It is hard to put this to words – the way that I know my spirituality and sexuality to be intimately connected. There is an energy – an aliveness – that I am aware of when I am in touch with my sexuality. This does not necessarily mean that I am having great sex with my husband. It is something much broader that carries through my whole day, into every corner and cranny of my life. It’s how I know myself, a deep joy in my bodily existence that I can tap into at any time.
Aromatase Inihibitors – Femara for me – brought all of this to an abrupt stop. Extreme vaginal dryness not only has made sexual intercourse painful and something that I fear (what if my skin in there tears? what if I get another urinary infection?) but also has confused my sense of sexuality.
I have been taking Femara for 9 months. After using a myriad of over the counter creams and gels, 3 major urinary tract infections and repeated complaining about the discomforts of vaginal dryness, both my oncologist and my gynecologist have recommended that I use Vagifem. Vaginal atrophy is progressive, they tell me, and will not get better with time. It most likely will get worse.
This is confusing and scary to me.
The articles on the Internet say that Vagifem is not recommended to women taking AIs because it counters the effect of the AI – blocking all estrogen from the system. Estrogen levels are elevated in the blood of women using Vagifem with an AI.
So, I would be taking a drug ($30 a month) to block estrogen, and another one ($30 a month) to put estrogen back in.
Money matters aside, I wonder if I wouldn’t be better off stopping both drugs.
I’m annoyed about all those years that doctors were prescribing estrogen, en masse, to menopausal women. The drug companies made a bundle before they discovered that estrogen increased the incidence of breast cancer.
Now the drug companies are making a bundle on estrogen-blocking drugs taken by all those women who got breast cancer. Who is to say that in a few years we won’t find the down side of these drugs?
Doesn’t Nature know best how to manage the hormones in my body?
And then there is the cancer worry. What is it that caused my body to develop breast cancer? Something in the environment? Hormone pumped cows? The synthetic estrogen that I took 10 years ago?
Will an estrogen free body keep the breast cancer from returning, and should I diligently pursue this approach, even if it means no sex and urinary infections?
I have many questions.
Showing posts with label femara. Show all posts
Showing posts with label femara. Show all posts
Saturday, October 18, 2008
Wednesday, June 4, 2008
the thing about the Femara
The thing about the Femara is that I never know if my feeling bad is due to the drug, or just the way I would be feeling anyway.
Well, almost. I do know that my bones and joints ache a lot more. And that the vaginal dryness is like nothing I have never before experienced.
But why do I feel so disconnected from my body? Like my body is no longer me, but somewhat distant. I think that sex has a lot to do with connecting myself with my body, and that has been less than satisfactory. But also I don’t seem to get a rush of endorphins when I exercise anymore. I always feel more or less, not well.
Well, almost. I do know that my bones and joints ache a lot more. And that the vaginal dryness is like nothing I have never before experienced.
But why do I feel so disconnected from my body? Like my body is no longer me, but somewhat distant. I think that sex has a lot to do with connecting myself with my body, and that has been less than satisfactory. But also I don’t seem to get a rush of endorphins when I exercise anymore. I always feel more or less, not well.
Thursday, April 10, 2008
no end in sight
My visits with the oncologist are always somewhat depressing for me. Like, is there ever going to be an end to this?
Every time I go in I have to have my blood checked to see if my liver is holding up under the onslaught of the Femara (the estrogen blocking drug). And she always wants more tests – a bone scan, a lung x-ray, a colonoscopy. Will I ever be considered “cured” of cancer? All this looking is nerve-wracking. One of my computer clients says that they will look until they find something.
When my oncologist saw my reconstructed breast, she said “oh no, no, who did this to you? Why do they always insist on cleavage rather than softness? You must get this fixed!”
So … just when I think I’m getting to the end of this saga, it seems I’m still somewhere deep within it.
I still haven't started the antidepressant that she says will make me "feel better". I have yet to determine just what it is that I'm trying to make my way through here.
Every time I go in I have to have my blood checked to see if my liver is holding up under the onslaught of the Femara (the estrogen blocking drug). And she always wants more tests – a bone scan, a lung x-ray, a colonoscopy. Will I ever be considered “cured” of cancer? All this looking is nerve-wracking. One of my computer clients says that they will look until they find something.
When my oncologist saw my reconstructed breast, she said “oh no, no, who did this to you? Why do they always insist on cleavage rather than softness? You must get this fixed!”
So … just when I think I’m getting to the end of this saga, it seems I’m still somewhere deep within it.
I still haven't started the antidepressant that she says will make me "feel better". I have yet to determine just what it is that I'm trying to make my way through here.
Saturday, April 5, 2008
sex help wanted!
For the first time in 35 years of marriage, John and I need “help” – as in a lubricant. I blame the damn Femara for this vaginal dryness. I don’t even know what to look for at the drug store. Maybe I should go to a sex store. And I still don’t feel comfortable making love while exposing my breasts.
Bummer.
Bummer.
Monday, March 10, 2008
surgery jitters and more drugs
The woman before me in exercise class this morning was tall and thin. She used the high step and kept up well with the instructor, so she was easy for me to follow as well. When I looked at her in the mirror, though, I noticed that she had very high (and large and round) breasts. She wore a low top, and at times her breasts looked like they were going to jump out!
My gosh. Why do women do this? And yet here I am, 2 days away from “doing it”! I called my plastic surgeon’s office this afternoon and spoke to Leah again. I won’t end up like this, will I? I mean, I’m almost 60 years old, and breasts like that would make me look like a freak. Leah assured me that Dr. L knew what I was expecting from the reconstruction surgery, and that I would not end up with such exaggerated breasts.
Last minute jitters, I guess. I am nervous about the surgery – more about the anesthesia than everything else, though.
I saw my oncologist today and complained to her about the femara. The hot flashes are so pronounced through the night that I don’t get a lot of sleep, and end up very tired most of the time. Along with my bones and joints aching more, I’m pretty cranky. She suggested an antidepressant – Effixor – says that it will relieve much of the night sweating and help me to sleep better.
I’ve never taken an anti-depressant before. Even though I have my moments of feeling “down”, I’ve never considered myself to be clinically depressed. And I’m hesitant to take yet another drug to cover the side effects of a drug.
Anyway, we’ll see. I’m going to get through this next surgery, with all the pain pills and antibiotics that go with it, before I consider taking another drug.
My gosh. Why do women do this? And yet here I am, 2 days away from “doing it”! I called my plastic surgeon’s office this afternoon and spoke to Leah again. I won’t end up like this, will I? I mean, I’m almost 60 years old, and breasts like that would make me look like a freak. Leah assured me that Dr. L knew what I was expecting from the reconstruction surgery, and that I would not end up with such exaggerated breasts.
Last minute jitters, I guess. I am nervous about the surgery – more about the anesthesia than everything else, though.
I saw my oncologist today and complained to her about the femara. The hot flashes are so pronounced through the night that I don’t get a lot of sleep, and end up very tired most of the time. Along with my bones and joints aching more, I’m pretty cranky. She suggested an antidepressant – Effixor – says that it will relieve much of the night sweating and help me to sleep better.
I’ve never taken an anti-depressant before. Even though I have my moments of feeling “down”, I’ve never considered myself to be clinically depressed. And I’m hesitant to take yet another drug to cover the side effects of a drug.
Anyway, we’ll see. I’m going to get through this next surgery, with all the pain pills and antibiotics that go with it, before I consider taking another drug.
Thursday, February 28, 2008
recurring cancer
I have been thinking about cancer lately.
Over Xmas, my sister’s brother in law was complaining of a cough, night sweats. They discovered cancer – in his lungs, his bones, his lymph nodes. They don’t know where the primary cancer began, just that over the last few years it had metastasized everywhere without his knowing. He’s undergoing chemotherapy now, but they don’t expect him to live more than 6 months. Verne has always been healthy, he ate right, his father is still alive and 95 years old.
When I was discovering my breast cancer, another friend of my sister was discovering hers. We were both on the same page – 2 cancers in one breast, so a mastectomy was required. She underwent reconstruction during her mastectomy a week before mine; they took tissue from her tummy to make a breast. Her surgery lasted 7 ½ hours. I had an expander put in. Though my initial mastectomy surgery and recovery was easier, I’m now facing another 3 ½ hour surgery next month (in less than 2 weeks, as a matter of fact).
Her cancer was HER2 positive but was not estrogen responsive. Mine was HER2 positive and estrogen responsive. She is undergoing chemotherapy now. I’m taking the estrogen blocker for 5 years.
The big fear is a recurrence of cancer. My cancer was small, only detectable by MRI – but it was invasive. The cancer cells could have gotten into my blood or lymphatic system and spread somewhere else in my body – my bones, my brain.
A recurrent cancer is much more problematic than another primary cancer. A primary cancer can be removed and then treated with chemotherapy. A recurrent cancer means that a cancer has ventured out of its site of origin, and there’s no telling where it will turn up next.
I guess I’ve sobered up some on this issue of cancer. I no longer feel so invincible. I take my Femara every day, even though I blame every ache and pain and sleepless night on it.
Over Xmas, my sister’s brother in law was complaining of a cough, night sweats. They discovered cancer – in his lungs, his bones, his lymph nodes. They don’t know where the primary cancer began, just that over the last few years it had metastasized everywhere without his knowing. He’s undergoing chemotherapy now, but they don’t expect him to live more than 6 months. Verne has always been healthy, he ate right, his father is still alive and 95 years old.
When I was discovering my breast cancer, another friend of my sister was discovering hers. We were both on the same page – 2 cancers in one breast, so a mastectomy was required. She underwent reconstruction during her mastectomy a week before mine; they took tissue from her tummy to make a breast. Her surgery lasted 7 ½ hours. I had an expander put in. Though my initial mastectomy surgery and recovery was easier, I’m now facing another 3 ½ hour surgery next month (in less than 2 weeks, as a matter of fact).
Her cancer was HER2 positive but was not estrogen responsive. Mine was HER2 positive and estrogen responsive. She is undergoing chemotherapy now. I’m taking the estrogen blocker for 5 years.
The big fear is a recurrence of cancer. My cancer was small, only detectable by MRI – but it was invasive. The cancer cells could have gotten into my blood or lymphatic system and spread somewhere else in my body – my bones, my brain.
A recurrent cancer is much more problematic than another primary cancer. A primary cancer can be removed and then treated with chemotherapy. A recurrent cancer means that a cancer has ventured out of its site of origin, and there’s no telling where it will turn up next.
I guess I’ve sobered up some on this issue of cancer. I no longer feel so invincible. I take my Femara every day, even though I blame every ache and pain and sleepless night on it.
Sunday, February 17, 2008
Femara
I suppose because I squeaked my way out of chemotherapy, I didn’t put up much of a fuss when Dr. Bertrand prescribed the Femara.
Femara is an estrogen blocking drug. The invasive cancer that was removed from my breast was 10% estrogen-responsive, which means that in the presence of estrogen, it grew faster. The theory now is that if there are any more of those cancer cells in my body, if there is no estrogen around, they will not grow or spread.
Since I am post-menopausal, most of the estrogen in my body comes from adrenal androgens rather than my ovaries. These androgens are converted into estrogen by an enzyme – the aromatose enzyme – and Femara works by blocking this enzyme.
My problem with all of this is that there must be a reason that my body continues to produce and need estrogen after menopause. Long term effects of blocking estrogen are not known. Of course, the Femara website touts the wonder of the drug with happy-looking women graphics. Just like they did when they prescribed Hormone replacements en masse for women 10 years ago - before they admitted that women who took the drug had increased chance for breast cancer.
But the doctors seem to think that my chance for a recurring cancer outweighs the risks of taking the drug. And they want me to take it for 5 years!
I’m on my 5th day.
The list of side effects is daunting. Hot flashes, sleeplessness, muscle aches, fluid retention, weight gain, fatigue, headache, dizziness, bone fractures, nausea, etc.
I try not to focus on the list because I’m susceptible to psychological suggestion side effects – if you tell me I could get it, I will. But I do feel tired, ach-y, and bloated. My throat is dry and sore. I think that I have bad breath. This is after a few weeks of feeling really good after the mastectomy.
I guess I am feeling a bit depressed of late.
John and I are trying to get away some before my reconstruction surgery on March 12th. We visited Eric in Fort Myers, and are going to Kiawah Island the last week of February. I am hoping that things work out so that we can get to the Southwest in April.
But I’m learning not to make too many plans, rather to be attentive and follow the cues of life as they are given. Something is unfolding. Trying too hard to impose my own agenda screws up the unfolding.
Femara is an estrogen blocking drug. The invasive cancer that was removed from my breast was 10% estrogen-responsive, which means that in the presence of estrogen, it grew faster. The theory now is that if there are any more of those cancer cells in my body, if there is no estrogen around, they will not grow or spread.
Since I am post-menopausal, most of the estrogen in my body comes from adrenal androgens rather than my ovaries. These androgens are converted into estrogen by an enzyme – the aromatose enzyme – and Femara works by blocking this enzyme.
My problem with all of this is that there must be a reason that my body continues to produce and need estrogen after menopause. Long term effects of blocking estrogen are not known. Of course, the Femara website touts the wonder of the drug with happy-looking women graphics. Just like they did when they prescribed Hormone replacements en masse for women 10 years ago - before they admitted that women who took the drug had increased chance for breast cancer.
But the doctors seem to think that my chance for a recurring cancer outweighs the risks of taking the drug. And they want me to take it for 5 years!
I’m on my 5th day.
The list of side effects is daunting. Hot flashes, sleeplessness, muscle aches, fluid retention, weight gain, fatigue, headache, dizziness, bone fractures, nausea, etc.
I try not to focus on the list because I’m susceptible to psychological suggestion side effects – if you tell me I could get it, I will. But I do feel tired, ach-y, and bloated. My throat is dry and sore. I think that I have bad breath. This is after a few weeks of feeling really good after the mastectomy.
I guess I am feeling a bit depressed of late.
John and I are trying to get away some before my reconstruction surgery on March 12th. We visited Eric in Fort Myers, and are going to Kiawah Island the last week of February. I am hoping that things work out so that we can get to the Southwest in April.
But I’m learning not to make too many plans, rather to be attentive and follow the cues of life as they are given. Something is unfolding. Trying too hard to impose my own agenda screws up the unfolding.
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