Ramble On

Almost as soon as I spewed out that last post, my energy picked up and my outlook brightened. Perhaps I had turned a corner with my cold/flu thing, perhaps I experienced an out-gassing of hormones or perhaps the very act of writing was a sort of sloughing off the bad juju.

Anyway, I feel good. But that post remains for anyone to see and assume I’m in tatters. I guess if I want to honestly document this process I can’t delete it. Just more proof of how sideswiped we are by changes to our delicate physiology and that we need to feel a sense of purpose in life if we’re going to make it through.

Working on getting strong again for this next surgery. Going off the tamoxifen for a few weeks to prevent blood clots. My excorcism hysterectomy is November 12th and the doctors want to make sure I’m good to go.

You know what’s weird? When you stop getting your period. I suppose if you’ve been pregnant this does not seem weird but on some visceral level I keep waiting for it to come. There is a twinge I guess. Sort of like losing my 34Ds. They were kind of a nuisance, but they were my nuisance, you know? I wonder what I would have said a year ago if someone had said, hey, you can stop having a period, make your breasts smaller and firmer, lose weight, get free narcotics and all you have to do is look into the abyss.

Bet I would have said, hells yeah, sign me up!

Cloudy With A Chance Of Shoes

Last week I was up in the middle of the night, tossing blankets, stripping off my shirt and distancing myself from the various heat sources in our bed, and I began to think how un-depressed I was, how the other shoe had not dropped. We were dealing with my medical issues, had absolutely no work, living in a house filled with dust and exhaust from basement construction, the weather had gone all cloudy and cold, and yet I didn’t have an overwhelming sense of dread. I realized that I had had more anxiety at 32 than I do at 42. As if, once you’ve made peace with the big anvil falling out of the sky, all the other stuff is totally maneuverable.

Then I woke up with chills and a sore throat and one of those sand papery coughs. A week on, I’m still exhausted, I go to bed early and can’t truly wake up until mid-morning. I feel so useless and I absolutely hate that it falls exactly in line with the medical predictions. I don’t want to be depressed. It’s not my bag really. But I do feel as if I’ve lost the plot of whatever story I was supposed to be living. My family makes it better. They’ve been very understanding even though I’m essentially a part of the furniture, like a threadbare ottoman with a missing leg. I had only an inkling before this of how important hormones were. They are a lot of what drives us to keep reaching for those youthful aspirations however feeble. And I don’t mean to say that after menopause (or manopause) that we’re all somehow directionless. But that a gradual process is more like a door opening than one slamming shut.

Talk of menopause makes people uncomfortable. Something we shouldn’t discuss, or if we do, we shouldn’t speculate and say something unfeminist. And that’s fine. Women don’t want to be devalued after they pass childbearing age. Men find it icky and mysterious. My friend Mary G. says the whole concept of labeling menopause is silly and a way to subjugate women. Like, it’s not that big of a deal and she’s probably right for many of those who transition naturally. But the brain fog I’m in right now is making it difficult to even blog correctly. (My apologizes for that.)

What is the positive? What can the reader pull from this murk? Well, other than being thankful for the relative normality you may be experiencing as you read this, I guess that it's possible to wade through the fire without ENORMOUS incident. And that even in this mess of a year there is so much to marvel at. Yes the pills and shots are putting me through my paces. But without medical science, I would have never met Cheryl. She would have already been dead seven years from thyroid cancer. There would be no Cameron and Madeline, no duplex to house our little family and our business, no relationship with Cheryl's family and soon there would be no me.

But still we persist.

Putting Out A Fire with Salt Water

Big Ass Needle and I had our second date on Thursday. We met in the “big comfy” chemo chair this time. There was a man in the adjoining room, receiving his chemo, watching a baseball game. I gazed out the window at the eclectically manicured Cancer Center gardens, imagining all those who had sat in this chair before and received something more toxic. It didn’t hurt as much this time, the nurse gave the lidocaine plenty of time to work. She explained that the Zoladex is a tiny tablet, that’s why the needle is the diameter of a swizzle stick and also why last month I could feel a little bump under the skin. Anyway, I didn’t bruise or start bawling and decided I would be all right this time. Maybe my ovaries had already gone to sleep and this month was going to be about leveling out.

So on Friday I decided I wasn’t sore or anything and went on a bike ride. I mean, it was going to turn cold and it might be one of the last good days, right?

I’m not sure if it’s the hormone loss or just the season winding down but my rides lack aggression. Really having to tell myself to get out of the saddle and sprint. There’s less joy at the apex of a climb and my heart feels non-committal in my chest. I keep trying to tell myself it’s all in my head, that I’m just being suggestible from all the stuff I’ve read. It was a GOOD ride all in all. I’m still very strong (always am by the end of the year) and I even took the dogs on their walk when I got back. After that I was hungry and clammy. So I wolfed down some dark chocolate and cranked on the hot water for a shower. (One of the results of my surgery is my implants don't hold heat like real breasts and I don't have a lot of fat up there for insulation.)

After I got dressed, I realized my ovaries weren’t done with me yet. See, Zoladex tells your pituitary gland to stop talking to the ovaries. And so by the second day, they start getting uppity. The ride and the shower was bound to exacerbate the symptoms. A throb in my belly came on, like this horizontal bar of heat and tenderness. My face turned red and in the middle of dinner, I just started crying into my soup. But I wasn't exactly sad and even began laughing in the middle of it.

It might seem depressing on the outside. It isn't. The hot flashes are easily dealt with by layering my clothes. I'm experiencing an amazing transition—one that induces reverence and awe for the human body. It really does feel like it’s all going up in a blaze of glory.

Of course, such hyperbole could be the out-rush of estrogen and testosterone as they leave the building.

Of all my lady parts left scattered about like so much roadkill, I would be sad to see my ovaries go. My Oncologist and my OB surgeon are at odds on this. The Onc wants them gone. The OB says I’ll need their residual effects. I can totally understand the two viewpoints. The Onc is only concerned about cancer returning. The surgeon comes from a place that sees surgery as the cure. He probably thinks I was cured the day they took my breasts. Why hurt my quality of life? And of course the Internet is all over the place.

I want to keep them. Just one last party favor from a time when I was powerfully driven by the force of Mother Nature. But am I playing with fire? Even after all that we have been through in this house, I often forget my diagnosis. And I don’t foresee ever having cancer again. Is that the human capacity to live or just willful ignorance?

Thank You, May I Have Another

Today I had an appointment with the OB who delivered our twins (as well as removed a humungo fibroid first so that Cheryl could carry those twins). His focus is generally fertility but we trust him and he’s a crack surgeon. He’s conducted over 600 procedures since our last visit.

After much discussion and an in depth exam, we decided on a hysterectomy in November. The Zoladex may shrink the fibroid up to 20% but once I go off the shots, it will likely grow larger than it was originally. And if I just have the fibroid removed, my uterus will grow more to replace it! According to the doctor, if you do not want to have babies, there is no reason to hold onto your uterus. And I feel the fibroid's presence now, every moment. The doctor said at this size it's like being 3 months pregnant. My friends are probably tired of me making pee stops every time we go out. So any hesitance I should have at this point would be more about the surgery itself and recovery.

Not so with the ovaries. Gotta keep them. I don’t really want these bruises once a month for the next five years, but looks like I have no choice.



The OB said we really shouldn’t remove my ovaries unless I have the gene that indicated risk. I don’t. And I need them even after menopause, to keep my bones strong, my heart healthy, my libido cooking and my emotions stable.

In some ways, this next surgery is the least of my worries. The doctor said that after my next shot my hormones will have hit rock bottom and that some women hate it so much they don’t want to keep it up. He’s a real ray of sunshine that guy, but he’s honest and I like to know worst case scenarios.

Today I feel pretty good, bones a little achy, but I'm happy to be alive. What a year this has turned out to be. So many famous people leaving this world that the snarkier blogs are calling it The Summer of Death. The healthcare debate is the latest subject to reinforce this country’s divides. Young soldiers are still giving their lives every week in a far away country.

We’re all tested along the way. My first was being gay. Can’t say I rode that one out of the gate very smoothly. When Cheryl came along, I showed marginal improvements. By the time we had kids, I was reasonably equipped to be a normal human being. And now cancer has awarded a badge of authority I probably don’t deserve. I have received so many cards and well-wishes from people I had no idea even thought about me anymore. It’s really amazing. I hate to admit it, but I may have finally grown up.

I now believe that a life fully lived is our shot at triumph over tragedy. No matter what portion has been taken from you, you must not hide. You must go out and live it.

Estrogen! The Musical

So, I’ve been on the Tamoxifen for a few weeks now and am starting to see the effects. Headaches aren’t that bad but I am a little weepy. It’s as if a yearning John Barry soundtrack is playing in the background. Anything will set me off. Oliver caught a cicada today and tortured it. Waaaaaa! Kids pick up that playdough, or I'll, I'll, waaaaa!

Also, my fibroid is beginning to radiate a constant pain now. A child’s elbow, a dog’s paw—it feels like a punch in the gut every time I get poked in the abdomen. My oncologist told me today that my fibroid is only a centimeter smaller than my uterus and sitting on top of it, so I should probably consider surgery. The Zoladex shot I got today might lessen that but I wont see any results for a while.

I thought the Zoladex shot was going to be a quick shot in the butt or arm. But it is more like the core biopsies in that they lay you back, numb you up with Lidocane before they use the “big ass needle,” as my nurse called it. The difference is it goes in the belly instead of the boob. Ouch. Once a month. Sigh. At least it’s not chemo, right?

Anyway, I walked out of the cancer center, tears streaming down my face, looking like I just got a fatal diagnosis. What an idiot. Suppose it’s kind of good to cry sometimes; it flushes the system. Plus I’m not just crying over sad things, but good things too. (The hibiscus blossomed again, waaaaa!) It’s weird. I never cried a ton before. It’s like the lady parts are going out with as much drama as possible.

According to the onco, it’s really going to kick in now with the shots. Hot flashes apparently.

Maybe I can keep the family warm this winter and we'll save on energy bills.

Shameless, Absolutely Shameless

Breaking: Leo Keeps Mane

Okay, bad news first. I got a friggin’ staph infection from my surgery. So my doc switched me to malaria grade antibiotics to kill that. Ick.

But the good news is my Oncotype results show that #1: My cancer recurrence is slim. And #2: It probably would have been resistant to chemo anyway. So no chemotherapy! Who-hoo! I fell into a category below even the shaggy grey area and would have only gained a couple percentage points for a cure by taking chemo.

Where does that leave me? Well, I have a bottle of Tamoxifen sitting in front of me, for when my staph infection subsides. I will be on that five years. I also will be receiving a shot once a month of Zoladex (for the same amount of time) to suppress my ovaries. My oncologist says that these two treatments have much the same effectiveness for my cancer as chemo does in other non-estrogen cancers.

I have an appointment with a geneticist to determine if I have the BRCA gene that indicates ovarian cancer risk. And an appointment with my OB-GYN to determine if I need a hysterectomy. The whole she-bang could be taken at once and I would stop the Zoladex shots. But I won't know for a month or so. And really, do I want another trip into a staph-riddled hospital?

We're not exactly dancing around, because there are still a few twists and turns, side effects etc. But it is entirely likely the worst is behind us. And that counts for A LOT.