Change of Direction

Unfortunately not in dancing.

Yesterday I saw the endocrinologist. I hope you never had to experience a doctor telling you that she can’t help you, as that is what happened to me yesterday.  She had a look at all my bloodwork, my history, etc. and told me that other than prescribing a medication for weight loss (which may not be covered by my medical plan), there is nothing she could do for the PMDD, high estrogen levels and low progesterone levels that would not put me at high risk for cancer recurrence.

Needless to say, I left her office feeling pretty defeated and like I would be spending 2 weeks of every month for the next 20 or so years being non-functional, depressed, and sick.  On top of that, after almost 2 years of absence, my period returned signalling a clear sign that I am no longer in ‘chemopause’.

The one thing she did tell me was to go speak with my oncologist, which was the next stop I made.  I haven’t seen him in almost 6 months but I was able to sit down with him and explain everything that was going on.  He was concerned about my estrogen levels being so high, especially while taking hormone therapy as that in itself is a risk for recurrence.

I asked him about returning to taking the progesterone supplements I was taking before diagnosis to balance out the high estrogen levels and he said it would be risky.  Then he suggested something that is a rather newly approved treatment for preventing breast cancer that also coincidentally dramatically lowers estrogen levels–ovarian suppression.

Basically, I am injected with a small ‘pellet’ of medication that shuts off my ovaries and puts me into chemical menopause.  It has the same side effects as menopause (hot flashes, body aches, fatigue, increase risk of osteoporosis), which I experienced over the past 2 years already.  There is an option of an injection 1/month or once every 3 months.  The issue is that once I have been injected, I have to live with the side effects until it wears off.

I did some research on the medication (called zoladex) and discovered it has been used to temporarily treat women with PMDD to see if an oopherectomy would solve their problems.  Many of them reported that despite the menopause side effects, the ovarian suppression dramatically changed their lives–for the better.

Everything about it made sense and I am not willing to live only half my life, so I have decided to go for the ‘hail mary’ and try the injection for one month.  I have to increase my calcium supplements, but other than that, my fingers are crossed.  I was injected this morning.  One unexpected bonus is that the pellet is injected into my belly–where I still have no sensation so I couldn’t feel the injection at all.

I was told to expect an estrogen surge over the next couple days which will make me emotional and achy, but that it will subside.  The surge somehow leads the brain to tell the ovaries to shut down.

So far today, I feel good.  I had a couple hot flashes, but not very intense ones and a few moments of feeling light-headed.  One thing I will say is that around 2 pm I felt almost like a wave of calmness come over me and suddenly I did feel better than I have in over a month.  I have had a few more dizzy and light-headed moments since then, but the calmness seems to be staying–and I hope it lasts.

I can honestly say that there were moments today when I felt more like myself than I have in a very long time.  It seems strange to want to be in menopause, but one thing I can say is that even during chemo and after while the hot flashes were at times very difficult to deal with, overall I felt stable and even.  I hope that this medication will have the same effect on me.

Being in menopause will make my weight likely difficult to manage, but it is hard to say.  I lost my most weight while taking progesterone supplements to balance out the estrogen in my system and that is apparently unusual.  If my medical plan does cover the weight loss medication the endocrinologist prescribed I will try it for 3 months to see if it makes a difference. My family doctor is optimistic they will cover it.  Fingers crossed.

If all goes well, I will be injected again in early January (every 28 days for now), just before the competition I am preparing for.  I am hopeful everything will go well and this won’t interfere too much with the competition or my preparations for it.

I am more than ready to feel better. Even my oncologist told me I was due for something to work out for me, and perhaps the ovarian suppression plus the weight loss medication will be a ‘double whammy’ for me that will allow me to get back to being fully myself.

I feel good about the decision to do ovarian suppression, even though it was a hard one.  Looking to the future, if the suppression is effective I will give serious consideration to having my ovaries removed for a more permanent solution.  It is not ideal, but it would free me from the injections and the PMDD, and while it would cause surgical menopause my body would adjust to it just as it would to natural menopause.

The other thing that happened today was that I was referred back to acupuncture to help with the side effects I will feel, especially the joint and bone pain.  It was really effective for me during chemo and radiation and I am hopeful it will help with how I feel overall.

It’s been a crazy week and it certainly has gone in a different direction than what I expected.  There has been dance this week, I have a new paso routine and some modifications to my rumba routine.  One more lesson tomorrow and rounds practice on Sunday.  I will try to write more about dance and my competition prep soon.

Fingers crossed this is truly the beginning of the end of this long journey.  The past couple weeks have been reflective for me so I will write a bit about that.  I do feel like I am coming out of a shell and resetting and I have some very definite ideas for moving forward after my next competition.

Until next time–wish me luck that this ‘hail mary’ will work….with few side effects.

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