Count Your Blessings + Labs + Dr. Cole + Last Herceptin + Zometa

So amid the conflict, whether great or small, do not be discouraged; God is over all.   Count your many blessings; angels will attend. Help and comfort give you to your journey’s end.

Count your blessings; name them one by one.

Count your blessings; see what God hath done.

We are in the season of thanksgiving.  I have much for which to be grateful.  

After a particularly difficult Friday, I got back on the horse and headed down to have labs taken Monday morning. I had a smile on my face, being with people who know my face and my name and that my port is not something to complain about.  I also shared the story of my annoyance with having to pee on my hand in a cup in order to prove that my signature stating that I am not pregnant, complete with verifiable proof, was not valid enough for "hospital policy."  

She laughed along with me, but also made me feel validated.   And, when she noticed that the ordered tests on the blood she had just drawn (from that very port that had been declared unusable 3 days prior) included one for pregnancy, she instantly became one of my advocates by asking me if I actually wanted this test done.  When I told her to make a note that I would only allow this test to be performed if it was accompanied by a million dollar bet beforehand, in my favor, she laughed and added a "patient refusal" to the orders.  "When people are giving you a difficult time, know that you have other people in your corner," she promised me.  

Fueled by the love from my oncology home base, I had an incredible rest of the day, having the energy and ability to accomplish almost all of the 17 items on my to-do list. (Still haven't gotten around to making that banana bread!). It was a small victory and one that was truly needed after a rough weekend.  

Fast forward to Tuesday and my regularly scheduled appointment.  (I had to make the trip for just labs the day before because the pharmacy is currently in renovation mode.  That means that my clinic cannot mix drugs on the same day as infusions because they have to be mixed and delivered downtown, often with specific stats in mind.) Before I could even get into an infusion room, I met with my doctor.  

 I had a list of questions for Dr. Cole.  First, was:  "Do you have the results from my scans?"

"Yes.  And, they're not good." 

There came the sinking feeling I've experienced a handful of times before.  

Cancer is back.  

The good news is that my brain is still clear.  My chest is clear.  My bones are still stable.  The pain in my sternum and under my left breast did not even register in the scans as anything new, and are probably just areas that have been agitated by my sleeping positions or clothing choices.  

The new, concerning spots are in my abdomen and bowels.  The few I could truly make out on the images of the scans are 1) a spot just outside my liver in the peritoneal space, and 2) several suspicious lymph nodes.  For those of you who are actually trained to see these as sections of my body and not black screens colored over with a white paintbrush or erased in certain places, here are the photos from my phone from the computer screen in the doctor's office.  

I asked Dr. C how concerned she is.  is this terrible?  It is an easy treatment?  Is it my death sentence?  

As if often happens when I get this news.....those answers couldn't be given right away.  There are at least three things that must be done before she can make a plan.  

1. Receive results from a blood biopsy that she ordered to be taken before my infusion.  (This test will hopefully identify markers/receptors on this new outbreak of cancer.  There is a possibility that I may no longer be her2+, as several of her patients who were previously labeled that way now show up negative.  Perhaps, after so many treatments of Herceptin, the cancer got smart and mutated, making it useless to treat with Herceptin at all.  
2. Schedule a PET scan.  This will give more information as to the size and frequency of irregular areas, letting us know if the CT and bone scan missed anything.
3. Schedule a CT-directed biopsy, I'm assuming of the irregular lymph nodes.  

The results of these tests will give me treatment options.  

1. If I am still her2+, there is a trial for a new partner drug for Herceptin that looks quite promising.  (It seems that everyone I have told about this new diagnosis immediately cursed BCBS for denying the partner drug, Perjeta, which I had been taking up until this June.  I didn't even register that fact amongst all the talk and explanations from the scans, etc., but it was a hot topic among my warriors.  The first reaction, in fact, which led me to recall that my last scans, which were clear, were taken in July, after which I had four more doses of Herceptin without the sister drug before Friday's discoveries.  The good thing about this option is that I am familiar with the side effects of Herceptin and am assuming that the additional trial drug will pretty much follow suit. The bad thing about this trial is that is would all have to be done downtown, requiring someone to drive me for everything.  
2. The other options are more vague.  There are several more powerful chemotherapies that I have not used before.  We would consider those options after receiving more information from the tests.  The good thing about this is I could most likely continue my treatment at Dr. Cole's office.  The bad thing is I would be much more sick and lose my hair, yet again.  But, how many people can truly say that they have grown their FIFTH first ponytails?  

I complained about all the small fires that I always seemed to have to put out in this battle, tired of fighting all the things, all the time, with my last post.  However, after a Saturday Pity Party, I was reminded in church on Sunday that I needed to remember that I am not fighting alone.  The words from our opening hymn (the top of this post) filled me with comfort and hope, reminding me to be strong and be grateful for God and His loving care over my life.  This is not only my battle, but one in which I have an entire army of warriors--both earthly and heavenly angels--supporting my cause.  

Beyond that, and most importantly of all.....it is not I who has the strength on my own to fight, GOD IS OVER ALL and it is in His strength that I will be able to fight and face this new challenge.  (And, it's boot season, so.....time to get on boots and get to kicking cancer to the curb!)