Julie can't eat cheese

I finished radiation on 9/21 – which marked the end of my active treatment. My skin did well overall and healed up in less than 2 weeks. My radiation oncologist had said my skin may continue to get worse for about a week after radiation, but luckily it didn’t. I will see my RO in January for a follow up. She is really great and said I could come in earlier if I had any questions or wanted to talk about anything.

I found out right before radiation ended that my oncologist is leaving. Ugggghhhhh. I saw her on 9/27 for a post-radiation/pre-hormone blocker conversation. We discussed my labs – my neutrophils and lymphocytes were low and she said lymphocytes can be low for a long time as my immune systems bounces back, so I have to keep masking for awhile. We made a plan for me to start taking Tamoxifen on 10/2 – this is the pre-menopausal hormone blocker. Potential side effects: hot flashes, mood changes, risk for blood clots, uterine cancer, and eye changes. My onco said I will stay on Tamoxifen for a few years and then they will move me to an AI (post-menopause hormone blocker). I will be on hormone blockers for 5-10 years.

My first scan post treatment will be a mammogram (scheduled for 11/13). I was surprised it was a mammogram first and not a full body scan and said this. My onco asked if I was having any new/concerning symptoms – but I had ZERO symptoms before I found my cancer so… I don’t know if I trust myself to know/recognize any new symptoms. So umm, no, no new symptoms? I did have scans in January of this year that were fine and my rational brain knows this… but it is my irrational brain that is very loud in my head. I will talk with my onco once more before she leaves, via a phone call in November to discuss how I am doing on Tamoxifen (her last day is then the next day and I will get transitioned to a new oncologist).

After seeing my oncologist, I went to get a port flush in the infusion room. It was super visceral being back in the chemo chair, although it was also really great to see my old chemo nurses. I had forgotten to ask my onco about getting my port out when I saw her, so I emailed her while I was in the chair. I do not want to keep getting flushed, I don’t want to pay for it in the new year (2 years of medical bills is enough), and I would like to start 2024 without it in. She said that was fine and someone from general surgery would call me to schedule. I was initially scheduled (11/15) and then rescheduled for a day later (11/16) due to a conflict in the surgery room and it’s my breast surgeon (who I love) taking it out!!!! I won’t get put under for the port removal and they said I can even drive myself home if I need to. Super excited to get that out.

Back in February, my surgeon had recommended getting a functional medicine doctor as part of my anti-cancer lifestyle. I finally felt I could explore this and found one who specializes in oncology. I had my first appointment (10/05), was sent for labs a few weeks later, and had a follow up appointment (10/25). It was *SUPER* helpful to talk about all the aspects of health and to come up with a personalized plan. Surprise, surprise my cortisol is high and I have elevated inflammation markers. I never got back to meditating after surgery and have a lot of work to do to better manage stress/anxiety. I will see the FMD again in early December to check in on my plan and re-do some labs.

I also had pre-op calls for my ovary removal (coming up on 10/27 – my and Dan’s wedding anniversary!). I spoke with my doctor about the procedure and recovery: no physical activity for 2 weeks and I am taking the week after off to recover (my body has been through so much the last year, I wanted to give myself time to heal!). They will send the cyst for pathology, which will take about a week to get back. They think it’s a dermoid cyst, which can have fun matter inside (hair, teeth, fat… I am really hoping for teeth!). I am not sure what to expect in terms of side effects after surgery – I am already in menopause from chemo and have been on Tamoxifen for 3 weeks. I have had some pretty mild hot flashes, brain fog, and fatigue (but who even knows anymore what the brain fog and fatigue are from, because also… THE WORLD… it’s a lot)… As my RO said to me after finishing chemo – it could take a year to recover from all this (“this time next year…”). I have read a few books on menopause and there will be health impacts from the lack of estrogen I will have to manager and prevent.

We did get in a short celebration trip to Disneyland! I needed a little get away and we had a really fun time! I did, however, bring a cold home – I lost my voice and then had a terrible cough for a week. I actually took a sick day to rest early on! Sick days seem so weird now with work from home, but I didn’t want to get worse before surgery.

So phew! It has been a lot and still a few more things to go. Can I call myself a survivor yet? Am I cancer free or NED (no evidence of disease)? Who knows! I hope so and am working hard to put things in place to stay healthy! But overall, I feel good (fatigue is only major side effect) and hopefully I will continue building up my strength and stamina. I am sure there will be some scan-xiety with the mammogram, but I am also looking forward to that first one post treatment.

There does feel like this treatment cliff – I have been a medical frequent flyer for the last year – seeing my team often and then what?! I am on my own now?! I am definitely struggling with new normal/survivorship and incorporating all the things needed to stay healthy, deal with stress and health anxiety. I had joked I was going to have a major breakdown once I finished treatment to deal with all I’d been through. There was a sense of urgency to get it all done and just keep moving forward, don’t think about anything too hard – and while I haven’t had a major breakdown, I don’t feel the same (physically, mentally, or emotionally), I know I am not the same I was a year ago, and there is a lot to now process and deal with.

I stopped wearing wigs a few weeks ago – my hair is finally long enough where it maaaaaaaybe looks like a style choice.