WARNING: to my male readers or anyone who doesn't want to hear about any uterus-related issues, stop reading now. I won't be graphic but there are some things just are what they are. You have been warned. 

Let me start with some background. I take a daily dose of a drug called Tamoxifen.  My type of cancer was hormone receptive so I take the Tammoxifen, which works to block the hormones.  This works in breast tissue. Apparently, not so much in the uterine area. Down south, from what I understand, the drug actually mimicks the hormones.  One of my super smart doctor friends will have to explain the "why" of that one. As a result of this weirdness, tamoxifen can have some less than desirable side effects. It can cause things like thickening of the lining of the uterus and uglier things like endometrial cancer. As a patient, I was informed of all of this from the very beginning. It's quite rare, affecting about 1% of users each year, but it is possible. The doctors, as always, did a great job of explaining the risks but also why the benefits of taking the drug outweigh those risks.  The other thing you need to know is that they will not/cannot do a "proactive" hysterectomy. Believe me, I asked! You have to have symptoms before they will yank the remaining lady parts out.  That means that I have to be diligent in keeping up with my regular exams and take advantage of the various screenings for which I qualify as a younger breast cancer patient. I have to know the symptoms and signs to look for and what to do if I have them. The other thing you need to know before we proceed, is that I went through chemotherapy induced menopause way back in 2014. Other than the raging hot flashes that came with it, it was the best gift of cancer treatment! Ladies, you know what I'm talking about. I was warned that things could start up again but it could really go either way based on my age. Maybe, maybe not. Now let's get on to our story...

I started working again last Wednesday after taking a couple of weeks off to recover. I didn't make the trip to Louisville until Tuesday 1/10 and went back again on Wednesday 1/11. I eased back in but was still dealing with soreness and the travel and the pace wore me out a bit. So by Wednesday evening I was spent! I thought I would just need some rest and try to slow down a wee bit and all would be well. Then it happened. My body said, "Not so fast there Sassy Pants!" Wednesday evening I started spotting. That's not good. It makes your brain jump ahead to the list your doctors gave you of things you have to address quickly. Your brain also tries to convince you of the weirdest things. Things like, you've overdone it, you're doing too much too quickly.  Really?! How much would you have to overdo it from reconstructive surgery to make your dang uterus leak. It makes no sense! Anyway, spotting is scary - any unexpected bleeding of any amount after menopause is not a good sign. Yes, I began to stress, just a bit (a lot). I considered for a moment that I might not share this development with anyone...but the moment passed. Rewind to my initial breast cancer diagnosis, I made the choice at the time to not tell anyone I had found a lump or that I would be going through tests, etc. My family and friends received the news after I was diagnosed. I vowed that I would never do that again. I immediately let Bobby know, though he knew something was up because of the look of fear in my eyes. After the initial shock wore off, I was able to sleep...well, more than I expected, anyway.  

First thing Thursday morning, I called my GYN to schedule an appointment. When I explained the situation to the wonderful lady on the other end of the phone, she said, "He's going to want an ultrasound."  Yep! She scheduled me for an ultrasound first thing Friday morning and a visit with the doctor immediately following. Great! I was all set. But, I had 24 hours to wait. Have I mentioned that I don't do waiting very well. I kept busy with work and household responsibilities. I'll spare you the details but as the day went on, things started to change a bit. Things changed enough that I began to believe that, based on my symptoms, this might not be cancer, but a case of overachieving ovaries. Could it be possible that I went through menopause 2+ years ago but things started up again? Could I be "lucky" enough to have the opportunity to go through menopause, not once, but twice?! It was looking that way - that's good news!

When Friday morning came around, I got up early and headed to town. All went smoothly - I quickly found a good parking spot, I actually arrived at the office door before it was even unlocked. When they opened a few minutes later, I was checked in quickly and then escorted to the ultrasound waiting area. For anyone who hasn't had an ultrasound, the techs are not permitted to provide you with the results. The doctor has to deliver that news. Once everything was done, the very sweet tech simply said, "I got some really good pictures for the doctor."  It's kind of difficult to interpret anything from that but I remained optimistic. I headed back out to the main waiting room. I didn't have to wait long before they called me back to see the doctor. I chatted with the kind nurse, she took my vitals, we discussed my history, etc. As she's typing her notes into the system, I look around the room and I noticed that the counter across from me held off the tools necessary for a biopsy. Yay!  Again, this was not a surprise to me. I told Bobby the night before that I expected a biopsy whether the ultrasound showed anything or not. If it did, I would need to have that tissue tested. If didn't show anything, they would want to be safe and would test the tissue to see if anything came back. Sometimes it's not always fun being right.  The nurse wrapped up and a few minutes later my fabulous doctor joined me. Bless him, he started off by saying, "You've really even through it, haven't you?"  Yes, it's been an interesting few years. I'll spare you the rest of the small talk and get to the good part. The ultrasound was clear. He didn't see anything that concerned him. He said that there was thickening of the endometrial lining but that was expected with the Tamoxifen. He then officially broke the news that a biopsy was imminent. He advised that a prophylactic hysterectomy wasn't recommended but that he would likely be doing a D&C in the not so distant future. So much for 2017 being procedure-free. 

The biopsy was not very pleasant but, thankfully, it was over in a couple of minutes. We should get the results back by Wednesday. Of course our hope is that it comes back negative, as we expect it to. If you have any prayers left to spare, whisper a quick one for negative biopsy results. If they do come back with any abnormalities, I expect that I'll be having a hysterectomy rather than a D&C.  We will accept whatever comes next and meet it head on. 

I'm reminded that this is our new norm. Once a cancer patient, always a cancer patient. 

I'll keep you posted on results and next steps. 

Love to all!

Andee