What Do I Know?

Over the past week I’ve been working on a new blog post, but then new information arises, things change, and what I’ve been writing becomes inaccurate or just plain wrong. Color me deleting and starting over so often that it could be humorous if I didn’t find it just plain annoying.  

You might recall that at my first oncology consultation back in August, I signed a written consent to have blood drawn and testing done for a panel of the eleven most common genetic mutations that increase risk of breast cancer. On that day it was explained to me that the blood panel would be run, and when I met with the genetic counselor, I would receive results.

Originally and unhelpfully scheduled for February, the genetic counseling appointment was moved up by four months and occurred on Thursday, October 3. The genetic counselor’s name was Lauren, and she was young and engaging and excellent at explaining things. She delivered the news that BCBS had not yet reversed its denial of my genetic testing panel, though I more than met national standards for coverage. “I’ll be submitting a letter of appeal today,” she reassured me, “and it will contain all necessary evidence for Blue Cross to approve the testing.”  

I also learned that the insurance denial had quashed processing of the lab work. There were no results waiting for me—the tube of blood had not been tested. Lauren said it would likely take ten to fourteen days for the insurance company to reverse its decision, plus another few weeks for testing to be completed and results to post to my medical record.

But that’s not what happened.

Two evenings ago, Friday, October 11, I received a text message informing me that new lab results were available. Weird. All my pre-chemo labs had resulted quickly last Monday. I logged into MyChart to discover that there were no mutations of my BRCA1 and BRCA2 genes. I concluded that Blue Cross had swiftly sanctioned my genetic testing and that perhaps the turbo button had been pressed on a machine deep in some laboratory. Other items in the panel were listed as pending, and a few moments later Dr. Beckwith sent a message saying she was happy to report the BRCA portion of my genetic testing was negative, and that she expected the remainder of the results within a week.

The distressing effects of Hurricane Helene did not pass over the waiting room of Masonic Cancer Center. I’d been called last Sunday and told I would have labs drawn and see my provider as scheduled on Monday, October 7, but due to nationwide IV fluid shortages and uncertainty of when shipments might arrive, I should be prepared to be rescheduled for chemo. I did end up receiving chemo that day, but observed, heart wrenchingly, many patients being called to have their ports de-accessed and heading home to await rescheduling.

The side effects of my first infusion of THP were far milder than those of the two rounds of TCHP I’d received. Because the drug Taxol (paclitaxel) was new to me, several pre-chemo medications were given to diminish any adverse reactions that might occur. This defensive cocktail left me feeling drugged, drowsy, restless, and agitated—a strange, unpleasant mishmash of feelings. Aside from a headache that almost never went away, that was probably the worst I felt all week. In the ensuing days there were no mouth sores, no nausea, no outbreaks of acne, no torrents of diarrhea. I was able to eat and drink, did not require any additional IV fluids, and my weight remained stable. Though my hemoglobin and hematocrit have sunk further into anemia, my white counts, hepatic function, and chemistries are largely normal.

Per external measurement, the tumors continue to shrink. Six weeks ago, the palpated mass of three tumors was firm and measured 9 x 6 cm; three weeks ago, it was softer and 6 x 4 cm; last Monday, 4 x 3.5 cm and very soft. Rationally or irrationally, I wonder if this less ruthless-feeling THP chemo will kill cancer cells as effectively as its callous TCHP cousin. Time will tell, and a follow-up breast MRI is scheduled for mid-November. Dr. Hui’s nurse called last week and said with the new chemo ending six weeks earlier than the original regimen, my surgery would now be planned for the second or third week of December. I will see Dr. Hui again in November after the MRI.

Vivid aurora displays lit up the skies several nights last week, providing hours of marvel and wonder . . . and a mystery. At an undeveloped area of shoreline located a few hundred yards from our property, a disquieting distraction developed. Two loud kerplunk-type splashes came from the darkness—each sounding as if someone had heaved a bowling ball or heavy stone into the water. This was no slap of a beaver tail nor plop of a fish, and my lizard brain prompted me to cut short my skygazing and hasten back indoors. When I heard the same thing a second evening, a trail camera went into my Amazon cart and was purchased. Stay tuned for treatment updates and to learn if Bigfoot really does exist.