Saturday 31 July 2021

Menopause: Our experiences and coping; BRiC's Collective Voice

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Our most recent Sunday discussion focused on the topic of Menopause, its impact on us and how we deal with its effects. This heated discussion revealed that chemically induced menopause through breast cancer treatment affected those of us who were in our 30s and 40s as well as those of us who’d experienced a natural menopause prior to diagnosis. What was agreed on was that the severity of a chemically induced menopause was much greater than a naturally occurring one. For those of us who’d already experienced menopause there was a chance to be affected by it yet again.

A running concern through our comments revealed the lack of communication from our medical teams about menopausal effects, or how to manage them. We were to research the effects of treatment induced menopause ourselves and seek help on how best to manage the symptoms which are at most times debilitating. There were very few who reassuringly had more manageable symptoms. Many of us were grateful to support groups like BRiC who provided some information on how to address the symptoms.

Menopausal symptoms are challenging and can be debilitating. BRiC members discussed a vast range of symptoms affecting our quality of life: from vaginal atrophy and dryness, lack of libido and sexual dysfunction threatening our ability to maintain intimacy, to brain fog, forgetfulness, joint pain and cramps, as well as fatigue and hair loss, weight gain and let’s not forget hot flushes and insomnia… the list continues.

For many of us such symptoms persist for years post active treatment mainly sustained through endocrine therapies such as Tamoxifen, Anastrozole and Letrozole. The impact of such symptoms adversely affects our workability with many of us reporting that we’ve either had to scale down, take early retirement, or change jobs to less-demanding ones. Our self-esteem is affected and our confidence diminished in the workplace, with some of us reporting we felt dumb and stupid (something also pointed out by family members). A radically induced menopause with full blown symptoms can leave us emotionally and physically shattered and increase our vulnerability to anxiety and depression.

We discussed the possibility of supplements aiding in the management of menopause, though these were organic developments not necessarily prescribed by our medical teams. Some of us mentioned Vitamin D and Calcium with Magnesium, as well as cod liver oil. Any supplements taken should be discussed with our medical teams we noted. Some of us mentioned that acupuncture has helped and many emphasised the positive effects of exercise and diet, though shedding weight even with a balanced diet and much exercise was a challenge for many. The benefits of exercise are long documented and research from BRiC shows that challenging our brains in adaptive ways can help with brain fog improving cognitive health. With research documenting a causal role for cognitive function in protecting against anxiety and depression, this self-management tool can only empower us with the control that cancer has so cruelly taken away.

Unfortunately, unlike cancer-free women, HRT is NOT an option for us as it can fuel recurrence and increase our chances of secondary breast cancer especially if our original diagnosis was hormone related. In fact some of us wondered if our diagnosis was fuelled by HRT in the first place. In addition, most women who are not affected by breast cancer do not know that HRT is NOT an option for us, so some comments on how HRT can help us may come across as insensitive. The fact is that there are no simple solutions for us.

No one symptom of menopause affects us in isolation, the symptoms are very much linked providing a difficult environment to function healthily at best of times. Our emotional, sexual and cognitive health are all interlinked as our bodies work in harmony. A collective threat to our basic functioning is damaging and our members' experiences clearly demonstrates the emotional and physical pain they endure. This calls for an urgent need for measures to systematically address menopausal effects, longer term. A link suggested by one of our admins: Dr Caroline Humber, provides some useful information as a starting point, but more needs to be done:

Monday 5 July 2021

What advice would you give to someone newly diagnosed with breast cancer? BRiC's Collective Voice

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What advice would you give to someone newly diagnosed with breast cancer?

When we are diagnosed we go through a trauma and our brains are emotionally overwhelmed. We asked our members what would have helped us at this emotional time when we are feeling vulnerable, tearful, and scared.

For some of us, we would have liked to know “you will get through this”, that the treatment is “doable” but that the treatment wasn’t something we could “sail through”. And that those who offer toxic positivity “Stay strong, you’ll beat this” may drive us crackers. Some definitely learnt the hard way, trying to be “super woman” and “push through” while caring for everyone else as they always did, and would now offer advice of “take it one day at a time” and, a recurring theme, “listen to your body”, alongside encouraging women to take all the help offered by friends and family. A few members said “knowledge is power” which related to us gleaning as much information as we could about our disease and its treatment. However we acknowledged that it was easy to be overwhelmed with too much information and that we can all handle it at slightly different rates. Some of us did feel we had not been given enough information at the start of our treatment plan, that knowing the long term side effects more thoroughly could well have affected our treatment choice. This also ties in with, as one member put it, “be firm with your medical team, you are the expert on YOU”. Ask for copies of your medical reports if you are like me and need to know everything” And take time to consider choices you are given about your treatment, take a 15 minute walk round the car park if you need to in order to help clear your mind. Also, celebrate the wins: “if you get out of bed and stagger outside for a walk on some days that’s bloody amazing”.

From an emotional level, we needed to be reminded to look after our stress levels, that “this too will pass” even if it takes a while to feel emotionally stronger. We should give our emotions the attention they deserve, that this is “your story”, that it was ok to not be super strong about this, that it was wise and even healthy to acknowledge our feelings. Some of us felt that some warning about the emotional rollercoaster that may happen afterwards would have been good, that we may push through emotionally to get through the treatment, but that we may crash down when it has finished, that even though our friends and family think it is all over when treatment has finished, it isn’t over for us. And that we may need to seek help at this point and acknowledge our struggle, and ask for support from a professional, many of us didn’t know this was available.

For self care, we needed to know how to administer some self care! That breast cancer is a disease, not a cold. Members suggested treating ourselves with kindness and compassion, and also seeking out support groups such as ours, (Building Resilience In Breast Cancer private group or BRiC) to find women who would just “get it” and could provide some answers. One member said groups like BRiC gave her hope as there are members here who talk about being 5, 10 or 15 years post diagnosis and that helps us see beyond the immediate danger we feel. One member offered some practical self care advice that she would have liked: “You will laugh again. Eat well. Rest. Treat yourself. Take time in nature. Put on your best clothes and makeup - it will make you feel good” Another member said: “It’s ok to feel everything you feel, don’t bottle it up. This is crap, but if you stay open, your life will open up and change in ways that you would never have thought possible”.