My First Lupron Injection

I received my first injection of Lupron today, October 28. It was a painless injection in my hip. I really didn't feel a thing.

I'm hopeful the days ahead will be equally uneventful, but just like I did with Letrozole, I will post regular updates on how I am feeling on Lupron and (eventually) whether or not it is efficacious for me.

A brief update - Oct 11

As many of you know, I had labs, a PET CT scan, an appointment with a nutritionist, and my pre-op visit yesterday. I will have more to share next week, but as a number of you have reached out by text to check on me, it’s easier to just share a brief update now and fill in details later. The PET scan information has not been published to MyChart, though I have seen it and discussed it with my health care team at Duke.

The basics:

• The scan showed interval increased size of the previously seen nodules, as well as new hypermetabolic peritoneal nodules, consistent with worsening peritoneal disease.

• Surgery is canceled as it’s no longer a realistic option.

• Dr. Rossi and I talked last night about the possibility of pursuing chemotherapy and/or a different endocrine hormone option.

• I am seeking a second opinion from Dr. Tyler Hillman at UCSD, but I do not have any intentions at this time of transferring my care from Duke.

Thank you to those who reached out by text yesterday with encouraging words, not expecting a response. That was meaningful to me.

I know many will ask how I am feeling. Physically I feel great. I have no real symptoms. Emotionally I am pragmatic and moving into planning mode, though we don’t fully know yet what that will look like.

For this weekend, there are plenty of other things to concentrate on, most importantly Hannah’s baby shower which is tomorrow. She and Ethan are having a GIRL!

When I was a child, I memorized the entirety of Psalm 27, and this morning verses 13 and 14 are on repeat in my head:

I remain confident of this:
    I will see the goodness of the Lord
    in the land of the living.
Wait for the Lord;
    be strong and take heart
    and wait for the Lord.

September 16 appointment

It was an early morning as I left for Duke before 6 a.m.

The redeeming factor in the early start was I got to see a gorgeous sunrise on the drive.

I went to Duke today for my new patient/pre-op appointment with Dr. Sabino Zani, Jr. Duke’s website lists his areas of expertise as:

• Metastatic Disease

• Complex Biliary Surgery

• Robotic Surgery

• Liver Cancer

• Pancreatic Cancer

I check three of those boxes, so I am hopeful we’re a good fit!

This was a simple appointment with conversation and time for questions on both our parts.

A few key takeaways:
1) No dietary restrictions before the liver resection. I’m thankful that I have a healthy liver apart from the noted areas of concern.
2) He is cautious about the idea of my leaving the hospital same day. He said there's a possibility of needing to stay one or two days. There's a lot that is unknown until they have a clear view of the inside of my abdomen.
3) He believes I'll have 5 incisions, the largest being reserved for the portion of the liver being removed.
4) He did a rotation under Dr Rossi during residency, and they’ve now both commented to me that they work well together.

Today marks one more appointment down that brings me one step closer to surgery on October 22. There are still details to work out and a number of unanswered questions, but I feel like today was productive.

I even stopped at The Mad Boar for their Build Your Own Sides plate lunch, a great way to break up the long drive back home.

I was reminded today of an old hymn from my childhood. The words seems fitting.

“I don’t know about tomorrow,
I just live from day to day.
I don’t borrow from its sunshine,
For its skies may turn to gray.
I don’t worry o’er the future,
For I know what Jesus said,
And today I’ll walk beside Him,
For He knows what is ahead.

Many things about tomorrow,
I don’t seem to understand;
But I know who holds tomorrow,
And I know who holds my hand.”

— Ira Stanphill

The surgery date is set

Important dates:

• September 16 - consultation with Dr. Zani who will do my liver resection

• October 10 - PET CT scan & pre-op visit with Dr. Rossi

• October 22 - Surgery with Dr. Zani and Dr. Rossi. They are hopeful that this procedure will be able to be done laparoscopically, but because Dr. Zani will be re-sectioning my liver, my recovery time will be longer than it was 6.5 years ago when I had my first laparoscopic surgery.

• November 14 - post-op visit when we will discuss adjuvant therapy options.

The August 29 MRI and the Current Plan

On Friday, August 29, I drove up to Raleigh for a DEXA scan and an MRI of my liver. I have not gotten results on the DEXA scan yet, but I do have the MRI results, and I have spoken to Dr. Rossi’s office regarding them.

I actually got the MRI results Friday afternoon, but I wanted to speak to someone at Duke before sharing, especially since the MRI noted: “Musculoskeletal-subtly enhancing marrow replacing diffusion restriction lesion in the right L1 vertebral body is suspicious for metastasis.” This is the first time there has been any indication of spread to that area of my body, and I questioned whether this would change the recommended treatment we had talked about after the July PET scan. (It does not.)

To keep it simple, here is what we currently know and here is the current plan. There are many unanswered questions, but hopefully those will be answered to the best degree possible after the October 10 appointments.

October 10 - PET FDG SCAN and Pre-Op Visit with Dr. Rossi.

October 15 or 22 - Laparoscopic surgery at Duke.

The Goal- Minimally invasive surgery

Recovery - I have been told not to schedule anything from October 15 through November.

Treatment options for after surgery are being discussed, as noted in a recent post. Much will depend on the PET results on October 10 and how the surgery itself goes.

I am thankful for those of you who continue to pray. Please pray that my medical team and I will be able to discern together the best course of treatment after surgery.

I’m especially thankful for friends who, though eager to know these results themselves, have given me time and space, offering to “check the blog” instead of asking me to text them directly. A little bit of understanding right now is incredibly helpful.

And to end on a positive note, I am thankful for my friend - Rachel Dobrowolski. We were able to coordinate schedules between my two appointments, and spending time with her was refreshing and encouraging. To know Rachel is to love her.

A faith with no coincidence

I was walking the beach this morning, praying through the thoughts in my mind, when this song came up on my playlist. I listened once and hit repeat. And then hit repeat again.

Burning Bushes

(Gullahorn/Kinney)

I've never seen a dead man come to life or seen a blind man get his sight.
I've never seen water turned to wine.
It isn't that I don't believe but it would be easier for me if you would just send down a sign.

I remember the childlike innocence.
A faith with no coincidence.
The world around was living proof.
Has that world just disappeared or is it me that isn't clear how to recognize it’s you.

I walk through the water and the waves looking for a drop of rain but you're still not coming through.
Maybe its new eyes that I need or maybe it takes more faith to see I'm drowning in the truth.

Chorus:
I'm praying for a miracle to let me know you're listening.
Waiting for a lightning bolt to strike.
Walking through a garden of a thousand burning bushes looking up to heaven for a sign.

---

As I was thinking about “It isn’t that I don’t believe, but it would be easier for me, if you would just send down a sign” - asking myself what it looks like to ask God for a sign, what it means to see that sign for myself, I saw the most beautiful shark’s tooth in the sand. In fact, I had walked right past it before I processed what I had seen and had to turn to go back and pick it up.

I was reminded of a conversation from over a year ago with my friend, Jenni, when she asked me, “What is God trying to teach you through these sharks’ teeth?”

I remember laughing a bit when she asked me that question, but this morning I realize that on the very morning I was thinking about asking for a sign, it was there.

The May 16, 2025 appointments

May 16. 3 pm.

Though my appointments at the Duke Center for Women’s Cancer Care Raleigh were in the early afternoon, I headed to Raleigh early Friday morning with Rick. He had work to do in Raleigh, so it made sense for us to ride up together.

That gave me time to meet a friend for breakfast, take a walk at Lake Johnson Park, and go to the State Farmer’s Market before heading to my CT scan and labs.

The check-in process once I arrived was a bit of comedic error as the young lady at the front desk insisted I wear a “Fall Risk” wristband (I just hiked to the summit of four mountains earlier in the week with Rick. I think I’m okay) and 30 minutes later when I hadn’t been called back for my appointment, it was discovered she had never actually checked me in!

My scan and labs were done simultaneously and were quick and easy. In fact, my scan results were back before I even saw Dr. Rossi. She came in, excited to tell me the good news, but I had to admit I’d already seen MyChart.

Based on this scan and the last one three months that read the same (and despite the elevated Inhibin B levels from my last labs), Dr. Rossi decided to move me to 6-month visits with 6-month CT scans, a slight, but significant, change to my protocol. I’m thankful for more “time to breathe” between appointments.

When I asked Dr. Rossi why she was comfortable with this, she said that despite the elevated Inhibin B levels, we can’t operate on what we can’t see. I am comfortable with that, too.

So I said goodbye to Duke for what I hope will be the next six months (provided the inhibin levels haven’t jumped a crazy amount) and headed here to Lucky Tree to plan the next six months of life (something I had sort of been holding back on, pending the results of the CT scan.)

I won’t share this post publicly until I get the blood work back - in about a week - just in case there’s something substantial there. But, in this moment, I am feeling really good about what’s ahead.

Since I first started seeking answers in 2017, I’ve never had six months between physicians’ visits. I’m thankful for a good visit and looking forward to having six months before I have to really think about this again.

May 22. 7:30 pm

I got my Inhibin A and B back. B is trending up again. A is out of range for the first time since surgery two years ago.

I suspect Dr. Rossi isn’t going to change anything she told me last week, but I’ll have to wait and see. I have noticed some significant physical changes this week that remind me of the symptoms I had in 2019 and 2023, but again, we can’t operate on what we can’t see. So, I guess we’re now in a waiting game.

My current plan is to enjoy the summer ahead to the fullest, just like I did after surgery in May of 2023.

May 30 update

Dr. Rossi just called me herself to let me know I need to come back in August, and I need to get a PET in the next couple of weeks.

It’s my anniversary!

This journey began on May 2, 2019, when I had my first surgery here in Wilmington. Last year on this same date, I had my second surgery - the big surgery - at Duke University Hospital. Two life-changing surgeries. One date - 4 years apart.

How thankful I am for the excellent care I have received through the years and the kind support of family and friends through it all.

Today I am reflecting on the goodness of God, and I'll be listening to this "Just as Good" (Chris Renzema) on repeat.

And I will build an altar

And stack it stone by stone

'Cause every Ebenezer says I've never been alone

My faith will surely falter

But that don't change what You've done

'Cause every Ebenezer points to where my help comes from.