Tamoxifen

Weighty Issues

/ Jennifer / 2 Comments

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When I was first diagnosed with cancer, amid the fear of death, treatment and hair loss, I managed to have the stupidest, most-vain thought I possibly could: “Maybe at least I’ll get skinny!”

Fucked up doesn’t even begin to cover having such a thought, but I’d be lying to you if I didn’t secretly hope I’d lose a little weight during chemo. Getting skinny when you have cancer is not a good thing. It means you’re not eating. It means you’re probably throwing up. It means you’re not well.

Yet there I was, hoping to drop a few pounds. Insane, right?

I’ve never been a super-skinny person. I’ve also never been very overweight. Like most people, I fall somewhere between–not obese, but I could stand to drop a few pounds.

My mother was always overweight. Even as a child, she was chubby. Three pregnancies and the stress of making ends meet while raising a family did nothing to help her situation.

Not to say she didn’t try mightily to change that. My childhood is filled with memories of my mother trying everything–from Weight Watchers to Richard Simmons to that wacky “Stop the Insanity” lady–to drop weight. We ate fat free cheese before they figured out how to make it edible (remember how weird that texture was?). My sister and I played while my mom walked lap after lap around the track of a local school.

But no matter what she tried, she couldn’t seem to shake the extra weight.

And she hated it. I have just a few photos of her because she always shied away from having her picture taken. When we went on vacation, she rarely went out on the beach during the day–staying indoors until evening, when she could walk on the sand fully clothed.

Though she never once did anything to make me feel like I needed to lose weight (even though I went through a pretty chubby period between third and sixth grades), seeing her struggle stuck with me. And it instilled a deep fear of gaining too much weight.

Fast-forward to today. For most of my adult life, I’ve done a pretty good job keeping my weight under control. Sure, I got so big during pregnancy that I’m pretty sure I had a couple of moons orbiting me, but I managed to drop all that weight (and then some) afterward.

But this cancer mess has thrown me all out of whack. Between my oophorectomy-induced menopause and Tamoxifen (apparently, “Tamoxifen tummy” is a thing), the numbers on my scale keep climbing. In fact, just this morning at my yearly physical, I realized I’ve apparently gained two pounds.

Sure, a little weight gain isn’t a huge deal in the grand scheme of things. But when you’re actually trying to lose weight, get in shape and be healthier, it’s a bit dispiriting. I’ve joined a gym and actually go, and I’m keeping track of what I eat, for the most part. I’m actively trying to make better choices.

And honestly, my weight has become more than just a vanity thing at this point. Carrying extra weight can put you at higher risk of cancer–particularly breast cancer, as fat cells have been proven to produce estrogen. If you had estrogen receptor-positive cancer like I did, that’s not a good thing.

So, what am I to do? For now, I plan to push forward and continue the good habits I’ve adopted–regular exercise, more fruits and veggies, less red meat, etc. I’m also really going to try to cut back on refined sugar (a monumental task for someone with a massive sweet tooth).

I’m also going to try my best to stop thinking about the numbers on the scale and focus on ones that matter even more–my blood pressure, my cholesterol, my vitamin levels. Hopefully, even if I never reach my goal weight, I’ll still become a stronger, much-healthier person in the process.

One Year Later

/ Jennifer / 3 Comments

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It’s hard for me to believe this, but today marks one year since I last had chemo.

I know that’s kind of a weird anniversary to mark, but it signaled the end of the hardest part of my treatment, and a turning point in my treatment plan.

I was originally scheduled to receive four rounds of two drugs, Adriamycin (doxorubicin) and Cytoxan (cyclophosphamide), followed by 12 rounds of Taxol. The AC regimen was tough. But I made it through.

Taxol was supposed to be a walk in the park compared to the cocktail of these two powerful drugs (Adriamycin is nicknamed “The Red Devil” both for its crimson hue and how it makes you feel). But I ended up being the special case that can’t tolerate the medication, and I became very ill. After two terrifying, uncomfortable weeks of fevers, headaches and MRIs, my still-depleted white blood cell count made it clear that the chemo was behind all my troubles.

At that point, my doctor decided to discontinue chemo and proceed with surgery because he feared continuing with the drug would damage my bone marrow. So, I missed the last 11 doses of Taxol. While I sometimes wonder if that will come back to haunt me in the future, I can’t say I was too upset about getting an early reprieve from chemo.

So, how am I today, one year after completing that part of treatment? Pretty good, all things considered.

Physically, I feel great. It’s funny because most of the actual feeling bad from having cancer came from the treatment, not the disease itself. Once I finished treatment, most of that unpleasantness (fever, headache, nausea, fatigue) went away. I’m still dealing with the side effects of menopause–which technically started with chemo and kicked into high gear after my oophorectomy–but that stuff is pretty manageable.

My hair is still a work in progress. A year ago I was completely bald, save about half a dozen little whispies that never fell out (my brave soldiers!). This was my hair about a week ago:

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As you can see, it’s still pretty curly. Although, I think the curl is starting to phase out a bit (the hair coming in at the roots seems straighter). I actually even had a real haircut last week, as the back was getting a bit long and unruly (I basically had a curly mullet).

I also lost a toenail due to chemo (a lovely side effect of Taxol), and that has almost completely grown back in.

Chemo can also cause lingering cognitive issues (chemo brain). While I certainly have my moments of fogginess, I’m not sure they can be chalked up to chemo.

Last week at my checkup, my blood work showed my white blood cell count slightly down. My oncologist said this was normal in someone who’s had chemo, though, so I guess the lingering effects of the drug can still mess with my immunity, too.

So, where am I with treatment now? I am essentially done, save the adjuvant therapy I’ll be on for the next decade. That’s a pill I take every day called Tamoxifen. Since my cancer is estrogen-receptive (estrogen basically feeds it), Tamoxifen works to block estrogen from feeding cells and causing them to become cancerous. Some people have a lot of difficulty with this drug, but thankfully I’ve handled it pretty well thus far.

At this point, I’m mostly just dealing with all the emotional aftermath and figuring out how to move forward in my life. That’s getting better every day, too, and I’ve learned some new coping mechanisms to help me along the way.

Cancer treatment is a long process. I don’t think I fully understood that even at this point a year ago. But standing here now, I’m thankful to have come as far as I have in this past year.

 

 

 

 

 

 

 

 

 

Down the Rabbit Hole

/ Jennifer / 5 Comments

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My back hurts.

It’s a pretty minor pain, to be honest. I’ve had issues with my back much of my adult life (another hereditary thing, I’m certain, since my mother and sister both suffered/suffer back issues), and I’ve had backaches much worse than this. Plus, I’m coming off several major surgeries to my torso, I’m on Tamoxifen, I’m going through menopause, and I lift a 30-pound toddler on a daily basis. Of course my back hurts.

But that rational explanation can’t quite quell my fear. Even the smallest twinge of pain conjures that insidious little voice in my head, whispering, “maybe it’s cancer.”

On a good day, I tell that little voice to fuck off, pop an ibuprofen and keep it moving.

But on bad days, I turn to the place I should probably avoid most–the internet.

It all starts with Dr. Google. After I’ve Googled symptoms, I’m usually still unsatisfied. That’s when I go to a place I definitely should avoid.

The community message boards on breastcancer.org are actually a really great resource. Women and men at all stages of the game can talk to each other, share stories, ask questions, offer support–it’s truly a fabulous space.

It’s also a dangerous place for a person like me. I usually start by scrolling through the topics, but when I can’t find threads addressing my particular issue, I do more targeted searches. These searches bring up threads that are years old, full of people experiencing symptoms and fear similar to my own.

As I scroll through these threads, I can’t help but notice something that makes my heart sink. Members of the message board all add a signature to their posts that lists their diagnosis(es), treatments, etc. Most of them started out with early-stage cancer. There are folks whose cancers are hormone-receptive (like me), folks with no lymph node involvement (same), folks who seemingly should’ve been done with this mess after the first go-round. Their stat lists also include things like “Stage IV,” “bone mets,” “lung mets,” “liver mets,” “brain mets.” (Mets is shorthand for metastasis.)

When you see words like that on a post that’s several years old, you can pretty much draw some solid conclusions as to what has happened to those people in the interim.

In Nina Riggs’ brilliant memoir The Bright Hour, she talks about this online medical obsessing in the essay perfectly titled: “www.heyninariggseverythingisgoingtobeok.com”:

A couple years back, when a therapist helped me realize through a series of exercises that the only thing that would satisfy me on the internet was a website that explicitly said: “Freddy and Benny are going to be just fine. So are you and John.” I laughed out loud at myself. But it didn’t really stop me from seeing disaster at every corner, or checking from time to time to make sure the magical website did not in fact exist.

Yep, that’s what I need. I’m looking for some validation that what I’m feeling is no big deal. A little reassurance that it’s nothing, and I should stop freaking out all the time. I know this is nuts. I know there is nothing on the internet (or anywhere else, for that matter), that is going to give me this reassurance. And even if it did, would I believe it?

The thing is, coping with all of this calls for a healthy dose of faith. I certainly have a strong faith, and while turning my fate over to God and my oncologists is freeing in a way, it’s also terrifying. Just like riding on a plane, I no longer have control, and I think that’s what scares me most.

 

Ultra-Sad

/ Jennifer / Leave a comment

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Last month I started taking Tamoxifen, an estrogen blocker often prescribed to women with breast cancers that are estrogen receptors, like mine. This medication helps block the hormone from feeding cancer cells, and works to reduce recurrence.

As one would expect, though, any medication that tinkers with hormones can have some wonky side effects. I’d heard some horror stories–side effects so bad that the patients had to discontinue or find an alternative medication–but my side effects have been pretty minimal, thus far.

That said, I started noticing some mild pelvic pain a couple weeks ago. Nothing major, just a little pain/pressure, mostly when I was walking or active.

Old me would have just ignored it and moved on. New, paranoid cancer patient me lets very little go unchecked. Though inconsistent, the pain persisted for more than a week, so I called my OB-GYN’s office to let them know (per the instructions on my Tamoxifen patient leaflet).

Yesterday, I went in to have everything checked out.

Going to my OB-GYN office is kind of a sad experience for me nowadays. The place is teeming with women at various stages of pregnancy–the newly-pregnant, with their nervous significant others in tow; the second-trimester gals, all cute belly and glowy faces; and the almost-done ladies, bellies about to pop with that third-trimester look of being completely over feeling like a beached whale.

I’m done having children. I’d made that decision long before my cancer diagnosis. But I still can’t help feeling a pang of jealousy when I see these women. I loved being pregnant, and there are days that I would love to be pregnant again, but that’s not in the cards for me.

This visit only intensified those feelings. After my exam, my doctor sent me to the ultrasound room for a quick look-see just to be certain everything was kosher.

The last time I was in this part of the office, I was one of those pregnant women, excited to get a look at my unborn child. I absolutely loved getting ultrasounds. It was so cool to see my little guy moving around inside me. That blurry black-and-white screen was full of promise and excitement.

Not so much this time. As the tech went to work, I watched the screen nervously, this time hoping my womb and surrounding area were empty. She made a few measurements, and when I asked questions, she gave me some vague answers–standard protocol for ultrasounds. But sensing my terror, she reassured me when she was done that it looked good.

My OB seconded that opinion when we met in her office shortly thereafter, going so far as to say that my uterus and ovaries were “textbook perfect.” Too bad these model parts are where no one can see them!

I left the office with a sense of relief tinged with sadness. Though my decision to be one-and-done was already made, a part of me still mourns the end of this chapter of my life. And I’m angry about the no-turning-back finality that my cancer adds to that ending.