Medication meltdown

So today I met my oncologist (yet another word that I never anticipated using in reference to myself). Dr N. is a pale, slightly built and timid looking man of a seemingly nervous disposition. I couldn't decide whether his previous client had scared the sh*t out of him or was it me he was afraid of? Or maybe everyone has that effect on him. I fought the urge to shout "BOO!" for fear he might literally pee his pants.

He brought with him a female trainee/intern (or whatever it is they call them), who was similarly fragile and had the handshake of limp lettuce. I wondered if they were anticipating I'd burst into floods of tears upon discussing the treatment plan. If that was the case they'd be relieved - or disappointed - since the one thing I haven't done up till now is shed any tears about all this, which is perhaps a little odd, I don't know.

After another round of stripping down and being poked, prodded and even being told by the Doc that I have "what we call lumpy, bumpy breasts" (charmed, I'm sure), we sat down to discuss the treatment plan; 16 radiation treatments to the entire breast plus a further 6 'booster' treatments concentrated on the area where a few cancer cells were left behind (the spot where I'd narrowly escaped a second surgery). I was still doing okay up to that point, despite having previously been led to believe I'd need only 3 weeks of radiation but hey, if they need to do 6 extra treatments to make sure they zap those last remaining cancer cells, then I'm certainly okay with that.

It was the next part of our discussion that was, for me, the kicker.

"Now, you were probably told already that your cancer tested estrogen receptor-positive (ER+)." Which, as he  went on to explain, means the cancer cells bind with estrogen and use it to fuel their growth and it can also enable cancer cells to be carried through the bloodstream to other parts of the body. Yikes, I hadn't even thought about that. And naturally it suddenly flashed through my mind, what if these cancer cells have already gone elsewhere???? And why has nobody explained this whole ER+ thing to me before now?

"The good news is," (Thank goodness - at least there's still some good news) "there are several medications that have proven highly successful in blocking estrogen, the most commonly prescribed being Tamoxifen - which is very effective in preventing the recurrence of this type of breast cancer in pre-menopausal women like yourself. So we'd like to get you started on that two weeks after completing your radiation. This course of treatment is generally prescribed for 5 years."

I know he was offering up a positive solution but I can't deny that my heart sank. I'd read a little bit about Tamoxifen - for which the main 'side effect' (in most cases) is that, as an estrogen blocker, it actually brings on menopause that bit sooner. Brilliant! The very thing I've been dreading - I mean DREADING -  for years but had hoped to keep at bay for at least another 8-12 years. Now I'm inwardly terrified that, joy of joys, I get to start on that miserable road even earlier - turning into a 55 year old when I'm only 44.

Dr N. dutifully detailed many of the potential side-effects of Tamoxifen, including the possibility of endometrial cancer, blood clots, stroke, cataracts etc. but I could only focus on the whole menopause thing because of all the 'delights' it entails: mood swings, weight gain, hot flashes, memory loss, depression, insomnia....to name just a few.

By the time I left the cancer agency, I was consumed with an underlying sense of dread and despair - moreso even than when I received the initial breast cancer diagnosis. While I know I should be (and I am) eternally grateful that such a medication exists, I'm nevertheless terrified of the person I'll become once I start taking it, albeit I would have to enter menopause at some point in the coming years anyway.

I went home, pulled out all the info I could on tamoxifen and menopause and sank a beer while I wallowed in my fears and dread. By the time poor Lorne came home from work I could barely tell him about the appointment before my words washed away amid a flood of tears. I was devastated - mortified that I'm going to change into a sweaty, moody, fat and depressed mess of my present self. "I'm afraid I'll become a different person and that person might well be an absolute nightmare to live with." I blubbed. "I'll become a miserable, irrational, moody, overweight and psychotic monster. It'll be like having PMS 24/7/365 only on a much bigger scale. I don't want to be that person. Added to which  the weight gain will make me feel worse about myself. What a treat! It's bad enough I've dreaded menopause anyway but the thought of having to face it even earlier terrifies me. I feel like I just won't be myself anymore!"

Poor Lorne, I don't think he quite knew what to do/say. I was a stressed, wailing mess.....perhaps an early glimpse of exactly the type of emotional wreck I'll be once I'm on this medication anyway, only minus the sweaty pits. (For now at least.)

On the one hand, I know it seems irrational that I'd be this upset over a medication that, to all intents and purposes, will help prevent the recurrence of this awful disease - and it's nowhere near as drastic as chemo and I get to keep my hair, but I could almost live with the whole breast cancer thing knowing that I'm at least still the same person I was before it. The thought of taking tamoxifen and starting menopause makes me feel that I'll lose that. I won't be myself any more. I won't be the same Katrina - the one Lorne knows and loves. I'll be moody, paranoid and irrational and the prospect of a 15-30lb weight gain really bothers me; a) because I have a wardrobe full of nice clothes that just won't fit anymore and b) because, added to feeling crappy, I'll also feel bad about myself being heavier - God knows I suffered hideously low self-esteem for long enough in throughout my teens and 20's. The last thing I want is to go back to feeling as shitty about myself as I did back then. I was downright miserable, self-conscious and depressed.

I realize I must sound shamefully vain. That my dread of menopause must make me seem so horribly ungrateful for the fact there's even a medication available to me to help protect my health. On the contrary, I'm extremely grateful and I also know just how lucky I am to not need chemo, or worse, and to be living in a country where such treatment is even available to me and it's paid for by the government. Incredibly lucky. How ridiculous then to be crying over potential side-effects that may - or may not - even happen, or at least perhaps not to such a great extent.

The more sensible part of me suspects that maybe my upset and tears are moreso the result of a culmination of events from the past several months rather than actually just centered on the (by all accounts) irrational fear of menopause. I've stoically navigated my emotions through the diagnosis, surgery and upcoming plans for radiation while feeling thus far incredibly 'lucky' that it was found so early, perfectly treatable, and that my outlook really is among the best case scenarios for breast cancer.

So to find myself so ridiculously distraught over the thought of menopause starting a few years early makes me wonder if my upset isn't somewhat misplaced. Having felt that my scenario was, in many ways, a good one (I got the cleanest point of a shitty stick), I'm not sure I've even allowed myself to really address how I feel about all this - it's a bit of a life-changer after all. The fear of menopause and all its glory has perhaps given me the outlet, albeit somewhat misdirected, for spewing an accumulation of feelings/fears/uncertainties that I haven't yet been able to face about all this. In being so grateful that my prognosis is so much more positive compared to many, many others who get a cancer diagnosis, being upset about it just seemed pithy and self-absorbed. I felt like I'd merely dabbled' with breast cancer and - by and large - had a 'lucky escape'. Clearly the british side of me was all set to simply brush it under the carpet, treat it as a minor misdemeanour, say nothing more about it and just be grateful that nothing got too damaged. Yeah - not quite so fast there, Missy!