Good Evening wonderful family and friends.

A bit of an update for all of you. 

April came with some appointments and a trip to Madison and then a video call with Madison, Gundersen appointments and various activities. After Becky was done with the antibiotic for her infections she was still feeling run down and had some back pain so her primary doctor put her on a strong antibiotic after running some lab work and getting a CT scan to see if there was a kidney stone. There wasn't so we were in the clear there. She had another CT chest, abdomen, and pelvis to see if any more Cancer had shown up and to look at a few things that showed up on her PET scan she had before she went into the Hospital. The CT scan came back showing that she still has a small bit of fluid collection from where her lung was removed but the doctors do not seem to worried about it as they say "It will be reabsorbed into your body."

When we went down to Madison we met with the Head of the Melanoma Oncology team and really really liked the doctor. We were presented with immunotherapy, close PET/CT scan follow up for the next 5 years post surgery, and a team who wont stop until she tells them too. The immunotherapy that they presented us with was different than what Gundersen did. So we did some research and asked lots of different questions about each different medication and pros/cons of each one. They answered each and every question even a couple of times to make sure we understood all of the information we were given. In the end we choose to go with the medication Madison presented us with but that is where we came into a dilemma. If we wanted to go with that medication that meant we would be driving down to Madison every 28 days for a whole year. Yes, I know that doesn't seem like it's that big of a deal but it would've been pretty close to a 11 hour day when all was said and done. Not knowing how treatment's would make Mom feel afterwards and not sure a car ride would be comfortable we asked if the Doctor at Madison could prescribe it down at Gundersen. He could not because he doesn't have privilege's there but he does know a great doctor that works at Gundersen who actually did his internship with him at Madison. So he put in a referral to Dr. Oettel at Gundersen and all of his recommendations were sent there as well. The doctor at Madison is still going to be part of our team just not the one we see every month. He told us to give him a call anytime we have questions or concerns and he will help to the best of his ability's and be available to the Gundersen team anytime they need him. All this meant that we now needed to get Gundersen on board with what was being requested. We had even talked about that if it wasn't able to happen at Gundersen that we would make the drive to Madison as we really feel this medication is the one she is suppose to be on. Thank goodness Gundersen was on board and willing to listen to what Madison was referring and willing to go with this plan. We met Dr. Oettel on Tuesday of this week and surprise we had her first treatment today. 

Her treatment plan. We are going with a medication called Nivolumab - Nivo for short. She will have 1 treatment every 28 days for the next year. So 1 treatment down 11 to go. This is to help boost her immune system to fight any hiding cancer or any that try to start growing both inside and outside her body. The side effects are low but can include - rash, bronchitis, sore joints and some other ones. Some major ones would be that just while she is on the treatment blood sugar issues or kidney issues but they don't happen often. They will draw blood work before each treatment and if labs are off or she isn't feeling while they will hold off treatment and prescribe a steroid. The biggest change that we weren't aware off but we both agree would be the best idea is that she will be getting a port later this month. The port will sit under her skin on the left side by her collar bone. It will make getting blood draws, any Imaging that needs contrast and her medication way easier than trying to find a vain to start an IV each time. It was a bit of a shock to Becky at first but the more we talk about it the better she feels about it. The port will stay in for as long as we need. The other piece of PET/CT Scan will be a lot longer than the Medication. For the first year she will get one every 3 months. The second year it will be every 4 months, and then years three/four/five will be every 6 months and then once a year there on out. This treatment plan is only in place unless a scan shows something has popped up then they will figure out a new plan and what the next steps are. 

Extra information we learned and feel we should share. Her cancer is considered stage 4. This stage means that the cancer has spread to other organs or parts of the body. It may also be called advanced or metastatic cancer. The medication she is on has been tested on all 4 stages of her cancer which is why we wanted to go with that one. We also had the option to do nothing and waiting and seeing if it comes back which is something we didn't want to do since the cancer has shown to have come back a couple of different times. Without the medication she would have a 2 out of 3 chance it will come back. With the treatments she has a 1 out of 4 chance that it will come back. We liked her odds better with doing treatments. All the doctors are positive that she will live a long life and that she WILL DIE OF OLD AGE!! 

We continue to be blessed by all the prayers and people checking in and offers to help in anyway. Please keep praying for her health and the worry of another minor surgery for her port being placed. We have been and will continue to take each day one at a time and one step in front of the other. Thank you for walking along side us during this journey.