Tamoxifen, MRI, and Fertility FUN

Okay, here we go. It’s June, baby. And I mean baby.

This morning I spoke with a young lady who works in the local imaging clinic. She was booking me in for a MRI this upcoming Tuesday morning. All I could think of as we talked over my ‘pre-screening’ on the phone was: “I hope I don’t cry again. Oh, and I hope I don’t pass out. Annnd I hope I don’t throw up. AND there better not be cancer.”  Not crying would be a glorious first.

June is huge

(The other stuff all happened the very first time I had an MRI. The situation was simply too overwhelming, but no wonder given the circumstances of diagnosis.)

But it’s a wonderful thing that I’m even having an MRI. The fact is, a woman in my situation – without any family history or any faulty BRCA genes – isn’t generally welcomed to MRI breast screening. But Dr Canada sent in a request, and apparently the requisition went through. It might be because I told them I was kaput with the tamoxifen.

As I said before, it’s June, baby.

What has been an emotional month for the past couple years now has an additional mark of importance. I’m not just getting screened this month, I’m stopping my tamoxifen. I’ve now been on Tamoxifen for 2 years and five months. So, basically 2.5 years. The oncologists recommend 5 years, and that might even be going up to 10 years with some new study recently released.

But I’m not waiting 10 years to try and have a baby. You can just forget that.

It’s so funny. I was saying to my husband, Zsolt, the other day that there are times in my life when I don’t want to be stopped. You know? Like when I want something so much, so badly, and feel that it is so right that it takes on a certain sort of power. I really only ever regret the moments where I didn’t follow my gut. For choices this big, this important – I need to go with what resonates through my being. And it’s saying TRY, DAMN IT, TRY.

I WANT to do this with every single part of my being, and therefore, we are going to do it. We are going to go for a baby.

My oncologist, as I’ve said before, is of two minds in the matter. In one aspect he thinks I should stay on the Tamoxifen. But on the other side of things, he reckons young women actually benefit from getting pregnant in terms of protection from cancer. He is in two minds. I am in one mind. My single mindedness helps this decision feel a little less scary.

The Tamoxifen stops as of June 15th. We then wait three months. And then, we try. That’s all I can do. Try. And I guess give up all dairy products and other food that encourages too much estrogen, since I will be without the Tamoxifen – it’s like the least I can do. And make sure I sweat every day since that also burns off extra estrogens.

So Monday is the MRI. June 27th is the mammogram. I’m stopping Tamoxifen on the 15th. And if the scans come back clean, then onward and upward. Today I also swallowed my nerves and called the fertility clinic for a check-up. More on that some other time.

June is a big month.

Everything will be okay.

I’ll try not to cry.

Making Circles and Plans and Circles and Plans

It’s hard to be caught between two long-distance families. It’s hard not only for us, but also for the people we leave behind with each plane ride back to that slippery concept of “home.”

Yesterday evening Zsolt, his mother and I were at the kitchen table looking at some stitching she had done. Anna is very creative, and she’s been working on a beautiful pillow case of red flowers. It’s taken her several months to stitch, on and off as she watches television in the evening.

Anna Stitching Hungarian

Anyhow, there we were yesterday evening. The dinner had been put away, and we were sitting at the table just talking, which is a bit of a rarity since normally it’s a choice between playing cards, watching a movie, or me escaping to our upstairs bedroom where I can watch some English webseries and chill out.  Frankly, I’m not a fan of the movies, and while the games are fun I get tired of them easily,but talking . . . talking is very, very interesting. Even if it’s all in Hungarian.

Anna was telling us about all kinds of things. One was that she had wanted to be an architect, but ended up in banking instead because her parents thought she was too skinny to do the co-op necessary for architecture that took place on a construction site. (She says she could have done it, but her parents worried she could not.) And so she studied accounting instead and ended up working at a bank.

Interesting no? I’m accustom to seeing my mother-in-law as a mother. Cooking, caring, and fussing all the time – that’s what I see. I’ve never met the young woman who had aspired to design buildings and dared to get married in a miniskirt. But I bet we would have gotten along, had we been able to understand one another.

And then she said what somewhat struck an even deeper chord within me. Anna related that back when she had children, (back when she was working 12 hour days at the bank, coming home late at night and only seeing her kids on the weekend – it was communism in Hungary back then, very work-focused rather than family-centric. . . had she been given the choice, I suspect she would have stayed at home more often) – back when she had children, she had wished they’d hurry along and grow up already. And now that she is older with far more time, she kinda wishes the reverse, that they could go back to being kids again.

I guess it’s empty nest and missed opportunities. And it made me feel a little bit frustrated with our own lack of children. We never talk about the baby stuff with Zsolt’s parents. They understand we need to wait before trying. But part of me would love to scoop up all those grandmotherly vibes and pour them over my own kids. I feel as though there’s a circle of life here, and we’re missing an essential loop.

Because really, Zsolt is never going to be four years old again. And, I reckon, instead of wishing him back to childhood, it should be wished that he become one heck of an amazing man, which he is – supportive, loving, caring, and growing; I think that her loneliness is more a result of family being far away, then her children no longer being children. At least, that is my guess.

Of course, I’ve known for a very long time that Anna sees Zsolt as her little boy. It makes all the sense in the world. She’s so full of love, and it’s the sort of thing that needs to be passed forward. But at the same time, I shouldn’t worry about her empty nesting, should I? That’s her journey to navigate. Though it is still a little heartbreaking.

Children grow up, parents step back, and families continue in a way that spreads outward rather than closing back inwards. It’s a theme I’ve written about in this blog, and loads in my fiction – and to be honest, since leaving Canada those many, many years ago for England and therefore taking my first steps ‘outward’, I have been just a little bit heart-broken. Once you step ‘out’ you can’t step back ‘in’.

Kids won’t solve long distance. But that’s not why I want to have children. I simply feel like we’re ready. It’s time. Let’s continue the circle. And not for the grandparents, though they are in my heart too, but because it’s right, and Zsolt & I want it. And frankly, we’ve got a whole lot of love to pass forward as well.

So, I’m counting down. April in Hungary. Then May in Canada. Scans at the hospital in June. If all goes well, then I need to wait three more months before trying. And then we try. And then we see.

And I have no idea what will happen next.

Babies & Bargains with my Oncologist

Last week was my six month follow-up with Dr. Canada. While I only get tested and scanned once a year, these cozy little chats are required every 6 months. This is how they often play out.

I arrive and take a survey where I mark all my ranging emotions and nausea conditions at 1 (meaning not at all a problem & thank god that part is over), except for anxiety which I always mark at 2 (not bad but feeling a little nervous.) You’d have to be a robot, I reckon, not to feel at least a 2 for anxiety during these check-ups.

on one hand

Then I wait a while and the nurse eventually calls me over.

We go to the scale and I take off my shoes/boots. Weight is measured in kilograms, so I happily get off the scale not having a clue what that reading actually means. (Thank you for the blissful ignorance, Imperial System).

Then I go in a room . . . generally the first room, and wait. Just wait. I can look out into the hallway through to the waiting area; I can look at the poster that says I should have brought my medical records (then think, “oh well,” because I never bring my medical records); and I look at the table that I never sit on where there is a gown I never wear.

Eventually Dr. Canada arrives. He’s a lovely fellow who was so incredibly patient and helpful when I was going through chemotherapy, so I try not to hold it against him when he now plays the “how fast can I get out of this room?” game. I’m not an emergency or a priority. I’m just a check-up.

But this time I wanted to hook him for just a minute longer.

The nurse, after taking my weight and showing me to the room asks: “Is there anything you’d like to focus on in today?” (I guess this is a test for how much time I’ll be taking up.)

I answer: “Babies.”

And she smiles and says, “Okay, I’m sure you can talk about babies.” Then leaves me to look at stuff and wait.

Suddenly, I was becoming more and more nervous. There was all that baby drama when I was first diagnosed (The guilt inducing should I/shouldn’t I get fertility treatment), and then the baby drama after I finished chemotherapy with an AMH test that was never properly explained and left me thinking I couldn’t get pregnant EVER. That is devastating news, and not something that should be shared over the phone without an immediate explanation of the AMH meaning except for the nurse saying “IVF isn’t going to work for you.”

And THEN there was the baby clarification, when I regained my menstrual cycle with a steady 30 day interval, which suggested that ovulation was in fact happening. After insisting on being referred to the fertility clinic, I had my eggs checked and yes, a few remained. “But you better get on it,” advised the nurse who scanned my ovaries.

“You better get on it.” Those words have rung in my ears ever since.

So I’m sitting there waiting for Dr. Canada to tell him that I’m nearly done my 2 years of Tamoxifen, and don’t try to stop me! I’m going off the medication to get pregnant.

My palms are sweaty. My anxiety had grown to a 4. And I left my tablet in the waiting room with my dad, so I couldn’t even tweet my way through the anticipation!

Finally, Dr. Canada arrives. He immediately launches in – asking about family history, then saying he’ll try to order an MRI though isn’t sure it will be approved, and a mammogram, and an ultra sounds . . . and. . . and . . . and he wants me to stay on Tamoxifen for at least another year.

Bollocks!

I tell him there is no way that is happening. I’ve been on for 2 years, and there’s just no way I’ll wait for three.

He changes course, and says something along these lines but not exactly: “Well, I’m torn in this situation. On one side,” (and he holds up one hand) “I’ve seen far too many things to advise you to go off Tamoxifen early. But then on the other side,” (he holds up the other side) “pregnancy in young women hasn’t been shown to put them at any higher risk of recurrence, and can actually have a protective aspect toward breast cancer.”

So he is in two minds.

I am not. I have made my decision. So I say to him,

“I know you don’t think I should go off early, but this is important to me. It is very important. And I’ve already been told that I need to get going if I’m going to have a baby.”

At this point, I am guessing he regretted referring me to the fertility clinic. But that’s only a guess.

And so he came back with a compromise so reasonable I couldn’t really say no. He suggested I stay on for another 6 months till June when my scans are all set to be done. If that’s all clear, he will step back with the Tamoxifen pressure and let me get on with having a baby.

“And in six months, you won’t tell me I should stay on longer?”

“No.”

Okay. I can pretty much assume that in six months he will tell me to stay on longer, but that’s because it’s his obligation. With clean scans, I’ll move forward and just get on with my baby craving adventures.

Anyhow, It’s weird negotiating with an oncologist. He said that many doctors in his position wouldn’t support me whatsoever, which is very possibly true. However, that doesn’t mean in any way that I would continue working with an oncologist who didn’t support me. Sometimes I can be a little bit stubborn about what I want. And in this case, I know what I want.

And so there is it. Fertility after cancer is a juggling of tests, opinions, drugs and opportunities. But I can hang in there, because obviously it’s worth it – and then, once the kid arrives, that will be a whole new kinda challenge. :)