I was having a good stretch there for a while. Reengaged with work, writing on here about the political economy of drugs rather than the experience of cancer and its treatment. It was all good.

But the “all good” was missing a critical piece. At the end of October, when my body was really falling apart and I was struggling mightily with brain fog, I stopped taking my aromatase inhibitor. This is the drug that suppresses all estrogen production, and reduces the risk of cancer recurrence by 50%.

It has a panoply of side effects, including cognitive and mood problems. I made it through nearly four months but when things started to get bad, my NP suggested a break.

It took weeks, but things very gradually improved. By mid-December things had taken a turn for the better, and this past week was the first week that I really felt fully engaged with work again, vs. just struggling to respond to what absolutely had to be done.

But I knew I had to try again. On Thanksgiving I tried a dose of the old drug, which immediately brought back a deep fog that took several days to go away. Yesterday I tried a new drug, a different one in the same class.

Well, the brain immediately went haywire. Within hours, I felt like I was behind a thick plate of glass. I found myself crying uncontrollably and deeply despondent for no external reason. I spent the day trying to distract myself from the wave of awful feeling that dominated my senses.

So here I am on day two. I didn’t take the drug this morning. I thought if I were going to take it at all, I’d try this evening, on the theory that maybe I can sleep through some of the side effects. But I still feel shitty—depressed and zooey in the head.

It’s really strange how our minds are, at base, such physical things.

At some point I’m going to have to decide whether I push through this misery for a while in the hopes that it gets better—which it could. There are other things I can try. I can add various cocktails of stimulants and antidepressants to try to make the side effects manageable enough to continue. I can try another, slightly less effective drug with a slightly different side effect profile.

But it really, really sucks. And obligations do not pause themselves just because your brain has fallen apart. Of course people would mostly understand if I asked for forbearance. But I don’t want forbearance, I want to have a functioning brain.

I am ambivalent about posting this, because it feels so personal. But that is sort of the point—that just because “active treatment” is over, it doesn’t mean that you’re not still dealing with the aftermath. There are steps forward, and steps back. Writing it down in a rational tone helps, somehow, even if I question my own judgment in putting it out there.

In the meanwhile, I’m going to try a run, in the hope that some endorphins can counter whatever horrible thing the lack of estrogen is doing to my brain. Fuck cancer.