Radiation, and the illusion of control

I’m overdue for posting! Many thoughts, but I’ll start with an update. For the past few weeks I enjoyed a bit of a holiday from being a cancer patient. Chemo toxins purged, arm and shoulder recovered from surgery, eyelashes and eyebrows flourishing. I even got a falsie (aka breast prosthesis), so I am feeling downright human again.

The feeling might be short-lived, as I started radiation today and already feel like I have a mild sunburn in the irradiated area. I’m slathering it with something called Manuka cream and plan to procure more potions; apparently the impact is cumulative and the discomfort and fatigue tend to worsen through the six-week course of treatment.  

I’m getting used to my scar and zone of no-sensation, and so is Alder. I don’t know if I’m creating (yet more) fodder for future therapy sessions, but I don’t always bother to kick him out when I’m getting dressed. I was careful about the surgery area for a while because I thought it might be a jarring visual (well, it is a jarring visual), but he’s gradually seen more of it. And? He is entirely unfazed. So maybe I’m helping create a man who will see beyond women’s physical flaws, and will respond with compassion and caring … that’s my positive spin on it, anyway.

Anneliese, the Nordstrom bra lady who fitted me with a prosthesis, couldn’t nod vigorously enough when I told her I don’t plan to get reconstruction. She has an actual certificate in fitting misfits to breasts and bras, and has seen a lot. Given all that she’s learned, she said she’d go my route. Incidentally, she said the only really convincing faux-boobs she’s seen were on a former man.

I’m almost a month into Letrozole, the estrogen-suppressing drug I’m supposed to take for the next decade. I haven’t yet vaporized and been replaced by a crone, but the achiness is a reality. I’ve been able to exercise, which according to virtually everyone is the key to keeping the side effects at bay. Thanks to the treadmill, my walking is becoming jogging is occasionally becoming running… ever so slowly and fitfully. I’ve also started walking with a few women I’ve met on the island, and despite my effort not to make friends here, the companionship is a boon.

Winter break has been a peaceful blend of baking, sleeping, lounging and letting my kid do too much screen time, punctuated by the occasional visit to the great outdoors. Brian’s son Hatcher visited and we all went to a small resort nearby called Alderbrook over Christmas. The lobby cat, Alder, is the first non-tree I have met who shares my son’s name. I love hotels with big warm lobbies – this one had a big fireplace, gingerbread houses, a communal jigsaw puzzle, bowls of apples and oranges, two cats and lots of board games. I was in heaven. I re-taught Alder to play Checkers and we attempted Chinese Checkers, which I pretty much played for both of us.

Over Thanksgiving and Christmas I compromised my self-imposed dietary restrictions, which are a constant source of second-guessing – mostly from others and occasionally from myself. I fundamentally believe what we ingest has a huge impact on our health and well-being, but I don’t want to be one of “those people” who makes everyone feel like an ogre, who won’t go to restaurants with friends, who drones on about the nutritional benefits of quinoa versus brown rice, whom you have to text four times for ingredient approval if you invite her over to eat.

So like everything else, it’s a question of balance. The goal of my eating choices is to reduce the risk of my cancer recurring. There isn’t a lot of clinical data linking specific foods to increased or decreased risk of cancer (not because the links don’t exist, but because no one puts a lot of money into clinical studies that don’t involve a drug or procedure), so my diet is based on a combination of research[i], observation, personal preference and voodoo, all of which I like to sum up as educated intuition. Besides the obvious – eating almost no processed food and lots of fresh fruits and veggies – here are some of my basic dietary goals:

-no alcohol (big breast cancer risk factor)

-low-to-no sugar or refined carbohydrates (which are sugar, which cancer likes)

-only organic meat and dairy (I don’t want those nasty hormones)

-no tofu or soymilk (it’s a natural estrogen, which feeds estrogen-positive cancer, though the role of soy is debated and could be the subject of its own intensely boring blog post)

Then there are particular spices that are good  -- like turmeric – and fats that are bad – like canola and safflower oil and animal fats -- but it's all starting to sound very Portlandia. Blah blah blah, gluten, blah blah, tree nuts, allergens, toxins, blah blah blah.

None of these dietary restrictions has felt terribly onerous, which may be because I’m not a tyrant. For example, I just had to bake five batches of cookies in five days before Christmas, and obviously I had to make sure they tasted okay. 

My self-imposed diet plan has gotten somewhat mixed reactions among the medical crowd. One oncologist said, “I hope you’re not blaming yourself for your cancer – you didn’t get it because of what you ate.” No, I said, totally exasperated, I don’t blame myself. What I thought but didn’t say was, Why must eating well invoke psychosis? A radiation oncologist told me diet is unrelated to cancer except in cases of metabolic disorders, which I clearly do not have, so I should eat whatever I want. I think my medical oncologist, who pooh-poohed some of my dietary decisions as not supported by clinical data, was mostly concerned about my losing weight, which did not happen.  

I understand that the docs are trying to temper my expectations about being able to master cancer. And it’s true – the effort to control what I’m putting in my body is at root an effort to control what happens to my body. I know the impact may be marginal, but in the face of an uncharted future, it’s healthy and necessary to focus on the things we can control in order to stay sane and stay positive. As I told one dubious doctor, “I know – it’s the illusion of control, but it’s working for me.”

Wishing you all love, laughter, good food and good health in 2014.

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[i] The following website provides a well documented, annotated list of foods – the good, the bad and the ugly – for breast cancer: http://foodforbreastcancer.com/recommended-foods.php Another great source is the cookbook/guidebook, The Cancer-Fighting Kitchen by Rebecca Katz.

For some reason this reminds me of a scene from a Woody Allen movie... it was my radiation simulation. The real thing involves a different contraption but the pink robe is my actual institution-issue radiation garb.

My friend Laura sent an amazing gift -- 43 (I counted) hand-made cards from kids (and a few adults) with riddles and jokes for Alder. One of our new faves: What did one snowman say to the other? (Answer: Do you smell carrots?)

Hatcher and Alder with their first round of all-you-can-eat Christmas brunch buffet.

 

Twelve minutes later.

Rainbow catch at Fay Bainbridge State Park