Thursday, June 5, 2014

This is what I feel

It is very painful - this longing, for what, I don't know. A homesickness even when home. I feel very Pennyroyal tea, which may make sense if you know anything about Nirvana. I think pennyroyal is an herb used to induce abortion and Kurt Cobain maybe wanted to abort himself. I understand. I'm talking about nirvana the band, not the state. The state, actually, in which I find myself today is not very good. I'm done with a lot of the cancer stuff right? Here I am at the end of everything, or is it? Or am I? Oh are you?

I'm at the end of chemotherapy, I'm at the end of radiation, I'm at the end of four painful surgeries, everything is supposed to be wonderful right? But it's not, it's so anti-climactic that it hurts. It's hard, A hard anti-climax. I'm so mentally stretched and stressed out that the universe has turned itself inside out and is folding up in on itself like a velvet watermelon. That doesn't make any sense and I don't give a shit. This is how I feel.

PENNYROYAL TEA
I'm on my time with everyone
I have very bad posture

sit and drink Pennyroyal Tea
Distill the life that's inside of me
sit and drink Pennyroyal Tea
I'm anemic royalty

Give me a Leonard Cohen afterworld
So I can sigh eternally

I'm so tired I can't sleep
I'm a liar and a thief
sit and drink Pennyroyal Tea
I'm anemic royalty

Lemon, warm milk and laxatives
Cherry-flavored antacids

sit and drink Pennyroyal Tea
Distill the life that's inside of me
sit and drink Pennyroyal Tea
I'm anemic royalty
"Pennyroyal Tea" by Nirvana

I'm so tired I can't sleep

My timeline with cancer is so not the Lifetime channel plot where you get through each step and burst through the finish ribbon at the end, bursting with pride and joy as the crowd bursts into bursting applause. I'm not dissing my support staff - my friends and loved ones have been loving and friendly but this is getting old. It's too long and we lose interest. It's not a clear journey. It's confusing. When is the intermission when do the cheerleaders rah rah when do we serve cake when is the party?  No, I've taken a more circuitous route that seems to meander around and around like the sludge at the bottom of a crockpot. I'm in the crockpot of cancer and can't get out. And it's unplugged and the chefs have departed.

This is how I feel.

So don't tell me things are all right and that I'm doing so well and have the best treatment and attitude and right support and right treatment and right care and right doctors and luck and things are just awesome that pisses me off and almost literally makes me sick and you don't want to make a cancer patient suck do ya? I'm not a Hallmark card I'm a person and this sucks.

My cheer has exited on a tide of unswept porch leaves. It may come back in but right now it's low tide.

However secretly I'm above all this and ok.

Radiation ended two Fridaya ago. No hoopla, no one really noticed, not even me. The rays kept boiling my molecules for days (weeks?) and I'm still broiler-red and scabby and bone sore, and yes I think the radiation broke part of my lung or something because I had beastly pleurisy pain on and off (only off because slayed by drugs twice thrice) that instantly sprang up when I got zapped. 

Anyway - that department of cancer ended and I was sent to the department of post-everything-else stuff. Which means for estrogen positive breast cancer types like me (we are very common - how gutter snipey of us) NOW YOU HAVE TO TAKE POISON PILLS FOR TEN YEARS TO SHUT DOWN ANY ESTROGEN IN YOUR BODY! 

Odd things about this:
1. Isn't this "chemo" therapy cuz it's chemicals? 
2. Isn't estrogen kinda good for your - you know- BODY? As in bones, heart, brain...not to mention your female sexuality sexual sexiness sex stuff? Well yes it is. Without it will I shrivel into a dried crone toast end?
3. Well yes but here is the deal - breast cancer just LOVES estrogren - it's like food for the cancer, so if you have my kind of breast cancer you better get the rest of the estrogen in your body the hell away or the fucker WILL COME BACK.
4. Statistics argue strongly that it's a very very good idea to do this anti estrogen thing - it super helps your chance of breast cancer not coming back SO I AM GONNA DO THIS STEP even though I don't want to
The drug of choice for this is Tamoxifen. It is an estrogen blocker - when the little cubes of estrogen try to dock in the estrogen docks, it gets in the way. But I have a problem with this - if you have ever had a blot clot or stroke or bleeding in the brain you can NOT take tamoxifen, because it can cause blood clots and do really bad things to you like kill you. I did have bleeding in my brain, or what's known as a TIA, transischemic attack, otherwise known as a small stroke, in 1995. So I am not a candidate for tamoxifen. I told my oncologist all about my brain bleed and the idea that Tamoxifen seemed like it was contraindicated for me back in August when I met her, because I had already read ahead and knew about it. I had an instinct intuition that Tamoxifen would be BAD FOR ME.  I told her again in September, October, November, December, January, February, March, April, May, and yesterday. Yesterday she said "Really?!  You didn't tell me that!" And then she looked at my file and realized that yes it was true I could not take tamoxifen. She was surprised. I was not. And the little anxiety man that lives inside me started to run.

So for people who can't take tamoxifen there's another class of drugs called aromatase inhibitors. Instead of blocking estrogen, they inhibit other hormones in the body from turning into estrogen, things like testosterone and androgen. Those hormone sometimes go into little changing rooms at the back of Victoria's Secret and  take off all their clothes and put on little pink panties and bras and they turn themselves into estrogen and when they come back through the curtains they are now estrogen, and no longer what they used to be before they changed. Aromatase inhibitors don't let them do that. They INHIBIT this change. I guess they're kind of like little bouncers hanging outside of the changing rooms to stop the transformations.

The result is the same as with Tamoxifen - less estrogen, therefore less chance of breast cancer returning = good.

Some interesting facts about taking aromatase inhibitors:

1. You absolutely cannot take them to prevent breast cancer from returning unless you're 100%, no actually make that 300% done with menopause. As in it's been two years since menopause hit and your ovaries have completely exited stage left. As in no periods for two years. 

2. Why? Because if your body has any estrogen left in it, if there's any wind left in the sails of your ovaries, and they get a whiff of the chance that these aromatase inhibitors are NOT letting other hormones turn into estrogen, guess what? The ovaries panic and worry that someone is stealing estrogen and decide they need to MAKE MORE! They go in to full overdrive - pumping out estrogen like the Beverly Hillbillies' oil well. This is stupendously dreadful bad because it makes breast-cancer come back.

3. So doctors only give aromatase inhibitors to people are completely in menopause for sure for sure for sure for sure for sure.

4. No one is sure if I'm in menopause or not, I haven't had a period since last summer, but most likely chemotherapy just put my ovaries to sleep. There's no really good definitive way to measure this, because blood tests only measure one moment in time. So nobody knows if I'm in menopause or not. Oh great. Fuck.

5. So... The only option is to manually shut down my ovaries. This can be done in one of two ways:

    A. Shots that squelch the ovaries - every few months until the mountains crumble into the sea. And the side effects "make you feel really bad."

     B. Oophorectomy (cool word huh?!) - ovary removal! Through laparoscopic surgery, your two little gonads are sucked out, therefore completely obliterating any ovarian production of estrogen. 
PROS:
Gets rid of chance of future ovarian cancer
Quick easy surgery easy back up on feet part
My doctor is skilled at this
Shuts down estrogen effectively so that aromatase inhibitors can be safely used, increasing my chance of long term survival (re: not croaking from breast cancer)
CONS: 
Throws you into instant menopause - harsh
Low/no estrogen puts you at risk for osteoporosis, heart disease, Alzheimer's, dry vagina, weight gain, low libido, crepey skin, loss of collagen, frumptitude and bitchiness. Well I already have a few of those right? Oh yes and insomnia and hot flashes. Got those.

My oncologist (Dr. G)?wanted me to rush and go consult with my OB (Dr. S) about this. Huh? WHAT???!!!! I thought YOU were in charge!!! This whole "who's in charge" thing has been a real cluster fuck but no matter I shall charge forward and did - I finagled an appointment the very next day...

Nice/good/wonderful unexpected thing: I've been going to the same OB practice for 20 years, and had a really great doctor who was pretty famous and awesome named Margaret Thompson. A few years ago she decided to go to law school at the age of 55 (I love this) and left the practice and sold it to Dr. S, so I inherited a new OB - one that I've never met! An invisible secret OB. Every year when I would go in for my well woman check, I would just see the same nurse midwife Lisa I had always seen, so I never had the chance to actually meet the actual doctor under whose practice I was a client. I always thought "Eh...whatever, I'm fine with my sweet nurse Lisa, who cares if I see the doctor?" 

So when my oncologist Dr. G that I should talk to my OB, my ACTUAL OB DOCTOR I thought, oh great yet another weird kink in this bizarre story of my cancer journey: I've never even met my freaking OB! 

Well today I got to meet Dr. S and I just loved her. 

Thank Ye Goddesses. 

Yesterday when the oncologist said I needed to hurry up and meet with my OB for opinions about having my ovaries removed, I felt slighted, ignored, pushed away. I have been feeling lately like my some of the cancer doctors are just shuffling me off to Buffalo - I don't really know what's going on or who's in charge, so it was with a heavy heart that I made my appointment to see the OB today.  Dr. S walked in and I just said help. She was kind, compassionate, smart, attentive, aware, with me, with it, waving on my wavelength, on the ball, kind, kind, interested in me, engaged, and fascinatingly smart. And kind. She listened to every single word I said, and to the words I didn't say. She explained a lot to me in detail, and then said she wanted to do more research and reading up on this and come up with a game plan for me in one week. She said I want to see you in one week and I'll have a plan. Do you know how much I love that? She had the nurse take my blood so they can test for my hormones right now, even though we all know one blood test is just a snapshot in time, but at least it will give her some information. 

I felt like I was managed and cared for by someone who knew what the hell what's going on. Her receptionist said I couldn't come back for two weeks, but she intervened and got me squeezed in for exactly a week. Then later today Dr. S emailed me, after studying up on my case and the latest science, and she does recommend that I have another surgery to have my ovaries removed soon. She included a copy of a report that she read that she thought I might enjoy reading. Thoughtful.

This is how I feel.

So. 

I think I'm about to have a fifth surgery in the last nine or ten months. I feel completely numb except for the time that I am so freaked out but I can't breathe or think. Like all night long every night when I can't sleep. I am about to embark on new chemicals but for the moment I am on no drugs and on a searing roller coaster ride of anxiety. I am going to right this ship and write this blog and ride this storm

This is how I feel:
Shitty
Not drunk
Pissed
Bored
Restless
Not hungry
Incurious
Dull
Like eating fish skin
Drowned
Flat
Burned
Panicked
Hopeful but only for a minute because the I must not have inhibitors to stop good feelings from transforming into panic - that is: if I LOOK or THINK or CONCENTRATE on something good coming up it squeezes my throat and hurts me so I look away
Sick
So tired but sleepless
Panicked that the poor sleep will turn onto Alzheimer's (on the news) or breast cancer or poor posture or bad parenting or heart attack or stroke or more anxiety yes it is (do you know how not helpful it is to have sleep problems and then be bombarded with NEWS and IMPORTANT NEWS that lack of sleep is BAD for you???!!!)
Removed (in lucky minutes)
Apologetic - shouldn't I be rallying my troops and better at this?

This is how I feel.
This is how I look - today marching in the broiling sun to HEB in long sleeves angrily marching just to have something hot and awful and painful to do to distract 


This is what I read:


There Comes the Strangest Moment
There comes the strangest moment in your life,
when everything you thought before breaks free--
what you relied upon, as ground-rule and as rite
looks upside down from how it used to be.
Skin's gone pale, your brain is shedding cells;
you question every tenet you set down;
obedient thoughts have turned to infidels
and every verb desires to be a noun.
I want--my want. I love--my love. I'll stay
with you. I thought transitions were the best,
but I want what's here to never go away.
I'll make my peace, my bed, and kiss this breast…
Your heart's in retrograde. You simply have no choice.
Things people told you turn out to be true.
You have to hold that body, hear that voice.
You'd have sworn no one knew you more than you.
How many people thought you'd never change?
But here you have. It's beautiful. It's strange.
-- Kate Light
"The Purpose of Time is to Prevent Everything from Happening at Once"
Suppose your life a folded telescope
Durationless, collapsed in just a flash
As from your mother's womb you, bawling, drop
Into a nursing home. Suppose you crash
Your car, your marriage -- toddler laying waste
A field of daisies, schoolkid, zit-faced teen
With lover zipping up your pants in haste
Hearing your parents' tread downstairs -- all one.
Einstein was right. That would be too intense.
You need a chance to preen, to give a dull
Recital before an indifferent audience
Equally slow in jeering you and clapping.
Time takes its time unraveling. But, still,
You'll wonder when your life ends: Huh? What happened?
-- X. J. Kennedy
This is what I see:










8 comments:

  1. I love Dr s. And am glad she is taking good care of you. I can't imagine how mentally done you must be. I have a patio and done nice wine ready to go if a mini escape is in order.

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  2. Oh Amy. I was wondering how you are doing especially since you've been quiet lately. I am thrilled that you saw a doctor that made you feel cared for. Benjamin's urologist helped us through so much over the years with his caring, amazing smarts and lots of diagrams of various urological parts including penises, kidneys, bladders, etc. I hope she will help ease the journey for you. It sounds like she is a good match for your inquisitive mind!

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  3. You have a lot of amazing things you are seeing,which takes away the sucky part.Yes?

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  4. Thanks for the update Amy. I have been worried about you. Please keep writing and updating. Love and hugs, Jenna

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  5. You're dealing with so much information and ambiguity now that I'm surprised you're not totally numb. I don't envy what you're about to go through emotionally and physically, but it's great that you have a new, attentive GYN.

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  6. I hear you and feel you. Toss the idea that you should be "better at this". How the heck are you supposed to deal with all the uncertainty and pain and sleeplessness and somehow be ok with that? Screw that idea!! It is what it is, and you're doing the best you can to move through each minute/hour/day navigating how you feel and what needs to be done. I hope for you that you can find some small things along the way to either distract or comfort you - Fiona's beautiful smile, a nice cup of tea in a sunny spot on the couch, Violet's self-expression in ripped (what are those, pants, leggings?), Orange is the New Black, Nancy visiting, reading,writing, texting, chatting, venting, painting your toenails the perfect shade of blue, or whatever else floats your boat.

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  7. Dena has nailed it. A friend once pointed out to me that sometimes all you can do is hold your place in line. And that in itself is a really big deal. (Kris)

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  8. You may be pissed and not drunk but you will never be dull! You may have crepey skin and bitchiness (we all will) but you will never be frumpy. You are this incredibly cool, amazing person who can write like a mad woman (I mean that in a good way). You are loved and admired. Get Dr. S. to give you something for the hot flashes. You will sleep better - I promise!

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