One of the hardest parts of the whole process for me was the waiting game that came in the beginning... First, waiting for the biopsy results. Then, waiting for surgery. Then, waiting for chemo.
Even though I kept things moving relatively quickly, there was about a month gap time between diagnosis and surgery, and almost another month between surgery and chemo (July 4th is notoriously a bad time in the hospital).
As I said at the time, as soon as I got the biopsy results, if I could have gone straight to the ED and had surgery, I would have. Granted, I might have done other rash things that I did not want to do (like immediately opting for a bilateral mastectomy, for example) but that is a story for another post.
Since there was nothing I could do about the wait, I decided to come up with a list of things that I could do in the mean time to improve the situation as much as possible. Below is a bulleted list of those things, by no means exhaustive, but jumping off points of sorts.
1. Changing my birth control.
When this whole mess started, I had a Mirena IUD in place for birth control. IUDs are a very safe, effective, and easy form of birth control. The Mirena, unfortunately, also has embedded hormones, and secretes low-levels of progesterone, thought to mostly act locally. While the jury may still be out on whether or not the Mirena is safe in patients with breast cancer (particularly in progesterone-receptor negative disease), there is theoretically some systemic absorption of progesterone and I certainly did not want to be doing anything that might feed the tumor in any way.
Non-hormonal methods of birth control include classic barrier methods (such as condoms, the sponge, or the diaphragm) as well as the para-guard IUD (also known as the copper IUD). Any of these birth control methods are safe in any kind of breast cancer, however, the copper IUD is the most effective method of birth control (as an infectious diseases specialist, I have to comment that it is not the most effective at preventing the spread of sexually transmitted infections!). Unfortunately, unlike with the Mirena, periods tend to be heavier, but other side effects tend to be less.
So I switched my IUD out very quickly to a paraguard, and immediately took a deep breath that at least I had taken away a food source for the tumor- and this was all in my hands! (And, as an aside, I have had no problems with the paraguard whatsoever. If anything, I might even like it better than the Mirena).
2. Exercise.
Physicians often sound like broken records when it comes to diet and exercise, but it is true: The better shape you are in going to surgery (or to chemo), then the easier time you will have getting through. After having my first child, I made getting to the gym a priority, and do weight training once a week and dedicated cardio work outs three to four times a week. (Plus, exercising has been shown to reduce your risk of breast cancer recurrence by up to 45%!)
Even if you do not have access to a gym (or simply have no time to make it there), here are some other simple things you can do:
- Get a pedometer and set a goal. A general recommendation is 10,000 steps per day. Even if you cannot start at 10,000 steps, pick a place you can start and then work your way up. Rome wasn't built in a day! Even in studies where activity is not increased at all, just knowing how much you are actually moving around can lead to weight loss and improved physical fitness.
- Stop taking the elevator, and walk up and down the stairs instead. A little bit goes a long way.
- Take public transportation instead of driving. This forces you to walk a little bit on each end, so you move around a lot more.
- Offer to take your friend's dog for a walk.
3. Diet.
Unfortunately, multiple studies have demonstrated a clear epidemiologic link between alcohol consumption and breast cancer; this association has even been shown even with light drinking. Does this mean that you have to give up every glass of wine for the rest of your life? No. But consideration of reducing intake is probably wise.
Coffee, on the other hand, may significantly reduce the risk of breast cancer recurrence! Two cups a day was associated with significantly reduced risk among tamoxifen users. My husband likes to make fun of me for being an addict, but now I have a great excuse!
4. Educate yourself.
The delay between diagnosis and treatment gave me some time to take a step back and figure out how I wanted to tackle the situation, and to do some of my own research, so, by the time I did go into the OR, I felt really good about my decision. The power of the positive attitude is real.
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