So far, Tamoxifen sucks

OK, I'm trying to be a trooper about this. I'm trying to have an open mind. I'm trying to stick with it. It's just hard.

I started Tamoxifen one month ago. In fact, yesterday I picked up my first refill. Of (potentially) 59 refills if I stay on the drug for the recommended 5 years. A review - tamoxifen is a drug that changes the way estrogen affects different parts of the body. For most people, it decreases estrogen's effects in the breast, making it very useful in treating breast cancer (since most breast cancers are estrogen-responsive), and in preventing breast cancer in high-risk patients. However, tamoxifen also affects other parts of your body. In most women, it increases estrogen's effects in the uterus (resulting in a thickened uterine lining and increased vaginal secretions) and in the bone, reducing osteoporosis. It also screws up the temperature regulation system in the hypothalamus, resulting in hot flashes in up to 60% of women taking the drug. Apparently, this side effect gets better with time. I am counting on that.

I had some GI upset the first few weeks on the drug. I also had some cramping and spotting, but not too bad. However, lately I've been waking up in a sweat a few times a night. I didn't figure out until today that it was hot flashes! Why today? Well, they started in force today. They come on in a flush of heat and a little nausea and last maybe a couple of minutes. I think I have had a dozen hot flashes today. Let me tell you, it kind of sucks. I'm too young to be having menopause symptoms, especially when I'll have to go through it all again in about ten years.

So why take the drug? I don't even have cancer, right? Is it worth these effects to maybe prevent me from getting cancer in the future? I really don't know. What I do know is that if the symptoms don't get better, I won't put up with it for five years. But I will try to stick it out a couple more months until my next oncology appointment. I feel like I should do something, and I also realize that these symptoms are nothing compared to what patients undergoing chemotherapy have to put up with. So maybe I'm doing it in solidarity with all of the cancer patients who are dealing with much worse.

Maybe, however, I want to feel like a cancer patient. Not that I want cancer, but I want to feel like what I've been through wasn't for nothing. That I'm doing something to treat something. That the big chunk is missing out of my right breast for a reason.

It's easy to get philosophical about things like this, especially if you're an over analyzer like me. I'll keep you posted about the physical and, I suppose, emotional side effects of this drug.

And to all my menopausal friends - I feel your pain.

Fifteen miles is good enough for me!

This is one hot and humid week in Minnesota. Seriously, it was more hot and humid here yesterday than in the Amazon. So I was sort of dreading my long run this morning. But I was also prepared. I woke up at 5 am, because I wanted to get started before it really got hot. I ate my typical pre-long-run breakfast of frosted mini-wheats and fruit, and also had half a shot of 5 Hour Energy, because the caffeine is a proven run-booster. I wasn't thirsty, but I drank 6 ounces of water. Gunther (my dog) and I hit the path at 5:45. At this time the temperature was 81 with a dewpoint of 71 and 69% humidity. My plan was to run around our lake 4 times this morning, stopping after each 3.7 mile lap to cool down and re-hydrate. I was also not going for speed AT ALL, just distance. The first lap went really well - it was humid, but the blazing sun hadn't come up yet. Gunther and I also came within 10 feet of a doe, 2 fawns, and a yearling. I stopped, drank, ate an energy block, and hosed myself down with a garden hose.

My friend Margaret met up with me for the second lap. It is much more fun to run with a buddy! I also switched dogs - I now had Marley. After 7.5 miles, I still felt pretty good. Stopped again at the house, drank some more Gatorade, hosed myself off again, and went out for the third lap. At this point my calves were really starting to ache, plus I had this new pain at the top of my foot. Margaret had a good idea - change shoes later in the run, so for my last lap I put on the ultra-cushy super-supportive running shoes that I last wore over a year ago. Wow! My feet felt like they were running on pillows! However, the shoes were heavy and HOT. A half mile into the last lap, I ran into another friend of mine! We'd been trying to hook up to go running together for weeks, but it never worked out. So it was awesome that we happened to meet each other just as she was starting her lap around the lake. I feel sort of bad because by this time I was running pretty slow and I probably held her back a little. She was all fresh and chipper and talkative. I could barely muster a one-word answer to her questions. Definitely a one-sided conversation. But having her there to run that last lap with me was like a gift from the running gods. I am not sure how i would have made it without her.

The last 1/2 mile went on for an eternity but I FINALLY made it home. I headed right for the garden hose (thank you, garden hose, for being there for me today) and played in the water like a little kid for quite some time. How cool and refreshing! When I finished my run at about 9 am, the sun was out in all of its glory and the temperature was 85 degrees with a dewpoint of 73 and 68% humidity.

I took my temperature after hosing myself off and it was still 2 degrees above normal. I also weighed myself before and after the run, and even though I drank 20 ounces of Gatorade and 24 ounces of water, I still lost 2 pounds.

But... my knee didn't hurt one bit!

Honestly, if I weren't about to pass out from the heat and humidity, I would have shot for 18 miles today. But I am happy with 15. Mostly because this time, my knee wasn't the limiting factor.

My Week at Work

Wow, it's only Thursday and I'm exhausted. My associate vet is out of town so I've been working more than usual. And I've seen quite a few interesting things in her absence. Let me tell you a little about them...

On Monday I diagnosed a dog with Lyme disease, another with some sort of really bad problem (likely cancer but I can't be sure given the limits of what the owner will allow me to do), and another with small cell lymphoma that I had to research a little in order to come up with a treatment plan. I also referred other two pets to the University for a work up of their problems.

On Tuesday I saw a bunch of super old cats. I swear the average age was about 18. And then I turned around and saw a litter of 6 puppies. I found bladder stones in a male standard poodle and oversaw a cardiac ultrasound on a dog whose murmur I had just diagnosed. I also saw a dog with a very high calcium level and brilliantly thought to aspirate her one oh so very slightly enlarged lymph node.

On Wednesday I saw some crabby people (What do you mean, you won't refill my dog's medication even though I've no-showed for the last 4 appointments and he's 4 months overdue for an exam? And, What do you mean I have to pay for the vaccine that was given and also for the exam that was done on a work-in basis?) and euthanized some pets (one of them being one of the old cats from before). I also saw a group of 4 farm kittens, 2 of which were Feline Leukemia positive (and sick), so I had to euthanize two kittens. Ugh. That did NOT make my day. But what did make my day was seeing, for a WELLNESS EXAM, a patient whom was diagnosed with bone cancer 8 months ago after spontaneously fracturing her leg. She has a pin in her leg and is doing GREAT! Which is not true of most bone cancer patients. I also saw a dog with a corneal ulcer and did a work up on another dog who had been vomiting all week (so far no answer on that one).

Today I found out that my high calcium dog does in fact have lymphoma so I had to make that phone call. Sad. The owner is considering chemo on his pet. I also surgically removed the eyeball in a young cat, several teeth in various animals, and some reproductive parts in a couple of other cats. The no-show owner from yesterday just no-showed again for his appointment and it was rescheduled for my last appointment of the day today. Really? So I have to stay around to see if this guy will actually come in?? Grrrrr...

I'm hoping my associate is reading this on her vacation and feeling sad that she's missing out on so much.  :)

Well, at least I can take solice in knowing that last year at this time, I was on a two week hiatus when she had to deal with the American bulldog Parvo breeder from an earlier post.

I will be very happy to get to the end of the week, especially since I have also had to work in an hour of exercise each day (part of the weight loss challenge that, yes, I made up) and I haven't been home any evening this week.

Whine, whine some more.

At least I'm not the veterinarian in Virginia who forgot her 2 year old in the car while she worked all day and didn't discover him (dead) until she got home. I actually couldn't sleep a couple of nights ago because of that. She is being charged with murder (which I think is a bit extreme given that, yes, it was wrong, but not intentional). I feel bad about the whole situation.

It's 5:38 and my 5:45 repeat no-show guy just called to reschedule his appointment to tomorrow. Anyone care to wager on whether he'll show up? Anyone?

$57 for shoes for a kid? Well, ok!

Today I took the kiddos to the Arbor Lakes Mall in Maple Grove. I was looking for a nice compost container for our kitchen at William Sonoma, plus I thought an outdoor mall would be a great way to spend a sunny summer afternoon as I bided my time until Lisa got off of work. I must say that although the kids resisted the idea (especially Carter, who really wanted to watch the Twins game on TV), the outing was actually pretty enjoyable and I think the kids had fun too. The Pop Rocks I bought them at the Good Things Store helped.

Carter just last night apparently had a growth spurt and suddenly his tennis shoes are too small. So while at the mall, we stopped by a shoe store. Upon entering, we were immediately greeted by 4 young men, employees of the store. The 16-year-old who helped us was really nice and eager, since it didn't appear there was much else going on in the store. Carter picked out a pair of sweet Reebok shoes with a bright green zig zag sole. They were pretty cool, I admit. He tried them on and ran around the store a few times, you know, to make sure they were fast shoes. So the decision was made to buy this pair and I then thought to look at the price tag. $56.99!!! Holy cow!

You know I am as cheap/frugal as they come. I know that with a coupon and some Kohl's Cash I could get this same pair for about half the amount elsewhere. But, the kid was so friendly, and we were right there...

Actually, the decision wasn't even that hard. Carter is such an inexpensive kid to have around. All he eats is peanut butter. He only needs a couple of T-shirts and he's happy. He actually wears his twin brothers old hand-me-down shoes because his feet are a size smaller. So I didn't feel bad splurging on shoes for him. And we even shelled out another $5.99 for some waterproofing spray that the 16-year-old salesman demonstrated for us.

You see, sometimes it's better to spend the extra money to make a kid happy. Both Carter and the shoe salesman. And now I don't have to drive around town later to find the same shoes at a better price. And I'm helping the local economy by spending a few extra dollars.

You kow what? I actually feel good about buying the shoes! And I'm not sure I would have felt that way a few months ago.

Listen already!

I am as bad as the next person when it comes to using my listening ears. I like to multi-task, so if you're trying to talk to me I'm probably doing a few other things at the same time. During appointments at the vet clinic, I will perform the exam while simultaneously taking a history. Perhaps that means that I am super efficient. Or maybe it means that I do a poor job of both since I'm not giving my full attention to either. My practice manager feels the same way when she is trying to discuss a business topic with me as I write up my charts or read email (or worse, Facebook). Our conversations have become so disjointed as one of us will interrupt a discussion about planning our next staff meeting with something like, Oh my God, Casey Anthony is not guilty? (It's that Facebook thing again.)

But it works. My exams get done, the clients seem happy, my business hasn't fallen apart.

However, I have been driven to the point of near madness by my sons. Those precious almost-ten-year-old little men, who, like most men, cannot multi-task at all. (This is a gross over-generalization, I know). And when I say multi-task, I mean something simple, like the act of listening to me while petting the dog. It just can't happen! I have resorted to making them repeat back to me what I just told them and that still doesn't work all of the time. It's crazy. And God forbid you try to tell them something when the tv is on. I may as well tell it to the tree out front - the tree probably hears me better.

So of course I just LOVE it when my boys tell me, in exasperation, YOU NEVER TOLD ME THAT!!! Sure. Do I need to write it down too? Maybe act it out?

Are they really unable to hear my words, or are they smarter than I give them credit for, using their male-singlemindedness as an excuse for not doing what I ask of them? I feel sorry for their future spouses, that's all I have to say. I've heard that this is not a trait that one grows out of.

10 miles isn't much when your goal is 16.

I have been such a good little marathon trainer. I have balanced the need for mileage with the need for my knee to get adequate rest. I only ran once last week - under 4 miles, thereby giving my legs a break. Also, as part of my Loser weight loss group challenge, I spent at least 15 minutes a day stretching last week - and I never stretch! My last long run of 14 miles (2 weeks ago) went really well - no knee pain. So I thought for sure my 16 mile run today would be a piece of cake.

Oh, how wrong I was (again).

I got out of bed at 5:30 am and took my time getting ready for my run. My running buddy Margaret was MIA, so I was on my own for the whole run. Sad! I had a teeny tiny breakfast of peanut butter and chololate chips and water. I grabbed one of the dogs and went out for my first 5.5 mile loop at exactly 6 am. It looked to be a hot day, but the temperature early in the morning wasn't so bad. In addition to the above-mentioned knee-sparing strategies, I also walked for a minute about every mile - I read last wek in Runner's World magazine that intermittent walking can stave off injuries. However, it hurt my time, but I am going for distance right now, not speed. The first loop went pretty well and I stopped off at home to change dogs, get water, and take a couple of Shot Blox energy squares. My entire family was still sleeping.

My knee started to twinge at about mile 8, and I had to walk at mile 9. Dammit! %^*&#$! I walk/ran the rest of the loop and ended my morning at 10.5 miles, in 2 hours. Even a continuous loop of Hannah Montana's "The Climb" couldn't inspire my knee to not hurt.

Why? Why? Why does my knee feel ok after 14 miles one week, but hurts at 9 miles two weeks later? What am I doing wrong? Did I baby it too much? Not enough? I have seen enough specialists to know that the answer will never be clear. So I just need to try again in a week and hope for the best.

Sad how I can get depressed about running over 10 miles. Many people would be ecstatic. It's all a matter of perspective, I guess.

I feel like I only have one marathon in me (yeah, for life), and I really want it to be this year, so I can get it over with and not have to think about it anymore. I want to move on! Please!

Funny how we can't recover from an injury by sheer willpower. Any more than we can recover from any illness, I guess.

On a (somewhat) related note, I am giving a sermon at our church in a couple of weeks about pain; sort of expanding on a blog entry from a month ago. I plan to discuss how people live with, or even recover from, chornic pain - especially using non-traditional medicine or spirituality-related methods (even prayer). If you have any experience with this and would be willing to share your story, please contact me. I won't use your name in the sermon.