Juicing & Smoothies

Towards the end of my chemotherapy treatments, I started hearing more about the benefits of juicing and smoothies in documentaries that I was watching and from my Naturopath. Fat, Sick and Nearly Dead is a great documentary on Netflix about an Australian named Joe Cross who is tired of being overweight and unhealthy. In the documentary, he sets out to regain his health by juicing for 60 days. At the end, you will see that he was able to lose the excess weight and get off of medications that he was taking every day due to an autoimmune disease.

This movie inspired me to start juicing as an easy way to ensure that I am getting the proper amount of fruits and vegetables every day. Unfortunately, after juicing for about a month, I discovered that it wasn't for me. I was buying a ton of vegetables just to make a tiny glass of juice and didn't like how all the the fibre was thrown out. Instead, I decided to try smoothies which are also a good option to ensure you are eating fruits and vegetables but in a way that you are keeping the fibre and there is not as much waste. If you are interested in the pros and cons of juicing versus smoothies, I found this article helpful:

http://simplegreensmoothies.com/tips/juicing-vs-blending-whats-the-difference

Regardless of which option you choose, I highly recommend it as a way to ensure you are eating right during chemo and radiation. At my hospital, I found they took a 'eat whatever makes you not feel sick' approach. What I wish they realized is that there are people who still want to try and eat healthy as much as they can and encouraging us to eat popsicles (which are pretty much void of any nutritional value) probably isn't the best approach. If you can stomach a juice or smoothie, regardless of whether it is homemade or store bought, it does so much more for your body than popsicles which are lacking vitamins and minerals and are full of refined sugar. 

Here are some delicious smoothie recipes that I enjoy:

The Green Monster

Dairy Free Field Berry & Banana Smoothie

Chocolate Blueberry Spirulina Smoothie
Kale, Pineapple & Almond Milk Smoothie

When I go back to work, I realize that making a fresh smoothie every day will be a bit more of a challenge. It is best to drink your smoothie/juice right away to get the optimal nutrients but you could always make it the night before and refrigerate if you don't have time. I find it easiest to wash all of the fruits and vegetables the night before so in the morning, all I have to do is throw them in the blender and go.

Tip - Don't forget to put some veggies in there! I find most of the store bought smoothies contain all or mostly fruit which makes them high in sugar (although it is natural sugars). When searching for recipes, I always look at the fruit to veggie ratio and either add additional veggies if there aren't enough or cut the amount of fruits with a high glycemic load like bananas and dates. For example, if the recipe calls for a banana, I usually put half and find it is plenty sweet. 

Chasing the Cancer Answer

I feel like everyone I have talked to with breast cancer has some theory as to why this horrible thing happened to them. You can't help but think "what have I done to cause this?". Any social worker, mine included, will likely tell you that you didn't do anything...this is not your fault! As a patient, that's nice to hear but the increasing number of people getting cancer has to be somebody's fault. It's not just chance that 1 in 8 women will develop breast cancer in their lifetime. Everyone has heard that statistic advertised, especially during breast cancer awareness month in October when you can't seem to escape it. The equally as troubling statistic to me is that 2 out of 5 Canadians (45% of men and 42% of women) are expected to develop cancer during their lifetimes. Not only that but the number of new cancer cases in Canada is expected to rise about 40% in the next 15 years, according to a new report – Canadian Cancer Statistics.

Most of the articles with these statistics usually have a subsequent paragraph saying something like "you can reduce your risk of developing breast cancer with early screening and being aware of the risk factors". Unfortunately a lot of women that get breast cancer, especially young women like me, don't have any risk factors. I have no family history, I am not overweight, I was never exposed to radiation as a child, I drink little to no alcohol...the list goes on. So what the hell caused this?

Genetics - I have been tested for the BRCA 1, 2 and P53 gene mutations. Especially if you are triple negative, this is something to ask your doctor about and the sooner the better as the results take some time (mine took about 2 months). Depending on the results, a different chemo may be prescribed, for example, studies show that BRCA positive women might respond better to platinum chemotherapy drugs like Carboplatin.

The Birth Control Pill - I was on the pill for 10 years and had just stopped it 1 year prior to being diagnosed. Coincidence? I think not. Although drug companies obviously aren't publicizing the fact that the pill is linked to an increased risk of developing breast cancer, there are quite a few studies that have shown this and the International Agency for Research on Cancer has now listed it as a known carcinogen.

http://www.nbcnews.com/id/8759578/ns/health-womens_health/t/hormone-pills-added-list-carcinogens/#.VrFeIVMrJ8c

There are a ton of other things that could have caused my cancer, some I will probably touch on in a later post but for now, I will leave you with this really interesting video of Wendy Mesley who is a Canadian journalist that was diagnosed with breast cancer. It is from 2006 but in it she asks a lot of the same questions I am asking today that we still don't have answers for. There is one part where she says "at what point do you stop looking for the easy answers like 'eat your veggies' and tackle the more complicated issue of all the carcinogens that we are eating and breathing and drinking every day?" I couldn't agree more!

http://www.cbc.ca/marketplace/episodes/archives/chasing-the-cancer-answer

Radioactive

I began radiation recently and again, had to call the hospital and follow up multiple times regarding the start date. Based on some studies I have read (click here for an example), the optimal time to start radiation is within 6 weeks after surgery. For some women who get an infection or have complications after surgery, this is not possible, however, I was healing well and had no issues so couldn't understand what was taking so long. After speaking with the Radiologist, they corrected me that the optimal window is actually 12 weeks but why wait that long? In my mind, sooner is better so after a couple calls, I started radiation 7 weeks after surgery. I write about this because it is just another example of why it is so important to be your own advocate. Yes, it may be uncomfortable to be "pushy" with the doctor, you definitely already have enough to deal with and it may be exhausting to follow up every day but this is your health and it is worth it.

The other thing I wanted to write about is Mepitel film which can prevent or at least reduce radiotherapy skin reactions. It is a breathable dressing that is applied to the area being treated which in my case is the breast and armpit. You wear it all day every day for the full course of radiation which can be annoying, especially if you live somewhere with warm weather as it is hard to cover up. I have been showering and working out with it on and haven't had any problems other than patches peeling off so the radiation technicians replace them. My view was that if the claims are correct and it reduces skin reactions by 80-90%, it was worth the inconvenience and cost (approximately $200-$300 for the full course of radiation depending on how much film is needed). I spoke to a few women that used it and either had no skin reaction or it was very mild. If you are interested and want to ask your Radiologist about it, here is the study that was done: http://www.molnlycke.com/news-media/wound-care/mepitel-film-prevents-radiotherapy-skin-reaction/. It is still considered experimental at this point although from what I understand, women in Europe have been using it for years. My Radiologist ensured me that it did not affect the effectiveness of the radiation so why not give it is try.

I haven't completed radiation yet so cannot comment on the end result but so far so good. I will post an update later!

Confessions of a Former Meatatarian

Before being diagnosed with breast cancer at the age of 30, I was a big foodie. I ate a lot of meat and remember repeatedly saying that I could never be a vegetarian. I liked all of the posts on Instagram poking fun at vegetarians and vegans and can't remember the last time I went a full day without meat.

Fast forward 7 months later and my how things have changed. I still eat meat but not even close to the same amount I used to, I have incorporated fish into my diet and my fridge is always stocked with vegetables.

The first sign that something needed to change was after my third round of chemo when feeling good with no major side effects, I decided to have a steak for dinner. The nurses tell you not to eat a big meal after chemo and there is a reason. That remains the only time I felt really sick during chemo...I felt nauseous and my body couldn't digest it. If that wasn't enough of a warning that I needed to cut down my consumption of red meat, this announcement definitely hit home. In October, 2015 the World Health Organization was in the news for publishing a warning that red meat causes cancer:

http://www.cancer.org/cancer/news/news/world-health-organization-says-processed-meat-causes-cancer

People who love meat, like my husband, will say that everything causes cancer these days....the environment, microwaves, deodorant, the list goes on. Obviously not everyone who eats large quantities of meat will get cancer but I figure that if I am already susceptible to it, maybe I should be cutting back.

Cancer aside, the documentary Cowspiracy on Netflix will give you some other reasons to cut back or cut it out completely. Who knew that animal agriculture is responsible for 18% of greenhouse gas emissions, more than the combined exhaust from all transportation? I am not an environmentalist by any stretch but this documentary is worth a watch!

Tissue Expander

When surgery was finished, a tissue expander was inserted under my chest muscle. In my mind, it was traumatic enough to wake up after surgery and have a huge scar across my chest....if there was an option to avoid being completely flat, I was going to take it. I explain the tissue expander to my friends as a temporary implant - it is something that holds the shape of your skin until the permanent implant is ready to be put in. In reality it is a lot more involved than that.

First of all, if you are getting a tissue expander inserted at the same time as a mastectomy, your surgeon and plastic surgeon have to coordinate the timing since they will both play a role. This presents challenges if you are having surgery during a busy time of year when people tend to take vacation and they also need to obviously be in the same location. Make sure you decide on a plan a few weeks in advance and follow-up! I would have waited 7 weeks after chemo ended if I would not have insisted the surgery be done sooner. I was told that some women have a mastectomy then a tissue expander put in as a delayed procedure but if at all possible, it seems easiest to do both at the same time.

After 2 weeks, I returned to the hospital to begin the process of having my tissue expander filled with saline. The expander has a fill port that was accessed with a needle through the skin. The needle itself did not hurt as I have lost quite a bit of feeling in that area. The weird part of the experience is seeing your chest growing as the saline goes in. For me, they put in 120 cc's of saline each time until I was at 420 cc's (a C cup on my frame). What they did not warn me about is that this part hurts....a lot. After each injection, I was in more pain than after my surgery. I did not take any Tylenol which is my own fault but beware! After about 2 weeks, the pain went away.

At the advice of my surgeon, I had a skin sparing mastectomy after chemo and decided to wait until reconstruction and do a prophylactic mastectomy on the other side. Now, after talking to other people and getting more information, I wish I would have pushed to have both breasts done at the same time. It would have been nice to just get it over with at once and ascetically they would look better, not to mention the worry I have that a cancer could be growing on my unaffected side. Regardless of what surgery you are having it just shows the need to be educated and be your own advocate. You said it, Sheryl Crow!

Lashing Out

I am now 2 months post chemo and my eyelashes and eyebrows are back! My eyelashes are almost longer than they were before chemo thanks to Latisse. I have been using it since approximately 1 month after chemo ended, when I started to notice some re-growth. According to the aesthetician where I bought it, there is no point in starting until some re-growth is visible as it will not work.

This product claims to help you grow longer and thicker lashes within 16 weeks and is actually a version of a glaucoma drug in eye drop form called bimatoprost. Some people say that it can change the colour of your eyes but based on what I was told, that would only happen if you put the drops directly into your eyes for a prolonged period. So don't do that! Simply follow the instructions and hopefully it works as well for you as it did for me. I did not need a prescription and got it from a local "medical spa". Here is some additional information:

http://www.latisse.com/WhatToExpect.aspx

Tip: You can also use it off-label on your eyebrows to help speed up re-growth. 

I don't usually endorse products like this but from what I have read, Latisse appears to be safe, as long as it is used as directed. The box that I bought lasts around 2-3 months and I likely won't continue it after that but for a time when all I wanted to do was hide out in my house and avoid any mirrors, it gave me the push I needed to go back out in public and keep living my life. I never thought being able to put on mascara again would make me so happy!

Take Your Vitamins!

After surgery, I started seeing a Naturopath and am so glad I found one with the FABNO designation (Fellow of the American Board of Naturopathic Oncology). It was important to me that they had this designation because it requires an additional board certification examination in oncology. My Naturopath is familiar with the chemo drugs that I received and has experience treating cancer patients. He recommended high dose Vitamin C IVs prior to surgery to promote wound healing and in high doses, Vitamin C can kill cancer cells. I am skeptical about the second claim but figured there is no downside so it was worth a try. If it does kill cancer cells, great, and if not at least it can help me recover from surgery quicker. If anyone is interested, here are some articles regarding high dose Vitamin C:

http://www.cancer.gov/about-cancer/treatment/cam/patient/vitamin-c-pdq

http://www.oasisofhope.com/cancer-treatments-therapies/vitamin-c/

The Naturopath also suggested some other supplements to take before and after surgery, one of them being Vitamin D. There are many articles showing that the majority of women with breast cancer are deficient in Vitamin D. This is something that my family doctor, Oncologist and Naturopath all agree on (and is probably the only thing they agree on). At the beginning of chemo my family doctor suggested taking 1,000 IU a day even though my levels had never been tested. After 3 months, I requested a blood test which showed that my levels were still below the normal range so my Naturopath has me taking 5,000 IU a day until they increase. I am not saying everyone needs to take this much but I do think it is important to have your Vitamin D level tested! If I wouldn't have questioned it, I would still be taking 1,000 IU a day thinking that was enough, never knowing that I was still deficient.

Seeing a Naturopath is not an option that is available to everyone as it is expensive and not usually covered by drug plans. I am of the mindset that if you can afford it, it is money well spent. The supplements I am taking combined with the lifestyle changes I made have me feeling better than I did before cancer.