Thursday, July 23, 2015

Sleep Disturbances

Monday was my 27th month appointment for the PRESENT trial. This was an easy one. All they asked for was 6 tubes of blood and some urine.

In these five tubes they checked my cholesterol, triglycerides and normal basic metabolic profile. My labs came back normal and my triglycerides had improved. I found that surprising because I hadn't fasted for the test and ate mostly ice cream the day before (It was 90+ and humid, I don't cope well). So that is all good.

However, I am tired. Really tired. And I know that part of it from scheduling myself down to the second for the past 6 weeks. But, there is another large part of it.

My hormones are likely going awry.

According to the HOW study (Health of Woman) #2 Problems with Sleeping occurs in 49% of all breast cancer survivors. This is a far increase from 34% of all woman who overall list sleeping problems. Here is what happens for me. I have no problem falling asleep, but I cannot stay asleep. Last night for example I fell asleep at 8:45 pm. I then woke up at 10:15 pm. Then slept until 3:15 am. Then woke up every 10-15 minutes until my alarm went off and I went for a run. Or sometimes I will sleep until 2 or 3 in the morning and be awake for a couple of hours.

My room needs to be cool in order to sleep. I have to be able to have at least a sheet on or I will not be going to sleep. I use my sleep timer on the television like it's my job. It's quite handy to not have the tv wake me back up and I keep running. I try to run at least 4x a week, but lately its been more like 3 times a week.
And I've been reading up on some tips for menopausal symptoms. I found this article from Dr. Susan Love Research foundation that confirmed I need to keep my AC cranking.

On Monday, I dragged my ass into my appointment. The research RN asked me how I was feeling. I told her tired. She asked me about hot flashes and I told her thankfully still none. She asked me about when my thyroid was last checked. I told her April and it was normal. Then my Oncology NP came in. Her and I are quite friendly and she asked me how tired I was. She said that she noticed that I have been a lot more tired lately. She knows that I am frustrated with how slow I've been running (she and I had a brief chat after the Lahey 5K) and she asked me how I was sleeping.

Me: "Not well"
NP: "Trouble falling asleep?"
Me: "No, staying asleep"
NP: "Should we start melatonin or anything else?"
Me: "I don't want to."
NP: "Ok, but I'm going to be checking in on you"

And then she added the thyroid onto my labs. And called me an hour later to let me know it was normal.

For now, I'll make liberal use of my AC and TV. And hopefully catch a nap or two,or three.

Tuesday, July 14, 2015

Too much fun, too little reading

Sometimes in the Summer I like to do nothing, and sometimes I like to have myself so scheduled that I have no plans only one night of the week. I've been doing the latter and having a blast. However, this has put me way far behind on my breast cancer reading. Even though I'm long out of school, I still feel like I have required summer reading. Thanks to the Dr. Susan Love Research Foundation facebook page they've been keeping me updated on all the goings on in the breast cancer world. It also has demonstrated how far behind I'm getting in my reading.

Let's catch up a little.

Age of menarche may effect if breast cancer is ER positive or negative
African-American woman have a higher rate of ER negative breast cancer. This study looked at the probability of younger age of menarche and an increased rate of ER negative breast cancer. It found that it is probable that earlier age of menarche (as seen more in African American woman) can lead a woman to have ER negative breast cancer. I think this study is fascinating because it shows that the path to developing breast cancer might start when your younger. You can read the article recapping the study here.

How do we identify chemicals that can lead to breast cancer
This study looked at what methods are used to identify synthetic chemicals that could potentially lead to breast cancer. The researchers identified that a chemicals ability to damage genetic information as well as its ability to be an endocrine disruptor, were both categories that a chemical needed to be tested for. The researchers found that there were not many tests in order to identify the chemical's genotoxicity or endocrine disruptor function. The study also found that for existing methods there was not great data to back up those tests. This study concluded that better methods/tests are needed and identified places where the gaps were needed. Methods in which testing is done is important because we cannot identify causes of breast cancer if we cannot do consistent, well defined tests. A review of the study can be found here. Being able to identify genotoxic and endocrine disruptors likely has implications beyond breast cancer is well.

Just in case you needed yet another reason not to smoke...
For premenopausal woman, smoking increased your risk from dying from dying from breast cancer by a 3.4. And it was even more significant for ER/PR + cancer (like mine). Just another reason not to light up, among the hundred of thousands.

More reasons to just keep moving
Women who sit for work and also in their spare time, have hobbies that are sedentary, are 2.4 times more likely to develop breast cancer. This study followed woman over 25 years. I couldn't find the actual article but a summary can be found here. Which for me, this raises more questions about the causation of my own breast cancer, because I am hardly sedentary and a life long non-smoker. But, it is good motivation to just keep running.

Sleep quality effects long term survival in breast cancer patients
If you don't snore and sleep more than 6 hours a night your going to do better in the long run than those who snore and sleep less. Breast cancer survivors report sleep disturbances as one of the top items that effect their quality of life. It's recommended that if people are having sleep issues that they be investigated by specialists to identify the causes. Lately, I've been able to identify why my sleep has been lacking. It's called fun. But, truth be told even with all the fun the least amount I sleep at night is 6 hours. I usually aim for at least 8 and have been known to go to bed before 8 pm when I'm very tired.


Well at least that answers the pertinent question the Barenaked Ladies raised; it turns out cancer survivors need sleep.