I saw the endocrinologist today, and – lo and behold! – I left with a scrip for Climara, a low dose (.0375 mg per day) estrogen patch.
It was not a decision she made lightly, and she wants me to add an SSRI at some point (I agreed, reluctantly, on the condition that we start with estrogen supplementation alone, so I can more easily judge where effects are coming from – and she agreed).
The relief is amazing. Whether or not this will be the ultimate answer to balancing my hormonal needs, it’s an amazing relief to have a doctor who listens, and who trusts me enough to know that I’m capable of understanding and evaluating risks/benefits around my own health. Finally.
I ended up with the generic, same dosage but made by Mylan. Picked it up this early evening, swiped off the appropriate acreage, and slapped the sucker on. It’s a bit bulky and stiff, not exactly attractive, but if it works, I can deal with that. It should be good for a week, then I’ll peel it off and repeat the process (though in another area, in order to reduce the risk of skin irritation). Results should start to show up in a couple of weeks – though knowing me, it’s likely to be sooner.
She also agreed with my analysis that my ovaries are most likely utterly fried; I might as well as have had them out for all their functionality (and that’s judging by the levels taken early November, before I went to Scotland, before things got really grim). Now what’s important to understand about that is that even after menopause, the ovaries continue to produce hormones, albeit at a reduced rate. If mine aren’t working at all, my baseline levels of hormones are going to be inadequate for meeting my body’s needs – and that’s pretty much just what I’ve experienced.
(for a more complete discussion of this see: http://surmeno.blogspot.com/2006/03/surgical-menopause-definitions.html. Yes, the author is referring to surgical menopause, rather than chemical but, in my case, the reality is much the same)
This not only has the obvious immediate effects on quality of life, as I’ve so amply demonstrated, but causes long term health risks (most notably in terms of cardiovascular health and bone health).
When I entered chemotherapy, I knew there would be four months of hell. I knew I’d lose my hair, I knew I’d likely lose some brain function, I knew there was a possibility of neuropathy. I wasn’t happy about any of that, especially the brain function, but I put it on the table, I made that trade with my eyes open. I agreed to it. And it has come to pass, and I’m not best pleased, but it’s the trade I was willing to make, the trade I agreed to. There’s no such thing as a free lunch.
This other, this chemical castration, I did not agree to. What I am doing now is attempting to right that balance – to restore to my body something close to the levels of hormones I would naturally be producing, the levels of hormones my body and mind need in order to function.
The relief of finding a doctor who will work with me, who is willing to – o, it is beyond words.