Highs and "lows"

How tamoxifen works, from a paper not terribly relevant to me but still interesting

In the last post, I talked about endocrine therapy: what it is and how it works. With my diagnosis, I am relegated to 5+ years of endocrine therapy. In my case, for now, it is tamoxifen.

High: starting new medication that keeps cancer at bay

As I mentioned, it's been around for a while and is generally well tolerated. My doctor said I could start any time so I just said screw it, let's get this f-u estrogen party started. With the addition of endocrine therapy, my risk of cancer recurrence in the next 9 years is <3%. Definite high.

I got the prescription filled and on Saturday, I entered yet another whole new world and good lord I am tired of that Disney song now. I'd like to be done with whole new worlds please.

Tamoxifen comes with a patient information pamphlet that is dense and long. I of course undertook to read the whole thing. As I lay in bed, folding, shuffling, refolding the very thin paper to a size I could actually read in the very fine print, I said to Stephen that it was not simple. "I don't think they make that so you can read it, Kris."

Fair point. It was definitely not done with accessibility in mind.

Anyway, I read all the side effects and their frequencies in all the studies. Nausea was extremely rare (WOOT). Hot flashes were the most common. It takes several days for the medication to reach the full, long-term concentration in the blood because of the way we metabolize it, so I'm about at that point now. 

So far, no hot flashes, but the headaches and insomnia are real. And probably linked to the insomnia: a bit of space cadet feeling. Not terrible, but I am not at my prime. I'll ask in the follow up how long this typically lasts if I am still having side effects, but hoping they resolve themselves.

Still, these are so far extremely minor. The headaches are not migraines. I can work through them (if a bit more slowly and perhaps intentionally). Insomnia sucks but I have the luxury of a job where I can generally pop off and nap as needed and come back and work later. I let my team know what's happening (I've tried to be as transparent with them as I can since this affects them in the work they have to pick up), and so far, no one has expressed anything but support.

Low: back 2 life, back 2 (a new) reality

Now that song will be in my head all day.

I didn't mention one other thing my oncologist mentioned in the appointment.

Alcohol.

Before cancer, I had a drink (just one) on most days. It was part of our end-of-day ritual where we'd sit down, talk about the day, and unwind. 

After surgery, of course, alcohol stopped being a part of the day because it didn't seem ideal to do to my body during recovery. My amazing friend Deirdra got me a bottle of Lyre's non-alcoholic beverage and that went fast. I've had a few other things (including a host of things from Lyre's now) and some weird sage drink that is reasonably tasty...and haven't so far felt like I'm missing out.

But also, if you got here from my instagram account, or know me IRL, you know that we have a propensity for beverages.

The oncologist mentioned that higher alcohol consumption is implicated (cause? correlation? not sure) in breast cancer. Her advice was not to stop entirely, but to limit to three drinks per week.

I must have grimaced because she said, "I KNOW. I love my wine so every time I have to say that to someone, it hurts." So I have an oncologist who gets me. That's great.

Still...I will be sad to cut back on this small ritual, even if I'm glad that I don't have to cut it out completely. 

As with everything, these are small prices to pay, and while I call it a Low...holy shit am I lucky that that is all I have to give up so far.