Thursday, November 15, 2012

MORE KIDS vs. NO MORE KIDS

I was never that woman who felt that she wasn't complete until she had kids.  I mean I always wanted kids, a couple, ok several maybe.  But you know what I mean.  Don't get me wrong, when I found out I was pregnant, I was all on top being a mom.  And a mom of twins no less.  Well, you can just imagine what this did for my multi-tasking, organizing efficient, micro-managing self.  But I knew from the moment my GYN said, "Well, this is interesting," that I would return to work after my three months of maternity leave.  I know what some of you are thinking.  I worked at home during my maternity leave - negotiating contracts, writing and signing checks, updating budgets - all while handling twin newborns, and sometimes while double breastfeeding.  Seriously. 
 
So before chemo started, when my medical oncologist asked me if I wanted to freeze any of my eggs (since a major side effect of chemotherapy is the onset of pre-menopause and infertility), Graham and I thought about it for a mere minute and opted not to. We did discuss it before we entered the doctor's office, and had decided that we have two beautiful little girls. If for some reason we did want more, we thought, 'There are lots of kids who need homes. We could have a kid in so many ways. Why burden ourselves with just one?' The oncologist made the notation in my folder, as if it was a requirement.  I mean, she was the one that made a couple of snafoos.  I'm sure there's been a lawsuit somewhere, at sometime, in which a woman wasn't told that the Red Devil poison would make her sterile, and thus could not fulfill her life long dream.  Ever.
 
I stopped having my period prior to my third of six treatments (about a month and a half), and immediately the hot flashes started. I was thankful to have a bald head, since it emanated so much heat I literally felt I could fry an egg on it. Over time, I appreciated not having to worry about 'that time of the month,' but could be found at home, the office, the subway dripping down to a mere tank top and yoga shorts no matter the negative degrees outside - all in the blink of eye. And with another blink? I'd be fully clothed again.
As I ended chemotherapy and went through the six weeks of radiation, I grew accustomed to my new normal.  No menstrual cycle, hot flashes that felt as if everyone had an inner bipolar thermostat, and my hair started to come in.  But right when you feel you've figured it all out, it turns upside down.  Once I completed radiation, I went back onto the daily dose of Tamoxifen, the estrogen blocker. It's known that estrogen is an inhibitor of cancer growth, another curse of being a woman, as if we asked for it - yet again. The side effects of this hormone therapy are, as similar to the chemo, hot flashes and onset of pre-menopause - hence, infertility.
 
But over the course of a couple of months, I started to realize I wasn't having any more hot flashes, as if I actually had to try to remember when I last had one.  Was that it? Was that my menopause? Is that all it took?   When I went in for check ups, each doctor (remember, there are four of them) over and over again showed a glimpse of surprise when I said 'no' to the question of hot flash side effects. (I'd also say no to any achiness, cramping, mood swings, although who was I to say anything about that last one.)  'Is this normal?' I'd ask.  'Everyone's different,' they would respond with a tinge of bewilderment. Then again, what is normal in the midst of all of this madness?
Then, on august 7th, exactly eight months after I had my last cycle, it returned. Not much to get excited about, especially the cramping.  I mean, if you had to choose, which would it be?  Cramping or having to deal with tampons, pads, panty liners, etc.  You see, when my period returned after breastfeeding, it was pretty much insanity.  Like it was on the schizo cycle.  And the same happened now.  Like clockwork, I had my period for the next two months.  I thought, wow, maybe I'm that lucky woman who is spared.  Maybe, I can in fact have more kids! 
 
I return for my medical oncologist follow-up, which is every three months for the next two years.  I get weighed, have temperature & blood pressure checked, and wait for the doctor.  As always, the mildly obnoxious assistant comes in first, and I amuse her as I can so that I get in front of the doctor as fast as I can.  Done.  She leaves to get the doc, I remove my shirt, put the robe on, and mount that butcher paper covered table.  The oncologist, with her assistant in tow, enters, and examines me.  As I tell her the lack of side effects, and the good news that my period returned, there's no confetti.  No noise makers, balloons, or fireworks.  In fact, she goes on to mention how she might recommend an additional estrogen blocker via a monthly injection, as is the norm in the UK.  You see, being so young, with so much cancer, so many lymph nodes affected, apparently, the doctors are a bit worried for the cancer returning.  So blocking as much estrogen as possible that could further that along the better.  I take a pause.
 
'So I can't have anymore kids?' Now at this moment, from the corner of my eye, the mildly obnoxious assistant (who I might as well call MOA from now on) emphatically shakes her head 'no.' I quickly turn to her without hesitation.  'That is not acceptable.  That does not help a patient.'  She's stunned, as she should be.  I mean, no matter what, a patient doesn't need the opinion of a doctor.  One needs the information, all of it.  Then, you can make whatever decision is best for you.  My oncologist calmly looks at me and says, 'I recommend that you stay on the Tamoxifen for at least two years before considering to go off it and try to have anymore children.  Look at your options then.  If you want to have any kids again, you shouldn't take the additional estrogen injection.  You had alot of cancerous lymph nodes, and advanced tumors in your breast, all at a young age.  You have two beautiful children, and should be there for them.'  I politely thanked her, and wanted them to leave the room as soon as possible.  She continued to tell me that if I wanted to have a PET scan once a year or two years, she'd authorize it for me in order for me to officially feel being 'cancer free.'  We extreme pleasantries, they left and I dressed as fast as I could.  I still had to go to the Blood Draw room, to get my blood tested for varying levels in my liver and iron, signs that would indicate the return of cancer.  Then I left.
 
You never know quite what you want, until you can't have it.  Right?  I know that I should be thankful, and I am.  It doesn't help that Penelope keeps talking about wanting a sibling, twin boys in fact, one for both she and her sister.  I'm trying not to hold onto baby things, as I had done before.  Hurricane Sandy helped with that.  As for my period, it hasn't returned this month.  It's probably for the best.  I mean, what's the purpose of it, if it can't give you anything in return?