Had some great progress this week that’s worth a share.

Nutrition

The transition off of the low-residue diet is going well! As I mentioned previously, the re-introduction of fiber-rich foods has to happen incrementally and intentionally. 

This week, I added back in: oatmeal, blueberries, strawberries, sweet potatoes, quinoa, a small amount of raw arugula and spinach, a handful of raw cherry tomatoes, almond flour crackers, almond flour chocolate chip cookies, Trader Joe’s protein granola, Dave’s Killer Bread, walnuts, and larger quantities of greek yogurt… with negligible GI changes and I feel better.

You guys. I’m so happy. It’s like a small part of my “old” self is back.

Things like lentils, beans, cruciferous veggies, and salads will come later—maybe some in my next recovery week. We’ll see how chemo week—when I have to dial back to a more anti-nausea focus—goes!

I think of it like this:
Chemo week→ dial back
Recovery week 1→ establish baseline
Chemo week→ dial back
Recovery week 2→ return to baseline, add 1% if no upset

*repeat*

And, frankly, this pattern can apply to everything I’m doing—being mindful, also, that my chemo side-effects are also cumulative. That said, we know what they say about plans!

I’ve also been adding electrolytes to my water at a level I’ve never done before. My body seems to love it even though it goes against what I’ve been taught. (Though, to be fair, chemo hydration seems to be a totally different ballgame.) I plan to check in with my oncologist and oncology dietician about this this week and am curious if I see any changes in my bloodwork as a result.

Boobs

I had to make another boob decision this week, in advance of a “fill” appointment with my plastic surgeon. The decision that needed to be made was: do I want to add a small implant to Right Boob (the non-cancer breast) to have better symmetry with the reconstructed, left, side? This would happen during the expander-to-implant swap surgery.

Why do this? In case you’ve never seen boobs, reconstructed boobs and implants are round at the top. Natural boobs slope at the top. So, if I were to put a small implant (because I don’t want to be bigger) in Right Boob, then both breasts would be rounded at the top and be more symmetrical—and symmetry is very important to me.

My plastic surgeon had told me you probably wouldn’t be able to tell the difference between my reconstructed breast and Right Boob when wearing a bra or a swimsuit, but you would naked (obviously).

But to test her theory, I’d have to do the really scary thing I’ve been avoiding: try on my swim suit tips and various bras and stare at myself in the mirror and think, “Do I like the way I look?” which brings up all kinds of thoughts about my self-esteem, my future sex life as a single person, my past sex life—shit I haven’t had the capacity to fully look at yet—though it pops in quite often.

Welcome to just one of the psychological effects of breast cancer.

And of having it very soon after a divorce.

So I did the hard thing.
A decision had to be made.

I decided to not add an implant to Right Boob.

Why? Though symmetry is so important to me, a tiny voice inside said, what if you don’t put your body through more than it has to this year? You can always do augmentation later.

And for once, it seems in my entire life, I chose the option of doing less.

At my appointment with my plastic surgeon, I got confirmation on how I could expect the left breast to look after the expander to implant swap and the final decision was made. Surgery will be set for the end of June.

And let me tell you, it was very reassuring to stand topless in the middle of her room for what seems like the billionth time—but is no longer so sad and so uncomfortable—and have her say, “You look good. Really good.”

And it’s pretty fun to be able to respond, “That’s all you girl!”

And, there is no doubt that the decision to lift Right Boob was the right one. That story is worthy of its own post—and, as you can see, a categorization as her own proper noun. She looks great.

Physical Therapy

Had my first PT re-eval this week. The numbers show real progress in my shoulder range of motion.

Reminder: 

Right side had the mastopexy
Left side had the mastectomy

They are:

Flexion (overhead reach) right went from 115° to 165°
Flexion left went from 90° to 154°

Abduction (side reach) right went from 115° to 165°
Abduction left (side reach) went from 75° to 135°

External rotation (90 degrees) right went from 50° to 65°
External rotation left went from 4°5 to 65°

Internal rotation (90 degrees) right went from 90° to 90°
Internal rotation left went from 90° to 90°

The goal, or “normal” looks like:
Flexion (overhead): ~160–180°
Abduction (side reach): ~160–180°
External rotation: ~70–90°
Internal rotation: ~70–90°

And you want these numbers to be as symmetrical as possible too.

Can’t wait to be “normal” again, you guys. 

My PT says I’ll get there before the expander-to-implant surgery—just in time to get knocked down again!

As always, you want to be in the best shape possible when you get knocked down—so where you land is higher than it would be if you hadn’t.

But here’s the thing about PT, or good PT: it’s not about just hitting the numbers, it’s about restoring functional movement.

Here’s a little list of the things I can do now that I couldn’t do when I walked into the doors of PT on Monday, March 2—three weeks post-op:

Reach for something on a top shelf, wash my hair, put on a shirt—a crewneck shirt, lean to my left and reach for the driver’s side door to close it, turn the steering wheel using my left arm, carry a bag of groceries, lay flat on my back, lay on my left and right sides…and more! Amazing.

The plan now is to continue to work on my range of motion and add light weights, focusing on endurance and not strength. We’re also adding some lower body work for conditioning since my entire body took a hit post-surgery and now in chemo. This is where I feel like I’m struggling the most in my day-to-day right now. For example, I want to be more confident walking more than Toby’s walk route two times per day.

As my PT said, “we’re working on endurance now, not strength.”

I was like, girl. You have no idea the kind of endurance I need. 

That, too, is worth of post after post after post—one tiny step at a time over and over through more chemo, two more surgeries, more chemo, more infusions, and so on.

In the trajectory of my life over the last year, we went from strength, to a marathon, to an ultramarathon.

Seeing these small wins is what keeps me going.