The Chemo Diary – First of four sessions – what happens when!

One of the biggest fears about being treated for cancer, breast cancer in my case, is not knowing what affect the chemo treatment will have on you. In this diary, I share what is happening to me during my first ten days of experience. If you don’t have cancer or have never taken chemo, you might find it interesting. If you are just starting your own treatment, hopefully, you will find it helpful!

For those you who know little about chemo treatments, side affects can include the following: loss of muscular and motor skills, mouth sores, nausea and vomiting, loss of appetite, loss of hair, chemo brain, skin and nail irritation, bone weakening, swollen extremities, and depression. For more specific information, see www.Healthline.com.

When you begin chemo, you don’t know if any of these things will happen. This means that the prospect of these side effects occurring can weigh on your mind like a nuclear  weapon that might explode. (The picture below is with wig on the left, and my natural hair on the right.)

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Preparation for Chemo

I was lucky in that obtaining a second opinion about my condition stretched the time between learning I had breast cancer and the actual administration of chemo to almost five months. During that time, “trained” to become the healthiest person possible, despite my affliction. Training included:

  • Switching my eating habits to a plant-based diet recommended in the book “How Not to Die” by Dr. Michael Greger.
  • Easily losing over 30 pounds having stopped eating wheat-based products as well as potato chips and fast food.
  • Working out frequently on my mini-glider throughout the day in 5 to 15 minute increments.
  • Shaving my head and buying a wig on the onset of treatment so it wouldn’t concern me later.

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The “glider” is a Gazelle. I own the Gazelle Supreme model, but I think any product in their line would work. Its small footprint can fit into almost any space and its reasonable price fits into any budget. Best, it is easy on the ankles, knees, and hips, which is an important consideration for people with arthritis or joint injuries.

Day 1 (10/12/16)

I felt great the day of the infusion (see my article, “Chemo – suggestions and thoughts about your first infusion“) and today.

Day 2 (10/13/16)

I continue to feel great and also expected to laze around the house, but an extended family emergency cropped up, so I was out and about. I still felt OK when I returned home.

Day 3 (10/14/16)

I feel tired today and am taking several naps. Upon waking, I hit the Gazelle for 6 minutes, walk around (or write) a bit, then return to sleep. Last night I felt weird small pains dance around my body while sleeping which possibly caused enough sleep interruption to make me feel tired today.

My appetite is good, however the difference between eating while sick in the good old days and now is that I don’t chow down on ice cream, cupcakes, or other treats. Before starting treatment, I made a big pot of grains brimming with beans. On my own initiative, I’m also taking Choline as a supplement.

Luckily, I am retired. If I needed to go to work, as some cancer patients must, I believe I still have the energy to do so.

As the day went on at around 5PM, I begin to feel pressure on my thighs and knees similar to fibromyalgia, became very tired and chilly. I’d prefer to go back to bed, but I have to put some clothing away. I’m hoping that nausea does not occur this evening . . .

I eat a bit around 9:45PM and have found warm water to be absolutely delicious! And now is time to go to bed for good. Cheers!

Day 4 (10/15/16)

10AM – a report on the previous night: As I tried to sleep, muscle spasms started going off all over my legs, from hips to feet, in a pattern seemingly similar to twinkling Christmas tree lights. At least I think they were muscle spasms. If they were something else, however, I do not know how to describe them.

I got up to try my Gazelle to see if some walking action would calm the spasms down, but after about 1.5 minutes, I felt sick to my stomach. So in good techy faith, I Googled the subject “leg exercises for hospital patients” and learned that keeping your legs straight while making circling and other motions with your feet would help a lot. And it did!

Around 3AM my urine turned to acid. OMG. This condition was unlike a common bladder infection. Fortunately, a good sloshing with cold water relieved this.

Generally, I concentrated on relaxing to avoid a headache that was trying to push through. I’ve practiced meditation since my early 20s and the techniques I learned all came in handy now.

By the time I got out of bed (8AM) I was a lot less tired than I was throughout yesterday evening and I was hungry! Given how I felt, I recommend that people who have to go to work when receiving chemo insist upon the third and fourth day off!

Early this afternoon, I am going to attend a talk given on breast cancer by Dr. Weiss of www.myEthosHealth.com. Phil will be driving me there because my attention-span is touched by grogginess.

Late Afternoon: I’ve been up and on the road since 11:30AM. The Drive to Dr. Weiss’ farm was almost two hours given slow traffic, his lecture two hours, then lunch at Cracker Barrow (I had a baked potato, a sweet potato, and broccoli) brought us home around 6:30PM, when I fell asleep. Actually, I slept in the car and had a hard time holding my head up during the lecture and lunch. Zzzzz.

Actually Sleeping: After peacefully sleeping for a few hours, the bones in my legs began to hurt. This was different than what I considered to be muscle spasms from the day before. These were actual pains that seemed to travel along the bones. After tossing for a few hours, I googled the subject.

Bone Pain: I do not have metastasized cancer, a condition where bone pain really kicks in,  My Google Search, however, describes the pain as I was now experiencing it; a pain similar to fibromyalgia, a condition I’ve managed to keep under control since my mid-20s.  To combat it, I’d get on an exercise device and work out a bit, which is what I did now. I spent 6 minutes on my glider, fell back in bed, and all the pain dissolved.  Note that 6 minutes on my feet was about all I could “stand,” as I was very, very tired and the motion suggested that I’d get nauseated if I spent more time up.

Acid Urine: Ouch! The way I’ve experienced this is different than having a bladder infection in that the urine burns delicate skin once it is expelled. This most certainly would have kept me awake at night, but fortunately, we have a bidet installed that we purchased through Amazon. Should you experience this condition, you need to flush your skin clean in some way. An inexpensive and clean way to do this is is with a plastic squeeze bottle. Should you be starting chemo, I recommend having one or more of these around!

Day 5 (10/16/16)

I am currently “suffering” from sleeping too much and not being able to stay awake. Yesterday through last night, I was constantly trying to sleep or actually sleeping, so around 1 AM, my mind wasn’t tired, although I was too sleepy to get up and do something else. It was during that period when bone pain became apparent.

I have limited my time on the Gazelle to 6 minutes so I wouldn’t fall off of it asleep after 7 minutes. The motion also suggested that I might become nauseous, something I want to avoid at all costs.

Short bouts on the Gazelle really help my attention-span. It is almost 11 AM this morning and I’ve been on it 3 times since getting up. While I have had a light breakfast, my main activity is throwing myself in some position on the sofa or bed and not moving a muscle to become more comfortable. I just sink into a dozy sleep.

Eating Advice from Dr. Weiss: Dr. Weiss recommended I start a plant-based diet in April when I discovered I had cancer and I’ve kept it up to my benefit. His recommendations for daily consumption on a cancer-fighting diet are as follows:

3 tablespoons of ground Flax seed a day. I’ve been doing 1 tablespoon, so will up that today.

1 cup of soy milk or equal amount of tofu and similar products daily

Cooked tomatoes mixed with nuts and seeds. Tomato juice.

Trader Joe’s appears to have canned tomatoes that do not include BPA-lined cans. I understood that the thickness of the cooked tomatoes would be like sauce. Later, I’ll go to Trader Joes to buy its spaghetti sauce.

Plain, white mushrooms, cooked, not raw. At least 5 large per day.

Cruciferous vegetables. I understand that these should be eaten as a combination raw and steamed. Broccoli sprouts and steamed broccoli sprinkled with powdered mustard seeds appear to provide significant cancer cell killing properties.

Beats, eaten steamed. These are very powerful cancer fighters. Note that I have no experience with beats, but do have some in the frig. I have to work up courage to try them.

Remaining afternoon: I have a slight cough and continue to feel weak and sleepy. Hope I can “wake up” soon because I’m looking forward to working on several projects.

3:00 PM – Taste is changing: I believe that my sense of taste is changing as I have become aware that my tongue is in my mouth and it is a little tingly. Strangely, my tongue looks like the picture of health. I’m still really tired, but have upped my time on the Gazelle to 7 minutes followed by flopping in bed. Within the next hour, Phil and I will be leaving to meet friends for dinner, then a concert. We’ll see if I can stay awake for this.

10:00 PM – Changed Tastes, aborted headache and fever: Happily, we went out with friends for dinner, but I was not able to sustain the rest of the planned trip, which was a concert.

At dinner, I noticed that I could not taste soy sauce and that the front, top of my tongue felt irritated. This is not the worst in the world, but I hope it does not get more pronounced.

Driving home, I slept except when a headache tried tried to creep in on various parts of my head; a bit to the upper life, then the upper right, then around my ears. Luckily my medication-skills kept it away by my repeating to my self relaxing suggestions and staying really calm.

What was scary is when I walked into the house, I felt short of breath. It took me about two seconds to drop into bed where I noticed my body temperature rising. Several temperature readings later, I went up to 101.5 and if I creeped up to 102, I would have to call the hospital. Fortunately, a wide-open window, plus little sips of orange juice reversed the trend. I got up the next day at 99 degrees.

Day 6 (10/17/16)

. . . the way I feel

It is 11 AM, and I have not stopped feeling tired. I exercised a bit (6 minutes) when I got up, but essentially, once up, I yearn to go back to sleep.

Note that constipation is a side effect of chemo. Well, I have almost the opposite. I do not want to be further than a few minutes from a toilet within 10 minutes after I eat. That, and acid urine, are a concern. So far, I am managing the situation.

Right now, I am making baked potatoes for lunch for Phil and me. This is a big change from interesting large veggie meals I made before starting this. Frankly, outside of little sips of orange juice, I could skip eating, but my research shows me that potatoes are a good option. We’ll see? I’ll have mine smothered in lemon juice. My tongue is still irritated, but is not scary painful.

Right now, I am going to take another short nap. I will report back later . . .

2:15 PM: Just work from a nap I started 11:45 AM. I could not hold my head up while eating lunch. I eat my baked potato (yum!), walked to my bed and dropped into it. I did not rearrange myself. I just dropped into it and went to sleep. I was in the same position when I got up. That is type type of sleepy I feel.

Note for the past couple of days, when I blow my nose, the discharge is bloody. This does not result in the look of a Halloween Horror Story, but something is wrong with the skin inside.

6:00 PM thru the next morning: I started feeling more like moving around without the urge to go directly to sleep within seconds of stopping. The top of my tongue burns when rubbed against something, like food or drink. I definitely lost my taste sensitivity. Drinking orange juice or tomato juice burns slightly and if they had some taste, I don’t remember what. Fortunately, I am not nauseous and am eating small amounts of natural foods, like potato. That said, any taste of salt is almost non-existent, which is good as cutting down on salt is healthy . . .

I started looking at some programs, but my attention span is still limited. I couldn’t get past the first 15 minutes of Project Runway, for example. Still, I began feeling that I was gaining energy.

Now, when I attempted to sleep, my mind was flooded with dream scenarios. OMG, I had to tap them down and use a lot of meditation techniques to quiet my mind. All were in brilliant color and very active. Generally, I seemed to be building some type of housing development. (And I couldn’t keep up with Project Runway?)

I ended up keeping one dream thread. I created a nice wooden home based on Ellen DeGeneres’ styling which rests on a long pier on a very nice body of water. It had several rooms all rustic modern. A large wooden porch. Great furnishings. Things like that. Hope I can vacation there some time in the future . . .

Day 7 (10/18/16)

I got out of bed with more energy and am now contemplating some kind of breakfast. Without taste it seems like eating is unnecessary.

9AM – loose bowels: I read that there is a crisis point in chemo where the patient doesn’t eat enough and then gets hit with diarrhea.  Could this be it? Yesterday, I didn’t eat a lot, but did have two baked potatoes, one for lunch and the second for dinner. Yikes!

So this morning before I ate a thing, I was spending considerable time in the bathroom wishing that I had a contraption like you’d find in severe nursing homes which straps you upright on the toilet so if you did want to fall over asleep, it would catch you on the can. Yes. I am tired.

I went downstairs for coffee (saving liquid) and peanut butter toast (prior to chemo, I’d have fruit including nuts or oatmeal filled with fruit and nuts as well as ground flax seed). At the moment, the type of food I’d eat really doesn’t seem to matter. I read the paper, then went upstairs to bed. Fell on the bed and didn’t move until around now.

11:40AM – Get up get up eat at Whole Foods

Before telling you how I currently feel, I must re-suggest to anyone about to get chemo, “buy a bidet from Amazon.” Today, this model was $26 PRIME. If you can’t afford it, I will buy it for you! You *must* have one.

The last thing anyone needs while undergoing chemo is a burning lower half due to acid urine or loose bowels. Really. Save yourself. There is another device (a bowl) called a “sitz bath,) but com’on. The bidet attached to your water supply that sprays you all over like a fire hose is the product to have. It puts out fires.

OK, so once again, the minute I got to my bedroom after breakfast, I fell into my bed and didn’t move until just now. And “just now” I do feel weak and my breath is a bit labored and frankly, if I weren’t worried about accidentally starving myself to death, I would still be lying motionless in bed.

Note that in my half awake state, I visited my imaginary ultra-deluxe wooden “cabin” on the lake pier and arranged furniture in my bedroom (with floor to ceiling windows overlooking the lake) and adjacent workout room, a glass cube with perfect air conditioning overlooking my surroundings on three sides. I even designed my “bathrobe” and workout clothing all of the softest fibers and all of which my staff would wash.

. . . and then an idea struck! I would not starve to death today. I’d dine at Whole Foods which serves the plant-based diet I normally eat. Frankly, in terms of taste, I really don’t care about any type of food other than I could eat small portions and someone else makes it for me. We leave shortly.

3:15PM – Eat at Whole Foods then napped: The most tempting food at the Whole Foods buffet were the mashed potatoes. I tried, however, for the first time, Vanilla Soy Milk and found it removed the roughness on top of my tongue and quite a bit of pain. Note that when I say “pain,” the tongue-thing was more of an irritation coupled with reduced taste BUT Vanilla Soymilk offered a significant relief.

Luckily, the table in the shop’s cafe was right next to the restrooms. It is apparent that my body wants to get the poison (chemo) out of me and has no regard to whether I’ve been eating or not.

I also have to be careful about how I move. Under no circumstances do I want to experience nausea, so if I feel the slightest bit of discomfort, I slow way down.

After eating, we returned home immediately. The day is bright blue and fall colors are here! Tomorrow we will go for a ride. But for now, I fell into bed and just work up. I am about to have some coffee and stroll around the living room for ten minutes. Hopefully, I will pick up steam, a bit of food, and maybe the desire to go for a walk outside.

4:50PM – 10 minutes continuous walking: Wow! I just walked back and forth across our living room for 10 minutes! No joint pain. Good strides. Feel great! Although, of course, I’d like to take a nap. The vanilla soy milk really rested my tongue and now I am sipping small amounts of orange juice.

If you want to try vanilla soy milk, but you live in a small community, Amazon to the rescue with various products for shipping. Frankly, I was very reluctant to try it, but after getting over my expectation prejudices, I was very pleased with the way my tongue felt after sipping it. Actually, it turned into a huge relief! My tongue isn’t 100% back to normal, but it doesn’t burn when drinking a cool liquid and I’ve regained quite a bit of my ability to taste things.

10PM – brain and tongue came back: Well, I started to be able to think cohesively around 6PM and my last living room walk lasted 16 minutes! I should be able to get back on my Gazelle glider tomorrow. I’ve eaten more of the dinner I started at Whole Foods earlier in the day and had a glass of orange juice and tomato juice without feeling lime my tongue was going to burn off. I also stopped running to the toilet, so I hope tomorrow I start going back to normal.

No sign of hair loss yet. The approximate timetable is two to three weeks after chemo.

Day 8 (10/19/16)

11:15AM – brain normal, breathing a little heavy: Amazingly, I was able to watch TV and read last night, no bathroom runs, no extreme fatigue. My knees were a bit swollen from walking around the living room, but other than that, I felt good.

This morning, my tongue was still a bit tender, so the first food I had was a cup of vanilla soy milk, followed by some “rough” food that would have been painful to eat the day before. Outside of labored breathing which makes me a bit drowsy, I am looking forward to lunch and doing some of my normal activities; things I look forward to.

Soy Milk: If I did not have the soy milk yesterday, would I still be feeling confused today. I wonder if anyone else ever had this experience. It would be a nice antidote for chemo. This article suggests that soy milk can have a positive impact on chemotherapy – Soy, May 2006 in LifeExtension Magazine.

Chemo Blogs: I plan on finding good blogs on people’s experiences during chemo and will list them on a reference page. Claire’s Blog takes her readers on a journey through all her procedures and seems to end in 2010. It’s very informative and would be helpful for people just starting this journey themselves.

Day 9 (10/20/16)

Since drinking that cup of vanilla soy milk, I’ve felt 100% normal. That said, late last night when in bed and this morning when getting out of it, I experienced vertigo so extreme that it knocked me backwards. I’ve been up now for a couple of hours and it has not reoccurred.

I saw my oncologist mid-morning and had a wonderful discussion, with many details of it following up the notes I made in this diary. Top points:

I weigh 172 – now down from an original 205!!!

My breast tumors shrunk considerably and my nipple is looking normal

I currently do not have a bone pain in my body. Places where I have arthritis (base of spine, right hip, and injured knees) feel 100% clear, like I have never had a problem. Soy milk effect?

Soy milk is excellent. My oncologist (Dr. Siu) is Chinese and he and his family drink a lot of it, plus regular soy, and it is popular in China. He highly recommends it!

And he recommends bidets! He has them and said they were common in China and Europe, but not in the US.

He looked over the foods recommended by Dr. Weiss and supports the plan.

I am currently in the low white blood cell count period in my treatment and will be for the next few days. If I get a fever that reaches 100, to call him immediately.

He explained how treatment affected my tongue, acid urine, and now, vertigo. I lost balance again in his office, so I am glad I demonstrated the effect! At any rate, I need to remain healthy.

The chemo infusion burn on my hand is best treated with ice, which I had been doing.

His office will fax materials to Sloan Kettering for a second opinion on surgery

And he loves this diary, will continue monitoring it, and will adjust my next chemo dose depending on what he learns from it.

Tomorrow, I see Dr. Weiss to discuss nutrition. Dr. Weiss has one foot in traditional medicine and one in nutritional healing. His advice to me has helped me up to now. At this point, I am balancing chemo and surgery against natural healing. I’d like to think that there is someway to integrate everything so it all works better together. We’ll see.

Day 10 (10/21/16

I met with Dr. Weiss today, the physician who got me started on the whole-food, plant-based diet. Since then (early May), I have been exclusively vegan. The results? Since that visit:

I’ve lost 33 pounds total

I no longer have fibromyalgia

My blood pressure is significantly lower since any time that he has known me

I have no “arthritis” pain at the base of my spine, right hip, and knees

And my cancer tumor has been shrinking

That, and I’ve  recovered from bowel cancer surgery very quickly.

I am currently in Stage 2+ cancer, which means it is curable, with the current recommended therapy to shrink the tumors and remove my breast. That said, I am going for a 2nd opinion as to how to proceed with breast surgery.

Frankly, if I had a poor prognosis for recovery, I would not do chemo at all, nor would I chase cancer around my body until I did from old age (I am 72.5). I am not happy about subjecting myself to chemo and as part of the next step am trying to find out how little of it I must be subjected to.

I am not sure if the second opinion can be arranged for next week, although I’m hoping it can be during the time I have the most energy before the next session.

Days remaining in this cycle

10/22/16: I have decided to document the entire experience. At present, I am in the phase where I am might likely to catch something. I have, fortunately, regained my full capacity to think and have actually started picking my my scarf design work again.

Dr. Weiss – Plant-based diet: After I’ve been cured of breast cancer, I plan on returning to the doctor who has images of my lower spine, right hip, and damaged knees. The reason is that since starting on the plant-based diet, 100% of the pain and weakness in those areas is gone. If new images show no arthritis (roughness around the bones) and reduced wear in the hip (or new bone growth), that will be a powerful testament to how the PBDiet can help the body regenerate.

Thoughts and Decisions: My oncology team insists that I have a very good shot at 100% cure because my tumors have not advanced to stage 4 and that I am very healthy. My issue is, and the reason I am seeking a 2nd opinion on surgery, is that chemo hurts many parts of the body while shrinking cancer. This includes the nerves, heart, and respiratory system. I would like to drop chemo ASAP as there is the suggestion that my tumor size is within surgical success range. I see no reason to have one drop more of chemo, just because blasting it with four doses is considered the most conservative practice. IMHO, there is nothing conservative about poisoning my body to save one part.

The other issue is whether I’d just go the dietary healing route and see if tumor growth stops or continues shrinking. The only reason I’d do that is to be monitored monthly to make sure things don’t reverse themselves, and to date, I have not found an option for that to happen.

10/23/16: The will finish this diary, although I might make a note when my hair starts falling off. Between now and my next one, starting on Monday, 10/31, I will post at least three travel articles.

At this point, I am very careful about how I eat so I don’t introduce any aggravation into my system. I do not want to be attacked by nausea.

Also, for anyone who might feel like a bladder infection is coming on, I strongly recommend taking a supplement called “Cranberry with d-mannose.” I read about it some months back in a health newsletter and it works. For me, it usually works after 4 pills, taken 2 at a time, maybe 4 or 6 hours apart.

Last, I have no pain at the base of my spine, right hip, or knees. If this is a product of eating a vegan, plant-based diet, I hope that you take notice. After all is said and done with this cancer, I plan on seeing my Orthopedic Surgeon and having scans retaken to see if there is a difference. Check this link on food and arthritis on nutricianFacts.org.

10/25/16: I’ve had a light cough on and off, but around 6PM, it started getting worse and I began a fever which, at last check, was 99.9 degrees. Fortunately, a large mug of tomato soup reversed the trend and I returned to normal. I’ve continued the sniffles, however, and a light cough.

10/27/16: Ugg. Hoped to be over side effects of chemo by now. Last night, I got up to go to the bathroom six times. It was like for every quarter-cup of liquid I drank, a quart came out. I also began feeling burning crotch again, and worried that I had a bladder infection. Going to the toilet continued for most of the day, both dedicating and urinating and feeling an impending bladder infection. I have no idea where all this stuff was being held in my body! I took 6 cranberry pills throughout the day as well as numerous naps. By 6PM I started feeling feverish, but my temperature only went up to 99 degrees. By the end of the evening (11PM) I began feeling normal again on all levels. Note that I made terrific use of the bidet! While this probably seems like too much sharing, if you or a loved on has had chemo and is in the last week before a new session starts, being aware of what might happen has a lot of value. My number one objective is to not get a bladder infection. As my white blood count is down, I could be very susceptible to infections and I’ll do whatever it takes to fight them off.

10/28/16: OMG! I am now noticing that I am losing hair! After a shower this morning, I noticed a few short-cut hairs on the sink and thought that they might have been left there by my husband trimming his beard, although that would have been very unusual of him. Shortly thereafter, while sipping my morning coffee, I noticed short hairs all over my black, fluffy bathroom and realized that these were from my head. Returning to the bathroom sink, I noticed a lot more, then saw many more after checking my pillow.

Note that prior to chemo, I had my head shaved to just under 1/2″ lengths. For some reason, my hair is even shorter now (I expected that I’d have some growth on my short hair, but none occurred). Now I can see little rivers of “no hair” among what existed after shaving. Further, if I pet my head, lots of short hairs float down onto my shirt and desk.

I wonder if this is part of the “sick” process I experienced the day before.

Anyway, yikes! I am glad that I was prepared for this event because even though I knew it would happen, it still freaks me out a bit. We went out later in the day and I did not wear my wig because I was afraid that its rough interior surface would “saw off” more hair and I did not want to withstand a snowstorm of falling hair when time to take the wig off.

I will post my hairless look when I start my next Chemo Diary which will document the second infusion period and how it is the same, better, or worse than the first.

10/29/16:  On my next diary, I will have more information about acid urine, UTIs, and the effort to keep pain away. I have now, however, found some reference to D-Mannose, which I will take 4 to 6 capsules a day if I feel like a UTI is returning. I am currently ordering mine through Amazon (NOW – 500 mm of D-Mannose). It is not a common product (it is usually sold as “Cranberry with d-mannose”) and you should be able to get it through the Vitamin Shoppe, or other specialty dealers if you have one locally. Last I checked, Walgreens did not have it, but you definitely should check your local pharmacies, too. Anyway, you can get it through Amazon and it has several brands to choose from.

Two articles on the subject are D-Mannose for UTI Prevention Validated in a Clinical Trial by Dr. Mercola and a very recent article, D-Mannose Destroys Urinary Tract Infections published by Health Impact News. You can also search the Internet on the subject. Be aware that any type of crotch pain can make it exceptionally hard to think and function normally. And if it gets out of control, you can ruin your kidneys. so stay alert!

Links

Author

This diary is written by Karen Little on a day-to-day basis as she experiences her first chemo treatment for breast cancer. Photography by Karen and Philip Little. Published in October 2016. All rights reserved by Karen Little and Littleviews. Questions? Please contact Karen at Karen@Littleviews.com.