What If's

It's been an interesting week..... I have spent a lot of my time figuring out how to get close to death but not die yet be ready nonetheless. Confused? So am I.

I finalized and signed all my updated legal documents on Monday. Ironically, the last time I had attended to my legal matters was before I left for Seattle for my bone marrow transplant, all those years ago. While a somber task, I am glad to be legally ready for the possibility of my incapacitation or death.

Tuesday was doctor day. First I met with my surgeon. She was able to give me the go ahead to begin chemo. It is very odd to be so happy to receive clearance to get poisoned. It was, however, extremely gratifying to know that finally I have made the progress needed to be ready to move to the next phase of treatment. And a personal shout-out to my surgeon and her team: You are the best! I am not sure if I can name my surgeon here but friends, should you or someone you know ever need a breast surgeon, please give me the opportunity to make the referral. They never gave up on me and really listened to my desire to go the distance to keep my implants all while achieving the optimal outcome in completing the surgical portion of my cancer treatment. Incredible team!

I left the surgeon's office and went straight to the breast cancer chemo oncologist. She agreed it is time to move forward. So there was lots of discussion about the type of chemo (more on that later) and pertinent details. I left overwhelmed but ready to get going and fight!

Then there was the ordeal of the insurance company approving my white blood cell count boosting medication. So the plan to start chemo on Thursday started to look challenging. To be honest, I had a bit of a problem understanding why a request for prior authorization for the medication had not already been submitted. It turned into a minor detailing a few hours later .......

At 6:00pm Tuesday night, my chemo oncologist called. She discussed at length a HUGE problem with the regimen I need to best fight my cancer. Essentially it could kill me and kill me quickly due to a total toxicity from receiving it for my original breast cancer, during transplant preparation, and then again now. So what if I take it and end up in that group? Once you start, there is no turning back.

There really wasn't a firm Plan B offered and regardless Plan B would not be what I really need to best fight my cancer. So I asked what will kill me more quickly: the potential AML (Leukemia) from Plan A regimen or breast cancer if Plan B does not work? The emphatic answer was the potential consequence of Plan A. Oh, and the doctor needed an answer by Wednesday.

I am fortunate that I have some pretty terrific people in my life that I was able to talk to, consult, and brain storm with. By Wednesday morning, I had decided to not use Cytoxan, Plan A. I didn't fight this hard to survive leukemia already to turn around and roll the dice of bringing it back in my life, and to let it kill me. And if I were to develop AML, I would die very quickly, as in weeks. Nope, I'm playing a long game, slow and steady. I am aware that I am losing efficacy and that PLan B may not work. It is not designed for my situation.

So when my oncologist called for my answer one Wednesday, I was ready. I had weighed the "What Ifs" and decided no on more Cytoxan. She had also consulted with some other breast oncologists and those familiar with my transplant background and she and her colleagues had decided that Plan A was too risky. So ultimately the decision making was taken from me. It was no longer up to me if I wanted to worry about the "What Ifs".

So if you've stuck with me this far, during this very long post, thank you. Today, Thursday, at 8:30am, I finally move forward to the next phase and one step closer to being well again. It will be a brutal regimen: every Thursday for 18 weeks. But I've done bigger and badder chemo so I can do this too. Bring it.