Monthly Archives: January 2012

Learning options at the Fertility clinic

26 Jan

One year after chemotherapy and I’m back at the fertility doctor. This is because I pressed my oncologist for the referral, though he insists – absolutely insists – that I wait at least two years with my hormone therapy before doing anything in regards to having a baby. If I can have a baby. . .

Let me catch you up, real quick: Before chemotherapy I was given the option to freeze an embryo. I said no, because my tumour was estrogen loving, and goodness knows IVF involves a lotta estrogen. Therefore, we took a chance on Zolodex. For the five or six months that was chemotherapy, I had the Zolodex pill (and that GIANT needle) inserted in my belly each month which repressed my ovaries and stopped all periods. But then after the chemo and Zolodex were over, I still hadn’t gotten my period. Waiting, waiting, nothing . .. doctor orders an AMH test, the results of which are very bad – i.e. low. Nurse tells me on the phone that I don’t qualify for IVF, I realize my eggs are super low, and extreme panic ensues because – what the heck? Do they mean I can’t get pregnant? And then, a few months later, my period returns. I am confused.

Fertility becomes so stupidly confusing after having had chemotherapy. We’re all told it can strip our eggs, throw us into early menopause (now that I’ve had  my taste of menopause, I’m in no hurry to revisit that hot-flashing experience again, though it is inevitable.) and just make things difficult. Alternatively, it might not. But if you are like me and want a family one day (or want to grow your family), there are questions that need to be answered.

So we go to the fertility clinic in Ottawa. This place is located at the back of a business park complex, and it’s a freaking miracle that we found it. Zsolt and I were working from a map when we pulled into a random parking lot (I almost freaked out without my GPS, but Zsolt is actually quite competent with a map) . . . we pull into this parking lot and stare at all the ‘you must have a blue pass’ signs for parking, and we’re about to turn back out onto the main road when I figure, ‘Hey, let’s just drive around this place and then loop back . .. what’s the building number again?’ Zsolt digs out the address number and reads it aloud as we’re passing through the back of that labyrinth lot and – hello!—there is the building, and –look!—there’s a parking spot for visitors.

How perfect is that?

We park. We go in. It’s not like the hospital with narrow halls and florescent lighting. Instead there’s an indoor rainforest, and the fertility clinic is carpeted, with curved reception desks and a sofa-filled waiting room. (The waiting room is huge, by the way, like three little rooms divided by Ikea bookshelves, and I wonder how many people do they normally expect? At that moment, it’s just Zsolt and I waiting.) We sit down, ready to wait the standard 1 hour. In England, we always waited approximately 1 hour. But instead the doctor comes out and calls my name immediately – I haven’t even finished filling my form!

Another good sign.

We follow her into her office. She has one of those giant screen computers that I’d like to eventually purchase myself. This Doctor is quite young (or at least, young looking) and I like her calmness. She has us sit down, and begins to ask questions . . . you know, all those personal things you need to divulge to every new doctor at any initial visit.  And once the history and physical stuff is filled out on her computerized form, we start to talk about babies.

[This is approximately the conversation. I can’t remember the actual words spoken, so if you’d like real medical advice for fertility, definitely go and speak to a real doctor.]

“So you want to meet today, but not actually do anything for about 2 years?” she asks.

“That’s right,” I answer.

I’ve told her about my previous AMH test in England, and the terrible result. I’ve also told her I’m getting regular menstruation every thirty days. (And now you know too!)

“Well the AMH is more a test to see if IVF would be an option for you. With results like yours, it may not be, but something is likely there if you are menstrating. Basically you could still get pregnant naturally, even if we’d have trouble with the IVF.”

“WHAT THE HECK?!”

I don’t really say that, but I feel it. All the freaking time I think I’m eggless – even having my period didn’t convince me to anything different . . . girls can get their period without ovulating . . . but . . .they still have eggs, don’t they? Hmm.

So I’m all – what the heck, how come no doctor ever mentioned this? (Well, my mother who is a naturopath and chiropractor mentioned it, as did my acupuncturist in England, but not once did I hear it from one of my medical doctors until this wonderful lady.)

And she’s all – hey, that’s how it works. You may get pregnant naturally, I’ve seen it happen.

While I’m doing a happy dance in my head, and we can assume Zsolt was too, she begins to discuss egg donation. Get these numbers:

If you find a donor here in Canada, because there is no egg bank, the process costs ~ 15,000 dollars.

If you go to the USA, where women get paid for their eggs, and therefore candidates are plentiful, the process involves six tries and costs ~ 34,000 dollars – money back guarantee if you don’t have a baby. (Money back guarantee! I thought that sort of thing only happened in retail.)

If we adopt, she thinks it costs about 20,000 dollars and can take several years.

With egg donation they’d have the donor take the IVF hormones but I’d also have to take hormones . . . I’d be taking estrogen and progesterone to sync my period to that of the woman who is donating. (Why can’t we just share tea and bond? We’d sync up naturally.) Meaning I’m still exposed to that excess estrogen. Alternatively they could create embryos and then freeze those little guys to be de-thawed when my uterus is ready. . . that’s one way to avoid the extra hormones, but not all embryos can withstand the freezing, and I could possibly have less chances of success.  The final alternative would be to have a surrogate, but I’m not hot on that.

And there are my options. Now come the tests.  (MORE TESTS)  Two blood tests to see if I’m ovulating, another shot at the AMH, plus . . . wait for it . . . a sperm test. Zsolt is about to become involved. :) Apparently he’s to stay out of hot tubs beforehand, since they slow the boys.

Okay, this is a long post. All this to say, really, that I might get pregnant naturally – so that’s something I’ll definitely try doing in another year or so when I’m still totally healthy and cancer free and have been on Tamoxifen for 2 years. Assuming I am still menstruating regularly, we can give that a shot and see what happens. If nothing happens, then I’ll likely go back on the Tamoxifen and wait for the 5 years to finish. After that we can break our piggy bank (if necessary – fingers crossed we get preggers naturally) and go to the USA, or something.

So, if you’ve been through chemo and want to know your options . . . why not ask? At the very least they can paint you a picture, and for me, though I expected anxiety, it’s actually left me optimistic.

First a great parking spot in front of the building, and then not waiting for the doctor – good signs, I think. So who knows what else might be possible? :)

(Plus I’m working with some alternative health doctors to help with my fertility and ovulation, much like I’m also working on staying HEALTHY. These are good things, and I pray pray pray it all amounts to me going on to live a long, happy, successful and most certainly family-filled life.)

P.S. Want to say hello and meet in virtual-person? You can find my Twitter home here or Facebook home here. Maybe we can have a virutal tea, and sync-up our virtual periods. ;) Wohoo!

Posted in cancer treatment, chemotherapy, fertility, life after cancer | Tagged , , , | 5 Comments

The ritual of a winter-night blackout

18 Jan

Last night, as I sat in bed and began reading the pages of my latest Terry Pratchett (and when I say latest, I mean most-lately-picked-off-the-shelf, but likely read at least five times before), the power went out. Blackness. It flicked back on for a moment (hope!) and then again, gone. Dark.

And this was the beginning of our evening. Turns out the entire street had lost power, which – while my mother may debate me – happens often enough in this area, like once every few months, and more so in the winter. Then again, it’s often a fuse blown in the house when the space heaters are turned on . . . but nevertheless, blackouts happen frequently enough that my family has an unspoken protocol.

First, turn on the flashlight. There’s always a flashlight. By my bed is a light so bright, it illuminates entire rooms. I flicked this on and headed for the basement room where my husband had been on his computer. He had his tiny flashlight going as well (just this weak orange light) and we proceeded to head upstairs. On the way up, we came across my brother leaving his room with a candle lit. Something about him with this long white candle reminded me of a Dickens novel.

Ready with our lighting of choice, we proceeded to the second step: Go upstairs to the living room.

I think darkness has a sort of magnetism. It brings people together, you know? Before the blackout my parents were upstairs watching NCIS, my brother was in his room watching Netflix, Zsolt was playing card games online, and I was in my room reading. After the blackout we instinctually gravitate to the living room and each other’s company.

There’s a gas fireplace in the living room, which offers a nice amount of light and heat. With a bit of searching for the matches (at which point my brother passes me his candle, which is easier than searching for the matches in the dark), we light up some more candles and group them on the coffee table.

Here the third step of blackouts came into play: Entertainment. Zsolt and I played some card games (like real, card in hand games. No computer involved), Daniel whipped out his ipod and he and my parents collectively played angry birds. Later we decided to look outside and slide on the ice rain. And eventually we all settled into conversation.

I love blackouts. I love those dark nights with candles spent with my family. They’re a special time, so long as the lack of power doesn’t extend into an actual emergency. In Canada there is a national holiday called “Family Day”. Maybe we need to have a national, monthly blackout called, “Family Night.” That or we could just turn off our computers and televisions occasionally. Sometimes it feels like there’s so much ‘on the screen’ that we forget how much the real world offers.

Once the lights were restored that dark-night magic vanished and everyone went their separate ways. But at least we had that lovely hour by the fire. It’s almost a shame that the lights hadn’t stayed off all night. . . or at least until the house began to turn cold.

Almost a shame. Though I have to say, I do also love reading my Terry Pratchett in bed.

And speaking of building relationships, why not say hello on Twitter or Facebook? You can find my Twitter here or Facebook here. :)

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Genetics consultation for BRCA screening: Q&As

4 Jan

Sooo…today I did two things. One: tobogganed behind the house and slide into the school wall several times. (Does that make sense? There’s a school behind my house at the bottom of a hill. We slid down the hill. We slid into the school’s brick wall – our sleds were just that fast.) Two: went to the CHEO hospital in Ottawa and had a visit with a genetic consultant.

Let me tell you how it went.

Having braved the Canadian winter morning and arrived at the hospital, we headed up to level three and checked in. Apparently there was some blip with my health card, I have no idea what was wrong, but as the receptionist frowned at the screen I waited patiently. In my opinion when things go wrong, so long as I know I’m in the right, there’s really no reason to worry.

Eventually she fixed the problem. Something about the number being entered improperly.  And were escorted into a small office.  In came the genetics consultant – a very pretty woman about my age, and so we had our meeting.

Q) She asked me who my doctor was and why they referred me.

A) My doctor is Dr Canada, and he referred me because he reckons I ought to be tested (see my Queen Victoria connection for the reason why).

Q) And having had no history of cancer in my family, why do I want to get tested?

A) So I know. Once I know, I will know. I get why people delay getting tested for the BRCA mutation when they’ve had it in their family . . . say you are told you have it, then what? Then you need to make some huge decisions. Personally, I’m in absolutely no rush to cut off any more body parts, but nevertheless, knowing one way or the other would be useful. I guess.

Q) Did I study biology?

A) Yeah . . .

Zsolt was with me, holding my hand. He had also studied biology in high school. Therefore, everything seemed to make sense as the pretty consultant took out a binder and gave us a page-by-page presentation on how cells have genes, and genes have two bits (like shoelaces have two bits that tie together) that spell out who we are and sometimes those genes can have a mutation. The more mutations, the worse off the cell . . . worse off, as in, cancerous.

Did you know that the BRCA gene is a GOOD thing? It PREVENTS tumours? And here I was thinking it was a bad old gene that caused a lotta trouble. Nope. Not at all. It’s when both dangly bits in the gene have that bad mutation (effectively stopping BRCA from killing weird cells) that things become a lot more risky.

Q) And have you considered the implications of this test? On your well-being, your treatment options, your life insurance [by the by, my life insurance is essentially shot – except I may already have some thanks to Mom and Dad – but otherwise ticking that box of ‘cancer’ on an application isn’t going to get me anywhere too quick. Mind you, the consultant did say that if I get this test and it comes back negative for the mutation, there are some Canadian life insurance companies that will take that into consideration. ]

A) Yes I have. (Well, kinda.) Please give me the test.

Well heck, like I said in a previous post – what am I going to do? Having already gotten sick once, I’d be crazy not to investigate further. And my well-being has already been challenged. Fact is things are as they are; knowing or not knowing isn’t going to change the way things are. Therefore, I choose to know.

Maybe that’s why Eve ate her juicy Red Delicious. She figured, hey, what’s the harm? And then – BAM – kicked outta paradise!

Ignorance is bliss to a large degree. Not knowing I had cancer was easier than knowing. But it certainly didn’t do me any favours. Sometimes (rarely) I imagine what it would have been like to have found my bump earlier. Would I still have a right breast? Would I have needed months of chemotherapy? Anyhow. I want to know – regardless of the possible difficult decisions that may or may not follow.

I have decided. Give me the test. I want to know.

(And in four months I’ll get the results. Talk about building the suspense.)

(OH! And good news for Zsolt and I, the test is covered by OHIP because I’m absurdly young for this disease. My ‘freak of nature’ status has worked in my favour this time. Fantastic.)

(One final thought. Please keep your fingers crossed that result come back negative: nothing found. I’d rather still wonder, “why the heck did I get cancer,” than know a BRCA mutation was at the root. Much rather.)

And hey – I love talking and meeting new people, particuarly those who can relate to this blog, this site, and what we’ve all been through. So do  say hello on Twitter, eh? You can find me here. :) I look forward to meeting you!

Posted in Uncategorized, breast cancer, cancer screening, cancer treatment | Tagged , , , | Leave a comment