Wednesday, May 26, 2010

Benefits versus Risks

I cannot help but wonder about the benefits and risks associated with some of the medications taken daily in the hope that I will be given time, along with reasonable quality of life.

Towards the end of 2009 I commenced taking Arimidex, which belongs to a group of drugs called Aromatose Inhibitors. These drugs are useful when given to stop the production of estrogen. After three months on the drug I mentioned the debilitating joint pain to my oncologist. She told me to stop taking it immediately.

My instructions were to have a six week break and then to begin a course of Femara (belonging to the same group of drugs.) This was about the 10 December. Approximately 2 days later I began suffering unbearable pain in the right arm/hand. Palliative Care were summoned. I was given an injection that provided almost instant relief. Whew! Don't want to go there again! I believe I actually managed to put some sort of a Post together at the time. I had daily visits from my amazing Palliative Care team until both the pain, and medications, were stabilised.

My General Practitioner (doctor) suggested that the Arimidex may have been controlling the cancer. When it was withdrawn, the pain indicated that it was, once again, on the move. Of course we have no way of proving his theory.

Back to the present.

I commenced taking my Femara in February and there appeared to be no visible repercussions. That is until a routine visit to Dr Milton Sales, (my GP) about one month ago. Not only is this man caring, he is very thorough and believes that more things are missed through not looking than not knowing.

An examination indicated that I could possibly have a thrombosis in the right arm. Sure enough, I was referred for imaging where a Dopler showed a 9 centimetre blood clot. The concern being that it could spread up the arm and could easily move to the lungs or the heart. I commenced a 10 day course of Clexane immediately as well as being put onto a three to six month course of warfarin to thin the blood. This means regular blood tests to check that INR levels are between 2 and 3 indicating that the meds are doing their work.

While visiting Dr Sales yesterday, I mentioned that there was an unusual pain between the wrist and the elbow. He is now confident that the blood clot runs almost the full length of the arm. Blood clotting is a risk factor for approximately 1.2% of patients taking Femara. Dr Sales feels that the benefits outweigh the risks. I am not so sure but will certainly be discussing it with my oncologist when I attend clinic next Wednesday.

There is a 'fear' factor for me. Having experienced the uncontrolled pain of the recurrence in the brachial plexus I am reluctant to discontinue a medication that may well be working effectively to prevent the spread of cancer. I am hoping that my PET/CT Scan on Wednesday gives a clear picture. I am uncertain... finding my current situation quite challenging.

Every day I give thanks for the many blessings in my life and I pray to God to be given the strength to endure whatever it is my future holds.

Saturday, May 22, 2010

Playing Mind Games with Myself

These are tough times for me.

I was full of optimism with the move to 67 hectares (almost 200 acres) of bushland in the Hunter Valley in July 2008. The right to the 'good life' had been earned. Or so I thought.

Retirement is what dreams are made of. At last! The opportunity to have a vegie patch and do some of that travelling that had always been just out of reach. Why was it that my health began spiralling downward at that time?

It took 12 months of incredible pain, and many hard earned dollars, to determine the recurrence of the breast cancer in the brachial plexus. The only treatment offered was a 'super size' dose of radiation that left me feeling downright fatigued and yet, optimistic that I would have years to undertake the many tasks that had been put on hold following the death of my beloved Jeremy Jon just days after his 24th birthday in November 2006.

What happened? Why did the cancer eat into the nerves and muscles effecting the use of my dominant right arm/hand? For reasons that I do not fully understand, driving became more of a challenge. Quite possibly, it was the fatigue that plagued me, leaving me just too tired to keep my eyes open. I became less self reliant and more dependent on Haydn to act as my driver and my carer.

My hair had always been my crowning glory. I could go to the store in my house clothes, providing my hair was freshly shampooed and dried. I was secure in the knowledge that people had, for years, commented on my handwriting. The joy of sending greeting cards fast disappeared as I struggled to learn to write with my left hand. Not only had I lost the ability to take care of myself I felt like I was losing HOPE. No longer able to touch type, the frustration of becoming a one finger typist annoyed me. Yes! There is voice activated technology and I may well end up becoming more familiar with it, but for now my motivation is simply not there.

Life can be very cruel! I feel sure many of you will testify to that.

The countryside, once a thing of beauty, now has me feeling trapped. I seem to have lost my confidence in so many areas of my life. Unable to prepare a meal, I rely on Haydn to do the food preparation. I then have to bite my tongue when he shows little respect for my request to, PLEASE..chop the vegetables the same size allowing them to cook evenly. Thankfully, my obsessive compulsive disorder is not fully blown. I have not driven for months. Indeed, my days of complete independence may well be a thing of the past.

I sit here wondering just how I am going to get used to the life of isolation at the farm. If indeed, I have to.

My days consist of medications, indeavouring to keep the pain under control. Meditation, in an effort to empty my mind of the useless, damaging chatter. Exercise, to enable me to retain some use of this somewhat useless arm, thus preventing a frozen shoulder. The extraordinary Palliative Care team always a phone call away.

On my 'better' days, I realise that I still have a story to tell; history and information about myself. All the things that my children, and grandchildren, will one day look back on. An opportunity for them to get a sense of the 'real' me.

What do I want for them to see? Definitely not a wimp. Rather, someone with incredible strength and courage. Someone that did no give up just because the going got too tough. Someone that found the strength to dig deep and to use all that friends and acquaintances bring to the table. This is the time to make the most of all the cyber world offers. When I am unable to get to friends, then I will feel secure in the knowledge that they will come to my desktop.

How could I not smile knowing that I am in the PERFECT place....