Rethink Breast Cancer is a Canadian, volunteer-driven, registered charity working to help young people concerned about and affected by breast cancer. They provide innovative breast cancer education, research and support programs. Visit their website to get access to, among other things:
The Underwire is Rethink Breast Cancer's newsletter. Published four times a year, The Underwire provides up to date research on diagnosing, treating and preventing breast cancer, as well as other news for people affected by breast cancer. Lots of very good, current information.
Breast Cancer Now What
Popular British Columbia sex educator Saleema Noon spoke at a cancer breakfast I attended soon after my diagnosis. Her breast cancer was diagnosed when she was in her mid-30s, newly married and planning a family. She was a perfect example of how younger people with breast cancer usually have a different set of concerns than those fighting it later in life. You may be undergoing treatment while attending school, starting or building your career or raising small children. To help young people connect with and support others going through the same thing, she suggested Rethink Breast Cancer's program Breast Cancer Now What. Visit this site to learn about current research and connect with others on the discussion board.
Tell Her 2 connects Canadians affected by HER2+ breast cancer. Share your story and read those of others. Find current information on estrogen positive breast cancer and then give or receive emotional support and inspiration.
Tuesday, June 22, 2010
Saturday, June 19, 2010
Cool diversion
Some days it can be hard to be inside my head with "the cancer." On those days, I look for a way to get outside of my brain. Here are a few sites I turn to to help me think about better things.
Kiva - Kiva connects people who want to help with people who need help - in the form of microloans. As of November, 2009, Kiva has facilitated loans totalling more than $100 million. Kiva makes it so easy to connect your desire to help with someone in actual need. See how it works here.
Color Me Katie - Katie Sokoler is a freelance photographer and street artist in Brooklyn. The joy she injects into life around her makes me want to be a more creative and spontaneous person.
Nienie - Stephanie Nielson and her husband survived a plane crash, but the road to recovery is long and challenging. Her blog covers every step on that road, with much humour and grace.
make something - crafty list of things to do Karyn owns the Toronto shop the workroom where you can take classes, sew by the hour on her sewing machines and sergers, and more. I can't visit her store but I love scanning through her running list of "things to do" to find inspiration closer to home.
not martha - Megan talks about crafting, cooking, blogging, technology and more...and takes damn good pictures of all of it. She's in Seattle and I love finding out what we should check out the next time we visit.
dooce - Heather Armstrong writes about being a mom, wife and blogger. She survived post-partum depression, became a succesful auther, got a show on HGTV, drinks good bourbon and takes pictures of her dog Chuck with things balanced on his head. Why are you still reading my blog when you could be reading hers?
Kiva - Kiva connects people who want to help with people who need help - in the form of microloans. As of November, 2009, Kiva has facilitated loans totalling more than $100 million. Kiva makes it so easy to connect your desire to help with someone in actual need. See how it works here.
Color Me Katie - Katie Sokoler is a freelance photographer and street artist in Brooklyn. The joy she injects into life around her makes me want to be a more creative and spontaneous person.
Nienie - Stephanie Nielson and her husband survived a plane crash, but the road to recovery is long and challenging. Her blog covers every step on that road, with much humour and grace.
make something - crafty list of things to do Karyn owns the Toronto shop the workroom where you can take classes, sew by the hour on her sewing machines and sergers, and more. I can't visit her store but I love scanning through her running list of "things to do" to find inspiration closer to home.
not martha - Megan talks about crafting, cooking, blogging, technology and more...and takes damn good pictures of all of it. She's in Seattle and I love finding out what we should check out the next time we visit.
dooce - Heather Armstrong writes about being a mom, wife and blogger. She survived post-partum depression, became a succesful auther, got a show on HGTV, drinks good bourbon and takes pictures of her dog Chuck with things balanced on his head. Why are you still reading my blog when you could be reading hers?
Stretching your dollar
From time to time, you will notice me recommending products, books, clothes and the like - things on which one might spend money. Let me say up front that I do not advocate the LET'S SHOP FOR FUN! philosophy that some bloggers do. I believe that rampant consumerism is a huge problem in today's society, leading people to submerge themselves in debt and our landfills in junk. And, if you are someone coping with a chronic or life threatening illness, you have likely taken a financial hit. Now more than ever we must make careful choices on how we spend money.
If you have to spend money, do it mindfully. That means shop used (Craigslist, garage sales) before new, and reduced (sales, liquidation stores) before retail. Buy local before imported and quality before crap. And do your research first. That means reading comments from previous buyers when you buy online and checking out performance reviews on sites like Consumer Reports, Cooks Illustrated and Epinions. If you are looking at a site like Etsy for quality, handcrafted art, clothes and gifts, remember to checkout the feedback left by previous customers.
Please know that if I recommend a product or website, I strive to follow these rules. And when I learn about new and better ways to help you save money, I will pass them along here.
And for the love of all things holy, please don't let all the fashion, home decorating and beauty websites feed any sense of dissatisfaction with yourself or your life. Be happy with what you have, or get crafty and make stuff you love. Plant some seeds, paint a wall, frame a child's artwork. Stop letting people sell you things that they think you need. Take back control of how you spend your money.
If you have to spend money, do it mindfully. That means shop used (Craigslist, garage sales) before new, and reduced (sales, liquidation stores) before retail. Buy local before imported and quality before crap. And do your research first. That means reading comments from previous buyers when you buy online and checking out performance reviews on sites like Consumer Reports, Cooks Illustrated and Epinions. If you are looking at a site like Etsy for quality, handcrafted art, clothes and gifts, remember to checkout the feedback left by previous customers.
Please know that if I recommend a product or website, I strive to follow these rules. And when I learn about new and better ways to help you save money, I will pass them along here.
And for the love of all things holy, please don't let all the fashion, home decorating and beauty websites feed any sense of dissatisfaction with yourself or your life. Be happy with what you have, or get crafty and make stuff you love. Plant some seeds, paint a wall, frame a child's artwork. Stop letting people sell you things that they think you need. Take back control of how you spend your money.
Tuesday, June 15, 2010
PICC insertion
Because my oncologist was in a hurry to begin my chemo treatments, he ordered the insertion of a PICC (Peripherally Inserted Central Catheter) immediately. Then, given I was going to be receiving infusions for a year (chemo followed by Herceptin), I would have a port surgically implanted at a later date.
A PICC is inserted in the arm opposite the breast with cancer. The tube is inserted in a vein in the arm and advanced through increasingly larger veins until the tip comes to rest near the heart. A tube extends from the underside of the arm, above the elbow, and the chemotherapy drugs are infused through that tube. By infusing the drugs almost directly into the heart, the toxic chemo drugs do not damage the veins in the patient's arm, a significant concern with long term chemotherapy. Instead, they travel immediately to the heart which flushes the drugs into the body quickly with little damage to surrounding veins. In between treatments, the tube is covered by gauze and plastic dressings. Home care nurses monitor the PICC, flushing it freqeuently to ensure the line is clear and monitoring the entry point for signs of infection.
Given the stressful event that was my surgical biopsy, I was worried about the PICC insertion. I needn't have.
The wonderful woman who would be inserting the PICC was gentle, clear and informative. She guided me through the procedure using diagrams, checking often to ensure I understood what would happen. She also outlined aftercare and how I would need to adjust my life to accomodate the PICC. I would not be able to lift anything heavier than 5 pounds, so she ran through ways I would have to adjust how I managed my two young boys.
Then she gave me advice that, at first, shocked me. But in the months since then it is advice that has helped me again and again. It was bad, she said, to hold my breath. Holding my breath would put too much pressure on the PICC tube and could cause problems with it. "When you need to cry, you must cry. Don't hold it in." She locked eyes with me and did not look away until I had nodded. This was the first health care professional who had acknowledged that crying...fear...sadness...would be part of living with cancer. It was a remarkably empowering and moving moment.
Then I put on a gown, was settled on the bed and met the nurse who would be assisting. And we were off. First up, "What do you think? You look like a Nora Jones person. How would that be?" Are you kidding me? With that, the stereo was turned on, the lights were dimmed and we were underway. It took most of the album to complete the procedure, but it was painless and stressless. Compared to the surgical biopsy, it was like going to the spa. (And for, like, a happy procedure like a scrub or massage rather than a bikini wax.)
The after care was the problem. Because chemotherapy is very hard on your body, you can develop skin sensitivity. This happened to me. Never one to have any skin issues at all, I was dismayed to learn I had developed a sensitivity to plastics and latex. The plastic dressing over my PICC led me to break out in a dreadful rash. The nurses needed to replace the plastic dressing with gauze and paper tape and I needed to be vigilante about the use of any more plastic dressings during any form of treatment. Other than that, the main concern was keeping the dressing dry. I could not shower or bathe without covering the dressing with plastic. Typically, I used (and reused) disposable plastic shirt sleeve protectors, purchased at a local Japanese dollar store, Daiso. Sort of like a gator for your shirt. I also used plastic bags, opened at both ends, along with elastic bands and additional tape to ensure a tight seal.
Living with the PICC was not a huge challenge. But it was inconvenient. It is very hard not to lift your children, laundry or groceries. Pretty significant shifts needed to happen in my home. I could not do yoga, swim or bike ride. Sleeping was really uncomfortable. And the rash made my arm sore. There was a significant concern that the rash could lead to infection. Luckily it did not. But I knew there was no way I could do the entire year's worth of treatment with the PICC.
And luckily I didn't have to.
Up next - port insertion. :-)
A PICC is inserted in the arm opposite the breast with cancer. The tube is inserted in a vein in the arm and advanced through increasingly larger veins until the tip comes to rest near the heart. A tube extends from the underside of the arm, above the elbow, and the chemotherapy drugs are infused through that tube. By infusing the drugs almost directly into the heart, the toxic chemo drugs do not damage the veins in the patient's arm, a significant concern with long term chemotherapy. Instead, they travel immediately to the heart which flushes the drugs into the body quickly with little damage to surrounding veins. In between treatments, the tube is covered by gauze and plastic dressings. Home care nurses monitor the PICC, flushing it freqeuently to ensure the line is clear and monitoring the entry point for signs of infection.
Given the stressful event that was my surgical biopsy, I was worried about the PICC insertion. I needn't have.
The wonderful woman who would be inserting the PICC was gentle, clear and informative. She guided me through the procedure using diagrams, checking often to ensure I understood what would happen. She also outlined aftercare and how I would need to adjust my life to accomodate the PICC. I would not be able to lift anything heavier than 5 pounds, so she ran through ways I would have to adjust how I managed my two young boys.
Then she gave me advice that, at first, shocked me. But in the months since then it is advice that has helped me again and again. It was bad, she said, to hold my breath. Holding my breath would put too much pressure on the PICC tube and could cause problems with it. "When you need to cry, you must cry. Don't hold it in." She locked eyes with me and did not look away until I had nodded. This was the first health care professional who had acknowledged that crying...fear...sadness...would be part of living with cancer. It was a remarkably empowering and moving moment.
Then I put on a gown, was settled on the bed and met the nurse who would be assisting. And we were off. First up, "What do you think? You look like a Nora Jones person. How would that be?" Are you kidding me? With that, the stereo was turned on, the lights were dimmed and we were underway. It took most of the album to complete the procedure, but it was painless and stressless. Compared to the surgical biopsy, it was like going to the spa. (And for, like, a happy procedure like a scrub or massage rather than a bikini wax.)
The after care was the problem. Because chemotherapy is very hard on your body, you can develop skin sensitivity. This happened to me. Never one to have any skin issues at all, I was dismayed to learn I had developed a sensitivity to plastics and latex. The plastic dressing over my PICC led me to break out in a dreadful rash. The nurses needed to replace the plastic dressing with gauze and paper tape and I needed to be vigilante about the use of any more plastic dressings during any form of treatment. Other than that, the main concern was keeping the dressing dry. I could not shower or bathe without covering the dressing with plastic. Typically, I used (and reused) disposable plastic shirt sleeve protectors, purchased at a local Japanese dollar store, Daiso. Sort of like a gator for your shirt. I also used plastic bags, opened at both ends, along with elastic bands and additional tape to ensure a tight seal.
Living with the PICC was not a huge challenge. But it was inconvenient. It is very hard not to lift your children, laundry or groceries. Pretty significant shifts needed to happen in my home. I could not do yoga, swim or bike ride. Sleeping was really uncomfortable. And the rash made my arm sore. There was a significant concern that the rash could lead to infection. Luckily it did not. But I knew there was no way I could do the entire year's worth of treatment with the PICC.
And luckily I didn't have to.
Up next - port insertion. :-)
Thursday, June 10, 2010
Summer dishes on the horizon
Find a balance between eating food that's good for you most of the time and food you love a little bit of the time. Win-win when you find food you love that is good for you. I'm picking and choosing from the list below over the next month, with an emphasis on lots of lightly steamed or raw vegetables with every lunch and dinner, and small portions of desserts.
Doris Day's popovers - normally, I would slather them with butter and jam or honey, but now I`ll have them with fruit salad and plain yogurt...and leave the slathering to the kids. From Delicious Days.
And the healthier breakfast choice - Multigrain Waffles from 101 Cookbooks.
Dips, dips and more dips - get your veggies in with this selection from Apartment Therapy's The Kitchn.
Carrot Salad with Harissa, Feta and Mint from the Smitten Kitchen is a nice match for flank steak. I love flank steak. I really do. Here's Mark Bittman's recipe. :-) I love Mark Bittman. Did I say that I love Mark Bittman? I really do. It's ok - my husband loves him, too. And flank steak.
I`m getting my omega 3`s from Cooking with Amy`s Slow Roasted Salmon. I don`t think you have to use Copper River salmon. :-)
Lentil Artichoke Stew; Cucumber, Mango and Spinach salad; and Green Goodie Smoothy - three cancer fighting recipes from dieticians with the Cancer Project.
Sour Cherry Slab Pie from the Smitten Kitchen, last year.
Looking for something to do with all this year`s great rhubarb? Rhubarb Tart with Lemon Verbena at Chocolate and Zucchini, Rustic Rhubarb Tarts at the Smitten Kitchen and Roasted Rhubarb from Orangette look great (and if you need a giggle listen to Orangette's Molly Wizenberg's Spilled Milk podcast on the lovely fruit...uh...vegetable...uh plant.)
Olive Oil Cake, because I'm dying to try this Kim Boyce whole grain flour cookbook. From the Wednesday Chef.
Doris Day's popovers - normally, I would slather them with butter and jam or honey, but now I`ll have them with fruit salad and plain yogurt...and leave the slathering to the kids. From Delicious Days.
And the healthier breakfast choice - Multigrain Waffles from 101 Cookbooks.
Dips, dips and more dips - get your veggies in with this selection from Apartment Therapy's The Kitchn.
Carrot Salad with Harissa, Feta and Mint from the Smitten Kitchen is a nice match for flank steak. I love flank steak. I really do. Here's Mark Bittman's recipe. :-) I love Mark Bittman. Did I say that I love Mark Bittman? I really do. It's ok - my husband loves him, too. And flank steak.
I`m getting my omega 3`s from Cooking with Amy`s Slow Roasted Salmon. I don`t think you have to use Copper River salmon. :-)
Lentil Artichoke Stew; Cucumber, Mango and Spinach salad; and Green Goodie Smoothy - three cancer fighting recipes from dieticians with the Cancer Project.
Sour Cherry Slab Pie from the Smitten Kitchen, last year.
Looking for something to do with all this year`s great rhubarb? Rhubarb Tart with Lemon Verbena at Chocolate and Zucchini, Rustic Rhubarb Tarts at the Smitten Kitchen and Roasted Rhubarb from Orangette look great (and if you need a giggle listen to Orangette's Molly Wizenberg's Spilled Milk podcast on the lovely fruit...uh...vegetable...uh plant.)
Olive Oil Cake, because I'm dying to try this Kim Boyce whole grain flour cookbook. From the Wednesday Chef.
Wednesday, June 9, 2010
Chemotherapy and mouth care
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.
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.
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!
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