Day 7: Life off Letrozole

It’s been seven days with no Letrozole (sung to the tune of Nothing Compares 2 U).

That’s the aromatase inhibitor (AI) I was taking to reduce the risk of breast cancer recurrence (by suppressing estrogen production, since my cancer was hormone positive).

I’m on a 3-4 week “vacation” from Letrozole before trying a new AI. The hope is the next one won’t cause such significant joint pain for me.

What I’m most hopeful about is how I might feel next week at this time. Letrozole has a 2-day half life, which means by approximately the two week mark, I could feel relief from symptoms. Just a smidge of estrogen. That’s all I want. I never thought I’d utter those words after my diagnosis of triple positive breast cancer.

My most significant symptom from Letrozole is joint pain. My knees are stiff and achy 24-7 and I’ve developed sciatica from my lower back down my leg and into my foot. I’m never not noticing it.

Last year, I thought, “joint pain? I can handle that. I’ve had three knee surgeries. I’ve experienced joint pain. I’ve made it through chemo. I’m tough.”

Nope. Nope. Nope. Or yes, I’m tough. But Letrozole is tougher.

It’s painful, and it’s a drag. I don’t move like the athlete my brain knows I am. I have an amazing trainer and coach who is helping me stay strong like an athlete and keep a good mindset.

And yet, it feels like the third time in a year that I’ve experienced a sort of identity loss. Chemo was one, Bell’s palsy was another, and now AIs. And the road ahead is long- I’m supposed to be on this treatment for 5,7, or 10 years. It’s only been 7 months.

The other main side effect I experience is hot flushes. I’m using the UK term “flush” v the US term “flash” for two reasons; 1) I love etymology and it appears that flush was first, and 2) it just MAKES MORE SENSE. Theres nothing flashy about sweat.

I have been experiencing 5-10 of these hot flushes every day. Yes, they are super annoying and inconvenient. But I learned pretty quickly to always wear a tank top with sweaters on top, immediately discarding layers whenever I sensed it coming on. I went from being always chilly at work to being the woman in a tank top on the zoom. Classy. But to be honest, I would take 10 hot flushes in a hot second compared to any joint pain.

A few days ago, I noticed that I was getting hot or warm a few times each day, but no flush was happening. So that seems to be a quick response to going off the AI. Nice.

And then there are the side effects one doesn’t necessarily “feel” like osteopenia and worsening lipid panels, again from the lack of estrogen.

But I really am hopeful about this break from the AI and resetting my body before the trying the next one. And I’m hopeful about the future- that during these next few years we find better ways to mitigate the impacts of cancer treatment.

To be clear: I’m so glad to be in remission. AND ALSO I want to feel good in my remission. That’s the whole point, right?!

My early morning walk to shake off the stiffness from Letrozole.

Buckwheat Granola FTW

I just accidentally developed my own recipe. I have zero qualifications. But it’s delicious and so I’m sharing.

Since I hate seeing long backstories in front of recipes, I’ll keep this brief. I recently started a Whole Foods plant based diet (WFPB) And was looking for ways to use buckwheat groats. I had intended to buy buckwheat flour for making galettes but accidentally bought three packages of groats instead.

And you know what they say, necessity is the mother of invention. The back of the buckwheat bag had a very long recipe for granola. I took one look at it and decided to make my own. Here it is and it’s delicious.

Preheat oven to 300.

  • 2 cups cooked buckwheat groats

  • 1 cup uncooked old fashioned oatmeal

  • 1/2 cup applesauce (no sugar added)

  • 1/2 cup pumpkin seeds

  • 1/2 cup dried apricots (cut into pieces)

  • Cinnamon to taste

These amounts are an estimate- I didn’t measure. So use your judgement (the applesauce should moisten the mixture but not make it wet).

Mix all together, spread onto parchment paper and bake for 45 min at 300. Stir after 15 min, and again at 30. At 45, remove or lower oven to 200 and keep baking if you want it crispier.

Next time, I may experiment with vanilla extract or more dried fruit or adding almonds. But this base is a great start.

Buckwheat granola- zero added sugar and zero oil. I’m basically a rockstar.

Aromatase Inhibitors, Booooo

AIs are the worst. And I don’t mean Artificial Intelligence.

I mean Aromatase Inhibitors.

They are the category of drugs given to “hormone positive” (“HR+”) “post-menopausal” women after “active treatment” to lower their risk of recurrence and “increase survival rates.”

There were a lot of quotation marks in that last sentence, and that’s “purposeful”.

Let’s break it down:

  • “Hormone Positive” which is often indicated as HR+, is a breast cancer which has receptors for estrogen or progesterone or both. Tamoxifen is a drug that blocks estrogen receptors on cancer cells in premenopausal women. Aromatase inhibitors are drugs that reduce estrogen production in the body for post menopausal women.

  • “Post-menopausal” in the cancer context is often referring to an early, chemically or surgically induced, menopause. Going naturally into menopause over the course of years is much different than being slammed into it in a matter of months, weeks, or days.

  • “Active Treatment” refers to the chemotherapy, surgery, radiation, and immunotherapy phases of cancer treatment. After you’ve completed the protocol for your cancer, or when you show no residual disease, you are considered done with active treatment. The problem with this label is that now people (the patient included!) assume you are done. For those with HR+ breast cancer, the current standard of care includes 5-10 years of tamoxifen and/or aromatase inhibitors.

  • Studies show that taking AIs for 5,7, or 10 years can “reduce recurrence”. However there are so many side effects for the rest of your body. I’m at the point now where I’m questioning if the side effects are worth it. A year ago I would have thought any side effect would be worth avoiding risk of recurrence. WOW, did I not understand what they meant by joint pain!

As of today, I’ve been on Letrozole for nearly 7 months. Because the medication reduces estrogen everywhere in my body, I’m have significant joint pain. Like, bending down or reaching for anything or getting into the car or out of the car or tying my shoes or…. You get it. Daily life causes pain and makes me emit a grunt like a 90-year old grandpa.

As I mentioned, a normal woman going through menopause may over time experience a number of side effects that really suck- like brain fog and joint pain and hot flushes and night sweats and weight gain. Breast cancer survivors (like me) are hit quickly with side effects and then also discover that the AIs magnify these already pronounced menopausal impacts.

Here’s why: estrogen normally plays a cardioprotective role by regulating lipids and promoting vasodilation, and it is crucial for maintaining bone density. In just 7 months, I’ve seen significant decline in both bone density and in my lipid health. It’s really depressing for an otherwise very healthy person (this thought always reminds me of The Devil Wears Prada quote- “I’m just one stomach flu away from my goal weight”… “I’m just one chemo/AI/treatment away from healthy”)

Anyway, I’ve been doing a lot of research on estrogen, on the pros and cons of AIs, and out of the box solutions being explored (like micro-dosing GLP1s). There’s a lot of exploratory stuff out there in the world of breast cancer treatment and vaccines, and I know that in the next few years the standard of care will shift. But for now, there’s nothing specific I can point to that I can take advantage of.

And so I’ve been powering through my days, modifying workouts but still doing them (“movement helps!” Say the experts. You know what I say to that?- Shhhh….). I’ve been downing ibuprofen. I added Claritin to my morning cadre of supplements as some say this can offset Letrozole (my AI) joint pain. And last but not least, I’ve switched to a Whole Food Plant Based diet. I feel better food-wise, but my body just hurts to sit, it hurts to stand, it hurts to walk. If only I could lie down all day…?

Yesterday I hit my breaking point. Work has been stressful and that doesn’t help- but I decided I’m done with this AI. My doctor and NP agreed to a short break and then I’ll try a new AI- perhaps the side effects will be less. We’ll see.

In the meantime, I’m starting my temporary Letrozole Vacation now. Metaphorical palm trees and sunny days ahead, fingers crossed.

Just a pretty pic of my whole food plat based diet shopping at the farmers market. Better than a photo of joint pain.

That’s the Good Stuff

This week’s prompt is to “be the bearer of good news.” This may be the long way around but I promise to get there.

I had already been thinking along these lines- how to actively find good news. There is so much disconnect and judgement and sadness in our country right now, and same goes for my beautiful city. My morning walk to the train just took me past two SFUSD schools with teachers and families striking.

On top of this, I’m dealing with the physical pain of cancer survivorship. I won’t go into detail this time, but my “can-do” attitude has taken a serious blow. It’s more like “wish-do, ouch.”

So I’m often preoccupied with how my body is [not] functioning and when I do manage to lift my head out of the metaphorical sand, the world still appears pretty dismal.

But this weekend was a bit of a forced reset. Our youngest was attending a college tour and soccer camp, which left Matt and I hanging out in California’s Central Coast (San Luis Obispo and Paso Robles).

As I crawled into the soft hotel bed the first night, I giggled as I remembered what my college roomie says to herself at this cozy, delightful moment: “ahhhh, now that’s the good stuff.”

The next day, we had nothing to do and nowhere to be. We just enjoyed the weather and the conversation. The good stuff: we decided we will be excellent at retirement. In fifteen years.

We got home and school was still cancelled for Monday. The good stuff: Oliver gets to practice his leadership skills and plan/lead his team’s soccer training.

And we watched the Michelle Obama documentary about her Becoming book tour. So much good stuff there- we teared up, laughed out loud, and felt grateful.

I woke up with my hips and knees in pain. The good stuff: a) I don’t have cancer and b) I talk with my doctor today.

Wrapping this up as I exit the train station on my way to work… and I’m planning to seek and bear little bits of good stuff all day. I hope you do too.

Hanging out at the Backyard in Paso Robles, practicing being retired. Matt got lucky- we arrived in time for a tapping of Pliny the Younger.

Dear Hope: Finding Joy

This week’s Sunday Letter prompt was to write a list of “I Hopes” and then use one to expand upon. Felt like the right approach, give the heaviness in the world right now. Here goes:

  • I hope my children lead fulfilling and happy lives

  • I hope I keep leaning into taking more “risks”

  • I hope I can say I have no regrets in life

  • I hope for a life with a delicious amount of sleep, fulfilling work, soft but firm boundaries, and delightful times with the people that are most special to me

  • I hope our collective resistance to this current regime results in a changing tide with new leaders who demonstrate compassion and strategy

  • I hope we all bring a little more joy into our lives

I’ve been thinking about this last one a lot lately. How to experience more joy. How to be the bringer of more joy.

…I have a colleague at work who pops by to tell me funny things or leaves me a trinket of an inside joke. It makes my day and brightens my outlook.

…Yesterday I met up with a good friend from my breast cancer survivor group. We took a walk and then went to the farmer’s market. Every time I go, I’m reminded of why I love it. Everything is fresh and beautiful, you’re among community, the sun in shining. The mushrooms were gorgeous. And they had wasabi sprouts! Talk about joy…

…And then I’ve been watching Timm Chuisano on instagram. His approach to being happy is noticing the little joyful things in life. So simple, but so doable.

Especially during times like this. When our country is upside down and people in our community are living in fear. It puts any individual struggle into perspective and makes connection with others so critical. Finding and sharing joy in our daily practice is life-giving.

So for me, I’m starting my days thinking about what brings me joy. What I hope for. How I can actively seek it. How I can notice the moments. How I can actively be part of creating this for others.

A pretty good way to start the week.

My farmers market haul. Picking it out felt decadent and healthy and full of joy.

Dear Universe: Course Correction

Dear Universe,

I’m feeling a little “off.” Off from my goals, and off in my daily practice.

  • Physically, my body hurts. Sciatica is no joke. But I’m dealing with it through Advil and icy hot and mobility work.

  • Mentally, I’m maxed out. Work is a whirlwind. On top of a fast-paced January, my office is next to the bathroom and I’ve made it an inviting environment so I’m interrupted by friendly hellos from nearly everyone. The social side of me wants to engage (it’s so fun! Hi! What’s up?!) but the amount of toggling from focus work to interaction and back to focus is starting to take its toll. I know I need to set a boundary or structural change but haven’t yet.

  • Emotionally, I’m fatigued. Cancer survivorship is a process and it’s a constant in my life; constantly modifying medications and supplements, learning about emergent strategies and protocols to ensure remission, understanding my new whole food plant based diet, and taking the time for self-care (which is hard to prioritize even though it should come first. And during my medical leave I was able to take this time. How and what should be carried over to “normal life?”)

In a nutshell, I’ve already gotten off-track with my goals for 2026. I wrote them down at the end of December and have done nothing yet to put them into action. If I’m not careful, I feel I could easily slip back onto my previous pre-cancer life of high stress, and that’s something I learned during chemo that I can and want to control.

So today is the day. I’m revisiting my goals and taking the first step to get back in the saddle and “control my controllables.” I’m back to keeping my goals front of mind; 1) strengthen my remission, 2) curate more “brand Lara” (ie be my most “me”), 3) pursue joy, 4) practice life balance, and 5) improve my financial health.

And here’s how my daily practice will support this:

  • Physically, I am keeping my 5:30 am wake time but starting it with a short walk. This will help my back mobility, but also get my brain moving as well. I’m also recommitting to a 9pm bedtime. (I know, I’m ancient)

  • Mentally, using a few helpful mantras, I am reminding myself of my priorities, and separating urgent from important. And giving myself some stronger guardrails to ensure time to focus. I am the boss of me!

  • Emotionally, I am acknowledging that this phase of survivorship is best understood by other survivors. I’ve recently talked with two friends who also went through breast cancer and it was just so nice to commiserate and learn from each other. My instinct upon remission was to stop talking about cancer but I’m now understanding that this journey requires connection.

Here’s to a quick course correction in late January- and I’m proud of myself for noticing. Hopefully next week’s letter says I’m “on.”

Love,

Lara

One of my “extracurriculars” is serving on the board of Friends of the Urban Forest, a nonprofit that connects people with nature and each other by planting and caring for San Francisco’s street trees and sidewalk gardens. I’m delighted to be part of this organization, and my work here is aligned with two of my personal goals for 2026.

Dear Past Self (And Other Younger Women)

Dear Past Self (And Other Younger Women)-

I’ve been learning a lot this past year and I’ve had a new awareness this week. I thought it important to share with you. Buckle up, this is a longer one.

See, there are some health-related things I’m discovering could be clearer now if I’d done things differently back then.

Don’t get me wrong- I’m not in a “woe is me” mood. I don’t have regrets- I just have a good ol’ case of reflection.

In fact, 2026 is heading in a good direction. I’m in remission (now at 10 months), and my Bells Palsy is 95% resolved (which means I can look in the mirror and take photos again!). I’ve begun to really understand what bothers my back (bulged disc) & sciatica, and how to make it feel better. I have a strength and mobility plan in place (and an awesome trainer). And I’m actually quite enjoying my new heart-healthy Whole Food Plant Based (WFPB) diet (who knew?!).

And I’m confident as an advocate for my own health. I learned from the best; my mom is a nurse practitioner and a genetic counselor. While all her questions to doctors embarrassed me growing up, I’ve benefited greatly from this skill. And of course I carry on the embarrassment to a new generation (my kids).

See?? That’s a lot of good.

But still-  if I could go back, I would do a few things differently.

We know about financial literacy, and encourage people to save for retirement long before it comes. What about health literacy? Why do we not encourage people in their 20s, 30s, and 40s to prepare for a longer healthspan by “banking” wellness and understanding their personal health metrics?

Here’s what I mean:

We have all heard the saying “youth is wasted on the young.” Perhaps. But maybe in regards to health, it’s about understanding how to maintain the benefits of youth while we age. Our healthcare system is mainly set up to be responsive. It often falls to the individual to educate themselves and learn to advocate for what they need.

Over the course of this year I’ve learned what i would recommend to my past self, (or other younger women):

  • As a young woman, my bone density was at its peak around 30. This means that the opportunity to finish building bone was in my 20s. While I was very active, I could have focused more intentionally on strength and impact activities.

  • I’d also go back to my 30s and start prioritizing sleep. In a different way, and before I experienced difficulty falling or staying asleep. I’d practice good sleep hygiene earlier. I’d learn that sleep is not the absence of growth, it’s where all the good stuff happens.

  • And lastly, in my early 40s, I’d get a full “baseline” blood panel done. Not to look for problems, but to have a baseline of what my “normal” is for every major bodily function.  (If I knew about my genetic risk factor for heart disease, I most certainly would have altered my diet earlier.) I’d also consider genetic testing for known family disease so that I could focus on lifestyle interventions to lower my risk.

Similarly, before doing chemotherapy, I was given lots of scans and bloodwork. This was all to know the baseline for during and post-chemo and also to make informed medical decisions. But it was only really related to oncology. It was a whirlwind time full of chaos and uncertainty and a lot of decision-making. Yet if I had to do it again:

  • I’d have taken a DEXA scan for bone density. I was casually offered this but declined since all bloodwork looked good, and they did not encourage otherwise. I did not know that a year later, I would want a pre-chemo baseline before starting aromatase inhibitors, which can severely reduce bone density.

  • I’d have pushed for a more complete bloodwork panel. They tested for chemo-related items. What I should have asked for was a panel that gave me a baseline for any future health issue- cardiovascular, neurological, and more. Who knows what will surface in the coming years, and my baseline is forever changed.

And yet- I can’t go backwards. And it’s not helpful to dwell on “the shoulds.”

I spoke with with my mom (a healthy and vibrant 76 year old) which helped me think about prevention and “banking health” in a few categories like heart, brain, dental, bone, genetics, hormones.

So overall, this reflection has me thinking in two ways:

  • What can I share with others so they know in advance?

  • What can I do now so that I am best positioned for the second half of my life?

I like the way this feels proactive and action-oriented. I have an amazing primary care doctor whose specialty is cancer survivorship and thinks holistically about prevention. My next step is to talk with her to see what else I may want to consider as I bank as much wellness as possible for the coming decades.

Love,

Current Self

Crissy Beach on a sunny day this weekend. I always feel grateful for my health with this view.

The Power of Framing with Identity

Dear Future Self:

I said I’d write a weekly letter. Every Sunday. However, it’s Monday morning at 6:45 and it’s not yet written. Not my favorite way to kick off a New Year’s commitment!

Usually my writing style is to wait for inspiration. I have an idea that’s been in my head, turned over many times, and explored from all sides before I put metaphorical pen to paper.

But this Sunday Letter project asks one to write with consistency, not intermittent inspiration. I was listening to a short podcast with Jay Shetty yesterday- he talked about breaking habits by interrupting the response loop and by identifying as the person you want to be. (Episode linked below- it’s short and sweet!)

It immediately made me think of my writing. I thought, “i want to be a writer but I don’t really write until motivation strikes.” He suggests we lean into the identity you want. I gave that a try. “I am a writer, and this is the year that I write every Sunday.”

It also made me think about my health. Lately, I have been subconsciously thinking, “I’m still physically recovering and have limitations. I’m tired all the time but wish I could have better and more consistent workouts.” Through Jay’s lens, I changed it to, “I am an athlete. I’ve been through a lot, and in order to focus on strength, bone density, flexibility and heart health, I prioritize sleep to ensure I have the energy I need.”

Both revised statements will be something I can say to myself as I start to create a new habit loop.

Cheers to positivity, reframing, and owning your identity.

Jay Shetty on breaking the loop of a bad habit. https://open.spotify.com/episode/5hY70J9ofjhfpvkoyk5yHD?si=KS-uQAgWRrGx9lme9N-lcA&t=1799&ct=1162

My most recent photo, on a Waymo ride with good music.

Dear Future Self

I recently saw a writing prompt called “Sunday Letters.” I loved the idea; taking a bit of time each week to put pen to paper. I think the main point of this project is to get back to the old-school art of letter writing. (I’ll link the project below in case you’re interested)

I found myself interested, but for a different reason. The prompt itself is intriguing and I like a weekly ritual. I’ve decided to write my weekly letter to myself (and perhaps share here). So here goes.

- - - - - -

Dear Future Self:

This is to document that 2025 was the year I discovered my 3 tenses. And my tendency to live in the future tense.

(Sidenote: this is especially funny to me given my newfound love for the futur proche in French. But I digress.)

I’ll explain. Past, Current, and Future Laras all have different competencies.

Current Lara always has lots of ideas. She’s curious, excited, and insatiable. She has a zeal for adventure. If something is fun, more of it will be more fun. If it’s interesting, more will be fascinating. You get the point.

Also, Current Lara is a doer. She will sign you up for everything. She will send the calendar invite. She’ll also buy all the books and other things related to any emerging hobby. She may have just bought a Mahjong set after playing the game once. (Past Lara wasn’t thinking about the fact that it’s a 4-person game and she doesn’t know it well enough to teach 3 other people. But Future Lara is so good at challenges!)

In addition, it was an especially anticipatory year; Current Lara had to do a lot of recovering from surgeries and setbacks. So she lived vicariously through Future Lara. She knows how much Future Lara will appreciate her efforts.

But here’s the rub: Current Lara also thinks Future Lara has more time and energy than any of the Laras. (“She’ll be inclined to use this! Or to do this very interesting and fun thing!”) Which is often true. But just as often untrue.

Sometimes Future Lara (who is now Current Lara- and I know that’s confusing but stick with me here) is grateful for Past Lara. Past Lara was organized and efficient and thorough (is anyone else now singing the Cake song “She is fast, thorough, and sharp as a tack/ She is touring the facility and picking up slack”).

Past Lara was who you wanted planning your group vacation. And also: Past Lara sometimes overestimated how much time and energy Future Lara would actually have. Sometimes Current Lara is sitting on the couch with a good book and very irritated that Past Lara thought a 7am workout was a great idea.

So you see the dilemma. They’re all right, it’s really more about time and place.

And so joking aside, the learning is this: I am working on making sure Current Lara lives more in the present tense, and balances the restraint & wisdom of Future Lara with the enthusiasm and curiosity of Past Lara. I’ve never known myself as well as I do right now- and I’m excited to see where 2026 takes me.

And en français: Maintenant, je vais faire de cette année une année formidable.

Bisous,

Current (aka Past) Lara

- - - - - -

Thanks to the Sunday Letter project for the inspiration. www.instagram.com/thesundayletterproject

This is a photo of Past Lara with her family over Christmas vacation.

Pigtails As Progress

The last few days have been hard, emotionally.

I cried. I did lots of zone 2 cardio. I listened to George Winston’s December. I went to acupuncture (which really means: I sat with my thoughts for an hour).

And then I wrote about it. And I shared what I wrote. Mostly cathartic, slightly vulnerable. I think that’s what growth is supposed to feel like, right? (See previous post on Seven Stages of Not-Quite-Grief)

And then I got ready for the day. AND MY HAIR FIT INTO PIGTAILS. What!?! Has life ever been this DELIGHTFUL?

I’m back, people! One inch at a time, I’ve been told. Growth, indeed.

Post-chemo success = French braid that stays and one-inch pigtails.

I mean… how cute are these little guys?

The Seven Stages of Not-Quite-Grief

I’ve got a new list for you.

I’m sure you’ve heard of the Seven Stages of Grief; shock and denial, pain and guilt, anger and bargaining, depression, reconstruction (working through things), acceptance, and ultimately, hope. Sorry for the spoiler, but this list is not that. You’ll see.

In case you need context: it’s been a year of cancer diagnosis and chemo and surgeries and Bell’s palsy and recurrence scares and neuro scans.

But that’s mostly in the rear view mirror- I’m in remission- and so I pop back up, because it’s what we do! We power through! We soldier on! (Note: I once said a version of this to my kids and husband- as in, “we’re Hitchcocks, we don’t stop trying until we succeed!”- and after a moment of kind but confused stares, my youngest said, “mom, i think that’s the Farrell side.” To which Matt corroborated, “yeah, Hitchcocks are cool with ‘good enough.’”)

Regardless, part of my self-commitment to stay on top of remission (besides lifestyle changes and ongoing meds) includes doing additional quarterly bloodwork. In doing so, I discovered an entirely new issue- unrelated to cancer or Bell’s palsy. Despite [what the summary report called] my “otherwise excellent metabolic health,” I fall into the severe risk category for heart disease based upon a genetic marker (Lipoprotein A). There are nuances here and ways I can mitigate this, and I know I’m lucky in so many ways. And nothing has happened … but my point is not that- it’s the near-grief one goes through at a time like this, when you’re hit with continued big, bad news.

So here are my Seven Stages of Not-Quite-Grief (perhaps yours are similar? Different?)

1.Overwhelm & Brain Box

“Are you #%+#! kidding me? This is ridiculous.” I literally just got through a year from hell. (I would have categorized myself as “very healthy” before cancer and “super freaking healthy” now so it feels unbelievable that I may have to change more aspects of my life). I start googling things but I just don’t have brain space to think about it- so I put it in a box in my brain and tell myself I’ll deal with it later.

2. Sadness

Booo! I’m rarely a sad person, but yesterday I cried. I want to be externally focused in the world again. I’m tired of thinking of my health. But here it is again.

3. Injustice

The hits just keep on coming, I told myself. (I am now a petulant toddler. An articulate one, though.)

4. Cynicism

I told my sister that I should probably stop saying I was “dying with laughter.” And I told my friend that she should find herself a back-up bestie. Dark, I know. But I’m keeping it real, people. That’s where I went. I kept thinking about my maternal grandfather who had a heart attack at 55. Luckily my people know me and can handle all of me, even the cynical parts.

5. Sarcasm

I think this is where I landed yesterday evening. Still making jokes but slightly less awfully dark. My sister reminded me that the “severe risk” category is from a population health perspective, and that my healthy cholesterol and fitness levels make me less likely to experience a problem. And that population health doesn’t translate to individual health; something I learned already during chemo. Seems like I needed a reminder.

6. Benign Humor

I can feel myself entering this zone. This is where I embrace reality but keep it light. This is the place where I can talk to others outside my inner circle. (I think that’s why I’m writing this, actually). I can make fun of myself and call out the ridiculousness. Like- I thought I was done with this, but apparently I still need to be at the center of all food conversations in my family. Such a drama queen.

7. Action & Gratitude

I’m not solidly here yet. (In fact, over thanksgiving I was feeling frustrated about not feeling grateful.) But I’m close- I can feel myself thinking about my options. My questions. My alternatives.

And I am entertaining this idea: what if everything I went through this past year brought me here? I never would have taken this additional bloodwork panel if I weren’t trying to stay on top of my remission. So maybe this all had to happen for me to find the thing I never would have seen coming… maybe. I do believe things happen for a reason.

So I’ll be solidly in this zone, likely by tomorrow morning at 5:15 am. In front of the fireplace, snuggled up with my health journal. I plan to make my lists- what do I know? What don’t I know? What do I think are the levers I can pull? What am I thinking is out of my control, and is it? Who do I need to talk to? And more.

Ultimately, I know I’ll figure this out. I always do. After all, I’m a Farrell. And it’ll be good enough, because I’m a Hitchcock, too.

Packing in the zone 2 cardio at the Independent Health Family YMCA in Buffalo, NY.

My Eye Is Twitching & Other Annoying Things

My eye is twitching. Constantly. Since September. It’s November now.

It’s pretty omnipresent and frustrating. At the beginning I researched everything it could be and all the possible contributing factors. It comes down to this: maybe it’s chemo recovery. Maybe it’s Bell’s palsy recovery. Maybe it’s my body’s way of dealing with stress. Maybe, maybe maybe.

It sort of doesn’t matter. It is what it is.

And yes, I’m taking ALL THE SUPPLEMENTS.

It’s the same story with my hip/glute pain, my joint pain, and my crazy brittle fingernails. And the fatigue. And the neuropathy in my left foot. And the acute/ exaggerated symptoms that come with chemically-induced menopause. And the side effects from my aromatase inhibitors (mainly more joint pain). Blah, blah, blah. So annoying, and so very boring to talk about.

Normally I’m in the “power through it” mindset. I’m lucky to be NED (no evidence of disease) after breast cancer and happy to be focused on staying in remission. And I dont make much time or space in regular life to think about how much havoc cancer has wreaked on my body.

But I’m home in Buffalo this week, visiting my mom. It’s given me a few days to pause again. And im realizing that I need to feel some compassion for myself in this phase. It does suck. And yet I know I’ll figure it out. I always do. [wink]

Nope, that wasn’t a wink. Just an eye twitch. :-)

At the AKG Gallery in Buffalo with my mother.

1 Year Update on Mind & Body

It’s the end of breast cancer awareness month and I’ve also finished my “active treatment” (recently completed a year of targeted therapy/ Herceptin infusions).

It’s that strange time they warn you about in the breast cancer world when you’re in between selves. Mostly back to “normal” on the outside… maybe a bit of a different person on the inside… and definitely not done feeling the repercussions of cancer.

Overall, I’m feeling super lucky and grateful for family & friends and proud of myself. But here’s where things stand- the good, the bad, the ugly. :-)

What’s On My Mind

  1. To Port or Not To Port: I put on a dress the other night for a work event, and you could see my port and scar if you looked. It reminded me that I need to schedule a procedure to get the darn thing out. (And why am I weirdly dragging my feet on the thing I initially hated? I felt like a Cyborg when it was put in… and now I feel strangely attached and superstitious about getting it out).

  2. Defining Normal, Always: Every week, and probably nearly daily. There’s something I notice about my body and wonder if it’s “normal.” The harder ridge on the side of my implant? Normal. The sweating on the top of my hands (not the palms) when I get a hot flush? Normal. (Yes, weird. But normal.) The forgetting where I’ve put things? Normal. The excruciating pain in my glute and hip? Probably normal- but I am getting an MRI. There’s just always that lingering worry- is it cancer/cancer-related? I’ve mentioned this before- that I tend to quickly tuck that thought into a tightly sealed box in my brain (labeled “Panic: Cancer”). I rarely access it. I’m not sure if this is healthy or not healthy- but is it normal?- Probably.

  3. Joy Is All Around Me: This is the piece I’m most grateful for. If it were not for this last year, I’d still be mentally in the rat race. Doing all the things. Worried about all the things. Perfecting all the things. Always focused on the future. All these things can be good in moderation but I was leaning into excess, to my detriment. Now, I’m aware of this tendency. I’m practicing enjoying “the now” more than I ever did. When things go wrong, I’m asking myself “what’s the worst thing that could happen here”- and usually the answer tells me I can relax. I’m slowing down before reacting. I’m finding things more humorous. I’m engaging more creativity. All in the name of having more joy for me and those around me.

How My Body is Doing

  1. My Joints Ache, Badly: I have to take medication that inhibits estrogen in my body, so as to limit the risk of recurrence by creating an environment that is the least hospitable to an estrogen seeking cancer. That means my joints are stiff and ache so much. (When I first heard about this side effect, I remember thinking, “achy joints? That’s so doable.”) But for a really active person, this is a very big bummer. It impacts my flexibility, my physical ability, and my everyday life. For example, getting into and out of the car is the most painful part of each day. (Actually it’s tied with putting on socks and shoes). I’m working through it and may change medications if it doesn’t improve, since I need to take this medication for 5-10 years.

  2. Hair is Growing! I have been so pleasantly surprised at how quickly my hair is growing. Plus, it is coming in thicker than it was pre-cancer, which is a bonus. It’s also growing in grayer, but I couldn’t care less. I’m definitely hitting an awkward stage where a headband isn’t sufficient, but I still can’t tuck the hair behind my ears. But I’m experimenting with this short hair and it’s actually a little fun. There were so many options for Halloween this year!

  3. Nose Hairs Still MIA: They still haven’t returned in full force. As the weather turns colder, I foresee a lot of tissues in my future. I’ve mentioned it before, but this is one of the most surprising side effects from chemo. Matt jokes I’ll be like the old ladies who tuck a tissue into their sleeve.

  4. Bell’s Palsy On Its Way Out: my face is probably 85 to 90% back to normal. That’s not a scientific number… it’s just how I feel. I can still tell that my lower lip is a little off and my right cheek is a little lower. Most people tell me that they can’t tell and wouldn’t notice it unless I mentioned it. So that makes me feel mostly fine. But I’d like to look in a mirror and see 100% of myself looking back at me. I still do acupuncture weekly and Gua Sha daily, and I’m hoping that it will continue to resolve all the way.

  5. Fitness, Regained & Reimagined: Besides accessing joy, the other thing I’m most grateful for is my body and my resiliency. During chemo I lost about 25 pounds and a lot of muscle; however I made a point to continue doing what I could. I worked out weekly with my personal trainer & Coach, Keir, and we focused on strength and breath work and mobility. I’ve regained 15 pounds and most of the muscle strength. My breathing and ability to meditate far surpass my pre-cancer abilities. And we continue to focus on things that maintain and improve my bone density, move lymph, strengthen muscle, and improve flexibility and mobility. On my non training days, I’m going for long walks, using the sauna again (yay!), doing yoga, and loving The Class. If you haven’t tried out The Class, I recommend for anyone looking for movement that has an aspect of silliness/joy to it.

So, that’s where I am these days. Balancing medications, thinking about my physical body and how I move it, reducing stress as much as possible, and focusing on experiencing the joy that is around me.

Working on strength and mobility with Keir & Foghorn Fitness (photo credit: Keir Beadling)

Hiking with my sister Kristen in Newburyport, on a recent trip back East.

Dinner with Oli in Boston while on college tours

Me as Medusa for Halloween. Never pass up the opportunity to dress in costume.

Short hair Halloween options included Effie Trinket from the Hunger Games. Matt made a stellar Haymitch!

BYOB: Bring Your Own Bell

Today is my last infusion and it was BYOB. Bring Your Own Bell. The infusion center doesn’t have a wall bell so we are making sure I have my own little celebration.

And the day started off celebratory right from the beginning, with texts from friends and family celebrating this moment with me.

This infusion is my “last chemo” though actually it’s not technically chemotherapy. The medication is called Herceptin, or Traztuzumab, and it’s considered a targeted therapy. Patients with HER2+ breast cancer typically do one year of this medication to prevent recurrence.

But it’s another one of those survivor milestones. A big one. After today, I’m no longer considered in “active treatment” (though I have 5-10 years of oral meds to take). Today I get to ring a bell- and then more importantly, toss (read: burn) this poor white v neck t-shirt I’ve worn every third Friday morning for a year.

I knew Matt (husband), Oli (son), and dear friend Peggy were in the lobby, waiting to join me in celebration. And then we’d head to brunch with a few other friends as well. I was wearing my “brunch pants” (aka party pants).

When I walked out into the lobby I was surprised with even more of my friends, multiple bells, and pink hats that read’ “BELL YEAH!”

I was so overwhelmed by the love.

These women (and others who were there in spirit) have been with me through the hardest year of my life. What a huge blessing this has been. They came with BELLS ON, literally.

Of all the things this year has taught me, celebrating the moments & creating our own joy is the highlight. Sometimes you just need to bring your own bell.

That Little Red “1”

There’s no jolt of caffeine or energy that can mimic the adrenaline that courses through you when you see the Little Red “I” Notification.

A new test result.

It’s hard to believe it’s been a year since my diagnosis, but it has— and that makes it time for another mammogram. I’m only 12 weeks out from my last surgery, and still have one infusion of Herceptin left, and still have 5 years of aromatase inhibitors to take. And yet- it’s time.

This time it’s a 3-D mammogram (and it’s right breast only, since I had a mastectomy and implant on the left). The appointment took just 10 minutes. And then I put it out of my head for days. Packaged it neatly in that little box in my brain marked, “Panic! Cancer-related info.”

Then the day comes and there’s a little red “1” on the medical app. Heart racing, brain spinning. I think, “am I ready for this? Please please please, no cancer.” And I open the notice.

I quickly scan, looks ok. Read more thoroughly. It’s good news. No cancer. And that’s where I stop for today.

Fashion Show? Who Knew!

For the past year, i’ve been so lucky to be part of a weekly Breast Cancer Support Group. We meet online every Monday evening and share the ups and downs of this journey of cancer survivorship.

This Spring our facilitator encouraged a few of us to participate in a fundraising effort for breast cancer. We were all nearing the end of our “active treatment” phase (chemo, surgery, radiation) though many of us have 5-10 years more of cancer related medications and procedures to look forward to.

The fundraiser is for an organization called To Celebrate Life, and it provides funding to Bay Area nonprofits which provide emergency & financial assistance and direct services for underserved patients struggling with breast cancer.

The event itself is called Stepping Out*, and it’s a fashion show in which the models are all recent breast cancer survivors. I thought, “sure, that sounds like something I’d like to be part of.”

Little did I know what I’d be getting in to! This is a months-long annual effort, powered by so many dedicated volunteers, the majority of whom are breast cancer survivors themselves and former “models” for this very event. And this is the 30th anniversary of the event.

Last weekend we gathered for six hours of training on runway-walking. This weekend is another six hours, and next weekend is the dress rehearsal and the main event. We’ve discussed turns and poses and shoes and timing and staying right and doubles and chevrons….

It’s been so fun, and so life-affirming. Yes, because [as our Model Coach Lisa says] we are practicing being embodied… walking confidently, shoulders back, broad smiles on faces.

But it’s not just that. I’m drawn to these women. We’re sharing laughs at eager rose tossing. We’re appreciating each other’s newly grown chemo hair. We are helping each other walk faster or slow down (ok, that’s me- and thanks, Geri!). We are feeling the levity in the room. There is only positivity.

As I’m learning, it’s another version of the Joy that keeps showing up when I look for it. I’m so grateful for these women and for the opportunity to take a risk outside my comfort zone.

Stay tuned for Fashion Show photos after next week’s event (Saturday 9/27); in the meantime enjoy our rehearsal pics!

- - - - - -

* I had so much support from my friends and family along the way. I get teary just thinking about it. I can’t imagine enduring this past year without the meals, notes, errands, visits, gifts, and… the list goes on. But many women don’t have the same support, for a variety of reasons. If you’d like to support this effort for those who need assistance please check out my fundraising page. Proceeds from my fundraiser as well as the Stepping Out event go directly to Bay Area nonprofits serving women with breast cancer. Thank you!

https://wl.donorperfect.net/weblink/weblink.aspx?name=mbcc&id=102&cfifid=175

Peeking out from “backstage”

Someone may have tossed a rose too early

Tricky; a double meets a chevron

“Do we stop halfway?” The eternal question.

Methinks Zoe has done this before. #pro

I haven’t met a chevron I didn’t love.

Another chevron! Woot!

Supporting each other.

Where are the Tall Gals?

Getting ready for the super fancy double turn.

Last instructions before the full run-through.

Loving it.

Second-to-last Infusion Musings on Stress

I’m already running late; I left the house with 13 minutes to get to the infusion center which a 15-18 min drive away. My husband jokes that I think everything in SF is 10 min away (he’s not wrong. What can I say, I’m a glass half full gal…)

Of course then I hit traffic along the way. And/but I had my 432 Hz frequency music playing, which audibly reminds me to breathe. It’s a cue to pause, remind myself “this is not urgent. People run late all the time.”

Then I arrived at Kaiser (the medical infusion center), and the parking garage was slammed. I circled multiple times to find a spot. “It is what it is, I’ll do the next best thing” I told myself. This mantra works for me in most stressful situations.

I stepped into the elevator and pressed 8 for the top floor. Others got in and pressed 2,3,4,5, and 7. Of course they did. I tried not to sigh aloud, but I might have. (Also: why do elevators have a “door close” button when it doesn’t help the doors close any faster?)

The 8th floor Infusion receptionist is one of my favorite people- she’s always so positive. “So sorry I’m late,” I apologized. “You’re here, and it’s a clean slate!” She said with a smile.

My infusion nurse greeted me and got me set up for my second last Herceptin dose. “I remember you,” she said. “You have a great port!” (I love chemo and cancer compliments; they’re so specific and appreciative. I was also recently told I “have great ears for a short haircut” which made me giggle).

Now it’s quiet, my infusion has started. And I’m sitting here thinking about the morning and how my perspective is starting to shift. Perspective and positivity were important to me a year ago, but they are now absolutely front and center in my life. They are not just things I wait for, or hope for, or value— they are things I employ. They are no longer nouns, they have been glued to a verb. There is a centeredness that comes from noticing when I actively interrupt my own patterns of stress and intentionally choose a calmer path.

Let’s be clear— no one will ever call me a calm person!— but it’s nice to notice another silver lining to this past year.

In the chair, and with a nice view today!

And done! ONE INFUSION LEFT!!!!

Chemo Supplies: A Prep List

Starting chemotherapy is a big deal in so many ways. It’s terrifying, it’s anxiety-provoking, but it’s also exciting in a scary way. You have no idea what to expect but you know it’s the first step in this phase of your survivorship journey.

As a type A person, I had been carrying a notebook with my daily, jotting down cancer-related questions or learnings on the fly. I had a running list for each doctor plus a list for a few friends who had been through this before me.

One of the lists I ended up creating was an “Infusion Day Go Bag” list. I began this a few weeks prior to chemo as I started learning what I would need to ensure the best possible outcome.

Here’s my list; keep in mind this is specific to Breast Cancer and yours may differ depending upon your type of chemo and your personal needs.

  • Take any necessary morning meds before going to infusion (in my case an oncology pharmacist called me in advance to talk through which meds I’d take and which ones I’d pause for chemo)

  • Many people put lidocaine on their port an hour in advance to numb it. I never did, but it goes on the list.

  • Cold cap bag (includes cold cap itself and toiletries to help with putting it on. If you are cold capping be sure to arrange this in advance as these differ widely in how you use them. And practice putting it on twice in advance)

  • A long scarf you don’t care about in case you need to tighten the cold cap from your head to your chin.

  • Cold mittens and booties (similar to cold cap, but here they prevent the chemo from causing neuropathy. See links below. And get extra ice packs to switch out if you have a long session)

  • Medium sized cooler with ice packs for keeping extra ice packs cool

  • Ice Popsicles (to ice the inside of your mouth. I learned this one the hard way and got terrible mouth sores after the first chemo. It’s the same concept as cold cap and booties- protect your mouth lining! I made popsicles of ice or electrolyte water. Some nurses will bring you ice to chew on if you ask, too)

  • Heating blanket (to keep the rest of your body warm)

  • Readers if needed (my glasses sides did not fit over my cold cap but readers had more “spring” to them)

  • Books or kindle or iPad if desired

  • Cheap stylus with rubber end (to use for iPad and turning book pages when you have mittens on)

  • Air pods or headphones

  • Chargers

  • Journal and pen

  • Water bottle with electrolytes (I love LMNT, see below for discount link)

  • Snacks (the infusion center only had crackers and juice- I was on my FMD so I brought a thermos of soup or friends got me green juices)

  • Wear comfy clothes (I wore the same v-neck tee each time and plan to burn it in celebration at my last infusion! I also wore a cozy wrap sweater given to me by a friend who went through chemo herself. And wear a bra that makes it easy to access your port)

  • Change of clothes- just in case

  • Easy slip on shoes (in case you need to remove booties and use the restroom. I had fuzzy birks)

  • Beanie for post chemo (wore this after I started losing some hair- the bamboo snood from headcovera was really soft and cozy)

  • A basket or small open container where you can put all of the things you want to easily reach- and this can sit on the side table of your infusion chair. Mine contained iPad, phone, water bottle, stylus, pen, journal, and a snack.

  • Snacks for the infusion nurses. You don’t need to do this but they have a tough job and are often understaffed so I’d bring a box of donuts or bao or energy bars most times.

Most of these things I kept together as a “Go Bag” and after the second round it was like clockwork.

Supplies referenced above:

This poor v-neck tee has been pulled in every which way. But it was easy to access the port for my infusion.

Ice mittens make it very hard to do anything. But I never got neuropathy in my hands, so they worked.

Ice booties are thé worst. I hate cold feet even more than I disliked the cold cap. But I kept them on most of the time. I did experience some neuropathy towards the end of my rounds of chemo, and then became a little more rigorous in keeping them on during treatment.

Improving Chemo: My Fasting Mimicking Experience

When I started chemo, I was nervous and eager to begin treatment. There was so much to think about and prepare for— medications to take in advance, a hair-preserving cold cap to figure out, and lots of supplies needed for infusion day.

I had heard about the Fasting-Mimicking Diet (FMD) and how it could be beneficial during chemotherapy, but I didn’t have the mental bandwidth to figure out how to incorporate it into my treatment process.

After my first infusion was in the rear view mirror, I felt I had more capacity to learn something new and began looking into a Fasting-Mimicking Diet (FMD). FMD allows cells to activate their repair functions, similar to fasting, but without the severe restriction of fasting. This short-term dietary change, I found, could be potentially increase the efficacy of my chemo and also reduce the toxic side effects. Those both sounded worth looking into.

For my subsequent rounds of chemo, I decided to use the FMD, beginning two days before my infusion and continuing for one day afterwards. I used a number of sources* to build a plan for myself— understanding that most FMDs call for restricting calories to between 600-1000 per day, and focus on high fat and low protein.

Using the FMD, I noticed less nausea during my “worst” days, and overall, tolerated chemo fairly well. I also liked having something proactive I could do that could possibly help my treatment.

I ended up doing a 4 day FMD that was 600 calories, using an avocado-berry shake in the morning, a vegetable blend soup for lunch, and a leek and cauliflower saute for dinner. I never was too hungry and could imagine myself starving the cancer cells so they’d be stressed enough to be eradicated by the chemo.

Obviously I’m not a doctor nor a nutritionist, but as a patient I found the FMD useful. I did end up having a complete response to my chemo which I attribute in part to my dietary changes that included the FMD before each infusion.

I plan to continue using FMD as a way to reset my body at a cellular level, probably every 3-4 months. I just completed a 5-day FMD using Prolon, and will likely use this again at some point. I’m continuing to learn more about this and will add a post later when I have more remission experience with FMD.

- - - - - - -

*A few of the many sources I used to learn about FMD and build my own menu:

One Year Later / Lara 2.0?

Today is exactly one year since my diagnosis. I remember— it was a Monday, and I took the call between meetings. I can picture where I was standing in the house and the quality of the light near my desk.

Yet here I am. It almost seems like a lifetime ago. I’m sitting on my sofa, in front of my fake fireplace, another warm glow, and enjoying a cup of coffee. Thinking about how much has changed.

A year ago, Anxiety lived with me 24/7. It set up shop and probably helped me power through the whirlwind of doctor appointments. It certainly kept me on task with researching my disease and what could help. It made me singularly focused.

Now, I have a new appreciation for peace and acceptance in my life. The simple phrase “it is what it is, you’ll do the next best thing” has become my mantra. I’ve also learned to regroup when I feel Anxiety knocking at my door; I move, I breath, I listen to 432 Hz. My therapist told me “anxiety lives in the future” so I work on connecting to the present. As a cancer survivor there will always be the “what if” question of recurrence- but fearing it doesn’t change a thing about what is or is not. And so the more I can choose things that bring me joy, the better I’ll feel, and the more connected I’ll be.

A year ago, and before my diagnosis, I may have been considered a high-strung person. I’m driven, have high expectations of myself and others, and wanted everything to be the best it could be. And there’s nothing wrong with any of that, in my opinion. Except that for me, this often created a level of stress in my life that was unhealthy, despite how “healthy” a person I was.

Now, I’m working hard on prioritization, increasing my perspective, and using my empathy in a new way. This means I’m asking myself “in the grand scheme of things, does this matter?” And “what’s the most important part about this?” And other similar queries. I can actually feel the lowered frustration and the increased access to humor and joy.

Sometimes I wonder how different I feel to others, now. Do I still seem like “Lara”, the one they’ve known?

I’ve heard versions of this from many cancer survivors- there’s an in-between phase. You’re not the old you, but you’re not done processing what you’ve gone though. The new you is still developing.

Stay tuned for Lara 2.0. We hope you’ll like the upgrade.

Just a photo of the Bay. Seemed appropriate.