Sunday, July 28, 2013

At 63 Years Old


2013 July 28


At 63 Years Old


Before I begin what will likely be a rant, perhaps a little background information is in order. I have been happily menopausal/post menopausal for about nine years. That in itself will give you some indication of what this rant will encompass, so if you are offended by discourse regarding female issues, stop reading NOW!


My reproductive system has never really been user friendly. I have endured PMS, infertility, arrogant fertility specialists, and assorted surgeries, pains and discomforts over the years. Once having come to terms with all of the challenges offered up on a monthly basis by my uterus, ovaries and fallopian tubes, I settled in, and learned to "tell time" by the passing of each menstrual cycle. If nothing else worked well in that system, it was, at least, regular as clockwork. For me, a month was the length of time from the beginning of one cycle to the next.


When menopause began, I actually felt a little sad, in spite of the tempestuous relationship with my lady parts, because it required me to rethink my time passage measurement. But, as women always do, I adjusted. And I cruised along becoming comfortable with a new season of my life. 


In many ways, a very pleasant season. No cramps, no mood swings, no sudden gushes during a period caused by doing something strenuous, like lifting something heavy no unexplained cravings for chocolate, no emotional outbursts - none of those unpleasant, annoying aspects of womanhood. Learning a new way, albeit "normal" way to measure time transit seemed little to take on in exchange for loosing so many annoying things.


So, in this new found freedom, I have cruised through the past nine years. Granted, my family doctor, who does my pelvic exams, would occasionally bug me about a uterine polyp with which she was concerned. Mostly, I have been able to ignore her. However, once we were in Pittsburgh for an extended period this late winter into early summer, I could ignore her no longer. (The reason I was ignoring her requests to have the polyp checked was that it required me to visit the gynecologist whom I did not like. And because I was too lazy to seek out a different gynecologist) To placate her, more than for any other reason, I scheduled an appointment with the dreaded gynecologist.


Poor Raymond. I made him go with me, even into the exam room. To my dismay, his impression was that, "he seems like a nice guy". That really isn't relevant, though. The initial exam, concurred with my PCP's concerns, and I was scheduled for a procedure, to remove the polyp and biopsy it and my uterine lining, with was "too thick for someone so far post menopausal". Suddenly the lovely period of detente between the lady parts and I was at risk.


The polyp was removed and was benign, as was the too thick uterine lining. It seems that although I am indeed post menopausal, my ovaries are producing more estrogen than is considered normal, which in turn, causes a thickened uterine lining. Both the gyne and my PCP are concerned that left to its own devices, this lining might decide to evolve into uterine cancer at some point. In order to combat that possible issue, they both thought (think) I should follow a course of treatment that would require me to take 10mg of Provera (a hormone my menopausal self no longer produces ~ progesterone) for ten days at the beginning of each month for three months. In fairness, the gynecologist wanted me to take it for June/July/August, but I didn't start it in June, as I waited until I talked to my PCP, to get her take on it. Since I trust her, and since she seemed to make a case for taking it, I acquiesced, and decided to move the treatment to July/August/September. Since my next appointment with the gynecologist isn't until late September, I figured it really didn't matter.


So, on July 1, I began my first month taking Provera. The doctor had warned me that if I had been prone to PMS symptoms, they could return with this medication. PMS would've been welcome! Instead, I became a screaming, psychopathic, irritable bitch! There is no other word for it! It was as if my evil twin had taken up residence and even though I wanted to, I could NOT evict her. I hated everything and everyone! I was critical of everything Raymond did or didn't do. I was cranky beyond measure. I cried or yelled, more or less constantly. Everything and everyone irritated me to the point that I wanted to slap them, or worse. In a word, I was UGLY! I was SO UGLY that I couldn't even stand myself! It seemed like the longest ten days of my life! I can only guess how long it felt to my poor husband.


In the midst of the early days of July on Provera, I also began a course of Medrol (a steroid - yet another hormone!) this one for the treatment of the severe arthritic changes in my cervical spine which were causing problems with a nerve root. I asked the pharmacist if this would interact with progesterone which was already recking havoc with my personality. He said that it might "intensify" things for the first few days, but somehow thought it reassured me when he told me, "it's really not a 'you' thing - it happens to everyone taking progesterone". I was not comforted!


The pharmacist was correct, though, as the steroid for the arthritic stuff didn't seem to effect me as badly as the other hormone.



Finally, day ten arrived. No more Provera. Thank you, Lord! I won't say I mellowed out immediately, but there was light at the end of that tunnel. 


Remember the joke about the light at the end of the tunnel being the oncoming train? Yep, there it was three days later, as promised by the gyne, the light at the end of the tunnel that turned out to be my first period in nine, did you hear me? NINE!!!! years! While I knew this was the expected outcome resulting from dumping progesterone in my body, it still came as a general shock to my 63 three year old system!


Let me say this as simply as I can: at 63 I am too old to be standing in line buying tampons and pads! Granted the whole period was over in five days, but it sucked! I don't want to have a period at 63! especially after not having one for 9 years! The whole process, from the crazy irritable person inhabiting my body, to the shedding of excess uterine lining, to finally staring to feel human again took up more than half the month of July! I don't want to repeat that process in August and September! 


Yesterday, while driving to Adams, NY, Raymond and I were discussing all of this. I said that I was leaning toward stopping the Provera. He was enthusiastic in his support. Until he questioned why I was doing it in the first place. When I explained to him that the doctors were concerned about the thickened uterine lining developing into uterine cancer, he suddenly had a change of heart, and thought I should take the remaining course of Provera, in spite of the maniac we both fear I will temporarily become.


I'm still not convinced. As I told Raymond, if I'm 63 and on a scale of 0 to 10, with 0 being no chance of cancer and 10 being cancer, I am at 1.5,  and if I have been at 1.5 for at least 9 years, what are the odds that I will develop cancer? And if I do, couldn't they just yank my uterus? Raymond's response was to question whether that type of cancer would spread if it did develop. 


So… here I sit, just a few days away from the beginning of the next month with no idea what I am going to do. Take it, or not, that is the question. I do not want to become a screaming mimi for for the first ten days of August. I also do not want to deal with having another period. I hate the whole process. It feels so unnatural. Yet, I certainly do not want to develop uterine cancer. But the question remains, if I have had a thickened uterine lining for the past nine years without it being positive for cancer (it has been pre-cancerous - but NEGATIVE for actual cancer cells), what are the odds that I WILL develop cancer? I don't want to tempt fate. I have been down the cancer road with my bladder and am grateful for how contained any abnormal cell growth there has been.


I'm thinking phone calls to both docs are in order tomorrow. Perhaps the severity of my reaction to Provera will decrease with each consecutive month. Perhaps it won't. I need some straight answers and NOT simply, being told this is what we generally do. In spite of the song, I am NOT every women! I am an individual and perhaps this is not the course of treatment for me. I certainly don't want to take medication that in the long run, may not really have any effect. But, on the other hand, I don't want to see my uterine lining morph into cancer. What's a 63 year old to do?


Oh! and just a little side note. When I asked the gyne if we couldn't just do a hysterectomy, back in April, his response was, "I can't in good conscience take out healthy tissue." So, if it's healthy, why am I taking Provera and scheduled for yet another biopsy in September? It all seems rather convoluted to me. 


Perhaps I should've called him while I was harboring my angry twin during those early weeks in July. 



Wednesday, July 17, 2013

The Weight


2013 July 16


Weight ...


Lately, things have been weighing on me. 


What kinds of things? Well, the air conditioning in our barely four month old car gave up cooling. That was a BIG one, especially in the midst of the current heat wave. Especially when the service department told me the part was on "national back order". There was my trip to Erie to get the tow plate installed on the little car. That was an OK experience, but it lead to me start wondering about towing and my abilities. My Dad has been a constant concern, but not because of his cancer diagnosis. No, that's something we can't do anything about. Rather, I have spent months asking him to travel with us for the time period when we leave the Pittsburgh area in late July and when we will return to the area in late September. He has been resistant, but always using "Dad speak", never refusing outright. Finally, I had an epiphany, and approached him as he was resting one afternoon. I told him that I was going to stop asking, because I didn't think he wanted to come along. The look of relief that washed across his face and lit up his eyes as he said that, no, he really didn't want to come with us, broke my heart in little pieces. All this time, I have been asking, begging, plying with ideas and reasons why it would be a good thing and in that moment I realized that it would've only been good for me, not him! All this time, I thought I was being a good daughter, when in fact, I was being a pain in the ass. It hurts my heart to think that all this time, I have been annoying him when all I wanted was to be helpful, to him and to my brother. Yeah, my brother. Another area that has been weighing on me. My brother retired after 30 years at the USPS on January 31, 2013. On February 15, Daddy's decline began. My number three baby brother has been Daddy's primary caregiver since then. He has had no time to relax, to travel, to enjoy the fruits of his thirty year labor. I feel guilty. So, if Daddy would come along with us, it would allow my brother some relaxation time, without this added responsibility. Then there's the financial aspect of having been relatively stationary since February 22. Campgrounds in the area have been expensive by our standards. that put a dent in our budget. Then Greyla needed expensive diagnostics and surgery in April, has had blood work since that isn't cheap, and needs daily medication for her arthritic hind quarters. So much for trying to get debt free. In point of fact, we have too often relied on credit cards during out time on the road. And all of this is without even mentioning any personal health issues. Yep, things are weighing on me.



This morning the service guy from the car dealer called to say that the compressor for our car should arrive tomorrow, and would I like to make an appointment for repairs on Thursday. Felt like turning the corner, even though it was such a little thing - someone following through on what they needed to do.



I think that the general circumstances of our extended visit have fueled my natural tendency to be emotional. Add to that, the fact that my PCP and Gynecologist have encouraged me to follow a treatment plan which includes the ingestion of hormones over a three month period, from July through September. Is it any wonder that I am an emotional mess, with feelings of intense emotionality and feeling the weight of the world on my shoulders?





Thursday, July 11, 2013

2011 July 11: An Old Email Letter Found

[This is an email letter I sent to friends back when I was first suspected of having bladder cancer. I recently found it buried among other things in my documents folder. It made me wonder who this person was, because I don't feel I have this level of faith and trust at the moment.]



Feb 22 2008

Dear family, friends and wonderful intercessory prayers,

This is just a note to let you all know that everything went well on
Friday with the surgical removal of the bladder tumor that was only just found last Monday.  


I am feeling pretty good, and only have some pain (which is relieved
with extra strength Tylenol) upon urination. I am keeping well hydrated, which will help the healing process.  The tumor will be biopsied and results should be available in 5 working days. I will let you know what happens when I know.  For right now, I am at peace, because God has me in His hands and I am ever so aware of His presence.


Throughout this whirlwind week, things have happened that I know to be 
Providential. The discovery of the bladder tumor during the course of
an examination for something completely unrelated...the availability of
both the appointment with the urologist AND the surgical time, due to
cancellations by other patients...especially considering that the urologist was well booked through mid-March...the presence of  people in my path to testify personally about the nature of this type of cancer (if it turns out to be cancer).  There are no coincidences, only God incidences.


The doctor said candidly that this type of tumor is cancerous in 80% of
cases.  Well, that means it's NOT cancer in 20%, right? I'm hanging onto that!  But, the Doctor and some of those 'others' who passed through my life this week, also said in not so many words, that if you have to get cancer, this is the one to have, because it is generally a contained type which does not spread.  So, either way you look at it, it's good news.


There are so many things for which I am grateful. The love and kindness
shown to me has been a wonder. I am blessed to have such support.  From my dear brother who was the first to see me immediately after the urology appointment when I was scared and approaching a meltdown, to Raymond who has been my rock, to my wonderful friend and SIL, Barb, who took the day off work, took me to the hospital and then kept Raymond company during the procedure, to all my praying friends and cyber pals.  God has blessed me with an incredible support system!  


As a good friend said just the other day, "If God brings you to it,
He'll bring you through it". To that I say, "Amen!" 


The graciousness of my employer in the midst of this situation is also a blessing.  This has created havoc in her life, yet she made phone calls on my behalf to ask for prayers for me. 


The week before all this began, we had one of the most relaxing, wonderful and enjoyable vacations EVER, in the 4WD area of Currituck County, North Carolina.  That was definitely a gift from God. He was lying the ground work of peace and comfort, of learning to rest in Him that I would need so desperately during this week just past. 


Praise God with me!  He is good all the time. He is in control all the time. We have His promise that He is with us always (Matt 28:20).  Never have I been more sure of that promise than during these last two weeks.


In Gratitude for His Peace,

JeanMarie


~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~


[Followed by this email one week later]



2008 Feb 29 More on Bladder Cancer



Dear friends,

The biopsy report came back positive for cancer.  However, it was low stage, low grade and contained: all excellent news! In addition, the tumor was growing out & up, which means it didn't infiltrate surrounding tissue. I have a CT scan scheduled for 3/7, a post op Dr's visit ion 3/18, and barring anything as yet undiscovered, I will see the urologist every three months for the next two years. It's all good!


On 3/5 I have a gynecologic appointment to address issues that lead me to have the original ultrasound that found the bladder tumor.  Hopefully all will go well with that appointment, as well.  After talking to both my PCP & Urologist and asking the questions that I awoke in the middle of the night mulling over, I fell very sure that the two problems are completely unrelated.  Since they both revolved around abnormal cell growth, I had many questions.  I thank God that I have a long-term relationship with my PCP and feel comfortable asking her anything, even those questions which may seem insipid, or unnecessary.  Plus, there is a comfort in the fact that she knows me & my husband and sees us a whole, complete, entities, not just the sum of our "parts".


Thank you, all of you. It has been a great comfort to know that you have been praying me through this process.  I am blessed to have so many good friends and prayer partners.  I thank God for each and every one of you.


Apparently, if you must have cancer, this is the one to have.  Seriously, because it was low grade, low stage, and contained, it is extremely unlikely that I will need any further treatment.  The need to be followed closely is due to the good possibility that this type of tumor may re-grow.  However, by frequent visits to the urologist, any new growth can be spotted early and removed in his office, without further surgeries and anesthesia. 


Cancer has long been a dreaded fear of mine. My Mother died at age 49 from lung cancer.  I often thought that cancer would take me at a young age and spent a good portion of my 49th year living in dread. I have lost friends to the disease and have seen other friends and family plod through the diagnosis of "cancer" to come out the other side, scathed but alive.  I am no longer afraid of cancer.  This experience opened my eyes to what possibilities there are in living without fear, knowing that God is in control. 


Again, thanks to all of you and may God bless you.


Love,

JeanMarie




Monday, July 1, 2013

THOUGHTS ON BIRTHDAYS AND MORTALITY


2013 July 1




As we age, you might think birthdays would be more special. At this point in our lives, though, we seem to take them for granted. They seem mundane; just another day. Perhaps we have become jaded. Or perhaps we simply don't want to be reminded of how long we've been around. Maybe we've simply become more low key, secure in ourselves, not needing the affirmations of others. I'm not sure into which category R and I might insert ourselves at this point.



Today is my husband's birthday. We do not normally make a big deal of the event. Happy Birthdays are said. Perhaps ones favorite food is made or ordered from a local restaurant. Raymond doesn't eat sweets, so there is never a cake on his day. But, in general, we are lackadaisical about birthdays.



But, this year, his birthday seems as if it should be more. Perhaps it results from having had so many changes in plans over the past four - five months. Perhaps it is because I feel like I "owe" him because he has been so patient in the midst of my Dad's illness. Perhaps, (and I think this might be the real reason,) it has a lot to do with having met our next door neighbors here at Indian Brave Campground. 



Meeting H & W, and now, watching them as they face H's terminal condition, gives birthdays new significance. If you read my post about them, http://meandrayandadognamedgrey.blogspot.com/2013/06/strangers-no-more.html you know that H (husband) and W (wife) are a sweet, quirky, lovable couple we met when they pulled into the space next to ours, back in May. They have recently been told that H's liver is shot. Without a transplant, he is facing a decidedly shortened life, barring a miracle. On his last birthday, did he suspect that it might be one of his last? Did W, who is eighteen years older than her partner, and dealing with severe health issues of her own, think that she would face the possibility of birthdays without her H?
I doubt it, on either question.



Too often we go along, just as R and I have, expecting that there will be another day, week, month, year, birthday. But, none of those are promised to us. So, let's celebrate while we can! Each day is a gift. Each birthday, a milestone to be celebrated! And, it's OK if you celebrate in a low key manner. Just remember to celebrate! And remember to be grateful!