Archive | February, 2010

Off of Tamoxifen for now

10 Feb

Hello All,

I called my breast cancer oncologist at UCLA to tell her of some of the symptoms that I have been having since I started the Tamoxifen. She has asked me to stop taking it for two weeks (to make sure that the side effects are from the drug and not from something else) and then I will see her in two weeks for a re-evaluation and to consider some alternative to taking Tamoxifen. I am not sure what that would be.

My chief complaint about taking the Tamoxifen was the “amped up” feeling (quite intense) that I would get within a short time of taking the pill (and I was only taking a half dose – had not yet worked my way up to the full dose, was gradually trying to do that). This “amped up” feeling is what has kept me from getting any sleep and has really messed up my days, nights etc.

But, I was having other side effects – dizziness, nausea, numbness in my limbs and some other odd feelings throughout my body (kind of hard to describe, but the best way I can describe it is how you might feel about 4 hours after coming in contact with a jellyfish – in my arms and lower legs mostly – I would get this stinging kind of sensation. Very strange.

I know that my doctor has some concerns that these side effects or symptoms could be from something other than the drug. But, so far, the side effects have all virtually gone away in the less than 48 hours since I have stopped taking the drug. Last night I slept so well and I didn’t have any of the symptoms I had been having except for a little bit of stinging and numbness – but not nearly as pronounced as even the day before. Now tonight, I did not sleep – or I should say – I have not slept yet (it is 4:30 am right now, not so great). But, the insomnia side effect is not one of the ones that my doctor is concerned about as it would not be suggestive of any other problem.  Anyway, I am sure the side effects are from the drug and not something else. And, I am just so glad to have a breast cancer oncologist who is smart, on top of things and knows what she is doing!

Okay, signing off for the night/morning. Hope to be asleep very soon.

L.

On a Positive Note . . .

8 Feb

Hello again – two posts in one am, why not?

On a much more POSITIVE note (than my previous post of a few minutes ago where I whine about how I can not sleep) – the physical therapy I am getting is doing wonders. I am driving again (the most – so far in one round trip was about 42 miles). So that is absolutely wonderful. Also, I can do so much more now physically for myself. I love the physical therapy location that  go to (three times a week) and it has made such a marked improvement, I am astonished – and thrilled!! (And I imagine everyone who has been driving me to doctor’s appointments, treatments, grocery stores etc. is thrilled too). 🙂

It is just really encouraging to see results so fast. I go three days a week and spend about an hour and a half there working out (not so much a traditional workout, but sort of a combination of a “normal work out”  and exercises that are designed to unlock my right “frozen” shoulder, exercises designed to stretch out muscles in my both shoulders, arms and chest (I have had significantly limited range of movement and strength since surgery).

The therapists and trainers are great. They physically work on me too – pulling, stretching and moving my arms and shoulders in ways I could not do without them (and, yeah, it hurts, but they know what they are doing and I see such good results). In addition to their forcing my arms into positions that I could not physically make my arms do, they are also working out – through some pretty deep tissue kinds of manipulation I guess – those tightened up muscles and ligaments (which I understand now have healed short since my surgery). What they do to me and ask of me can be quite painful at times. BUT, the results are amazing AND I have much, much, much less pain in my everyday life as a result.

For example, it used to be very painful just to reach back for my seatbelt, to close my car door, to DRIVE (which really meant that I couldn’t safely drive). I still have a ways to go, but I AM getting there and the results are coming fast.

It is just so encouraging to me to be able to do more for myself and it is SO encouraging to go to a place three days a week that literally each time improves my quality of life. So, it is worth every minute and I look forward to going to every session.

I am back to going for walks again (although this darn rain gets in the way of that a bit). I wish I could go running, but that is not allowed right now – not that I feel like I could do that anyway – but, I just need to do more endurance type training and with this weather, walking isn’t always an option. Plus, it isn’t a very intense kind of work out.

Unfortunately, I can’t really go to the gym right now because my white blood cell counts are too low for that. My doctor doesn’t want me to work out in that kind of environment. They would like me to supplement the exercises I do with the physical therapists and at home with time on a recumbent bike. So, I may look into trying to find a recumbent bike/exercise bike for home. I am very motivated – especially when I see the strength I have already gained and the lessened pain doing everyday things.

If anyone knows of anyone who has a stationary exercise bike or recumbent type exercise bike that they are not using and would be willing to loan out for a about three months, let me know.

I am going to check on Craig’s List too and see what I can find there. But, this not working thing makes purchases a bit difficult.

Well, I guess it’s time for breakfast. Maybe I will be able to sleep some later today.

L.

I can’t sleep!!! Aaargh!!!

8 Feb

I’m on my third night in a row now of no sleep. This is awful. The drug I am taking now (Tamoxifen) is causing insomnia like crazy. I am hopeful that I will adjust to it over time. Perhaps taking it at a different time of day will work better. But, the idea was to take it in the evening so that I could sleep through the side effects (nausea, dizziness and just a general not feeling so great feeling – kind of hard to explain – just uncomfortable).

I haven’t had very many nights with good sleep in a very long time, but the last three have been pretty much zilch – maybe an hour or an hour and a half and that is it. I either am wide awake until 4 or 5 or 6 am and then fall asleep for an hour or so OR, I fall asleep (after a lot of work getting to sleep – melatonin, meditation, a whole routine and it works to get me to sleep) but, then I wake up an hour or so later. That was the case tonight – I finally fell asleep sometime after 1:30 am only to wake up at 3:00 am and completely unable to go back to sleep.

I can’t do this – I have to figure out a way to get rest, real sleep. It is SO important for my getting well and recovering, healing. And not to sound vain, but, I look sicker now than I did during chemo – I have such dark circles under my eyes now – presumably from a lack of sleep. I just have to fix this situation.

I tried sleeping pills way back at the beginning of this thing (when I was first diagnosed). I took sleeping pills initially because I couldn’t sleep because of anxiety and fear and, well, just all of that normal kind of stuff that would (I presume keep any cancer patient from falling asleep). I had those problems before cancer – the occasional bout with insomnia simply because I had too much racing through my mind or I was anxious or worried about something. Who hasn’t experienced that in their lifetime?

But, those pills gave me headaches and so I stopped taking them and replaced it with Melatonin and just a better sleep routine. And, largely that worked. But, now, this new medication is just really messing up my clock I guess.

Oh well, I am bound to figure it out, I have to because this just does not allow me to function well.

Wish me luck and any suggestions are welcomed (I am going to call my oncologist’s office up at UCLA today and see if I can speak with her nurse about it, maybe get some help or advice through her).

Well, I think it is now time for breakfast.

Goodmorning/Goodnight (in case I can somehow get some sleep in today – maybe after a bowl of oatmeal) 🙂

L.

Rainy Weather, Surgery in March

5 Feb

It is really rainy here today. My dog Molly refuses to go out for a walk, well, can you blame her? But, at some point she is going to have to go on that walk. Her mistress insists.

So yesterday went well. I had an appointment with my plastic surgeon and everything looks good – to her, that is 🙂  My skin has healed very well from the radiation – there is no redness or discoloration at all. Some women end up with permanent tanned or red areas. I am convinced that the cream I was recommended to use has something to do with this healing. It was not suggested by anyone in the radiation department where I was getting my treatment – but, instead, by my then primary care physician. It is a cream called Calendula cream (Calendula is a type of marigold flower). Anyway, it has been used for it’s skin healing properties (for burns, rashes all kinds of stuff) for centuries. So, under the advice of my PCP doctor, I tried it out. It was amazing, it helped so much with the pain and irritation of the radiation treatments. Sadly, this wonderful doctor no longer accepts HMOs, so I lost her. But, she is/was excellent.

Anyway, even though my skin appears healed – I still use it, what the heck. There is probably damage to my skin that I can not see, so I figure keep on using it.

I have a tentative surgery date for March 22nd. That seems so soon and I am still just now doing physical therapy from the last surgery. But, it is my lot and what I must do. The sooner I get it over with the better I guess. Supposedly the healing time from this surgery will be much quicker. I certainly hope so. I have to get my arms &  shoulders in better shape before I have the surgery in March. So I am in physical therapy three days a week now for that.

It is helping a great deal. I also have exercises that I am supposed to do in between treatments (mostly stretches). It is making a difference. It is just frustrating to be so limited. There is quite a difference between my left and right shoulders. The left is coming along really well. But, my right one is really locked up. For example, I can raise my left arm up almost completely over my head (not quite there yet, but pretty far) but, my right arm I can not do that at all.

From a playing the bass standpoint, I am glad it is my right shoulder that is the worse one and not my left – because the left one is the one that has to reach up the full length of my bass and the right arm is the one that plays down low, so I think I can at least still play the bass – even if I can’t yet open a jar of peanut butter or unscrew a water bottle by myself 🙂 Funny – but, I certainly get a lot more joy out of playing the bass than opening up jars, so I guess if that is the way it is for now, then so be it. It will get better and I will work hard to make the physical improvement fast.

I got a call from the Lance Armstrong Foundation yesterday – they have some support services available (hopefully some that are financial in nature) that I inquired about. Unfortunately, when the gentleman called I was on my way out to my doctor’s appointment. But, hopefully we will be able to talk today. I have contacted so many organizations and most don’t call or email you back. Even Susan G. Komen’s foundation – the arm of it that provides financial support to breast cancer patients – I have called their New York office multiple times (which is where you have to call for that arm of their services) and never a call back. Very disappointing.

Oh well, so far I am impressed with Lance Armstrong’s Foundation – at least they call you back. So hopefully they can be of some help.

Well, I am off to my physical therapy appointment!

Thank you for your continued prayers and positive thoughts,

L.

Sleep is a beautiful thing!

4 Feb

Last night I slept for the longest stretch in months – over four hours, maybe closer to five – yippeee! I can really feel the difference. I would love to get 6 or 7 or really, 8 hours! But, last night was a definite breakthrough in that I was not waking up every 1/2 hour or hour. Up until last night, the most sleep I was able to get in one stretch was three hours. Not so great.

Anyway, I am still pretty darn tired, but, wow it was nice to sleep for such a long stretch. And, I presume it will just keep getting better that way as I adjust to the new medication.

I do still feel kind of a surge of energy (or a feeling of having just had way too much caffeine) after I take the Tamoxifen at night, so it makes me a bit restless. But, that seems to wear off and I ultimately do get to sleep. It sounds as if i should consider taking Tamoxifen in the am instead of the pm. But, it causes some other symptoms that I do not think I would want to deal with during the day – eg., nausea, dizziness.

But, I’ll have to see as these symptoms seem to be lessening. So we shall see. I just have to keep taking it, increasing the dose gradually until I get to the 20 mg dose. So far this method (of starting out at 5 mg for a few weeks and then increasing to 10 mg – that is where I am at right now – and I will then continue to increase it by 5 mg until I reach the 20 mg dose I am supposed to take) seems to be working a lot better than just taking the 20 mg all at once – that was awful. I was pretty sick from one 20 mg pill in just an hour or so after taking it.

Now, however, by taking these lower levels and gradually increasing the dose, my body seems to be adjusting to it. It makes sense. Hopefully, as I build up to the 20 mg dose, my body will continue to adapt and I will continue to get sleep at night 🙂

We’ll see. Oh, and isn’t this stuff exciting? I probably should find something else to write about or no one is ever going to read this thing 🙂

VICTORY!!!

3 Feb

I’m telling you all – this cancer thing is literally a full time job. UGH! I am doing pretty well actually. But, today was just one of those days where I had to spend a bunch of time on the phone, navigating, pleading, arguing etc. with my insurance provider (or, actually the branch of it that I am in – Greater Newport Physican’s Group – GNP) and the medical facility where I receive treatment (and have been receiving treatment since April 2nd, 2009, my first day of chemotherapy).

Anyway, I got a call from GNP this morning telling me that they believed that everything was worked out, (see today’s earlier post: “Now What?”),  but, that I would hear the final word from the treating facility. Anyway, I finally got my answer – that I WOULD be able to continue my needed treatment at their facility at the end of the business day today.

You can be sure there was talk amongst lawyers today on this one. I may sue them, I may not. But, most certainly I have grounds to do so. But, right now my focus is and must be on being cured. So, after hearing the crappy news this am that my former doctor was not going to allow me to continue treatment at their facility, I had to go through a ton of hoops, make a bunch of calls, sit around and wait by the phone (skip my physical therapy treatment as well – because God forbid I should miss their call and then where would I be) and just deal with stupidity all day long.

But, Dr. Hurvitz up at UCLA told me something a long time ago that yet again gave me the courage to go after these people and fight for what I am supposed to have – she said: “Lisa, you are in the driver’s seat with them.” (She told me this after I had told her of what had happened – my near death experience caused by their negligence, the inaccurate information I was given by my doctor, his refusal to even read my file, it is far too much detail for today – and, besides,  it is all covered in this blog – if you care to read all about it, just go back to April and start there) 🙂

She said that I was in the driver’s seat because what they had done and what they have failed to do for me was “complete malpractice” (the anaphylactic shock that was caused during my second chemo from their prescribing the wrong premedications prior to my treatment, etc.)

So, why would I want to stay there, you might ask? I don’t have to see the doctors there and the doctors do not administer the treatment. The nursing staff does. And, one nurse in particular – Dawn, is the only person who can consistently get in an IV line. She is also, just a saint and absolutely saved my life – truly – she did.

I really would not be here today if it were not for Dawn. There are other excellent nurses there but, Dawn is sort of my angel. I was seconds away from not coming out of anaphylactic shock – I knew I was dying, I couldn’t breathe, and I felt everything in my body just collapsing in on me – by far the scariest day of my life. I could not speak, I could not alert anyone to my situation – it all happened so incredibly fast. But, to my incredible, incredible great fortune, a woman who was there visiting her mom (and happened to be a cancer nurse) walked into the room as I was going through this and immediately grabbed Dawn. Dawn acted so incredibly fast and truly saved my life. So, you might say there is a bond there. The treatment that I receive now is not chemo, but it still requires an IV and it still presents some potential risks (I am just a tough patient – I react to things in ways that many don’t). So, I feel most comfortable having Dawn.

It will probably be a little weird returning there now that everyone knows how I feel about my former doctor – but so what. I felt it last time. And, last time I was there, Dr. Burtzo already knew anyway – it was clear from the fact that every time he had to go to the nurses station – he would walk all the way around to avoid me – kind of amusing actually. He usually comes by the treatment area and says something stupid to us (the patients connected up to IV’s). An example of one of his stupid sayings is “Oh, look at you? You’ve got the best seat in the house!” – referring to anyone who is hooked up, getting hours of chemo in a particular chair that has a view of the outdoors. He says the same thing every time. I wonder if he has ever had an original thought. But, not last time 🙂  He was quite noticeably over on the other side and walked all the way around to make that happen. Well, I guess he will be getting a little extra exercise on my treatment days. Ha, ha, ha.

Trust me, I didn’t, and won’t, miss him one bit 🙂

So today was another day hijacked by cancer, but at least I won. I just wish I didn’t have to fight so hard for it. It is tiring and all-consuming. I had other plans for today. But, for now at least, it looks like we are back on track.

So hopefully tomorrow I can get to today’s planned “to do list”.

Much love to all.

L.

Now what?

3 Feb

I have been officially fired by my oncologist (not the doctor up at UCLA), but the local oncologist that I have been unhappily seeing this past year or so. So, not a big deal – or so one would think. He called me yesterday, left me a phone message saying that he was going to send me a list of new doctors to choose from (there is only one other oncologist on my plan) and canceled my Herceptin treatment that is scheduled for this upcoming February 12. He called yesterday – on the 2nd of February – and said I had three weeks to get in my next treatment, to make arrangements with a new doctor to do so etc and wished me the best of luck.

Okay, well, I don’t know about Dr. Burtzo, but my math – from the 2nd to the 12th would be 10 days, not 21. So, I now have 9 days to arrange for the Herceptin treatment that I must have every 21 days.

Also, I have to have a local oncologist who will co-sign for my oncologist up at UCLA’s requests (for testing and treatment that I am to have locally). But, somehow or another, my case manager forwarded an email that I sent to him (the the case manager  about my history of poor care with this doctor and some of the problems that the facility has done wrong) to the facility where I get treatment and to Dr. Burtzo.

After that had happened, Dr. Burtzo called, said he’d read my email (which was not intended for him), cancelled my upcoming treatment and said I needed to seek treatment elsewhere . . . as if I can just walk down the street and ask someone to give me Herceptin – AND – as if I can make these arrangements within 9 days. And, I so need this stress right now.

Well, I am hoping it will work out. What I was told originally was that the medical director of the facility, who is very well known in his field and has a good reputation and is Dr. Burtzo’s boss) was going to “take over my case” and “co-sign” for my treatment (as in, he would authorize whatever Dr. Hurvitz up at UCLA requests so that my treatment can continue locally).  But, now I am unsure as to whether this is happening or not. I am really worried about it as I certainly can not delay my Herceptin treatment and, unfortunately, I can not have it just anywhere. They have trouble getting an IV with me, so there is a nurse (Dawn, who literally saved my life last year – another story) who knows my body and how to get in an IV – in most cases in one attempt.

I am what they call a “hard stick” – small veins, overused veins. I have had to go home on a scheduled Herceptin treatment day after different nurses trying five times to get an IV in and simply sent me home to have me come back on another day. So, it is ME, not them.

But, Dawn, my nurse at the center where I have been getting my treatment, who knows me and has the best probability of successfully getting in an IV, is really the only person I am comfortable with doing this.

So, now I wait to hear back (I have made several calls this morning on this) as to whether they are going to put me back on the schedule for my next treatment or drop me. I can’t imagine it would be in their best interest to drop me (despite my displeasure with my doctor there). And, since it seems to be all about their (the doctor’s, the owner of the clinic, the clinic’s medical director) best interest – – i.e., not getting sued – – I would think that they would take care of this, co-sign for my care and allow me to continue the Herceptin locally with someone who know what they are doing.

Well, wish me luck, say some prayers they do the right thing.

L.

Tamoxifen

3 Feb

On the Tamoxifen front, I seem to be adjusting to the increased dose (I started at 5 mg, am now at 10 mg, where I intend to stay for probably 1 1/2 to 2 weeks). I felt definite increased side effects the first three nights I took the increased dose. But, I think I am adjusting to it now. I do have a little bit of nausea, but not too bad. One of the big side effects that I hear women complaining of the most is hot flashes and weight gain.

I do have the occasional warm feeling, but the weight gain, I don’t see it. And, it isn’t on the list of side effects for the drug – instead, one of the possible side effects is loss of appetite. I would have to echo that one. I am still losing weight and I do not need or want to lose any more! In fact, I would be quite pleased to add a few pounds in the next week or so if I can. But, it is a struggle to eat enough in one day. I am working on it. The thing is I eat a low fat diet (and I am supposed to for my health, reduces the risk of recurrence of cancer, for example, as does exercise). So, keeping with the low fat diet and filling up so quickly, well, it doesn’t bode to well for me in terms of trying to put on a pound or two. I am not too skinny, I am in a healthy range (but at the lower end of it for my height etc.).

And, I just don’t want to lose anymore weight. And, it is not like I can just go have a chocolate milkshake everyday (that’d be an easy way to add a 1,000 calories or more in a day) 🙂

But, it’s just not part of what I can eat. So, there’s no short term, quick fix solution here. I just have to find a way to eat more each day. I do want to and need to gain some weight before my next surgery, so I will be doing my best to do that.

Well, wish me luck 🙂

L.

Monday: Physical Therapy & Not Much Sleep

2 Feb

Last week I started (finally) getting physical therapy for both shoulders and arms. I have what is called a “frozen shoulder” (right shoulder) and just limited range of movement with my left shoulder. I have had three sessions so far (and I do exercises in between the sessions). The sessions are Mon, Wed and Fri. Today’s session was brutal – I had a male therapist – my regular PT – Jill – was late today and so when I got there she was already behind with patients and so the only way to be seen was to be seen by John (John-the-masochist). I thought he was going to break my arm. Anyway, I will have Jill back the next time (I’m going to call to make certain of that).

The left arm/shoulder have greatly improved since I started physical therapy just last week (I can’t say about today’s session yet – he was so rough on me and it caused so much pain, that I just don’t know if it will be part of the improvement or if it will instead be a set back. But, as I said, I will NOT be going back to him).

After the first two treatments with Jill, I felt a dramatic improvement in my left arm and some improvement with my right shoulder – the “frozen” one.  The right shoulder is a bit more problematic and is what limits me the most physically. I am told it can take about a year to “fix” a frozen shoulder?!! This was what one of the physical therapists told me. I think I will ask an orthopedic doctor the same question, as I can not imagine this taking a year (plus – it is a year that will be interrupted by two surgeries). Not good. Well, I am not accepting that it will take a year to fix this problem. I will work hard and do everything the physical therapists tell me and more.

It simply has to be fixable in less time (I am far too impatient).

On the insomnia or lack of sleep front – tonight I slept from about midnight to 3:00 am and have been up ever since. I often wake up within an hour of going to bed, so this was an improvement – to get three hours in a row. I just need to somehow get it up to 6 hours and then maybe 8 hours in a row. It is now 6:00 am and I am going back to bed. I hope to sleep for a few hours at least – that is if my dog cooperates and doesn’t need to be walked in an hour. 🙂

Well, goodnight or good morning 🙂

L.

Tamoxifen Blues (probably not a great song title) :)

1 Feb

Hello All,

So, one of the things that I haven’t mentioned on here yet is the fact that I am taking a new drug (yippee . . . that is a very facetious yippee, by the way). The new drug is Tamoxifen. It is given to pre-menopausal women who have ER+ cancer (cancer that is estrogen responsive). Tamoxifen does not block the production of estrogen in my body. Instead, how it supposedly works is to block the effects of estrogen in my body. I have a lot more to learn about this drug (how it works, etc.).

I generally do the research long before taking the drug. But, Tamoxifen has been around for 30 years of more and is the standard drug used as a way to help reduce the risk of recurrence – of the cancer coming back. So, I am supposed to be on this drug for 5 years. I have met women who have been on it for 4 or 5 years (some stop taking it earlier than others and some, try it out for a few months and stop and some, just don’t take it at all).

As I want to do everything that I possibly can to reduce the risk of recurrence, I am taking this drug. But, it is definitely something that I have to adjust to. The normal dose is 20 mg per day. I started with that dose, took it as prescribed and within about 2 hours was nearly upside down – the room was spinning, I was very dizzy and had to walk holding on to the walls and furniture just to make my way to the restroom.

So, the next day I got on the internet and read several breast cancer forums where the topic was Tamoxifen. There were many women who said that after trying the drug for a few months – decided not to take it again because the side effects were just too great.

Then I came across a woman who said that she had a lot of problems with the drug initially (when she was on the 20 mg dose), but really wanted (as, of course I do) to stay on it for the benefits it provides in helping to reduce the risk of recurrence. She said that since she has always been sensitive to medications of nearly any kind (me too), that she decided to stop taking the 20 mg dose and instead,”build up” to the 20 mg dose. She did this by taking 5 mg for a week, then 10 for the next week, then 15 the next week and then finally up to 20 mg the following week.

She said that by doing it this way, she did not have the symptoms that she originally had when she just started taking the 2o mg dose (without gradually building up and letting her body adjust to increases in the drug over time).

Well, after taking that one 20 mg dose and having a pretty bad reaction to it, I decided to wait on taking anymore until I could see my oncologist up at UCLA (it was only a few days later anyway, and I just did not want to go trying something out without her input).

Well, I asked her about that and she said that it was fine to start out that way. So, that’s what I am doing. I took the 5mg dose for about 2 1/2 weeks. I had symptoms at first (milder form of what I had experienced with the one 20 mg dose) and then eventually virtually no symptoms as far as I could tell.

Well, I upped the dose this past Friday night to 10 mg. The first dose kept me up all night (it can have the effect of either making you drowsy or causing insomnia). I experienced some dizziness and nausea in the night, but nothing too bad. Then Saturday, again, another 10 mg dose, more symptoms than the night before. Then again last night and wow – more symptoms than the prior to nights. I did not have, however, the insomnia at all, instead I was quite tired and went to sleep pretty easily last night. But, I woke up in the night several times with symptoms.

Still, since I did adjust to the 5 mg dose – over time – I think that I will eventually adjust to the 10 mg dose and then once I do, I will increase it up to 15 and so on. It is clearly pretty strong stuff. I woke up not feeling too well from it today. But, what are you going to do? Or, I guess I should say, what am I going to do – – pretty much everything I just said – gradually increase the drug over time until I adjust to it, which I hope my body will do – it is amazing how just upping it from 5 mg to 10 mg this past weekend has made such a difference in how I feel. Ugh. But, I will get there.

So that is my Tamoxifen story for now. I will conduct my own research on it and see what I can learn about the drug and any way that I can through diet and/or exercise perhaps reduce the side effects and or compensate for anything else the drug might cause.

How’s this for great advice – when I picked up the drug – the pharmacist told me “not to read the list of side effects” . . . nice. 🙂

So, that is my Tamoxifen story so far . . . we’ll see how it goes the rest of the week.