Wednesday, September 14, 2016

"you certainly usually find something if you look, but it is not always quite the something you were after". from the hobbit by j.r.r. tolkein

you could also say that this is an addendum blog. i posted in haste last time. the new drug that i was so excited about, aromasin( exemestane) 25mg , turns out not to be so great after all. i was so hoping to have less muscle/bone pain with it- my oncologist assured me that 50% of women who were having the muscle/bone pain with the arimidex( anastrazole) did not have that side effect with the aromasin. i should have fully researched the drug before getting all worked up about it. turns out that the side effects profile ( i researched a  professional drug information site) on the aromasin is worse than the side effects profile of  the anastrazole.

even though my oncologist told me about the 50%  prize, he must have read about it in some professional journal?, it still lists bone/muscle pain as a side effect. that was acceptable. but what was NOT acceptable were two side effects listed as "very common".the  article that i read  listed side effects into three groups: very common, common, and rare. the two "very common" side effects with the aromasin, which were NOT listed in the anastrozole profile, were leucopenia ( which means diminished white blood cells, which means your immune system is compromised) and depression with  insomnia. these are deal breakers for me! when i was having my chemotherapy, my white blood cells tanked every time, causing me to have to have extra neupogen injections. my immune system is not back to my "normal" as yet, so i am concerned about any drug that would adversely affect it.

so back to the "devil i know" as they say. taking an aromatase inhibitor ( a drug that decreases the estrogen in the body) is  crucial to preventing a breast cancer recurrence. in my case, i will just stay on the anastrozole, and hope that either i find better ways of coping with the pain, or i am one of the lucky ones who ( for some reason) stops having this side effect.

Tuesday, September 13, 2016

" go back, he thought. no good at all! go sideways? impossible! go forward? only thing to do. on we go! so up he got, and trotted along with his little sword held in front of him, and his heart all of a pitter and patter." quote from the Hobbit, by j.r.r. tolkien

this is my second favorite quote from the hobbit. i needed to muster up all of my courage yesterday to go to my six months appointment to check on my breast cancer. it was an appointment with the oncologist- and they did blood work, and went over the results from  my CAT scan that i had  a few months ago. i thought that i was not nervous until the night before my appointment. it hit me like a ton of bricks. what if the cancer is back? is that why i have a basal cell carcinoma that i have to get taken off next month? i just finished a 10 day treatment of antibiotics for a sinus/throat infection. is my immune system shot? ( really, i feel that i have the immune system of an ant. a very, very small ant). i seem to catch everything coming and going as they say.

i am not afraid of needles. i am not fond of them, either. unlucky for me, i am a " hard stick" as the med techs lovingly refer to people like me. my veins head south- i mean, who can blame them? i did do what my favorite med tech told me to do last time- drink lots and lots of water 24 hours or so before you have to have blood drawn. that " plumps up the veins" so she said. honestly, it seems to work. and yes, i do have a favorite med tech in my oncologists office. she uses a butterfly needle, sounds sweet, but still hurts. not nearly as much as a regular needle though . and this med tech seems to know where my veins are hiding out. she gets one every time! i asked her if she could come down to raleigh with me next month when i have my big thyroid cancer check up. the med techs at my endocrinologists office seem to always dig around in my arm for a while, never strike gold there, and then i end up having to have one of the " man veins" in the back of one of my hands stuck. hand sticks really hurt, by the way. i have such good veins there because of all of the child proof lids i have opened over the years. i have decided that this time, i will just tell the med tech to stick my hand and get it over with.

back to my breast cancer check up. at my oncologists office, it is such a big practice, that you always see a physician's assistant first, then the oncologist comes in the room for the big finish. so, the PA and i went over the basics- and i told her i was doing pretty well except for the medicine that i have to take for TEN YEARS . it blocks estrogen, but one very bad side effect is muscle and bone pain. i am especially sore in the morning, and i look like i am 100 years old when i try to get out of bed. this is a medication that i have to take. period. but, there is another medication in this same category ( they are called aromatase inhibitors for those of you who are interested). my doctor said that about 50% of the women who had bone/joint pain on the anastrozole ( arimidex) did not have this side effect on the other drug, which is called aromasin( exemestane). i am going to research this as much as i can from reputable breast cancer websites, and my research material . but honestly, i have pretty much decided to give it a try. unless i discover some horrible side effect from the new drug. and it is going to have to be something pretty horrible for me not to try it!

my oncologist ordered a CAT scan a few months back. i had quite the scare at first when the radiologist read the x-ray and mentioned that i had a tumor on my liver. the radiologist wanted me to have an MRI to check it out further. i called up my family doctor and talked with him about it. i have mentioned him before- he is the voice of reason. he reminded me that i have had this place, and it is called a hemangioma- just a fancy word for a cluster of blood vessels, for years. it is benign, and can be on the outside of the body, as well as inside your body.  my family doctor suggested that i get copies of my other CAT scans and take these to the radiologist so that he could have something to compare the latest picture to. that worked! i did not have to have an MRI.

my oncologist did not know all of this back story, though. he said, well, your CAT scan shows a spot on your liver. i could just see the wheels turning in his head. i imagined that he was thinking something like this: " cancer patient + tumor on liver = cancer??!"  he looked pretty relieved when i filled him in. in fact, he looked at me, smiled, and said : Good Job!! i have to give my family doctor some credit, though. sometimes it is good to take a step back, and breathe before making a huge decision. one should not wait too long, but rushing to have a test done  that would only give me more radiation exposure when i probably already glow in the dark ( in large part to the I-131 dose i received with my thyroid cancer treatment) would not have been in my best interests. this is another example of  being a good patient advocate for yourself.

my oncologists office will mail my blood work results, the ones they were not able to do in the office, to me in a few days. unless something weird pops up in these, i am good to go for another six months. now, i will just dust myself and my trusty sword off and get ready for my thyroid cancer check up next month. going forward is the only way to go.

Thursday, September 8, 2016

"don't worry, 'bout a thing. cause every little thing, gonna be all right." by Bob Marley

i saw the special "mohs surgery trained dermatologist" yesterday. thankfully, he is willing to do the surgery in the office. sometimes, if the cancer is larger, in a tricky place, etc, they will send you to the plastic surgery center at Baptist hospital in winston -salem. i was afraid they might want to do that. the lesion is on my face is  between my nose and eye, a little closer to my eye. but the dermatologist seemed confident that he could do it without any problems. he told me that i would be in the office for a few hours, due to the process, and that i would have stitches and most likely a black eye. my surgery is scheduled for monday, october 10th. just in time for halloween! actually, i am hoping that i will have had my stitches removed before halloween- i forgot to ask. the scar takes a little while to heal up, so i guess i can dress up as the bride of  Frankenstein again this year.

i was a little more "concerned" yesterday at the dermatologist than i thought  i would be. it was just a consultation, so i went by myself. this is a basal cell carcinoma, not a melanoma, or even a squamous cell for goodness sake. basal cell can spread to tissue and bone, but only if you let it go for a long time. my carcinoma is a relatively new kid on the block. but it is STILL CANCER! i am tired of my adventures with cancer over the past six years, and i told the dermatologist that this is it for me. thyroid cancer in 2010, squamous cell on my leg in 2012, breast cancer in 2015, now basal cell on my face  this year. enough already. the doctor gave me a little pamphlet on basal cell carcinoma. here is a list of the factors that increase a person's risk of basal cell carcinoma:

1) pale, light colored or freckled skin.  CHECK

2) blond or red hair.  CHECK

3) blue, green, or gray eyes. CHECK

4) a family history of skin cancer. CHECK

5) a weakened immune system . another  CHECK

6) using tanning beds or other indoor tanning services. NOPE, not this one.

but with 5 out of 6 risk factors for developing basal cell skin cancer, i guess it was kind of inevitable.

now what? well, as i said, i told my body " no more cancer!". and of course, i will see my dermatologist now every six months just to be sure that nothing sneaks up on me, so to speak. the thing to remember, as i said before, it early detection and treatment. if you are afraid to go to the doctor, please remember that skin cancer has to be treated in some way, and better when it is smaller and contained, versus later on when it has gotten larger and more aggressive.

per my usual way of coping, i will freak out for a couple of days, then i will be fine. i have a plan, and i know that "everything is going to be all right." i have a lot of support from my family and friends and i am very thankful for that. and as a bonus, i have the perfect outfit for halloween this year.