Hormone Therapy and Lymphedema

This isn´t the sexiest title I´ve ever come up with, but I do have some more cancer related information to impart to you, so this will have to do. Today is Saturday and here I am, bright and early at Clinica Alemana, receiving my antibody treatment. Jon was a trooper and set the alarm at 7:00 so he could walk the dogs and gather our various Apple gadgets in preparation for the long morning ahead. Luckily the outpatient oncology wing is open Saturday mornings until 1:00, so if I get here at 8 I can just squeeze my five-hour session in. This is great because it will prevent me from having to miss class time during the school day. But also unfortunate because every third weekend I will be waking up early and spending a good chunk of my weekend in the hospital. Unfortunately, the oncology secretary was very reluctant to schedule me in since my treatment takes so long, which I found very frustrating. Work with me, people…. Work with me! Anyway, so far it has been a quiet morning. The oncology nurse rode the elevator up with us from the parking lot and Jon and I are the only people here, typing away in silence. Strangely, I somewhat enjoy my treatment times because it gives me a chance to sit and breath and think about life. It also gives me some quality time to write. In addition to keeping up with this blog, I am also thinking about writing a fictional novel about teaching, so that is exciting as well.
This week I also began the final stage of my regular preventative treatment regimen. I am now taking a daily hormone therapy pill called tamoxifen. Hormone therapy is a standard treatment for all women whose cancer is estrogen positive (HER+). According to the internet, tamoxifen, along with Herceptin, is considered one of the biggest breakthrough drugs for breast cancer patients. Basically, it is an anti-estrogen pill that binds to the hormone receptors in the cells so that the cancer cells won´t. Not being a science person myself, I find it fascinating that this small, round, white disk of a pill that I take every morning with a swig of water and a swallow of banana is currently fighting off potential cancer invaders. Amazing! Of course Dr. Majlis told me precisely nothing about the drug or its benefits/drawbacks and so I had to do my own research. Like usual, he said there were no side effects and nothing to worry about. I decided to get a second opinion from my fellow breast cancer patients by posting a question on the internet boards. I found out that for many women the drug basically simulates menopause and the women have terrible hot flashes, night sweats, and nausea in the mornings. For the first few days I felt these symptoms as well, but they have subsided as of late. In addition, some women have gained about ten pounds as a result of the pill. Awesome! Just what I need five months before my wedding… Thank you, cancer drugs!
Which then made me realize that I really need to figure out whether or not I can start exercising in order to combat this potential ten extra pounds. It has been very difficult to get a straight answer from my doctors here about what kinds of exercise I am allowed to do, and so I have been doing my own research on this topic as well. Whenever I feel like I might not have been given all of the information I need in regards to my health or my treatment, I always go to the women on my breast cancer apps for additional support and information. For example, when the radiologist told me a few weeks ago that I should never again use my left arm to exercise I thought, “Hmmm… forcing your arm to limply hang from your shoulder socket for the rest of your life can´t possibly be the only solution for the thousands of women who´ve had lymph nodes removed during their surgeries.” So I asked the ladies on the app and came back with an overwhelming number of responses that indicated that limiting exercise was an outdated philosophy regarding lymphedema. In the United States, most doctors now recommend working with a physical therapist doing stretches and exercises to strengthen the arm. They also prescribe a lymphedema compression sleeve to wear while exercising so that it would force the fluids that could possibly build up to circulate through the arm. So I put Randi to work attempting to procure me a compression sleeve at UCLA hospital where she works. Last weekend I was gifted a beautiful box with a smiling blonde woman on the front wearing her nude compression sleeve with a cute spring outfit. Well, after Jon and I attempted to tug that thing onto my arm I decided that I was less enthused with the aesthetics of my new accessory, but happy that I can now exercise without worrying if my arm is going to swell to the size of an elephant´s limb, which can apparently happen. In my last meeting with Dr. Majlis, I mentioned the compression sleeve and somehow got him to recommend that I use one when I “make exercise”. So, whew! Now I can wear it without worrying that I am going against my doctor´s recommendations.
The third breast cancer related news of this week is that I have again started the reconstruction process. You may recall that before my radiotherapy my plastic surgeon had begun filling my expander, but then had to remove the liquid before radiation could take place. I then had to wait a month after the radiation for my skin to properly heal so they could begin the process again. On Monday Dr. Schwember filled the expander with 50 CC of liquid, which he will do every Monday for the next four or five weeks until the left breast matches the one on the right. Unfortunately I had forgotten how painful the expander is for the first few days after a filling. Remember the soreness and tenderness of tightening your braces? Well, it´s like that, except it affects all the skin and muscles in your upper torso, shoulder and neck. The weight of it is very heavy and it is basically as hard as a rock for the first few day,s which makes it very uncomfortable to sleep, bend over, cough, laugh, or really do anything which involves chest movement. I can´t wait to feel like that for the next month! But I know the end result will be worth it, hopefully. Sometimes the muscles and skin don´t stretch the right way, depending on how good of a job the surgeons did, sooooo we won´t really know until more liquid is put in. Currently most of the liquid is sitting pretty high up on my left shoulder, just under the collarbone, so I hope that it falls a bit. Most women who have a singular mastectomy often have to have a lift done on the other side to make the breasts match. I´m assuming that will be the same for me. We shall see. And thus ends one of my least interesting blog posts yet. Stay tuned for more adventures of cancer Eli! Hopefully the next one will be less scientific….