At one of my previous appointments, my oncologist had asked me to write a blog post talking about how benign tamoxifen was and how I had really no side effects. I agreed with her as I can count on one hand the number of hot flashes I've truly had, how I've learned to cope with increased severity of PMS (Captain Crazy Pants), and how I generally feel pretty good on it. After walking out of my mammogram and surgeon follow up like a boss I was totally prepared to write that post. But, all of this changed in the past week or so.
My brother, sister-in-law and 2.5 year old niece were in town for a really big princess party (also known as their wedding). So, naturally I took 2 weeks off from work and had a grand old time running around after the 2.5 year old and being Auntie Sara and part of the centerpiece production team. There were hair trials and multiple trips to Michael's craft store and a lot of playing with bubbles and movement. The only time there was sitting was to eat or when I was asked to read "Where the Wild Things Are" (as my niece would say, "Let the Grumpus Begin!"). Then came the actually wedding which is still a beautiful blur. Generally, there wasn't a lot of immobilization of my legs in the past week and half.
Starting on Saturday (the day of the wedding) my calf felt like I had had a charlie horse the night before and was sore in the middle. I had worn a lot of different shoes than my sneakers in the past week and my calves cramp all the time so I though little of it. I went for a run on Monday and my calf pain didn't get any better. I was concerned that I had torn the muscle which given the amount of picking up and tossing of a tiny person that had occurred in the week and half seemed reasonable. Tuesday, I noticed that the more I walked around the better it felt, but it was especially painful after sitting and the most painful after lying down for sleep. I found my right foot to be aching as well.
Thursday morning I was scheduled to get on a flight to Chicago. So, early Wednesday morning when I found myself doing what I know I shouldn't do, googling symptoms of DVT (deep vein thrombosis) and rationalizing that I didn't have any swelling (true), didn't have any redness (true), but that I did have pain that was fairly constant, no physical knots in my calf and point source tenderness in the belly of my calf. I decided that it was better safe than sorry and I called my PCPs office to make an appointment. "Hi, I'm been having calf pain for 5 days and I am scheduled to get on a flight tomorrow. Yes, 1:30 pm would be great". Thinking that a quick ultrasound would determine that my calf pain was a small tear and that my training for the Lahey 5K would be slightly derailed.
I meet with a lovely NP at 1:30 pm and I state why I am there "5 days of calf pain, on tamoxifen, want to get on an air plane tomorrow". She smiles, but gives me some words of caution, she had a 40 year old woman who was a patient last week who only had calf pain (no redness, no swelling) and it turned out to be a blood clot. She signed me up for my ultrasound of my right leg.
So now instead of shirtless fun, it is time for more pantless fun! A lower extremity ultrasound involves the ultrasound tech pushing the wand very hard against your veins to get good pictures of what is going on. The start in your groin and work their way down to your ankle. Now, when you are having some tenderness in your calf and someone needs to press really hard with a solid object against it multiple times you better sit on your hands or lock them together because your first instinct is to knock that wand out of the very kind ultrasound tech's hand. And when she is done, she states that she needs me to point to where the pain is and has to double back and take even more pictures right there. She apologizes, I just nod at this point.
Then they send me back in to see the NP. I get put in a room right away and I think great, she will roll right in and tell me that I should back off on the running for awhile.
And then I wait.
And wait.
And wait.
About 40 minutes later, the NP comes in with 3 pieces of paper and apologizes for the wait, but states she had to talk to 3 different physician's about the plan and still had more people she wanted to discuss this with.
I look at here and ask "What the farfanoogin (this word has been edited?"
She tells me that there are two clots in the proximal veins (those below my knee) and they are small, but they are present.
Me: Litany of expletives
The NP then goes on to state that it's not recommended that I get on the flight the next day, but I am an adult and can make my own decisions. She also tells me to start taking a full strength aspirin daily and that in a week I will have a follow up ultrasound to see if the clots have dissolved.
Me: Expletives and bargaining like my 2.5 year old niece in order to still get on the flight the next day.
The NP is just shaking her head right now and sends my oncologist a message to make her aware about the blood clots, a known side affect of Tamoxifen. And then states that I am pretty close to the 5 years that they have people on tamoxifen. I explain to her that I am supposed to be on it for 10 years. She now looks like she would like to use a litany of expletives.
I leave the appointment totally flummoxed. I keep very active. I haven't had long periods of immobilization, how could my calf pain be two blood clots (not just one!).
Then I get mad. Forget these blood clots, I'm living my life! I'm getting on the air plane, who cares what the vascular surgeon whose an expert in DVT suggests!
My very rational thought process than proceeds to fear. What if I have to stop taking the tamoxifen? What happens then? I haven't even hit a minimum of 5 year?
And then the final stage sadness. I had to tell my boyfriend who had rearranged his entire schedule for the past week and a half to do a ton of stuff with my family that our trip was off. No fancy hotel stay in downtown, no architectural tours, no great restaurants for dinner.
So, for now, it's back in a holding pattern. Taking aspirin, still taking the tamoxifen until I'm told to stop and walking around frequently to lessen the pain and waiting for a follow up ultrasound.
Damn you tamoxifen (But, please don't take me off of it!)! So conflicted...and back to pacing while I wait.
Damnit! More evidence that Tamoxifin is the devil. Damnit!
ReplyDelete