Dear ****,
Your fear and your anxiety are totally normal. Being in shock at first is totally normal. So you do need a friend/partner who can accompany you to every appointment and hear what the doctors are saying because it is hard for the patient to be little more than a deer in the headlights when you hear the big "C". I am not familiar with the FEC protocol but will forward to my doctor. How big was your tumor?
Your course may be absolutely appropriate and I don't want to cast doubt on that but I do want you to be sure before you start treatment because it's easy when we are in shock to just go with what the doctors say but in fact this is the most crucial time. So be confident, be strong but as Ronald Reagan said: "trust but verify." I trust no one and I double check everything. Again, I don't want to create more stress for you, but I want to empower you to feel 100 percent confident with your course - so these next days are crucial before you start. Also I HIGHLY recommend starting to exercise 45 minutes a day - it is the one proven alternative approach that for Triple Negative has reduced the chance of recurrence by 50 percent. It will help you handle the chemo effects too and just keep you strong through the chemo. And it will help the anxiety - which is huge - and will help you handle the steroids that they give you to counter the nausea. The steroids are a bit of a roller coaster.
Here are some tips for handling chemo - take them for what they are worth (toss them out if you think they sound too kooky) but I find in this situation where you have very little control that nutrition, food and exercise are extremely helpful in handling the chemo - so here goes:
1) Get your teeth cleaned before you start because you can't get them cleaned during chemo and you tend to get mouth sores - you can minimize these by brushing your teeth 3 - 5 times a day and rinsing with a mild mouthwash - I use a mild dry toothpaste and mouthwash called Biotene (baking soda and saltwater gargles work, as well.)
2) Get your wigs now - find a really cute fun one or two and go with your girlfriends before you start losing your hair. Have fun with it - no one in Hollywood wears their own hair - they are ALL wigs - I am a redhead right now and never was before and love it. I don't know about the drugs you are taking but the typical chemo drugs cause your hair to fall out on day 14 - 17 - shave it off before it starts falling out - it's much more empowering that way - invite your girlfriends to do it with you. Plan to have lunch somewhere fun afterwards. Embrace it. Bald is very powerful but remember to get a hat - a fuzzy fleece one - because bald is also breezy and you will will catch drafts that you didn't even know existed. You need to sleep in the fuzzy hat all the time. I like to wear cute knit hats over the wigs because they look a little less wiggy and a little more young. (Let your friends throw a hat party for you - like a baby shower but with hats.)
3) Get some nice body lotion and lip balm because the chemo dries out your skin (on the flip side chemo is better than botox and takes all the toxins out of your skin and suddenly your face is as smooth as a baby's butt.)
4) Get some powder bronzer so that when your face looks pale and drawn and a little green from the drugs you can throw on a little extra bronzer powder and blush and feel that you don't "look like a cancer patient." There is a reason that the American Cancer Society has what is called the "Look Good, Feel Better" campaign because if you get up each morning and shower and put on your blush and your wig, you literally feel better. It is so easy to start the downward spiral into feeling sorry for yourself. There's a great title of a book: "Why I wore lipstick to my mastectomy..." My husband Greg once asked me why I was getting so dolled up? "After all," he said. "We were just going to chemo...." I told him that was exactly why I was putting on lipstick and a bright scarf and great earrings. It's your body armor. Don't go out without it. Every time I have, I have regretted it.
5) Get some clothes that are your "chemo uniform". I went to Max Mara and got comfy leggings, long cozy sleek sweaters, furry boots (like Uggs) - cashmere everything. Anything to make you feel cozy and sporty. All easy to throw on - so you just reach in your closet and grab your uniform - taking all the stress out of what to wear.
5) Order from Amazon immediately two cookbooks by Rebecca Katz (a San Francisco chef) "The Cancer Fighting Kitchen" and "One Bite At a Time" and tell your friends about them so they can cook healthy things for you that help with the chemo side effects and not bring you donuts and cakes to make you feel better. I remember at the first "group" session at my hospital the women were all going around introducing themselves and consistently they talked about having gained weight through chemo. One woman said she had gained 70 pounds - I thought - no way - then I WILL kill myself. The drugs and the steroids can cause havoc to your metabolism so it's best to try to find a reasonable but pretty strict eating regime to give your body and immune system the strength it needs to fight and bounce back. Your mouth will feel like Chernobyl pretty quickly and your taste buds die so there are tricks in Rebecca Katz's books to make food still taste appealing and to stimulate your appetite so you can stay strong. Certain foods definitely boost your immune system.
6) I immediately eliminated all processed foods, all white sugar, nearly all dairy, (Triple Negative responds well to a VERY low fat diet - to be a vegan is ideal, but you will find that when you get anemic during the chemo you may have to bend the rules a bit on meat - at least that is what I have found and was tucking into some veal shank for the marrow at midnight last night. Also a low glycemic diet is very good for Triple Negative because there is some research that shows that Triple Negative may have something to do with insulin levels.
7) I drink only water, bubbly water and green tea (don't want the sugars in the other drinks.) I put lemon in and on everything - it cuts through the chemical taste and you need 3 quarts of water a day to wash the chemicals through your system - staying hydrated also keeps you from being nauseated. They recommend 3 - 6 mugs of green tea a day to get maximum benefit from the anti-oxidants in the tea. Start eating all organic. Check out Jane Plant (British geologist's book) on how she survived breast cancer by giving up dairy.)
8) Don't touch any milk, eggs, or meat that have any hormones in them. I still eat eggs and fish - but only wild caught fish - salmon and white fish - don't want the swordfish and other things that are higher up the food chain because they have a lot of mercury.
9) Eat a lot of cabbage - "Cancer Hates Cabbage!" (Chapter 10) When you are eating this clean detoxed diet filled with Super Foods then you are going to be as strong as you can be to counter the tsunami like effects of the weekly, biweekly or triweekly chemo treatments. It's like girding yourself to take each wave head on - like body surfing. And even those days that you don't feel great - go out for a walk. Don't miss your exercise - the oxygen and endorphins will help so so much. And eat like a pregnant woman overcoming morning sickness - small meals 5 times a day - don't let your stomach get empty - helps counter the nausea. Sleep with a banana by the side of your bed and a pitcher of water - hydrate all night long and have the banana in case you are feeling a little queasy first thing in the morning. Demand that your doctor is giving you a wonder drug called Emend - best anti-nausea drug on the market. Insist on it. Look into getting Chia seeds from your health food store or on line. They are flax on steroids. They are wonderful on your oatmeal in the morning and have all the Omega 3s you need and fiber and calcium.
10) Ginger - best natural anti-nausea food. Chop fresh ginger into everything. Eat it raw. Make tea from it. It got so desperate the other day I went straight from the gym to a nearby sushi restaurant to eat a mound of pickled ginger because it was the only thing I could think of to settle my stomach.
I know there are more tips that I have found useful, but I'll leave it at that for now.
Be strong, kick ass and remember this pithy Australian cancer awareness slogan: "Cancer...a word - not a sentence."
Call me if you would like to chat.
You will get through this. Don't let the name Triple Negative scare you. This is beatable.
Love, Jennifer
