March 2022 – The Metastatic Breast Cancer Journey

March 29, 2022March 29, 2022

ECHO Echo echo

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It seems like I keep repeating myself. Scan, rinse, repeat. Every…six…months. Another half-day of scans and a doctor visit. It may sound a bit redundant after a while.

However, there is an upside to today’s story. They didn’t do contrast (so no IVs or pokes) and they included a scan of my carotid arteries as well. It’s the first time I’ve had this one. Due to family history, my cardiologist ordered this test along with the echocardiogram. Note: The echocardiogram is not the same as an EKG. This involves a 30 minute ultrasound of the heart and nearby arteries. Breathe in, hold your breath, breathe. Breathe out, hold your breath, breathe normally. It sounds more relaxing than reality when they are jabbing your ribs with the goop and a wand.

I’m happy to say my echo looks good. Yes, that is a bit of an echo (insert rimshot) which I’m pleased to report. Treatment can continue.

The carotid scan is also an ultrasound, looking at both arteries on the left and right sides. The right side looks good. The scan detected some plaque on the left side, but it looks small enough not to worry about. That’s what the tech said, as he showed it to me on the screen. It looks like less than 50%. I’ll know more when the doctor gets the results, but it doesn’t seem to be cause for concern.

I am comforted by the care they give me at MD Anderson. I know the Lord put me here at just such a time as this. I’m also happy to be in our RV on the day I had to be downtown for all these appointments. Thirty minutes to the downtown medical center is not nearly as bad as driving from Conroe. Yay! Another upside.

On another note, I saw the colorectal surgeon at MD Anderson for a consult last Friday, and she concurred with the external surgeon’s opinion. They both agree I should get a colonoscopy with a specialist, to remove the polyp, and only do surgery if it is required at that point. They have specialists at MD Anderson who do this, who are not surgeons.

While private practitioners shouldn’t do surgery if it is not necessary, they can do it if they think it is necessary. Tim noted they get paid more money to do surgery versus a colonoscopy so there’s that 🤷‍♀️. Just saying…

MD Anderson doctors are paid on salary, so they don’t have a need to justify surgery unless, well, it’s justified. They have specialists at MD Anderson who are trained to dig deep enough to get out large polyps, but they are not surgeons, so they would not do surgery while I’m incapacitated. I wouldn’t really want to wake up thinking I had a polyp removed and discover nearly half my colon was also missing 😳. Although it could be a good weight loss plan 🤷‍♀️. Hmmm 🤔.

At any rate, I will go back downtown for another consult with the specialist, and then most likely go in for the procedure (colonoscopy) to remove the polyp. That sounds much better than losing 40% of my colon. I’m hoping and praying that is sufficient. Stay tuned on that one as well.

Medical stuff is a constant waiting game! First this scan or this doctor, then the next. Wait for results (still waiting on CT and bone scan as well as today’s carotid). Wait for the consult. Wait for the procedure. Wait, wait, wait. (Do I hear another echo?)

What does the Bible have to say about this? For one, worrying won’t make us live longer (Matt. 6:27). And Paul tells us not to worry, but to cast our cares on the Lord (Phil. 4:6). Also, you may remember the story when King Saul jumped in too quickly and failed to wait for Samuel to offer a sacrifice, so he missed out on the blessing of a forever kingdom (I Samuel 13:8-14).

I don’t want to miss out on a blessing. Maybe by waiting I’ll keep my entire colon intact. Maybe I’ll meet someone along the way who needs a word of encouragement. Whatever it is, I’m going to give it to the Lord and wait… patiently. Perhaps in the waiting, I will not miss out on a blessing.

Will you wait patiently for the Lord and look for your blessing?

“That was stupid!” Samuel said. “You didn’t obey the Lord your God. If you had obeyed him, someone from your family would always have been king of Israel. But no, you disobeyed, and so the Lord won’t choose anyone else from your family to be king. In fact, he has already chosen the one he wants to be the next leader of his people.”
I Samuel 13:13-14 CEV

À la prochaine…until next time!

March 27, 2022March 29, 2022

The Four Boys

Sometimes Tim and I visit model homes to get decorating ideas. That’s what we did on this beautiful Sunday afternoon while we were waiting for our granddaughter’s party to start. But, wait, this is titled “The Four Boys,” so it has nothing to do with our beautiful granddaughter who just turned seven, or the Urban Air experience, or the yummy chocolate cake, or watching children float down the zip line and run through the mazes.

Four young teenage boys from different cultural backgrounds were friends. They were wandering the street when we pulled up to the first house on model row. One was riding a bike; another was carrying a plastic baseball bat; and they were having some fun interacting with the model hosts as well as guests. We were the only guests at the moment.

They told us we would have to pay an entrance fee. They informed us we would need a million dollars to buy that house. They told us not to go inside because they were asked to leave. They were harmless, really, just hanging out and having some fun. But boys will be boys, and the agents were concerned they might accidentally break something.

After some friendly banter, off they went, and we went inside the first house.

I didn’t think more about it until we were walking down the path to the second and third house. The boys turned back around and began interacting with us. They seemed willing and even eager to engage us in conversation, so I turned back to greet them before following Tim into the model home.

I immediately picked out who was who, and decided to have some fun with them as well. Mr. Knuckles reached out his hand to shake mine, then winced as we shook hands; he showed me the sores on his knuckles. As it turns out, he was trying to adopt me as his mom so he could get inside the house. I nearly had to pry him away.

Before I went in, I felt the urge to talk with them more. I asked the boys, “You say these houses are expensive, right?”

Yeah…they all nodded their heads in agreement.

“You need at least a half-million dollars to own one, right?”

More nods. More playful hits on their friends’ arms and chest.

“Okay, so I’m going to give you a little lesson on your future. One day you’ll look back on this day and remember the crazy lady that stood in front of the model home, and you’ll thank me for this.” They got a laugh out of that, but they stuck around for more.

“I’m going to ask you a question, and I want you to think about it seriously.”

Intrigue seemed to increase.

“Look at this house. Look at it closely. What do you need to do…right now…and in the future…to buy one of these homes?” I asked.

They came up with several answers. Mr. Afro said, “play in the NFL” and “be an entrepreneur,” as Mr. Cheeseball wearing the AC/DC shirt came up with anything from selling drugs to being a porn star. He didn’t get the reaction he was seeking from me. Mr. Knuckles kept begging to be my adopted kid.

Mr. Intuitive on the bike seemed most interested as well as sincere when he said, “Save money. Get a job. Go to college.”

“Great ideas!” I said. You’re going to go places. I thought.

This conversation continued as I challenged the boys to start thinking about their future now. Today. What do they need to do to go to college (get good grades), and what if the NFL doesn’t call (if they do, you can buy a house for all your friends). Or what if that drug deal goes south. You need a better plan.

Mr. Intuitive seemed to listen the most intently, but I think the others maybe heard as well. I challenged him to think about that, to plan for his future, and to remember this conversation.

Take your future seriously. Keep a mental picture of this house, and what you need to do to buy one some day. Be smart. Don’t wait until you’re thirty and wonder what you are going to do with your life.

I said a few more things to encourage them, and then I went inside the model wondering if that conversation had an impact. Sometimes it takes just one person to leave a mark.

I know they left a soft spot in me. I truly wondered if those kids will grow up and make something of their lives. They are just hanging out, enjoying life on a Sunday afternoon. They have no idea what lies ahead of them. Will they take life for granted, or take it by the horns?

It is for moments like these that I believe I am still alive today.

As we were exiting the home, the boys were still out there. We had a few more exchanges, then Mr. Afro told me his name so I could remember him when he’s a famous NFL player. I think he was listening.

Mr. Intuitive said he would remember our talk. I looked him square in the eyes and told him he had some potential. I can see it in him. He is going to do something great with his life.

He’s already looking for ways to make money. He tried to guess my age for $20. He missed by four years.

I would have given it to him if he was right.

À la prochaine… Until next time.

March 25, 2022April 14, 2022

Dr. Who, I Mean You

My daughter introduced me to Dr. Who years ago. We watched the whole series. The knowledge has come in handy from time to time, as I now know what a Tardis is, amongst other things. It was hard to imagine Dr. Who as Queen Elizabeth’s husband in “The Crown” series, but there he was! I kept imagining he would find a red phone booth somewhere in London and poof!

Sometimes I wish I could be transported into the future when technology can eliminate the need for doctors. But for now, it’s the life I live. One specialist after another. I’ve kind of lost count, but I have many doctors following me, and they all have their niche reasons. It’s a full-time job being my own personal assistant. Fortunately, I have a calendar to keep me straight. Most of the time.

Dr. You is a colorectal surgeon at MD Anderson. She comes to The Woodlands once or twice a week, so I agreed to see her. My oncologist referred me to her when I told him about the polyp in my colon. I liked Dr. Knapp (see previous post), but it doesn’t hurt to have a second opinion.

As it turns out, MD Anderson has a team of specialists who can remove challenging polyps laparoscopically. This can help me to avoid surgical removal of part of my colon. That’s the hope anyway! Dr. You referred me to Dr. Gee. (It’s not pronounced “Jee” like I thought. The G is hard as in “goose.”) Anyway, he will perform a special procedure to get the polyp out of there.

It’s scheduled for Wednesday, April 27th. Downtown. Fortunately we will already be downtown so I won’t have to fight quite as much traffic. There’s a bit more prep than a regular colonoscopy, including a Covid test the previous day, followed up by a week-long liquid diet ramped up to normal.

The upside is, I might lose some weight in the process. One can hope! I’ll keep you posted on the outcome.

À la prochaine…until next time!

March 24, 2022

Another Long Day…sigh

It’s 1:28 PM and the day is only half over. The morning started with a drive through traffic to MD Anderson in The Woodlands for my 8:00 AM bloodwork. Third Floor.

Then I was off to getting prepped for CT scans of the chest, abdomen, pelvis and whole body bone scan (access port, drink the peach tea contrast, inject the nuclear tracer). First Floor.

A few abnormalities happened to me today, but since I’m used to the process I didn’t panic. A little trouble with blood return. Raise your hand. Make a fist. Lay back. Cough… That did take care of it. In addition, they had too many nuclear medicine tracers in my room. Three to be exact. Fortunately, I had a savvy nurse who quickly figured out which one is mine. Is it a full moon? 🙄🙄

The CT tech took me back a little early, so that cleared up some time between scans to go and eat the oatmeal I had brought with me. I also bought some tea in their café. Second Floor.

I’m pretty good at math, but when the bone scan tech said today was a slow day with about 120 patients, I was quite surprised. They normally have between 150-160 patients every day 😳.) I couldn’t wrap my head around it. They only have the one machine. Mine takes about 15-20 minutes. How do they fit them all in? It’s one of those mysteries I may never know the answer to.

After some humorous comments by the bone scan tech about various people snoring over the loud speaker, I’m pretty sure I fell asleep 🥱. He concurred, but he said he didn’t have any recording to prove it. Whew 😅. First Floor.

I normally do these scans about every four to six months. My oncologist brought me in at the three month mark this time due to some pain in my right ribcage. It comes and goes. It is reminiscent of when and where the cancer started in my left ribcage, so he’s scanning a bit earlier than normal to be certain. I suspect all will be clear, but you never know with this disease.

That took us until noon. We should get the results in the next few days.

They left my port accessed for chemo (immunotherapy). Tim picked me up for lunch, and we left the building. We also got to pop into Circle K and say hello to Elizabeth. It was nice to see her in the middle of the day. She looks tired, but I think she is doing okay. I’m really proud of her for working so hard to keep her family afloat.

I came back early for chemo, with hopes of getting in and out a bit early. I just checked in, and pulled out my computer while I am waiting. I am an hour early, so who knows whether they will call me early or not. Third Floor.

When I opened my computer, I was welcomed by the normal MD Anderson Internet connection. But this time a special announcement came with it. A press release dated today caught my attention. This is just one more reminder of what a wonderful facility I am blessed to be a part of.

MD Anderson just opened a research center in his name, devoted to the work of immunotherapy. If you want to read more about it, click here. Very incredible work they are doing!

Jim Allison is an interesting scientist. They really should make a movie about him. He’s the one who said our immune system can fight cancer, while all the others in the field laughed at his ideas. Well, we all know about immunotherapy now, and how much it has changed the health world. Amazing stuff. He was awarded the first Nobel Peace Prize for his immunotherapy treatment. Totally brilliant.

“Mr. West?”

“Who are you looking for?”

“Mr. West?”

“What’s the first name?” I said this with some degree of hopefulness.

She double-checked. It’s a guy. Rats. Looks like I’ll be waiting a bit longer.

At least they won’t have to poke me again. There’s always an upside.

À la prochaine…see you next time.

March 4, 2022

Back to the Colon

Not everything I do medically is because of breast cancer, but it certainly has an impact.

I saw Dr. Knapps, a colorectal surgeon, for a consult today. Don’t worry if you don’t know what that is. The benefits specialist at my insurance company didn’t know what it is either. (I’m not sure he spoke English, to be honest.) But, it’s covered, so that’s all I wanted to know.

I was referred by my gastroenterologist, who did my colonoscopy.

He reviewed Dr. Maheshwari’s reports, looked at the path report and determined we are not in an emergency state. Whew! I knew that, but it’s good to hear him say it. The pathology report on the piece of the polyp already removed shows it is benign. But they have to take it all out to ensure there isn’t something else lurking underneath. Since it’s in the fold, I was referred to a surgeon.

The good news is, he can attempt to do it with another colonoscopy. (Yay! More prep 🙄.) Since he’s a surgeon, he can clip more aggressively to remove the whole polyp. If he accidentally clips my colon in the process, he can repair it. My gastroenterologist can’t do that, so they are more careful when dealing with the folds of the colon. He said I can do that in a couple of months or so. If that doesn’t take care of it, he may remove a section of my colon. I prefer the former option, so I’m praying that works.

In the meantime, I got a referral from my oncologist to see one of the MD Anderson colorectal surgeons for a second opinion. I’ll see her on the 24th, and then I can make my decision. If she says the same thing, I’ll most likely go back to Dr. Knapps. I liked him, and Tim liked him, so there’s that. Another benefit…He can do it locally rather than downtown Houston.

An Insurance Hiccup

Medical insurance has been a life saver, but this week it was a bit of a stressor.

I received a call from MD Anderson, telling me Cigna was only going to approve one more treatment. That’s today’s treatment. After this, they said I would have to go outside the MD Anderson system to another facility.

I get these infusions every three weeks, so my doctor was concerned about doing everything in time for my next treatment. Also, how does that work? He can only write orders for this facility, which means I need another doctor elsewhere. How do they monitor everything? And how does MD Anderson keep up with everything if it’s not all done in house?

This could be a real pain. 🤨 The closest center they want to send me to is 45 minutes from my home.

I get it. I’m sure it’s all about saving money. MD Anderson is considered a hospital system, and any time you do something at the hospital it is quite a bit more expensive than when you go to an outpatient facility. However, I’ve been getting treatment here since 2012, with no hiccups like this. Routinely and more frequently since 2017. Why the sudden change?

I’m sure it probably has something to do with Covid. Isn’t everything?

I pleaded my case. I informed the Cigna case manager that I will be going on Medicare starting in July, so please don’t make me move for a few more infusions. My 29-month waiting period to get on Medicare will finally be over. They will not only let me on Medicare, but force it on me.

She asked if I would be using Cigna as a supplemental policy to Medicare. Uh, after this fiasco? My answer is a confident NO. I will seek another company for supplemental insurance.

If they’ll have me. 😳😳

After multiple calls with Cigna back and forth, discussions with the medical director, and reviewing my case, she called me back this morning. Since I only have five more treatments until July, they authorized the remaining treatments until my Medicare kicks in.

Hooray! 🥳🤩🥳 See, your prayers were answered before you even knew what to pray for!

So, today I’m on round eighty-something of Perjeta and Herceptin. There are five more rounds until I go on Medicare. At least, I believe I’ll be on Medicare at that point. If not, Cigna is holding fast to their decision to move me outside the system. I guess we’ll see when the time comes.

“…your Father knows exactly what you need even before you ask him!”
Matthew 6:8b NLT

À la prochaine…see you next time.