Monkey-wrench

Okay, I admit it: it is getting harder and harder to stay perky and positive through this thing. And maybe I shouldn't write this post yet, as it may be too full of raw emotion, but, well, you've been with me so far, so maybe you won't mind if I just bare my soul even more than is usual for me (this is saying something!).

I met with the medical oncologist yesterday. She was very nice, but more reserved than other doctors I've had so far. (By this I mostly mean she didn't laugh at as many of my jokes, Oh, it hurts!) She is a preacher's kid, too, which I went ahead and took as a good omen. My parents are in town, which is great, and they were able to come with me. Michael had to be at work. It was "just like old times," going to the oncologist with my parents - except, as they pointed out, this time I had to do all the paperwork myself and they didn't even have to co-sign!

The doctor started by laying out the treatment plan possibilities. I could do surgery, as discussed. I could do radiation, as discussed. And/or I could do Tamoxifen, "hormone therapy," which we would discuss. Radiation, she said, she would take off the table. The risks are too great, and especially given the high risk of this returning (given other indicators), I don't want to risk not being able to have successful surgery in the future (like a mastectomy). Ok, good, that's where I was headed already. So surgery it is. But, she said, she would also really urge me to take the Tamoxifen. Here's the scoop on on Tamoxifen: It is a drug I would take for 5 years, and serves as a preventative for estrogen-fed cancers like mine. It would in fact cut my risk of recurrence by about 50%. It is an estrogen blocker, so side effects would be similar to what I would experience in menopause (hot flashes, short-term memory problems...). More significantly, I can't get pregnant while I'm on it. Or rather, I could get pregnant, but the risk of birth defects is very high, so I'd need some heavy-duty, non-hormone birth control for the next 5 years. Well, this puts a bit of a damper on the whole starting-a-family thing that Michael and I were hoping to get busy with on July 20, 2013. Not great. I can deal with having a scarred breast. I can deal with having to breastfeed on just one side. I can deal with knowing that I am at extremely high risk of this returning and I can even deal with the possibility that I may have to have a mastectomy in my 30s. But this latest bit is not something I'm having an easy time with.

Now, there are some other options. I can, of course, not do it. Not that I'll choose to do that, but it is nice to remind myself now and then that I have this power, that I am in charge of my own body and health. Another, more feasible option is that I can take Tamoxifen for a couple years, go off it to have some babies, then go back on for 3-5 more years. It's not the norm (neither is having breast cancer at 29), but it is a possible and the doc thought very workable option, given my particular situation, especially because pregnancy can, in itself, be protective against breast cancer. That is, having been pregnant lowers one's risk for breast cancer, because breast tissue then matures fully and stops changing quite so much. Another option is, we could adopt children. Or, we could get hitched tomorrow and start a family right now! (I'm only partly kidding - this has occurred to us as a reasonable option, and Michael's been saying all along he'd marry me tomorrow if I said I would!)

I know that this isn't the end of the world. But in some ways, it feels a little like it is, in that it is challenging my understanding of my life purpose. My whole life, I have dreamed about being a wife and mother. I have always considered wife-hood and motherhood to be my primary vocation, and now I am feeling very frustrated that just when I finally am planning to get married and start a family, my body has rebelled against the idea, and all these roadblocks and detour signs have been thrown up. Why now? Even my other vocation, as a pastor - I'm a year into my ministry, it's going well, and then I get smacked with cancer again? How is that affirming of my following your call to serve your church, God, huh?? What am I supposed to make of this??

When I started this thing, I had a couple concerns, given that it was clear this cancer would not take my life: 1) maintaining the ability to breastfeed, and 2) to some extent, my vanity - wanting to still look as "normal" as possible. I didn't expect that my ability to stay on my life track as far as timing for starting a family would be affected. Maybe I was just in denial about that, because I did know Tamoxifen was a possibility from early on. At this point, even being able to breastfeed or not seems so insignificant compared to having to wait 5 more years to start a family. At this point, I would gladly give that up. Funny how perspective changes. (Just kidding - it's not funny at all.)

I'm an emotional wreck. Please pray for the wisdom to make the right decision. Thank you.