Thursday, May 31, 2012

The Party In My Ovaries Never Ends

I have been cheated, duped, tricked, fooled, deceived, and hoodwinked.  After one week on Zoladex, which is SUPPOSED to stop my ovaries from producing, I have instead started my period (excuse me, make that my FUCKING period). WHY HAS MY BODY TURNED AGAINST ME? I've been pretty good to it. I deserve better than this (especially after the 37 day seige that started right after my surgery).

I called the oncologist's office to report this finding, as I had not read about this in any of the literature I received, and the nurse agreed with me that this seemed to contradict the purpose of the drug. She said she would talk to the doctor and get back to me. I spent the rest of the afternoon feeling a little crampy and a lot sorry for myself.

Late afternoon, the nurse called me. Dr. Croy apparently wasn't surprised that this happened (at least ONE of us wasn't). The nurse said he could explain it to me better at my next appointment, but the bottom line is my pituitary gland is a complicated little bitch and she's barking out orders to my reproductive organs that has them confused as hell. (Those may not have been his exact words.) Seems to me it's kind of like the pilot dumping all the fuel when the plane is about to crash land. All I can say about it is, if THIS one lasts 37 days, someone is going to die. 

In the meantime, no other side effects to report from either the Zoladex or the Arimidex. I'm still employing the Think System to keep it this way (the freaking, stupid period slipped past me). I'm dutifully taking my calcium supplements and additional Vitamins D and E.  I'm also taking it very seriously that weight-bearing exercise can help prevent bone loss caused by the Arimidex, so I have been walking two miles nearly every morning. Can't wait until my Zumba teacher is finished with her month long sabbatical and resumes teaching, because Zumba is much more fun than chuffing up and down hills in Landreth Park. Plus, the outfits are cuter. Can't wait to see what happens next....

Thursday, May 24, 2012

Waiting For The Other Shoe To Drop

Not anymore....
I know I have complained for YEARS about having fully functioning ovaries, but this past Monday night, the reality that they were going to be chemically turned off hit me like a truck. I cannot begin to explain why I was upset. Having my tits cut off didn't upset me. (Of course, I didn't experience having NOTHING there - my reconstruction was immediate. I went to sleep with one set and woke up with another.) 

So why did this procedure of turning off my ovaries make me so emotional? Because it's the end of a chapter that's been going on for almost 40 years? That by no stretch am I still in my child-bearing years, and that equates, to me, that I've entered into senior citizenship? But I'm still 11 inside!

As if I weren't already emotional enough heading into my oncology appointment on Tuesday, it was also the first anniversary of the tornado. As I drove to the oncologist's office, I had to pass rows of tv station satellite trucks, lined up on the street adjacent to the destroyed St. John's hospital. It brought back all the emotions of a year ago and piled them on top of my already shaky little self.

My actual appointment with Dr. Croy brought the news that he had talked to my ob/gyn, and Dr. Lacey did not want to do anything surgically to me to remove my ovaries. Laproscopic surgery would require that my abdomen be inflated for the procedure, and he didn't want to do that after my tram flap surgery. He didn't feel vaginal removal would work out because of the likelihood of scar tissue from my two previous c-sections. And going in through my old c-section incision would be major abdominal surgery with several weeks of recovery time. That left Zoladex, the pellet inserted under the skin, as the only viable option. But instead of it being done once or twice until the ovaries could be surgically removed, it would now be a monthly procedure and would continue for the duration of my hormone therapy. In other words, for five years. Dr. Croy told me that, once enough of the Zoladex had been absorbed, menopause symptoms would come on "like gangbusters." I asked if that meant TODAY and he said probably not, but this week. The waiting game begins.....

The Zoladex was administered in the infusion center. The infusion center is a place that no one would ever wish to visit. Due to space limitations (thank you, tornado), the room was very crowded. Lined against the walls were hospital-issue recliners with chemotherapy patients sitting in them, iv bags of the necessary poisons hanging next to them. The patients and the staff were all cheerful and chatty with one another, but I thought it was depressing as hell, and I said a prayer of thanks that I had been spared this kind of treatment.

My nurse was Lauren, and she took me back to a little room to give me the implant, since it has to be inserted into my stomach. (This would be a horrible proposition if it weren't for a large section of my stomach being numb.)  She let me pick the spot, and when she washed it off with an alcohol swab, I felt nothing. Same with the shot of Lidocaine that I received to deaden the area (BAHAHAHA!!!) before the implant was inserted. (Lidocaine stings like a sonofabitch ordinarily, and I know this from all the breast biopsies I had.) And I didn't feel the pellet of Zoladex going in, either, which I believe to be a good thing, because it is, indeed, about the size of a Tic Tac. (She became my favorite nurse EVER when she said I was pretty thin and the pellet might show slightly. Who cares if it shows? She said I was pretty thin!)  Lauren put a bandaid on my puncture, then gave me a spare because "they usually bleed a lot." She wasn't kidding! By the time I got to the car, blood had soaked through the first bandaid, and I had to cover it with the spare. 

Next step was a little retail therapy, because I thought it was the LEAST I deserved, followed by a little chocolate therapy (ditto).  

I forgot to pick up my prescription for Arimidex, the aromatase inhibitor, from the pharmacy (I swear it wasn't intentional), so I didn't start it until the next day. That morning, I lined up all my bottles on the counter and nearly cried. Arimidex; Calcium with Vitamin D, because the Arimidex can cause bone loss; additional Vitamin D, because it can help with bone and joint pain associated with the Arimidex; Vitamin E, because it can help with the hot flashes the Zolodex is supposed to cause; Metamucil, to counteract the effects of taking high doses of calcium. NOOOOOOO! I'm going to be just like my parents, who carry a gallon-sized ziplock bag filled with meds with them every time they travel. Next, I'll be using one of those plastic day-of-the-week sorters and counting out my pills every week. If I start wearing Alfred Dunner clothes and sensible shoes, somebody bitch-slap me. Please.

Sunday, May 13, 2012

Save 2nd Base? Too Late! Save The Hair!

Oncology appointment time. THIS time, however, I prepared for my appointment with the oncologist by taking a shower, thoroughly shaving my legs and underarms, liberally using my Philosophy lotion on my legs and feet, and wearing a decent pair of underpants, and...he didn't look at a thing. Only talked. Sigh. But I'm certainly satisfied with what he had to tell me: no chemotherapy! 

A diagnostic test was run that studied the behavior of 21 genes in my tumor. I then received a score that predicts the likelihood of my cancer returning and whether chemotherapy or hormone therapy would be the best treatment. On a scale of 0-100, my score was 14, which translates to, roughly, a 9% chance that my breast cancer will recur in the next ten years. At this low rate, the side effects of traditional chemotherapy outweigh the benefits of doing it, even in conjunction with hormone therapy.

Happy dance time! The hair is saved! (I'm sure someone will remind me of this the next humid day when I'm complaining about the frizzy, curly mess of straightening iron-defying hair that I have.) 

Now, hormone therapy (in my case, an aromatase inhibitor, which makes me think of aromatherapy, a happy thought that has absolutely nothing to do with being an aromatase inhibitor) is not without side effects of its own (although hair loss not being one of them is awwwwesome).  These include hot flashes, nausea, decreased energy and weakness, bone and joint pain, bone thinning and weakening, vaginal dryness (there's a fun one), and a cough.  Because I will also be thrown full-force into menopause, then mood swings are another side effect (to which my son asked, "How will we notice a difference?"). This is also the point when the husband asked the oncologist for a prescription for Valium for himself. That's okay, because right after he gets that filled, I plan to ask the oncologist for a prescription to crank up the air conditioning and present it to the tightwad who is always trying to save on the gas and electric bills. 

My son was (mostly) saying the bit about the mood swings in jest, because I'm really not a moody person, as long as nobody PISSES ME OFF. As for the rest of the side effects, I am once again employing the Think System. If 30% of the women taking this experience the side effects, then 70% don't. I am planning to be part of the 70%. Of all the potential side effects, the only one I am willing to succumb to is the loss of appetite one.

Until Dr. Croy and my gynecologist figure out what to do about my highly functioning ovaries, I will also get a shot IN MY STOMACH of a drug that will suppress the ovaries. It will be in the form of a pellet (their word, not mine) that will be implanted under the skin (I'm picturing a Tic Tac) and which will jack with the pituitary gland so that it doesn't signal the little fuckers to produce. Side effects are similar to that of the other drug, but since I don't plan on having ANY side effects, I am going to skip them (although the one about the inability to obtain or sustain an erection is troubling to me).

I don't like taking over-the-counter medicine, and now I am going to be taking a chemo drug and calcium supplements and who knows what else every day for the next five years? Time to concentrate on the positives: no i.v. chemo treatments, cute, perky boobies, flat tummy, no hair loss, no pesky erections. And there's my silver lining....

Friday, May 11, 2012

Dancing My Tits Off (Wait - They're Already Off)

I met my goal this week of returning to Zumba class by six weeks post-surgery. I was a total bad-ass, too, although I found I couldn't jump. (That surprised me, because my trial run was doing the Cha Cha Slide with my pre-k class, and I danced like a, well, like a 5 year old.) And while I had a little pulling around the abdominal incision, what I DIDN'T have is pain from swollen, tender, fibrocystic breasts. Yay!

The stitches came out of my newly created nipples this week, and I must say, the entire package is going to be spectacular when the entire reconstruction process is complete. Without the black stitches sticking out all over, the nipples no longer look like freaky cockleburs. They are still oversized, rather like nipples that have been nursed on by a baby barracuda named, oh, let's say, Kyle, but they look normal. Okay, normal-ish. 

One part of the nipple surgery kind of creeps me out: Dr. Geter reopened the original incisions across the equator to do God only knows what part of the nipple creation. I knew there were steri-strips across them, but I didn't realize until the strips were removed that they were covering new stitches. Not entirely sure why it bothers me, but it does. Maybe he should have installed a zipper. This is the third time he's gone in there.

I was admiring the new boobies in the mirror this morning as I was getting ready and realized the incision lines are not exactly straight. They don't look like a scenic byway on a road map, but they do have a bit of a wave to them. I pointed it out to the husband, telling him that this would be the work of Dr. Bumberry, the general surgeon, to which my husband replied, "Think what he had to work with. You were lying down on your back, and he had to pick them up out of your armpits to make the incisions." (Lest you're new to this blog and think they were in my armpits because I was well-endowed, the truth is I never was, and the reason they were in my armpits at all is that they had lost their will to live after nursing my kids.)

So, even though my family very quickly returned to treating me like they always did, my return to Zumba signified a real step closer to being back to my old self. My old self with new tits. And cancer. Can't forget the cancer. Damn! And I was so close....

Monday, May 7, 2012

Stop Crowding Me Already

"I have a little shadow that goes in and out with me,
And what can be the use of him is more than I can see."

(Robert Lewis Stevenson, A Child's Garden of Verses

Pollyanna has given me the slip this week. I've cried hot, angry tears, aching inside from the things I cannot change. I thought the surgery and recovery were going to be the worst part of this whole ordeal, but I was wrong. I have fucking, stupid cancer, and it's taken over a part of me, edging something else out of its way. Wonder when I'll figure out what got pushed out of the way to make room for it?

Physically, though, I feel great. There is still pulling and some pain along the tummy tuck incision, but I can stand upright MOST of the time. The nipple surgery never caused any pain, other than the horrifically itchy tape episode. In fact, I have set a goal for myself to return to Zumba at 6 weeks post-tram, which would be this week, and I feel pretty optimistic that I will be able to do it. Maybe not do it WELL, but I'm willing to give it a somewhat feeble try.

One bright note: the period from HELL may have finally ended. 37 days of it. 37 days. THIRRRRRRRTYYYYY-SEEEEEEEEEEEVENNNNNNNNNN!!!!! I deserve a reward.

Wednesday, May 2, 2012

I Have An Awesome Oncologist That I Wish I Didn't Have

Just when I thought I was sailing through this cancer thing, reality hit me square in the face when I had my first visit with the oncologist.

I had no idea just how thorough an exam I was to get when I went to my scheduled appointment. Had I known, I would have worn different underwear and shaved my legs. There's a back story behind the unshaved legs.  I had just had my nipple surgery the day before and was not allowed to get the bandages wet, i.e., no showers. I toted my shampoo, conditioner, body wash, towel, etc., to the downstairs bathroom with the idea that the smaller bathtub would be easier to use than the big jacuzzi tub in my bathroom (it wasn't), but it wasn't until I was already in the tub that I realized I had forgotten the razor and shaving cream. But no big deal, right? The oncologist is only going to be talking to me, going over my pathology reports, bloodwork, and treatment options, right? Hah!

Thanks to the tornado, the oncologist's office is now located in a trailer behind the only remaining building in the St. John's complex. It was so hot in the exam room that I began to wonder if poaching the patients was part of the treatment plan. Dr. Croy came in then, and when we mentioned that it was a liiiiiitle warm, he said, "Welcome to Trailer Town." 

The exam began with him asking me what events had brought me to his office. My first instinct was to say, "YOU know," since I knew that he did, indeed, know why I was there, especially since his wife was one of my babysitters in the hospital. But there he sat, with his legal pad and pen and an expectant look on his face, and I laid out the entire story for him, trying to disassociate that we had been friends for a dozen years before he became my oncologist. (I have always said IF I ever had cancer, I would want David Croy to be my oncologist - just never thought I would have a need to follow through with it.) It was only minorly uncomfortable when I had to tell him extremely personal things (you know, the same personal crap that I bandy about on my blog like it was nothing).

Next, he had me undress down to my panties (which I heard as "take off everything AND your panties" which, thankfully, he heard me repeat and corrected me before I made it really awkward to sit by him at church). I had a lovely paper gown to put on that included a rather short strip of something resembling a kitchen trashbag to use as a belt. I was already sweating from the stifling heat in the exam room and the paper gown did not decrease my discomfort. My skin grew damp with sweat, triggering an unbearable itch under the tape covering the bandages from my nipple surgery. 

The doctor started out looking in my eyes, nose, throat. Then things got more complicated. He had me do things like follow his finger with my eyes, squeeze his hands with both of mine as hard as I could, and push against him then pull him towards me as hard as I could with my arms (which hurt my incision and oh-so-tight stomach muscles). The next series of tests involved my legs and feet and had me wishing I had at least put lotion on, although maybe my dry feet and legs distracted him from my failure to shave. I didn't fare well at this game of Simon Says, because he fired directions at me so quickly that I couldn't keep up and was pushing when he said to pull and bending when he said straighten. 

He asked me to lie back on the table so he could feel my abdomen, at which time I found out that I had sweat so much that I had to peel myself off the table in order to scootch back and lie down. Finally, he had me get up off the table and walk across the room (which I think I did pretty well), then do the heel-to-toe field sobriety walk (which I DON'T think I did pretty well), and then he directed me to get dressed. Now it was time for HIM to talk.

I wish I could remember everything Dr. Croy said to me. I can't. (I was concentrating on not breaking down and bawling.) He talked about chances of recurrence and different treatments that would lower, but not eliminate, those chances. My breast cancer is estrogen-receptor positive, roughly meaning my cancer cells need estrogen to grow, and eliminating estrogen in the body will (hopefully) prevent the cancer from growing or recurring. It also means there is a good chance that treatment will be in the form of a daily hormonal therapy medication, rather than traditional chemotherapy, which is delivered in approximately four sessions, three weeks apart. The hormone therapy is for post-menopausal women, and since I have clearly demonstrated that I am NOT post-menopausal, the good news (here comes Pollyanna and her glass-half-full) is I would be MADE to be post-menopausal. This could either be in the form of injections into my stomach muscles (pass) OR the removal of the ovaries. YESSSSSS! AT LAST!!!  

Dr. Croy is waiting for an additional pathology report to determine whether we will go with hormonal therapy or chemotherapy.  I do know the immediate future holds a chest x-ray, a bone density scan, a colonoscopy, and (yay) the removal of my over-achieving ovaries. 

What I did firmly grasp from the doctor is that as good as my pathology report was (clear margins, clear lymph nodes), I am not home free. This whole thing is far from over. In fact, it will never be "over." Vagabond cancer cells could be anywhere in my body, lying in wait. And there's still no backsies.