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Old 04-22-2015, 09:54 AM   #20
rhondalea
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Join Date: Jun 2011
Location: Somerset, NJ
Posts: 487
Re: Weight Gain, No loss - Due to Tamoxifen?

When I started chemo, I had just hit 139.2 pounds. By the time I started tamoxifen, I weighed between 150-155. Seven months later, I was 156, and I was too tired to keep my food diary.

My weight went slowly but steadily up after that until I hit 175, possibly 180. Since last November 6, I've been keeping the food diary again. Interestingly, when I started phentermine (prescribed by my endocrinologist for my weight), my brain became sharper--just as I hoped--but my weight loss decreased. Nonetheless, as of a couple of days ago, I've lost 20 pounds (25, if I did in fact hit 180, but I don't have a scale measurement for that--I'm just estimating by the fit of my jeans).

I've got 9 more pounds to go to 146, which is probably a good weight for me. It's not that I don't want to get back to 139, but a little more weight is probably healthier, so that's what I'll go with.

I'm still on tamoxifen, and I hope to continue it for a full ten years.

I lost the weight by cutting out about 500 calories a day--sometimes more, sometimes less. The key for me is being mindful about what I eat. I don't deprive myself of anything I really want--in fact, I just ate a crispy brownie cookie (okay, two) from Whole Foods. Sometimes I eat chocolate. I listen to what my body tells me, and I eat accordingly.

I had one day when I was craving butter. Couldn't figure out where the craving came from, so I looked at my diary and realized I'd been inadvertently cheating myself of fat. Once I increased my fat intake, the craving subsided. More recently, my labs came back with low sodium and low chloride. I've always needed a little more salt that most people, and when I checked my diary, I realized I'd cut my consumption of salt by more than half. I was barely getting the lowest recommended amount. My water consumption had also decreased. As soon as I became mindful of getting more salt and water (starting with several days of drinking salted water), I started feeling better. A lot better. It remains to be seen if my labs are normal, but I'll have the answer to that in a couple of weeks. I'd put money on the outcome, though.

My point is that unless you're writing all this down, you have no way to keep track of your eating patterns and to correlate them with weight loss, weight gain and overall wellness. During my period of not using the food diary, I really didn't understand why I was gaining weight, because it seemed to me that I wasn't eating too much differently, but 100-200 extra calories a day adds up over time. You won't remember that extra 28 grams of pasta you put in your mouth, but your body will.

Without a doubt, endocrine issues can wreak havoc on weight lost. Persistence is key. I went a whole month without losing any weight at all (in fact, I gained a little), but I just kept doing what I was doing. Suddenly, I was back on track and my weight loss was exactly where it was supposed to be. (My food diary predicts the weight loss based on the information I input about myself and my food consumption.)

I'm not saying it's easy. I weigh everything I eat. Admittedly, over time, you get to know what certain things weigh, and that makes it a little easier, but the whole process of keeping records makes eating a bit more difficult. More important, you'll find that if you do weigh your food and insist on precise measurement of your intake, there are foods you will bypass simply because they're too much trouble. For example, bakery goods with no nutritional information on the packaging.

So while I believe the hormonals contribute to weight gain, I also believe their influence can be defeated. More important than losing the weight is becoming conscious of one's nutrition and how more healthy eating can be achieved, but weight loss is a nice side effect.
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2/6/09 Core needle biopsy: negative; Mammos through 2010: no change
3/30/11 Pea-sized lump in left breast at site of prior biopsy; mammo negative, sonogram not so much
4/14/11 Core needle biopsy: negative for cancer
5/18/11 Excisional biopsy 1.2 cm tumor, LVI, positive margin; ER+60%,PR+20%,HER2/CEP17 5
6/15/11 BMX: Left DCIS & LH; Right ADH; SNB: 2/3 nodes: 1.4 cm and 1 mm; ALND L1&2: 0/10; Stage IIa, Grade 3
7/14/11 CT/Bone scans NED; MUGA 66%
7/19/11 Biweekly dd AC w/Neulasta; done 8/30/11
9/13/11 Transfusion (Hemoglobin 8.6); MUGA 64%
9/20/11 Start Taxol + Herceptin; Taxol done 12/6/2011; continue Herceptin until 9/4/2012
12/27/11 Radiation - 6 weeks; 2/27/2012 - DONE! Yayyyy!
2/29/12 Start Tamoxifen 20 mg/day; continue until 2/28/17
5/16/12 Start five-years Metformin trial
6/19/12 MUGA 61%
8/21/12 Brain MRI NED (head still hurts, brain still fogged)
9/4/12 Herceptin done!
9/6/12 Port out!
7/11/13 Aricept 5mg for cognitive impairment; increased to 10mg as of 8/23/13; back to 5mg 12/2013
5/2014 Add Namenda 7mg
9/2014 Stop Aricept and Namenda; Neuropsychological evaluation
10/24/14 Start cognitive rehabilitation therapy
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