Symptoms

Watchful waiting is most often utilized for indolent lymphomas such as follicular lymphoma. As such, patients may have enlarged lymph nodes that are not causing symptoms and patients may feel well without significant anemia or other signs of disease. Patients may be monitored monthly of every other month with blood testing, symptom survey and physical exams to determine the need for treatment. Watchful waiting is most often utilized for indolent lymphomas such as follicular lymphoma. As such, patients may have enlarged lymph nodes that are not causing symptoms and patients may feel well without significant anemia or other signs of disease. Patients may be monitored monthly of every other month with blood testing, symptom survey and physical exams to determine the need for treatment.

My sysmptoms were that of Ovarian Cancer. Upon surgery a tumor was found in the uterus. Having had a lifetime of issues with my uterus and fertility issues, things not feeling quite right or workong right were 'normal' for me. 20 years prior to my cancer diagnosis I was diagnosed with Intra Uterine Synechea (Ashermans Syndrome. This is where the lining of my uterus was covered in adhesions (scar tissue) and would not shed. This is usually caused by trauma to the uterus such as multiple miscarrages or abortions, none of which I had ever had. I had several D&C's and Operative Hysteroscopies to cut away at the adhesions over the course of several years. My gyn/oncologist could not say if the medical history or three years of fertility treatments did or didn't play a role in my cancers. My sysmptoms were that of Ovarian Cancer. Upon surgery a tumor was found in the uterus. Having had a lifetime of issues with my uterus and fertility issues, things not feeling quite right or workong right were 'normal' for me. 20 years prior to my cancer diagnosis I was diagnosed with Intra Uterine Synechea (Ashermans Syndrome. This is where the lining of my uterus was covered in adhesions (scar tissue) and would not shed. This is usually caused by trauma to the uterus such as multiple miscarrages or abortions, none of which I had ever had. I had several D&C's and Operative Hysteroscopies to cut away at the adhesions over the course of several years. My gyn/oncologist could not say if the medical history or three years of fertility treatments did or didn't play a role in my cancers.

They warning signs were vague if looked at them indivdually which is what I did, but there were many and in hindsight I should have put them all together. Let me state that I had stopped fertility treatmenmts in January 2004, 11 months prior to my diagnosis in November 2004 at the age of 42. In January 2004 I had my last internal and external sonongram to measure uterine lining & ovary activity and there was no sign of any tumors. Durining my TAH/BSO debulking surgery 3 tumors were removed. One the size of a human head, one the size of a grapfruit and one completely filled the uterus. About 2 months prior to my diagnosis. I experienced some horrible low abdominal cramping. Due to other long standing gyn issues I no longer menstruated through I did occasionally ovulate so I thought it was bad cramps. I had really bad back pain but again I expereinced lower back pain on and off for many years. I am a big girl what you might call reubenesque, but I have a shape, a noticable waist, body in proportion. Even being a big girl I did enough physical activity to not get out of breathe easily and that was happening. I also started to "loose" my waist line the way a pregnant woman does and my abdomen was getting bigger yet at the same time I simply could not eat at all and my abdomin was hard and my stomach was physically painful. What I learned at my disgnosis was that I had ascites which is free floating fluid in the abdomen & it was putting pressure on all my organs specifically my stomach and my lungs, not enabling them to expand and contract the way they needed to which caused pain. By the time I was diagnosed I looked like I was 5 or 6 months pregnant. Nothing fit. I was constantly urinating, or had the urge to and nothing happened. I also experienced constipation & diarrhea within the same day on a daily basis for about 2 weeks. This ended up being a result of my tumors putting pressure on my organs as they grew. When I did mange to get a little food down I expereinced horrible indigestion. It was the GI issues that finally had me go to the doctor. They warning signs were vague if looked at them indivdually which is what I did, but there were many and in hindsight I should have put them all together. Let me state that I had stopped fertility treatmenmts in January 2004, 11 months prior to my diagnosis in November 2004 at the age of 42. In January 2004 I had my last internal and external sonongram to measure uterine lining & ovary activity and there was no sign of any tumors. Durining my TAH/BSO debulking surgery 3 tumors were removed. One the size of a human head, one the size of a grapfruit and one completely filled the uterus. About 2 months prior to my diagnosis. I experienced some horrible low abdominal cramping. Due to other long standing gyn issues I no longer menstruated through I did occasionally ovulate so I thought it was bad cramps. I had really bad back pain but again I expereinced lower back pain on and off for many years. I am a big girl what you might call reubenesque, but I have a shape, a noticable waist, body in proportion. Even being a big girl I did enough physical activity to not get out of breathe easily and that was happening. I also started to "loose" my waist line the way a pregnant woman does and my abdomen was getting bigger yet at the same time I simply could not eat at all and my abdomin was hard and my stomach was physically painful. What I learned at my disgnosis was that I had ascites which is free floating fluid in the abdomen & it was putting pressure on all my organs specifically my stomach and my lungs, not enabling them to expand and contract the way they needed to which caused pain. By the time I was diagnosed I looked like I was 5 or 6 months pregnant. Nothing fit. I was constantly urinating, or had the urge to and nothing happened. I also experienced constipation & diarrhea within the same day on a daily basis for about 2 weeks. This ended up being a result of my tumors putting pressure on my organs as they grew. When I did mange to get a little food down I expereinced horrible indigestion. It was the GI issues that finally had me go to the doctor.

I suggest that you see your breast specialist (surgeon) to have the area assessed. The lumps could likely be related to scar tissue, but you always want to err on the side of caution and make sure they are not a recurrance.
As for the underam arm ache...
Make sure you have full range of motion in that arm if it is the one where your lymph nodes where removed. Likely it is scar tissue or something like that but you should see a healthcare provider to determine if there could be other causes for this aching.
Thanks,
Heather I suggest that you see your breast specialist (surgeon) to have the area assessed. The lumps could likely be related to scar tissue, but you always want to err on the side of caution and make sure they are not a recurrance.
As for the underam arm ache...
Make sure you have full range of motion in that arm if it is the one where your lymph nodes where removed. Likely it is scar tissue or something like that but you should see a healthcare provider to determine if there could be other causes for this aching.
Thanks,
Heather

If you have symptoms that are worrisome of IBC or Paget's disease of the breast it is important that you have a skin/punch biopsy to rule out this diagnosis.
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com If you have symptoms that are worrisome of IBC or Paget's disease of the breast it is important that you have a skin/punch biopsy to rule out this diagnosis.
I would urge any woman who is experiencing symptoms to get a second opinion such as seeing another pcp or even going to a dermatologist. If your insurance does not require referrals make an appointment to see a breast specialist/surgeon. Do NOT ignore any symptoms because every person has a different severity in their presentation of IBC or Paget's disease of the breast.
Hope that helps.
Heather
www.mybreastcanceranswers.com

You are so right. The impact of a cancer diagnosis on the patient and family is reciprocal in nature. Essentially, the family is the "unit of care." What affects one individual in the family system will reverberate within the entire family. Therefore, if you suspect that you may be suffering from post-traumatic stress syndrome (PTSD) then the family as a unit may be suffering from the same symptoms.

PTSD is a response to events that involve actual or threatened death or serious injury or other threat to one's physical integrity, to which the person's response involves intense fear, helplessness, or horror. PTSD is a psychiatric diagnosis that is linked closely to an acute stress disorder resulting from experiencing a traumatic event. The actual Diagnostic and Statistical Manual of the American Psychiatric Society (DSM IV-TR, 2000) defines a life-threatening diagnosis such as cancer as a traumatic event. The National Cancer Institute (2010) estimates that approximately 35% of patients experiencing cancer may suffer symptoms of PTSD.

The signs of PTSD may be similar to signs of other states such as depression and anxiety. In fact, a majority of patients who suffer from PTSD also suffer from another co-morbid condition such as depression, anxiety, panic disorder, or obsessive compulsive disorder. Therefore, it is important that a thorough evaluation be carried out so that the individual is appropriately treated.

One of the main signs that distinguishes PTSD from other disorders is the reexperiencing of symptoms related to the traumatic event. This reexperiencing is often in the form of recurrent dreams, recollections, or intrusive thoughts that are related to the traumatic event. In the case of a cancer diagnosis this could be recurring dreams about receiving chemotherapy or radiation therapy. Often these dreams or recollections can even consist of sensations from the event, including taste, smell, touch, and sound. It is not uncommon for a chemotherapy patient suffering from PTSD to say that they can "taste" the metallic taste of chemotherapy at different times with recurrent thoughts of the event.
Traumatic memories can be triggered by certain stimuli related to the trauma. For example, a patient who had chemotherapy in the doctor's office may feel slightly nauseated when going to see the doctor for follow-up treatment. The doctor's office and the doctor him/herself may be the trigger for this feeling. If chemotherapy was traumatic for the individual then this event may be reexperienced with objects that remind the patient of receiving chemotherapy.

Other signs of PTSD consist of avoidance and feelings of emotional "numbness." Reexperiencing the event in the present may cause the individual to avoid certain situations or stimuli that remind them of the trauma. For example, a patient with alopecia from chemotherapy may avoid going to their local grocery because everyone he/she meets may ask them, "How are you feeling?" bringing forth unwanted memories of the trauma they are experiencing. With avoidance comes feelings of detachment or isolation from other people or certain events. It is not uncommon for the patient with cancer to feel isolated in their feelings or to avoid certain social situations.

The anxiety component of PTSD is through the state of hyperarousal. The individual's nervous system always feels that it is on alert for danger! The "fight" and "flight" reaction is always on even though there is no present danger at hand. The individual has a heightened startle response and sleep patterns become disrupted. Individuals will many times complain of feeling "jumpy," "on-edge," or "irritable." They will also find it difficult to concentrate, to stay on task, or find that short-term memory is affected.

Overlapping symptoms of depression may also occur with PTSD. Individuals may have overwhelming feelings of grief and loss associated with feelings of helplessness, worthlessness, and sadness. Other signs of PTSD include somatic complaints such as chronic pain and the individual also runs the risk of substance abuse (which is a behavior to help mask the psychic pain). Lastly, an important sign of PTSD is that quality of life becomes diminished because the individual has difficulty in relationships, poor work performance, social impairments, and mood disorders.

You can see how many symptoms of PTSD may overlap with symptoms of depression and anxiety and also overlap with symptoms of the cancer diagnosis and treatment, e.g., short-term memory loss related to chemotherapy. That is why it is so important to have a professional person diagnose PTSD and initiate appropriate treatment. In addition, the individual with PTSD does feel isolated and lonely, making it imperative to have the correct treatment.

Treatment for PTSD can take on many forms. Psychopharmacology is very effective in treating PTSD. Medicines from antidepressants to anxiolytics help to decrease the co-morbid symptoms of depression and anxiety. Psychotherapy focused on the trauma is very important for individuals suffering from PTSD. A psychiatrist or psychologist should diagnose the disorder but there is an important role for therapy from counselors, psychiatric advanced practice nurses, social workers, etc., who are trained to treat individuals with PTSD. Cognitive-behavioral therapy is effective in helping the individual "re-frame" the traumatic experience and there is a definitive role for integrative medicine such as acupuncture, yoga, guided imagery and relaxation. You are so right. The impact of a cancer diagnosis on the patient and family is reciprocal in nature. Essentially, the family is the "unit of care." What affects one individual in the family system will reverberate within the entire family. Therefore, if you suspect that you may be suffering from post-traumatic stress syndrome (PTSD) then the family as a unit may be suffering from the same symptoms.

PTSD is a response to events that involve actual or threatened death or serious injury or other threat to one's physical integrity, to which the person's response involves intense fear, helplessness, or horror. PTSD is a psychiatric diagnosis that is linked closely to an acute stress disorder resulting from experiencing a traumatic event. The actual Diagnostic and Statistical Manual of the American Psychiatric Society (DSM IV-TR, 2000) defines a life-threatening diagnosis such as cancer as a traumatic event. The National Cancer Institute (2010) estimates that approximately 35% of patients experiencing cancer may suffer symptoms of PTSD.

The signs of PTSD may be similar to signs of other states such as depression and anxiety. In fact, a majority of patients who suffer from PTSD also suffer from another co-morbid condition such as depression, anxiety, panic disorder, or obsessive compulsive disorder. Therefore, it is important that a thorough evaluation be carried out so that the individual is appropriately treated.

One of the main signs that distinguishes PTSD from other disorders is the reexperiencing of symptoms related to the traumatic event. This reexperiencing is often in the form of recurrent dreams, recollections, or intrusive thoughts that are related to the traumatic event. In the case of a cancer diagnosis this could be recurring dreams about receiving chemotherapy or radiation therapy. Often these dreams or recollections can even consist of sensations from the event, including taste, smell, touch, and sound. It is not uncommon for a chemotherapy patient suffering from PTSD to say that they can "taste" the metallic taste of chemotherapy at different times with recurrent thoughts of the event.
Traumatic memories can be triggered by certain stimuli related to the trauma. For example, a patient who had chemotherapy in the doctor's office may feel slightly nauseated when going to see the doctor for follow-up treatment. The doctor's office and the doctor him/herself may be the trigger for this feeling. If chemotherapy was traumatic for the individual then this event may be reexperienced with objects that remind the patient of receiving chemotherapy.

Other signs of PTSD consist of avoidance and feelings of emotional "numbness." Reexperiencing the event in the present may cause the individual to avoid certain situations or stimuli that remind them of the trauma. For example, a patient with alopecia from chemotherapy may avoid going to their local grocery because everyone he/she meets may ask them, "How are you feeling?" bringing forth unwanted memories of the trauma they are experiencing. With avoidance comes feelings of detachment or isolation from other people or certain events. It is not uncommon for the patient with cancer to feel isolated in their feelings or to avoid certain social situations.

The anxiety component of PTSD is through the state of hyperarousal. The individual's nervous system always feels that it is on alert for danger! The "fight" and "flight" reaction is always on even though there is no present danger at hand. The individual has a heightened startle response and sleep patterns become disrupted. Individuals will many times complain of feeling "jumpy," "on-edge," or "irritable." They will also find it difficult to concentrate, to stay on task, or find that short-term memory is affected.

Overlapping symptoms of depression may also occur with PTSD. Individuals may have overwhelming feelings of grief and loss associated with feelings of helplessness, worthlessness, and sadness. Other signs of PTSD include somatic complaints such as chronic pain and the individual also runs the risk of substance abuse (which is a behavior to help mask the psychic pain). Lastly, an important sign of PTSD is that quality of life becomes diminished because the individual has difficulty in relationships, poor work performance, social impairments, and mood disorders.

You can see how many symptoms of PTSD may overlap with symptoms of depression and anxiety and also overlap with symptoms of the cancer diagnosis and treatment, e.g., short-term memory loss related to chemotherapy. That is why it is so important to have a professional person diagnose PTSD and initiate appropriate treatment. In addition, the individual with PTSD does feel isolated and lonely, making it imperative to have the correct treatment.

Treatment for PTSD can take on many forms. Psychopharmacology is very effective in treating PTSD. Medicines from antidepressants to anxiolytics help to decrease the co-morbid symptoms of depression and anxiety. Psychotherapy focused on the trauma is very important for individuals suffering from PTSD. A psychiatrist or psychologist should diagnose the disorder but there is an important role for therapy from counselors, psychiatric advanced practice nurses, social workers, etc., who are trained to treat individuals with PTSD. Cognitive-behavioral therapy is effective in helping the individual "re-frame" the traumatic experience and there is a definitive role for integrative medicine such as acupuncture, yoga, guided imagery and relaxation.

Inflammatory breast cancer (IBC) is a clinical diagnosis, meaning the diagnosis is based on the visible changes to the breast. However, there are other symptoms, not all visible, that patients have reported.

Typical symptoms include (but are not limited to):
--rapid, unusual increase in breast size
--redness, rash, 'blotchiness' of breast skin
--what appears to be a 'bug bite' or 'bruise' that doesn't go away
--persistent itching of breast or nipple
--lump or thickening of breast tissue
--stabbing pain, soreness, heaviness, aching or breast feeding 'let down' feeling in the breast
--feverish bresat (increased warmth)
--swelling of lymph nodes under the arm or above the collar bone
--dimpling or ridging of breast
--flattening or retracting of nipple
--nipple discharge or change in pigmented area around nipple

One or more of the above symptoms may be present but seldom all. It is important to note that any of the above symptoms can be associated with a benign (non-cancerous) condition. However, it is important to report any breast change to your physician if it doesn't resolve within two weeks, on its own.

To see photos of various presentations of IBC, check out www.ibcresearch.org and the photo link on the left column. Inflammatory breast cancer (IBC) is a clinical diagnosis, meaning the diagnosis is based on the visible changes to the breast. However, there are other symptoms, not all visible, that patients have reported.

Typical symptoms include (but are not limited to):
--rapid, unusual increase in breast size
--redness, rash, 'blotchiness' of breast skin
--what appears to be a 'bug bite' or 'bruise' that doesn't go away
--persistent itching of breast or nipple
--lump or thickening of breast tissue
--stabbing pain, soreness, heaviness, aching or breast feeding 'let down' feeling in the breast
--feverish bresat (increased warmth)
--swelling of lymph nodes under the arm or above the collar bone
--dimpling or ridging of breast
--flattening or retracting of nipple
--nipple discharge or change in pigmented area around nipple

One or more of the above symptoms may be present but seldom all. It is important to note that any of the above symptoms can be associated with a benign (non-cancerous) condition. However, it is important to report any breast change to your physician if it doesn't resolve within two weeks, on its own.

To see photos of various presentations of IBC, check out www.ibcresearch.org and the photo link on the left column.

In my case,at age 47, menopausal symptoms presented itself as soon as chemotherapy was over although my periods stopped after my first cycle of chemo. I have hot flashes, vaginal dryness, and difficult sleeping. For hot flashes, I exercise regularly, eat healthy and wear layers. Bedroom windows are open all night, my husband has down comforter to help with our temperature differences. Vaginal dryness was painful and my oncologist recommended estring which works wonderfully. I occasssionally take melatonin for sleeping when I need to. Overall, my hot flashes have diminished or else I have gotten used to them. I'm so glad cool fall days and nights are upon us. That is a great question. Not doing well managing frankly. I drink a lot of water, exercise regularly, try to ensure my calcium and vitamin D intake is adequate. Hot flashes and night sweats really stink and taking a daily dose of Femara doesn't help. I tried the Chillow (chilled pillow - like the opposite of a heating pad - but it leaked all over my bed and smelled of vinyl). Cotton blankets and pj's help. Getting a decent's night of interrupted sleep has been very elusive but I'll take an occasional Ambien because it helps me sleep through the night sweats. Looking forward to hearing some other best practices on beating the menopause blues!

The symptoms of lymphedema are grouped by stages.
Stage 0: lymphedema may be present but the patient does not notice any changes. Lymphatic function is reduced in this stage but not to point that causes symptoms..
Stage 1: Swelling is visible and may go away if the affected limb is elevated. There may be some pitting of the skin.
Stage 2: Changes occur to the tissue and elevating the affected limb will not usually reduce the swelling.
Stage 3: The swelling is more severe and changes are often seen in the skin. The skin changes include pitting, thickening, and warty growths.

The stages of lymphedema do not ALL have to occur in any given patient.

The swelling can make it difficult or impossible to perform normal functions with the affected limb. Severe lymphedema can result in joints that are 'frozen' (hard to move) and painful. In breast cancer patients, the shoulder is the joint most likely to be affected by this outcome.

Learn more about lymphedema diagnosis: http://www.cancerquest.org/diagnosis-of-lymphedema
Learn about lymphedema treatment: http://www.cancerquest.org/treatment-for-lymphedema The symptoms of lymphedema are grouped by stages.
Stage 0: lymphedema may be present but the patient does not notice any changes. Lymphatic function is reduced in this stage but not to point that causes symptoms..
Stage 1: Swelling is visible and may go away if the affected limb is elevated. There may be some pitting of the skin.
Stage 2: Changes occur to the tissue and elevating the affected limb will not usually reduce the swelling.
Stage 3: The swelling is more severe and changes are often seen in the skin. The skin changes include pitting, thickening, and warty growths.

The stages of lymphedema do not ALL have to occur in any given patient.

The swelling can make it difficult or impossible to perform normal functions with the affected limb. Severe lymphedema can result in joints that are 'frozen' (hard to move) and painful. In breast cancer patients, the shoulder is the joint most likely to be affected by this outcome.

Learn more about lymphedema diagnosis: http://www.cancerquest.org/diagnosis-of-lymphedema
Learn about lymphedema treatment: http://www.cancerquest.org/treatment-for-lymphedema

Be clear and persistent! A recent report in the New England Journal of Medicine found numerous studies showing that doctors often downgrade the severity of patients' self-reported symptoms, particularly when it comes to medication side effects. This is case when keeping a symptom diary can come in handy—specific data can help both you and your health care team.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm
There are a couople of things I might add to this, having been a nurse.

1. Ask yourself how you will know when the doctor IS taking your symptoms seriously. What will you see or experience when that happens? Are you concerned you aren't getting proper treatment or enough treatment, or are you wishing for some compassion and emotional support from your doctor? Expect that you may not get 100% relief from all of your symptoms all of the time, but don't suffer in silence because you fear your doctor's wrath if you tell him about that pain or nausea again.

2. Doctors and nurses have a hard time quantifying how much a symptom is affecting a patient. That's why there is a scale for pain, for example, that runs from 0 to 10. Health Care professionals use this to try to create a level playing ground on which to communicate. Be as descriptive of the symptoms as you can be and let the health care professional know how the symptom is impacting you. "The pain is so bad I can't cook dinner for my family." "I'm so dizzy I can't walk down the hall when I need to urinate." These sorts of descriptions will let the professional know that it isn't just an annoyance, it's impairing your ability to function.

3. Not every symptom is related to what the health care professional may be treating you for. Sadly, our medical system is structured into silos; oncology, family medicine, internal medicine, gastro-intestinal, proctology... you get the idea. Specializations are great from the standpoint of getting expert care, but they don't help when patients have symptoms that might be outside a treating specialist's area. In cases like this you may need to ask, "Do you think this is related to what you are treating me for, or do I need to see a different sort of doctor?"

4. When people become anxious (which many people experiencing cancer diagnosis and treatment often times can), they may become hypersenstitive to what the body and mind tell them is going on. This is a natural effect of the fight/flight response that can be triggered by an accumulation of stress. Not to say that you don't experience the symptoms, but they may not be an indicator to the doctor of an urgent problem that needs to be treated. It might also be that treating a particular symptom might interfere with other treatment that is more urgent. Tell the doctor about your symptoms and then tell him what you just understood his response to be. Then ask if together you should alter the care you are receiving.

"Doctor, I feel pressure and pain at about an 8, especially when lifting. It's making it difficult to pick something up and move it."

"Well, I don't think that's anything to be concerned about. You should be resting. I'll see you next week."

"Doctor, I understand that you don't feel it's anything to be concerned about, but I brought it up because I AM concerned. Now, do you think there is some way we can decrease the pain without interfering with my treatment? I'd really like to be able to do as much as I can around the house. It helps me to feel normal."

5. Doctors, like any other experts, sometimes forget that their patients don't have the same level of knowledge about their conditions and need to be clued in to what they can expect and what may be "normal" symptoms/side-effects that are experienced during treatment. Keep asking and consider approaching other health professionals until you get an answer that puts your mind at ease. But be careful you don't end up doctor shopping until someone gives you a prescription. "Too many cooks spoils the broth." All your health care providers need to be aware of your medications and other treating physicians so that they don't end up over medicating you or prescribing treatment that is contra-indicated for another health problem.

• Try using descriptive words. Is your pain dull, throbbing or piercing?
• Be specific about how your symptoms affect your daily life. Rather than “I’m tired all the time,” try “I’m too tired to walk to the mailbox” or “I’m sleeping for 12 hours a day.”
• Keeping a diary of your symptoms can help you to be specific and accurate about the frequency of your symptoms.
• Talk about what you’re feeling, not what you think your diagnosis is.
• Try talking about your symptoms in different ways. Not everyone describes symptoms the same way, and you may have to try several times to get your story across.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm
• Try using descriptive words. Is your pain dull, throbbing or piercing?
• Be specific about how your symptoms affect your daily life. Rather than “I’m tired all the time,” try “I’m too tired to walk to the mailbox” or “I’m sleeping for 12 hours a day.”
• Keeping a diary of your symptoms can help you to be specific and accurate about the frequency of your symptoms.
• Talk about what you’re feeling, not what you think your diagnosis is.
• Try talking about your symptoms in different ways. Not everyone describes symptoms the same way, and you may have to try several times to get your story across.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm

• Share a basic description of your problem—one to two sentences is ideal.
• Tell them when you experience symptoms and how often they occur.
• Let them know if anything makes the symptoms better or worse.
• Tell them if you have ever experienced the symptoms before, and under what circumstances.
• Tell them if anyone else in your family or workplace is experiencing the same symptoms.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm
• Share a basic description of your problem—one to two sentences is ideal.
• Tell them when you experience symptoms and how often they occur.
• Let them know if anything makes the symptoms better or worse.
• Tell them if you have ever experienced the symptoms before, and under what circumstances.
• Tell them if anyone else in your family or workplace is experiencing the same symptoms.

For more advice about talking to your providers about symptoms, see our full-length feature article: http://www.cfah.org/hbns/preparedpatient/Vol3/Prepared-Patient-Vol3-Issue8.cfm

Sometimes the symptoms can be less obvious too. In my case, I had a great deal of fatigue and sharp pains that were misdiagnosed as athsma. In younger patients with breast cancer, it can be more difficult to diagnose early (due to dense tissue), but regular checks and finding a doctor that takes any and all of your concerns seriously is important. Some of the more common symptoms are:
Mass or lump in the breast
Breast skin dimpling, reddening, or thickening
Nipple retraction
Breast swelling or pain
Nipple pain and/or discharge
Swelling or lumps in adjacent underarm lymph node

I know when I am depressed when I do not want to do the things I normally do such as daily activities like washing my face or eating. I will wake up and do not really feel sleepy but a general tiredness or fatigue and I wind up going back to bed or the couch to lay down. I do not actually fall asleep but laying down also doesn't end the tiredness.

I feel a sadness and emptiness that just doesn't seem to go away. I have difficulty concentrating on one thing and often space out. I start to believe that whatever it is I am supposed to be doing is impossible and that maybe other people can do it but I can't because I am just not good enough.

These feelings plague me each month in relation to my PMDD however, they I have also been depressed for long periods of time. Other symptoms of depression are: difficulty remembering details or making decisions, feelings of guilt, pessimism or helplessness, insomnia or excessive sleeping, irritability, restlessness, overeating or appetite loss, persistent aches or pains that do not go away even if pain medication is taken as well as thoughts of suicide or suicide attempts.

Depression is a serious situation. We can often be depressed for long periods of times, years, before we realize that what we are feeling is depression. If you think you may be depressed, please speak to your doctor or a therapist. They can assist you by listening, suggesting alternative actions or prescribing medicine, even if only for a short time.

Depression carries a high risk of suicide. Anybody who expresses suicidal thoughts or intentions should be taken very, very seriously. Do not hesitate to call your local suicide hotline immediately. Call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255) -- or the deaf hotline at 1-800-799-4TTY (1-800-799-4889). I never suspected that it was depression that made me feel poorly. A psychiatrist finally suggested it to me after asking me some questions. I could handle the surgery. Each day I could feel the healing taking place. On the other hand, the chemo treatment did not have a healing effect that could be detected. It seemed to weaken my body, my spirit, rather than heal it. I was always tired, bored, listless. Still, I could not describe the feeling with a word. I visited a psychiatrist who labelled it "depression". Once labelled as such, my task became clear. It was mental. Even though I couldn't feel it or see it healing, I assured myself and believed that it really was healing.

Common symptoms of a mild allergic reaction include:
- Hives (especially over the neck and face) and itching
- Nasal congestion
- Rashes
- Watery, red eyes

Symptoms of a moderate or severe reactions include:
- Difficulty breathing, swallowing, wheezing, chest discomfort or tightness
- Swelling of the face, eyes, or tongue
- Dizziness, light-headedness, weakness
- Flushing or redness of the face Common symptoms of a mild allergic reaction include:
- Hives (especially over the neck and face) and itching
- Nasal congestion
- Rashes
- Watery, red eyes

Symptoms of a moderate or severe reactions include:
- Difficulty breathing, swallowing, wheezing, chest discomfort or tightness
- Swelling of the face, eyes, or tongue
- Dizziness, light-headedness, weakness
- Flushing or redness of the face

Yeast infections (also referred to as a fungal infection of the skin) typically occur in the armpits, under the breasts, or in the groin. A yeast infection is a superficial growth of fungus on the skin.

Common symptoms of yeast infection include:
- redness and swelling of the skin
- rash and itchiness
- sometimes a faint white substance appears on the skin and oozing may occur
- pimple like pumps Yeast infections (also referred to as a fungal infection of the skin) typically occur in the armpits, under the breasts, or in the groin. A yeast infection is a superficial growth of fungus on the skin.

Common symptoms of yeast infection include:
- redness and swelling of the skin
- rash and itchiness
- sometimes a faint white substance appears on the skin and oozing may occur
- pimple like pumps