The Tiny (Big) Yellow Pill

femara

At 6am on a Friday morning in late January, my alarm goes off. Most days my most pressing question at that hour is “over easy or scrambled?” but today I am thinking “Well, bra and jeans are out. What else can I wear that doesn’t have any metal in it?” I have yet another date scheduled with my old friend, the PET scanner.

As I drive in the dark to get the scan, I’m transported back in time to the beginning of the whole story. My diagnosis was almost exactly three years ago. Back then I was on the cusp of turning 34; now I am turning 37. Yael was two; now she is five. Ayla was only five months old; now she is three.

Three years. It’s not a long time really, but to me it feels like my entire life. The transition from cancer patient to survivor is like being born again. Sometimes I feel like I’m walking around pretending to be an adult but really I’m three years old, like Ayla. After all, our hair grew in at the same time.

The three-year scan came back negative— no evidence of recurrence. Phew. These trips have become almost routine. At least I can handle it better each time. And so, recently, I’ve told people that I’ve entered a new era, one where I finally feel like I have my bearings again. Life doesn’t feel like an epic battle, just normally hard­­. The demands are not life and death, but about not having enough time in a day, and how I am going to get my kids to brush their teeth. Aside from the periodic PET scan, I go about my day immersed in work and family, not thinking at all about the trauma of cancer and the fears that linger. Except for one little, quick moment each night, when I take my tiny, yellow pill.

The pill is a hormone blocker called Femara, the final part of my cancer treatment. Since my type of breast cancer was fueled by estrogen, the hormone blocker’s job is to starve any possible remnant cancer cells of the estrogen they would need to survive. There are long-term side effects such as osteoporosis, but I’ve decided that the risk is worth keeping the cancer at bay. A significant research study recently revealed that Femara is significantly decreasing the rate of recurrences in breast cancer survivors. At my last appointment, my oncologist told me, “Let’s just say for now you are on this indefinitely.”

A tiny, little yellow pill, taken once before bed—it is nothing, right? Such a small price to pay for survival. Still, some nights I find myself lying in bed, having made it through the day without thinking even once about cancer (a mental feat which has taken years) and then, all warm and sleepy, I remember that I forgot to take the pill. I need to rouse myself from bed, pull away from a still-sleeping Ian, and walk into the bathroom. I open the medicine cabinet, swallow the pill, and really swallow the whole experience all over again.

More than a reminder of what I’ve been through, that tiny yellow pill is my reminder that I cannot have any more children.

I have two healthy children. I don’t even think I would want anymore. And yet, as I’ve watched some close friends go through pregnancy, birth, and breastfeed their babies, I cannot help but remember what my body once could but now cannot do. This probably is similar to what other women going through menopause experience, but the trauma of being diagnosed with breast cancer while breastfeeding a baby carries its own unique experience of loss.

I saw my therapist the other day, whom I’ve seen less frequently since entering this new era. At the time I saw her I was not yet able to articulate all that I am writing now. I told her that I was feeling a little frantic and that it was hard for me to slow down. She said: “Perhaps you are feeling like finally you are in a better place. You have worked so hard for this. You just want to hold onto it but you are worried about how long it will last.”

Yes. This resonated with me. But we both knew there was more to it. I told her I was feeling pain, like a deep emotional pain.

She asked me where I felt it. I told her I felt it in my throat.

She asked me to describe it. I told her that it felt like a big ball stuck in my throat, but that I did not imagine it to be cancer. It was just kind of big and white, although it was really darker than white.

She told me that she wanted to give me the Heimlich maneuver and help me cough it up. I took a deep breath at that moment and let her help me get it out (figuratively).

Later that night I lie in bed with the girls. I read Yael and Ayla a new story called Imaginary Fred, about two imaginary friends that find each other so they will never be lonely after their real-people friends finally make other real-people friends and slowly forget about them.

On my way to bed I go to the medicine cabinet, as usual, and grab my bottle of Femara. I pull out one tiny, yellow pill and walk around with it half melting in my mouth before I can get a glass of water to help push it down.

But it won’t go down. I drink and drink and drink, but the pill will not go down. It is going to take the rest of my life to wash this pill down. There is really nothing tiny about it.

 

 

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