March 2021 – The Metastatic Breast Cancer Journey

March 17, 2021

Pyogenic Granuloma Surgery

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Pyoge…what?

Yeah, that’s exactly what I thought when my podiatrist told me. It’s a benign tumor of sorts, where blood vessels connect together and cause swelling as well as other problems. Women are more prone, and people on chemotherapy are also more prone to these issues.

Chemo…the culprit!

I have been struggling with my toes, toenails, and fingernails ever since I started receiving chemotherapy in 2013. I’ve already had surgery once to my left big toe to deal with severe ingrown toenails; but, I wasn’t actually expecting another surgical procedure.

I scheduled this appointment a few weeks ago, after waiting to see if they would get better. It never did. I won’t go into all the gross details because you can google it and see as many hideous pictures as your heart desires. Consider yourself forewarned!

Two toes bandaged in the picture were problematic. I couldn’t get the bleeding to stop on most occasions, or it would take a long time to stop. My toes are very swollen. The infection appeared to be taking over my left foot, and it was hurting to walk. So my primary doctor gave me an antibiotic (Reflex) last week. That was a good move, apparently, as these things can get out of hand very quickly.

I’m happy to say, it felt much better within a couple of days. The swelling in my foot went down and the pain went away. Praise God!

I need my feet, and my toes. I have enough trouble with balance as it is. I think I’ll keep them.

🤣🤪😜🤪😜😂

The surgery entailed numbing the toes, scraping out the tumor, and cauterizing the blood vessels. It’s all done in-office, and my appointment was over within an hour. I really like this podiatrist. He explains everything in detail, and has a good bedside manner as well. His staff are very friendly as well.

I learned something else today. Medicare covers a routine exam by the podiatrist every 10 weeks. Why? Because it helps prevent these kinds of things from happening. I will be on Medicate starting next year. At least, that is what I’m told since it will be 24 months since I was approved for SSDI.

Apparently, they learned from me too. I do love the fact I can still teach. I may not be teaching doctoral learners or counselors at the university as a faculty, but I am constantly educating people about metastatic breast cancer, stage 4, and what that means in terms of my treatment.

Public Service Announcement: If you have diabetes or neuropathy, you need to go more frequently to get your toenails clipped. Insurance covers this as well, because foot problems can result in very serious issues if left unchecked.

À la prochaine…Until next time…

March 16, 2021March 16, 2021

To Treat or Not to Treat?

You may recall my treatment was canceled in February because they could not get the preauthorization from insurance in time. (They eventually did get it a few days later; I was told by Cigna it’s good for a year.)

So, today is six weeks since my last treatment. This requires a reload, meaning double the dose and a lengthier infusion. Plus I’m getting Zometa today for the bones, so an even lengthier day in the chemo room.

That’s all well and good. Yay, I’m getting treatment…or not??

BUT THEN… I get a call this morning from Dr. K’s nurse and she said I need to have an echocardiogram before I can get treatment, “I’ve scheduled one for you today, downtown at 11:00.” What?? I can’t just drop everything and go downtown. (Have I told you how much I detest going downtown? 😤😤) I have to work up to that trip. In addition, we have meetings this morning and I couldn’t get there in time anyway, as well as get back in time for chemo.

Besides, I already have an echocardiogram scheduled for March 30th. My cardiologist said I’ve “graduated,” and he gave me six months before I needed another one. The last one was in September.

“Yes, but it was September 4th. It’s been more than six months.”

Wow…they are really pedantic about six months. To. The. DAY.

So this started a series of “what if” questions, a flurry of phone calls, self-talk, and stress over whether I would be able to get treatment today. This may not seem like a big deal. At least to me it didn’t. Just go ahead and treat! But apparently it is a big deal.

Then my oncologist (Dr. K) gets on the phone. “What if you just come in tomorrow?” he presses.

Does that really do anything for us? What if I don’t get the echo in time? What if my cardiologist doesn’t clear me for treatment? Why did they wait until the day of treatment to tell me this? Why didn’t they have the preauthorization last time, until after treatment?

If I don’t get it today, this disrupts our entire year of planning. We have identified the days I will have chemo, when we can travel, and when we will be at home. It’s not like I’m dying for crying out loud (or am I? 🙄).

I asked, “If I can’t get it today, can’t I just keep my echo appointment on March 30th and keep the chemo scheduled on April 6th?”

“Absolutely not. We don’t want to do that. We can’t wait that long.” There was an urgency in his voice. He continued with a discussion of the importance of this treatment, and how we should be careful not set any of our plans in stone. Always be prepared for something to come up, and be flexible with those treatment dates.

Try telling my hubby that 😔😔.

Dr. K. said he would try to get in touch with my cardiologist (Dr. I.) to see if it’s okay to go ahead with treatment today. He is concerned about my safety, and he wouldn’t want to jeopardize my heart. I was praying he could get in touch with him, because when I called my cardiologist they said he was not in today–probably doing some type of procedure.

Happily, Dr. K has Dr. I’s cell phone. Within an hour he was able to get a positive response. As long as I’m asymptomatic, continue to take my heart pills every day, and no swelling, Dr. I doesn’t see any reason I can’t get treatment today.

Whew! Crisis averted.

All kidding aside, I do appreciate my doctor’s diligence to keep me safe, as well as treat me for this awful disease. This did serve as a reminder that I’m not merely taking an aspirin each day. These are very heavy doses of immunotherapy (#chemonotchemo) that can be hard on the heart. So far I have been tolerating it well, but you never know what could happen in the long run. They have to be cautious. It’s also a reality check that without it, the cancer could rear its ugly head. We certainly don’t want that. 😳

At least I get a chemo room with a view. 😊

I’ve also come to the realization that I need to be my own case manager. When it’s almost time for a preauthorization, it will be in my calendar so I don’t miss another treatment. When it’s time for an echo, I’ll make sure my appointment is at least 6 months minus a couple of weeks, so we don’t echo this problem again. (See what I did there?)

À la prochaine…until next time!

March 9, 2021March 16, 2021

In the Hands of God

God is so good. We don’t talk about finances much because we were both raised with a strong work ethic. We are self-sufficient. We take care of us. We trust in God, but we also do what we know is the responsible thing to do…pay our bills.

But—suffice it to say—cancer treatment is expensive! On a reduced income it can get pretty tight at times.

The good news… I just received a phone call from MDAnderson. When I saw the name on caller ID I assumed it would be the typical recorded voice. You know the kind.

“Hello, this MDANDERSON, calling to remind …
Lucinda West…
about an upcoming appointment on…“

I imagine you probably get those same recordings from time to time.

Well, this time is was a real person. She was calling from the pharmaceutical financial services team, about my outstanding bill. I don’t usually get collection calls from them, but again I assumed they were calling to collect. Tim and I were just discussing the balance so I took a breath to explain our plan on monthly payments…

But that’s not why she called!

Instead, she told me of some other news. GOOD news. VERY GOOD news!

Apparently the drug company (Genetech) that makes Herceptin and Perjeta has assistance for co-payments. (I receive these infusions every three weeks.) She will send me an email, and after I apply it should be approved nearly immediately. This will take a huge dent out of the large out-of-pocket expense we have been burdened with every year. This is a new program apparently, and it may only work for this year, but we’ll take it!

I am so grateful we get it now, because this year is especially tight since I am no longer working. I will have to pay for COBRA starting in July. And, we are starting our new ministry.

Just before the call, we were discussing whether this is the right time to start the ministry. With the pandemic, and the economy, when is the best time? But God seems to keep saying YES! This is another confirmation of his omniscient and omnipresent provision.

God is so good. If ever you are questioning whether He will take care of you…don’t! Yes, we need to be responsible. Yes, we should pay our bills, and yes, work for food. But we should not worry about it.

The sixth chapter of Matthew gives us much food for thought about worry, as well as God’s provision. Take some time to read it. You might also take a mental break to watch and listen to this song. Ask Him to show you the areas where you have a hard time letting go. Trust Him. He WILL care for you! You are in the hands of the God who made everything.

Please leave a comment below if you found this helpful. Perhaps we can support each other in our ongoing dialogue as we learn how to release our fears and let God have total control.

À la prochaine…until next time!