When
I used to work at a clinic that served mainly women over forty years
old, I never failed to note the irony that right when most women are
going through the hormonal changes of menopause, their children were
deep in the agonies of puberty and adolescence. Just when a mom’s
resources for staying centered, grounded in reality, and compassion
are at their lowest, the children are needing herculean amounts of
patience and understanding. And so, in another one of life’s
practical jokes, just as I appear to be embarking on a second round
of menopausal excitement, my beloved is having his own hormonal
changes.
Eleven
years ago, after over a year of spending every night throwing the
covers off and putting them back on, over and over, all night long,
and never feeling rested in the morning, of trying every natural
hot-flash remedy on the market, plus traditional Chinese medicine, of
upping the doses - hoping for a good night’s sleep – I gave up
the search. Through it all I worked thirty-two hours a week as a
nurse and taught six or seven Nia classes a week, without ever
feeling fully rested. I didn’t know what ‘normal’ felt like,
anymore. So, I opted for bioidentical hormone replacement therapy.
The doses are titrated to the lowest dose of estrogen needed to
control symptoms, plus progesterone to balance the estrogen. I have
enjoyed good sleep, for the most part, and no hot flashes. At ten
years into the therapy, my doctor decided it was time to wean me off,
and we have been decreasing the dosage for over a year. Last
March, I started having a little vaginal bleeding. I thought it was
related to the hormones, and was not worried about it, but after a
few months, decided to inform my doctor. She ordered tests, and in
September, I found out that I had endometrial cancer. One week later,
it was gone - following a hysterectomy. No need for chemo or
radiation. Just gone.
I’ve
tried (accidentally) to cold turkey the hormones, but the night
sweats came back in a fury, even if I took half the dose.
Historically, I don’t cope well with sleep deprivation, I’m
not ready for that plunge into misery. So, the slow plod into
allowing my body to balance hormones continues. Someday soon, I will
do it on my own.
In
the meantime, Austin was diagnosed with carcinoid tumors, for the
second time, the same week I found out about my cancer. We have been
awaiting his surgery, coming up soon. His original surgery (eleven
years ago) took out all of the primary tumors they could find in his
small intestine, but no lymph nodes. It is a slow growing cancer
(“sluggish” is the term doctors use to describe it). You might
note that 10.5 years is a long time for a cancer to reappear. It
appears to have been growing in at least one lymph node. His symptoms
suggest that it may be in the liver, as well, which has a much more
positive prognosis, after treatment, than most cancers. (Unlike the aggressive, star shaped tumors of other cancers, carcinoids are round, and look, to me, much like sebaceous cysts. I once watched a doctor remove a large sebaceous cyst from a man's head, and it popped out and rolled across the floor. Carcinoids can behave in a similar manner. Really, sometimes they just roll across the floor and have to be recovered.) This is a
neuroendocrine cancer of cells that produce different hormones and
neurotransmitters, Austin’s tumors produce excessive amounts of
serotonin, and possibly other things. (Another aside about carcinoids of the small intestine, that I would like to get out there: The excessive amounts of serotonin produced by the tumors cause scaring of the small bowel that is clearly visible on the outside surface. The scar tissue causes the bowel to shrink or kink at the sites of the tumors. Some people who have them experience a lot of pain when they eat, and are misdiagnosed for years with irritable bowel syndrome, or even Chron's Disease. Austin had no pain. Carcinoids are difficult to diagnose, and I have had many friends over the years with abdominal pain that could warrant an evaluation, if treatment does not appear to work.) Austin’s surgery could end up
being very extensive, his doctor is the regional specialist for this
type of cancer, has done lots of research on carcinoids, and was
instrumental in developing treatment guidelines. He is aggressive
about finding and extracting most of the tumors, as this
significantly extends the life of the client (even if they don’t
remove all of them). Austin has been assured that he can have a good
quality, long life after removing as many tumors as possible. Still,
the prospect of losing organs and parts of organs, and having his
innards rearranged, is frightening for Austin. We can also assume
that the excessive amount of serotonin in his system could be
creating some mood changes, adding to the (justifiable) presurgical
anxiety.
So, true to the ironic nature of menopause, it seems that one never goes through the change alone. There must always be more than one hormonally challenged person in a household. Austin gets to cross the threshold into some semblance of normalcy a little quicker, but with more discomfort and scars. Together we exercise religiously (I would say joyously), meditate, eat healthy, write, talk, and support each other. We have a community that provides support when we need it. We live in a beautiful environment and feel connected to the natural world. Excepting a few bumpy hormonal (and surgical) rides, life is good.
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