Hello friends and family,

I apologize for being off the grid for a while. This "stay at home" order makes us busier than we ever used to be and with zero screen time when the kids are awake, it leaves a LOT to get done after they go to bed...

Radiation: I don't think I ever posted about the beginning of radiation. This was an interesting and very humbling experience. 3 weeks after my surgery, I went in to get "fitted" for my radiation pillow. I had to fight to get my arms over my head. This was the position I would be in for about 45 minutes while they took multiple measurements and x-rays to line up the lasers with the tattoos that they placed on my chest and my underarm the day before. The actual procedure, once they lined you up, took about 8 minutes. I had to do a breath hold in order to bring my heart away from the radiation lasers. During the breath holds, the radiation would begin on 4 different parts of my chest. This process often brought up immense feelings of humility. The thought that, not so long ago, someone with breast cancer would not have had the option for such a targeted therapy made me feel incredibly lucky.

Now, I have finished 25 rounds of radiation to my chest and lymph node area. My skin held up very well. During my Wednesday "doctor days", I was always told that my skin looked amazing for how many rounds I had. I still have some blotchiness on my back but by applying lotion a couple of times a day and staying out of the sun, it should heal quickly. 

As of my 25th day of radiation, I still was unsure about my decision to do the double mastectomy or not. If I was not going to do it, the radiation oncologist wanted to do a "boost" of radiation which was basically another 4 rounds, directly to the breast, not the lymph node area. I left my 25th session telling the lady who checks my temp that I might see her tomorrow, I might not. She stopped me and asked me why and I let her know that I had been contemplating the double mastectomy but really could not make a decision. All of my doctors were telling me that it was not medically necessary for me to get a double mastectomy. After all of my chemo followed by surgery and radiation, the chance of reoccurrence would be down to 5% after a double mastectomy, possibly 3-5%. Basically it came down to my own personal fears of the future and constantly looking over my shoulder, waiting for cancer to strike again. As I walked out of radiation that day, Carol, the lady who took my temperature every morning, talked me through her double mastectomy 25 years ago. Even with a horrible infection that left her in the hospital for 5 days, she still would not change a thing. The peace of mind that the surgery gave her was worth it. As we were talking, I said "I am not sure if I would regret getting the mastectomy, but I know that I could regret not doing it." She said, "well, Amy, I think you answered your own question". She was right. When Josh and I met with the surgeon later that day, I was basically waiting for him to give me a reason not to do it. Of course, he did not do that. He gave me a few options that would be best for my body and I decided to go forward with my decision. I did not go to radiation the next day.

The surgeon mentioned that my skin looked so good that he was willing to do the surgery in just a couple of months. Unfortunately, with starting the oral chemo pill, which slows healing, it is not recommended that I get the surgery until after I have completed my final step in chemotherapy. 

Yesterday, Josh and I met with the oncologist to talk about the next steps. She gave the OK to start the oral chemo. It comes from a special pharmacy in California right to my doorstep. She said I most likely wouldn't receive it until the end of next week. This was disappointing to me. I was so ready to just get on with the next step. Tonight, I got the phone call from the pharmacist who is sending it to me and she went over all of the details and it will be here by this Monday! I will be taking 3300 mg of Capecitabine every day for 14 days followed by 7 days off. This 21 day cycle will go on for 18-24 weeks depending on how my body handles it. The main side effects are nausea and diarrhea and I will have meds for this. Supposedly hair loss is pretty minimal, if at all. After this, I will make my appointment for my double mastectomy. 

I have also been asked to take part in an immuno-therapy study. Basically, there has been a lot of research on immuno-therapy's success for many cancers. However, it has not been successful with ERPR positive breast cancer. There is no research on immuno-therapy for triple negative breast cancer which we know is a more aggressive form of breast cancer. They want to see if immuno-therapy could be successful in treating triple negative. This would be another year of my life. It would not change the timeline of the surgery. I would start the immuno-therapy after I finished the oral chemo pill. It would be every three weeks, and I would receive it intervenously. Again, fatigue is the biggest side effect. The idea is that immuno-therapy unmasks cancer cells that are masquerading as healthy cells. As a trial, there is no guarantee that this is improving my chances but who knows. Just another thing to think about and consider. 

That is all for now! I have been feeling a bit fatigued but other than that, very very good considering everything. I have still been able to exercise, play with my kids, get my master's, start my internship and role with whatever comes next. 

Thank you for continued support and prayers. I will try to be better about keeping in touch.