Thursday, March 26, 2009

Sexual Issues With Hysterectomy

In my article Someone Save My Sex Life! The estrogen cream I used is called Premarin. It is a topical cream you insert much like yeast infection creams. It is thick and does not leak. I used it every night for a week and then every other night for 2 weeks. The maintenance is twice a week. It is very easy and works miracles. Your vagina regains fullness, lubrication and elasticity.

Bring it up to your doctor. If they are hesitant ask them to try a low dose. If they are still hesitant because of the level of relation that estrogen has to your cancer testosterone cream is also an option. I don't know anything about it, but was at a support group last night and learned about it from the breast nurse who ran the group.

Do not be afraid to talk about this. You will need to be your own advocate. The gynocologist is the person to talk with and have them consult with your oncologist. These medecines will not be your oncologists specialty so the conversation between the gynocologist and the oncologist is the protocol. If you feel you need a second opinion get it! If you feel your doctors aren't sensitive to sexual issues get new doctors. Sex is an important part of live and is one of the things that makes living more than surviving.

Someone Save My Sex Life!

I didn’t have an attachment to my ovaries until they were in jeopardy. I’ve never been the girl so in touch with her body she knew she was ovulating. When I was angry and irritable I just thought I was in a bad mood I didn’t realize it was PMS. Even when I was pregnant I was shocked that sex worked, cells were dividing and a baby growing, because I never felt pregnant for the first 6 months except for my missing periods.

I didn’t really talk about my period with anyone not even girlfriends. I didn’t avoid it, I just felt like it was a non-topic. I take that back. It wasn’t a non-topic it was just a private thing for me. It represented womanhood, although I never really thought that at the time that thought is just apparent to me now in retrospect. I didn’t talk about it because when I did complain about it or jabber about it in any way it cheapened the whole thing and made it sound disgusting and horrible when it really was natural and fine. Yes it was a pain in the ass sometimes, but life is full of pain’s in the ass no need to point this one out. Anyways at one point in my young girl head I prayed for it to come like a rite of passage into adulthood so it felt foolish to complain now.

As a kid you always rush to grow up and rightly so in my mind. You have no control over anything and that’s tough! People are in charge of when you go to bed, what you eat, where you go, you name it it’s done for you. As an adult we long for someone to put us down for a nap every day after lunch, but I empathize with kids on the lack of control thing. For me starting my period would be one step closer to the freedoms of adulthood. I think most girls want that day to come. There’s always some girl who is a complete woman in seventh grade while you are still playing with your Polly Pockets. For me that girl was Stephanie. She was gorgeous throughout junior high and high school. She had nice round boobs and a figure you had never witnessed on someone your own age and announced she got her period when she was in 5th grade. By the end of eighth grade I was still trying to go through puberty. In 10th grade I only weighed 80 pounds and my measurements were 27”X27” X27”. A bean pole comes to mind. A pretty bean pole I thought. I had good self esteem I just wished I’d become a curvy, hormonal girl like Stephanie or my mom who I thought was gorgeous, so I was sure I had the gene pool to do it.

In the end I didn’t get my mom’s gorgeous figure my sister did. I always felt feminine, but not all womanly like my sister who was stacked in all the right places and swept all the dad’s off their feet while they took pictures of her and her friends in their driveways before prom. I went more for the alternative, artsy college girl look. I figured if you can’t be one thing, be another.
Then fast forward a marriage, a couple kids and lots of maturity later. I finally, at 37, felt good! I hit my stride and it was glorious. I decided I still kind of wanted those boobs I never got and had them added on and for the next 3 years I really felt womanly. Then the breast cancer struck. I got through that, but then they wanted the ovaries out.

Suddenly I was protective of my ovaries. I loved them. You took the breasts and reconstructed them why the ovaries? Soon I would be a man. Well there’s a little thing called the BRCA 1 gene that has gone haywire in my family and it ups your chances of ovarian cancer by 50%. Breast cancer has nothing on ovarian cancer! My mom had had both and was fortunate to have lived, but not all my relatives were able to get through the ovarian cancer and it was a horrible thing to watch. So I couldn’t find one doctor to join my Keep Tammie’s Ovaries team. Everyone wanted them out before they caused problems.

They came out.

But wait a minute no one told me anything about menopause except for there will be hot flashes. I found out quickly menopause can be rude! Without losing all class it threatened to take my sex life away or at least make it the most boring orchestrated process ever. Once again I was only 39, married 20 years and still liked my husband. We were doing well in the sex area until this whole thing. I decided right then and there I would fight for my sex life!

As I write this I hesitate. Menopause has a bad social stigma. It’s like announcing you’re no longer vital (but hello you are). The second you mention it your hotness factor decreases by 100%. I admit that some of that comes from within my mind, but I’ve seen the look on people’s faces and I’m pretty good at reading people. There was all kind of preparation for starting my period. My mom talked about it, my dad talked about it, my friends talked about it and my school educated me about it. There’s a million commercials and movies talking about periods, but menopause….it’s whispered quietly behind a hand held to the mouth and called…”the change”. Change to what, old? I realized quickly it didn’t mean “old”. However, my girl parts were feelin’ old.

What happened to my fountain of youth, it seemed to dry up and shrivel. Consequently, as my husband made advances which I would normally have enjoyed I was deathly afraid. It was like making sparks and starting a fire down there! Okay there was KY Jelly but I seriously wanted to throw that stuff at the wall, actually I did once. I’m not a girl who needs that, at least I didn’t want to be, and it didn’t work well.

After the “the anger” went away I decided to rethink this give some things a try and look at this as an adventure with the hub. We would work through this. We did this we did that. It was fine, but it wasn’t great and I was actually getting depressed about it and ended up crying after sex one night saying I was ruined, done, over. I was at a low point. I was so pitiful I actually brought tears to my husband’s eyes which is hard to do. He’s not a crier. He told me this is not over. He pointed out it is not in my nature to quit or to despise myself. He knew I would figure this out.

So I did.

I went to my gynecologist and told her what was up. I told her we had to figure this out. She asked if I was willing to try a topical estrogen if my oncologist agreed. Why hadn’t anyone mentioned this before? Shouldn’t it be just part of the hysterectomy check up? I talked with my mom, my husband and myself and we all agreed that even though estrogen was my enemy as a breast cancer survivor with a broken BRCA 1 gene, sex made life worth living to some extent and I was willing to take a little risk for a lot of gain. In the end surviving is different from living and I want to live life not just survive cancer.

That topical estrogen was like a fountain of youth to my vagina! If it would take the years off my face like it did my vagina I would rub it on my face.

Why do I feel the need to tell this story…because it seems that no one felt it important to take a pro-active stance about my sex life and menopause like they did about my cancer. It didn’t seem to be any big deal to my doctors or our culture to talk about menopause and its natural ramifications unless I brought it up. If I wasn’t an extrovert with the ability to talk about private topics would my sex life be dead? Would I have assumed that that part of my life was over for my husband and I? Do people assume that woman don’t care if their sex life dies?
I don’t know what would have happened, but I do know we need to start thinking about this differently. So I thought I’d bring it up and hopefully in a positive way because I’m still vital. Maybe this will save someone else’s sex life!

Tuesday, March 24, 2009

The Many Lives Of My Breasts

My breasts are like cats, but with a third of the lives. While cats have nine lives my breasts have had three. All of their lives have been great! Some of the lives ended more tragically than others, but my breasts keep recommitting themselves to me and move forward with their lives. They stay proudly attached to my chest as if to say,” No matter what you do to us we will land tits out.” just as a cat lands feet first no matter what height they are released from. To give a full biography of my breasts and their tenacious lives I need to go back through their history.

I started with my beautiful little A- / B cup breasts formed by my parents’ DNA and God! They were sweet, small, perfect mounds. They definitely did the saying “more than a handful is wasted” a great justice. They were perky, round and pink in all the right places. I worked those babies! I could go without a bra and it was sexy not obnoxious. My college boyfriend Bill, who is now my husband of 20 years, always liked my first life breasts. He was always trying to get at them. Before I realized there were security cameras in the grocery store on campus, I would flash my first life breasts between the cantaloupes and grapefruits for comic effect as we tried to grocery shop. They were mischievous breasts!

Those first life breasts also went through two pregnancies and rebounded quite nicely back to perky little mounds. Not quite the same as before, but pretty darn close. They were most definitely on the A cup side post babies, but I still worked them with the help of Victoria’s little Secret called the Miracle Bra. It really could do miracles.

My first life breasts moved a few times and ended up in sunny California. Living in the land of augmented breasts made me curious. I was in the shower when I was 37 washing my first life breasts. I started thinking my breasts had done me well for so many years. I’ve adored them, but it would be great to try a new pair that matched my curvy J Lo-esq ass and go into my forties with some fun, new fuller ones. So three months and lots of feverish research later I was introduced to Dr. M a local plastic surgeon. My friend Jenn had had her breasts augmented by him and she had beautiful breasts.

I had met with several doctors, but it wasn’t until I talked to Dr. M. that I felt confident putting my precious breasts into someone else’s hands. He was perfect for me and he had this great physician’s assistant who worked with him named Sarah. She was 4’9” and reminded me of a fairy. She was also smart as a whip and called me sweetie from her heart! I was never rushed by Sarah or Dr. M. When I asked questions I got facts. When I was afraid I was assured and most importantly I was convinced I wouldn’t end up looking like Pamela Anderson with my boobs entering the room before I did! I wanted balanced and the ability to go to a school PTA meeting without looking like I would be working a pole later. After my meeting with Dr. M. my first life breasts didn’t stand a chance. It was time for a breast metamorphosis. I entered the operating room and gave birth to my second life breasts.

They were seriously the most beautiful things I had ever seen! I was and still am thoroughly enamored with those breasts! They were perfect, perfect, perfect works of art! Dr. M. gave them an A+ for their healing abilities (then again he was grading his own work). I worked those second life breasts just as I had the first. Every shirt I bought I bought with them in mind. Every morning I did a little boobie dance for my husband and said, “Aren’t these awesome!?” He continued to try and get at them. For once in my life, my second life breasts helped me like my ass. They made it seem the right size instead of huge. They were the “v” in curvy.

Then 3 years passed and I found a teeny tiny little bump on the upper left second life breast! It needed to be looked at by a surgeon. My gynecologist flippantly picked a name off an insurance list, but insurance or no insurance no one was going to touch those babies except Dr. M. Any woman finding a lump in their breast is nervous. I was frantic because there was a long history of breast cancer in my family. Ironically, my mom was still in chemotherapy for her third breast cancer as this lump appeared on me.

I emailed Dr. M. and asked if he would do the biopsy. Miraculously he still remembered me from two and a half years before. He and Sarah were calm and reassuring. I went in two weeks later for a biopsy and got a call later that week from a very sincere Dr. M that this was indeed breast cancer. His voice quivered as he told me. I realized in an instance that the end of my second life breasts was near and their ending was not going to be an easy one.

The next two weeks were a blur. Dr. M. and Sarah went into action for me immediately. Bill and I were a ball of nerves and sadness. I needed to make a decision about the life of my breast in two weeks. In that amount of time I tried to learn as much about breast cancer as it took a doctor to learn in six years of schooling and come to a decision about what to do with my second life breasts. What would allow me the greatest chance of living to be an old lady with Bill… lumpectomy, single mastectomy or double mastectomy with reconstruction? How could I best avoid a reoccurrence? My second life breasts and I were exhausted, overwhelmed and didn’t like any of the choices. I looked at Dr. M. and asked what he would recommend to his wife in this situation and he told me. He welled up with emotion, held back tears and said a double mastectomy with reconstruction and gave me the reasons why. He personally called a surgeon and oncologist he knew to be good and who he worked with often. I looked at doctor M. that day crying and freaking out like a trapped wild animal and told him I knew those doctors would be good, but I only trusted him and I needed him to be responsible for me through this. He said without hesitation he would take that responsibility wholeheartedly.

He and Sarah hugged me a million times. I made them promise I would not be a fat, wrinkly, breastless, old lady when I was through this. I knew what breast cancer treatment meant. I had witnessed it three times with my mom and it was ruthless in so many ways. The lost hair and fatigue it caused was the least of it. It was what you were left with after the treatment that really affected your life. It had already stolen any bit of innocence I had left at the age of 39. It made me face my mortality and sucked the youth out of me. I was aware that chemotherapy often stole your estrogen by shutting down your ovaries and putting you in menopause. I had been ready to age gracefully to face menopause and the sexual and physical side effects of it with my peers, but not now. Not at the age of 39! Cancer was robbing me of 10 years of my life. I knew in an instant my life, as well as, my breasts life was going to change forever.

Already on life number two, my breasts were such a part of me. They were part of my femininity, womanhood, sexuality and beauty. I realized I truly loved them, I would miss them and I would mourn them. After many meetings with Dr. M and the general surgeon we decided we would save them as much as we could. I was clear with the doctors that as much as I wanted to do the best for my overall well being, I also wanted the most beautiful breasts we could salvage. I was my breasts advocate. The tumor was high up on the breast and far from the nipple and we all thought it safe to save my nipples! A traditional mastectomy leaves little skin and no nipples, but I am not a traditional person and I wanted them saved if it was a possibility. After all, the nipples define the breasts like your eyes define your face. If all went as planned it would be possible to lose very little skin and rebuild my breasts in one surgery. I would not for one second be breastless.

I cried just as I was being pushed into surgery. I cried for my second life breasts. I cried for the life transformation I knew was just beginning for me. I am a firm believer, however, that life is now and you can choose to be happy or sad. In the end I always choose happiness. That doesn’t mean I am never distraught or taken over by emotion, but I wasn’t going to be defined by breast cancer. I chose happiness and light and I woke with hope. I was eager to see the third life of my breasts. I couldn’t wait to have the bandages removed and at the same time I was terrified of what I would meet. Would I hate these third life breasts? Would they ever feel like mine? Would we be compatible?

Sarah came in early in the morning to introduce me to my third life breasts. As she did she warned me that my breasts would be swollen, bruised, scabbed and there would be drainage tubes circling my breasts coming out at my armpits. I was prepared for the worst. As they were slowly introduced I realized that they were still there reborn into their third life! They looked like Cyborg boobs from Star Trek, but I could see their potential. They were recommitting themselves to me again. They had fought and landed nipple out on my chest. I didn’t hate them. I loved them as I always had, drainage tubes and all, and they just kept getting better over the next year. My breasts went into their third life fighting for their life and mine and we came out alive and kickin’.

Thanks to Dr. M. and Sarah, my guardian angels, I got to keep my figure, my life and my peace of mind! They called me at home while I was recovering, saw me all the way through chemotherapy, answered a million questions on email and are now my friends. Dr. M gave the mastectomy an A- (do you see the trend in his self grading)! The A- was for the right nipple that just couldn’t get enough blood flow to survive and peeled off. There is still a beautiful pink circle there and sometimes when you’re on your third life you’re thankful for what you have and perfection is not so important.

So that is the story of my breasts three lives. Just as there are no words for how thankful and appreciative I am to Dr. M. and Sarah there are no words to express how thankful I am to my breasts. The strength they have had through my attempts to enhance them and the disease that invaded them is nothing less than heroic. Their tenacity is greatly appreciated and I hope to know them for a long, long, time. My husband is still trying to get at them.

Wednesday, March 11, 2009

Look Good Feel Better

I just posted a new site under sites I like. It's called Look Good Feel Better. This organization offers classes to cancer patients on how to do makeup and hair to feel better about your looks during cancer. There are teen and adult classes and I think you leave with some free products!

I have a knack for fashion and I was able to rock the bald head, no eyebrows and no eyelashes to their fullest on my own (I called it Cancer Glam!), but my sister-in-law told me about the Look Good Feel Better organization when I first shaved my head and it felt reassuring to know I could get help with my looks if I needed to!

It doesn't matter how positive you are or how much self esteem you have going into cancer, when your hair is gone, your eyebrows are gone and you can count your eyelashes, not to mention possibly your fingernails are turning black, you have moments when you feel you look like an alien. You long for your old looks that you may have criticized in the past, but now know weren't so bad. So your hair was limp and wouldn't hold curl, so your eyelashes needed extensions you'd gladly take them back as they were and be more than happy to look "normal" to yourself when you looked in the mirror to brush your teeth.

I know when I would pass the mirror after my morning shower and see all of the above plus scars and silicone boobs I wondered (with disgust sometimes) how I would ever love that girl again. And then there were the times I was back on track and feeling good about the bandanna I made to go with the outfit I was wearing and then I caught a glimpse of myself in the store window and was reminded for the millionth time that I had cancer and looked like an alien with a matching bandanna! It takes a lot to get through chemotherapy and still love yourself, but you just keep recommitting to you yourself, reinvesting in the future over and over! That's how you face any tragedy and walk through to the other side.

If you need a pick me up click on the site Look Good Feel Better! Sometimes you need a little inspiration!

Don't give up put on your makeup (or not), dress up (or stay in your Pajamas), but reinvest in you and you'll make it! http://www.lookgoodfeelbetter.org/

Sunday, March 8, 2009

The next 2 Gmail Updates were sent by my mom soon after hearing my diagnosis. Ironically she was just finishing chemotherapy and getting ready for radiation for her own breast cancer at the time. She was the hardest person for me to call. As a mom myself, I had empathy for her pain for me! No one wants to hear their child has cancer wether they are 3 or 39.

I also knew that my mom would be the person that gave me the most hope. She had her first breast cancer at 42. Then had 8 cancer free years and found out she had Ovarian Cancer at age 50. (It is typical if you carry the breast cancer gene to develop ovarian cancer later.) She once again braved through chemo and was cancer free for another 8 years before getting breast cancer in the opposite breast at the age of 58. She braved chemo again and was just finishing up as I called to say I would carry on our family cancer tradition!

She, as well as I, are cancer free again today! She has made it 20 plus years. So it made me not think cancer was a death sentence that I could do this. Her response though was as human as any mother out there. Fear and sadness followed by inspiration. We are all more alike than different.

Gmail Update 3

Tammie,
Your news hit me hard. Dad and I like you were crying most of the night. We prayed that some peace would come over you and have you rested for today. We are here for you Tammie.
Love Mom and Dad

And a bit later...

Tammie,
You will be amazed at how you handle this new challenge. You are much stronger than you will ever have thought and you will be strong not only for yourself for your family. (Bill, Max and Truman and most of yourself YOU!) You have so many dreams keep them alive. Find friends and family to laugh with and cry with. All emotions are Good during this time.
Love Mom

Thank God for moms!