Card-Carrying Member of the Pill Box Club

From the beginning of my diagnosis, I've joked with every doctor, nurse, technician, etc. that I am a poor candidate for "cancer patient." I do not like doctor visits; I am not a fan of blood-sucking; I avoid unnecessary pill-taking like a vegan avoids bacon. So imagine how thrilled I was to bring this home:

A pill box. Don't get me wrong...I'm a fan of the pill box. I"ve counseled many patients as a medical social worker on its benefits. But me? That's for later...when diabetes catches up with me or worse yet, Alzheimer's, and my brain becomes addled. Not at 41!

But here I am, needing a pill box -- mostly because my ability to remember to take pills on a twice daily basis is tenuous at best. (Especially if the time to pop said pills coincides with the dog peeing on the carpet or a pot boiling over.) My medicines, however, I cannot forget. Here's why...

Pill no. 1 is Tamoxifen. This is as close as you can get to an anti-cancer pill. Because my cancer is so estrogen receptive, I need to shut down the ol' estrogen factory in my body. For pre-menopausal women, this is done with Tamoxifen. I will take it for TEN years (or until menopause, whichever comes first -- I'm not taking any bets). Tamoxifen blocks estrogen from entering (thereby feeding) any cancer cells freeloading in my body. In other words, it reduces the likelihood that my cancer will return in another place in my body (which is bad, bad, bad). And since my oncotype score was so low (refer to my hyper facebook post a few days ago!), I will not need chemotherapy. The doctor describes my cancer cells as "lazy bums" who won't even open up for chemo. So Tamoxifen will provide the only defense against my cancer returning elsewhere. (Which is, if you ask any cancer patient, the true demon that keeps you awake at night.)

Pill no. 2 is one baby Aspirin a day. The most serious side effect of Tamoxifen is blood clots. While rare, it's serious enough to warrant joining the ranks of the baby-aspirin poppers.

Pill no. 3 is a combination Vitamin D/Calcium supplement. I had very few risk factors for breast cancer -- no family history, no health concerns  (I'm the healthiest I've ever been, thank you), and no midnight dips in radioactive pools. I did, however, show a deficit in Vitamin D. While I probably discovered that fact too late to make a difference, it is one of the few risk factors I had for the cancer. Low levels of Vitamin D have been connected with an increased incidence of breast cancer. (Have your levels checked ladies, especially if you live in the northern climes, or have a strong aversion to outdoor activity.)

Pills no. ? and ? are unknown based on the side effects of treatment. Tamoxifen is notorious for bringing on some wicked hot flashes. (Menopause mimicry for 10 years? Yes please!) So I have a script for Neurontin "just-in-case" I wake up in a waterbed. Another "just-in-case" script is for Keflex, an antibiotic. Evidently, having a lymph node removed (even one) increases the risk of infection in my right arm. The doctor recommended taking it for a few days if I scratch or otherwise cut myself on that arm. Good thing we are not cat people!

And thus I have entered the land of the pill people! I'll let you know how those side effects go...

All of my mock-whining aside, I still remain very, very lucky throughout all of this. My course of treatment has been manageable, extremely tolerable, and above all, hopeful. My personal hope is that you sense all of these things by reading the blog. Cancer is not the last word for many people. No matter how serious, or at what stage, cancer can be met head-on and faced with dignity and humor by any of us, even the ones who weren't cut out to be cancer patients.

Just ask my doctor. Yesterday, she waved her arms when she reviewed my oncotype test and joked, "Can we clone you?" Yep, that's me -- Phi Beta Kappa of the cancer world. I might make a good patient after all!

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