Saturday, April 22, 2017

20 Days of Radiation

Back in December I was diagnosed with DCIS non-invasive breast cancer.  I blogged about the first portion of my diagnosis & treatment HERE.

The last phase of treatment is radiation.  I met with the radiation oncologist the same week I met with the medical oncologist.  I wasn't nearly as resistant to radiation therapy as I was the hormone therapy.  I met with the radiation oncologist on Thursday, March 16th.  Dr. Hayne, although nice, wasn't as open to discussion to radiation as an option like Dr. Ari was. Of course I could have declined treatment but it wasn't like the discussion Dr Ari & I had. It was more to the point, how many days, what to expect, what you can & can't do, etc and I was OK with that. When you look at the DCIS trial data below radiation therapy seems to be the big hammer when it comes to reoccurrence.  
B24 Trials
My treatment plan was 15 days of radiation plus an extra 5 days to the tumor bed. This was due to the inferior margin.  I was scheduled to come back the following Monday (March 20th) to get scanned so the planner can create the radiation profiles. They also marked me with body paint & stickers. On March 22nd, I went back for a dry run of sorts so the techs can make sure the profiles were accurate so we would be ready to start for real the following day.

Day 1 of radiation was on Thursday March 23rd.  I picked the end of the day since it worked better with my work schedule.  Plus afterwards I could just go home & rest which would be needed about 2 weeks into treatment. Below is the table & equipment.  Every Tuesday was a quick visit with the nurse & doctor to make sure all was OK.  Every 5 days the techs took an x-ray while on the table to make sure the position was still good.  The treatment takes about 5 minutes total of which about 1 minute is of actual radiation. Most of the time is spent aligning you on the table using the body markings.  Treatment is daily, Monday through Friday, for 20 days. 

Radiation Table
Day 1 Post Treatment Arbo Walk with Steve
I was told the main side affects would be fatigue & possible sun burn on the treated area.  It seemed crazy that only a minute of zapping would cause fatigue but about 10 days in I really started feeling it.  Especially as the week went on.

Quarter Horse Relay Marathon - 3 days after I started radiation
Another issue I had was a really tight, painful upper back.  I think it was partially from the surgery & partially from the treatment.  It was so sore that ibuprofen wouldn't touch it. When I got home after my last treatment of the second week I massaged some Tiger Balm into my upper back.  That actually took the edge off.  I used it all weekend & by Monday it was feeling much better. Unfortunately after Monday's treatment it was sore again. I didn't use the Tiger Balm on Monday since I didn't want it to interfere with the treatment.  On Tuesday I saw the doctor & explained what was going on.  She didn't have an issue using the Tiger Balm on my back but didn't want me using it on my armpit since that was part of the treatment area.  Apparently I wasn't the first patient that day to complain about a sore back. They discussed looking at the table ergonomics the next day to see if adjustments could be made.

One nice benefit is the massages at the Wellness Center next to the radiation treatment.  I had a massage scheduled for Wednesday after my 5th treatment.  Since they are in the hospital they are trained to work with cancer patients.  The prior weekend the masseuse had gone to a craniosacral training seminar.  It was unlike any 'massage' I have ever had.  It was amazing! My back felt so much better after I left and it never got really bad again after this session.

Around Day 7 you could start the notice the redness on the treatment site. The area was swollen & tender.  The doctor said this would be expected until after the treatment is over.

Baptist Health - Lexington, KY
About 10 days in I started to feel the fatigue.  It wasn't awful but it would hit me suddenly. I would take a 30 minute nap & feel OK after that.  As the treatments went on the fatigue got progressively worse.  Never so bad I couldn't get up but definitely more tired than normal.  Also, as the week went on the likelihood of needing a nap increased.

The first 15 days was treating the full breast, the final 5 days was called a tumor boost.  The radiation was focused at the tumor site.  On day 15 after my treatment they set me up for the last 5 days.  There was an attachment that was used & the angle was different.  The setup took about 15- 20 minutes but each actual treatment is only about 30 seconds.  Getting me lined up on the bed took more time than the actual treatment.

Tumor Boost
After day 16 & 19 treatment I got another massage.  Since the last session went so well we agreed to do the same treatment again for both sessions.  It was the correct call.  My upper back is feeling normal again after these sessions.  It is really amazing. It is the most relaxing massage I have ever had & I leave feeling so much better.  My upper back is no longer in any pain.  Yay!

My friend Ruth joined me for my last treatment.  She was also there for my first dry run day.  We followed up the last treatment with a walk around the Arboretum.

After my last treatment

Yes, they gave me a radiation diploma :-)

Post treatment & walk celebration beer!
Overall, the 20 sessions were not bad.  I do have some general soreness, fatigue & itchy skin but that will pass.  I am really grateful that the cancer was caught early & chemotherapy was not needed.

What's next?  

I have a follow up in 3 weeks with the radiation doctor then I go into monitoring stage.  My next screening MRI is in late summer.  Hopefully I can avoid the embarrassing passing out episode from my first MRI.

We head to Washington state for an overdue vacation in May.  Lots of hiking & exploring to be done!

I signed up for the LIVESTRONG program at our local Y to jumpstart the rebuilding process. It starts the first of June & goes for 12 weeks.

I am hoping I can build up enough endurance to bike the GAP trail this summer.

Cancer, even a stage 0, puts things in perspective. Life is short. Choose to be happy. Plan the vacation. Call that friend. Tell someone you love them. Don't dwell on the past. Plan for the future but live in the present.

Lastly, I am so appreciative of all the love & support I was given during this process. Thank you, thank you, thank you. You never know what someone is going through so sending them love, prayers & positive energy goes a long way, even when they seem to be AOK on the outside.

Love & peace to you all!

'Pink tulips for your last week of treatment - Jennifer'






Saturday, April 8, 2017

Two Week Food Intolerance Test

I don't remember how I came across this website, I suspect it was on Facebook but it intrigued me.  I had packed on an extra 5 pounds this past winter, was feeling really blah & oh, had this little cancer diagnosis I was still processing.  I needed something to kick start my metabolism & originally planned to start the Sunday after the Quarter Horse.  I decided to pull it in a few weeks for a couple of reasons.  One was I already dialing the intensity down thanks to my lumpectomy & two, I wanted to be off the sugar & carbs prior to starting radiation.

I started the two week test on Sunday March 5th.  The test seemed really straight forward.  The Yes food list was short.  Lots of veggies, high quality meats & full fat dairy.  I estimated the hardest thing for me was going to be giving up the sugar in my coffee & all the fruits for two weeks.  I knew I could reintroduce fruits after two weeks but the daily sugar is gone forever.

I was already pretty good with Sunday meal prep so that didn't change too much.  I added a lot more meat to my meals - bacon, beef, pork, chicken.  Before I started the test I created a two week meal plan & grocery list. This helped significantly with the food prep & meals especially during the week when time is short.

Breakfast consisted of some kind of egg dish.  I started fancy with frittatas & souffles but  after a few days ended up eating an omelette every day.  Initially it was really hard for me to eat so much food shortly after waking up.  Before the test I was drinking a green smoothie loaded with fruit on the way to work. I figured out if I brought the omelette to work & ate it when I arrived it was much easier. My daily omelette consisted of 2 eggs, a splash of heavy cream, spinach, sautéed onions, peppers, bacon & cheese.  I drank coffee with heavy cream but no sugar.

Omelete
Lunch was either a cabbage or spinach salad.  I would add carrots, sweet peppers, feta and/or blue cheese, toasted almond slivers & some form of meat - bacon/chicken/tuna.  The salad dressing was homemade - olive oil, balsamic, salt & pepper.

Cabbage Salad

Spinach Salad
Dinner was various meat - pork, chicken, fish, beef & veggies.  My favorite was an alfredo recipe that I altered to use 'yes' foods. I used heavy cream in place of the half & half & creme fraiche instead of the cream cheese.  I used my spiralizer for the zuchinni noodles.  I think I could eat this every day - it's that good.

For snacks I ate almonds, macadamia or pistachio nuts and string cheese.  I didn't keep track of calories at all.  I just ate to my hunger level.  The first few days I was really missing fruits.  I felt sluggish for the better part of the first week.  Day 5 & 6 I had a wicked headache.  By the second week I was not craving any foods & had high energy levels.  My legs still felt dead which was really noticeable climbing the 2 flights of stairs at work.

I took before measurements & weight and re-took them at week 1 & 2.  In two weeks I lost 6.2 pounds & just over 7 inches.

Here are the notes I took right after the 2 week test ended:

Pros:

- No cravings. Not stress eating or feeling peckish. This was a huge problem for me.
- Sleeping better, not waking up groggy. Another problem area.
- Garmin says I am getting over 1 hour more of deep sleep every night
- If I wake up in middle of night I fall back asleep right away. Prior to test I would toss & turn most of the night.
- Lost 6.2 pounds --> haven't been below 140 in at least 2 years.
- Lost a total of 7.25 inches across belly, hips & thighs

Cons:

- Legs are dead on long runs. Even when changing intervals to 4 min walk / 1 min run. Legs really feel dead around 6 miles. Although, this test is supposed to occur in the off-season so long runs/races won't yield good results.
- Yesterday's 10 miler was a 4.8 of 5 effort. Even though I only ran 20% of the time.
- Weird taste in mouth. Ketones? Not sure what that this but read in the Q&A this may be the cause. This does make me brush my teeth more frequently so my dentist will be pleased.

Other Items of Note:

- If you are not used to food prep this will be a LOT of work. Also, our grocery bill went up but for me, my eating out bill went to virtually zero.
- Withdrawals will be dependent on how you are eating before the test. I ate veggies every day & limited my bread intake so it wasn't awful. I did have some nasty headaches on days 5&6 & I really missed fruit. I was also eating at least 5 servings of fruit everyday.

The past few weeks has been spent re-introducing 1 food serving per day. The order goes like this:

1Legumes
2Low-glycemic fruits (berries, grapefruit, prunes)
3Medium-glycemic fruits (apple, orange, pear, strawberries)
4Gluten-free grains (whole oats, brown rice)
5Grains with gluten, if not intolerant
61 teaspoon of organic honey with coffee or tea (excluding agave, or any other kind of sugary substance)

So far, fruits are OK but beans & sprouted bread is not.  A few hours after eating them my belly will feel bloated & I confirm this by my waist measurement.  Both cases my belly measurement was 2 inches greater.  Most days I notice a 1/4 to 1/2 inch difference between AM & PM measurements.  For the first week I was taking my belly measurement every morning & evening to see how the daily food affected me.  Now I am not so religious.  I am only measuring if I think something had a negative affect.  I can see how some folks could get obsessive over this.  That certainly wasn't my intent.

I am back drinking my green smoothie most mornings with modifications. Now my smoothie contains coconut cream or milk, spinach, carrots, a scoop of almond butter & 1 serving of fruit - either banana, blueberries or strawberries.

Green Smoothie Before

Green Smoothie After
My current favorite post test recipe is banana muffins.  Coconut flour is my new best friend.  These are surprisingly good.  The recipe makes a dozen & can be frozen.  These have been my mid afternoon snack.

Coconut Banana Muffins
I also made slow cooked steel cut oatmeal.  I used to make this recipe all the time.  The only modification I made was omit the brown sugar.

Slow Cooked Steel Cut Oatmeal
It's been 5 weeks now since I started the test.  I am down a net 5 pounds & my measurements are down 11.25 inches. Note that I actually gained back a pound but continued to lose inches over the following 3 weeks when compared to the post 2 week measurements. Personally, I really liked the test.  My husband on the other hand has not.  He isn't a fan of eating salads everyday. He also had terrible sugar/carb withdrawals, much worse than I had.  Now that he is re-introducing foods he is more aware of how foods affect him.  I think we are both glad we did the test but we certainly had vastly different experiences.   

Fitness wise, I still have the intensity dialed down due the cancer treatment. I am planning to do the MAF 180 test next since I already backed down my running to walking.  The timing for me to do these tests have been good.  This is something I have wanted to do for a long time but never had the proper motivation.  That is one good thing about this cancer diagnosis!  I am not sure I would have been motivated to do the 2 week test otherwise.

Happy, healthy eating everyone...


Sunday, April 2, 2017

Nevertheless We Persist

Back in January Ruth, Audrey & I volunteered for the Urban Mountain Challenge which earned us a free entry to a future RaceRise event.  We picked a new spring race, The Quarter Horse Marathon Relay and recruited our running buddy Mary to be our 4th runner.

About our team name - Nevertheless We Persist.  Around the same time we were trying to come up with a team name, Mitch McConnell said the now infamous quote "Senator Warren was giving a lengthy speech. She had appeared to violate the rule. She was warned. She was given an explanation. Nevertheless, she persisted"  I never felt connected to the Nasty Women campaign but the Nevertheless She Persisted soooo resonated with me for so many reasons.  We decided to name our team with this slogan in mind - Nevertheless We Persist. 

Mary, Me, Audrey, Ruth
The event was held at Spindletop Hall on March 25th.  Packet pick up was the evening prior & we were able to pick our tent location.  Thankfully, the weather was going to be beautiful.  We arrived around 8AM on Saturday to get everything set up.  The race started at 9AM.  The first runner runs 3.5 miles then each team member will run 1 lap (approximately 1.5 miles) before handing off the baton to their next teammate.  There is a total of 16 legs.  I had no idea how long it would take us to finish.  None of us knew how we would feel running a 1.5 every 45-60 minutes.  It was a unique race to say the least. 

Audrey was our runner #1 & got to run the extra couple of miles.  Mary was runner #2, followed by Ruth & myself bringing up the rear.  



And Audrey is off...

Everyone was running faster than we each thought we would.  The 1.5 mile lap kind of messed with everyone.  It's only 1.5 miles so everyone went out hard.  I originally was going to do a 1 min run/4 min walk but immediately threw that out.  I switched back to 4 min run / 1 min walk.  We all pushed ourselves on this race.

Ruth handing off to me

Finishing Lap #1

The first & second laps were good, the third lap I started to feel it & by the last lap my legs were dead.  The temperature warmed up into 70's by mid day which we all felt.  I averaged just under a 11 minute mile for the 6 miles.  Overall the team finished in 4 hours 42 minutes.  

I wasn't sure how to eat for this race and to complicate things I was still doing the food sensitivity test.  Before the race I ate an omelet.  After my first lap I ate one of my banana muffins, after my second lap I drank a green smoothie and after my third lap I ate some dry roasted almonds.  Overall my belly was fine but the third & fourth laps my legs were feeling it thanks to this test.  My heart rate was really high and the run was a 5.0 effort.  

At the end of the day, the race was so much fun.  It certainly helped that the weather was perfect.  I really liked the laid back atmosphere & hanging out between runs.  

Audrey, Mary, Me & Ruth

Nevertheless, We Persist!





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