Unexpected Bump in the Road

When are bug bites not truly bug bites? When does the change in how food tastes not have anything to do with the food? When does having a bit of trouble breathing on my walk have nothing to do with my conditioning? The answer to all these questions lies in a small pill I've been taking the past week.

If you can read the small print in this picture, you see that one of the rare side effects of Arimidex is hives and itchiness. On Tuesday, I felt what seemed at the time a mosquito bite as I walked. It was on my stomach, just below the waistband of my pants, and very difficult to get to while bundled up against the rain and chill. When I got home, I put cortisone on what turned out to be 4 small bumps.  My only thought at the time was how weird to get mosquito bites this time of year and in that area.

By yesterday, these bumps had multiplied, spreading to my thigh and one on the top of my foot. I remember having a reaction to amoxicillin, and the rash was all over. This didn't seem like a bad reaction, if it even was such a thing, but I perused the medical information included with the prescription and online to see if hives might be a possible side effect. Last night, I told Walt that it is likely that I am having a mild allergic reaction to the drug, especially as I saw no change to the bumps after several days. I looked at pictures of hives online and realized my bumps looked more like those than mosquito bites, after all.

At dinner last night, I noticed that all the food tasted bland, which helped me not enjoy the food as i usually would. I still didn't connect the dots that my tongue might be numb because of the Arimidex.

Intending to call my doctor this morning but still unsure if this was a true allergic reaction, I took my pill as scheduled last night. This morning I didn't have any achiness when I woke up. To tell you the truth, that has been the side effect I was zeroing in on, making sure I exercised and stretched so I could prevent or alleviate any stiffness. After seeing the kids off to school and having my daily time reading the Bible and praying, I set out with Sugar for a walk. I had climbed a hill outside our neighborhood and felt a tightness in my throat. At that moment I started thinking that this really was a reaction,  and I hope it isn't serious. Then I remembered that I hadn't taken a Claritin this morning. Since it worked so well at eliminating the sharp back pains I experienced my first days of the medicine, I faithfully took it every morning. In hindsight, I think taking that antihistamine daily kept my allergic reactions to a minimum, which is why I had a hard time believing they were real.

I had only been walking about 10 minutes at this point, and knowing I probably wouldn't get out another time today, and since it really didn't seem all that bad... (yes, I can rationalize with the best of them), I continued on my walk, electing to take the shorter route, just in case, but still going further away from home. At one point, with the rain soaking my pants, feeling my throat tightening a bit more that I slowed my pace, I wondered how good of an idea this actually was.  Fortunately, I made it home safely, but I have to say, not without some concern toward the end.

As soon as I got home, I took a Claritin and almost immediately felt the swelling and numbness lessen. I called my doctor and spoke with the nurse, who said she would relay the information and get back to me as soon as she was able to connect with Dr. Kohn. I mentioned that I knew I should discontinue Arimidex, but would I need a time for the medicine to clear my body before starting back on Tamoxifen?  I noticed when I spoke that my tongue felt a bit clumsy and my voice sounded like I had a sore throat.

While waiting for the return call from the doctor, I sipped water and felt my throat loosen up even more. I don't think Ben noticed anything different as I read and discussed history with him. When the nurse called, she said Dr. Kohn agreed that I should stop Arimidex, that I should take Claritin or Benadryl (which I told the nurse I had and it was helping), that I could go back on Tamoxifen tonight without a waiting period, and that we would discuss trying one of the other aromatase inhibitors at my next appointment. I told her that I thought that was a good plan and hung up.

From the start, I was hopeful that I was going to be able to handle this medicine, expecting to gain a bit of advantage in this fight against the cancer coming back. I think that desire for it to work prevented me from seeing how it was truly affecting me. I am thankful that the reaction was minor. I'm glad to be back on tamoxifen, something I know. Every new entry into the world of prescription drugs is tainted with lots of uncertainties and cautions. For now, I'm thankful that I have something that will work (tamoxifen), and my doctor and I can figure out in February if we should try something different.

Today, I'm still recovering from this unexpected bump in the road. My body is a bit shaky, my mouth is still numb but breathing is fine. My skin and eyes are still itchy, (connecting that final dot that it wasn't my contacts that was causing my eyes to itch so badly). I foresee these all returning to normal soon. In the midst of all this, I'm thankful, at peace, knowing God is in control of all this.

Job 11:18 

You will be secure, because there is hope;

you will look about you and take your rest in safety.

Yes, what he said.

Day 3 of New Meds

Thursday night I took the new anti-estrogen pill. I woke  up Friday feeling a bit achy, almost like I was coming down with the flu. I went for a walk, trying to work out the slight achiness in my back. Exercise helped my back, but the slight nausea remained. Since it wasn't a school day, I decided to spend some down time reading a novel. By the afternoon, I decided that too much laying around wasn't helping, so I started on a project for our bedroom. We have lots of mismatched picture frames, so I decided to paint them all white and work on organizing a wall collage. While they were drying, Becca and I went shopping. Being out helped take my mind off of how I was feeling, but I grew tired quickly. Friday night I went to bed early.

Saturday, I woke up feeling better. The achiness was there in my back, but I tried taking a Claritin and it seems to help. When I was getting shots during chemo to boost my white blood count, I found Claritin helped with the bone pain. I read on breastcancer.org that sometimes Claritin helps with the bone pain of the anti-hormonals. I am hopeful that the problems I'm having are temporary, as my body adjusts to the new medicine. Sometimes symptoms can increase over time, so I'm still figuring this all out. I want to give this a good shot, hoping that I don't have to make the hard choice of deciding between whether the way I feel is tolerable and worth the extra percentage points against recurrence...or if I should switch to something else. 

After putting on a second coat of paint on the frames and doing a bit of cleaning, we left to watch Nathan's soccer game. 

It was rainy and cold. It looks like fall has settled into our area at last. I huddled under an umbrella, a bit achy, but thankful that I could watch this game. Nathan played very well and his team won. I remembered the days during the fall of 2012 when I was too sick after chemo to make it out to soccer games. My bit of nausea was a piece of cake compared to that. 

I'm hopeful that my symptoms are improving. Today, Sunday, I felt less nausea and only occasional sharp pains in my back. I planned to go to Becca's soccer game this afternoon, but the game was cancelled. You probably all heard of the school shooting in Marysville, and Becca's team was playing against girls from that school. While at first they wanted to play to get their minds off of the terrible circumstances, they changed their minds when a memorial service was being arranged at the same time as the game. So instead of watching Becca's game, I went for a long walk which helped eliminate any lingering feelings of sickness. 

My plan for now is to make sure I get my exercise in to help with the muscle soreness (as well as numerous other health benefits that exercise offers), try to eat well, and monitor the effects for a few weeks. Hopefully, I won't have much to say as my body adjusts. If not, I know that God has another plan in this.

Anastrozole

I've had this prescription for over a week. Filled it a few days ago. Plan on taking my first dose tonight. Anastrozole is the generic version of Arimidex, which is my new hormone therapy prescription. Even though the list of potential side effects seems extensive, it is actually fewer than the ones for Tamoxifen. I remember feeling a bit of anxiety before taking Tamoxifen for the first time. God's grace allowed my body to tolerate it with little negative effects. The slight chance of a new cancer or a deadly blood clot inspires me to try the new brand of anti-estrogen pills that I am now qualified to take. While the serious side effects are gone, quality of life side effects are possible. Some women have no problems at all, but others have terrible stiffness, aches and pains,  or various other "minor" effects. I hope I'll be able to tolerate this medicine well, since it gives me a boost of a few percentage points against recurrence, If this particular medicine is not tolerated, I have two others in this category to try. If not, I'll go back to Tamoxifen, and know that this is God's will. So, tonight, day one of about 3 more years? (By the time I've reached my 5 year mark, studies may indicate benefits of more years of popping pills, so I hold any timelines loosely.)

When I told Walt about this medication, he said he wished I didn't have to take it. I misread his heart and thought he needed convincing of the benefits. Instead, he just was responding empathetically to having to take a drug that causes my body to age prematurely. When I realized he wasn't questioning the wisdom of taking it, mostly still grieving the effects of cancer in my life, I understood his words. He wasn't saying, don't take it, but I'm sorry you have to endure this. I try not to go down the road of  "wish I didn't have to" or "if only..." I put energy into staying in the present, appreciating that right now, all the treatment has worked at keeping this terrible beast at bay. As much as I don't like the potential effects of taking any medication, I am thankful that I have this tool to use. So, as my computer runs out of battery, I take this cue to end this post and go take my pill. Praying for the best.

Not Going to Torture You

As my doctor eased open the door in the examining room Monday morning, a big smile on her face, she offered, "I don't have anything to torture you with today." Because this appointment was spaced longer than the usual 48 hours because it took a week to get the bone density results, I was able to access the blood test results already. As you probably recall, one of my tumor markers stubbornly remained elevated since last November. The elevated marker won me return visits to draw more blood every two months. I had one pause where the tumor marker went back to normal in January, but since April, the marker slowly rose every two months. Dr. Kohn then ordered a trip for a colonoscopy which yielded the helpful advice to add powdered fiber to my diet. My first blood draw after that was normal, and I was hopeful it would remain the same. Crazy turns happen with cancer, so I still had to press into God's peace before I accessed the results online on Saturday morning. When I scrolled down to the CEA marker, I wanted to shout. 2.2!! I darted into the family room where Walt was watching football and shared the good news with him. What a great start to the weekend!

Dr. Kohn had no idea that I already knew the results of my blood test, but to see an oncologist smile is a wonderful thing. I'm sure her other appointments on that day weren't all so nice and easy. I know tears and anguish are as common in the examining room as smiles and chit-chat. Every time I go into the oncology clinic, I'm amazed at the levity, the smiles, the welcoming comments and familiarity present. I think these are developed because of repeat and frequent visits. Most patients I see have overcome the horror of their initial diagnosis or recurrence and are living the life they are now dealt. One man sheepishly returns for keys he left behind. The receptionist is thrilled that they have been returned to the rightful owner. I overhear pleasant conversations about a funny answering machine message or activities that happened over the weekend. Most of the patients are veterans. New patients stick out with their anxiety and uncertainty written all over their faces. Veterans grab the clipboard offered at checkin, scan the columns to quickly note any new symptoms, and pop back up with the work completed. Newbies take time to read every line, every page. It's still hard to believe I am one of the veterans, comfortable in a place I never thought I'd be, but walking with God in the story He is writing.

Dr. Kohn quickly went over all the results, including my bone density. She was a bit surprised that it was so strong because of how "petite"  I am. I chuckled, not ever considering myself petite. I'm sure my bone strength has its roots in the dairy of Wisconsin and continues through the weight-bearing exercises I keep a priority in my schedule. I don't deny the good family genes, too. We come from sturdy folk.

The one discussion we had was changing my anti-hormonal from tamoxifen to an aromatase inhibitor. In postmenopausal women who are on a aromatase inhibitor, the percentage of non-recurrence goes up a couple of percentage points over tamoxifen.  Dr. Kohn said that isn't significant, so some choose to stick with the pill they already know. The other side benefit of switching, however, is tamoxifen has a very small chance of causing uterine cancer or developing a blood clot, while the AI drugs do not pose this risk at all.  That was enough for me to be persuaded to give it a try. Dr. Kohn said I can always go back to Tamoxifen, since I know the side effects are minimal for me. Some people have no side effects on the AI, but others have experienced achiness in their joints or an over all sick feeling.  Sometimes it'll take a few weeks to feel better, and other times the achiness remains. Every one responds differently. I have the prescription in my purse. I wanted a week of feeling good, basking in good test results, knowing that the tamoxifen I take nightly was good enough for now. I think tomorrow (Friday), I'll venture to the pharmacy and pick up the bottle of pills. If this particular type doesn't work for me, I can try two others. If all of them produce an achiness that takes away from the quality of my life, than I'll go back to tamoxifen. I'm praying that it'll be just another pill I take every night.

By the way, this afternoon before I went for my walk, I put my hair in a ponytail for the first time since 2012, when I had my hair cut short before chemo.

Here is what it looked like in 2012

 Here is a picture of my tiny ponytail today.

Moderately Elevated

Finally, I decided to be proactive and call my endocrinologist to see what I could find out about the thyroid uptake scan. The receptionist mentioned that the doctor just mailed a letter to me today with the results. Would I like her to read what it says over the phone? Yes, you better believe I do!

Basically, she read that my thyroid levels were moderately elevated. The right-side nodule, the one that grew, is unlikely to shrink with medicine since it absorbed very little of the iodine. His plan is for me to check back in with him in 6 months, unless it grows so large that it interferes with swallowing or speaking. She said I should be receiving the actual letter tomorrow or Saturday. I thanked her profusely and hung up. No biopsy. No surgery. No new medication. My day got so much brighter in those moments on the phone.

God has been so faithful. Even before the call, I grabbed onto the peace I knew He'd willingly give to me. Tests, as  my kids will agree, are hard, yet they also bring me closer to God as I lean into His word and prayer. So in that respect, they are good.

After my long post the other day where I wrote about letting go of things, I took out my Jesus Calling devotional and read this: "In order to hear my voice, you must release all your worries into My care. Entrust to Me everything that concerns you...Let Me free you from fear that is hiding deep inside you..."

Perfect timing. Perfect words. Perfect encouragement.  I've gone through this devotional twice, and even though currently I don't read it every day, from time to time I'll grab it and read what the day's devotional is. Most times, God uses Young's words to speak directly to my soul.

Sometimes it causes me to wince because it hits too close to home. Like today's: "You have been on a long, uphill journey... Though you have faltered at times, you  have not let go of My hand. I am pleased with your desire to stay lose to Me. There is one thing, however, that displeases Me: your tendency to complain..."

I wish I could say, nope, that doesn't apply to me. Unfortunately, it is too true. Instead of complaining to others (usually it's not about my health but other things--but still complaints), I need to shut that door against the deadly sins of self-pity and rage. Instead of grumbling, I need to turn to God and talk it out. I want His thoughts in my mind and His song in my heart.

For today, the conversation is easy and sweet. I'm so thankful for the good news, for God's protection, for His presence during this journey.

Jeremiah 31:25

For I will satisfy the weary soul, and every languishing soul I will replenish.”

Good News, Crazy Schedules, and Letting Go

Yesterday was a busy day of testing. After an hour commute to the hospital, I arrived about 8:15 for my blood draw. The list of items to be tested was a couple of pages long, ranging from the normal white and red blood counts to vitamin D, fasting cholesterol and glucose. Of course, tucked in the middle are tumor markers, which I am hoping stay in the normal range. After the needle prick and vials of blood left safely behind, I went to the other side of the hospital for my bone density screen and mammogram, which both happen to be in the Breast Center.

After filling out paperwork (much of it already completed because of computerized records), I was escorted back for my density scan. The scan was one of the easiest procedures I've ever had done, simply lying with my legs bent and then straight and feet turned in as the  dual-energy x-ray absorptiometry(DXA) scanned my bones. Simple, fast, and easy. 

Once that was finished, I went back out to the same waiting room until I was called for my mammogram. Donning the warm robe, I tried not to let emotions or worries overcome my thoughts. I prayed for God's peace, that He would go before me and be my help. As I flipped through a magazine, I wondered why I wasn't anxious. Oops, I prayed for God's peace. It's funny how often God gives me what I pray for, and I still question.

When the mammogram technician called my name, I realized that I didn't recognize her. I've been here so often, I thought I knew everyone who worked here. She was very thorough and kind, letting me know she would do her best to get excellent pictures the first time. She understood that I would still be sore on my surgical side, but that she would try to be as quick as possible. Because this was a diagnostic mammogram (all of mine from here on will probably be categorized likewise), she had to take several shots on the 3-D machine, then we'd move to another room for a few more shots on a different 3-D machine on only my left side. As we were finishing up the first round of pictures, she offered sweet words of encouragement, letting me know that she knew this was hard for me and that I was very brave. Of course, her kindness opened up the floodgates, and as I tried to hold my breath while compressed in the machine, I felt tears trickle down my cheek. 

We then had a bit of a break as she cleaned the machine, and she pretended not noticing how much I was wiping my cheeks. Moving into the second room, she asked me about my kids. Good, a safe topic. Unfortunately, we got to talking about high school and how I was questioning the classes we placed Becca into, and that it's been a tough month so far, and of course, you guessed it, I struggled to fight back tears again. She mentioned that she also has a tenth grader, a son, and it's just a hard year. No matter what classes, it was going to be tough for her. The technician remembered high school being hard, but watching her child go through it seems harder. Yes, that's exactly what I have been feeling. I once heard parenthood described as deciding forever to have your heart walking outside your body. Up to this point I homeschooled all my kids, so this is the first time my hearts are walking without me as they journey through school. 

Back to the mammogram, we finished up these last pictures fairly easily. I went back to the waiting room for the doctor to review the films. I also was scheduled for an ultrasound because Dr. Kohn wanted to check on some lumpiness on my right side, which she felt confidently was either a cyst or some fibrous tissue. As I waited, I texted my friends who all said they were praying. The waiting room was fairly empty, very little comings and goings. The magazines didn't hold my attention, but I wasn't nervous, either. I knew that the door would open up soon, and I would find out what the rest of my morning would include.

The tech called me back, escorted me to a small alcove to give me the news. I didn't even try to read her expression. She told me the doctor looked at all the pictures and said everything looked benign. I didn't have to come back for a year. I didn't question that, as I usually come back every six months. I rely on Dr. Kohn to let me know when I need to come back...and then I heard her say that the doctor said I wouldn't need an ultrasound. Nothing looked suspicious. I looked at her again. You mean I'm done? Yes, she nodded, you are all finished. Everything is benign. She said she was a hugger and gave me a big hug, as I let the tears flow again. Good thing the waiting room was empty as I didn't want anyone to think I got bad news. Before changing back into my clothes, I sat in the dressing room a few minutes, letting the tears flow. I know this is just one piece of my health, but that,at that moment, it was a tremendous relief to get good news. I even was sent home earlier than expected.

 I return next Monday to get the results of my bone density scan and blood test. I'm still waiting on the results of my thyroid scan. Usually before a test or waiting on results, I don't sleep well. My family will admit to a bit of grouchiness on my part, too. While I have all this medical stuff going on, my head is also overloaded with all the schedules and pieces I'm trying to keep track of, most of which I need to let go.  Today we drove up to the school early so we could be near the front of the line in order to pick up Becca and Nathan and make it to the kids' dentist appointments. The timing worked out perfectly, except, I got the date wrong. When I made this appointment,  the dental secretary and I went back and forth, ... we could have Becca come back for her ortho another time...what about this date? No,we need to have a later time..   When it was done, I thought I knew what we agreed upon, but my calendar had different information than hers did. Frankly, I was so focused on surviving September along with my own medical appointments and concerns, that the dental appointments were low on my priority list. So on Sunday when I saw it listed for today, I planned out how we were going to get there on time. I remembered receiving a postcard of the appointments (didn't verify the date, but assumed it was the same one I  had), didn't remember getting a reminder  phone call, but maybe I forgot about that. I thought about calling today while we were at home, but the day flew by and we needed to go up to the school so we could be near the front or we would make it to Mill Creek in time. Ben remembered all the things he needed to bring in the car to finish, but I felt I needed to remind him. I could have used that time to call the dentist to check on whether we needed to be there today in the first place.  It's not the first mess up I've had this fall, and unless I let go of things, it's  not going to be the last. 

Life has been very crazy, but I can't let it take over as it's been. I need to let go of things the kids are facing and entrust them to make the right decisions, to put in the hard work, to be accountable. I need to not worry about things that I can't change, like classes we chose last spring, my health, or the results of a test. I need to allow God to work through all things for His good. I need to remember this: 

8 It is the Lord who goes before you. He will be with you; he will not leave you or forsake you. Do not fear or be dismayed.” Deut 8:31.