MRI Findings---For the Record

I kept meaning to put up the exact findings from my MRI results, for those who are interested in the science-y part of all of it, plus just for the documentation of it.

Date: 2/03/17


FINDINGS:

The diffusion-weighted imagine demonstrates no evidence for acute infarction.  The axial gradient school imaging demonstrations no evidence for intracranial hemorrhage.

There are scattered opacified mastoid air cells on the right Paranasal sinuses/mastoid air cells are otherwise unremarkable.

There are numerous enhancing intra-axial lesions throughout bilateral cerebellar hemispheres, as well as scattered throughout the supratentorial brain bilaterally, left greater than right.  Posterior fossa intra-axial lesions include a cluster of three lesions in the vermis, each measuring up to 7-8 mm.  Within the superior aspect of the left cerebellar hemisphere, there is a mass measuring 2.5 cm in transverse dimension and there re numbers confluent masses within the interior and posterior aspect of bilateral cerebellar hemispheres, left great than right, measuring up to 6.0 x 3.1 cm on there left and up to 2.9 x 1.6 cm on the right.  There is associated edema as evidenced by increased T2 and FLAIR signal adjacent to these lesions, especially on the left.  This exerts significant mass effect on the fourth ventricle, which is markedly narrowed.  There is no transependymal flow of CSF or evidence for vertriculomegaly at this time.

In addition to the metastatic disease within the posterior fossil, there are supratentorial enhancing lesions.  This includes a left lateral temporal lobe lesion measuring 1.1 cm, an inferour and lateral left frontal lobe lesion measuring 1.7 can, and a posterolateral left frontal lesion near the vertex measuring up to 1.4 cm.  On the right, there is a lesion within the lateral aspect of the temporal lobe measuring 1.6 cm.

There is a lesion within the left occipital lobe measuring 1.1 cam and there is a lesion without the right occipital lobe measuring 1.7 cm.  There is also a posteromedial right parietooccipital lesion meaning 1.3 cm.

There is mottled abnormal signal intensity throughout the calvarium including the cloves.  There is also mottled abnormal signal intensity within the upper cervical spine, suspicious for osseous metastatic disease.  (*Dr. Fleener not concerned about this part for now.)



IMPRESSION:
Widespread intra-axial metastatic disease, including supratentorial and infratentorial lesions.  Numberer cerebellar lesions are present with associated posterior fossa edema and mass effect on the fourth ventricle.  Signal abnormalities within the osseous striations suggests osseous metastatic disease as well.






THERE YOU HAVE IT!!!!

H&P #19 + Leave it to Fleener

We are back on regularly scheduled appointments with Dr. Fleener and for the once every 3 weeks treatment of Herceptin and Perjeta.  

Before my treatment today, I met with Dr. Fleener, who is still optimistic that radiation will melt and shrink the tumors from my brain and put me back in a state of remission.  "I don't want to blow smoke at you, but I have that hope, one, because I choose to, and also because so far your cancer has been so sensitive to treatment, that it makes sense that would continue.  Plus, you responded so well with your symptoms, so quickly, that gives me great hope, too." 

Now, we go back to treating the rest of my body and hoping that I'll be back on the longer end of the time frame.  

She told me that she and Dr. Goble presented my case at a conference, along with another one from the area, and that she has also been researching alternative options for future treatment, plus clinical studies.  There is an option to have a port in my head and treat the brain directly with Herceptin.  Dr. Fleener feels that my having HER2+ can be a good thing, in this case, because these drugs have done so well at keep cancer out in the rest of my body.  "Before these drugs, we were having patients die of  lung or liver metastasis, but now that H&P have done such wonders on patients, they are seeing more of the cancer show up in the brain, which stimulates studies and clinical trials." 

She also wanted to tell me that she's seen my name all around town and how great this community is for rallying around families like mine.  

Finally, I asked about my MRI results, which included a small blip about modeling on the cervical spine, which is suspicious for bone mets, but Dr. Fleener thinks it was residual.  "Plus, the radiation most likely got that, as the upper spine is within the treatment area.  

In leaving, she reminded me how much her staff has been thinking about me, praying for me, and loves that I'm doing better.  "I was SO glad and relieved when Dr. Goble told me how much better your symptoms are and how much better you're feeling.  That, alone, shows that radiation has worked on some levels.  That's in part because of you and your strength, so keep it up!"

As I continue to walk this journey, there are still the pulls to ask, "WHY?"  Instead of dwelling on that, I'm one to just ask, "What I can do now?"  And, I do something each day to make memories or set up plans--just in case---something happens again quickly.  I don't know if I'm meant to become a miracle or simply just to press forward in faith and inspire others to endure their own trials with a happy heart and unbreakable faith.  

I came across this quote a few days ago, which may have been an answer to prayers.  

 Cancer is a heavy mountain to carry...or push...but I'm ready to continue in the battle and, like Dr. Fleener, choose to have hope.

Rock the 'Hawk

One major side effect I was promised before radiation began was hair loss.  Again.  "You'll lose all your hair, and it might not grow back."  

Well, suck.  

This last time, I've TOTALLY babied by hair, and it was SOOOOOOOO close to growing out to the exact style I wanted, plus thick and healthy and strong.  OH, well.  Just hair, right?

I did talk to the techs who gave me SOME hope, that not EVERYONE completely loses all their hair and some people do see it grow back.  You just never know.  They also couldn't promise me exactly when it would fall out.  The closest answer was, "Sometime after the last treatment ends."

So, this was the week to do something.  And, by Thursday, it was coming out on its own.  My scalp kind of feels like it's sunburned, from radiation, I assume.  So, as I was trying to massage my head and ease some of that discomfort while watching tv, this started happening, too:

Thank goodness I had an appointment for Friday.  


My friend, Jenn, met me for fun and emotional support.  I also brought my wig to be styled, since there's a chance I might never have to color/cut my own bald head again!

Still with some optimism that it might not be gone forever, we decided to go with a faux hawk because that top part is the HARDEST and LONGEST thing to have to try to grow out!!!!

Just a bit of a pile on the floor!!

 There is goes, again.  For me, by the third head shave, there was no sadness, no tears.  Just another step in the process.

Wig time!!! 

I am so grateful for this girl.  When we moved to College Station, I was feeling like I needed to lose the platinum and start going back to "me."  I just happened to sit in her chair, and she's been such a part of this journey ever since.  It's amazing how great good hair can feel and how poorly the opposite can be.  Being forced to choice the sad choice has been so much better with her there to help.   Much love!

"Burg-a-lar"

(a nickname with a LOOOOOOOONG story!)

The boys all told me that it looks weird and that I look like a boy.  "But, you're still pretty, Mom.  I like your eyes."  

Boy-ish or not, time to rock what I got! 

LAST RADIATION!!!

We did it!  We made it through 10 radiation treatments!!!

What a difference radiation has made.  Between medical science and prayers, we've seen a major turn around in symptoms over the last 2 weeks, which means that--on at least a few levels--it's working.  Now, we wait 6 weeks for another MRI and see how well.

February has been rough this year.  The hardest--and scariest--thing in all of this is just how quickly cancer came back and nearly took me out.  I went from myself to planning a funeral in a matter of days.  A 37 year old should not do that.  It just goes to show you how much you REALLY do need your brain to be----you. And alive.   It also goes to show just a bit how aggressive and quick my cancer is turning out to be.  So, we know a little more of who we're dealing with, but as Dr. Fleener said, "it's aggressive, but so far it's responded well to treatments."  Fast growing, but weak.  Comes at you with everything, but backs down with battled.  Like a yiping little dog.  I can handle that for now.  

Now that my brain is mostly back and my body doesn't seem so far behind, I can actually record a little more of the experience and timeline of the last few weeks.

On January 31, I had a scheduled PET scan.  In preparation for that scan, there is a 24-hr low carb/fast.  The morning of the scan, I woke up not feeling great.  When I walked into the kitchen, I just threw up on the tile. Weird, but figured it had to do with blood sugar/nerves/prep for scan.  Went about day with few other problems than mild headache, which I assumed had to do with scan stuff.  Went to scan, ate.  Improved.

The next morning, woke up the same.  Vomited in kitchen sink, continued with uncontrollable dry heaves, causing my bladder to freak out and peed all over myself with each wretch.  Drove kids to school and threw up multiple times in car rider line.  Faculty insisted on sending me to school nurse.  Water and crackers and back out.  Seemed fine for rest of day, minus worsening headache.

Thursday morning was similar.  Headache worse.

Friday drove to Fleener's office.  Fluids, meds, MRI planned.  Cancer's back.

I babied myself over the weekend, so as not to end up in ER.

Goble on Monday.  Cancer is back and BAD.

Fleener on Tuesday.  Skipped chemo.  Movie and lunch with Stephen.  Steroids and Zoran working to control symptoms.

1st radiation.  Vomit.  Meds not helping enough.  Fluids.

More vomit.  Headaches all the time.  Starting to not think straight.   Car rides not good.  Mostly in bed.

Here's where it all starts to run together.  I was not able to eat or drink without throwing up.  My head hurt all the time, I was starting to lose balance and the ability to remember or think.  It got worse and worse until Friday Stephen was thinking I'd be in a wheelchair over the weekend and funeral plans were starting to get underway.


And then, SLOWLY, radiation started to work.

My headaches eased.  I wasn't throwing up every time I moved or breathed.  I could actually call my mom on the phone on Sunday.  There was a breakthrough.

And, then it was the long process of digging back out of mostly dead.

Stephen and I actually went out for a real dinner for Valentine's Day.  I ate.  Not much, but I ate.

Stephen was able to leave on vacation and we all survived---with MUCH help.  But, we made it.

And, I haven't thrown up in over a week---even without the meds!!!




The truly scary thing was just how quickly it all went down.  So fast and so far.  We were not AT ALL prepared for that.  From 6-12 months down to 4 days?   Not fair, cancer.  Chill, okay?


At least the good to come from that shock was the blaring reminder that we are blessed to know ahead of time that I don't have all the time we thought I might.  We have the chance to say things we'd want said, to plan for my wishes and have it all booked and scheduled so when the time comes, it can be a peaceful time and not a stress of phone calls and scrambling for accommodations.  I can personally ask my loved ones to be part of my life celebration, even through the heart aching tears.   I can write letters and buy gifts.  We can make videos and take photos.  We can make precious, cherished memories.  We can talk of life beyond and of eternal families and Mom continuing to be mom beyond the veil, to continue to mother and love from heaven.  Even some known time is better than being gone without letting those I love know that the happiest all my favorite days have been with them.

So, that's where we are now.

Radiation is complete.  We wait.  And, while we wait, we go back to treating cancer in the rest of my body.  So, if my brain could just stay in remission, we'll be on to guessing where it's coming back next.

And, I'll keep on telling you that I'll be dying every other year.  And, then...SURPRISE!!...we beat it back.  Again.  Maybe I'm not dying this year after all!

There's too much of the world I still haven't seen and too many milestones of which I still need to be part.

Breakout

Well, the breakout's back.  It had been such a miracle to FINALLY be done with, what we could only guess, was a reaction to Herceptin and Perjeta last fall.  I started noticing this painful, ugliness coming back on Friday, and it keeps on coming.  My arms, my abdomen, my legs, mostly upper thigh, but spots all the way down.  Not to be left out, my face also seems to want to join in.  Doctors don't get it, as it doesn't make sense with radiation and my meds haven't changed.  Maybe, just maybe....stress?  

Or, perhaps, my skin is just trying to be extra helpful in clearing my body of toxins.  Thanks, skin.  You can relax, though.  

Friday Radiation + Weekend

I feel like I'm a mom of a newborn again, only my body is the newborn I'm trying to keep alive.

Wake up on all hours to keep meds up.

Make sure the baby eats.

Try to get out of bed so as to not become a vegetable.

Stay washed and dressed.


Thank goodness for everyone else for everything else because this is a tough enough job, just trying to keep this 37 year old, 80-year-old, newborn baby alive.

Time for another nap.

More Radiation

My new radiation time is 9:45, M-F.

This day, Jenn came again.

Overnight was rough.

I was up all night, throwing up, barely able to walk.

There is no telling how I got to boys to school that day, but they got out the door.  

I made it to the clinic, but immediately needed a wheelchair.  I was now an old woman, not able to walk to move on my own.

After the radiation, I rolled back to Dr. Fleener's office and got fluids and meds.  

Then, it was home to try to rest again.

The next day was much the same, me needing a cane to walk, just trying to keep alive.