind off all of this for a bit?”

Post-Traumatic Stress Disorder, another anxiety condition, is widely publicized as something that combat veterans get after serving in war. Fun fact – anyone who has been through any kind of trauma can get PTSD. After being diagnosed with cancer, there are so many things that can trigger anxiety and panic attacks. A few of my triggers include hearing of someone young who died of cancer, upcoming medical appointments (particularly with new doctors or doctors that don’t know my recent medical history), and especially blood draws, but other events or news may trigger someone differently. Please be kind and allow space for others to feel their stress and anxiety.

Another thing I’d like to address is actually the first thing I experienced after surgery confirmed I was NED. Survivor’s guilt. I was surprised that I felt this since I was very confident in my doctors and myself that I would get through this (I guess when you’re doctor writes on your FMLA paperwork that your cancer is “curable” it leaves you mostly hopeful). But this “guilt” hit me hard and unexpectedly and so I’ve taken some time to sit with it and understand it.

Truthfully, I don’t actually feel guilty that I survived cancer. I know many other survivors and have met many amazing women this year who’ve overcome a breast cancer hurdle, and they never talk about feeling guilty to be alive either. So I came to the realization that what I’m feeling is actually empathy for those still in treatment and compassion for those who will always be in treatment or for whom treatment didn’t work. Being a survivor is a strange position to be in, but I’m hoping that my experience will only make me a better friend and clinician when I have the opportunity to support someone going through a similar experience.

Expectation of Transformation

The one last thing that’s been on my mind is this idea that because I’ve survived cancer, I must be a changed person. Cancer is eye-opening in many ways, that’s true, but it’s not like Cinderella putting on that glass slipper. I don’t suddenly have this new lease on life, and I don’t feel newly inspired to pick up the torch and run wildly toward some new life where every experience is profoundly meaningful and joyous. That’s great if someone else does have a big transformation, but for me (and likely many others) it’s just not the case. Instead, I feel a bit more reserved. I want to live a simple, mostly happy (sometimes messy) life focused on loving the people I surround myself with and learning as much as I can with whatever time I have left here on this Earth.

I don’t strive to be an inspiration and I hope everyone can recognize that a diagnosis isn’t a definition. I had cancer. I am not defined by that or limited to that. I share my experience because I hope it can help someone else who’s going through it. While I’ve learned a lot, I’m not going to dwell on the experience. Instead, I’ll take what I’ve learned and get back to my life, applying that new knowledge whenever I get the chance. I hope you’ll all hold me accountable to that.

Aloha ❤

Happy New Year!

Happy New Year!

Well, we did it. We made it through 2020, a year no one could have ever expected. A year that we were all “safer at home” and “socially distanced.” A year in which we all struggled as a collective against a common enemy and were challenged on a personal level as well.

It’s easy to look back on this as a very difficult year, but for me it was also a year of major growth, learning, and finding love. Love for myself, my partner, my family and friends, and even for strangers. A year to prioritize my health, both physically and mentally. A year to allow many tears and also to find joy in the most ordinary of days.

I’m actually unable to hold back tears thinking of all we went through this year with such little reprieve. To go through cancer on top of it all was just ridiculous, honestly. So, I am grateful to sit here and reflect on the highs and lows of 2020. I am even more grateful to be able to look ahead to the ordinary joys, the eventual hugs, and the lessons that 2021 will bring.

I know I’ve mentioned this before, but on my 30th birthday last year, I kept feeling that 2020 would be a big year. Not like the “best year ever” kind of year, but the kind where you’re challenged in all the important ways. I usually decide on a word that symbolizes my intentions for the year, and I just couldn’t pick one last year, but as the second quarter of the year began with COVID and a cancer diagnosis, I found myself always coming back to a Japanese phrase I learned a few years ago:

And so that’s what I’ve done this year. I just kept putting one foot in front of the other and doing the best I could to get through each day. Trust me, some days were better than others and there were many days that I had to ask for help. So to those of you who prayed for me, who let me cry with you on the phone, who laughed with me on zoom calls, who sent cards and letters, who wore masks & socially distanced to protect the immunocompromised – I am incredibly thankful for you.

A few highlights from this year:
Getting to spend a whole month with my mom in Hawaii. Staycations. Cooking at home and learning new recipes. Being outside more often. Meeting new people (mainly my excellent medical team and an incredible group of cancer thrivers). Growing closer to my husband as we rounded out our second year of marriage and head into our third. Working on my Pilates certification. New babies. Friends getting married. Learning my own strength.

I won’t dwell on the lows, but I will remember how much I learned from them. This year my word is JOY. I hope to find more joy in each day, be more present, and celebrate every little victory. There will be setbacks, I’m sure of it, but if I’ve learned anything this year, it’s that they can be overcome. Wishing you all a happy, healthy, safe new year and sending you so much love and gratitude.

Cheers to 2021! ❤

A Fertility Update

A Fertility Update

How it’s going…

You may remember me posting a while back about the different ways I tried to protect my fertility as I prepared to start chemotherapy. First, I froze some eggs. In case I’m unable to conceive naturally later, I can use them for IVF. I also started monthly Zoladex injections – a medication that halts ovarian function in an attempt to preserve fertility overall.

And so, at age 31, I’ve been in a Zoladex-induced menopause since June. Six whole months later, my estrogen levels have tanked and my joints ache like I’m an 100-year-old lady! Some other fun side effects include amenorrhea (lack of a period), hot flashes, and dyspareunia. So, I’m currently staying as active as possible (mostly walking and stretching when I have the energy) in order to mitigate some of those side effects, and thankfully, my oncologist and I decided it was time to discontinue the Zoladex now that the bulk of treatment is behind me. Today marks one month since my last injection!

For more detailed info about fertility preservation, you can read my earlier post here.

What to expect now?

Typically, the menstrual cycle can take a few months to return as the body figures out its new normal once again. As I have some previous experience with amenorrhea after I came off the birth control pill in 2019, I know that what I eat will play a huge role in how quickly my body gets back to normal. Thus, the plant-based diet continues (plus no dairy, processed sugars, or alcohol) and I will try my absolute hardest to cut back on caffeine to keep my nervous system calm.

I also plan to use seed cycling to help my body regulate the essential hormones it needs for menstruation and ovulation. This is a great article about how to do seed cycling if you’re interested in learning more. Seed cycling is an excellent, natural way to balance hormones, however if you have hormone-positive cancer, please ask your doctor if a daily dose of phytoestrogens is safe for you!

Once I’ve completed radiation therapy, I’ll speak with my medical oncologist and OB/GYN about when it will be safe to start trying to conceive. With that said, I think my body deserves a long break to heal completely before that all happens. Actually, this might be a good time to kindly remind you that it’s just not acceptable to ask a person when they plan to have children. A person’s body is their own to make decisions for and, sometimes, people aren’t capable or willing to have children at all.

My goal for this blog has always been to be as open and honest about my experiences as possible in the hopes that whoever may be reading this can gain some insight for their own health and wellness. Personally, I don’t think there’s ever TMI (too much information) disclosed when it comes to learning about your own body and how it works. This coming from a pelvic floor PT who talks about poop all day… Anyway, I’d love to know what questions you have about:

  • fertility preservation during cancer treatments
  • long-term side effects of the birth control pill
  • nutrition around hormone balance
  • seed cycling

Drop your Q’s in the comments below!

Rad.

Rad.

I had my consultation with my radiation oncologist yesterday which went well. Dr. Tsuji spent well over an hour with me taking my history and explaining the process and side effects of radiation therapy. It’s always extra comforting when a physician comes in having already reviewed your chart and having an individualized plan in mind.

Although I had an excellent response to chemo and the post-surgical pathology shows that there was no residual cancer in the tumor bed or the lymph nodes, radiation is important with breast-conserving surgeries to get rid of any cancer cells that may remain in other areas of the breast that weren’t removed (as they would have been in a mastectomy). So, Dr. Tsuji recommends 4 weeks of whole-breast radiation (no axillary radiation since nodes were clear) with a boost to the tumor bed. After everything’s been set up, I’ll go for radiation 5 days per week, likely starting the 2nd or 3rd week of January.

Birthday stay-cation! Thankful to have many options to “get away” in Honolulu!

The side effects of radiation therapy are fatigue, which generally increases as the treatment progresses, and skin irritation which is basically like a bad sun burn. With radiation to the breast, the radiation oncologist takes as much precaution as possible to minimize radiation to the lungs and the heart. One way to protect them is to perform a breath hold during the treatment to raise the breast tissue away from the organs as the lungs expand and so we may see how that goes when I do my simulation in a few weeks.

I also need to be sure my left arm range of motion improves before I can start radiation since I’ll likely be positioned lying on my back with my hands behind my head. I can get there now, but it’s not at all comfortable due to the cording. My PT did work on it last week and it got significantly better after just one treatment, but it’s not quite there yet so I have some goals in the next few weeks!

I’ll see my oncologist on Thursday for a post-surgical follow up and planning and will see my surgeon after that to have my bandages removed from my port surgery. Thankfully, all is going well and everything is healing up nicely. Overall, I’m feeling well but definitely looking forward to being able to be more active again. I’m thankful to be on the last stretch of treatment and starting the new year cancer free!

Aloha ❤