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 ❤

Birthday Week

Birthday Week

Yesterday was my 31st birthday, and I’ve been feeling so grateful to have made it to this day. I can remember the night before my 30th birthday last year so vividly, and I just knew that this year would be big in so many ways. It has been one of the most challenging years for me personally, as well as physically, but I have learned so much about myself and Justin and I have grown deeply in our relationship. With that said, all the learning was great, but I’m ready to leave 30 in the dust. This year, I’ll celebrate my birthday, looking forward to the year ahead (cancer free!) and I’ll celebrate all that I’ve accomplished this year with the help of everyone I love.

We had a great time celebrating my birthday yesterday (my mom always knows how to make birthdays very special), but this morning, Justin & I dropped her off at the airport even though I tried really hard to convince her to move here (or at least stay through Christmas). It was so nice to have her here and we were able to have plenty of good dinner chats, walks, coffee dates and couch parties binging Schitt’s Creek. I’m looking forward to getting back to Montana next year sometime to see her and the rest of the fam again.

Mama ❤

I went to take my 3rd COVID test today. I needed to do a rapid test because – surprise! I am having my port removed tomorrow! I had really been hoping this would have been removed with my lumpectomy, but it was left just in case there was any residual cancer or other IV treatment required. So tomorrow that little guy is coming out, and I don’t think I’ll miss it!

I’ll have a consultation with my radiation oncologist on Monday next week and will decide on a plan for radiation. I will likely need several weeks of radiation to eliminate any rogue cancer cells (should they exist) in the breast tissue that was not removed during surgery. I’ll update as I know more.

Otherwise, I’m still recovering from surgery (today I’m 2 weeks post-op). Swelling has been less in my arm, but I am developing a “cord” which I can feel from my armpit to my wrist. Cording, also known as axillary web syndrome, is common after a lymph node removal procedure and is a sign of scarring along a lymphatic vessel. It is thankfully treatable, but right now it’s painful and limits my range of motion in my left arm. I’ve been working on some lymphatic drainage techniques including lymphatic massage and exercise, and I think that as my shoulder mobility improves and I can get in to see my PT, the cording should resolve.

Delicious birthday din at Istanbul!

With Christmas only a few weeks away, Justin & I are busy putting gifts together (I am always a last minute gift buyer) and preparing for the end of the year. I am hoping to be able to transition back to some light duty work until I can treat patients again so we’ll see what happens with that. I may update a little bit on the blog over the holidays, but will likely be a bit quiet, so I hope you all have a safe and wonderful holiday season with your families!

Aloha ❤

GratiTuesday

GratiTuesday

It seems like time is moving so slowly some days during this pandemic, and yet here we are in Thanksgiving week already. Though 2020 has had it’s detours, I can honestly say there has been more to be grateful for this year than ever.

Yesterday, I went in for my pre-surgery blood work and COVID testing. In all honesty, my white count was still quite low and I was pretty sure we were going to have to bump my surgery, but my surgeon and oncologist agreed that it’s high enough to proceed on Friday so today, I’m most grateful not to have to delay. My COVID test was also negative – not surprising since I never go out without a mask on or practicing social distancing. That immunocompromised life, though…

Peep that 4-week post-chemo hair growth!

My mom has been here for a little over a week now and it’s been so nice having her here. Thankfully, she’s been up for trying all of our vegan cooking, walking almost daily, and watching plenty of The Crown and Holiday Baking Championship. We were lucky enough to be able to have a little stay-cation at Aulani Resort thanks to my mom’s colleague, and we had a really nice time relaxing by the beach and pools.

I know that it would be easy to look back on the last 9 months and say what a shit show this year has been between COVID restrictions and a cancer diagnosis, but what I’d rather remember from this year is the simple, day-to-day moments that are the true blessings in life.

I’m grateful for the way my husband has stepped up more than I ever could have expected he would after my diagnosis (I should have known better, though…he’s the best person I know).

I’m grateful for my my mom calling and FaceTiming with me on a daily basis and who patiently waited for a safe time to come visit. For my sister, who has sent care packages, shared my posts, and called often. For my dad, who’s been calling more often just to say hi and to check in on me. For my stepdad, who calls and texts me just to let me know he loves me, too.

I’m grateful for texts, calls, & vent sessions with my besties and zoom mocktail dates. For care packages and cards from my aunties. For frequent check-ins and notes from my co-workers.

I’m amazed by the empathy and integrative care I’ve received from my doctors and healthcare providers this year who are doing their jobs excellently while dealing with added considerations from a pandemic.

I’ve enjoyed trying new plant-based recipes and taking an extended break from alcohol and processed sugar. I was lucky to get to work with fun nurses and to be able to give people good news while working safely from home. I’ve been able to walk outside often and to improve my Pilates skills at home.

If I can sum it all up, I’d say that I’m most grateful for my people who make this life so beautiful. We all have a responsibility to each other, and with all that has gone on for me personally this year, I urge you to be kind to one another and take care of each other as best you can.

Happy Thanksgiving, friends! Take a moment to write down what you’re grateful for this year!

Aloha ❤

Surgery Update

Surgery Update

Hey everyone- hope you’re all having a good week! I had a few people text me about the results of my MRI & surgery consult so I figured I better update you!

I did my MRI two weeks ago and they took images with and without contrast. The good news is that the mass that was present on the ultrasound did not “light up” on the MRI so we’re hopeful that small mass is just scar tissue rather than residual cancer cells. However, we will not know for sure until the mass is removed and sent to pathology after surgery.

I met with my surgeon on Monday, and we agreed to go forward with breast-conserving surgery (aka “lumpectomy”). She will also do a sentinel lymph node biopsy to be sure there is no cancer in the lymph nodes. We are planning for surgery on November 27 as long as my pesky white blood cell count comes back up – it was really low last week again. I better enjoy my Thanksgiving dinner because no eating after midnight!

From what I know now, I’ll check in early in the morning and will have a radioactive dye injected into my left breast. The dye traces the circulation from the tumor itself to the lymph nodes. The surgeon will then remove the first node to which the tumor drains as well as any other lymph nodes which may contain cancer cells.

Once the nodes are removed, they are sent to pathology to determine how many contain cancerous cells. If there are cancerous cells in a majority of the nodes, the surgeon may choose to remove additional nodes while I’m still under anesthesia. Otherwise, she will remove the mass and that will be that!

The recovery should be relatively “easy” as I should only have 2 small incisions and no precautions or drains like I would have if I opted for a mastectomy with reconstruction. I should mention that I’m not choosing a mastectomy for several reasons:

  • I do not have a BRCA gene mutation, therefore my risk of a local recurrence and my overall cancer survival rate is not affected by choosing a more conservative surgery.
  • As a rehab professional, I am well aware that a mastectomy is a MAJOR surgery, and the recovery is more difficult and the healing timeline can be longer.
  • Had I chosen mastectomy, I would have likely chosen to have reconstruction as well which would require multiple additional surgeries & I just don’t have the energy for all of that!

Breast-conserving surgery is my personal choice based on what I know about my cancer now. There are many reasons why someone else would choose a mastectomy. Everyone’s situation is very different so just because this seems to be the right option for me doesn’t mean it’s the right (or best) option for someone else.

I will need radiation after surgery as well and I’ll be referred to a radiation oncologist to determine the plan. I’m also going to see my PT colleague for pre-operative lymphedema measures so I have a baseline to compare to after surgery.

2 weeks Post-chemo Faux-Hawk!

My hair and eyebrows are growing in nicely! In fact, I can almost make a baby mohawk. For 3 weeks post-chemo, I’m pretty excited about that! With my eyelashes growing in, my eyes have become super irritated, but I will be SO thankful to have lashes again! I miss mascara!

If you have any questions for me about surgery, lymphedema risk, or anything related to breast cancer or physical therapy – leave a comment for me below!

Hop you all have a great weekend! My mom will be here in two days! How lucky am I?!

Aloha ❤