5/30/22: My Medical Oncology NP Messaged Me

Actually, I messaged her first.

I sent her a message on Friday via the online patient portal because I had some spotting. Normally, this unexpected spotting would be somewhat alarming, and the last time this happened is when I went down the Tamoxifen detour. 

None of us has a crystal ball, so who could have known that the Tamoxifen would end up causing non-alcoholic fatty liver disease. Still, looking back at my blog entries, it's clear I didn't want an oophorectomy due to the risks, so Tamoxifen absolutely made sense at the time. 

I guess all the risks still exist, but I don't really have a choice now.

Anyway, as I mentioned to my NP in my message, I figured the spotting wasn't too alarming this time because we already know the Lupron isn't fully working and I'm already scheduled for an oophorectomy, but I decided to report the symptom anyway since I haven't actually had the surgery yet. 

So today the NP responded, expressed sympathy for ongoing complications, and said she'd let my OB/GYN surgeon know.

5/13/22: Lupron + Blood Draw and Results

After more than 2 years of monthly Lupron appointments, if the BSO surgery goes according to schedule, today will be my second-to-last Lupron injection. 

During check-in, the receptionist who is always extra friendly to me (not the original receptionist who always recognized me, who's long gone by now) was training a new person, and I waved to another familiar receptionist. The new hire remarked that I appeared to be well-known in the hospital, and I explained that I've been coming in at least once a month for almost 3 years! Ironically, I then told them about my upcoming surgery, which will put a stop to my monthly visits. The extra friendly receptionist was happy for me, that I might finally reach a point of stability in my treatment, with no more new interventions.

I got my blood drawn, and then went upstairs for the Lupron shot. The nurse who gives me the shot is not always the same, but most times it's the one who was trained by my old infusion nurse. I like her because her shots are the least painful - sometimes even pain-free - and she's always easy to talk to. She saw in my medical records that I have a surgery coming up, and I told her how the surgery means I won't be coming in for shots anymore, after the next time. She, too, expressed support and wished me luck. 

It's funny, you do something long enough, and you feel a sense of loss, even if that thing wasn't exactly something you enjoyed. I know I will appreciate not having to schedule my life around monthly appointments, but at the same time, it's a big change to my routine. In a good way, of course, but still a change, and I will miss the kindness and support of all the people I've been seeing regularly.

The good news is that my LFTs have continued to go down. Yay! They are now the lowest they've been while still being "high". (My first "high" results came in December 2021.) I don't know if lower LFTs automatically means the steatosis is also improving, but I certainly hope so. I will ask my hepatologist when I see him in August.

Meanwhile, my estradiol is back down to <5, which is where it should be. I guess it doesn't matter, though, since we know that it fluctuates and can get "too high". So it just happens to be low this month, but I don't think that will change my BSO plans. 

5/11/22: Pelvic Ultrasound, Results, and Some Pre-Surgery Instructions

Yesterday I had the pelvic ultrasound to make sure there's nothing unusual about my ovaries that would complicate my BSO surgery. 

Like last time, I was told to drink water before my appointment to make sure I had a full bladder. The person I spoke with recommended 2 bottles of water, but that's an awful lot of water for me, so I again did some trial runs with 24 oz., the amount recommended last time. I couldn't do it. I kept having to pee. On the day of my appointment, I drank only 12 oz., like last time.

My bladder was plenty full for the first part of the procedure, when they pushed the probe around on my abdomen. It was pretty uncomfortable, I had to consciously hold in the pee! I was allowed to use the bathroom before the internal part of the procedure, which was a lot more uncomfortable than I remembered from last time. 

Anyway, I checked online today and was surprised to see my results available already. I couldn't understand most of the report, but it did say, "Bilateral ovaries are within normal limits." A little bit later, I got a friendly phone call from the OB/GYN's office letting me know the results were fine.

I mentioned that the doctor had told me to expect a phone call with pre-surgery instructions, but I hadn't received any call yet. She said she'd check in with the surgery coordinator.

I have to say, I'm impressed with how responsive this office has been. The surgery coordinator promptly sent me an email confirming my surgery date and providing pre-surgery showering instructions. The instructions said to use Hibiclens, but since I had an allergic reaction to chlorhexidine when I got my port installed, I called up the surgery coordinator to ask about it. She said I should just use any antibacterial soap. It occurs to me that I did shower with Hibiclens for my double mastectomy surgery, and I didn't have an allergic reaction then, but I figure it's better to be safe than sorry, so I'll just steer clear of it.   

I also asked about the pre-surgery covid testing requirements, which weren't in the email. She said the hospital will call me closer to the surgery date to give me more instructions, including when and where to get tested before the surgery. My area is in another covid surge - right now my state has Delta-level case numbers, and the kids' school district has more daily cases than our Omicron peak! - so I'll need to be even more cautious to make sure I don't get infected before my surgery.