T-rage

I have a new Tamoxifen side-effect to add to my long list: T-rage.

T-rage joins an unpleasant cast of characters that feature starring roles in my daily existence. These characters take turns on center stage and compete for screen time. They jostle and nudge each other in their attempts to take over for real.

Who are these characters? The cast list is long, so bear with me. I’ll save the newest, T-rage, for last. These characters are all sponsored by my frenemy Tamoxifen. It’s my frenemy because it’s alternatively saves my life while also making me miserable. That life it is busy saving is increasingly becoming one not worth living.

Anxiety: because once you’ve faced down cancer, you need heightened worry and fretting, right?

googleimages.com

googleimages.com

Bone pain: an ache so constant it only changes with the inexplicable flares that come along. Pain so acute I swear I can see my bones under my skin, because the pain illuminates them. I’d say I’m like a skeleton, except I’m not because of the extra weight that literally weighs me down, thanks to my frenemy Tamoxifen. If only I were a joyful, dancing skeleton.

paperspencils.com

paperspencils.com

Joint pain: while I don’t envision the joints beneath my skin the way I do my bones, they hurt. A lot. Most of the time. And I don’t even want to think about Tamoxifen’s contribution to my bad kneejoint-pain

Hot flashes: because living in Houston–land of eternal summer and omnipresent humidity–isn’t enough to keep one drenched in sweat.

medulous.com

medulous.com

Sweat, sweat, and more sweat. Like the clown car at the circus, the sweat just keeps coming.

drybabe.com

drybabe.com

Dry skin: Why can’t all that sweat moisturize?

googleimages.com

googleimages.com

Brown spots on my face: I’m aging at a quick clip. Not pretty on a banana, not pretty on meimgres

Thinning hair: To go along with the dry skin and brown spots. Pretty. Real pretty.

yourfitnesspoint.com

yourfitnesspoint.com

Peach fuzz: there’s hair where I don’t want it while that on my head is withering. By then end of my proposed 10-year course of this damn drug, I’ll have a full beard and a bald head.imgres

Mental fogginess: huh? What was I going to say?

butyoudontlooksick.com

butyoudontlooksick.com

Trouble concentrating: Ditto.images

Sleeplessness: because the previous characters don’t wreak enough havoc, now there’s no escaping them.

soberfornow.wordpress.com

soberfornow.wordpress.com

Fatigue. Crushing fatigue. As in, each of my limbs feels as if it weighs 50 pounds. As in, it’s a Herculean effort to get off the couch. As in, I’m not rested after a full night’s sleep. As in, this bites.

trialx.com

trialx.com

Irritability. Major irritability. Sometimes I can barely stand myself. It is ugly.

googleimages.com

googleimages.com

And, introducing irritability’s next-of-kin: T-rage.

You’re heard of ‘roid rage and road rage, and now T-rage. It’s similar to the other rages, in which something — in this case, Tamoxifen — causes a major-league reaction to a minor provocation.  The sight of a Toyota Camry ahead of me in traffic (I hate Camrys). The guy conducting a shouting match on his cell phone in the middle of the grocery store (does anyone want to hear him squabbling with the unfortunate soul on the other end of that conversation?). The lady in the grocery store who leaves her cart in the middle of the aisle then gives me a go-to-hell look when I say “excuse me.” The asshat in the middle of the parking lot waiting for the person loading their groceries to pull out rather than picking another space. There are a hundred parking spots, but he’s gotta have that one.  It’s a wonder I got out of the store without someone filing assault charges.

The T-rage sends me into certifiable-crazy mode in an instant. It’s not enough to just get around the Camry in traffic; I want to ram it. I’m not satisfied with shooting the cell-phone combatant a dirty look; I want to yank the phone out of his hand and shove it so far up an orifice he’d need it surgically removed. I’m not at all content to say “excuse me” to the inconsiderate grocery shopper in a shitty tone; I want to push her down and run over her repeatedly with her ill-placed cart. I don’t want to just shake my head at the fool holding up traffic in the parking lot while he waits for that close spot; I want to hurl my gallon of organic milk through his windshield.

Don’t even get me started on the moron in the mini van at middle-school pick-up yesterday who thinks the “No parking” sign doesn’t apply to her. No longer content to roll down my window and politely (or rudely) ask her not to park there, with T-rage, I want to do mean and horrible things to her.

I’ve got the T-rage. Real bad.

This. Is. Not. Good.

I know full good and well that I would not do well in prison. I’m much too fond of my own personal space, unlimited moisturizer, and fresh produce. Oh, and alcohol. Some inmates want a cake with a file or a shiv baked inside; I’d need my visitors to smuggle in booze.

Since prison is not a viable option, I need to get a grip on this T-rage. I need to figure out how to get through my day without murderous thoughts about the neighbors who can’t be bothered to pick up the crap-tastic freebie newspapers littering their driveways. The sight of so many neglected second-rate publications should not incite such violence. And yet, it does.

There are tips for dealing with road rage, and I’d suggest the best way to avoid ‘roid rage is to simply not take steroids. But I’ve not found any helpful tips on avoiding the T-rage. I’m gonna have to look for a 12-step program. Right after I punch someone.


WEGO HAWMC

day2

 

The WEGO HAWMC is quite a mouthful! WEGO Health describes itself as “social media’s most active online health community — Health Activists. These influencers, organizers, connectors, leaders and contributors are passionate about helping others lead healthier lives.” WEGO Health Activists have thrown out a challenge: the HAWMC, or Health Activist Writer’s Month Challenge. It’s a post-a-day challenge taken on by several bloggers I greatly admire. One of them asked if I was planning to participate, so here we are.

I missed Day 1, so will start with Day 2, which is pretty scrambled logic for this Type-A girl, but part of the challenge is thinking — and blogging — outside of our comfort zones so I guess I’m in.

Today’s prompt:

Introduce your condition to other Health Activists. What are 5 things you want them to know about your condition/activism?
Yikes. I hate to think of breast cancer as “a condition” but I suppose it is. I certainly don’t think of myself as an activist, but for these purposes I’ll assume I am.
Ok, so introducing y’all to breast cancer. Y’all, this is breast cancer. Breast cancer, this is y’all.
It’s safe to say that everyone knows about breast cancer, thanks to the pink-ribbon brigade, so on to the 5 things you need to know about breast cancer. Those who have it already know. Those who care for/care about someone who has it already know, too.
#1 — “Early detection is key.” Yes, and no. Early detection is important in that it can prevent breast cancer from spreading and progressing to a more complicated prognosis and a less favorable outcome. But it also leads to overtreatment and contributes to our skyrocketing health-care costs.
#2 — “Breast cancer is a “good” cancer. This is rather loaded. Yes, it is “good” in the sense that it occurs in a body part that is nonessential to sustaining life, and in a body part that can be removed, ostensibly also removing the cancer. But let’s face it, no cancer is a good cancer. And while have a lumpectomy or mastectomy is perhaps easier than removing a lung or other vital organ, the aftereffects for women are brutal, both physically and emotionally.
#3 — “Taking Tamoxifen every day for 5 years is a pretty easy way to manage the disease.” Tamoxifen is rough. Its side-effects are numerous, and even if a women suffers just one or two of those side-effects, they’re quite disruptive. And quite sucky. For those of us diagnosed before menopause, Tamoxifen fast-forwards us to the land of hot flashes, night sweats, mood swings, and other lovely challenges. Within days of starting my Tamoxifen, brown spots appeared on my face. My skin grew noticeably thinner while my body tried to grow fatter. My anxiety level soared while my endorphins crashed.   Having to remember to take my little white pill every day stresses me out: taking it ensures these awful side-effects, but stopping it puts me at risk of recurrence. What part of this is easy??
#4 — “Your breasts don’t define you.” True. Very true. This is true for all women, whether they have breast cancer or not. Huge strides have been made in women’s rights and it’s a wonderful thing that society “allows” us to be more than window dressing. But pick up any magazine and look at the ads or watch any random commercial or walk through any suburban grocery store and notice the boobs. They’re everywhere. And they’re big, round, and perky. If we aren’t defined by our boobs, then why is losing them so traumatic? If we aren’t defined by our boobs, then why do more than 300,000 women a year in the United States undergo elective, cosmetic surgery to enhance their breasts?
# 5 — “Being diagnosed with cancer makes you stronger.” Perhaps in some ways it does. I am no longer afraid of needles after the bazillion shots and injections I’ve received, and can now give myself a shot if need be. I barely flinch when the phlebotomist pierces my skin with a wide-bore needle to extract a blood sample. I know that I can endure an awful lot — physically and mentally. But did I need to be diagnosed to become stronger? Doubtful. And that newly gained strength is a pittance compared to the things that cancer costs me — physically, mentally, and financially.

 


Nature or nurture?

npr.org

npr.org

The literary world is abuzz at the memoir of Supreme Court Justice Sonia Sotomayor. Her book My Beloved World chronicles her early life in the Bronx as a part of a close-knit but troubled family. Her dad was alcoholic and died when Sotomayor was 8 years old, the same year she was diagnosed with juvenile diabetes. Her mom struggled to open herself up to happiness after a tumultuous marriage, and Sotomayor faced difficulties as a young Latina with big aspirations.

I’ve just started reading Sotomayor’s book, and already I’m hooked. In an interview with O Magazine, Oprah asked Sotomayor about a question that Sotomayor raises in her book: How is it that some people are faced with adversity and it makes them want to rise to the highest part of themselves, and other people, faced with the same adversity, get knocked down. Is that nature or nurture?

I’ve often wondered this myself, and never more than I have while enduring the cancer “journey.” What is it that makes some people wither under the strain of the disease, while others adopt a “take no prisoners” attitude and commence with the ass-kicking?

Sotomayer’s answer is not driven by cancer, but what she says applies to pretty much any adversity that comes along. She says that people who have been nurtured, presumably as young children by loving and involved parents, have the confidence to be optimistic and to try things even when there’s a risk of failure. She says “The test of your character is how often you get up and try again.”

I can only speak for my own experience, which was a Cracker-Jack idyll of childhood in a loving home with parents who believed in me and instilled confidence and optimism. Is this why I was able to face my cancer diagnosis head-on and without taking to my bed with covers pulled tight over my head?

I dunno.

Was it a by-product of my childhood, or was it from watching my mom endure her own cancer “journey” without a shred of self-pity? Even though her “journey” was a bazillion times harder and more trying than mine has been, she never once complained or said “I can’t do this any more.” She did every single thing required of her, even when her body was giving her every reason not to, and she did it quietly and stoically. The disease prevailed in the end, claiming her life and robbing her legions of loved ones of her presence, but she put up a hell of a fight.

There’s been nothing quiet or stoic about my “journey,” and many times I could imagine my sweet mama chiding me for expressing my frustration so vocally and with so many curse words. Many times I heard her voice in my ear reminding me to be patient with the slower-than-molasses healing. Many times I felt her gentle reminder to go easy on my docs, who were doing their best to help me (and if she were around, she would have baked them a loaf of bread or a batch of kourambiethes as a peace offering for the not-so-nice way I vented my frustrations in their offices).

I wish my sweet mama were here now, so I could ask her opinion of the nature-vs-nurture question. I think she would relate to Sotomayor on many levels. I know she would downplay the enormous gift she gave me by being a loving, nurturing, involved parent by telling me that it’s just what you do. And I’m pretty sure she would boss me and tell me to allow my kids to have dessert more often, because they need a treat.

Despite my sweet mama’s undeniable effect on my life, I don’t feel especially confident or optimistic these days. While the worst of the cancer “journey” is behind me, the toll it’s taken on my sense of self is great. The reality of creating a life after cancer isn’t easy, with body issues and fear of recurrence being key players. My hormone-blocking BFF, Tamoxifen, wreaks untold havoc on my body and has aged me at an alarmingly accelerated pace. The rigors of check-ups, follow-ups, and scans for new cancerous activity are wearying. The uncertainty of why a group of cells went haywire in an otherwise healthy body is unnerving and serves as a reminder that nothing is a sure thing: you can eat right, exercise, and be pro-active about your health and still fall victim to cancer. It’s not fair, it’s not right, yet there it is.

Perhaps this is a commonality the befalls those of us on this “journey” — like moving through the stages of grief. Perhaps it’s normal that at a certain point, after cancer is no longer the main focus of the majority of our waking hours, we realize how crazy hard the whole thing was and still is. Perhaps instead of being left with a sense of pride in having survived the worst-case scenario, we realize it’s a hollow victory. Perhaps once the adrenaline wears off, we’re left with the dull thud of reality saying, “You survived the worst, now whatcha gonna do?” As I’ve written before, perhaps the soul-crushing depression about the “new normal” that follows a cancer “journey”  is what we’re left with when it’s all said and done. Add all of this to the confusion over whether we dodged a bullet by surviving or were dealt a direct hit right between the eyes by being diagnosed in the first place; then throw in a healthy dose of survivor’s guilt; and heap on the searing realization that all we endured is a walk in the park compared to other people’s “journey.” Considering all of this, it makes me wonder how anyone can rise to the highest part of themselves rather than being knocked down by adversity. Although I’m not sure how it’s done, I’m certainly glad Sonia Sotomayor raised the issue.


Tamoxifen and kids

Did y’all hear about this? A Trenton, New Jersey CVS pharmacy accidentally dispensed tamoxifenn instead of pediatric fluoride pills.

abcnews.com

Yikes.

I love CVS for the generous donations they made to Extreme Home Makeover, the feel-good show that used to be on TV. I searched to find a source to tell me how much CVS donated via the show over the years, but my patience wore off before I could find an answer. Suffice to say it’s a lot.

When I read about the drug mix-up, I cringed. The estimate is that as many as 50 kids received Tamoxifen instead of their chewable fluoride pills between December 2010 and February of this year. CVS hopes that any one of those 50 kids who tried to chew a tamoxifen pill instead of the usual fluoride pill would notice that something was different. Daniel Hussar, who teaches at the Philadelphia College of Pharmacy, was quoted as saying that because tamoxifen is meant to be swallowed, no effort is made to make it taste good, as is the case with chewable fluoride. He says a child who tried to chew tamoxifen would likely “want to spit it out or tell his parents it tastes bad.”

If they didn’t notice the taste, I wonder if they noticed the side effects. I pity the parent who has to deal with a moody, hot-flashing kid.

Because tamoxifen’s job is to block estrogen and prevent breast-cancer recurrences, it can monkey with one’s hormones. I’ve written about this very topic. More than once. I feel pretty qualified to complain about the side effects of tamoxifen, even though I know it’s an integral player in the recurrence-prevention game. I know well that this drug is my best shot for keeping that infernal cancer beast from showing its ugly mug around here again. The National Cancer Institute says explains it, “As adjuvant therapy (treatment given after the primary treatment to increase the chances of a cure), tamoxifen helps prevent the original breast cancer from returning and also helps prevent the development of new cancers in the other breast. As treatment for metastatic breast cancer, the drug slows or stops the growth of cancer cells that are present in the body.” Great right? Yes. Definitely. But, as we all know, there is no free lunch, and tamoxifen comes with some heavy side effects.

At the risk of sounding like one of those annoying commercials that lists every side effect under the sun, here goes:  increased chance of blood clots, increased risk of strokes, development of uterine cancer, and cataracts. But wait, there’s more: menopause-like symptoms such as mood swings, hot flashes, joint pain, and leg cramps. Not listed is the accelerated aging characterized by dry skin, loss of collagen, brown spots (aka “age spots”), and thinning hair. Because losing my rack isn’t enough, I also got thrown into chemically-induced menopause and became a brittle old woman decades before my time.

Not that I’m complaining.

Instead, I’m looking on the bright side: when I pop the little white pill every morning, I know exactly what I’m getting. No surprises. No mistaking a chewable fluoride pill for a powerful anti-cancer weapon.