IOU

You may be wondering what’s happening in CancerLand, or maybe you’re not, and if that’s the case, you’re in the wrong place. But if you have been patiently waiting here’s the IOU that is due.

Three weeks ago, I went in for my usual infusion appointment. It just so happened to also be an appointment where I was getting scan results, so I brought a friend. Scans were stable. For those of you lost on what that means, that’s good news. We love shrinkage, and we also love stability. Stable is good. Great, in fact. The longer I am stable, the longer I get to be on this drug line, and that means I won’t exhaust my limited treatment options too quickly.

But on that day I ran into a little hiccup. My blood work didn’t look as good as it has in past workups. I was neutropenic, which means my white blood cell (WBC) count was lower than 1000 or 1.0 depending on which scale we are looking at. Low WBC indicates a suppressed immune system, which means treatment adjustments. It turns out that in the grand scheme of things, this ended up being a minor issue that day because my neutropenia wasn’t severe.

After some discussion between my oncologist, my research nurse, and myself, we agreed that I would still get my pembro infusion, but we would hold the abema (the daily oral drug) for a week. I would return in a week for blood work, and if my white cells rebounded, I would have my oral medication released to me. One of the things I love about my team is that they listen to me. I fully got a vote on how to handle this situation. So that’s what I did. I got my infusion, returned in a week, my numbers rebounded (just barely), and I got to re-start on the abemaciclib.

I was really anxious about being off my meds for a week. But oh what a sweet week it was. I drank coffee with no stomach cramps or other GI issues and I had normal levels of energy. I still had menopausal symptoms, but it all seemed tolerable with a daily cup of Joe. And as soon as I went back on the oral drugs all of the side effects returned.

As you might recall, I have been having some back pain for a while now. It’s something that hasn’t gone away with OTC or stronger pain medication, but it is manageable. But I went in for an MRI of my spine to see what we could see, just to make sure it wasn’t anything affecting my spinal cord. Turns out I have some disc degeneration/maybe arthritis, which isn’t uncommon, so I am heading back to BWH to meet with an orthopedic specialist in a couple of weeks to discuss how to manage the pain and learn more about what it all means. Right now, I feel lucky that I am still mobile and can handle most days, even if I feel more limited than I did before.

And that sort of wraps everything up! I came in today to have my infusion and blood workup done. My WBC numbers are just barely over 1.0, but what counts is that they are good enough to receive my pembro infusion and get my oral drugs again. At my last visit, we discussed why my counts might be dipping, and my oncologist said that after a year or so of using these drugs bone marrow can get fatigued; in other words, it is having a harder time regenerating itself. That’s why a break from the medication allowed my body to recuperate. If I have another episode of neutropenia, then I will have to do a permanent dose reduction on the abema. For now though, it’s full steam ahead!

Coming up, I have a couple of cancer events I am looking forward to participating in. This weekend I am going to a Vintage Vogue Runway for Research fundraiser. The event will consist of a panel discussion and a vintage runway show. The funds raised go towards the MBC research fund at DFCI. And then next weekend I will be heading to Philly for the Living Beyond Breast Cancer (LBBC) conference. I was able to secure some funding to attend. The LBBC conferences tend to be research-heavy, which if you know me is like music to my ears. I’ll definitely let you know how they go.

Alright friends, if you have read all the way to the end here, I am impressed. Thank you for all of the support and love! xoxo