Last week was my six month follow-up with Dr. Canada. While I only get tested and scanned once a year, these cozy little chats are required every 6 months. This is how they often play out.
I arrive and take a survey where I mark all my ranging emotions and nausea conditions at 1 (meaning not at all a problem & thank god that part is over), except for anxiety which I always mark at 2 (not bad but feeling a little nervous.) You’d have to be a robot, I reckon, not to feel at least a 2 for anxiety during these check-ups.
Then I wait a while and the nurse eventually calls me over.
We go to the scale and I take off my shoes/boots. Weight is measured in kilograms, so I happily get off the scale not having a clue what that reading actually means. (Thank you for the blissful ignorance, Imperial System).
Then I go in a room . . . generally the first room, and wait. Just wait. I can look out into the hallway through to the waiting area; I can look at the poster that says I should have brought my medical records (then think, “oh well,” because I never bring my medical records); and I look at the table that I never sit on where there is a gown I never wear.
Eventually Dr. Canada arrives. He’s a lovely fellow who was so incredibly patient and helpful when I was going through chemotherapy, so I try not to hold it against him when he now plays the “how fast can I get out of this room?” game. I’m not an emergency or a priority. I’m just a check-up.
But this time I wanted to hook him for just a minute longer.
The nurse, after taking my weight and showing me to the room asks: “Is there anything you’d like to focus on in today?” (I guess this is a test for how much time I’ll be taking up.)
I answer: “Babies.”
And she smiles and says, “Okay, I’m sure you can talk about babies.” Then leaves me to look at stuff and wait.
Suddenly, I was becoming more and more nervous. There was all that baby drama when I was first diagnosed (The guilt inducing should I/shouldn’t I get fertility treatment), and then the baby drama after I finished chemotherapy with an AMH test that was never properly explained and left me thinking I couldn’t get pregnant EVER. That is devastating news, and not something that should be shared over the phone without an immediate explanation of the AMH meaning except for the nurse saying “IVF isn’t going to work for you.”
And THEN there was the baby clarification, when I regained my menstrual cycle with a steady 30 day interval, which suggested that ovulation was in fact happening. After insisting on being referred to the fertility clinic, I had my eggs checked and yes, a few remained. “But you better get on it,” advised the nurse who scanned my ovaries.
“You better get on it.” Those words have rung in my ears ever since.
So I’m sitting there waiting for Dr. Canada to tell him that I’m nearly done my 2 years of Tamoxifen, and don’t try to stop me! I’m going off the medication to get pregnant.
My palms are sweaty. My anxiety had grown to a 4. And I left my tablet in the waiting room with my dad, so I couldn’t even tweet my way through the anticipation!
Finally, Dr. Canada arrives. He immediately launches in – asking about family history, then saying he’ll try to order an MRI though isn’t sure it will be approved, and a mammogram, and an ultra sounds . . . and. . . and . . . and he wants me to stay on Tamoxifen for at least another year.
I tell him there is no way that is happening. I’ve been on for 2 years, and there’s just no way I’ll wait for three.
He changes course, and says something along these lines but not exactly: “Well, I’m torn in this situation. On one side,” (and he holds up one hand) “I’ve seen far too many things to advise you to go off Tamoxifen early. But then on the other side,” (he holds up the other side) “pregnancy in young women hasn’t been shown to put them at any higher risk of recurrence, and can actually have a protective aspect toward breast cancer.”
So he is in two minds.
I am not. I have made my decision. So I say to him,
“I know you don’t think I should go off early, but this is important to me. It is very important. And I’ve already been told that I need to get going if I’m going to have a baby.”
At this point, I am guessing he regretted referring me to the fertility clinic. But that’s only a guess.
And so he came back with a compromise so reasonable I couldn’t really say no. He suggested I stay on for another 6 months till June when my scans are all set to be done. If that’s all clear, he will step back with the Tamoxifen pressure and let me get on with having a baby.
“And in six months, you won’t tell me I should stay on longer?”
Okay. I can pretty much assume that in six months he will tell me to stay on longer, but that’s because it’s his obligation. With clean scans, I’ll move forward and just get on with my baby craving adventures.
Anyhow, It’s weird negotiating with an oncologist. He said that many doctors in his position wouldn’t support me whatsoever, which is very possibly true. However, that doesn’t mean in any way that I would continue working with an oncologist who didn’t support me. Sometimes I can be a little bit stubborn about what I want. And in this case, I know what I want.
And so there is it. Fertility after cancer is a juggling of tests, opinions, drugs and opportunities. But I can hang in there, because obviously it’s worth it – and then, once the kid arrives, that will be a whole new kinda challenge. 🙂
16 thoughts on “Babies & Bargains with my Oncologist”
Loved reading this. Doctors are in a tough spot but you know what is best for you. 🙂 Good luck!!
I’m glad you have a physician you can talk openly to. The reality is we don’t know if it’s ok to stop tamoxifen early, to get pregnant – FOR YOU. So based on the information you have, you make the decision that seems best for you, that you are most comfortable with. Good luck!
I always appreciate your clarifying responses, Dr. Attai. Thanks very much!
It’s your life, live it as you want to. Good Luck – my annoymous heart is with you.
It’s your body, it’s your life, it’s your decision. – Good for you and Good Luck. My thoughts are with you.
Thanks very much 🙂
Oh my, so much to deal with isn’t it? I love the title of this post. You’re so clever. Ultimately, all these decisions are yours to make, but I’m so glad your oncologist is listening to your side and is as you said, of two minds on this. I do hope your dream of a baby comes true some day. It must be so hard to wait patiently. Good for you for knowing what you want, but still thinking everything through so thoughtfully. Good luck! Thanks for writing about this topic.
Oh and one more thing, I like those kilogram weight readings too. I’m completely clueless. Well, not really, but you know what I mean!
Yes 🙂 I might have some vague idea, but I don’t both thinking too hard for that conversion! Thanks for your comments, Nancy.
Oh my dear, this is a HUGE issue for younger women with a diagnosis of breast cancer. I had the same conversation with my oncologist about coming off Tamoxifen. It is a very individual choice. For me, I couldn’t live in a future that didn’t have a possibility of children in it, so I came off Tamoxifen.. sadly it hasn’t worked out for me in terms of having a child, but I don’t regret my decision to try. You are younger than I was though so you do have some more time, although it doesn’t feel like it I know.. and you are impatient to get started… but do take the time, when it is on your side.. well a little more time – as much as you can stand 😉 Love Marie x
Yes, I’ll take a little more time. As much as I can stand. You know, it’s very hard thing to fly in the face of statistics; I couldn’t do it with chemo (which is fine), but on this point I feel like it has to happen. Thank you so much for your comment, Marie.
Catherine, this is a huge issue. I’m glad you and your doc could arrive at a compromise that you can live with. And there have been a few studies out there that have suggested that even 2 years of tamoxifen seem to provide a protective effect that lasts longer, but I’ll have to look them up again to see if that applies to women your age. Oh, I feel impatient with you, reading this!! I want you to get your wish & have a baby, so we can all be cyber-aunties!! xoxo, Kathi
Cyber Aunties. Ah, that sounds great 🙂
Go with your gut! (Sounds like you are.) I think it’s fabulous news. Much luck!
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