Emerging From the Chemo Chrysalis

BYE CHEMO
I am emerging from my chemo chrysalis! It sounds beautiful, doesn't it? -- so I am going to run with it. Several times over the course of chemotherapy I would remark to John that I wish I could just be put in a cocoon and taken out once all the infusions have been infused. And surely then I will emerge a beautiful butterfly! Or whatever. If you follow me on social media, you will also know that I do expect some super powers. I will keep you posted on how that goes (and yes, I definitely will settle for the super power of life).

Reflections on Chemo:

• Chemo is gross. 
• The first 12 infusions (Taxol/Carboplatin) were super tolerable, although annoying to have to go weekly. 
• The next 4 infusions every 3 weeks provided a bit of a reprieve for my schedule, but in reality it sucked pretty hard some days physically. It was a stronger chemo, and coupled with the Pembro (which I now believe I am getting), I had a few harder days.
• I was frustrated when it was harder than I thought it would be. Basically, I expected sucky, but just regular sucky, and a few days exceeded that and I really hated to admit it.  
• Chemo infusion days were not really bad at all, aside from some queasiness. For me and for most other survivors, the harder days are often 3-5 days after an infusion, when the premeds wear off. 
• My family, my Chemo Buddies, and entire support network truly got me through this and I cannot thank you all enough. Knowing that you are out there cheering me on propelled me through this tedious and queasy part of my life. 
• John, my hero partner in all of this, is an incredible human being. I hope you let him know that when you see him. He would often thank me for enduring chemo, and then also tell me it will not be like this forever. Both of these sentiments saved me on numerous occasions. 
• People who work in this field are a whole other breed, and they are amazing. 
• CBD oil was in fact useful for alleviating the side effects of the last couple of infusions. I highly recommend, even though it tastes disgusting. 
• Food: While I was super healthy in the beginning, I became very food-averse with the last few infusions, and lost weight too rapidly. Food literally disgusted me, especially food that I had eaten in December (chemo gets associated with it and renders it inedible). Thus, I adopted the rule that "if the head and the stomach agree, I eat it." This led to eating much more meat and pasta than I would normally, and maybe that entire 5-package of Cadbury Creme Eggs from my dad. I will get back on track as this final infusion's effects abate.

What I Look Forward to Most:

HAIR. The big hair grow-back has begun! I have a fuzzy head right now, with lightish-colored hairs. I am debating doing a final shave of these chemo-laden fuzzies. Some say it will help the healthy stuff to grow back faster; others say that it does not really matter. In the meantime, you will see me with my wig or with a soft beanie. 

I have sprouts of eyebrows. I have eyelashes (these will likely fall out again in a few weeks, but I'm happy they are here now). Thank goddess for Sephora. 

FOOD. Sushi, sprouts, raw vegetables and fruits, coffee, the occasional glass of wine, an over-easy egg. Blue cheese. Did I mention sushi.

SOCIAL LIFE. With the flu season being so bad this year, I did end up avoiding mass transit and public spaces and this severely curtailed my social life. Now that my neutrophils won't be obliterated on the regular, I can see you again! In person! 

EXERCISE. Chemo diminished my lung capacity and energy levels and increased my heart rate, so I am looking forward to building back to strong and healthy. I hope to find a run or two this fall to work toward. Exercise also has proven to diminish the rate of cancer recurrence, so it is time for me to truly commit to myself in this way.  

NORMALCY. I have some treatment left but the worst of it is mostly over, and I will be able to get more consistently back to "regular" life including with work and for us to move back into our own home. We are so lucky to have the help that we do-- family is everything, people. 

What's Next:
This is a marathon, my friends. Chemo is over, though, and believe you me, I am freaking ecstatic! So please do not feel badly for me that there are still some big things ahead for my treatment. They won't be fun, but they won't be chemo. I am upbeat and so should you be.

Surgery.
"Of course they're fake. The real ones tried to kill me!"
I will have a double mastectomy on April 11. It's an overnight event at most, and I should expect to need some help for a couple of days. They say healing is about a week or so. My mom will be here from MN for a week to help out. Thanks, Mom!
While some in my situation opt for unilateral (just one breast), given the high rate of recurrence for Triple Negative Breast Cancer in the first 3-5 years, I am happily offering up both as tribute to the cancer goddesses. Prophylactic, as they say.
Along with the obvious surgery and reconstruction that takes place, this will allow for us to get the real picture of where my cancer is/was and to re-stage it based on that information. I was originally staged at III, but was told it could be II. They will likely inject a dye before surgery so they can tell if there is still any lymph node activity-- the last they checked with an ultrasound in December showed that there were still a couple nodes showing inflammation (which means active cancer).
In the meantime, I have appointments with my breast surgeon and my plastic surgeon to discuss details and decisions, including size, shape, saline vs. silicone, expanders vs. direct-to-implant, and whether or not I would like to have nipple-sparing surgery or go with the Barbie boobs and 3-D nipple tattoo. Feel free to ask me questions directly about all of this, I truly do not mind.

Radiation. After surgery, I will need to do radiation, or "rads" as the cancer community tends to refer to it. This means that they will point radiation at the spots that had cancer as a means to further eliminate any potential cancer cell stragglers. How do they ensure they hit the same spot(s) every time? Tiny little blue tattoos. My very first tattoo ever!
This will be done every weekday for about 5 or 6 weeks, for about 10 minutes at each appointment. While not everyone needs radiation, I will on account of being Triple Negative; this additional treatment will give me a higher rate of success and survivorship. Ultimately I am just glad it is not more chemo. I have a consult scheduled with a radiation oncologist next week, so I'll learn more then. For me, the toughest decision so far with regards to radiation is where to have it done, because John and I hope to be back living in DC this summer and we want to be sure it is convenient to home and work.

Additional Pembro Infusions. Part of the clinical trial I am participating in requires an additional 4 Pembro (or placebo) infusions at the tail end of this whole thing (these would be spaced out over 3 weeks each, just like the AC). I am fine with that, and I do not count it as chemo. It will not take my hair or anything. It tacks on time at the end but overall it will not be super disruptive to my life and schedule, and it could potentially be incredibly helpful in preventing recurrence.

Neutrophils are Working Hard

I have to guess that with all the flu and other stuff going around, my neutrophils are working hard to keep me healthy-- and thus they are depleted. So no chemo today!
Not ideal.
Cannot be helped.
Try again next week.

 

Happy New Year & Other Musings

Happy New Year!
I have not been one for keeping you up to date, I know. Holidays and general laziness. Also, despite being from the North, I just really do not enjoy being cold and thus end up bundled up under blankets with a book and a cat as often as possible. As such, I am quite happy that the next five whole days will be noticeably warmer, and Toby the dog will love me once again as we resume our walks in the woods. Also, if I have not told you yet, or you do not follow me on Instagram, there are gorgeous deer in the nearby woods. I love them. One of them is piebald, which means mostly-white but not albino (not the technical definition, but you can look it up). Very rare! and I consider a positive sign for me. Also, we have come to call her my patronus. Which in my head sounds like the song "My Sharona." Are you with me? lulz

Public Service Announcements
It seems that the flu is really terrible and an epidemic this year so please stay home if you are sick. THANKS
Also if you did not get a flu shot, please do so.
THANKS

What's New
I did finish my first phase of chemo-- all 12 TC or Taxol/Carboplatins are complete. That was a lot of chemo, my friends. Yuck.
I also began Phase 2, which is known as AC or Adriamycin/Cytoxan (sounds delicious!). I will have just 4 total of these infusions, every 3 weeks, so cross your fingers that March 2 is the end of chemo for me. Prior to starting the AC, which I did the week after finishing TC, with no breaks, I had to have another Echocardiogram and ECG. Adriamycin is apparently not always great for heart health so they monitor it pretty closely. Additionally, since I only go every 3 weeks, each time is a potential Pembro infusion. John is convinced that I am getting it, and I am not sure, except for a slight rash on my cheeks (attractive, yeah?) I have gotten the last two times of potential Pembro. All I know is that saline solution does not give me a rash. Chemo is definitely testing my beauty limits, and I praise the Sephora goddesses (monetarily).

Chemo Buddy Features! 
In December, my chemo buddies were: Christine (who I unfortunately never did get to see, due to my low neutrophil count-- and I so appreciate her taking the time off work for me! I was sad to not have chemo that day-- because what is worse than chemo? Not having chemo... and not getting to hang out with your chemo buddy), Megan (featured here), Jessie, Barb, and John.
Jessie also brought me a gorgeous quilt that she MADE HERSELF. As I get older, I realize that more and more of my friends have creative talents, and it shocks me every time. How amazing! How did you even make time for that?!
I have known Jessie since 2004, when we met in Vegas on a post-election sad sack trip with a bunch of Dean friends (although she worked for Edwards... blame Courtney 😉).

Jessie is the best. 

My MIL, Barb, who is amazing, was in town for Christmas, and got to be my final chemo buddy! (John will be chemo buddy for the remaining infusions.) Barb is wonderful, and I am very lucky to have married into this family. 

Best MIL ever. 💗

The loml, at my first AC infusion. 

Gratitude

I also want to thank all of you for every single one of your well-wishes: your cards, care packages, tea, gift cards, a free week of food delivery service!, blankets, books, text/social media messages, phone calls, chemo buddies!, in-person visits (Becky! Kate! Matt!), FaceTime chats, flowers, and the *many* other incredible and thoughtful gifts and your different ways of being there for me during this suboptimal period. You get me through the tough parts, which mostly are just feeling as though this will never end... chemo is drudgery, and it can be discouraging on the vanity front... and I can do anything for another month and a half-- so wish me well with tomorrow's labs (let's go neuts!). 

Chemo is Boring but We Know How to Bring the Party

Hello, friends.
First things first: I did resume chemo last week, after my neutrophils bounced back above 1.0; they were 1.03, which means that while I was successful, I also had to begin the booster shot Neupogen (or Zarxio, for those who like knowing specific brands of cancer-related drugs). This is a "growth factor," which I guess describes the fact that it stimulates the growth of neutrophils, which are found in the bone marrow, which is why one of the most common side effects of using it is bone aches or pain (I have also learned from experience that the muscles get achy as well). While this does not sound fun, it's really just a dull ache akin to growing pains. But minus the growth, although I would not be upset if that happened... I have always hoped to push beyond 5'3." Alas.
I will now receive the booster shot for two days (it could be up to four days, depending on how low the neuts dip) post-chemo infusion, so last weekend I had to go in mid-morning both Saturday and Sunday. Once my insurance okays it, I will be able to self-administer these shots (exciting, right?!) at home, which will save an hour each day in travel, as long as I am willing to stab myself. I can do this, dear reader. I will breathe through it (also, thank you Riely for coaching me via text on this!).

Colds and Such
When I was in elementary school, my mom was taking college courses. One day she brought home an illustration from a biology class that showed the immense amount of germs released per sneeze, and how many germs were on things like doorknobs. I will say that this has really stuck with me, and I am somewhat of a germ-phobe. Imagine that, plus going through chemo and having a challenged immune system... What I am trying to tell you is that I am a lot of fun! I walk around with disinfectant wipes (lemon is a great smell, don't you agree) and anti-bacterial everything. I have even self-quarantined over coughs and sneezes. Thankfully, those enduring living with me respond kindly by getting set up with amoxicillin. Also thankfully, I am getting Zarxio and have a better shot (pun intended) at fending off these germs.

Holiday Prep
This week, in preparation for the thanksgiving holiday, I had my labs today (the booster worked!), and chemo tomorrow with Lisa returning as my chemo buddy. Next week, labs will be moved to Tuesday, and chemo to Wednesday, with-- wait for it-- my mom AND my dad as chemo buddies! This is the part where you fall out of your chair because my parents have been divorced since I was two years old. How freaking amazing is that?! They are traveling here to be with me for the holiday. It is incredible, super sweet, and I will be honest when I say I was a little surprised (they were considering just surprising me by having my dad arrive without prior knowledge... thank you for rethinking that!). It isn't that they do not get along-- thankfully, they do-- it's just really touching. I am really looking forward to showing my dad around-- he has never been to DC!
Also, so much gratitude and love to Kelley and David for opening their home to my family for the holiday. You are incredible people.

Chemo Buddy Feature: Josh
Last week's chemo buddy was my friend Josh. I frequently call him Joshy, or pumpkin, but I have known him for more than a decade, so I get to do that. Joshy and I met when we moved into a group house on Euclid St. NW in 2006; I remember when he first walked up to the house and shooed the birds away, emphatically stating, "I hate birds. Ugh." Even though I do not hate birds, I do love when people have strong feelings about everyday things. It was the start of a beautiful friendship, even though the whole group-house thing really imploded.
Josh signed up as chemo buddy and immediately purchased these amazing pink wigs for the occasion. I will be frank, chemo is boring (this whole chemo regimen is pure tedium), but this was super fun, especially when paired with dance party music. Love you, pumpkin!

Don't worry, the pink wig will most certainly make another appearance!

No Camp Chemo Today

I want to start by reassuring you, lest you feel disappointed for/with me, that this is all part of the treatment process. To have a delay in chemo is okay and often expected. For those who enjoy the specifics, my neutrophil level was .800 (must be 1.00 to proceed with chemo. Last week was 1.20).
I have been referencing my neutrophils for weeks, so you may already know that I would necessarily need to hold off on a week of chemo once they fell. This is the week that has happened, and while no doctor or medical professional has outright told me how amazing I am for having held off nearly six weeks without this happening, dear reader, I read between the lines (heh) and assume that is why-- I am amazing. It has been a great sign that I came into this experience with a healthy amount of white blood cell levels that withstood chemotherapy (and again, this is expected to happen no matter what) for quite awhile. I am a healthy sick person!
I have also mentioned that I was told that when this happens, it is time for the booster shot, so I was surprised yesterday when I got the call from Oncologist F.'s office to say that she would like to wait a week, do my labs, and see if I have rebounded. I suspect that they think a week off for me will indeed cause the neuts to bounce back. If not, I was told they may hold off again another week, rather than introducing the booster shot. Or, they might choose to proceed with chemo, but at a lower dosage. It depends on what Onc F. thinks is best at the time, and I have an office visit with her already on my schedule for next Thursday. For what it's worth, I stated that I would "not be keen" on delaying my treatment TWO weeks. The kind nurse on the line said something to the effect of: we aren't either, but we are also not keen on pumping you full of unnecessary drugs. FAIR.
So today I have the day off. How will I enjoy it?

I will drink all the coffee. (Actually just this one cup.)

I will enjoy this amazing cup of coffee. While I am not prohibited entirely from drinking delicious coffee (if you know me you know I love coffee, and I especially love a really good latte, particularly those you might find at Dogwood or Rustica in Minnesota), I am not supposed to drink it 48 hours before an infusion, the day of an infusion, and for 48 hours afterwards, which when you are receiving weekly infusions is pretty much the whole week. Also it dehydrates, and I have a pretty strong need to do the opposite at all times. 

Chemo Buddy Feature: Megan P.

This weekend my good friend Megan P. is here from Minnesota to be my Chemo Buddy, so I do feel some disappointment that she will miss the experience of sitting next to me during an infusion (aka my weekly Benadryl high-and-then-slump) and being bloated from the steroids and chemo. I am sure we will find plenty of other things to do, and that we will certainly get our fair share of cancer talk in; I am mostly excited to have her see where we are living, and to just catch up generally. The fact that we have massages scheduled for tomorrow is pretty fabulous as well. 

Megan and I have been friends since our undergraduate days at the University of Minnesota, Morris, which if you are not aware is aka the Harvard of the midwest, the "smart" school of the four U of MNs, etc. (you can punch me in the face later). It is a small public liberal art school in the middle of corn fields where you can oft find budding liberal activists. Megan is and always was a leader, and I got to know her from the Women's Resource Center (the women's activist group on campus). After college, we worked together for a while at an abortion clinic as peer educators, we worked on campaigns, and there were years where I was a de facto third roommate/couch crasher at Al's and her apartment in St. Paul. I repaid some of that debt by putting her up in D.C. when I lived here the first time. Together we have enjoyed countless dinners, wine, the Klituation dance party, and the highs and lows of our love lives and careers (we were together on election night 2004 AND 2016...). She is now the executive director of an amazing nonprofit called Gender Justice, and I need to get dressed now so I can pick her up from the Metro station. 💕

Update: Here she is, and we took a really nice fall walk today!

Camp Chemo Update #5: This is Starting to Feel Redundant

Yesterday's chemo infusion happened! This sentence is indeed worthy of that exclamation point, since I was certain that my neutrophils had dropped below 1.5. Actually, they did-- so I was surprised when Researcher S. told me that I "squeaked by this week," and that my count was at 1.2... so there seems to be some leeway, apparently. What that means for me now is that I am in the "risk of infection" zone, and that I must stay away from germy places and people (Researcher S. always mentions germy children in this warning), at least until Thursday when I have my next labs and we see if the neuts (as Cousin Kate calls them) have indeed fallen to the level of needing the booster shot. Again, that will mean delaying chemotherapy one week as I begin taking the shot that will assist the neuts.
So chemo was fine, although the Taxol again irritated the fibroid, which is highly uncomfortable in the way of cramping and was tamed as cramps often are, with an Advil procured by Nurse S., who also instructed my Chemo Buddy Kelley to distract me by chatting. This team effort was successful and much appreciated. In terms of side effects, so far so good; not feeling nauseous at all today, which is a huge relief from last weekend. I did not go on a hike (or bike) today, as John is in Minnesota getting our winter belongings from storage, but I did take the dog on a longer walk. Even my fatigue seems lower today as compared to last week (yay).

Chemo Buddy Feature: SIL Kelley!
This week's Chemo Buddy was Kelley, my wonderful sister-in-law. Kelley is a force; a ginger, a high achiever, successful career lady budget analyst number cruncher, lover of spreadsheets, runner, super baker and cook, quilter, sewer, highly fashionable, mom to my nephew M., and incredibly kind and generous host to John and me as we unexpectedly stay with her (plus D. and M.) far past our original timeline so that we have extra support during my treatment. She also is very good at raising two of the sweetest cats that I have ever encountered, Pepin and Jax.

Here we are at Camp Chemo! She has great bangs.

Pepin (orange tabby) & Jax (gray tabby)

I am the Neutrophil Queen (& WTH is Immunotherapy Anyway)

This week's labs (CBC, or complete Blood Count) report came back from this morning's blood draw, and my neutrophil count actually increased! I am up to a 1.89 from a 1.68. This is surprising because the chemo drugs that I am taking (Taxol and Carbo) are supposed to guarantee a drop in neutrophils (which are a type-- one of four-- of white blood cell, and help prevent infection. Infection is not a good thing for me.). Since the chemo wipes cells out indiscriminately, bad or good, because it cannot differentiate between them, it is expected that they will inevitably drop. [I am not a medical professional and so I know I am likely missing important details but hopefully am catching the gist... please bear with me if you are more knowledgable than I am.]

Since my counts are still above 1.5, chemo tomorrow is a go. If they had dropped, I would have had my chemo pushed back a week and would have instead started a neutrophil booster. If you read my earlier post about this, a possible side effect from the booster is bone pain (or ache). Luckily, since I do not have to have the booster this week, that means one less booster overall during the course of my treatment. It is, however, inevitable that I will have the neutrophil booster. It's okay. It's going to be all right.

Since I am going to have chemo tomorrow, and it will be the third week, that means I will also receive immunotherapy (pembro or Keytruda) or the saline solution placebo, as part of the clinical therapy trial I am participating in. Here is a review of immunotherapy and my trial:
It is a 2 to 1 chance that I am receiving immunotherapy. My trial is in Phase 3, which means it has had positive results in its first two phases. My non-medical explanation of immunotherapy is as follows: immunotherapy is some of the most groundbreaking research in cancer treatment in recent history, and is blowing researchers and the medical community away with its results. It works with the body's immune system to identify, target, and kill cancer cells. My immunotherapy is the type that works with the immune checkpoint inhibitors, and has already been approved for other cancers such as melanoma (and a few others). Former President Jimmy Carter reportedly was treated by the immunotherapy that I might be receiving. The really kickass thing for me is that while Triple Negative Breast Cancer makes it so that there are some types of treatments (namely, hormonal) that do not work for me, immunotherapy puts a big one back on the table.

Here is more about immunotherapy if you are interested.

Camp Chemo Update #2: Cousin Kate is here!

The second day of chemo infusion (2 of 16) is in the books! Thank you to all of the wonderful and amazing friends who have reached out to see how it went and sent well-wishes via card, text, Snapchat, FB, email, and incredible gifts (scroll to bottom to see my new turtle chum from my friend M.).

My Day-to-Day
I have been enjoying the ease of these first two infusions as much as possible with bike rides, yoga, frequent walks with Toby the dog, daily dance party (this is the best and recommend everyone incorporate this into your morning life routine), plus just being awake and not needing to take naps. Don't worry,  I am getting the appropriate amount of rest and Netflix-watching in, I promise. Now that I have a treatment schedule, I am still trying to figure out what my day-to-day looks like.
As mentioned in my first post, I am in the middle of a job search, but have changed direction a bit to focus on more project/contract jobs. After December, it changes to once every three weeks, and I'll stop turning down amazing interview opportunities (this is a very frustrating aspect to all of this for me). Anyway, my point is that I am now shaping what my day-to-day looks like. I will likely write more about this in a future post.

Chemo Buddy Feature: Cousin Kate!
My cousin Kate arrived Thursday night from Ohio to join me for chemo as my Chemo Buddy, and for the beautiful Fall weekend. She brought me a batch of delicious vegetable soup for the freezer! Food is love, my dear reader. We both decided that I have joined the Welte Women ranks with my short brown hair (hi, Letha and Beth!). Kate and I have a history of fun adventures, such as hiking/scrambling up rock walls outside of Squamish, British Columbia (see my FB cover photo); driving across the country for big moves, such as when she left Washington state for Louisiana last year; and plenty of camping in various state and national parks around the country. Today our adventure is, of course, Camp Chemo.

Cousin Kate & me, glamming it up at Camp Chemo! 

Here is a comically bad pic of the two of us + her dog Reese, during her cross-country move of 2016.

Kate was able to hang with me while I got hooked up to the IV (ha!) via Power Port, got my "pre-meds" cocktail of Benadryl, steroids, and whatever, then an hour of Taxol and a half hour of Carbo and then out of there! It takes about 2.5-3 hours. The added benefit of joining me as a Chemo Buddy is witnessing how loopy I get from the Benadryl. (I also refer to my IV as my buddy, as she goes with me if I get up to walk around.) My eyes droop and eventually I rest them for a few minutes. Riveting, to be sure. 

Labs Report & Bone Pain

I also had a chat with Researcher S. about my labs report, which ultimately looks great. She let me know that she is most closely watching my hemoglobin levels (have dropped a little, but not alarming), platelets (have not dropped much at all), and neutrophils (with the chemo I am taking, it is a given that these will drop). 

Neutrophils help fight infection, so if you are low on them you are more at risk, which is not ideal for people on a chemo regiment. Here is more info about neutrophils if you are interested. I will be referencing them in the future, I am sure. My level is currently 1.68, and once it goes below 1.5 I will need to take a "booster" which is a really deceptive way of saying that I will have to take a regiment from now through the end of my phase I of chemo (through mid-December) of subcutaneous shots that I personally administer of something that may (likely) bring about a bit of bone pain. BONE PAIN. BONE. PAIN. So here is where we all say together, "Everyone responds differently, so let's just be cool and see how it goes." I'm cool. You cool?  

(Note: Nurse S. further explained that the 1.5 number is for the study requirement, but the "normal" number for concern isn't until a 1 is reached, so at least that's something in terms of fear of infection.) 

Healthy Food & Exercise

The rest of the day was about eating healthy food (just kidding, John came home and ordered pizza while he watched baseball playoffs... I am 80/20 on my food, meaning I am fine going off course some of the time. I had a half of cheese pizza. To be honest, it wasn't that great.). It's okay because I had a lunch of organic kale (I do love kale, sorry haters) and sweet potatoes with a TBT (tempeh-bacon and tomato) sandwich, courtesy of True Food Kitchen. 

Today, Kate and I are heading out to the woods for a hike. Exercise is important, and I love it, but let me tell you that once I get busy (pre-cancer life) with work, grad school, campaigns, etc., it is the very first thing I chuck. Well, no more of that sh#$, dear reader, because research says that regular exercise will reduce recurrence of breast cancer significantly (percentages vary). The research seems to point to better outcomes for those with hormone receptor-positive tumors, which I am not, but logic lends itself to the idea that it would still be incredibly beneficial to us TNBC-ers. 

From Cancer.gov:

Consistent evidence from epidemiologic studies links physical activity after diagnosis with better breast cancer outcomes (35, 36). For example, a large cohort study found that women who exercised moderately (the equivalent of walking 3 to 5 hours per week at an average pace) after a breast cancer diagnosis had approximately 40% to 50% lower risks of breast cancer recurrence, death from breast cancer, and death from any cause compared with more sedentary women (37). The potential physical activity benefit with regard to death from breast cancer was most apparent in women with hormone receptor–positive tumors (37).

Another prospective cohort study found that women who had breast cancer and who engaged in recreational physical activity roughly equivalent to walking at an average pace of 2 to 2.9 mph for 1 hour per week had a 35% to 49% lower risk of death from breast cancer compared with women who engaged in less physical activity (38).

So yeah, I am no longer sacrificing exercise. Get it! 

My new turtle buddy, from my friend M. He is nestled atop a beautiful and so-soft poncho that she also sent. Love you, M.! 

Selected quote:

"You asked for laughs... so I just called the form of breast cancer you have triple x instead of triple negative." -- J.