Sooooo, here's the new plan: ovarian ablation now -- as in shutting down my ovaries ASAP.
My wound, while doing very well and visibly healing even to my untrained eye, is still taking a while to fully close. Estimates are at least another month before I can even think of starting chemo.
That's just too long.
Oncologist I saw today says why not start the hormone suppression now so at least any potential cancerous cells floating around my body are starved of estrogen (ER) & progesterone (PR) while I wait to start nuking myself with chemotherapy. For those keeping track my tumors were strongly ER/PR positive (a good thing) so depriving my body of these hormones is necessary anyway, it's just usually done after chemo.
Normally a pre-menopausal woman like me would take a drug called Tamoxifen for about 5 years. But Tamoxifen causes blood clots and with my known genetic mutations it is NOT advisable. So instead they need to essentially turn me into a post-menopausal woman so I can then take the drug typically used for that stage of life. It's an aromatase inhibitor (basically an estrogen blocker) usually the drug Arimidex.
My ovarian function will be chemically stopped via injection, usually either Lupron or Zoladex -- they are what's known as GnRH agonists...they cause the pituitary gland to cease production of certain hormones and that in turn prevents ovulation. The bottom line is no more periods, no more ovulation, no more fertility.
As someone who struggled with infertility and yet was blessed to have two kids...one of which was only three short years ago, this is all disconcerting to say the least. We are lucky to have the two beautiful healthy kids we do considering all we went thru. But I suspect if I were younger I would try and have more children. Truthfully we never completely ruled it out despite my age now. According to my perinatologist I have the womb of a 30 year old (if only I had the body to match, lol!)
But by as early as next week all the choices will be gone. Boom. The end. I mean, I could freeze eggs or create embryos...but when would I have the chance to use them? The earliest would be age 52. I know women do that and I think more power to them. However for my life that would be a bit later than I think is advisable...not to mention that the hormonal changes during pregnancy would spell trouble for my chance of cancer recurrence anyway. This is it. No more babies.
I always expected menopause could be difficult on many fronts...not the least of which is the emotional issues for me regarding loss of my hard-won fertilty. But I also figured it would happen somewhat slowly...you know, sort of sneak up on me a little before I had a chance to really let it fully sink in. The natural progression of intermittant periods and various symptoms would gradually increase until I knew I was smack dab in the midst of it. I'd have time to adjust, to get used to the idea if not the physicality of change.
But this is so sudden, so quick, so...drastic. And I have to admit I'm really scared of the side effects...there's no HRT for me, no bioidenticals. We're talking cold tofurkey (remember, vegan here). Or maybe that should be steaming tofurkey considering the hot flashes I will no doubt be experiencing shortly ;)
All weak atempts at humor aside...I really do know I have to do this. In fact this is the one thing all along I have been sure of. My surgery choices were up in the air...chemo or no...axillary dissection or not, but hormone suppression was a given based on my biopsy report from way back in April. It's probably the MOST important part of preventing my death from this disease, second only to removing the actual tumors themselves.
So brace yourselves along with me, dear readers...within the next week or two I take the menopausal plunge. Hold onto your seats and get the fans and ice chips ready!