Absence makes the heart grow fonder...

I didn't realize it had been so long since I last posted to my blog. Over a year. Wow. Well, I guess I've been pretty busy and things have been getting back to normal so I really haven't had much to say. Until now.

I went to the doctor this past Tuesday and got some unexpected news. I'm three years out from my mastectomy and I still have a little over two years to go taking hormone/endocrine therapy. Since I had an estrogen-receptor positive tumor, the recommendation is to take something to block estrogen for five years post chemotherapy. When I went to the oncologist to set up the chemo, she suggested I enroll in a clinical trial comparing an aromatase inhibitor (exemestane) to tamoxifen, the traditional treatment. I was randomized to the test group. Because I've not entered menopause yet, I've also been taking a shot that completely blocks my ovaries from producing estrogen. Exemestane blocks the estrogen produced by other parts of your body (who knew that estrogen came from anywhere else?). So I guess you could say I'm in a chemically induced menopause.

Because I'm menopausal, I am more likely to have decreased bone density. They did a bone density scan about 2.5 years ago and it didn't look bad for my age. However, I had another one Tuesday and I now have osteopenia, which is mild bone loss. In 2.5 years I've lost 8% of my bone density. That doesn't sound like much but apparently it's pretty bad. My oncology NP wanted me to go over to the chemo area and get an IV of Reclast (same type of drugs that Sally Field and Blythe Danner advertise on TV). I've heard some bad things about bisphosphonates so I was leery and since my bone density didn't decrease overnight, I decided to come home and do a little research.

Come to find out, my menopause formula vitamins only have 25% of the RDA for calcium. You'd think a vitamin made for women who are at risk for bone loss would have enough calcium in it!! As I look back over the course of the last couple of years, I realized that after I cut soda out of my diet and started eating healthier, I don't have nearly as much heartburn so I rarely take Tums anymore. I used to take 2-4 of them a day, in addition to taking Pepcid.

So trying to be healthy has made me...less healthy.

Good grief.

Oh, well, at least we caught it. After doing a little more research, I found that tamoxifen can actually improve bone density. It's a drug that's in the same class as Evista, which treat osteoporosis!! So if I'd been randomized to the control group of the study, or opted not to do the study, I likely wouldn't have osteopenia right now.

So trying to help others has actually...hurt me.

Seriously?

It is what it is. I can't change what's happened to me over the past three years but I can make changes for the future. My oncology NP called me this morning and she's going to call in a prescription for tamoxifen. I'm still going to take the sweet monthly menopause shot. I'm also taking calcium supplements and *gasp* walking and lifting weights to hopefully improve my bone density. We'll do another bone scan in a year to see if it's better, the same or worse. Better would be best, but even the same is acceptable since bone density does not change quickly.

After a few days to mull this over, I'm over my initial anger and fear. I'm super stoked that I've gotten a clean bill of health once again as far as the cancer goes. I'm glad that my complication is something that can be treated with diet and exercise and a medication change rather than adding another medication. I'm glad that in all my clumsiness I haven't broken any bones.

It's all good.