12 in 100 women will develop breast cancer

The majority of women who develop breast cancer do not have a significant family history of breast cancer and so regular screening and self awareness of changes in breast tissue is important for all women. Check here for a general description of age dependent screenings for women at low and medium risk of developing breast cancer. Not sure what your risk is? Check here.

Approximately 10% of women with breast cancer have a genetic form, that means that they inherited a mutation in a gene from either their mother or their father, it can be from either. The breast cancer gene test, or BRCA (“BRAH-kuh”) test, can determine if someone has inherited a specific gene change. This change can make them much more likely to get breast cancer and for women, ovarian cancer also. The BRCA test is only recommended for those who have a family history of breast cancer or  ovarian cancer. Most people with a family history of breast or ovarian cancer do not have BRCA gene changes. It’s important to note that not everyone who inherits a BRCA gene change will get cancer.

Our Healthwise Encyclopedia includes a decision-making tool to help you determine if you should consider the BRCA test. As with all resources online they do not substitute for the expert advice of a medical professional.

For more posts of our posts on breast cancer including personal stories check here.

This story is a little different. Leeanna Murphy, Application Specialist for Patient Financial Services at TMC, received a gift from a friend that was directly intended to maintain Leeanna’s health.

In 2011, Leeanna was out of work for the better part of a year. Unemployment benefits covered mortgage and some utilities, and the rest of her living expenses came from her meager savings. Any “wants” were eliminated from her budget in order to cover the “needs”.

Leeanna had had bariatric surgery a couple years before her unemployment, after a lifelong battle with obesity. She could only eat small meals, and working out provided a great deal of stress relief. One could argue that her gym membership fell into the “need” column as it was a big part of her overall health maintenance. But when it’s a matter of having a roof over one’s head, or not, gym memberships become optional.

She still had a few months left on her current membership at the time of her layoff and was wondering where the next payment might come from, if she was able to pay it at all. Not only did her workouts keep her healthy, but in her water aerobics class she had a supportive and caring group of friends.

Relationships were very important to Leeanne, who through her work with a life coach had learned to think of friends as filling different roles in her life. She imagined herself giving a performance on stage, and envisioned the people she’d want in the front row, cheering her on. Those friends, she knew, were her real, true friends. Other people she better imagined in balcony seats–these people maybe weren’t those who she could count on to be there for her.

She had quite a few friends who would invite her out for meals and movies because they knew how hard it was for her being in the house all day on the computer looking for a new position. They knew she was stir crazy. These true friends were there for her, keeping her from feeling low during a rough time.

One day, a friend of over twenty years took her to lunch as a way of provided a much-needed interruption from what had become a fairly dull routine. During the meal, Leeanna’s friend asked if she was still working out. She knew how important Leeanna’s workout time was to her, physically, socially, and psychologically. Leeanna told her she would continue to go to the gym as long as she could afford it, but eventually the expense would be too much. Their conversation turned to other topics and Leeanna enjoyed the rest of her time with her dear and wonderful friend.

Later that day she received an email from her longtime friend. After lunch, the friend stopped at Leeanna’s gym and paid her membership for four months. This allowed Leeanna to continue working out to alleviate stress and maintain her weight during her unemployment.

Not only was she able to maintain her physical health, but she learned that her life was full of supportive, caring people and was reminded that regardless of her circumstances, she always had cheerleaders. When she did find a new job, her weight had been maintained and her spirit was alive.

Leeanna said, “Believe it or not, the eight months of unemployment, though hard, gave me some of my greatest times of joy. I learned much during that time. I learned that no matter what, life is a joy to live. I learned that I am just as strong as I always wanted to be. Most of all I learned that people in my life are special and wonderful–just the type of people who would belong in the front row of the theater for my debut performance.”

Five tips for healthy shopping in the produce aisle

Secret admission: I love grocery shopping, specifically produce shopping.

Once in the store I make my way directly to the produce aisles and pretend I’m standing in front of the farmer’s veg and fruit stands of my youth. I can mill around those stands smelling the tomatoes, tapping on the watermelon, and peeling back the husks to examine the corn for, well for a long time.  Yet, a grocery store tour with TMC’s Director of Wellness, Mary Atkinson, and TMC Registered Dietitian, Laurie Ledford, as part of TMC for Women’s Bootcamp was an eye-opener for this seasoned produce buyer. The take home messages we can all use when we grocery shop below:

1. Buy in season

Buy the fruit and veg that is in season. Not only is it cheaper it’s also typically tastier, having travelled shorter distances and being fresher. Not sure what is in season? Check out this guide for what’s fresh from local Arizona farms. Go to the store with a list of what is in season. If you’re a planner use the guide to plan in advance what you’re going to eat that week.

2. Weigh convenience over cost

Oh how pretty those butternut squash and how much cheaper than the pre-peeled and diced bags of squash, but if the chances are that those butternut squash are going to sit on the counter and not get used because the prep is just too daunting then go for convenience.

3. Fresh or Frozen > Canned

Fresh seasonal and/or frozen fruit and veg can both be nutritionally rich. Other than beans Mary advised against canned goods other than beans. Frozen goods can offer some great cost savings, are typically frozen at the peak of ripeness and immediately following picking and offer you the option of out of season favorites.

4. Buy what you’ll eat.

You know you should eat Brussel sprouts, or broccoli, or some other much maligned veg, so you buy a bunch of eat and it languishes in the fridge. Or perhaps something is in season and a great price so you can a bunch of it, only to not eat it in time before it goes off. Buy in quantities you know your family can eat and not tire of. Plan ahead for the week. If you know that you can manage the big box of spinach with a couple of salads, in smoothies,  omelette, added to soups or lasagna go for it! Another option when there are great prices on large quantities of a favorite fruit or veg is to share with another household.

5. Try something new

Whether it is celery root or a honey tangerine, find something you’ve never tasted and try one. You might discover something terrific. Perhaps try something that you refused as a kid. I recently found out that beets were quite tasty, but I’d avoided them for nearly 40 years.

In 2006, I had a biopsy after finding a lump in my breast. My baseline mammogram a few months earlier was all clear, as was the second one I had after finding the lump, so I wasn’t that worried. Also, I had no family history of breast cancer, no lifestyle risk factors, and, well, I was young.

But in a phone call that I’ll never forget, I was told that I did in fact have breast cancer. How could this be true? I was forty years old, and had two little kids. I actually told the nurse who called me “That’s impossible. I have two young boys.”

In short order, I had a lumpectomy, chemotherapy, and radiation. Everything you’ve heard about chemo is true, at least it was for me–I felt worse than I’d ever felt in my life. But my friends did everything they could to make things easier for me.

One of my friends, Kassie, organized dinner for my family for the week of each of my chemo treatments. Different women brought amazing dinners every night and several others packed my older son’s lunch and delivered it to him at school. Knowing that my kids’ lives maintained some semblance of normalcy, even though I couldn’t think about food, let alone cook a meal, was so comforting. The hardest part about my diagnosis and treatment was wondering how my boys would be affected. Thanks to my friends, our home still felt like a home, even while I was unable to get out of bed because of nausea and pain.

After several harrowing follow-up biopsies in the span of several months, I ended up getting a bilateral mastectomy and reconstruction. Enough was enough. The stress of waiting for lab results was incredibly hard to bear and I didn’t want that to be part of my life anymore.

A mastectomy is no simple surgery, and the process of reconstructing breasts is complicated and painful, especially when tissue expanders are placed under the pectoral muscles to make room for implants. Because I had radiation, my skin wasn’t very elastic. My amazing friend Patty, a gifted massage therapist, worked on my pecs and shoulders, pro bono, before each fill of my tissue expanders during reconstruction, which went a very long way in cutting down pain and making me more relaxed before the treatments. Also, I was able to actually enjoy some time with her, even if it wasn’t in a usual social situation.

Besides Kassie, Patty, and the friends who made dinners, there were a huge number of women who just continued to be my friends, go to dinner, go to movies, dress up in ridiculous Fourth of July outfits and take photos even though I had on a scarf and had minimal eyebrows. We talked about kids and jobs, broken plumbing, new restaurants, books, and vacations, just like we always had. Those people kept me focused on who I was as a whole person, on my “real” life, on the self I was pre-cancer–on the self I knew still existed.

I’m not good at having people do stuff for me, but experiencing these kinds of support was one of the major things that kept me going during those overwhelming months. I’m so grateful to my friends for keeping my head above water when it felt like I might drown.

85% of women with breast cancer have no family history of the disease. As demonstrated by Alicia’s experience it is critical to demonstrate breast awareness, if it doesn’t feel right, have it checked out. Make sure you know what is normal for you throughout your cycle and when it’s not normal.  Oh, and screening mammograms start at 40 years old, and every year after. TMC for Women’s Breast Center offers comfortable, swift and experienced breast screening mammograms. For more information visit our website. 

Once, long long ago–well, in the earlier part of the new millenium–I was going through a painful, protracted breakup. One of those stop-start kinds, with lots of reunions and tears and separations and did I mention pain?

It was physical pain, and hurt as much as anything else I’d endured.

Two friends in particular got me through this prolonged and arduous process, and today I will tell you about one of them.

Here is the story of something Alicia did for me, something that meant more to me than she probably could have imagined.

It was before the final-final breakup, and in fact he and I weren’t even broken up, but he was gone, as he often was, in a remote part of the world, inaccessible even by cell phone (not that he had one anyway). When he left, things weren’t looking good, so I was in the middle of a month of dead air, a month in which to wonder which way things would go upon his return.

I was, in short, utterly and completely anxious, nearly all the time. I could barely sleep or eat, and the only thing that I seemed capable of was walking. So I walked, and walked, and walked.

Usually I’d walk to Alicia’s house, where I inserted myself into her family’s life. They had an adorable toddler son, and through the years they had accepted me as an honorary relative. I spent Thanksgivings and Christmases with them (the boyfriend always spent Thanksgiving with his family and I was never invited), and most weekends I’d walk from my duplex west of the University to their bungalow, north of the University. It was a long enough walk to calm me down a bit, and in any case, being in their midst felt way better than being alone with my obsessive thoughts.

One day, Alicia told me she had a surprise, and that it involved a walk across Campbell. I had no idea what to expect. We walked to her husband’s friend’s house, a place I’d been only once before, and there in the backyard awaited two known sources of pure joy for me: a trampoline, and some baby chicks.

Alicia knew me long and well enough, and cared enough about me, to know that simple visceral pleasures were usually the only remedy for my anxiety. I already had a therapist, and was working on my “issues”. But when I was anxious, stuck in a loop, things like stroking my dog’s ears or going on one of my long walks were the best solutions. And jumping–oh I how I love to jump! And chickens! Alicia knew I had a thing for them.

So she’d arranged this special treat for me, a backyard with jumping, and chickens, just her and me, no itinerary. So I jumped for a long time.

And finally I got off and stood in the early winter sun with a chick perched on my shoulder while Alicia took her turn on the trampoline.

We didn’t talk much. I jumped some more, and after a long while, we left. And inside me there was a growing seed of strength and hope, one I hadn’t felt before: I knew that, no matter what happened with the boyfriend, I’d be okay. If I could feel joy on this afternoon, without him, it meant anything was possible. No matter which way things went, I could hang onto this feeling of hope whose source was wholly within my being, and I believed that in the end, it would all be okay.

Thank you, Alicia, my friend, for reminding me how to be alive, for providing respite from suffering, and for giving me the hope I very much needed.

Have you ever had a friend do just the right thing exactly when you most needed it? Do your friendships sustain and inspire you? How do you know when you have “enough” friends to maintain a balanced life? Read more about why friendships matter, and how to build and maintain a strong and healthful social network.

Mary Atkinson, RD, Director of Wellness,

With heart-felt honesty, I do not want you to “eat your heart out!”  In fact, I would tell you in a heartbeat, that it pains me to think that so many of us believe that a way to someone’s heart is through their stomach.  I would much rather we all eat a healthy diet so that we can go on living a heart-warming existance and doing whatever it is we most enjoy to our heart’s content.   What’s with all the “heart” phrases, you might be asking by now.  Do you realize just how many phrases we use fairly routinely that contain the word “heart”?  And conversely, do you realize just how little attention most women pay to their physical heart?

In today’s blog post, Julie Ward RN., our Chest Pain and A-Fib Coordinator, offers her insights and advice regarding our heart health.

Finally, please join us and  TMC employees at the American Heart Association’s Heart Walk on April 20^th at Reid Park.

This week, ‘listen to your heart’ and be well!

~ Mary

Julie Ward, RN. Chest Pain Manager

Women focus a lot on their breast health due to the great work done by the Susan Komen Foundation. When I ask a group of women if they know what the chance of getting breast cancer in their lifetime is, almost unanimously they will answer 1 in 8 women.  They have heard it over and over and have that number registered in their memory bank.  However, when I ask the same group of women what their chance of being diagnosed with heart disease in their life is they sit quietly.  I have never had a group give the correct response which is 1 in 3 women.  Women view heart disease as something that happens to men, not them.   How often do you see a woman clutch her chest and fall to the ground on a TV program or commercial?  Very rarely.   Work and family are often prioritized over a woman’s own needs.  Why don’t we place ourselves in the number one slot?  Women are traditionally in the role of caregiver, and therefore her needs are minimized.  If a woman has a heart attack she is less likely to seek help—she doesn’t want to be a bother.

Women may have different signs and symptoms of a heart attack and not the chest pain we often see on TV.  Signs and symptoms may include:  shortness of breath, nausea, arm pain, jaw pain, back pain, heartburn.

The message? Know your body and get help when something is not right.

TIPS:

• Balance your life Eat a proper diet, get regular exercise, relieve stress, and meet your spiritual needs
• Ask questions when you are at a doctor’s appointment (make an appointment if you haven’t seen a physician in awhile!-What is my blood pressure? (Normal is less than 120/80)
  -What is my total cholesterol? (Normal is less than 200)
  -What is my good cholesterol? (Normal is >65)
  -What is my bad cholesterol? (Normal is <100)
  -What is my blood sugar? (Normal is less than <100)
• Do not avoid the doctor because you are afraid of the answers to these questions.  Information will help you make a plan.  If something is too high you have the opportunity to make it better before it is too late.
•  Go to American Heart Association’s website at mylifecheck.org and take the Life’s Simple 7 quiz.
• Be the first in your family, at work, or in your group of friends to initiate a conversation about women and heart disease. Open dialogue equals increased awareness.
• Age healthily. I read an article on ABC News titled “Secret to Active 80s? Fitness-Heavy 40’s”.  The general gist? It’s is never too late to start a fitness program.
• Children learn from example. We owe it to our kids, grand kids, nieces, nephews, and neighbor kids to show them what healthy living means.

Author Julie, keeps a regular date with a girlfriend. Time to catch up and check in.

Nothing can turn a bad day around like having a chat with a good friend. Whether she offers sage advice, provides a balanced perspective, or just cracks me up, within a few minutes the world seems a better place.

It turns out that not only do I feel better as a result of my friendships, but I’m actually healthier because of them!

People with a strong social network live longer and healthier lives. Recent studies show that friendships provide benefits ranging from increased immunity, lower risk of cardiovascular problems, fewer and less debilitating incidents of depression, and better cancer survival rates.

Having connections with many family members, incidentally, doesn’t seem to provide the same health benefits. And interactions between “frenemies”, or those with whom we have conflicted relationships, actually raise blood pressure and presumably are detrimental to our overall health.

Why is this? One theory is that friendships ease our burden, lighten our load, and therefore decrease stress, meaning they lower levels of cortisol. High cortisol is associated with increased blood pressure and accumulation of abdominal fat, the type associated with higher risk of heart disease.

Another way in which our pals make us healthier is they support our efforts to make lifestyle changes. If you’re trying to stop smoking, you’re likely to have a built-in cheerleading team, and a chorus of voices ready to remind you just how awful cigarettes are. Tell your BFF that you’re trying to eat better and you just might get a raised eyebrow when you reach for that plate of potato skins. You can even come up with a code word or phrase if you want to be reminded to make healthy choices. Don’t worry—no one will notice if every time you head toward the candy bowl your officemate says “Are the Wildcats playing tonight?”

Coming up, we’ll feature several real-life accounts of friendships that have made people healthier, and, presumably, happier.

Your mission for this week, if you choose to accept it, is to come up with your own personal “diet”.  List the parameters of your “diet” and post it on your refrigerator.  You must however only list things that are realistic for you to maintain for longer than 3 months.  Here is an example:

Eat 4 different types of fruits and vegetables everyday

Have 3 servings of calcium rich food/beverage everyday such as Greek yogurt, string cheese and almond milk.

Drink at least 8 glasses of water

And with her ever cheerful signature, ‘Have a healthy week!’ Mary signed off. At first I thought this was an easy challenge, and then I started thinking about it, 3 months, threeeeeeeeee long months, every day.  Mary’s challenge has niggled at me for the past couple of weeks.  What can I do to make healthy and sustainable changes to my  eating habits, that I can maintain for three months?

Back in January I announced (publicly no less) that I was going to actively work to improving my cardiovascular health this year, AND that I was going to share my journey here. One of the first small steps I took, after a rather sobering reflection on my eating and exercise habits was to recognize that late night snacking is kind of an issue for me. It’s when I discover the bags of salt and vinegar chips, or the cookies, or the jar of peanut butter, not because I’m hungry, but because it is there, because I’m bored, because I’m avoiding what I’m supposed to be doing. Over the past three months I’ve turned that around, I don’t tend to snack at night anymore, other than occasionally fruit. I have a glass of water, and herbal tea and usually I’m satisfied by that. That’s part of my ‘personal diet’. After much thought I’ve come up with four healthy sustainable changes to my behavior around food, that doesn’t focus on eliminating up whole food categories.

What are your healthy eating guidelines to live healthy by? Oops missing one – Better be able to pronounce what you’re about to eat

1. Eat because you’re hungry, not because you’re bored

To that end I’m eating at meal times, after dinner if I’m tempted I will have a glass of water or a nice cup of herbal tea, and if I’m hungry still – a piece of fruit.

2. Eat a rainbow at every meal…or at least most of a rainbow

The more fresh veg and fruit I eat the more satisfied I am.  Sometimes, its a healthy salad, but sometimes it’s mac and cheese. Instead of the plate full of pasta and cheese I can have an actual portion size and bulk up the dish with veg. Or it’s fish and asparagus. Sometimes I can see forgetting and after that dish of rice and beans that looks distinctly beige and not rainbow like at all, I can dig into a fruit salad satisfying my goal.

3. Be honest with yourself about what you’re eating

For me that means tracking. I have a tendency to plan healthy and then not follow through at mealtimes. I started tracking three weeks ago and I’m still going strong AND it’s making a difference at my waistline. (While I don’t suppose I will track what I eat for the rest of my life, getting in the habit of being honest with myself about my eating behaviors tracking provides a great start.)

4. You better be able to pronounce what you’re about to eat

That sounds a little weird doesn’t it, but have you ever looked at the ingredients in most of the packaged food we eat? Not only is a lot of it unpronounceable and questionable as something with nutritional value, processed food tends to the salty, the sugary and the fatty. Now, in all honesty I have two young children, and probably like you a pretty busy life, chances are I’m going to have days when I just reach for something easy, something ‘gasp’ in a box, but we can with realistic planning  make that the exception rather than the norm.

Based on Mary’s suggestion in her last Words of Wellness post I’m making changes that I can follow for a lifetime not just starting a diet that will then end.

And now I’m passing the challenge on, what would your healthy eating parameters be?

- Rachel

Mary Atkinson, RD, Director of Wellness,

March is National Nutrition Month, so let’s talk FOOD!  Food is a very personal and individual thing.  What satisfies and makes one person feel wonderful, may make another feel awful and cause their blood sugar to soar.  That is why I really like the theme for this year’s National Nutrition Month…”Eat Right…Your Way, Every Day” implying that our preferences, lifestyles, cultural and health concerns impact our individual food choices.  While there are some general guidelines that can be applied broadly such as choosing lower fat foods, increasing our intake of fruits and vegetables, or choosing whole grains, specific food recommendations must be tailored to the individual.

This is why so many diets don’t work long term.  They make sweeping generalizations that either don’t work for an individual’s lifestyle, or so restrictive that it is near impossible to maintain.  Diets by nature aren’t ever going to work because they are always “started” which implies we will end them at some point.  When we do stop dieting or slip up, the weight returns with our previous unhealthy eating habits. Why then do we tend to fall prey to the diet that proclaims things we logically know can’t be true….because regardless of how intelligent we are, it is impossible not to get sucked into the idea of getting something for nothing!  Who wouldn’t want to “eat whatever you want” and still lose weight?!   SIGN ME UP!  But alas, it never works, so we must rely on the tried and proven method:  Consistently make the healthiest food choices you can that fit with your lifestyle.  The Academy of Nutrition and Dietetics website, Eat Right, contains some of the top fad diets that have popped up over the past century.  It is interesting to see how many show up repeated, just re-named.

How do we make healthy food choices when there seems to be so much conflicting information?  Carbs are bad, carbs provide energy…Meat causes cancer, choose lean meats….have three servings of dairy, dairy is bad for you!  If you buy into everything you read, you will think that nutrition professionals are crazy, or perhaps you will realize that all sources aren’t necessarily reporting information accurately.  Here are a few suggestions from TMC’s Medical Librarian, Marni Dittmar, about how to find and recognize legitimate health information:

•  Look for sites that end in ‘.org’ or ‘.gov’
• Avoid any site that demands your personal information before giving YOU information or one that charges money
• Avoid sites that tells you, in any form, that your doctor is wrong and that only that site can help you
• Avoid sites that states “limited time to take advantage of this special offer..”

These three sites that contain GOOD information on nutrition and consumer issues.  All of these are government sites, all FREE to access, with full text to download:

National Institute of Health 

 Medline plus

and the FDA home page (here is the consumer site within FDA)

Have a healthy week!

Mary