Sunday, March 14, 2021

Update March 14, 2021

 

This update starts out very bad. Please read it to the end though, it gets...less bad.
 
Amanda had her PET scan on Wednesday evening. It seemed like it went well, but she became concerned when they thought she was done, and then asked her to move into a different position and took an extra scan.

She already had an appointment scheduled with her radiation oncologist for Friday. They anticipated having the scan results ready by then, so she could discuss it with the doctor. Given that modern technology exists, though, and that Amanda is “a persistent little bugger” (her words), she knew the scans would be available online on RadNet as soon as they were finished. So she spent Thursday refreshing the page regularly, ready to pounce on that report as soon as it was available. The images themselves came up early in the day, but she doesn’t know what she’s looking at, so she kept waiting for the interpretation.
 
Shortly before our scheduled JackBox night with Nat and Cal, i took the dogs out to go potty. When we came back 10 minutes later, Amanda was crying, and pushed her laptop at me with the report open.
The cancer has spread to her bones.
 
Positive new lesions were found in four of her vertebrae and in her right scapula. This is a Stage IV diagnosis. Stage IV is typically considered a terminal diagnosis, incurable. Stage IV patients typically live an average of 2½ years after diagnosis.
 
Cal called literally minutes after we read that. Her and Nat got the full brunt of the raw pain over the next hour or so as we talked through what this probably means for us and the future. I started drinking. We each had an edible. We started calling and texting Alyssa. When the edibles kicked in, we ended the call and sat by ourselves, trying to manage our emotions, until Alyssa finally arrived. By this point Amanda was high as a kite and when the door opened she tactlessly shouted “Guess what! I’m going to die! The cancer is in my bones!!” And i could see Alyssa’s heart just drop straight out of her body. She knew she was walking in to bad news. But that was unexpectedly blunt. We each had another edible. Alyssa tried some scotch. We ate two packages of Oreos. We watched Into The Spiderverse and spent the night just trying to come to grips with this devastating new reality.
 
Some would argue that Amanda shouldn’t have gone looking for that report before having a chance to go over it with the doctor. They may be right. I might be one of them. But at least this way, we got all of our emotions sorted and out of the way privately, at home, before having to go into a doctor’s office and deal with it there. And also this way, we kind of knew what we were looking at and we were able to assemble a list of questions ahead of time. So, there are ups and downs to doing it this way.
 
The radiation oncologist was very impressed with her for having found the report, read it, and prepared questions. She said that she wanted Amanda to work for her. Once she found out Amanda is a vet, she said that makes sense, lots of vets tend to be like that.
 
So she went over the report with us, and she thought this was actually not a terrible report. First of all, she stressed, this is not a death sentence. Yes, it’s a Stage IV diagnosis, but we caught it early enough and the lesions are small enough that there is still a good chance they can be targeted and dealt with productively. The most likely outcome is that the cancer will become manageable, and Amanda will just have to be on medication the rest of her life to manage it, like diabetes or high blood pressure, but at least she will have a “rest of her life.” But honestly, curing it is still not entirely off the table; it’s just a slimmer chance. Amanda has chosen to cling to the “treatable” possibility; that definitely seems manageable and vastly preferable to dying at 35. We can still hope for “cured,” but she doesn’t want to get her hopes up too much.
 
As Drew put it, “this is the best worst diagnosis.” Still the worst because Stage IV, but the best Stage IV diagnosis possible.
 
So we have something we can work with at least. We’re still going forward with the hormone treatments previously discussed, but there will be additional drugs added which may or may not include more chemo. The plan for radiation has also changed, they may be able to specifically target the lesions and hit them directly with radiation. So there’s still hope.
 
It’s really concerning to think about some of the implications here though. We’re lucky we caught this so early. But it only happened because Amanda was persistent and firm with her doctors. After we got that lab report, she wasn’t scheduled to see her medical oncologist for ten days yet; she called immediately and got the appointment moved up to the next morning. The medical oncologist never gave any indication she planned to get a new PET scan, that was something Amanda wanted and demanded and the medical oncologist ordered just to make her feel better. Given their track record for getting orders filed timely, Amanda gave them a two-day head start and then started calling daily to make sure that PET scan actually got ordered. We’ll never know if that persistence is actually what annoyed them into approving it so quickly, but we do know this is the fastest insurance has approved anything regarding her treatment in the last year. So if we had just gone along with the doctors’ recommendations, let the flow carry us, and just taken everyone at their word, we would be at least ten days behind, probably fifteen or more, in finding these new bone lesions. Would we have still “caught them early enough?” Would we have caught them AT ALL? 
 
Even with these new words of hope & comfort from the radiation oncologist, it’s still been tough to process everything that’s happened. These last several days since the moment we saw that report have felt like forever and an instant at once, we have no concept of linear time right now and if we thought we were in low-power mode before, we’ve gone past the empty tank and are running only on borrowed energy now. There’s still no guarantees. This is still a terrible diagnosis, even if it’s not quite as horrible as we first thought. But she’s not going down without a fight.
 
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I want to once again thank absolutely everyone for all the support we’ve received through this last year. I know there is so, so much going on, virally, politically, personally, apocalyptically, and everyone is struggling. You have all been amazing to us and we truly have only made it this far because of your generosity, be it the money, the meals, the care packages, the video calls, the virtual game nights, the postcards, and everything else. I’m just going to gently put this GoFundMe link out here again, as always expecting nothing but humbled and grateful for anything.
 
 
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On a more positive note, Amanda was able to get her Covid vaccine yesterday! She got the Johnson & Johnson vaccine, one and done, so she doesn’t need to go back for a second dose. She should be considered fully protected from Covid (at least as protected as one can get) in about two weeks. She’s definitely feeling the effects of it today, she’s very tired, her non-surgery arm hurts now also, and she has a headache, but it’s a small price to pay.
 
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One last bit of news. We’ve low-key been planning this since December, for as soon as we had her post-op follow up schedule finalized. We’re coming back to Wisconsin for a visit. Originally, due to Covid, this was just going to be a small-scale, mostly hang out with our parents kind of deal. Given the news we’ve just received, though, we are hoping to see more of our friends and family. Amanda wants to hug everyone who’s willing to hug her. We know it’s not Covid-compliant, but we are seeking comforts in this moment, and if worst comes to worst... 

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