All I can Do is Smile


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Things & Stuff: September Edition with Added Science!

First off, I cannot believe it’s nearly October. Time, she is flying! Kenji and I had a discussion recently around perception of time and how it changes as we age. We figured out that a 50 year-old’s perception of a single day is just over a week to a 1-year-old. Put *that* in your pipe and smoke it.

We’ve regained a sense of normalcy this month, with my being back at work full-time. I have never been more grateful to work, love what I do, and feel like I’m making a difference. My brain is happy to have something else to focus on 8+ hours each day.

We’re preparing for another diet change in November. Ever hear of the ketogenic diet? There’s compelling research in mouse models on how it affects cancer growth, and currently, there are nearly a dozen human studies being done. There’s strong anecdotal evidence in human studies with small sample sizes, so we’re going to give it a whirl. Remember that thing about focusing on the things I can control?

Some of the research we’ve looked at:
Nutrition & Metabolism, 2015: The glucose ketone index calculator: a simple tool to monitor therapeutic efficacy for metabolic management of brain cancer

Redox Biology, 2014: Ketogenic diets as an adjuvant cancer therapy: History and potential mechanism

Nutrition & Metabolim, 2011: Effects of a ketogenic diet on the quality of life in 16 patients with advanced cancer: A pilot trial

Nutrition & Metabolism, 2007: The calorically restricted ketogenic diet, an effective alternative therapy for malignant brain cancer

PLOS, 2013: The Ketogenic Diet and Hyperbaric Oxygen Therapy Prolong Survival in Mice with Systemic Metastatic Cancer

The author of the above study was on Joe Rogan’s podcast (episode #994), and talks extensively about the ketogenic diet.

It is a huge shift, and unfortunately, not one you can ease into. This will require the metaphorical light switch — starting November 1, that switch is on! We’re using the month of October to do more research, understand what foods are complimentary or not, and savor our carbs one last time. There’s also the matter of added tests to monitor ketones in the blood, as well as supplements to replace what’s missing from the diet (namely, nearly every damn fruit that exists).

You’ve probably heard of Atkin’s. Atkin’s is based on the ketogenic diet, which most people find difficult to follow. The keto diet has shown efficacy in childhood epilepsy, where traditional treatments have failed (tons of research has come out of John Hopkins around this). The make-up of the diet is 90% fat, 8% protein, and 2% carbs.

Because I have no gall bladder, processing that amount of fat is problematic, so we’re looking to apply the modified ketogenic diet — which increases protein intake to 65%-70%. Carbs stay the same.

Essentially, the point is to bring your body into a state of ketosis — where the body’s cells use fat for its energy source instead of sugars. Cancer cells cannot do this, so the thought is they starve and die.

Both my oncologist and breast specialist are lukewarm (at best) about diet making a difference in cancer volume. I get it. There’s no definitive evidence (yet), so they can’t exactly say, “Yes, do that and your cancer will go away!” However, my former oncologist is positive about it and even participated in a meeting a few weeks ago in Portland with a naturopathic oncologist who counsels on this very subject within the Kaiser system. I’ve inquired if I can be connected with someone like that in Southern California, or if I can do virtual counseling with that person in Portland.

That’s all for this month — and frankly, I think it’s plenty. XO

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The progress you don’t know you’re making

The path towards change is not an overnight one. It’s a path that requires you to choose, over and over again, the changes you want to enact in your life. Some days, your choices aren’t the ones that bring you toward your goal(s). Other days, they do. Every day, every hour, every second, we’re given another opportunity to choose.

It’s exhausting, isn’t it?

Not surprisingly, change is hard. And making lasting changes to one’s life is hard work.

It has been just over 3 months (94 days) since we stopped chemotherapy. Ninety-four days since I was told I needed to reduce my stress levels and focus on the things I can control. Every day since, I’ve repeated this mantra to myself:

Focus on the things you can control. Release the things you cannot.

My life’s lesson.

After 3 months, my meditation practice is pretty set. The benefits of this addition to my daily routine were felt nearly instantaneously. I cannot recommend the app I use, Headspace, enough. To pretty much everyone I meet.

Fitness continues to be a different beast. A power test on the bike confirmed what I already knew — my power output is down. Significantly. (By 38% for you data nerds out there. *cough* Kenji *cough*) And that’s to be expected! My body has been through A. LOT. This data only helps to inform my training and to (continue to) not be so hard on myself.

It’s been my yoga practice that has shown me — that despite the above — progress is being made. Ninety-four days ago, I could barely make it through the balancing portion of the Bikram series. I constantly fell out of poses. I had to modify nearly every single pose to accommodate my lack of strength and balance. Over 3 months later, and despite inconsistent practice, my balance is improved. My flexibility is improved. My strength is increased.

Slowly, sure, but still in the right direction.

I share this not to #humblebrag, but to remind myself (and maybe you) that change takes time. It takes choosing to do the hard work. Every day. Every hour. Every minute. Over and over again. And sometimes — most oftentimes — we can’t see the change that is happening. Not until we’re further down the road.

Focus on the things you can control. Release the things you cannot.

Lather, rinse, repeat.


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Shingle all the way

The holiday season is upon us!

Just kidding.

Sort of. (I’m sure Costco will have their Xmas display any day now…) It’s just I like a punny title and that’s all I could come up with today. Bear with me, as today is the first day it doesn’t feel like I’ve been punched in the face.

So yeah, I got/have shingles.

On my face.

Again.

This time, it occurred in and around my left eye. Also this time, I addressed it FAR SOONER than I did the last time (11 years ago now), so I’m calling this a win, even though getting shingles is definitely, definitely NOT a win.

So much for heading into full-time work with a smooth transition from vacation land. We had a rough travel day coming home, which was followed by many sleepless nights as I got back on the California clock. Turns out, sleep deprivation really messes with your immune system, among other things. My eye had been bugging me since our travel day, but I assumed it was from some rogue piece of sand irritating my eye. Upon closer inspection in the mirror a few days later, I immediately knew what I was dealing with.

And immediately said to myself “FUUUUUUUUUUUCK.”

And then promptly got my ass to urgent care.

The receptionist (bless her heart) red-flagged me so I got in right away (I had barely picked up my magazine of choice from the waiting room when my name was called) and my self-diagnosis was confirmed, much to my chagrin. A course of antivirals was obtained. (Valtrex, which not only treats genital herpes, but also herpes of the eye, which is exactly what this case of shingles is. Fun fact.)

Ophthalmology wanted to see me as soon as possible and OF COURSE the department upstairs didn’t have any availability, but a location in Anaheim did, so off I went. From there, I received 2 more prescriptions and upon filling them, discovered one required compounding and wouldn’t be ready for an entire week. Not exactly helpful. So an alternative was suggested by the doc, aaaaaaand that alternative was not available at that particular pharmacy. Or any other pharmacy that was remotely near where I live.

But it was available in Downey.

Tour de Kaiser facilities, ho!

I got to Downey, got my meds, and then got to remember why I don’t do anything north of Tustin on a Friday afternoon. Southern California rush hour, you are so cruel.

In any case, I’m on the mend, I’m totally fine, and there will be no lasting damage to my eye. It’s a pretty bitching shade of bloodshot right now, so it’s a good thing I work from home.

In other (more important) news, the latest CA-125 looks good and this whole “holding pattern” thing seems to be working. I meet with my oncologist as well as my breast specialist next month and there will hopefully be nothing to report, except that everything is the same and we continue to march on.

Work starts on Monday (!!!!) and I’m excited and nervous all at once. I’m enjoying these final days as a Lady of Leisure (ha), but I can’t wait to have some structure in my day that isn’t dictated by a chemo schedule. Onward we go.

The Journey of the Warrior

“This is it.

The journey is learning that pain, like love, is simply something to surrender to.

It’s a holy space we can enter with people only if we promise not to tidy up. So I will sit with my pain by letting my own heart break. I will love others in pain by volunteering to let my heart break with theirs.

I’ll be helpless and broken and still — surrendered to my powerlessness.

Mutual surrender, maybe that’s an act of love.

Surrendering to this thing that’s bigger than us: this love, this pain.

The courage to surrender comes from knowing that the love and pain will almost kill us, but not quite.”

– Glennon Doyle Melton (yep, still reeling from Love Warrior. Read it already.)


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Things & Stuff: July Edition

1. Health Status Report
I had a breast MRI last week. Kaiser farms this work out to a 3rd party since they don’t have the right set up (which is to lay face down with my boobs in separate holes, hanging). I forgot how LOUD NOISES MRI machines are, but it was painless and quick, less the IV for contrast. (I almost made it through July without getting poked.)

The results were clear. Yesssssssss. *fist pump*

I spoke with the breast specialist yesterday about the plan moving forward since prophylactic surgery is off the table (for the moment). I’ll do a breast mammogram in December/January & another breast MRI in a year. That way something is being done every six months. It’s scary to know that my chance of breast cancer is still a coin toss thanks to the BRCA1 gene. But onward we march.

Focus on what I can control and release what I cannot. Repeat to self.

2. Read any good books lately?
I recently devoured Love Warrior, though it was sent to me ages ago. Just as in other things in life, timing is everything. I don’t think I was “ready” to read it yet. In any case, it’s wonderful and I, as well as Oprah, recommend it!

You are not supposed to be happy all the time. Love hurts and it’s hard. Not because you’re doing it wrong, but because it hurts for everybody. Don’t avoid the pain. You need it. Be still with it, let it come, let it go, let it leave you with the fire you’ll burn to get your work done on this Earth.

– Glennon Doyle Melton

Another friend sent me a really fun fantasy series called The Circle of Magic. Four books highlight a different child mage and how they learn more about their unique powers, both individually and together. It’s an easy read (meant for ages 10-15, but so was Harry Potter) and I thoroughly enjoyed it.

Any recommendations from you that I can add to my pile of books?

3. Reset button
Kenji and I are headed to Kauai this Friday for 9 days in paradise. We’ve got a beachfront property on the East side of the island, near Kapa’a, and I cannot wait to get on island time. The slower pace of life is just what I need before returning back to full-time work in mid-August.

4. Returning to normal life
That’s right! I’m going back to work come August 21. I am so excited. Truly.

That’s all for now, folks! Will post some photos from HI while we’re there! You know, just to make you jealous keep you informed of the progress. ❤


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On life after trauma

I saw this reposted on Instagram, and it’s pretty damn close to explaining my sentiments as I go through this.

From @bymariandrew:

I’ve been trying to draw something about living through a traumatic experience for a while, but it’s a really sensitive and complex topic, so I’ll just focus on this one part of my own personal experience:

The common conception is that you’re just so grateful to be alive afterwards, but that conception implies that you’re the exact same person you were before trauma. Same person, now with a new lease on life.

In fact, living on the other side of trauma feels like being a different person altogether — and a person who doesn’t quite belong anywhere.

It’s isolating, and is often accompanied by feeling of being a stranger even to one’s own body. It’s not the same Mari who is now just happy to still be here, it’s a Mari who has lost some trust in the world and herself and has a hard time talking about it.

In my experience, it’s frustrating to anticipate a swell of gratitude that may take years to set in, and it’s lonely trying to explain that it hasn’t happened yet.

I’m grateful for the wisdom that come with a brief visit to hell on earth, but it doesn’t exactly look like a new lease on life. Post-traumatic growth is certainly real, but complicated. Journaling helps. Nature helps. People help.

Yep.


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30 Days & What Have We Learned?

It’s been nearly 30 days since my last post. I’m constantly amazed at how time seems to pass in the blink of an eye. There’s much to report, so let’s get this party started, shall we?

Most importantly, we met with my oncologist today and are now officially in “wait & see,” or as I’m going to call it “go forth and conquer” mode. My CA-125 levels continue to stay in the normal range. This is a blood test I will get monthly, in addition to another cancer marker, called HE-4. There’s a small chance that the CA-125 won’t be an accurate predictor of cancer volume, however so far, it has been. That’s where the HE-4 blood test comes in. It’s just another marker for ovarian cancer that we will monitor closely. I anticipate getting a CT scan in September (3 months since my last scans in June), where we’ll track any growth (or not) of the cancer in my pelvic area (currently contained within a lymph node). Prophylactic surgery on the breasts is currently on hold, but I’m still working with a breast specialist to monitor that area of my body.

I will likely live with ovarian cancer the rest of my life and it will be treated as a chronic illness. This reality forces a shift in… well… everything.

That’s where the energy of the past 30 days has been focused. It has meant, in my words to Kenji: “no more fucking around.” My diet has to be on point. My exercise has to be consistent. And my mental health has to be under control. These are the things that I have control over that affect cancer’s growth. It’s my intention to do everything in my power to keep that growth at bay, and to learn to let go of those things that I can’t control.

Frankly, it’s hard work.

The past 30 days have had three main goals: eat well (gain weight!), reduce stress, and exercise. I’m proud to say I’ve put the work into each of these areas and am already seeing gains.

The reduction of stress has been one of the more difficult areas of growth. I continue to see a therapist, and I’ve added a meditation practice to my day. I’m using an app called Headspace to help guide me, as well as track my progress. It’s been hugely beneficial and it doesn’t hurt that the voice guidance is an Australian dude. (Sexy voice = more willing to listen. Ha ha ha. Hey, whatever works, right?)

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Fitness has come easier than expected. Sure, there are days where I have to drag ass to make it happen, but I ALWAYS feel better afterwards. I started with 10-minute intervals on the elliptical and have increased to 25 minutes. I also began a courtship with the bicycle two weeks ago, first riding 7 miles, and last weekend 12. I can do laundry without needing to sit down for extended periods of time. I can cook a meal. These things I took for granted now mean the world to me.

After my stint in the hospital, my weight was a startling low 117 pounds (a number I can’t recall seeing since well before high school). My diet has been focused on whole foods, reduction of processed sugar, and just plain eating enough each day to sustain my body and fuel my muscles as I increase activity. Because we were already implementing these dietary changes into our lifestyle prior to my recurrence, this has been an easier shift to continue. Honestly, the hardest part when first coming home was simply eating enough. Thankfully, we’ve passed that hurdle.

I have another 30+ days before I return to work full-time, and my intention is to cement the aforementioned habits and refine them (particularly where diet is concerned). Being able to focus solely on myself has been weird, but wonderful. Mostly because I’ve never done so before in my lifetime. It’s a great reminder that when we take time to care for ourselves, we are then able to bring the best version of ourselves to the rest of the world.

I’m treating myself with grace and kindness and finding it to be exactly what I need. It’s not easy, but it’s worth it.

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Home Sweet Home

I have 3 days of antibiotics left no more antibiotics left  and there’s really no good word to describe how amazing it will be to NOT have an IV in my arm (I’m on #5) any longer.

Oh, bathtub, I’m coming for you. And pool. And jacuzzi. And basically any body of water where I can soak up the sun/relaxation.

The nurse practitioner I met with this morning for a follow-up agreed enough was enough, and as she put it: “It’s your body.” I said, “We’re done.”

Being at home made the suck of self-administering these antibiotics about a million times better than letting a nurse do it in a hospital. We had a small snafu two days ago when my line came out, but the nurse was able to fix it without having to poke me again. Sidenote: I am now considered a “hard stick” because my veins are tattered from all the abuse of so many IVs, blood tests, and lab work ups.

Speaking of abuse, chemo really took a toll on my body and my doctor has decided that we’re stopping for now. Actually, we couldn’t have continued even if we wanted to — my platelet level went dangerously low (7,000 — normal range is 100,000-150,000), and chemo cannot be administered with those numbers.

I’m not going to lie — I was relieved to hear we’d be pausing.

We were fighting a small amount of cancer with some pretty potent drugs and he was not happy to see me land in the hospital for a 2nd time during treatment. His MO is more “watch & see,” meaning monitoring any growth before taking action versus my more “something is in there, let’s kill it with everything we’ve got now!!” approach, which clearly didn’t do me any good.

We have a follow-up mid-July to decide how we’re going to move forward. In the meantime, the focus is on mental and physical health.

XOXO