Monday, May 3, 2010

A Busy Doctoring Day

It's a good thing I was able to get a decent sleep last night because I had a busy day.

I thought I might be able to get through the night without morphine but no sooner was I in bed, when the pain started to increase again and so I popped some morphine, sat in bed and read until the pain decreased enough for me to fall asleep. It didn't take too long.

The pain wasn't bad when I woke up but even after carefully slurping back some warm pudding for breakfast, the pain returned with a vengeance. Aspirin and heat brought it back down to a simmer. I didn't take any morphine, though, because I needed to drive and last night I felt faint after taking morphine.

I saw my family doctor and he checked things out in more detail. He mentioned trigeminal neuralgia but said what I'm experiencing isn't exactly how it normally presents. He thinks it still might be tooth related so I'm booked in to the dentist tomorrow morning for a more thorough look. At least now I've been able to pinpoint some of the throbbing pain in my upper back left teeth. Maybe there's something rotten in that state of Denmark. Whether all of this is related to the drugs I've been on, it's hard to say. I told my Doc that I'd gone off the Tamoxifen and his feeling is that it's the only way to figure out if that drug is the culprit and he recommends I discuss it with my Oncologist. He prescribed me some more morphine to see me through and sent me on my way.

I then met with my massage therapist. As soon as I lay back on the table, the pain in my jaw started up again. She gave me some TMJ massage and the most interesting thing to me was while I was on my back, she's standing at my head, she laid her hands on my face with her thumbs flat between my brows. With the very lightest pressure and shifting of my skin upwards, I felt the pain in my jaw just ebb away. It was so soothing! Very surprising. Kevin and I speculate that the release was through my sinuses. During my "jaw pain" research, I found lots of cases where sinus medication cured severe jaw pain. Something to do with pressure from the sinuses on a nerve. Anyway ... during the remainder of my treatment, I felt no jaw pain at all. She even put on a rubber glove and massaged my teeth and gums. I say "massage" but it was more like "touch" ... the gentlest of pressure and slight shifting. No real movement.

Then she massaged my shoulders ... or more like "manipulated" my shoulders ... more aggressively this time I think. It was tender at the time but it felt much better after. She encouraged my breathing exercises because deep breathing can act like a lymphatic pump which can keep my restricted lymphatic system moving better. I'm to breathe in to a count of 6 and then out to a count of 6. Try it. It's good for everyone, you know. This massage has been such a good idea. Thank you to those who encouraged me to try it.

Right after that, I went to the Champion Centre for bloodwork. I have such tiny, rolly veins, they really don't like dealing with me. Two pokes later, the nurse was able to navigate into a vein. I assured her that if it only takes two pokes she can pat herself on the back and consider it a job well done. Whodathunk I'd be so relaxed about multiple pokes. I've come a long way, baby.

Then ... the oncologist. Kevin was with me so I'd have some back-up and a second set of ears. Thanks, Kev. It was a good discussion and I got some answers and, even better, I felt good about the information I got. It made sense to me and was reasonable.

He said that it can take 6 months for the effects of Arimidex to leave one's system. I've been off Arimidex for 5 months. Tamoxifen can cause bone and joint pain but not so severely as Arimidex, so he can't say whether or not my continued joint issues are related to the Tamoxifen. He doesn't think my jaw problems are caused by the Tamoxifen, but he can't be certain. We talked about my estrogen levels and he explained that the benefit Tamoxifen provides isn't just in reducing estrogen. Based on my pathology and my tumour being so big (3 cm) and at 100% estrogen, he thinks it is in my best interest to try to continue using the tamoxifen. It can improve my odds of not getting a recurrence by 5 to 10 per cent, he says.

I asked him about the osteoporosis drug that had been compared to Tamoxifen and he said that until further studies are done, we can't know if it will help reduce recurrence rates because it has only been studied as a preventative drug, meaning "preventing breast cancer in the first place for high-risk women". I understood that about the study but I wondered if, since the Tamoxifen is considered preventative for both initial and recurrent breast cancer, the osteoporosis drug might be in that same class. The Oncologist said they just can't know that until it's tested. I understand. It's an unknown at this stage. He also told me that my bone density had tested very good. In other words, prior to starting Arimidex, my bones were strong and normal. That's good to know. I hope they still are. I don't know when I next get them tested. Probably in a year.

I asked him about Vitamin D as a preventative measure. Did you see the little bit about Vitamin D being preventative of breast cancer in today's Star Phoenix? I've been reading about that for some time. The Oncologist said that he thinks Vitamin D WITH Tamoxifen is probably beneficial but that it doesn't REPLACE Tamoxifen. I understand.

I told him that I'm seriously considering going off the Tamoxifen because of all the joint and bone problems I'm having. He gave what Kevin and I both feel is sound advice. He suggests that I go off Tamoxifen and every other thing I've been taking for a month and see if there's any improvement. If there isn't, he suggests I go off for two months. Even though it can take longer than that for the drugs to clear one's system, he doesn't recommend I go off it for longer than 2 months. Then, her suggests I go back on Tamoxifen for a month and then, one at a time, start re-introducing the other supplements I'm on. That will be the best way to see if the Tamoxifen or, perhaps, something else is causing me some problems. I think that's sound advice and at least it's trying something. It might prove insightful. It might not prove anything. But it's worth trying. I'm satisfied with that and was very happy with my Oncologist and his conversation with me.

So now I'm home. I took my morphine now that I know I'm not driving and can afford to sleep ... it does make me sleepy ... more like groggy. I've had a banana and a pudding and will sleep for a while. I have a date with some soft, baked beans and scrambled eggs for dinner and then ... and then ... the most exciting thing ... picking up Luke from the airport!!! I'm glad to be able to manage this pain better before he gets home. I didn't get all the things done that I'd hoped to before Luke gets home, but his room is ready and that's the main thing.

And that's been my eventful day. I don't wish you any such days.

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