Cancer helps you meet the nicest people in the world. It's true! Case in point - within 3 days of sharing my cancer diagnosis with the mother of one of my 7 year old's buddies, I was receiving a gift from her mother. Tucked in a bag were a a bottle of Oxyfresh Zinc Mouth Rinse, a note of encouragement and an email address. Pat is a retired nurse who has been through the cancer story herself and she has been the source of great, practical advice. First piece, look after your mouth. Chemotherapy often leads to mouthsores. Invest in a soft bristle toothbrush and be gentle with your gums. And, consider adding a good, gentle mouth wash to your routine. I used this Oxyfresh mouth rinse everyday, morning and night. Results? Not one sore.
Oxyfresh can be hard to find. Here in Canada, it is carried by some dental practices. Or, you can purchase it online through their website.
Wednesday, June 9, 2010
Tuesday, June 8, 2010
Chemotherapy and constipation
Here's a fun topic! Ok - cancer has rendered me shameless so if you don't want to hear about poo stop reading now. Ready?
Some chemotherapy drugs loosen your stools and some plug you up. Mine did the latter. Big time (or not so big time, if you get my drift). During the first two months of chemo, I experienced more distress at being constipated than at any other side effect. No joke - it was seriously mentally distressing to not be able to poo.
So I will give you the big heads up NOW! Do not let it become a problem. If you are proactive, you can avoid this distress.
1. Increase your intake of dietary fiber. Women are advised to consume approximately 25 grams of fibre a day. If you are constipated because of chemo, you will need to eat at least that. I turned first to lists of high fiber foods to find out what foods I could quickly and easily add to my diet. I found this list of high fiber foods and an additional chart that guides you through making choices from the various categories of foods by fiber content. My first revelation - a medium avocado has over 11 grams of fiber. A cup of cooked black beans has almost 15 grams! I started adding quacamole and garlicky black beans as side dishes to my meals to significantly increase my fiber intake, painlessly. I knew prunes were an option but now I could add in other dried fruits (figs - 3.7 grams in 2, apricots - 2.89 in 5) more appealing to my tastebuds. And for fresh fruit, the chart showed me that blueberries were a good choice (4.18 grams per cup), but raspberries (8.3) were twice as good. Grapefruit and papaya were also good choices. Cooking greens? A cup of mustard greens has 2.80 grams to collard greens' 2.58, but kale has 7.2! You get my point - using the chart made meal and snack planning much easier.
Some people will also tell you to decrease the amount of animal protein you are consuming. During chemo I didn't eat much animal protein so it was hard to cut back. But see if this works for you.
2. Drink up. Make sure you are drinking enough fluids, especially non-caffeinated ones. Best - water. Nurses will tell you to try prune juice so give it a shot. I usually ended up diluting it so I could get it down. Advice you may not hear in terms of caffeinated beverages - try some coffee. I made sure I had a big latte every morning, hold over advice from a lovely doctor who oversaw my repair after the delivery of my huge headed first baby. ;-) If coffee is what works for you in normal circumstances, it will probably work for you now. It certainly won't hurt.
3. Move your body. Have I told you yet that my husband is a retired tank commander? The first advice out of his mouth when you are feeling crappy is either go get some exercise or suck it up. Since sucking it up was not an option, we walked. Around the block in the wind, around the block in the pouring rain. Nothing. Around the block again. Nothing. But I kept going and eventually there was a bit of, um, movement.. Every little bit of physical exercise does help your body fix the problem naturally. Plus you get additional benefits from the exercise.
4. Talk to your nurse or doctor about laxatives and stool softeners. What worked for me was Senokot S, a natural source laxative with an additional stool softener. I'm sorry - I should probably dance and sing here - woohoo!!! In your face constipation!! Movement of the business with no cramping at all. The key is start taking it one or two days before chemo to prevent the constipation from starting rather than trying to reverse what has already happened. A straight stool softener, docusate sodium capsules for example, is another recommended option but for me it didn't help much.
Now - my best advice - ExLax is only for the truly desperate. One pharmacist recommended Extra Strength ExLax. Good lord. The cramping was so bad it left me sweating, crying, and curled in the fetal position, something I thought I had left behind when I stopped mixing scotch and oysters. I will never take it again. All of the nurses say the same thing - try everything else before you try that.
Again, be proactive. It is easier to solve the problem when you begin focusing on your stools a day or two before your chemo infusion.
Alright - now we're done. :-) Happy pooing!
Some chemotherapy drugs loosen your stools and some plug you up. Mine did the latter. Big time (or not so big time, if you get my drift). During the first two months of chemo, I experienced more distress at being constipated than at any other side effect. No joke - it was seriously mentally distressing to not be able to poo.
So I will give you the big heads up NOW! Do not let it become a problem. If you are proactive, you can avoid this distress.
1. Increase your intake of dietary fiber. Women are advised to consume approximately 25 grams of fibre a day. If you are constipated because of chemo, you will need to eat at least that. I turned first to lists of high fiber foods to find out what foods I could quickly and easily add to my diet. I found this list of high fiber foods and an additional chart that guides you through making choices from the various categories of foods by fiber content. My first revelation - a medium avocado has over 11 grams of fiber. A cup of cooked black beans has almost 15 grams! I started adding quacamole and garlicky black beans as side dishes to my meals to significantly increase my fiber intake, painlessly. I knew prunes were an option but now I could add in other dried fruits (figs - 3.7 grams in 2, apricots - 2.89 in 5) more appealing to my tastebuds. And for fresh fruit, the chart showed me that blueberries were a good choice (4.18 grams per cup), but raspberries (8.3) were twice as good. Grapefruit and papaya were also good choices. Cooking greens? A cup of mustard greens has 2.80 grams to collard greens' 2.58, but kale has 7.2! You get my point - using the chart made meal and snack planning much easier.
Some people will also tell you to decrease the amount of animal protein you are consuming. During chemo I didn't eat much animal protein so it was hard to cut back. But see if this works for you.
2. Drink up. Make sure you are drinking enough fluids, especially non-caffeinated ones. Best - water. Nurses will tell you to try prune juice so give it a shot. I usually ended up diluting it so I could get it down. Advice you may not hear in terms of caffeinated beverages - try some coffee. I made sure I had a big latte every morning, hold over advice from a lovely doctor who oversaw my repair after the delivery of my huge headed first baby. ;-) If coffee is what works for you in normal circumstances, it will probably work for you now. It certainly won't hurt.
3. Move your body. Have I told you yet that my husband is a retired tank commander? The first advice out of his mouth when you are feeling crappy is either go get some exercise or suck it up. Since sucking it up was not an option, we walked. Around the block in the wind, around the block in the pouring rain. Nothing. Around the block again. Nothing. But I kept going and eventually there was a bit of, um, movement.. Every little bit of physical exercise does help your body fix the problem naturally. Plus you get additional benefits from the exercise.
4. Talk to your nurse or doctor about laxatives and stool softeners. What worked for me was Senokot S, a natural source laxative with an additional stool softener. I'm sorry - I should probably dance and sing here - woohoo!!! In your face constipation!! Movement of the business with no cramping at all. The key is start taking it one or two days before chemo to prevent the constipation from starting rather than trying to reverse what has already happened. A straight stool softener, docusate sodium capsules for example, is another recommended option but for me it didn't help much.
Now - my best advice - ExLax is only for the truly desperate. One pharmacist recommended Extra Strength ExLax. Good lord. The cramping was so bad it left me sweating, crying, and curled in the fetal position, something I thought I had left behind when I stopped mixing scotch and oysters. I will never take it again. All of the nurses say the same thing - try everything else before you try that.
Again, be proactive. It is easier to solve the problem when you begin focusing on your stools a day or two before your chemo infusion.
Alright - now we're done. :-) Happy pooing!
Monday, June 7, 2010
Yum
Last night we needed supper on the table quickly. It was late, it was Sunday. A quick trip to Chow led to a super easy, super yummy stovetop macaroni and cheese. I used medium cheddar since that is all I had. And I added hot sauce at the table since the kids...well they`re kids. Next time, I`ll add a blend of cheddars and some gruyere. I`m normally a roux girl when it comes to mac n cheese. But this was so easy and so great. I`m trying this baked next time, with a a few good canned tomatoes stirred into half of the dish (I`m the only one here that likes them) and buttered crumbs and more cheese on top. Not the most cancer friendly dish, but a salad on the side and fruit for dessert evens it out. And come on, this is a family that has earned some comfort food! :-)
Life saving tip of the day
Whether you are a cancer patient yourself or a caregiver, get yourself a good cookbook. My current favourite is The Cancer Lifeline Cookbook. It has appealing, easy to make recipes, some great pictures, and lots of tips for recipe adaptation and food preparation. But, more importantly, it has a mass of current, valuable information that has fundamentally changed the way I shop, cook, and eat. Kimberly Mathai, MS, RD and Ginny Smith cover topics ranging from the top ten superfoods and nutrients that promote good health, to coping with treatment side effects and getting help from family and friends. Recipes have been included from top chefs as well as cancer patients, cancer survivors and people working in the cancer field. You will want to make the dishes for the way they taste, not just for how they will help your health. My favourite recipes so far are Black Bean Soup (they add kale and shitake mushrooms making this my new go to version), Gingered Carrot Soup, Summer Rolls with Red Chili Peanut Dipping Sauce, and a rockin` citrus marinade that is great with chicken and with fish. In our near future, Seafood Stew and Pronto White Bean Chili.
Located in Seattle, Cancer Lifeline is a non-profit organization providing emotional support, resources, and education to cancer patients, and their support network, at all stages of the cancer process. They help patients, survivors, their families, friends, co-workers and caregivers throughout the Puget Sound and in 16 Western Washington counties. They do good work. If you are in need of support, and live in Western Washington, consider getting in touch with them. If you need to talk, call their 24 hour lifeline at 206-297-2500 if you live in the Seattle area or 1-800-255-5505 if you are further afield. Or visit their website for information on their services, classes and events.
Located in Seattle, Cancer Lifeline is a non-profit organization providing emotional support, resources, and education to cancer patients, and their support network, at all stages of the cancer process. They help patients, survivors, their families, friends, co-workers and caregivers throughout the Puget Sound and in 16 Western Washington counties. They do good work. If you are in need of support, and live in Western Washington, consider getting in touch with them. If you need to talk, call their 24 hour lifeline at 206-297-2500 if you live in the Seattle area or 1-800-255-5505 if you are further afield. Or visit their website for information on their services, classes and events.
Sunday, June 6, 2010
Cool diversion
Etsy is an online global marketplace where you can buy or sell handcrafted goods. Jewelry, clothing, food, makeup, art, cards, perfume, leather goods...where does it stop? Find goods nearby or buy from the other side of the world.
I'll give links in the future to favourite sellers and special finds. As a start, check out the lovely work of April Kawaoka.
I'll give links in the future to favourite sellers and special finds. As a start, check out the lovely work of April Kawaoka.
Deep breaths
Ok - so after the needle biopsy confirmed the presence of cancer cells in my breast, my surgeon scheduled a surgical biopsy for a few days later. Problem was, he was heading out of town on holiday so a locum would be doing the procedure.
I arrive at the hospital on time and, after getting robed and prepped by the nurses, settle on the bed and wait. After 20 minutes of harried phone calls and under the breath muttering from the nurses, the locum is located and asked politely (told) to get over because his patient is waiting! Turns out it is his first day at the surgical practice and the hospital and he is having trouble getting everything together, parking pass, id etc. to check in at the hospital himself.
Deep breaths.
So finally he gets here, introduces himself to me, shakes my hand as I lie flat on my back (get used to this - you will shake lots of hands while half nude and on your back) and says "How are you, darlin?" before getting started. No sedation, just local freezing and away we go. For the next, I don't know, half hour, I lie there, head turned away, looking at the wall while he slices into my breast and begins removing chunks of the tumour and my skin.
Deep breaths.
After a few moments, the nurse takes my hand, smiles at me and suggests a little music on the stereo. Nurses are really good. So now the procedure continues to the tune of a little light rock from a local station. Now I am not a huge fan of light rock. But I would have listenend to a selection of Bobby Vinton's greatest hits at that point.
Ok -so the first song up is Can't Fight the Moonlight. Now add in the sporadic interruptions of the surgeon's cell phone ring tone - which I think must have been a sample from the soundtrack to Kung Fu Hustle. I'm not joking. Every five or ten minutes, off goes the phone. Swish...swoosh...aaaah...dada dada dada da da da. Ok - can you put it on vibrate or something, please?
Deep breaths.
Once he gets up close to the tumour he starts talking to the nurse about what he is seeing. He isn't happy. The tumour is big. And many blood vessels are involved. He starts taking pieces and placing them on slides for the pathologist. After he has taken several samples of the tumour, he announces he will be taking samples of the skin. I don't know if this is standard with all surgical biopsies, but it is certainly necessary if Inflammatory Breast Cancer (IBC) is suspected because they are checking for the presence of cancer cells in the skin.
Deep breaths.
Finally he cauterizes the tissue, sutures the incision and finishes me up. He asks the nurse how long it should take for the pathologist to prepare a report. "Ten days or more." He doesn't like that. "Can we put a rush on it?" he asks politely. My heart stops. "We can try," is the response. More smiles for me from both the surgeon and the nurse. And then he is out the door. He is a kind, if distracted, man. But I know he is making an effort to be positive and attentive. She is a pragmatic, empathetic nurse who sees a lot. I feel cared for, but dazed.
I am a little shocked by the abruptness of the procedure, of how aware I was going to be of every little slice, every off hand comment. During the procedure, be prepared to hear your surgeon discussing what he or she is finding with the nurse or with you. Do not be alarmed. Your surgeon's observations are going to help your medical team determine the best way to fight your cancer. Information is good. The more your doctors know, the more effective the fight will be. I really wished someone had warned me that I would be both awake and aware during the procedure (I never asked). I would have been in a better frame of mind to process it all.
The pathologist did rush the report and within the week my oncologist had received it.
I arrive at the hospital on time and, after getting robed and prepped by the nurses, settle on the bed and wait. After 20 minutes of harried phone calls and under the breath muttering from the nurses, the locum is located and asked politely (told) to get over because his patient is waiting! Turns out it is his first day at the surgical practice and the hospital and he is having trouble getting everything together, parking pass, id etc. to check in at the hospital himself.
Deep breaths.
So finally he gets here, introduces himself to me, shakes my hand as I lie flat on my back (get used to this - you will shake lots of hands while half nude and on your back) and says "How are you, darlin?" before getting started. No sedation, just local freezing and away we go. For the next, I don't know, half hour, I lie there, head turned away, looking at the wall while he slices into my breast and begins removing chunks of the tumour and my skin.
Deep breaths.
After a few moments, the nurse takes my hand, smiles at me and suggests a little music on the stereo. Nurses are really good. So now the procedure continues to the tune of a little light rock from a local station. Now I am not a huge fan of light rock. But I would have listenend to a selection of Bobby Vinton's greatest hits at that point.
Ok -so the first song up is Can't Fight the Moonlight. Now add in the sporadic interruptions of the surgeon's cell phone ring tone - which I think must have been a sample from the soundtrack to Kung Fu Hustle. I'm not joking. Every five or ten minutes, off goes the phone. Swish...swoosh...aaaah...dada dada dada da da da. Ok - can you put it on vibrate or something, please?
Deep breaths.
Once he gets up close to the tumour he starts talking to the nurse about what he is seeing. He isn't happy. The tumour is big. And many blood vessels are involved. He starts taking pieces and placing them on slides for the pathologist. After he has taken several samples of the tumour, he announces he will be taking samples of the skin. I don't know if this is standard with all surgical biopsies, but it is certainly necessary if Inflammatory Breast Cancer (IBC) is suspected because they are checking for the presence of cancer cells in the skin.
Deep breaths.
Finally he cauterizes the tissue, sutures the incision and finishes me up. He asks the nurse how long it should take for the pathologist to prepare a report. "Ten days or more." He doesn't like that. "Can we put a rush on it?" he asks politely. My heart stops. "We can try," is the response. More smiles for me from both the surgeon and the nurse. And then he is out the door. He is a kind, if distracted, man. But I know he is making an effort to be positive and attentive. She is a pragmatic, empathetic nurse who sees a lot. I feel cared for, but dazed.
I am a little shocked by the abruptness of the procedure, of how aware I was going to be of every little slice, every off hand comment. During the procedure, be prepared to hear your surgeon discussing what he or she is finding with the nurse or with you. Do not be alarmed. Your surgeon's observations are going to help your medical team determine the best way to fight your cancer. Information is good. The more your doctors know, the more effective the fight will be. I really wished someone had warned me that I would be both awake and aware during the procedure (I never asked). I would have been in a better frame of mind to process it all.
The pathologist did rush the report and within the week my oncologist had received it.
Saturday, June 5, 2010
Life saving tip of the day
Vitamin D - talk to your doctor about whether you are getting enough. Many studies (like the ones cited in this article) suggest that the sunshine vitamin can be a powerful tool in extending your life and warding off diseases like breast cancer.
1,000 IU of vitamin D is the daily dosage recommended by the Canadian Cancer Society. During the spring and summer, that can be accomplished through normal daily exposure to the sun. Some advise that as little as 10 to 15 minutes of sun exposure a day twice a week will allow the body to generate sufficient levels of the vitamin. In the fall and winter months, especially here in Canada, a vitamin D supplement may be necessary. You could also increase your consumption of oily fish or fortified foods.
But don't overdo it. 2,000 IU is the daily maximum tolerable amount as established by the U.S.-based Institute of Medicine of the National Academies. Exceeding it could be very dangerous. Health Canada warns people that taking too much can lead to kidney stones as well as damage to the heart, lungs and blood vessels.
1,000 IU of vitamin D is the daily dosage recommended by the Canadian Cancer Society. During the spring and summer, that can be accomplished through normal daily exposure to the sun. Some advise that as little as 10 to 15 minutes of sun exposure a day twice a week will allow the body to generate sufficient levels of the vitamin. In the fall and winter months, especially here in Canada, a vitamin D supplement may be necessary. You could also increase your consumption of oily fish or fortified foods.
But don't overdo it. 2,000 IU is the daily maximum tolerable amount as established by the U.S.-based Institute of Medicine of the National Academies. Exceeding it could be very dangerous. Health Canada warns people that taking too much can lead to kidney stones as well as damage to the heart, lungs and blood vessels.
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