Thursday, June 19, 2008

How to turn a pear into an apple

Just had my first mammogram since my surgery, and I'm relieved to say that the radiologist saw nothing out of the ordinary.

My oncologist recommended taking aspirin or ibuprofen about half an hour before the screening. Mammography is a low-dose x-ray of the breast while compressed to the thickness of luncheon meat. I have some internal scar tissue, and the muscles leading from my armpit to my ribs are pretty tight. On top of big squeeze, it felt like my entire right side was being slowly pulled apart like taffy.

What's with all the food analogies, you ask? I blame my current anti-cancer drug, tamoxifen. I gained about fifteen pounds during chemo, and put on another five during radiation. I don't eat more than I did a year ago, and my activity level is about the same, so what gives? My oncologist said "Some people blame tamoxifen, but it's probably just menopause." I have noticed that doctors are reluctant to admit the extent of drug side effects. This kind of dismissal always drives me straight to MedLine, which is why I'm such a pain-in-the-ass patient.

There's some relatively recent literature linking tamoxifen to excess visceral fat. Visceral, as in gut. I'm trying to get used to my new belly. Ever since I hit puberty, off-the-rack pants ballooned around my waist, even while they were too snug in the hips and thighs. I guess I should thank tamoxifen for transforming me into a more conventionally-shaped fat woman.

"Relationships between tamoxifen use, liver fat and body fat distribution in women with breast cancer." Intl. J. of Obesity. Feb. 2001. [Link]

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