Episode Overview

In this episode of the Better Than Before Breast Cancer podcast, we're diving into how common post-treatment medications—like Tamoxifen, Aromatase Inhibitors (Letrozole, Anastrozole, Exemestane), Herceptin, Fulvestrant, and Bisphosphonates (like Fosamax and Reclast)—can deplete critical nutrients your body needs to feel good and stay strong.

Have you ever wondered if the medications you're taking after breast cancer treatment could be affecting your energy, mood, or even your bone health? You're not imagining things.

You'll learn:

• Which nutrients are most commonly depleted by these medications (like magnesium, vitamin D, calcium, B12, and CoQ10)
• The symptoms that may be tied to nutrient deficiencies (think fatigue, brain fog, joint pain, and more)
• How some medications may increase cholesterol levels or raise your risk of fatty liver
• Why supporting your body with the right foods and lifestyle habits can make all the difference

Plus, I’ll share simple, whole-food nutrition strategies and daily lifestyle tips that can help you feel more energized, support your bones, balance your mood, and reduce long-term side effects—without adding overwhelm.

Whether you’re taking medications now or just want to be prepared, this episode is packed with practical, supportive guidance to help you stay nourished and in tune with your healing body.

Resources and Studies Mentioned:

Tamoxifen and Metabolic Risks

Aromatase Inhibitors and Bone Health

Bisphosphonates and Bone Metabolism

Fulvestrant and Bone Health

Herceptin and CoQ10 Support

Metformin and Vitamin B12 Deficiency

Subscribe, listen, and share to help other women embrace joy as their right and not just a reward.

 💌 Join my email list for weekly wellness tips & podcast updates → The Breast Cancer Recovery Coach
👩‍💻 Follow me on Instagram for daily inspiration → @thebreastcancerrecoverycoach
🎙 Subscribe & leave a review on Apple Podcasts → Better Than Before Breast Cancer with The Breast Cancer Recovery Coach

Keywords:
breast cancer medications, tamoxifen nutrient depletion, aromatase inhibitor side effects, breast cancer bone health, post-treatment nutrition, breast cancer fatigue, Herceptin side effects, bisphosphonates and calcium, breast cancer recovery tips, managing cholesterol after cancer

Read the full transcript:

0:00
You're listening to better than before breast cancer with the breast cancer recovery coach, I'm your host, Laura Lummer. I'm a certified life coach, and I'm a breast cancer thriver. In this podcast, I will give you the skills on the insides and the tools to move past the emotional and physical trauma of a breast cancer diagnosis if you're looking for a way to create a life that's even better than before breast cancer, you've come to the right place. Let's get started.

0:33
Hey friends, welcome to episode 407

0:36
of better than before breast cancer. I am your host. Laura Lummer, I am very happy to have you here with me today, because we're going to talk about something that is so important, and maybe you've never even heard of it, thought of it, considered it. And after we talk about this today, it could be life changing. Could really help you feel a lot better in your own body. So when we go through breast cancer treatment, and, you know, I think most, most people don't know this until they've gone through it, like we know what happens after chemotherapy, after radiation, after surgery. We know that we go through years of ongoing treatments after that, which most people, if they haven't had breast cancer, or they don't have someone close to them in their lives that has had breast cancer. They don't really understand that. They don't understand being thrown into chemically induced menopause. They don't understand managing the side effects that many of these very powerful drugs that we take for many times, up to 10 years, can have on our body and our lifestyle. But I also think that we as the people using these treatments, we sometimes think that the side effects like fatigue and joint pain and digestive distress and mood swings, we think that's just the side effect of a medication, and that we would there's not really anything we can do about it. So I'm going to offer you a different perspective today. I want to talk with you about five of the most common medications that we take to support ourselves when active treatment and chemotherapy, radiation, surgery, when we've been through all that we've been released, or if, like me, you're living on medications to treat metastatic disease. I want to offer you a different perspective today, and I want you to help you understand that many of these medications, well, all of them that we're going to talk about today. One of the side effects medications have is they can deplete certain nutrients in your body, and the depletion of those nutrients can cause some physical symptoms that are not comfortable. But I think we can confuse that a little bit by just thinking it's a side effect of a medication, but not maybe, what else could be supporting that side effect? So again, we're going to talk about five of the most common medications. I want to share with you the nutrient impact that those medications have on your body, and I'm going to offer you different foods that can help to support that. And of course, when you hear me talk about the nutrient depletions, these are things you can go and speak with your doctor about to see if supplementation is appropriate for you. I want to make sure that I make a very clear disclaimer before we discuss this, and that is that I am in no way, shape or form saying these medications are bad and don't take them absolutely not. That's not what I'm saying. I just want to help you see that there's a nuance here, that if you understand it, maybe you could support yourself more. So that we get the benefit of the medication, but we also get the benefit of bringing the nutrient status back to something that can help us feel better so we don't have to suffer as much. Because I am not down for suffering. I don't like suffering, and like to help anybody I can relieve their own suffering. So these medications can be essential for your healing and your ongoing healing and your wellness. Okay, so we want to be careful when we take an integrated approach to health and healing that we're not demonizing one side or the other. Do medications have powerful impact? Does that impact sometimes suck? Yes. Does that powerful impact sometimes saves lives? Yes, and we like saving lives, alright, so let's dig in to five of the most common medications that we take after to support ourselves when we have finished our active treatment for breast cancer and how they act in our body. So number one, let's talk about tamoxifen. So. Oxygen is important for hormone control. It helps prevent cancer recurrence by blocking estrogen. However, it can also reduce essential nutrients like magnesium, vitamin D, calcium and vitamin B, 12. And when these nutrients get low, here's some of the things you could be experiencing muscle cramps, anxiety, insomnia, mood swings, I will tell you, Tamoxifen was one of the first drugs I was put on back in 2012 when I finished my chemotherapy. And man, I have never been a moody person, but tamoxifen just changed the way I responded to anything, and God forbid you add alcohol to that mix, one glass of wine, one Margarita, and my emotions were off the charts. So know that in addition to right it's right after cancer treatments, we're already processing a lot, but tamoxifen can really have a big impact on our mood and our mood swings, let alone being put into chemically induced menopause, right? That's a whole whole huge ball of wax so low calcium and vitamin D can mean weaker bones and fatigue. That's not a surprise for most of us. We go through other treatments and meds, which I'm going to talk about in a minute, to support our bone health. And this is why it's so important that we exercise. We have got to make sure we're maintaining optimal vitamin D levels, and then we're exercising to support our bone health, especially while we're going through these treatments. Okay, so depletion of vitamin B 12 also can leave you feeling tired, foggy, and again, it can, it can affect your emotions and lead to just feeling down and maybe mild depression, even, or maybe more, if that's already something you're dealing with. So already we can see at listening to what these what these medications, how they impact the nutrients in our body, we can relate it a little bit sometimes that brain fog, chemo brain, right? We think about, is this just chemo brain? How long will this go on? But maybe it's deeper than that, and maybe it's taking a look at your labs and understanding the status of specific nutrients. So there was some research published in breast cancer research and treatment, and it found that tamoxifen increased the risk for high cholesterol and fatty liver disease. Here's a statement from that study. Tamoxifen significantly increases the risk of hyperlipidemia, so cholesterol and increased cholesterol and fatty liver impacting your overall metabolic health. Again, come back to the importance of integrative medicine, using our standard of care and supporting our metabolic health with lifestyle nutrition and other therapies so that we're getting benefits on both sides. Obviously, if we're taking something to help manage if we're especially hormone positive, we're taking something to help manage cancer, but it's giving us non alcoholic fatty liver disease that's going to create a whole another storm in the body. So we want to be aware so we can support ourselves with good nutrition. So when we know this is a side effect of tamoxifen, especially the fatty liver disease that's well documented side effect, we want to support our nutrition with plenty of magnesium rich foods. Those include dark green leafy vegetables. Eat those greens, avocados, nuts and seeds. As I say, these foods think about, are they a regular part of your nutrition plan? Do you consume these foods on a very regular basis? Some of the foods that are higher in calcium and vitamin D, that we want to be sure we're mindfully including our fatty fish, so like your salmon, mackerel, fortified plant based milks, if you want more vitamin D and you like plant based eggs are a great resource, and obviously getting outside sunshine lifestyle habits like gentle weight bearing exercise, and again, I say gentle because we don't want to injure ourselves, so we want to train sensibly and reasonably, and especially if we've been through surgeries, I always recommend that we find someone who is an expert, a Personal trainer or a physical therapist who can teach you safe and effective ways to exercise, but weight bearing exercise, daily walks, relaxation techniques like yoga, Qigong and deep breathing, breath work, these all can be very supportive. So when we're onto moxifen, and if. Feel like, oh, gosh, these are the side effects I'm having from tamoxifen. Check into those nutrients and think about the foods I just mentioned and the lifestyle habits. Are these a part of your diet? Are these a part of your lifestyle? If not, how can we begin to incorporate them into your lifestyle so you might feel better, all right, other aromatase inhibitors, so this is our anastrozole, letrozole, eczema stain. These also can help to protect against cancer and cancer recurrence, and they are especially used in post menopausal women. Unfortunately, they also reduce calcium, vitamin D and magnesium levels, and so they can potentially cause, and I'm sure this is no surprise to you, if you're taking them, joint pain, stiffness, muscle cramps and bone thinning. So there was a study in the Journal of Clinical Oncology, and it emphasized that aromatase inhibitors increase bone turnover and the risk of osteoporosis, making calcium and vitamin D supplementation essential support your bones and muscles by including cruciferous vegetables. The cruciferous vegetables are just so important for us to consume, broccoli, kale, cabbage, other foods like almonds, sesame seeds, salmon and again, you're going to hear this thread throughout this podcast. Weight bearing, exercise, daily stretching routines can be significantly helpful in improving joint health and mobility and relieving some of the stiffness you can experience. So we we get into this thought pattern oftentimes, especially when we're stiff and achy, that we don't want to go exercise because we're stiff and achy. But the truth is, the more you move, the less stiffness and achiness you're likely to experience when we move our joints produce more synovial fluid, more of that nice lubrication in the joints. So it's hard at first to get started, and our mind is like, I don't want to do that. It's not going to feel good. But trust me, even a a nightly routine of doing or a morning routine of doing a few minutes of gentle stretching, yin yoga amazing because it's a type of yoga where you hold a pose for a long time. Restorative yoga classes fabulous, and you can find these on youtube if you're not by a yoga studio or have access to something like that, find some yin yoga and some restorative classes online. Restorative classes are great because they use supportive things like bolsters and pillows and blankets and blocks, and you support your body and lay in certain positions, so you're literally just staying there sometimes for five to 10 minutes a pose, and allowing your connective tissue to just elongate, to stretch right and opening up the body. So this can be really helpful with stiffness. So biphosphonates, these are things like phospho Max, and they're used to help protect our bones, especially when we're taking aromatase inhibitors. But they lower your calcium. They can lower your calcium, magnesium and vitamin D. So again, we're hearing common thread between all these medications of some of the most common nutrients that they have an impact on. And I will tell you that when I do lab work for my clients, and we look at their labs and evaluate them from this functional nutrition perspective, it is very common for me to see low vitamin D and magnesium levels, very common. So some of the symptoms that you might be experiencing that will give you an indication are muscle cramps, bone pain, anxiety, again, we gotta realize how much these essential nutrients impacted the way that our brain works. Right? Our brain is just another organ in the body, like the liver, like the lungs, like the heart, like the pancreas, it is an organ, and it needs to have specific nutrients to work properly and lifestyle habits to help it work properly. So anxiety can be part of that, and insomnia, and I know that a lot of post menopausal women really struggle with insomnia. Many of them say it's because of their hot flashes, a lot because of muscle cramps, waking up with spasms in the middle of the night, and anxiety and just thoughts running rampant in our brain. So thinking about some of the nutrients that can support less suffering in that area can be helpful. So there was a study published in osteoporosis International, and it highlighted that while biphosphonates can effectively prevent bone loss, careful monitoring of calcium and vitamin D levels is crucial. So. So when I started this podcast, I said, this is not to demonize any medication. This is not to say medication is bad and don't take it. I also want to say this is not telling you go out and start taking a bunch of supplements, because especially with calcium, and I did a podcast a while back on calcium and how that can play a role in our health and in cancer progression. So we don't want to just be taking a bunch of supplements of calcium. We want to stay within optimal levels of all of these nutrients. And it's not frequently that I see this in people. So something you want to be aware of, what is your vitamin D level? What is your magnesium level? What is your calcium level? Want to focus again, on foods rich in calcium and magnesium, those dark leafy greens, sardines. People going to freak out when they say sardines. I know years ago, when I first started doing keto, and people talked a lot about eating sardines, and I just picture this, these little fishies looking back at me, and that was not cool. But I found I think it's wild planet sardines, and I buy them from Costco, and they're de boned and D headed and detailed. So it's actually like tuna, and that's how I use it. I prepare them like I do with tuna, but they're packed in olive oil. So I get some good we'll see fats and omega threes there, almonds, chia seeds. So many fantastic recipes for chia seed puddings that can be a great treat. When I did my in person retreat back in September, we had in our refrigerator a pumpkin chia seeds pudding and then also a regular chia seed pudding, and it was a big hit with all the ladies there. It's really delicious, easy to eat. Can make it a little jar so it's easy to grab on the go, because we want to plan ahead to be able to support good nutrition. We want to include vitamin D rich foods, again, salmon eggs, some fortified plant based products if you're using almond milk or things like that, even regular milk, oftentimes is fortified with vitamin D. But we want a good, clean, pasture raised, grass fed source, organic milk, please. And we also, again, want to be mindful of getting out in nature when at the time of recording this podcast, this is April, so a lot of people are just starting to see a little bit of warmth and a little bit of sunshine. It can be a lot more challenging in the winter to get that sun exposure, but fortunately, we have access now to things like red lights and UV lights, and that can be very helpful as well to bring into your world and just keep giving yourself some of that exposure, even when it's really cold out again, gentle exercise is very important, resistance training and yoga, I don't think a lot of people think about yoga as a weight bearing exercise. If you've never done yoga, then you don't realize how much body weight is resistance training. And if you have done yoga, you know what I'm talking about. So yoga is excellent, right? We resistance bands can be helpful. And of course, weight lifting is great for increasing and supporting good, healthy bone density and also reducing stress. Okay, number four, filtran filtration can be used. I took it for a quite a while, but fil Western can be used to help manage advanced hormone positive cancer, but it also reduces calcium, vitamin D and magnesium. So there was a point in my treatment where I was taking both letrozole and full vestrin, and I was on an oral chemotherapy. So you could imagine how much depletion could be happening. So I had to be very careful of my labs and my supplementation, very mindful of it, and work with my physician to make sure that we kept all of that in the optimal ranges. Ways that you could tell if you're again experiencing some of these deficiencies could be muscle cramps, joint discomfort and fatigue. So we can't always dismiss fatigue by thinking it's just everything that you've been through. It's just because there's a lot of stress in life, it's just because you're getting older, if you're you should be able to in a healthy life. You should be able to wake up feeling refreshed, have the energy to get through your day and then go to sleep soundly, and be able to sleep soundly like that's a good, healthy cycle for a body. And if that's not happening and there's different signs your body is sending you, then we need to pay attention to those signs and ask, How can I support my body? Rather than say, this is just the way it is and dismiss it, and then you suffer and you live in misery. Okay? There was an article in clinical therapeutics, some research that that that said, volved therapy requires attention to bone health and regular monitoring of electrolytes, so our magnesium, our calcium, our potassium, making sure that we are hydrating Well, adding electrolytes if needed a lot of times. You know, there are people that use different electrolyte products. I. Just put like a half a teaspoon of a good Celtic salt in my water once a day, and I make sure and use good salt on my food on a regular basis. Most people that I work with, which was very surprising for me to see, have sodium levels from sodium levels that are below even standard of care optimal ranges. So something to be aware of. And again, check you'll see them in your lab, sodium, magnesium. These are often in some of our common labs, and you can ask your doctor to run those for you too. So again, some similar foods, prioritizing things like salmon, almond, spinach, fortified dairy alternatives, and doing exercises like Pilates, really focusing on adequate hydration and electrolyte balance can help to reduce some of those symptoms. Okay, number five, the big one for us, for those of you are her two positive Herceptin. So Herceptin is used to target that her two positive breast cancer, and it can be really effective, and it can also deplete nutrients like magnesium, potassium and CO enzyme Q, 10, co Q, 10, which is essential for heart health, so you might feel muscle weakness, fatigue, experience irregular heartbeats if these nutrients become too low. So again, something to be aware of and not just dismiss as a side effect of a medication, but keep an eye on your nutrients. There was an article in the cardiology journal, and it said supplementing with CO Q 10 significantly enhances heart health and reduces fatigue during Herceptin treatment. So again, we're going to enjoy magnesium, rich foods like spinach, pumpkin seeds, potassium, rich foods like bananas and avocados, bananas, for those of you who are not following a ketogenic diet and CO Q 10 rich sources which are like grass fed beef and fatty fish, again, essential incorporate gentle cardio Exercise and mindful breathing, again, that's very supportive of our heart health, of our pulmonary health, of our lung health. So I want to talk for a second about understanding cholesterol and NAFLD non alcoholic fatty liver disease risk. Tamoxifen and aromatase inhibitors can increase those your cholesterol and your risk for non alcoholic fatty liver disease, as we talked about, and when that happens, a physician might suggest that you go on statins. So statins is one of the most highly prescribed drugs out there, and they're prescribed to manage cholesterol, but they also reduce CO Q 10, vitamin D and omega threes, potentially causing muscle aches and cognitive issues. A lot of people shy away from statins because they'll hear about muscle pain and they think, Oh, it's a side effect of a statin. Is muscle pain? But are you having that muscle pain? Because the statin is depleting these essential nutrients, and could looking at them in your labs and increasing them through your food and lifestyle, help you so in our world where overweight is very common, obesity, diabetes, pre diabetes, blood sugar dysregulation, Metformin is another very commonly prescribed drug, and it's given To help manage insulin resistance. And insulin resistance is also linked to non alcoholic fatty liver disease. So Metformin can also lower vitamin B, 12, folate and magnesium, which can lead to fatigue and mood disturbances. And here's another important thing about that, so let's start thinking about this vicious cycle. So let's say we take a drug like tamoxifen or aromatase inhibitor, our cholesterol goes up. We get put on a statin to reduce that cholesterol. Maybe we're already dealing with blood sugar dysregulation and non alcoholic fatty liver disease. If we're considerably overweight, we've got that visceral fat. You see the cycle of medications to help manage the symptoms of these imbalances, and then the side effects of nutrient depletion because of these medications, and then the side effect of physical discomfort due to these nutrient deficiencies. So that's why, if we can pull back the curtains on this and see what nutrients can be affected. Maybe can really help yourself. So there was a 2020, study in nutrients, and it cautioned that Metformin significantly reduced vitamin B, 12 levels affecting neurological health and overall quality of life. So I think back on myself after my first IV chemotherapy, I had significant neuropathy, very painful in my hands and feet and all the way up my shins. Well, I was taking Metformin. My doctor at that time said that Metformin would be good because. Because of the benefits that it could have with managing blood sugar. I no longer take it for many, many reasons, but at that time, I was taking it, and so was that contributing through vitamin B 12 deficiency as well. And one of the things that I did meet a physician who said, Hey, we need to get you on some of this methylcobalamin, which is the methylated form of vitamin B 12. Need to get you on some methyl cobalamin supplements, and it worked wonders for me. Okay, so something to be aware of now. A lot of the women that I work with, when we do their 3x four genetics, we see that they have a high impact, or they have a lot of genetic variants that affect their ability to go through the metabolic process of methylation, and one of the very important nutrients to support effective methylation is B 12, folate and choline. So if again, part of this cycle and perfect storm of medications is the depletion of B 12, then we could see how that would also undermine our ability to effectively methylate, and if we do not effectively methylate, that increases inflammation and reduces effective detoxification abilities and affects our mood. Wow. It's so tied together, right? It's all so integrated. And it's fascinating to see that supporting these nutrients through good food and supporting a healthy lifestyle could really change these impacts while it's allowing you to do whatever it is you need to do to be supporting yourself to save your life. Okay? So again, nutrients here that we could talk about doing it support your body. Omega three, rich foods, we got the chia seeds. Again, salmon again, magnesium, rich options. Plant based animal foods are super high in B 12 and B 12 is going to be very important for this eggs, nutritional yeast. I don't know if you're familiar with nutritional yeast. It was something that I became very familiar with when, well, for years, I followed a vegetarian diet, and for a short period of time a vegan diet, and nutritional yeast is what is used in vegan or dairy free dishes to give it a cheesy flavor, I will put nutritional yeast, oftentimes in salad dressing. So putting all of the ingredients for salad dressing, like basil and olive oil and garlic and nutritional yeast and all of that in a blender, and whip it up, nutritional yeast usually comes in like a flaky texture, but it gives a lot of a cheesy taste to your food, and it's really quite delicious, and so it can also be a great source of B 12. And then again, obviously, we want to support our body with regular physical activity. And I cannot emphasize enough stress management practices, meditation and yoga, and not just for stress management, but to get to know yourself, to listen in on yourself, to turn down the confusion of all the external noise, of all the things people tell us we should be doing, and tune into our own body and listen to ourself and ask ourselves, what do we need? What feels good, what feels right, what feels off. And meditation and yoga gives us that space and that quiet time to connect to our breath and to be able to just really embrace and understand the language of our body and the signals that it's sending to us. So how can you be proactive? How can you apply all of this well regularly monitoring your nutrition levels through blood work, asking for regular blood work, obviously, following a balanced diet, consulting with your naturopath or your oncologist or somebody who understands the value of supplementation and the safety of supplementation along with treatments. That's the person you want to find, right? So who is that person? It's not always your oncologist, because they are not necessarily trained in supplements, but there are lots of doctors out there who are or who are MDS and have training and understanding of supplements and nutrition, and there are well trained naturopaths who can understand both sides of this. I'll put a link here to the directory for metabolically trained doctors, doctors trained in the metabolic approach to cancer who are just amazing at understanding all of the nuances involved here. Because when it comes to supplements, you want to be safe, you want to make sure you need them, they're freaking expensive, so you don't be wasting money on stuff you don't need to have. They're powerful, so especially if you're if you have non alcoholic, fatty liver disease and your liver is already struggling to detoxify, do we want to be adding a bunch of supplements that you don't even know what you need, which have to go through the liver? In order to be processed, oftentimes, to be changed into something that's biologically available to us, like the liver does a lot of work, so we don't want to be overburdening it with things that we don't need. Now, I personally take what I consider to be quite a lot of supplements, but I know why. For each one of those supplements, I know what I'm trying to accomplish with it. I know that I've talked to my doctor about it, that we have a plan, that we have the ultimate goal. I know the rotation cycle, so I believe we have to be just as careful with our supplements as we do with our regular pharmaceutical medications. All right, there's powerful stuff, so always be safe. So check your blood work, check with your doctor, and just remember that your body has an incredible ability to support the healing process and to thrive, especially when you give it the right nourishment that it needs. Okay? So being open with your doctor, being open about understanding nutritional health, changing thoughts and working on your thought process that are saying this is hard, or this is too much work, because I'll tell you what, it is hard, and it is work, and it does take intention, and it does take attention, and it does take money, and it does take planning. And you know what, it's worth it to live and feel healthy and feel well. There are a lot of things that we put energy into in this world that maybe we don't need to be putting energy into. And if we could redirect that energy into self care and self love and self compassion and the work on having the healthiest, most energetic body and happy life that we possibly could. You could experience just amazing change. Alright, if you need help with that, come to my website, the breast cancer recovery coach com, where you can choose private coaching. You can become a member of my better than before. Breast Cancer life coaching membership. You can get a metabolic health coaching package where we look at labs, we look at your genetics to see what your nutrition genome is, how your body responds to food and lifestyle, and so you can understand that you don't have to choose from what plan is best for me. Should I follow this? Should I follow that? They said this. I hear this all the time from people. This resource said this. This resource said this. This person said that's the only way. And I've said it a million times, and I'll say it a million more, the only way is the right way for you and your individual body, your individual microbiome, the current state of your gut health, your current ability to incorporate things into your lifestyle. These are factors that are going to have the biggest influence on what a healthy lifestyle and excellent nutrition plan means for you. So understand your body and the language of it. Understand what the choices you make in medical treatment, understand how those may impact your body and its nutrition status, so that you can support it, not so that you can stop it, so you can support it, all right? And then we'll have healthier, stronger, happier, thriving bodies, and that's what I want for all of us. All right, my friends, I hope you found that helpful. You can always find me on Facebook and Instagram as the breast cancer recovery coach Laura Lummer, the breast cancer recovery coach and DME, if you have questions, come and join my free Facebook group, the breast cancer recovery group, where we have over 1000 women who have been through breast cancer, and you can ask your questions and connect to people who may understand what you're going through too. And all those resources, free downloads, all kinds of great stuff is available for you on my website, the breast cancer recovery coach.com, I'll see you there.