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Dr. Z, drugs and breastfeeding

March 21, 2018

We met with Dr. Z on Monday afternoon. He explained that for him, the PET scan was not to check my breast area – just to check for spread to other areas. He apologized a couple times for not making that clear since it led me to think that I was free of cancer altogether.

His recommendation is to have a mastectomy. I wasn’t surprised since during my last visit he said something along the lines of “if this comes back with more cancer, we will have to consider that your breast is trying to tell you something.” Part of his reasoning for mastectomy vs. another lumpectomy is that as you remove more and more breast tissue, (besides looking bad) you can eventually run into more complex issues like cancer getting to the chest wall. Ugh. He did say that the surgeon might recommend something else, but that is what he thinks personally.

I asked him if he would recommend removing both breasts. He said no, and in many more words (AND while acknowledging that he was being recorded), stated that he doesn’t like how ready many doctors are to remove healthy breasts without adequate risk. His demeanor about this as well as his actual response were very comforting to me since I also feel strongly about unnecessary mastectomies.

We brought up the issue of the current dynamic we have with my surgeon. Again, his response was just right – immediately recommending a surgeon he knows who is like-minded with him, thinks outside the box, is very kind, etc… He also confirmed what we had been feeling from my surgeon (“my way or the highway.”) It still feels a little weird to be quitting a doctor, but as with all the rest of this, how other people feel should not/can not be a determiner in the choices of care that I make.

I had a list of questions with me, because it’s so easy to forget when you’re in there. We talked about whether I should continue the other hormone stuff I’m doing with Dr. B (natural estrogen blocker, progesterone and testosterone) since I’ll be switching to Tamoxifen. He said for now I should stop so it doesn’t muddy the waters.

Next we talked about Zoloft. (And I’ll give you some related back story). I started taking it in February 2016 when I was diagnosed with postpartum depression. It was hard for me to do, but I’m so glad that I did. That is a story for another day. (And, just so you know, me being able to put that out in so public of a forum is a huge testament to the growth I’ve experienced over the last few years.)

When you stop breastfeeding, there is another huge hormonal shift and some women experience depression. I was hoping to avoid that by continuing to take the medicine until my hormones had stabilized (post pregnancy and breastfeeding.) I thought Elin would wean at a year like the other two had, but she was still breastfeeding last fall (at 2 years 3 months) so I was still on it. After surgery, she still nursed on the left side. It wasn’t until I met Dr. Bergeron that we quit. He told me that the hormones that stimulate milk production are stimulating activity in the breast, which was what we were trying to avoid. He also explained that at that point, battling cancer, I needed to keep all the good stuff my body could produce instead of passing it on to my child.

I went home that day and told her the doctor said we had to stop, and she did pretty well with it. It was a lot harder on me than I had expected though. I was ready to quit. I had never imagined that I would be nursing a 2+ year old child, but she’s my last child and it was a mostly sweet time for us. It forced me to be still a few times a day. And, it was so sudden. With my hormones all amok, us going into winter, and me in treatment, we all agreed that I would continue taking it. (No one needs to be fighting depression and cancer at the same time if they can help it.)

At the beginning of the year, I started feeling like I was ready to go off of it. I had been feeling stable for a while, and was starting to think I need to be able to feel more. There were times when I thought “this is really funny, I should be laughing my face off” or “I feel like I should be crying about this, but I’m not.” I’d like to know what 37 year old me is like without extra hormones or medicine. I’d like to stop worrying about tooth decay because one of its side effects is dry mouth. Things were also looking good cancer-wise, so I had hoped that with spring coming, when I got back from Haiti I would start going off it.

But alas… here we are. So Dr. Z recommended I switch to lexapro. He said it could also help with potential side effects from tamoxifen. Ugh. Taking drugs to deal with your drugs sucks. So does having cancer.

I went home with a prescription for tamoxifen and lexapro. I felt fine. We talked on the way home and agreed that none of this was really a surprise. This cancer continues to be a bigger beast than we anticipated, so we are having to fight it harder than we anticipated. It wasn’t until close to bedtime when I started reading about women who had had a mastectomy that I got really sad. I read about a woman and her husband having to mourn the loss of her breasts. It’s a big deal. You lose part of your body. And it affects both of you. It’s also a scary surgery. So I cried and wished I wasn’t dealing with this. Jonathan hugged me and comforted me and then reminded me that we don’t even know if that’s going to be my story. At this moment, I can’t be wasting energy crying over things that I don’t even know will happen.

So now, we wait to see the new surgeon. (And as I was writing this, I got an appointment with her for next Monday morning.) We continue to ask for prayer for clarity. For agreement among the doctors so I can have peace in my soul. And obviously for healing.

More later. It’s dinner time.

2 Comments leave one →
  1. Lisa Frisby permalink
    March 21, 2018 17:15

    Thank you for sharing this with us Grace. I am praying for God to direct you, Johnathan and your doctors & the choices.
    Standing with you in prayer & hugs!
    Love to you,
    Lisa & Bill

  2. Jessica permalink
    March 22, 2018 09:41

    Keep writing. Keep fighting. Keep being the funny, witty, smart, kind, loving beautiful soul you have always been and are now. You Always inspire me Grace. Big Love and Hugs. #Godisbigger ~Jessica.

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