Happy St. Patrick's Day and Scanxiety

 Happy St. Patrick's Day to all!

 For those who have not googled it, today is appropriate to reveal the meaning of my blog title, Saol Gáire Grá, which means Live, Laughter, Love in Gaelic.

 I'm feeling a bit better and actively working on not having:

 My next MRI is Wednesday to determine which direction we go. I should know results by Thursday or Friday and will update once I know.

 We're starting to get more and more sunlight and the temperatures are warming to a balmy 35-40 degrees. It's time to:

Pep Talk and Keep on Swimming

 

Still fighting the nausea pretty hard, but I'm making it! Keep on swimming.

This one feels different.

 Well, this go round feels a bit different. I'm having the worse nausea I've had so far and my fatigue is real. I'm still making sure to move and be functional, but relying heavily on my prophylactic medications and electrolytes to keep me upright.

 The yoga for the day:

No way this one is too long you didn't read (TL;DR).

LSKD and Skin

 My sister purchased a surprise box from a company, LSKD, who makes exercise apparel and we were pleasantly surprised when on one of the sports bras, there was a QR code and the words “Early detection is key. Scan to check your breasts.”

 The QR code takes you here.

 I can’t think of a better place to put a reminder for this important check. We’re often told to do it in the shower, but with our minds racing a million miles a minute about our day ahead or what happened last night or even belting out our favorite song, who truly stops and thinks, “let me do a breast check right now”. I give kudos to this Australian based company for getting after it right where it’s most obvious! Way to go LSKD!

You know who you are. 😉

 

 Now for chemo and skin. I can’t speak for others but this has to be the best internal chemical peel for adult acne ever! My face is clearer, my skin is smoother, and I guess I have it all to thank to TCHP? 

 Since my skin is doing so well, I’m hoping radiation doesn’t give me the raging 2nd degree burns that my 12 year old self inflicted upon me when I felt putting tanning oil on in Florida was a good idea for me, but we’ll cross that bridge when we get there. Think Klingon when you imagine what I looked like. 

 I guess I learn everything the hard way as I’m a big proponent of sunscreen and preventing skin cancer… now. 

TL;DR

• Leave it to Australia to figure out that our bras should have QR codes for self breast exams. 
• Worrying about your day is not fun. Singing in the shower is fun. Self breast exams can save your life. 

Etsy is amazing.

• Chemo seems to be doing very nice things to my skin. 
• Learn from 12 year old me and wear sunscreen to prevent skin cancer. 

Blood and Joy

 Needless to say, I was ecstatic when I got a good lab report being able to proceed with Cycle 3 yesterday! It isn't uncommon to have to delay of a week or two based on low white blood counts and I felt for the two individuals who had just that happen yesterday. 

 While looking at my labs, there were a few newer things I found very interesting and figured it would be neat information to share. You learn something new every day!

 Most people know about red blood cells and white blood cells in a general sense. Red blood cells and plasma can but ideally shouldn't come in various shapes and sizes. Two lab results from a Complete Blood Count that show these variances are Red Cell Distribution Width (RDW and RDW-SD) and Mean Platelet Volume (MPV).

 In short (and by short I mean long):

• Red Cell Distribution Width (RDW)
• What is a red blood cell?
• Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so it can be exhaled. Red blood cells (RBC) are made in the bone marrow and contain hemoglobin, a protein that carries oxygen to the tissues in the body. These cells are also known as erythrocytes.
• The RDW value tells you whether enough of your red blood cells are of normal size and shape.
• Why is this important?
• The red blood cells are usually flat and lenticular (disc-shaped) with a diameter of around 7.5 µm (micrometer).
  
  
  
• OK, back to the red blood cells and their distribution width:
• Blood cells must squeeze through the body’s smallest blood vessels, the capillaries, to do their job, but capillaries often become narrower than the cells in their normal disc shape. Capillaries can be as small as 4 µm in diameter. So the cells must deform and “curl up” to fit through those capillaries. Remember a normal red blood cell is around 7.5 µm in diameter.

• Some red blood cells are however not optimally formed. To a certain extent this is normal as there are 2 million red blood cells formed per second. Usually there are around 85% to 89% of red blood cells developed properly.
• By looking at the red cell distribution width value one can see how many red blood cells have a deviating form factor. If 85% to 89% are usually normally developed the RDW value then should range between 11% and 15%.
• Mean Platelet Volume (MPV)
• What is a platelet?
• Platelets, or thrombocytes, are small, colorless cell fragments in our blood that form clots and stop or prevent bleeding. Platelets are made in our bone marrow, the sponge-like tissue inside our bones.
• Mean platelet volume is a test that measures and calculates the average size of the platelets.
• Low MPVs indicate smaller platelets, meaning the individual is at risk for a bleeding disorder.
• This guy is a platelet:

 New side effects - wobbly knees! I got up in the middle of the night and walked myself to the bathroom and all of a sudden, I had wobbly knees. While not new to me as a concept, it was new to me as a person. I kicked in my PT brain and told my quads to contract and reached for the wall and made it, without a fall. I'll be sure to check in with myself more often. Just one more thing to help me relate to my patients, which has always been the basis of my success with patient experience.

 One last helpful thing for a side effect of my dry eyes. An amazing member of my healthcare team and someone I appreciate giving me a major heads upon what to expect after my initial pathology results arrived, let me know early on which drops to get. 

Refresh Digital drops are a godsend.

TL;DR

• Super jazzed I got to proceed with Cycle 3 and feeling for those who had to wait due to low white blood cell counts.
• I introduced two lab tests included in a Complete Blood Count that are worth reviewing up above if interested - Red Cell Distribution Width (RDW and RDW-SD) and Mean Platelet Volume (MPV).
• New side effect - wobbly knees - old side effect of dry eyes still holding strong.

Cycle 3 is a go!

Great news! Cycle 3 is a go! Labs were beautiful if I do say so myself! My gran team really kicked it!

 More great news! During the tumor board when my case was discussed, the radiologists input identified that what was found on my T11 vertebra was not suspicious of malignancy. At this time, it’s monitor and rescan but whew! did that take a load off my shoulders. A biopsy will not be needed for true pTNM staging and it’s not even being considered as a potential for metastases. 

 My oncologist was a sport and answered all my questions from my checklist and we’re on a positive trajectory! 

 I’ll be here, enjoying my view. This is my glimmer for the day! Thank you all for your continued support! 🥰

TL;DR

• Cycle 3 is a go because my labs were amazing. 
• T11 vertebra is no longer a dark cloud looming over my head. It is not considered a concern for metastases and does not need biopsied at surgery for pTNM staging. 
• You can do hard things!
• My glimmer is sunshine and mountains. 

Happy Monday!

Chemo Side Effects: Cold Sensitivity and Neuropathy

 Hello side effects. While I've been keeping many side effects at bay, cold dysesthesia (extreme sensitivity to cold) and chemotherapy-induced peripheral neuropathy aka CIPN (a nerve disorder that can cause weakness, numbness, pain, and tingling or a “pins and needles” feeling) have found a home. While some could argue that my previous robust head of hair kept my warmth in, it is amazing to feel how deep this cold sensitivity hits well beyond what my red locks could have aided. I'm the type whose hands would steam when outside in the cold Alaska winter, and now if I don't hide them under many layers, they hurt to the core. Thank you Carboplatin and Taxotere!

 Ironically, I've been trying to mitigate these side effects by actually using ice packs on my hands and feet during my chemotherapy treatments. While it might be helping to minimize the side effects, it clearly isn't preventing them. It could be permanent or it might not, we'll just have to see.

T-13.75 hours until I should know if I can get my next chemo cycle tomorrow. Not that I'm counting. Really working on my breathing tonight after enjoying an amazing day of family and sunshine. While I know I can't control everything, it was nice knowing for sure that the next chemo cycle was a go the night before.

TL;DR

• My two chemo drugs can cause extreme sensitivity to cold and a nerve disorder that can cause weakness, numbness, pain, and tingling or a “pins and needles” feeling, and I've got them.
• Elsa forgot about the rest of us.
• Breathing my way through until tomorrow.

Trust the Process and Early Detection

 Here I am, just trusting the process. Next day to focus on is Monday, March 11th.

I was able to visit with some fellow team members yesterday, and one resounding message from all of them was the hope that I could make an impact on others getting the timely cancer screenings. These important screenings are needed to allow for early detection, so one may have the best chance for successful treatment.

 Did you know:

 Honing in on breast cancer specifically, with breast exam screenings by a primary care provider every 1-3 years and recommendation for mammograms starting at age 40 (unless other indications), it is very important to do monthly self-exams to ensure no changes are occurring. This is especially important in anyone under the age of 40. 

 Are we all guilty of putting these off? Absolutely! 

 Would I have been in a very different place with my treatment options and chance of survival had I waited two more years until age 40 to have a mammogram? You betcha.

 With triple positive invasive ductal carcinoma at a stage IIA and a grade 2 (see my previous post explaining these diagnoses) at my diagnosis on December 26, 2023, it is reasonable to say that it could have evolved to be easily a stage III if not stage IV, further decreasing my survival rate. I am grateful for my primary care provider and the early detection of my breast cancer.

 Here are some tips and tricks to be more diligent in performing timely self-exams:

 Here is a link to print a shower hanger from The Ohio State University, so you'll never forget!

TL;DR

• Next day of focus is Monday, March 11th.
• It is worth scrolling back up and looking at the early cancer screenings that can save your life.
• Print the shower hanger and commit to self-exams.

Yoga and Reframing

 More on yoga. Here is another favorite Yoga with Adriene that we did today. Root to Rise is a great series of yoga moves to get you grounded and start your day right.

In case you needed more convincing, this is your brain on yoga:

Yoga also allows you to open your mind to reframing, yet another cognitive behavioral technique for your toolkit:

Today was another good day. I'm anxiously awaiting Monday in hopes that my labs are great and I can move forward with chemo cycle 3!

TL;DR

• Any Yoga with Adriene video is great, but Root to Rise really hits the mark.
• Your brain functions better on yoga and allows you to be more open to reframing, another cognitive behavioral technique.
• Goal is chemo cycle 3 Monday if labs look good!

This has been brining me peace:

Power of Positivity and the Cognitive Behavioral Model

 I have been doing quite well this second round. I often find myself questioning if I have somehow received a placebo, despite the nosebleeds and poor healing, but have heard from many, that my mindset has to be having a huge role in my recovery. Here are a few of my tips and tricks that keep me going, courtesy of the Cognitive Behavioral Model, which I have the great opportunity of teaching to our amazing team members at MSRMC:

 Have I always been this way? Hell no! I've done a lot of work on locus of control and reframing. I am fortunate that my life has allowed me to develop these skills BEFORE cancer, as I can only imagine if I had not. 

 I've found:

And I still remain a realist:

 There is also power in realizing how similar situations impact different people. I have the real life opportunity to think about this as I am surrounded by stories of others going through the same or other types of cancer. Each person handles the same or similar situation differently, and that is OK.

 If we just step back and think, "What if it all works out?", imagine how much time we would have to focus on the good and channel our energy into positive thoughts.