Let's talk about sex

Yes, I did just open that can of worms. I suppose it's obvious that Reader Discretion would be advised.

But since some of you sang that title instead of reading it (hopefully not my parents*- hi guys!), here's the link to the song: Salt-N-Pepa, your blast from the past I claim no credit for any of it, but kudos to the group, the producer(s), the record label for airing it. If you watch the video and meander through the comments, you'll notice that the song is from 1991. I was in high school when it came out, Ryan White had already lived and died, "Hook" and "The Silence of the Lambs" and "Father of the Bride" were released, the Pens won their first Stanley Cup, lives were being lost in the Gulf War, Magic Johnson revealed his HIV diagnosis, Terry Anderson was released from seven years as a hostage in Lebanon, and the Cold War ended...

Is it just me or does that feel like a lifetime ago? It is astounding to me how much happens that I forget completely about. You guys, that was all before the Y2K panic. Before everyone and their mother (hi Mommee!) had cell phones. 

Here I am, older and hopefully wiser, but some things are slow to change. We know that sex sells and we are continuously bombarded by advertisers using it to their products' advantage. Sexy is big business. Why else would everyone know about the Kardashians?

I'm going to switch gears a little bit here as I'm attempting to use this blog sometimes as a teaching tool. Quick exercise time, think fast: what are the obvious aspects everyone thinks of when you hear chemotherapy?

*imagine the theme from "Jeopardy" playing here*

Let me guess. You came up with nausea/vomiting, hair loss, and fatigue. All very real. Other unfortunate side effects can be diarrhea (which, even after way too many posts, I still can't spell without autocorrect), foods seeming to lose their flavors or flavors being over-enhanced, fuzzy thinking/chemo brain, in my case watery eyes, and today's topic: sex.

Because chemotherapy can cause sudden menopause. Didja know that? Like really sudden. Hormones made in the adrenal glands and ovaries are diminished by the chemo drugs. Obviously that would affect estrogen and progesterone in women, but women also make testosterone, which as we know is responsible for producing sexual desire and all that follows. (I have to be sensitive in wording because despite the Reader Beware header there are still some young ones reading so bear with me and read between the lines of your own experiences.)  When menopause happens naturally, these changes take place gradually. Chemically inducing menopause happens much more suddenly. In my case, I quit taking birth control pills in May, immediately had one last menstrual cycle and have had nothing since. Second exercise time, think fast: what side effects come to mind when I say "reduction of estrogen and progesterone"?

*cue the "Jeopardy" theme again*

Time's up. All the ladies probably rattled them off in one breath: mood changes, night sweats, hot flashes, and dryness in sensitive areas. 

I've been wading through an incredible book which my radiation oncology nurse Barb lent me. It's called Breast Cancer Treatment Handbook, 7th Edition by Judy C. Kneece, RN, OCN, and it's through the Covenant HealthCare and Breast Health Program. It is very user friendly and has the real nitty gritty. The honesty and the thoroughness is refreshing. 

Let's talk mood swings. Almost every one of you just rolled your eyes and thought, "PMS". Yes, it's a real thing. Here's the why: during a woman's normal cycle, estrogen and progesterone levels drop to allow menstruation. In other words, it's chemical and not something in our heads. And for cancer patients who undergo chemo, those hormone levels don't go back up. Yep, some of you just opened your eyes wide. This book says that essentially some people feel they're not handling having cancer well because their emotions are all over the map when the reality is that their hormones have basically all been flushed down the drain. We as women are used to them ramping back up again and evening things out, but with chemically induced menopause, "yeah, that ain't happenin'."

I think this is where the nugget of mental health needs to be inserted. The book goes on to say that this side effect of treatments is real and chemical based and hormone based and not in anyone's head. Talk to health care professionals about how they can help. Sometimes medication can be a helpful tool in your tool belt. How are you magically supposed to deal with something physical and chemical without help? You're not! There is no shame in taking meds if they help you live to be the best you! Plenty of us wear glasses so we can see. Meds for mental health are no different!

So what about the one-two punch of dropping testosterone levels and the fatigue, two desire-slayers? Let's talk about sex. That's what you need to do. Talk. "Be open with your partner" blah blah blah. Seriously, your partner may know you really well but they most likely aren't a mind reader. If you're having a hard time with finding the right words or getting them out once you've found them, try books. I've been inundated with books since my diagnosis. Honestly, some of them I haven't even opened because I've been so overwhelmed. Let me know if you want to borrow some! And online resources are invaluable as well. For instance, I belong to a Facebook group of ladies who have made the decision to forego reconstruction and stay flat. We talk about confidence, scars, finding clothes that flatter our new shapes (which is harder that you'd think, might I add), other people's opinions, all kinds of things. The support is amazing. You hear a lot about social media only showing the best of the 27 selfies you took, the perfect vacation, the fabulous dinner, but it is also an opportunity to have real, raw, honest conversations about just about anything! Get plugged in somewhere. Life's too crazy of an adventure to go it alone. And no, I'm not only talking to fellow cancer patients. If you'd like more discussion about mental health, check out Dooce because she writes very candidly about her own struggles. She's the real deal, so use her search bar to begin your hunt. 

Read, research, listen. And talk. To your medical team (that's why they're there), to your family, to your kids, to your partner, to your friends, to the Facebook nation, to yourself. Get it out. You're normal. There's plenty of space in the State of Hot Mess. You do you. The Southwest corner is mine.

If you're a friend or a family member of a patient, listen. Hug. Help. Don't take it personally if we melt down completely or if we don't. Hormones and drives are just like other personality aspects- they vary from person to person. If we're not dumping all over you, don't take it as a sign that we don't trust you with it. We may just have other outlets for channeling the mess like exercise, faith, journaling, art, crying in the shower, screaming into our pillow, all of the above or something else entirely. I still don't recommend crying in a hammock. If we do purposely or inadvertently drag you into our mess, it's your responsibility to talk to us, too; we're not mind readers and if our issues are overwhelming you, take a step back and let us know. Don't just ditch us, k? 

That also or even especially goes for the sex part. If you're experiencing dryness and have no idea which OTC product is safe to use, especially if you're worried about extra estrogen, start a conversation with your nurse. If you just can't bring yourself to talk about it, make a list of questions ahead of time and just hand it over to them. They can't help what they don't know about. Again, you have to tell them what the problem is or they can't help you fix it. After all, might as well get every penny out of the medical bills you're racking up, right? Same with low or no desire. Talk about it. They can point you in the right direction of where to look for suggestions if they themselves don't have any. They are your tribe, your team, and they're rooting for you. People are not meant to do life alone, so summon up your courage and start some conversations. To be very clear, if something hurts, don't just endure it, thinking that's just how it is or how it's supposed to be or that it's just you. That means you're going to continue to be in pain. You are your own best advocate, so step up and get whatever help you need. Knowing the holidays can be incredibly hard, why wait to make it a New Year's resolution when you can start on the road to feeling better right now?

Just because we may be seriously too tired and/or have little to no desire, does not mean that we don't still want and need hugs, affectionate touches, closeness. I am so incredibly blessed to have a husband that gets this. He is my most amazing support and I'm getting teary eyed just thinking about how hard he has it to be beside me but not able to wave a magic tool to fix me. Thank you, babe. I am well aware of how lucky and blessed I am. I love you eternally.

So put up that mistletoe, surprise your friends with a squeeze, and don't forget to smooch your sweetie! (Of course there is always a flip side; if you have germs, please don't share them! Cough into your sleeve, wash those hands, and stay home to get better instead of sharing the little buggers. Bleah!)

* Forgot all about my darn asterisk. I'm crossing my fingers that my parents don't remember the song or that I'd be singing it while doing the dishes back in the day (eek), but they can surprise me. Once while they were visiting, our family was playing the letter game with our Echo Dot and Alexa gave us the letter U and "musician." Without raising her head from her crossword puzzle, my mother chirped, "Usher." We all looked at each other, astounded, and my Dad quipped, "she is un-believable." I guess anything's possible!