Oh, hey!

Oh, hey!

It’s officially been a minute (or a few months, but who’s counting?)! I had every intention of continuing to write, but in all honesty, I just needed a break from the cancer updates and info sharing.

Recently, Justin and I have been super busy! We were finally able move into our new home a few weeks ago (thanks, mom & Malia!), and then we immediately left on vacation to Montana and Washington, leaving our cute new place a mess with unpacked boxes and mismatched furniture. We are so grateful to have a new space where we can start fresh after navigating so much uncharted territory in 2020. I’m looking forward to lots of memories made here ❤

While traveling, we were able to visit with all of my family, celebrate the 4th of July in Butte, America (there’s no better place to be on the 4th – don’t knock it til you’ve tried it!), catch a few fish on the Big Hole, reconnect with our best buds from PT school, and even witness one of them get married (Congrats, Riki & Anthony!). I was so elated to be able to hug everyone and see all my favorite kiddos. Hawaii is great y’all, but it’s times like this when you realize living on an isolated island in the Pacific isn’t always all it’s cracked up to be! I cried so hard before we came back home because I know I truly have such special relationships with all of you.

Besides our recent adventures, all is well down here. I’ve been working heavy part-time and I’ve realized that I’m now able to help my oncology patients on a much deeper level. I’ve always tried to empathize as much as I could, but the reality is that, unless you’ve gone through cancer yourself, you probably can’t relate. This isn’t to discourage anyone from working with oncology patients, but rather a reminder that what they’re going through is far more than just physical discomfort.

As far as my health goes, I had an ultrasound on my left breast a few weeks ago due to a suspicious spot I found while doing one of my way-too-frequent self-checks. It turned out to be just scar tissue (as expected), but they also found a small cyst-like area above it, and I’ll go for aspiration next week just to be safe “because of my history.” I wonder if it will ever get easier hearing that, but likely not…

I’ve continued to work with my naturopathic doctor to get to the root cause of my autoimmune thyroid dysfunction. I completed a urine test to determine heavy metals toxicity and the results indicated high levels of mercury and platinum and moderately-high levels of lead. Mercury is linked to many environmental sources, but is primarily associated with high levels of dietary fish. The platinum levels are residual from the platinum-based chemotherapy (Carboplatin) that I received over 12 weeks last year, and lead is also find in many environmental sources including water, pipes and paint. So I will treat it with a chelating agent which will strip the metals from their sneaky hiding places in my body….after I eat one last giant poke bowl!

I also completed a food sensitivity test and will get those results back in a few weeks. Again, I am a huge believer in holistic care. If there are things I can do to optimize my health going forward, then it’s worth a shot to me. I still go to acupuncture about once a month and have continued seeing a mental health professional. It truly takes a village to make it through a cancer diagnosis, and you are all part of that team for me!

I’ll try to be more consistent at posting updates and sharing helpful information, but for now, I’m just going to keep focusing on LIVING and finding joy in each day. Sending you all my love!

Aloha ❤

Chemotherapy: Stretches for Health

Chemotherapy: Stretches for Health

Before beginning any exercise program, please check with your physician or physical therapist! Not all exercises or stretches are appropriate for everyone – please read my full medical disclaimer here before trying any of the exercises listed below.

It’s no secret that it can be difficult to stay active during chemotherapy. While exercise has been proven to have many physical and emotional benefits during cancer treatment, some days it’s just difficult to get moving. I’ve designed this short stretching compilation to stretch the spine and major joints of the body to promote mobility and circulation on even the most difficult chemo days. Make these stretches part of your daily routine or use them to loosen up after a nap or before bed!

Watch the video for a full demonstration:

*Note: Video plays at 2x speed! Take your time when you’re stretching!

Child’s Pose

From a kneeling, or seated position, slide the hands forward until you feel a stretch in the shoulders and lower back. Hold for 30-60 seconds as tolerated.

Modifications: For greater stretch of the side body, walk the hands to the left or right.

Cat/Cow

Begin on hands and knees in a neutral spine position with hips stacked over knees and shoulders stacked over the wrists. Inhale and slowly drop the belly to arch the back, lifting the breast bone. The, exhale and round the back from the tailbone to the neck, broadening the space between the shoulder blades. Alternate moving into each position for 5-10 repetitions.

Modifications: Perform in a seated position, reaching forward as you round the back, and allowing the arms to reach behind you as you lift the chest.

Hip Flexor Stretch

In a kneeling position, square your hips and tuck your tailbone until a gentle stretch is felt across the front of the hip. Perform deep breaths. Hold 30-60 seconds as tolerated.

Modifications: Perform in a standing partial lunge position, hold onto something for balance. To increase the depth of the stretch, sidebend the body away from the bottom/back leg.

Hamstring Stretch

In a kneeling or seated position, stretch one leg out in front of you. Square the hips and straighten the knee as you hinge from your hips to deepen the stretch along the back of the leg. Try not to round the lower back to allow for the best stretch. Hold for 30-60 seconds as tolerated.

Modifications: Lie on your back and use a strap/towel to pull a straight leg up toward the ceiling. Flex your foot to deepen the stretch.

Butterfly Stretch

Sit with the soles of your feet touching and knees dropping down toward the floor. Perform deep breaths. Hold for 30-60 seconds as tolerated.

Modifications: Place pillows or yoga blocks under the knees to reduce strain on the hips, lean forward to deepen the stretch.

All stretches are designed to be gentle, but can be progressed if they become too easy. Stretches can be performed 1-3 times per day as needed.

Happy stretching!

Aloha ❤

Breast Surgery: Post-Op Stretches

Breast Surgery: Post-Op Stretches

Before beginning any exercise program, please check with your physician or physical therapist! Not all exercises or stretches are appropriate for everyone – please read my full medical disclaimer here before trying any of the exercises listed below.

After both breast-conserving surgeries and mastectomies, people often find they have difficulty reaching overhead or behind their back, washing or fixing their hair, or feeling tightness throughout the chest wall. The following stretches are helpful to improve range of motion and help you restore your ability to complete your usual daily tasks!

These stretches should be done after a sufficient amount of time has passed post-operatively so all incisions in the breast, chest, or axilla (armpit) have healed. Be sure that any incisions are well-healed before attempting these stretches without guidance from a healthcare professional. Normal soft tissue healing of the skin and underlying tissues takes about 4-6 weeks. Stretching might be uncomfortable as you push into tight areas, but you should not typically experience pain >5/10 while performing stretches.

Watch the video for a full demonstration:

*Note: video plays at 1.5x speed – take your time when you stretch!

Shoulder Stretches

In a kneeling, or seated position, slide the hands forward until you feel a stretch in the shoulder or axilla. Perform gentle repeated stretches (10-15 repetitions) or hold for longer durations (30-60 seconds) as tolerated.

Modifications: For greater stretch of the side body, walk the hands to the left or right.

Cat/Cow

Begin on hands and knees in a neutral spine position with hips stacked over knees and shoulders stacked over the wrists. Inhale and slowly drop the belly to arch the back, lifting the breast bone. The, exhale and round the back from the tailbone to the neck, broadening the space between the shoulder blades. Alternate moving into each position for 5-10 repetitions.

Modifications: Perform in a seated position, reaching forward as you round the back, and allowing the arms to reach behind you as you lift the chest.

Sidebend Stretch

In a seated or standing position, grasp your affected arm with the opposite hand and gently lean away to stretch the shoulder and side body. Breathe deeply into the ribs on the affected side. Hold 30-60 seconds as tolerated.

Modifications: Lie on the unaffected side over a pillow or foam roller and gently stretch the affected arm overhead, limit the range of motion as tolerated.

Pec Stretch

Lie on your back and allow one or both elbows to fall out to the side. For mastectomy patients, perform only one side at a time until cleared by your physician to perform both sides together. Do not allow the back to arch away from the floor or bed. Hold for 30-60 seconds as tolerated.

Modifications: place pillow/s or a yoga block under the elbow to allow tight shoulders/chest walls to relax during the stretch. This stretch can also be performed standing with forearms placed against a doorframe.

Open Book Stretch

Begin lying on the unaffected side with knees bent to 90 degrees to protect the low back. Place the affected arm behind the head and allow the body to rotate and open up the front of the affected shoulder/chest. Breathe in as you open and exhale to return to the starting position. Repeat 5-10 times.

Modifications: Straighten the affected arm for a greater stretch or circle the arm over the head to stretch in various angles.

All stretches are designed to be gentle, but can be progressed if they become too easy or maintained if full range of motion is achieved. Stretches can be performed 1-3 times per day as needed.

Happy stretching!

Aloha ❤

365

365

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

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

YOU ARE NOT YOUR DIAGNOSIS.

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

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

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

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

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

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

Aloha ❤

It’s Going…

It’s Going…

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

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

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

1st post-chemo cut!

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

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

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

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

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

Curious what current TNBC research focus is on?

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


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

Aloha ❤

Heart Health & Breast Cancer

Heart Health & Breast Cancer

❤ February is American Heart Month ❤

Did you know that heart disease is the #1 leading cause of death for Americans and that 1 in 4 Americans will die of heart disease each year?

Did you also know that women who’ve had certain types of cancer treatments are at a greater risk for heart disease as well? As treatments for breast cancer have advanced, more breast cancer survivors are living with these long-term consequences of treatments. Some treatments known to have adverse effects on the heart include:

  • Chemotherapeutic agents:
    • Anthracyclines (doxorubicin, epirubicin…a.k.a. “red devil”)
    • Anti-HER2 Agents (herceptin, perjeta)
  • Hormonal therapies (tamoxifen, anastrozole, letrozole)
  • Radiation to the breast/chest wall

For all of the treatments listed above, risk of cardiovascular disease including coronary artery disease and cardiomyopathies (dysfunction of the heart muscle) is elevated. Evidence of cardiotoxicity can show up several months to several years after these treatments are administered. So what does the research say about prevention or reversal of these cardiac side effects?

Prevention of Cardiotoxicity during Cancer Treatments

Firstly, anyone starting any of the above-listed treatments should undergo a baseline cardiac function screening such as an EKG and electrocardiogram to allow for close monitoring of the heart once treatment is administered or completed. Doctors will specifically watch the left ventricle ejection fraction which is an indicator of how well the heart can pump blood to the body.

The benefits of eating a healthy diet full of fruits, vegetables, and whole grains and maintaining a consistent exercise routine during treatment also apply to cancer patients (we’ll discuss this more in a minute). Avoidance of smoking and drinking alcohol is also very important.

From a medical standpoint, oncologists can specify the dosage, timing, and frequency of chemotherapy treatments to minimize their effects on the heart. In some instances, they can prescribe a cardioprotective medication such as a beta-blocker or ACE inhibitor to reduce strain on the heart during chemotherapy, especially if a patient is symptomatic.

Some symptoms that may indicate heart concerns include:

  • shortness of breath
  • swelling in the feet or lower legs
  • rapid or irregular heart beat
  • pain or swelling in the abdomen
  • mental confusion

During radiation, the heart is most at risk if the left side is being treated. Radiation oncologists can have a person use a deep breath hold to minimize the risk of radiation to the heart. They use the radiation simulation to plan the most effective delivery of radiation and ever-advancing treatment techniques to reduce the dose of radiation to the heart.

As you can see, there are many ways to be proactive about heart health during cancer treatment. Patient should never feel as though it’s inevitable to come out on the other side of treatment with heart problems!

Management of Treatment-Related Cardiotoxicity

Should a person develop cardiac issues during cancer treatments, there are more and more evidence-based guidelines emerging for how to improve cardiac function and prevent long-term health consequences. In many cases, treatment-related heart conditions are reversible!

Just like any other muscle in the body, the heart needs to be challenged to get stronger. During cancer treatments, people tend to lose about 27% of their exercise capacity. This means that, as a survivor, it’s time to get in shape.

Ideally, patients and survivors are recommended to get 150 minutes of moderate aerobic exercise per week – that’s about 30 minutes, five days per week. Walking is a great place to start, but patients should choose their favorite type of exercise! Aerobic exercise like running, biking, swimming, or high-intensity interval training (HIIT) are very effective ways to promote healthy heart function. Those who consistently get 150 minutes per week are also shown to reduce their risk of mortality by up to 60% – perks!

From a physical therapy perspective, supervised exercise is best for a few reasons. A knowledgeable physical therapist or exercise physiologist can help prescribe exercise according to guidelines related to the phase of treatment someone is in. Someone in active treatment should not be exercising at the same intensity as a survivor who is 6-12 months out of treatment. Just like recovery from an injury, exercise progression should be progressive and individualized!

Cardiotoxicity is a serious side effect of cancer treatments and should not be overlooked. There are many options for prevention and management of heart conditions that arise for cancer patients and survivors. To find a physical therapist or exercise physiologist who is experienced working with oncology patients, ask your physician for a referral to a trusted provider in your area or use the APTA Find a PT locator!

Sending love to you!

Aloha ❤

To read more, check out these articles:
1. Cardiotoxicity of Contemporary Breast Cancer Treatments (Chuy, et al.)
2. Prevention and Treatment of Chemotherapy-Induced Cardiotoxicity (Avila, et al.)

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 ❤

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! ❤