bone loss: a public service announcement

I have been reading Cancer Fitness by Anna L. Scharwtz. I'm only a few chapters in, but the book has already taught me some important things.

I don't tend to devote a lot of thought to preventing bone loss but I did know that regular weight-bearing exercise helps prevent bone loss and to build strong bones. And while I walk and run (just finished the Running Room's beginner program again), I really don't do any strength training (or core work, for that matter, despite repeated promises to myself).

The women in my family tend to have strong bones (and good bone density) but what I didn't realize was how many factors put me at risk:

• early menopause, as a result of chemotherapy.


• doxorubicin (Adriamycin, the infamous "red devil). I had 6 rounds (this is also the drug that temporarily damaged my heart).


• decadron and other steroids (I had higher doses with the first 6 rounds of chemo but I still get decadron through IV with every chemo treatment, to help mitigate side effects).


• lorazepam (Ativan, which I use only occasionally for insomnia. I had absolutely no idea that it caused bone loss)


• regular consumption of caffeine.

And I don't drink very much milk, either.

Remember, that promise to myself I made in January? Well, I have not made as much progress as I would like. So, I signed up for a fitness class at my local community centre that incorporates core work and strength training (since the free weights, stability ball and exercise bands don't seem to be doing much more than collecting dust) to get myself started. Now, I have another reason to get to it.

I also took a calcium supplement today for the first time in months. Those suckers are horse pills but I think I need to get back into the habit of choking them down.

What are you doing to prevent bone loss?

taking care of my body in 2009: part 6 (or you have to be ready)

First of all, let's review the goals I set for myself last month:

1-Walk VIGOROUSLY for an average of one hour, five times per week (300 minutes a week).

This is a good place to start, since I did well, accomplishing this goal and exceeding it. Next month, I may think about doing something to ratchet up the intensity.

For now, I am also riding my bike around town. As a result, I have a sore rear end. I am sure this will get better.

2- Do either 10 minutes (at least) of strength training or yoga with the Wii Fit or abdominal exercises every day (chemo recovery days excluded).

I did this only 4 times. I also hurt my back this month, pulling my suitcase down from a shelf on the train. I was in a hurry and not paying attention. It was a bit of a wake-up call about the need to improve my core strength.

To that end, I saw my physiotherapist again on Monday. She surprised me by saying that, when it comes to my back, the stiffness in my hips is a bigger problem (she actually said, only half-joking that she is surprised that I can walk). She said it she hasn't seen anyone as stiff as I am in a long time.

So, I now have some stretches that I need to do regularly in addition to the core strengthening.

3-Go to yoga once every week.

I didn't go at all in May. And despite the fact that my physio says that she sees "a lot of yoga in my future" I think that I may not go again until the fall.

It's becoming harder to find a class I can attend regularly (and this will only get worse over the summer, with fewer classes and the kids around more). And I don't really want to go back to the class I have attended the most regularly (the timing is good but the teacher, always more impatient than most, actually yelled and swatted another student the last time we went. It was a bit of a turnoff).

Besides, I feel that I have a lot on my fitness plate right now.

4- Take my vitamin D and calcium supplements daily.

I didn't do this in May either but I am 2 for 3 in June. And going to take them with lunch, I promise.

Now for the big change. I have decided to start doing the Weight Watchers thing again. It's a program that has worked for me before (I lost almost 50 lbs after D. was born) and I feel ready to do it again.

I know I said this last year but this time I have a support group, comprised of two good friends who also would like to get down to their pre-breast cancer diagnosis weight. For four weeks now, we have been weighing in every Monday. They are both doing WW and I have just been reporting on exercise and my quest to eat more veggies.

Then, on the weekend, I admitted to myself that I have the best success when I write everything down that I put in my mouth. And I also realized that I am ready to do this. It wouldn't have done me any good to start earlier in the year. I am ready now. And it feels like the right thing to do.

I did check with my doctor. The conversation went like this:

Me: "I am thinking of making some changes to try and take off some of the weight I have been putting on since my diagnosis..."

Dr.: "Have you considered Weight Watchers?"

So, clearly I have the green light to do this now. And I don't have the discipline to do this any other way than really slowly.

This process will also help me reach these goals:

5-Cook dinner at least once a week.

Easier to count points if I know what went into dinner. Easier to stretch those points out if I prepare lower points options for all of us.

6-Cut down on refined sugar.

I really don't want to waste points on empty calories.

7-Eat seven servings of fruit and veggies a day.

Conversely, filling up on fruit and veggies makes those points go further.

As you can see, I have all the zeal of someone on the third day of a diet. And I'm hungry.

I need to make vegetable soup today.

What goals did you set for yourself this year? How are you doing?

taking care of my body in 2009: part 5

Alternative title: "a mixed bag"

Alternative title: "doritos do not make a healthy lunch"

Alternative title: "time to bring in some support"

As my first alternative title suggests, I have had some mixed success this month, in my quest to "treat my body as well as I treat my mind" in 2009.

Let's review, shall we?

1-Walk VIGOROUSLY for an average of one hour, five times per week (300 minutes a week).

I did very well on this front, meeting my goal and exceeding it. I am especially pleased, given that I had such a terrible cold for a while. And I am very proud of the fact that I went for a long walk every day that I was at the Conference for Women Living With Advanced Breast Cancer (near Philly). I walked after checking in at the hotel, at the end of a long day on Saturday and organized a late check-out so that I could walk again before going to the airport.

2-Go to yoga once every week.

I went twice. I can definitely do better. I did have semi-valid excuses (conflicts and a head cold that made it impossible for me to bend down) but really, I can do better.

I'm going Wednesday morning, OK? I'll report back afterwards.

3. Do either 10 minutes (at least) of strength training or yoga with the Wii Fit or abdominal exercises every day (chemo recovery days excluded).

I used the Wii Fit once. I did the abdominal exercises three times (every day when I was away and then not again). Yeah, I caught a cold and then had chemo. But there were lots of days I could have worked at it and didn't.

I think I will lower the bar to 5-10 minutes and try again.

And that's the good news.

4-Cook dinner at least once a week.
5-Cut down on refined sugar.
6-Eat seven servings of fruit and veggies a day.
7- Take my vitamin D and calcium supplements daily.

When it comes to input, things have been a little out of control.

The dinners I "cooked" were as instant as possible.

I have eaten more sugar and fried stuff in the last month than I have in a very long time (Easter, Passover, travelling and my son's birthday provided the excuse). And the volume of food has vastly exceeded my needs.

The whole fruit and veggie thing has been extremely haphazard. I stopped keeping track but I'm probably averaging three servings a day (if I am incredibly generous in my calculation).

I can't remember the last time I took the lid off a supplement.

Clearly, it's time for some more drastic action.

I'm not talking about buying into the beauty myth or wanting to look like Posh Beckham. I just need to take better care of myself.

My lymphedema is worse and has started to be painful.

The bigger pants I bought are becoming tight.

I have aches and pains in my joints.

I feel sluggish and run down.

Now, I know not all of this is attributable to diet (early menopause and chemo are playing a role) but I do have control over what goes into my mouth.

I keep attending workshops on diet and nutrition, as it relates to cancer (went to another excellent one at the conference I have yet to write about) and I have years of Weight Watchers and reading obsessively about diets under my belt.

Going back to Weight Watchers might help (I tried doing the online last year and without a person to hold me to account, it was a bust) but we really can't afford it right now and the idea of dragging my ass to meetings is extremely unappealing.

So, my friend C. (who is feeling much as I have been) and I have hatched a plan. We are going to track what we eat, weigh in weekly and report in to each other. And then we'll have a little mini-meeting about what things are working for us and why other things might not be. My goals for this month aren't changing (no specific weight loss goal and I won't count points) but I will keep careful track of my promises to myself.

This kind of accountability has worked for me when it comes to my writing goals so it can only help on the health front. When I was meeting with my coach in January (without whom I would never have finished the book, started writing fiction or done so many other things that made me feel happy and purposeful in 2008), I set the following goals for the year:

I want to fit back into my pre-diagnosis pants (two sizes smaller than my current ones).

I want to have a strong core.

I want to feel fit and strong.

I think these goals are realistic and achievable. I just need to keep my eye on the prize.

Going to go throw out the empty Doritos bag and weigh myself with the Wii Fit now.

you in?

Of all the things that we can do to help prevent cancer, the evidence that exercise provides enormous benefits continues to mount (and yes, I know we all know folks who were really fit who still got cancer). The magic number is 180 minutes a week (and yes, I know I have said this before. It just bears repeating). You need to break a sweat but you don't need to do all the minutes at once (in fact, you really should spread them out through the course of the week).

So just get out there, OK? Put one foot in front of the other. Go for a swim. Take a class. Jump rope. Do a little pole dancing, if that's your thing (and it is for many, if the popularity of the course at my local community centre is any indication). Just move.

And yeah, it would be a whole lot easier if the weather would cooperate. My walks have been considerably shorter since the snow started falling again.

Accountability Time (or taking care of my body in 2009: part 4).

I didn't make a whole lot of progress in March but I am pulling up my socks and getting back on the horse (and mixing a whole lot of metaphors while I am at it).

Let's review the commitments I've made so far, shall we?

1-Walk VIGOROUSLY for an average of one hour, five times per week (300 minutes a week).

I almost made it. In fact, I came just under 100 minutes short for the month. All things considered (illness, chemo, travelling), that's not too bad.

2-Eat seven servings of fruit and veggies a day.

Not even close, although there were some good days. And we ate well in Florida. I need to focus a bit more on this one.

3-Cook dinner at least once a week.

It depends on how you define 'cooking dinner.' We've been eating way too much junk and prepared foods around here lately. However, I am certainly taking much more responsibility (as compared to almost no responsibility) for the family dinners (and I do that more than once a week).

The last couple of weeks have not been great but if I take a longer view, I am doing much more (and healthier) cooking than I have in my life.

4-Go to yoga once every week.

I went twice in the last five weeks. Not good enough. Especially since I am paying for 8 week sessions.

5-Cut down on refined sugar.

Well, if the goal had been to increase my sugar intake to the point that I felt well and truly addicted and jittery and my pants were getting tighter, I would have done very well.

It all started on the road trip. I would get treats for the kids and a little something for myself. And then the if the kids didn't like the chocolate (my big weakness) I got them then I would get them something else. But a chocolate bar shouldn't go to waste, right? I think my all-time low was the day I ate half a Three Musketeers, half a Milky Way and one and a half of those chocolate bars they sell at the cash at Starbucks.

Or maybe my low point was sending my oldest son to the corner store in the rain last night to get me an Easter Cream Egg (this was after my spouse had failed to return with one for me from the grocery store).

The truth is that for me, sugar is addictive. Once I have a little bit, then I just want more. And I really don't like how it makes me feel.

So it's time to stop.

Except for the organic, vegan chocolate bar that came in the mail today. Raw, organic cane sugar doesn't count, right?

4- Take my vitamin D and calcium supplements daily.

I may have remembered three times. I did get lots of Vitamin D from the sun in Florida, though.

5. Do either 10 minutes (at least) of strength training or yoga with the wii fit or abdominal exercises every day (chemo recovery days excluded).

I did five minutes of abdominal crunches. Once.

But I plan to go and use the Wii Fit (I did buy the thing) right after I finish writing this. Or at some point this evening. Really.

OK. So there is lots of room to improve here. I promised myself that I would end 2009, feeling healthy, fit and strong. Time to renew this commitment.

And I don't think I will make myself any new promises this month. I just need to actually fulfill the old ones.

How about you? How are you doing with the goals you set for 2009?

small changes, small successes.

I had just experienced the first concrete encouraging sign in my journey of small changes.

I tend to spend the couple of days after chemo in pajamas. After spending all day pulling up my pjs, (the drawstring seems to have gone missing) it occurred to me that they might be getting too big. I pulled out a pair of pajamas that my parents had given me for Christmas that had been too tight to fit comfortably. I pulled them up easily and I'm wearing them now.

The thing is, this encouraged me to do something else that was healthy. As a pre-dinner snack, I had been considering toast or a granola bar. Instead, I had an orange.

I am inordinately pleased with these developments.

taking care of my body in 2009: part 3

My one New Year's resolution this year was to start "treating my body as well as I've been treating my mind." However, I decided that the best way to go about making these changes stick was by taking very small steps.

You can read my review of January here.

Here's how I did with February's goals:

1-Walk VIGOROUSLY for an average of one hour, five times per week (300 minutes a week).

I fell short by almost 300 minutes (or almost a week's worth of walking) this month. However, given the fact that I got the flu after chemo and that I travelled and attended a conference, I am not being too hard on myself.

I am also mightily impressed that I took breaks from the conference to walk (doing loops around the little track in the back of my hotel) on the non-travel days that I was in Texas. My walks have also become more vigorous and I miss them on the days I don't get out.

One of the things I learned last week end is that the body of evidence that exercise helps prevent the recurrence of cancer continues to grow. And studies show that all you need (in terms of cancer prevention) is 180 minutes a week. I am doing that, easily.

2-Eat seven servings of fruit and veggies a day.

I am struggling with this one but continue to work at it.

Another thing I learned at the breast cancer conference is that the consumption of fruit and vegetables does not seem to be as effective in terms of cancer prevention as scientists first thought. However, they do help prevent heart disease and with weight control (and there is a link between obesity and cancer prevention).

3-Cook dinner at least once a week.

I am doing pretty well in this area. I am also pleased to find that cooking is becoming more intuitive and that I don't always have to rely on cookbooks to figure out what can work.

I would like to cook more vegetarian dishes that my kids will eat, though.

4-Go to yoga once every week.

I went twice in four weeks. One week I had the flu and then, this past Monday, I was just too exhausted after attending an intense conference all week end and then arriving home after 1:00 in the morning.

This month, I'll aim for four times, which will mean making up for the classes I miss when we're in Florida (we are going to visit my in-laws in Sarasota).

5-Cut down on refined sugar.

I caved a few times (less than a dozen) and generally, only when the treat was really worth it. And when I was really hungry in the airport, I ate two oatmeal rains cookies. I do feel better when I don't eat sugar so I am going to keep working on this one.

4- Take my vitamin D and calcium supplements daily.

I remembered to do this about half the time.

I think I need to keep my goals very modest this month, in order to entrench the steps I have already taken. Our vacation, while therapeutic in other ways (if the kids don't drive each other and us crazy on the drive), will not be conducive to entrenching new habits. This month, I pledge to:

1. Do either 10 minutes (at least) of strength training or yoga with the wii fit or abdominal exercises every day (chemo recovery days excluded).

I'll start this one on Saturday.

And if I can get enough fruit and veggies and keep the junk food in the car to a minimum I will be happy.

While on the subject of nutrition, the Rowan Chlebowski, the oncologist who spoke about diet and nutrition at the conference said that the relationship between alcohol and breast cancer is a controversial one. And there seems to be no link at all between moderate alcohol consumption and recurrence. So I needn't worry about the occasional glass of wine.

Alcohol is, on the other hand, a source of empty calories and it increases the appetite. I generally try to save the booze for weekends and special occasions (which are admittedly fairly broadly defined) but with a vacation on the horizon, I think that in April I will look at cutting back in this area.

taking care of my body in 2009: part 2

This year I promised myself to "treat my body as well as I have been treating my mind."

That's my ultimate goal but I am trying to be S.M.A.R.T. about it (setting small goals along the way that are specific, measurable, attainable and realistic and timely).

In January I set out to:

1-Walk VIGOROUSLY for an average of one hour, five times per week (300 minutes a week).

I did pretty well at this. I fell about 90 minutes short of my goal for the month but given the truly lousy weather we had last month, I am still giving myself a pat on the back.

It certainly felt good to pick up the pace again. I hadn't really noticed how my walks had turned into strolls (and a lot of time standing around in the dog park). When I had to stop running (just after the Run for the Cure in October) because of tendonitis, I didn't really think about getting my heart rate up again during walks. I'm pushing myself again now and it feels really good (once I convince myself to get out the door).

A big benefit (I was going to write "side benefit" but it's really not) of exercise is the psychological boost it gives me. My weight hasn't changed and my clothes still fit the same way but I look different in the mirror. I see myself differently. I was going through a period where I would wake up in the morning and really dislike my own face in the mirror (the word "hag" actually crossed my lips once or twice, I am embarrassed to admit). But I feel pretty again. I (mostly) like the way I look. And I have more energy.

Not bad a bad payoff for four weeks.


2-Eat seven servings of fruit and veggies a day.

Doing it. I seem to have actually developed an addiction to blueberries in the morning.


3-Cook dinner at least once a week.

I did this one too! At least on average. One week I cooked five times. Sometimes the meals were extremely simple and none were particularly fancy but I am actually starting to enjoy it. I never thought I'd see the day.

And I would welcome any suggestions for healthy, kid friendly meals.


So, still taking baby steps, here are my additional goals for February:

1-Go to yoga once every week.

This one felt huge because I hadn't been since some time in the spring. But I went on Monday! My friend L. was in town and she goes to a weekly yoga class. I asked if she would force me to go to class come to class with me and she readily agreed.

Iyengar yoga can be a little weird (lots of props, lots of precise instruction, less flow and lots of talking) and my teacher is a bit eccentric. L. was game and a very good sport about it all (I had warned her ahead of time) and we both liked it that there are people of all ages and shapes (the teacher is the exact opposite of the stereotypical yoga instructor) in the class I go to, dress is very casual and they know how to accommodate a range of disabilities (there was a woman who had obviously injured her back, doing modified poses on a contraption with a rail). The atmosphere is extremely comfortable and it's a three minute walk from my house.

My teacher recognized me instantly and I found myself wondering in the first three minutes why I had found it such a big deal to come back. We worked hard and although I didn't realize I had been working my core, I was sore in all the right places the next day.

I have to remember that feeling next time I am curled up on my couch and it all just seems like a lot of time and trouble.


2-Cut down on refined sugar.

What do I mean by 'cut down'?

I am allowed to have a low sugar cereal in the morning (or a bit of maple syrup on unsweetened cereal).

I can have one row of dark, fair trade chocolate, if I am craving something sweet (and only once per day).

And during and after chemo, if the only thing I want to eat are bran muffins, than so be it.

But no more ice cream or desserts unless they are very, very special and then only rarely. I don't like how sugar makes me feel and it doesn't take long for me to become addicted. I think I will feel less tired.

Anyone know any good recipes for making muffins with stevia or other non-chemical sugar substitute?


3- Take my vitamin D and calcium supplements daily.

It's Wednesday and I haven't done this once, so I had better get on it.


How have you been doing with the goals you set this year?

words to live by in 2009

We spent New Year's Eve with a family we have known for a long time. It was low- key and great fun. We set up a projector and a screen and watched Mamma Mia (I LOVED it!) and The Blues Brothers (which I am embarrassed to say I had never seen). We turned it all off at just before midnight to do the countdown, wish each other 'Happy New Year' and break out the champagne. It was just exactly what I wanted to be doing.

Someone asked about New Year's Resolutions. I wasn't really paying attention until my friends' son, R., looked me right in the eyes and said, "What about you, Laurie?"

Without thinking, I answered,

"Treat my body as well as I've been treating my mind."

It was a revelation.

As some of you may have noticed, my updates on my Resolutions for 2008 kind of fell by the wayside after a few months. I still think that making SMART (specific, measurable, attainable, realistic and timely) goals makes a lot of sense (whether you set them at New Year's or not). And in some areas I did extremely well (I have already written about how proud I am of the writing I did this year) and in others...not so much (I didn't as much as re-organize one closet under the "getting organized" category).

I was the most uneven when it came to taking care of my health, especially as I became absorbed in other pursuits.

For a while, I was running but then I injured myself. I kept walking but at a pretty leisurely pace and spent a fair bit of time standing around in the dog park. By the end of the year, I had abandoned yoga, stretching of any kind and even token attempts at strengthening my abs.

I started cooking more regularly (I am very proud of this) but stopped ensuring that I ate enough vegetables.

I indulged way too much in the things that aren't good for me (hello sugar, fat and wine) and stopped doing the little things to enhance my diet (no more flax seed, berries or green tea).

It is time to start taking care of this precious body again. And while I am fortunate to have remained in remission for more than a year, it's time to do what I can to bolster my health.

The mind and the body can't really be separated. If I treat myself well physically, then my mind and soul will thrive.

My SMART goals for January when it comes to my health:

1-Walk VIGOROUSLY for an average of one hour, five times per week. I've been working hard at this and was surprised to realize how much fitness I've lost. And walking in the snow at a good clip? Every bit as good a workout as running.

2-Eat seven servings of fruit and veggies a day. This is so hard. But I'm working on it.

3-Cook dinner at least once a week. Missed last week but made an elaborate, time-consuming vegetarian meal last night that was basically a flop. It still counts, though.

I'll keep you posted as to how it goes.

What are you doing to improve your health in 2009?