Nasty Anastrozole

In February I'll pass a milestone - five cancer-free years from the end of breast cancer treatment.  I understand there's nothing scientifically special about the five-year mark except that it's when most studies call a person "cured", however it's still encouraging to stop and notice how healthy I am now.

Here's me in the fall of 2010 as my hair was falling out.  I like it better now!

When I first completed all my treatment, which was a lumpectomy followed by chemotherapy followed by radiation, my oncologist recommended I take a drug called anastrozole for five years.  It is an aromatase inhibitor that significantly reduces the total amount of estrogen in a post-menopausal woman whose ovaries no longer produce estrogen.  For women whose cancer is hormone receptor positive, reducing estrogen in the body can help reduce the chance of the cancer coming back.

Side-effects of anastrozole are bone weakness which can lead to fractures and osteoporosis, joint pain and heart problems, along with the usual effects of reduced estrogen like hot flashes and memory issues.  I was aware of that, and had already been reading online conversations in which women complained of debilitating pain from the drug.  Naturally, I wasn't keen on starting it myself.  I talked it over with my naturopath who urged me to follow my oncologist's advice, but also mentioned that if I chose not to take anastrozole, there is a mixture of Chinese herbs, called Myomin, that does the same thing without the side effects.  Hmm, it didn't seem like a tough decision to me!  I read the literature about Myomin and at the time it was all about reducing estrogen in the body for the purpose of body-building.  The literature (and I use that term loosely - it was mostly ads by places selling Myomin) made no mention of fighting cancer - apparently they can't advertise it for that purpose since the FDA has not cleared it for that purpose.  However, it made it very clear that Myomin works by inhibiting the enzyme aromatase, just like anastrozole.  Recent literature mentions it being used for treatment of endometriosis, ovarian cycsts and uterine fibroids, and also for protection of people taking bioidentical hormones.

So I said no thanks to the anastrozole and took Myomin for six months.  On each visit to my oncologist, she urged me to reconsider, citing studies that showed a better outcome for cancer patients who follow up with anastrozole.  (Of course, there are no such studies on using Myomin, since no drug company would be motivated to pay for them.)  She wore me down, and finally I ordered the prescription.  When the pills arrived they were tiny - maybe 1/8 inch in diameter - and I thought how could something that small, taken in the middle of a meal, possibly hurt me?  I was also thinking of how I'd feel if the cancer came back and I hadn't taken the pills.  I wanted to feel I'd done everything possible never to go through that again.

So, around August of 2011, I started taking anastrozole. As you know, I've had a lot of hip pain over the last several years, and I wondered if anastrozole was making it worse.  I knew it wasn't completely due to the drug because I already had hip pain before that, and I didn't have pain in other joints.  Seattle Cancer Care Alliance gives me a dexa scan bone density test every year to check for osteoporosis and the result, while not perfect, is "appropriate for my age". 

Now, after having had physical therapy and chiropractic and my year of health, I have no more hip pain!  I think learning to tighten my "core" and use my butt muscles has made the greatest difference.  I've been pretty faithful taking the pills, stopping only for a month before and during our trip to Italy in 2013, when I wanted to be as pain-free as possible for walking around, and I didn't notice any great difference from stopping at that time.  I do have hot flashes - not desperately strong ones as when I first started menopause, but just an inability to keep my body temperature steady - I'm always putting on a sweater then throwing it off again.  And I definitely have memory issues.  I blame my age and years of killing brain cells by drinking wine, but it's possible the drug is making it worse.

At my last appointment, my oncologist reminded me that in August I will have been taking anastrozole for five years.  She is okay with my stopping, but recommended continuing as long as it's not bothering me much.  We talked about my taking time off from the drug, and she said six months would be a good length of time to see whether I notice any difference.  That sounds good to me.  I'll wait until summer, maybe for my 69th birthday in July (yikes!) and then take a six-month vacation from anastrozole.  It will be interesting to see if I feel any different.  If by some miracle my memory returns or I start sleeping soundly, that would be a good reason to quit for good, but I might also look into Myomin again.

That was a pretty dense read, but an important topic.  Life is such an adventure, don't we all want to stay healthy and active to enjoy it as long as we can?!  Our Thanksgiving holiday was another reminder of how fortunate I am.  Melanie, Ben, Ben's brother Jason, and doggie cousins Wilbur and Banjo joined us for fun at the coast.

A serious game of UpWords after dinner.  I was playing with real experts - didn't stand a chance.

A great photo of Melanie and Wilbur.  He was so good to stop running around long enough to pose for the camera.

It was a great day!

Breaking Up is Hard To Do

Another diversion from healthy eating, this time to tell you about a stressful situation in our lives right now.  Stan and I have decided to leave the investment club we joined a bit over a year ago, after gradually realizing our ideas about investing and how an investment club should operate are incompatible with those of the club founder and president.

It's funny how stressful this can be - sort of like quitting a job or getting a divorce.  Leaving any group of nice people can be sad, and I think this situation is extra stressful for two reasons - first of all, besides just not attending meetings any more, we will be withdrawing the money we have invested over our time in the club.  This is not a great time, as the stocks held by the club have been in a swoon lately, and we'll be leaving with a significant percent less money than we have put in.  Second, I think having shared investments may make the group a bit closer than just having fun together.  We've all contributed a lot of time not just for meetings, but doing homework, attending educational workshops and even a weekend retreat.  In the process we've enjoyed getting to know these folks.  It's fun to be part of a diverse group of smart people, working together for a common goal.

So why are we leaving?  Two reasons:  one, the way the club chooses and invests in companies is not compatible with what we have learned about investing, and two - the more important to me - instead of discussing and comparing companies and voting on every purchase or sale, the president has great latitude to buy and sell, based on a few loose, and we think faulty, criteria.  This is fair, as that one person owns a large proportion of the club's funds, but makes it less satisfying for us.

A bit of background:  our club is part of Better Investing, a national non-profit organization that helps educate people about investing, and provides an umbrella organization with chapters throughout the country for many, many individual investment clubs.  I've been a member of the organization for many years, part of the time in a different club and part as an individual.  We're leaving our club, but will remain individual members of Better Investing and perhaps find a different club.  I am on the board of the Puget Sound Chapter, (board Secretary, woo woo) and will remain so for at least the rest of my one-year term.

We feel the method of investing we learned from the organization is a solid strategy for people who want to choose individual company stocks.   We just attended our chapter's annual educational conference a few weeks ago and it was wonderful - very motivating to hear successful folks who are also great teachers talk about investing, stressing the organization's goal - to buy fundamentally high quality companies and only when their price is lower than average. They teach a specific way to study and compare companies and it works!

This is Costco's yearly Sales, Pretax Profits, and Earnings.  Better Investing likes to see these lines up, straight and parallel.

 Here's Starbucks.  That dip is the recession of 2008-9.

 Look at Priceline!

Other companies are more cyclical - not necessarily bad investments, if you buy and sell at the right time, but Better Investing recommends against them unless you are an experienced investor.

For example, Ford:

or Century Link:

So, we sent our resignation email last week, having waited until after the conference so as not to cause any drama or awkward feelings during the weekend.  We felt a bit sorry about talking with our fellow club members as though nothing was changing, and we said so in the email, as well as saying how we have enjoyed the social aspects of the club and hope to stay in touch at Better Investing events.  We kept it as brief and positive as possible.  We are gratified to see the emails that have arrived in response from club members, although a bit sorry to have no acknowledgement at all from the President or Treasurer.

I have changed jobs many times and I have noticed that after announcing I'm leaving a company, several people who I didn't know very well during my time there would come and talk to me.  It is though it's now "safe" to express their discontent, since I have obviously expressed mine by planning to leave.  We're seeing some of that now in emails from our club-mates, all so far expressing disappointment that we're leaving.  Some have expressed interest in what we'll do next and in staying in touch in the future, to which we are replying we'd love to stay in contact.  I'm not interested in starting a club myself - too much work and responsibility - but we're happy to discuss our ideas with anyone who asks.  It's nice to know they like us and will miss our participation  : )

 On a lighter note, I'm writing this post from a nice little house in Cannon Beach, Oregon.  Stan and I are spending some time here both as a relaxing get-away, and also to see a bit of what it would be like to retire to a smaller town, maybe on the coast.  (No near-term plans - I know it will probably take decades for me to pry Stan and his treasures from the big house we have now.  I just wanted to see what it would be like.)

We have some goals while we're here - mainly to do some study work on our stock portfolios and to lose a bit of weight.  I said I planned to walk every day we're here, rain or shine.  Well, for several days it rained really hard!  I walked one day in the rain and nearly got blown off the beach!  Since the sun has come out we've walked a lot.  Here are some photos Stan took yesterday and today:

Stormy Weather

Stan and I are in Cannon Beach Oregon.  We decided to spend some time here in the off-season to see what life at a small coastal town would be like.  Well, whew!  It has been very stormy!

We have gone to the beach several times with the plan to get some good photos, but it has either been fogged in, or very windy with rain or hail beating down and we're afraid of destroying the camera.  The waves have been very big, and we're hoping they'll still be big when it dries up a bit.  Here are a few shots we took.

Stan took this panorama with his new camera.  Nice!

The night before the big storm, when we had first arrived, we saw these birds all facing south.  I wonder if they knew a storm was brewing, or do they just face into the wind?

Needless to say, we've spent a lot of time snug in our rental house with books and computers.  It's quite comfortable, and the power's still on, though it has blinked a few times (fingers crossed!)

After a few days of cozy resting, we ventured out... groceries called!  What an interesting trip!  Sorry I don't have photos to show you - I was too scared and amazed.   The Safeway is in Seaside, 9 miles up the coast, and all along the way there were little creeks that you would normally not even notice, only now they are giant lakes, right up to the sides of the road.  At one point there was a traffic jam where the road actually went under the water for 100 yards or so.  Cars were slowly going through it, so we did too.  Glad we brought the Subaru with 4-wheel drive and all-weather tires!  I was afraid they would close the road before we got back, but it looks like they're used to this here.  On our way back, the water was even higher, I would say a foot deep, and there was a rescue vehicle parked ready to pull out anyone who got stuck.  No one had, and we got through fine.

Look what else we encountered in a semi-dry moment!  We hiked from Cannon Beach to Ecola State Park.  The map said 1.5 miles to the park, but didn't mention it was quite uphill.  The woman in the Tourist Info center looked surprised when we mentioned we were walking there, and advised us it could be very muddy.  She didn't mention the mud would be on a very steep trail, sort of like a ski run in spots.  We made it up hill okay, but it was quite slippery going down.

Another traffic jam as we headed back into town.  Can you see this big guy eating the hedge??  There was a whole family of elk grazing and resting in a vacant patch of grass.  Great photo op, but I was scared!  The other folks were in cars, but we were walking along the sidewalk right by them, and I was afraid they might get startled as my umbrella flapped in the wind.  (Of course it was raining.)  We avoided eye contact and they let us go by with only a cursory glance.  I was a bit grateful Stan didn't have his camera, as he doesn't scare as easily as I do!

This picture shows how close we were - scary!

Cannon Beach is such a nice little town.  I love the idea you can leave home on foot and get a coffee, some library books, visit the quilt shop and yarn store, and eat at any number of good restaurants.  My plan was to walk on the beach every day for exercise...  not working so far, instead we've been staying home by the fire with wine and snacks.  Oops.

The library is all-volunteer, and they let us join for $5 so we can borrow a few books.

I browsed through this yarn shop thinking a crochet or knitting project might be fun, but I didn't actually know what to get.  Some of the yarn is really beautiful, but also pretty expensive.

I had almost given up my walk as the rain beat down, and then I turned the corner and came upon this rainbow.  I walked a bit further, and came out into the sunshine that you see in the photos above  : )