18 Months Post and Chemobrain

LBBC Breast Cancer Helpline volunteer, blogger and friend Ronda Walker Weaver is back today to discuss her experience with "chemobrain" and what she learned about the topic from a webinar LBBC hosted in September of 2014. 

Well, happy day here. Not that I was expecting anything different than what I received, but I tell you, the anniversary anxiety, which comes every 3 months for the first 2 years, is tough. I look at these doctors' visits as markers of moving past and beyond breast cancer, but they are also reminders of where I was, and quite frankly, where I could be, if any indicators were there.

So - great blood pressure, great weight, mammogram was clear, and I'm just waiting to hear about blood tests - red and white blood cell counts. But I don't expect anything other than "all is well."

Today, prior to my doctor's appointment (visited with my chemo oncologist, Dr. Rich) I listened to an LBBC webinar on chemobrain. I have been blessed with this lovely gift, and I have worked hard at being aware and on top of this, but the symptoms and signs are always evident.

These include:

• Brain fog - almost like a dust cloud is over my head, causing a darkening of my thoughts. Not dark as in depression, but dark as in not being able to see clearly.
• Wart on my tongue - yes, you heard me correctly. It's not even like the word is on the tip of my tongue, but the word is covered by something, and I can't uncover that to get to the word. It's as if I can't even find the file in my brain with the word I need to access.
• Short-term memory loss - not long-term, but forgetting to pay a bill, forgetting where I parked, forgetting an appointment. And it's more than forgetting - it's not even computing.
• Inability to multi-task - I'm not talking doing 19 things at once, but simply putting the clothes into the wash, working on a writing project, while dinner is cooking. That's the type of multi-tasking that has been tough. I have to systematically order out my tasks, and then focus, and walk through each one, individually.
• Overwhelmed - too much stimulus can cause headaches, increase brain fog, increase anxiety and stress. Feelings of being overwhelmed can be simply too many emails, too many phone calls, too many people in the room, and too little space to process.
• Lack of Focus - many women report feeling as if they are ADHD. I have a tough time staying focused, particularly during meetings or in group settings. As well, occasionally I have a difficult time finishing something I start - leaving many projects half-finished.

So - are there solutions? Yes! There is hope! About 75% of breast cancer chemo patients have short-term chemobrain. This is typically evident post-treatment, because face it, we are too busy surviving to really address any of the changes that are happening to our bodies. Most women with chemo brain will have some affects through about 6-9 months post-treatment, then they issues will slide away, and the women will be just fine, with no residual affects. About 35% of those 75% will have chemo brain that lingers up to 5 years post-treatment, with 20% of cancer survivors having long-term issues. However - there are things that all women who are going through breast cancer treatment - chemo and radiation, to regain their real, rather than chemo, brain.

These include:

• Patience - If you are experiencing long-term memory loss or your chemobrain lingers or seems to be getting worse, see your doctor and ask for a neuro-eval. This is most likely not chemobrain. If you are 8 months post-treatment, you should see an increase of brain function. However - life with cancer is about changes, and changes in attitude and dealing with memory issues is probably necessary. Laugh off memory loss mistakes (I teach 3 writing classes at my university, and when I forget a word or an assignment or to whom I was just speaking, I just have to laugh). Smile when you forget to pay a bill, apologize, blame your cancer (legit), and then ask for fees to be waived.
• Simplify - write appointment dates down so you don't forget them. Organize your world - a place for everything, everything in its place; use a calendar, reduce distractions. Make lists - I have a small tablet I carry with me, and I have an app on my phone for lists. I also e-mail myself things I need to remember to do electronically.
• Sleep - the body heals when it sleeps. A dark bedroom, no artificial light (computer), and a cooler rather than warm room. Women need about 8-9 hours of sleep at night. Naps are good, but deep REM sleep is important.
• Exercise - Get those endorphins pumping, get your body moving, and get the blood flowing. All of this purges the body of toxins while also strengthening muscles - including the heart and brain. Obesity exacerbates brain deficits. While exercise stimulates the body, remembering the exercises, breathing, thinking about routines and posture, all help the brain. Consider doing word or number puzzles, reading new material, or writing as ways of exercising your brain.
• Nutrition - Eat right! Stay away from trans-fatty anything (hydrogenated oil), and highly processed foods should be avoided. Interestingly - most chemo offices do not offer healthy snacks, rather they offer quick carb highly processed trans-fat munchies. Perhaps dealing with chemo brain is getting your oncologist to offer healthy alternatives. Protein heals, fruits and vegetables give quick energy and are filled with fiber, and eating simple is the key to your brain and body healing.
• Vitamin D - natural sunlight is a gift we all should recognize. D heals chemo gray skin, helps build strong bones (chemo and radiation are not kind to our bones), helps heal the immune system, and decreases the chances for heart disease. Vitamin D and its accompanying sunlight also help with sleep.
• Cytocines - read about them!
• Be kind to yourself - Recognize when you are having a chemobrain moment and determine what sources are contributing to it. We can be our worst enemies (next to cancer), and really, we just have to put one foot in front of the other some days, and be grateful we can do this.

Lastly - if you, or someone you love has had breast cancer treatments, listen to this podcast about chemo brain from LBBC. It will rock your world.

Ronda is 54 years old. She was diagnosed with breast cancer on Thursday, Sept. 6, 2012. She went through surgery, chemotherapy, and radiation. She teaches folklore and writing at Utah Valley University and works for an online education company, LearningU. She is using her recovery time to read, listen to music, garden, walk, play with her grandchildren, children, and enjoy her dear husband – who has been her pillar of strength through her journey. She also writes her own blog called Folklady’s Adventures.

The LBBC webinar Ronda is referring to in this post took place on September 17, 2014 and featured Arash Asher, MD, the Director of Cancer Surivorship and Rehabilitation at the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center and Assistant Clinical Professor in the Health Sciences Department at The University of California - Los Angeles.