Zoladex

Breast cancer lesson 136: Say goodbye to the fake menopause – and hello to a good night’s sleep

Contrary to what my oncologist thinks (although I fear he was trying to lighten things), no woman needs a fake menopause to prepare themselves for the real thing. You may see it as an end to periods as you know them. In truth, the menopause disrupts so much more than that (sleep being top of the list) and, enduring it more than once is not something ever to be encouraged.

That is, unless you want to try and give your ovaries a chance of coming back to life after chemo!

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Four weeks ago today, I was waiting patiently in the oncology clinic for my very last Zoladex injection (click here for lesson 124 and a quick reminder). Zoladex (also known as Goserelin) is a hormone therapy sometimes offered to pre-menopausal women throughout chemo to send their ovaries to sleep. The idea is that chemo drugs tend not to attack things that aren’t actually doing anything (similar to the cold cap treatment to reduce the chances of hair loss). While its effectiveness is still yet to be proven, it is widely agreed that while taking the drug may not guarantee you retain your fertility after treatment, it certainly doesn’t do any harm (unless you see four months of sleep deprivation as harmful)!

With no Zoladex appointment scheduled, today marks the start of the waiting game. Up until now, I have not expected a period. Now, I live in hope that my body will return itself to normal and not actually send me into the official menopause (if feels strange to be wanting something like a period. I will probably regret saying that if it comes back with a vengeance). The odds, based on my age, are good. The reality? No one knows and no one dares predict. It’s saving me a fortune in sanitary products, but I would really rather just take the hit.

I haven’t written much about my feelings surrounding the prospect of infertility. I have always been a great believer that things are meant to be. I remain thankful that lots of my friends have been able to conceive and I feel lucky to have so many children in my life (if not under our roof). Whatever happens (even with seven embryos in the freezer), I just feel happy to be here. The future can take care of itself. The way I see it, childless and alive is still a good result! And, if children do feature in our future, I have Zoladex to thank for preparing me well for months of sleep deprivation.

Of course, it’s not just the periods I am willing to return. A night without a yo-yoing temperature is something about which I have been dreaming (when I get the rare chance) for a long time. I understand that Tamoxifen – my soon to be best friend for the next 10 years – is likely to cause at least some of the same symptoms (lucky me!), but given I don’t have to start taking this daily delight until radiotherapy is over, I am hoping for at least a little break (PLEASE!!!!!!). I am now pretty effective on about three hours (my usual pattern is to fall asleep straight away and then wriggle around in a few different outfits from 2am onwards) – but I really wish I didn’t need to be. When a lie-in is once again a treat, you will all know about it. The title of this post may seem a little premature, but I am hoping by expressing it publically, my body might just take the hint!

My fingers are well and truly crossed. Let the waiting game begin!

 

Breast cancer lesson number 124: Happiness is ticking off those appointments!

Today, I looked down the end of the giant Zoladex needle for the last time. That means no more hospital trips, no more holes in my left side (it’s like my very own constellation down there) and, in just four weeks, NO MORE MENOPAUSAL SYMPTOMS (unless Tamoxifen decides life is just too boring without them).

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I remember the oncologist joking about it being a useful dress rehearsal for the real menopause. You can tell my oncologist is a man :-). Trust me, there is no reason why any woman would wish to experience a hot flush before being forced into having one. Before active treatment started, I had not even given the menopause a second of my attention. Now, the very thought of going through this again for an extended period makes me want to run for the hills!

As I mentioned in lesson number 78, it does seem apt that the drug designed to shut down my ovaries to protect my fertility causes sleepless nights. I already have a huge amount of sympathy for new parents – just without the dirty nappies! All I hope is that the implant has done its job (the effectiveness of the drug for use in this way is still being examined) and that the giant needles will be replaced with not-so-giant periods in due course.

As you would probably expect, this momentous occasion was the subject of today’s ‘100 happy days project’ post on Facebook (I’m already up to day 21). For those of you not on Facebook, here’s a quick rundown of the first 20. You can also read more about the project by clicking here. It really is a great way to pick out a smile from every day and I do encourage you all to have a go if you haven’t already.

Day 1
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These beautiful flowers, given to me over a cup of peppermint tea this morning, remind me of a lovely few lone-overdue hours spent with a friend. My friend said to me: ‘life is not about waiting for something big to happen. Life is all around, waiting to be lived.’ Thought it was a beautiful and apt message for the project. If I am allowed two, I have also just been sent a lovely e-card with the following quote in it: ‘You gain strength, courage and confidence by every experience in which you really stop to look fear in the face. You are able to say to yourself: “I lived through this horror. I can take the next thing that comes along.”’ I think it would be fair to say, I do enjoy a good quote! Hope you are finding happiness in your days!

Day 2
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I decided to go off piste at the hospital and try and vanilla yoghurt shake instead of a breakfast tea. It was so delicious and certainly something to look forward to on a trip there. I also handed out two more of my pink hearts today (one to my physio and one to the lady who gives me massages at the cancer unit). I love writing out the accompanying cards and thinking of all the different ways in which that person has touched my life. NB: I have only handed out seven so far, and have many many more to go, so don’t worry if I have seen you and not given you one. They take a while to write. If you want to read more about my pink hearts campaign, visit: http://bit.ly/1nHsc4w

Day 3
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Chemo day can be a happy day! Just two rounds to go. Ginger cookies baked for the cancer unit, experimental lemon and ginger muffins ready for sampling too and some jelly babies and lollies for mum and me! Smiling. Hope you find a small pleasure to raise a smile today! J xx

Day 4
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Back at my family home for a wedding (on chemo day 2 no less)! Have just dug out my GCSE art book to remind me why I have always wanted to work in the creative industries. It sits in my bedside table at home and I get it out every time I stay. It always raises a smile! Possessions such as this are priceless. Packed with memories. Hope you are having a happy day. J x

Day 5

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Today, the beautiful Hanne (pictured here) would have turned 33. Sadly, however, she lost her life in the Oslo bombings and I only found out about it last year while making a long overdue visit to her Facebook page. I am celebrating her birthday today because she was a real free spirit and a beautiful person who brought sunshine into the lives of the people she met. She loved life and I only wish she had lived to see more of it. The way in which I found out about her death showed me just how important it is to touch base with people outside the wonders of social media and remember the people who mean the world to me. Thank you Hanne for teaching me the importance of friendship. I hope you are still smiling, wherever you are. Much love, Jackie x

Day 6

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I have always been a bit of a winter person (scarves, hats, gloves, Christmas, mulled wine etc). But since getting a garden and discovering the joys of growing, I have really started to see the beauty in all seasons. Fresh garlic is the latest bit of produce to find its way out of the soil and into our kitchen. I can’t wait to use it.

Day 7

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What does every cancer patient fighting fatigue need? A copy of Games of Thrones, that’s what. I have been saving it up for the right moment and now (thanks Claire Sargent for the loan) that moment is here. It is so important to have something to look forward to in life – even if that something is a little on the gory side. I may be gone for some time! Hope you are having a happy day. J x

Day 8

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For me, the joy of baking lies not in eating cake fresh from the oven but in licking the bowl! Have just made a light ginger cake to try and distract myself from dizzy spells and this syrupy goodness (or not so goodness) was a real treat. J x

Day 9

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It may not look like much, but this little but of paper, which now contains the date of my last PICC line flush, has a very special place in my heart. For me, it reinforces the fact that, whatever race you are running, there will always be a finish line. And, every finish line, however small, is worth celebrating. It may be a small stage in a longer race, but it is a sign the end is in sight. When you see the finish line you know you’ve been running in the right direction all along. So, there is just one thing left to do. Keep running.

Day 10
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This is our Agapanthus, which until very recently was without a single bud (it had three last year). We discussed repotting it or planting it in a bed to make it flower, but ended up just moving it across the decking. As you can see, it now has 16 buds and they have started to come out today. When I look at this plant I think about just how important it is to give things time and be patient. Some things just take time. There’s a lot to be said for the phrase: ‘good things come to those who wait’. We won’t have to wait much longer! Have a happy day. J x

Day 11
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Thanks to a wonderful friend, I am now the proud owner of the word ‘happy’ for one whole year. This kind gesture not only makes me smile the widest of smiles, it also supports the wonderful charity I CAN, which helps children communicate. Thoughtful friends are one of life’s most precious gifts and I feel truly blessed to have so many by my side. Thank you. J x

Day 12
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Old friends, tea and ice cream. Perfect Sundays are made of this. Catching up on seven years! Great friends are like stars. You don’t always have to see them, to know they are there. Here’s to many more Sundays just like this. Hope you are having a great day. X

Day 13
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This little garden scene at Eltham Palace is a short drive from my house and it has taken two years of living in the area for me to drive out and see it. Often when we live somewhere we don’t appreciate the beauty and the little details that exist right on our doorsteps. We are never tourists in our own back yard. But why travel when you can find your own slice of happiness a few steps (or miles) away! Happy exploring! J x

Day 14
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Since being diagnosed with Breast Cancer, I have tried to make every day count and smile through this life-changing disease. Writing to help others (and myself) has been a massive part of that, so I was delighted when Breast Cancer Care asked me to become a regular blogger. Here’s my first post (just published)

http://www.breastcancercare.org.uk/news/blog/vita-bloggers/jackie
I have also spent the day being photographed for a magazine feature about smiling through cancer. Here’s me with new eyelashes, proper make-up and some cookies I baked earlier . I have never been in front of a camera in this way before, so am a bit scared about seeing the feature.
I hope, through my writing, I will be able to help more people smile through cancer. J x

Day 15

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This little car and I have been together for 15 years. She got me to my A-level exams and she is still transporting me all round the country. She may be old and undesirable but that makes her really desirable in my book (especially on London roads). I am happy today because I have managed to get a really good deal on my car insurance renewal. Another reason to love this little blue bundle of unleaded-fuelled joy. Thank you little car. J x

Day 16
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While I have embraced the wonders of the digital age (a bit), for me there is nothing quite as exciting as receiving a bit of post through the door. I have just opened this beautiful card with alliums on the front (selected because they are my favourite flower). It has brought a huge smile to my face. The words also, are beautiful. I won’t share it all, but the amazing sender writes that she (through illness) has: ‘learnt the value of ‘being’ rather than ‘doing’ as well as appreciating so many little things in life.’ She adds: ‘you are being given the opportunity to learn things that so many people miss as lives are so full of busyness.’ She is so right. Happiness isn’t about getting what you want. It’s about making the best of what you have and being grateful for it.

Day 17
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Strangely Justgiving has stopped sending me emails when people donate, so imagine my surprise when I logged on just now to find I had received even more support. I am so humbled by all the kindness I have experienced over the last six months and can’t thank you enough. With your message, likes, cards, hugs, donations, flowers, chocolate, paperclips and love, you have given me so much strength. The 10k is on Sunday and, for me, it is a massive milestone. When I signed up, I thought it would take every last little bit of strength to get to the start line. My medical team think I am bit bonkers wanting to run a race with dodgy hips and chemo drugs in my bloodstream, but I want to do this for everyone who has every had to hear the words ‘cancer’ and get up day after day to face the rollercoaster that is active treatment. I wanted it to be hard and I know it will be. And I want every step to matter. I will cross that finish line on Sunday thinking of you all. Kindness is the best currency there is. Thank you for making me feel like the luckiest person alive. J x As a side note, I have also just had a wonderful day with a friend and her beautiful baby. I didn’t take a piccie although it made me very happy indeed!

Day 18
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There are two things making me particularly happy today. The first is the fact that I have just put out two window boxes full of marigolds Duncan grew from seed. Last year, somebody stole one of our window boxes. At the time, it upset me, but by moving them up to the first floor, we are fighting back. This is my small way of saying to the world, sometimes you try to take things away, but I will always find a route through to happiness. The second is the fact we have just spotted a tomato growing out of the drain at the back of our garden. I think we could all learn a lot from nature. Nature doesn’t give up. It just finds a way. It’s like a weed growing through a crack in the pavement. If obstacles are put in its path, it just creates a new one. Here’s to nature! J x

Day 19

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I am delighted to report team small boobs, big smiles have all crossed the finish line. 9k jog/running an 1k walking not bad for a lady with no hair, dodgy hips and chemo in the system. Thanks so much to all those who sponsored us. Feeling so humbled due to all the support and a little bit proud. One massive finish line crossed, just a few more to go!

Day 20
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This may look like an ordinary glass of water, but it is, in fact, very special indeed. That’s not because it comes from a special spring or bottle. It is straight out of the fridge and it is the first glass of water in about four months that I can actually TASTE! The simple pleasures in life are the best! Brief respite before I lose my taste buds all over again.

May your days be as happy as they are long!

Breast cancer lesson number 69: When your ovaries are at stake, do what needs to be done

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While most people were on their way to work in the Capital today, I was on a quick detour (also on my way to the office I hasten to add). Yes, it involved the hospital. And, yes it involved this rather exciting gold box.

Now don’t be deceived by its shiny exterior. Inside this box is one of the largest and strangest syringes I have ever seen – and would ever want to see. That’s because, like a lot of syringes, it’s not designed to administer liquid. Instead, it houses an implant (a small pellet) that needs to be injected under the skin to release a drug called Goserelin. In the hands of a nurse with no local anaesthetic cream (and only a side and not a stomach in which to inject said implant), there is only one outcome – and it’s pretty painful.

Why would I want to inflict this optional pain on myself I hear you ask? Well, if you’ve followed my fertility journey, you’ll know that Goserelin (otherwise known as Zoladex) is all part of the try-to-stop-cancer-taking-away-my-fertility plan. Even though we have embryos in the freezer, we would still rather not use them. Zoladex is a synthetic version of a natural hormone that controls how the ovaries work. By switching off the production of oestrogen, it suppresses the ovaries and sends women into an artificial early menopause (hot flushes here we come). Just when you thought you’d had enough of side effects, it throws in a few more!

Now, it’s not the first time I have received this injection (the first one was alluded to in lesson number 42). I have already had a hot flush and I still have three more to go. But, it is the first time I’ve not just slotted it alongside other news of the day. And that’s because, it’s a big syringe, with an even bigger role to play. Nobody wants to sit in the chemo chair thinking they haven’t done everything they can to protect their ovaries and their chance of bringing children into the world. Everyone undergoing chemo should be given the choice, where appropriate, to go up against this oversized needle and endure a period of self-inflicted hot flushes. If the prospect of being able to have children fades before your eyes, you’ll know just why this gold box deserves a little post all to itself. Goserelin is not just a side note in the fight against cancer. It’s a star.

This box also reminds me of just how amazing medicine really is. We often take it for granted as we’re popping our paracetamol and rubbing in our ibuprofen gel. But, medicine has given us hope where are bodies have tried to take it away. Medicine knows how to trick cancer cells – and kill them. Medicine is the reason I can still picture myself changing nappies. And, most importantly, medicine is the reason I am alive today. I am in awe.

Read the Goserelin (Zoladex) factsheets and they sometimes say that the use of the drug during chemotherapy is still something currently being tested as part of clinical trials. Apparently oncologists don’t all agree about its use in this context. I’m not an expert, but I am writing this because I want to help others in my situation find out about the options. You may not be able to receive the drug (or have it recommended to you), but now you know to ask – and that’s all that matters. You also know not to look inside the box or at the needle. You just need to do what needs to be done.

In every other way, it was a normal day at the office. But, as I sat there answering emails and discussing visuals, I couldn’t help but smile at the throbbing in my side. Inside that little pellet is where the magic of medicine really comes into play. It may not work for me, but I will always know I gave it my best shot.

If you are interested in finding out more about the fertility journey as part of cancer treatment, I have written a blog for Breast Cancer Care. Here’s the link in case you find it of use: http://bit.ly/1gnEnyq