exercise, port decision, and update on those "missing" mammograms

Well last night went reasonably well - managed to sleep most of 8 hours, interrupted by an hour in the middle. My latest new "friend" was 0.5 mg of Lorazepam. I'm feeling a little sleepy and was slightly queasy this morning, but the morning anti-nausea meds have helped a lot (the persistent symptom I'm having is nearly continual bouts of burping). 

As I said before, I've become quite serious about exercise in the last couple of years, in part a result of assisting with the Special Olympics swim team that my step-daughter Sarah joined, and in part as a result of the Strozzi somatic coaching training I've been doing. I have joined a Masters' Swim workout and even competed once at a meet; I have been seeing a fitness trainer twice a week since Oct. 2013. A highlight of last summer was figuring out how to walk down to Vilas Park, swim across Lake Wingra to Wingra park, and walk home, with a minimal amount of gear in tow (flotation device and rubber crocs).  I have been learning to describe myself as "an athletic person."

One of the most difficult aspects of the series of biopsies was not being able to swim, and I have wondered about how chemo would affect my ability (and desire!!) to work out. Medical staff have been pretty supportive of keeping on exercising. So, I went to bed early the night before the chemo, and woke up without an alarm at 5:15, with plenty of time to get in an hour swim at the Y before heading to the hospital. Yay!

I asked my oncologist and she confirmed that people who exercise more seem to do better through treatment. So yesterday, after feeling semi-okay/semi-queasy all day (and learning to give myself the Neulasta injection that I'll do the day after each chemo treatment), I talked to a nurse about my continued queasiness; she adjusted my meds a little and encouraged me to exercise, so I went to my regular fitness training appointment. I started off slowly and picked up a lot of energy and confidence, and by the end of it, I didn't really feel sick anymore! (for a while, until after I ate some dinner, that is). I'd also looked pale all day but after exercising my cheeks were rosy. 

My friend Nina just sent this link to an article on research in mice with a certain type of induced breast cancer that shows that exercise makes tumors more susceptible to chemotherapy. Not totally clear it translates to humans yet, but that information combined with my oncologists' and my own experiences makes me really want to prioritize this as much as I can. I might even try to make it to Masters Swimming tonight?!

One implication of prioritizing exercise is, I believe, to decline to get a "port" installed at this stage. This is a device that once it's installed under the skin, makes the repeated injections much easier (and makes the slightly scary one where there can be tissue damage if it gets outside the veins somewhat safer). However, it is a surgical procedure under sedation, and would require me not to swim for a week, and limit my weight lifting somewhat also during that time. While a week isn't long in the grand scheme of things, I know myself well enough to know that any loss of momentum makes it harder to get back to where I was, and I think this early phase could be crucial in terms of my *belief* in my ability to keep exercising. And they are saying I have good veins, and I'm not needle-phobic, so it shouldn't be a problem for them to continue to inject me directly. Also, the BRCA negative result makes it more likely that I will have only 4 months of chemo rather than 5, if the tumors are responding well (which exercise can perhaps help with!). 

For my female family and friends in their forties: I've been meaning to report that I did ask the oncologist to explain why she said that these cancers might well not have been detected even if I had been doing annual mammograms throughout my 40s, instead of stopping after the new recommendations came out. She said that this kind of triple-negative cancer grows quickly, so it often crops up in between mammograms. She said this was no reason to discourage women from getting mammograms, because they are more likely to help detect some of the slower-growing estrogen-sensitive etc. cancers. -- just that she wanted me not to feel guilty about it, since in this particular case it likely wouldn't have helped. If you are moving ahead with a mammogram soon though, I suggest you read this article about the gray areas with biopsies.