Nasty Anastrozole

In February I'll pass a milestone - five cancer-free years from the end of breast cancer treatment.  I understand there's nothing scientifically special about the five-year mark except that it's when most studies call a person "cured", however it's still encouraging to stop and notice how healthy I am now.

Here's me in the fall of 2010 as my hair was falling out.  I like it better now!

When I first completed all my treatment, which was a lumpectomy followed by chemotherapy followed by radiation, my oncologist recommended I take a drug called anastrozole for five years.  It is an aromatase inhibitor that significantly reduces the total amount of estrogen in a post-menopausal woman whose ovaries no longer produce estrogen.  For women whose cancer is hormone receptor positive, reducing estrogen in the body can help reduce the chance of the cancer coming back.

Side-effects of anastrozole are bone weakness which can lead to fractures and osteoporosis, joint pain and heart problems, along with the usual effects of reduced estrogen like hot flashes and memory issues.  I was aware of that, and had already been reading online conversations in which women complained of debilitating pain from the drug.  Naturally, I wasn't keen on starting it myself.  I talked it over with my naturopath who urged me to follow my oncologist's advice, but also mentioned that if I chose not to take anastrozole, there is a mixture of Chinese herbs, called Myomin, that does the same thing without the side effects.  Hmm, it didn't seem like a tough decision to me!  I read the literature about Myomin and at the time it was all about reducing estrogen in the body for the purpose of body-building.  The literature (and I use that term loosely - it was mostly ads by places selling Myomin) made no mention of fighting cancer - apparently they can't advertise it for that purpose since the FDA has not cleared it for that purpose.  However, it made it very clear that Myomin works by inhibiting the enzyme aromatase, just like anastrozole.  Recent literature mentions it being used for treatment of endometriosis, ovarian cycsts and uterine fibroids, and also for protection of people taking bioidentical hormones.

So I said no thanks to the anastrozole and took Myomin for six months.  On each visit to my oncologist, she urged me to reconsider, citing studies that showed a better outcome for cancer patients who follow up with anastrozole.  (Of course, there are no such studies on using Myomin, since no drug company would be motivated to pay for them.)  She wore me down, and finally I ordered the prescription.  When the pills arrived they were tiny - maybe 1/8 inch in diameter - and I thought how could something that small, taken in the middle of a meal, possibly hurt me?  I was also thinking of how I'd feel if the cancer came back and I hadn't taken the pills.  I wanted to feel I'd done everything possible never to go through that again.

So, around August of 2011, I started taking anastrozole. As you know, I've had a lot of hip pain over the last several years, and I wondered if anastrozole was making it worse.  I knew it wasn't completely due to the drug because I already had hip pain before that, and I didn't have pain in other joints.  Seattle Cancer Care Alliance gives me a dexa scan bone density test every year to check for osteoporosis and the result, while not perfect, is "appropriate for my age". 

Now, after having had physical therapy and chiropractic and my year of health, I have no more hip pain!  I think learning to tighten my "core" and use my butt muscles has made the greatest difference.  I've been pretty faithful taking the pills, stopping only for a month before and during our trip to Italy in 2013, when I wanted to be as pain-free as possible for walking around, and I didn't notice any great difference from stopping at that time.  I do have hot flashes - not desperately strong ones as when I first started menopause, but just an inability to keep my body temperature steady - I'm always putting on a sweater then throwing it off again.  And I definitely have memory issues.  I blame my age and years of killing brain cells by drinking wine, but it's possible the drug is making it worse.

At my last appointment, my oncologist reminded me that in August I will have been taking anastrozole for five years.  She is okay with my stopping, but recommended continuing as long as it's not bothering me much.  We talked about my taking time off from the drug, and she said six months would be a good length of time to see whether I notice any difference.  That sounds good to me.  I'll wait until summer, maybe for my 69th birthday in July (yikes!) and then take a six-month vacation from anastrozole.  It will be interesting to see if I feel any different.  If by some miracle my memory returns or I start sleeping soundly, that would be a good reason to quit for good, but I might also look into Myomin again.

That was a pretty dense read, but an important topic.  Life is such an adventure, don't we all want to stay healthy and active to enjoy it as long as we can?!  Our Thanksgiving holiday was another reminder of how fortunate I am.  Melanie, Ben, Ben's brother Jason, and doggie cousins Wilbur and Banjo joined us for fun at the coast.

A serious game of UpWords after dinner.  I was playing with real experts - didn't stand a chance.

A great photo of Melanie and Wilbur.  He was so good to stop running around long enough to pose for the camera.

It was a great day!

Open Wide

For many years my half-yearly dental cleanings have been easy and quick.  Since I started using an electric toothbrush there has been a minimum of scraping and poking necessary to keep my teeth clean, but not this time.  Nothing really bad, but in one spot I have two crowns next to each other that create a cozy pocket for stuff to get into and be hard to get out, even with floss.  I have noticed lettuce and nuts are the two worst offenders - both something I eat a lot of.

Kristine, my favorite hygienist at Dr. Zimmer's office, asked if I use a Sonicare and when I said no, I have an Oral-B toothbrush, she recommended switching.  She and her colleagues feel there is a great enough difference that it is worth buying a Sonicare if possible.  I was happy that she told me about the different models and that unless I need a lot of settings, which I don't, the least expensive would be fine.  They also have a dual kit, with two brushes on one charger, but I sort of like how Stan and I are set up now, with a personal sink and bit of counter space for each of us.  No sense meddling with what works, right?


So, here's my new gadget.  It has a few features my old one didn't - times the brushing for two minutes and turns off automatically, and beeps to signal each 30 seconds so each quarter of one's mouth gets equal time.  It has three levels of intensity, which would be useful if I were a new user.  It also comes with a nice travel case and cover which will be handy.  I always had to put a small plastic bag over the old one when traveling.

 Here's the old Oral-B.  Must say it has served me well.  It has the original battery and it lasts fine through a 2-week vacation without needing to be charged.  I think I'll store it for awhile, just to make sure I like the Sonicare.  I had a Sonicare a long time ago, and it seems to me my reason for switching was because it stopped working.




btw - I did look online for comparisons and found opinions both ways.  I think Sonicare may have been the better brand some years ago (at least according to a PubMed article from 1997), but more recently the Oral-B has been found better.  Here's a study from the American Journal of Dentistry from 2012 that says "The novel multi-directional power brush consistently produced significantly superior anti-gingivitis and anti-plaque reductions relative to pre-treatment versus the sonic control brush."  I didn't understand what the part about pre-treatment means, but it just means compared to each study participant's condition at the beginning of the study.

I think the best comparison is this one at Best Electric Toothbrush Hub.  It points out that most of the studies have been done by one of the two brands and there is really no definite winner.  Both are excellent and some people prefer the feeling of the sonic vibrations and others prefer the oscillating brushing motions.  Bottom line for me:  I have already bought the Sonicare and I trust the advice of my dentist's office.  A new one of either brand would surely be more effective than my old one, and after having used it a few times, I like how it feels.

Kristine also recommended actually using the mouthwash I bought after my last checkup, but don't always remember to use.  And she gave me a variety of extra-thick floss and other items to help in the difficult spots.   Just watch as my teeth begin to sparkle in the coming months  : )

Hmmm, kind of a boring post after all those Russia photos...  but this is important stuff.

In an effort to make this post more interesting, here's a book I read while I was sick that I really liked.  It takes place in 1946, when World War II had ended and the last soldiers were being returned home.  Apparently there were about 600 Australian women who had married British soldiers and were still in Australia waiting for passage to join their husbands.  The aircraft carrier Victorious became their home for 8 weeks as they traveled to England on its last official journey as an aircraft carrier.  According to Wikipedia, there actually was an HMS Victorious and it did travel from Sydney to Portsmouth with war brides.  This was a good story set into an historic event.

Cutting Down on Caffeine

I spotted this book in the library, and found it quite interesting.  As you may remember, I went one month without coffee in May.  That month the only caffeine I knowingly had was in tea and chocolate, quite a bit less than my usual 2 or 2+ large cups of coffee per day.  During that month I lost weight and slept well, although I was also being extra zealous in my diet and exercise, so I can't give all the credit to the reduction of caffeine.

The book has some interesting information about the history of caffeine use, and how it is different in other parts of the world.  The author calls it "a bitter white powder" and says without question it is a drug, and how convenient it is legal!

Here are some things I learned from the book:

• We use caffeine to wake us up in the morning and it definitely works.  However, those same morning cups may be still hanging around in our systems when we're trying to go to sleep at night, causing a vicious circle of sleep deprivation and needing more coffee. 
• Caffeine doesn't affect REM sleep, as other stimulants do, but disturbs stages 3 and 4 sleep, which account for about 20% of our sleep time and include some of our most restful and restorative sleep.
• A study found that susceptibility to caffeine's disruption of sleep varies with a person's chronotype (this is whether you are a day-person (lark) or a night-person (owl)).  Larks are more susceptible - darn - that's me!
• Another study found that caffeine disrupts sleep more in people who are already having sleep issues due to stress.
• Caffeine can trigger anxiety.  This was news to me.  Sometimes when I can't sleep I find myself worrying about all kinds of issues I hardly think of during the daytime, and I feel sort of tingly and almost frightened, even though I know I'm safe in my own bed.
• The half-life of caffeine in the human body is an average 4 to 5 hours, however this varies a lot from person to person.  (Half-life is how long it takes for the concentration in the bloodstream to lower by 50%.)  For a woman on birth control pills, it is twice as long.  For a pregnant woman, especially in the last four weeks, it is even longer.
• A smoker gets half the caffeine kick as a non-smoker.
• Here is an interesting example from the book:  imagine a couple where the man is a smoker who weighs 180 pounds, and the woman is on birth control pills and weighs 135 pounds.  If they sit down for a cup of coffee together, she gets a caffeine effect that is nearly five times as strong as his!
• Vegetables in your diet may play a role.  Cruciferous veggies like broccoli can increase enzyme activity that breaks down the caffeine, giving you less of a "hit".  Apiaceous veggies like celery and carrots can reduce the enzyme activity, giving you more of a hit.  (Here is a paper about this in relation to how various types of vegetables affect cancer, but it didn't seem to come to a definite conclusion.)
• This book caused me to realize how much caffeine many children are drinking in orange soda, Coke, Mountain Dew and energy drinks like Red Bull.  Apparently the FDA limits the amount of caffeine powder that can be added to soft drinks, and recently has made regulations about the amount in energy drinks and "energy shots".  This issue is a bit outside my topic here, as I have no plans to drink any of those products, but there is much information online, including a case where a teenager died after drinking an energy drink, and a study in 2010 showing that young children who used the most caffeine slept fewer hours.
• Caffeine's effects aren't all bad.  It is a very effective headache remedy, and is also effective as a morning-after solution to a hangover.  It is also an effective treatment of breathing problems in premature infants.
• Headache is also a common symptom of caffeine withdrawal.  There are over-the-counter suppositories available for people who are fasting and a prescription called Cafergot for people who are too nauseated to keep down a caffeinated beverage.
• In 2012, Harvard researchers found a relationship between caffeinated coffee and a lower incidence of basal cell carcinoma, a very common skin cancer.  This is being studied, and mouse studies have shown that caffeine can help to eliminate sun-damaged skin cells.
• There is conflicting information about whether caffeine is harmful during pregnancy, but many women choose to avoid or limit their caffeine consumption during that time.  I was lucky - very early in my pregnancies coffee was the first thing to disagree with me.  I felt queasy in the mornings and didn't want coffee throughout my entire pregnancy.

So what am I going to do with all this information?

Aarrrgh!  I didn't really want to know : (   I do love my morning coffee.

And I love my occasional treats later in the day, too!

Can you tell I love Starbucks??  I own SBUX stock too, and it has done nicely  : )  I wish I had purchased some many years ago when I was lining up downtown every day before work!

Okay, seriously, I know I'm not going to give up coffee!  I am glad I don't have any interest in Coke or other soft drinks, and I drink my tea so weak that I don't think there's a problem there.  In fact, I think tea is overall a pretty healthful beverage as long as one doesn't add cream and sugar.

• Since I drink most of my coffee at home, as of today I'm only going to buy decaf.  I don't taste much difference, as long as I get a good brand (the one on sale, of course), and I can start making it a bit weaker.
• I have already stopped buying the bottled frappaccinos, since I noted my weight gain last month.  These will remain my treat for long car drives - like when I go to Portland or when Stan and I take a long road trip. 
• How about 2 or 3 tea-only days each week?  I got used to this during May, although I do find myself looking forward to my coffee as soon as I'm up in the morning.
• Or, how about having my first cup of coffee and following up with tea if I want more?  These changes will take some determination and getting used to.  I'll let you know how it goes.

P.S.  Younger readers:  don't give your kids soda pop!  Do you know about Soda Stream?  This is a gadget that makes carbonated water, and they sell syrups in cola, orange, lemon-lime and other flavors, both sugared and sugar-free.  There are several flavors that are completely caffeine-free, and others have had their caffeine content reduced recently.  Here is a list.  You can get them in Target.  I like to make the sparkling water and then add a few drops of the syrups that folks put in coffee, like caramel or raspberry.

This flavor sampler came with our SodaStream.  We haven't used most of them, as we like the sparkling water straight or with a few drops of flavored syrup, but for kids, you can add some flavoring to make it like regular soda.

Water

In my effort to wean myself from my favorite beverages, like coffee and wine, I've been focusing more on water.  I noticed that although I always had a cup of cool filtered water at my desk at work, since I retired, once I stop drinking my morning coffee or tea I drink little or no fluid until cocktail hour comes around.  No wonder it feels like time for a drink!  I decided to do a little research on water and how much I should be drinking.

Here is a long list of the good things water does in our bodies:

• Transports nutrients in the body and enables the kidneys to flush out waste products
• Helps regulate body temperature
• Helps the heart pump blood more effectively
• Aids in digestion
• Energizes muscles.  Cells that don't maintain their balance of fluids and electrolytes shrivel, which can result in muscle fatigue.
• Keeps skin hydrated, plumping up the skin cells and making you look younger
• Helps lessen achy joints and muscle cramps
• Helps lessen congestion during colds or flu
• Helps prevent kidney stones
• About 70% to 80% of your brain tissue is water.  If you're dehydrated, your mind is stressed.

For more details see  http://greatist.com/health/reasons-to-drink-water


So, how much water should I drink?

According to the Institute of Medicine (IOM), reported in Medical News Today, an adequate intake for men is approximately 13 cups (3 liters) a day. For women, an adequate intake is around 9 cups (2.2 liters).  Yikes! This is even more than the 8 8-oz glasses we were taught in health class!  Of course, all fluids count, not just water.  "Anything but alcohol", says Kaiser Permanente nephrologist Steven Guest, MD also an adjunct professor of medicine at Stanford University, in Medical News Today.  He says,  "Alcohol interferes with the brain and kidney communication and causes excess excretion of fluids which can then lead to dehydration."  Beverages containing caffeine are also less than ideal due to having diuretic properties, meaning that they cause the body to release water.

I counted up my fluids for a typical day - 7.5 cups, not too bad, but 3.25 of those were coffee.  I see I had better drink more water instead!

I learned it is possible to drink too much water.  This is called water intoxication and apparently it isn't very rare.  When your kidneys are unable to excrete the excess water, the electrolyte (mineral) content of the blood is diluted, resulting in low sodium levels in the blood, a condition called hyponatremia.   It can happen to athletes who go overboard in drinking water to avoid dehydration, and also to young people who challenge each other to water drinking contests.  It is serious and can even be lethal.

 For myself, just increasing my water consumption by a few glasses seems good enough, but if you want to be more technical about it, here is an online hydration calculator, which computes your ideal amount of water based on your size and activity.

How important is it to filter my drinking water?

For many years I have kept a Brita pitcher in my refrigerator for drinking water, and I find it tastes much better than water straight from the tap.  However, I do fill the tea kettle, coffee pot and pots of cooking water from the tap.  There are many, many articles online about the importance of filtering water, and after reading some of them, I will hopefully be more patient about running coffee and cooking water through the Brita.  

Eating Well blog says standards for tap water are set by the EPA, however, there are many toxins found in drinking water that are not controlled by the EPA and can legally be present in any amount.  They recommend having your own tap water tested, and once you know what is present you can choose a filtering system effective against those particular toxins.  It's possible the Brita will do just fine.

 I can't possibly list here all the scary news I found, but here are a few items that made an impression.

This tip from Pure Water Services in New Zealand caught my eye because I used to live in a 100-year-old house, and my granddaughter lives in a fairly old home.

Very few water systems can remove lead. Lead may be a problem in older homes where lead solder was used to join copper pipes. If the water supply is acidic, it will eat away at the lead - and copper - overnight, so that your first water in the morning may hold high levels of both minerals. For this reason it is always a good practice to run the tap for a minute or so before using the filter first thing in the morning.

The Environmental Working Group makes a note about fluoridated water being harmful to babies' teeth, and says that the carbon filter of a Brita does not remove fluoride.  They suggest all water for babies' formula be made with water from a reverse-osmosis filter.

EWG also reminds us to change water filters on the recommended schedule.  A dirty filter can be worse than no filter at all, harboring bacteria as well as letting contaminants through.

I was especially shocked to hear there are a lot of hormones and drugs like Prozac and Viagra in ordinary drinking water!

Bottom line:  at my age I'm not going to do more than use the Brita pitcher, and perhaps now I'll use it for cooking and coffee too.  However, if I were raising young children and/or living in a home I planned to stay in for a few decades, I would look into getting the water tested and getting a full home system of some kind. 


 So, how am I going to drink more water?

Well, mainly I think it takes awareness.  I need to remember to go to the fridge and pour myself a nice cold glass of filtered water.  I'll be more likely to do that if I haven't had three or more large cups of coffee, so note to self:  cut back on coffee!  I did well drinking no coffee at all for the entire month of May.  That's a bit too drastic long-term, but I can go back to having a few coffee-free days each week.

Here are a few things I can do to make water seem more special:

Squeeze in a lemon wedge

Use my SodaStream to make sparkling water

Then add a few drops of raspberry or caramel or vanilla syrup 

Order a drink Mira introduced to me - sparkling lemonade - one-third lemonade and two-thirds club soda

Order San Pellegrino or Perrier and take it when we travel or visit friends

Order iced tea - unsweetened of course

Add a lot of ice to any other beverage.  Granted I shouldn't be drinking any Starbucks frappuccino, but at least with lots of ice is better than without! 

 
Carry my water bottle, filled from the Brita, and just drink it!

Water Tasting?

Did you know there are people who taste water like wine?  Here is an interesting article about Martin Reise, a water sommelier, certified by the German Water Trade Association, who holds water tastings.  It sounds like fun!




 

Healthy Products for our Bodies

My friend (and co-grandma of Mira), Charla, has been my role model for healthy living.  She's a great cook and gardener and makes her own healthy products for skin and body care.  Charla is also a writer and the author of a blog about writing and online dating!  You can check it out at Out Of My Mind.  This post is from Charla:


I am a believer in only putting organic and natural products in, and on, your body. Growing up in the science and consumer-mad ‘50’s and ‘60’s I am sure I was exposed to a lot of “supposed to be good for you” personal care items that were plainly just not.

I use vinegar to clean my floors and Bon Ami in my tub and sinks. Vinegar and baking soda followed by a pot of hot water has cleared many a drain in my home as well. 

I use Charlie’s Soap Powder exclusively for my laundry (www.charliesoap.com), which leaves the clothes soft without the need for a chemically enhanced fabric softener.

One of my favorite things is an air freshener that is so easy and cheap to make. All you need is a small plastic or glass spray bottle (the smaller one’s have a finer spray) filled with distilled or purified water and a few drops of your favorite essential oil or oil combination. My favorite is Lavender and Ylang Ylang.

From my friend and fellow writer Judy Manzone’s book, FamilyHoney, here is her recipe for:

Lip-gloss:

1/4 cup light oil (she recommends olive oil I use sweet almond oil)

2 tablespoons Shea Butter

2 tablespoons Cocoa Butter

2 tablespoons grated beeswax

Combine oil, Shea and cocoa butters in a small saucepan and heat slowly (or microwave on low in microwave-safe bowl) until clear. Grate in the beeswax and stir until melted.  If you are inclined you may use an eatable organic color or flavor at this time. Pour into small pots or decorative glass bowls.

From The Detoxinista (www.detoxinista.com), my favorite face and body cream. I have made it three times now and it gets better each time. I will note the changes I made and why. BTW, Detoxinista is one of my favorite go-to sites for vegan, paleo and gluten free goodies!

Favorite 2-ingredient Lotion

4 ounces raw Shea butter (I ordered what is pictured from Amazon. It is great)

2 tablespoons extra-virgin olive oil (I use sweet almond oil, also from Amazon, for a more moisturizing cream, olive oil can be drying. I also use 3 tablespoons to make a slightly softer lotion)

(Essential oil of your choice. I use Lavender and Ylang Ylang because it is one of my favorite combinations. A few drops of each should do it; everyone has a different nose. Shea butter, because of the way it is processed has a sort of burned smell to it, while not unpleasant, I prefer to scent the lotion for my tastes.)

Gently melt the Shea butter over the stove using a double boiler (oven safe bowl in a larger pan of water). Add the oil and put in the fridge until it is halfway solid, then whip with an electric mixer for about 5 minutes until fluffy looking and white. I put it in an easy open glass jar for quick access. If you add anything with alcohol or water in it, to make it thinner, this lotion will not keep long. You need to warm it between your hands before it spreads easily on your body.

Here is her recipe for:

Home made deodorant

2 tablespoons coconut oil

2 tablespoons Shea butter

1/3 cup baking soda

¼ cup arrowroot

6 drops pure essential lemongrass oil

Melt the cocoanut oil and Shea butter in a microwave safe bowl on low, or in a small saucepan on low. When melted, whisk in the baking soda and arrowroot powder, the stir in the essential oil and pour into a 4-ounce glass jar with airtight lid.

A caveat: I tried this and one other baking soda based deodorant but seemed to have a reaction. I have known others who use it with no problem. I prefer Pit Powder (by Muddy H2O on Amazon) or either of the Crystal deodorants. None of these irritate and seem to serve me well without the added preservatives and chemicals. Here is a picture of them.

I also have used a great tooth cleaning concoction from www.yogicameron.com, which tastes great and freshens your mouth as well. One part sesame oil mixed with one part licorice powder, premixed in small, lidded jar.  I bought licorice root and ground it in my coffee grinder

Another tip is to use an equal combination of Lavender oil and Tea Tree oil for toe and fingernail fungus. (ugh, but it had to be said)

Of course, you should try to use organic whenever possible.

Another added bonus to making your own products is that you don’t have the trash from store-bought containers and you have the personal satisfaction of knowing that you are not supporting chemicals and unsafe plastic packaging that can outgas into your home environment.

Have fun and experiment. It is freeing when you realize you don’t NEED to go buy something at the store!

By the way - Pam has a guest blog on my site, Out of My Mind,  that should be interesting  (and personal) to read!


P.S. from Pam:  Thank you Charla!  I look forward to trying out some of these products and recipes!