Three Month Follow-up with My Oncologist

As I said in my previous blog post, I have had some struggles recently. I have been trying to write about what has been going on, but it has been challenging to put it into words. I am still not prepared, but there may never be a good time, so I may as well start to talk about it.

I had a check-up with my oncologist back on the 7th of January. I didn’t write about my appointment right away because it was an unusual appointment, not my usual, “Yes, I am doing fine on my medication. My sleep is improving, as I am averaging just one night a week, where I am still awake at 5 or 6 am, instead of several nights a week. I am still fighting fatigue…blah, blah, blah…”

My bloodwork has improved to where all of my levels are normal except for my red blood cell count, it’s still low, and unfortunately, it may be my regular reading from now on. It’s not terribly low at all, 4.18, where 4.20 to 5.40 is a normal range. But being even slightly low, I can feel it, so hearing that I might not ever be in the normal range makes me terribly sad as I hate feeling this way. I asked if there is anything I can do, that some cancer patients say that they take iron to fight the fatigue. My PA said that I could take iron, but she cautioned me that it could upset my stomach, so I should take it only every other day to start if I decide to try it. She also said that she had heard that there is a liquid version that might be easier to take, but she hasn’t seen it, so she wasn’t even sure where I could get it. I am on the fence about taking iron, so for now, I am not doing it.

My PA explained that one of the essential readings they are looking at when I come every three months is my Hgb or hemoglobin. Low hemoglobin levels usually indicate that a person has anemia. There are several kinds of anemia: Iron-deficiency anemia is the most common type. This form of anemia occurs when a person does not have enough iron in their body, and it cannot make the hemoglobin it needs. High Hgb is known as polycythemia. This means you have too many red blood cells. Polycythemia vera is a cancer of the blood in which your bone marrow overproduces red blood cells. With polycythemia, a blood test also shows a high red blood cell count and high hematocrit. So low or high Hgb would be bad for me, it would mean I am either anemic, which was also a concern during my chemo treatments, or I have cancer in my blood. My Hgb is a little low, only one point from the lowest acceptable level, but nothing to worry about for now.

Now for the tough part…for most of my appointment, I cried a lot. It was hard to talk about, even with my PA, whom I adore. I kept looking away from her while I was talking and crying; I was embarrassed. Why was I crying? It was a lot of things, but mainly the fact that I have had an overwhelming feeling of guilt recently. Why do I feel guilty? As it is, it’s hard being a cancer survivor, and for me, it is tough because I have always had a great deal of empathy for people, but now it includes other cancer patients. Recently quite a few people I know, through various ways, are dealing with having a cancer recurrence. I feel guilty because I am still doing well; I am OK for the most part. They are experiencing my greatest fear, and I am feeling guilty because it isn’t me. It is also a reminder that my breast cancer was incredibly aggressive, and it could return at any time.

It is easy for most to say, “don’t live in fear, don’t worry about it,” but honestly, someone who says that to me clearly doesn’t understand how horrifying it is to go from barely needing to see a doctor to countless scans, blood draws, chemotherapy, radiation and four surgeries in a matter of fourteen months. All three of my doctors, my cancer treatments, everything I went through saved my life without a doubt, but it also damaged me in every way. I don’t know if I will ever be myself again, many cancer patients tell me that I won’t be, but I am doing everything I can to defy that future.

At the end of February, I will reach the second anniversary of my first appointment with my surgeon when I was diagnosed with breast cancer. In many ways, I can’t believe that it has been that long already, and in other ways, it feels like it has been a lifetime.

Thank you for being here; it helps to know that people care enough to read my blog, that the information I am sharing helps other cancer patients and their caregivers, and it helps me in more ways than I can say.

9 Things You May Not Have Heard from Your Doctor About Breast Cancer

I can relate to quite a few of the issues described below. I appreciate this article because it reminds me that the way I have been feeling recently is very common for cancer patients. I need to continue to give myself time to continue to heal both physically and emotionally.

Medically reviewed by Michelle Azu, M.D. — Written by Anna Crollman on September 24, 2020

It can be difficult for others to understand what you’re feeling without going through it themselves.

When it comes to breast cancer, your medical team can provide you with a wealth of expert medical advice.

But when it comes to the actual experience — how to manage the side effects and long-term insight on your options — some insight may be better understood by talking to other women who have walked the breast cancer path before you.

1. Fertility treatment options are best explored before you begin chemo

Many times, this step can be overlooked in the process of expediting your treatment.

However, discussing fertility preservation options before beginning any chemotherapy — which could impact long-term fertility — is important.

2. When your hair falls out, it could be painful

As the follicles die, there can be a painful and tender sensation on the scalp.

Many survivors will recommend you shave your head with a close razor as soon as this sensation begins in order to minimize the discomfort.

It’s always important to talk to your treatment team about unfamiliar side effects you’re experiencing to know if they’re expected parts of the treatment.

3. You may experience significant weight gain from the steroids

Many people associate weight loss with chemotherapy, but some women have the opposite experience and actually gain weight. Either can be challenging, both physically and emotionally.

4. Medication can affect your sex drive

Lupron and other hormone-blocking medications can cause vaginal dryness and painful intercourse, as well as decrease your sex drive.

You’re not alone in these challenges.

There are treatment options, and the sooner you intervene, the better. Don’t be embarrassed to ask about your options in terms of topical lidocaine, dilators, and daily moisturizing.

If your oncology team cannot advise you further in this area, they should be able to refer you to a health practitioner who can. Your gynecologist may also be a good choice for discussing your concerns.

5. You have options when it comes to breast reconstruction

Don’t be afraid to get a second or third opinion. Most surgeons offer or recommend the surgery types they’re most familiar with.

They won’t be offended by you getting another opinion, and it will help you come to a decision as a more informed and empowered patient — which is critically important.

6. Your implants may be cold to the touch

This is a rare and unexpected experience that occurs in some women who’ve had implants, and it can be helpful to be prepared for this ahead of time.

Regardless, it’s important to inform your surgical team so they can ensure there are no concerns related to your healing.

7. Complementary treatments help to manage side effects

More and more, oncologists are recognizing the benefits of holistic and complementary therapies, such as massage, acupuncture, and more.

Ask your local cancer support centers or organizations for referrals. Some centers have an integrative oncology program where these services are offered by a team that can communicate with your cancer treatment team.

8. Life after cancer can be harder emotionally than active treatment

When all the appointments are done and you’re not being monitored regularly, it can be unsettling.

Sometimes it can feel even harder if those around you are ready to celebrate and “move on,” and you’re not.

Don’t be afraid if you find yourself struggling to cope. You’re not alone in these feelings and it’s a good idea to reach out to your treatment team about support services, which may include a mental health professional.

9. Reconstruction is a journey

Not everyone feels comfortable with their outcome after reconstructive surgery. For many, the first surgery is the first phase of a two-step process, or more in some cases if needed.

In my case, it has been 5 surgeries over 4 years, and I’m planning to do more revisions this year.

If you’re dissatisfied, give yourself time to adjust to the changes and then don’t be afraid to ask what revision options are available.

The bottom line

The first-hand experience you will gain by connecting with other breast cancer patients and survivors can help you feel less alone and help you navigate your own cancer journey with support.

Find other cancer survivors with similar stories in the BC Healthline app, the Young Survival Coalition groups, and even through hashtags on social media, such as #breastcancersurvivor#youngbreastcancersurivor, and #doublemastectomy.

1 Year Update: Reconstruction, Breast Reduction & Port Removal Surgery **WARNING: GRAPHIC SURGERY PHOTOS**

Mood: Thoughtful & Grateful 😊

If you have not read my previous entries about this particular surgery, including photos, the links are listed below in order.

Reconstruction, Breast Reduction & Port Removal Surgery

Post Surgery Follow-Up **WARNING: GRAPHIC SURGERY PHOTOS**

A Month After Surgery **WARNING: GRAPHIC SURGERY PHOTOS**

On November 14th, 2019, I headed into surgery for the third time. I was excited about this surgery because my surgeon was fixing my lopsided chest. When I had my first surgery, he was removing cancer and planning for the reconstruction surgery that I would go through after chemotherapy. Now that chemotherapy was over, and we had given my body time to get rid of all of the drugs from sixteen treatments, I was ready for surgery.

As I said in my previous post about this surgery, my surgeon checked in on me before the surgery; he measured me, referenced his notes and pictures, and explained again in detail what he would be doing. He could see that I was nervous, so he assured me that while this would be my longest surgery to date, three to four hours, he was not worried about it at all and that I shouldn’t be worried either…I would be just fine, and as before, I would get through the surgery easily.

Recovering from this surgery, as far as pain was concerned, was not as difficult as recovering from my cancer surgery. I didn’t have any drains to deal with, which was great, but this time both of my breasts were opened up. I had cuts and sutures all over my chest, and coping with the trama of how I looked was difficult. I felt ugly, like I was a stitched up monster, so it was tough to look at myself in a mirror for the first few weeks of recovery.

Now it has been a year since this surgery, and I can’t believe how much my scars have faded! As time goes by, I am sure that my scars will fade even more; using Bio-Oil a few times a week seems to have helped immensely. 🙂

Birthday Trip 2020

Mood: Exhausted 😴

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.

🎀 Breast Cancer Awareness Month 🎀

I can’t believe that it is already October 1st! Up until now, it seemed like 2020 was going by as slowly as possible, tormenting everyone with endless challenges and sacrifices. But it is finally October; Fall has begun, and the end of the year is around the corner.

I have to admit that October never really held any special significance for me in the past, but after going through my journey with breast cancer, it has a new meaning for me. October is a time to reflect on everything that I went through last year, to help newly diagnosed women in any way I can through a breast cancer app that I am active on, to support those going through treatments and surgeries, to chat with other survivors and see how they are coping, and to remember those that we have lost to this horrible disease.

I received a free eBook today that I want to share with everyone because, as I have learned over the last 19 months, knowledge is power! I share information that I trust with you, my readers, because I have been there. I know how scary the words “you have breast cancer” are and the thoughts that flood your brain after hearing it.

If you have any questions for me or if you just want someone to talk to, please contact me at any time. I have a Contact Me page on this website, or you can contact me through one of my Social Network links at the bottom of each page on this website.

Your free eBook, Breast Problems That Aren’t Breast Cancer, is here! We are thrilled to provide this helpful guide for you.

Click this link to get your free copy

Did you know National Breast Cancer Foundation is committed to helping people (including you!) with their breast health? NBCF is helping people at every step of the journey by providing breast health education, delivering access to vital early detection screenings and breast health services to those who could not otherwise afford them, and helping those diagnosed with breast cancer—and their families—navigate the complex cancer care system.

I hope you enjoy this free resource!

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.