Back to Work!

I go back to work tomorrow. I have been off since October 11. Not anything profound here. Just a little bit of an update on my health:

• I completed radiation therapy on December 14.
• I continue to have fatigue and stomach upset. 
• This is likely still the result of the radiation.
• I broke out in a rash and a nice sunburn like pattern in the area that I had radiation. That makes me think that what is happening on the skin is happening inside my body. That makes me hope that my symptoms are going to get better in the coming days to weeks.
• I continue on mitotane. This is the oral chemotherapy that is specific for adrenal cancer. 
• The mitotane also causes fatigue, lack of appetite and stomach upset. It is confusing whether what I feel is because of the residual effects of radiation or if it is from the mitotane or a little of both. Only time will tell.
• I am in the process of increasing the dose of the mitotane to the “maximally tolerated” dose. This means that I keep increasing it each week until I feel so poorly that I can’t continue and then I can reduce the dose some. 
• I am not sure what that completely means. I already have persistent nausea, but I guess it is tolerable. It is not thrilling to think that I might just feel this way for a long time but maybe my body will adapt? They would like me to take the mitotane for 3-5 years depending on whether or not I have a recurrence.

What does this mean for returning to work?

• At some point I need to try to see what I can tolerate. I might as well start back and see what I can do.
• I will be starting slowly and then hopefully ramping up as my energy levels allow.
• Others who have walked this path tell me that they were able to work full time eventually, but they had to be able to take breaks. They often had to stop to rest or nap. 
• Some tolerated the mitotane very well. Maybe I will be like them.
• Others felt that the time on mitotane was like a prison sentence. It was something that they endured and counted the days until they could come off of it. I hope that I won’t be as bad as that.

Uncertainty:

• Adrenocortical carcinoma (ACC) has a nasty habit of recurring. It seems that people with ACC never really consider themselves free of it. They just say that they have no evidence of disease (NED). Time will tell my story. The longer we go without recurrence (NED) the better my chances. For now, I feel obligated to do everything that I can to minimize the risk of recurrence.
• I don’t know how much energy I am going to have.
• I don’t know how much work I will be able to do.
• I don’t know how severe my nausea will be.
• I don’t know what dose of mitotane I will tolerate and whether my levels will get to therapeutic.
• I don’t know if I will have recurrence and if I do what it will mean for me.

And so, for now I am looking forward to seeing everyone again. I hope that all will understand that I am testing my body to see what it can handle. I did a test yesterday by going to the mall with my family. Today I am home resting because of that. I hope that I will have more stamina as time goes on.