If you ask someone who has gone through breast cancer treatment if chemo brain is a real thing they will 100% say "yes". If you speak with some doctors about suffering from chemo brain and probe a bit deeper about long term side effects, you may hear a different response. Some scholars think that the jury is still out on whether or not chemo brain is real. The Chemo Brain Debate Consequences from aggressive chemotherapy treatment include nausea, hot flashes, and hair loss, but why does "chemo brain" or "chemo fog" not always make the list? In this blog we are going to address this debate and let you know how you can get involved in advancing the research on this important topic! What is Chemo Brain? According to the Mayo Clinic, chemo brain is a term used to describe the mental and cognitive challenges one experiences in day to day tasks. It's been described as being in a daze or heavy cloudy fogginess. It is also described as being a very debilitating and frustrating side effect of cancer treatment. Understandably so, imagine not being able to articulate your thoughts because the word is at the tip of your tongue but you just can't get it out. You use so much mental energy to concentrate, focus, and stay organized that it is almost impossible to muscle through a 9-5 workday without wanting to take a nap. Fatigue sets in and short term memory may even be compromised. Chemo Brain can last up to six months post chemotherapy and includes symptoms such as confusion, difficulty concentrating, short attention span, short term memory problems, difficulty with word retrieval, and difficulty learning a new skill. So why the Chemo Brain Debate? The University of Texas MD Anderson Cancer Center acknowledges that chemo brain is a legitimate diagnosis and several others including Dr. Susan Krigel, Ph.D. agrees that chemo brain is a complex and evolving science. The challenge is that researchers have only recently begun to conduct studies on the cognitive impact of chemotherapy. Prior to the 1990's there was no scientific evidence to support the antidotal claims breast cancer patients were describing despite the fact that 16-75% of this population was experiencing some degree of memory dysfunction. Chemo Brain Considerations Interestingly, there are so many factors that must be taken into consideration with regards to memory and brain function. According to Krigel (2015) considerations need to be made in terms of age, genetic predisposition, baseline cognitive performance, diet, and hormonal levels to name a few. As you can see: More research is needed so that we can obtain a better understanding of the short-term and long-term impact of chemotherapy on memory and cognitive performance among those who have been diagnosed with breast cancer. Here's how you can take action and help advance Chemo Brain research. Since 2004, the lab at the University of Colorado Denver (UCD) has been studying the effects of cancer chemotherapy on the brain, and on cognitive abilities such as memory and concentration. As you may know firsthand or from others, chemo brain can have significant negative effects on quality of life, but we still don't really understand what causes it, and more importantly, we do not know how to treat and prevent it. Susanne Withrow from UCD is looking to learn more about the factors that are associated with the experience of chemo brain symptoms. Breast Cancer Treatment and Chemo Brain Withrow and her lab are studying the effects of breast cancer treatments on cognitive functioning among women with and without a history of breast cancer between the ages of 35 and 85 years. If you would like, you may choose to voluntarily participate in the anonymous 20-30 minute survey which focuses on background information, memory, concentration, and mood. The research has been approved by the Colorado Multiple institutional Review Board (COMIRB, Protocol #15-1509), which is responsible for approving the adherence to ethical standards of all human subjects research conducted at the University of Colorado Denver. Click Here to take the survey now. If you have questions about this study please feel free to contact Susanne Withrow directly. Thank you from the SBC team and helping us advance research! Xo

“Inspiration, move me brightly. Light the song with sense and color; Hold away despair, more than this I will not ask. Faced with mysteries dark and vast, statements just seem vain at last. Some rise, some fall, some climb, to get to....” --Jerome Garcia, Robert Hunter SurvivingBreastCancer.org founder and executive director Laura Carfang, myself, and best friend for life Braydon Germain recently experienced the most wondrous, inspirational vacation imaginable. Allow me to start this narrative at a point that seems so very long ago. Laura was diagnosed with breast cancer some 18+ months before this expedition @ the tender age of 34. Prior to that she and I (her most willing caregiver) would run up monthly to NH, from our base in Boston, MA to experience the wonder of the White Mountains. We would camp, hike, bicycle, swim, and marvel at the natural spectacle that surrounded us. Occasionally we would trek out to the Great Southwest to do the same at National Parks in Colorado, Utah, and Arizona. However, after she was diagnosed with breast cancer we were forced to scale back these activities to accommodate chemo infusions, surgery, more chemo, radiation, and finally, and most recently hormonal therapies and night sweats and more. Throughout her journey we would philosophically reminisce about how much we missed the enjoyment of participating in and getting back to nature. So we set a goal to once again head out to the wilderness to experience nature at her finest. We scheduled a date and place, July, 2018, Yosemite National Park, and invited our dear friend, Braydon Germain, to accompany us. Braydon, a young recording engineer in a famous LA studio, was up for the challenge. We informed him that our itinerary was to fly to LA, visit some old friends from NH who moved out that way (another cancer survivor), travel northeast 6 hours to Yosemite, explore for 8-10 days, then head over to San Francisco to finish up with a multi-day stay there before hosting a survivingbreastcancer.org meet and greet with our partners Driver.XYZ. If he so desired, we’d pick him up in LA and take him along for as much of the two-week vacation that he could tolerate. His response was “I’m in it for the entirety.” So off we went. Yosemite is right up there with some of the most must-see destinations in the world. It occupies John Muir’s “range of light” in the Sierras. It is a land of incredible diversity and features elevations that range from 2,000 to 13,000 feet above sea level. There are several groves of giant sequoias, the largest, and among the oldest living things on this beautiful earth. The magnificence of the mountains, valleys, rivers and lakes remind one of the Book of Genesis. El Capitan is beyond remarkable, Yosemite Falls is gigantic and the uniqueness of Half Dome is striking. Seeing all of this in person leaves you totally inspired. "I knew Yosemite was going to be spectacular, but nothing could have prepared me for the breadth of impactful moments it gave me. The scenery we experienced allowed me to tap into my childhood wonder, and the challenges I faced on my Half Dome hike unveiled deep layers of my subconscious mind. I will always look back at my time in Yosemite and how the Sierras turned my close friends into family." --Braydon Germain And it is exactly the experience of that inspiration that was so transformative. For 8 days we hiked, swam in the ice-cold Merced and Tuolumne Rivers, dove into Cathedral Lakes, camped along the rivers and cooked 4 star meals, including freshly caught brook trout, over a raging, hot fire. “Only by going alone in silence, without baggage, can one truly get into the heart of the wilderness. All other travel is mere dust and hotels and baggage and chatter.” –John Muir It was as if the Three Musketeers came to life in one of the most remarkable parks known to mankind. After dinner we’d clean up and then sit by the fire, waxing philosophic about life, music, literature, etc. The discussions were lively, entertaining and even businesslike on occasion. Of course, the focus would turn to survivingbreastcancer.org and how to build up the non-profit to be able to positively impact as many survivors and caregivers lives as possible. Following our stay at Yosemite we drove through California’s fertile plains and navigated our way to the picturesque Big Sur. This fantastic and rugged stretch of California coastline is stunning and reminds one of the Beats authors Kerouac and Brautigan coming to terms with life’s demons by confronting their internal struggles, ghosts and various states of consciousness. Through our time together we had this feeling of being in the presence of something vast or beyond human scale. Meditating on the beach, sleeping under the stars, hiking along the coast, diving into the icy Pacific, our togetherness transcended our current understanding of things. This truly electrifying experience, positively impacted our lives in measurable ways. It taught us to live in the moment. It inspired us to be better; To delve into our consciousness; To strive for excellence; To be at peace with who and what we are. The impact of experiencing such inspiration has vast potential to lift one’s spirits, improve health, and assist you with your developing mindfulness. Intentionally pursuing it will change your life for the better. Use the power of positivity to solidify your place in the world. “Ere dawn had kissed the level valley floor / He climbed to summits through the sleeping wood / By the inerrant guide of forest lore, / And found companionship in solitude / He feared no beast and by no beast was feared / And none was startled when his shape appeared.” -- Excerpted from the poem, “With Muir in Yosemite,” Robert Underwood Johnson

There is a cruel myth about surviving cancer. In this myth, when the medical treatment is successful, the story ends. Having survived cancer, we pick up our lives where they were interrupted and carry-on, with increased gratitude for the simple acts of daily life and the clarity of purpose that only a brush with death affords. The real story does not end in this way. Instead we live in limbo. After cancer, we know that we are on uncertain ground. We have to adjust to the trauma on our bodies from the effects of intense treatments and surgeries. Some symptoms (and treatments) may last for months, years or even the rest of our lives. In addition to the physical trauma, there is: The emotional trauma, The grief, The loss of our bodies as we knew them, The loss of the trust in our world and in some of our loved ones who disappeared or didn’t show up when we needed them. We have unsure footing and anxiety of what’s next. There is no longer order in our universe. When we resume daily life, we are disoriented, confused, fragmented, worried, jumpy and we no longer “fit in”. The people in our lives think we are getting back to normal but nobody realizes that normal is actually gone. The trivia of life drops away and there is no question about what’s important, but those around us have trouble relating to us, and us to them. This is a lonely place to be. All of these things are omitted from the survival myth. #Breastcancer

It’s Sunday Morning. The coffee is brewing and I cuddle up on the couch to start reading the morning news. Half asleep, a little groggy, and scrolling through the media sites on my iPad my scroll comes to an abrupt halt. A flurry of excitement washes over me as I reread the headlines of a breakthrough study literally just published this morning. Headlines from Genomic Health read: “Landmark TAILORx Results, Published Today in The New England Journal of Medicine, Demonstrate the Oncotype DX Breast Recurrence Score® Test Definitively Identifies the 70% of Women with Early-stage Breast Cancer Who Receive No Benefit from Chemotherapy, and the 30% of Women for Whom Chemotherapy Benefit Can be Life-saving” This news was not only published today in the New England Journal of Medicine, but was also announced and presented at the plenary session at the 2018 American Society of Clinical Oncology (ASCO). Ok, so let’s break this down a bit and I’ll explain why this is so exciting! First, this was a much-anticipated study and has been in the works for a decade! It illustrates the important relationships and conversations between the patient and the oncologist in determining treatment post-surgery as it relates to one’s prognosis and survivorship. Medicine is not a perfect science. As much as I wanted to hear that the cancer will never return, and this was a “one and done” experience for me, it’s impossible to get a 100% guarantee. You can comb over reports, data, statistics, get second or third opinions, cry, pray, hope, you name it, but at the end of the day, it’s your decision and one you have to become comfortable with. To quote the whimsical Jerry Garcia, “Nothing is for certain, it could always go wrong”. So let the music keep playing and we make the best decisions with the information we have at the time. But what this study found, according to Allison Kurian, an oncologist at Stanford University and quoted in the Washington Post revealed today was that these findings “are going to change treatment — and remove uncertainty for women making decisions.” In 2018 alone, there are going to be approximately 266,000 new cases of breast cancer! Women with early stage breast cancer however, may no longer need chemotherapy. This applies to 85,000 women with the most common type of early stage breast cancer who now, under consultation with their oncologist, may confidently forgo chemotherapy. Groundbreaking right? So, what is this common early stage breast cancer and how is this all determined? According to this study, early stage breast cancer referrers to: You’ve been diagnosed with Stage I or II breast cancer The cancer is Estrogen-Receptor-Positive The cancer has not spread to the lymph nodes If you fall into this category, your medical care team may recommend you receive a genomic test. This test analyses your genes to determine the behavior of the cancer and its likelihood of responding to treatment. This is done by an OncoType Dx Test. Depending on the score of your OncoType, you may be able to forego chemotherapy. Like any study, there are exceptions and outliers. As published in the Washington Post (2018), Joseph Sparano, associate director for clinical research at the Albert Einstein Cancer Center and Montefiore Medical Center posit that women who are 50 or younger and have received an OncoType Dx recurrence scores of 16 and above got a “substantial” benefit from chemotherapy and should consider it. There is a lot of uncertainty involved with a breast cancer diagnosis. In some cases, you are living week to week and waiting on test results to know what happens next. There are a lot of challenging time-sensitive decisions to make and long-term stressors that bubble up like “why did this happened to me?”, or “what if it returns?”. Waking up on a Sunday morning to this news makes my day! I’ll take this positivity any time! Thank you to all of the researchers, advocates, grant writers, participants, medical care teams, caregivers, and families for moving the needle forward and advancing treatment in breast cancer! Research continues to save lives and I am thrilled that Survivingbreastcancer.org is able to raise awareness through our blog and community outreach and be part of the movement! Additional resources on today’s topic: NPR NewYorkTimes PRNewsWire Multivu BBC #Chemotheraphy #Chemo #BreastCancer #Treatment #Ontotype

Staying on track with diet, nutrition, and weight management is hard enough as it is, but to compound that with a cancer diagnosis, well, let’s just say all bets are off! I have spoken with several people, and I have received tons of emails asking the question of whether or not it is possible to loose weight after being diagnosed with breast cancer. Moreover, I hear the distress among women, myself included, who do not understand why weight gain over the years is more prevalent in those who have been diagnosed with breast cancer compared to those who have not. An interesting study from Johns Hopkins Kimmel Cancer Center addresses some of the reasons. Going through active treatment, it’s important to get some physical exercise when you can. There were definitely days I was so fatigued I could barely walk a block. Other days, I was able to walk 10,000 steps! It was also important to nourish my body with nutrients. I rewarded myself after completing 6 months of chemotherapy with a fancy juicer, specifically the Breville Juice Fountain I was committed to getting my health back and fueling my body with healthy fruits and veggies every morning. That, in addition to making smoothies with my Vitamix, I thought I was on track to lose the “chemo weight” and start feeling my best. Well, that was a year ago and I haven’t lost a pound. That’s not to say it’s impossible to lose weight with a breast cancer diagnosis, but it may take a different approach. I did some research. Let me share with you what I discovered and how I am approaching diet, nutrition, and weight management now as part of my strategy for survivorship post breast cancer! Hormonal receptive breast cancer accounts for 65-75% of all breast cancer cases. If your cancer thrives in these hormonal environments it is common to be placed on hormone therapy drugs that lower estrogen levels or block estrogen receptors all together. It is common for women who are pre-menopausal to be placed on Tamoxifen while post-menopausal women may be on Aromatase Inhibitors (AI) such as Anastonrozole, Exemstine, or Letrozole. Though one’s menstrual cycle isn’t the only consideration taken into account. In my case, I am under 40, haven’t yet gone through menopause, and after several discussions with my oncological team, choosing the right long terms therapies for me included Letrozole plus a Lupron shot. Since starting these hormonal therapies, I have noticed I have to be extra conscious about diet and nutrition. While these therapies are saving my life from cancer, they are also throwing my body into a forced, medically induced menopausal state, where weight gain, muscle loss, and bone loss are all legitimate side effects! (Because of these side effects, my care team and I are being proactive. Prior to starting these therapies, I have taken a base line bone density test and will continue to be tested to ensure the health of my bones. Additionally, I have started to take Zometa to strength bones and hopefully prevent the onset of osteoporosis). Medically induced menopause abruptly alters the body by lowering hormonal levels within days or weeks, instead of gradually over several years. This drastic onset can be particularly challenging. Not only is your body changing due to breast cancer, it is also changing due to hormonal levels! After struggling with body image for some time, (losing my hair, losing part of my body through surgery, and needing to rediscover my femininity, changes in body shape, size, and physical ability) I had reached a point where I wanted professional support from a nutritionist. If you have ever googled weight loss, we all know the “simple” formula that you have to burn more calories than you take in; if one pound equates to 3500 calories, in theory, by eliminating 500 calories a day, in 7 days, you would expect to have lost 1 pound. You do this enough over time, you will lose weight. Well, that wasn’t happening for me and I didn’t understand why; I didn’t fully understand how this “new post-diagnosis me” was functioning. While meeting with my nutritionist, uncensored and disclosing everything I eat in a day, I realized that my idea of “healthy” wasn’t adding up. The culprit: Eating all of the good healthy fats like avocado, walnuts, olives, and olive oil are great, but when you combine them all into a big salad for lunch, your salad can quickly between 700+ calories! The solution: Choose one healthy fat to add to your salad and vary it up during the week. Not only did this reduce the calories in my salad, I actually started looking forward to the different salad options I was having each day! Some days there were avocado, which was a treat, and other days I got to eat delicious Kalamata olives! The culprit: Eating fish is a great way to get your omega 3 fatty acids. Not to mention it’s a great source of nutrients like vitamin D and B2, calcium, iron, potassium, zinc, and minerals! I fell in love with discovering the health benefits of fish and how my hair and skin had a new healthy glow to it! However, no one ever told me to pay attention to the portion sizes! Yes, size does matter! The solution: ¼ of your plate should be dedicated to a protein source. Agood measurement of this size is about the size of your fist. If it looks small, don’t worry, fill up 1/2 of your plate with delicious veggies like carrots, asparagus, Brussel sprouts, broccoli, beets, snow peas, peppers, or zucchini. The last ¼ of your plate is dedicated to starchy veggies and grains, think corn, potatoes, quinoa and rice. Now, tell me you are still hungry after eating all of this! I was surprised how full I felt, not bloated, and I even slept better! Who knew? (My nutritionist did and I am so glad she shared this visual with me!) I literally have it on my refrigerator to remind me every day what healthy looks like! The culprit: Red wine. As an Italian/American, how could I give up the vino? It’s common practice to have a glass or two at dinner most nights. Plus, depending on what you read, some advocate that there are health benefits of drinking red wine in moderation! Well, the more research I did, the more I was discovering that wine, and specifically the sugars in wine, could actually lead to breast cancer! I was in shock! The last thing I want is recurrence of this disease! Now, I share all of this with a grain of salt because studies have come up with conflicting evidence as to the link between alcohol and cancer. However, the bottom line – if it’s toxic and you are putting it in your body, there’s a chance it can cause harm. The solution: You can definitely choose your own path here. Personally, I know going cold turkey wasn’t going to be sustainable for me so instead of giving up alcohol as an absolute, I’ve switched to a light beer that I have on special occasions. The verdict. It’s taken about 4 weeks, but I’m starting to notice a shift in the way my clothes fit and the way I feel. I’m focusing on the quality and quantity of my foods, getting 30 minutes of exercise in daily, and not obsessing about my post cancer body. Instead, I’ve embraced it and thank it every day for allowing me to be alive and get back to the life-style I enjoy! I’m not claiming to be perfect, I’m claiming to be human! --> Interested in what my food diary looks like take a peak here. --> Click here for some great resources on health and wellness #BreastCancer #DietandExercise #Diet #Exercise #Nutrition #hormonaltherapy #weightloss

By Ashlee Duttweiler Navigating the world of healthcare is complex. I know from personal and professional experience that a diagnosis of cancer (of any kind) changes your life. Not only does it affect the cells of your body, it changes everything. That is why holistic care is so important and that is one of the reasons I got involved with the Surviving Breast Cancer organization. My name is Ashlee. I met Laura at a fundraising dinner for an amazing lab making huge strides in cancer research (shout out to Dr. Whetstine and Whetstine Labs!). As soon as she started telling me about the work she was doing in terms of breast cancer survivorship, I got super excited. Holistic health was my platform in the healthcare field and cancer has touched family and friends surrounding me. In addition, I care a lot about supporting and advocating for patients and caregivers which is why I am planning to pursue a career in social work. It is my desire that through my education and involvement with this amazing organization, I will be able to bring hope and light to the darkness that often goes along with health struggles. With that in mind, I’ve put together a few tips for navigating the world of healthcare that I have learned from working with doctors (professionally and personally) that will help and encourage you as you begin surviving cancer and navigating the health care system. 1. Advocate for yourself (Or find someone who will do it for you) The healthcare field is overwhelming. As a patient, you have rights and are not entirely subject to what the doctor initially tells you. If you have questions, ask them and don’t stop asking until you get answers and you have a full understanding. It is usually helpful to have someone accompany you to doctor appointments, or talk to insurance providers on your behalf; this person may ask questions that you might not have thought of, or to help remember all the information that is being thrown your way. Laura said she always brings a notepad and paper to all of her appointments, she takes notes, and asks for correct spellings of medicines so she can do her research once she returns home. In addition, if you do not feel like you are being treated properly or fairly, speak up! While it can be scary, you are allowed to take ownership of your care. This point is also important because sometimes it can feel like it is you (the patient and your family) against the doctors and insurance companies. Professional advocates are fairly new to the scene, but take advantage of this option! It puts someone in your corner whose sole purpose is to help you understand, check bills and information, and get you the fair treatment that you need. 2. It is OK to get second (or third) opinions The more eyes that are looking at something, the better! If you don’t feel right about something or don’t like a particular doctor, it is totally fine to look elsewhere for care. There is not just one doctor who deals with your particular type of case, so if you are not satisfied it is ok to look elsewhere. One thing that is important to remember in this case, however, is that doctors are experts in their field. My point in saying this is that they do know what they are talking about, but it is perfectly acceptable to get as many eyes on your case as you can so that you are able to make an informed decision about all of your health care options. Looking for second or third opinions? Survivingbreastcancer.org has partnered with Driver (as startup based in San Francisco) who can assist you in setting up appointments for second opinions throughout the U.S. regardless of where you are located! In addition, Driver offers several other support services such as managing medical records, access to clinical trials, and is helping our Surviving Breast Cancer community pay for these services through a GoFundMe Champaign that they are donating the first $100 to your goal! Got questions on this – definitely reach out to Laura@survivingbreastcancer.org for details! 3. Do your research There are so many great resources available specifically for you! survivingbreastcancer.org, for example, which has a focus on survivorship from day one and beyond, but there are many organizations that will cater to your needs whether that be financially, house cleaning, or child care to name a few, and who want to help you through this difficult season. You are not alone! Join our Surviving Breast Cancer community. #BreastCancer #secondopinions #healthcare

It can be overwhelming attending doctor appointments week after week with a plethora of information thrown at you each time, new vocabulary, new side effects to worry about, and additional risks all come flying at you at warp speed. I always came prepared to my appointments with a note pad and pen taking copious notes, and asked for correct spellings of technical terms, knowing I would come home and google absolutely everything! Often times, our discussions in the oncology office revolved around discussing the various approaches to treating my cancer along with weighing the benefits and risks. About one year ago, as we were discussing my surgery options, my nurse came in and handed me this pamphlet and said we should talk about Lymphedema. My head was already spinning as I was nervous about my upcoming surgery and like a deer in headlights, I now had to worry about this potential risk? While having lymph nodes removed does not always result in developing lymphedema, it quickly became clear that this was something I would need to look out for and manage for the rest of my life; it is something that can develop immediately after surgery, or even months or even years down the road. My only real experience with lymph nodes were usually associated when my primary care physician was checking if I had any swollen glands around my neck and to ensure I didn’t have strep throat. I was pretty clueless about the lymphatic system, how it worked, and the benefits it has on the body. What is the Lymphatic System? The basics: Our bodies have a network of lymph nodes and lymph vessels. This system collects and carries a watery, clear lymph fluid, much like how veins collect blood from distant parts of the body and carry it back to the heart. This fluid consists of proteins, salts, and water, as well as white blood cells, which help fight infection. Lymphedema Definition: Lymphedema is a chronic condition in which excess fluid collects and causes swelling, generally in the arms or legs. What Causes Lymphedema: Lymphedema is most commonly caused by the removal of, or damage to, your lymph nodes as a part of cancer treatments. It results from a blockage in your lymphatic system, which is part of your immune system. The blockage prevents lymph fluid from draining well, and the fluid buildup leads to swelling. According to the National Cancer Institute, anywhere from 5-17% of women who have sentinel lymph node biopsy develop lymphedema. Among women who have axillary lymph node dissection, the percentage is higher — from 20-53% — and the risk increases with the number of nodes taken out. Not surprisingly the risk is even higher if you receive radiation to the breast, chest, and under the arm area. My Story with Lymphedema: As things are shaping up, I shouldn’t be surprised that I was a prime candidate for developing lymphedema. I had an auxiliary lymph node dissection resulting in 16 lymph nodes being removed, as well as 30 rounds of radiation! Prior to my surgery, my oncological team took baseline measurements using the L-Dex machine. If you are having any lymph nodes removed, I highly recommend to ask your care team about getting baseline measurements taken. This will allow you and your team to catch any changes post-surgery and catch lymphedema early if it is developing (sometimes swelling isn’t obvious to the naked eye). The procedure is painless and only takes a few minutes. It’s worth it! Lymphedema Signs and Symptoms After surgery, things seemed to be going well and I thought I was in the clear until one day I started to notice the following symptoms: · Heaviness in my arm · Tingling in my fingers (that sense when your arm falls asleep) · Discomfort raising my arm above 90 degrees · and I started to notice my watch and rings were no longer fitting comfortably. I looked down, and my hand definitely looked swollen, I was developing stage 1 of lymphedema. Below is a picture of my emerging lymphedema There are additional symptoms that I didn't experience but that patients should be aware of. These include: · Burning or itching sensation ·Skin redness ·Difficulty seeing veins or tendons in hands and feet · Restricted range of motion ·Recurring infections Lymphedema Diagnosis and Treatment While lymphedema is not curable, it is manageable (phew). I took matters into my own hands and called my hospital to schedule an appointment with a lymphedema specialist. I’ve been seeing my specialist now for 4 weeks and the improvements are profound! It was recommended that I wear a compression sleeve daily, even during my workouts to help reduce swelling. Additionally, I do lymphatic massage (also known as manual lymph drainage (MLD)) twice a day. The lymphatic massage plays a crucial role of rerouting stagnated lymphatic fluid. The goal is to stimulate the lymph vessels and lymph nodes and to redirect the lymph flow around these blocked areas into more centrally located healthy lymph vessels and nodes. At night, I do not wear my compression sleeve, but rather, I wrap my hand to prevent swelling. While my bedtime routine is now about an additional 30 minutes to account for managing lymphedema, I have to say, my arm feels so much better and I am confident that I will remain at stage 1 so long as I continue to take care of my skin, arm, and manage the swelling! For more information on treatment for lymphedema, please click here

One of the many FAQs that we have been asked at Survingbreastcancer.org is “How should I deal with side effects, i.e., to lessen their impact and eliminate them entirely?” There are many potential side effects to chemotherapy. The shortened list includes nausea, vomiting, loss of appetite, dehydration, mouth sores, fatigue, diarrhea, constipation, water retention, “chemo brain” and hair loss. Of course, you should always notify your oncological team to any side effects that you may be experiencing. In this blog I’d like to address six of the most commonly experienced side effects that I and my cohort have faced, and typically how we have dealt with them: 1. Hair Loss. Hair loss is quite common and can be quite an emotional tug. This occurs in most cases within 6 weeks from the start of chemo, depending on the treatment, and should start to return shortly after the cessation of chemotherapies. There are a few notable ways to lessen the impact, but typically if you are going to lose your hair it may behoove you to take a graduated approach. I’ve found that cutting my hair quite short after the start of chemo was a very helpful first step. Cutting my hair short was something I would never do otherwise, so this was my chance to try out a fun pixie cut with no risks! Shortly after starting Adriamycin and Cytoxan (AC) treatment, (aka the “red devil”) clumps of my hair started to fall out. At this phase, I wasn’t sad to lose my hair, rather I was frustrated at how annoying it felt every time I put on a shirt and whisps of hair would fall out; every time I ran my fingers through my hair, more whisps would fall out. Imagine those tiny little hairs after a haircut falling out everywhere, shedding like a cat - annoying right? So, feeling empowered to take control of the situation, I shaved my head. Don’t spend tons of money either on this type of haircut. I literally went to a barber shop and asked them to shave it all off. The barber was initially confused, and asked if I wanted any sort of etching or designs. As innocent as the question was, I explained that I was sick and I was taking it all off! Other less drastic remedies include: Use mild moisturizing shampoos and conditioners – avoid harsh chemicals Use a soft brush Wear a scarf, wig, or hat. I chose to rock the bald look and it helped me to accept my condition. Note: I also shared my diagnosis and treatments on YouTube and other Social Media so this choice may not be for you. While everyone associates losing hair on your head as the only place you will lose it, don’t be surprised if you start to lose hair on your legs, under your arms, as well as your nose hairs, eyelashes and eyebrows, etc. Take care of your scalp by lubricating and protecting it from the sun. I found tea tree and castor oil to help my hair follicles grow faster! 2. Fatigue is a common side effect and typically starts when commencing chemotherapy. Ongoing exhaustion and/or overall weakness can prevent one from performing normal/routine tasks and activities. And just as importantly, it can contribute to the emotionality of dealing with cancer. What follows is a list of ways to mitigate fatigue: Rest is more than appropriate and should become part of your everyday routine. Naps are highly encouraged Additionally, an exercise regimentation is strongly recommended (be sure to consult with your medical team to determine the limitations of your work outs. Walking and swimming are two of the best. (See our previous blog on exercise.) As counterintuitive as it sounds, getting 30 minutes of exercise a day helps combat the systems of fatigue. Don’t be afraid to ask for help, i.e. grocery shopping, housecleaning, errands etc. Proper nutrition/diet goes a long way to alleviate fatigue (see our nutrition blog). Also, lean on your support group, parents, significant others, or roommates to be your advocates. I have a hard time saying no and I love being social, having friends over and entertaining. However, my caregiver got to play the “bad cop” reminding people that I am fighting cancer and sometimes the answer had to be “she needs her rest.” Personally, I came to really appreciate this. It took the pressure off of me knowing that my caregiver had my best interest and realized when I was easily becoming over taxed. 3. Nausea and/or Vomiting is another side effect and is attributable to chemo damage to healthy cells in your stomach and gastrointestinal tract. The following recommendations may offset both: Avoid hot spicy foods. Eliminate or greatly reduce the garlic, chili oils and hot peppers, and cool down your exotic foods. I have gone so far as to request mild Indian, Thai and Mexican foods, which is something I never thought I’d do. Bland foods are easier to handle. Easy examples include: Saltine crackers Toast Cereals This is a case where bland is better. Another trick I found helpful was to suck on hard candies and utilize ginger in my juices and smoothies. I also found it important to reduce the size of your meals. Eat smaller portions and more often more often. Drink plenty of water. I’ve gone so far as to measure my water intake and set goals that approached 120 ozs daily. Hydration is key! If these natural remedies do not help and the nausea persists, talk to your medical care team. They may prescribe steroids to help manage this system. I was on Decadron (http://www.chemocare.com/chemotherapy/drug-info/decadron.aspx) , Compazine and Zofran which helped me tremendously! Acupuncture and natural supplements may also help. More on these treatments in a follow up blog. 4. Mouth Sores are common inside the mouth and along the throat. These can be painful and make it difficult to swallow. The ways to mitigate and or remediate include: Gargling with salt water Avoiding hot spicy foods Staying away from tomato based sauces Refraining from tobacco and or minimizing alcohol Use Non-alcohol based mouth wash Change your tooth brush often 5. Gastrointestinal Irritation (Diarrhea/Constipation) can result from chemo damage to the lining of your stomach and intestines. Note: Severe diarrhea can be quite dangerous and one should get treatment ASAP to resolve. Typically, patients may experience watery stools at first and the following remedies may eliminate or reduce the severity: Stay hydrated. As mentioned above drink plenty of water. Minimize milk and other dairy products. Try yogurt for their bacteria cultures. Avoid fatty food, choose easy to digest foods, eat smaller portions several times daily. A lot of times breast cancer patients mention that their diets have changed and that is because so much of our bodies are changing at warp speed as chemotherapies are working their magic. If you are in your first few weeks of a chemo regimen, it may take trial and error to see which combinations of foods agree with your stomach. Here is a list of foods that can cause binding and lead to constipation: Bananas Red Meat Dairy Fried foods Processed grains Here is a list of foods that can cause loose stools and lead to diarrhea: Dairy products Greasy foods Onions Corn Citrus fruits 6. Hot Flashes. As a premenopausal woman of 36 years old, I cannot leave off the list of chemo side effects, the dreaded hot flash! Chemotherapy destroys fast-dividing cancer cells and according to Breastcancer.org, can be harmful to your ovaries. As a result, younger women may notice that their menstrual cycle stops and they experience medically induced menopause. Unlike older women who enter menopause over the course of several years, younger women are thrown into this state in a matter of weeks! As such, menopause-like side effects associated with chemotherapy treatments can be surprising, and unpleasant. One of the most common are hot flashes. While it is not clear what exactly causes hot flashes, studies suggest that it is most commonly due to chemical changes in the body. Therefore, if you are estrogen receptive positive (ER+) and your treatment plans requires the reduction or elimination of estrogen and/or ovarian suppression from Lupron or Zoladex, then it stands to reason that medical induced menopause and hot flashes are a common side effect. Hot flashes (or night sweats) are sudden changes where you may feel red, hot, flush, or even experience severe sweating anywhere from 1 to 10 minutes. While there is no magic cure to eliminating hot flashes, here are a few tips on how to reduce their severity: Notice what triggers hot flashes. A lot of times it can be linked to certain foods like spicy entrees, garlic, caffeine, or alcohol. Dress in layers. Invest in tank tops or t-shirts that are made with wicking material, they are loose and wick away sweat to help you stay comfortable. I personally loved pj’s from Cool Jams. Take a cool shower before bed; this will take away any sweat from the day so you are not freezing at night and also help you remain cool so you can fall asleep. Finally, discuss with your medical care team! While they may not be able to prevent hot flashes, they may offer a prescription which could help, for example, Gabapentin. There are many more tips and many more side effects one may be exposed to when experiencing chemotherapy. Post a comment below of what you are experiencing and I will be sure to include information in our upcoming blogs on chemotherapy. In the meantime here is a list of helpful links that I found quite helpful: 12 Tips & Tricks to Get You Through Chemotherapy - My Cancer Chic www.mycancerchic.com/12-tips-tricks-to-get-you-through-chemotherapy/ Ten tips for getting through chemo - Breast Cancer Care https://www.breastcancercare.org.uk/information.../ten-tips-getting-through-chemo 11 Tips to Get Through Chemotherapy - Oprah.com www.oprah.com/health/11-tips-to-get-through-chemotherapy Tips for Managing Chemotherapy Side Effects: Nausea and Vomting https://www.webmd.com/cancer/tips-for-managing-chemotherapy-side-effects Ten Tips for Surviving Chemo | Breast Cancer Support - Ready for ... https://cancerplanners.com/ten-tips-for-surviving-chemo-for-cancer-patients/ 10 Tips to Help You Through Chemotherapy – Health Essentials from ... https://health.clevelandclinic.org/2013/12/10-tips-to-help-you-through-chemotherapy/ Tips for Handling Chemo Side Effects - Side Effects - Guide2Chemo ... guide2chemo.com/tips-handling-chemo-side-effects

The power of positive thinking is so pervasive today that many doctors and nurses strongly recommend developing a positive mental attitude to prevent sickness, to help overcome medical setbacks like disease, and to assist in the recovery from surgery. There is healing power in positive thinking. But can you heal yourself just by being positive, optimistic and focused? Yes! It is believed that positive thoughts are able to prompt physiological changes in your body that strengthen your immune system, decrease pain, and provide stress relief. The “Power of Positive Thinking”, a self-help book by Norman Vincent Peale, published in the last century, first proposed the method of "Positive Thinking". It aimed to ensure that one could achieve a permanent fruitful and optimistic attitude through constant positive influence of his/her conscious thought. This was to be accomplished through affirmations/visualizations, thus allowing one to attain higher satisfaction and quality of life. Similarly, in the book, “The Secret” by Rhonda Byrne, the Law of Attraction is explored and suggests that whatever energy, thoughts, or visualizations you put out into the universe, you will receive. So, if you send out negative vibes, or think something negative will happen, it probably will. If you send out positive vibes, positive things will be returned. How to develop positive beliefs, and drive expectations to activate self-healing Start by applying the right kind of positive thinking so that you direct your subconscious mind to help heal your body and improve your life. 1. Direct your conscious and subconscious mind to help you heal. 2. Apply positive thinking. Don’t worry, be happy. "Worry only takes the joy out of your day". 3. Find a way to focus on the positive. What are you grateful for? Start a mental list of the things and people in your life that you are thankful for. 4. Be optimistic. Imagine you can see your cancer, take a deep breath, and now as you exhale, visualize the cancer floating away and leaving your body. If you are experiencing pain after surgery, say “hello” to your pain, acknowledge that you can feel it, perhaps your pain has a particular color, or name. Experience the sensation, and then, tell your pain that it is time for it to leave and say “goodbye”. Develop a positive attitude. By getting your conscious and subconscious mind to be more positive and optimistic, you tend to attract greater positivity into your life. Migrate towards positive thoughts and positive beliefs. The changes begin when one’s subconscious mind begins to pick up the new belief system. It then starts to guide you to those opportunities that help you improve your health. Once you begin to calm your mind the subconscious begins to calm the body leading to better health. When your mind begins to focus on what you want and stops being negative you will begin to see dramatic changes. Try the following: Create a belief system that allows you to heal. Develop a new positive, optimistic attitude and outlook. Eliminate negativity. Surround yourself with people who make you smile, laugh, and are encouraging. Remove limitations. Remain focused on what you want. This isn’t to say never be upset or that you cannot have a bad day, we all go through our ups and downs; we all have our good days and bad days. However, the Power of Positive Thinking is a mindset a way of life. You have to believe in yourself and get your subconscious mind and inner self working for you. You have to give them the right instructions and they’ll bring you what you want and more. You can help to heal yourself and improve your life when you’re positive, optimistic and focused on improvement. A tip of the hat to the following: The Science of Positive Healing Thoughts - https://articles.mercola.com/sites/articles/archive/2016/02/04/healing-thoughts.aspx Can Positive Thinking Help You Heal? | Psychology Today https://www.psychologytoday.com/blog/owning.../can-positive-thinking-help-you-hea... Can positive thinking make you well? - CNN - CNN.com https://www.cnn.com/2011/12/05/health/positive-thinking-deepak.../index.html Healing With Positive Thinking - Affirmations For Positive Thinking www.affirmationsforpositivethinking.com/Healing-with-Positive-Thinking.htm The Science of Healing Thoughts - Scientific American https://www.scientificamerican.com/article/the-science-of-healing-thoughts/ Positive Thinking Improves Physical Health | Psych Central https://psychcentral.com/lib/the-power-of-positive-thinking/ Positive Thinking, Faster Recovery - ABC News abcnews.go.com/Health/story?id=117317 Can Positive Thoughts Help Heal Another Person?: NPR https://www.npr.org/templates/story/story.php?storyId=104351710

It is well documented that physically active women have a lower risk of breast cancer than do others who are not. Thus, it stands to reason that physically active breast cancer survivors may reduce the risk of cancer’s return, and dramatically improve quality of life. As always, consult your oncological team before starting out on your fitness program. Exercise is safe Per Breastcancer.org (one of the attached links below), “a roundtable convened by the American College of Sports Medicine in 2010 reviewed available research and concluded that exercise is safe during and after all breast cancer treatments (as long as you take any needed precautions and keep the intensity low) and improves physical functioning, quality of life, and cancer-related fatigue. There also is evidence that exercise can help breast cancer survivors live longer and lead a more active life.” Risk reduction According to Cancer.gov (link below) “studies show that physically active women have a lower risk of breast cancer than inactive women. Physical activity has been associated with a reduced risk of breast cancer in both premenopausal and postmenopausal women; however, the evidence for an association is stronger for postmenopausal breast cancer.” This study further elaborates on how exercise can reduce the risks of cancer, and, or its return: Exercise has a number of biological effects on the body, including: Lowering the levels of hormones, such as estrogen, and of certain growth factors that have been associated with cancer development and progression Helping to prevent obesity and decreasing the harmful effects of obesity Reducing inflammation Improving immune system function Cognitive Impairment (“chemo brain”) Furthermore, a new study (found in the Sciencedaily.com link below) “indicates that cancer patients and survivors have a ready weapon against fatigue and "chemo brain": a brisk walk. Their data suggests “that being more physically active could reduce two of the more commonly reported symptoms in breast cancer survivors: fatigue and cognitive impairment". Cognitive impairment, such as memory problems or shortened attention spans, is a common complaint among cancer patients and survivors, and is thought to be similar to decline due to aging. Fitness recommendations With the above (and below) referenced studies in mind, we at Survivingbreastcancer.org are recommending the following exercise possibilities: Walking – The health effects of a brisk walk cannot be overstated, notably for cognitive impairment, but also for muscular and circulatory systems. Yoga – This discipline combines stretching, deep breathing, toning of the muscular system and offers a wonderful way to relax the nervous system. Meditation – According to the Laura-Sage (link below), meditation can effectively reduce stress, anxiety, depression, fatigue, and fear of recurrence. It can also help reduce hot flashes. Weight resistance & training program – In another recent study, researchers looked at data from the Physical Activity and Lymphedema (PAL) trial to determine whether slowly increased weight lifting could increase muscle strength among breast cancer survivors and help them avoid frailty and maintain physical function. Aerobic and cardio training (swimming, running, elliptical, stairmaster, etc.) – Lastly, another recent study (for the NIH) showed that a “10 week moderate-intensity aerobic exercise program significantly improves quality of life and physical functioning in breast cancer survivors.” Please note that further long-term studies have been recommended We found the following links to be beneficial: https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/physical-activity-fact-sheet https://www.scribd.com/document/268275865/Breast-cancer-and-physical-activity https://www.acefitness.org/education-and-resources/lifestyle/blog/6753/exercise-for-breast-cancer-survivors https://www.sciencedaily.com/releases/2017/07/170725122242.htm https://www.cdc.gov/physicalactivity/basics/pa-health/index.htm#ReduceCancer https://www.cancer.org/treatment/survivorship-during-and-after-treatment/staying-active/physical-activity-and-the-cancer-patient.html http://www.breastcancer.org/tips/exercise https://community.breastcancer.org/forum/44/topics/836196 http://www.lbbc.org/building-and-restoring-physical-fitness-after-breast-cancer https://www.mindbodygreen.com/articles/what-you-need-to-know-about-exericse-and-cancer https://www.huffingtonpost.com/laura-sage/5-benefits-of-meditation_b_10617412.html https://www.cancer.org/.../study-weight-lifting-helps-breast-cancer-survivors-stay-health... https://www.ncbi.nlm.nih.gov/pubmed/25313756

I cannot believe it is 2018, another year of survivorship is upon us, with new resolutions, new goals, inspiring ambitions, and when the holiday cheer winds down and the excitement wears off, I realize I’m still just taking it one day at a time, and that’s OK. I fall into the category like most people around this time of year; I set new health and fitness goals, still trying to lose the “chemo” weight I put on last year, planning new financial goals, striving to be kinder each day, and to laugh more. But as the weeks go on, the overzealous plans to make this the best year ever starts to fade away like a dream. I was doing the 2017 inventory of everything I’ve been through in 2017: 12 months of chemo therapy (multiple drugs) 1 surgery 6 weeks of radiation And just a few weeks ago, I finished my last round of the oral chemo drug, Xeloda. Now that I am finished with one drug, it is time to look ahead and start taking others! As I head into 2018 I am looking at 10 years of hormonal therapies and shots, infusions to counter bone decay and osteoporosis, and additional meds to assist with joint pain, fatigue, mental health, the list goes on. The only way I can describe this is that I am 36 years old on the outside but 80 on the inside, but I’m grateful! I am alive and thriving! Can you relate? Among the breast cancer community, I hear a lot of people saying this is the “new normal” and we need to learn to live with lymphedema (or being at risk for it for the rest of our lives!), joint pain, the fear of recurrence, quarterly diagnostic testing, mammograms, CT Scans, MRI’s etc. Unfortunately, we were the ones indoctrinated (not by choice) into a lifelong club, but don’t get me wrong, the pink sisterhood is a bond like no other and for that I am grateful. While the initiation process into this “club’ is grueling, the perspective gained makes the fight worth it! Cancer has actually made me a better person! Instead of focusing on what I cannot do and settling for the “new normal”, I am approaching 2018 as my year of REDISCOVERY. Rediscovering the things that matter most Rediscovering the activities I enjoy doing Rediscovering the foods I enjoy tasting (now that my taste buds have returned) Rediscovering how I can take a devastating experience and make a difference. Follow me on my rediscovery in 2018! There is so much more to learn about breast cancer and while I have gone through the traditional steps of chemo, surgery, and radiation, no one has given me the road map for what happens next. While several amazing women with inner strength have gone down the path of survivorship for 5 years, 10 years, and decades, understanding how being diagnosed with breast cancer manifests in terms of longterm treatment continues as rollercoaster ride; I am so glad you are on this journey with me! What have your experiences been like? I’d love to hear from you! Share Your Story.

The holidays are fast approaching and my mantra lately has been “2018 is going to be my year”. I have already starting outlining all of the New Year resolutions and goals I have for 2018 from vacations, career goals, to getting back into running and yoga shape, the list goes on! However, amidst the excitement of a new year with new beginnings and opportunities, it has also been hard to realize all of the hardship my body has gone through from treatments to surgery, radiation, and experimenting with various hormonal therapies. I thought the hard part was behind me, but accepting and understanding this next phase, this next phase that will most likely consist of 10 years of hormonal therapies to ensure breast cancer does not recur, is equally as hard, and I wasn’t expecting it to be! Are we ever prepared for what comes next? I think it all hit me when I was mid-air, on an airplane and heading south to visit my family for Thanksgiving. These feelings always come at the most inopportune time don’t they? I was doing what everyone usually does around Thanksgiving: -My bags were packed, -I was visiting family, -The holiday cheer was in the air, and 30,000 feet somewhere over New York, it hit me, “I had cancer”, wait no, “I survived cancer!” As if somehow, I forgot what a tumultuous year I had endured; my hair was growing back, my energy level was increasing, I was back to work etc. I was living the “normal life”. But out of the blue, mid-air, I started to panic. My mind started to race and all I could focus on was the millions of “what if” questions: “What if flying is going to cause me to get lymphedema” as I glanced down on my stylish compression sleeve from lymphadivas. “What if the cancer comes back”? I have been having a lot of joint pain lately. Has it spread to my bones? “What if the tingling feeling in my toes spreads and the neuropathy travels up my legs?” Maybe I should loosen my shoe laces. What is going on? That’s it, I thought to myself, I’m going to be that person on the plane that presses the flight attendant call button requesting that we land in DC, I needed to get off the metal missile jetting through the air at colossal speeds. A minute felt like an eternity and I was starting to wonder if I was ever going to make it to my final destination, in beautiful sunny Florida. This fear, anxiety, panic attack, or whatever you want to call it lasted only about 20 minutes. I’ve never experienced anything like this before nor was I expecting to! We can prepare as much as possible for the required protocol of breast cancer, the doctors can tell us all about the side effects and what we can expect from chemo, surgery and radiation, but what I was not prepared for was the mental health component associated with cancer. To some degree, it’s the underbelly of cancer we do not talk about because there is still such a stigma associated with it. I am determined to change that narrative! In fact, I think it is essential that we continue to share our stories and talk about the uncomfortable. The topics of fertility, dating, sex, identity, and mental health! This is all part of cancer care – treating the whole person, not just the disease. If the quality of life becomes too compromised, we tweak and adjust. Suffering is not an option; the only choice is living! The holidays can be stressful and bring up emotions we may or may not be prepared for. Here are a few tips for dealing with a diagnosis and the holidays: Remember, it’s ok to say “no”. Don’t overbook or over commit yourself Invite family and friends over to help with the cooking, you don’t have to do it all by yourself. Plus the social company can take your mind off of things too. Use services like PeaPod to have items delivered if it is too hard to get to the store, or ask a neighbor to pick up a few items for you if you can’t get out. Don't be afraid to ask for help. Take time during the day for yourself. Cozy up with your favorite book or magazine and enjoy reading with a cup of tea Plan a phone date with a long-distance friend Take a 15-minute walk, get outside and breathe in some fresh air Look in the mirror and tell yourself you are beautiful, smile, and think of one thing you are grateful for on this day. Happy Holidays from the SurvivingBreastCancer.org team Have a story you would like to share! Let us know! Interested in writing a Blog post? Let us know! #BreastCancer #holidays #stress #hormonaltherapy

Life threw me a curve ball and I handled it the best way I could, with dignity and grace. The mountains I had to climb now seem like bumps in the road. I was given terrible news - "you have cancer", but it wasn't the end of the world. I underwent multiple rounds of chemotherapy, I had been pricked and probed with shots and IV's, I had invasive surgery and was zapped with radiation for 6 weeks. All of these things were part of the plan, I knew they were coming. But what I was not expecting was how challenging returning to the workforce would be. This was supposed to be the easy part, right? The return to work (albeit while still undergoing treatment) is now just the next phase in the recovery process. However, I think there are a few things to acknowledge, maybe breakdown some misnomers, and offer personal advice as I reflect on my first week back: 1. You are back at work so you are all better now. The good news, yes, I am better and able to return to work and that is a great sign! However, depending on one's cancer journey there still may be a lot that the person is enduring behind the scenes. Some people may be open about their health journey with coworkers while others may keep it close to the vest. I think it is a good reminder that even though someone may look "healthy" and "all better" on the outside, there may still be a lot of pain on the inside. In my case, I am glad to be returning to work because yes, things are returning to a normalcy. But that doesn't mean I'm magically "cured". There are a number of "medical cocktails" I continue to take to ensure that breast cancer does not recur! 2. Understanding your sense of self The American Cancer Society suggests that returning to work helps promote a sense of self, purpose, and reminds one that they have a life outside of cancer. There are a lot of benefits that come from these daily interactions with colleagues. However, I want to bring to light that it can also be scary, and that's OK too! As someone who went through cancer treatments, I do feel different, I do feel like my perspective on life has changed, and although the circumstances of cancer were not ideal, this experience has forever changed and shaped me. There is acceptance and peace that comes with understanding yourself as a survivor. 3. Those who plan achieve Rethink Pink offers 5 valuable tips for transitioning back to the workforce and planning makes all the difference! Work can be stressful and induce anxiety on a normal day, let alone returning to work after going through such a life altering health event. A few tips that have helped me profoundly was centered around planning! For example, I rehearsed scripts. I knew a lot of colleagues would be visiting my office to say hello. This was fantastic, but I had to decide (prior) what information about my journey I was going to share. Did they need all of the grueling details, probably not. I picked a few funny stories about losing my eyelashes, or the new "punk rock" hair do I was rocking, and everyone had a good laugh. You cannot take yourself too seriously - Humor is key! Also, be sure to connect with your boss and HR. You have a lot of rights and protections which can also help if you are looking for accommodations as you return. In the U.S., we have the Rehabilitation Act and the Americans with Disabilities Act (ADA). Some people also benefit from the Family and Medical Leave Act (FMLA). 4. Managing Chemo Brain What was once debated as not being a legitimate side effect from chemotherapy, oncologists now acknowledge that chemo brain is a real condition impacting one's cognitive ability for up to 6 months post treatment, according to a 2017 study. We all want to preform well at work. Therefore, I have started to incorporate a few daily habits to offset this side effect. First, I am not afraid to take notes, or even ask colleagues if I can record a meeting, so that I can listen to it again later and ensure I have captured all of the key take-a-ways. I also set aside time at the end of the day to make a task list of where I left off on various projects and what priorities are set for tomorrow. This has been extremely helpful because now, when I walk into my office each morning, all of my notes, tasks, and to-do's are right there waiting for me. It not only helps with chemo brain, it reduces stress and anxiety too! 5. Finally, let's take some time to breathe The breath is one of the most powerful tools we have and is often underutilized. When was the last time you took a deep breath? You know, one of those breaths that fill up your entire lung cavity and travels deep down into your inner belly? Unless you are taking a big sigh of relief, or in a yoga class, taking big belly deep breaths are not unconscious acts. When you take longer inhales and exhales, you are immediately sending signals to your mind which trigger the nervous system to return to a state of calmness. While we may not all have time to attend a yoga class or sit still and meditate, I would recommend practicing breathing techniques if you notice yourself becoming anxious, heading into a meeting, or before responding to emails. Within seconds you become more mindful and back in control, empowered to tackle the day! #BreastCancer #Returningtowork #Work #Cancer