The Icing on the Cake

I don't care for that expression in this situation, can someone offer an alternative? The thought of icing on a cake makes me so happy when I have tastebuds. It is the most significant part of most cakes, especially cakes from Hesh's (on Castor Avenue in Northeast Philly, you have to go there). The icing on my figurative breast cancer cake (have to differentiate because Barb brought me a literal breast cancer cake after my surgery) is making me miserable.

You may have seen the new research showing that SSRI antidepressants such as Zoloft, which is my lifesaver, counteract the benefits of Tamoxifen, which is the necessary pill I'll take for five years once I finish radiation therapy. All four components of my treatment (surgery, chemo, radiation, Tamoxifen) are considered vitally important in ensuring my survival. Skipping Tamoxifen would be akin to skipping the chemo.

About three years ago I realized that anxiety was slowly but surely overtaking my life. I wasn't sleeping, I was socializing less and less, and I couldn't make a decision. Sometimes it felt like a physical pain. After reading on the Internet about which meds might make me gain weight or not (which of course had to be my primary concern), I decided to give Zoloft a shot. It's so easy to get a prescription. I just had to tell the doctor what I wanted. Zoloft turned out to be perfect, even with my low dosage. It didn't change anything about me, but it removed the irrational anxiety as if it had never been there. I have been so grateful for Zoloft. I couldn't imagine facing the cancer diagnosis without it, when I fell apart quite enough with it.

Now this study. How can I go off Zoloft? What's going to happen to me? After everything that's happened, and everything I've been through, now this? I have never once asked "why me?" but I do have to ask WHY THIS? It is, so rightly and wrongly, the icing on the cake. Perhaps because I'm already weaning myself, just writing this paragraph reduces me to tears.

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This is like a new post, so I'm using the dotted lines. Here in the middle of the night, I suddenly have lots to say. Actually, yesterday while subbing I wrote down three topics I needed to get off my chest (another cruel expression to use on this blog). This one is about my intro to radiation. What a week!

I had been putting off making an appointment with a radiation oncologist, and then suddenly realized that some on my chemo board who'd finished the same week I had were already starting their rads sessions. I was going to go to Penn, but it was more important to have a good recommendation from someone. I had lunch Tuesday with my friend who has been far too connected with breast cancer in the past few years, and she slipped me a paper with Dr. Lydia Komarnicky's name and phone number. Under that she wrote "top doc." My friend listed several reasons for recommending Dr. Komarnicky at Hahnemann, and I called her office on Wednesday. Susan, one of lord knows how many Susans in that office, found a cancellation and got me an appointment for Thursday! Getting there was a trip, glad I gave myself lots of time. You'd think, you pass Hahnemann every time you drive into Center City, how difficult could it be? Well, heh heh. Famous last thoughts. Finally I settled on valet parking. I hope I get back to THAT subject.

For now, I'll just write that Dr. Komarnicky and her staff are so incredibly, umm, nice! I need a better adjective, but the ones popping into my head don't work as well. Before long we were all sharing our most personal stories with each other. How does that happen? Also, I got friendly with a retired kindergarten teacher in the waiting room, a 5-year breast cancer survivor who loves coming to the office because Dr. Komarnicky is fantastic in every possible way. During my appointment on Thursday Dr. Komarnicky discussed why radiation is warranted in my case (mass greater than 5 cm.) and then explained the CAT scan, the tattoos, the treatment schedule. She suggested I could come the next day for the scan! Even after subbing! So yesterday afternoon I trekked back to Hahnemann in more rain. I didn't even consider valet parking, which is so completely disorganized, the attendants on Thursday were trying to deal with an irate couple whose car they'd lost. Yes, lost. Yesterday I got a space in the lot right next to the Feinstein Building, yay! And all of my parking is free at Hahnemann while I go through this.

The CAT scan was easy, the tattooing hurt. Why would anyone choose to inflict that pain upon himself or herself? I have three tiny dot tattoos under my bra line. I've never mentioned this here, but I was born with a third nipple, which was not removed during my surgery. I still have a nipple, ha ha. It's tiny, and now it's going to be radiated just in case there's breast tissue around it. I will have 28 treatments, starting June 29. I'll go every weekday, at a time that works for my schedule, and I'll meet with Dr. Komarnicky every Thursday. In early August I'll be finished. The treatment might make me tired, but probably not for the first couple weeks, and hopefully not nearly as thoroughly as the chemo. I brought my mom home (poor woman lost her job again, thanks to some incompetent reporter named Greg), and the traffic was terrible. In my effort to circumvent it, I went the wrong way and got stuck in more. Plain old Murphy's Law.

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More dotted lines. I did mention I wrote three topics on the post-it. The last one is that I think I've discovered what I need to do. Maybe this whole experience isn't about what I'm supposed to learn, but what action I'm supposed to take. So I'm going to start advocating for low-risk women to remember to get their mammograms. If I had gotten my baseline done when I turned 40 instead of waiting a year and a half, I most likely would've at least been able to skip this step in the process. The cancer would've been an earlier stage. I'm just lucky it wasn't aggressive cancer. I was completely taken in by my low risk factors: no family history, physically fit, breast fed three babies, young. There is no such thing as low risk. All women are at risk. I didn't even have a lump to feel. The breast cancer site (think it's thebreastcancersite.com) has a button you can click everyday. Each time that button is clicked, money is donated so women can have free mammograms. If you can't afford a mammogram, get in touch with the people at that site. But get a mammogram, every year. Or I'll bother you about it. Incessantly.

Don't go through more than is necessary. If you have breast cancer, you want to know as soon as possible. I know that rationally you all know this. Putting off a diagnosis does not make it go away. It just makes it worse. I'll have to figure out how to advocate better than just on this blog.

I wonder if I could fall back to sleep now. Or if I should take my half dose of Zoloft.