Things That Would Have Been Nice to Know

Did you know that a hysterectomy and the hormone changes that come with it can change the density of your breast? And that the tissue can become much more fibrous?  I had no clue.  I knew hormone changes could cause soreness, but I did not realize it could change the whole make up of “the girls.”

 

Since my surgery, my breasts have been intermittently sore. Often to the point that hugs hurt. Normally, this might not be too big an issue, but I come from a family of huggers.  And they don’t give little spaghetti armed, polite pat on the back sorts of hugs. They hug you with the intention of squeezing any sort of sadness right out of your ears.  So needless to say…OUCH.

 I really thought the soreness would have gone away by now. It’s been 6 months since my hysterectomy but it hasn't. And about 2 months ago, I noticed that my left side was particularly sore under the arm.  And it was non-stop.   I finally called for a mammogram. I was a year and half overdue, so I figured I might as well get it done.

I told the scheduler about my hysterectomy and hormone replacement when I made the appointment. She acknowledged that and I assumed had put the information in my chart.  I went in on the 22^nd and had the procedure done and fully expected an all clear post card a few days later.

On the 28th I received a call telling me that I needed to come back in for more screening because my left breast looked “suspicious.”  The appointment was made for the following week. A day later I got a letter in the mail informing me that additional imaging was recommended. (yeah, I figured that out when I got the phone call.)  The letter also said:
“Effective July 1^st, 2013, The Indiana Senate passed a law (SenateBill 414) stating we must notify you of your breast density type….”    OK. That’s interesting. 

The options were:  Almost Entirely Fatty, Scattered Fibroglandular Tissue, Heterogeneously Dense, and Extremely Dense.

Apparently mine are heterogeneously dense. “Your mammogram shows that your breast tissue is dense. Dense breast tissue is very common and is not abnormal. But dense breast tissue can make it harder to find cancer on mammograms. Also, dense breast tissue may increase your breast cancer risk.”   

Really?  I understand that awareness and education are key. These are very important. But jeez oh Pete!  Way to add fuel to my already overly active and anxious imagination. I KNOW that my risks are low. There is NO family history of breast or ovarian cancer. But that is still a bit nerve-racking. 

So, for the next week instead of thinking about my boobs, I stuck my head in the sand and  hyper-focused on vacation planning. (which I had started doing a couple days before I got the call)  I looked at several hundred rentals in Michigan and the Chesapeake Bay area of Virginia. In that time I spent well over 40 hours obsessing about finding the perfect place.  I spent maybe an hour looking up information on breast issues. At that point, I figured it was better for me to NOT dwell on what may or may not be going on.  

I had my second screening this morning. The technician explained that they were concerned because my breast looked dramatically different from my last mammogram. I had gone from “Almost entirely fatty” to “heterogeneously dense” in a year and a half.  I mentioned the hormones and hysterectomy again, which seemed to surprise the tech.  It was NOT in my file. She actually looked relieved.  But we still had to go through the whole squishing thing. This was a LOT more uncomfortable than before. In this sort of situation they want as FLAT a view as possible. And the fact that the suspicious area was near the chest wall made it that much more difficult to get a good image. The doctor looked at the scans immediately and decided that I also needed an ultrasound. That was a lot easier and did not hurt at all.  

Doc decide that this was fibrous tissue caused by hormone changes but wants me to come in for another scan in 6 months to make sure nothing has grown.  

Everything seems to fine and that is a huge relief. Not crazy that I have to come back in 6 months. It is what it is. But it certainly would have been nice to know that these changes were a possibility right from the start.  It would not have changed my mind about having the surgery. But knowing would have prevented a bit of worry on my part.  

 A site with information on the importance of understanding breast density.  http://www.areyoudense.org/

Still Fighting

Maybe Starting to Fight would be better

Depression has not let up. Hormone levels are higher and a bit steadier, but I am still an emotional mess.  In fact, it became bad enough that I decided to go back on anti-depressants before Christmas. That decision made me feel terribly weak.  Of course I would never let one of my friends say that about themselves if they had to take ADs.  But for some reason, I’m different, right?  

I really need to cut myself some slack.  I spend so much of my time feeling guilty. (I am good at that) Guilty for not being a better mom or wife. Guilty for not having all the answers to fix my Grandma’s situation. (another long story) Guilty for missing the past two semesters of school. Guilty for gaining back lost weight.   Guilty for things that are completely out of my control. Guilty for feeling guilty.  And guilty, so very guilty, for being depressed.

I realize a lot has happened over the past few months.  Physical challenges and emotional events.  Any one of which could trigger a bout of the blues. But all combined is taking its toll. Add to that, the long, dark days of winter. It makes digging out of this on my own overwhelming.  I should not feel guilty for needing to ask for help. Of course, I do. 

So medication and therapy it is. I’ve been on the AD for 3 weeks now.  It takes a while for it to kick in. I need to be patient.  Patience is but one of  many virtues that I do NOT possess.  Monday I start therapy.  That is going to take a while as well.  I think most people think therapy is just lying on the couch and spewing out your mommy or daddy issues to a shrink.  But it is so much more than that. (at least if it’s done right) It is actual work.  It is retraining your brain.  And it is not easy.

 I am hopeful, though.  I see a small light at the end of the tunnel. I am starting to make plans again. I am taking a class this semester, and I am starting to feel like writing.  I think these are good signs and steps in the right direction.

Where I've been, why I haven't been writing, and why I really should be writing more.

I really do not want to write this. I want to be positive and upbeat and encouraging.  But I  do not have that in me right now.  And I resent the hell out of that.  I live such a blessed life that I have NO LOGICAL REASON to be depressed!  I live in an amazing country, have a great house, and belong to a wonderful community.  My kids are smart and strong and have very few health issues. I have a loving husband and extended family.  Very few financial stressors. My family never goes hungry or has to wait for health care.  Yet..the depression is there.  And it is far more than "everybody feels a little blue sometimes."  That I could understand. THAT I could cope with. It is this overwhelming sadness that I just can't wrap my brain around.

I have been dealing with some pretty rough depression over the past several weeks.  Had my hormone levels tested 2 and half weeks ago and my testosterone was down to 87. (when it should be between 100-300)  I can't remember my estradiol, but it was higher than it was at the last check.  So they inserted 1 testosterone and only 3 of the E2 this time.

I felt "okay" after that, but not great. Then last week on Monday, Tuesday, Wednesday, and Thursday I felt GREAT. I was sick on a couple of those days, but emotionally I felt really good.  I should have gone in to get my hormones retested. The doctor calls this my "feel good" test. They want to see where my levels are when I am feeling great. And then we would try to keep them in that range. 

Friday was a very low energy day. I was feeling a bit blue, but not horrible. Then Saturday was really rough. Not sure what set it off.  Anxiety in the morning, and just got worse throughout the day.  Even though we went to visit my son, I felt awful. Then on Sunday, things were pretty upbeat.  We drove back up to see the boy again, went to see a movie, and then took him shopping for groceries. I wasn't over the moon happy, but things felt "good."   

Today I'm feeling overwhelmed with depression and anxiety.  Irrational thoughts floating around. Nothing horrible, but the thought of renting a one bedroom apartment somewhere far away seems really appealing. Also regretting having the surgery done. Which I know is ridiculous.  Physically I am feeling a LOT better.  No more cramps, don't have to deal with menstrual cycles , and my libido has improved.  But the emotional ups and downs are more intense.  I've also been contemplating looking into antidepressants again, which is something I would rather NOT have to do. But, the doctor advised that I wait until hormones get leveled out. Which, logically I agree with, but dammit, I want the "quick fix." What I really need to do is find a good therapist. Specifically one who works with woman's issues.

I KNOW I do better when I am out of the house most of the time. Last month, the time I spent dealing with the death of my grandpa and the hospitalization of my grandma, I felt strong and focused. Which feels odd to me. That should be the time when I am overwhelmed. But I had a job to do and people depending on me.  

I do better when I am around people, (not a LOT)  but at the same time, I don't want to be around anyone. I also do better when I am exercising. But days like this, when I am in such a deep hole, it's damn near impossible.  

Something else the doctor said...stress makes you burn through the hormone pellets faster, which might explain why my testosterone level was so low. However, exercise helps keep the hormones level for longer.  Not sure how that works because I figured that with the increased metabolism from working out, you would burn through the pellets faster. But I guess that is not the case. 

I also just had a thought today. I am wondering if part of this is due to the upcoming holidays.  Thanksgiving is my favorite holiday, but with all the stores RAMMING Christmas down our throats before Halloween, I just feel yuck about the whole damn thing.  And no matter how hard I try, the memories of my childhood Christmases always out "glare" the memories of the last 25 years.  Which is pretty pathetic. And...maybe a post for another time.

With luck, in the next couple of weeks I will be doing a bit better.  I've been asked to help a friend out with the upcoming community theater production. In the past working with this group has really lifted my spirits. They are energetic and funny and I do love being around them. Feeling hopeful this will be a step towards climbing out of the hole.  At the very least, it will help me get through the next few weeks and through the holidays.

Long Month

Part 2

Early Monday morning Grandma had started suffering from severe stomach pain and shortness of breath. The EMTs were called and she was taken to a nearby hospital.  By the time I made it to the hospital Monday afternoon, they had just decided that Grandma would be having surgery that evening.  She was suffering from a very large hiatal hernia.  So, Dad, his fiancé, and I waited while Grandma was in the OR. When we finally got back to see her it was pretty late. She was sedated and on a ventilator.   If you have never seen a loved one in that condition, let me assure you, it is rough.  At one point she woke up and was very wide eyed and scared. 

Grandma had the vent in until Wed afternoon. It was heartbreaking. Most of the time she was sedated, but every now and then they would put her on “sedation vacation”, turn the vent down, and see if how well she could breathe on her own.  During those times she was conscious, she would desperately try to talk to me.  She tried using her hands to get points across, but she was wearing these huge clumsy mittens to prevent her from pulling the vent out on her own.  There were times she would be crying and I could do nothing to help her but hold her mittened hand and tell her that she wasn’t alone.  I felt incredibly helpless. 

I stayed in Ohio until Friday morning. Spending my days at the hospital with Grandma and Dad and my nights at my in-laws home, 30 minutes away.  I am so blessed to have the in-laws that I do.  Their home is a place I consider a safe haven. A place I can recharge.  I can go there and be completely at ease.

My husband and I ended up driving back down to visit Grandma Saturday afternoon. My aunt and uncle drove back up from Tennessee as well. After visiting Grandma at the hospital we all went back to the condo to see Irwin. Hospice had just put him on 24 hour watch.  While we were there Irwin’s sister called and he was able to talk to her a bit. I was holding his hand while they spoke to each other and when he told her that he loved her, he reached up and started gently patting my face.  I know he was imagining that I was his baby sister. Maybe it makes me weird, but I can’t express how that made me feel, to be part of such loving moment was very special.  

At that point my uncle said “Well, if he was able to talk to his sister…”  I didn’t even let him finish. I said “YES! We HAVE to let Grandma talk to him!”  I had wanted to have them talk on the phone since she’d gotten off the vent…but I felt that I was “just the granddaughter” and did not have the confidence to suggest it.  (I hate that I am like that)  So, my husband, aunt, cousin, and I went to the hospital to be with Grandma and the others stayed back with Irwin.  I felt that it was important that Grandma had someone on her end while they talked.  They were able to talk for about 5 minutes. And Irwin was more animated than he’d been in a couple of days.  They were able to laugh about the first time they’d met when my grandma was 12 and he was 17 and the train rides they took together 50 years later. They were able to say their last I love you’s and their last goodbyes. Grandma kept telling us that we had given her a gift by making sure they got to talk again.  Again, I am the one who felt like I’d been given a gift to be part of something so intimate.   

That night we stayed with my aunt and uncle at a rented condo next to Irwin’s. We expected a phone call or knock on the door in the middle of the night, but it did not come.  My uncle and I both woke up early the next morning and spent a couple of hours talking.  I’m grateful for that time. My uncle is very special to me and we do not get to see each other often. To have that one on one time meant a lot to me.

After visiting both Irwin and Grandma one last time, we left for home.  The girls and I had to pack because we were heading out to Florida the next day.  I spent a long time debating on whether to go. I felt guilty, but for a variety of reasons, we decided it was the right thing to do.   

It's Been a LONG Month

Part 1:

It’s Been a Long Month

Running…has sort of been on hold.  The AFM 5K on Friday (Sept 20) was canceled due to t-storms. Good call on the organizers, but I was disappointed.  People still got their medals, which was cool. (Of course I felt that I had to earn my medal, so that Monday I went out and did a total of 4 miles.  And my 5K split was 45:54, and I was pleased.  But since then, I’ve only run 4 times, and I have a 5K in just over a week which I am NOT prepared for.  Oh well.)

After the cancellation of the 5K, we went to our friends’ house and had dinner. It’d been far too long since we’d spent time with them and we really enjoyed ourselves. During dinner I was introduced to a brand of wine called Rex-Goliath: Giant 47 Pound Rooster…or as I like to call it “The Giant Cock.”  (I know, not terribly creative)  She’d bought Moscato, which I had JUST tried for the first time a few days before. I LOVE it.  I’m sure I’d be criticized by “real wine connoisseurs” because it is far too sweet.  Well, they can bite me. It’s yummy.  

 

The following morning my husband did his 10K. His goal was to beat his time from when he was 22 years old.  He honestly did not think he would pull it off.  But he did…by nearly 2 minutes, 54:29.  I was very proud of him.  I have now challenged him to go for 50 minutes.  (yes, sometimes I’m the little devil on the shoulder.)

Jim after 10K walking to get his finishers medal. (I won't lie, he was looking pretty sexy at that point)

That night we went to visit my Grandma and step-Grandpa to celebrate their birthdays. Grandpa Irwin had been fighting prostate cancer for years and I knew that fight was coming to an end. But when we saw him that night I was stunned at how much he’d decline in the past month. He was so frail.  They’d brought in a hospital bed and put it up in their sun room.  When we’d been there just a few weeks before, he’d been sitting in the living room on the couch.  But now he was only leaving the hospital bed to go to the bathroom. 

 
Grandma was telling me that she was having problems caring for him due to her own health issues.  So that night my family decided that I would come back on Monday and stay the week with them so Grandma wasn’t trying to care for him alone.  And selfishly, it allowed me to spend some more time with him.

By the time I got there on Monday, they had aides coming in to help during most of the day. That was a HUGE help.  It was a rough week, but also a good week.  He was in a lot of pain and at times he was very confused and agitated. Then there would be periods of time when he was sitting up in bed, doing the crossword puzzles and laughing.  We watched Dancing with the Stars together and talked about the news. Sometimes he would get irritated about all the different aides coming in and out of the condo and would rant about that for a while. Or get upset about his medications and lash out a bit.  But the man was in pain and he was scared and dammit, he DESERVED to be able to bitch and complain and holler! I do NOT begrudge him of that at all.  And the fact that he would always apologize later, after the pain subsided, would break my heart.  But, *I* was able to handle that. Grandma was not. *I* knew it was not personal. Grandma would internalize it. It was very sad. I was torn between wanting him to be able to yell at the world and wanting him to stay calm so Grandma wouldn’t get worked up.

 
The last night I was there was a good night. The three of us stayed up late and he was telling me some stories about the end of World War ll.  Some sad and some funny.  We all ended up laughing before it was time for bed.   As sad as it was, I will always cherish that week and especially that evening. 

The plan was for me to come back the following Monday and stay for a couple of days and then his children would come and take turns helping.  But I got a text early Monday morning from my dad.  Grandma had been taken to the ER.  

The end of week one and start of week two.

Pre-Race Blahs

I really don’t want to be writing. Haven’t wanted to for days.  But, the husband said I should. The point of me starting this blog was to talk about what I’m going through with the whole menopause and bHRT.  OK. Fine. You’re right, Dear.

The past week (maybe even 2 weeks now) have been rough. More than half the time I am feeling blue. I have no drive and no interest in most things. I want to stay hidden. I want to cry.  I want to yell.  When I DO go out, it’s because I have forced myself to do it.  The thing is, there are times when I just CAN’T force myself. 

Please, please, please do NOT give me the “You just have to make yourself happy” or “you just have to make yourself do it” bullshit.  Because it does NOT work for everyone.  One of the WORST things you can tell someone who suffers from major depression is “Just THINK yourself happy.”   Because when they try and they are not able to do it, that is just ONE MORE THING they feel they have failed! 

I am not saying that cognitive therapy is not helpful. FAR from it.  It is vital! But know it is not as simple as “just think happy thoughts.” It takes a LONG time. It takes “retraining” your brain.  It’s not just a simple switch that you can flip on or off.  It is a total rewiring!   
OK. OFF that soap box.

I’ve also been a bit more snippy.   The husband has been irritating me.  He actually had the nerve to try to recommend a solution to a complaint I had the other night.  I was getting really mad at him.  When he wouldn’t stop talking I finally yelled “IT'S NOT ABOUT THE NAIL!!”  At least that soothed things a bit and we were able to laugh.

 Then yesterday morning, I got mad at him for trying to make me a ham sandwich.  WTH?  He was trying to be nice. He was doing something I had asked. But it wasn’t fast enough and I changed my mind and I snapped at him.   I did apologize.  He said he was sure it was the hormones and that I’m really not that much of a bitch. (OK, he didn’t add the bitch part. That was me) And that was when he suggested that I write about all yuck that I am feeling.

For whatever reason, I am feeling far more down than I did while I was recovering from my surgery. More irritable.   I think I got overconfident when I was feeling so upbeat emotionally (most of the time) those first few weeks.  Now, I guess the hormone roller-coaster is in full swing. 

Hell, this is Air Force Marathon weekend. I should be super excited!  But I’m not.  I had to force myself to leave the house yesterday morning. Yes, I was looking forward to seeing my friends and family, but I’m not excited or really happy about the rest of it.  I’ve only had a couple minor episodes of pre-race butterflies. I am hoping that changes as the day goes on. But I’m not terribly hopeful as the weather is looking iffy for tonight. 

This will change. Things will get better.  I know I was foolish to think that maybe anxiety and depression would somehow be surgically removed with the uterus. But hey, can’t blame a girl for hoping.   On the plus side, I’ve dealt with depression enough that I am not blindsided by this.  I can’t imagine how it must feel for women who have never been depressed to suddenly be swallowed up by it after surgery or once menopause starts.   

So now, time to force myself out of the house. I need to hit the bank and then go back to the expo to buy a couple items.  Retail therapy?  Maybe a little. But these were two things I’d already allotted for. (Don’t worry Farmboy, I promise not to go overboard.)