What the.....?

I have been so busy with other things this summer that I didn't even post my results from the one-year follow-up with Dr. Naqvi.  I planned in my mind to have a fun photo shoot---my pink tutu and crown, lots of balloons and glitter, perhaps the pink boxing gloves--something great to commemorate making it to one-year cancer free.  I even talked to a local friend and started planning things.

Then, summer happened.

Stephen had scheduled surgery the last week of May.  I hadn't been feeling well for a few days, but figured it was something I ate or nerves.  Then, 5 days later I was up all night with crazy pain.  Went to the ER and discovered I had gall stones.  My labs were SO high---like 650 when it should be around 50.  It was laughable how crazy they were!  I had my gall bladder removed the next day, only to discover there were TWO stones blocking my bile duct, even though an ultrasound found none the night before.  I had another procedure the day after, and was on to recovery.....well....I thought I was.

I was due for my one-year follow up with Dr. Naqvi, so I had labs drawn and went.  She was NOT HAPPY about my gall bladder and insisted that she told me at our last appointment to schedule surgery so this very thing didn't happen.  My labs were still high.  In fact, one of the nurses saw them and asked if I got really drunk right before getting my blood work!  Other than getting scolded for not being proactive about my gallstones, they appointment went well, and I said my goodbyes.  (I had already planned on transferring to a local oncologist for ease after my one-year date.)  It was like closing a bad chapter of life.  

The following week, I threw my back out.  I couldn't remember how.   I just woke up one day, and it hurt to sit up in bed.  I couldn't bend over well, and walking tweaked it.  I just thought it was muscular because stretching and heat and ice seemed to ease the pain.  I had people from church help with cleaning and mowing the lawn, and felt better the next week. 

A few days after that, all the boys went into the doctor with ear infections, sinus infections, eye junk (we thought it was pink eye, but it wasn't) and sore throats.  Strep was making its way around the family, so we got them all on antibiotics.  At the end of that week, my throat started hurting, so I started taking some.    Instead of seeing improvements, I got significantly worse----crazy night sweats, fever/chills, no energy, back pain again.  I went back to the ER and they found I was dehydrated, had low potassium, and kindey and UTI infections.  I was told this was "probably" why my back was hurting and explained some other symptoms.

The infections cleared up, the skies quit raining all day/everyday, and we were finally able to swim!  Things were going well, and it was starting to feel like summer. 

I was able to transfer to a local oncologist and had my first appointment with her last week.  I loved her from the start, and came home feeling great about the decision.  She explained that there was research that for my type of cancer, Tamoxifen might only be as effective as losing even 10-15 pounds.  {I was only 5% ER+, which makes Tamoxifen about 3-4% effective, which isn't much, and research has showed that weight lose and exercise can have a 3-4% increase in preventing cancer's return.)  We didn't make any decisions, but it was refreshing to have a doctor who was willing to take my personal case by itself and figure out what was best FOR ME and not just stay exactly to the plan. 

Things were going well---we were all healthy, I was starting to get back on track, and we were able to plan a few activities.  Then, I slipped and fell coming inside from the pool and hurt my back---again!  Back to the ER for me, and I was diagnosed with an SI strain and told to see a pain specialist if it didn't improve in 5 days.  Thankfully, Stephen was able to contact a doctor in his group who squeezed me in for later that week.  I met with Dr. Owens, and he did an assessment.  After asking me questions and then examining me, he had some concerns.  My actual pain wasn't quite matching up with the diagnosis.  I had too many other factors going on and it didn't all match up.  I got a pain injection, and he ordered an MRI to further investigate some of the issues.

I had an MRI on Monday, July 27, 2 months after my one-year cancer date.  I found out yesterday--July 30---that the MRI showed a fracture, but more concerning---metastatic legions, most likely associated with my former breast cancer.  (From the radiology report:  "abnormal signal involving all visualized thoracic vertebrae (T1, T3, T6, T7, T8, T10, T11, T12. Findings would be concerning for diffuse metastatic disease to the thoracic spine.....abnormal mottled signal seen involving all visualized lumbar vertebra. Abnormal low T1 signal is seen involving L1, L4, L5, S1, and S2.  There is abnormal mottled signal in the other visualized vertebral bodies.  Images through the sacrum show abnormal signal involving the posterior right ilium, which is worrisome for metastatic legion.  Diffuse metastatic disease is suspected.  Recommend further evaluation with bone scan to assess the entire skeletal system.)

Dr. Owens was able to contact Dr. Fleener, my new oncologist, and squeeze me in---barely.  I was her VERY last appointment of the day, since she was leaving on vacation.  I had 15 minutes with her, which was only enough to scrape the surface.  We still don't know a lot, only that it's back.  She couldn't believe I was walking around with this because I must be in terrible pain all the time.  She said I was either amazing tough or had a crazy-high pain tolerance.  She scheduled a brain CT, a PET scan, and meeting with radiation to get more information.  All this is happening in the next few days.
 I asked, "how could this have happened?  Why didn't this show up with my labs, which I JUST had 2 months ago?  Or on the CT scan I JUST had in March?"  She said she didn't think this was something that has been going on for 6 months---probably just a few months.  (I would have to have a super aggressive cancer.)  And, unfortunately, some of the same markers for this kind of cancer are also the same markers which are elevated with gall bladder issues.  So.......since I HAD gallbladder issues right before my last appointment, that made sense and no further testing was done.

Like I have learned to do,  I am looking for silver linings in this.  I am glad I slipped and fell because without that, I might have waited even longer to see a doctor.  That significant injury led me to have a valid excuse for an MRI.  Also, I'm SO grateful that I was already in Dr. Fleener's system.  If I hadn't already transferred my records, I WOULD NOT have been able to get in yesterday, or next week, and would be scrambling trying to transfer reports back to Houston and make plans to set up scans there, going back and forth and back and forth.  (It's all feeling very familiar---the 1st time, I found out right before my doctor went on maternity leave.  Now, it's right before vacation.  Nothing like dropping a big bomb on you without all the information!!!!)

It's scarier for me this time around.  Stage 2 seemed easy to beat from the beginning.  There never was a serious scare that I would die.  Stage 4 is terrifying.  Now the scare is facing me head-on.  It is always Stage 4 when it's metastatic, so we know it's bad.  We just don't know how bad.  The additional scans will let us know. 

I thought all of these issues were coming up as tests of patience and faith during times of getting to write several articles about my cancer battle and faith, plus preparing my son to be baptized.  It turns out that the tests of patience are only beginning.  I even talked about part of me wishing I still had a reason to turn to the Savior and stay closely converted to faith.  I guess I got that wish.

Cancer Warriors, you just thought the war was over.  We only won the first battle, so it's time to regroup and get ready to fight again!