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Sunday, November 3, 2013

Life after cancer

Things have been going really well for my family and I recently.  We went on a family trip to Spain in April and May, which was amazing.  I ran 2 half marathons and a triathalon over the summer, and have also done a lot of road biking.  I have been back to work for a little over a year, and am liking that.  Because things are going so well, I am a little nervous that something bad is going to happen.  For the last 3 weeks I have had pain in my lower right back.  I let it go, thinking that it would go away, but after 2 weeks of worrying and angst, I decided to go in.  My new primary care Dr. reassured me that it was probably just a muscle strain, or bulging disc, but with my history she recommended getting an xray just to make sure the pain wasn't from breast cancer metastasis to my spine or ribs.  The xray came back normal, which is reassuring, but I am still having the back pain:(  I am tired of thinking that every pain I have is breast cancer metastasis.  I am wondering if this worry will every go away, or if it is something I will be dealing with forever.  

Last Tuesday was another 6 month visit with my onologist, Dr. Whisenant.  Everything is looking good, Yeah! We talked a lot about my having lots lots of hot flashes, sometimes as many as 20 a day.  (This is a side affect of early menopause from having my ovaries removed, and the anti-estrogen medication arimidex)  The ones  during the day are just an annoyance, but the night ones wake me up.  So a lot of the time I feel kind of tired.  He thinks I should start taking low dose Paxil, which is an antidepressant.  (It was recently approved by the FDA as the first non-hormonal treatment of hot flashes.  I'm not a candidate for hormonal therapy because of the breast cancer)  I am not 100% sure I want to take this, but am seriously considering.  We also talked about my bone density, which is not so good.  The chemotherapy, early menopause, and anti-estrogen medication have not been very good for my bones.  We were hoping that the Zometa (medication that has been shown in studies in Europe to decrease breast cancer recurrence in combination with arimidex, and also increases bone density) would stop the osteopenia that I have in my back, but it was worse on my most recent bone density test.  Don't get me wrong, I am grateful to be alive, but sometimes I wonder what my quality of life will be like a few years down the road.... 

Saturday, January 12, 2013

Happy New Year!

I hope everyone had a Merry Christmas!  My life is getting back to normal, which is so nice, but it doesn't make for a very interesting blog.  I've had a little medical excitement, which included having my ovaries removed on November 14th.  I debated back and forth for a month trying to decide whether I should do a full hysterectomy or a bilateral salpingo-oopharectomy (This is a fancy name for the removal of the ovaries and fallopian tubes which I will refer to as a BSO).  There are advantages and disadvantages to both procedures, and I waffled back and forth until 5 minutes before I had the surgery.  In the end I opted for just the BSO.  A hysterectomy is a bigger surgery and has a 6 week recovery time which includes no lifting.  This is a problem because of my 2 year old.  I have already had 2 surgeries which made it so I couldn't take care of Zach, and couldn't face another one so soon.  The BSO recovery was only about 1 week, and had no lifting restrictions.  Also, a full hysterectomy would give me no advantage as far as getting ovarian cancer.  So why suffer more than necessary?  I am 6 weeks out from the surgery and it wasn't bad at all.  It was a laparoscopic procedure with minimal pain.  And, the best part about it is that my pathology was clear! No Cancer! My Dr. told me that about 10% of women my age with a BRCA mutation already have ovarian cancer by the time they have the surgery, so I was really worried.

The worst part about having no ovaries is menopause.  Natural menopause is gradual, but surgical is instant and it is way worse and irreversible. (If you have had breast cancer, hormone replacement is not an option) People laugh about it, but it is isn't funny,  I am not sleeping well at night because of multiple hot flashes and night sweats. It is also not good long term because of increased risks of dementia, heart disease, and osteopenia (weak bones).  It actually shortens your life span.  So, I will have to be really careful about diet and exercise from now on.  That being said, at least I won't have to worry about ovarian cancer, and in the whole scheme is things, it is not the worst thing either.

I am still dealing with a lot of fear about a recurrence.  I talk about my cancer very openly, and try to find the humor in all of it, but inside, I am worried that it will come back.  I had a cough that just wouldn't go away from September until the first part of December.  You can guess what was going through my mind during that time.  The anxiety culminated about 3 weeks after my surgery when  I started having chest pain on the right side.  It lasted for 2 or 3 days, and I think the angst about it exacerbated everything.  I ended up in the ER thinking for sure I had a pulmonary embolism or lung metastasis.  I had a CT scan of my chest and lots of labs drawn and everything came back normal.  I was so relieved when the dr told me the results that I started crying.  The pain went away the next day, and I felt so dumb for going in.  Especially for getting the CT scan that exposed me to so much radiation.  I did get some peace of mind, and it taught me a lesson to not overreact and be irrational, so I guess it wasn't all a loss.

Five of my cousins have come back positive for the BRCA mutation, and one of these has been recently diagnosed with breast cancer at the age of 40:( When I heard about the diagnosis, it made me sick to my stomach, because I remember how hard it was when I first got diagnosed.  I want this to be the last time someone in my family gets breast cancer, and I feel the only way this can happen is if everyone gets tested.  The knowledge that I was BRCA positive would have at least given me options.  It would have allowed me to have a prophylactic mastectomy and BSO, or I would have caught my cancer much sooner.  If you are reading this and if you are related to me on my moms side.  Please please please get tested for the BRCA gene mutation, and go get a mammogram.  Early breast cancer has NO symptoms, I felt completely fine before I was diagnosed, that is why it is so scary.  I am worried that I have cousins walking around with breast cancer right now, and they have no idea it is there.  The men in my family need to be tested too because they are at an increased risk of breast cancer, and also, they can pass it to their daughters.  I feel so strongly about this, because I don't want anyone else to go through what I have been through in the last year and a half.  I am thinking a lot about my cousin that has been recently diagnosed and I am hoping and praying that all goes well for her.

My next surgery is planned for May 3rd.  I am going to have my radiated boob, abdomen, and sides of my abdomen touched up a little bit.  I hate to have another surgery, but I feel like my body is so messed up, and I want to get it a little more back to normal.

On a lighter note, we are going on a fun trip to Spain in April.  This is our third attempt at this trip and I think it will be a go this time around.  It was initially planned for 2 years ago right before Paul's Dad passed away.  He always wanted to go there and it was going to be his last trip before he died,  but his cancer progressed faster than expected and he didn't make it.  We were going to reschedule for last year, but I was undergoing treatment for my cancer. We are taking all of the kids except for Zachary, and Paul's mom is going too.  I am really looking forward to it!

I am back to work and liking it.  It has been 4 months now, and is it is good to be back.  I missed taking care of babies, and all of the fun people I work with.  A lot of my co-workers are still wearing the Team Nancy pink bracelets.  I am grateful for all of their support!

I have a lot to be grateful for at the start of this year.  Foremost, I am thankful to be alive, and that my family is healthy.  I hope that everyone will have a happy and healthy new year.