Things have quieted down in my world as a breast cancer survivor...I guess that's a good thing!  I'm still getting used to that new "title," honestly. I felt like I had won a sort of victory when my psychiatrist contacted an oncologist at the Mayo Clinic regarding the antidepressant I was taking and was told he would not recommend continuing on it due to the potential for interference with the effectiveness of the tamoxifen (unpublished research, though.) So I started on a completely different one, Effexor (venlafaxine), which has appeared to have the weakest inhibitory effect of several different antidepressants investigated in studies published thus far. It has been about 4 weeks or so on the Effexor (and off of the Wellbutrin, which had worked well for me for many years) and unfortunately this week has been a tough one emotionally. I have been feel down and out of sorts for no apparent reason, have trouble focusing on things at work, home and for my grad school projects and my motivation to do just about anything has dropped incredibly low. And I'm sleeping a lot more...or wanting to. I can't be sure, of course, but I have a feeling this is a result of the med change. It sucks.  I am hoping things will get better with time, but at this point I'm not terribly hopeful, since this med is missing one of two key components of Wellbutrin...and it is one that was missing in every other antidepressant I tried before it (Wellbutrin is a norepinephrine and dopamine reuptake inhibitor, all the other antidepressants-Paxil, Lexapro, Zoloft--I had tried before that were serotonin reuptake inhibitors, and Effexor is a norepinephrine and serotonin reuptake inhibitor.) You just never quite realize how much something like breast cancer can change your life...even after you're technically "in remission."

The other issue is that I have developed some mild aches and tenderness under my arm (seems to be sort of around the area where my nodes were removed), but also in the breast area, moving from the side toward the front and sort of under my breast. This is NOT the area where my lump was removed from, so I am puzzled by the location. It is also pretty tender in that general area when I put my hands behind my head and open my arms (like when doing ab crunches). One thing I wondered about was a possible rib fracture-the radiologist said that my ribs could be more brittle after radiation and that sometimes things like car accidents-even just a fender bender, she said-can cause a rib fracture due to the seat belt pressure. I haven't had that happen, but I did wipe out on the ice a month or two ago and landed pretty hard on my back. I can't say that I noticed any pain in that area at that time, but who knows? I have never broken any bones or ribs so not sure what might be normal for that. I have an appointment with my oncologist in early May, so obviously I will ask about it then, but I noticed Kaye's post about underarm pain/sensations (which do sound different than what I am experiencing) so thought I would throw mine out there, too.