Decisions, Decisions

Hello again! Yes, it’s time for my annual ‘don’t worry it hasn’t come back’ update.

So, today I had my annual check up with Dr SmileyBloke the surgeon, who was his usual jovial self. He congratulated me on making it to three years clear and confirmed that because all seems well they will now discharge me from the surgical clinic. This just means I won’t need to have these annual check ups – I’ll still have the yearly mammogram and he reassured me that if I have any worries need of them I only have to call.

After our usual chat about diet, exercise, etc. (I’ve lost a stone since I was last there – he hasn’t Ha!) we moved on to whether or not I should move over from Tamoxifen to an aromatose inhibitor – Letrozole. He explained that ordinarily after five years of Tamoxifen I would then be moved on to Letrozole for another five years (something I don’t think I’d been told before). However, I could move on to it now because – after three years of Tamoxifen and at the grand old age of 51 – he’s pretty certain I will now be post-menopausal. Tamoxifen isn’t as effective when you’re post-menopause, apparently, and there are strong benefits to moving on to Letrozole – not least that it’s supposedly as effective at zapping cancer as six months of chemotherapy but without the hideous side effects.  He said that Letrozole does have some potential side effects, the worse being joint pain,  but that they tend to wear off after a few months. The pros seemingly outweighed the cons, and although I was disappointed I couldn’t just stop the Tamoxifen altogether, we decided I would move on to Letrozole, and he wrote me a prescription and said he’d see me again in six months to see how I was getting on.

And then, as I sat in the pharmacy waiting for the prescription, I made the mistake of reading the accompanying leaflet which filled me with horror, then Googling ‘Letrozole side effects’ which just about finished me off. I very nearly told the pharmacist not to bother, but being typically British and meek I didn’t. I just took the tablets and left.

I’ve spent the rest of the day not knowing what to do for the best. Most of the potential side-effects are very similar to the ones that I had when I first started taking Tamoxifen. I’ve no idea whether I’d get them all over again, given I’ve been on Tamoxifen for 3 years, but I’d hate to go back to the worst of the menopausal symptoms, fatigue, etc. – it’s only been this year that I’ve felt like I’ve started to get over them. But it’s the joint pain that really worries me. I’ve read a lot of accounts of women online who are suffering the most horrendous pain alongside other side effects. And there’s a risk of osteoporosis which Dr SmileyBloke never even mentioned.  I think I could move back to Tamoxifen if I found the side effects too overwhelming – but in all honesty right now I don’t even want to contemplate putting myself through them. My mental health’s not been brilliant in recent months and I feel at the moment like more physical issues might just be a bit too much to deal with.

Ideally, I’d like to talk to someone else about the risks and benefits of Letrozole before I move on to them. But I don’t really know anyone who’d be more expert than Dr SmileyBloke and there doesn’t seem a lot of point in talking to him again as he’ll doubtless repeat what he’s told me today. Plus, he’s a busy man and I doubt I could just pick up the phone and talk to him! I might just see if my GP can offer any insights. In the meantime, I’ll stick with the Tamoxifen and keep the Letrozole in a drawer to come back to later. “Better the devil you know” and all that!

Any excuse for a Dave pic!

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Three Little Words

It’s been a while since I updated this here blog, but here I am again – don’t worry, there’s no bad news in store, just a general update.

Work has been a bit up-and-down over the past few months, and I ended up returning to temping while I tried to find a part-time job, in the hope it would help with work-life balance and the fatigue issues I’d been experiencing in full-time work. I recently started working as a part-time vet’s receptionist and so far it’s going ok. Being around cute furry animals all morning, then being able to come home at lunchtime and sink into a Nanna Nap if I need to is great. I can completely see why you’re encouraged to ‘phase in’ a return to full time work after treatment and why I should’ve done this last year instead of going straight back into a stressful job.  Lesson learned!

This week saw me back at St. Luke’s for my annual follow-up appointment with Dr SmileyBloke, of the surgical team. I went prepared with a list of questions/concerns, which he answered with his customary smile and reassuring tone. He asked how I thought I was doing, and I answered honestly ‘still struggling a bit’. Explained that I’m still finding the tiredness hard to cope with, that the bulgy armpit is still causing me issues and that I have put on two stone since I started on Tamoxifen and can’t seem to shift the weight (admittedly mostly because I can’t stop shoving pies, chips and chocolate into my cakehole). I don’t so much have a spare tyre these days as all four wheels, plus the one in the boot.

I was surprised when he confirmed that the weight gain is most likely related to the Tamoxifen – it does, apparently, increase appetite (something I’ve definitely noticed since being on it). I could stop taking it if I wanted to, but there is a 5% chance of recurrence. Knowing my luck, I’d be one of the 5%, so at the moment coming off the meds is not something I want to do.  He also explained that after three years of Tamoxifen, if I’m confirmed as being post-menopausal, I could be switched to an aromatase inhibitor which should reduce/stop the menopausal side-effects (weight gain included). I’m well aware that aromatase inhibitors can have their own nasty side-effects though, so I’ll have to think about that a bit. We will review that on my appointment next year.

Interestingly, he said losing a stone in weight would benefit me as much as taking Tamoxifen does, for sciencey-type reasons (something to do with the body’s production of estrogen when there’s more fat, but I must admit I glazed over slightly at that point – I don’t really do science).

giphy

We discussed diet and exercise & he gave me a few hints and tips based on his own recent experience of trying to lose ‘the cuddle factor’ as he called it. Basic common sense stuff, really – eat less, exercise more. I’m going to try to cut out some of the crap that I eat between meals and to drink more water, too.  He’s a big advocate of the Couch to 5k – something I only do when I’m ‘training’ for a Race For Life. I told him I’d recently downloaded the app with Michael Johnson as trainer. He asked if I’d started yet. Blimey mate, give me a chance! I only downloaded it three months ago – I need to ease in gently!

I remembered to ask about alcohol and Tamoxifen and he reckoned that having a couple of glasses of wine a week wouldn’t increase the risk of the cancer recurring. I don’t really have a problem with being teetotal, but it will be nice to have a little bit of vino with my Christmas dinner for the first time in two years.

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Me. Christmas Day 2018.

Finally he copped a feel examined both boobs, told me everything was fine, reminded me to ensure I go for the annual mammogram in the spring and then said the three little words anyone in any form of recovery wants to hear:

“You’re doing great”.

And, do you know what? I think I just might be.

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Here We Are Again, Happy As Can Be

A few weeks ago, I noticed a blemish on the BoD. Given that’s how this whole cancer malarkey began almost exactly two years ago – and being a Sensible Old Hector – I went straight to see my GP, who referred me to the one stop clinic. So Tuesday saw me back at St. Luke’s, where I saw another surgical consultant (not one I’d seen before) who basically reassured me that all was well and – according to some online calculator thingy – my life expectancy has only reduced minimally and I should live to be at least 80. Presumably this doesn’t factor in being hit by a bus, or tripped on the stairs by a lunatic cat – the latter of which will doubtless have me six feet under within a few months if I’m not very careful.

Mo, casually plots his next move.

Mo casually plots his next move

It was interesting to get another opinion on the various things that have been causing me concern, but a wee bit frustrating that his advice seems to contradict what others have told me. According to him, the blemish is most likely caused by radiotherapy, as is the discomfort around the armpit and the pain and ‘pulling’ sensation in the BoD. There is nothing I can do about the pain other than take analgesic if it gets too bad. Apparently radiotherapy ‘freezes’ the tissue, which stops the localised cancer returning but also means that there’s not much you can do about the resulting issues with pain etc. A lot of the discomfort is also due to the change in sensation after nerve damage and it’s not likely to change – although the nerves can recover in time.  All I can do is keep massaging with bio oil or moisturiser.

I’m not at high risk of lymphodema due to not being massively overweight/old, and I have good movement in my arm despite the lumpy feeling in the armpit (he says there’s no actual lump there, whereas the previous surgeon said there is. Ho hum). There are no exercises that will improve the armpit issues, but I should make sure I raise my arm above my head at least once a day and keep it moving as I do now.

He didn’t think I needed a mammogram there and then as I have my annual one coming up soon. He says I am now most likely to be post-menopausal now and I can have a blood test after I’ve been taking Tamoxifen for two years to check. This contradicts what I’ve been told before, so I will have to check that one again next time. Apparently if I am post-menopausal they can then change my medication from Tamoxifen to something else, but again this contradicted what I’ve been told before so I’m not counting on it. Plus I’m not sure the ‘something else’ would be any less annoying side-effects-wise than the Tamoxifen currently is.

So, basically, everything negative is down to radiotherapy and it’s all pretty permanent. The cynic in me think this is a bit of surgical bias, and obviously I’m going to question all this again when I go for my regular check-up in a few months time. But for now I’m just happy that the blemish was just a blemish and nothing more.

 

 

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In The Bleak Midwinter…

…Grumpy Sue made moan.

Last December, I returned to St. Luke’s for a follow up appointment with the surgeon, a genial, smiley chap who made me feel like he just wanted to get me out of the room as quickly as possible to get through his appointments. I’d gone with a lot of questions I wanted to ask, and although I did ask most of them, on reflection I never really got the full answers I was seeking. Maybe there actually aren’t any, I dunno.

Anyway, upshot of the appointment was that everything was ok with the BoD, everything was also ok with Other Boob and my armpit will stay swollen and uncomfortable – probably permanently – and there’s not much I can do about it. I mentioned that I had been struggling with fatigue since I started the new job and he was very sympathetic, giving me a mild rebuke for going back to full time instead of ‘phased entry’ (util I explained to him that I had no job at all so had very little choice!) He also told me that in the majority of cases the fatigue doesn’t start to lift until at least a year after chemo finishes. There’s not a huge amount I can do over and above what I am already doing to help myself there. So that did make me feel a little more optimistic at the time.

Forward wind a couple of months and I feel like I’m going backwards instead of forwards. The job I had so much hope for has fallen apart (I leave next week) and I’m sick. Sick of feeling so tired all the time. Sick of the extremes of mood I swing between on a seemingly daily basis. Sick of the vicious circle of comfort eating + weight gain +  misery at my unhealthy lifestyle. Sick of being in thrall to drugs that are, I’ve no doubt, contributing to all of the above, but which I am forced to take for fear that the bastard cancer will come back.

I’ve no idea what to do to change things. Well, I do have some but I haven’t the emotional or physical strength to even think about doing acting on them. I don’t want to blame everything on ‘the drugs’, and I’m aware that the emotional fall-out from cancer treatment can go on for years – but I’m just so utterly fed up of feeling this way. Early in my treatment, I vowed not to be a ‘perpetual victim’ after it was all over. I seemed to be able to be determinedly positive about pretty much everything. Right now, though, everything just feels ‘meh’ at best and unbearable at worst. I need to see a light at the end of this particular tunnel, but my hormonally frazzled brain would probably just assume it’s the train, and tell me to lie down and let it run me over.

I have good days and bad days, of course. Unfortunately, today is a particularly bad one. Everything feels quite dark and bleak and horrible. Tomorrow, I might wake up feeling like life’s a breeze and wonder why on earth I allowed the Black Dog to take me over as much as it has today. I’ve no idea why I’m writing this, except to vent a bit. I guess I’m also writing it in part so that, if anyone’s reading this and going through the same experience, they can realise that they’re not alone. Even a year and a bit after diagnosis and treatment, the recovery process can be a rocky one but we have to remind ourselves that, ultimately, it’s ok to not feel ok.

Some of the time, at least.

 

Posted in Breast Cancer, Recovery, Tamoxifen, The Future | 9 Comments

Oh. So. Tired.

As it’s now been a month since I started my New Job, it’s probably time for an update on just how the whole post-cancer-back-to-work malarkey is going. Now, you know me well enough to know that I’ve tried very hard to be positive over the past 18 months, but that I’ve always strived to be honest in this blog, even if it means occasionally slipping into negativity. So please be prepared for a bit of negativity…

So, how’s the New Job? Well, in all honesty, I’m struggling. The answer to the previously posed question “Am I setting myself up for a huge fall? ” has turned out to be a resounding ‘Yes you bloody were, you blithering idiot!”

Putting aside the tooth infection I got two weeks in, the cold-lurgy thing that I’ve had for the past two weeks and the general crapness of the job itself (it’s been not so much a steep learning curve as the Matterhorn of learning curves), I’ve also been struggling massively with tiredness. I’m sleeping badly and my brain has decided I absolutely have to wake up at 5am every day, meaning I go to work feeling knackered even before the general manic-ness of the day begins (and believe me, every day is manic!) I get home most nights and only have the energy to eat dinner and then flump. Weekends have been similarly flumpy.

There’s not a huge amount I can do to rectify the situation at the moment. My usual ‘fight-or-flight’ reaction of just wanting to leave NOW has kicked in big-time, but leaving NOW is not currently an option – not least because I’ve nothing to go to. Although the prospect of temping again appeals to me, I know I’d be even more exhausted if I was having to commute into Leeds every day, getting up earlier and home later. Common-sense tells me to give this job time, learn as many new skills as possible and then leave when a better (part-time, hopefully) position comes along. Or go temping again if and when the tiredness has improved. Who knows? Maybe over time, the job will become what it was supposed to be, the fatigue will lift and I will look back and wonder why on earth I got so stressed in those first few weeks. I’m old enough and ugly enough to know that there’s always light at the end of the tunnel, even if the tunnel feels like it’s a very long one…

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On that note, It’s only two weeks ’til half-term – and a Nanna-Nap-fest the like of which will never have been seen before!

 

 

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Working 9 to 5…

Hired

Well hello again. It’s been a while. Given that I’m about to embark upon the next ‘chapter’ in my recovery, I thought an update might be in order.

As you might have guessed already, I’ve got myself a job – which I’ll be starting in exactly one week’s time. Now, my fellow cancer-kickers out there will all be aware that we’re usually advised to gradually re-acquaint ourselves with work by going for ‘phased’ returns or part-time positions. So have I been a Sensible Old Hector and done that? Have I bogroll! I’ve gone and got myself a full-time role that’s going to entail a lot of training-up onto new systems, a totally different working environment and a very steep learning curve.

Am I mad? Yes. Probably.  But when I saw the job ad back in July, it screamed out at me to apply (not literally, obviously, that only happens in Harry Potter films). It’s at a local primary school, and I initially applied with it in mind that it would be good interview experience, but having gone on a tour of the school and heard more about what the role would entail, I realised I really wanted this job. I prepared like never before for the interview, getting some great advice and tips from schoolteacher chums and parents of anklebiters.  I interviewed pretty well (she says modestly) but then completely buggered up one of the admin tasks and went home convinced I’d blown it, only to be pleasantly surprised a few hours later to get a call from the headmaster saying they wanted me. Hurrah! Everything got confirmed just a few days before they broke up for the summer, leaving me with six whole weeks to just relax and enjoy myself. In theory, at least.

Unfortunately, as the weeks have gone by, I’ve been increasingly concerned that I’ve potentially taken on too much. My constant tiredness, in particular, has been a big worry. I got myself in a bit of a tizz about it all a couple of weeks ago, after reading an awful lot of information online which suggested that going straight back to work full-time is a big mistake. It all began to weigh very heavily on me. When you’ve been out of work for more than a year, it’s always going to be difficult to get your head around going back. When you’ve had the added issues of the whole cancer malarkey,and trying to remotely deal with a parent with dementia, it’s harder still. But does that mean accepting this role was a mistake, or that I won’t be able to handle it? Am I setting myself up for a huge fall? I honestly don’t know.

During my tizz, I spoke to hubby about my worries and fears and he very sensibly advised me to think back to how excited I felt when I got the job.  I also decided it was time to stop panicking and start being practical.  I stopped reading about going back to work after cancer. I started setting my alarm earlier each day so that the early start next week won’t kill me (with mixed results – most days I wake up to the alarm but still can’t seem to haul myself out of bed for another half an hour or more!) I’ve tried to increase the distances of my daily dog walks (peaked at four miles today!) and I’ve tried to be more active during the day. It’s too easy just slump on the sofa in front of the Homes Under The Hammer* and then not budge for the day except to make cups of tea and blame it on being tired – but doing nothing all day just breeds more tiredness doesn’t it?

I’ve also embarked on a diet, having gained two stones since treatment started. I’m aware that it might be difficult to shift, given that many women blame Tamoxifen for their weight gain, but I’m also aware that I’ve spent the most part of the past 9 months or so sitting on the sofa shoving cakes, biscuits and sweeties down my greedy gob, so it certainly isn’t all down to the tablets. In two weeks I’ve lost 4lbs and an inch and a half off my hips and waist – which bodes well.

Last week I went back over the job description to remind myself why I wanted it (and to put some of my worries about the pressure of it into context) and then I drove over to the school – partly to suss out the various routes I can take on my daily commute and partly to remember exactly why I was so excited about working there in the first place.

It all worked and now I feel a little clearer and more positive about it all. Yes, it’s going to be really hard getting back into a work routine again, especially in a totally new role and environment. But it won’t be impossible.  I’ll be home by 5pm every day (in time for Pointless* – yay!) and if I feel exhausted I can just have Nanna Naps in the evenings and at weekends. It’s term-time-only, so I can also take advantage of the frequent holidays to rest up and recover. And besides all that (and most importantly) I’ve also remembered that I’m really lucky – I’ve been able to take a full year out for treatment and recovery, whereas many people have no option but to work through all of it. For that, I’m massively grateful.

So, there we go. Just a week left to psyche myself up (and try to relax!) ahead of A Whole New World Start!

 

*Other TV shows are available

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Happy!

Three positive things to mention:

1. Being asked to share my experiences of breast cancer in an online article, thanks to someone reading this here blog (wish I could’ve found a better photo though!)

2. Trips away. Have spent the past couple of days celebrating our 3rd Wedding Anniversary in Chester, where we got married. Despite the bone-aching side-effects of Tamoxifen, I still enjoyed/endured lengthy walks around the zoo, the city centre and the river. I ache like an achey thing in achey land during the festival of ache, but it was just so lovely to be away with hubby, with lots of time to do everything and nothing.

3. The letter received today from the Breast Clinic Department that says:

“The results of your recent breast mammography are now available and I am pleased to inform you that there are no radiological features to cause any concern.”

I think that’s more commonly known as ‘being given the all clear’.

I didn’t actually think it would affect me very much, but on reading those words I got hit by a huge wave of relief, and after hugging hubby I had a little, grateful cry.

It’s gone. I knew it had after chemo and surgery, and I knew the radiotherapy would zap anything that was left over. I know the Tamoxifen should keep any nasty little ER receptive cells blocked. But I just needed that confirmation that no, it hadn’t snuck back up on me while I was trying to get myself better. It’s gone. And with luck (and medication!) I’m hoping it will never come back.

I can now officially say it – I’m cancer-free.

I kicked its arse, good and proper.

So..what now? Well, I’ll still update this blog from time to time with updates on side-effects, recovery or anything I feel might be useful or interesting*. But for now, I’m off, happy to be ‘all clear’, happy to be planning some good things for my ‘not-bucket list’, just…

Over and out.

*You can’t get rid of me that easily! Bwahahahaha!

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