CT-Guided Biopsy

The second scan is now complete.

I have had plenty of CT scans in my cancer life, and I have had a biopsy that was much worse than I had expected at the very beginning of my breast cancer diagnosis, but I have never had a CT-guided biopsy.

I was not sure what to expect.

Sadly, I expected the worst.

However, the first tech was able to put in an IV on the first try, and with VERY little pain.  Next, a scan was performed, to check for the location in which to take the biopsies.  After the scan, a large, grid-like sticker was placed on my chest, and another scan was taken.  [The grid showed up in the scan.]. After validating the correct entry point, the tech drew with purple marker to show where to collect the tissue samples.

It was then time to officially begin.


I was promised a sedation in which I would not remember the procedure.  That promise what not kept, due to the nurse only giving me the minimum amount of versed and fentanyl. I kept telling them I had been doing this since 2013 and needed more.  They didn't listen, so instead of a quick nap and forgetting it all, I am able to explain the procedure here.

Hopefully, the results will help us understand the best treatment options for moving forward.

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!)      

  

 

Last Quarter Scans

I'm tired.


I'm actually tired because of leaving early for scans today and not sleeping well after an AMAZING Halloween, but I'm also just tired of always having to fight for medical care.

First, I am BEYOND tired of dealing with the amount of time I spend on the phone trying to fight for my health or put out fires.  Whether it's insurance on covering scans or treatment and the on-going *discussion* of how they seem to understand more perfectly from reading paperwork what my body needs or does not need better than my own doctor(s).  There's time spent trying to reschedule appointments which were scheduled without consulting me on my availability, like my entire life simply involves waiting around, counting the minutes until I get to go downtown again and see medical staff!  I have other responsibilities and more on my calendar than just cancer treatments.  I'm tired of not being consulted by the doctor's office beforehand, which means I have to spend hours and hours as a patient trying to correct those mistakes, if there are even appointments available by the time I find out for rescheduling to be possible at all!  It's exhausting.

I'm tired of having to remember everything about this fight for reference to my nurses or techs.  Have you had a bone scan/CT/MRI/PET scan/ECHO before?  When was your last scan?  Where was it?  Isn't this why this hospital system is connected and all my past scans/images have been uploaded?  Can't you access that information because I'm your patient today?  My brain is full of information and memories about cancer treatments, but there's been so much that often the wires seem to have been crossed.  My brain is exhausted.

I'm tired of having to pee in a cup to prove that I'm not pregnant because I'm a female who is under FIFTY.  I've had a tubal ligation.  I've had an oophorcetomy.  My cancer treatment has put me into early menopause.  I have NO OVARIES and have been FIGHTING CANCER SINCE 2013!  Yet, I STILL have to pee in the cup.  Why?  Again, I have to defend my case over and over, but because it's "hospital policy," I can't be taken on my word about MY OWN BODY.  I'm tired of it all.

Then, there's the *lovely* conversations about my port.

What's wrong with your port?
You don't have a POWER PORT????  How could you not have one?
Is it a mediport?
I don't know if we can access that for this test.
What needle do nurses use to access this THING?
You must have a double port.
Your port is weird.
This is the first time in my whole career I've even NOT been able to access a port!
We are not going to be able to use THAT port.

I even have an x-ray in my phone to show inquiring minds who want to know.  They don't believe me that I've been accessed before for scans like this.  WITH THIS PORT!  Beyond that, isn't it THEIR job to know the type or the needle and where and for which procedures it has been accessed? Is there only ONE BRAND of port in the world?  We live in DALLAS, TEXAS, for heaven's sakes.  Shouldn't these people be trained on more than one type of equipment, not just for my treatments, but for anything else that might come up on the job?  When they don't have any nurse available who can access ports, or don't want to call anyone, or don't want to access it, or don't understand why ivs are such a big deal for me, it's even more frustrating.  I have been fighting cancer for nearly seven years, before that, I seem to have iv issues with every procedure, and now I have something like IVPTSD.  It's a thing; trust me.  And, it's beyond exhausting!

As if *simply* fighting cancer wasn't tiring enough!

I know positivity does wonders in both mental and physical health and healing, but there are some days that I just don't even want to deal with it all.  I'm tired of have to try to handle all the extras and I just don't even want to get out of bed, unless it's into a hot bath.  

I feel fine. I'm fine, fine, everything's FINE!  (For the most part.)  The pain is manageable. The treatments are manageable, especially now that I have fewer infusions that the drug company will pay for.  The whole fight is fine, and even somewhat monotonous, until something new comes up, or I have to do something extra, or any of the above situations come into the picture.  I'm exhausted, but I'm fine.



I had a bone scan and a CT today.  I vomited before I even took a sip of the *delicious* vanilla shake.    It's fine.  The office manager is THE SAME WOMAN I've had every time I have been to this place, the one who needed ME to explain to HER that an oophorectomy is the surgical removal of the ovaries, but that's not good enough---pee in the cup.  FINE.  I had a few very kind nurses and other medical staff today and also some who were real pills.  Now, I get to wait for results and wonder if the scans found out what this weird and painful new thing in my chest could possibly be.

I'm done with today.  I'm tired, but its fine.  

Herceptin #SIXTY!!!!

I have been doing this Herceptin thing for over 180 weeks.  

Some days it can be a challenge to stay strong.  After such a positive and encouraging appointment about my heart yesterday, I received the ACTUAL report about said appointment this morning.  I'm pretty sure someone inputs Dr. Raza's notes and my information from vitals and the computer pops out rote information and suggestions.  Well, I was feeling pretty great about my heart being on the mend, and then I found out from this report that I'm "BORDERLINE OBESE"!?? My great feelings took a trip down to not-so-great.  

However, I decided to get out of the mom uniform (t-shirt and yoga pants) and go to chemo a little more fancy today.  Out came the red, curly wig and vivid colored high shoes!

And then I got a headache because it is BLASTED hot outside.  (Thanks, Texas, for that great welcome to fall.....)  I'm assuming that red wig and my attempt to cut out Dr. Pepper for my overweight-borderline obese was also contributing to that headache, so off came the fancy, and on came the Nutter-Butters and a nap. 

Fancy or not, I'm still fighting and living the only life I have.  

Dr. Raza + ECHO

It was a very good appointment today.  

I made a new friend AND my heart made new improvements!

Three months has already passed, so it was time for another ECHO + meeting with my cardiologist.  

I got all dolled up in this amazing gown, open to the front.  

My new buddy, let's call him Randy, is new to the HeartPlace.  He is my kind of person, and brought me joy from the beginning.  (He whispered a number lower than my actual weight on the scale!). Before we began the scan, he stopped everything and said, "Hold on, girl.  I gotta get my Motown goin'!"  He then grooved and sang during the whole thing, which I loved.  We got to know a little about each other.  He is a survivor.  At age 16, he died (asthma attack) for 3 minutes, but was brought back to live his best life every day of whatever he has.  God has a plan for him, just like he does for me.  I chuckled when he asked me if I was a Baby Boomer.  I DID just turn FORTY, but am a baby of Baby Boomers! We laughed again when Randy was putting on my leads and his fist bumped my chin.  I told him, "If you want me to be still, just ask me.  You don't have to knock me out!"  At first, he wasn't sure if I was serious.  "Don't say that out loud!  I don't want to get fired!"  And then we laughed and jammed throughout the whole thing. 

After a quick EKG, Dr. Raza came in.  

GOOD NEWS:  My ejection fraction is improving!!!  I was down to 45% last time, and now I'm almost to 50%. She was so happy with this news that she's downgrading me from a 3-month interval patient to a 6-month one.  That's pretty big news in my book!  

Brain MRI Results + Appointment with Dr. Wardak & Crew

Last week I had the easiest MRI experience of my life.  Traffic went smoothly, we chose the correct location the first time (UT Southwestern's downtown complex is, literally, complex), I got in right on time, I was able to wear my *favorite* disposable scrubs + no-slip hospital socks, had the 2nd best IV stick of my life, and the actual scan was quick and painless.  (Shout out to my all FEMALE team for the day!!)

It takes a few days to receive results.  The scans have to be read.  Reports must be dictated and reviewed, then sent to my doctor.  Someone transfers the reports to my online file and to MyChart, online access to my own account information.  These online reports are often confusing because, although I have gained a lot of medical knowledge in the last six years, I haven't quite received my degree in radiation oncology. I've discovered over much experience in PET, CT, MRI, and bone scans that usually the longer the reports and the greater the medical vocabulary, the worse the report.  

This report was short and intelligible, 

especially these highlighted words and phrases!!!  

No areas of abnormal enhancement are seen, with particular focus on the cerebellum.  Enhancement in the bilateral cerebellar hemispheres are unchanged.  The ventricles, sulk, and basal cisterns are normal.  Hydrocephalus or pathological extra-axial or midline shift is not detected. 

Hemorrhage or diffusion restriction is not evident.  Scattered foci of susceptibility are unchanged from prior imaging and may be related to prior radiation. 

The calvarium and central skull base are normal. 

The paranasal sinuses are clear.  The mastoid air cells are unchanged.   

No areas of abnormal enhancement.  The previously noted cerebellar vermis lesion and right cerebellar hemisphere sessions are no longer seen.    

Miracles keep coming, y'all!!!

I had the actual follow-up appointment with Dr. Wardak and his team to confirm what I was pretty sure was all good news.  

After my vitals, the RN, asked mucho questions.  I was expecting Dr. W next, but was greeted by a colleague.  He pulled up my images and asked and examined, again with mucho questions.  Finally, my actual doctor came in.  I got this feeling like the whole team needed answers to all the questions they could think of.  It was a different feeling than I've had in many moons.  Perhaps this is just what it feels like when you once had cancer and then now are normal.  Perhaps these results make me a bit of an outlier, and these medical professionals are intrigued to know why.  

Is this result too good to be true?  

Why is there not more wrong with her?

She should be in more pain than she claims and in more areas.

How can all this be explained?

It doesn't need to be explained to me as anything but miraculous, unless something I'm doing or some treatment I have received will help another survivor to have results like mine.  

Before (3/19/2017) and After (9/9/2017)
:

The only explanation I need is that with God nothing shall be impossible.

My thought for the week is borrowed:

"While the world is filled with uncertainty, there need not be uncertainty in your heart and mind about what is true and what is not... 

...In a coming day, you will present yourself before the Savior. You will be overwhelmed to the point of tears to be in His holy presence. You will struggle to find words to thank Him for paying for your sins, for forgiving you of any unkindness toward others, for healing you from the injuries and injustices of this life.
You will thank Him for strengthening you to do the impossible, for turning your weaknesses into strengths, and for making it possible for you to live with Him and your family forever. His identity, His Atonement, and His attributes will become personal and real to you." 

                                    --Russell M. Nelson,  January 8, 2017 

Herceptin #59 + Crazy Rash

How grateful I am that this last three weeks didn't require any scans or other doctor appointments.  I needed a break on medical stuff in order to wrap my head around school starting again!  

Next week will be back to tests and labs, but it's been a much needed break.  

The end of summer has been interesting--trying to soak all the free time and joy out of each day. I also turned FORTY, which is actually miraculous.  In January of 2017, my doctors thought I might not even make it six months, and here I am celebrating 40+!  

My doctor and I have pretty much given up on insurance covering Perjeta for me.  The latest excuse is that the drug doesn't work, i.e, it doesn't stop cancer from growing in my body.  WRONG: My body has been cancer free since December 2015, minus my head, "that lump that's three feet above my [backside.]"--movie, anyone?  Perjeta was not able to really keep cancer out of my brain, as IT DOESN'T CROSS THE BLOOD/BRAIN BARRIER!!!!!!!!!!  Herceptin doesn't, either.  But, so far, cancer has been kept at bay through the rest of my body.  What do these "doctors" working for insurance companies know about this, anyway??? 

Dr. Cole is fine just moving forward with Herceptin for now.  She also is always on the lookout for drug trials.  There is one that I fit quite well: Stage IV breast cancer, Her2+.  The one roadblock might be that I need history of Perjeta + the chemo Taxotere or Paclitaxel.  I cannot remember if I have taken them together, and for now I don't have active cancer.  It seems crazy to take strong chemotherapy with no active cancer in my body, just for the opportunity to be accepted for a trial study.  I'll keep looking out for possibilities.  Like I've said for the last few years, "I just need to stay alive long enough for something new to be invented and then take that until something else is invented and soon someone will invent the cure!"   

Keep kickin' cancer to the curb! 

***Added:
Saturday, I did some work in the yard, just pulling weeds and cleaning out some beds.  I woke up on Sunday with a itchy mess of a rash that still hasn't gone away.  Why?  I stop fighting for Perjeta and find that my old allergic reaction (which was probably TO Perjeta) is gone, I just can't go without switching one kind of drama for another!  That reminds me of my grocery order last week.  I wanted tomatoes.  They tried to substitute for artichokes!  What in the world?  Perhaps that's my lot in life.  I will survive cancer, but will have to put up with all kinds of craziness in the process.

Also, just got a call from the school nurse:
The 2nd grader accidentally got stabbed with a pencil behind his ear and has a big, bleeding gash.  No  graphite in there, though!"

It's always something around here.  BTHO Cancer!