Name Your Poison

Roll the Dice: Cancer or Heart Attack?

I am sitting in church beside my squirming grandson when pain hits my chest and my jaw. While the sermon drones on, the boy plays with his baby book, pulling out photos of himself with my ex-husband, with my daughter, with my ex-wife. Meanwhile I’m thinking: How will this child get back to his parents if I drop dead in the pews?

A minute later the pain eases, then stops. “Do you want to leave?” I whisper. He nods. I take his hand and lead him out, past frowning congregants.

I drop the boy off at my daughter’s house. Back home it takes an hour to reach the on-call doctor who says, “You have a new cardiac issue. Go to the ER. Don’t wait.”

Graham drives me and sits in the exam room while a gray-haired nurse does my EKG. She fiddles with dials and asks, “How long have you two been married?”

“We’re not.”

“Just dating?”

“We’ve been living in sin for ten years.”

“Ah! That’s what I’d like. I never want to be married again.” Then she goes off about all the jerks on dating websites. I hand her my card and tell her to read Brilliant Charming Bastard. I may or may not be having a heart attack but I can still sell books.

They take an X-Ray and draw blood. When my labs come back I sit in a different room with an ER doc. She says everything looks OK for now (”I can’t predict the future”), and sends me off with a prescription for a slow-release nitroglycerin, with its dreary list of side effects. I walk outside with that heightened feeling of reality you get when death passes you by.

“Want to go out to dinner?” I ask Graham.

“I was thinking the same thing,” he says.

“Great minds think alike and so do ours.”

“Fools seldom differ.”

We sit in an Art Deco restaurant downtown and order the Valentine’s Special, because yesterday was Valentines and they still have asparagus and steak on the menu. It tastes delicious.

At three the next morning I wake up thinking, I got angina because I stopped HRT. Could that be? My phone is on the charger by the bed and I turn away from Graham to search the internet without waking him. Sure enough, the risk of heart attack goes up in the year after stopping hormone replacement therapy. I stopped wearing the patch six months ago during my second bout with Stage Zero breast cancer. The data linking HRT and breast cancer is incomplete and contradictory, but in that moment I wanted to do whatever I could to prevent another cancer.

I did think about restarting HRT two months ago. On top of renewed hot flashes, I’d developed a nasty case of Candida, which is clearly linked to lower estrogen. When I asked about restarting the patch, the PA treating the infection said, “You’ll have a hard time getting a prescription for HRT after breast cancer.” I bit my tongue and didn’t tell her about the six month supply in my bathroom cabinet (Amazing what you can get online).

So now it’s six in the morning and I’m thinking, Should I start HRT again? What will my body make of it if I’m on again, off again? Because, given the surge in demand after the FDA abruptly took the Black Box warning off the HRT label (skipping the required Public Comment Period), women are having trouble getting their hands on the stuff. The patches in my bathroom cabinet are as precious as gold in an effed up economy. And if I did restart and couldn’t continue when I ran out of my current supply, what then?

It’s no news to anybody that older women’s health is understudied. It’s also no surprise that HRT has historically been hugely overpriced, or that we now have a supply chain crisis. All those macro issues come down to each woman making her own choices based on fragments of information and best guesses.

So, which way to go? Breast cancer or heart attack: Name your poison. I mean that literally: If you were me, which path would you choose?

• Choice #1: Put on the patch! What’s another Stage Zero compared with dropping dead of a heart attack?

• Choice #2: Doctor’s orders! No HRT, just take the nitro. Dizziness, headaches and nausea? Side effects be damned.

• Choice #3: Both! Take the belt and suspenders approach.

• Choice #4: Neither! Eff the pharma industry!

• Choice #5: Who the hell knows? Roll the dice and name your poison.

I have books to write and grandkids to raise. But as one of my professors said back in the day, each of us dies with a full inbox. Not today, I hope.

In my sixties I was sure I was immortal. It’s good to wake up.

Or you can buy Stella a cup of tea. That’s lovely too.

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Frustrated with online dating? Here’s the book I recommended to the ER nurse:

When three women scientists in their sixties discover they are dating the same lying dilettante, who is stealing their ideas as well as their hearts, the best revenge is getting rich. Check out Stella’s novel, Brilliant Charming Bastard, available at all the online stores, on order from your local bookshop, or direct from Stella.