Re: at least 42 questions, (another great email between me and my doc)

Hello Heather!

So, here are some things on my mind:

1. I am getting my blood pressure taken a whole lot with the exercise study and recently it has gone down and stayed down noticeably. Of course the fitness guru's always say 'cool great!'. I also had another echo done yesterday for the study and the tech said something like "you definitely don't have heart disease" when he was done. BUT...of course I am still scared that this might be some indicator that the chemo is hurting my heart. Your thoughts?

2. TMI (except you are a doctor, so no such thing right?) my body hair is starting to fall out, but not the hair on my head....but this probably means my head is next, right?

3. My sister in law sent the following to me...I don't often take these things seriously but y'know....what do YOU think?

Subject: Drinking Bottled Water Kept in Your Car

This is interesting because it probably happen with sodas as well. This is how Sheryl Crow got breast cancer she was on the Ellen show and she said this same exact thing...The doctor said that the heat and the plastic of the bottle have certain chemicals that can lead to breast cancer. So please be careful and do not drink that water bottle that has been leftin acar and pass this on to all the women in your life.

4. I have been reading a bunch of things about how I should eat during treatment. The one that made the most sense to me was a diet that recommends tons of meat, dairy, cheese, grains etc. Essentially a 'bulk up' approach .Ken Moorehead at Oriental Health Solutions had read the same book and totally agreed. Then a woman from my church, H.W., who has worked in the Duke Cancer Clinic in many capacities and now volunteers there, emailed me and said that with my having a 'triple negative' tumor she recommended a low fat diet. She had even written an article on the subject.(she's a smarty pants PhD type too...gives her a lot of credibility to me)What do you think?

5. You had mentioned you could write me prescriptions for Acupuncture and Massage so I might see about getting it covered somewhat with my insurance. Think we could do that?

6. Finally.....What is the air speed velocity of a laden swallow?

I hope you have a great weekend!

Thanks,
M.J.

***Heathers Response Email***


M.J.,

1. I agree with the tech -- we would definitely see a change in your ejection fraction or "squeeze" on the echo. I would be more worried if your heart rate started to go up -- that is a very early indicator of Adriamycin related heart damage.

2. Unfortunately, all hair seems to come out in varying amounts. I hope that everywhere you had to shave has fallen out, at least! Your head hair should start falling out any day now.

3. Regarding plastic bottles and cancer risk: No individual person can know what environmental exposures might or might not have influenced their cancer. Phthalates are endocrine disruptors that may act as estrogen in cells. Most exposures come from PVC plastics, but they are pretty ubiquitous in our environment these days. Plastic bottles are mostly recycle #1, which is polyethylene terephthalate. Microwaving food in plastic film containers does cause the phthalates to migrate into the food, so it's certainly possible for it to leach into the water when heated in the car, although it certainly wouldn't be anywhere near the boiling point. In reviewing the environmental safety literature, it appears that exposure from bottled water is negligible, but exposures from food are much higher. So, there is no way to avoid all phthalates, as they are in the air we breathe, the fabrics we sit on, the skin products we use...... I generally avoid microwaving plastic wrap, but I eat lots of Stouffer's, so I'm not sure how it evens out!

4. The only thing I recommend as far as diet is to make sure you get 5 servings of fruits/ vegetables a day, keep fat calories to no more than 30% of total, and eat whole grain carbs vs refined as much as possible. I also recommend organic rather than "regular" fat as much as possible (butter, oil, cheese) as fat holds more pesticides, etc. Horizon and Organic Valley make a good selection now, and Weaver Street Market has a lot of the local producers if you can't get to the farmer's market. Celebrity Dairy makes some really nice soft cheeses in addition to their chevre. Though these must be consumed with the appropriate delivery device (eg crusty French baguette) and beverage (preferably alcoholic of the grape or grain variety) :-)

5. absolutely we can write --should we mail to you?

6. What do you mean, an African or European swallow?

Cheers!

Heather