Tag: Breast Cancer

Round 3

Round 3

by bridewitt ♥ 2 Comments

On Thursday, I completed my third of four AC treatments, and it feels soooo good to know I only have to do one more round! Despite the spike in COVID cases on Oahu (& everywhere), Justin is still allowed to come to my appointments with me and I’m very grateful that he can.

Before I went into this round, I made up my mind that it was going to be easier than the past two. I wanted less nausea, less fatigue, and better appetite. Guess what, everyone – I got it. The mind is so powerful, and manifesting your goals and desires is an amazing tool no matter what you are going through.

My last AC treatment will be in two weeks, and then I’ll get two weeks before starting taxol treatments, which will be weekly, on August 6. While everyone says taxol is the easier one, I’m really not looking forward to weekly treatments, and I’m praying that it really is “a piece of cake” like my oncology APRN said.

Otherwise, there is not much else new. We are still social distancing quite a bit as COVID still lingers around. My immune system in the first week or so after chemo is really crappy, so it’s just better to be safe than sorry. My mom was hoping to come down to Hawaii the first week of August, but it’s looking like that may get pushed back a bit due to tourism restrictions.

That hospital parking garage lighting, though…

I still get to work from home a few days of the week, and next weekend I get to take an online continuing education course for oncology rehab that I’ve been wanting to take for months now!

I’d love to start up a more comprehensive oncology rehab program for our cancer patients at the hospital where I work. This is something that one of our inpatient therapists has been very passionate about and got me on board with as well. Hopefully, in the next year, we’ll have a good system to get more oncology patients in for baseline testing and guidance before, during, and after their treatments. I know that exercise has been one of the most important things for me during chemo, and I hope to help others understand the importance as well.

I hope you all have a really great weekend!
Just a little P.S.A. before I go…No matter what you hear on the news or Facebook, wearing masks is a VERY important step to reduce the contagion rate of COVID-19 (if it weren’t, none of your healthcare workers would bother with them, trust me). It’s true, the death rate from COVID is very low, but the high rate of contagion is the scary part. Please wear your masks to protect those around you – don’t be selfish. Mahalo!

Sending love to you all ❤

xo

Understanding your Lab Results During Chemo

Understanding your Lab Results During Chemo

by bridewitt ♥ 0 Leave a Comment

During chemo, there are a few important labs that your provider will run frequently. These specific tests help them determine the best course of treatment for you and give you and your provider an idea of how your body responds to treatment, guide future treatments and help you understand your risk for infection, anemia, or liver/kidney damage as you go through treatment.

Knowledge is power.

Below, I’ll outline two common panels that your doctor may order to check on your general health. This is meant to be a rough reference guide so be sure to ask your doctor what it might mean for YOU specifically if something comes back outside of the reference range!

Complete Metabolic Profile1

A panel that relays important information about your body’s metabolism and chemical balance. Click on the number under additional info to read more!

TestNormal RangeAdditional Info
Glucose70-99 mg/dLYour blood sugar levels! Glucose is the body’s main source of energy so it’s important for this to be balanced. It can indicate diabetes if high.2
Blood Urea Nitrogen (BUN)
6-23 mg/dL

An indicator of your kidney’s ability to remove waste products from the blood.3
Creatinine0.7-1.4 mg/dLA waste product of muscle breakdown which happens with everyday activities. This test indicates kidney function as the kidneys typically clear creatinine from the blood/urine.4
Sodium5

Potassium6

Chloride7

Carbon Dioxide (CO2)8
133-145 mEq/L,
3.3-5.1 mEq/L,
95-108 mEq/L,
21-30 mEq/L		Substances, sometimes called electrolytes, which help balance your body’s fluid and acid/base regulation. These tests can indicate a variety of metabolic disturbances such as dehydration, irregular heart rhythms, or alkalosis.
Calcium8.3-10.5 mg/dLAn important mineral for regulation of nerve, muscle, and heart function! Not just good for your bones!9
Alkaline phosphatase (ALP)10,
Alanine transaminase (ALT)11,
Aspartate aminotransferase (AST)12		35-129 IU/L,
0-41 IU/L,
0-40 IU/L		A variety of liver enzymes which indicate liver function.
Bilirubin0-1.2 mg/dLA waste product from the liver that indicates liver function.13
Albumin3.5-5.2 g/dLA protein made in the liver that helps to carry out various bodily processes. Low levels may indicate liver or kidney dysfunction.14
Total protein6.4-8.3 g/dLA measure of the total protein in your blood.

Complete Blood Count15

An assessment of various cells which circulate in the blood which are good indicators of overall health and your risk for infection or disorders.

TestNormal Range Additional Info
Red Blood Cells (RBC)3.6-5.4 x 106/uLRBCs carry oxygen from lungs to your body. Low RBCs could indicate anemia.
Hemoglobin (Hb)11.2-15.7g/dLA protein that binds oxygen to RBCs. Low Hb can indicate anemia.
Hematocrit (Hct)34.1-44.9%The percentage of your blood made up of RBCs. Low Hct can also be used to screen for anemia as well as for dehydration.
Platelets151-424 x 103/uLPlatelets help with clotting. If platelets are low, you could bruise or bleed more easily, and if platelets are high, you could be at higher risk for blood clots (deep vein thrombosis or pulmonary embolism).
White Blood Cells (WBC)3.8-10.8 x 106/uLWBCs are immune cells which help to fight infection. Low WBC count could mean you are at higher risk for infections and you should take extra caution to stay healthy.16
Neutrophils34.0-72.0%,
(Absolute:
1.56-6.20 x 103/uL)		WBCs formed in bone marrow which specifically target bacteria and fungi. They are the first line of defence against infection!
Lymphocytes12.0-44.0%
(Absolute: 1.18-3.74 x 103/uL)		WBCs abundant in the lymphatic system that identify and destroy foreign invaders (like cancer cells!).
Monocytes0.0-12.0%WBCs that fight bacteria, viruses, and fungi, but which also play a role in tissue repair and healing.
Eosinophils0.0-7.0%WBCs that are involved in allergic inflammatory response and also target larger parasites (like worms).
Basophils0.0-2.0%WBC involved in allergic reactions.

Again, if your labs come back with any unusual values, be sure to discuss them with your physician so you fully understand the interpretation.

Here are some good questions to ask your doctor about your labs:

  • Why do you choose to run these specific lab tests?
  • What does it mean that my lab values came back high/low?
  • Are there any symptoms I should watch for that could indicate dehydration, anemia, blood clots, or infection?
  • What should I do if I think I am showing signs of infection (i.e. fever, chills, etc.)?
  • Is there a way I can see my lab values online? If not, can you print them for my records?
  • When should we run these tests again?

I hope this is a helpful reference guide for you as you begin to better understand your general health, but especially during chemotherapy. As always, feel free to leave any questions you may have in the comments!

xo

Celebrate

Celebrate

by bridewitt ♥ 3 Comments

Happy 4th of July, everyone! Justin and I snuck out of the house to our favorite swell little spot in Waikiki today (IYKYK…) for some brunch and music to celebrate. We’ve been trying to have days of “normalcy” where we plan something that would resemble a “pre-covid” date, and this has made all the difference since I’ve started chemo.

Of course, we have to be cautious, make sure my blood counts are good, wear our masks, and avoid heavy crowds, but going out lightens the mood and keeps us in good spirits despite the many other responsibilities we both have right now.

Generally, I’ve been feeling really well this week and was even able to go into work for one day! A very big step (even if I was pretty exhausted by the end of the day)!

I’ve been trying to focus as much as possible on my mindset, beliefs, and visualizations (read: goals) surrounding my treatment and the cancer in general. I’ve been doing a lot of meditation and EFT tapping and have been very specific about the thoughts and words I use to describe my treatment and also my outcomes. The mind is a very powerful tool, y’all!

Today, even though there will be no official fireworks shows or parades, it feels more important than ever to celebrate every freedom and privilege we have after all of the ups and downs of COVID and cancer and life in general for the past few months…

I know that Independence Day has been a touchy subject this year and that a lot of people are feeling very mixed emotions about patriotism and our country’s politics as a whole right now. I will not downplay the very real pain that BIPOC and LGBTQ populations are feeling now. I do, however, want to reflect on some of the reasons I am grateful to be an American:

I am thankful to live in a country that allows me to speak my opinions freely and to use my voice to stand up for myself, women, and minorities.

I am thankful to live in a country where I can vote in my leaders, support them when they’re doing well, and challenge them when they are failing.

I am thankful to live in a country where I can have friends and family of any race, gender preference, religion, social status, or otherwise. I love you all!

I am thankful to live in a nation where we fight for equality, no matter how much work there is left to do.

It is not lost on me that everything I mentioned above may not be available to me had I been born elsewhere. These things we take as “fundamental rights” are not ever guaranteed, and I am so grateful to see the people I love around me speaking up to protect these rights and freedoms for all of the people in this country. May we all just try to love and understand each other ❤

I hope you all have an incredible weekend celebrating your freedoms! Please, wear your mask, & celebrate responsibly!

xo

Tips for Chemo-Induced Hair Loss

Tips for Chemo-Induced Hair Loss

by bridewitt ♥ 1 Comment

So far things are going pretty well after my 2nd AC treatment last week. I caught up on plenty of sleep, forced fluids and attempted some short walks. I feel better today and according to my lab work, my white count is looking good this time around!

As I’ve mentioned, I’ve been working on my mindset around everything cancer, and as positive as I may come off on here, I forget to share that there are very real moments of anxiety and sadness that come with a cancer diagnosis. It’s important to me that I don’t put on a false front that “even though I have cancer, I’m totally fine.”

Yeah. There have been a few breakdowns here and there, especially this past week when my hair started falling out in big clumps in the shower. That’ll make a girl cry for sure. I have always been one to try different cuts and colors in my hair, but going bald wasn’t exactly on my list of things to try in my 30’s.

All jokes aside, it was a pretty emotional experience so I asked my husband if he’d shave it for me. Mind you, this is his first time using clippers and he nailed it! Taking control of the situation really helped ease my mind. Also, phone calls with your bestie and making inappropriate jokes really helps!

Here’s a few tips I’ve learned for chemo-induced hair loss:

  • Wash with baby shampoo for several weeks before hair falls out. My oncology APRN recommended this and I think it’s helped to reduce scalp sensitivity with the hair falling out.
  • Cut your hair in stages if you don’t feel comfortable shaving it right off the bat. I ended up loving my short pixie cut and it gave me an idea of what styles I can try as my hair grows back out!
  • Use coconut oil or lotion to moisturize the scalp after shaving and give yourself a little scalp massage to relax while you’re there!
  • Play around with fun head wraps, hats, and wigs OR just rock the bald look and show off your cancer warrior status. I just ordered some super cute, high quality head wraps from The Wrap Life and highly recommend (Click the link for $5 off your first wrap)!
  • Unofficial advice: Google pics of “bald female celebrities” and know you can rock that look too!

One more reminder as I wrap up today – It’s time to #FeelItOnTheFirst! Do your monthly self breast exam – it takes about 5 minutes and could be the most important thing you do all week! If you’re not sure what to look for or how to do one, check out my earlier post here!

Sending lots of aloha to you all today!

xo

Round 2

Round 2

by bridewitt ♥ 2 Comments

Just got home from #2 of 4 AC treatments – that’s halfway done with the red devil! I’m so thankful to have had a relatively easy go of it with my first round and hoping this time goes smoothly as well.

Because my white blood cell counts tanked so hard last time, my oncologist decided to reduce my dose by 10% today. We’ll also do the normal dose of my udenyca injection tomorrow to boost those little WBCs right back up.

I was laughing at myself as I left the house today – it’s the first day in over a week that I’ve been in the car and definitely the first time I’ve worn makeup in like 2 weeks…what can I say? Quarantine life suits me!

Completed Round 2 – Cheeeehooo!

I thought I’d talk a little bit about what I like to have on hand at home during chemo recovery for those of you who are also going through it or know someone who is. It’s really important to stay hydrated, eat enough calories, and manage side effects as best I can. Like Beverly Zavaleta said in her book, Braving Chemo, “You will not get a trophy at the finish line for having endured the worst of the side effects!”

  • Water! I make infused water or green tea, too. You can add a sugar-free flavoring if water tastes bad. I pretty much just continuously refill my 32 oz. water cup throughout the day so I can help my liver & kidneys detox the chemo meds.
  • Liquid IV – this is a super delicious electrolyte mix that you just add to water. Water alone isn’t always enough to replenish your body, so I usually have one of these drinks per day for at least 3-4 days after chemo.
  • Easy to make meals like soup or leftovers. BUT, be careful with leftovers! Be sure they’ve been refrigerated no more than 2-3 days and that they are reheated well to avoid any stomach upset or catching a foodborne illness!
  • Ginger ale, ginger candies, or ginger tea to help tone down any nausea.
  • Guided meditations or time set aside for meditation/prayer to help ease anxiety. I like the Calm app and am just about to start a free 21-day Deepak Chopra meditation series (they occasionally offer new 21-day courses, but they do have their older ones available for purchase as well). Check it out here.
  • Pilates/yoga mat – I always set aside time to move my body in some way. It helps my mind relax and helps to detox the chemo as well. Usually, for the first several days exercise looks like some light stretches on my mat or going for a short walk in the evening. HIGHLY recommend!
  • Entertainment – Netflix, books, journal, coloring book – whatever floats your boat! You’ll have a lot of time to kill.
  • All of my usual prescription medications and supplements – chemo now is made SO much easier with these medications (thanks, Zofran)!

My coworker gave me the Braving Chemo book after I was first diagnosed, and I would definitely consider it a great gift for anyone who’s going through chemo. Beverly Zavaleta is a physician who also went through breast cancer and has excellent tips to prepare for chemotherapy. It’s a super easy read and a quick reference guide for any side effects that may pop up.

Proof I got dressed today!

Hope you all are having a great week! Wear your masks!

xo

House Arrest

House Arrest

by bridewitt ♥ 3 Comments

On Monday, I had a chemo follow up which was just to check in on blood work and how I’ve been feeling overall since my first AC treatment. In reality, I’ve been feeling well and only had a few issues in the first 3 days after chemo with some nausea and fatigue which I expected and did manage pretty well. Hydration is key, my friends.

What I did not expect was that my white blood counts came back “critically low” because otherwise I’d been feeling almost back to normal. It sounds like my counts weren’t able to come back up after my udenyca shot last week as they should have, maybe because we chose to administer a lower dose. I’ve been advised to stay home so I don’t catch any bugs (or God forbid, COVID), and my oncologist put me on a short course of preventative antibiotics just in case.

A quick note on COVID – cases are rising everywhere as we ease up on social distancing guidelines. PLEASE, please, please wear your masks. It’s a quick selfless way to take care of your neighbor, friends, and families. My anxiety is sky high with my immune system running so low, so do it for me or for anyone else you know with a compromised immune system!

Since I’m home, I filmed a little Pilates video for those of you who are also at home and might need a quick workout! Bear with me – I’m still working on a few things too (like video editing….how do I remove the background noise?!). But I hope this gets you moving and connecting with your body today!

Enjoy!

Hoping Justin & I can sneak out for a little drive around the island or walk later this afternoon. I’m scheduled for my next chemo on Thursday next week – please say a few prayers that my white counts have come up by then so there is no delay ❤

xo

Move Your Body

Move Your Body

by bridewitt ♥ 0 Leave a Comment

Happy Aloha Sunday, friends!

I’ve been feeling much better the last few days and was able to work a little bit over the weekend. I’ve been lucky to keep working my “COVID” job (giving good news to patients who’ve tested negative), and I can’t say enough how grateful I am to work with such a supportive rehab team, COVID team, and organization!

Yesterday, I went for a walk around the neighborhood by myself. It feels so good to get outside and have some time to process everything. I’ve been using the Calm App recently, and I used their mindful walking exercise yesterday which was soothing. It helped me stay more conscious in the moment, rather than letting my overactive brain run wild.

I also used one of my favorite apps called Charity Miles. This app tracks your distance using GPS, and their sponsors donate so many cents per mile walked/ran/biked to a charity of your choice. It may be a small way to give back, but I am grateful I can have even a little bit of impact just by taking my daily walks. I hope you’ll try it, too!

Workout with a view!

As a physical therapist, I have seen how significant the impact of regular exercise can be for anyone, let alone someone going through cancer treatments. There are some general guidelines that are good for everyone, but for those with cancer, the exercise type and intensity may need to be monitored more closely.

For example, for people undergoing chemotherapy, it’s important not to overexert themselves during exerce in order to protect the heart! It is equally important not to be a couch potato in order to keep the heart strong. During chemo, the American College of Sports Medicine (ACSM) recommends 150 minutes per week of moderate intensity aerobic exercise like walking, biking, or swimming. That’s about 30-60 minutes, 3-5 days per week – not so bad, huh?

Interestingly enough, these are the exact same guidelines they recommend for a “regular” person too! Aerobic exercise is a great way to improve cardiovascular health, aid sleep, and boost the immune system along with many, many other things!

Personally, I am trying to stay at about 30-40% of my maximum heart rate to avoid too much strain on my heart (normally I would walk at about 40-60% of my max heart rate), which is why I’ll likely stick with walking and light hiking for aerobic exercise over the next few months. I’ll miss you spin class (*sobs*)!

I also had my husband help me perform a baseline treadmill test so I could know where I started from, and I plan to repeat this test mid-chemo as well as after treatments, so I can be sure to catch any significant deconditioning as early as possible.

Strength, or resistance, training is also part of my routine, but usually only 2-3 times per week. I prefer Pilates, yoga, or bodyweight training. Resistance training improves mood, helps build lean muscle and reduces body fat, but it also becomes extremely important for helping to balance blood glucose & insulin levels (here I go again, I know…). Also, doesn’t it just feel gooddd when you can lift heavy things?!

Exercise (especially during cancer treatment or for an injury) should always be tailored to a person’s individual preferences and goals. Working with a physical therapist can be extremely helpful to prevent cancer-related fatigue, muscle atrophy, and functional decline, and if you need help finding a provider in your area, reach out to me or check out this handy tool through the American Physical Therapy Association!

*I would highly recommend any patient undergoing active care for cancer to have a physical therapist or exercise physiologist follow them throughout treatment to keep you as safe, strong and active as possible.
ALWAYS check with you doctor before beginning a new exercise program.*

Remember, * Exercise * IS * Medicine *

xo

Round 1

Round 1

by bridewitt ♥ 2 Comments

I had my first dose dense AC treatment on Tuesday, and so far it has gone better than anticipated. So far I’ve had a little nausea which I was able to manage well with some meds at home and I pretty much fall asleep any time I sit down on the couch, but all-in-all I’ve felt pretty good. Coming out of the fog a little bit today.

I also went in for my udenyca shot yesterday which helps to boost my white blood cell count. My oncologist actually gave me a slightly lower dose of this since, typically, younger people are more “robust” (as she put it) and can upregulate white blood cell count more easily. So far no significant side effects like bone pain, so I’m very thankful.

Round 1 – DONE!

I also haven’t had a chance to mention that I received my genetics results last week and I do not have a BRCA 1/2 mutation. This means that I’ll likely be able to choose a less aggressive surgery (lumpectomy v. mastectomy). It also means I have less chance of recurrence in my breasts or ovaries and it also means that my family members don’t have an increased risk of breast or ovarian cancer. Yay!

Just wanted to say thanks to everyone who’s reached out and who have sent very thoughtful gifts and prayers. I couldn’t get through any of this without you!

Especially a big thank you to my husband who is now head chef (ok, he always was), home pharmacist and water-bringer extraordinaire. So grateful for you, Justin ❤

Not the worst view from my chemo chair….

Hope you’re all doing well – will continue to update as much as I can. I’m hoping to get into work a few days next week if I’m feeling well enough.

xo

Food for Thought

Food for Thought

by bridewitt ♥ 4 Comments

This blog post is going to open up a whole can of worms for me. I feel so passionately about nutrition and I have soooo much to say so I’ve delayed writing this post because I wanted to do more research before I put just any old information out there.

Before I dive in, I want to give you a little history about my diet and health pre-cancer. I’ve been vegetarian (…well, “flexitarian”) since 2010. I chose this out of personal preference but also because there’s some decent history of heart disease in my family and I (always) like to be proactive.

“An ounce of prevention is worth a pound of cure.”

Benjamin Franklin

Last February, I also went off my birth control pill which I had been on for 12 years (OMG, I know!). I have always suspected that I had polycystic ovarian syndrome, or PCOS (symptoms can include irregular menstrual cycles, infertility, acne, excessive hair growth on the face/chest/back, and weight gain), since high school and the pill helped me to manage most of those symptoms for a long time. PCOS also goes hand in hand with insulin resistance as it is primarily a condition of hormonal imbalance.

This is where it gets juicy, guys. Insulin is a hormone that lowers our blood sugar and helps us to use those delicious carbs that we eat as fuel.
If a person has insulin resistance, their body has difficulty using blood glucose for energy/metabolism and blood glucose levels stay elevated or we begin to store it as fat. When blood sugar keeps increasing, the body produces more insulin, and on and on we go….

It sort of works like this:
If I eat a donut, or a bowl of pasta, my blood sugar increases. Then, my insulin levels go up to try to reduce my blood glucose. If my body has a limited number of insulin receptors in certain cells, the blood insulin level stays high and, in the long term, can increase my risk for developing diabetes (if I don’t already have it) or obesity.

Borrowed from: renewedvitalitymd.com

There have been many studies about the link between insulin resistance, especially in people with diabetes or metabolic syndrome (yes, we’re talking about the same insulin), and cancer. As it turns out, those with high blood insulin levels are at an increased risk for tumor development and for more rapid tumor growth.

Here’s the funny thing, though – this doesn’t only happen when we eat carbohydrates (FYI all “sugars” are carbohydrates). It can also occur when we eat animal products like meat, dairy, or eggs because those foods have something called insulin-like growth factors which are similar to insulin in that they have some ability to lower blood glucose, but they primarily promote cell growth.

Now, for someone with cancer, their tumor/s, just like every other normal cell in their body, also have insulin receptors (IR) and insulin-like growth factor receptors (IGFR). It seems that for those with insulin resistance, the IR and IGFR are more sensitive, and the tumor can grow more quickly dependent on what we eat!

If I haven’t bored you to death already, then you may be starting to understand why Justin and I have chosen to be very strict about diet during my cancer treatments. We are eating primarily vegan (no dairy, no eggs, no meat, no poultry), limiting the “bad fats,” and eliminating alcohol and processed sugars. We are far from perfect at this, and I do occasionally sneak a dark chocolate peanut butter cup from Trader Joe’s, but if I am going to kick cancer’s butt, then I need to make my body the most inhospitable place for it to live!

I’ve also been doing intermittent fasting (I fast for 16 hours, then eat all my usual daily calories in the remaining 8 hours) to help regulate my blood sugar and metabolism. I’ll save you and write about the benefits of intermittent fasting in another post!

We’ve been working with a local MD who specializes in nutrition and has recently moved his practice toward working mostly with patients with cancer.
Check him (& his delicious cookbooks) out here: http://www.drshintani.com/

I’ll let you digest this totally fascinating information, but before I do, I just want to mention one more time how important it is to know your own body! Be curious, ask your doctors questions, and if something doesn’t seem right check with your doctor – your life could depend on it!

Thanks for coming to my TED talk!

xo

Mindful Breathing

Mindful Breathing

by bridewitt ♥ 0 Leave a Comment

Happy Aloha Monday!

Photo by Naman Nayar on Pexels.com

Just a quick update today – It was a busy weekend with having my chemo port placed on Friday and my egg retrieval procedure today. Both went as well as possible and I’m so thankful the recovery has been really smooth.

I’ve been finding myself needing to take more “mindful minutes” to myself in the past week since starting chemo next week has me a bit anxious. In this video, I’ll teach you my favorite mindful breathing exercise to stimulate the parasympathetic nervous system when you only have a minute or two during your busy day.

Feel free to add in your own affirmation with each breath or you could even do some EFT tapping as well! Some of my favorite affirmations are:

  • I am grounded & safe.
  • I am loved and cared for deeply.
  • I choose to live with joy and love.
  • I am enough.
  • I can heal my body.

P.S. June 1st means it’s time to do your monthly breast self-exam!! For more info on how and why to do a self-exam, check out my earlier post here. #EarlyDetectionSavesLives

xo