Tag Archive | exemestane

The Silent Hell of Cancer After Treatment

Everyone thinks that once you finish chemo, surgery and radiation it’s done. You go right back to normal and aren’t you the survivor for getting through all that. Yay you!. Well, I sometimes think during treatment is the easy part. They tell you where to go, what you are doing and why. You spend a year just doing what you are told and try to keep up your strength to make it all happen. Then treatment ends. And when it ends. It just ENDS! Sure, you go in for follow up appointments that you have panic attacks over starting a week before. But no one talks about all the physical damage that you are left to tend to.

Right after you finish treatment you have a few days of excitement because you are done. Then you start to freak out and get depressed and anxious because all of a sudden you have no one to tell you what to do and you have to pick up all the pieces and put your life back together. It takes a year or more to get your mental capacity to work correctly. Right about the time your mind starts to work you then realize that your body is an absolute mess.

Yesterday I had an appointment with my Med. Onc. We did bloodwork again because I have some numbers that are out of wack and we are trying to figure out why. But they ask you all these questions about pain, which in the past I’ve brushed off. Well, when you have ER/PR Positive breast cancer you get to take these really cool meds for the next 10 years. I got to be put on Aromasin (exemestane).  I started out doing Lupron shots every 6 months to stop my ovaries from producing estrogen, and then the Aromasin to inhibit any estrogen that is still being produced from other sources. There are side effects to all these. I was in a really bad place after my last Lupron shot. I was just miserable. So we decided to just remove my ovaries so I didn’t have to endure the lupron any longer. Fabulous. At this point, I’ve been in menopause for the last year. And when you don’t have any estrogen being produced in your body, it starts to break down and change.

Right now because of the extream bone and joint pain I have, I’m stopping the exemestane for a few weeks to see if it gets better. If it does then we are switching me to Tamoxifen. I’m kind of hoping that this happens because then I won’t have the bone pain for sure and my hair will get thicker. (in theory!!) Oh…when you take exemestane it thins your hair so you see your scalp. Although better than being bald, it’s just unnerving.  But Tamoxifen is supposed to strengthen bones. So that would be nice. I would love to move without pain!!

A major issue that no one talks about with breast cancer is what happens to the ladybits. One of the major drawbacks of not producing estrogen is vaginal dryness. And I’m not talking you can just use some cream and it’s better. We are talking full out atrophy. Imagine your lips chapped to the point where they are dry cracked and bleeding. It hurts to talk. Same premise. They tell you to use over the counter suppositories but for some people, it doesn’t work. Yay! I’m some people. Now we have to sit around and talk about my lady parts to everyone.

Let me just say that when you go through breast cancer you lose all your inhibitions about your body. You have had more people look at, examine, study and touch your breasts that it doesn’t phase you anymore. And once you don’t have any breasts it’s very strange because you still cover up and hide things and there is nothing to hide but two really big ugly scars and a huge brown/gray circle where the radiation was done. So you ALWAYS know exactly where it was! Yes, I’m a little bitter about the whole thing still. I was not given the option of reconstruction. I was told by all my Drs. that it would probably be best if I didn’t. I didn’t push it because honestly…I heard the surgery can really suck, especially when you weren’t set up for it after a DMX. And I do actually like not having to worry about them.

Okay so now we are going to talk about the only thing I have that distinguishes me as a woman (in my eyes). And that doesn’t even work anymore! It hurts to do everything! So they have this procedure called the Mona Lisa Touch. I have been told about it for the last year. At first, I blew it off because…I won’t need it! I’m too young to have to worry about this yet!. HA! You also just went through a year of hell and yeah…you need to worry about it. When I was having my ovaries removed my Dr. (bless his heart) said that it was really bad and there was no discussion. I had to have this done. Okay. sign me up let’s do it. I had to wait until after my surgery to schedule it so I could heal from that.

Let me just explain. Insurance does not pay for this. As I was told…When the machine and technique came over to the US they didn’t want to have to wait for all the correct paperwork and regulations so they designated it under “cosmetic.” And insurance won’t pay for anything “cosmetic.” My argument is that if you are a cancer patient and insurance will pay for reconstruction of breasts…which is cosmeitc….they should pay for the reconstruction of your lady parts! But I digress.

I was told that it took like 5 minutes and was painless. Your initial treatments are 3 sessions 6 weeks apart and then once a year for maintenance. Okay. No problem. It costs $1950 for the first 3. $750 for each individual treatment. Well, okay, let’s do it.

I go in for my appointment. They explain what everything is and how it works. Basically, it’s like microdermabrasion on your ladybits….inside and out….with a laser. The whole thing is to remove the layer of skin that is atrophied so it can produce collagen and become healthy. Great!  There is a metal cylinder with markings on it, the actual machine and then a vacuum to suck up the flying debris of skin. Doesn’t this sound like it’s going to be fun?

They put a lidocaine cream over your bits and let you sit there for 7-10 minutes so you numb up. (wait…why do you need to numb anything…I thought this was painless!!!)

They come back and ask if you can feel anything. I’m like, um, yeah I still can. Well, my bits are atrophied to the point where I guess we are not going to get all the way numb. Yay! At this point, I’m super excited about the whole thing. They give you some cool glasses and a mask to put on. Of course, I ask why we are doing this. And it’s because of cells flying and well…this laser.

The first thing they do is a pH test. Evidentally the pH level of the vaginal area should be between 3.5-4.0. Who knew. Mine was 7.4. Yep….not good. As we do each procedure the pH level should go down as everything gets health, er.

Okay lets do this! They insert the cylinder. Fantastic. Then they insert this other thing that has the laser and also vibrates. It’s a very bizarre feeling, but it doesn’t hurt. Whew! Up until this point, I’m good. Then they start.  You’ve got the Dr doing the procedure and the nurse assisting. They start inside at the top and work their way down. For the most part, it was fine, every now and then it felt like either a pinprick or someone dragging a string along your skin. So I’m like, this is doable. Then they get towards the end. This is also where it’s the worst. And OMG. I felt it. Now I couldn’t feel all of it, just the parts that were super bad. Take that same pin, switch it to a larger needle and start jabbing. I jumped a few times, but it was tolerable. The last part they do is outside the vaginal canal. They go from the clitoris down to the perineum and everything in-between. It wasn’t excruciating, but it wasn’t pleasant either. I held my breath the whole time and I do have nail marks on my hands from holding them together. They did ask if I wanted to take a break at any point, and I said no. I didn’t curse at the Doc and tell him off…so it wasn’t completely awful.

When you are done they give you an ice pack. Yep. ice is good. It’s hot, it burns. This goes away after a few hours. Then you apply Aquaphor for the next few days. (no baths, clean the area 2-3 times a day and keep it moisturized while it heals) The whole thing from start to finish took about 30 minutes. So a little different than that 5 minutes mark they say.

Afterwards, my poor doctor just felt so bad that I was in any discomfort or pain. It so wasn’t his fault. I mean. the nurses who have reached menopause who had it done did not have the same experience I did. They did not have any pain and it didn’t take as long. I think if you are getting it done due to cancer treatments it’s not going to be a la la walk in the park. I mean why would it be. When you go into menopause naturally it’s gradual and your body has time to adjust. When you go into menopause medically, BOOM! You’re here! No gradual anything and it’s a lot harder on your body. Besides chemo and the medication you are on amplifies everything. So just keep in mind when these nurses say they had it done and it’s a piece of cake, they are coming from a different place than anyone coming from Cancerland.

When I got home I laid down with my ice pack and just rested. I did take some ibuprofen to help with the pain and discomfort. I removed the icepack about 5 hours after the procedure. Oh and the first time you have to go to the bathroom it hurts like a bitch! Sleeping was a bit uncomfortable. There will be blood so don’t freak out. That’s normal. And it doesn’t last. I mean, you just got a layer of skin obliterated from your body…

Today, as expected, everything is itchy and uncomfortable. No pain though, just a mild stinging that is like when you have a sunburn. I’ll lay low today and tomorrow should be even better.

I do believe that the next session will not be like this. I think it’s like when you get a really bad sunburn and the first time you put anything on it, it hurts like a bugger and then it gets better each time you do it. I do believe that the next procedure will have less pain and won’t take as long. But of course you know that I will do anothe update!

The next step in become a real girl again.

If anyone has any questions about anything please don’t hesitate to ask.

DX: 2/9/16 | Breast Cancer | Stage 3B | Chemo – DMX – RAD | NED: 11/7/16

 

I recently had a friend who made a comment about being at a store and a lady in front of her started talking to her about how she just had this procedure done. My friend was appalled that anyone would talk about something like this and with a complete stranger. I know to normal people it seems very odd. But until you go through it, you can’t possibly understand. When you have been in pain and suffering and you finally get a treatment to end it, it’s amazing. You are so excited that you do want to share with everyone. The fact that this is available to women and we don’t have to suffer in silence anymore is major. All I keep thinking about is all the women who can’t afford this and continue to suffer because insurance won’t pay for the treatment. It’s a very emotional subject that women haven’t been able to talk about. I feel so blessed that this treatment is available to me and that I’m in a situation that I can afford it.

I’ve got to do some research to see if there is any assistance for women to get this done. Noone should have to suffer.

 

Let’s Get this Party Started!!!

So the first week after treatment was pretty much a wash. I had a heck of a time with the transition of one of the new meds they put me on. I decided to not take that one anymore and just stick with what they originally had me on (Lorazapam/Ativan).  I’ll take 2 pills vs. 1 pill.  It works well enough most of the time. I would rather do that then deal with the mess of the other stuff. The side effects are pretty minimal for the Aromasin. I’m slow to get moving in the morning and then get pretty fatigued later in the day. I do have muscle and bone pain if I sit too long.  As long as I get up and move regularly I’m pretty okay. I have my ditzy days….I mean trying to do more than one thing at a time is a challenge. I’m going to start doing word puzzles and other mind game things to see if that helps any.

Becuase of my lack of sleep last week I didn’t go to the gym. Went Sunday finally. Only did 20 minutes, but I changed over to the treadmill again.  My initial thought was to start out slow and just take it from ground zero. Then about 10 minutes in I decided to jog every other minute. I wanted to see if I could do it and how it would feel afterward. I was a little swollen in the arms and chest but nothing major. Probably more from my lack of water intake! Yesterday I had a super bad day mentally. I was having issues with doing little things.  I went to the store and what should have taken maybe an hour, took me 4.  Nothing concerning just would lose track of what I was looking for and then got distracted looking at other things. So I’ll start Yoga next Monday!  Today I went and started out on the elliptical again…yeah, I now have this thing in my head. I’m a goal oriented person. So this jogging/walking thing is meeting that.  I got on the treadmill and set it for 20 minutes. Instead of doing every other minute, I had the track setting on so I ran half the track then walked half the track to see how far I would get.  So the goal is to be able to run the full 20 minutes and then add from there.  I had the thought of doing the 5k I did in January when I first got to Missoula. In talking with a friend tonight, she pretty much convinced me that I should set that goal. Now I am not expecting to run the whole thing and place. I just want to be able to run most of it and cross the finish line. I started thinking about it and it would be kinda symbolic for me. Last year’s 5k was on January 29th. I was officially diagnosed February 9th.  So it would be kind of a pick up where I left off sort of thing.

I feel like I’m on the right track. Diet wise I’m doing pretty good, other than not drinking enough water. I’ve started to plan the meals on Sunday. And I actually went grocery shopping by myself for the first time in 9 months. It felt good. It felt normal. So I have my little cards with the dinners for the week. So far it’s working (okay yeah, it’s Tuesday). But I haven’t been too keen on anything overly sweet. It seems if I have anything too sweet or too salty my arms and chest area swell up. So at least I now have a built-in indicator. OH! I got little pill cases with the days of the week on them to make sure I take everything I’m supposed to. I know it’s silly, but these are the things that excite me these days.

Saturday we went out to get a bed frame for the guest room. The mattress has just been sitting on the floor.  Well, they wanted like $80 for just a basic metal frame to get it off the floor.  We went into one of the furniture stores and there was a clearance/scratch and dent section and there was a complete headboard and everything for $200. It was originally $599.  So I think it was a good deal. This thing is so high the side railings are used as steps to get up in the bed.  IT’S AWESOME!!!!! And of course I had to get a new bedspread…then the curtains didn’t match…it just snowballed.  But the guest room is now all set up. Now to work on the craft room so I can start….crafting!

Oh. So I go to look for a picture for this post. I google “Party” and then go to images. Wow…..just wow.  Sorry no picture I’m still processing.  LOL

First Day of the Rest of My life

Well…yesterday was my last radiation session. I was doing good emotionally…then I stopped in the Chemo lounge like I usually do to say hi to everyone.  And I lost it.  Luckily the Social Worker was there.  So I asked her if we could talk a bit.  Sunday I had a complete mental breakdown. I had decided I wasn’t going to finish and just quit. (yes with one session left…I’m such a rebel).  She explained to me that it is completely normal. Some people after treatment go back to work after everything (or just continue to work) and like 3 months later it hits them like a ton of bricks.  In my case, I don’t have a job to continue or go back to.  When I got to Montana the plan was to set up house and then get a job and start over.  But this got in the way.  So between the pressure of selling the house last year, and then moving and then getting diagnosed, I folded.  I was to a point where I didnt’ HAVE to be strong anymore.  As I explained to her, throughout this process I would have my little hissy fit and cry for like 5-10 minutes and then shake it off and deal again.  There was that little voice in my head that would tell me to knock it off and woman up and get back in there.  Sunday, that little voice wasn’t there.  It just let me go.  So after talking to her it really helped to hear that it’s okay. That I’m normal. That I need to look at this as an opportunity to do whatever I want. I have a totally blank slate to work with.  And yes it can be scary…but it can also be exciting.  She told me to write down everything I like to do. What I want out of life. Then go and find things to try. Take a class or go to some club meeting.  I have absolutely nothing to lose.   My little voice is back…he is tired…but he is back.  So after treatment we went and had a beer at the place we had a beer the day I was diagnosed. Seemed fitting.

Last night I started a new sleep anti-anxiety medication Trazodone (Desyrel).  I’m not sure how I feel about this one.  I took it at 8:30 and about 20 minutes later I felt like I was floating. Then I was out like a rock. Woke up at midnight. Went back to sleep for 2 hours and then was up from about 2:30 to 4:00am. Went back to sleep until 5:15am. Stayed up for about an hour and then went back to sleep again, woke up about 9:00am.  Now the first 3 hours no dreams, I was out.  Then the next 2 hours I had crazy dreams. I mean at one point I had no idea what was real and what was the dream. I was having dreams within dreams. I mean in my dream I woke up and was telling my husband about the crazy dreams I had.  It got a little better the last few hours…normal kind of dreams but very vivid.  It’s almost like everything that I fear or that has happened that bothers me came out in my dreams.  I’ll see how it goes tonight.  I was a little groggy when I finally woke up…but if the dreams don’t calm down we are going to have to change this med.  I mean I don’t mind vivid…and sometimes they can be entertaining…but some stuff is just down right scary!

Today was my first day on Aromasin (Exemestane).  So far so good.  Took it at 9:30.  Didn’t have my first hot flash until 3:45.  That’s doable.  I don’t expect I’ll start feeling anything terribly different the first day…if I feel any different at all.  I mean a lot of the side effects are the same as the Lupron I’m already on, so they may just intensify a bit and I won’t notice….(let’s hope for that).

I was also supposed to just sit here all day and just watch TV. That was the plan.  I was going to be a total bum!  Well…I went downstairs and ended up starting on my craft room.  Mind you, I haven’t had the energy since we moved in to get to it.  So just about everything is still in boxes.  I have to figure out a shelving system of where I’m going to put all this stuff!  I also organized all the CD’s we have. You know, made sure the right CD was in the right case.  And then proceeded to put them in a box since no one really uses CDs anymore.  But it was fun to see what we have!

So my plan is to finish setting up my craft room.  Then make some stuff. Look to see if there are any classes on anything I might be interested in. Keep an eye on the job boards to see what is out there. I have kinda been doing this since I got here so that won’t really be any different.  I’m going to see how I feel the first of the year and maybe register with the staffing agency in town do some temporary work for a bit, maybe part time until I find something I like to do that they will give me money for.

My goal is to move forward and not look back….there really isn’t anything I need back there.  I’ve spent the last week mentally preparing myself for LIFE AFTER CANCER. Well, here we are. We have broken me down to rock bottom mentally and physically.  And this is how we start to make a Diva…

Because I’m Fabulous!

I met with my Medical Oncologist today.  I’m going to start on Aromasin (Exemestane) on Monday.  I take the Lupron shots every 6 months. This shot shuts my ovaries down so I don’t produce any estrogen. The adrenal glands still produce hormones so the Aromasin will stop this production of estrogen. This should ensure that this cancer that is estrogen driven can’t redevelop or do anything. I will be on these two medications for the next 10 years.  So the Lupron forces me into menopause.  Because there is no test to see when exactly my body will go into menopause for real, they are doing 10 years….by that time my body should have hit the natural menopause state. Interesting stuff right?  Now the Aromasin is a bit on the harsh side. Most people get put on Tamoxifen which has fewer side effects but isn’t as effective for my type of cancer. But if I can’t tolerate the Aromasin I’ll get switched over to the Tamoxifen.  If I can tolerate the Aromasin I may end up getting my ovaries removed so I don’t have to do the Lupron shot anymore. That would be one less medication to take. We’ll see how it goes. (just like Christmas…going to be quite the surprise!)

We are also stopping my Ativan (Lorazepam) for insomnia since it has seemed to stop working. We are going to change it up and going to Desyrel (Trazodone) we’ll see how that works out for me.  It’s supposed to not only help me sleep at night but help with any mood swings due to all the lack of hormones in my body. We’ll see how that works out. YAY Drugs!

At this appointment, my oncologist tells me now that I’m pretty much done with treatment that not everyone who goes through the rigorous aggressive course of treatfabment I took makes it.  I honestly didn’t know how to take that?  I mean that’s kinda scary. I have to think she meant that they had to break the treatment up some or change chemo drugs. Go me. Wow. Oh. I honestly have no idea how to react to that.  Just glad I didn’t know the odds before hand.
She checked out the lumps that have been bugging me the last few weeks.  I developed some bb sized lumps in my chest so when I found them a few weeks back my heart just sunk. She said they were probably nothing but we would keep an eye on them. The odds of any cancer developing at this point is about impossible.  But again, we would check them to see if they have changed in 6 weeks when I go back.

After this appointment, I went to Support Group.  Lately, I can only stay for the first 1/2 hour since I have to go to radiation.  Well, there is a new member. She had been diagnosed with stage 1 breast cancer 12 years ago. She had a lumpectomy and was good.  A few months ago it came back as metastatic breast cancer – Stage IV. My heart just hurts for her. She was so strong to come to support group and to announce that you have Stage IV cancer has to be just one of the hardest things in the world to do. I just wanted to hug her. While not curable, it is treatable. She’ll go on an oral chemo to keep it under control…..And I was just sitting there freaking out that this new medication said that I could lose my hair.  So I’m no longer freaking out about the possibility of losing my hair again or have it thin. This is why they make wigs.  So be it if it happens. Again something brought me down to the reality of the whole situation and to just be thankful to be alive. I also thought: I’m sure glad I made the decision to have a double mastectomy vs. just the single.  I mean they said that the odds of it coming back in another breast were slim to none. I was like yeah, it was a slim to none chance I got it in the first place so….I’d rather go through this once then have to go through it twice. But hey..there is no guarantee something else won’t develop down the line.  So I think I’ll just enjoy the time I have here and deal with whatever comes when it does.

Then I went to radiation. #30 #2 of the booster. 3 more left.  I’ve resorted to gang signs in the count-down.  But the chest is looking pretty bad ass at this point.  It’s getting quite impressive. Met with the Radiology Oncologist.  I told her about the bb sized lumps and she checked them out and said it was just scar tissue and effects to the tissue from radiation. Nothing to worry about. But again she said that we would keep an eye on it over time when we did CT scans.  Because you know I get to do those every 6 months now. So if anything develops from here on out we will catch it pretty quick. But she wants to see me again on Friday to check the status of my skin to see if we will do the last radiation treatment on Monday or just end it on Friday.  They are pretty impressed that I haven’t had to take a break with radiation. Most people have to take a few weeks off about half way through. It’s because I’m just that fucking amazing….really.

Now I’m not usually the type of person that boasts about myself…I’m actually very modest….even though I joke a lot about the whole Fabulous thing. But you know I think for this I’m going to make an exception.  Don’t worry…I won’t let it get to my head and I’ll only do it for a few days. :)

Oh. The downside of all this anti-hormone nonsense….my drinking days are pretty much over. I suppose it’s okay. I had a good run. And any more when I have wine or beer I feel like crap after just 1…so be it.