It’s been two weeks

I am incredibly happy to share that this week I have “turned the corner” and am basically back to regular everyday life. I’m having to remind myself not to lift heavy objects, and I am trying to be intentional pacing myself so as not to overdo it. But my appetite is back, for most of the day my energy is back (cue an early bedtime), my abdomen is healing nicely, and I can concentrate on tasks (which means I am back to driving). I’ve even started back “running” - gingerly, carefully - since we do have the WDW Half Marathon in just over 2 weeks!

Thank you for all of your kind words, visits, and support during this time.

I had my 3rd Lupron injection on Monday at Zimmer Cancer Center with Dr. Robinson, and I will see Dr. Rossi at the Duke Cancer Center on Monday, December 29. I am hopeful we’ll be able to agree on a plan of action for 2026. I am going to remind her that I want to live, not simply be alive. I believe there’s a huge difference in those two things.

No, Baby Clara is not here yet, but every day brings us closer to her arrival, and we will be seeing her very soon!

This morning I read Luke 2:19, “But Mary treasured up all these things and pondered them in her heart.” The question from Catching Whimsy asked, “With all the mysteries and unknowns in your life, what would it look like for you to treasure up in your heart the ambiguity God allows?”

I’ll be pondering that question in the days ahead.

Merry Christmas!

One last delivery

The time has come. Rick and I will head to Durham in about an hour, and I have packed as much as I could into today. I am happy to report I was able to go for a run, then a walk on the beach early this morning. Beyond that, all Christmas presents are wrapped and under the tree, and laundry is washed and put away. I made one last bank transaction for Haiti Awake, and I even had a chance to do one more delivery for Moe’s. (No matter how well surgery goes tomorrow, I won’t be able to lift much until sometime in January. Therefore, I’ll be out for a while.)

This is what was waiting for me at work when I arrived. It was so unexpected. My heart was touched. Nearly six years ago when we stopped at Moe’s one night for dinner and the GM asked, “Hey! Are you interested in a little part-time job?” I’m so glad I said, “Yes!” I enjoy getting out in the community, meeting people, and bringing them food. (Who doesn’t love Moe’s?)

If you had asked me what I needed today, I would never have guessed this was it. But it was.

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.