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January 04, 2011


for the new year are not my strong suit.  It only takes one seriously freezing morning to quell my desire to continue my new exercise plan or a fabulous meal out (with select 'forbidden' food) to quash my good intentions of a stricter diet. I was going to resolve not to resolve (as many wise people do) and then fate intervened.

Remember that guinea pig post a few weeks ago?  I was moping and griping about me having to be one of sorts, as the doctors didn't seem to have any experience dealing with someone who has had my combination of issues.  Well, we finally met with the gatroenterologist (or Dr. K.) on December 23rd (a great pre-Christmas Eve treat!) and guess what?!

I was right. Oh, the suck, I was 100% correct.  The doctor of the day indicated that I would make a "fabulous case study" and that they would likely never find someone else who had already been through cholestasis of the pregnancy, then not, then BC and now dealing with medication issues.  He did say that it was an excellent idea to have met with him first, and then told me the only testing to prove whether (or not) I really had cholestasis was too invasive.  Apparently, he missed the memo where I have been subjected to fairly invasive stuff recently.  Too bad, as I was all geared up for a final yea or nay.

Alas, it will not happen, but he is "on my team" and given my excellent lab results, I should likely not have any issues.  He decided another ultrasound (of my liver this time...woot!) couldn't hurt to have as a baseline of sorts and sent me on my merry way.  While I am thrilled to have yet another doctor to add to ye old card directory, I am really weary of the not knowing.  Now, what on earth does that have to do with New Year's Resolutions?

Working backwards a bit:  I finally met with the doctor of functional medicine the day before I met with Dr. K.  We reviewed my history thoroughly, she confirmed that "the" surgery was the correct option (I'll not say a word here...sigh) but then went on to review the other treatments.  I was really more curious as to her assessment of radiation and Tamoxifen.  If you remember, I was recently (still am) up in the air on both.

Her answer?  If it was a choice, hands down take radiation over Tamoxifen any day.  She realized it likely was not necessarily an either/or and went on to mention that most patients she treated did not have a good experience with Tamoxifen.  Granted, I realize there are many who may be fine and thus didn't seek treatment, but it unnerved me a bit.  Then she offered that I might take a blood test and depending on the results, it may pinpoint whether Tamoxifen could be of assistance.

Since the breast surgeon so delicately ripped out four lymph nodes on my right side, I can never have blood drawn on that side again.  Guess where the good veins are?  Yup.  So, they dug deep on my left arm, found a vein, and ten minutes and a numb arm later had enough blood to measure my estrogen levels.  If one was found to be particularly out of whack, it could indicate an imbalance that could be helped by the Tamoxifen.  

Last week the test results arrived, and lo and behold my 16-alphahydroxyestrone level was through the roof.  It's considered, to simplify, a bad estrogen.  The good estrogen, 2-hydroxyestrone, level was just fine and the ratio of both was, well, okay.  However, those who tend to have higher levels of the 16 (as I call it for short), also could tend to have the same problems I did.  Naturally, I freaked.  The last thing I want is confirmation that this nasty drug (sorry, it is...I don't think anyone can argue that) might actually help me... if the side effects don't prevent me from taking it.

Along with the test results were ways in which I could lower the 16.  Mind you, I don't think I am doing a lot to increase the levels, so unfortunately it may be a predisposition for me.  However, am I doing absolutely everything to change them?  Well, I wasn't.   Here's where we get back to that resolution business.

After reading the test results (and for the love of God, why didn't my oncologist just order this test?) and pondering the information for several days, I have come to the conclusion that I cannot rule out that Tamoxifen, as dangerous as it is, might be worth a try.  However, there is an 'if':  I will consider giving it a go if I cannot somehow resolve this issue naturally.  Now, how to do that?

By creating a short list of resolutions that I must keep and ensure that I work on them every day for the next two months.  At the end of the two months, I will have my levels re-checked.  If there is little or no budge, then I may have to re-consider the *shudder* medication.  If there is a significant to huge decrease, then I might have justification for revamping things even more and possibly avoiding the medication entirely.

What will I try?

  • Giving up my glass o'vino.  I'll allow myself a few special occasions (yesterday and one other 'night out' next week), but other than that will just do away with that for the time being.
  • Exercise daily.  If nothing else, I will walk for a minimum of 35 minutes.  Yesterday found me hopping with no time to walk during the day, so I headed out at 9:50 p.m.  Late, but I got the walk in and felt all the better for it.  I've also re-started the couch to 5K, am signing up for a Pilates program, will be hitting the gym for the elliptical and will also try my hand at a Yoga class again.
  • Really, really watch what I eat, with veggies coming first.  I won't become a vegetarian overnight, but will work to limit the meat.  I'm already careful about the meats we buy and try to eat as much organic and all natural as possible (veggies, too).  It's not always possible, but I'll do what I can.
  • Limit my sugar intake.  I am working on substituting agave and maple syrups for sugar and upping the good spices for extra flavor.  I really am not a huge sugar nut, but it can't hurt to be more careful.
  • Watch my dairy intake.  I've never been a big milk drinker, though the brie does like to call my name (occasionally).  Other than half and half in my coffee (sorry, some things are off limits from limits), I won't be going nuts.  
  • Ensure that I am supplementing properly.  Though kale chips are my new favorite snack, the multivitamin, fish oil, turmeric, Flaxseed (ground) and Vitamin D supplements won't hurt.  I prefer to get my vitamins from my food, but the extra (in proper doses) has been put forth as a good idea by both my functional medicine m.d. and my oncologist.
  • Try to get a good night's sleep.  I'm a night owl, and as you have probably noticed, this is an area where I need work.  The past few months have been particularly difficult due to stress-related insomnia.  However, with Pete back at work and the kids in school, I'll be up at 7 a.m. at the latest and likely exhausted earlier than usual (we'll start that one tomorrow night).

I have probably missed something, but leaving it at that for now.  I have until February 28th and then it's all up to the testing gods.  Am I hoping for a miracle, that my estrogen somehow drops like a rock to a more acceptable level, making me some sort of wunderkind of resolutions?  Yes, that would be fabulous and I would throw a rockin' organic vegetarian mocktail party to celebrate.  

Do I expect that to happen?  No, quite honestly, I don't.  I would love for any sort of decrease, at least into an acceptable level (I am about 25 points above) and would do jumping judys and jacks for hours if that happened.  Even if I ended up taking the dreaded dose, at least I would have the knowledge that I could naturally effect some change and that would be a reward in and of itself.

The absolute worst case scenario?  My estrogen level drops the teeniest bit, I am still in scary-level land, but I drop a pant size or two and gain more muscle and flexibility.   I have a hard time finding the down side in those results.  



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I think this is an awesome plan! I just opened my mailbox to see Kris Carr on the cover of Veg News with a whole article about her, her philosophy and her new book Crazy Sexy Diet. I ordered it on Amazon immediately. I am hoping to join you in these same resolutions.. although to me it seems I am SO far from them.. the sugar addiction alone (sigh). And gluten free. and exercise. (sigh again). Anyway, she is pretty inspirational from what I've ready so far and if these things made such a huge difference for her, then I bet they will for you! and for me too. Good for you for following your own guidance and seeking out the natural path!

good for you, Jen. Reading this made my head spin -- proud of you for just embracing and moving upwards and onwards!

So if 16levels are too high, how will you know if they are lowered ... via another test? Or can you test yourself at home?

Good luck. I wish you well with all of it. When you see the oncologist again will you ask why they didn't order the test? I'd be curious what their thought process was. So much to learn to try to do the best you can for yourself.

Well-written, and a smart plan.

Hoping you get that organic mocktail party, but I'm sure you'll feel better no matter what. Now I really need to quit being so lazy and join in. Sounds like a great plan!

Well, I imagine you're going to be feeling pretty good by doing that plan. I hope it also gets you all the results you want. It sounds like the kind of things I resolve to several times a year, well, except for the vino part. :)

Wow, that is so interesting! I've never had that hormone test, now I'm curious. Sounds like great lifestyle changes, I've made several of those myself. I should do better in the supplement department, and oh yeah, then there's that wine.

Happy New Year! Here's to a healthy 2011.

Good luck with the resolutions. I hope the health modifications do work and you can avoid the nasty meds. Hang in there!.

I'm so excited for you! I'm a huge believer in nutrition and just know that you'll have fantastic results! I love Kris Carr also and have picked up a lot of tips from her as we made our transition to a plant based diet a few years ago! Since I found out about the kidney disease, I've increased my juicing and raw food intake and I've already seen great results with my blood work. I'm rooting for you on this end!!

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