Vacation from Tamoxifen

I've been under the weather for what seems like way too long. On Tuesday night, I noticed I had a sore throat that started around bedtime. Then my daughter woke us up in the middle of the night to tell us her throat hurt, and in the morning woke up crying and saying she couldn't go to school (which means it's bad, because Ellie loves school). Unfortunately for her, not going to school meant coming to physical therapy with me, then up to work, where she took a nap in my office then threw up in the trash can outside my office. We came home after my work meeting and both took a nap. The only thing worse than taking care of a sick kid is taking care of a sick kid when you yourself are sick. Ugh. By Thursday, Ellie was fine, but me... not so much. I don't feel sick sick, just under the weather and very blaaaaah. And I feel like I'm getting progressively worse rather than better.

Anyway, I'm not writing this as a woe is me post. I'm writing this because I saw my oncologist on Friday, and I was feeling pretty dang crappy at the appointment, and NOT because I was hungover, haha. In fact, my litmus test for sickness is my desire for alcohol, and the thought of wine has repulsed me for four days. The tricky part about being sick is that the appointment was to discuss how the tamoxifen has been treating me, and it's hard to know when you've been feeling soooo crappy for the past few days. The tamoxifen does seem to have some side effects, but of course it's hard to know what is the tamoxifen and what is the cold and what is just... life.

I told Dr. M that the tamoxifen wasn't as bad as I was expecting, which admittedly isn't saying much. Then I mentioned that one thing I've noticed about the tamoxifen is that, in a way, it makes me feel like I'm pregnant: I have a bit of nausea in the morning, higher than normal levels of fatigue, and unexpected aversions/cravings where food is concerned. Then he looked at me suspiciously and asked, 'You aren't pregnant, are you?' I sat there for a second, shocked, before I was able to reply, 'No. NO! I'm definitely NOT pregnant!'

We then discussed the fact that a lot of what I'm feeling isn't textbook tamoxifen, so it may or may not be due to side effects. As Dr. M pointed out, I have been through a lot; I should be tired. That actually made me feel a little better, because I feel like at this point I am supposed to be normal and happy and cherishing life and making the most out of every day because, after all, YAY I AM A CANCER SURVIVOR! Or something like that. But I don't feel that way; I feel pretty blah and crappy - sort of like I had my abdomen sliced open, scooped out, and super glued shut in the recent past! Dr. M nicely pointed out the latter to me, while at the same time not dismissing my fatigue altogether. It could be the tamoxifen. It could also be something else - a thyroid problem, for example. He also mentioned that my MCV (mean corpuscular volume) from my blood draw last week was a little low, which suggested I might be slightly anemic. We also talked about my on and off insomnia, and how that could be a factor, too. He asked me if my insomnia was a 'pre-existing condition' and I said yes, though the tamoxifen certainly isn't helping, because I do have hot flashes at night that wake me up.

The thing is that none of this really matters. There is no alternative to tamoxifen, other than not taking it, which would not be a prudent decision, IMO. I mean, I could always go for the ovarian suppression + aromatase inhibitor, but that would almost certainly have worse side effects. Nevertheless, Dr. M seemed to feel that we should try to tease out the real effects of the tamoxifen to make sure we aren't missing anything else that needs attention. Once we are more certain of the side effects, we can perhaps work toward managing some of them, as needed. As he said, 'I don't want you to be miserable for the next ten years.' Oh yeah? Me neither.

With that in mind, Dr. M invited (yes, invited) me to 'take a two-week vacation from tamoxifen.' The cancer isn't going to come back in two weeks, and 'If the clouds part, and the sun comes out, and you're like ahhhhhhh! then at least we'll know it's the tamoxifen.' Then he said, 'I have a Ph.D. in biology. I understand how it works: you eliminate one variable at a time.' LOL. I joked that he should come in and cover the cancer section in my classes. (And being that he is no Dr. T, he pretty much rolled his eyes at me and said Chhhhhyeaaaaah, right.) He also said that it couldn't hurt for me to take some supplementary iron or try to beef up the amount of iron in my diet to address my low MCV.

As much as I'd like to be like to be like YEEEEHAAAW, no tamoxifen for two weeks! I've decided to give it some time. Whatever the side effects, they are really not terrible. Plus, if I stopped taking it right now and started to feel better, I wouldn't know if it's because this damn cold finally got better or because I stopped taking the tamoxifen. Plus, I think I'm going to re-start taking a multivitamin, and wait, wouldn't that be introducing two variables at once?! See? I understand how biology works, too. LOL. There are so many moving parts in my life right now, there's no way to completely pin down what is causing what, but I will definitely take Dr. M up on his invitation at some point between now and my next appointment with him in six months.

In other news, I e-mailed Dr. T to tell him I was backing out of the surgery. The grown-up professional in me told me I should call him, but then I figured that would be more of a bother for him. Besides, if he were a normal doctor, I would not have his cell phone number, and at best I would be able to call the office and leave a message for him, or e-mail him through the patient portal. I thought I would feel really good after I canceled the surgery with his scheduler and let him know, but then the insecure schoolgirl in me stressed until he responded: No worries, Waning. I support you any way you decide to go. Have a wonderful holiday.

I'm really going to try to have a wonderful holiday. As I told Dr. T in my e-mail, I need a vacation from thinking about all this - hips, cancer, everything. I feel like my stress levels have been rapidly rising as I realize that it is almost December, and before you know it, it will be January, and I will have to go back to work. But that is getting ahead of myself. I really need to stay in the moment and enjoy the remainder of this year for what it is.