Tuesday, July 12, 2016

Austin for life!

Why in the world - in the middle of everything going on - would we up and move to Austin?! THAT is an amazing question and I will attempt to answer it, because I'm not even sure we know all the reasons just yet - but we know the main one ... because we just wanted to.

If you've ever been lucky enough to choose where it is you want to live - to actually pick the place you want to make a life for yourself, and not be somewhere because you were moved there for work or other circumstances or because that's where you've always been (which there's nothing wrong with either of these reasons) - then you know the sense of happiness, sense of freedom and unique sense of connection to the location it brings you. I've been lucky enough to do it twice in my life. The first time was my move to Denver right after I graduated college. It was the best decision I had ever made as a young adult. I had $2,000 to my name, just finished college, dropped everything and moved. I learned what it was like to live on my own and be a fully fledged adult where I had only myself and my close friend to rely on. I learned how to cook for one (it's not easy), how I like to spend my fledging adult mornings in my new place (with quiet and coffee, sitting on the roof looking over the pool), and I learned what it truly meant to stand on my own two feet. I met Mike there. We bought our first house and adopted our first dog there. We had Camden there.

The second time was this move to Austin. A fantastic work opportunity for Mike moved us to San Jose. One could argue that we "chose" to go there and so it's the same thing. In my eyes, it's not really. The choice was to work for a company who happened to be located in the bay area. If that company were located elsewhere, we would have ended up elsewhere. So to me the location was an add-on. Austin on the other hand, was chosen after months of research by both Mike and myself - chosen as a future location for us to put down roots and raise the boys. The beliefs, culture, life approach, schools, cost of living, space ... it all very much appealed to the direction we wanted to take our life ... in a few years.

And then our current circumstances changed dramatically. At first all I wanted to do was run home to San Diego to be closer to my mom. I was terrified and I didn't know how we could keep everything running without her. How were we supposed to manage everyday life with a newborn and a toddler and everything that comes along with that as well as my insanely crazy slurry of medical appointments AT THE SAME TIME. Not possible without momma within a 20 mile radius.

And then more and more days slowly passed and we got a tiny bit farther down the road of treatment and learning to live with this on our plate. Medical teams were established, progress was being made ... we were starting to breathe a little. We started considering where to move once more. I could drag you through the him'n'n'hawing and highly emotionally charged conversations Mike and I went through to even get some tiny bit of semblance of a sense of direction (let alone the turmoil to actually pull the trigger on a decision), but I will spare you the fuss and pull you forward instead. In the end, we chose to move forward with our life plans to make our home, our life, where we wanted to, without other influences. Austin happened to still be the best option for what we wanted all around. Yes, it lacks any family in the area, but it puts us in the middle between my mom and sister and actually closer to Colorado where Mike's mom is. It also puts us within 3 driving hours to MD Anderson ... a nice perk. There are wonderful schools for the neighborhood we chose and all of the other reasons I've already mentioned are still a factor. We even have friends who - moving for similar life reasons from southern California - are right around the block coincidentally. It the end, it still made sense, when everything else certainly wasn't.

It's been a month now in the new house and it certainly has been a whirlwind. We're 99% unpacked and established in the house. The boys and Haley have adjusted. We've found a pre-school for Camden and even a babysitter (which we didn't have in the entire 3 years in San Jose because I'm ... well ... me). I'm even driving without GPS already ... for the most part. We've had a water gun fight, been to the children's museum, set off our own fireworks, have had landscaping quotes (painful), pool quotes (more painful), rain gutter quotes, painting quotes, and numerous other vendors parade through here as well. Camden also started his first fire (you don't want to know) and now we own a fire extinguisher. In the midst of all of this, I've also established care at a new oncology office and have picked up treatment right where we left off.

Since San Jose, I completed one more 100 mg cycle of Ibrance and letrozole (cycle 3), am in the final week of 75 mg Ibrance and letrozole (cycle 4 / 1st cycle on dose reduction because my neutrophils were too low at the end of cycle 3), have had an MRI of my left femur, right hip and C3, and have had another injection of Xgeva. We left San Jose shortly after completing the cyber knife procedure to my brain, but follow up for that isn't happening until August. My new oncologist also strongly recommends I have my ovaries removed because I'm still not remaining clinically suppressed and my estrogen levels are pre- to peri-menopausal. She strongly believes this is one of the best things I can do for treatment above all else. She made the case that she would hate to have to make the decision that I would have to be switched off a new, revolutionary drug, like Ibrance, that I'm tolerating really well aside from neutrophil counts, because I'm having progression, and it's unclear if that progression is from failed ovarian suppression or because Ibrance isn't effective. So out they must go. I had the consult today with the gyn who will be doing the surgery and it was an emotionally difficult consult to say the least.

The MRI of my left proximal femur revealed that 100% of the marrow space is being taken up by the tumor. I have no pain thankfully and thankfully it's contained in the marrow space still. Docs say I am at risk for a pathological fracture and because of where the tumor is located on my femur - which is the little diagonal bone on the top that links into your hip - that if it does fracture, I'd most likely have to have a hip replacement. So ... radiation starts on Thursday this week, 10 sessions like before. Most likely after that, if my neutrophils are high enough, my oophorectomy surgery will follow, anticipating the first Wednesday in August (evidently the gynecologist only does surgery on Wednesday ... kinda like our neighbors who do pizza on Fridays ... it all makes sense).

But let's talk about this radiation decision for a moment. My scan also showed activity in my right iliac and if you remember, we treated my left iliac because I was having pain there. I currently don't have pain in my right iliac. However, I wanted to be pro-active and wanted to radiate my right side since I'd be coming in for treatment anyway to my left femur and I'd rather not wait until I have symptoms, because to me, that is too late. I posed this as a question/please weigh-in scenario to one of my mets Facebook groups and the feedback I received was interesting. What those more experienced with mets than I recommended - was that I don't radiate my right iliac if I'm not having pain. They said that it's better to save that treatment until I have pain or really need it. Because there's a lifetime limit on how much radiation one can have, they are advising to save it. They've planned for the worst and they are advising me to do the same, just in case. My optimistic nature drives me to move forward and tackle it all now, be proactive, use the resources I have at hand now, to eradicate the cancer that exists now ... not future cancer that may or may not exist. I am optimistic that I'm going to continue to respond very well to the current treatment and that I will have a very, very, very long time where we don't see any progression or change. But perhaps they're right - that despite my optimism, I should temper in some caution ... just in case. So I've opted to radiate just my left femur ... for now.

In the mean time ... we continue on ... we go forward and meet our vida loca head on ... business as usual. We go on, making our home ... growing our roots in Austin, living our life, a life we chose.