Before October passes I wanted to write something for breast cancer awareness month. Almost a year ago I finished treatment for breast cancer and have been doing well since. But, a neighbor recently passed away from cancer and so did my publisher Cynthia Black so cancer has been all around me this month and I know how hard it can be.
Yet, with challenge can come growth and that is why I wrote several books about my cancer path while I was going through it--to help others (and their loved ones) who are facing it too.
So, here is a condensed excerpt from one chapter in my book, 'My Quick Guide Through Breast Cancer' in case it can help anyone:
"Life isn’t about waiting for the storm to pass. It’s about learning to dance in the rain."
– Vivian Greene
Once you make your treatment choice, it helps to figure out what will best support your success on your journey. What supplies will be helpful? What guides and people will point you in the right direction? What will provide a morale boost and spiritual sustenance? What knowledge and resources will be good to have?
Here was my initial shopping list:
Claritin D – for the bone pain which can come from the Neulasta shot
Throat lozenges – for sore throats
Arm & Hammer Baking soda toothpaste
Ginger candy – for nausea
Vaseline lotion for dry skin
50 SPF sunblock
Carmex lip balm
Big sunhat and sunglasses
Notebook to record your blood counts, chemo cocktails and doctor notes
A digital thermometer to know if your temperature goes above 100.4
A small makeup bag for your medications
A binder for business cards (from the Container store) to hold cards of all my doctors/ helpers
Aquaphor skin ointment – a big tub of it for after radiation treatments
Here's a list of organizations to hang on your wall or refrigerator for easy reference:
www.cancercare.org – 1-800-813-4676
www.cancerandcareers.org – living and working with cancer
www.chemoangels.net – they send things to encourage you
www.families.org – for help with explaining things to children
www.cleaningforareason.org – free cleaning help for patients
www.youngsurvivalcoalition.org – help for younger patients
There is also a magazine called Cure which addresses the interaction of science and humanity. It’s free in many hospitals for survivors and their caregivers. There’s a free subscription form inside the magazine, or you can call them at 800– 210-2873 or subscribe online at www.curetoday.com/subscribe.
Two other good magazines are Living With Cancer which I could often read in my oncologist’s office. You can also check out www.HealthMonitor.com to learn more. You might also want to get the magazine, Breast Cancer Wellness. I also liked the website www.4wholeness.com, which provides survivor stories that helped me feel less alone, and I got some great tips.
One thing about cancer is that it makes you very aware of the love and support around you. It can make you feel supported or lonely. But as you can see from all these organizations, even strangers are willing to give love and support and that is a wonderful thing for your psyche. If you are a helper type (like me) it may remind you that it’s okay to receive as well.
Creating Your Healing Team
One of the most important things I did was to make a list of my supports so that I could see how much I was surrounded by love, support and skills. Even if you don't have a huge community, once you add in your three doctors, a therapist or spiritual mentor, a few friends and family, you will realize you have a team of support. You can do your first homework assignment and construct your own Healing Team list now.
People need their own group of like-minded doctors, healers, family and friends to construct their healing team. Sometimes this team will have conflicting opinions and sensibilities and this can be hard on you. In a rowing team you have 4, 6, or 8 rowers but if they don’t row together, it’s better not to have them in the same boat.
As a new patient you will need to take in the information from different healers and integrate it to decide your own path. You will call in support and decide who is on your physical team, who is your emotional support, who is on your mental team, and your spiritual one. Do this exercise and it will make you stronger for the journey ahead. Hang it on your wall so you can see it when you feel alone and need support.
For your support tree, here are a few examples of how you can label your branches in categories, to get you started:
• FRIENDS – make a list of friends to call for support
• FAMILY – list members who might visit or pitch in
• TRANSPORTATION – some hospitals will give you metro cards or pay for a car service, or you can get access-a-ride
• ORGANIZATIONS – these have grants, counseling and groups
• SUPPORT GROUPS – These are great places to meet people going through the same experiences
• CLEANIING HELP – some organizations offer volunteers to help clean your house when you’re sick
• CHEMO BUDDIES – some volunteers will go with you to appointments
• HEALERS – there are tons of modalities that can renew your energy and decrease stress
• FUN ACTIVITIES – there can be fun ways to distract yourself, raise your energy level and vibration.
Just having a visual of your “Tree of Life” posted somewhere where you can readily see it will remind you that you are not alone and that you can always reach out for help, health, and growth.
Getting Mammograms & A Biopsy
When I received a suspicious mammogram, my lab’s radiologist said I needed to see a breast surgeon. When I did, my breast surgeon told me that we needed to do a biopsy. This was a somewhat painful experience that was done in the doctor’s office. Then I had to wait a week to find out the results! When I called, I found out I had breast cancer and that I needed to have a lumpectomy. You may need a biopsy and surgery to give you a good idea about what you are dealing with.
Getting a Lumpectomy
A lumpectomy is the removal of the breast tumor and some of the normal tissue that surrounds it. It is most successful when there are clear margins. When a lumpectomy has clear margins and it's followed by radiation treatment, it is as successful in reducing recurrence as a mastectomy for tumors under 4 centimeters, according to research in the New England Journal of Medicine (2002).
During a lumpectomy they also remove the sentinel node from under your arm. Taking out the sentinel node is a great advance because sometimes it spares a woman’s lymph nodes from full dissection. Some dye is injected into the tumor site and the surgeon tracks how that dye moves through the lymph nodes. The first node where the dye moves to is then removed. If it has no cancer, the surgeon may remove one or two more lymph nodes just to be sure. This is called a sentinel node biopsy.
It is important to remember which arm the nodes were removed from because you want to be sure that any subsequent blood drawing or blood pressure testing is done on the opposite arm. This may prevent lymph edema later. I have had nurses forget to ask me which arm was biopsied. They started to draw blood from the wrong arm until I told them, so don’t forget!
Also, 20% of women who had lymph node dissections get lymph edema or cellusitis. This is chronic swelling of the arm due to a blockage in the lymph system. Such a blockage can result in limited mobility, infection, or cellucitis. Remember to call your doctor if you have any signs of pain or swelling. Luckily, I didn’t. You can do gentle arm exercises each night to reduce your risk of lymph edema. Gently swing your arm in a circle, forward and back.
On our next visit, the pathology reports came back and showed that I had triple negative cancer, stage 2a, so now treatment entailed surgery, radiation, and chemotherapy! Doctors can determine a lot more after analyzing your tumor.
You will probably have a different doctor for surgery, chemotherapy, and radiation. These doctors will be your surgeon, medical oncologist, and radiation oncologist. Get used to the big names and an ever-expanding medical vocabulary.
Chemotherapy uses chemicals to destroy cancer cells throughout your body. They can linger in the lungs, liver and bones, the lymph nodes, brain, or elsewhere, so chemotherapy is also a preventative measure.
Reward Yourself After Chemo Day
Your chemo days can be hard. So, I found it was good to do something nice for myself. I would go to the beach and listen to my meditation tape. Also, Beth Israel West was in this cool Ganzevoort/Meat Packing district of Manhattan. I found a place that served unsweetened green iced tea right next door. There was a great Mexican restaurant called Dos Caminos where I would buy a salad after each session, and if I wanted to window shop, there was the Chelsea Market a block away. There was also the beautiful High Line, an elevated park that overlooked the city. These little pleasures gave me something to look forward to. So, look around your neighborhood for some delights to add to your day. At the very least, you might treat yourself to some flowers.
Take a Chemo Buddy
Medical personnel normally recommend that someone come with you when you take chemotherapy because you may feel dizzy and unwell afterwards. Some hospitals may require it. So, find out and decide what feels best for you. Especially the first few times, I wanted someone supportive there with me. I have heard other people say that they much prefer to be alone. If you want company, then map out your chemo days ahead of time so people can make arrangements to be with you. My husband was able to take off a few days from work to go with me, but he needed notice. The same thing occurred with my mom. If no one is available during the day, you can pay a helper $10 an hour to go with you for company. You can find one on Craigslist or go to an agency. For me it was only eight sessions, so I was able to plan ahead.
Since you’ll be at the hospital all day, make sure your pharmacy is open late. I had to take steroids and anti-nausea medication for three days after each chemotherapy appointment. Sloan Kettering could have been better about explaining my medications, so a word to the wise is to keep asking your doctor or nurse questions about the medication protocol until you are clear. They gave me a medication calendar, with the names of the medications listed, but when I looked at the medication bottles at home the names were completely different and I did not want to guess wrong. Plus, you will have “chemo brain” and sometimes the nurses will not call you back that same day. So, get very clear instructions about the treatment you will be doing from home, which includes administering your own medication, usually for at least three days following chemotherapy. If you are taking Neulasta, which can help boost your white blood count, you’ll also want to take Claritin D as needed for possible bone pain.
Your “No Can Do” List for Chemotherapy
My sister also wrote me a “No List” of seven things so I’d remember What Not to Do:
– no vitamins and herbal supplements during chemotherapy
– no sushi
– don’t eat uncooked meat or eggs
– don’t cut my cuticles
– do not go out into the sun without 50 SPF sunblock and a hat
– don’t eat raw food without washing it well
– no strong alcohol
Put your “No List” somewhere visible so that you’ll remember what not to do.
I was able to keep working the week my treatment started, which was a relief for me. When I’d asked my doctors about working during treatment, they said to wait and see how much I could work—and that everyone was different. Since I am very structured, and my patients rely on me, I felt I needed to plan in advance.
If you are also trying to figure this out, you probably want to take off from work on your chemotherapy day and the day after, which is what I did. Then you can also rest on your weekend. I decided to try to work an 80% schedule and see how I felt. I was able to work 80% throughout my chemotherapy and radiation treatments. A few clients dropped out but most stuck through it.
So, I can’t say that it will be the same for you. You will be tired, but if you love your work, or need to keep working, you may well be able to do so. I read that in a study of cancer survivors by the National Coalition for Cancer survivorship, 81% of respondents said that some type of normal work routine gave them emotional stability during the ups and downs of treatment!
On the other hand, many of the cancer friends I met were able to stop working for five months and just focus on their treatment, and they seemed to prefer that. So, see what is right for you given your situation. My social worker at Sloan Kettering said that 70% of women with breast cancer that she saw did not work throughout their treatment, but a few worked part-time. The website I mentioned earlier, www.cancerandcareers.org, gives information on working while you have cancer.
Get Your Sleep
Sleep was difficult the first three days, due to the steroids. My body was so tired but my energy level was too high to sleep. I was given Ativan to take at my discretion for nausea and to help me sleep, but I felt like I was already taking so much medication that I chose not to take it. You can ask your doctor what to do to help you sleep ahead of time, and you may choose to take additional medication. Sometimes I would toss and turn and get hot flashes due to the chemotherapy. I usually found by the third or fourth day after chemotherapy I was so tired that I could finally sleep.
Remember, your sleep is a very important aspect of your health plan. According to Dr. Amy Lowry of Sloan Kettering Hospital, 10% of the population has sleep problems lasting three months or more, and with cancer survivors the rate is three times higher!
Also, sleep may be helpful for preventing recurrence. Researchers at University Hospital’s Case Medical Center in Cleveland, Ohio, showed an association between insufficient sleep and biologically more aggressive tumors. Thompson’s study showed the hazard of too little sleep for women who already have cancer. Participants with six hours of sleep or less per night had higher tumor recurrence scores.
In an article by Angelina Tala called, “Lack of Sleep, Light at Night Can Raise Cancer Risk,” the author found that 70% of Americans are not getting the average hours of sleep they need.
Research shows that blind women have 50% less breast cancer than sighted women. They live in darkness 24 hours a day and sleep more than the average American sighted woman, producing higher levels of melatonin and cortisol. Melatonin is an antioxidant thought to fight cancer cells and it needs darkness.
Sleep is also when your body repairs itself at the cellular level, and the body’s circadian rhythm is interrupted during poor sleep. Researchers say we do much better with at least eight hours of sleep, and cancer clients going through chemotherapy ultimately need more sleep and naps so their body can repair and rest. Keeping the same sleep and wakeup time every day is optimal for our health and circadian rhythm.
Take a moment to note how much sleep you are getting and what might improve your sleep. We need rest to refuel. Author Donna Eden says, "Your body forces you to slow down so it can rebalance, release toxins, and regenerate itself in the energy-restorative magic of sleep."
Getting adequate sleep is one very enjoyable change to make, so you may want to begin your self-care with sleep aids.
Drink Lots of Water
It is very important to drink lots of water to flush your system of chemicals and toxins during chemotherapy. So, get used to drinking water and try to buy alkaline water. Some healers say that cancer likes acid and dehydration so that drinking alkaline water makes it harder for cancer to return. Drinking water also helps energy production and keeps our lymphatic system clean.
My dad ordered me two cases of Essentia water every month because we heard it is the most alkaline water. Another brand that’s easier to get (usually in your local deli) is Fiji water. By the way, after forcing myself to drink water I began to find it refreshing, so you might too. I sometimes flavored my water bottles with lemon juice, Stevia, or Elderberry. Stevia actually helps regulate blood sugar levels and it doesn’t cause the pancreas to produce excess insulin (most other artificial sugars are even worse than sugar in terms of affecting insulin levels). So try it out!
The Neulasta Shot
I also had to administer a Neulasta shot to myself the day after chemo so that my white blood cells would return to normal within 10 days. Cancer patients receiving chemotherapy may be more susceptible for various infections and Neulasta can help replenish white blood cells so that cancer patients are able to more effectively fight-off dangerous infections. This section is important because you can get your Neulasta shot in the hospital the day after chemotherapy if you want, or some insurances will send it to your house so you can save yourself a commute and administer it yourself. The shots can cost $3,500 each so you want to make sure you receive it at the right time and that you know what you are doing. My insurance company sent two shots for $7,500. At that price, you don’t want them to get or lost or be wasted!
Definitely call your insurance before you start chemotherapy. Make sure they cover this Neulasta shot financially, that they have the right delivery information, and also ask whether your hospital pharmacy will supply you the needed steroids and anti-nausea medication, or whether you will need to get it yourself from a pharmacy. You don’t want to be in a panic for your medications at the last minute when you are tired and dizzy. So, my advice is to make all these calls before you start so you know the setup and procedure and will be all ready to receive the medications you need for your particular treatment at the appropriate time.
The side effects of Neulasta are bone pain, mild headaches, swelling at the injection site, allergic reactions, and difficulty breathing, but it’s very important to rebuild your white blood cells. So, take a deep breath, muster up your courage and get it over with.
BRCA Genes & Testing
In its normal state the BRCA gene keeps us healthy by repairing damaged DNA. When it mutates it loses power the control other genes. Jewish Ashkenazi women have a significantly statistically higher chance of having genetic mutations that cause ovarian and breast cancer. Five to ten percent of all women with breast cancer have BRCA 1 or 2 from their parents. In addition, 80% of women with BRCA 1 will get breast cancer, 60% ovarian cancer, and 50% might develop cancer in the second breast. BRCA 2 patients still have a 50% breast cancer risk but the ovarian cancer risk is 25%.
It’s usually a good idea to find out if you have this gene because it can affect the course of your treatment. For example, if I had the BRCHA gene, I might have opted for a double mastectomy instead of radiation to reduce my recurrence risk. I was lucky to test negative for BRCA.
Sometimes insurance won’t pay for this test and it can be at least $1,000, so definitely check. Our insurance paid for it and hopefully yours will too.
Radiation therapy uses high-energy rays to kill cancer cells. It’s localized to the chest area only and damages the cell’s DNA structure. The healthy cells can repair themselves but the cancer cells cannot. Some studies say that women with lumpectomies without radiation have a 35-40% chance of recurrence, but that with radiation, recurrence lessens to 7-12% in that local area. This sounded like good odds to me, and the prospect of significantly reducing the odds of recurrence made my commutes more bearable.
Radiation required that I go to the hospital every single day (Monday through Friday) for 33 consecutive treatments! To get there I had to take two subways and travel for 2 hours each way. This meant getting up at 5:30 a.m. every day in order to be at the hospital for an 8 a.m. appointment, which allowed me to get in a good day’s work after the treatments. My doctor finagled my coming in Fridays at 11 a.m, so I could get on the train at 9 a.m. that day.
The positive side of radiation was that the actual treatment was short and relatively painless. You just change into a gown, have your radiation treatment by lying down on a table and receiving the radiation, and change back into your street clothes. Radiation treatments lower your local risk of recurrence considerably, and the risk of secondary cancer attributable to radiation was less than 2%, so for me the potential positive effects outweighed the potential negatives.
And I did find some ways to make that “downtime” useful. For example, since I had a two-hour subway commute, I would read and listen to meditations via headphones and my iPhone. I got a knapsack to carry a few books and a journal with me, along with snacks and drinks. I continued writing my book in a notebook and would transcribe thoughts into my computer twice a week when I had a chance, so it did not slow down my writing goals too much. At the hospital was a small library with a delightful waterfall, and since I usually arrived 15 minutes early for my appointment, I would drink my iced green tea or fresh juice, read, and relax before my treatment. Taking this quiet time really helped me to feel centered.
When I had my radiation treatments, I would say a prayer to surround myself with angelic light and imagine the radiation eradicating anything that was not love. This could be cancer cells, limiting beliefs, fear, anger, sadness or ego. I figured the radiation could make me healthier and lighter in more ways than one. It could leave me freer, more loving and open than ever before. You can do a similar meditation or visualization so you contextualize the radiation as helpful rather than harmful.
I should mention that the nurses also spoke to me about side effects and skin care during radiation. Here’s what you should know about that:
Radiation Side Effects
• Your skin can be red, itchy, dry
• breast swelling and tenderness
• nipple sensitivity
There’s a “no list” with radiation treatment too:
Radiation No List:
• No deodorant
• No underarm shaving
• No tight clothes
• No underwire bras
• No icepacks
• No commercial powders, cologne, lotions or makeup in the radiation area
• No direct sunlight to that area
• No scratching
• No heating pad, sauna, or hot baths
In terms of preparation, get yourself a few sports bras because you won’t be able to wear any underwire bras for a while. Also, buy some Calendula ointment which can reduce inflammation associated with radiation treatment for cancer patients, and it can also be useful for treating dry or cracked skin. My nurse told me to put this on the affected area after radiation and at night, daily. Put a reminder in your phone so you will remember to put on this Calendula ointment twice each day every day, or you will probably forget, and it’s important to take care of your skin during this time.
Even though you may not have to commute to get to your appointments, the important point is that you think about what can make you happier during this time, and what supports and resources can make your path easier.
At the very end of my radiation treatment (the last 2 weeks), my chest was red and brown, and it hurt and peeled. It was painful to sleep on that side. I just had to remind myself that “This too shall pass” and keep going! Once it is over you won’t have to look back. Keep applying the Calendula ointment twice a day because that seemed to reduce the pain and swelling.
I also believe that the context you have around radiation on a daily basis can have a big impact. Christopher, my Spiritual mentor, told me to think of my radiation treatments as a Sundance ceremony. A Sundance ceremony is a Native American ritual, during which the participants would exhaust themselves so their ego and personality could no longer resist or interfere with the initiation about to take place. He suggested I allow for fatigue, and let stubbornness and any resistance go. I could imagine that I would be filled by God’s will whenever I released something and I’d be softer as a result. I’d direct the radiation mentally toward any parts of me that were critical or judgmental to soften them and invite them home to Source and Love. Try it!
Getting a Port
After I switched to Beth Israel hospital due to our insurance, I was informed that I also had to get port surgery. The port is a plastic device that is inserted into your chest so the medical staff can access that vein easily. Each time someone takes blood or gives you chemotherapy drugs, they can give you a numbing cream for the area, so it’s easier than trying to stick your veins each time.
A nurse showed me that you have to apply the whole tube to the round port area an hour before and then apply a clear bandage to hold it on. So ask for a tube of numbing cream and a few clear bandages to take home. Put this on the right way before your appointment if you have a port. The whole experience of chemo will be more pleasant!
Getting a Short Haircut and a Wig
There are some chemo drugs that may not make you lose all your body hair. Mine did. This is something your doctors should warn you about up front.
I knew that my hair was going to fall out and that maybe my eyelashes and eyebrows would too, so I decided to cut my hair short so that it would be less traumatic for me and my clients when it did fall out.
Then one day (after chemo #2) my hair started to fall out in clumps so I decided to go to my hairdresser and shave it all off.
I visited a few wig places in my area. Plus, I called my insurance to see about wig coverage. Oxford would only cover a synthetic wig from one particular place and 1199 said they would cover one synthetic wig for any amount. I loved red hair, so my wig was my chance to be a red head.
I had to get a prescription from my oncologist for a “hair prosthesis,” keep my wig receipt, and fill out a claim form and then send all three pieces of paperwork in to apply for reimbursement. I did this after spending $720 on my synthetic wig (which is actually much less expensive than a wig made of human hair), but I still was not reimbursed for over four months. Insurance companies will often give you a lot of red tape, so if you can’t afford to wait for reimbursement, you might want to get a free wig instead. There are a few organizations that offer them:
For Free Wigs contact these organizations:
American Cancer Society - 1-877-227-1596
Cancer Care - 1-800-813-4673
Y-ME National Breast Cancer Organization - 1-800-221-2141
Duke Comprehensive Cancer Centers - Wig and Turban program
Susan G. Komen for the Cure
You can also buy an inexpensive, fun wig to make you and others laugh. Consider getting one in blue, green or pink. Might as well have some fun with this! In New York City, you can get cheap, fun wigs at a store called Ricky’s. If you are unable to get to a store to pick up a wig, you can order one online.
In the summer, I often preferred going bald—it was hot with the wig on and it just didn’t feel like me. But other times I wore my wig.
Henna Crown, Anyone?
Henna crowns are a great new option for women who lose their hair from chemo. I heard about this through an organization called www.hennaheals.org. They referred me to a henna artist in NYC called Kenzi. She came to my house (and commuted 90 minutes) to apply the henna. She created my henna crown in 2 hours for just $100, which to me was worth it.
Many of these artists do Indian or Moroccan henna designs. I wanted a labyrinth with a heart in the middle of my head with some butterflies and flowers, representing growth, transformation and the spiritual cancer path. So you can create your own design or use traditional symbols. This henna art will last two weeks.
For those of you in locations with no henna artist, you can do a henna crown with a friend. You can order an art transfer stencil for a henna crown pattern at www.chemochicks.com and choose between a few patterns they have, or if you are brave enough, just try it freehand. Please make sure that you only order good quality pure henna so you won’t have an allergic reaction.
Other Things to Do For Symptoms and Treatment
Obviously, when you have your cancer treatment, you may be exposed to a veritable array of unpleasant symptoms.
Prepare yourself with solutions but don’t over-focus on this yet because you probably won’t get all of them!
My friend Ana, who is a doctor, recommended that I have a few free phone sessions with Susan Silberman from www.beatcancer.org. Her organization allows you to make suggested donations of $25 per call but if you can’t afford this, it’s free. These sessions were extremely helpful and I highly recommend Susan’s organization. I told her about some of my symptoms and she gave me some good recommendations for supplements to take that I thought I would share here. Of course, always check with your doctor before taking anything.
Susan made a good point about all the suggested changes. She said to make one change a week and to notice how your body reacts. She said that it’s tougher to gauge how your body reacts when you are doing the chemotherapy, so give any new changes some time.
Heart Symptoms from the Chemo – Some chemotherapy medications cause heart problems, so Susan suggested that I order the Coenzyme Q10 from Healthy Origins. She told me to take two a day of the soft gel capsules, which are more absorbent. It's good to take these capsules with salmon, olive oil, or avocado because this helps absorption. Not only does this treatment protect the heart, but according to Susan it has anti-breast cancer properties. So ask your doctor and order it.
Digestive Tract – Chemotherapy can mess up your digestive tract and some people say that 70% of your immune system is in your digestive tract. Susan told me to order probiotics to coat my digestive tract to aid elimination and digestion and repair your gut. You can take a probiotic in the morning and one at night. Simply called, “Probiotic” this can be ordered for just $3 on www.iherb.com.
Immune System issues – There is a type of green tea that you can order that has anti-cancer properties. There were 4 studies performed on how it helps with cancer, and results showed that this tea has 13 mechanisms for fighting cancer. It does contain caffeine though, so don’t drink it before bed. You can go to www.teaforhealth.com and order the standard green tea there.
To make it: Brew the leaves with boiling hot water in your mug and put a saucer over it for twenty minutes. Then you can drink it hot or cold and put in some Stevia. Drink up to 40 ounces of this tea a day.
Yeast Infections – Susan said probiotics can help with this too but you can also try drinking unsweetened cranberry juice.
Feet and Toenail Issues – One of the biggest symptoms I had from chemotherapy was that my feet got all cracked and calloused. A few times my toenails turned black and once the entire toenail fell off! My oncologist said just to let it grow back, and he told me that it would take a while. My neighbor, Dan, was concerned about my Vitamin D intake and said to ask my doctor if I could take supplements.
Teeth – Just as I was starting chemo treatment, my tooth broke in half (unrelated to the chemo). You are not supposed to get dental work done during chemotherapy. Luckily, Sloan Kettering had a dental department so I could get a consultation there, with dentists familiar with chemotherapy. They decided to wait until I was all through with my treatments to fix my tooth. So, my advice to you is to get dental work done before you start. Also, get Arm and Hammer toothpaste and brush every day to avoid cavities and sores. Biotene also works well.
I know this all sounds overwhelming but it can help you to have practical tips in your purse so that you feel less alone and know what to do should these things arise. If you are the caregiver for someone going through this, it helps to know the ropes so you can help them to trouble shoot.
You can get through this!
I wish you many blessings and greater awareness from this challenging experience. And of course I wish you good health.
My Best in Love,