The Trouble with Tamoxifen

If you're brave enough, take a look at the possible side effects of Tamoxifen listed on the packet.  It's awe-inspiring - everything from hot flushes to dizziness to uterine cancer.  So I was somewhat nervous when I started my ten year stint of taking the daily drug a couple of months ago.

But, as I reported in an earlier post, things have gone remarkably well with few side effects.  The only significant problem I have is something totally unforeseen... remembering to take the wretched thing.

I did so well in the beginning, never missing a day.  After a few weeks, I started to forget to take it at my regular morning slot but somehow always remembered by lunch time.  Then the holidays began and I went to pieces.  My routine is all over the place and I sometimes can't remember what day of the week it is, so remembering to take that little pill is a major challenge and I confess to waking up a few mornings with the sinking realisation that I completely forgot to take it the previous day.  I try to take it with my morning coffee on the grounds that caffeine addiction ensures that I never forget to make a coffee first thing, but the slightest change of routine - a sunny day so I take my coffee outside for example - can mean that my pack of pills lies forgotten while I enjoy my caffeine shot in the sunshine. 

This week I outdid myself.  On Monday, my husband made me my morning coffee.  By this time I was keeping the pack of pills right next to the coffee jar but, as I didn't make the coffee myself, I didn't see the packet as I enjoyed my breakfast and never even thought about my pill.  Then the kids and I headed to the airport for quick visit back to London ...and I forgot to pack any Tamoxifen at all.  Oops.

I remembered on the plane.  But, by the time I arrived it was really too late to do much about it so I waited until the next morning to go straight into the chemists and beg for help.  By this time, of course, I had already missed one day.  The very nice pharmacist told me that she could give me an emergency supply but she needed to know the strength; unfortunately I didn't even realise that Tamoxifen came in different strengths.  So I waited until my husband got home in Brussels and he checked for me.  Back to the pharmacist to report: 20mg. 

But by this time it was a different pharmacist and he told me that he needed more proof that I really was on Tamoxifen. I wanted to say - just look at my hair!  Instead I got my husband to scan my Belgian prescription and email to me.  The pharmacist looked doubtfully at my oncologist's scrawl on the screen and shook his head.

"We don't have that brand," he said.

Surely one brand of Tamoxifen is the same as another?  But it seems that a pharmacist can't make that decision - it requires a doctor.  I'd just met a friend for drinks and a catch up so, instead of going to the planned riverside pub, I took her to a walk-in clinic and we chatted in the waiting room.  You see, I make a great date.  Mind you, it somehow seemed appropriate as I updated her on the events of the last year which has involved many, many hours in hospital waiting rooms.  An hour later I went in for five minutes to see a doctor and emerged brandishing the required prescription as if I had been awarded first prize.  We got back to the chemists with minutes to spare before closing time and, at last, the pharmacist accepted that the required paperwork had been done and handed over the pills.

My lesson has been learnt.  I now have an emergency supply of Tamoxifen in my handbag, just in case.  I have another pack in the car and the details of my prescription on my phone.  And I'm going to set a daily alarm to remind me. 

And yet, in a way, I feel oddly cheered by this latest adventure.  If I forget to take my medication for a day or more, it's because I don't even think of the Cancer in that time.  It's taken a year, but life is finally getting back to normal. 

Maybe next time I meet my friend, we might even make it to the pub instead of a hospital.