"Sometimes the questions are complicated and the answers are simple"-Dr. Seuss
Oh, how powerful our brains are! One of my biggest flaws has been (and unfortunately always will be) my need to over think every situation. It's human nature and it's in all of us to make things much more complicated than need be. I have struggled and obsessed over the question of ovarian suppression vs Tamoxifen. What is right for me? What do the books say is the best option? What would? What if? How come? How long? I have thought so much that I wore myself out.
I have talked to friends and family, I have created a folder (anyone who knows me, knows my love of calendars and folders. If I can create a folder on something, I am all about it). I have printed out just about every single article I could find on the benefits of ovarian suppression in ER positive breast cancers, on menopause at 35, on hysterectomies, on oophorectomies (removing just the ovaries), on the recovery, on the surgery. I have read and re-read every line. I have highlighted statistical facts, I have highlighted opinions, I have highlighted information solely because it looked important. I have been consumed with this for over a week. I had a mini break down the other night over this. I am pretty sure I just mentally wore myself out.
The other night as I was driving home from work, I was thinking about how I make this choice. I started crying in my car and when I got home I held it together during dinner, then I went into our bedroom and I lost it. Ryan came in and asked me what was going on. I broke down and told him everything. Every fear, every reason I did not want to get my ovaries out, every reason I did want to get my ovaries, how I know I am making this bigger than need be, how I wish I was never told about this new option, how I NEEDED him to tell me what the right thing to do was. Ryan just simply said "do what's in your heart Amy". I felt like saying well, if I knew that I wouldn't be sitting her crying! However, when he said that, something inside me told me, my answer wasn't in research papers, it wasn't in Google's search engine, it wasn't in any of the places I was looking. To some this might be a no brainer, to some this might seem like I am making a mountain out of a molehill. It's just my head, my heart, and my gut are telling me different things. My head says stay on Tamoxifen. My gut says do the surgery. My heart, felt torn between the both.
I decided I needed to find some clarity. I needed something to help me make the choice that was right for Amy. As I sat and thought about where do I find this? Do I pray (well, honestly I am not religious)? Do I listen to the advice I have gotten from friends and family (after all they do care about me)? Where does clarity come from? Then sitting on the couch staring at my computer screen, I decided to re-read my blog. Now, I have only re-read this blog one time and honestly after I was done, I felt sad. I logged in and started at the first entry, March 24, 2011. By the time I had gotten to round 3 of chemo, I knew my answer. I think I always have, I just needed to be reminded. Having gone through everything I have, I mentally blocked out all the bad, all the feelings of sadness, all the feelings of fear. By this I mean from a chemo point of view. I still and will always have feelings of sadness and fear related to cancer, but re-reading the beginning of the blog, when things were still new and my feelings were still all over the place, I instantly in my gut felt like it was happening all over again. I remembered very vividly all those feelings and fears. Then I found the post, the blog post where I sat in my oncologists office in the very beginning of chemo and asked if I could have my ovaries removed. After learning my cancer was 65% estrogen positive and estrogen was made in my ovaries, I wanted them gone too. At that point I was told there was no statistical evidence that removing your ovaries was any better than taking Tamoxifen. Well, look now, there IS evidence that this option can be more beneficial. All I needed was to remember that I told myself from the start, I didn't care how drastic or aggressive it was, I wanted to do every single thing that would make my recurrence rate the lowest.
So, surgery it is. I can handle menopause at 35, I am kind of thinking it will be nice to go through it young and get it out of the way. I already have hot flashes, I know what it is like to go from a comfortable body temp to pins and needles and feeling like a fire is rising from your chest up. I am already moody from Tamoxifen (I hope it cannot get any worse, there are plenty of days I cannot stand myself). I am already over weight from Tamoxifen and poor lifestyle choices I have made since this all started. I can handle this. I am strong, I am stubborn, I am resilient. I have asked how soon this needs to be done, since it's not emergent (I am 4 years out from chemo in July) but should be done sooner rather than later, I have decided this fall is a great time to go under the ol' knife again. I would like to work hard and drop at least 10lbs (I read, shocking right, that if you go into menopause over weight the side effects are worse).
I feel good about this choice. I know it's the right one for me. I will meet with my Gyn in the next few weeks and discuss which surgery he thinks is best, total hysterectomy or an oophorectomy. And then I will pick my date. Four years ago, I told myself being a victim to cancer was not an option. I was lucky enough to be diagnosed before it had spread, I was lucky enough to be get chemo and surgery and to be put into remission. I was and still am willing to be as aggressive as possible to make sure I stay in remission. I have 2 amazing children who are becoming their own and who continue to amaze me everyday with everything they do. I am not willing to possibly jeopardize not being there for every game, every dance competition, every argument they have. I am not willing to not be around to continue to annoy the crap out of Ryan ;) We have been married for only 12 years this year, he has a lot more of me to deal with!
So, like I said in the beginning of this post, "sometimes the questions are complicated and the answers are simple"- Dr. Seuss.
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