The Faucet of Side Effects
Up until Thursday (4 days ago), I thought I might actually experience a miracle and sail through taking Tamoxifen. There had only been minor hot flashes and 2 days of feeling a bit nervy and tremor-y. No such luck.
On Thursday afternoon, it was as if some force had turned the faucet of side effects on full blast because they came on all at once. The worst have been the migraines. Since that time, I've had one migraine after another, like a non-stop vise on my head.
Back in August, I began working with a neurologist, Dr. Leconte, because my pretty typical migraines had gotten much worse. Remember, that's part of the beginning of the BC story -- I went to get a CT of my sinuses and had a mammogram the same day since I was at University Radiology. (The sinuses were clear, BTW.)
Dr. Leconte prescribed Ubrelvy, which is taken as soon as I feel a migraine ramping up. It works within an hour to stop it or I take another dose within 2 hours, which will get it if the first one doesn't. It makes me feel a bit tired, though. Up until 4 days ago, since I've been taking Ubrelvy, I haven't had migraines day after day. I might have one a week or one every two weeks, or even just the one really bad one before I start my cycle.
The headaches I've been having since Thursday are treatable with the Ubrelvy, but only to a degree. Also, there's a limit to how much Ubrelvy I can take in a day (200 mg or 2 big doses, smaller doses are 50 mg). Because I'm waking up in the middle of the night with what seems like the next migraine flight about to take off, it ends up my needing 3 big doses a day.
At the same time the headaches started, so did the hot flashes. I don't mind these half as much because they are short-lived. However, they wake me up when I'm sleeping every couple of hours, which is not cool at all.
Why am I up at 3:30 a.m. writing this? An hour ago, I had a full-on night sweat, where I woke up completely soaked. Prior to taking Tamoxifen, a night sweat wasn't unfamiliar to me. In fact, before my most recent period, I had a run of them. It was the same each time, I'd awake with the front of my night gown or sleep shirt soaked from the chest up, as well as the back of my neck. I'd go towel off, perhaps put a large towel down on the bed (if needed), and go back to sleep. This time, I was in a pool of sweat down to my knees.
I had to towel off, re-clean my radiation burn area and re-apply the steroid cream (oh, just in case you thought I'd be free from any skin changes, the itchiness and irritation has returned in the past few days, too).
I took an Ubrelvy because the next migraine was queued up and sat down, wrapped up in my Aniversario blanket to write this to you. And now, I just unwrapped because I'm having another hot flash. Oh, the fun.
There has been some weepiness, as well. For most of my life, PMDD (I have a type of PMS that's pretty severe, gee what a surprise) has looked like either really weepy and down or really angry. Sounds like typical PMS? Well, the really weepy end can get pretty dark, and I don't talk about it much except to very trusted friends. I can tell it's hormonal because I don't typically feel this way except during PMDD (athough I felt pretty crappy about myself during the years prior to my divorice, but that's a whole other kettle of fish).
The last side effect is that I've started bleeding/spotting. This is definitely the Tamoxifen because it started on Thursday, at the very same time as everything else. I'd just ended a pretty typical period cycle on the 8th (today is the 20th), so it definitely wasn't time. This side effect should be watched because Tamoxifen causes endometrial (the lining of the uterus) cancer in 1 of 500 patients who take it. I'll be having an annual gynecological exam in a month, and I'm sure to be checked very carefully.
On Friday, I called Dr. Omene to speak with her about the faucet of side effects, but most importantly, the bad migraines. After hearing my experience, she suggested I take "a holiday" for 2 weeks from the Tamoxifen to see if it truly is the drug that's causing what's happening to me. Because I already get migraines (but not like this) and night sweats (but not the hot flashes), we have to test it.
She really wants me to be able to tolerate the Tamoxifen because if I can't, then we're in a bit of a pickle. I'm unable try the other type of drug (aromatase inhibitors) for breast cancer recurrence prevention until I'm menopausal. We spoke a bit about my preference for oopherectomy over taking the ovarian supressant drug. While she prefers the drug, the surgery would quickly put me into menopause (and I'd get whatever I'd get as far as hot flashes, etc.), and then we could try the aromatase inhibitors.
Those can be tough to tolerate for other reasons, but are much more effective in preventing recurrence than Tamoxifen in postmenopausal women. The one that Dr. Omene wants to try causes bone loss and pain, but taking calcium after menopause is necessary anyway, especially for women with osteoporosis in their family (me) and/or who might already be osteoporotic (also me, although to a small degree, as detected in spinal x-rays from a number of years ago).
So, I'm on "holiday" from Tamoxifen for a couple of weeks, awaiting the half life of 5-7 days to weaken and stop the migraines. It would be great if I didn't have to take any medications, but since the likelihood of recurrence is greater without them, it's best if I can try to take them.
Thanks for continuing to read along, send prayers and love, and support me in all the ways you do. Yesterday, as I wound the wool sent to me by Djaz, Mom and Dave, and Tom into workable balls, I thought about all the generousity of spirit and purse that has been aimed my way during this now 6-month journey. As ever, I am enormously grateful for every tiny bit of positive energy expended for my benefit. Every moment of it helps. Thank you.
Remember to schedule your screenings. Early detection is key.
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