Hi there! I’m so glad you’re here. Throughout the breast cancer portion of my blog, I’ll be sharing my journey over the last 5+ years with you retrospectively. I considered writing a blog many times over the past few years but I didn’t actually start writing until October 2021. At some point in these posts, we’ll catch up to real-time and I’ll be sure to let you know when that happens!

I wanted to write this blog for a few reasons actually. First, not everyone knows someone who has gone through breast cancer at a young age. I, unfortunately, didn’t know anyone remotely close to my age (25 at the time) who had breast cancer. Don’t get me wrong, I’m grateful that no one I knew at the time had breast cancer but it made me feel like I was going in blind. I turned to blogs to learn from others’ experiences and while they were helpful, there were only a few blogs out there that felt relatable to me.

I’ve also benefited in numerous ways over the years when others have shared their stories with me, primarily people I met after I finished treatment. I felt connected to others, I learned from their lived experiences and I even found new doctors and other resources for survivorship. I hope that by adding my story to the collective, I’ll be able to pay it forward.

Still Rising,

2022: My New Years Reflection

This past year was an incredibly challenging year for me, even though we got the best gift in the world with the birth of our sweet daughter Yael.

I’ll start with my career. After facing burnout and the need for change, I worked toward becoming a personal trainer and thought that I had a solid plan to do so. Along the way I faced unexpected career challenges and set backs, but I eventually found my footing and a gym to call home, even while pregnant.

During pregnancy, I struggled in ways that I never anticipated. Of course there were the physical struggles of severe nausea and gestational diabetes causing my diet to change and me to lose nearly all interest in eating, but the emotional toll was largely unexpected for me. In the beginning I was terrified. After 4 rounds of IVF and one failed embryo transfer, I knew too much. While a non-IVF pregnancy was the most wonderful surprise, I knew a lot about my egg quality and the things that could go wrong, which made me feel wildly insecure in the health of our baby. I was so scared that we would have a miscarriage or our tests and scans would reveal some medical issue(s), so fear took over. A part of this also stems from my own experience with breast cancer, which made me acutely aware of how a single screening or diagnostic test can change your life forever. It was also the first major medical experience I was having since cancer, which I’m sure triggered some of my emotions as well.

While our loved ones were elated, I mostly felt scared and detached, which in turn made me feel isolated. It’s pretty rare for people to discuss the not-so-pretty experiences or feelings when it comes to pregnancy, so I felt this pressure to portray rainbows and butterflies to most of the outside world. Sometimes I did well with this and other times I stayed home and chose to keep to myself so I didn’t have to deal with it all. As time went on, I felt more positive emotions and less fear – the regular scans really helped me! It was also wonderful when I could feel her move although I continued to protect myself emotionally until the very end.

Labor and delivery was a whole other struggle too. I endured 72 hours of labor with nearly every intervention, preeclampsia, an unplanned C-section, a hospital readmittance and so much more. It was brutal, but I made it through with the help of my husband, family and the incredible staff who took such great care of me.

And now, postpartum has been another ongoing struggle for me. Chronic, undiagnosed pain has led me to the emergency room twice and to multiple specialists who have no idea what to do with me except send me for test after test. I’ve had multiple EKGs, Echocardiograms, blood tests, MRIs, CT scans, a bone scan, an upper endoscopy and more. Gratefully, with the help of a pain specialist, my pain is more controlled so I can now care for our daughter the way I need to and want to, for the most part. I couldn’t do that for the first month of her life and it was heartbreaking. While I had to cut my breastfeeding journey short, I’m still in pain, and we’re still searching for answers, I’m continuing to give myself grace and do the best I can. 

I wanted to share my struggles during my reflection this year, not to complain or gain sympathy because I certainly don’t want that, but to show that what we experience or share doesn’t always have to be rainbows and butterflies. Many of us have had a hard year, whether we choose to share it with others or not, and that’s okay. You’re not alone.

I think it’s important though, if you can, to acknowledge the good alongside the not-so-good, because that can help us endure. 

So on that note, some of the good things that happened this year for me include enjoying our first snow day since living in Charlotte, getting pregnant without IVF (yay for fewer needles!), attending the first ever Charlotte FC soccer match, tubing and boat ride adventures, a few weekend trips, watching Elton John perform during his farewell tour, a lot of time spent with family and friends, and the best gift of all welcoming our baby girl into the world. 

For 2023, I hope for better health, continued personal and professional growth, more time with family and friends, outdoor adventures with Ivy, and travel. I plan to set realistic goals for myself throughout the year that I can work toward in a healthy and sustainable way and I’ll try to take time each day to appreciate the good moments. Last but certainly not least, I’ll continue to learn and grow as a first time mama and do everything that I can for our sweet baby girl, Yael.

Happy New Year! Wishing you all a year of health, growth and happiness.

My recovery story

We had a lovely day and a half at home trying to relax and feel a sense of normalcy…

before I was readmitted to the hospital with symptomatic preeclampsia. For me, that included a severe headache, chest and back pain and a high blood pressure reading of 145/97 at home and 150/100 at the doctor’s office, despite being on medication. So, off we went back to the maternity center. When you have preeclampsia and your blood pressure goes too high, you’re at risk for seizures so depending on the situation, they’ll do a magnesium IV. They warned me that the Magnesium IV makes you feel awful, but I wasn’t prepared for how awful.

At first it wasn’t so bad but as time went on and it accumulated in my system, it worsened. Between the hot flashes, drowsiness, muscle weakness and more, I felt like I was hit by a truck. It makes you feel so bad that they said I wouldn’t be able to hold Yael unassisted and I wouldn’t be able to make it 5 ft to the bathroom. They oh so generously brought me a bedside commode – how glamorous. I used that twice and it was actually hard enough to get in and out of bed while on the Magnesium that I actually requested a catheter. Never in my life would I have guessed I’d want a catheter but here I was – desperate for some sleep and unable to keep getting out of bed due to how awful I felt. I was on this IV for 24 hours and 10/10 I do NOT recommend.

They also added another blood pressure medication to try to manage it better – but the combination of meds caused my blood pressure to drop too low. It was a Goldilocks situation and we kept trying to find the right dosage of meds. After the new meds and the Magnesium IV, my blood pressure was more under control but I was still symptomatic so they didn’t want to discharge me yet.

The next day we tried an anti-anxiety medication in case my chest/back pain was physical anxiety but a few hours later I broke out in full body hives. We thought I was allergic to the anti-anxiety medication so I didn’t take that again. I was an absolute mess so the following day they ordered blood work, an EKG and an Echocardiogram to rule out any major heart issues. Luckily we got the all clear from cardiology and my blood pressure meds were figured out (so we thought) so despite the chest/back pain and hives, I was discharged. 

Hives like this on most of my body

Just two days later I had a follow up with my OB at the office and since I still had hives, we agreed that I was likely allergic to my blood pressure medication. I switched from one to the other and we decided to try adding another anti-anxiety medication (through my psychiatrist) in case that was the cause of my pain.

By this time, we were two weeks out from our original admittance date and my biggest recovery issues were not related to the C section surgery, at least directly. My chest and back pain became more frequent and severe and the hives were not going away as fast as I anticipated when we stopped the blood pressure medication. My pain has been impacting my ability to care for Yael, which I’ve absolutely hated, but my mom has so generously stepped in on my behalf. It has also impacted my sleep, so it’s been a real struggle.

Thanksgiving was spent at our house with our parents. That night, however, was the worst night thus far for me with how severe and consistent the chest/back pain was. When Friday evening came around and I felt severe pain again, I wasn’t sure what to do. I knew I couldn’t do another night of this pain and no sleep, so Ilan offered to take me to urgent care, something I honestly hadn’t thought of myself. Because they were closing, I ended up in the ER where they gave me IV Morphine and did a CAT scan to rule out a pulmonary embolism, cancer recurrence, and other serious possibilities. While getting the all clear was reassuring, I was still concerned about the pain because the morphine only helped a little bit and seemed to be wearing off. They ended up giving me an injection of Toradol, which works like magic for me. It was the best I’d felt in the last 3 weeks, hands down. Unfortunately, it only lasted a few hours and I woke up in the middle of the night in pain again. 

The next morning we picked up prescriptions to get me through the next couple of days – a muscle relaxer, an anti-inflammatory and lidocaine patches. While the medications worked the first night, they certainly did not the following night. I was in such severe pain that I couldn’t sleep and nothing helped. Every minute felt like forever and I was miserable yet again. 

Luckily I had an OB appointment the next day and he prescribed two new medications to hopefully help. The ER doctor thought it may be Costochondritis (inflammation of the chest wall) but that can’t be found on any of the scans I’ve had thus far, so he couldn’t be sure. This is our new guess as to what’s going on and I’m working with all my providers to figure it out since there isn’t really a diagnostic tool for it but rather it’s a process of elimination.

All in all, we’re 3 weeks out from when Yael was born and I’m still struggling with physical recovery in ways I never could have imagined. I will say that I’m thoroughly surprised at how well I’ve been doing mentally, despite all the challenges and feeling like I can’t care for Yael in a meaningful way while I’m dealing with all of this. I am so grateful to Ilan and my mom for doing such an incredible job with Yael while I try to figure out my own recovery. We’re all just taking it day by day.

Pregnancy and childbirth are no joke and it’s a time when you really will need to rely on your family and friends for help. That can be hard to accept but I promise you, it’s worth it to not have to go through it alone. They say it takes a village and in my experience so far, I cannot agree more. Huge thank you to my village. ♡

My labor and delivery story

After learning that we’d be heading to the hospital in a few hours to be induced, I went into logistics mode. We needed my dad to get Ivy girl from us, we needed to tell our families in Florida so they could prepare and start driving up, and I wanted to finish some things around the house. It was our last day at home before the baby came and I couldn’t stop moving – definitely a response to the nerves!

The time quickly approached for us to head to the hospital and off we went! We pulled up to the maternity center, unloaded our car and headed inside to get situated. Our first room was a tiny room, but would only be ours for the first night. They have triage rooms, labor and delivery rooms, C-section recovery in the PACU (post anesthesia care unit) and mother and baby postpartum rooms for non-surgical recovery – all of which we inhabited at one point or another.

In our first room, we were essentially starting the induction process. I thought I’d just be taking a pill that night to start the process, which is something I learned about in our hospital course, but they had a different plan in mind. 

We started with Cytotec, the oral pill used to start labor and soften the cervix so it’s ready for dilation, but they also wanted to insert a Foley Balloon Catheter to actually start the dilation process. Essentially they thread a balloon catheter through the cervix and slowly inflate the balloon with a saline solution to initiate dilation. Putting it in felt a bit like my IUD insertion, so it was uncomfortable but tolerable. The inflation process caused intense contractions for me though – severe enough that I could not fall asleep and I was curled up in pain. They offered me Stadol, which would help with the pain, and I decided to accept. I knew I needed rest to prepare for the next day(s) and felt that was a priority for my physical and mental health throughout my labor.

I did not, however, know that Stadol would make me high as a kite. It offered immediate pain relief, although I still felt pressure, but I was wildly high. I remember cracking up hysterically because I was trying to explain something to Ilan that I thought was funny but I couldn’t get the words out. It was a better feeling than pain, that’s for sure, but I certainly would have preferred more direct pain relief and much less of a high.

All in all that night and the next day, after 4 doses of the Cytotec medication and the foley balloon, I ended up 4 cm dilated. Progress was made and I was hopeful! Usually I think they start Pitocin earlier but there’s a Pitocin shortage right now so they were pushing more of the Cytotec up front to hopefully reduce the need for Pitocin (or at least the amount needed).

Unfortunately, I didn’t progress any further with the Cytotec after the balloon foley came out, and I started to have blood pressure issues where it raised as high as 170/110. They started me on medication when the blood test revealed an elevated liver enzyme indicating preeclampsia. I didn’t know it at the time, but you can develop preeclampsia during pregnancy, labor or even postpartum. There’s no known cause so I just happen to be one of the not-so-lucky people to get it.

After 36 hours of labor, on Wednesday morning, we started a Pitocin IV. I was hopeful that this would jumpstart progress but lo and behold, by the mid-afternoon nothing had changed yet. The doctor recommended breaking my water and the nurses advised that I get the epidural before they do that, since they knew I wanted an epidural anyways. So, I followed their guidance and got the epidural before they broke my water that evening. They don’t let you go more than 24 hours after your water breaks because of the risk of infection so this way I knew that the end was near-ish. 

In the middle of the night, after little progress, they decided to do a ‘pit break’ where we stopped the Pitocin for a short time before starting up again. This seemed to have helped and by Thursday morning I progressed to 8cm dilated. Yay! We were SO close. They kept adjusting the Pitocin dosage and helping me to change positions every hour or so. We basically pulled out all the stops to try to get me to 10cm and to get baby to move further down.

Unfortunately, it had been 24 hours since they broke my water and I still hadn’t progressed past 8-9cm, when you really need to be at 10cm, so the doctor recommended a C-section. While this wasn’t what we wanted, we knew it was the safest way for us to proceed. I was definitely nervous but Ilan, being the most wonderful husband ever, solicited pep talk videos from some of my closest friends. It was the perfect distraction before the surgery and certainly helped me feel loved and supported. I am so grateful to have such caring and supportive friends.

Ilan was ready to go!

As they rolled me back, they told Ilan that he’d be waiting outside while I got set up in the operating room and then they’d take him in. Since my epidural was waning on my right side and I was in a decent amount of pain, they decided to remove the epidural and give me a spinal block instead. We didn’t want to risk pain during the C section.

I felt a sense of calm and acceptance prior to the surgery but for some reason, as I was getting set up in the operating room without Ilan, I broke down. I had already been in labor for 72 hours at this point and I was exhausted and scared. The idea of being cut open while awake freaked me out and it started to feel real as soon as they were setting me up. The spinal block felt a lot like the epidural and while I really didn’t enjoy it, I managed okay. It was when they laid me back that I started to feel nauseous and tears started rolling.

I kept focusing on my breathing and I couldn’t quite pinpoint why I was crying but it was uncontrollable. Ilan was finally brought in and he was quite surprised to see me crying, since I had been so calm before. I immediately felt a little better with him by side but I was still very anxious. The worst part was the nausea though – it was severe. I worried about vomiting during the surgery, especially because the spinal block temporarily paralyzed me from the abdomen down and when I had to cough I couldn’t really control the muscles to truly get the cough out. This freaked me out and all in all, I felt miserable.

When the time came, I wanted Ilan to be the one to tell me if we had a baby girl or boy, since we decided not to find out during pregnancy. Nearly everyone thought we were having a boy and I’d heard it so much the past 4 months that it felt like a truth. As soon as our sweet baby was born, the doctor told Ilan to stand up and look. When he told me we had a baby girl, I was in shock. My immediate response was, “No fucking way! We have a baby girl?” and everyone laughed. Since I was still wildly nauseous and couldn’t manage skin-to-skin right away, they took her to the table in the corner where Ilan could be with her as they did their typical newborn check. Meanwhile, I ended up vomiting 3 or 4 times – not fun. Ilan brought her over to me though and I got to touch her face, have her hand wrap around my finger, give her a kiss and eventually hold her on my chest. That alone helped me feel better. It was definitely an emotional time for both of us.

Once they closed me up and all was good with Yael, we were moved to the PACU (post anesthesia care unit) for immediate recovery. They wouldn’t release me to the normal mother and baby recovery room until I could wiggle my toes – weird threshold but that’s what it was. Usually that takes someone an hour or so but it took over 3 hours for me because I had the epidural for so long and then the spinal block. I was so ready to feel somewhat normal again at this point. 

Although the C section was Thursday night, they kept me in the hospital until Monday, partly because of traditional monitoring but also partly because I developed preeclampsia during labor. Since my blood pressure was still high and not under control yet, they started me on a blood pressure medication that I’d likely take for 4-6 weeks postpartum. It was a bit of trial and error with the dosage, and I felt unwell with pulsing back pain, but they decided to discharge me anyway. So on Monday, November 14th, one full week since we arrived at the hospital we were finally heading home. They told me what to look out for with preeclampsia symptoms postpartum and we were on our way.

Leading up to labor and delivery

We knew as we neared the end of pregnancy that we wouldn’t be allowed to go past 40 weeks due to my gestational diabetes, so it really felt like a countdown to November 13th. During the last few weeks of pregnancy we were going to weekly appointments for either an ultrasound or non-stress test (15 minute heart rate monitor of baby), as gestational diabetes can result in variations of amniotic fluid levels that can impact the baby.

On Monday, November 7th, we went in for one of those routine appointments. After the ultrasound we met with my OB, who for the first time, mentioned induction as a likely possibility. We always knew it was possible but had not seriously discussed it prior to this appointment. In our labor and delivery course through the hospital we learned a little about induction but otherwise, we didn’t know much.

My doctor said that my amniotic fluid was a little bit high, which could be a risk to the baby although he didn’t anticipate anything happening. He remained calm and didn’t seem very alarmed, but he did recommend inducing labor that week, before my due date on Sunday, the 13th. We talked through what that would look like and agreed not to take any chances, as we were in the 39th week and full term at this point. 

The way it works at our practice is that the doctors have specific shifts for labor and delivery, so the doctor you get during labor and delivery relies primarily on availability and their schedules – rather than who your primary doctor is. They also aren’t allowed to schedule more than, I think it was 3, inductions on any given day.

So, he reached out to the scheduler requesting an induction on our behalf and said we would get a call to find out when it was scheduled. All in all, we left the office feeling good and knowing that we’d likely be inducted in the next few days – toward the end of the week. It started to feel very real. 

Ilan and I had taken separate cars to the appointment so I decided to go to the grocery store afterward while he went home. I had only been at the grocery store for 5 minutes before I got a call from an unknown local number while standing in the soup aisle. I had a feeling this was the call. I anxiously answered and sure enough, it was the scheduler from our practice. She calmly and straightforwardly said that my doctor had requested an induction as soon as possible (maybe my doctor was more concerned than he let on?) and that we were scheduled for an induction at 8pm that night. Ummm what?! Tonight? I was not prepared and immediately felt shaky and a little in shock. She gave me all the information I needed and then we hung up. I stood there, alone in the soup aisle, staring at my phone trying to digest what I just learned.

In retrospect, I knew I could go into labor at any point with how close I was to my due date so I shouldn’t have been so surprised about the induction and it all happening so soon. However, as a first time mom, I had been nervous about labor and delivery from the beginning and tried to keep it out of my mind. Major medical events are scary for me since cancer too, so it was a big deal to me in a variety of ways.

While I felt excited about meeting our sweet baby, I was mostly overcome with nervousness about the days to come. I immediately called Ilan who was just pulling into our driveway and he was so shocked that he ran over a paver ledge adjacent to our driveway – oops haha! We both truly thought it would be scheduled for later in the week and we’d have a few days to prepare. He didn’t go inside the house but rather immediately came to meet me at the grocery store to be together.

We continued our shopping trip, with me feeling shaky and a bit in shock the entire time, and just tried to process this news together. In just a few hours, we’d be heading to the hospital to be induced and finally meet our little baby – wow!

It’s the final countdown!

Wow – so we’re nearly 2 weeks away from our due date and baby can really come any day between now and then. That comes with so many emotions! This entire journey has been a wild ride with plenty of ups and downs but we’ve made it this far and we’re almost to the end.

We’ve been through 8 months of fertility treatments, one failed embryo transfer, finding out we’re pregnant without IVF, 17 weeks of nearly all day nausea, managing gestational diabetes from week 19 onward, mental health ups and downs and much more. While I may be more transparent than many, I expect that many people experience a wide variety of ups and downs during pregnancy and with good reason – it’s both incredible and unlike anything else. I know we’re not alone but I have to say, I’m so proud of us and how we’ve handled everything.

It hasn’t always been easy but we’ve worked through everything together. I’m so grateful to my wonderful husband who has done everything in his power to support me through the physical, mental and emotional challenges. He’s been by my side every step of the way and handled everything with patience, understanding and optimism. And while I’ve obviously been through all the physical pieces, he’s been through it all mentally and emotionally with me and I’ve done everything I can to support him throughout as well. We’re a team, and a damn good one at that.

We wanted to honor our experiences and celebrate this journey by getting professional photos taken during pregnancy (at 35 weeks) and we are thrilled with how they turned out. Here’s a peak at some of our favorites – peep the grasshopper in the 3rd slideshow photo!

Honoring my body and all it’s been through!

Now that baby will be here in the next couple weeks, we’re just trying to enjoy these last weeks together. It’s been a whirlwind few months and we’re now at the point of trying to slow things down, take time for ourselves and spend evenings talking about our soon-to-be life with our baby. We’re as ready as we can be at this point and are just looking forward to meeting our little one soon enough!

When breast cancer, mental health and breastfeeding collide

When I was making decisions about my breast cancer treatment, I was only 25 years old. I was not in a stage of my life where I was even remotely settled down, yet I was trying to make decisions that would affect me the rest of my life. It wasn’t easy.

One of the biggest decisions I had to make was which surgery to get. I discussed the details of that decision previously, but I want to touch on something that recently came to my attention, in addition to some other new revelations. Since my doctors agreed that there was no strong evidence indicating one surgery over another would improve my chances of survival, one of the main factors in my decision was breastfeeding. Now, I wasn’t entirely positive if I’d have kids in the future, but in the event that I chose to and was able to, I really wanted the opportunity to try to breastfeed. So, I chose the less invasive surgery and had a lumpectomy so that maybe one day, if I had any biological children, I could try to breastfeed.

Well here we are! I am now 36 weeks pregnant and nearing the moment I had planned for during that time. As I’ve gotten closer to our due date, I’ve sought out specific lactation support given my unique situation. I don’t know anyone else who is a breast cancer survivor and also trying to breastfeed after treatment, so I had no idea what to expect.

After many phone calls and plenty of googling, I found a unicorn! Her name is Dr. Katrina Mitchell and she is 1 of 2 specialists in the US with knowledge of breast cancer and lactation. She is a breast surgeon, an international board certified lactation consultant (IBCLC) and a certified perinatal mental health provider. She is the whole package and while it took me a little over a month to get an appointment, it was well worth the wait. She’s based in California and luckily I was able to get a telehealth appointment with her, covered by insurance. Somehow, it worked out perfectly. 

During our telehealth appointment, which my husband joined with me, I explained my history and she was able to provide lactation information specific to my situation.

The most important takeaways for me were these:

  • Continue to get my annual diagnostic mammogram, ideally before baby arrives and annually even while breastfeeding, as well as try to get a whole breast ultrasound screening to supplement
  • Ignore my right breast as it pertains to breastfeeding – do not try to breastfeed on that side and do not use a nipple shield or supplemental nursing system at all
  • Seek out mental health support/medication management from a reproductive psychiatrist (only 8 centers in the country) for postpartum

Now, the instruction to continue with my diagnostic mammogram was actually different from what my oncologist recommended nearly two years ago as we were discussing the start of our family-planning journey. I’m not sure if the guidelines changed in the last two years, but Dr. Mitchell provided evidence-based recommendations that I could share with my oncologist as I requested to continue follow-up surveillance. Knowing that I didn’t actually need to go possibly 2-3 years without surveillance gave me a sense of security that I thought I’d have to give up. Luckily I managed to get a mammogram already and I’m all clear for now! Phew!

For the second major takeaway, the news to ignore my right breast altogether was a surprise. While I anticipated less than average milk production on my right side based on the difference in growth between my breasts during pregnancy, I did not know that I wouldn’t be able to/shouldn’t even attempt to breastfeed from my right side altogether. Remember, part of the reason I chose a lumpectomy was for future breastfeeding.

I learned that it wasn’t actually the lumpectomy that impacted my ability to breastfeed on my right side but it was actually the radiation. So regardless of my surgery choice, I never would have been able to breastfeed from my right side, and I had no idea at the time I made these decisions. Would I have chosen a single mastectomy instead of a lumpectomy, given this information? I have no idea but I didn’t have all the facts at the time.

Now, I don’t blame my doctors as they were fantastic and there could have been a variety of reasons I didn’t know this. First off, it’s possible that I didn’t outline my decision-making process to my surgeon but rather just told him my decision. I can’t quite remember. If I did tell him my thought process, it’s possible that he simply wasn’t aware of the impact of radiation on lactation. It’s not fair to expect a surgical oncologist to know very specific details about radiation and the impact on lactation, as those areas aren’t their specialty. 

While my doctors didn’t work in silos and actually did communicate with each other, their focus is eliminating the cancer in my body and reducing recurrence, rather than my ability to breastfeed in the future. I’ve learned over the years to seek out very specific support, as in my opinion, the medical education system currently doesn’t do a great job of cross-training in areas that are connected, at least from my breast cancer experience. I can only hope that this will continue to improve over the years and doctors will receive more comprehensive cross-training of connected specialties that may impact their patients’ decisions.

Lastly, the mental health side of things. I’ve been worried about this from the beginning of pregnancy, to be honest, as my depression has ebbed and flowed from the start. I have sought out the appropriate support systems during pregnancy though and have been very intentional in making sure I have support set up for postpartum as well. Prior to my consultation with Dr. Mitchell, I had never heard of a reproductive psychiatrist though. I didn’t know there was a speciality in which someone could help with my medication management specifically as it relates to both my depression and postpartum hormones. I decided that I’d prefer a more specialized support like that, rather than the basic medication management that I was currently receiving.

Unfortunately, I ran into insurance issues and/or state telehealth restrictions with each of the places that I found. The out-of-pocket costs were absurd too and I simply couldn’t justify it, no matter how important my mental health is to me. Instead of giving up though, I altered my search slightly to include psychiatric mental health nurses with a perinatal specialty, which seemed to be the next best option. I found an in-state practice that has telehealth appointments and accepts my insurance – win!

My first appointment was today and I’m so glad I didn’t give up when faced with financial barriers. I continue to seek out specialized support and advocate for myself, and it continues to pay off. Not only was the nurse incredibly personable and a great fit but she works directly with a psychiatrist and is getting a plan together for medication management just in case my mental health trends in the wrong direction postpartum. Having a plan in place gives me peace of mind that we can act quickly with medication management if needed, and that was the last piece of the puzzle. Maybe I’ll be perfectly fine postpartum but I have a variety of factors that have the potential to trigger mental health struggles (medical trauma, breastfeeding challenges, lack of sleep affecting depression and more). I try to be as self-aware as possible and setting up these supports ahead of time is the best way I can set myself and our family up for success when our baby arrives.

I’m now feeling as prepared as I can be when it comes to breast cancer surveillance, breastfeeding support, and mental health. It took a lot of work and self-advocacy to get here but it’s truly what I needed and I am hopeful that I’ll have all the support I need when the time comes – less than 4 weeks away!

If you or someone you know is looking for invaluable, evidence-based breastfeeding support, please visit Dr. Mitchell’s website. It has information for all types of breastfeeding scenarios, not just breast cancer-specific, and I think it could truly benefit many people. https://physicianguidetobreastfeeding.org/

Additionally, if you or someone you know needs postpartum support, you can visit postpartum.net.

Personal training: How it started vs. how it’s going

I officially started training at the Jewish Community Center in July and it’s been going incredibly well. At first, I felt nervous and needed to find my footing in this new environment. I learned a lot in my studies, through shadowing other trainers, and through training a friend since March, but it still takes more practice and experience for me to feel confident in something new.

Leading up to my first session with my first client in this gym, I felt what I’d consider pretty standard first day of work jitters. I decided that I prefer to do a video chat prior to a first session with a client to go through their exercise and medical history, health goals and more. Speaking with this client previously helped lessen my nerves on the day of and it’s been part of my process ever since.

I take training seriously and I wanted to make sure I was prepared for our first session together and that I would leave the assessment with a much better understanding of my client’s needs, especially since he was recovering from a medical situation. It went really well and by the end, I felt like I had the information I needed to create a training plan for him that would address his goals while supporting his recovery.

Fast forward a couple months and I now have 4 consistent clients at the JCC, training each 2-3 times per week. That may not sound like much, and it certainly was a slower start than I anticipated, but I’ve enjoyed every moment of it. My clients have signed on for more sessions with me and have all expressed that they’re feeling progress from our sessions together, which is truly all I want. While it’s only been a couple of months and a handful of clients at the gym, I’ve felt really fulfilled and like I’m actually able to make a difference in their lives.

There has always been a part of me that loves doing work where I can interact with strangers and build relationships with them. Even with my high school and college customer service jobs, I always appreciated having ‘regulars’. To me, personal training is a huge step up in that I get to exchange daily pleasantries with folks at the gym who I don’t yet know while also building relationships with and supporting my clients on a deeper level.

I also love the freedom and flexibility that comes with personal training as a contractor. I am able to decide who I train, I can determine my training schedule with my clients directly and we know enough about each other that when a scheduling conflict arises, there’s a level of understanding that doesn’t always exist in other types of work arrangements. I also love being in control of my work. There is no one telling me what to do or how to do it, but rather I am entirely responsible for the service I’m providing, which helps me grow in a way that I truly value.

I am so grateful to have found personal training as a new career path and while it’s a unique time in my life as it coincides with my first pregnancy, I am confident that this is the direction I want to continue to move in. When our baby arrives, I’ll have to take time off and I’m guessing it’ll be another slow start when I am able to get going again, but now I have the confidence to move forward full steam ahead.

I am very much looking forward to being a strong example for our child of prioritizing health and wellness, pursuing your passions and finding your own path in life. It’s not easy to be brave, take chances and push yourself to grow, but with the right support system, it truly is worth any hurdles you may face along the way.

Pregnancy: Finding my groove

Well, it’s been about a month since my last pregnancy update and a month sure does make a difference! I feel like I’ve finally found my groove in pregnancy, at least for a little while. The past month has been filled with work (personal training is going well!), spending time with loved ones, weekend trips, baby preparation, and of course, gestational diabetes management.

Boat day – 27 weeks!

It’s been a whirlwind with a chaotic schedule that made it a bit difficult for diet consistency as it relates to gestational diabetes. I had a heart-to-heart with my diabetes nurse about my struggles mentioned in my previous post, and she assured me that I’m managing my levels really well and I do not need to worry right now but just keep doing what I’m doing. She reminded me that my mental health is really important and she’ll let me know if I need to adjust anything, which felt like a bit of a relief. Sometimes I really need that type of objective assurance and guidance, which is probably one of the reasons I love therapy too!

Don’t get me wrong, I still feel guilty with every elevated reading, especially with the restaurant meals I’ve had over the past month during travel and social activities, but until she tells me otherwise, I’m just going to trust her that I’m doing alright. Or at least I’ll try. Plus I’ve finished the last of my travels until the baby comes (as far as I know), so that will help my consistency tremendously.

As far as the rest of pregnancy goes right now, I’m feeling great! I have the normal aches and pains and fatigue but no swelling yet, my blood pressure is great, and I haven’t gained any weight, which blows my mind because I’m definitely getting bigger! I know the lack of weight gain isn’t normal but because I had 17 weeks of nausea and then had to start the gestational diabetes diet just 2 weeks later, I didn’t really have the opportunity to eat like a normal pregnant person and put on weight. The doctors assure me that it’s completely fine as long as my diabetes numbers are controlled – so we’re good! We also had another ultrasound last week at 28 weeks and the baby is measuring perfectly!! As of last week, they weigh 2lbs 10oz and are in the 50th percentile – so that was additional reassurance for me!

Hi Baby!

While the medical aspects of pregnancy tend to take the lead in my life, and in these posts, there are some non-medical aspects worth sharing too. The best part of pregnancy so far has been feeling the baby move! It’s honestly been the only part I’ve actually really enjoyed thus far and I’m relishing in it now. Baby can move, kick and punch me all they want because it’s a regular reminder of why I’m doing everything I can to keep us both healthy. It’s also just a wildly unique feeling that never gets old (or at least hasn’t yet). I wish everyone could feel what it’s like to have a baby move inside them… it’s surreal.

I’d say the strangest part of this pregnancy to me is my lack of weight gain and that I’m carrying all in the front – to the point where we took photos last week when I tried on a black bathing suit because you couldn’t really tell I was pregnant until I turned to the side. I’m definitely not complaining about that but it’s bizarre nonetheless!

Now that we’ve reached the 3rd trimester, I have an OB appointment every 2 weeks and one more ultrasound at 34 weeks because of gestational diabetes. I’m very grateful for the additional monitoring that happens at this point though because it gives me a bit more peace of mind. Although I know my physical discomfort will likely increase over the coming weeks, and my diabetes will continue to ebb and flow, I am so excited to be in the final phase of pregnancy and getting that much closer to meeting our little one! 

The dust has finally settled

It’s been a month since my first gestational diabetes (GD) appointment where I learned the intricacies of how to manage GD and the dust has settled. As you may have gleaned from my last post, I felt quite overwhelmed initially and for the first couple weeks, I really struggled.

My first week of diet change, food calculating, timed eating intervals, 4x/day finger prick glucose testing and walking/exercise after meals felt like a huge endeavor. Physically, sure, but even more so mentally. I basically spent every waking (and sleeping, thanks to stress dreams!) moment thinking about aspects of these changes and how I was going to manage my diet accordingly while still getting all the nutrients I need as a vegetarian and living a semi-normal life.

In the beginning, I tracked every morsel of food that I ate using MyFitnessPal because I wanted to ensure I was eating the correct amount of carbs per meal or snack, and I wanted to track my protein and calorie intake to be able to gauge how this new diet was affecting those. My doctors were (and still are) primarily concerned about glucose levels but I was worried about protein and calorie intake as well.

In the beginning, I was managing about 1200-1500 calories, which is even a calorie deficit in my non-pregnant state, so I was worried. I lost my appetite entirely and was force-feeding myself on a schedule just to follow the guidance and I simply couldn’t eat any more than I already was. I wasn’t used to eating every 2-3 hours. Plus the challenge of non-carb vegetarian options (apart from dairy) being so low calorie that it hardly made a difference calorie-wise if I could manage to eat more veggies in a day.

I’ll be honest, and I mean absolutely no offense to anyone who truly struggles with this, but this is the closest I’ve felt to experiencing disordered eating. I can’t ignore nutrition labels now. I am mentally labeling foods good and bad (which I don’t agree with, but can’t help in this situation). I’ve lost most of my joy in eating – since everything is so prescriptive and I’ve lost so much of my food freedom. I am limiting certain social interactions around food because it’s often too taxing to try to figure out what to eat in uncontrolled environments. I feel guilty when I’ve experimented with new foods and my glucose reading is high. I struggle with my mental health when I am too strict with the plan and I worry about negative consequences for baby or myself if I ease up a little. And every day is different. Just because something worked for me yesterday or last week, doesn’t mean it will work for me today. My body and hormones are continuing to change during pregnancy and there is no “I’ve got it figured out” with this. It’s ever-changing and I’ll have to continue adjusting throughout the remainder of my pregnancy.

As you all know, I struggle with medical trauma from breast cancer and all that I’ve been through since then, so this is an added mental health struggle for me. Luckily, like my doctor said, it has become just a little easier to manage as I’ve learned more through trial and error. I’m trying very hard to find the balance of it all and I’m continuing to work with my gestational diabetes doctor every week. This is simply another challenge that I need to manage and work through and I’ll keep on keeping on as best I can. Thank you all for your support throughout!

Gestational Diabetes – Lessons Learned

I had my educational session at a diabetes clinic last week and wow – there is a lot to learn! I was very grateful that my nurse also had gestational diabetes (GD) and told me how angry she was when she was diagnosed. She said whatever I was feeling was valid and that set the tone for the start of our relationship. I appreciated that more than she likely knew – since I’m not the biggest fan of ignoring feelings and jumping straight to silver linings.

She started off by explaining what was happening in my body and assumed no background knowledge. While I knew some of what she was telling me, I liked her approach a lot so I’ll try to explain here in a similar manner. I’m no expert but I find it interesting and hopefully I relay the information in an easy to understand manner and definitely simplified.

Essentially, during pregnancy, your pancreas needs to produce 2-3x more insulin to process the glucose into energy for your cells. If it doesn’t, the glucose stays in your bloodstream and causes elevated levels in both you and baby. Baby’s pancreas then has to work a lot harder to try to produce enough insulin, which isn’t ideal.

She explained that I did not cause this and it is hormone-based during pregnancy. Family history and other risk factors do play a role in that but there’s nothing I could have done to prevent it. As frustrating as that is in some respects, it’s very helpful to know so that I can let go of any guilt that I’m feeling. 

Managing this through nutrition and exercise is the best plan of attack, and sometimes even then someone will need insulin injections. Why insulin instead of medication? Because insulin doesn’t cross the placental barrier so you’re addressing the problem in the mom to help baby, rather than medicating both. She said that most women who need nighttime insulin injections do so because their morning glucose reading is high, and there’s nothing you can do about that as long as you’re following the guidance about what/when to eat before bed. Sometimes the pancreas simply can’t keep up with this intensity of insulin production and needs some help.

So, I learned exactly how to manage it based on my clinic’s requirements. Here’s an example of a day in the life now:

8am – Wake up – finger prick glucose test
8:30am – Eat breakfast (within 30 minutes of waking up – 15-22g carbs)
8:45am-9am – Walk at least 15 minutes
9:45am – post-breakfast glucose test
11:45am – Eat lunch (30-45g carbs)
12:15pm – Walk at least 15 minutes
1:15pm – post-lunch glucose test
3:15pm – Eat a snack (15g carbs)
6:15pm – Eat Dinner (30-45g carbs)
6:45pm – Walk at least 15 minutes
9:45pm – Eat a snack (either 30 minutes before bed snack 30g carbs or reg snack 15g carbs)
11:45pm – 30 min before bed snack if staying up late (30g carbs)

*Make sure to eat protein and fat with every meal and snack
**Track everything
***Eat “free foods” when I need more calories or if I’m feeling hungry (these are foods that have little effect on glucose levels)

Eating and testing times vary based on when I wake up but essentially I need to test first thing in the morning, eat every 2-3 hrs, walk 15 minutes after every meal, test an hour after every meal and make sure breakfast is within 30 min of waking up and my bedtime snack is 30 min before I go to sleep. I also need to follow their carb guidelines and track everything.

Now, this first week has been trial and error to see what works for me. Based on my morning test numbers, I don’t need insulin injections right now so that’s great! However, I’ll have to keep this routine for the remainder of pregnancy and because my body and hormones continue to change, my body’s response to glucose will continue to change.

One interesting piece is why I need to eat so frequently! Apparently, if you go longer than 3ish hours without eating, your liver releases stored glucose because it thinks you’re in a fasting state and your body needs it for energy. So if you eat after your liver releases glucose, you have glucose in your bloodstream from your liver and then also from whatever carbs you just ate – likely elevating your level if you don’t produce enough insulin to convert it all to energy.

Anyway, I’m really grateful that right now, I’m home a lot so I can really take the time to figure this out and follow somewhat of a schedule. As I continue to get more personal training clients outside of the house, I do wonder how I’ll manage such specific guidelines. I know women do it all the time with work and kids and all sorts of responsibilities but it is all I think about/plan for right now and I just hope it gets a little easier.

I am being proactive though. I created a spreadsheet with some of my most cooked meals at home and used MyFitnessPal to calculate everything so it fits within the required carb guidelines. This helped me come up with options for every meal and snack requirement that I can choose from as needed. I also found some restaurant nutrition information to come up with a few eating out options if I’m in a bind outside the house. It’s a start, and hopefully I can keep building on this list to help me stay on track with everything.

In the meantime, I’ll feel what I feel as my emotions ebb and flow and I will really try not to force myself into toxic positivity. I always feel pressure to suck it up and just deal with it with a smile on my face but sometimes I need to feel my feelings first. Yes, GD is completely manageable and 2-10% of pregnant women each year get diagnosed with it, but that doesn’t mean it’s a walk in the park. I had cancer… so I certainly have perspective and I know it will all be okay, but that doesn’t minimize my experience as I have to manage the situation. Additionally, I feel added pressure because I’m not only doing it for myself but I’m doing it to keep our baby healthy and hopefully prevent any future medical issues that could be caused by this. That’s a huge responsibility (as is being a mom, so this is just a start, I know). But I keep reminding myself that it’s okay to feel whatever it is I’m feeling as it can be so easy to try to force positivity and silver linings.

If anyone reading this is going through something similar – GD or not – know that your feelings are valid and you do not need to suppress them. Feel your feelings and work through them as best you can, with outside support if needed. You’ll likely get to a place where you feel better about the situation, but you don’t have to force it and there is no timeline. Remember, we’re still rising! ❤