3/4/20: Medical Oncologist Appointment

Today I saw my new medical oncologist for the second time.

At this point, these are the lingering symptoms in my hands:

• When I wake up, my fingers feel tight. It can be difficult to make a fist. It feels better once I get moving, especially if I open and close my hands a few times.
• My thumb, pointer, and middle fingers feel mildly numb and tingly all the time. It feels worst in the mornings after waking up, and gets better during the day. Bending my elbow (like when talking on a phone) makes it worse. Also, my left hand feels worse than my right.
• My left hand is still puffy.  

My oncologist thinks my fingers feeling tight is not joint pain because they feel better after I open and close my hands. She said if it was joint pain, moving my fingers wouldn't help them to feel better. She thinks the tightness is due to fluid retention from Lupron or menopause. It could be that all my various symptoms of numbness and tingling and tightness and puffiness in my fingers are because of the swelling. 

During the physical exam, she also noted that my legs looked a bit swollen, too. I hadn't noticed it at all, but maybe that would explain why my legs have been feeling stiff.

I asked her how much I should be worrying about these symptoms. First, how do I know they are side effects, and not symptoms of some other unrelated condition? Second, if they are side effects, can they be alleviated, or do I just have to accept them as part of my "new normal".

By the way, I have really come to dislike that phrase, "new normal". I have heard it so much as a way to describe my post-cancer life. I just want to roll my eyes, even though I know it's an accurate phrasing. 

Anyway, she said I should just continue to bring up all my concerns at our appointments. Probably we start by assuming that reported symptoms are side effects, but if they can't be managed, I could be referred to some other specialist. And if they are side effects, it's mostly a matter of whether or not I can live with them. If they are disrupting my daily activities (like they were before), then maybe we should try some kind of intervention. But if it's just a little annoying (as they seem to be now), then maybe just let it be.

As it is, in my efforts to improve my symptoms, I am wearing the wrist braces to sleep, doing nerve glides and deep breathing, and trying to get in some daily walking. I'm still trying to drink 2-3 quarts a day. I think I will also Google other ideas to reduce fluid retention. I have the Lasix on hand, in case the swelling gets noticeably worse.

(Also, as a friend reminded me later, menopause and medication-related side effects can be temporary. Already my symptoms have improved a lot, so maybe if I'm patient, and keep up with the efforts listed above, my hands will eventually feel back to normal.)

She took a look at my port incision, and said it does look better than before. I told her about how my infusion nurse and I talked about getting the port out in April if it's still not healed. She said the last time she saw me, she thought the incision looked bad enough that she wanted to see the port taken out. But now, it looks good enough that she considers it closed, and she recommends I leave it alone. Boy, what a roller coaster this port has been! I definitely don't want to get it out early if I don't need to. I will ask my infusion nurse her opinion the next time I see her.

Regarding my blood work, she said my phos was back to normal. Apparently the lab orders didn't include vitamin D, so I'll have to wait until next time to get that checked.

She put in orders for me to get another echocardiogram (I need one every 3 months), and also a baseline bone density test, since osteoporosis is a possible side effect of exemestane.

Finally, she said my next appointment would typically be in about 3 months. Again, I had that "baby bird" feeling, and hesitated. She offered to reduce the timeframe to 9 weeks, but in the end I decided to stick with the 3 months. It's just reassuring to have these appointments, but if something comes up, I can always call for an appointment.