Long Overdue Update

This post was originally a 6 month update & I wrote most of it but never finished it.  With that said it's now been 9 months since I finished radiation for breast cancer.  In my 3 month update I was recovering from a bad case of pneumonia.  The recovery took a full 12 weeks to feel mostly normal again in every day life but I am still building up my fitness levels.

I had another follow up CT scan & pulmonary visit in early October.  For the most part my pneumonia is cleared, my radiation pneumonitis is improving but I continue to have pulmonary infiltrates.  Each of the 3 CT scans have shown a spot but each month the spot is in a different location. In order to rule out any other funk they did a full blood work up.  They took 7 vials of blood plus a urine sample to check for a litany of things including, TB, histoplasmosis, CBC levels, fungal, C-Reactive Protein, ANA, ANCA, stronglyloides & sedimentation rates.  Thankfully all came back negative.

In November & December I had follow ups with the Radiation Oncologist, Pulmonary doc & my first mammogram since treatment ended. The Radiation Oncologist appointment was uneventful. One last checkup & then I was officially released.  The Pulmonary doc had good news as well.  My last CT scan after Thanksgiving finally came back clear. No more pneumonia, no more infiltrates but all clear! I then went for my first mammogram since treatment. As usual for me, it showed something they want to follow but the results fell in the 'probably benign, come back in 6 months.'  So all in all, really good news.  It took a year but I am finally fully recovered and now able to focus on getting my fitness back.

Prior to pneumonia I had signed up for the Gobbler Half Marathon on November 18th.  During the summer I had written off being able to run the half.  I was thinking I would back down to the 10k.  As I started to feel better I decided to hold off switching distances & just let the training tell me what distance to run.

Seen During Arboretum Run

As of early October my long run was up to 7 miles.  I was doing run / walk intervals of 1 minute run / 4 minutes walk. I can't remember at what point I decided to drop down to the 10K but I eventually made that call and was glad I did.  It took the pressure off & allowed me to enjoy some of my other favorite activities.

In addition to running, I have got back on my bike a few times.

First Post Pneumonia Ride

We also got in a couple of paddles and good hikes in the gorge.

Captain Sammie - Kentucky & Dix Rivers

Mallard Point SUP

Steve's Birthday Hike to Courthouse Rock

Another Red River Gorge Hike

Hike at Big Bone Lick State Park (Photo credit Mary Henson)

After a fun filled fall the Gobbler kicked off the holiday running season.  This year didn't disappoint!

Gobbler 10K

Turkey Trot 5K in Kansas City - Day 1 Run Streak

Frankfort Frosty 5K

Reindeer Ramble 10K

West 6th Holiday Run

New Years Day 2018 - Day 40 Run Streak

2017 was a rough year health wise and I am grateful to have all of that behind me. As we are wrapping up January, I am now half way through my training plan for the Lucky Leprechaun 10 Miler on March 10th.  

I must say it feels really good to get back to normal!

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3 Month Update

So today is 3 months since I finished radiation for DCIS breast cancer.  The actual breast cancer treatment wasn't too bad.  I was lucky.  I sailed through the surgery & for the most part the radiation was easy.  Fatigued yes but I got through it without any major illness or time off work.

Last Day of Radiation

I took May very easy.  I continued to walk instead of run.  I did a couple short bike commutes to work.  We had a great vacation in Washington. I came back to work after Memorial Day feeling healthy.  I continued bike commuting a couple days of the week.  I slowly started adding run intervals to my walks.  I even hit the pool in early June.

Shillito Pool

Then came the second week of June.  It started with a scratchy, dry sore throat.  Then a little burn in my lungs with any exertion.  I figured I had a cold or allergies.  Several folks I knew had hacky coughs so I figured  it was my turn.  I managed to stay really healthy all through the cancer treatment so I was due.  I went to the work doctor & he said it was just a cold.  So I didn't think much about it.  Just went on my way.

The problem was I just wasn't getting better.  I dialed my workouts down even more.  No more jogging, only 1 bike commute each week, used fins at the pool but nothing helped.  I was tired.

We went to New York to visit family for a long weekend at the end of June. We always hike & explore while we are there but this time I was perfectly content to sit & hang out all weekend. That damn cold was really hanging on. Over 2 weeks since the first symptoms.

Queensbury, New York - Mom, Grandma, Steven, Jason & me

The following weekend was 4th of July weekend & we headed to Savannah to visit Nina.  I had to take naps every day.  We barely did anything.  By Saturday I knew I was heading downhill fast.  We had rented kayaks & I could barely keep up.  The effort was exhausting.  I felt bad but I had no interest in exploring Savannah. Just the thought was exhausting. I was so freaking tired.

Tybee Island - Me, Nina & Steve

I had 2 extra days off at home thanks to the holiday so I was just trying to get home knowing I could rest.  By the evening of the 4th I was done.  I was coughing, barely could breathe & my chest hurt something fierce.  I thought I had bronchitis.  I called my GP office first thing Wednesday (7/5) morning.  Thankfully they were able to see me that morning.

To my surprise the doctor told me I had pneumonia or possibly radiation induced pneumonitis.  Huh?  I was stunned.  She sent me to have a chest xray to confirm.  While waiting, I was googling radiation induced pneumonia.  I didn't like what I read at all.

Later that afternoon the doctor called me to confirm that I had pneumonia & that I needed a CT scan.  They got that scheduled for Friday morning & she started me on antibiotics. By Monday (7/10) morning I had zero improvement so I called to schedule a follow up with my GP.  When she walked in she said they are trying to get me in with a Pulmonary specialist ASAP because my pneumonia was severe.  My entire left upper lobe was full of pneumonia.  The CT could not determine if it was bacterial or radiation induced.  She assumed bacterial so they gave me a shot of antibiotics & a stronger antibiotic prescription.  She also told me no work for 2 weeks.  I thought she was nuts at the time but believe me I have needed every bit of those 2 weeks off.

I went to the Pulmonary specialist on Tuesday (7/11) morning.  He showed me my CT scan & explained how the next couple of weeks were going to go.  He re-iterated that they couldn't tell if the pneumonia was bacterial or radiation induced without a lung biopsy.  He treatment plans were this: 14 days of strong antibiotics & steroids.  If I get better, then it's bacterial.  If I am the same in 1 week then we do a lung biopsy.  If I get worse, go straight to the ER.  No exercise, no work, no being outside in the heat until I start to feel better.  Period.

See all that white?  That's pneumonia.

That bright white spot is most likely pneumonia on my right lung

Well, you would think being cooped up inside in July would be the worst thing in the world for someone that enjoys being outside & active.  The reality was I was so miserable I didn't care about the mandatory couch time.  The first 10 days were spent sleeping 9-10 hours each night, a morning nap & an afternoon nap.  When I was awake I watched the Tour de France & HGTV.  Each afternoon I would try to spend a few minutes online checking work emails but that was pretty much the extent of my working.

I had such a hard time determining if I was feeling better.  The improvements were so minor.  I remember telling the doctors that if I stay still & don't move I could convince myself that I am feeling better but as soon I got up it was a completely different story.  I was exhausted.

I had my first follow up with the pulmonary doctor on Tuesday (7/18).  I had little to go on from my perspective on whether or not I was truly improving.  I resorted to my Garmin data & a couple of things others said to me.  First, one of my friends said it didn't sound like I was as out of breathe when I spoke.  OK, that's good.  I still felt like I was out of breathe but that was good feedback.  Second, the same pulmonary nurse saw me each week & she said I looked better even though I still felt rough.  The rest was on my Garmin data. Yeah, total data nerd.

I looked at Garmin Connect to check my average resting heart rate & sleep trends.  My average resting HR on June 4th was 57 bpm.  Through the month of June it creeped up to a high of 67 bpm by July 2nd.  I started antibiotics on July 5th.  By July 9th it was down to 60 bpm & by the 18th it was down to 54 bpm.  The antibiotics & the rest were clearly helping even if I didn't feel better.

The next thing I looked at was my deep sleep time.  Prior to starting antibiotics my deep sleep was 3-4 hours per night even though my total sleep time was 9-10 hours each night.  After two weeks of antibiotics I was sleeping deeply 5-7 hours each night out of the 9-10 hours.  I interpreted that as I was breathing better & not coughing nearly as much in the night.

Using this data & feedback from others we decided to delay the lung biopsy which relieved me greatly.  This was not something I wanted to do AT ALL.  My next follow up is 7/31 & I am optimistic that I will be feeling much better.  I still have a few days before going to work but I have gone 2 days without a nap.  I have much more mental energy than I did even earlier this week.  I am definitely breathing better.  I am still very fatigued & don't see myself doing any real workouts for several more weeks.

In addition to my inhaler optri-chamber, I got a breathing apparatus called a flutter valve this week.  The way the pulmonary nurse practitioner explained it was it is like doing bicep curls for your lungs.  I use it 6 times a day & I noticed right away that it noticeably improved my breathing.

Flutter Valve

Opti-Chamber

The doctors said the total recovery time was 8-12 weeks provided I don't have any other underlying issues.  I go back on 8/21 for a follow up CT scan to see how much my lungs have cleared up.  At that point we should be able to determine if this was just a nasty case of pneumonia or something else is lurking.  Fingers crossed it is the former.

Sammie - My couch surfing buddy

While on rest, I have thoroughly enjoyed watching the Tour de France this year.  I have watched all but 2 stages so far.  It has been the highlight of my days this month while recuperating.

Conversely, I am entirely sick of HGTV.  I'm so over those shows. I think HGTV will now always remind me of radiation treatment & pneumonia.  That channel is always on in the waiting rooms.

I read a few free prime books this month nothing worth noting.  Just easy reads. My biggest accomplishment this week was that I finally got our paperwork in order to meet with a financial advisor. I have been putting that off forever.

Tomorrow I go for another craniosacral massage.  It helped a lot during radiation treatment so I am hoping it will help a bit with my fatigue since Monday I go back to work. I am hoping that I can make it a full day but we shall see. 

Stay healthy, y'all!

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'