Tomorrow I start the last five days of radiation, what they call the 'boost', when they target just the area of the lumpectomy, rather than the entire breast. So far, I basically have no irritated skin symptoms. Interestingly, the Indian doctor today said that while she typically saw fewer skin symptoms with Indian skin than white skin, African-American skin often showed fairly intense symptoms. So it's not just melanin at work there; weird. Regardless, I'm grateful. I haven't really had noticeable fatigue either, I think. For me, radiation has been boring and time-consuming, but neither painful nor traumatic.
In the meeting with the oncologist (whom I really love, btw -- she is just excellent; smart, funny, thoughtful, thorough, knowledgeable, empathetic, kind -- couldn't ask for a better doctor, and thanks again to Anne Marie Murphy for the recommendation), we reviewed the last several weeks, and then talked about a few other things. Specifically:
- on the shape of the breast, she says it'll keep shifting for a few more months, and they usually recommend waiting until at least six months after surgery before looking into reconstruction as an option. She said that as the swelling from the surgery continues to go down, the breast will lose even more fullness, and if it's bothering me, I could get fitted for a prosthesis to fill in a bra with -- so far, I think I'm okay without one. (I can't say I'm happy about how it looks, but I think I'll save more discussion of that for another post.)
- my type of cancer is receptive to hormone therapy. There were a couple of options, but one isn't recommended for me until I'm in menopause, the other would require monthly self-injections in the stomach to put me firmly in menopause, and the third, Tamoxifen, is just a daily pill. I opted for the pill, which was also her recommendation (and then twelve months after the surgery, which I should be firmly in menopause, I can switch to the first option if I want). Tamoxifen blocks the actions of estrogen, and the side effects seem likely to be fairly minimal. Well see. I'll start taking it in a few days, when it arrives at my house via mail order prescription. (I did not actually know that was a thing. Convenient!)
- we talked about whether I'm in menopause or not, and she says that my ovaries may still be suppressed from the chemo, so they say to be careful with birth control until I've gone a full year post-surgery without a period. She asked if I was having any menopause symptoms: irritability (check), trouble sleeping (check, although a bit better since the semester ended and I started exercise classes), hot flashes (not yet). So, maybe?
- she asked if there was anything else, and I admitted that I was actually kind of stressed out and anxious (hence the terrible sleeping) -- that things like the Herceptin treatments, the holidays, etc., were getting to me more than they normally would. She asked if I wanted some Xanax, which actually startled me -- I would never have thought to ask for some, but I think it was really perceptive of her to realize I could possibly use some. I told her I didn't take pharmaceuticals that often, and she said she could just prescribe a few, at the very lowest dosage, which I could leave sitting on a shelf. They'd be there if I needed them. I have to say, I found myself really relieved to say yes.
I think, like a lot of people, I have a lot of emotional resistance to taking psychopharmacological drugs; I don't like to think of myself as someone who needs them. But I think some of that is just ego. The Xanax was really helpful the one time I took it before (for the needles going into the areola, which was totally freaking me out), and having a few around over the next few weeks, just in case? I think that'll be good.