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The Good, The Bad, The Ugly

I've always been acutely aware that the six-month mark after any event can be some of the most challenging times. Sometimes I have to remind myself that it hasn't been that long since I went through a diagnosis, surgery and prognosis. As much as it was all good news in the end, January 9th marked six months since my surgery.

A lot of what contributed to my outcome was luck, finding the weird painful thickened line on my own. Other parts were decisions. I chose not to have reconstruction to prevent waiting any longer than needed for surgery and to hopefully stay ahead of any metastasis. I chose not to have radiation due to the small percentage of survival it provided. Tamoxifen was also a choice I made, I decided to take the hormone blocker to prevent a recurrence.

In November the Cross Cancer pharmacy phoned to ask how I was doing on Tamoxifen. To recap; it blocks the attachment of estrogen and progesterone in your body even though your body still produces it. Essentially putting you into menopause. I felt great no joint pain, no emotional response, nothing unusual at all from being on it.

Then Christmas rolled around, my ankles started to ache, and the arthritis in my foot hurt once more but nothing unmanageable. I've lived with chronic joint pain for a long time. January came and my mental state started to become very flat. It was subtle at first and not immediately recognizable as anything out of the ordinary. It's winter, and the lack of sunlight can play a role on mood in the northern hemisphere.

Since my surgery, there is obviously scar tissue and adhesions but between physio and my stretching/releasing it was as good as it could be, working in a full range of motion. I was working out full force feeling stronger than ever.

Mid January I was doing pull-ups when I felt a strong pull during the exercise. I shortened up my set and continued to finish the rest of my exercises. At work that day I had a sharp stabbing pain all day in my armpit. This didn't resonate with me as being anything other than a tight muscle. I forget that I have no feeling on the left side of my chest. A couple of days later small striations of bruising showed up. Weird.

A week later there's a large lump above my scar line shaped like a hard-boiled egg and as hard as one. Extensive bruising underneath my scar and my mind freaks out I couldn't imagine what I did. The irony is on January 6th I had a follow-up MRI, which my surgeon recommended due to the cysts and density in my right breast.

The reason for this was the risk of having something going undetected in a mammogram or ultrasound of the right breast. Ironically the Cross Cancer Clinic refers you back to your family doctor with this sage advice: self-checks, yearly mammogram and ultrasound if any lumps are felt on self-examination. What?

Even the radiologist before my surgery after examining my right breast urged me to always ask for an MRI on that breast due to the difficulty of getting accurate images on ultrasound. You will always get the bare minimum in health care if you don't advocate for yourself.

The MRI showed a small seroma on Jan 6th which is normal I didn't know I had it, I could have this small seroma for a long time but now Jan 19th I'm dealing with a mess worried somehow I have a big seroma that may need to be drained. Phone calls and photos with the surgeon and physio along with an urgent care visit deem it to be torn scar tissue and bruising.

When you remove lymph nodes bruising lasts way longer than normal in the area. Tearing scar tissue adhesions off the chest wall can cause fluid build-up and bruises. Without any nerves in this area I don't feel anything at all. Instead I watch the carnage from the injury that has occurred, it's a very weird feeling. Damaged tissue without any pain feedback. Through self-massage, I get it to release and drain but there is still bruising that continues to show up to this day.

Smiling but feeling like shit

Meanwhile, I become void of emotion, very flat, feeling like I have a chokehold on my throat. Unhappy with everything and as this progresses I feel emotional crying, upset, in pain with my joints more and a literal mess. Very unlike myself, feeling so abnormal in my brain it was crushing. There was no happiness and no purpose in life. This is scary I felt this for a brief period of time, I cannot fathom people who feel like this regularly.

Even while out on a hike I felt shitty, something that brings me joy usually. Since then I have chosen to half my intake of Tamoxifen to 10 mg from 20 mg which was mentioned by the pharmacist.

We will see how this plays out, if I have a noticeable improvement in mood and pain it is the right choice. Some studies indicated that even 5 mg can have a positive outcome on hormone interference with far fewer side effects. The standard of care for all women is "20 mg" but clearly medical professionals understand how much it can affect people's mental health when the pharmacist repeatedly asked me in my first check-in if I had any changes in mood at all.

The GOOD: my MRI was clean I was given a clean bill of health and I've had improved imaging in my right breast from the prior MRI! Less density and cysts. Thank you Tamoxifen.

I also just signed up for my first trail race in many many years, I can shuffle my sore joints around the trail!

The BAD: WTF is this mental rollercoaster I've been on? No thank you Tamoxifen.

The UGLY: The bruising remaining is not pretty but I feel good again. Working out with light loads again not that I really stopped I just avoided pull-ups.

I feel very grateful to have gone through a lot of this cancer journey with minimal problems. The responses I have had from others who were struggling with health problems have been humbling. It is important to be transparent so others don't feel alone when these side effects happen and that everyone can realize it's not always sunshine and rainbows which social media has you believe.

One cannot underestimate the psychological effects that a cancer diagnosis can have on your life. Anxiety between scans, wondering if your lower back pain is a type of metastasis, is this headache just a migraine? Overall you do your best to mitigate these thoughts and move forward but it does change you for a time and as time marches on I'm sure worries begin to fade with it.

Sending You Love N' SUP,

Lisa Stocking

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