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]

Chemo: The End

Goodbye, Baxter 6300 I.V Pump. I'll miss hearing you erupt into loud alarm after I exercised the utmost care while rolling you into the toilet. You always waited until I was seated on the throne, you joker. But most of all, I'll miss the way you drip, drip, dripped poison into my veins. May we never meet again.

I completed the 8th and final chemo today. I told Nurse L that she was the only thing I was going to miss about it, and she gave me a big hug. Dr. G, who I'll see again after my radiation, examined my breast and said that the tumor looked "good," and that it was hardly palpable. Tomorrow, I call the surgeon* and try to get a tentative date. However, he'll probably want another MRI before proceeding. The process of arranging cancer treatment is reminiscent of using more than one contractor on a home improvement project. You have to do all the coordination with the different trades, continue to monitor the work quality and progress, and then the flooring guy (or oncologist) suddenly doesn't show up for a month. I need to hire a general contractor--one that specializes in cancer.

There's one more plus to ending chemotherapy: I won't have to buy a yet larger pair of "fat" jeans. I stepped on the scale to be weighed today, and discovered that I had gained another three pounds since my last visit. I weigh more than I ever have in my life. And I'm bald. Fortunately, both are reversable.

*Yes, my husband and I both are positive the oncologist told us his office would contact the surgeon. You have to get it in writing from these people.

Chemo 7/8

In honor of National Breast Cancer Awareness Month (just in case you didn't notice all of the pink crap for sale everywhere):
6,000 Runners Fail To Discover Cure For Breast Cancer

Before today's chemo started, a nurses' aid took my blood pressure, temperature and checked my weight. I've gained 11 pounds since starting chemotherapy. Not too surprising to me; lately I've been straining to get into jeans, and zipping skirts up three-quarters of the way and covering the gap with a long top. Weight gain during chemotherapy for breast cancer is very common. It is poorly understood, however. It could be due to hormonal changes, stress-related overeating, or lowered activity levels. I am an over-achiever in this regard--apparently a 10 lb. gain is typical of women receiving a six month regimen of chemotherapy, and I've only had not quite four months.

During my session, Nurse L dragged Dr. G in to take a quick look at me. It was the least he could do, seeing that he missed the last two scheduled appointments. I was already hooked up to the drip, so disrobing wasn't an option. Thanks to an American Apparel t-shirt bra and my rapidly eroding sense of modesty, I just hoisted everything up to give him a look-see. "The tumor appears to be shrinking," he confirmed. He seemed to think I was doing well, otherwise. We asked him about the surgery, frustrated with the fact that we had no idea when it was going to actually happen. He said that his office would contact the surgeon when I have my final chemo. I'll believe it when I see it.