I always talk about intuition, knowing your body, trusting your gut and being your own advocate. A lesson I learned in 2011 when I was told cancer does not cause pain, and yet there I was with a DCIS diagnosis, and here I am learning that lesson yet again. Back in December 2017, I went to my plastic surgeon complaining of pain in my breast. I didn’t know which doctor to see but thought it had something to do with the implants from my bilateral mastectomy and reconstruction 6 years earlier. He checked, saw nothing, and sent me for a CT. The CT did not show anything. I was disappointed that I could not  get an explanation for my pain. It was not nothing, I knew it. But I let it go because there were so many other things going on. By August, I couldn’t deny or hide the pain anymore. It became so intense that it forced me to slam on the brakes with 3 of my girls in the car and grab my breast and try not to cry in front of them. It scared them nonetheless. I knew I had to get an answer. My husband and I went to see my GP. She could not feel anything or see anything but she trusted my pain. She took the steps necessary. She sent me for an ultrasound that came back clean. She then sent me for an MRI. I was set up for one in October, having to wait until I got my period to schedule it, with and without contrast. I made sure both were back to back so I did not have to make two trips. I went for the MRI only to find out that the radiologist canceled my contrast one. I was irritated because I specifically had to wait the extra month to be able to get both done and I really felt I needed the contrast to see what was really going on. I was told if the MRI came back clean, they would have me come back the following Monday (this was a Thursday) for the contrast. Ugh! I called my doctor the next day for the results. She was told that both my implants had ruptured, the right side right where I was showing the pain. So off to the plastic surgeon I went again. He was surprised, said that ruptures usually don’t present with pain. He really believed it had nothing to do with the implants. Regardless, they had to come out. I was torn with the decision of replacing them or not, fully believing there was something causing the pain. My concern was if it was BIA-ALCL, or an infection, do I really want them back in….but it was the easier procedure, quickest recovery. So I made a deal with him, they could go back in unless he saw evidence of mold, infection, BIA-ALCL, or anything suggesting that the implants were the cause of my pain. He agreed, stating that he did not believe that would be the case.

On December 11, 2018, he prepared for a 3 hour surgery. All marked up, I was wheeled off to the surgical room in tears, still not happy with my decision. Less than 3 hours later, not only was I out of surgery, I was awake. The surgery only took a little over an hour. He told Dave that all looked good but he removed a large amount of scar tissue and sent a big chunk off to pathology. He saw me briefly and told me that the implants were not even ruptured, he does not know what they saw on the MRI but the implants were intact. He replaced them anyhow, adjusted my chest wall to make more room, in hopes of alleviating whatever may have been causing the pain. He asked me at my follow up if I felt better. I told him I don’t know. There was all the obvious pain from surgery, which actually was not too bad and I was off the pain killers after a day, but I don’t know if I feel better, emotionally or physically. Something was causing that pain and I had no answers for it. That never sits well with me. He repeated that ruptures don’t cause pain, that there were no ruptures, that everything looked clean and that he didn’t see any concerns but we would wait for the results of the pathology. I still felt something was wrong. I did not feel relieved, I actually felt like my sister with my raspy voice from the surgery, under my blanket, not being able to shake this feeling. I tried though, I hoped it was just the scar tissue causing the pain, or the tightness of the skin from the radiation like he suggested though it made no sense that it only started to hurt 6 years, now  7 years later……well, today, Dec 18, 2018, what is supposed to be luck in the Jewish world because it is double chai, my poor plastic surgeon had to call, while on vacation, at 8 o’clock at night, to deliver news he probably never had to deliver before, that I had cancer. You know, the whole first round, they never called it cancer. Initially a radiologist told me I had to stay for an ultrasound because they thought I had cancer,  but after that it was always DCIS. This time he called it invasive cancer. He said the tissue he sent to pathology looked abnormal, it was part of the encapsulated part of the breast (he actually never told me that and only told Dave  that he sent a big chunk of scar tissue off), and that was what came back as invasive. I have invasive ductal carcinoma, grade 3, poorly differentiated. That is all we know right now.

So, I was right in knowing something was wrong, again, I trusted my intuition, I 

pushed, I advocated for myself, I got answers. I just hope they did not come too late…

Today marks the first day of Breast Cancer Awareness Month. I am a 7.5 year survivor of the earliest stages of breast cancer. Though I live with the daily reminders of having had a bilateral mastectomy and reconstruction that is starting to show some negative side effects, I consider myself lucky. I also worry about reoccurrences and spend a lot of time researching and applying my knowledge to my daily life so as to try to prevent that from happening.

After 5 years of walking in the Avon Walk for Breast Cancer, I have heard many stories of those who we lost to this disease and those of survivors. What shocked me was the number of survivors who went through more than one battle with this disease. It made me realize that I will always be at risk for a reoccurrence and I may not catch it as early the next time.

What I have learned in my education and research is that there are many factors that may have caused my breast cancer, but there is also a lot of conflicting information. The following is what makes sense to me.

I have learned that I carry the KRAS genetic mutation which, according to Joanne Weidhass’ research, puts me at a greater risk for developing both breast and ovarian cancer. I have learned that I was likely in an estrogen dominant state that may have contributed to my development of breast cancer. I have learned that eating soy, which I ate a lot of as a vegetarian thinking it was a healthy form of protein, likely put me into an estrogen dominant state. (There are arguments being made that eating soy can actually protect your risks of breast cancer but that is a separate debate for me to tackle in another post).  I have learned that eating sugar of any kind, in excess, can create a positive environment for the cancer cells to grow and thrive. I have also learned that eating sugar can put a person into an inflammatory state so that the immune system is weakened thereby allowing the cancer cells to grow. I have also learned that eating any foods that a person may have a personal sensitivity to can put the body into this same inflammatory state and thereby compromising the immune system.

My personal conclusion is that there had to be a flurry of circumstances, all coming together at the right time, to have allowed my preexisting cancer cells to express themselves. Due to my KRAS variant, I had existing cancer cells, but it was my lifestyle that caused their expression. I believe that eating soy, sugar, and white carbs all worked together to put my body into both an inflammatory state and estrogen dominant state. I have since learned that I have Celiac Disease which means that every time I ate gluten, I damaged my GI system, inflamed it, and thereby weakened my immune system so it could not fight off the cancer cells that should have died through apoptosis but instead were thriving because I was feeding them. It was my epigenetics brought on by my dietary lifestyle that I believe caused me to develop early stage breast cancer, and it was my self-advocacy that helped me discover at its earliest stages.

As I mentioned earlier, I still consider myself lucky. I caught it early, I went extreme with surgery and radiation, and I am 7.5 years out. But I know the risks of reoccurrence are real so I work every day to try not to replicate that host of circumstances that led to its original growth. I have learned which foods are inflammatory for me and have removed them from my diet. I have significantly reduced the amount of sugar I eat, well below the recommended 6tsp a day. Most days I don’t have any added sugar but there are days that I eat out or I am in the mood for a little sweetness, but I still stay under the recommended amount. I avoid soy at all costs. I drink my recommended amount of water daily. I try to eat as well as possible for my diet, including as many veggies, proteins, and good fats that I can.  I supplement my diet with chemical, gluten, soy, sugar, and food dye free vitamins based on my personal needs, to fill in the nutritional gaps I have. I exercise 5 days a week and I try to handle my stress as much as I can when in a house of 5 children and multiple pets. I also make every effort to get 7-8 hours of sleep each night, not always successfully, but I try. These are all actions I can take to ensure that I am doing everything I can to prevent a reoccurrence.

I share this because I truly feel that these actions will help me thrive and I believe it can help others as well. Learning which foods may be putting you into an inflammatory state and then removing them from your diet can be one of the best actions you can take for your body. Removing added sugar is another actionable item anyone can take.  Eating foods that are anti-inflammatory, and filled with healthy macro and micronutrients, is key to building up a healthy microbiome and strengthened immune system. Adding vitamins to fill in those nutritional gaps that we all have for one reason or another will help provide a complete diet plan. Learning how to reduce stress and increase sleep also helps balance your hormones to keep you out of a state of inflammation. Getting enough sleep will put all your actions into effect.

Want to learn more on how you can help protect your health? Please feel free to reach out to me and we can talk more.

Three Must Eat Break-Fast Foods

Many question whether breakfast is as important as we hear it is. Those who practice intermittent fasting say it is ok to bypass the breakfast meal. Others will argue that breakfast is the most important meal of the day and you can’t function properly without it. I am in neither camp. I do believe though that your first meal of the day, whenever you choose to eat it, is the meal that will break your fast, hence, breakfast or break-fast. What you eat when you choose to break your fast is very important.

Getting some protein at each meal can help with blood sugar management, metabolism, and weight loss. This is because protein helps you feel fuller longer and uses up a bunch of calories to absorb and metabolize it. So I’m going to show you how to get the protein, as well as some veggies and healthy fats for your soon-to-be favorite new “go-to” breakfasts.

Breakfast Food #1: Eggs

Yes, eggs are the “quintessential” breakfast food. And for good reason! No, I’m not talking about processed egg whites in a carton. I mean actual whole “eggs”. Egg whites are mostly protein while the yolks are the real nutritional powerhouses. Those yolks contain vitamins, minerals, antioxidants, and healthy fats. Eggs have been shown to help you feel full, keep you feeling fuller longer, and help to stabilize blood sugar and insulin. Not to mention how easy it is to boil a bunch of eggs and keep them in the fridge for a “grab and go” breakfast when you’re running short on time. And…nope the cholesterol in eggs is not associated with an increased risk of arterial or heart diseases. One thing to consider is to try to prevent cooking the yolks at too high of a temperature because that can cause some of the cholesterol to become oxidized. It’s the oxidized cholesterol that’s heart unhealthy.

Breakfast Food #2: Nuts and/or Seeds

Nuts and seeds contain protein, healthy fats, vitamins, minerals, and fiber. Nuts and/or seeds would make a great contribution to breakfast. You won’t be fooled by “candied” nuts, sweetened nut/seed butters, or chia “cereals” with added sugars – you know I’m talking about the real, whole, unsweetened food here. Nuts and seeds are also the ultimate fast food if you’re running late in the mornings. Grab a small handful of almonds, walnuts, or pumpkin seeds as you’re running out the door; you can nosh on them while you’re commuting. Not to mention how easy it is to add a spoonful of nut/seed butter into your morning breakfast smoothie. Hint: If you like a creamy latte in the mornings try making one with nut or seed butter. Just add your regular hot tea and a tablespoon or two of a creamy nut or seed butter into your blender blend until frothy.

Breakfast Food #3: Veggies

Yes, you already know you really should get protein at every meal including breakfast; but this also applies to veggies. You know I would be remiss to not recommend veggies at every meal, right? Veggies are powerhouses of vitamins, minerals, antioxidants, phytochemicals, fiber, and water. You can’t go wrong adding them into every single meal of the day so if you don’t already you should definitely try them for breakfast! And no, you don’t need to have a salad or roasted veggies for breakfast if you don’t want to but you totally can! You wouldn’t be breaking any “official” breakfast rules or anything like that. Adding some protein to leftover veggies is a great combination for any meal. Including breakfast. I’ve included a delicious recipe below for you to try (and customize) for your next breakfast. Recipe (Eggs Veggies): Veggie Omelet Serves 1 1 teaspoon coconut oil 1 or 2 eggs (how hungry are you?) ¼ cup veggies (grated zucchini and/or sliced mushrooms and/or diced peppers) dash salt, pepper and/or turmeric Add coconut oil to a frying pan and melt on low-medium heat (cast-iron pans are preferred). In the meantime grab a bowl and beat the egg(s) with your vegetables of choice and the spices. Tilt pan to ensure the bottom is covered with the melted oil. Pour egg mixture into pan and lightly fry the eggs without stirring. When the bottom is lightly done flip over in one side and cook until white is no longer runny. Serve Enjoy! Tip: Substitute grated, sliced, or diced portion of your favorite vegetable. Try grated carrots, chopped broccoli or diced tomato.

References:

http://www.precisionnutrition.com/eggs-worse-than-fast-food

http://www.precisionnutrition.com/encyclopedia/food/eggs/

https://authoritynutrition.com/eating-healthy-eggs/

https://authoritynutrition.com/12-best-foods-to-eat-in-morning/

Five Cholesterol Myths and What to Eat Instead

You knew there was a bit of an over-emphasis (borderlining obsession) about cholesterol, right?

Before we jump into some myths let’s make sure we’re on the same page when it comes to what exactly cholesterol is.

Myth #1: “Cholesterol” is cholesterol
While cholesterol is an actual molecule, what it is bound to while it’s floating through your blood is what’s more important than just how much of it there is overall. In fact depending on what it’s combined with can have opposite effects on your arteries and heart. Yes, opposite!

So cholesterol is just one component of a compound that floats around your blood. These compounds contain cholesterol as well as fats and special proteins called “lipoproteins”.

They’re grouped into two main categories:

HDL: High Density Lipoprotein (AKA “good” cholesterol) that “cleans up” some of those infamous “arterial plaques” and transports cholesterol back to the liver.
LDL: Low Density Lipoprotein (AKA “bad” cholesterol) that transports cholesterol from the liver (and is the kind found to accumulate in arteries and become easily oxidized hence their “badness”).
And yes, it’s even more complicated than this. Each of these categories is further broken down into subcategories which can also be measured in a blood test.

So “cholesterol” isn’t simply cholesterol because it has very different effects on your body depending on which other molecules it’s bound to in your blood and what it is actually doing there.

Myth #2: Cholesterol is bad
Cholesterol is absolutely necessary for your body to produce critical things like vitamin D when your skin is exposed to the sun, your sex hormones (e.g. estrogen and testosterone), as well as bile to help you absorb dietary fats. Not to mention that it’s incorporated into the membranes of your cells.

Talk about an important molecule!

The overall amount of cholesterol in your blood (AKA “total cholesterol”) isn’t nearly as important as how much of each kind you have in your blood.

While way too much LDL cholesterol as compared with HDL (the LDL:HDL ratio) may be associated with an increased risk of heart disease it is absolutely not the only thing to consider for heart health.

Myth #3: Eating cholesterol increases your bad cholesterol
Most of the cholesterol in your blood is made by your liver. It’s actually not from the cholesterol you eat. Why do you think cholesterol medications block an enzyme in your liver (HMG Co-A reductase, to be exact)? ‘Cause that’s where it’s made!

What you eat still can affect how much cholesterol your liver produces. After a cholesterol-rich meal your liver doesn’t need to make as much.

Myth #4: Your cholesterol should be as low as possible
As with almost everything in health and wellness, there’s a balance that needs to be maintained. There are very few extremes that are going to serve you well.

People with too-low levels of cholesterol have increased risk of death from other non-heart-related issues like certain types of cancers, as well as suicide.

Myth #5: Drugs are the only way to get a good cholesterol balance
Don’t start or stop any medications without talking with your doctor.

And while drugs can certainly lower the “bad” LDL cholesterol, they don’t seem to be able to raise the “good” HDL cholesterol all that well.

Guess what does?

Nutrition and exercise, baby!

One of the most impactful ways to lower your cholesterol with diet is to eat lots of fruits and veggies. I mean lots, say up to 10 servings a day. Every day.

Don’t worry the recipe below should help you add at least another salad to your day.

You can (should?) also exercise, lose weight, stop smoking, and eat better quality fats. That means fatty fish, avocados and olive oil. Ditch those over-processed hydrogenated “trans” fats.

Summary:
The science of cholesterol and heart health is complicated and we’re learning more every day. You may not need to be as afraid of it as you are. And there is a lot you can do from a nutrition and lifestyle perspective to improve your cholesterol level.

Recipe (Dressing to go with your salad): Orange Hemp Seed Dressing

Makes about ¾ cup

½ cup hemp seeds

½ cup orange juice

1 clove of garlic, peeled

dash salt and/or pepper

Blend all ingredients together until creamy.

Serve on top of your favorite salad and Enjoy!

Tip: Store extra in airtight container in the fridge. Will keep for about a week.

References:

http://www.precisionnutrition.com/all-about-cholesterol
http://summertomato.com/how-to-raise-your-hdl-cholesterol
https://authoritynutrition.com/top-9-biggest-lies-about-dietary-fat-and-cholesterol/

Coffee – Who can drink it and who should avoid it?

Coffee is one of those things – you either love it or hate it. You know if you like the taste or not (or if it’s just a reason to drink sugar and cream). You know how it makes you feel (i.e. your gut, your mind, etc.).

Not to mention the crazy headlines that say coffee is great, and the next day you should avoid it!

There is actual science behind why different people react differently to it. It’s a matter of your genetics and how much coffee you’re used to drinking.

NOTE: Coffee does not equal caffeine. Coffee contains between 50-400 mg of caffeine/cup, averaging around 100 mg/cup. Coffee is one of the most popular ways to consume this stimulant. But… a cup of coffee contains a lot of things over and above the caffeine. Not just water, but antioxidants, and hundreds of other compounds. These are the reasons drinking a cup of coffee is not the same as taking a caffeine pill. And decaffeinated coffee has a lot less caffeine; but, it still contains some.

Let’s look at caffeine metabolism, its effects on the mind and body, and whether coffee drinkers have higher or lower risks of disease. Then I’ll give you some things to consider when deciding if coffee is for you or not.

Caffeine metabolism

Not all people metabolize caffeine at the same speed. How fast you metabolize caffeine will impact how you’re affected by the caffeine. In fact, caffeine metabolism can be up to 40x faster in some people than others.

About half of us are “slow” metabolizers of caffeine. We can get jitters, heart palpitations, and feel “wired” for up to 9 hours after having a coffee. The other half is “fast” metabolizers of caffeine. They get energy and increased alertness and are back to normal a few hours later.

This is part of the reason those headlines contradict each other so much – because we’re all different!

The effects of coffee (and caffeine) on the mind and body

NOTE: Most studies look at caffeinated coffee, not decaf.

The effects of coffee (and caffeine) on the mind and body also differ between people; this is partly from the metabolism I mentioned. But it also has to do with your body’s amazing ability to adapt (read: become more tolerant) to long-term caffeine use. Many people who start drinking coffee feel the effects a lot more than people who have coffee every day.

Here’s a list of these effects (that usually decrease with long-term use):

• Stimulates the brain
• Boosts metabolism
• Boosts energy and exercise performance
• Increases your stress hormone cortisol
• Dehydrates

So, while some of these effects are good and some aren’t, you need to see how they affect you and decide if it’s worth it or not.

Coffee and health risks

There are a ton of studies on the health effects of coffee, and whether coffee drinkers are more or less likely to get certain conditions.

Here’s a quick summary of what coffee can lead to:

• Caffeine addiction and withdrawal symptoms (e.g. a headache, fatigue, irritability)
• Increased sleep disruption
• Lower risk of Alzheimer’s and Parkinson’s
• Lower risk of developing type 2 diabetes
• Lower risk of certain liver diseases
• Lower risk of death (“all cause mortality”)
• Mixed reviews on whether it lowers risks of cancer and heart disease

Many of the health benefits exist even for decaf coffee (except the caffeine addiction and sleep issues).

NOTE: What’s super-important to note here is that coffee intake is just one of many, many factors that can affect your risks for these diseases. Please never think regular coffee intake is the one thing that can help you overcome these risks. You are health-conscious and know that eating a nutrient-rich whole foods diet, reducing stress, and getting enough sleep and exercise are all critical things to consider for your disease risk. It’s not just about the coffee.

Should you drink coffee or not?

There are a few things to consider when deciding whether you should drink coffee. No one food or drink will make or break your long-term health.

Caffeinated coffee is not recommended for:

• People with arrhythmias (e.g. irregular heartbeat)
• People who often feel anxious
• People who have trouble sleeping
• People who are pregnant
• Children

If none of these apply, then monitor how your body reacts when you have coffee. Does it:

• Give you the jitters?
• Increase anxious feelings?
• Affect your sleep?
• Give you heart palpitations?
• Affect your digestion (e.g. heartburn, etc.)?
• Give you a reason to drink a lot of sugar and cream?

Depending on how your body reacts, decide whether these reactions are worth it to you. If you’re not sure, I recommend eliminating it for a while and see the difference.

Recipe (Latte): Pumpkin Spice Latte

Serves 1

3 tbsp coconut milk
1 ½ tsp pumpkin pie spice (or cinnamon)
¼ tsp vanilla extract
1 tbsp pumpkin puree

½ tsp maple syrup (optional)
1 cup coffee (decaf if preferred)

Instructions

Add all ingredients to blender and blend until creamy.
Serve & enjoy!

Tip: You can use tea instead of milk if you prefer.

References:

https://authoritynutrition.com/coffee-good-or-bad/
http://www.precisionnutrition.com/all-about-coffee
http://www.health.harvard.edu/staying-healthy/a-wake-up-call-on-coffee
http
://www.health.harvard.edu/blog/can-your-coffee-habit-help-you-live-longer-201601068938
http://suppversity.blogspot.ca/2014/05/caffeine-resistance-genetic.html
https://authoritynutrition.com/how-much-coffee-should-you-drink/