Life is so uncertainPosted: July 12, 2011 Filed under: breast cancer, tennis | Tags: adjuvant therapy, artificially induced menopause, estrogen, hot flashes, Lupron injection, Lyle Lovett, oncologist visit, oncology, oophorectomy, tamoxifen, tennis, the Wizard of Oz 6 Comments
Lyle Lovett said it best:
I understand too little too late
I realize there are things you say and do
You can never take back
But what would you be if you didn’t even try
You have to try
So after a lot of thought
I’d like to reconsider
If it’s not too late
Make it a cheeseburger.”
I don’t eat cheeseburgers, or any burgers, but I love Lyle Lovett, and his clever and playful lyrics have been running through my head all day as I contemplated my latest visit to my cutie-pie oncologist. Last time I saw him, we discussed whether I need yet another surgery, to remove my ovaries. See, those little suckers pump out estrogen, and estrogen happens to be fuel for the type I cancer I had. So the theory is this: cut off the fuel, starve the cancer and ensure it has nothing with which to reconvene. Since I wasn’t physically well enough to undergo the oophorectomy because of the post-mastectomy infection, we put that surgery on hold, but in the meantime I began getting a shot of Lupron once every 3 months. Lupron essentially does the same thing as removing the ovaries, which is to shut off the supply of estrogen.
I thought the plan was set: continue the Lupron shots until I was deemed well enough to undergo the oophorectomy, which would likely be in the fall of this year. Get the kids back to school, recover from the August 17th reconstruction revision, and get rid of the ovaries. I like having a plan. I like sticking with a plan. I’m not a fan of changing the plan.
Today, Dr Cutie Pie said he didn’t think I needed to keep getting the Lupron. I’ve been getting the injections for nearly a year now, so even though I was scheduled to get one today and was planning on getting one today, he thought I was done. The plan had changed.
Granted, I had complained to him about the major side-effects of Lupron: hot flashes and sweating like a pig in heat. It’s summertime in Houston. Not just regular old hot-as-Hell summertime in Houston, either, but record heat and record drought summertime. I can tell you with 100 percent certainty that hot flashes and Houston summertime are a wretched combination.
Do I think the hot flashes and sweating like a pig in heat are sound enough reasons to discontinue the current path of hormonal suppression? No. I haven’t murdered anyone (yet). Dr CP said there’s really not that much difference between hormonal suppression from Tamoxifen alone and suppression supplemented even further with Lupron. A year of Lupron injections seemed to be enough, in his opinion. The daily Tamoxifen will go on, though.
Disclaimer: I did not beg, whine, or persuade him to make that decision. Not like I did last summer with Dr S when trying to sway him to release me from yet another hospitalization or disconnect me from the dreaded wound vacuum, Sucky. I did not employ any such tactic with Dr CP today. He came up with the idea to cease & desist all on his own.
He also said maybe that oophorectomy isn’t necessary, either. While I’m completely in favor of eschewing yet another surgery, my gut instinct tells me to rip those ovaries out (gently, though, and with lots & lots of morphine).
Life is so uncertain. What’s the right choice? How does one make such a decision? Stop the Lupron or not? Pursue the oophorectomy or count my blessings that I won’t need another surgery? Where’s the Great and Powerful Oz to tell me what to do?
That’s the problem with cancer. One of the many problems. Big-ass decisions need to be made; life-and-death decisions. And while there’s research aplenty and resources available, there’s no clear answer. I like clear answers. And unchanged plans. Neither of which prevails in one’s “cancer journey.”
Nonetheless, we moseyed along through the rest of the check-up with the usual and quite popular assertions from Dr CP that my cancer is not coming back. I like that part. He says this at every visit, and I really like hearing it. He told me that my reconstructed chest looks fantastic, and I really like hearing that (even though I think he’s shining me on, because there is definitely some tweaking and fine-tuning that needs to be done). I still like that he says it, though, even if he’s shining me on.
We chitty-chatted about his new baby, my tennis game, and other pleasantries. He said he’s started playing tennis and is thinking about taking some lessons. When he told me he plays once a week, I told him he’ll never get better that way; it’s not often enough. He got all puffed up and said it’s enough for him because there’s such a thing as talent.
In the immortal words of Steve Martin, “Well, excuuuuuuuuuuuuse me!”
He even strutted down the hallway a bit, then turned to say something about how he’ll be ready in about 6 months to kick my butt on the tennis court. I said, maybe in about 60 years.
How on Earth do I manage to find such cocky doctors?????
We parted ways, him to daydream about beating me in tennis while I headed to the infusion room to get my port flushed. For the last time. Ever.
Yipee! That makes me very, very happy. I’ll get my port removed next month, when Dr S does my reconstruction revision. Can’t wait to bid adieu to that little guy (the port, not Dr S).
But while in the infusion room, I started to second-guess the decision to stop taking the Lupron shots. It didn’t feel right to me. The instant-gratification-girl inside me said, “Hell, yes, let’s forego the shot — that sucker hurts and leaves me bruised for weeks.” But the more-measured-approach-taking girl inside me said something doesn’t seem right with this decision. What’s the harm in continuing the Lupron therapy (besides the obvious, 20-gauge needle harm, that is, and the hot flashes and sweating like a pig in heat harm)?
Dr CP walked by a few minutes later, as I was discussing the pro’s and con’s with my patient advocate extraordinaire, Amy Hoover, and we grabbed him to say I’m not sure about the Lupron decision. He listened intently as we reviewed the pro’s and con’s and said there’s no harm in getting the shot. So I got the shot. Still not sure if it’s the right choice. No idea if it’s the right decision. My gut says yes, and my gut usually is right. However, the fact that it took 3–count ’em–3 tries to get the shot makes me wonder. The needle went in, but the Lupron wouldn’t go. Ow! 3 needle sticks with a 20-gauge needle could easily make a girl question her decision to question her decision. But, as Lyle Lovett says, “Life is so uncertain.”
Lyle also says, “She’s hot to go, she’s ready”. I don’t think he was talking about hot flashes when he wrote that one, but I like a girl who knows what she wants. I think you made the right decision with the Lupron (although it’s not the kind of shot you usually order).
I love that you love Lyle he’s one of my all time favorites! I would have never guessed you for a country crooner! You never cease to amaze me! We will have to have a port-removal-celebration party! Trying to figure out how to make it a play on words with “port-o-potty” in the title…more to come on that!
Lyle also said, “She’s no lady, she’s my wife.” Love the sassy-ness of it- suits us WELL!
Yes, Nancy, Life is uncertain. I tend to use the word random. Nothing against Lyle because I think he’s great ever since you took me to see him in Boston. I tend to feel the gut is the right guide. But when you do make the decision go with it. I have spent a lifetime second guessing myself and now I find If I make the decision and let it go,I save myself a lot of angst. Of course that’s now that I’m not addicted to angst. Only good thoughts for 2 weeks at Salisbury. Love Bettyanne
Don’t you just love Lyle? I’ve seen him several times. He’s a CP in his own way. I can see why Julia went for him.
Cancer decisions! What a quagmire! My only words of wisdom are “listen to your little voice.” I can count at least 5 times going through breast cancer that I would not be here if I’d listened to my little voice. Don’t feel pressured either way because it is YOUR decision.
Yes, life is so uncertain isn’t it and cancer makes it even more so. All these decisions are huge. These are our body parts for crying out loud! I had trouble with the ovaries decision, too, and the hysterectomy, which I also did. I figured I might as well get it all out. Sometimes I think, wow, where have all my ‘female parts’ gone? ha. Now that I did the surgeries, I am so glad. I can now say I did everything I possibly could to keep the cancer beast away… Still as your post title says, life is uncertain no matter what we do. So ultimately, go with your gut. You’ll do what’s right for you. Great post, Nancy. Hope I didn’t share too much!
There are so many scary decisions! Our little voices certainly do like to talk when it comes to treatment decisions (look at me, I did one more chemo treatment that my doctor told me I didn’t have to do). You should do what makes you the most comfortable.