Friday, May 15, 2015

Three Heads are Better than One

Three oncologists all attended one seminar.  Three oncologists with three different life experiences have three different takeaways from said conference. The data that was presented (as usual) leaves me somewhere in the "unknown", the "it's really up to you", the "well on the one hand.....but then on the other...."

Needless to say, since my last post I've been doing major soul searching. Soul searching is so exhausting. I had a solid week of nightmares and anxiety so bad I woke up clenching my jaw. I have been able to take so many hits on the chin and skip on down the lane but this one had me deadlocked in my boots.

Let me tell you about my new friend Dr. Mchayleh. I had met Dr. M in a public capacity when we both spoke at the BFFL event last fall. I have heard wonderful things about him since he began his oncology practice here in LaGrange and found them to be more than true when I consulted him for a second opinion.  He was so warm, personable, and uniquely knowledgeable to my personal circumstance.  He had even printed articles for me to read. He knew I was overwhelmed at the prospect of losing my ovaries. He paused, and sincerely spoke to me as he would his own sister. As a student in elementary, middle, high school, and even college, I have always done better with a more compassionate teacher. I am a firm believer that it takes all kinds of people to make this world go round, but at the end of the day, I am a patient with a sensitive soul who longs for a tender-hearted doctor...and I think I have found him. He has also ordered a genetic retesting of my entire gene panel to look for a new mutation, among other interesting reasons.

Dr. M knew I would benefit from one more set of listening ears, and he wisely suggested them to be female. So he made a call and sent me to see a firecracker oncologist at Northside named Dr. Amelia Zelnak.
Much more thorough and fact based, she broke down all the data that explained the recurrence and/or survival rates with those patients just like me who were under the age of 35, had chemotherapy, and were HR+.  We went on to further discuss the added benefit that was observed with exemestane.  Here comes your chemistry lesson: The main source of estrogen is the ovaries in premenopausal women, while in post-menopausal women most of thebody's estrogen is produced via the conversion of androgens into estrogen by the aromatase enzyme in the peripheral tissues and a number of sites in the brain. Estrogen is produced locally via the actions of the aromatase enzyme in these peripheral tissues where it acts locally.

In English, this means that rather than committing to the irreversible very permanent decision to remove all my baby-makin' parts, I along with 2 out of 3 of these savvy docs have decided to opt for Adjuvant Exemestane with Ovarian Suppression for the remainder of my total 10 years of cancer treatment.  This means that for the next five years, I will receive a monthly injection that will suppress the ovaries' estrogen production, in addition to switching medications from Tamoxifen (this blocks estrogen coming from ovaries) to Aromasin (this blocks estrogen coming from peripheral tissues). The hope is that when this leg of the journey is finished, and the injections stop, I regain ovarian function and nature allows me to live another 10-15 years as a normal woman.....before menopause makes its regularly scheduled stop.  Of course, there are no guarantees that this will happen.  There are no promises my ovaries will churn out estrogen normally once I have subjected them to this shut down madness...but there are no promises to the contrary either.

I am explaining this to everyone as if their favorite roller coaster has been temporarily closed for's a bummer, and it will take adjustments, but after a while hopefully the mechanics will be worked out and once the oil is added and the gears are checked....back in business!

Who knows folks......I may just get a little Baby Byrd after all. 38 is the new 22 right???