Wednesday, December 03, 2008

The saga continues

Yesterday I went to see my primary care doc, with a short list of items for discussion. He basically told me he was expecting me.

Apparently, he feels the after-math of cancer treatment is the part he plays in cancer treatment. He said he sees maybe 80% of his patients that have survived breast cancer and are on tamoxifen (the drug given to estrogen/progesterone receptive cancer survivorsto keep their cancer from recurring), with symptoms of fatigue, body and joint aches and pains, and depression. Despite my attempt to convince him that I was body-weary, not depressed, he was ready with a three-pronged approach to what he saw as my problem:
1. I need to increase my exercise even when I don't feel like it.
2. I need to get talk therapy from a psychoanalyst to work through my feelings.
3. I need to tke anti-depressant drugs to help realign things due to the tamoxifen.

Well, this wasn't really what I expected somehow. And may I just ask, if 80% of patients on tamoxifen have this problem, why are we jumping to the conclusion that they are depressed and sending them for psychoanalysis, instead of assuming it is a drug issue?

Well, I explained a few things to my dear doc. First, I committed to increasing my exercise. I can do that, and indeed was doing it until my endocrinologist told me to back off and rest. So I can do that again.

Secondly, I explained that I would be a very resistant patient in "talk therapy". He said he thought I'd do great since I do talk therapy with him all the time. I explained that I would certainly be coming from a different worldview than any psychoanalyst, however well-intentioned they may be, and he replied, "So this is a religious issue?" I explained it is not the religion that I'm talking about, but that the view of man the psychoanalyst would have (what man's basic problems are and how to solve them)would be completely different from mine. I told him I couldn't imagine a psychoanalyst that would tell me, for example, "That's sin and you need to repent," and I was quite sure that at times that's what I need to be told.

Thirdly, I told him I do not want to take any more drugs if I can avoid it.

He said he really didn't suggest I try exercise alone. He had found that unless you were doing two of the three approaches, you tended not to be successful. I asked if he would accept pastoral counseling in lieu of psychoanalysis, and he agreed to that. So poor Pastor I come! I will increase my exercise, and make regular appointments with my pastor, and return to see my doc at the end of December. He is skeptical that we can control things without drugs, but is willing to give me a chance to try.

Another issue from my list was the pesky rash that I have had for about 6 months. It is not bothersome, but it won't go away, even after treatment for fungus and treatment with antibiotics. My doc pulled in the dermatologist that shares the office space (2 docs for the price of one!) and they decided we need to deal with it. Neither thinks it is anything associated with the breast cancer. The dermatologist did say there is a possibility that it is related to my auto-immune disease (sarcoidosis). So we are going to try two weeks of a steroid foam, and if it is not gone, they decided I need to have a skin biopsy. I looked at her and said, "You've got to be kidding!" But she wasn't. She explained how simple and minor a skin biopsy is. I didn't tell her that everyone who has performed a biopsy on me in the last 6 months has told me pretty much the same thing. So, I have two weeks of steroids to see if I can avoid that.

If I wasn't depressed before the appointment, I was leaning that way afterwards.

So, my saga continues. This appears to be my new normal for a while, and I had better get about the fight of trusting the Lord even here.

Here are a few specific prayer requests for you prayer warriors. Thank you for joining me in this battle!
~Please pray that the steroid would be effective on the rash. Ask the Lord for mercy, and no need to do a biopsy there.
~Please ask the Lord to provide the strength I need to exercise more, and some sense of recovery and returned energy.
~Please ask the Lord to provide for my spiritual and emotional needs as well as my physical ones.
~Please ask the Lord to be gracious to me in the results of exercise, and for there to be no need for additional medications to manage the ones I've got to take to prevent the breast cancer from returning.
~Praise God with me for his bountiful provision of an excellent doctor, a wonderful husband, a compassionate pastor, and supportive friends. My cup truly overflows.


Lauracake said...

I had to laugh about the psychoanalyst. I once had a social worker who did not know what I meant when I mentioned "sin". Dear sister, I will pray for all requests.

Sheila said...

Dear Chris,
I will continue to pray for you. And I so agree with you about the psychoanalyst:). My hero - Elizabeth Elliott - maintains that we would have a far greater need for psychoanalysts if we would deal with the sin issue! (that is my paraphrase of her words:)).

Mrs. Edwards said...

"Talk therapy"? That's a new phrase for me. I can't imagine even the most well-intentioned psychoanalyst having anything helpful for your situation! Crazy.

I'll pray for these requests right now.

Kevin and Dawn said...

Okay, that previous post didn't come out right:). We would NOT need psychoanalysts if we would deal with sin.

MagistraCarminum said...

LOL Sheila! I knew exactly what you meant to say! :-)

Gail and Keith said...

Prayer? Consider it done!
Psychiatrists? psychoanalyst? Sometimes they are needed, but it was medication that caused my anxiety so when the doc suggested I see a psychiatrist, I was pretty much ready to slap him! :-)