Saturday, July 21, 2012

Less is More: Tamoxifen "accessories"

I jokingly call the the new things I have acquired "accessories". The new things I have gained came out of nowhere over the last 8 months. I didn't ask for these accessories nor do I want them.

I started taking Tamoxifen in August 2011. I got "lucky" at first and didn't have the weight gain and hot flashes that some people do. What I didn't know is that my normal/ typical uterus and ovaries were becoming an internal farm over those 8 months. At first it was only irregular periods, but they never got regular - that's when my gyn stepped in and set me up for a pelvic ultrasound.

If you never had a pelvic ultrasound, invasive is putting it mildly......you could say I am dating an ultrasound wand at this point. I "get" to have these dates every 6-8 weeks to see how the accessories are doing and if there are any new additions.  At first, there was only 1 cyst on my left ovary and an 8mm thickening of the endometrial lining. At my next "date" this one cyst had become 2/complex cysts, the left ovary was enlarged and there was a new cyst on the right ovary.
Clearly, this was not going to resolve itself as my gyn, and I, had hoped. 

At the following "date" night, I learned that more accessories had been added to my collection. I now had the 3 cysts (still there and slightly increased in size), an additional 10mm thickening of endometrial lining (for a total of 18mm), polyps and a fibroid in my uterus. 

I struggled to understand how my perfectly normal uterus and ovaries had turned into a dumping site for extra pieces and parts. I didn't have these things before I started Tamoxifen in August 2011, but there I was in June 2012 over accessorized.

In fashion, we are told to stop and take off one piece of jewelry before we leave our homes - because less is more. In my case, removing an accessory wouldn't be that easy. 

I ask for all the options. I was given the "wait and see" approach, possible surgery (loss of both ovaries) to remove the cyst if they became too painful and changing breast cancer drugs (requires shots to throw my body into early menopause so I could take the post-menopausal drug). Obviously, none of these were very exciting. 

After some serious soul searching, praying and ice cream, I decided to stop taking Tamoxifen. I told my onc and gyn about my decision - they were sort-of ok with this. My onc wanted me to say "hold off" on Tamoxifen as opposed to "stopping" Tamoxifen. I will still have my regular follow up appointment with my onc in October 2012 and we'll talk about this more.  
(side note: I am so happy that I have a great team at the hospital. They are supportive of my concerns, ideas, questions, etc. I'm sure they figured out early on that I was not a "follow standard protocol without a million questions" kind of girl) 

The last day I took Tamoxifen was June 28, 2012 and as of today, July 21, 2012, I feel good. I no longer have pain in my ovaries (one day one side, next few days the other side), no longer have spotting everyday (pantiliners should never become your best friend) and all that bloating in my abdomen is decreasing.
My hope is that on my next date with the ultrasound wand, there will be no new accessories and possibly some shrinkage of the current ones.

I'm not sure what the future holds but I do know that I am comfortable with my decisions. My choices are not for everyone - and should not be for everyone.
I also know that I am tired of "dating" an ultrasound wand.