Repeat Prescriptions, Withdrawal Symptoms and Having No-One Else to Blame

I have alarms set up on my phone.

I have a calendar with dates marked in red and blue – every twenty-eight to thirty-two days, depending on the medication.

I have daily reminders – the bottles emptying, the number of tablets dwindling, the old packets I take out with the recycling.

And still, I manage to forget to reorder my prescriptions on time.

I will sit down at my desk, looking at the calendar in front of me. ‘I’ll ring later on, after all, they only take repeat prescription requests after 11am.’

The alarm will ring on my phone in the middle of a meeting or a lengthy email at work, and I will turn it off. ‘I will do it in a bit, when I’ve got a couple of minutes.’

Usually, I remember after a couple of days, I ask my friends to remind me at a specific time – it is harder to ignore someone that it is to snooze an alarm. I always manage to find a way to reorder my prescription before I actually run out.

This month though, I was not that lucky.

I called last Thursday. Another painful phone call to the GP surgery, another ten minutes to wait to be put through to someone, another five minutes for them to check that I am actually allowed to reorder one of my repeat prescriptions. ‘As usual, we’ll need about five working days – you should be able to pick up your prescription at your usual pharmacy around mid-next week.’

It was a gamble. I had not run out yet, but the prescription I was ordering was my hormone treatment, which comes in an opaque bottle with 64 metered doses – that is 32 days of HRT. I never know exactly what day I am going to run out – I can tell when the bottle is almost empty, but that is pretty much it.

I shook the bottle that night, trying to ascertain how much was left. After all, I remember I skipped a couple of doses when I was home at Christmas. How many, I could not remember exactly. Would it last until Wednesday?

To absolutely no-one’s surprise, it did not. Thursday was fine. Friday’s dose came out of the bottle, albeit reluctantly – instead of two full doses, I maybe got three quarters of one. And by Saturday, it was all gone. It had happened once before – although last time, there were only three days between the moment I ran out and the moment I got my new prescription. I knew the next couple of days were not going to be fun.

It started with hot flushes, my body’s way of warning me that my levels of oestrogen are too low. That night, I could not get warm enough, and then suddenly I was too hot – I was boiling, I could not bear having PJs on, let alone a duvet.

Mood swings, even worse than usual. Feeling low, not feeling like doing anything. Trouble concentrating – I could barely get through a 20-minute episode of Modern Family on Netflix. Forget reading – I read the same page four times before realising I had no idea what book I was even reading. Fatigue – I took two naps on Sunday.

And then came the really painful symptoms. On Monday morning, I woke up with a slight headache. By mid-morning, my vision was blurry, I could see spots of light, I could barely read what was on my screen. The light coming from the window making me recoil in pain. I recognised the signs, I used to have them frequently. A migraine, and a migraine with aura at that. They are frequent in women with low oestrogen levels.

Nom nom, painkillers. Nom nom, a second tablet. Nom nom, nom nom. Nom nom.

What is worse than an unrelenting pain in your brain, which feels like it is about to explode? The thought that it is self-inflicted. That it could have been avoided, all I needed to do was pick up the phone a week earlier, when I had first set out to do it.

I am going to have to reorder medicine every month for at least twenty years. That is a pretty basic thing to do. I do not mind the phone that much (not when I am the one ringing – please do not ever call me without warning), so I was not particularly avoiding it. I am used to it. And I still cannot get it right.

Ever since I was diagnosed with cancer (and probably before then, although the experiences of the last year have definitely made it more obvious), I have struggled with self-worth. For a bunch of reasons, I wake up every day and know for sure that there will be a point during that day when I will feeling like a failure. And these things, the little things that should be easy to do and which I still manage to mess up, they do not help.

I feel like I deserve the pain. I only have myself to blame, after all. I have let myself down. I should not complain about the migraine, I should not take a day off work, not even a couple of hours, because I brought it upon myself. I am responsible. There are many things I cannot control in my life, but this I do. If I was not such an idiot, if I did not forget what is basically one of the only things I have to do to take care of myself, I would have been fine.

My body does not produce the hormones that I need, so I rely on drugs to give it what it needs. It is a sort of addiction, if you think about it. And what I am experiencing are withdrawal symptoms. My body craves the medication, it craves the HRT and it goes into survival mode when I do not take it.

So I set another alarm on my phone, every four hours, to remind me to take painkillers, alternating between various active molecules. I have been taking them almost religiously for thirty-six hours, trying to keep the migraine at bay, to be able to carry on with my day.

I dress in layers, to be able to remove them as the hot flushes hit me. I do CBT in the evenings, to try and get a better handle on the mood swings that the anti-depressants cannot control.

Five days. That is how long I will have deprived my body of hormones for. It has not been fun. Will I do it again? Probably. Will it affect me in the same way? That is pretty much a given.

Anyone up for nagging me in 27 days?

One Year On: We Are in the Clear

If I had any energy left after my one-year follow-up appointment this afternoon, I would probably blow up some balloons and put them up in my flat.

It was hard. My eyes are raw from crying. I used about two boxes of tissues – one in the waiting room and one in the exam room.

I cried in front of the receptionist. I cried in front of the nurse who checked my height and weight. I cried in front of the doctor, and I cried in front of the cancer nurse specialist.

Follow-up appointments are rough. You can go about your life for months, but you know that everything could change in a matter of seconds, in that same room where you first got the news. The. Exact. Same. Room.

I had a new doctor again, who asked me plenty of questions about how I was diagnosed, how it came to be, what tests were done, how thick the lining of my uterus had been on the MRI scan (I have no idea). As I was battling my way through my tears, she told me it was ok to cry. It was ok to be overwhelmed, to be traumatised. She told me that I had gone through a lot for someone so young – terribly young, and she could say that because we were exactly the same age.

I do not know why that comment struck me as odd. Why of all the things she said, that is the one that stayed with me.

But it is all said and done now. A quick exam, a lot of background info, a chat about any symptoms I could have had, an inventory of the medication I am on, and I have been declared cancer-free, until my next appointment in four months.

I will have more to say in the coming days. About how they told me if things remained the same, I would be discharged after one more year, instead of four. About how my dedicated nurse was self-isolating so I was not able to speak to her, but arranged a phone catch-up in a couple of weeks to discuss my ongoing mental health problems.

For now though, I will crawl under the covers, put a good audiobook on and try and get some much needed rest. I may order a celebratory takeaway later, making up for the fact I have had maybe 4 meals in the last 6 days. I will make myself a hot chocolate and put the Christmas lights on.

In the wise words of Adore Delano – Party.

Talking About Cancer – Making Light of It

Today marks exactly one year since the day my operation was first scheduled. It is also six days until my next check-up at the hospital, for the dreaded one-year mark (or as close as we could get without having me go for a check-up at Christmas).

At the moment, it is impossible for me to spend any length of time during the day not thinking about cancer. It permeates everything, it colours every feeling, every decision I make. It makes me cry, it makes me sick with worry, it makes me crumble to the floor in the shower until the water goes cold, it makes me forget how to breathe in the middle of my morning walk, and fall over in the park.

Because cancer is all-consuming, it is almost impossible to push it to the back of your mind, and not think about it at all. You need to find other ways to cope. Ways to tame cancer, to make it less of a threat, make it into a subject you can discuss, something that can make you laugh as well as cry.

I have found that making light of cancer helps. Making jokes, bringing it up in an unexpected way and observing people’s reactions can be priceless. When you make fun of it, for a few seconds, it no longer is the big C, or the other C-word. It is cancer, and it is something you can bring up without fear, something you have earned the right to laugh about.

I have always loved dry humour. Saying something unexpected, sometimes a bit dark but that will bring a laugh upon someone’s lips – or a shocked gasp, depending on who my audience is.

Just this week, even though I am battling one of the darkest weeks I have had all year, I made two of my ‘cancer jokes’, and it felt amazing. They were awkward, they were uncomfortable. They were not necessarily funny – I definitely will not be quitting my day job to start a career as a comedian – but they did make me feel more in control. For a few precious seconds, it felt like cancer was mine to beat, mine to laugh at. If I can laugh about it, surely it cannot hurt me anymore.

I was on the phone with a friend at the weekend, and we were talking about how I have been having a lot of mood swings and have been feeling very tearful lately – even more so than usual. My friend was asking whether I thought it might be hormone-related, or could it be an issue with my antidepressants maybe? In a deadpan, slow voice, I interrupted her and said ‘God, I hope I’m not pregnant’. A couple of seconds of silence, and an awkward laugh followed. Sorry to have made you uncomfortable – personally, I think that has been the highlight of my week so far.

The other joke I made was during a group video call, with a lot more people than I am usually comfortable with. I had not spoken to some of them since the summer of 2019, before it all happened, but they all knew, either because they had been told by other people or they saw something on social media, or read this blog. We were talking about how long it had been since we last saw each other, and I said ‘well, it’s been a while. Last time we spoke, I still had a uterus’. Some faces looked shocked. There were a couple of laughs, a few shaking heads and one amused ‘Can’t argue with that’.

I have been using humour to cope for months now. Earlier this year, I uploaded a selfie on social media, showcasing my brand new short hair and using a caption that would have made my mum cringe: ‘Getting rid of my hair like I got rid of that cancer – #snipsnip’. I felt so powerful in that moment. Cancer was nothing more than a punchline. Snip snip, my hair. Snip snip, cancer.

I understand these comments might make people uncomfortable. Not everyone is happy to have a laugh about something so serious. But for me, it is a way of getting over it, of proving that cancer is not as threatening as it looks, of feeling like I have the upper hand for once.

I think it is also important to show people that I can laugh about it. If I can make jokes, if I can make light of a terrible situation, maybe people will start feeling comfortable around me and my issues. Maybe they can make their own jokes, and I will laugh at them – no puns though, nothing make me cringe more than a bad pun.

I have earned the right to make those jokes, and to laugh when you make one. Not everyone with cancer will see it that way, and for some people cancer will always stay off-limits. For me, making light of cancer is proof that it has not taken over my sense of humour. I can still be hysterical.

Well. Not etymologically.