Tag: radiation

Breastfeeding after Breast Cancer

Breastfeeding after Breast Cancer

by bridewitt ♥ 5 Comments

Today wraps up World Breastfeeding Week. I’ve been promising myself I’d write this blog post for over seven months now after our sweet son, Jordi, was born December 10 (the day after my own birthday)! I’ve been so grateful to be all wrapped up in motherhood. There are so few events in life where everything really does change in an instant, and becoming a parent is the most incredible thing I’ve ever experienced.

I want to share my experience with breastfeeding here because there aren’t a lot of stories out there detailing exactly what it might be like to breastfeed primarily from one breast after a lumpectomy/radiation or unilateral mastectomy. I’ve got a lot to say so if this info doesn’t apply to you, feel free to check out now! I want to tell my own personal experience and share some of the resources I used to be as successful as possible.

I’m sharing my story with the caveat that I chose to persist through a LOT of challenges, and it’s absolutely acceptable if these options are too stressful, time-consuming, frustrating (you name the emotion of choice…) for you. Breastfeeding challenges can be extremely taxing from a mental health perspective and the immediate postpartum period is already hard enough. Your return-to-work options may not allow you an appropriate amount of time for your milk supply to stabilize. Whatever your unique situation is and whatever decision you make in regards to breastfeeding, just know that you are NOT a failure and you are NOT failing your baby if you choose to exclusively formula feed. Thank goodness we live in a world with options that allow our babies to thrive!

With that said, here are a few things we’ve tried to facilitate our breastfeeding journey:

Triple Feeding.

We were lucky enough to see a lactation consultant while we were still in the hospital who set us up with a breast pump and referred us to an outpatient lactation consultant right away. Because my supply was very slow to come in, Jordi actually had some low blood sugars in the hospital and we needed to supplement with formula right off the bat. Lactation recommended triple feeding as a way to mimic cluster feeding and thus increase milk supply. This entails:
1) Breastfeeding at a regular interval
2) Supplementing with pumped breast milk or formula (or we used donor milk from a very dear friend who was so generous to stock our freezer) at each feeding
3) Pumping for an additional 15-30 minutes
We were doing this EVERY 2 HOURS, y’all. This is crazy. But it worked and my supply came in and we were able to almost meet baby’s needs. At a certain point my supply stabilized and we were able to transition away from triple feeding after about 7-8 weeks. It took a minute and continued frequent feedings and nighttime waking to get to a place where I was exclusively breastfeeding from my unaffected breast at a normal interval.

*Side note: This would also be a good time to mention that my affected breast (lumpectomy + radiation) produced maybe 5 mL maximum, so it really wasn’t a reliable source of nutrition. I did and still choose to pump and stimulate that side to prevent clogs in the performing ducts.

Nutrition & Supplementation.

I was recommended to take a sunflower lecithin supplement to promote milk flow and a supplement containing goat’s rue to support milk production. I used supplements from Legendairy Milk and they’ve been great! You can also eat oats or make lactation bites like these with brewer’s yeast that can help with supply. I also splurged on some of these Kaimade lactation cookies which are delicious, easy to make, and a local Kauai-based company.

Getting adequate hydration is also a must and besides plain, old H2O, it can be helpful to add electrolytes or drink bone broth.

*Disclaimer: This is not medical advice! Be sure to check with your doctor before starting any new supplements.

Breast Massage.

Our lactation consultant’s office also offers professional breast massage to support milk flow. I have found this extremely helpful as Jordi initially had a lot of difficulty latching well due to a tongue and lip tie (more on this in a minute). The breast massage is meant to stretch the milk ducts, promote milk flow, and allow baby to access milk deeper in the breast. I actually feel like this was the most helpful of all of the many hoops I’ve jumped through to support our breastfeeding journey. I have no clue how accessible this is in other cities, but I know that, in some places, physical therapists offer these services. I imagine a Google search may help you find someone in your area who can help! In general, breast massage can be helpful for anyone dealing with clogs or mastitis as well.

Oral Tie Release.

As a PT, conservative management of any condition is my jam. I am not one to jump into a surgery or procedure unnecessarily. It was known to us from birth that Jordi had a tongue tie and upper lip tie, but we hoped we could manage without a release. At some point, we realized that even after Jordi ate (a good amount based on his weighted feedings) I could still pump up to one ounce of milk – he wasn’t getting it all! So we decided to do a tongue and lip tie release which is a very quick procedure (maybe less than 15 minutes) done using laser with a pediatric dentist. We did tongue and lip stretches for weeks after the procedure (which is the hardest part), but this made breastfeeding even more successful! Jordi wasn’t taking 20-30 minutes to eat or falling asleep while eating anymore and needed to eat less frequently. I’m so thankful we ended up treating this because it really helped him!

With all that said, this has not been an easy time. I’ve cried a lot, sacrificed time with friends and family to pump, and spent a lot of time and energy on making it all work. In late June, I got sick and my milk production dipped significantly and it still hasn’t fully returned. While this is super disappointing, I’m staying grateful that I’ve been able to breastfeed at all. Some of the best advice I’ve received is to strive for longevity, not exclusivity, and it helps me stay grounded. I don’t take a single ounce of breast milk I’ve been able to produce for granted as I know that not everyone gets to experience with their babes, especially after breast cancer.

With having worked so hard to get where we are, I hope I’ll be able to continue combo feeding through Jordi’s first birthday (HOW is it only 4 months away??). The benefits of continued breastfeeding last as long as baby continues to breastfeed and the nutrition of mother’s milk is constantly changing to meet baby’s needs. How incredible is it to literally sustain a tiny life in this way!

I’m sure there’s more to our story, but for now I’ll wrap up and just say thank you… to my husband for his unwavering patience and support, to my family and friends who continue to stand by me in motherhood just as much as they did in cancer-land and survivorship, and to the littlest love of my life, Jordi, for giving me the best gift of being his mama.

Sending all the Aloha,
❤ B

Radiation & Reflections

Radiation & Reflections

by bridewitt ♥ 0 Leave a Comment

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 ❤

Rad.

Rad.

by bridewitt ♥ 4 Comments

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

by bridewitt ♥ 1 Comment

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 ❤