Fatigue & Depression

I have been going through quite a bit of fatigue and depression lately. I am still experiencing fatigue almost every day, so when I do have a burst of energy, I make sure to take advantage of it. On days when my entire body is hurting, I try to remind myself that I had my 4th surgery not that long ago, so I don’t need to be so hard on myself when I just want to rest. Resting has become another problem in the form of not being able to sleep properly. It is not out of the realm of possibility for me to be awake until 2 or 3 in the morning, sometimes even later, at least a few nights a week. I realize that fatigue is linked directly with depression, so I am beginning to understand how everything I have been dealing with within the last few months is all part of the same problem.

Not all of my depression is linked to breast cancer, but most of it is. I was talking to a breast cancer patient the other day, and she was asking me how long it has been since I had finished each portion of my treatment. I hadn’t thought about the timing of everything in a while, so as I was answering her questions, I was surprised that time has passed much quicker than I thought. It has been 11 months since my last chemo treatment, 7 months since my last radiation treatment, and 4 months since my previous reconstruction surgery; at times, it feels like a lifetime ago, but when I am having a bad day, it all seems like it happened yesterday. Even with all of that time passing so quickly, my body and mind are still healing. I have been experiencing what I thought were some of the side effects that I had at the end of chemo again, but chemo ended almost a year ago, so I am beginning to realize that some of them are symptoms of depression, as described below. Luckily, we are going on vacation soon, and the timing couldn’t be more perfect. I need a break; I need time away from everything that has been hurting my heart and soul lately, and I need to get my mind and body back on track, and I will!

Depression may be a side effect of breast cancer and fatigue is often a symptom of depression. Some people may have a tendency to depression, which treatment can make worse. At the same time, fatigue itself can lead to depression. Not knowing why you feel drained week after week, and not knowing that this abnormal feeling is normal for many people going through treatment, can make you depressed.

Treatment for breast cancer may leave you feeling sad, tired, or depressed. These feelings are complex conditions, resulting from and affected by many factors: your cancer diagnosis and treatment, aging, hormonal changes, your life experiences, and your genetics.

If you’re abruptly going through menopause 10 years earlier than you naturally would, with a quick lowering of hormone levels, you may experience feelings similar to postpartum depression.

Sadness is a natural part of your breast cancer experience, something you need to express and move through. If you don’t allow yourself to feel sad and grieve, the unresolved grief gets in the way of feeling better and getting better. You may be having hot flashes and trouble sleeping. You may be feeling overwhelmed or even debilitated. All of these factors can lead to fatigue and depression.

How can you tell the difference between fatigue, sadness, and clinical depression? The symptoms of clinical depression include:

  • an inability to cope
  • an overwhelming feeling of helplessness and hopelessness
  • inertia
  • an inability to concentrate
  • memory problems
  • panic attacks
  • loss of pleasure in what used to make you happy
  • lack of interest in sex or food
  • sleep problems

If you think you’re depressed, talk to your doctor. If your doctor doesn’t have experience treating depression, ask for the name of an accredited psychotherapist. Together you can sort out if what you’re feeling is depression or extreme fatigue. Therapy can help you feel supported and allow you to talk about what’s bothering you. Antidepressant medicines can help ease feelings of sadness and anxiety and help you feel better. An accredited psychotherapist with experience treating depression can help.

My 4th & Final Surgery

Mood: Relived ๐Ÿ˜Œ

**Please note, if you are going to judge me for my choices, just go ahead and stop following my blog. It is unfortunate that I have to even mention this here in my blog that has been a huge comfort to me while on this terrible journey. Until you have spent even just one day of my cancer journey in my shoes, you have no right to judge me!**

I decided last Thursday to call my surgeons office to see if it was possible to come in and see him before my August appointment. When I wasn’t able to get a call back in a timely manner, time was not on my side so I needed to speak with someone quickly, I remembered that my surgeon had told me to never hesitate to text him if I needed him for any reason. So I decided to text him knowing that he was most likely going to be in surgery all day so it might be a while before he could respond back to me, but I was shocked when he responded back about 5 minutes later. I explained my situation to him, he answered “probably yes” when I asked him if we could move my surgery up to now and he said to call his office and schedule an appointment for Monday morning. If they said there were no openings, I was to let them know that I had already spoken to him and that he needed to see me on Monday. I was thrilled that he wanted to see me and talk since I was not supposed to see him until a few days after my mammogram in August.

So on Monday I went in to see him and talk with him again about my final surgery. We had previously talked about the surgery back in February at my 3 month check up for my first reconstruction surgery that was back in mid-November. I asked him a lot of questions in February so when I saw him on Monday I had all of the information I needed to make a decision. He examined me again and we talked about the details of the surgery. He wanted to make sure that my husband and I were on the same page with him as far as the results I would get from the surgery and that we didn’t have any unrealistic expectations. We let him know that we understand what the results will be and I told him that I wanted to go ahead and get the surgery done. His surgery schedule has changed quite a bit due to the virus but he was thinking that he could get me in next week because the surgery will only take 45 minutes to an hour. So on Tuesday, April 28th I will have my 4th and final surgery, and it is classified as a second reconstruction surgery due to having breast cancer.

So here is the big question…..what am I asking my surgeon to do and why?

Going through breast cancer was a terrifying and life changing event in my life. No matter how well you appear to be fighting the battle, it forever changes you inside and out. There were many stages that my body went through during the last year…..losing my hair all over my body, losing both of my big toenails, having burns on my chest from my collarbone to underneath my breast, losing feeling from under my arm to half way across my breast from having 18 lymph nodes removed {I am still numb a year later}….the list goes on and on. I will probably never get used to seeing the scars on my chest and yes, the scars will fade eventually, it has helped a lot to use Bio Oil on them, but the scars are big and long in some places and even though they were put there by an amazing, talented and experienced surgeon, they are more than just scars on the surface, they are much deeper than that, they are a constant reminder of the hell I have been through in the last 16 months.

When I had reconstruction surgery in November my surgeon left the side that the cancer was on a little bit bigger because the radiation treatments can shrink the area that is treated. To make me as symmetrical as possible he had to take more tissue out of the right side of my chest than we expected, so it ended up being a pretty big reduction. Once I had healed from the reconstruction surgery it was obvious, to me anyway, that the left side was still bigger than the right as it didn’t shrink as much as expected and I felt out of proportion, plus I had lost a lot of volume, at least a cup size if not a little more. At first it was nice to have a smaller chest, something I have never had before; but as I healed and my chest settled into a natural position, it really began to bother me that after going through two surgeries, I am not happy with how my chest looks. I asked my husband what he thinks but he loves me no matter how I look, so this was not any pressure or comments from him at all, it is all about me and what I see when I am looking in the mirror. I need to feel whole again, feminine, beautiful….and I don’t feel those things at all so I am doing this for me.

So after much thought, research and more than one extensive conversation with my surgeon, I am getting breast implants. There are only a few options to add volume back into the breasts, flap surgery where fat is taken from the stomach and put into the breasts, or implants. My surgeon recommended implants as it is a much simpler surgery for me to heal from, where the flap surgery is very involved and painful. I trust my surgeon without a doubt and I know that he would not do this surgery unless he was absolutely sure that it is safe and my best option. Yes, he wants me to be happy, but he is a very responsible surgeon who actually cares about his patients and not making more money.

Getting breast implants is something that had never, ever, crossed my mind before breast cancer, but I do not think the same way now about myself or the world as I did before cancer….as I said before, fighting cancer forever changes you inside and out.

Dermatologist Appointment

Mood: Excited ๐Ÿ˜„

I think I mentioned a while ago that I found a dermatologist that can not only remove my radiation tattoos, but he does it for free for cancer patients. Today I went in to Atlanta to see him and have my first laser session. He immediately knew who I was when he came into the room because he held out both hands to greet me and said that it is a pleasure to be able to do this for me. He understood why I wanted the dots removed and understood about me not wanting a reminder of what I have been through with breast cancer.

I have never had a laser treatment before so I wasn’t sure of what to expect. The doctor let my husband stay in the room so that was nice for me. We were both handed glasses to protect our eyes and then he went to one machine and lasered my 3 tattoos, and then to a second machine with a different type of laser. It felt like little electric shocks and it did hurt, but not terribly. His assistant had a tube in her hand that blew cold air on me while he used the lasers so that helped a bit with the pain. My husband said he could see little specks of color lifting out from my skin….very trippy.

The areas that were treated are so small that I really don’t have any aftercare. They told me that the top skin that was lasered will scab and peel off. Once the scab is gone I will be able to see how much of the ink is gone and the doctor suspected that I will need at least one or two more treatments to have acceptable results.

I won’t go back until a month from now because the treatments, at least for me, need to be a month apart. Once I have my final results I will post some before and after pictures.

Oncologist Appointment: The Start of Hormone Therapy

Mood: Nervous ๐Ÿ˜•

Today I had an appointment with my oncologist to discuss hormone therapy. This is one of the final steps in my treatment for breast cancer. I will be on medication for 10 years and it will give me a 75% chance of my cancer not returning.

Just as I did all summer long while undergoing chemotherapy treatment, they started my visit with taking a few vials of blood. I haven’t had my blood tested since my last chemo treatment and that was way back in the beginning of October, so I am nervous for the results which I will have by the time my oncologist walks in to see me….yes, it is that fast!

After they took my blood I went into an exam room and waited for my oncologist. As with most cancer oncologists and surgeons as well, my oncologist is very friendly, caring, a good listener and compassionate but also very direct as we are dealing with a serious disease. I trust him, I respect him and his opinion as he is here to help save my life. My blood test results showed that my white and red blood cell counts are a little low but nothing to be alarmed about. My body has been through a lot over the past year and it will take a bit to recover and have everything go back to normal. We talked about the different options as far as medication goes and he decided to put me on Anastrozole. He asked me to give the medication a month or two for my body to get used to it as some side effects will go away with time. But, he is not expecting me to have any major issues as I have done well with everything so far and my body will start to recover and get stronger as I get further and further away from all that I have gone through. If I have any severe side effects I will let him know immediately and we can try a different drug, there are two other drugs that he can put me on if I have any problems. I have often read about other breast cancer patients having a lot of terrible side effects from the hormone therapy meds, so I would be lying if I said I am not both scared and concerned about how my exhausted body is going to react. I have also noticed that a lot of patients end up opting out of taking the hormone therapy meds, much to their oncologists disappointed I am sure, but I don’t feel that I have that option and here is why.

When I came out of my first surgery back in April, which was to remove all of the cancer, I was moved from stage 2b to stage 3. We were expecting 3 to 5 lymph nodes to be removed but my surgeon ended up having to take out 18 which is a high amount, making my cancer not only invasive which we already knew, but very aggressive as it had spread so much in a relatively short period of time. My surgeon and oncologist seemed to ramp up the urgency in my recovery from surgery and my starting chemotherapy treatment as soon as possible. The words “very aggressive” and “maximum treatments” were used, everything had changed, and my anxiety went through the roof. I remember my surgeon telling me during my follow up appointment after my first surgery that all 18 lymph nodes were positive for cancer and that he was aggressive during surgery so my margins were clear, meaning that he removed all of the cancer up to where the surrounding tissue had no signs of disease. But, with all of that being said, I would now have to go through the maximum, aggressive chemotherapy, a reconstruction surgery, the maximum radiation treatments and hormone therapy for most likely 10 years, for my type and grade of breast cancer.

So you can see why I feel that I don’t have a choice when it comes to going forward with hormone therapy. Of course, I do have a choice, but to me it is a simple choice between doing everything my doctors and I can do to keep my very aggressive breast cancer from coming back, or giving breast cancer a chance to come back, bump me into stage 4 and eventually kill me as there is no cure for stage 4.

9 months have passed since my first surgery and in the meantime I have had two more surgeries, 20 weeks of chemotherapy and 25 radiation treatments and I am now facing another scary part of my treatment, but I will get through this like I have with everything else, prayer, love from my family and friends, and most definitely, a few more tears.

My Support System

Mood: Grateful ๐Ÿ™‚

Every cancer patient needs a good support system. I am very blessed to have many different moving parts to mine, and I feel that it is time to give them credit in not only helping me through my journey, but also being a constant in my life since I had the difficult task of telling them about my breast cancer.

God: I have cursed him, screamed at him asking “why?” but my faith has not wavered. I may not understand why I have breast cancer but I know that God has always protected me in my life and will continue to do so as long as I am alive.

Matt {my husband}: Sadly I have read many stories about cancer patients being abandoned by their spouse, boyfriend, partner, etc… I get it, caring for someone going through such a difficult journey is not easy. You need to not only be strong for your loved one, but also for yourself. This is a long journey that lasts for well over a year with constant ups and downs, doctors appointments, surgeries and treatments and my husband has been by my side for all of it….I am so blessed to have him in my life! I will never be able to thank him enough for everything he has done for me during this terrible time. I love you so much sweetie!

My Dad & Brother: I do not have any family where my husband and I live. My Dad is in the Midwest where I grew up and my brother lives in Japan. Even though I do not have either of them near me, we talk often either on the phone, via email or messenger. I keep them updated on what is going on with me both good and bad. I know they wish they could do more for me but honestly just listening to me when I need them is beyond valuable to me. I love you both so much!

My Friends: I can’t possibly mention everyone so I will just discuss how various friends have been there for me since telling them about my diagnosis. I sent private messages to my closest friends on messenger to tell them the news. It was hard telling them, but it was the right thing for me to do. I didn’t want them finding out via Facebook once I was brave enough to post about what was happening, I love and respect my friends too much to have them find out that way. Almost all of them started asking me questions and checking on me here and there which I really appreciated. You never know how people will react when you tell them such terrible news but I have received nothing but love and support. Once I posted the news on Facebook I discovered that some of the women I know either online or in real life are either fighting breast cancer currently, just got diagnosed or have been through it in the past. It has been so helpful to me to talk with other women that understand what I am going through and so rewarding for me to have other patients thank me for being so open and honest in this blog. For me to make a difference in someone’s life is a blessing that I never expected, so thank you Linda for suggesting that I write this blog.

My Doctors: I am active on a few different apps for cancer patients and it is a double edged sword at times. One of the sad things I have noticed is the poor care that some patients receive from their doctors. Reading about doctors yelling at cancer patients, surgeons leaving large horrible scars on a woman’s chest and leaving patients with more questions than answers is horrible and terrifying. After reading of such horrors and seeing pictures as evidence, I have no doubt in my mind that I have been blessed with the best doctors to care for me and help me through my journey. I have three doctors, an amazing surgeon who is also a breast specialist so he has done all of my surgeries and has been with me from the beginning, an oncologist and a radiation oncologist. My surgeon reffered me to my oncologist, who reffered me to my radiation oncologist. My doctors work very closely together and I absolutely trust them to do what is best for me as we fight breast cancer together….they are my team and they fighting right along side of me! I will never be able to thank them enough for everything they have done for me and are continuing to do as my journey is not over yet.

My Hospital: All of my doctors are near or on the Gwinnett Medical Center campus. There is one building in particular where I have spent most of my time in from the beginning of this journey. In that building I have my surgeon, the surgery center where I had reconstructive surgery, my oncologist, the room where I had 16 chemotherapy treatments, the breast center where my wires were placed for my cancer surgery, the cancer support center and there is a rep for the American Cancer Society located there as well. The cancer support center in particular has been so helpful. I was assigned a breast nurse navigator who has been with me from my first appointment with my surgeon to present day. I told her how terrified I was of my first surgery as I had never had one before. I was shocked when she showed up at the hospital the morning of my surgery to bring me a bag of goodies and sit with me for awhile. I was crying alone in a waiting room when she showed up, I was so scared. My husband was not allowed to come back and see me yet so being alone and being terrified was just too much for me….thank God she showed up when she did. So now it is 10 months later and she stills calls to check on me and see if I need any help with anything, if I need to contact any of the many resources her office offers or just need to talk….I am so grateful for her! It is a shame that more hospitals do not offer such an excellent resource!

I have many people to be so thankful for, and I truly believe that it has made all of the difference in my journey! Love you all! ๐Ÿ’•

Reconstruction, Breast Reduction & Port Removal Surgery

November 15th, 2019

Mood: Uncomfortable ๐Ÿ˜ฃ

I am so happy that I had my surgery in my doctors surgery center and not the hospital! The staff was amazing and very attentive. I was checked in quickly, I changed out of my clothes and was taken to a pre-op bed. They chatted with me while they prepped me for surgery and once I was ready, they went up and brought Matt back to me. My anesthesiologist came by to talk with me and asked if I had any concerns. I told him about my experience with my first surgery at the hospital and he assured me that I would not have that nightmare happen again. My surgeon came by and chatted with us as well and once again assured me that the surgery was going to be easy and not to worry. He asked if I was ready to go and a few minutes later I was taken back to an operating room. Once I moved over to the operating table they knocked me out and that was the last thing I remember until I woke up.

My surgeon updated my husband afterwards and said that I did great and that everything went as planned. He said that I was being stitched up and would be in recovery in a little bit. I woke up fairly quickly and didn’t have any issues, just a bit groggy and wondering why I had so many bandages on my chest…..like I had forgotten about what just happened to me…๐Ÿคฃ

Now it is the next day, I am in a little bit of pain and I am sore, but doing well today. Matt is taking excellent care of me! I can’t lift anything and I have to keep my arms at my sides as much as possible. I am on antibiotics for the next 7 days and I am taking pain meds, Oxycodone, when needed, but being very careful with them as they scare me.

Next Wednesday I go back to see my surgeon for a follow up and for him to remove my bandages. I am sure that I will still have bandages, but hopefully not as much as I have now.

I have to admit, I am kind of excited and scared to see how different my chest is going to look!