Be Careful What You Wish For

Well, clearly, I screwed up. And I don't just mean that I ended the title of this post with a preposition. I mean something with much greater consequences, like barfing and cardiac toxicity and additional surgeries and the possible cancelation of our summer trip to England kind of consequences. And that last one really blows, because we have tickets to see Ed Sheeran at Wembley Stadium. 

In addition to Teddy and all of the regular tourist destinations, we're also going to see the ancestral home of Scott's family (the Berry Pomeroy Castle), the county in which my grandfather spent his youth (Surrey), Etihad Stadium (Manchester City's home pitch), The Prince's Head Pub (a.k.a. The Crown & Anchor Pub from Ted Lasso), the town of Oxford, the Jurassic Coast, and the Warner Bros. Studio where much of Harry Potter was filmed. In fact, I just received an email today from the Warner Bros. (the studio, not the siblings) letting me know that two new sections have just opened: The Burrow and Professor Sprout's Greenhouse. 

But enough of the good news. This is a blog about shitty news. I just swore. My apologies to any nuns, grandparents, or toddlers who are reading this. 

So, back to radiation and chemo. Oh, did you not know that's what we were discussing? It is. 

The last time I posted I was complaining about not knowing if I'm going to have radiation or chemo or nothing. I know the answer now and it is none of those options. The answer is BOTH. First chemotherapy and then radiation. 

How did this happen? It's easy. Everything that has a such a small chance of occurrence that the doctors just tell me about its possibility as an afterthought actually happens to me. Well, not everything. I mean today we heard that there is a 1% chance I could develop heart failure and/or Leukemia. I draw the line there. Blood transfusion? Fine. Scalpel slipping through my skin from the inside? That sounds reasonable. Nipples falling right off? Okay. But heart failure? No thanks. I'll not have that, if you please. 

In short, the OncotypeDX study of my cancer cells came back recommending chemo. The second opinion from The Mayo Clinic came back recommending radiation. So, damn. 

I just swore again. 

If you want to know all the details, they are these: 

• It is unclear if this is a second primary cancer or a true recurrence. There is no way to tell at this point. Because of the proximity and similarity to the first cancer, we're calling it a recurrence. That said, it could be a recurrence of the Invasive Cancer or of the Ductal Carcinoma in Situ. I guess it doesn't really matter, though, does it?
• My Oncotype score is 26. For someone my age with a recurrence, the threshold for chemo consideration is anything above 20 and the threshold for strong recommendation is 25. 
• My score for distant recurrence within 9 years (meaning metastatic disease in liver, bone, brain, etc.) is 16%. 
• My score for relative risk reduction by adding chemotherapy is >15%, meaning that my recurrence score drops to <1%. That's what doctors call a very substantial benefit.
• We were given two options for chemotherapy treatment plans. One is called TC. It is 4 infusions two weeks apart. The other is ACT for Adriamycin, Cyclophosphamide, Taxol. This is a teaching blog. Soak it in. 
• The ACT is more aggressive and more effective. It is 8 infusions, two weeks apart and is the one my doctor recommended for me based on the fact that Scott wants me to be around for several more decades of being the most entertaining part of his life. (He didn't say that, but I'm certain he would. I'm lots of fun.)
• The chemo will start next week and my hair will fall out sometime in the next three weeks.
• Each infusion lasts 3-4 hours.
• The worst days will be days 3-7 after each treatment. 
• I will be given strong anti-nausea medications at the clinic and to take at home. 
• It's very likely that some foods will not taste the way I expect them to taste. I'm hoping that happens for zucchini. I don't like zucchini, so maybe it will taste like my mom's smoked turkey sandwiches or my dad's chocolate cake? Let's hope. 
• I will be immunocompromised. Stay back all of you sickies!
• I will probably develop neuropathy in my hands during the Taxol portion (also known as Paclitaxel, but still called T chemo). Iced gloves will be provided for my discomfort in an effort to prevent it.
• Before I can start the treatment, I will have an echocardiogram (or an ultrasound of my heart), a chemo information session (also unpleasantly named Initial Survivorship Appointment), and surgery to place the port. 
• The port is a small disk that will be in for the duration of the four months. It will be under the skin right beneath my collar bone with a catheter that feeds straight to my heart. The purpose of this to get the drugs into my bloodstream as quickly as possible so they don't have the chance to cause chemical burns or skin rashes from the inside out. Neat. 
  
• I won't know much about radiation until Friday. So, stay tuned for that exciting announcement.

In closing, here are some photos for your additional edification. 

This is a port.
Isn't it tiny and cute? 

This is zucchini.
It is yucky.

This is Professor Sprout with a Mandrake.
Mandrakes are tiny, but decidedly not cute. 

This is the Jurassic Coast.
I think it's more magnificent than cute, but you may draw your own conclusions. 

These are metastatic cancer cells. 

They are beautiful, but I still don't like them.

No News is the Worst News

I keep waiting to post an update until I have something to share, but it appears that may never happen. I guess I better just go with what I know ... which is frustratingly little. I'll put the inadequacies of my cancer knowledge acquisition into categories for your convenience.

Medication:
I've been taking Arimidex for two and a half weeks now, so only 4 years and 50 weeks to go! (Although, they have warned me that by the time we get to the five-year mark, it's probable that the recommendation will be a course of 10 years instead of a mere 5.) Apparently early results of several studies show that an additional 260 weeks may be beneficial. We shall see. 

I'm managing it fairly well at the moment. The first week was tough. I was so weak and tired that I had a hard time walking down the hall to the copy machine. During a team meeting one day I started upright but became progressively slumpier (it's a word. I just coined it.) as the discussion progressed. By the 40-minute mark, I had morphed into a sea cucumber sporting business casual and testing the limits of my ergonomic chair. They sent me home. It was probably a good choice. 

DEXA Scan:
Monday, I had a dual energy X-ray absorptiometry test to get a base line for my bone density. It was no big deal, unlike some of the other scans I have had involving contrast dye or I.V. radioisotopes. I was not told that I could not fly after my DEXA scan for fear of setting off metal detectors with my very self. So, that's good, I guess. 

What wasn't good was that the technician seemed to be a non-sensical mixture of an adult and a hyperactive toddler. She threw her arms up to accentuate a loud "YAY" upon learning that I had not accidentally swallowed any calcium or antacids in the last few hours. I was startled. 

Then, after I was changed and ready to go, she inquired with entirely too much excitement for the occasion: "Are you ready to play?" 

I wasn't, but it seemed rude and possibly ill-advised to say so. 

The test was fine, but I didn't really have fun, which is the point of play as far as I understand it. So, I guess she isn't really that good at her job.

Radiation:
To radiate or not to radiate, that is the question. The answer remains elusive. We haven't heard back from radiation since my last post. As a review, it's up in the air, based on several things but mostly a second opinion from the Mayo Clinic. Hopefully that feedback will come soon. 

Genetics:
We met with a genetic counselor on the 12th. She was very nice and spent a long time explaining genetic code, mutations, variants, sequencing, chromosomes, and all other things I have forgotten since high school. Genetic testing on cancer cells can help determine why cancer occurs and if it poses a risk to others in the family. There is a high chance that we will learn something really helpful, like I was born with a predisposition for cancer or I have an acquired gene mutation that caused my cancer and may continue to encourage abnormal cell growth. I'm pretty curious to see a report card on my cells' delinquencies. 

Unfortunately, there is a lot of paperwork and arranging before the test can take place. So, although we spoke to her two weeks ago, I don't go in until this Friday to have the blood drawn for the testing. Once that is done, the sample will be sent to Utah visit a lab and possibly go on a hike in Zion National Park. We won't hear anything back for about a month ... presumably because climbing to the top of Angels Landing is terrifying and my blood might need a couple of tries to work up the courage.

Chemo:
I hate this part of the story. I still don't know if I'm having chemo. We're waiting on the results of a test called Oncotype DX. This report will tell us both the likelihood of recurrence of my specific cancer as well as the extent to which that recurrence percentage would be affected by chemotherapy. I was supposed to get this information last week. Then I was supposed to hear yesterday. Spoiler alert: I do not have the oncotype results. 

To be fair, I did talk to the oncology office yesterday. Unfortunately, what they told me was not the results of the test. Instead, they shared that there had been a snag between the lab and the insurance company. This resulted in a three-week lag during which time nothing had been accomplished at all. Naturally, I was delighted. 

I have been assured (and I obviously trust every medical detail that I'm told) that it shouldn't be another three week wait and that answers are imminent. I remain unconvinced. 

A Quick Radiation Update

Scott and I met with the radiation oncologist today. He was awesome. 

We conversed. We laughed. I cried ... twice.

Once again, there is a lot to report, but the short version is this:

• Radiation is the standard treatment for a recurrence of breast cancer. 
• If we do radiation, he recommends 25 sessions, plus a 5 session boost at the end. 
• If we do radiation, the sessions would be 5 days a week for 6 weeks.
• If we do radiation, we would start this summer, because of timing. It takes 1-2 weeks for the mapping/planning phase and you can't have any breaks in treatment. We have a vacation planned for June, so the planning would happen before the trip and the treatments would start as soon as we get back. 
• If we do radiation, I can expect to be tired, sore, maybe swollen, feel sunburned, maybe blister, probably have skin discoloration across my chest, into my armpit, and up on my neck. Also, about 30% of the patients have constricting around the implant that would require surgery.
• Because of the lupus, all of these side effects, particularly the blistering and the likelihood of surgery, are increased.
• Because my cancer in 2010 was a stage 1 and the cancer this time is a stage 1, the need for radiation isn't so clear. Both times it was a small, slow-growing, early discovered tumor. 
• Because I was so young with my first cancer, this indicates that radiation could be important.
• Because I'm still young now, this indicates that radiation could have late-developing side effects many years down the road and should be avoided. 

So, it's all debatable. It's ultimately up to me, but the doctor said there is both a good reason to do radiation and good rationale for skipping it. 

I'm VERY uncomfortable with doing nothing. As much as I'm unhappy about the potential side-effects of both radiation and chemotherapy, I feel like doing neither will leave me incessantly anxious, waiting for the cancer to return. 

As a result, today's doctor put in a request for the Mayo Clinic to review my case. They will look at both the pathology from 2010 as well as that from 2022. They will look at the oncotyping of both tumors. And, since it was at the Mayo Clinic that the initial lupus diagnosis was made, they will be able to review all of that lab work, as well. Within the next few weeks, we should hear back from them.

In the mean time, he also got me in to see a different medical oncologist. I explained my displeasure about Wednesday's visit and he just took care of it. So, that gives me relief. 

I wish that I knew what lies ahead, but at least now we have a partial plan for a DEXA scan, genetic counseling, another medical oncologist, and oncotype dx testing. Oh, and we picked up my prescription for the oral chemotherapy drug, too. 

So, that's my Friday. 

A Visit to Oncology: The Good, The Bad, and the Ugly

We met with the medical oncologist today. It was okay. It was SUPER frustrating. It was sad. There is much to report, but also much that remains unknown. I am trying to process everything and writing it all down seems as cathartic a response as any. So, without further ado - my Wednesday in evaluative thirds:

Good:
My current cancer is strongly responsive to estrogen (97%) and moderately to progesterone (64%).

Good:
I'm post-menopausal, thanks to the hysterectomy and oophorectomy of 2010. Therefore, I'm eligible for a course of Arimidex. Depending on if you prefer scientific or generalized internet writing, Arimidex can either be considered an aromatase inhibitor or hormonal chemotherapy. It's an oral medication to prevent the cancer from spreading and I'll take it for 5 years as an initial treatment and then a possible 5 years more after that. 

Bad:
The Arimidex won't make me lose my hair, but the main side effect is joint and bone pain. It can cause bone loss, which I learned is called osteopenia. Disappointingly, it's not the result of the spell that Gilderoy Lockhart casts to mend Harry Potter's broken forearm after a particularly nasty quidditch spill. That's something else entirely and it requires a medication called Skele-gro which no one even offered to me. 

I'm scheduled for a DEXA Scan, which stands for dual-energy X-ray absorptiometry. It will give us a base line for how strong my bones are or aren't so that we can monitor their porosity. Bones are supposed to look like honeycomb under the microscope. If mine look more like nerve synapses then we become concerned (or kind of impressed)? If I start breaking bones from sneezing or sitting down too aggressively, then I guess we have a problem.

Ugly:
My oncologist told me that I should institute a low carb diet for the next five years, as Arimidex has a tendency to make women gain weight. 

"How much?" I asked. 
"Do you really want to know?" he answered with a grimace.
"Yes."
"10% is the average. It could be less ... but it could be 20%." 

Come on! I don't want to tell you my weight, but I will say that 10% is not a negligible 5 pounds. It's significant. I told the doctor that I wasn't interested in gaining 10% of my body weight. He didn't seem to think that my objection would make a difference to the medication. 

Good: 
The invasive ductal carcinoma is grade 1. That is the slowest growing type of cancer.

Bad/Good:
There was also some DCIS (ductal carcinoma in situ) in the sample. DCIS is considered a grade 0 and is sometimes called pre-cancer. If left untreated, it will become invasive cancer. Some of that was found and was removed during the surgery. Is there more still hanging out in there? Unknown. 

Ugly:
The pathology report says that the "gross description" of the sample is "4 Fibrofatty core biopsies." That's just mean. I like French fries. I can't help it. Don't pick on me.

Ugly:
I don't want to be rude, but the lab report says that my case was "seen in consultation with Dr. Lundberg." I didn't meet Lundberg, but her/his name sounds suspiciously like Lumberg, who is the villain from the movie Office Space. I'm concerned. 

Bad:
The oncologist I saw today is not the doctor that I had in 2010. I loved that doctor, but he moved out of MN, I think back to his native country of Germany. For the last several years I have been seeing this other oncologist who is fine, but not the same as the guy who held my hand through the misery of Cancer 1. I see him once a year for follow-up and have always considered him to be acceptable. Today, he was notably sub-par. 

He asked me if I just had a mastectomy. "No. I had that 12 years ago."

He asked me about the lymphadenopathy and lymph surgery that I had in 2014. "That's when Dr. Petryk thought I had lymphoma, but it was later determined to be lupus."

He asked me if I am post menopausal. This was the killer.
"I had a mastectomy in 2010." (I pointed to the medical-gibberish on the computer that I have learned to decode.)
"A mastectomy doesn't mean that you are post-menopausal."
"An oophorectomy does. I had an oophorectomy in March of 2010. It's right here on the screen."
"Ooh. You're right. That's exactly what it's called when they take out your ovaries."
Me (in my head): "I KNOW! I'M NOT AN IDIOT. SHOW ME THAT YOU ARE NOT AN IDIOT OR WE ARE GOING TO SEE IF I STILL KNOW HOW TO DO TAE KWON DO."

I do, by the way. I have nun chucks and am not afraid to use them on anyone ... or on cancer.

Good:
Because I have had cancer twice and am young (medically speaking), it is concerning. My oncologist wants to do genetic testing on my healthy cells to see if there are any answers hidden in my DNA. The tests will tell us if there is possibly a genetic mutation with which I was born or some other reason that this is happening. His exact words were: "You're too young to have already had a cancer and a recurrence. Something is not right."
I agree.

Good:
The oncologist also ordered oncotype DX testing. This is a detailed look at the cells of the cancer tumor to determine several things, most importantly among them is the benefit that chemotherapy would offer to my specific cancer. I had this done in 2010 and the result fell into the intermediate category.  In 2010, it was determined that chemo wouldn't be beneficial. This time, we will see. I won't learn that until early June when I go for a follow-up appointment.

What else? Oh, right. Laila and Owen got hit by a semi truck this morning on their way to school. It was a low speed impact. They are both okay. The car is likely totaled. 

I guess that's it. I'm going to finish the trashy reality tv show I'm half-watching and go to bed. Tomorrow is a regular work day and then Friday is 2 hours with radiology. So, more to come I guess. 

Thanks for your support.

Liz

Conversations with Liz - The Paparazzi Version

When I started this blog in 2010, the main objective was to share the details of my cancer while I was home recovering. Friends, co-workers, and geographically distant family said that they wanted to be able to keep tabs on my progress without calling all the time and interrupting my naps. This was a wise plan, as a nap-deprived Liz is a cantankerous Liz. It's best to be avoided.

I had the initial surgery and was out for five weeks. Then I went back to work for a week of feeling human before I went back under the knife and was out for another six. During all of that time, it was really helpful to employ this digital format for medical information dissemination. 

In 2022, things are different. We all text more than we talk in person. Texting provides an easy, unobtrusive way to check in on each other and allows the recipient the ability to respond whenever it's convenient. (Although, to most of us "convenient" had better mean within 42 seconds ... or else a subsequent, slightly more irritable message will be deployed). 

Texting is great for me as a patient, because I can see all of the love that you are sending without having to pause my Netflix binge to answer the phone or the doorbell. P.S. Ozark finale is being released tomorrow, so don't even bother trying to call. I'll send you right to voicemail. 

2022 is also different because my surgery was much easier and the recuperation much faster. As a result, I went back to work yesterday. I'm only managing half-days, but that is enough to get my mind focused on fundraising and communication for a few hours before I come home to nap and think about cancer some more. Half-days are also enough time for lots of people to come to my office to offer support and ask questions. So, I thought I'd use this archaic blog forum to answer some of the most popular for you.

Friend, "How are you feeling?"
Me, "I feel okay."

This is true. I do feel okay. But things are all relative. I like to think of the surgery I just had as a bee sting and the one from 2010 as a shark bite. Bee stings are annoying. They don't feel good and you wish they didn't happen. But, you take some Advil, ice the site, maybe have a glass of wine and then move on with your life. Shark bites, though, involve hundreds of stitches, blood loss, skin grafting, and muscle atrophy. That's basically what I went through when I was 34. In comparison, this is okay.

Friend, "How did the surgery go?"
Me, "It went well."

This is true, too. The wound is small and seems to be healing perfectly. The anesthesia was manageable and I don't think I threw up on anyone when I woke. I don't really remember, but I assume that I asked clever and medically appropriate questions about the details of the procedure and the cellular structure of a cancer tumor, but right now all I remember is that they told me I wouldn't be able shower for two days. Incidentally, this is why I now have a sizable collection of surgical hair nets in my possession. Apparently, I was concerned about how I would look - to my family and dogs - going without a shower. My semi-lucid brain thought that wearing a hair net around the house would be less conspicuous than bed-head. I was incorrect, for the record.

Scott and I went to see the oncology surgeon on Tuesday. I was prepared for the worst, which doesn't mean I'm a pessimist. It just means I have a memory. My minimal Google research told me that 25% of lumpectomies result in the need for a secondary surgery and my first bout with cancer was within that stupid quartile. So, I expected it would be again. Not so! The dissected part of Liz that made a trip to pathology was rolled around in some dye and shockingly - to me at least - the tumor cells were within the obligatory 1mm margin from the dye. So, that is what we call a success. It is also what I call suspicious, because my history doesn't involve a lot of success, but I'm trying to be cheerful about it. 

Friend, "What is the next step?"
Me, "I go to see the medical oncologist on Wednesday and then the radiology oncologist on Friday."

Accurate. I do have those appointments. I also don't know much more than that. The Wednesday appointment will address medications, hormone blockers, and chemotherapy (which I don't expect to need, but am bracing for). The Friday appointment will address radiation treatment (which I have been told is the standard of care for a breast cancer recurrence and I do expect).

How much? How long? How often? I don't know. Will I feel okay or need to take time away from work? I don't know. Will there be more scans or will I start treatment right away? I don't know. Will I be well enough to go to Laila's graduation? I had better be or else I would advise everyone in the vicinity invest in ear muffs to drown out my incessant swearing. 

Friend, "How are you doing?"
Me, "I'm fine."

Nope. This one is pretty much a lie. Sure, I'm technically fine in the literal sense of the word. I'm not inconsolable and unable to get out of bed. I'm not so weak and enfeebled that I can't care for myself. I haven't come down with a post-surgical infection necessitating a hospital stay. But, I'm really sad. I don't know what is coming and I do much better when I can plan. I don't understand how one wayward cell could have the power to make this happen again and what could possibly prevent me from feeling like it's just going to keep happening forever. Cancer blows.  

I Don't Even Know What to Say

 

I can't believe I'm doing this. It's been so long since I've posted on here that I've completely forgotten how to do it. I wish that I didn't need to re-learn. I wish that I didn't have anything to report. I wish that I wasn't sitting here reliving the nightmare that I survived 12 years ago, but I'm clearly not in charge. I have had a recurrence. It's the same cancer in the same spot. It's still stage 1. It's still estrogen-receptor positive. And apparently, it's completely and totally resistant to a bi-lateral mastectomy, a hysterectomy, and five years of Tamoxifen. What a stubborn, tenacious, cellular jerk. 

Things have moved faster this time. In 2010, I found the lump myself and then it took six months, 3 ultrasounds, 2 mammograms, 2 gamma scans, 1 MRI, and 1 biopsy for the doctors to confirm what I already knew. It was a lot of waiting, a lot of confusion, and a lot of inconclusive results. My 2022 cancer experience has been markedly different. Here is a run-down:

March 26 - I noticed a lump in my left breast that felt like it maybe had aspirations to kill me.

March 28 - I called my oncologist (because I have one on speed dial. Doesn't everyone?) It was determined that the lump was likely scar tissue and the best course of action was to see my plastic surgeon.

March 29 - I went to see my plastic surgeon (because I also have one of those on speed dial). He felt the lump and right away agreed that we should treat it seriously and swiftly. He is one of my favorite physicians in the history of healthcare, by the way. If you need a referral, do let me know.

April 1 - I went to have an ultrasound, during which the radiologist recommended a biopsy that could go one of three ways:

1. Needle in, biopsy out. Easy-peasy. Lemon squeasy

2. Needle in, implant punctured. Oopsies all around.

3. Needle in, tumor is at an angle that is too hard to reach. Mission aborted.

I decided to go ahead with the procedure, hoping for scenario 1, but knowing that we could easily encounter 2 or 3. Six biopsies each the size of a grain of rice were taken. The implant was not damaged.

April 4 - I waited ALL DAY for results and finally decided that I didn't want to relive the 2010 diagnosis experience that occurred in my office cubicle. So, I went home. That evening, I got the call that it was not scar tissue and was, instead, a recurrence. SHIT. I screamed that into phone to my doctor. I swore ... out loud ... to a medical professional who was trying to help me. Then I apologized. Then he said, "it's okay. I swore, too."

April 5 - We went to see the oncology surgeon and learned that the best-case scenario was that I would have surgery and 4-6 weeks of radiation. Awesome. Super. I'm so glad to be here again. Worst-case scenario was that the cancer had spread to other parts of my body and was now incurable. Oh. That's less awesome. I see the difference, now.

April 8 - I went in for a PET scan. It showed that the cancer is contained to my breast which is news that caused waves of jubilation from all of those around me but I just kept thinking ... so what? I still have cancer.

April 20 - Surgery. My surgical oncologist took out the 6 mm tumor encased in 14 mm of my tissue that was not supposed to be inhabitable to cancer. And now you're up to date. I'm waiting for the appointment with my surgeon to tell me if we have clean margins. I'm waiting for the appointment with my medical oncologist to tell me if I will have radiation or chemo or both. I have cancer again. I did EVERYTHING I could to punch it in it's stupid little cancer face the first time and now ... I HAVE IT AGAIN. 

It's unfair. It's infuriating. It's demoralizing. I am consumed with sadness and anxiety and guilt and fear. How many times am I going to be expected to do this? I took it the first time, understanding that statistically 1 in 8 women will have breast cancer in their lifetimes. Me having cancer means that 7 women in my family and friend circles won't. So, I took it. I shouldered it. I attacked it and did everything in my power to eradicate it. And, now, I'm sitting on the couch with an ice pack in my bra again. 

What the hell? I mean, seriously. WHAT THE ACTUAL HELL?

It's Not a Vampire Bite

On Monday, Scott and I went to see a head and neck surgeon at the University of Minnesota.  We were referred to him (and squished into his busy schedule as a result of ) our good friend Bill, who also works as an ENT at the U.

At our request, Dr. Khariwala removed two more lymph nodes for a second biopsy.  His idea was to perform a needle biopsy, which is much less invasive than the surgery, of course.  On the downside, if a needle biopsy comes back negative, then you are unsure if the lymph node is negative or if the needle missed the cancer cells.  As a result of our history, we opted to have the whole thing taken out right away.

So, on Tuesday, I went in for another surgery.  It went very well, considering that the goal was to slice out part of my neck.  It was a general anesthetic surgery, so yesterday was spent dealing with the after effects of having a breathing tube down my throat.  Today is much better.

Now I'm recovering from the biopsy in my armpit and a new one by my left collarbone.  It's not terrible.  I've certainly dealt with much worse.  Plus, it gives me a chance to take a bunch of Vicodin induced naps and catch up on my trashy reality shows.

Plus, this week is a totally different waiting game from last week.  With the first biopsy, we were trying to confirm lymphoma.  It was a terrible, heartbreaking and anxiety filled several days.

This time, though, Scott and I feel like we are trying to rule out cancer.  Two negative biopsies would be a pretty clear indication that this isn't lymphoma.  So, maybe next week's results will bring us that.  We also hope to find out more about why I have symptoms, if they aren't associated with cancer; which is why the pathologists at the U are looking for EVERYTHING.

Half of the sample went to the pathology lab and the other half went to the microbiology lab.  With luck, they will find something like a bacterial infection or an autoimmune disease.  And if all of that doesn't solve the mystery, then I also have a rheumatologist reviewing my case and an appointment with the infectious disease department in two weeks.

So, we are confident that an answer is on the way.

Go science!