Fatigue & Depression

I have been going through quite a bit of fatigue and depression lately. I am still experiencing fatigue almost every day, so when I do have a burst of energy, I make sure to take advantage of it. On days when my entire body is hurting, I try to remind myself that I had my 4th surgery not that long ago, so I don’t need to be so hard on myself when I just want to rest. Resting has become another problem in the form of not being able to sleep properly. It is not out of the realm of possibility for me to be awake until 2 or 3 in the morning, sometimes even later, at least a few nights a week. I realize that fatigue is linked directly with depression, so I am beginning to understand how everything I have been dealing with within the last few months is all part of the same problem.

Not all of my depression is linked to breast cancer, but most of it is. I was talking to a breast cancer patient the other day, and she was asking me how long it has been since I had finished each portion of my treatment. I hadn’t thought about the timing of everything in a while, so as I was answering her questions, I was surprised that time has passed much quicker than I thought. It has been 11 months since my last chemo treatment, 7 months since my last radiation treatment, and 4 months since my previous reconstruction surgery; at times, it feels like a lifetime ago, but when I am having a bad day, it all seems like it happened yesterday. Even with all of that time passing so quickly, my body and mind are still healing. I have been experiencing what I thought were some of the side effects that I had at the end of chemo again, but chemo ended almost a year ago, so I am beginning to realize that some of them are symptoms of depression, as described below. Luckily, we are going on vacation soon, and the timing couldn’t be more perfect. I need a break; I need time away from everything that has been hurting my heart and soul lately, and I need to get my mind and body back on track, and I will!

Depression may be a side effect of breast cancer and fatigue is often a symptom of depression. Some people may have a tendency to depression, which treatment can make worse. At the same time, fatigue itself can lead to depression. Not knowing why you feel drained week after week, and not knowing that this abnormal feeling is normal for many people going through treatment, can make you depressed.

Treatment for breast cancer may leave you feeling sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

If you’re abruptly going through menopause 10 years earlier than you naturally would, with a quick lowering of hormone levels, you may experience feelings similar to postpartum depression.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don’t allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. You may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can lead to fatigue and depression.

How can you tell the difference between fatigue, sadness, and clinical depression? The symptoms of clinical depression include:

  • an inability to cope
  • an overwhelming feeling of helplessness and hopelessness
  • inertia
  • an inability to concentrate
  • memory problems
  • panic attacks
  • loss of pleasure in what used to make you happy
  • lack of interest in sex or food
  • sleep problems

If you think you’re depressed, talk to your doctor. If your doctor doesn’t have experience treating depression, ask for the name of an accredited psychotherapist. Together you can sort out if what you’re feeling is depression or extreme fatigue. Therapy can help you feel supported and allow you to talk about what’s bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better. An accredited psychotherapist with experience treating depression can help.

Breast Cancer Growth Rate

I came across this article recently and it was really shocking to me. I have always understood that breast cancer grows by cell division, but I had no idea of the timing from when it starts to when you can feel a lump in the breast like I did. I know that the information below is scary, but I am posting this to inform my readers because I truly believe that when it comes to breast cancer, early detection and information are key. If you won’t listen to me, listen to a doctor who makes it clear in the article below that a yearly mammogram is so incredibly important. As you know, I also believe that a monthly self-exam between mammograms is just as important. I don’t want anyone to go through what I have been through in the last 18 months, so if I can help just one reader understand the importance of mammograms then I have done my job.

Speaking of mammograms…my last mammogram was before my first surgery in April 2019. Now that I am over six months out from my last radiation treatment it is time to finally have a mammogram done to make sure that cancer has not come back. My surgeon explained that we couldn’t have a mammogram done any sooner than now because the radiation causes the images to look cloudy. So, next Monday I will have the mammogram done that my surgeon ordered back in February. I am scared, to say the least, but I am trying to have faith that all of the chemo and radiation treatments killed any tiny cancer cells that may have been too small to detect after my first surgery.

Ask an Expert: Breast cancer growth rate

From the expert staff of breast cancer research at the Robert W. Franz Cancer Research Center at Providence Portland Medical Center:

Like a lot of cancers, breast cancer grows by simple cell division. It begins as one malignant cell, which then divides and becomes two bad cells, which divide again and become four bad cells, and so on. Breast cancer has to divide 30 times before it can be felt. Up to the 28th cell division, neither you nor your doctor can detect it by hand.

With most breast cancers, each division takes one to two months, so by the time you can feel a cancerous lump, cancer has been in your body for two to five years. It can certainly seem like a lump appeared out of nowhere – especially if you or your doctor have recently examined your breasts and not felt anything suspicious – but in reality, cancer has simply doubled that one last time necessary to be noticeable. By the time you can feel it, a breast tumor is usually a little more than one-half inch in size – about a third the size of a golf ball. It has also been in your body long enough to have had a chance to spread.

This sounds scary, but what it really underscores is the importance of regular mammograms. These screening tests can usually detect breast cancer when it’s about one-quarter inch in size or smaller – a year or more before it would be detectable by hand. Mammograms also make possible the early diagnosis of some pre-cancerous conditions and early-stage cancers that appear as tiny calcifications (microcalcifications) on mammography but aren’t detectable by physical examination.

It’s important to realize that there are two types of mammograms:

screeningmammogram is performed in cases where there isn’t any known problem. This type of mammogram is used for annual exams.

A diagnostic mammogram is performed when there is a known problem that requires careful evaluation. Diagnostic mammograms provide much more extensive images than screening mammograms, such as views from additional angles and compression, or blow-up, views. Often an ultrasound will be done in addition to the mammogram if there is a palpable lump. Make sure you receive a diagnostic mammogram if you’ve found a lump.

Once a breast cancer gets big, every doubling is significant. If you find a lump, see your doctor as soon as possible. Don’t settle for just a mammogram if the mammogram doesn’t find anything. The next step should be a screening ultrasound, and if those results are indeterminate you need to get a biopsy. Ask your doctor for these tests if he or she doesn’t schedule them.

How Do You Tell People That You Have Cancer?

Telling people that are close to me that I was diagnosed with breast cancer was a very personal and difficult decision. I am sure you are thinking that I am crazy for saying that and I would have agreed with you when I was first diagnosed, but I don’t agree now. Why wouldn’t a patient want to tell their family and friends? Or, what would make a cancer patient regret telling them? It will probably surprise you to know that I have spoken with some cancer patients that didn’t tell anyone, or that after the fact, they had wished that they hadn’t.

Family members, friends, and co-workers are never comfortable hearing that someone they know and care about has received a breast cancer diagnosis. It is a hard subject to discuss and every cancer patient knows that to some degree once they start telling people that they have cancer, the flood gates open with questions and in some cases blame. It is sad but true that sometimes out of fear, people are ignorant enough to ask a cancer patient what they “did or didn’t do to get cancer”. I can tell you that I was blaming myself early on. I was sure that it was my fault, that I had done something wrong and that is why I ended up with breast cancer. I know now that it was ignorant of me to blame myself. I didn’t do anything to cause my cancer, cancer chose me.

Sometimes people stay away because it is easy for them to assume that since someone they know was terribly sick during chemo, that you will be too; or someone they know did not survive breast cancer, so you won’t either. Understandably, they are afraid to be close to you because they think that you will die and it will hurt more if they step into the reality of your cancer so if they don’t talk to you, it isn’t real. I have found myself reminding people that I am still me, that every breast cancer patient’s experiences and outcomes are different, even if they have the exact same diagnosis. So many factors go into how a patient will respond to chemo and radiation treatments as well as undergoing multiple surgeries like most of us do, so it is impossible to predict what will happen. I am happy to say that I am doing well now that I am well over a year out from my diagnosis…I am a survivor!

I didn’t tell anyone right away because my husband and I were in shock and we needed to process what was going on. I also had my first biopsy to go through and I wanted to have the specifics of my breast cancer before sharing the information with anyone. Just a few weeks later once all of the test results were back, I told my family and close friends first through phone calls and private messages. As the news spread of my diagnosis, some people reached out to me immediately and others often times the people I wanted to talk to the most, stayed away from me, not knowing what to say. I can’t blame people for distancing themselves because I understand how hard it is to hear about the pain, endless doctors’ appointments, and everything else that I had to endure both physically and mentally for months on end. I also understand that people think that they would be bothering me or burdening me if they wanted to talk about things that they are going through, but if that is what they are thinking, they couldn’t be more mistaken. Right now, especially while I am laid off from work, I need my friends and family, I need to connect with people.

Being diagnosed with breast cancer has taught me that we never know what tomorrow will bring. Putting off spending time with the people that we care about and love should not be left until tomorrow, or next week or when we think we will have time because time is not on our side. {Yes, I know that the virus we are all dealing with is not helping bring us together, face to face, but there are other ways to communicate.} Sometimes the choices we make will only bring us to feelings of regret in the future, and sometimes it is too late to go back to the cherished moments we should have had with those that we love and value.

Anastrozole Check-up with My Oncologists PA

Today I had a check-up with the PA at my oncologists office to see how I am doing on Anastrozole. I have been taking it for about 5 1/2 months and I have been doing well. I was having problems with dizziness in the beginning so I changed the time of day that I take it from right before bedtime to when I wake up in the morning. I haven’t had a dizzy spell in a few weeks so it seems that my body has adjusted well.

First we went over my labs from the blood that they drew today. My white blood cell count is finally in the normal range, on the low end, but that was good to see as it means that my immune system is getting back to normal. My red blood cell count is still out of range, just a little low, so that goes along with me still fighting fatigue. I had one other value that was high but she said that it indicates that I have allergies to which I said “I don’t have allergies.” She laughed and said that as far as I know I don’t have allergies but I could be developing them….I hope not.

For the first time ever, she actually mentioned my weight but in a good way. She was happy to see that I have lost weight since the end of chemo, which was at the beginning of October last year, 27 lbs lost in total so far. She said that she knew it upset me to gain so much weight during chemo but she said that while going through chemo it is good to gain some weight because my body needed me to eat well. We agreed that my gaining weight helped me get through chemo as well as I did. She was also happy that I have been losing weight while taking Anastrozole because most women complain that they gain weight while  on it, which for me will be 10 years, so I will keep doing what I have been doing to get to my goal weight.

She also asked me how everything went with the second part of my reconstruction surgery that I had 11 weeks ago today. She was happy that my surgeon was able to get me on his schedule so quickly before my medical insurance ran out due to being laid off. She reminded me that it has only been 11 weeks since that surgery and since I have had so much surgery in the last year, it will still take some time for my body to recover from all of the trauma I have been through.

I asked her when the 5 year count starts as it is the main focus now that I am done with my treatments and surgeries. She said that in their office they start the count from when I completed all of my treatments, both chemotherapy and radiation, which was this year at the end of January. I then asked what the next steps are in their care for me as a cancer patient. I will continue to have check-ups every 3 months for the first 2 years after completing treatments, then every 6 months until I get to 5 years after treatments and after 5 years she said that most patients go back to seeing their regular doctor once a year. My chances of recurrence are at their highest until I get to 2 years, then it will drop a bit until I get to 5 years and then it will drop substantially after 5 years without recurrence.

We also talked about my next mammogram which is coming up in August. I am nervous about it and she assured me that especially with this being the first imaging done in over a year, it is completely normal for me to be worrying and nervous. I told her that am paranoid about the cancer coming back so I am checking my breasts often for anything that feels abnormal. But, I also told her that I am well aware that I have been through the maximum treatments for my type of cancer, having had both chemotherapy and radiation, plus having an excellent surgeon who removed all of the cancer; so keep reminding myself that there should not be anything visible in my mammogram.

So all in all I am doing well and getting healthier and stronger as I get further away from having ended chemotherapy, radiation and 4 surgeries. Here’s to another 3 months of continuing to improve! 🙂

15 Foods That Boost the Immune System

With everything going on these days, it doesn’t hurt to add as many of these foods into your diet as possible. For cancer patients, it is particularly important to keep your immune system protected and boosted with good healthy foods.

Medically reviewed by Amy Richter, RD — Written by James Schend — Updated on April 30, 2020

Immune system boosters

Feeding your body certain foods may help keep your immune system strong.

If you’re looking for ways to prevent colds, the flu, and other infections, your first step should be a visit to your local grocery store. Plan your meals to include these 15 powerful immune system boosters.

1. Citrus fruits

wedges of grapefruit, lime, orange, and lemon on top of a turquoise table

Most people turn straight to vitamin C after they’ve caught a cold. That’s because it helps build up your immune system.

Vitamin C is thought to increase the production of white blood cells, which are key to fighting infections.

Almost all citrus fruits are high in vitamin C. With such a variety to choose from, it’s easy to add a squeeze of this vitamin to any meal.

Popular citrus fruits include:

Because your body doesn’t produce or store it, you need daily vitamin C for continued health. The recommended daily amount for most adults is:

  • 75 mg for women
  • 90 mg for men

If you opt for supplements, avoid taking more than 2,000 milligrams (mg) a day.

Also keep in mind that while vitamin C might help you recover from a cold quicker, there’s no evidence yet that it’s effective against the new coronavirus, SARS-CoV-2.

2. Red bell peppers

14 red bell peppers on top of a dark wood table

If you think citrus fruits have the most vitamin C of any fruit or vegetable, think again. Ounce for ounce, red bell peppers contain almost 3 times as much vitamin C (127 mgTrusted Source) as a Florida orange (45 mgTrusted Source). They’re also a rich source of beta carotene.

Besides boosting your immune system, vitamin C may help you maintain healthy skin. Beta carotene, which your body converts into vitamin A, helps keep your eyes and skin healthy.

3. Broccoli

hands holding up a bowl full of broccoli

Broccoli is supercharged with vitamins and minerals. Packed with vitamins A, C, and E, as well as fiber and many other antioxidants, broccoli is one of the healthiest vegetables you can put on your plate.

The key to keeping its power intact is to cook it as little as possible — or better yet, not at all. ResearchTrusted Source has shown that steaming is the best way to keep more nutrients in the food.

4. Garlic

cloves of garlic on a wood table

Garlic is found in almost every cuisine in the world. It adds a little zing to food and it’s a must-have for your health.

Early civilizations recognized its value in fighting infections. Garlic may also slow down hardening of the arteries, and there’s weak evidence that it helps lower blood pressure.

Garlic’s immune-boosting properties seem to come from a heavy concentration of sulfur-containing compounds, such as allicin.

5. Ginger

slices of ginger on a dark wood table table

Ginger is another ingredient many turn to after getting sick. Ginger may help decrease inflammation, which can help reduce a sore throat and inflammatory illnesses. Ginger may help with nausea as well.

While it’s used in many sweet desserts, ginger packs some heat in the form of gingerol, a relative of capsaicin.

Ginger may also decrease chronic painTrusted Source and might even possess cholesterol-lowering propertiesTrusted Source.

6. Spinach

spinach leaves in a silver pot with a handle

Spinach made our list not just because it’s rich in vitamin C — it’s also packed with numerous antioxidants and beta carotene, which may both increase the infection-fighting ability of our immune systems.

Similar to broccoli, spinach is healthiest when it’s cooked as little as possible so that it retains its nutrients. However, light cooking makes it easier to absorb the vitamin A and allows other nutrients to be released from oxalic acid, an antinutrient. 

7. Yogurt

yogurt topped with seeds and granola and placed in a small white and blue floral bowl

Look for yogurts that have the phrase “live and active cultures” printed on the label, like Greek yogurt. These cultures may stimulate your immune system to help fight diseases.

Try to get plain yogurts rather than the kind that are flavored and loaded with sugar. You can sweeten plain yogurt yourself with healthy fruits and a drizzle of honey instead.

Yogurt can also be a great source of vitamin D, so try to select brands fortified with this vitamin. Vitamin D helps regulate the immune system and is thought to boost our body’s natural defenses against diseases.

Clinical trials are even in the works to study its possible effects on COVID-19.

8. Almonds

unroasted almonds in a dark-colored bowl on top of beige fabric

When it comes to preventing and fighting off colds, vitamin E tends to take a backseat to vitamin C. However, this powerful antioxidant is key to a healthy immune system.

It’s a fat-soluble vitamin, which means it requires the presence of fat to be absorbed properly. Nuts, such as almonds, are packed with the vitamin and also have healthy fats.

Adults only need about 15 mg of vitamin E each day. A half-cup serving of almonds, which is about 46 whole, shelled almonds, provides around 100 percentTrusted Source of the recommended daily amount.

9. Sunflower seeds

sunflower seeds in a clear jar on top of a turquoise table

Sunflower seeds are full of nutrients, including phosphorousmagnesium, and vitamins B-6 and E.

Vitamin E is important in regulating and maintaining immune system function. Other foods with high amounts of vitamin E include avocados and dark leafy greens.

Sunflower seeds are also incredibly high in selenium. Just 1 ounce contains nearly halfTrusted Source the selenium that the average adult needs daily. A variety of studies, mostly performed on animals, have looked at its potential to combat viral infections such as swine flu (H1N1).

10. Turmeric

turmeric powder, turmeric roots, and turmeric supplements on top of a turquoise and white plate

You may know turmeric as a key ingredient in many curries. This bright yellow, bitter spice has also been used for years as an anti-inflammatory in treating both osteoarthritis and rheumatoid arthritis.

ResearchTrusted Source shows that high concentrations of curcumin, which gives turmeric its distinctive color, can help decrease exercise-induced muscle damage. Curcumin has promise as an immune booster (based on findings from animal studies) and an antiviral. More research is needed.

11. Green tea

loose leaf green tea in a white mug on a wrought iron table

Both green and black teas are packed with flavonoids, a type of antioxidant. Where green tea really excels is in its levels of epigallocatechin gallate (EGCG), another powerful antioxidant.

In studies, EGCG has been shown to enhance immune function. The fermentation process black tea goes through destroys a lot of the EGCG. Green tea, on the other hand, is steamed and not fermented, so the EGCG is preserved.

Green tea is also a good source of the amino acid L-theanine. L-theanine may aid in the production of germ-fighting compounds in your T cells.

12. Papaya

two large papaya halves on a dark wood table

Papaya is another fruit loaded with vitamin C. You can find doubleTrusted Source the daily recommended amount of vitamin C in a single medium fruit. Papayas also have a digestive enzyme called papain that has anti-inflammatory effects.

Papayas have decent amounts of potassium, magnesium, and folate, all of which are beneficial to your overall health.

13. Kiwi

whole kiwi fruits and two kiwi halves in a metal basket with handles

Like papayas, kiwis are naturally full of a ton of essential nutrients, including folate, potassium, vitamin K, and vitamin C.

Vitamin C boosts the white blood cells to fight infection, while kiwi’s other nutrients keep the rest of your body functioning properly.

14. Poultry

uncooked whole chicken on a metal pan surrounded by salt flakes and a white and blue plaid rag

When you’re sick and you reach for chicken soup, it’s more than just the placebo effect that makes you feel better. The soup may help lower inflammation, which could improve symptoms of a cold.

Poultry, such as chicken and turkey, is high in vitamin B-6. About 3 ounces of light turkey or chicken meat contains nearly one-third of your daily recommended amount of B-6.

Vitamin B-6 is an important player in many of the chemical reactions that happen in the body. It’s also vital to the formation of new and healthy red blood cells.

Stock or broth made by boiling chicken bones contains gelatin, chondroitin, and other nutrients helpful for gut healing and immunity.

15. Shellfish

fresh crab and half of a lemon on a white plate placed on a table

Shellfish isn’t what jumps to mind for many who are trying to boost their immune system, but some types of shellfish are packed with zinc.

Zinc doesn’t get as much attention as many other vitamins and minerals, but our bodies need it so that our immune cells can function as intended.

Varieties of shellfish that are high in zinc include:

  • oysters
  • crab
  • lobster
  • mussels

Keep in mind that you don’t want to have more than the daily recommended amount of zinc in your diet:

  • 11 mg for adult men
  • 8 mg for most adult women

Too much zinc can actually inhibit immune system function.

More ways to prevent infections

Variety is the key to proper nutrition. Eating just one of these foods won’t be enough to help fight off the flu or other infections, even if you eat it constantly. Pay attention to serving sizes and recommended daily intake so that you don’t get too much of a single vitamin and too little of others.

Eating right is a great start, and there are other things you can do to protect you and your family from the flu, cold, and other illnesses.

Start with these flu prevention basics and then read these 7 tips for flu-proofing your home. Perhaps most importantly, get your annual flu vaccine to protect yourself and others.

16 Months in Pictures

Mood: Amazed 😌

As I was looking through my pictures the other day I noticed that I have a picture of myself, taken in most months from when I was diagnosed with breast cancer up to the present time. So I decided to make a collection showing how I looked before breast cancer {the first picture} all the way up to how I look now {the last picture}. You can clearly see when the chemotherapy treatments really started to effect how I looked; the loss of my hair, eyebrows and eyelashes, my skin getting dryer and my fine lines showing more.

It’s a given that the last 16 months have been hard on me both mentally and physically.  But, nothing tore me down and damaged me more than the chemotherapy treatments did. Chemotherapy took a part of me that I will never get back. When the chemotherapy treatments were over I realized how much the drugs and the stress of everything I had been through up to that point had aged me, a lot. Looking back through my pictures it’s easy to see how much my face has aged and it breaks my heart. I am doing what I can to undo the damage but it has not been an easy process.