I remembered that my pressures tend to be higher at my winter appointments. My doctor showed me that one winter when i worried about it. He said, look, happens every year -- probably it will be better at your next pressure check -- and indeed it was. Well today it occurred to me that the higher pressures might be due to caffeine, not winter. I think I have seasonal tiredness, and use caffeine in the mornings in the winter, and not really any other time -- except now. It's not really a big deal; I'd been told that chemo fatigue may last as long as the time I was on chemo, again. My chemo fatigue was never bad (because of the exercise I'm sure) but it was there, and it's there still, as I had been warned it would be.
I can't tell you if I am tired like when I was on chemo or more, or less -- but it's unusual for me, and I'm not sick. I'm like..... when Mom was here last summer she read and napped a lot. Well I'm doing Mom impersonations a lot these days. (I'm reading a lot, too. I've only got three more Jane Greens left -- I've read 5-6. She's very can't-put-down. The most recent two are the best -- and there's a new one coming. Her only shortcoming is, all her characters speak British, even the ones that are supposed to be American. I can ignore it, though -- though I have gotten tempted to email her with rewrites on a passage or two .......) I'm still biking and swimming and walking and everything. I'm just napping more, too, and cutting down on supermom stuff. Less shopping, less squeezing one more errand into not-quite-enough time, less cooking..... can't pretend I ever did much in the way of cleaning, so that hasn't changed. I suppose it's partly about the books I'm plowing through ..... a lot of the time I'd just rather be reading, and sometimes when you read you get sleepy.
Still there is the morning caffeine, and it's not winter anymore -- so I'm guessing I'm chemo tired. It's not awful, and it's not forever, if I'm right about the cause. SO I'm going to go back on xalatan until my energy comes back such that caffeine is back to an occasional thing. Could be as late as October. I will make sure I have an appointment to see the eye doctor after I go off it -- which is really easy, since I see him every 3 months at least anyway. The doctor did say that caffeine has been known to increase eye pressures in large scale studies. He was careful to say that doesn't prove it increases MINE -- but the winter spikes back that up, I think. (Just so you know -- I'm talking about one cup of green tea in the morning. Caffeine's always affected me more than most.)
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Now for the teeth...... I have a hard decision to make. I'm going to see the periodontist on Thursday to talk with him about it, with a couple of x-rays (including a pan) and the letter from the endodontist with his recommendations and concerns. My oncologist had sent me to the endodontist to help me make the decision about taking bisphosphinates, as there is some risk of jaw cell death, especially when there is major dental work done within 10 years of having taken a bisphosphinate. Primarily the problem happens when there are extractions.
The conclusion is, I can take bisphosphinates, but I need to do some dental work first to prepare for it. I need a crown and maaaaaybe a couple of extractions. The extractions are the big decision.... to pull or not to pull.
I have had some bone loss, and my last molars seem to have single roots rather than double roots. All my teeth have shorter roots than they should, because, apparently, my orthodontal work was done too quickly when I was 11-13 years old. The endodontist said he's worried about teeth # 15 and 18. I have no wisdom teeth, so those are my rear molars on the left side, top and bottom. I had thought he was just worried about tooth #15, but he pointed out that #18 won't do me much good without it's opposing tooth anyway. The worry is bone loss; I have had 40% bone loss around tooth #15. (not sure about 18.)
I'm tempted to gamble and keep them. I am so fastidious with my home dental care, if anyone could keep those teeth for the next 10-15 years, it would be me. But.... the stakes are high on this kind of gamble. Apparently jaw cell death is not just more bone loss, but abcesses. (I've never had those.... ) On the other hand there is only a chance that I would lose a tooth in the next 10-15 years, and if I do, having taken bisphosphinates, the risk of jaw cell death is on the order of 10-15%. It's not miniscule..... but it's not a sure thing, either. So -- it's a hard choice.
I think I have some vanity about the idea of losing teeth actually. Weird about what triggers my vanity -- I'm totally cool with losing a breast and showing it off, but talk to me about giving up a couple of molars that no one can see and I have issues.....
