Post-cancer update: Heart and Mind

I had a check-in with my oncologist yesterday morning and she continues to be happy with my progress.

At our last meeting in July she switched me from tamoxifen (which works by blocking estrogen from binding to receptors in the breast) to Arimidex (which limits the production of estrogen altogether.) Tamoxifen is known to be an additional risk factor for blood clots and for uterine cancer, while Arimidex increases risks of osteoporosis and muscle and joint pain. In light of my pulmonary embolisms last February, my doctor (and I) felt the risk trade-off was logical.

I’m staying on Coumadin until and unless I become more physically active on a steady basis, at which point I could be switched to low-dose aspirine instead.

I will get my final MUGA heart scan in three weeks, and since all previous ones have been satisfactory, I don’t expect bad news. I will also be getting an MRI this fall, which will keep alternating with mammograms every six months for the foreseeable future (one of each a year.) That’s because of the dodgy genetic profile that suggest increased risk.

So no cancer-related health problems right now, and side effects are being monitored. I feel well cared-for, as usual. 

Unrelated, though: I got food poisoning last weekend. [EDIT: I would not know this for several weeks, but this was in fact my first brush with appendicitis!] I think it might be the first time I got what we really call food poisoning, as opposed to gastroenteritis. I think that, because I don’t remember feeling like this in my adult life. Ugh.

It struck in the night of Friday to Saturday, and made the weekend very unpleasant. The worst of it was when my stomach was long empty but I could not stop the dry heaves; all my abdominal muscles hurt for days afterwards. My gut also hurt to the point that I feared I might have to go to the emergency room to check for herniation, but it got better afterwards. By Monday evening I was better, i.e. not in constant pain, but I spent most of Tuesday and Wednesday sleeping.

All this brought me from a steady hum of activity in recent weeks, where I had been putting a lot of work in books I’m writing, Evil Hat projects I’m managing, game conventions I’m on staff for, the city planning commission, household financial challenges, and attempts at personal care, to a whimpering halt.

So after running like hell to nearly catch up with life, I found myself solidly behind again.

I’ve been firing on three cylinders for a long time now, and I don’t just mean because of cancer. When I was diagnosed 17 months ago, I had been dealing with depression for a long while. During my convalescence I did really well on that front, and it was not too hard with the momentum I had gained on the recovery path to just look ahead and whisper, “I think I can, I think I can, I think I can.”

Suddenly crashing like this and looking ahead at once again trying to catch up to the pace with the same three huffing, coughing cylinders was utterly demoralizing. I’m pretty sure this week’s sleep cure was only half in response to physical wear and tear; the other half was depression.

Then I think of all the help I’ve received, all the love my friends and loved ones have poured into my life, and I know I need to start again. “I think I can, I think I can, I think I can.”

I may have to ditch some cars on that train, though. I don’t intend to slow down on the writing and project management, because these tasks are both profoundly satisfying and my only sources of income right now. The city planning commission is super-interesting, a great opportunity to reconnect with the professional world after my year and a half of disability, and my chance to give back to the community on a scale made necessary by the horrible U.S. politics and policies.

Of the two conventions I’m still working for these days, I will probably have to let Dragonflight go. It was the tenth time this year that I prepared the program for this convention, something to be proud of. I know I’ve done a good job, and I know it has been appreciated. But this year was particularly rough for me; I received the information I needed at the very last minute, when I had all these other tasks on a to-do list that grows faster than I can cross items off. I had to spend a painful amount of time on the program—time I had scheduled for but over the course of April through August, not in one big wad.

I’m sad at the idea of dropping Dragonflight from my schedule, but I know that when that happens, someone will find to solve the challenges better than I do now, simply because they will have to. That’s the way humans work. The other convention, Big Bad Con, is a source of immense pride and joy, and I’m not planning on letting go yet. I think there is still much I can do to help it grow.

And I need to regain more strength and resilience, more efficiency, and to make better choices. I look at this past summer and I’m proud of how much I have recovered but also worried about how far I still have to go if I hope to be able to hold a regular full-time job again.