Some days are harder than others

It is just a fact.  I have been having trouble going to sleep even though I am brutally tired so I went and got some melatonin.  I took 10 mg on Monday night and within an hour I was out.   It was great...except for the fact that I spent all day yesterday dozing off.  Went to bed a little after 10 last night (without melatonin) and went right out and slept well and am much more awake today than I was yesterday.  I guess that 10 mg is too much for me so I will try half that next time.  Yesterday was rainy and gloomy all day too so that probably didn't help.  Today is still gloomy but not raining so far.  My arthritis pain is off the charts today however and since I am not supposed to be taking ibuprophen I am in a bind as that is the only thing that helps.  It sucks.

I don't recall if I mentioned that I was moved from anastrozole to exremestane for my estrogen inhibitor.  I was in a ton of pain from the ananstrozole and the exeremestane is a lot better for me.  I know they say that getting more exercise helps with this but conisdering that last night walking from one end of the house to the other at a decent pace left me out of breath, I guess this will have to be put off until after my heart surgery.  

I also reached out to the integrated oncology unit at my hospital and I hoping to get in and investigate some alternative pain relief such as massage and acupuncture.  I am very concerned about chest pain after the surgery since I already have quite a bit of pain on occasion from my lumpectomy.  My arm and side of my breast from the surgery are still not right especially when I try to extend that arm.  It is my dominanant arm too which is not helping.

Out with the old...

 and in with the new.  

When I saw my GP in September she recommended I go for a baseline echocardiogram since I had a heart murmur (I have known about that for probably 20 years) and we needed to keep a watch of my chest after having radiation.  I had the echo in early November and calamity has struck again.  I have severe to critical aoritc stenosis.  This meant another battery of tests to make sure that the echo was correct and to see just how bad it is.  Long story short, it is bad.  So as if cancer this year was not enough, I am now looking at open heart surgery in January.

I was given a choice of doing the less invasive TAVR (Transcatheter Arotic Valve Replacement), A bio prosthetic valve (Edwards Inspiris) or a mechanical valve (St. Jude). Kicker is that I am relatively young considering the life expectancy of any of those choices.  Odds are, I am going to end up needing another valve at some point in the future no matter what I choose.  When they looked at the TAVR, I was between the 2 smallest sizes.  If the were able to do the larger size, if and when it failed that only left the smaller one to go in and correct it with which would in all likelyhood make my valve too small to pass the amount of blood I would need. So for me, TAVR is a one off leaving me older and perhaps not as healthy in 10 years or so and facing open heart surgery. A mechanical valve would probably out live me but comes with some serious issues of it's own including living on blood thinnners for the rest of my life. Not a horrendous choice but not one I really want to deal at this stage of my life. (I play with sharp objects like scissors, needles and rotary cutters.)

That leaves us with this Edwards Insipris Bioprosthetic. Bovine Tissue that is treated to help reduce the chance of calcification and should I eventually need to do something more, I can do the TAVR or who knows what may be available in 10 years.  Science is advancing rapidly.

Sounds like a win to me, except for the part where they intubate me,  crack my breast bone in half, put me on bypass, and cut my heart open. Bah. I can do this...but man, I wish I didn't have to.