Tag Archive | aromasin

Sleeping with the Enemy

Or not sleeping, as the case may be.

Perhaps I am being melodramatic referring to my Aromasin (meds) as the enemy (and I apologize to those of you who might have thought I was referring to my husband…!), but the cumulative side effects of my aromatase inhibitor are catching up to me.

I started the Aromasin (also known as Exemestane) on March 7th of last year. I was handling it remarkably well, especially considering my experiences with Femara back in 2013. I had no side effects for quite a while, with the exception of an occasional hot flash and just being warm all the time. I could handle that. But over the past few months, other side effects are creeping in. I have some joint pain in my hands and feet, and that’s tolerable. It’s the absolute lack of sleep that is getting to me.

Most nights, for the past few months, I do not even attempt to go to bed until midnight. Then I tend to lie awake until wee hours of the morning. Tossing, turning, thinking, sweating, throwing covers off/on, and staring at the ceiling. I have started to just get up to do something productive rather than be continually frustrated with my inability to sleep. Last night, as an example, I did my menu plan and submitted my online grocery order at 2 a.m. I designed a t-shirt on my Cricut (for crafting, if you aren’t familiar), and I played some games on my phone. I returned to bed at 2:30 am and fell asleep about 4:15 am. One night, just a few weeks ago, I didn’t even go to bed until 5:15 am! Just about the time my husband starts his day.

I’ve always been one of those people who needs 8-10 hours sleep, so 2, 3, 4 hours just isn’t cutting it.

I’m not really sure what to do. I mean, when it’s a side effect of meds, do the usual things work? I try to limit my caffeine (no more than two cups of coffee a day) and certainly none after noon. I should probably do more reading and less time on my phone/laptop because of the light. I already take magnesium (which has helped me tremendously in the past). Melatonin and lavender have never really worked for me. It’s just something I think I’m going to have to suffer through for the next 5-10 years, which is sad. I do love to sleep!

If any of my BC sister warriors have suffered through this, any suggestions? And if any of you are up late, message me! We can chat!

* * * * * * * *

I would like to get back to recipe sharing again, so I’ll start with our New Year’s meal!

Growing up, January 1st meant my mother’s amazing roast pork and sauerkraut. Even when I ate meat, my preference was the sauerkraut. I loved that it cooked in the juices of the pork roast and it was one of my favorite meals of the year. But then I became a vegetarian and the pork had to go! But sauerkraut is still an amazing food!

Made from cabbage, sauerkraut is a cruciferous food with lots of anti-cancer properties. And one cup of sauerkraut is only 27 calories, with 4 grams of fiber, 35% of your Vitamin C requirements, 21% of your Vitamin K, and 12% of your iron for the day! As a fermented food, it contains healthy bacteria for great gut health. What’s not to love?

Enter the Tempeh Reuben! This is a twist on the fattier, less-healthy corn beef. It is totally one of our favorite meals. I pile the sauerkraut on top of my marinated/pan “fried” tempeh (no oil is used in the process), with a Russian dressing made from vegan mayo. It’s a delicious sandwich any day of the week, but it satisfied my sauerkraut fix for our New Year’s tradition!

If you make this, or if you have any questions, let me know! Enjoy!

IMDb: Sleeping With the Enemy (1991)

A.I. Artificial Intelligence

Most people, when they hear the term “AI”, automatically think of artificial intelligence. Unless, of course, you are a breast cancer survivor. Then AI means something completely different. For us, it stands for “aromatase inhibitor”.

What exactly is an AI? Susan G. Komen defines AIs as follows:

“Hormone receptor-positive breast cancers need estrogen and/or progesterone (female hormones produced in the body) to grow. (AIs) lower estrogen levels in the body by blocking aromatase, an enzyme that converts other hormones into estrogen. This slows or stops the growth of the tumor by preventing the cancer cells from getting the hormones they need to grow.”

The three aromatase inhibitors are Anastrozole (Arimidex), Letrozole (Femara), and Exemestane (Aromasin).

For those of you who have been following along here from the get-go, you remember that I took Femara/Letrozole. You also remember how very unpleasant it was for me and how, after about 6 months, I stopped taking this drug. I felt like $h*t and struggled with insomnia for several months straight. I was in pain all the time and the lack of sleep made me feel like a zombie. It was pretty nasty. I sought a second opinion at that time, reviewed a bunch of statistics, and was given permission by all my doctors to stop taking the Femara.

Fast forward to today, literally this morning, when I started a new AI. I am terrified of the side effects, but agreed to give the AIs another whirl given my recurrence. My Penn oncologist has opted for Aromasin, since it is molecularly different from the Femara and Arimidex. Since these last two closely resemble each other, it stands to reason that if I had trouble with one, I would have trouble with the other. It’s hard to believe that I would be terrified of something so tiny and unassuming:

But one glance at the side effects and it’s easy to understand the fear: hot flashes, muscle and joint pain, headache, fatigue, nausea and/or vomiting, osteoporosis (I have to go for a dexascan in a few weeks to baseline), heart problems, changes in mood, depression, insomnia, vaginal dryness/atrophy, and loss or thinning of hair. So your risk of dying is lower, but when I was on this previously, I felt like I was dying already.

On the plus side, my Penn oncologist thinks my side effects may not be so severe this time. She indicated that women who are thrust into menopause by chemotherapy have a harder time, as was my experience back in 2012. There was no opportunity for my body to gradually decline on hormone levels; it was more like “bam!”, you’re in menopause. So the drop in levels from the AI was significant, resulting in more severe side effects. This time it’s 7 years later, so I’ve had the chance to settle into menopause. Theoretically, the drop will not be as significant and the side effects more tolerable. Fingers crossed that is my experience.

If it turns out not to be the case, there are still other options to consider, but I need to give it at least 30 days.

I did recently learn that soy is actually an aromatase inhibitor, which might explain why those who follow standard Asian diets have lower incidence of breast cancer. If things get really bad, perhaps eating soy every day will be an option. Stay tuned.

Day one of my AI is here. Wish me luck!


IMDb: A.I. Artificial Intelligence (2001)