Post-surgery blues.

pabbie · April 2014

My simple mastectomy surgery (r-breast) was on January 23, 2014. My psychiatrist upped my Amitryptiline from 50 mg to 75 mg., and my .5 clonazapem to .5 1/2 during the winter holidays to alleviate some holiday stress from me. Then dx'd with my third cancer., second tumor in the same breast in early Jan. 2014. The started Femara on Feb. 5th which I'm already taking a break from because of a heavy/down depression and joint pain.

But I finally feel like crying today. I haven't cried yet concerning the mastectomy. I think it finally hit me 11 weeks later.

Thanks for listening.

vlnrph · April 2014

Dear, dear pabbie: you have been through so much in only a few months. Do be gentle with yourself, cry if you need to. This too shall pass.

Amitriptyline at that dose may have more side effects than benefit for depression. As you may know, it's one of the oldest tricylics ever made (original brand name=Elavil, for elevation of mood). Truly a wonder drug when first introduced decades ago, there might be better options for you now. Be sure to talk to your doctor. No sense in suffering if help/relief can be had simply by updating your prescription. Perhaps you take it for other reasons, headache, etc?

pabbie · April 2014

Hi vlnrph: Thank you for the kind words.

I found out about Amitriptyline from another BC survivor a few years back. I tried it and immediately liked it. I started at 25 mg. It's helped with my sleep, and especially my headaches/migraines. I agree, I probably could find something better for depression/anxiety. But I don't want to take a lot of meds.

And I have tried many anti-depressants: Celexa, (worked great with HRT before BC) Zoloft, Lexapro .5 (I might try this one again) Wellbutrin (when I quit smoking), and prozac. Many of these I found too activating so I would add a Benadryl to help me sleep.

I find 75 mg.of Amitriptyline a little sedating when I drive so I cut back to 50 mg. last week but today I'm feeling more down because of it maybe?

Who Knows? It could be a combination of all I've been through (like you said) in only a few months.

Thank you.

vlnrph · April 2014

Now that I see the history with your reply, I wish the moderators could fix things so it shows up with the original post. I think it's probably normal to be somewhat depressed after having another diagnosis so many years later.

Since you may be sensitive to the serotonin effects of sertraline & fluoxetine (I'm using generic names which helps point out the chemical relationship between the drug molecules), perhaps citalopram or escitalopram are better choices because you've had good results with them in the past. Ladies on tamoxifen have to avoid most of these due to metabolism competition but should be no problem with letrozole.

I'm getting a dry mouth just imagining diphenhydramine for sleep...

Many of us find Effexor/venlaxafine beneficial in minimizing hot flashes - you could ask your doctor about that one also even if "warm flushes" weren't bothering you too much.

The best remedy I've found for coping with side effects from my aromatase inhibitor during the past month is exercise. I especially like warm water therapy pool classes. The gentle movements ease the aches and seem to reduce the swelling in my lymphedema arm.

Looks like estrogen suppression would be a worthy goal for you. There's still a couple other meds to try in the AI class in case going back to your initial prescription doesn't work out. Hang in there: you've already proven you can do what it takes!

pabbie · April 2014

Thank you Vinrph:

Thank you for all your good info. I cut my amitriptyline down from 75 mg to 50 mg and am feeling more alert., actually waking up a little wired up and I don't need much coffee. But it feels weird because I've been a "zombie" since Dec.

Effexor was another activating med for me. I didn't get the hot flashes with Femara like the tamoxifen in 2008. I failed to mention I had a hard time tolerating tamoxifen, so I cut the pill in half for most of the 5 years.

I try to walk for exercise for more than half a week.

I have an appt. with my PT tomorrow to re-assess my lymphadema now after my mastectomy.

Take care.

polordqueen · April 2014

I had bilateral mastectomies March 28 2014. I finished chemo and just started Tamoxifen. Thank you for sharing. I thought something was seriously wrong with me. I woke up this Am and have been crying all day . Plan to call oncologist and ask if this is related to med or post op blues.

God Bless You. I will pray for you .

J

pabbie · April 2014

Polordqueen:

God bless you & I will pray for you too.

All during chemotherapy I was down but was never told that chemo can make us depressed. I found out on my own. That was back in 1999.

For you, March 2014 was just a short time ago. When you called your ONC did they mention an anti-depressant for you to take if you wanted? or maybe some talk therapy?

Anesthesia from surgery, chemo, radiation, tamoxifen is a big combo for depression. Make sure you ask for help if you need it.

I went back up to my 75 mg. of Amitriptyline and .5 1/2 of Clonazapem. I think it was way too soon to cut back on my meds. I'm taking life one day at a time and giving myself permission to heal. Walking for exercise helps my moods too.

Take care,

Pabbie

vlnrph · April 2014

Good job with the walking - sometimes a simple solution is the best! Helping another person (like when we post here) is also a great way to shift focus and keep our own problems from overwhelming us. Hope the lymphedema is easily controlled, not causing too much distress...

pabbie · April 2014

vlnrph:

Hi: Nice to see your post.

My physical therapy appointment went well. I got lymphadema after my lumpectomy surgery in 2008., so I was familiar with the lymphatic massage and wearing my arm and leg garments while walking. And when the PT measured my arm with the lymphadema after my mastectomy, the size of my arm actually went down.

I think a lot has to do with losing 20 lbs. too. I have 30 more pounds to go. Apparently estrogen loves fat., and in having an estrogen + tumor, I need to lose all my extra weight.

That made me feel good that I could help polordqueen. How are you?

Take care,

Pabbie

Post-surgery blues.

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