Hello everyone -

Hopefully you are all safe and well and finding ways to entertain yourselves at home as we move into this holiday season and see spikes in COVID cases across the country.

Like for many of you, it's been a long month. My appointment last week to the doctor was fine, but most of them are fine. The appointment consists of my sharing any side effects and then looking at my immediate blood work numbers. My neutrophil count bounced back up above 1 which is good. It's not clear why it dipped last month. These appointments in between scans have been pretty uneventful.

Some of my blood work results come back right away, they process them immediately over at the hospital (next door) and I have initial results within 10 minutes or so. A few more results trickle in within 24 hours and my tumor marker numbers (CA 27-29) don't come back for ~3 days. I learned this is because they don't process those here, they send them to the Mayo Clinic (Cathy!). The nurse told me a courier comes at the end of each day and they fly the samples to Minneapolis that evening. Apparently there has been some delay and change in flight schedules since the pandemic hit. I haven't noticed a change in when the results come back. It was interesting to learn all of this.

Speaking of tumor marker numbers, unfortunately I had a big spike in the value this month. I jumped 12 points higher (below 38 "normal", no MBC, my initial value was 122; dropped to a low of 42 in February, has been slowly rising and is now back up to 72). I feel like they've been relatively reliable for me - that's not the case for everyone. I'm actually hoping that they are NOT reliable for me now. Anyway, I will have another CT scan and bone scan next month and then we will see what those show. If there is progression then that means that the medication is not being as effective and there will be a conversation about what next.

My persistent headache went away abut a week before my appointment. I've had some aches and slight discomfort intermittently here and there (ribs, shoulder blade, hips). Recently there has been some discomfort in my mouth (one of the side effects are sores in your mouth). I have my continual dance with my GI system balancing medications and food and water (I know any of you on medications can relate to that). My skin is really dry a lot and sometimes I really feel like all the medication is taking a toll physically on me. Ever look in the mirror and think 'Who is that staring back at me?'

All this being said, I feel pretty good physically. I still walk 4-5 miles a day, cook, am working, helping kids with school and life. As Glen says, we are playing the long game so we have to continually look at the bigger picture and have an overall plan and strategy for dealing with this. We talk a lot about the future (post pandemic) and even retirement. We are all aching to travel again and see people. With time it will come.

Please be well, stay safe and continue to think of others during this pandemic. Until we all come together we're going to play wack-a-mole and damage so much of our mental health and society.

We will give thanks this year for so much - family, friends, we live in a beautiful place and have access to outdoors, the fact that we are still working, and science. Much love to you all.