Decisions, decisions.

I’m going to try not to go on, because I know reading people’s meandering thoughts on themselves and their issues – whatever those issues may be – can really be quite boring, and I like to think I am not arrogant enough to think my musings are any better than most. Nonetheless:

Being diagnosed with cancer is not a decision, but it’s the start of many. Treat or don’t treat (seems crazy, but look at Jackie Collins)? Lumpectomy or mastectomy? Chemo or no chemo? Naturopathy or no naturopathy? Radiation or no radiation? Hormone therapy or no hormone therapy? And on and on and on. Having cancer is one of the lowest blows I’ve been dealt, but I don’t get to sit back on my laurels and wait it out. I have to do research, ask questions, and look inside my own head and heart for answers that don’t exist, that are just guesses. Educated guesses, but guesses nonetheless. Some people are willing to take everything their doctor says as gospel and just follow that path, which is great – but it’s not for me. I have every faith in my doctor, in his education and experience – but he can only tell me what is right for the majority, not for the individual. And I am, if nothing else, an individual!

So as much as I wish I could simply say, “I’ll do whatever you say, just tell me where and when,” I just can’t. And now here I am at the last decision I mentioned above – hormone therapy or no hormone therapy?

I have talked about it ad nauseam in this blog, so I’ll just do a brief update here. The lesion removed from my breast was determined to be estrogen receptor positive – ER+. What that means, in brief, is that estrogen helps it grow. So as long as my ovaries are releasing estrogen into my system – which, according to Wikipedia, will be for the next 7 – 17 years – any stray cancer cells in my system, or new cancer cells that develop, are likely to be boosted by the estrogen coming from my ovaries. Solution? Taking a pill or getting a shot to turn off my ovaries for the next five years to deprive those cells of estrogen.

The drug of choice to do this is called Tamoxifen, and I have already decided against that. There are a myriad of reasons, which I have discussed in previous posts (several previous posts), but the primary reason is that it and Prozac are completely contraindicated for each other and I am not sacrificing my mental health. I’m just not doing it. So as I mentioned in my last blog, Dr. K suggested I stay on Lupron, which is what I am currently on now along with chemotherapy because it’s supposed to help preserve fertility (in some women, some of the time).

Lupron is… really shitty. I am bloated. I am fat. I am hungry constantly. I am getting new wrinkles (literally, it’s not just in my imagination). I cannot sleep. I have to be on ANOTHER medication to cut back on the hot flashes and night sweats, which were occurring roughly every half an hour – try to imagine waking up every half an hour on sheets completely drenched in sweat. I have never been anti-medication – it’s quite literally what keeps me sane – but I am caught in this medication to treat medication to treat medication cycle right now and I HATE it. I long for the days when all I needed was an antidepressant and an antacid daily! In the end, I don’t want to do Lupron either. Which means, really, I DON’T WANT TO DO HORMONE THERAPY. That’s it.

Last visit, while I was crying about this very subject, Dr. K said that with my cancer, when it was caught, how I’ve opted to treat it, etc., my survival rate is already in the 90th percentile. He also said that hormone therapy will only increase that percentage by a few points. So there’s the decision: Is five years of misery, of not feeling like myself, of pills and shots and feeling like I have no control over my body, worth those few percentage points? And the answer is: No one knows. If I don’t have a recurrence, it’s totally not worth it. If I do have a recurrence – we still don’t know, because I might have had that recurrence even WITH the Lupron.

So I think in the end, my decision, hard as it is, has been made. I will finish my chemo. I will do the radiation. And then I will say au revoir, cancer, and move on with my life.

And although this is already far longer than I intended, let me close with one last decision I have made: Cancer is not going to run the rest of my life. I have seen lots of posts about how breast cancer changes you, how once you’re diagnosed it’s always there, the other shoe waiting to drop (if you’re unclear why, please see my post on metastatic breast cancer). Yeah, it’s changed me. I will never forget this time, nor am I ignorant about what it means for the future. And I’ll follow up with every test suggested, stay on top of my health, remember that 30% of women with breast cancer end up dying from it – but also that 70% of women don’t. I’m planning to be part of that 70%.

2nd to last! Come at me, bro!

So. Let’s see. Where to start.

First the bad: Pretty trivial, but I’m starting to get serious muscle soreness/fatigue. Started after I took Georgie for a long walk. The next day my muscles were quite sore, which I didn’t think much of… but they never stopped being sore. So for about a week and a half I’ve had post-workout muscle soreness. On top of that, things I normally do – charging up two flights of stairs, plopping down on the floor and jumping back up – have become very difficult for me. Essentially I feel like I am in the worst shape of my life – it’s given me a ton of empathy for people who are actually in bad shape, and a lot of gratitude for how I normally feel!

  
Now, the good: Second to last chemo, baby! I’ve made it through 4, five and six to go. So glad to be able to see the light at the end of the tunnel. After 6 I get a three-week break, then six weeks of radiation, five days a week. Not looking forward to that, but Dr. K says for about 2/3 of it I’ll feel pretty good – fatigue won’t hit till near the end. 

Today I asked him about having another baby, assuming I am fertile when this all ends. He said the good news is there will be no danger to me or the baby, and there is no evidence to suggest pregnancy or breastfeeding will cause the cancer to recur. I’ll also be getting checked very often – every 3 months for the first year or two years, I can’t remember, then less and less often. Mammograms only once a year – the three-month checkups will be just physicals and blood work. They can detect breast cancer in blood now! Not with 100% accuracy, but he thinks within the next 5 years things will be even farther along. When people talk about how breast cancer research has not brought about changes, I assume they must not know about amazing advances like this.

The bad news is he also told me he still strongly recommends hormone therapy. Aagagaggahhhhh I DON’T WANT HORMONE THERAPY. I told him I can’t do the Tamoxifen because of my antidepressants, and he said I could stay on Lupron – the drug that has been making me fat, bloated, and giving me new wrinkles and hot flashes/night sweats. Cue the tears and me saying, “I don’t want to be old before my time!” to which he immediately replied that this was MY choice, he will work with me on whatever I choose, and that the difference in survival rate numbers is only a few percentage points given my specific situation. He said let’s quit the Lupron after the next admin, see what happens with my period, get me through radiation, and then see how I’m feeling about it. This is why I have the most awesome oncologist in the world. I love this man like a relative. Seriously, Team Kaplan for the win.

So I cheered up and we came down for the chemo. Last week the place was so full and we waited SO long. This week we waited maybe five minutes and have an awesome chemo nurse, Lauren, whom I love.

Swedish (Hospital) chemo is not like other chemos, from what I have heard. We don’t have the chemo circle here – you’re always in a private cubicle (curtained off) or, less often, in a private room. I think prior to this we have had a private room once or twice. They’re way preferable because you can close the door, talk about whatever you want, watch TV or a movie without worrying about disturbing your neighbors, etc., but they are often filled up quickly for this very reason. 

Today, Lauren asked if we wanted a room and we said HECK YES! Turns out there were three rooms available and we got to choose so did we pick the one with the chair, the bed, and the ensuite bathroom??? YOU BET WE DID!

  
  

So, on a bad news/good news day, the good (as usual) is totally trumping the bad. Had a dream about my Dad last night and he was looking after me again. Grateful for everything, but especially for the support of all my awesome friends (like Mari, who will be joining us here in a bit) and my Mom (who gets here tomorrow night, WOO!!!)
Happy Wednesday!

UPDATE: I have found the fault with this room.

  
Someone has installed the toilet paper roll incorrectly, and I cannot fix it.