Getting Old and Getting in Shape

This post has the potential to rival The Longest Post Ever, but it encompasses about six months of my life as opposed to six hours.

I'll start with something I've wanted to explain to all of my friends who are approximately my age and warily approaching or just past the big four-oh. That birthday, exactly one year ago, didn't bother me at all. It's just a number, I didn't feel any different, and I've never cared about getting "old" or having a bigger age. In fact, I had to be persuaded to have a party for my birthday (which didn't quite turn out the way I'd hoped) and basically, forty is no big deal. However, now that I've finished my fortieth year (actually, my 41st year for you math geeks), I have an announcement: If you can make it through the week of your 40th birthday without being diagnosed with CANCER, you've got nothing to complain about.

Obviously, during my recovery from the mastectomy and while undergoing chemo, I didn't quite feel my age. My body ached, I was tired all the time, and I seemed to be getting any ailment that could possibly exist. Knowing that there'd be a light at the end of the tunnel, I just plowed on through, waiting to be young(ish) again.

I know that the stereotype is that women doing chemo are bald and skinny because they're nauseous. However, I found that I was only eating comfort foods: cereal, pasta, breads, and uh, cookies. Add to that the fact that I was taking a steroid to make my body strong enough to handle the taxol, and I actually gained about 10 pounds during chemo.

I'd read many-an-article about how important keeping in shape is in keeping the cancer from coming back. Basically, studies and research have inconsistent findings about the kiwi and broccoli diet or the all organic lifestyle, but it is an absolute that being overweight or obese can increase your chances of recurrence. Though I indulged during the summer of awfulness, I knew it wasn't a permanent thing.

Early in my treatment, I was alerted to a fitness program at the YMCA through the national Livestrong foundation where they help cancer survivors get into shape. Knowing little about it but seeing that it was free, I signed up. After a few phone calls, I was enrolled in a class that would meet twice a week for twelve weeks, give me a personal trainer at each of those sessions, and tailor my exercises to the fact that I've been treated for cancer. Not only that, but the Livestrong program includes a free 3 month family membership, and since my body managed to grow the cool kind of cancer (breast cancer is very vogue these days), there's a grant to extend that family membership for a full year. October 2 was my start date for getting back into shape.

Between the end of chemo and the start of Livestrong, I began taking tamoxifen. Although I've alluded to it in other posts, here's my chance to explain how it has officially made me old. My breast cancer cells were classified as estrogen receptor positive, which is actually a good thing. (Best breast cancer ever, remember?) It means that the cells need estrogen to grow. This drug called tamoxifen can block estrogen from binding to other cells, thus giving any cancer cells that may be left in my body nothing to grow on. Dr. Kirshner, oncologist extraordinaire, actually told me that the tamoxifen does more for me than chemo and radiation combined. Unfortunately, tamoxifen, by cutting off my estrogen, put me into full menopause. But whatever. It was going to happen anyhow, and menopause is better than cancer.

Knowing that I cannot miss a pill or accidentally double-dose ("Uh, did I take my meds? I can't remember.  I'll just take one."), I bought one of those days-of-the-week pill boxes. Then I started taking the pills and the hot flashes began. It was the one-two punch of officially getting old.

Back to the weight thing. My first dose of tamoxifen was August 31. Starting then, I was gaining almost a pound a week by eating my normal, pre-cancer diet. I figured out, with the help of Google, why that may have been happening: Post-menopause, metabolism changes, so I was supposed to be eating like a 60-year-old, not a 40-year-old.

But hoping for an easy fix, I mentioned my weight gain to my doctors in November. A blood test for my thyroid was ordered because sometimes underactive thyroid causes weight gain. Results: overactive thyroid. I should have been losing weight. They repeated the blood test and got the same results. I was referred to an endocrinologist, who couldn't fit me in until February, so I was on my own with my weight gain for a while.

I thought that Livestrong, with the twice weekly meetings and my maintenance exercising a couple more times a week, would help out, but I continued to gain weight. In reality, Livestrong wasn't enough. The trainers, Elin and Al, were wonderful and knowledgeable, but the program is focused on strength and balance, and (sorry if I offend anyone) really geared toward older, less athletic people. I was a twice-a-day varsity swimmer through college. I've done a triathlon and numerous 5Ks. Yes, that was years ago, but my athletic body was looking for and needing more. I had to find something hard and go all-out!

In mid-December, up 18 pounds from when I was diagnosed with breast cancer, I asked a preschool mom/friend (Kristin) about some Facebook post she made about a Method 360 demo class. She explained that she and a trainer named Trish lead these classes that give you a full body workout (cardio, strength, core). I showed up that Sunday and gasped for breath, dripping with sweat for an hour. Absolutely perfect! The next day, I signed up for a 12-week program and committed to going to classes 6 days a week, sending Kristin and Trish daily food logs, and letting them measure my weight and body-fat every other week.

Those of you who know me well (or probably even those who only kind of know me) will have no doubt that I've gone all-in here. If I tell someone I'll be there 6 days a week, I will. If I have to send a food log, I will include the 3 M&Ms I ate this afternoon, no cheating. If a triathlon in June is mentioned, I'll register. (Actually, I'm now registered for one in June and another in August. Anyone have a bike I can borrow?)

It took me about 3 weeks of the daily workouts, but now I am not gasping for breath. I'm working hard and I'm really feeling fit. I'm down about 10 pounds on the scale (Trish says it's more like 13 pounds of fat gone and 3 pounds of muscle gained), but that's no longer the goal. I just want to stay in shape. Also, keep in mind that I'm not yet even back to my pre-cancer weight, though I'm more fit.

The sucky part is the diet. Paul and I have always agreed that a life without chicken wings is a life not worth living. We've said, "I'd rather die a few years earlier and eat what I want." Though I still agree with our sentiments, I have to refer back to the studies that show obesity can cause cancer to come back. If chicken wings cause me to be overweight, I guess I'll skip them. I'm sure I'll have wings, brownies, and McDonalds on occasion, but my daily diet has to be better than it used to be. For the first few weeks of this diet, I was hungry all day, but now I'm used to it and just accepting it, I guess.

So my endocrinologist appointment finally rolled around a few weeks ago and he did another blood test to check the thyroid. Now I'm actually showing the underactive thyroid that causes weight gain. His explanation is that sometimes our thyroid gland gets inflamed and becomes overactive (which would make sense because my radiation was pretty close to there), and then once the swelling goes down, it becomes underactive. I'm now taking a thyroid medication, another pill added to my days-of-the-week dispenser. We'll recheck the blood in a few months. Maybe thyroid meds will help me lose weight, too? I can wish.

When my parents were alive and I would get updates from my mom about her 60-something and my dad's 70-something friends, it was always about who had what ailments. In this ridiculously verbose post, I've mentioned my meds, menopause, my hot flashes, my oncologist, and my thyroid. I guess 40 is the new 60.

I'll end with a cool discovery I've made that'll help you young women in the future. Hot flashes are really quite uncomfortable. From summer when they started (menopause actually started temporarily with the chemo drugs) until December, I followed the generic hints: wear layers, have a fan nearby, use a cool towel or ice, etc. Literally, the very week I started Method 360, the hot flashes went away completely. Now, keep in mind that this is a very intense, boot-camp-like workout. Livestrong's 90 minutes of weights and stretching did nothing for the hot flashes. But serious exercise really does get rid of hot flashes. Now you know.

Now I'll Cliff's Notes this post:
- Chemo made me gain weight
- Tamoxifen cuts off my estrogen. Good at fighting breast cancer. Causes menopause
- Menopause made me gain more weight
- I started easy workouts with no effect
- Complete diet change and kick-ass workouts have had the desired effect
- I was diagnosed with hypothyroid
- I take pills from a days-of-the-week dispenser
- Triathlons in June and August

Happy 41st Birthday to me!

Cancerversary?

Cancerversary is actually a word that people in the cancer circles use. Ever since I heard it, I've been confused about it because I certainly don't want to celebrate any date involving cancer. Also, there are so many dates: the day I felt a suspicious lump; the day of my bad mammogram after which a doctor told me with 99.9% certainty that I had cancer; the day of the actual biopsy results proving that he was right; having the mastectomy which allegedly removed the cancer; finishing chemo; finishing radiation. Do I acknowledge all of them?

However, as this time of year has approached, February 24, 2012 is the date that resonates the most in my mind. I went into that mammogram thinking it was a three hour pass away from the kids. Quick doctor's appointment, then some grocery shopping sans herding cats through the aisles. I left that appointment having to concentrate on breathing in and out and putting one foot in front of the other.

Whether I will call February 24 my cancerversary remains to be seen. I'm trying to think of a better name. Suckity-suck day? Ninety-nine point nine percent sure day? Eat a brownie sundae day? Let me know if you think of a good name and I'll use it.

If it wasn't for the events of February 24, 2012, though, I wouldn't have started this blog. As you may have noticed, the blogging has tapered off recently. Maybe it's because life is pretty much normal, but there is a bit to tell. Stay tuned over the next few days to hear about how my life has changed since finishing my active cancer treatment.

Breast Cancer and Termites

I'm such a teacher. I want to make things easy to understand, so I spend time thinking about analogies that make complicated things seem much simpler. For the past few weeks, I've been working on a breast cancer analogy that I really think will work to explain where I am right now and why I'm not comfortable with words like "gone" or "cured".

Imagine that you are sitting on your back porch one day and notice that one of the wooden beams has something that looks like a bug trail running along it. You call the exterminator, and she confirms (yes, she...the one exterminator I've ever had was a woman named Leesa) that you do, in fact, have termites. She does a bit of probing and finds that there is a nest of termites in the wood of the back porch, and there are trails of termites marching around in the beam leading toward your kitchen. You know that termites, left untreated, can destroy a house completely, so it's time for action.

Feeling aggressive, you have your back porch completely removed, as well as that offending beam leading to the rest of the house. While the demolition team is at it, you tell them to go ahead and take off the front porch as well, since termites could show up there someday and you might as well be symmetrical.

Next, you're told that you there could be some termites, either individually or in groups, that walked away from that nest on your back porch and are hiding somewhere in your house. Leesa tells you that she has this termite poison that she can infuse throughout every wall of your entire house. It'll peel the paint and make the house stinky for a while, but it's pretty darn good at killing termites. So you let her come every other week for four months and poison your walls. It's okay. You'll just repaint when it's all done.

After that, she reminds you that although the back porch is gone, there is still that wall where the porch was attached to the house. Her next line of offense is to carefully use a blow torch to do a controlled burn of the wood that's left. That'll get any termites that survived the poison and prevent new ones from growing. After 28 straight days of gradual burning, the wall may always look a little darker, but it's better than termites.

Finally, Leesa advises you that your termites liked eating bread. You must now go for five years without ever having bread in your house, because there might still be that rogue termite somewhere. She cannot actually check every wall and every beam, so you just have to trust that all of these things you've done have actually removed the termites from your house. She tells you to call her if you notice anything odd about your house so she can look more closely, but you're basically on your own now.

Throughout this whole process, you've learned a lot about termites. You found the scary fact that 30% of houses that go through this will eventually have termites again. (This is called metastatic, or stage IV termites.) Unfortunately, the famous termite research foundations are spending more than 95% of their money on looking at porches. Don't you wish they would spend some more time and effort figuring out why, even after all you've done, you might still get termites again? And figuring out how to prevent that?

I hope this analogy is as clear to you as it is when I think about it. Should I give a list of what all of the termite treatments were really called in regards to my cancer treatment, or did you figure it all out?

Quiz on Tuesday.

More Appropriate Pictures

Now that you've become accustomed to seeing pictures of my topless, scarred, oddly shaped, radiation burned boobs, I'll surprise you with some G rated photos.

A couple weekends ago, we spent some time with Lisa Rossi. She's a photographer in the Syracuse area who came highly recommended, and she totally lived up to our expectations. We met her at her house in Fabius and she made us feel comfortable playing in her field while she followed us around with her camera. Within a couple hours of our session, she had this preview photo up on Facebook.

Just tonight, she alerted me that she's posted more photos on her blog. I know you want to see, right? So click here to check them out. I promise my boobs are covered in every single one.

Real Breast Cancer Awareness

I've been trying to think of something to say about this October breast cancer "celebration" going on. However, I've decided to let a couple pictures tell a thousand words here.

This is what you see in October 2012:

 

This is what I see in October 2012:

(And here's the topless version.)

 Not too much in common, right?

Tattoos and Cubbyholes

I'll start today with a little background on the radiation I'll be receiving over the next 6 weeks. Radiation therapy is when a high energy beam from a big machine is directed right at my breast. It will damage all cells in its path, but the healthy cells will grow back and (hopefully) the cancer ones will not. Since the beam is aiming only at my right breast, collarbone, and armpit, I will not feel the effects throughout my whole body like I did with chemo. To summarize what I've heard/read about how I'll feel, it'll be like a bad sunburn in that area which I'll treat with any number of creams until it heals.

In order to prevent the cancer cells from starting to grow, my radiation will be done for 28 straight weekdays. So that's almost 6 weeks where I go to my oncology clinic EVERY DAY, lay in a machine, get my right breast burned, and then walk out and continue my normal life. It sounded crazy and life-altering to me at first, but I've been assured that these appointments are 15 minutes long from the time you walk in the door until you are back at your car. The first time slot of the day is 7:45am and I've grabbed it up for the next 27 days, so my normal day starts at 8:00.

I had an appointment last Friday to set me up for this daily radiating. So I lay on a metal table with one arm up and they mapped out what they'll radiate. It took about 20 minutes of them telling me to hold completely still and "breathe normally" (can anyone breathe normally when they've just been told to do so?) for them to get the exact measurements they needed. Though I'd normally have been asking what they're looking for, I was told not to talk. The end result was me looking like this:

(Remember those drains from the double mastectomy? Those circle scars are where the tubes came out of my body. Also note the lumpy boob and the reason I considered getting the soft silicon put in now.)

The cool part is that dot with a circle. That's a new tattoo I have. It's a little blue dot that they'll use to line up the radiation beam every session, and I have two more of them. Wanna see? (Of course you do.)

My cleavage:

The top of my right breast:

As you can see, I'm a very moley person, so this new ink of mine won't make any difference in my appearance. I asked if they could make stars or hearts, but these are radiation technicians, not artists, so it was a no-go. (Probably a joke they hear frequently, too, as nobody even smiled.)

Now that I'm all inked up, I can go in every day and they'll burn the right place.

At 7:25 this morning, the whole family loaded into two cars and drove out to HOA in E. Syracuse. Paul took the girls to get coffee (him) and donuts (them), and I went into the building at 7:45. Instead of having a nurse come to the waiting room to get me, an intercom called, "Sharon L, come on back." I was told on Friday that I was to change into my gown (top only) myself and then sit in a holding area until someone came to get me. In order that they don't have to wash gowns that are used by the same person for a short period every day, I was given a cubbyhole. I took this picture after putting on my gown, so although you probably can't read that one says "Sharon L" you can look for the cubby with the white t-shirt and khaki shorts.

By the time I was finished snapping the picture, the tech was ready for me, and I walked into a room that had a foot thick metal door with the same radioactive symbol that Homer Simpson's plant has on it. The guy got me set up on that table and left the room. The machine whirred for about 15 seconds, then he reappeared. He put a thick layer of material on top of my breast and I asked what it is for. (I assumed I was allowed to talk since he was back in the radioactive chamber.) He said it simulates skin, so the next time they turned the beam on, the beam was actually going to a shallower level of my breast, thinking that it had already passed through skin when it hit the material. I guess that's a cool, low-tech way to treat different layers of tissue.

Two more 15 second whirrings, then I was done. I got changed and was back outside by 8:00 to send Paul off to work and take Maggie and Reese home. So that'll be the start to every day from now until October 12.

As advised, I put some special cream on the skin today and some Aquaphor this evening, but I really don't feel a thing. I guess it takes a few weeks for the burn to show up, and some people don't get much skin reaction at all. So with the exception of my still bald (but fuzzy) head, lumpy boobs, and some new tattoos, all's back to normal around here.

So Radiation It Is

No regrets. When I left you a couple weeks ago, I was on my way to talk to Dr. Alpert. Her advice was that doing the surgery first would be no problem at all. She gave all of the reasons that I listed in my Decisions post and could even add more. She said that studies have shown that starting radiation up to 12 weeks after chemo make no difference in the long run.

Despite her medical evidence, I still ended up choosing to deal with cancer first.

The final decision, though made by me, was really made by Paul. On that bad poll, he had voted to do the surgery first. However, seeing me wavering so much, he said the next day, "I think you should do the radiation first. It's the only way you'll never have regrets." And that's so true. If I did the reconstruction first and the cancer ever comes back, I'd blame the decision. Now the worst case is that I have some extra scars or less perfect fake boobs. But if the cancer ever comes back, I'll know I did everything I could right now.

So radiation will start tomorrow morning.

I'll tell you more about the experience of radiation in my next post, but I've been asked a few times since ending chemo on August 3 if I'm "in remission" or "cured" or whatever. The only answer I have is that the doctors believe they got all of the cancer out of me back on March 16 with the double mastectomy. So if we were lucky, I was "cured" then. But the question since then has been whether they really did get all of the cancer or if some of the cancer cells weren't attached to the tumor in my breast. That's why I've been doing all of this other stuff. Chemo, radiation, and hormone pills are just insurance policies in case of some stray cancer cells. So I think "cured" is a confidence thing. When I have been off the daily/weekly treatment roller coaster for long enough and I've had enough blood tests that come out normal, I'll start to feel like maybe they got everything. For now, I still have radiation so we'll keep on fighting the possible cancer cells.

(Though that sounded like a closing sentence, it actually opens up a whole new can of worms. For someone who has been diagnosed with cancer and has had a doctor-made plan to "fix it" since the initial mammogram, the last day of radiation will be a scary one. They'll say, "Congrats! We're done here. Go back to your pre-cancer life now." But I, as a patient, will have to actually do that, knowing that somehow cancer found me, it could come back, and the doctors aren't seeing me every week anymore. Something to look forward to, huh? I'm told they have counseling and support groups for people who have just been "cured" from cancer, and I now understand why.)