Birthday Trip 2020

A few weeks ago, my husband and I were finally able to get away and take our annual birthday trip. This particular trip had been rescheduled a few times due to my chemo treatments last year, and the resort we wanted to go to, not opening when scheduled due to the pandemic.

It wasn’t easy to travel internationally during the pandemic, but it was well worth it. We had to get a COVID test within ten days of arriving in Jamaica, and within three days of arriving, we had to go online, fill out a form for each of us, and send our COVID results in for approval. So, time was short, especially to get the test results back and sent in. We didn’t hear anything back after a little over a day, and we started to panic, so we called our travel agent to see if she could help. It just so happens that she has a contact at the Jamaica Tourist Board, so she got in touch with her, had us send some information to her via email, and we had our approvals the day before we were scheduled to leave by 6:30 am the next morning. Whew!!

I am not going to go over all of the details of our trip because this isn’t a travel blog; it’s a blog concerning everything related to and revolving around my breast cancer. So, something happened while on our trip, and to say that my reaction shocked me is an understatement.

A few days before we left, I let my husband know that I was not ready for the trip as far as my energy level was concerned. I had been battling fatigue, and I still am to this day, so I was concerned that the trip was going to wear on me far more than it did back when I was healthy. But I needed the break as I had recently been under a lot of stress, and it felt like everything I was dealing with was becoming far too much for me. We all have our breaking point, right? Well I was very much on edge, and I knew that I was headed for a mental breakdown if I didn’t get away to relax and destress. As it turns out, I was right; about halfway through our trip, I was already physically exhausted even though I kept my activity level much lower than I usually do while on vacation. But I powered through because we had some wonderful surprises during our trip that made everything we had to go through to get there, worth it!

So two amazing things happened during our trip! The first was getting to see and spend time with a few employees from the resort we were supposed to go to. Because the original resort didn’t open on time, there are several people from the entertainment department that are traveling around and performing at some of the resorts that are open in Jamaica. We have been friends with these amazingly talented people for years and years, and they are like family to us. We hadn’t been able to see any of them in two years, so I was super excited when I found out that they would be at the resort we were going to. So we had a family reunion of sorts, and we were able to have lunch together quite a few times and find a little bit of time to spend together on the nights they were at the resort to perform.

It was amazing to get to spend with our friends, and it made me so happy! But, at some point during the trip, I don’t remember precisely when, out of nowhere, I had a complete breakdown. Sadness suddenly overcame me, and at first, I didn’t understand why. I was embarrassed because an employee saw me start to cry and walk away from where we were seated, and she followed us out of concern for me. It was very kind of her to check on me, but I was overcome with grief and sadness, not a good moment for me, especially while on vacation in my favorite place in the world. I remember feeling like I did when I was diagnosed with breast cancer. I asked, “why did this have to happen to me? why me?” while crying my eyes out. It was painful because I remembered how things were two years ago when I saw my friends. Life was normal two years ago; life was good, or so I thought. The reality is that I already had breast cancer in September 2018, but I didn’t know I had it; there were no signs of it at that time. I eventually calmed down and enjoyed the rest of our trip, but my breakdown was a harsh reminder that it had not been that long since I found the first tumor and started down the long road of fighting cancer.

Our friends & family in Jamaica

The second amazing thing that happened was getting to see two more of our friends from the scuba diving department. My husband is a Master Diver, and a considerable part of our trips involve him diving twice a day, every day. As with our friends from the entertainment department, we have known most of the dive crew at our favorite resort for years, so they are also like family. My husband received a curious message from a friend the day we arrived in Jamaica, and we didn’t understand what he meant until a few days later when he arrived at the resort to dive with my husband! It was an incredible surprise to see our friend and find out that he was staying for the week to dive specifically with my husband. Our friend lives in Ocho Rios, where our favorite resort is located, and that is one and a half hours from where we were. The next day our friend’s boss arrived at the resort and had lunch with us! So we had another friend of ours came to see us, and that was another wonderful surprise! It was great to see my husband so happy and enjoying his week with a dear friend and having a few surprises along the way; it absolutely made his trip!

All in all, we had a wonderful trip, and it was great to get away and relax somewhere besides home. The next time we can travel and see some of the people we love, I will not be surprised if I have the same reaction; in fact, I will be expecting it. I am human, after all, and I have a very different outlook on life after everything I have been through.

Cherish your family and friends, and stop taking people for granted because someday, they might not be there anymore.

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.

Follow-up with My Surgeon

On Wednesday, I went to see my surgeon to go over the results of my mammogram and to have him take a look at my breast implants and surgery site from my surgery that was just about four months ago. When he came into the exam room, he said that yes, I have some small cysts in my right breast, but that he is 0% concerned about them. I asked him if the cysts could turn into cancer, and he said no, they wouldn’t as they are benign. I asked him if anything needs to be done about the cysts, and he said that we do not need to do anything concerning them; they will most likely go away with time. He said that he is very pleased with the images from my mammogram and ultrasound and that everything is clear and looks great! {He explained to me when he ordered the mammogram that we had to wait for at least six months after finishing my radiation treatments to do it, or the images would be cloudy, so that is why I had to wait so long.}

Next, he took a look at how I have healed from my last surgery and how my breast implants are settling in. Everything is looking good so far, but my chest has not finished settling into place, meaning that the area under my left breast, in particular, has not dropped down and rounded out, it is still somewhat flat. It takes time for the internal part of the chest to heal and for the implant to get into place, so there is nothing to be alarmed about; my body just needs more time.

We do have to watch for a complication from my breast implants. It is called Capsular Contracture, and it is a breast augmentation complication that develops when internal scar tissue forms a tight or constricting capsule around a breast implant, contracting it until it becomes misshapen and hard. When my surgeon put my breast implants in, he added donor tissue to help prevent this complication from happening, but that doesn’t mean that it won’t happen anyway. He said that if it does happen, I will need to gauge my level of pain, watch for distortion, let him know that I have a problem, and that I am in pain that I can’t bear. He explained that some patients would have a severe case of Capsular Contracture and have very little pain, while others would have a milder case and have horrible pain. He said that if the pain is too much for me, I need to tell him to fix it, meaning I will need to go into surgery and have my implants removed. Whether or not I would need to have a new set of implants put in or have them left out is hard to say; it just depends on the circumstances. Being the excellent surgeon that he is, he told me that this could happen when we were discussing the option of breast implants. I told him that it was worth the risk to me as I was feeling very out of proportion after my first reconstruction surgery. I wanted to feel like me again and not the stranger staring back at me in the mirror.

The reason why we were even discussing this horrible complication on Wednesday was that he pointed out that the implant in my left breast is much firmer than the implant in my right breast during my exam. The firmness is caused by the 25 radiation treatments that were part of the breast cancer treatment performed on my left breast. So, it is already firm, and I need to watch it and check to make sure that I don’t have any harder areas that could indicate a problem is developing.

Unless I notice anything in the meantime, I will not go back to follow-up with him until six months from now. I have fewer appointments with my oncologist and surgeon these days, a real sign that I am healing and adjusting to life after breast cancer. 💕

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.

6 Tips to Support a Loved One After Breast Cancer Recovery

Very helpful information…Once a cancer patient is in recovery most people think that the worst is over, and it is as far as treatments and surgeries are concerned. But recovery involves not only dealing with and healing from the physical effects, but the mental effects as well. As the first sentence of this article states, “Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.”  Breast cancer and what a patient has to endure to survive it, is indeed a trauma, so it is very important that their support system is there for them more than ever when moving into the recovery phase.

Recovery from cancer is not easy, it takes time to navigate through all of the experiences and emotions that come up during what seems like endless chemotherapy and radiation treatments, blood draws, scans and surgeries. Coming to terms with the damage that everything I have been through has done to my body and mind is overwhelming at times. Every time I look in the mirror it is impossible to ignore my slowly growing hair, the scars on my breasts and the discolored skin under my left arm, from radiation treatments. I know that as time passes my hair will grow back and the scars and discoloration will fade, and maybe as I see those changes then I will feel like I am moving through my recovery instead of feeling like I do now, impatient and stuck.

I have to say that with Covid-19 limiting socialization and disrupting life as we know it, there is a stress that normally wouldn’t be an issue. I would be working on getting back to a normal life, life before breast cancer, and I am, but I am also dealing with the isolation and depression that the virus has brought to most of us at one time or another in the last few months. Normally, I would still be working at my job, and not laid off, which really helps keep me focused in all aspects of my life. I would also be making plans to spend much needed time with friends and family as I miss them terribly and being around them would help my recovery in so many ways. So in the meantime as I wait to find out when I will be going back to work and we finally get to a time when it is safe to get together again with those that we love; I am doing what I can each day to get through these uncertain times as best as I can.

Medically reviewed by Krystal Cascetta, MD — Written by Theodora Blanchfield on July 6, 2020

Even if your person appears strong on the outside, understand that their mind and body are still recovering from a trauma.

If you’ve ever lost a loved one, you may remember what it felt like immediately after your loss: friends checking in on you, bringing you food, and generally showing up for you. But as weeks fade into months and months into years, those check ins drop off — or disappear altogether.

This feeling is all too familiar to some breast cancer survivors who may suddenly feel alone as they struggle to adjust to their new normal.

Do you want to be there for your friend but have no idea where to start? We talked to mental health experts who work with cancer survivors to get the scoop on how you can continue to show up.

1. Respect their trauma and grief

“Loved ones should understand that a great deal of loss has occurred for the survivor,” says Renee Exelbert, PhD, CFT, a psycho-oncologist and breast cancer survivor.

This includes loss of safety in their body, loss of safety in the world, and sometimes, the loss of physical body parts, or the loss of prior functioning, she explains.

With that loss comes relearning how to relate in the world.

Even if your person appears strong on the outside, “understand that their mind and body are still recovering from a trauma,” says Gabriela Gutierrez, LMFT, clinical oncology therapist at Loma Linda University Cancer Center.

The physical loss associated with breast cancer can lead to a kind of identity rebuilding, she says.

“Women are learning how to still see themselves as women even after their breasts have been altered or removed all together,” Gutierrez says.

2. Understand fear of recurrence

You may be wondering why your friend isn’t being more celebratory. After all, they just got a clean bill of health and survived cancer.

Unfortunately, it’s not that simple.

According to the Cleveland Clinic, up to 50 percent of breast cancer survivors worry their cancer will come back.

“This fear of recurrence is a very common phenomenon that patients face as their bodies learn how to adjust back into the ‘normal world’ and as their bodies process the physical and emotional trauma they just endured.”

3. Ask what their needs are

It may be tempting to want to jump in and try to “fix” things or to try to take the burden off of them, but now is the time for your loved one to tell you what they need.

Because their process was so emotionally grueling, there are all kinds of things that may be innocuous to you but a trigger to them, such as a food they couldn’t eat while they were sick.

“Careful listening will demonstrate the desire to help the survivor feel connected to and understood,” says Exelbert. “Knowing that someone wants to help you is extremely meaningful.”

“But if they’re feeling stuck knowing what they need, you might want to offer to help them get back on track with exercise or other forms of self-care,” she says.

4. Continue showing up

More than anything, your person just needs to know that you’ll continue to be there for them.

“Remind them to be patient with themselves, and to have compassion for themselves,” says Gutierrez. “Remind them it is OK to bring up hard conversations with you, so long as you feel like you are a safe person to do so with.”

They may be afraid to bring up these heavy emotions with you, and they need to know they’re not a burden to you.

5. Understand their priorities may have shifted

You’ve been running with your friend for 10 years, and now that she’s healthy again you’re wondering why she’s not interested in running.

When someone has gone through a traumatic experience like an illness, perspectives and priorities will shift. Understand that it’s not personal.

“Loved ones need to be aware that the survivor may not place the same value or importance on previously shared values, relationships, or stressors,” says Exelbert. “What was at one time significant to the survivor, may no longer carry relevance at all.”

6. Take care of yourself

How can you take care of someone else if you’re not taking care of yourself?

“Many caregivers feel they do not deserve a voice as they were not the patient, but cancer is a relational illness, and your experience matters as well,” says Gutierrez.

You were also part of the emotional cancer journey, and your feelings are valid, too.

If processing your own grief and trauma around the experience is too much for you, consider finding a therapist to help you work through it.