Saturday, February 23, 2013

Chemo Land


Insomnia again...

Just when I thought that my sleep habits were improving, tonight I woke up out of what seemed like a deep sleep with a ridiculous night sweat. I have never actually seen this written anywhere as a side effect of chemo but it must be one as it has been frequently plaguing me since I started the Taxol. It may be a lingering S/E as I am now more than 3 weeks PFC as it is said in breast cancer land. Post final chemo apparently though for the longest time I was sure it must mean post fucking chemo. So while towelling off a ridiculous amount of sweat, Flobi our tabby cat came meowing and joined me in bed. He seemed to enjoy licking my bald, salty head but soon curled up beside me while I found myself wide awake. Another hot chocolate late at night while I read my last blog post.

Then I read the results of my bone density test done last month. This was done as a baseline as I will start a drug called Anastrozole, an aromatase inhibitor on March 8. If all goes well I will take it daily for 5 years to ward off a recurrence. The main side effects are osteoporosis (bone loss) and fractures. But given the alternative, I will go for the bone loss. My oncologist says that due to my weight bearing activities, I should fare OK. All the more reason I think to have that Annapurna trek goal for next March! Meanwhile the density in my lumbar spine falls within the normal range but in my femoral neck it is osteopenic, the precursor to osteoporosis and thus hip fractures, which this report says I am moderately at risk for over 10 years. So I will be taking a risk but hope that for me, the side effects will be minimal.

I have found myself feeling angry, frustrated and sad once again and it is difficult to determine why. Well yeah, I do have breast cancer and have just entered the 8th month of treatment but still, why now and what can I do about it? Sometimes I just want to retreat and hide away but that is not very realistic. And I feel guilty for feeling the way I do. After all I am getting the best care in the world. But no matter how much I wish the troubling thoughts away, they persist.  Not having control over what is happening is a big factor. It is what it is, and though I accept it as necessary to save my life, it is tough to continue down the medical path of more drugs, more surgery and then radiation and more surgery. I work on being as healthy as I can to mitigate the side effects and to hasten the recovery from each treatment but I often feel helpless as I go through the process.

I have been a planner for a long time and those who know me understand that I thrive on working on the next trip, the next trek, the next sailing adventure or even next week's hike and of course, experiencing the fruition of that planning. But at this time, I feel like I am spinning my wheels. Intellectually, I know that there is an end to all the treatments for my breast cancer and by the end of the year I will be able to look back on it with relief but that is then not now.

And so it is; I am walking my 5 km a day, going to yoga, eating healthy food, drinking very little alcohol and looking forward to spring. The roller coaster ride of breast cancer continues and I suspect that the light is just around the corner and my darkness will lift, just as it has before. This is my hope as I try to go back to sleep.

Monday, February 4, 2013

Sick of breast cancer...

Yeah I am sick of it for sure. Funny how that looks now that I have written it~~but maybe it is apt. Breast cancer has after all made me sick. Not the cancer itself of course since it is just an insidious beast lurking inside me and without the lump, it could still be quietly waiting. But no, it is the treatment of course that has made me sick and sick of the reason for it. But without the treatment that insidious beast would awaken and it would not be the treatment making me sick; it would be the cancer which would also be seriously trying to kill me.

Insomnia is also part of this journey. I have always been a light sleeper and my hearing is so acute that the slightest noise can wake me. Dick sleeps like a log and though he rarely snores, he contentedly puffs away the night. This I hear even with my earplugs in. Ativan helps but then there is the addiction worry. I am not REALLY concerned though every time I take my Ativan I do have fleeting thoughts of sleepless nights down the road when I will have no excuse to take sleep aids. I tried Melatonin a few nights but it gave me nightmares so bad I can't even attempt to describe them. And then Ativan does not alway work as in tonight. Lying in the dark tonight while I tried to go to sleep on Ativan I thought about Cheryl Strayed, author of the book "Wild" which I had just finished. She hiked the rugged Pacific Crest Trail at age 26 totally on her own with no prior backpacking experience but with a pretty crazy background. What amazing spirit!

But then her hiking adventures led me to thinking about this time last year when I was training for a short solo trek (with guide and porter) in the Helambu area of Nepal and a high altitude trek to Lo Monthang in Upper Mustang near the Tibet border with Dick and a group of old friends from our Saudi days. Both treks were wonderfully successful and by the end of May I was back in Canada planning for another Annapurna Base Camp trek in October. That was falling apart due to group member circumstances just as I found the now infamous (at least to me) lump July 18.

I can mentally play out that ensuing drama on insomnia nights and let me tell it does not provoke sleep no matter how many times I run through it! "What the fuck" comes to mind often. How did this happen? Yeah it is what it is but still, I sometimes wish that it has all been one of those really bad dreams that you wake up from saying "thank god it was just a dream." Honestly I still want that to be true.

From training for treks to training for surgery is how it is now. Tonight I decided that tomorrow is the day I will really get disciplined and this will include yoga, meditation and walks with a few more snowshoe days thrown in. But then insomnia came along and here I am late at night downstairs drinking hot chocolate while I should be sleeping in preparation for the healthful training I have planned for myself.

It is almost impossible to go a day without knowing I have breast cancer, no matter how much fun we have. There are the side effects of course from chemo but there is also the long string of appointments with so many doctors, so many tests and alway the next looming treatment.

Tonight too I was thinking about my choice of surgery. Full mastectomy and axillary dissection are not optional but reconstruction is. For months I thought about that choice. I read all I could in my two favourite breast cancer books; "The Intelligent Guide to Breast Cancer" which we are all given here in Canada on diagnosis and "Dr. Susan Love's Breast Book" which is given out in the US. I spent time with a woman who had the same reconstruction done by the same plastic surgeon as I will have. Knowing that this requires more surgery, anesthetic and recovery time, I have often pondered my decision. I have spoken to women who have had bilateral mastectomies and done nothing and to women who have had reconstruction at the time or later. Each has her own reason for her choice. I do think that having both breasts removed may have swayed me to do nothing, though I am not really sure.

There has been much written about how women feel about losing their breast(s) and how they make the decision to do nothing or to have reconstruction. Though I have small breasts to start with this does not make it any easier to visualize my left breast there but nothing on the right side. To go through surgery, chemo, more surgery and radiation is wearing but that is not all that we have to contend with. There is nerve damage, numbness, the possibility of lymphedema, a very serious situation in which the lymphatic system no longer drains properly due to the removal of lymph nodes and to top it all off, our breast or breasts are gone. And there is still the fear of cancer still remaining or recurring.

Then there was even a small twinge of guilt or maybe selfishness. Choosing reconstruction means longer recovery time and more surgery months after radiation. This means more dependence on family and others to a certain degree. I also thought briefly that if I chose not to have reconstruction that maybe I could still sail across the Med and the Atlantic with Dick. I soon came to the conclusion that it is unrealistic to consider that idea as no matter what I choose,  treatment and subsequent care will extend far beyond the time frame for the start of the sailing trip.

So yes, I am sick of breast cancer. It has been a tough learning curve that never seems to end. I know it will end but is is not really helpful at this point to be told that a few years down the road much of this will be a distant memory. For now, breast cancer is front and center no matter how well I am coping. I also know that I should not feel guilty or selfish for choosing to still have a breast at the end of the day. If it does not work out at least I have given reconstruction my one and only chance.