Scan Results + Dr. Coolio + Enhertu#5 + Zomeda

It's that time again, the days and days of wondering and waiting and stalling calls and texts while the hours tick by for results.  Will this be the new miracle drug or will it strike out and bring up the next one on deck or even lead to a new clinical trial?  

First on the docket was port access and lab work.  At least the charts said lab work until I reminded the nurses about my labs drawn on Friday before scans.  It's not that big of a deal to have it taken again, but it takes time to get results, which is just unnecessary time and tools and money when we already have results from four days prior.  After a quick check with the boss, it turns out I was right.   [During the inquisition, I was cracking up the nurses and techs with the 'real' reason for avoiding more blood drawn--I didn't want them to discover my weekend bender.] Shaving time off my day and getting to keep my blood and getting to be done earlier than planned was a big win.  If you don't ask, you don't get.   

Then, it was over to the other side to meet with Dr. Cole.  Unlike an entrance from not so long ago, the one in which her first words were, " You're in liver failure," she walked in and proclaimed that she had very good news.  "Have you seen your results? Your scans show that things are 'dramatically better.'"

REALLY???? It's time to dance.  I jumped up and celebrated.  

The positivity is strong in this room:

My brain is clear.

My chest shows that all my lung infiltrates are gone.  Clear.

Scans show no enlarged or abnormal lymph nodes.  

Skeletal metastases appear stable compared with prior exam.  

Heart looks good.  No detected coronary artery calcification.

Peritoneal disease significantly improved, nearly visible.  Near complete [I would've said 'nearly,' but who needs that red pen out with such good news?] resolution of peritoneal implants.

All liver lesions decreased in size, by half or more, plus no new lesions identified.

The pancreas has significant interval decrease in size of head mass. [The one previously blocking my bile duct, causing me that annoying hospital stay and surgery recently.]

Spleen and adrenal glands and kidneys and bladder and uterus and adnexa [aka: all the stuff surrounding it] are unremarkable.

Previous bone lesions seen, with no change in disease. However, increasing sclerosis of some of the previously identified Lucent lesions in the body structures, likely indicative of positive treat-related changes.  In other words, the scans show my previous swiss-chesse-hole-looking spine/pelvis/femur regions have areas which appear to be healing, as if my body is trying to repair those areas with new bone.  

Today, positively trending lab results:

All in normal range!

Even potassium is normal, which means another infusion without two-hour potassium drip.

It is time for the bone strengthener, Zomeda, but I'm up for that.  Keep giving those bone masons more bricks and mortar and tools to fill those holes. Plus, it's a 15-30 minute drip.    

My history on the scan reports, the reasons for my exams seem a bit daunting:

"patient with history of breast cancer metastatic to the brain.  Status post radiation therapy, lung metastases, bone metastases, liver metastases, lymph node metastases, peritoneal metastases, status pose new chemotherapy regimen needs restating to assess res." [I'm not sure what res means.  I'm thinking it has something to do with using these scans to determine if my current treatment is working or we need a new approach to fight this ever-growing list of landing points for tumors in my body.]

I wasn't sure about this new drug a few months ago.  Memories of doubt and discouragement and depressing, tear-stained discussions about my options and the side effects of Enhertu, along with inner struggles over whether or not it was time to clock out with all the drugs and just live out the rest of this life came rushing back.  I knew then that I was a fighter; I just became anxious for a moment and stepped away from the determination for a bit.  Because that fire had been roaring for so long, but now might be burning out with only embers left, it felt for a moment or two as a sign that the intensity of my battle my be over.  Not so.  I still have strength and support.  I still have time.  Although a daunting and somewhat discouraging start to this drug, so far the results are delightful and directing me forward.    

Scans

I've been through 4 rounds of Enhertu, a new immunotherapy drug, targeted for my Her2+ cancer.  It's time for scans to check the progress.  

Got up and out and on the way on time today! (It's kind of a big deal.)

Stopped on the first floor to check in with imaging and sign the consents.....and always having to prove that I am not pregnant, even though an oophorectomy has been in my chart for years!  I mean, I know I'm pretty unique and miraculous, but REALLY?

No delicious vanilla shake today.  Just 2 big glasses of water.  

Went up to the Cancer Clinic to have my port accessed + lab work done.  Asked the nurse if these results would carry through to Tuesday, and I could skip that part of my chemo day.  YES!  That would give me some flex time for my, sure to be, lateness for an early appointment.  

Then, back to imaging and my second downed water.  

Soon, it was back to CT.  I was sad to learn that my pal, Lance, has transferred over to another department.

His old partner, Susie, was in charge now, with her new cohort, whose name I have forgotten.  (Not an uncommon thing for many years, but now I have chemo brain as an excuse!)

  

As I was moving through the machine, holding my head perfectly still, but so needing to sneeze, I tried to stay still and meditate on scans of the past.  I thought back on my middle son and concerns for his growth in utero.  Doctors discovered that I only had only a two-vessel umbilical cord.  This was concerning for possible growth and other defects.  

[Just what a mom of one child, who before that had experienced infertily concerns ranging from several miscarriages (so far along to need a D+C), genetic and fertility testing, and discussing options.  Then, miraculously after 7 long years, we got one to stick around!"]

The second pregnancy came along much easier, but was concerning for the baby's major organ growth and other developments, as usually the umbilical consists of a three-vessel cord.  I underwent many scans and met with prenatal cardiologists and other specialists, and other than being pretty small, we were blessed with a pretty great baby boy#2.  

I thought on that tech from 12 years ago, as well as scans I've had along my cancer journey to see that in just under another decade, the advancement is quite incredible. Better machines, better drugs, more education, and the speed in which all thing can be done is incredible.  Weird thoughts to think when you're under a huge, buzzing machine, I know, but I've been doing this a LONG time, and can see the improvements.  

Last, it was up to the clinic to have my port reaccessed, and on to lunch (introducing Lori to Lupe) and some fun furniture and design ideas with my new client! 

 

Enhertu #4 +Potassium

 My mommy brought me to chemo today!  

After normal BP + heart rate and blood drawn, Big Mike took me back to the other side to meet with Dr. Coolio.  It's been a long time.  She was on vacation, I was not on the same schedule, so we finally met up today.  

Amazingly, my lab work was mostly in the positive.  .  It's such a difference from not too long ago, when I heard that I was in liver failure!  All my liver numbers were normal today, and even my white blood cell counts were in the normal!  The only major concern was that darn potassium, yet again.  With that news, I knew my infusion time would have an extra 2 hours added.  I have had worse news!

Next, it was back to today's infusion room and ready to wait for pharmacy to catch up.  My nurse, Lisa, had the great idea to start potassium while we waited.  I just love when people think outside of the box and for the patients!  I wasn't able to completely finish potassium before starting Enhertu, but it was nice to get a head start on the whole process and cut out some of the pesky two hours.  

How fun it was to talk with my mom and get to catch up in person.  It's hard to live so far away, and we comment often on wishing we had a time machine or other quick transport device.  Today was a gift.  

There is so much love around me as I continue to fight the cancer beast.  How thankful I am for strong examples in my parents as well as in higher branches on my family tree.  Also, I cannot adequately express my gratitude for my spouse and the perfect team we have made for the last 21 years.  With all the stories I've heard through my journey of women's partners leaving during the cancer battle, my love and respect for this man only grows.  My children give me the biggest reason to keep fighting, and my layers and layers of support groups from friends and acquaintances, loved ones and family lift me up daily.  

 In 3 Fridays' time, scans should reveal if Enhertu is doing the job it been called to do.  I'm not focusing on the anxiety of worry.  I am a strong believer in a positive attitude.  As long I can be inspired by the love of my peeps and I continue to move forward with one foot in front of the other, I will be fine.  I choose joy.