Monday, October 29, 2007

Decisions, decisions!

Decisions galore, but I've made up my mind. ("Good grief, at last!" she heard them sigh relieved.)

Last Tuesday the bunch of information regarding prophylactic treatments threatened to drown me. Before "maybe" became definitely, I played with all kinds of scenarios, but when I had to choose for real, things changed a lot.

I seriously considered each and every one of the treatments below. Not just how it would feel, the financial implications etc, but there was a time during the past week where I had my mind set on every single one of them.

These are my prophylactic options considering the BRCA2 mutation:
  1. Bilateral mastectomy, oophorectomy and hysterectomy. No need to tell you about the traumatic implications on my emotions as well as my bank balance. If I do all of these surgeries at once, it will only reduce my chances of getting breast or ovarian cancer by 90%. Yup, even if you go through all of this, you can still get the same cancer in the regions around the amputated/removed organs.
  2. Just the bilateral mastectomy. Uhm, no thanks. Period. Read more about reconstructive breast surgery HERE, if you dare!
  3. Oophorectomy and hysterectomy. Doc Greta (the oncologist/gynecologist at the familial breast cancer clinic) said it would be better not just doing one or the other, like 2 for the price of one. This option also scares the living daylights out of me, because it puts you into menopause overnight. BAM. No thanks, I'll go there as slow as I can!
  4. Tamoxifen. One of the more serious side effects of this medication is an increased risk for endometrial cancer, but since I use the Mirena, it seems the specific risk doesn't play that big a role after all. Another side effect is blood clots and hot flushes. Read more about the rest of the gory details regarding the side effects here if you're interested.
  5. Doing nothing at all, besides going for a MRI scan every 6 months in stead of once a year or less. Doc Greta prefers this kind of scan above the normal mammogram since it can spot cancer much earlier and deeper. (Seeing that it's much less painful for big-breasted woman, this is a big plus for me!) The downside is that it costs about $1000 per scan, and THAT is where the ouch comes in!
I decided on the Tamoxifen route. Normally you take this drug for 5 years, and thereafter you switch to something like Arimidex. (The wealth of information you can look up on Wikipedia is totally awesome!) Fast forward to the menopausal symptoms since I'm not there by a long shot, but I think I'll be able to handle that better than arriving at the post-menopause station overnight.

The big cry still didn't happen, but I feel it coming closer every day. All in all I'm coping and doing well when life goes smoothly. The moment I hit the slightest of speed bumps, my tear ducts open full force for a few seconds, only to close down again before the flood can get it's foot in the door. This can be quite embarrassing you know! The man behind me at the pay station in the mall today must've thought I'm totally crazy when I started crying when the stupid machine didn't want to take my money. At least I can still see the humor in it - may it stay that way!

Thanks SO MUCH for your incredible feedback on my previous post. This is the one place where I can say what I want, cry when I want and still know you won't think I went off my rocker. If my surname was Gates, I'd flew you all over for an incredible spa weekend at a 5 star Safari lodge! And those of you who asked for more information about you-know-who, just sit tight till you forget about him again. *grin* Besides, I don't have a nice nickname for him, and that won't work. :)


JJ said...

You have my continued thoughts and prayers...I just cant say enough how much I am awed by your strength!
Sounds like you have a good plan in place--and Ill continue to check in on you!

Fertilize Me said...

I hope making a decision has allowed you to start being able to breathe more freely. Wiki-pedia is way too awesome. My husband is in awe of that website.

Char said...

Dear Karen0
I just returned from another spell of NO 3G SIGNAL for the last couple of days and am HORRIFIED to read what you've been going through! I am so sorry. (But v v v excited to read about the new man! Quick, think up a good nickname so we can hear more!)

Lori said...

OMG. I missed a mention of a mystery man.

How does it feel to have come to a decision?

Summer said...

I hope coming to this decision helps bring you a little bit of peace. Plus, you can still decide to go forward with one of the other options in the future, should you ever feel it is necessary.

You are a brave, brave woman in my book!

Schatzi said...

Sounds like you have thought through your options and come to the educated decision that you feel is best for you. I'm glad, and I hope having this plan in place will help you find some peace with the situation.

Oh and its ok... the guy at the mall probably just thought it was "that time of the month" *grin*.

Anonymous said...

You are doing a great job of making an informed decision.

Can't wait to hear more about the mystery man.

Anonymous said...

You are doing a great job of making an informed decision.

Can't wait to hear more about the mystery man.

Bea said...

In my books, that's almost a snap decision. I was expecting a few more weeks' worth of equivocating posts yet. Still, I know you'd done a lot of info-gathering and pondering before the result, so I guess you were some of the way there, even though it is different once it's not hypothetical anymore. Hope the side effects are easy on you.


Kami said...

I am glad you have found a solution. It seems a wise course to me. Does it help a little to have made a decision? I hope you are feeling safe in your life. And safe enough to cry when you are ready.

Geohde said...

Oh Karen,

None of those exacty screamed out 'this is an easy non-intrusive non-life altering option', did they?

I am so sorry, again.


Trish said...

I'm glad you have a plan. As an A(AAAAAAAAAA) personality, having a plan is usually a HUGE relief for me, even if I'm not altogether pleased with it.

I'll pray that everything goes well and the s/e are minimal.

And not for nothin', but I'm not forgetting about He-who-shall-not-be-named.

Pamela Jeanne said...

Sounds like a well formed decision. And I can well understand your spontaneous tears. They have to come out but sometimes they're not synchronized with the moment in our lives are they? Sounds like you gave the man in the mall something to think about. Stay strong. We're right here whenever you need some extra TLC.