Monday, June 29, 2009

Hormone Mania!

I have been going through what I will call "hormone mania" for years but recently I have had a reprieve from the symptoms of these sometimes unpleasant hormonal fluctuations. That is primarily because I am in menopause because I take Tamoxifen and I couldn't be happier( for those of you who don't know, Tamoxifen is given to breast cancer patients who are estrogen receptor positive). I know that it sounds strange to say that, everyone tells you about the horrible side effects of lower estrogen levels in your body but for me, lower estrogen levels seem to be a saving grace. I feel so much better than I did before I got sick and my theory is that I am "hormonally challenged." This is not a term that is currently sanctioned by the medical community but one that I think best describes my condition over the years.

First of all, I always had painful periods. Ever since day one. I remember sitting on the steps in my robe at the tender age of twelve and crying in pain. My mother and my sister both stared at me in disbelief at my anguish and whispered to each other, "It can't be that bad. She is so dramatic!" Even though I can be a drama queen on occasion, this wasn't the case with my periods. They were very painful, just about every month. Then came the next major side effect of the hormonal fluctuations, wicked PMS.

For those of you who suffer from severe PMS, you know how bad it can be. I had the classic symptoms: that feeling like you are going to crawl out of your skin, losing your patience with just about everyone you know; particularly your husband and children, anxiety about everything and nothing at all, and finally rage and paranoia. My episodes became more frequent and more pronounced as I got older. Two weeks into the month my husband would get this look on his face that would indicate that I "had turned." Sybil was out for a couple of weeks and it was time to walk on egg shells. Run for cover, he would think, nothing he could say or do was going to be right until the estrogen levels dropped.

Next came the migraines. This happened a couple of years before I had cancer. All of a sudden, the month after we moved to Pennsylvania, I got this awful feeling of vertigo accompanied by a terrible headache and nausea. I got my period the same day. For the next four months this pattern continued. I would spend at least one day a month completely immobilized from these headaches. I kept thinking that it was due to the stress of moving to a new place. Finally, at my husbands insistence I went to see a neurologist who diagnosed the events as menstrual migraines. Some women experience them when their estrogen levels drop right before their periods. I was given migraine medicine and told to consult an Ob/Gyn to see if there was some way to regulate my hormones to lessen the impact of these headaches. She put me on birth control pills which in turn intensified the headaches. Needless to say, after two weeks of that, I was back at the neurologist asking for more migraine medicine.

I continued to suffer from these headaches until I was diagnosed with breast cancer. Then my periods stopped while I went through surgery and chemo. A couple of months later I began to take Tamoxifen. At first it didn't seem to be working. I was still getting my migraines and my period. Then I stared to have the symptoms of premenopause: insomnia, night sweats, hot flashes, weight gain and infrequent periods. It was a little bit uncomfortable but not that bad. I gained a little bit of weight, but not much. I did have trouble sleeping but it would last for about a week and then stop. All in all, I think the insomnia was the worst part for me. Now, I seem to be past that.

I no longer have my periods but I still have night sweats and the occasional hot flash. The upside is that I am much more "even." My PMS is a thing of the past and the moodiness that went with it went away too. The biggest benefit of all is that I don't suffer from migraines any more. They are gone. I have lost the weight I temporarily gained and am in better shape than I have been in a couple of years. My husband hasn't seen Sybil for over eight months and is just as happy not to know her any more. And about that libido thing, I don't have any idea what those doctors are talking about. So good riddance to"hormone mania!"

Returning to the Scene of the Crime

I went running and played tennis today. Summer is in full swing. I am back at my in laws summer home where I bring my children each summer to enjoy summer camp and the feel of a small community. Imagine "Dirty Dancing" with a focus on sports and you can visualize this Shangri La for children. I have strong emotions about this place. It is wonderful for my children, yet it is here that I found the lump that started my cancer odyssey.

So it is with mixed feelings that I have returned to this summer haven for the past two years. I want my children to experience the freedom of riding their bike alone with their friends for hours at a time or to go to a friends house unescorted. I want them to get ice cream at the general store after a long day of fun at camp. It is hard on me though. I am the one who sacrifices my personal space and personal time for them to be there. Now, I feel like I have to be careful. My reserves aren't what they used to be. Limits, I have to remind myself, remember your personal limits.

I suffer from the "giving too much of yourself" syndrome that many mothers do. I want so much to make sure that everyone else is happy that I often put myself last. Way last, way too often. I am working on changing that. This year I went home to my own house and let my husband parent his children with his parents for a couple of days. I have to remind myself that this is in fact healthy for everyone. They will gain some independence and I will regain my strength. Each of us will benefit.

I am not sure why I am thinking a great deal about my cancer this summer while I am here in Mayberry. Maybe it is because I am finally feeling healthy again after almost two years, or maybe it is the fear in my subconscious that something bad will happen again just because I am here. Last year when we came, I had less than a half an inch of hair so I was still in what I will call "the other realm." That is the place where you almost feel like you are on the outside looking in. You see so much and yet you have this ability to instinctively discern the important from the unimportant. This year, I am much more in the real world. Maybe that is why I can't stop thinking about it.

So here I am, back at "the scene of the crime" and trying to remember that my health and happiness are paramount. My children need their mother to be strong. So I will remind myself to nap frequently, sleep in when I can and go home to my own bed when I need to.

Would He Remarry?

There was a story in the Washington Post yesterday that rattled me. A young mother was bringing five of her six children home from swim practice at a swim club that we used to belong to and her car was hit by a large tree branch. The mother and one of her daughters were killed instantly. I knew this woman. Years ago, when we belonged to that swim club, I chatted with her on several occasions, and I remember her as both vivacious and intelligent. Her passing, makes me think of my fear of dying.

It is something that I still think about even though I am almost two years out from my diagnosis. Since my children are so young, I know that they would need a mother if I were to die. I also know that my husband is an efficient and matter of fact kind of guy and he too would quickly realize that his children would need a woman's nurturing. He knows that he knows about five percent of what I do on a daily basis and he would be pretty much lost without my help. I am pretty sure that he would find it difficult to juggle two kids by himself and working full time(even though many women I know do just that). When I ask him what he would do if I were to die he responds, "I would never remarry." I really don't believe him.

I look around at all of the women I know and I try to figure out who he would marry. Would he find a widow who has lost a husband to cancer to be my replacement? I can hear the conversation in my head. "Oh, I know how you and your children feel. My children had a difficult time too but we are getting through." There would be a common ground established and he would be comforted by that. Or maybe it would be the younger, attractive PhD who doesn't have her own children but shares his interest in neuroscience research. "They are so precious." She might say, not knowing how much work they require. "I would love to take them to the zoo." I can go on and on with scenarios in my head.

Perhaps it might seem a little bit morbid to think of these things, but I can't help myself. It is the inevitability of life that we all die. Some of us have had to look our mortality straight in the eye and figure out how we feel about it. I, of course, worry about being replaced and not remembered. I don't think that I am unusual in that respect.

I do know that my relationship with my husband is stronger than it was before I got sick. What didn't kill me, did make us stronger. We are kinder and gentler with each other and a little more forgiving of each others faults. We try very hard to work as a team and parent together rather than in opposition to each other. He gets that I need more rest than I ever did in order to ensure that I stay healthy and puts the children to bed most nights. We are better than we used to be.

So, I think of this poor father left to parent five children and to deal with his sadness over the loss of his wife. I am sure they will all make it through one way or another. Inevitably he may marry someone else and she will become a faded memory to her children. It happens. Life will go on.

Sunday, June 7, 2009

The Fear of Recurrence

I had my six month check up on Friday. I had to take the children with me because they are out of school already for the summer so I dragged them kicking and screaming downtown to the oncologists office. Luckily for me, his office is in a new building next to the old building where I had my chemo. I used to have a Pavlovian response when I would pull into the parking lot of that building, becoming nauseous instantaneously. Now I rarely think about the six months of chemo I had when I walk into the building, that is until I see the women in the waiting room in their wigs and then it all comes flooding back to me.

As we sat in the waiting room, Bridget hung her legs over the side of the chair and Luke complained about the show that was on the television. I was just hoping that it wouldn't be too long of a wait. My patience was dwindling with them on the second day of summer vacation. I noticed an older woman looking at Bridget and smiling. The woman had on a wig and had a port catheter in her chest. Finally she asked me, "How old is she?" I replied that she was six. "My granddaughter is six too and she has the same color hair." I noticed that she had an Irish accent.

I began to talk to her and then she got up from where she was sitting and came to sit next to me. Normally I wouldn't have engaged in such an exchange, I never talk to the person sitting next to me on an airplane much less a stranger in the cancer center waiting room. But for some particular reason I wanted to talk to this woman. Maybe I was intrigued by her accent, being Irish myself. I explained that Bridget had gotten her red hair from my Irish grandmother who was originally from Galway. "I am from Galway too." She said. "I lived in a town called Tuam."

"I am never going to Ireland again though" She said. "I went the first time and six months later I got breast cancer. I was cancer free for eight years and then I went back for my nephew's wedding and six month's later almost to the day my cancer came back. I tell you I am finished with Ireland." I looked at her and suddenly my fear of recurrence surfaced from the back of my mind. I usually try to keep it back there, but on this day I couldn't keep it at bay.

Sometimes I have a dream that I have a huge tumor on my leg and it is the size of a grapefruit. It is on my calf and I am walking around trying to pretend that it isn't there when someone screams out, "Look at that thing on your leg!" I look down and realize that I have cancer again. Then I wake up in a sweat. So today, I look at this Irish woman, from the same town as my grandmother and I hope that in eight years it doesn't happen to me.