Two Months into Menopause

Some days are hard: breast cancer is the first thing I think of when I wake up, and like an unwelcome visitor, refuses to leave. 

Other days, I wake up and do what I love, and hours pass before the visitor rears it’s ugly head. Yesterday was one of those days. 

My first ride outside on the tri bike this year, and my first 60 miler. It was heaven - fresh air, sunshine, feeling strong and fast. 

In a different universe, I’d be deep into training for Ironman Coeur d’Alene, pushing my watts, and prepping for 140.6 miles of racing. In my new universe, there’s an unwelcome visitor - but some days, it sits quietly off to the side and doesn’t make its presence felt. I love those days. 

Three months since mastectomy, two since oophorectomy. In menopause, on an aromatase inhibitor (hormone therapy) for ten years - this isn’t exactly where I thought I’d be right now, but life is full of curve balls and unanticipated challenges. 

I’m so thankful for days like these, for what my body can still do, for the reminder to cherish every single moment. Grateful for a cold Diet Coke and some salty Fritos after 60 miles. Falling in love with my #quintanarootri bike again, and grateful for the chance to race next week. Oh, and #fuckbreastcancer 

Breast Cancer Patient Takes Care of Breast Cancer patient

 A few weeks ago, I was hiking in the sunshine, loving the spring weather, and feeling great, physically and mentally. 

This week, I went back to work. I took care of a breast cancer patient, who but for her hair and eye color, could have been me. In the moment, I did what I always do as a doctor. I took care of the patient. 

But I looked in that bed and saw what could be my future in 5, 10, 15 years or less - and when I got home, it broke me. It slapped me in the face with what might be - thoughts I’ve worked so very hard to push away. 

Thoughts I’ve consciously replaced with: It won’t come back. It won’t be me. I’ll outlive my cancer’s ability to regrow, and I’ll have a normal life expectancy. 

It took weeks of mental work to focus on those positive thoughts, rather than the terrifying alternatives. And last night, it was all undone. I feel like I’m back to where I was January 27, when I heard the words “It is cancer.”

I love my job, and I am so happy to be back amongst my night crew - for the most part, it is a welcome and happy distraction for my mind. 

Not seeing myself in every breast cancer patient will remain my challenge. Not letting my mind’s recovery be derailed by what might be will require strength I’m not sure I have. Maybe it will get easier each time - or maybe it will get all the more real, and even scarier. 

8 Weeks Post Mastectomy

 Eight weeks post double mastectomy, four weeks post oophorectomy. I love a prescription for exercise! With all due respect to the natural aging process - suck it, menopause. 

This weekend’s adventures included more time outside in the saddle, and trying out some new-to-us local pools. 

I finally feel like myself again - in the pool, and in my body. Swims are getting stronger, rides faster. Yoga every day and physical therapy once a week to keep my body healthy. Goals, small and large, to focus and strengthen my mind. 

Let's Talk About Aromatase Inhibitors

Let’s talk about aromatase inhibitors (AIs). Since ridding myself of estrogen-producing ovaries, the next step is to start medication that will wipe out any remaining sources of estrogen. 

AIs are from a family of drugs that are androgen/estrogen antagonists, or hormonal oncologics. The bottle says take 1 per day “for cancer”. It should say “to prevent cancer recurrence” because with all due respect to the pharmacy, I don’t have fucking cancer anymore. 

I will, however, take this drug every day for the next 5 years that I can tolerate it. Its job is to prevent any rogue cancer cells from taking hold and growing, because it blocks the enzyme (aromatase) that converts androgen to estrogen, and without estrogen, my cancer cells can’t grow (so goes the theory). 

Some women have no side effects. Others have crippling bone and joint pain, hair loss, weight gain, night sweats, hot flashes, hyper-cholesterolemia, fractures, and osteoporosis. 

The side effects can be so bad that I enrolled in a study to track my adherence to the medication; they will provide mindfulness and other techniques to help me adhere (see the cool pill bottle with the micro USB port? It knows every time I open the bottle...). 

These side effects are to be weighed against the very terrifying possibility of my cancer coming back, should I decide not to take the drug - they would probably have to be horrific for me not to take it, but I guess we’ll see. I don’t think anything could be as bad as the fear of cancer coming back, but for some the survival benefit isn’t worth a survival of suffering. 

Tonight begins this next chapter of my breast cancer treatment, and the official start of tracking me with the pill bottle. Here’s to five years....