I completed my year of treatment and came out the other side better than before.  I continue to survive and thrive through my breast cancer journey. I thought I would reflect on the things I have learned to date.  For those starting their journey or have a friend or family member starting I hope you find this helpful. 

No one really properly described to me in layman’s terms what was happening inside my body.  What I came to understand is that we all have good and bad cells in our body.  When the body’s immune system is compromised enough and for enough time, the bad cells have a chance to overtake the good cells and eventually tumors form and move throughout the body.  To change this not only do the bad cells need to be killed off, but the terrain in which the cells live needs to be altered for the good cells to take over again (Lifestyle Changes).  The purpose of Chemotherapy and radiation is to kill off the bad cells.  The problem is these treatments will also kill off the good cells.  When this happens those things in your body that are weak are exploited and this is often when the side effects happen. 
For example:

•  I learned that 80-90% of people that get chemo will encounter skin problems.  I wish I had known this and started a routine of multiple times daily moisturizing my skin before Chemo started.  I might have minimized or eliminated the rash I developed on my arm.  The danger of the rash (open skin) is the risk of infection that your body is not able to fight off due to the chemo. 
• All of my life I always experience cold hands and feet.  One of the known side effects of my chemo was Neuropathy.  Because I did not know to supplement with B6 and B12 which impacts nerves, I started it too late to possibly prevent the side effect.  Instead I played catch up and I am still dealing with some small issues.  I am hopeful that in another 6 months it will have gone away. 

My purpose for sharing my examples is to demonstrate there are ways to prepare yourself and make the journey a bit easier.  The medical professionals do not share unless you ask.  So, you and whomever your advocate is needs to be prepared with specific questions.  Do your research.  My oncologist never suggested the B6 and B12 but did not have a problem with me taking it.  I would highly recommend asking the following questions:

1. What Chemo will I be getting and what is the list of most common side effects? 
2. What are the specific nutrients in my body that will be depleted by the chemo I will be receiving?  (i.e. Vitamin D, Vitamin A, K, C…?)
3. Is there an Integrative Oncologist that they work with as a team that I can discuss what non-chemical ways to prepare and help my body get through the treatments more easily and comfortably, supplements and alternative therapies.  (See the One thing I Wished I Had Done Differently below)

The things I did that helped me get through chemo and never have a day I could not function.  My experience will be different than yours, but I am sure some of these tricks will assist you as well. 

Mental State
The first few weeks after diagnosis were chaos and fear.  I quickly realized I needed to find a way to channel those emotions and stay positive.  Although I felt like my life was being taken away from me, I decided to find a way to live day to day, find something to enjoy and laugh at because laughter really is the best medicine. 

I was so humbled by the many people that came out of the woodwork and wanted to help but trying to talk to all of them was exhausting.  I decided to form a team and identify someone as the point person.  I started a blog that I would post to keep everyone up to date on what was happening.  This helped so if I was talking to someone the discussion was not all about the disease but could be about real life.  I also opened a Signupgenius account.  This enabled me to post to the team of people what it was I needed, and people could self-select based on their own lives and I did not have to feel like I was begging. 

Do not be shy about asking.  I learned people really do want to help and feel good when they do.  So as uncomfortable as it is to ask, your friends and family really do want to be there for you.  Be creative about what you need.  So maybe you host movie nights, but part of the gig is people bring the popcorn and must clean up afterwards too.  If you need shopping done, you can ask weekly for someone to take your list with them when they go for themselves.  But think about what you really need; assistance with tasks, social company, motivator, or compassionate listener. 
 
Drink Water
The rule of thumb now is everyone should be drinking half their body weight in fluid oz.  That meant I normally should be drinking 64oz of water a day.  While on Chemo I was drinking 80 – 120 oz of water and still felt thirsty.  It helped to remove the toxins in my body after treatments and helped to relieve any nausea I was experiencing.  I think it also helped me to keep moving. 

Exercise
I would encourage you to find some type of movement that you can work up to and sustain.  You will know what the point is that it flips from dragging your butt to energizing you, for me it was 1 hour. 

I know how tired and crappy you will feel on any given day.  But find a way to do up to at least 1 hour of constant movement.  The movement gets the lymphatic system working which again helps to remove the toxins in your body. 

I started walking every morning with a neighbor.  I got up to 3 miles an hour.  Since I had company it was easier to ignore how I felt and just walk through the rough points.  By the time I got home I felt much better, and I would feel better the rest of the day.  The days I did not walk or waited later in the day I would feel like crap and the fatigue would take over.  Even now I can feel a difference when I do not walk.  When I cannot walk outside, I walk on a treadmill with a TV or book to distract me. 

Food
Start thinking of food as medicine.  As soon as I did this, I was able to prepare my body to withstand the chemo better.  What your body will do when it is hit with the Chemo is fight back.  It fights back by creating inflammation in your body.  If you are also eating food that create inflammation or do not help reduce it, you will not feel good.  Unfortunately, many of the medical professionals only focus on making sure you have proteins = meats, chicken, because it is an efficient protein source meaning you get all types of proteins in one serving on your plate.  Instead, they should be concerned with all types of nutrients that your body is being depleted as well as the protein. 

In my research I found the book “The China Study; Second Edition” This book addressed nutrition research from the 1970’s forward and addressed many of our diseases and what they learned about preventing those same diseases. 

I chose to move to a plant-based diet and kept wild caught fish and organic eggs.  I refer to this as a modified Vegan and modified Mediterranean diet.  I eliminated the food that cause inflammation; meat, chicken, dairy, sugar, and because my cancer is estrogen driven, I kept Soy out as well.  I also started eating mainly organic foods to again take toxins out of my world.  It required a new way of thinking and eating, but I felt so much better.  I never worried about how much I was eating, if I was hungry, I ate and still do. 

You may experience times when you just cannot eat.  I found that drinking my nutrients helped.  Making your own smoothies or overnight oats will help.  Do not go out and buy smoothies, they will have too much sugar.  If you cannot change your diet then I would recommend sticking to organic chicken, fish, organic vegetable, organic fruit, whole grains, beans, nuts and seeds.  Eliminate sugar that are not natural you will physically feel better.  Sugars that are ok would be those that also incorporate fiber (i.e. Dates, whole fruits, maple syrup, molasses).  A high-powered blender and food processor will become your friend in the kitchen. 

Acupuncture
One of the alternative therapies I tried was acupuncture.  OMG!  Did it work.  I started acupuncture the second week of chemo (I had 12 weekly infusions).  I had worse nausea week 3 than I did week 10.  I would always feel wonderful for a few days after a session.  If you can afford it, it will really help you get through the treatments.  
 
Things to Expect
Your stamina will diminish -   I did not feel a draggy fatigue feeling as much as my days got shorter.  I would get up in the morning do my morning rituals, eat breakfast, walk, then try to meet with friends, do a project, or something else, but by the time 7pm rolled around I was up getting ready for bed and asleep by 8 – 8:30pm. 

Your motivation will disappear – By my week 10 everything I wanted to do felt like way too much work.  I had a hard time getting myself to do anything that was not part of my daily routine; various body routines, breakfast, walk, lunch, often times walk again in the afternoon, dinner then bed. 

Your focus and memory will be impaired – When I switch tasks instead of it taking the normal 15 – 20 minutes to return to the first task it is taking days.  I am told this is normal with chemo.  I also had memory problems, but a year to two years out memory has improved.  Chemo Brain really is a thing.  I am told your brain does recover after chemo is done.  I always carry a tablet or notebook to write things down.  This way I can refresh my memory and recall things.  It is getting better. 

The One thing I Wished I Had Done Differently
Last summer I found a book that I want to recommend to you; “The Cancer Revolutions” by Dr. Erin Connealey.  She is an Integrative Oncologist in Irvine CA.  The book provides the road map for the “Lifestyle Changes” all the doctors speak of and recommend but say no more about or really address.  I found that a lot of the things I did, and changes put me halfway down the road already.  If I had had this book, I would not have had to recreate the wheel. The Cancer Revolution book and another one I found called The Cancer Secret (more technical about cancer disease) prompted me to search out an integrative oncologist to work with as well. 

I will warn you there is a lot of politics between these two types of medical doctors.  But I pushed through anyway.  My attitude was that the Oncologist was doing his part to kill off the cancer cells and remove tumors, it was my job to change the terrain of my body, so it was inhospitable to the bad cells.  I needed information about what was happening in my body to do this in a strategic and targeted way.  Hence the Integrative doctor. 

Once I went to the integrative doctor, I learned that my gut health needed repair.  He put me on a Pre and Pro biotic.  I am learning there is much research out there pointing to the fact that Cancer is a form of autoimmune disease and autoimmune diseases might start with gut health.  Fascinating! 

Reach out early to an Integrative Medical team.  It could make the difference in how comfortable you are, and longevity.  The medical doctors base everything on statistics, so they cannot tell you really what will happen to you. 
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Keep the Faith and stay positive. 

I skipped a week keeping everyone up to date.  I know that many of you have been reaching out to find out if I am ok.  All is well, it was just a bit challenging trying to manage all the symptoms that are starting to accumulate.  And since I was not sure what the out come in week 7 would be, I just sort of skipped it to try to have more to tell you. 


I should have known that one of the most challenging symptoms would be dry scaly skin, no one mentioned it to me, and it was not top of mind with everything else going on.  I have a rash on my arms that has developed slowly over the last few weeks.  Of course, week 7 & 8 were the weeks that it decided to become somewhat inflamed.  In addition, my hands have severe eczema and my face is so dry and scaly that no lotion works.  An hour after I apply the lotion it feels like nothing happened.  The area around my eyes felt like I had scratched it they were so irritated.  Thanks to me PEO sisters, the face wash and cream they found was able to do the trick.  After applying three times a day for a few days, I was able to fix my face for the time being.  And my oncologist recommended using a cortisone cream for my arms to repair and reduce the inflammation on my arms.  All of this took a few days to a week to get under control. 


Tip for anyone reading this:  If you know of someone starting Chemo of any kind, 80 – 90% of chemo patients have skin issues.  Lotions do not work.  You need to find a good cream meant for chemo and radiation.  I also recommend you start using it as soon as you start treatments.  This will help prevent/minimize some of the challenges most patients experience. 


The most concerning of symptoms was the neuropathy did not reduce or stabilize with the lower dose of Taxol in week 7.  During the week after treatment I started experiencing a spread of the numbness to the pads of my fingers as well as pain in my arms and hands.  One of the nights I also experienced pains in my legs and tingling/numbness in my feet over night.  After discussion with my oncologist we decided to complete the 8th week of treatment, then assess the best course of action.  So right now, I am watching and waiting to see what happens this week.  So far I have only had numbness in my finger tips the first few days after treatment.  Then today I have experienced an advancement of the neuropathy to my finger pads.  I have not had any continuation of pain or numbness in my legs or feet.  Right now, we are on a wait and see if I continue with Taxol and Herceptin for the remaining 4 weeks or however long I can go, or switch to Herceptin only. 


I also managed to catch a cold this week.  The morning after treatment I woke up with a scratchy throat and very stuffed nose.  I was hopeful that I just needed water to lubricate my throat and blow my nose a lot because it was due to allergies.  Not so.  The runny nose and sore throat lingered for a few days and by the end of the week was on the downhill side.  But it has been a wake-up call about how the build up of chemo is compromising my system.  I made the very hard decision to not attend an event due to the numbers of people that would be attending.  I am a people person, so that is hardest part of this experience.    


But do not be sad for me, I am filling my time with reading, movies, cooking and exercising.   I have lost 30 pounds since beginning of January.  During chemo treatments so far, I have leveled off due to the drugs in my system, but I really feel good.  Going to a mainly plant based diet made all the difference.  And I have to say, I do not have cravings, I am fully satisfied after every meal.  I do not have an urge to snack during the day unless my funky stomach comes back, and I need to make sure it has something in it.  Thanks to acupuncture, I have not had a seriously nauseated stomach since week three.   For those interested in learning more about the plant-based diet and why I chose to go this route search out the book, “China Study; edition two.”
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Speaking of food my first week of the CSA Lancaster Farm Fresh delivery will be Tuesday.  There will be way too much food for me, so look out for an invitation to a dinner at my house where we will have the pleasure of learning how to cook in a plant-based diet world by a local vegan/vegetarian chef.  I am determined that my friends and family will not have to take this route to getting healthy and avoiding any form of cancer. 

Woo Hoo!  Half way done with the most difficult of the stages of treatment. 


After the last post, I did experience a bad nausea day on Monday.  It was also the day of the week with the barometric pressure going crazy.  Clearly, I am very sensitive to changes in my environment now.   Week 6 chemo day was again uneventful.  Had acupuncture on Thursday.  I personally swear by acupuncture.  It is really working for me.  If I keep a strict schedule my nausea seems to be minimal to nothing.  But if I do not walk first thing in the morning, or eat at prescribed times of the day, or get to bed around 9 – 10pm, my body screams at me in not very nice ways.    It is frustrating because I have always had a very active life that had me running everywhere and doing things at night.  This is forcing me to take a step back and learn to say no to things. I guess not a bad thing, but very frustrating. 


This week my oncologist also addressed my oncoming neuropathy by reducing the Taxol dosage by 10mg and extending the infusion time in the hopes that we can hold back the neuropathy in my fingers and it does not become permanent.  I am trying to not borrow trouble, but I am also trying to come to grips mentally with the possibility that I may have trouble playing the violin and piano in the future. 


This week also brought about a huge change.  One of my walking buddies came by on Thursday morning and had to break the news that my hair looked like a bad comb over.  It was time to decide how to deal with the emotional impact of losing my hair.    Up until now, chemo days were just another appointment on the calendar.  Since I have been feeling so well, I could forget about the cancer for huge portions of my week.  But the loss of the hair is a constant reminder every time I look in the mirror.  So, like most things I needed to act rather than let life take me.  Two of my lions went with me to my hair dresser to record the event.  I shaved it all off! 
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I was nervous about what my head shape would look like, and if I could handle the look.  I decided I like it.  It is freeing; great on warm days, and no more good and bad hair days.  I have become the Warrior Jewish American Princess. 

Another week down and again the infusion day was uneventful.  The fun happens in the days ahead.  But surprise, as of today (Friday) this week has been one of the easiest.  I guess I should not count my chickens before they hatch.  I still have the weekend days to get through.  But so far this week the nausea was been almost nonexistent.  I am still keeping to a strict schedule and drinking lots of fluid and walking every day which is supposed to help with all symptoms.  I suspect the weekly acupuncture is making a huge difference. 


The neuropathy I experienced last week also went down to a dull undertone that just felt like it was going to rear its head if something changed.  One of the things I did was read up on the Dana Farber Cancer Center site.  The articles indicated that vitamins B6 & B12 could potentially help to alleviate the risk, although not scientifically conclusive.  While reading I also learned that those that do a plant based diet often can have trouble getting enough B12.  This week after clearing with my oncologist, I added to my vitamin intake with B6 & B12.  Between the acupuncture and vitamins, I might have changed the advancing neuropathy.  Time will tell. 


My hair is still shedding and getting really thin.  So far people are telling me I do not have bald patches, but I am not sure if they are just trying to be nice.  I cannot see the back of my head.  I am holding on so far, but if bald patches start appearing, I will probably have my head shaved.  I have found some wonderful hats, and I have the retro scarves from my great aunt.  As my cousin reminded me, wearing the scarves will be like getting a hug from my aunt. 
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This weekend I get to hang out with some wonderful friends form High School days.  I am really looking forward to catching up with everyone.  Here is hoping that the nausea does not rear its ugly head, so I can enjoy our time together.  One more week and I am half way done.   Staying focus and marching forward.