Menopause and mysteries.

Hope is hard.

Sometimes you hope in earnest for a soft place to land and get absolutely smashed on the rocks.

I’ve found many soft landing spots over the last nine years in the sea of cancer. I’ve continued to hope, even amidst devastation and disappointment. That hope has in many ways sustained me. But as I’ve sat in doctor’s offices and received phone calls and read pathology reports and looked wide-eyed at scans of my insides, lit up like a Christmas tree, I have had the smashed on a rock feeling many times over. The I can’t find my breath feeling. The what now feeling. The racing mind and the blank mind feelings. The there’s no use fighting back the tears feeling. I’ve been there enough to know that those feelings are important to sit in and not race through. That to push through and immediately go searching for a silver lining or a solution or an “at least” is to minimize the very real and raw pain of the moment. I’ve been there enough to know that true hope exists in the midst of those moments, not in spite of them. That deep and authentic joy can only run as deep as the caverns that pain has carved.

I had a smashed on the rocks moment this week and am still sitting in the pain of it.

My trial drugs and the five years prior to starting my trial of harsh cancer treatments have left my body very confused in many ways. One of those ways is my reproductive hormones. For an unknown and mysterious reason, for the last three and a half years I have experienced symptoms that I have lovingly come to refer to as ‘period flu.’ Some months I feel like I have the flu for about 36 intense hours. I will spare the worst of the details, but there is nausea and chills and hot flashes and severe fatigue and headaches. It was sporadic and odd and I would mention it from time to time to different doctors and everyone kind of scratched their heads. I just let it rest and dealt with it as it came, but in the last ten months it has been increasing in frequency and intensity. I have physically pushed through a lot in the last nine years, but this is not a thing I am able to push through. I am in bed or in the bathroom for nearly two days every month and sometimes more frequently. Finally, this summer I decided to push in a little more. It was becoming ridiculous the amount of days that it was interfering with my work and my well being. Based on the timing, the fact that I know I am rapidly losing estrogen, bone density and am fully in menopause already, I felt confident I had solved at least half of the puzzle – it had to be related to my reproductive hormones! After consulting with my oncologist and trial team, I felt even more confident. I had used all my best sleuthing to determine that the cause was probably related to the chemo pill in my trial regimen, but what exactly it was causing or why was the mystery. So I scheduled an appointment with my phenomenal gynecologist who specializes in reproductive endocrinology.

My appointment was Tuesday. Joe asked me Monday night how I was feeling about it. “Really hopeful,” I said. All the pieces were coming together. Half of the mystery was already solved, I just needed my doctor to do some lab work, maybe an ultrasound, hear about my symptoms, look at my meticulous record keeping and boom! I would finally understand the cause of those period flu days and know how to treat this awful thing. 

I’ve already spoiled the ending, so you know that that’s not how the appointment went at all. 

I detailed all of it, hoping that she would really understand just how not dramatic I am so that when I said things like “I can’t get out of bed,” she would understand that as a literal statement. I gave every date of every occurrence for the last nine months. I gave my best argument for the half of the mystery that I had already solved. She did an ultrasound and found my ovary (fun fact, I only have one!) covered (still) in cysts. She took a minute to review and when she returned to the room I was ready for my action steps.

The message was loud and clear – we don’t think this is related to your reproductive cycle or hormones at all. As a matter of fact, we have no idea what the cause is and here are the options. Option one is a Surgical one to remove the cysts in hopes that maybe there are weird endocrine signals being sent to them and messing with my ovary (unlikely and risky). Option two is to take a super low dose SSRI for a couple months because it has been shown to help reduce menopausal symptoms and hope that maybe it will help. So let me sum up. Surgery, where I could end up losing my only ovary and any estrogen I currently still have or another pill that might help or might not. Aside from that, we really have no idea what the root of the issue is and probably won’t ever know.

I was sure there was a knowable cause. My doctor who has been a great advocate for me, who I trust, was telling me there is not. That in 2024 medicine is still limited and sometimes we stop looking and just start treating symptoms anyway.

Frustrated. Sunk. Lost. Angry. Sad.

I walked out with a script in my hand and tears on my cheeks. 

I am so deeply grateful for life and breath and so deeply grieved at all I have lost in the process of still breathing.

And I am thankful for hope. And I am thankful for scriptures that give me the words for lament and for hope on the days when I can’t find my own. When I am smashed on the rocks. When hope is hard.

The thought of my suffering is bitter beyond words. I will never forget this awful time as I grieve over my loss. Yet I still dare to hope when I remember this: The faithful love of the Lord never ends. His mercies never cease. Great is his faithfulness.

Lamentations 3:19-23