Friday, February 20, 2009


In the past, I was compared frequently to the Energizer Bunny, but at this point in my life, I can say that I am no longer a stranger to overwhelming mental and physical fatigue.

The emotional toll of your diagnosis is one thing; it takes a huge amount of your energy to marshal all of your remaining wit and courage to put your psyche back together. This is when you find out what you're really made of. You try to maintain your focus, while wondering if everything you're going through will work: will you be one of the "success stories" in those statistics that you turn to, trying to reassure yourself? How will you plan for dying? Should you? Can you confront the possibility that your life may be coming to an end before you ever imagined it would?

Learning that I had to go through surgery a second time, when I had felt some degree of achievement at getting through the first operation, was quite a mental setback. About 40% of lumpectomy patients must undergo a second surgery, because there are still cancer cells on the margins of their surgery site. I wish that I hadn't needed to wait weeks for the site to heal, only to be cut open again. That was pretty terrible to anticipate, but at least the site was "clean" following the revision surgery. The post-operative infection was also something that I would rather have not experienced; I was truly very ill, and frightened.

Radiation left me a shadow of my former self, and even the smallest task seemed like a huge effort. I would walk a couple of blocks to and from my daily treatment, managing to do this only by sheer will. I had been someone who exercised regularly for decades, and now, I could feel myself becoming less physically powerful, which was frightening. Foods tasted different, and things that I could formerly eat with no problems would upset my stomach. Exercising wasn't possible, and napping became a major "activity". I would awake every morning wondering how I was ever going to drag myself through the day.

One month post-radiation, I began taking an aromatase inhibitor (AI) to prevent my estrogen-positive tumor from returning. I have to take this drug for five years, and I have now been on it for 1 year. It prevents your body from producing estrogen, so it really plays havoc with several aspects of your health. The side effects: "Weakness" - check! "Tiredness" - check! "Mental fuzziness" - check! "Frequent Hot Flashes" - check! "Weight gain" - major check!

I now weigh more than I ever have in my entire life, and I have read numerous accounts from patients who have gained significant weight while taking the AI drugs. These women also emphatically say that eating less and exercising does very little to counteract the effects of taking the AI, which is slowing down your metabolism even more in changing your hormone balance to fight the cancer. My physician swears that all of these drugs make you gain weight. It would be the height of irony to have a heart attack or become diabetic from taking a drug to fight your cancer, but this thought has occurred to me...

I am now keeping track of what I eat, and exercising regularly, hoping that I'll be able to kick-start my metabolism again. It's better to be tired from exercising than from inactivity; it's a whole different kind of tired, a "good" tired. I hope that in a few weeks I'll recognize my lower body again, because there's someone I've never seen before looking back at me in the mirror...

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