Getting ready for OPB

Hello everyone!  I have finished all of the appointments one day after the other and I have one more remaining, this Wednesday, before surgery.  I will try to provide a little update on each.

The echocardiogram did not require an IV this time (with the dye contrast), so I was very happy about that.  No extra needles.  I received the results on Friday and my heart looks good...no weaknesses detected at this time.  I always ask the technicians if everything looks ok, and they always have the same answer...."I really can't give you the results, they need to come from the doctor"....but this one was funny.  She said that same thing, but ended with"well......if I let you leave the hospital you should take that as a good sign."  I thought that was good.  Maybe funnier in the moment.

On Thursday I met with the Nutritionist at the Cancer Wellness Center, and Chris joined.  That was really interesting.  That is an area that has been causing me anxiety and lots of confusion.  I have heard and read so many different things, then I personally know a couple of people who are pictures of "health" with regular exercise and good eating, then cancer strikes, and strikes again.  I don't want to go on a big tangent right now, but suffice it to say that my general attitude is fear that cancer will come back.  In many ways I am scared to be off chemo.  I don't know what brought this cancer on, and though we have learned quite a bit of specific "stuff" about it, I am scared that it will come back, somewhere else in my body.  Even though I will be followed carefully during this first year, and I continue Herceptin for 40 weeks after chemo (so my blood will be checked regularly), my biggest questions have been, what can I DO to prevent cancer recurring?  I knew that exercise and a healthy diet play a big to giant (not sure exactly how big) role, but with regard to food.....what specifics are there?  This nutritionist gave me some solid tips and so Chris and I are going to go with them, since it is mainly in line with things we were reading but also it is one source who has studies this topic professionally and taken info from multiple sources and put it out there with Piedmont's stamp of approval, so that makes things easier...at least as a place to start.

So....since I know many of you will ask, here is what she told me....as a breast cancer survivor with a cancer that is NOT hormone driven; it is driven by protein, the HER2 protein.  This would be a little different for others.  For example, other breast cancer survivors might be told to switch to soy milk, while I have been told to avoid it, and try almond milk.

1.  Exercise - 6 days a week for 30 min (brisk walking is enough)
2.  Eat 5 servings of fruits & veg (yellow, orange & deep green) a day.  Increase consumption of cruciferous veg to at MINIMUM 1 cup per day of cooked or lightly steamed veg. (Kale, Cabbage, Broccoli, Collard Greens, Turnips, Brussels Sprouts, Cauliflower, Rutabaga...a few others)
3.  Maintain healthy weight.  She told me lose the "chemo weight" after I recover from surgery, which of course I had planned to do anyway.  But, having a person in the cancer center tell you to lose the weight means something.  Did I mention I gained 10-15 pounds, depending on the day?  I have lost 3 so far.  A lot of it is water retention, I know.  My fingers are puffy.   Anyway....I am highly motivated so I don't anticipate this being a problem.
4.  Limit red meat to 2 servings per week (yes, this includes pork), and avoid all processed meats (sausage, deli meats, smoked meats, bacon).  Try to make meat NOT the main focus of a meal.  If eating poultry, try to increase its quality (organic, etc.).
5.  Avoid charbroiled and overcooked (charred) foods.  There is a lot of explanation on this one about HCAs forming at high heat....which are carcinogenic.
6.  Aim for 1400-1500 mg of calcium each day and 1100IU of Vitamin D.  There is a big association in breast cancer patients of low levels of Vitamin D and recurrence.
7.  Drink 3-5 cups of green tea daily.
8.  Avoid alcohol.  Even small amounts matter.  Very sad about this one.  :(  If I choose to drink occasionally, she recommends a light beer or red wine, and to supplement with folic acid.
9.  Dietary fat should be decreased to 15-20% of total daily calories.  She calculated 28 grams of fat a day for me.  Breast cancer thrives on fat.  I just started really tracking my eating, and as she predicted, this is going to be really difficult.  But....we will get there.  I have always prided myself on not "dieting" and whenever I knew I had gained weight then I just decreased calories to get my pants to fit right again, or increased activity, etc.  Now, to have to pay so much attention to food, goes against my grain and does not make me happy, but at least it IS interesting, and I know it DOES make a difference, and I don't really feel like I have a choice at this point.  I am getting over it.  :)

The 3 most important are numbers 1, 2 and 9.

Today I met with the lymphedema specialist and my arms were measured and I was fitted for a compression sleeve and glove.  I will use those in the hospital and then have them if there is a problem later on.  The woman was really great.  I don't know exactly what happened, but she was talking about breast cancer and the journey and asking if I had "talked" to anyone, like a counselor.  I said no, and she was so warm, she grabbed my hands and said that I really needed to do that, and I don't remember what she said after that but I felt the tears start rolling down my cheeks.  I even made the poor lady cry.  I have found myself to be so emotional over the last week.  I am guessing it is all of these appointments where my/our attention is hyper focused on the cancer again.  My mind is reeling with new info.  I am dreading the surgery.  I cannot really explain it well, but I am still having trouble "accepting" that this is really happening and that I have to "live" with this for the rest of my life.  I so want to go back to the feeling I had before, of walking around and feeling so very fortunate, blessed, happy, light, free.  I know we are still all of those things, but it feels different and I prefer the old feeling.  I hope that makes sense.  Yes, I am working on accepting the "new normal"... a term I already dislike but it really is the best description I suppose.

I don't want to end on a down note, but I have to go pick up my sweet Caroline.  My final appointment before the surgery is this Wednesday for pre op with the plastic surgeon.  I will add more later!  Thank you for continuing to read and encourage!!