What Cancer Survivorship means to me

I haven't written a blog post in ages because I have been trying to get on with my life, move forward and get back to normal...whatever that may be!

This probably won't be a very long or informative post but I've found in the past that this blog has been a great outlet for me and almost like a therapy session.

Since I last posted, lots has happened! I'm back to work, I got engaged to my best friend, I have lots of family weddings coming up, one of my best friends asked me to be bridesmaid at her wedding in November and another very close friend is getting married in April. I have dealt with a lot of loss of people I have become close to through a support group on Facebook, one girl in particular who I had gotten very close to, who was only 28 when she passed away. I'm still living in my parents house but hoping that will change later this year, everything going well. So in this post I am just going to chat about a few things that have been going on/ have been on my mind.

Getting Back to Work

I started back to work in September of last year. 2 months after treatment had ended and a year and 2 days from my date of diagnosis in 2017. I started back doing 3 6 hour shifts a week - 8-2. Many people had said to me previous to this that it sounded like I was taking alot on and maybe I should ease myself back to work starting with shorter shifts or less days. I was having none of it, 18 hours a week should be manageable surely? It was manageable but it was absolutely exhausting. It would get to about midday each day and chemo brain would kick in and I was useless. This was very difficult to deal with as being in a supervisory capacity in work I wanted to be alert and able to do my job well. I couldn't understand that I was struggling so much with work when at one point I was doing 39 hours a week, attending college, had college work to do and had a boyfriend who lived in Kilkenny so I did alot of driving! I came home from work everyday and went straight to bed and was basically useless for the rest of the day.

After 4 weeks I increased my hours to 24 hours a week over 3 days - 8-4.5. The change was again so exhausting, I had barely gotten used to the 18 hours a week and here I was faced with longer days. I was never forced by work to increase hours, it was a decision I made myself because I felt I should push myself and should be able to manage it. After another 4 weeks I increased my hours to 30 a week over 4 days, 3 8-4.5 shifts and one 2.5-9 shifts. Initially this seemed impossible and made me feel dreadful that it was making me feel so exhausted and the main focus of my life became being able to go to work, the rest of the time I would be trying to rest and get ready for the next day/next week. I had intended on getting back to 39 hours a week in January 2019 but I realised it just wasn't feasible. I needed more time to adjust and work was very understanding and allowed me to take some unpaid leave until I feel ready to get back to 39 hours a week. So that is where I am now!

I might add that my job is very physical. It involves standing and moving around all day. Pushing, pulling and lifting and using your brain! Going from a year where alot of it was spent in bed or very sedentary to physical work was a huge adjustment. Having had a Mastectomy on one side also caused me alot of muscle pain when lifting and pushing, which thankfully has eased off but after a busy week I will still have muscle pain to contend with. I also have caught every bug going and have had a few sinus infections/chest infections, colds etc. I have been sick ALOT since going back to work but I guess what can you expect when your immune system has been poisoned! Work is gradually getting easier but I know it will take a long time for me to get back to where I had been and I can deal with that once I can see progress.

Diet and Exercise

I gained an absolute tonne of weight during treatment. I was inactive and during chemo I was the hungriest I had ever been in my life. Now treatment has ended and I am back to work I am really trying to get back in shape and get some form of fitness back. Before I was diagnosed I had just lost 4 stone doing a fairly extreme diet and I knew I couldn't handle doing something like that again. I want to lose weight in a healthy, balanced way that I will be able to maintain once I get to my goal weight. I have been using |MyFitnessPal to do this and its very early days so I don't have much to report on but it is starting to shift and I am absolutely determined to get back to where I was pre diagnosis. I walk 3-4 times a week also and I have just today joined a gym (a very lovely lady convinced me to do it!) So I am hoping I can push myself to get a good, healthy routine going.

I did cut out dairy and meat for a while but I found it to be very difficult and felt I wasn't getting enough nutrients in what I was eating. I have started eating both again but try to eat mainly Organic dairy and very little red meat, more fish and I will have a few days a week without any meat or fish for dinner, just plant based foods. I have stopped eating processed foods and have started cooking fresh meals and even making my own soup! I find that cooking healthy food from scratch is time consuming so I try to cook enough for a few days at a time as somedays after work I just don't have the energy to spend an hour+ cooking.

I am still taking supplements that I feel are beneficial to me; I take curcumin, immune support, fish oils and a multi vitamin every day. I take a teaspoon of Manuka honey alot too to try and help my immune system. I was taking a blueberry supplement as it had been found beneficial in Triple Negative Breast Cancer but decided to just have a decent portion of blueberries everyday instead as I'm not fond of taking pills unless necessary!

Hair

My hair is growing well. I've had it trimmed twice now and its strong and thick! Its a bit mad and hard to control as its kind of curly but I'm hoping that it'll calm down as it gets longer and the curls will drop out of it. Fingers crossed!

Mental Health

This is the main reason I wanted to write this post. I wanted to write about mental health after cancer, my own and my experience of talking to other women about it.

As I mentioned in a previous post I had suffered with Depression and Anxiety from a young age. I didn't struggle too much with it during treatment as I think my mind was so focused on getting through each stage of treatment and I had no other obligations at the time. I had no kids to mind, I was living in my parents so I had no house to worry about and I was off work so my main focus was getting through the year and trying to rebuild my life. Each stage of treatment went so well for me, I was lymph node negative, I had a complete response to chemo, I wasn't very unwell during chemo, I recovered well from surgery and I didn't have any issued with Radiotherapy so I wasn't struggling too much other than the normal fatigue and I guess the difficulties with my body and appearance changing so much.

Then treatment ends and it is a very very happy day. Everyone is delighted you got through it and you had a brilliant outcome. Time for everything to go back to normal? If only that were the case, that treatment ended and suddenly everything was normal again. I had gotten used to being in the hospital constantly during those 10 months, I felt safe because there was always someone at hand to answer questions or give me advice. Then suddenly that safety blanket is ripped out from under you. Obviously finishing treatment was one of the happiest days of my life, but it was also one of the scariest days of my life. I felt like I was just being sent off to live my life and that I was now completely responsible for my health. I was the one who'd have to recognise if the cancer returned.

The reason I wanted to write this is because many of the women I have become close to had said to me that often the hardest part of dealing with cancer is when all the treatment has ended. Because you now have the time to process what has happened during the last year and often it is a big struggle to regain normality in your everyday life.

I am lucky to have an amazing support system but there are days where I feel like people in my life have forgotten that I am only 6 months from finishing treatment from cancer. I am still exhausted, I am still trying to process that year in my head, I have times where the future seems very scary and uncertain. I have days where my anxiety is through the roof and I am overwhelmed by my thoughts and everything I need to do/should do.

Its so important to realise that once cancer treatment is over it doesn't mean that everything will immediately go back to normal. For some people they will never regain the same life and describe this as their new normal. Treatment may kill cancer (not for everyone) but it takes a huge amount from your physical and mental health and that takes a long long time to repair.

Follow up Treatment

Follow up treatment for me includes a yearly Mammogram and an alternating 6 month appointment with my Oncologist and Breast Surgeon. I had my first Mammogram since treatment ended in September on my remaining breast, as obviously the surgery side no longer has any breast tissue to be mammogramed. I had the test done and was told by the Radiographer that everything looked fine so I didn't bother to ring for results. I felt that surely she wouldn't have told me that unless she was absolutely sure. I got a call a few days later to say they needed me to come back in as there were some changes in the scan from the previous one. This was absolutely terrifying to hear, I was lucky they gave me an appointment the following day as I spent the entire time after this phone call crying and catastrophising. When I went back in the following day they did the scan again and also did an ultrasound and everything turned out to be okay, which made me feel like an idiot for losing my mind for the previous 24 hours!

I have decided to definitely go ahead with having a Mastectomy and Reconstruction on the non-cancer side as a Risk Reducing procedure. For me I feel like it is the only option that will allow me to move forward and worry somewhat less about what the future has in store for me. I was meant to have this surgery on the 14th of this month but unfortunately the surgery had to be cancelled as there has been an issue with implants in the EU. I am hoping that the surgery will be rescheduled in the next few weeks so keep your fingers and toes crossed for me!

Radiotherapy and Getting Back to Myself

So its been a few months since my last blog post. The reason for this was because I had nothing to really say as I had close to two months without any treatment to allow my surgical wounds to heal.

Firstly, I'll tell you the outcome of my results appointment on the 20th April - I had what is called a Pathological Complete  Response (pCR) to chemo. Which means that when I had my Mastectomy and the breast tissue was examined, there was no cancer left whatsoever after Chemotherapy. This was the very best outcome I could have asked for! My consultant had felt it was quite unlikely I was going to achieve this as I was starting off with quite a large tumour, but obviously my tumour was very sensitive to Chemo and it made those 5 difficult months so worthwhile. The great thing about this is it lowers your chance of recurrence to about 5% I think it is, so I am beyond happy about this result!

Post surgery I had one of my drains left in for almost 4 weeks. I had to stay on oral antibiotics for the entire time I had a drain in, which wore me down a bit. I got my last drain out on the 3rd May, a day after my 30th Birthday. Since then I have had no issue so far with my reconstruction, the scars have healed well, I have no pain and luckily I didn't have any issues with my arm mobility.

Radiotherapy

I am now on my 4th week of 5 weeks of Radiotherapy treatment. I have 8 sessions of 25 left to go. Radiotherapy consists of going into the hospital 5 days a week for 5 weeks straight, where they administer Radiation Treatment each day.
About two weeks before starting Radiotherapy I had a Planning Scan. This consists of having a CT scan where your alignment is examined and three tiny permanent tattoos are placed to line up with the machine. So I have a black permanent dot on each of my sides and one in the centre of my chest, which will remain there forever.
Radiotherapy treatment consists of being placed lying on your back, naked from the waist up, with your arms above your head, on a machine called a Linear Accelerator. The Linear Accelerator can move 360 degrees around your body to administer Radiation to different areas.

The Radiation Therapists then measure your position against lasers which shine down onto your body, against your tattoos. They have to manoeuvre you until you are in the exact position. A phrase I wont be tired of hearing when I finish is "Relax your shoulders Sarah, no relax them, no they're not relaxed!" Its very hard to relax your shoulders while about 4 people are intently staring at your boobs! Once you are aligned the therapists will leave the room and you have to hold this exact position until the treatment is over. The treatment itself doesn't feel or look like anything. The only reason you know its happening is because a high pitched noise sounds while treatment is in progress.

I've had very little side effects from Radiotherapy so far except for some fatigue but I also think that is due to the unusually warm weather in Ireland at the moment! I am using a cream called Biafine three times a day to moisturise the Radiated area, this is a cream which is made specifically for Radiotherapy and I have found it brilliant. I haven't found it available anywhere in Ireland, as its a French cream so I buy it on Amazon.

What else has been happening?

Diet and Exercise
I have been using MyFitnessPal to track exactly what I'm eating each day to try and make sure I'm not overeating and to try to ensure I'm eating healthily. I am starting to lose some of the weight I have gained over treatment, which is great! I got a Fit Bit for my birthday and I am absolutely obsessed with it! I started off aiming for 5000 steps a day, then 6000 steps and now I'm aiming for 7000. There are days where I do more steps and less steps but at the moment if I get 7000 a day I am happy with that. I intend to keep increasing my goal up to 10,000 and ultimately I would like to be achieving 10,000 most days when I return back to work. I have started walking most days and I am definitely finding it is helping to ease the fatigue I have felt with Radiotherapy. I am still consuming very little Dairy and Meat and have to say I don't really miss or crave either anymore!

While I was in hospital recovering from surgery I decided to set a goal for myself to do the Irish Cancer Society Colour Dash 5km on the 17th June. Setting this goal for myself gave me motivation to get out and start to regain my fitness. My boyfriend Iggy and my mum both did it with me. We set out that day intending to walk 5km but instead we ended up walking 10 due to the walk to and from the race, I was tired after but delighted to have managed it! We managed to fund raise almost 1000e with the help of my brother Daragh also, which is incredible and I just wanted to say thank you to everyone who donated and supported us!

Supplements

I have started to take a fair few supplements. Things that I have researched to be helpful for people having had cancer to prevent recurrence and spread. And just general vitamins that I am taking as I am missing out on some nutrients due to eating less meat and dairy. Curcumin is the active ingredient in Turmeric and has been found to be an anti-inflammatory and helpful in cancer prevention. Blueberries have recently been found to be very helpful in helping to reduce cancer/cancer spread in Triple Negative Breast Cancer. I think this study has only been done on mice and in vitro so far but is looking very promising. 
I am then taking a Vegan Multivitamin, Calcium Supplement and Omega 3 to replace vitamins and minerals I am not getting in my diet.
Interesting little fact I will place here, alot of women diagnosed with breast cancer seem to be deficient in Vitamin D. I don't know if there is a link but I'd say its unlikely its coincidental!


Hair growth and starting to look like me again!

So my hair has grown quite a lot since finishing chemo in March. I am still continuing to use Roots scalp treatment about once every week/two weeks. I was using Nioxin but I found it started to irritate my scalp so I have started to use Alaparf hair loss products, I have only been using them about a week so I can't really comment yet on how well they are working but they seem to irritate my scalp less! I am trying to put coconut oil on my scalp over night a few nights a week also as I tend to suffer from a dry scalp and I'm hoping it helps!

I have my eyebrows and eyelashes completely back now! I have to say thank you to Karen Hanrahan for recommending Rapid Lash and Brow to me because I really think they helped alot in regrowing my lashes and brows back quickly and fully.

My nails are still a little bit discoloured from chemo but I am keeping them covered with Shellac nails so I don't have to look at them, the discolouration is slowly growing out though. I am lucky I didn't lose any nails as many people do during chemo and I honestly think alot of it has to do with the Skin, Hair and Nails supplement I have been taking. My nails are really strong now, way stronger than they were even before chemo!

I hope this left picture doesn't upset or scare anybody! I just wanted to show that you do start to regain your former self and its helpful for me to look back on that picture to see how far I have come!

I don't really have any more news at the moment. Things are going good for me, I am really close to finishing my treatment and I guess the next time I write I will be finished treatment altogether!

Surgery

This is probably the longest period of time I have gone without doing a blog post and there is a few reasons for that! Firstly I had a few admissions to hospital since chemo finished. I was pretty well throughout chemo but exactly 12 days after chemo finished - Paddy's Day night my temperature spiked. I had had a few drinks throughout the day and was exhausted when I got home (and probably a little tipsy!) I got into bed and felt freezing cold and kept putting on more and more layers. It took me about an hour to cop that this was really weird for me - as I've become a much warmer person since having chemo. I took my temperature and it was over 38 degrees! So I rang the hospital and they told me to come in. This was my first admission due to a high temperature, my bloods didn't show anything going on so they prescribed me antibiotics and sent me on my way. About two days later, my temperature spiked again and I was admitted again. This time my red blood cells were low so they gave me a blood transfusion and started me on IV antibiotics. My temperature spiked again a few days later and I was admitted AGAIN! They didn't really do anything with me this time other than monitor and let me go home. I finished antibiotics and my temperature continued to spike a few times over Easter but I just took paracetamol to bring it down and eventually it stopped spiking! These few weeks were incredibly frustrating. I was so exhausted from continually being in and out of hospital. I was covered in bruises from IV cannula's being inserted and bloods being taken. My veins are very poor at the moment after having chemo! And I was anxious about why it was happening and scared it could push back my surgery dates - thankfully it didn't!

My first surgery took place on the 26th March - which was a Sentinel Node Biopsy. I was admitted on the morning of the 26th March and a few hours later I was brought to Nuclear Medicine. Here they insert a radioactive dye into your nipple (they do this 4 times and it was horrible!) 40 minutes later they perform a Gamma Scan which shows the first lymph nodes which the dye drains to and aids the surgeon to find the appropriate lymph nodes to remove later. I was brought to the Operating Theatre shortly after this to have surgery. Before I got sick, I always felt I would never want to have surgery in the hospital I work in but as soon as it happened I knew that was what I did want. Being wheeled down the corridor to the Operating Theatres which I usually spend my days in work running up and down with instruments was a strange feeling but also somewhat comforting. I knew all of the nurses working on my case and it gave me a sense of calm knowing that they would look after me well. I had no adverse effects from the anaesthetic and was discharged the following morning. The incision for a Sentinel Node Biopsy is just a small incision below your armpit on the affected side and really caused me no problems. I got the results from this surgery on Good Friday which showed that no cancer had spread to my Lymph Nodes! This was a huge relief and I went on to enjoy Easter Weekend in Kilkenny with my Boyfriend's family.

My second surgery took place on the 9th April. After having had an appointment with the Plastic Surgeon at an earlier date, I had come to a decision to have a Mastectomy and Reconstruction just on the affected side for the moment and to come back to the healthy side at a later date. So on the 9th April I was admitted to the hospital to have surgery in the afternoon. One thing which has stuck with me since that day is something the Breast Surgeon said to me. She said that after this surgery I would be able to say I had cancer. I think for anybody about to go through a Lumpectomy or Mastectomy this is an incredible way to look at it - essentially once the surgery is finished, the cancer has been removed and as far as you can possibly tell - you no longer have cancer!
The Mastectomy and Reconstruction took place during the same surgery, in the same hospital, in the same Operating Theatre! I didn't really have much anxiety about this surgery, I was looking forward to another step in treatment being over. After surgery I came back to the ward with a new boob, two drains and a vacuum dressing plugged into a battery pack. I stayed in hospital for a full week after this surgery. My pain was very well controlled and I was given physio exercises to do to ensure I had good movement back in my arm. I do now have two different sized breasts but I know this is temporary and its much more important to be able to say my cancer is gone than I have two breasts the same size!

I was discharged from hospital on Monday 16th April - still with two drains and a battery pack in tow! I still have these at the moment, they are a bit of a pain but what can you do! I have my results appointment tomorrow 20th April with my Breast Surgeon. At this appointment they will discuss the Pathology report on the tumour. This is a very important appointment as it will show how successful chemo was at shrinking and killing the tumour. The hope would be that there was no evidence of cancer when the tumour was examined but this is probably unlikely for me as I had such a large tumour. What I already know is that the Chemo significantly reduced the tumour to the extent it could no longer be felt anymore and I have already been told this was a fantastic response so hopefully tomorrow I will be told similar. The results tomorrow will also determine whether I need Radiotherapy and Oral Chemotherapy. Hopefully I might have a drain removed tomorrow too.

In other news...my hair has started to grow back very slowly including my eyebrows and eyelashes. I am using Rapilash on my eyebrows and eyelashes and a number of different products on my scalp to encourage hair growth including; Nioxin, Lush Roots scalp treatment, Lush Shampoo bars and |Lush Veganese Conditioner. I have started to use all chemical free toiletries and I am hoping to look into chemical free make up too once I start wearing make up regularly again! I am trying to go for a walk most days to build myself back up - I'm finding it tough at the moment but I know it'll get easier!

I'm feeling pretty good at the moment. I have been completely overwhelmed by the support I have received over the past month or so and I feel very lucky to have such amazing people in my life. The day I had my Mastectomy Surgery was also the date of my Best Friend's 30th Birthday - I don't think I'll ever forget that date as it was also the date that cancer became Past Tense for me!

Finished Chemo, Now What?!

I haven't done a post in a while as during the last while I was feeling a lot more tired after chemo and when I started to perk up I didn't feel much like writing about it!

So I am FINALLY finished 5 months of chemo, which is the most amazing feeling. I was eager initially to start chemo because I felt like I was in a limbo between being diagnosed and waiting for chemo to start. As time goes on, chemo just becomes more and more frustrating and more and more like your life is further away from you! My last chemo session was on 5th March, I basically sat and cried through the majority of the infusion because I just couldn't believe that this was the last time (hopefully ever) that I would have to have this poison pumped into my body. That was a huge sense of relief! I became most emotional when my oncologist came to do rounds and I burst into tears, she is not the warmest of people but I got a hug from her that day and all of the oncology nurses who have treated me over the past 5 months. I genuinely will forever be grateful to my oncology team, not just for pumping me full of the poison that has shrunk my tumour away to almost nothing but because they gave me amazing care, physically and emotionally. I always admire nurses, mainly because I struggled so much with Nursing that anybody who survives in nursing seems super human to me, but Oncology nurses are really something else all together.

Chemo was the first part of treatment and although I am definitely relieved that I have finished that part, there is still a fair bit to come and still at least another 6 months of treatment and recovery so it does feel a bit like an oncoming train!

On the 26th February, I had an appointment with my Breast Surgeon. This is the women who initially told me I had a benign cyst and 5 weeks later gave me the news that no, I actually had cancer! It was a little bit strange seeing her again but regardless of what has happened in the past I actually really like her and have confidence in her work. She gave me the results of my MRI scan, which shows that there is a significant decrease in the size of the tumour and after examining me she said 'I had a fantastic response to chemo!' I would have loved to be told that the tumour was completely gone because I can no longer feel a lump at all but there is a possibility that what is seen as being left there is dead cells or scar tissue. It's impossible for them to tell if all of the cancer is gone until the tumour has been removed and sent off to Pathology for examination. There is a possibility that if there is some cancer left that I will need to take some oral chemotherapy tablets down the line but hopefully this won't be the case.

The purpose of the meeting with the Breast Surgeon was to start making plans towards surgery. I had been discussed at the multi-disciplinary meeting which would have included input from my Oncologist, all of the breast surgeons who work in the hospital and radiation oncologists. The advice from the multi-disciplinary meeting is that I should have a Mastectomy rather than a Lumpectomy due to the large size of the tumour at diagnosis. I nearly fell off my chair when she mentioned the large size of the tumour at diagnosis because ultimately that is somewhat her fault due to misdiagnosing me. I will also be having a small surgery on the 26th March - Sentinel Node Biopsy. This surgery involves injecting radioactive dye into the tumour which will then travel to the lymph nodes. The first part of this procedure will involve X-Ray monitoring of which Lymph Nodes the dye is travelling to and then being brought to surgery to have the first 4 lymph nodes which the dye travelled to removed. The purpose of this is to make absolutely sure that there is no cancer in the lymph nodes. If cancer is found in the lymph nodes then I will have to have all the lymph nodes removed from the left hand side. She then went on to talk about reconstruction options and I have a meeting with a Plastic Surgeon this Friday to talk about that.

When I was initially diagnosed, I was told that if I needed a Mastectomy that I probably wouldn't need Radiation but it is now being recommended to me that I do have Radiation due to..you guessed it..the large size of the tumour at diagnosis. So two things I definitely felt after this meeting were that due to the number of people who felt 'I was too young to have Breast Cancer' I will now lose my entire breast instead of just a part of it and I will have to have Radiation which I most likely would have been able to avoid if diagnosed sooner.

Since very soon after diagnosis my feeling towards surgery has been to have a Bilateral Mastectomy and Reconstruction for a number of reasons but the main one being I want piece of mind that this won't happen again, I know that the cancer can still return to the chest wall, lymph nodes or organs but I still feel removing both breasts has to give you a better chance to avoid recurrence. I spoke to my Oncologist about this and this is what she said - due to the fact I do not have any of the 3 genes I was tested for, they take it as I do not have a genetic mutation (there is still a possibility I do have one that either hasn't been tested for/discovered yet). Therefore the likelihood of a recurrence of cancer is 0.5-1% per year. So having a Bilateral Mastectomy would lower my chance of recurrence by 0.5-1% per year, which doesn't seem like a lot until you look at it like this - if I am lucky enough to live another 50 years, having this surgery will lower my likelihood of a recurrence of Breast Cancer by 25-50% over a 50 year period. I mentioned that this is what I wanted to my Breast Surgeon and she was apprehensive, she said she would be willing to do a preventative Mastectomy in a years time when I am in better health but that at the moment their recommendation would be to do the least amount of surgery needed so that I can have Radiation as soon as possible because obviously more surgery means more healing time and more likelihood of complications. I am anxious to leave it a year to have the healthy breast removed as a lot can happen in a year and with Triple Negative Breast Cancer there is no after care like hormone/protein positive cancers. I would rather not spend a year terrified that the cancer has returned. So I will be having a meeting with the Plastic Surgeon this Friday and then another meeting with the Breast Surgeon and then a decision will be made on what kind of surgery I will have.

What else is happening?

• I am feeling my energy improve everyday since finishing up chemo which is such a great feeling so I am trying to get out a bit more for walks and push myself a bit more during the day.
• I have a tiny bit of hair growing on the top of my head but the sides are a bit dodgy looking! I spoke to the hairdresser who shaved my head and she told me not to shave it again for the moment, to let it grow and have it trimmed when I can hold it between my fingertips. I also went to visit my own hairdresser in Peter Marks, the wonderful Maria and she has given me Nioxin to use to encourage hair growth. I haven't started using it yet as I'm not sure it would have any affect at the moment but I will start using it very soon! I am also going to look into a good supplement for my Hair, Skin and Nails.
• I went to see a Dietitian a few weeks ago because I have been reading a lot about Diet and Cancer. What I have come across recommends a Whole Food Plant Based Diet which is essentially either vegan or very low amounts of meat, dairy and processed foods. At the moment I am starting to implement this, I have reduced dairy and meat hugely and I am trying to make as much homemade meals as possible from scratch. I don't know if in the future I will decide to become completely Vegan but at the moment I am still eating meat and dairy from time to time.
• My eyelashes and eyebrows have fallen out/thinned hugely and possibly will continue to do this for the next few weeks. I have ordered some Organic Castor Oil and am going to start using this on them to encourage growth. Losing your hair is one thing, you can put a hat or wig on and although its hard you get used to it. Losing your hair, eyelashes and eyebrows just makes you feel a bit crap! There's lots of people who go through chemo, lose all of their hair and can mask it with make up and still look great, I am just not one of these people! I generally wear very little make up unless I'm going out and now with the tiredness/hot flushes I pretty much never wear it so I'm fairly bare looking.
• I had my last Zoladex implant inserted on the 5th March. This is the implant which has put me into temporary menopause throughout chemo. So it is a waiting game now to see if my fertility will return - fingers and toes crossed.
• That's all I can think of at the moment! Things are going well, I'm perking up and ready for the next part of treatment to begin. It's a little bit like being in limbo again, finishing chemo and waiting for surgery but I am just trying to enjoy this time as much as possible because I will have to rest up again after surgery!

Treatment Update

I'm about half way through my second chemo regime and wait for it...TWO WEEKS FROM FINISHING CHEMO ALTOGETHER!! 

So I thought I would do a post on how I am getting on with this round of chemo.

This chemo regime is known as AC and consists of Adriamycin and Cytoxan. This regime has been different in that I am only receiving 4 infusions every 2 weeks. I have currently received 2 out of the 4 infusions and will be having my 3rd on Monday. Adriamycin is an anthracycline drug which works by stopping or slowing the growth of cancerous cells. Cytoxan also works by stopping or slowing the growth of cancer cells and is also an immunosuppressant.

Adriamycin is a red coloured drug which is referred to by some people as the Red Devil. It's a very strong cytotoxic drug and it has the potential to cause heart damage although this is a very rare side effect. I was extremely anxious about starting AC. I felt that because my tumour seemed to completely disappear on TC that I was putting my body under unneccessary strain and potential harm. I mentioned this to my oncologist and she immediately shut me down and said that his part of the treatment regime was definitely neccessary unless I could give her a very good reason. Obviously I couldn't give her a good reason other than fear! So I went ahead. I had an Echocardiogram done before starting treatment which showed my heart to be in good condition so I was deemed fit to start AC!

Infusion Procedure

Pre-meds before AC are a bit different from TC and only consist of  two IV infusions of an anti-nausea drug and a steroid. I was also started on another anti-nausea tablet called Emend. This tablet should be taken 1 hour before chemotherapy and then again for the following two days. Unfortunately on my first infusion the Emend was not given to me until after the Adriamycin had already been infused and I knew all about it later that day! Once I'd had the pre-meds, it was time for the Adriamycin. When they came towards me with this bag of bright red coloured liquid, it did not calm my nerves at all!

Adriamycin is a vesicant, which means that it is extremely damaging if it comes into contact with the skin and can cause very severe burns. This was another worry for me as I do not have a port or a Picc-line. During my first infusion I just sat there staring at the IV line terrified the crazy-looking red liquid was going to leak out and burn a hole in my arm, all while causing damage to my heart! The Adriamycin takes about 30 minutes to infuse and then they started me on the Cytoxan, which also took about 30 minutes. The time spent in hospital for this regime is only about 2 hours, which is about half the time in comparison to TC!

Side Effects

Nausea; The evening after my first infusion of AC, I was very unwell. I was vomitting and wasn't able to eat anything. For the following few days I took anti-nausea tablets regularly and although I felt somewhat nauseous, it wasn't too bad and I was able to manage bland food. This was not the case after my 2nd infusion and I think it was because my Emend tablet was given to me an hour before chemotherapy began, so I suffered much less with nausea.

Brain Fog; The worst side effect I have experienced so far happened after my 1st AC infusion. I was on steroids for 3 days after receiving chemo and then I stopped taking them, as instructed. Once I stopped taking them I had the most horrible foggy head for about 3-4 days. I felt like I was dreaming and I felt very disconnected from what was happening around me. Even simple tasks like just making lunch seemed more difficult than normal and I was extremely emotional and anxious. I spoke to my oncologist about this when I was in the hospital for my second infusion and she changed my post chemo steroids to a tapering off plan which completely eliminated this side effect, thank god!

Muscle/Bone Pain; When on AC, you have a high likelihood of becoming Neutropenic. This means one kind of White Blood Cell - Neutrophils, become very low, which opens you up to infection in a serious way. Due to this, when on AC, you are given an injection within 24-48 hours of Chemo which stimulates production of blood cells. This injection is called Neulasta. Due to the fact blood cells are produced in the Bone Marrow, this injection can cause alot of Bone Pain. I had read some serious horror stories online about Neulasta and the Bone Pain associated with it. I also had read that taking Claritin while on Neulasta reduced bone pain for some reason, so I decided to give it a try. I have been extremely lucky and have had very minimal pain after Neulasta! I don't know if this is due to taking Claritin but I am beyond happy that I haven't had to deal with that horrible side effect!

Fatigue; The fatigue I feel with AC has definitely been worse than TC but then again I expected this. I actually expected it to be worse than it has been. I have been able to do so much more than I thought I would!

Other; I have been having a bit of pain in my chest, a mild dull achey pain. I was told to come into the hospital to have some tests done yesterday to just make sure it wasn't heart related. I have also noticed that my resting pulse is higher than normal at about 90-100bpm. I also suffer from Hashimoto's Thyroiditis and am on medication for this. I had general, heart and some thyroid bloods done yesterday aswell as an ECG which all came back fine. They have put the chest pain down to a muscular issue and they are unsure of why my pulse is higher than normal and have said it could be due to steroids. I think the medication I am on for my thyroid problem is probably too high and has put my body into overdrive, I'm going to reduce down that medication and see how that goes!

In Other News...I got some great news since the last time I posted! I got my genetic results back finally! I was tested for 3 genes - BRCA1, BRCA2 and P53 and all three of these genes came back negative! I was actually in the supermarket when I got the call to say I had tested negative and I burst out crying! I'm sure other customers were highly amused at me. Getting this news really helped to give me some positive feeling towards my future. Not having these genes reduces my risk of recurrence hugely and also means that if I have children I wont be passing on this gene to them. I am also very aware of the fact that just because these 3 genes are negative, it does not mean that I don't have a genetic mutation that is unknown or hasn't been discovered yet but it definitely helps to know that these three known genes are negative! This news also gives me more information that I need to make a decision towards the type of surgery I'll be having. I will be meeting with my surgeon soon to make this decision, I currently don't have a clue what type of surgery I need.

On Monday, I go in for my second last Chemo. I am also having an MRI, Ultrasound and Mammogram done too in preparation for surgery. At the moment, it looks like the tumour has either completely disappeared or is very tiny. The scans will clarify this so fingers crossed its completely gone! I'm getting very excited to be coming towards the end of chemo. I know I still have quite a while to go until I finish treatment but the longest part of treatment is nearly over!

Loss of Identity and Mental Health

I wanted to do a post today to acknowledge the fact it is World Cancer Day! This post is going to be a little bit different as it is not really about my treatment. Every post I have done so far has been more about diagnosis and the physical treatment of my Breast Cancer. This post is going to focus more on the psychological impact that a cancer diagnosis has had on me and how I have managed that.

So before I get into how cancer has effected my mental health I will write a bit about how my mental health was pre-cancer.

Before Cancer

From a fairly young age I have been a person who has suffered on and off with my mental health. At a young age my main issue was that I suffered somewhat from Depression and I was excruciatingly shy and therefore found it very hard to interact with people which led to a bit of Social Phobia. As I got older I suffered less with Depression and more with Anxiety. I am a perfectionist big time and expect perfection in the things I try to do in my life. I can and have put myself under enormous amounts of pressure in the past to achieve things and find it hard to cope with any kind of failure or criticism.

From September 2014 to May 2017 I started to undertake a college course which consisted of attending college for one full day a week. I then worked 39 hours over the other 4 weekdays. In 2015, I was made Supervisor within my job which came with a lot of extra responsibilities! I also started going out with my current boyfriend who lived in Kilkenny at the time. So I was extremely busy with college, work and travelling to and from Kilkenny at weekends. I also had periods of serious stress during those three years where I wondered what the hell I was trying to do!

Diagnosis and Treatment

Obviously, diagnosis was a huge shock for me. I spent that day in a bit of a day dream and when I went to sleep that night I hoped I would wake up and it would all be a dream. Clearly that didn't happen and so I spent a lot of time trying to inform myself on what exactly I was dealing with. Initially I was smart in where I looked for information, I read a lot of Irish Cancer Society booklets, I bought a book about Triple Negative Breast Cancer and I stayed off the more casual unreliable websites for fear of what I might find.

For about the first two weeks after diagnosis I was very emotional and my mood was all over the place but once I accepted my diagnosis I became very positive about what I was about to go through. I have to say generally throughout TC treatment I remained very positive and I didn't feel overly anxious about having cancer. I started to see a Psycho-Oncologist and decided I would continue to see them throughout treatment because I had a feeling that the positivity I was feeling would not last forever!

While on TC I read a lot about AC. I knew that the A in AC was Adriamycin and I knew that drug was strong and that it could cause damage to the heart and sterility. I joined support groups on Face book and read lots of peoples experiences of AC. I read to the point I scared the crap out of myself. As TC was coming to an end and I knew I would be starting AC soon, I started to get very nervous. I had my first infusion of AC on the 22nd January and driving in to the hospital that day I was scared of what this drug was going to do to me. I have only had one infusion so far and it was definitely harder than TC. I was a lot more nauseous, tired, weak and I had a few days where I felt like I was in a daydream and found it hard to concentrate or even be around people. This brain fog type feeling lasted about three days and those three days I was extremely anxious. I spent those three days thinking and over thinking about my future, possibility of recurrences and possibility of infertility. I have to say I would take nausea, tiredness or any other side effect over feeling that way again. I have a feeling that this was caused by the fact I was taking steroids for 4 days and then I stopped taking them and I must have crashed in some way which caused the brain fog and anxiety. I have my second infusion tomorrow and I will be talking to my Oncologist about this so hopefully it wont happen again.

What I also noticed about this cycle of treatment is that because it is a stronger regime there is more downtime between treatments. Because of this there was more time where I wasn't up to leaving the house and I wasn't up to doing much inside the house either. Therefore, there is a lot more time to think and feel sorry for yourself and obviously this is going to have a negative effect on your mood!

I had an appointment with my Psycho-Oncologist on Friday and within a few minutes of meeting her she was able to tell from my body language and the way I was speaking that I was anxious. I didn't necessarily feel anxious but when she got me to stop talking and spend some time focusing on areas of my body I realised that I was tensing certain areas to the point they were painful due to the fact I was anxious. She stopped me a number of times throughout our session and again got me to locate the area of tension and helped me to relax. I had had a number of sessions with this psychologist in the past but this was the first one where my anxiety was obvious to her. I don't know exactly why this is but I had a feeling all along that it would eventually rear its head.

So, what do I do to help with anxiety?

I find that the best thing I can do to prevent myself over thinking and becoming anxious generally is to distract myself by doing something I enjoy;

• Getting out; doesn't matter what to do but feeling like I've achieved at least one thing everyday makes me feel somewhat productive.
• Going for a walk; I try to go for a walk as often as I can. Sometimes I find the most basic walk tiring but getting out in the fresh air helps crazy amounts!
• Knitting; knitting has become my obsession. I always enjoyed it but since I have been off work I have discovered I have an insane passion for it. I find it distracts me and calms my mind and I love creating things and gifting them to the people in my life.
• Spending time with friends and family; I have an amazing support system of people around me. If it wasn't for them I think I would have gone crazy from boredom by now but they keep me occupied and I probably don't thank them enough for that - Thanks guys!
• Having Baths; baths are incredible for helping you to relax. I fill it right up to the top and add in Epsom salts and bubble bath. I pick an album and just relax and listen to the music.
• Mindful Breathing; I try my best to incorporate this into everyday. It helps me to relax and focus on the present moment, even if its just for a few minutes.

Loss of Identity

I don't know if every cancer patient goes through moments where they feel like they've lost their identity but I definitely have had those moments. When a person goes from such a busy lifestyle to being unwell and having a huge amount of time on their hands they don't only lose a part of their identity but also a piece of their self worth. I complained so much about college, work and everyday things before being diagnosed. I would give anything now to be in the situation I spent so much time complaining about! I think perspective is everything though and I know that when I do get back to my normal everyday life it will never be the same again, I will be a much calmer person with a whole new perspective on life and I really look forward to that!

The other side of feeling like you've lost your identity is your self image. My self image has changed so much since I was diagnosed on the 15th of September. I had just lost almost 4 stone so I was the slimmest I had been in years. I have gained back some of this weight, which is to be expected and I try not to dwell on this too much. Being bald doesn't bother me hugely either anymore. There are times when I catch a glimpse of myself in the mirror and feel very unhappy about what I see looking back at me but I know all of this is temporary and I remind myself that this too shall pass.

In about two months time I will be having surgery, I don't know what type yet and how invasive it will be. At the moment I don't feel too concerned about it but I'm sure when all is said and done there will be an adaption period for me to learn to accept the change there will be to my body.

I plan on getting a tattoo when I finish up treatment. I haven't decided where or what of yet but I want to do it to remind myself of this time in my life where I was stronger than I ever thought I could be. Being faced with something as scary as cancer makes you reach inside yourself and find coping mechanisms that you didn't know you had, well at least for me it has. This whole experience has given me a new appreciation for life and I find myself crying over beauty as well as pain now which I never did before! 

Hair Loss, Steroids and all those lovely things

So this week has been a blur. I started a new Chemo regime last Monday and it is a completely different kettle of fish. I feel like I've lost a few days and I'm blaming steroids on that! Today is the first day I feel pretty normal and I actually feel like skipping around with happiness due to the fact I don't feel like I'm dreaming and walking around bumping into walls!

Anyway, rant over, I wanted to do a post about the side effects I have had from Chemo so far. Obviously, I have only had one infusion of the demon Chemo so far so I will probably do another post later just on the lovely experience that is AC chemo.

Steroids

I have had a very hate-hate relationship with steroids since starting Chemo in October. I know that they're given for a multitude of reasons but I just don't like them. When first starting TC chemo, I had to take steroids before treatments for the first two weeks to prevent an allergic reaction. Once, it was clear I didn't have an allergy to Taxol, these steroids stopped. I still had a steroid infusion before each treatment and oral steroids for two days afterwards. I did try to mess around with my steroids post chemo (after checking it was okay with my oncologist) and was able to reduce them down, which was great but when I tried to lower them too much, I ended up in A and E!

So steroids obviously have their advantages, they help with nausea, allergic reactions and I'm sure lots of other things which I haven't informed myself of because as I've said a few times already, I hate them! The disadvantage for me of steroids starts with the ridiculous hunger that they cause you to have. When you start Chemo, they tell you to try to maintain your weight which seems reasonable and then they put you on these tablets that make you hungrier than you ever thought possible. Its the type of hunger that can't be ignored either, as you start to feel weak and faint and crave crappy, unhealthy foods. I have been trying my best to eat as healthy as possible and have cut down on eating meat hugely but I am eating more than I was before treatment started and I will definitely have some weight to lose once I finish treatment! Steroids can also cause you to retain water, so they can make you feel very bloated. The combination of the water retention and the gaining weight can give you a bit of a puffy face which I like to call moon face.

The other thing about steroids which I find very frustrating is the false energy they give you before an almighty crash! Once the steroids stop, the energy stops and my brain feels foggy, which can take a few days to recover from. This come down also plays with my emotions in a big way, one minute I'm laughing and one minute I'm crying. I'm very lucky I have a very understanding boyfriend!


Hair Loss

I think for me, hair loss was one of the scariest side effects that I knew I had coming. When I was first diagnosed and my colleague came over to wait with me while my parents made their way to the hospital, I kept talking about losing my hair. I had just been diagnosed with cancer, but my concern was about losing my hair?! Seems a bit ridiculous, but its the same for many people when they're diagnosed and throughout treatment. When I was diagnosed, I didn't feel particularly sick. I suffer from an Auto-Immune Thyroid problem which has rendered me tired for years now so I hadn't noticed any difference in my normal level of feeling a bit worn out! But thinking of myself with no hair scared me and I knew when that happened I'd have to look myself in the mirror and deal with the fact I was sick.

Hair Loss started for me about 1 month into my TC treatment. I didn't have any pain or irritation or anything unusual associated with it, which many people complain about, it just simply started falling out. In the beginning, it was pretty gradual but it got to a point where I dreaded having a shower because when I brushed my hair afterwards, clumps of hair filled my hairbrush. I also found hair everywhere, my clothes were covered in hair, my bed was covered in hair, even my car was covered in hair! I woke up one morning, washed my hair and when I saw the amount of hair in my hairbrush I rang the hairdresser and told her I wanted my head shaved today and she had me booked in for 10 minutes time! I picked my favourite hat out and drove myself and my mum down to the salon.

Having my head shaved was a strange experience. I had it done in Pink Ribbon, which is where I bought my wig as its so close to my house. They have a separate room available for this purpose and the girls there are so lovely, it just felt like the right place to do it. When shaving my head, the hairdresser faced me away from the mirror, facing my mum, so I actually didn't see my hair being shaved off. I think that this was the most brilliant idea and I think it saved me al ot of upset. I sat across from my mum and watched her cry and obviously cried a little bit myself too. I think the experience was harder for my mum because she could see it happening and she said it was like I was turning back into a baby! Apparently, when I was a baby it took ages for my hair to grow in the first place so all those years of hard work were ruined in a few minutes! When the hairdresser had finished shaving my head, she put my hat on and told me to look when I was ready, which I also thought was a great idea, as it gave me some time to process what had just happened.

My biggest fear that day was seeing my boyfriend when he came home from work. He had gone to work and I had hair and he was coming home from work and I was extremely bald! I did warn him, I didn't want him to come home and have a heart attack when he had seen what I'd done. I didn't let him see me for a while without a hat on but fairly quickly we both got used to it and we have the giggles now about the tiny little baby hairs that have been growing back on my hair while on TC!

I did think to myself when I started this blog that absolutely under no circumstances would I put up a bald picture of myself for the world to see. I have made a compromise here and have three pictures to show you (all under Snap chat filter of course!)

This is my wig, which I bought in Pink Ribbon. The wig is beautiful and definitely nicer than my original hair was. It's a synthetic wig, so its really low maintenance but the only thing is it can't be styled so it always looks the same. I don't wear this all that often because I find it quite warm but when I do it makes me feel pretty normal!

Excuse my stupid face in this one! This is my fringe which I got in Roche's Wigs. This is my favourite hair/head piece that I've come across and only costs 30e! It sticks to your hat with a piece of Velcro and just gets rid of that super bald look. Unfortunately, due to the fact I have a gazillion hats, I have actually managed to lose this fringe somewhere but I do plan on buying another one very soon!

Now, this is the picture I said I wouldn't post but I made a compromise and and gave myself some ears and a nose staying in theme with the other pictures! I do have a very small amount of hair at the moment which is likely to fall out on the new chemo regime I am on. I also haven't lost my eyelashes or eyebrows yet but I think they'll also be gone in the next few weeks, so I'll enjoy them while I still have them! Also, remember when I mentioned Moon Face above? Example A above!

Hair/Scalp Care;

I read alot before losing my hair about what to expect and found alot of people complaining of dry and irritated scalps. I have been really lucky again with this as I have had no irritation on my scalp at all. I just wash and condition it the same way I always did and that has worked well for me. I do rock the bald head pretty much all the time while I am in the house, I don't really wear hats unless I am cold or am going out and I think that has probably stopped any irritation as it allows your head to breathe. I tend to run extremely warm at the moment, due to all the drugs and such and for that reason a hat isn't necessary indoors.

Other Side Effects;

As I said before, I pretty much sailed through TC so I don't have a huge amount of knowledge to share regarding other side effects, but what I do have I will share;

Nausea; I had virtually no nausea on TC but any nausea I did have was sorted out using anti nausea tablets. One thing I did find important to keep nausea at bay was to eat regularly and not allow myself to get too hungry. I found that if I allowed myself to get really hungry then I was much more likely to feel sick.

Fatigue; I did have days where I tired much more easily than other days but I was surprised at how much I could do while on TC. I tried my best to do one thing everyday, mainly to keep my head happy and I rested when I needed to.

Neuropathy; I ended up with a tiny bit of neuropathy in my fingertips from TC. It didn't happen until my 11th infusion and was minimal. I already feel like it is improving and doesn't cause me much bother.

Nose Issues; I have always had a very allergic nose so when I heard chemo could cause problems with your nose I knew I would definitely have this side effect. I tended to have alot of nose bleeds and blocked sinuses. I was prescribed a spray called Nasonex for the sinus issues which cleared that issue up. As for the nose bleeds, they were happening because my nasal passages were dry so the solution I was given was to put Vaseline up my nose. It's not a pleasant experience I won't lie but it helped alot with the nose bleeds so needs must!

That's all the side effects that I experienced with TC. I know AC is definitely going to be different, I can see that already after just one infusion! I have to say it feels like I have been having chemo for at least half my life at this point but this day 7 weeks (all going well) I will be able to say that I am finished chemo and I'll be a step closer to getting back to some kind of normality.