Medicine is a science of uncertainty and art of probability

Sir William Osler

I was so looking forward to this phase—being “done” after almost a year of treatment: 12 rounds of chemo and 18 rounds of Herceptin. It felt huge. But, just as my oncologist had warned, life after treatment brought a different kind of fear. For a year, my calendar had been full of blood tests, scans, and follow‑ups. Suddenly, all of that stopped and I was left with a strange emptiness and a question that wouldn’t leave me: “Now what?”

On top of that came Tamoxifen. It’s an estrogen blocker that helps prevent hormone‑positive cancer from growing, but it arrives with a whole menu of side effects that can feel like an early, unpredictable menopause. That tiny tablet can cause dozens of symptoms, and just when you manage one, another completely different one appears. I expected the “usual suspects”—hot flashes, night sweats, weight gain, weakness, irregular periods. Instead, my first and loudest side effect was emotional: terrible mood swings.

For the first few months, I was snapping at the smallest things. I felt constantly irritated, angry, and on edge, and Mahesh became the safest (and therefore most unfair) target. I would unload all my frustration on him and then feel horrible for the words I’d used. That’s the thing about misdirected anger: we rarely use that tone with bosses or clients—even when they’re wrong—but we let it spill on the people who love us most, the ones we know won’t retaliate. Having been on the receiving end of that kind of anger earlier in life, it broke my heart to realise I was now doing it to the person who had stood by me through everything.

Inside, I felt like I was permanently in “fight or flight.” I couldn’t sit still. My days became a blur of over‑doing: an hour of exercise, then cooking, groceries, errands, 1–2 hours of music, playing with the kids, park time, walks, reading, random sewing projects—anything to avoid sitting quietly. Even my movements became restless. My Chandrika aunty would joke, “Yeh toh jhaad pe chad jayegi” (she’ll climb a tree at this rate). In the kitchen, I’d literally jump onto the platform instead of using a stool, or grab hot things without tongs. Mahesh would ask, “Kuthe Chandra var janaar aahe ka?” (Where exactly are you trying to go—the moon?).

Every check‑in, my oncologist would ask about Tamoxifen side effects, and I’d say, “I’m hyperactive; I need something to slow me down,” and he would reply, “That’s not one I hear very often.” The restlessness was so intense that the simplest act—sitting and doing nothing—felt impossible. Eventually, I agreed to psychotherapy. The best part of that period was that I at least recognised something was off and needed to be healed from the inside. Slowly, with breathing practices (especially SKY breathing), meditation, and more self‑awareness, things began to soften.

A few months later, a new issue showed up: brief blackouts or “dizzy spells.” For about 30 seconds at a time, my vision would go fuzzy, sometimes even when I was driving, which was terrifying. I waited a few months because they were infrequent, but when it happened on the road, I knew I couldn’t ignore it. My oncologist referred me to a neurologist; by the time the appointment came, the episodes had started to fade and eventually stopped.

Then, after COVID, I had severe hair loss again. I don’t know whether to blame the virus, Tamoxifen, or both, but it was like reliving chemo: running my hands through my hair and ending up with a clump. At my next visit I was practically begging, “How many more years of this medicine?” Over time, I also experienced the classic Tamoxifen mix—pins and needles, joint pain, anxiety, low mood, hair shedding—yet most of it felt more mental than physical. Little by little, I either learned to live with these effects, manage them, or seek help when they crossed my tolerance limit.

Tamoxifen behaves differently for everyone, and sometimes differently for the same person at different times. The list of possible side effects is long—fatigue, hot flashes, vaginal dryness, mood changes, weight shifts, and more—so instead of focusing on the list, here are some things that truly helped me manage it:

• Take it at night:
  Shifting my dose to bedtime made the days feel lighter. Whether it was physiological or psychological, I felt less drained than when I took it in the morning.
• Take breaks when needed (with guidance):
  If side effects were really overwhelming, taking a short, supervised break helped reset things. Oncologists may not love the idea, but your day‑to‑day functioning matters too; discuss it honestly rather than silently suffering.
• Alternate‑day dosing (for some people):
  For a few women I spoke to, taking Tamoxifen on alternate days, with their doctor’s approval, eased side effects without completely losing the protective benefit. It’s not for everyone, but it’s worth asking about if daily dosing feels impossible.
• Meditation:
  Sitting still and breathing felt much harder to me than running 5 miles with headphones on, but over time it helped. Movement is great, but mind and body are one system; the mind needs its own training. Even short, consistent meditation sessions made it easier to ride emotional waves without drowning in them.
• SKY breathing:
  This became my go‑to technique for calming down when restlessness and anxiety were high. It gave my nervous system a kind of reset button on days when I felt like I was buzzing on the inside.
• Supportive food and nutrients:
  Eating plenty of fresh vegetables and fruit, getting enough omega‑3s, and supporting myself with B‑vitamins helped my mood and energy. It didn’t “fix” everything, but it gave my body something to work with instead of running on empty.
• Antidepressants as a last resort:
  For some, these medicines are life‑saving, but they can interact with Tamoxifen and aren’t always a long‑term solution. If you ever consider them, do it with a specialist who understands both your mental health and your cancer treatment.
• Massage and acupuncture:
  For joint pain and pins‑and‑needles sensations, gentle bodywork sometimes brought more relief than immediately reaching for painkillers. It also signalled to my body that it was safe to relax.
• Essential oils:
  Slow, deep breaths with basil, peppermint, or frankincense oils helped clear my mind on foggy days and gave a small lift in focus. These are not cures, but they’re simple tools that can make rough moments a bit softer.
• Staying hydrated:
  Water again. It’s easy to forget, but staying hydrated helped with weakness, bowel movements, and flushing out some of what my body was processing daily. I still rely on reminders to drink enough, but every glass makes a difference.

Post‑treatment life, especially with Tamoxifen, turned out to be less about “getting back to normal” and more about learning a new normal—one where listening inward, asking for help, and adjusting as needed were just as important as any pill on the prescription list.

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