Now She’s Well Again…

Right now, having been at .1 for just about two weeks, I feel my *self* again: I have energy; my physical symptoms are greatly reduced; I sleep well and wake rested; and the crushing weight of depression and fatigue is lifted. It’s good enough that I can almost consider lowering the dose – it’s as though I needed to fill in the backlog of need before my body could adequately supply the ongoing need.

(the only “side” effect I’ve noticed is an increase in the mild lympedema in my left arm & flank- weird, but true. I’m not noticing swelling, but a certain tenderness – and a mild increase in sensitivity in my left breast surgery site. On reflection, I figured out that this is far more likely a reaction to my increased activity level – I’m actually *doing* things, rather than merely sitting t my computer allowing entropy to take over my life – than a reaction to the ERT itself)

It’s fairly amazing… a complete turn-around from the past seven months’ downward trend, and very welcome.

I’m ‘me’ again – or close enough so that I can cope with the bits that aren’t matching up perfectly as of yet, which are mainly physical symptoms and are relatively mild. I want to stabilize at this state for long enough so that I can clearly recognize any changes that occur with the addition of a SRNI – and also just to give my body and psyche a rest from the turmoil I’ve gone through. It’s been a really rough year, from diagnosis to surgery to chemotherapy to radiation to the major and unexpected effects of chemical menopause.

And I recognize that part of that is justification for avoiding taking a medication that I fear – I’ve had such bad effects from psych drugs used for pain relief in the past that even though I *know* this is in a far different subset of medications, I still am unfairly resistant to it. I just got back to myself, I don’t want to lose that again. Add to that the known side effects of Effexor are some of the same effects that I’ve experienced already with chemopause, and I’m understandably reluctant.

I’m putting it off for now – I’ve filled the scrip, but I’m going to wait a bit before starting on emptying that bottle – and I’ll most likely start on a much lower dose than prescribed (looking at the scrip more closely, I found it’s actually prescribed at 150 mg per day, which is a fairly high starting dose).

My gut level feeling is that the doctors aren’t used to seeing patients with the extreme symptoms that I had developed – many women may seek relief far earlier than I did, and they’re more used to dealing with women who are having difficulties with hot flashes and night sweats and some more mild psych symptoms, rather than the full gamut of symptoms I’d developed, both physical and mental. The sense I got was that they were somewhat dubious that I wasn’t having issues (other than hormone depletion) that were causing my symptoms, both physical and mental*.

On one hand, I certainly appreciate their caution, and checking into other possible sources for my symptoms makes perfect sense and I’m grateful that they have – on the other, it’s pretty clear to me after all of this that the source of my problems has been extreme hormone deprivation.

Onward – into the light! And a clean and functional (relatively speaking) house! Progress is being made, albeit slow – there’s a year of entropy and debris to cope with, after all.

*in particular, dry mouth, dry eyes, depression & fatigue, and body discomfort (joint and muscle aches and stiffness) seemed to be seen as uncommon reactions – even though they are all recognized as symptoms of hormone depletion. The hot flashes and night sweats – the more ‘acceptable’ symptoms – were irritating enough, but livable.


This entry was posted in breast cancer, cancer treatment, chemopause, recovery. Bookmark the permalink.

8 Responses to Now She’s Well Again…

  1. Felonius Monk says:

    Welcome back, you.

  2. greenmtngrrl says:

    Geez, Meg, reading about your symptoms and reaction to the hormones is making me really rethink mine. I don’t have the dry mouth (or, mostly, the night sweats) but I have been struggling with all the rest of that for the last couple of years at least as I go through menopause. It’s great that hormones help and now I want some too—but it also makes me wonder, how much of those changes are the natural result of menopause regardless of how and when it occurs? (This is not to downplay your symptoms or criticize your choices, at all.) If all of that stuff is more or less “normal” as hormones wind down, then to some extent taking hormones is keeping one’s body in a state that’s not long-term “normal” at all, even when it feels better. It’s putting off aging symptoms which of course is why they started exploring HRT to begin with, and a number of women went on it as a matter of course, right? to address the symptoms of menopause.

    This is really my own musing because I’ve been having such a hard time for so long with all of that stuff, and I’ve known it’s connected to menopause, and I’ve just been waiting for my body to go through those changes and see what happens after that. Now I want HRT too! If I had more energy, if I felt like myself, if I didn’t hurt so much, if I wasn’t so fucking tired/fuzzy/depressed all the time . . . Even women who haven’t had cancer pay for that in the long run though, with all the side effects of HRT. So do you plan to gradually reduce the dose over time (years) to mimic a “natural” menopausal slope? Even if some of those symptoms come back? Or will it take more over time to keep you not having symptoms? And then what?

    The process of losing hormones is, itself, a natural part of the life cycle. It’s the sudden way it happened to you that isn’t usual. So what do we do about that? What do I do about that? Pondering. I really get the “Sick and tired of feeling sick and tired” (and sad, and in pain, etc) thing. Your experience is giving me a lot to think about.

    • dropjohn says:

      Ya, Beth, I can hear you. In some ways it’s almost easier for me to make the decision *for* ERT because of chemopause – it was such an obviously unnatural process for me, and one with such drastic negative effects. Had I gone through natural menopause, I don’t know that it would have been such a clear decision for me; my pride would have gotten in the way, and my insistence that *this* was the natural order of things.

      I know several women now who have gone through natural menopause with many of the same debilitating symptoms – some have supplemented, some haven’t. Some women breeze through the process without experiencing huge consequences; I always thought I’d be one of them (and I might have been – hard to say, not knowing), and thought that HRT was for ‘weaklings’ and those in pursuit of a false eternal youth. So are the mighty laid low!

      For me, the plan is to slowly wean myself off the ERT; my doctor would like to see that happen in the next five years. I’m willing to try, but I’m *not* willing to go back to where I was, even if it means increased risk elsewhere. I will need to add progesterone at some point, in order to reduce my risk of uterine cancer – with just estrogen and with an intact uterus, that’s a clear danger. And progesterone has been shown to increase the risk of breast cancer – it’s why HRT got such a bad rap to start with.

      I’m not seeing any short term side effects myself with ERT – I don’t feel unnaturally happy or sad or flattened or hyper; I feel my *self*. I’m still having some physical effects from chemopause, but they’re pretty minor in comparison to what went before. The long term effects are another matter, and hard to say. I’m doing the best I can to reduce those risks* (as I understand them) while still maintaining a quality of life – that I’m not willing to sacrifice, no matter how “natural” it may be.

      Honestly, though – before? I have never had that type of overwhelming fatigue and depression; women 40 years older had more energy than I did. My lips *burned* at night. *That* was not natural, that was crash and burn. Maintaining ERT at this dosage isn’t natural, either – and I’m hoping I’ll be able to step down gradually on the dosage and give my body and myself time to better adjust (and that my body and mind *will* better adjust, given time. Fingers crossed).

      Myself, I think it’s a matter of weighing the risks and benefits – there’s no ‘right’ answer, whether or not it’s a natural condition, just trade-offs. It’s a hard call all around.

      *transdermal, rather than oral; high estrogen/low progesterone regime

  3. greenmtngrrl says:

    I hear you. Still thinking about all that. I’m not going to go on HRT, at least I don’t think so, but this discussion sheds a light on some of the stuff I am dealing with these last few years.

    You know Laurel has been on transdermal HRT with the bioidentical hormones and the specially-mixed-just-for-you dose from that doctor in Boston, and she was just diagnosed with breast cancer (this is why I haven’t called you back; I will, but it’s been a lot this last couple weeks). Not saying it was because of the hormones (though, of course, she’s off them now), but it gives a person pause.

  4. dropjohn says:

    O, Beth, I am so sorry to hear.

    For me, even if it ups my risk of recurrence, it’s worth it – this is all bonus time, really (naturally, I would be dead by now, or well on my way there), and there’s no point to it if it’s just pain and suffering (which was pretty much where I was without).

    Everybody’s different, of course – but, for me, it was pure hell, and not something I could “get through” or “tough out”. It wasn’t getting better but worse on a weekly basis. It wasn’t the hot flashes, or night sweats, or a little tired – it was the cascade failure, one system after another going down. I’m not going to live like that – there’s just no point. I’d rather not be on hrt, but I can’t live without it. Really.

    As you point out, there’s no way to know if hrt contributed to Lauren’s cancer or not; most of the women I know who have had breast cancer (and there’s an appalling number of them) haven’t been on hrt (though who knows what our other exposure to hormones has been).

    It’s very much a mug’s game in the end, or so it seems to me, pick and choose as you might.

    love to you and to Lauren,


  5. dropjohn says:

    Laurel, dammit!

    can I blame chemobrain?

  6. jelebelle says:

    So happy you are seeing the light and enjoying it! Continued good luck!

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