Boring little update.

Boring is good.  I continued to feel moderately icky through the weekend, but was basically back to what I think of as my current baseline (weak and easily tired out, but not feeling "ill") when I woke up yesterday morning.  Now that I know when the nausea is likely to hit I'll take the meds a few hours earlier in the day next time, which should help prevent it entirely.  

I'm continuing on the sloooow taper of prednisone.  I'm down to 10mg this week, and will drop to 5mg on Friday, and then be entirely off of it by the end of next week.  And then I'll probably start on the decadron again for a day or two after infusions.  

I don't expect that I'll start to feel sick from the chemo again until I have my next infusion a week from tomorrow, so I should be in reasonably good shape for Thanksgiving, which I am thankful for.  (See what I did there?)  We'll be attending a potluck dinner hosted by friends here in Oakland and I'm looking forward to it.  

Tomorrow I've got a checkin with the oncologist to fill her in on how I did this time and then a consult with the gyno surgeon. 

Mentally/psychologically things have loosened up for me a little bit.  For a long time I haven't been able to read the way I would like to, and that's been frustrating.  My mind would just wander, and usually wander into some dark places it didn't really need to go.  I've been spending a ridiculous amount of time playing solitaire games on my phone instead.  It's distracting enough that I don't think about other stuff, but lightweight enough that I can do it and stay occupied when I'm feeling sick or tired. 

It's been nice to get back to reading fiction this week.  I finished the book club book (The Aviary by Kathleen O'Dell) and am reading some other YA stuff for now.  I might dive back into the deeper end of the pool in the next couple of weeks.  

On the projects front I've made small progress - I started to build out a website for the wedding, found somebody to do the flowers, and we think we've found food we like, although the guy hasn't responded to my question about a contract.  But he also seems to just not check email very often.  There's plenty of time to go a different direction if he flakes out in the next couple of weeks.  

On the PMP front, all I have accomplished was finally unpacking all of my books from when we moved 18 months ago.  The PMP books were literally in the very last box.  But now I have all my cookbooks too, and I did a big purge of old tech books that are going straight to recycling and have another box to go to Goodwill.  So actually I suppose that was quite a bit given my current energy levels.

 

Patterns start to emerge.

I slept in again this morning, and was a little hungry.  I ate a fairly sizable breakfast and then was a mix of tired/slightly nauseated/not hungry for most of the day.  I ate a cereal bar around 2, and then started really feeling sick around 5.  Basically the same as yesterday.  I took a zofran and about an hour later was able to eat dinner. 

The hardest thing is really getting in enough liquids.  I'm supposed to be drinking a massive amount of water, but then drinking when I'm not really thirsty makes my stomach uncomfortably full and that triggers the nausea too.  So I'm trying to remember to keep a drink at hand whenever I'm awake and just take a few sips every few minutes.  And I'm having the same problem bending over that I did at JavaOne this year - I discovered that when I attempted to load a couple of things in the dishwasher tonight.   It looks like Bob's going to be stuck with kitchen cleanup for a while. 

I'm feeling the neulasta now too - deep achy feeling in my thighs and pelvis.  I have no idea how long that's supposed to last or if it's going to get worse.  They said I can take alleve or ibuprofen for it, but those both mess my stomach up, so I'm staying away for as long as possible.  

Having said all that, I'm nowhere close to miserable.  Mostly I'm just really tired.  I've got a few good hours a day where I can have a conversation like a normal person or do a puzzle while listening to a podcast.  Then I start spacing out and it's time for another nap. 

So far, so good.

I slept pretty well and slept in a couple hours past my usual time, made my breakfast smoothie (yogurt, egg based protein powder, coconut water, and frozen strawberries today) which went down fine.  I felt good enough to drive myself to the doc for my neulasta shot. 

Apparently Thursdays are old people days at the clinic.  Standing room only in the waiting room and it took about half an hour before Anne had time to give me the shot.  Everyone there had a caregiver, and I'd say at least half of them had some kind of dementia based on the conversations I was hearing.  Maybe they try to do them all at once? It was odd.  Yesterday there was one other guy in the waiting room and we got a private room for my infusion. 

Now I'm home and feeling a little light headed and sleepy.  Not quite nausea, but I can see it from here.  I'm going to try to get  down another 20 ounces of water and something light for lunch and take a nap. 

One AC down, three to go.

I went and did my bloodwork yesterday and that all came back fine so I started the next chemo sequence today.  It is so nice to be doing it ten minutes from home instead of two hours.  Also nice to be able to park right in front of the building instead of waiting ten minutes for a shuttle to take me from the parking structure to the hospital (Stanford is building a new hospital and the parking is totally screwed up). 

I also spent less time there today because I did the blood draw yesterday - at Stanford I would go, do the blood draw, sit for an hour while they got the results back from the lab, and then start the infusion.  This time the labwork was done and I just walked in and they had me plugged in to the machine and starting pre-meds within a few minutes.  We were there just about 2.5 hours and were back home by 4pm. 

I'm still on the prednisone so they didn't give me any other steroids today.  So I started with two different anti-nausea meds (which I've now forgotten the names of, I'll write it down tomorrow when I go back in) which according to the nurse, should be good for a couple of days, and then I'll start to feel barfy sometime Friday or Saturday, at which point I start taking the Zofran I have.  Those took about an hour and then she set up the Cytoxin to go for an hour, and then when that was done she just did a straight push into my port for the Adriamycin, which took about five minutes.  The Adriamycin is a really bright red and turns urine red for a day.  Fun side effect.  And it kicks in fast - I had to pee when I got home and it was already pink, only 30 minutes after she pushed it.  Weird.

I go back tomorrow for a shot of Neulasta which stimulates bone marrow to make more white blood cells to fight infection.

So the regimen I'm on now requires a different set of supplements and followup medications, and a totally different set of side effects and warning signs that something's gone wrong.  If I develop a fever over 100 I have to call the oncologist and head to the emergency room.  The Adriamycin damages the heart, which is why I had to have to ECGs, mostly so we have  baseline after this is over to see what kind of damage is done.  The damage is cumulative based on dose, so there's a lifetime cap on how much you can take, and I think I'm getting the maximum amount over these four infusions.  Other fun things to look for are bowel infections, and painful swelling and redness in the hands and feet, vomiting, and fatigue.  That's just the one drug.

Cytoxin is itself carcinogenic and includes leukemia as one of its side effects.  Are we having fun yet?   Also, hemorrhagic cystitis because it's toxic to the lining of the bladder.  So red pee is good for the first 48 hours, bad any time after that.  I'm supposed to drink at least 80 oz per day for the next 72 hours to clear the stuff out of my system and make sure it doesn't sit too long in my bladder.  It also suppresses the immune system and can cause mouth sores and joint pain, vomiting, and fatigue.

Neulasta causes bone pain, joint pain, vomiting, and fatigue. 

There seems to be a pattern there. 

I'm feeling a little sleepy but otherwise OK now, and I expect to spend a good chunk of the next few days in bed.

In other side effect news, the neuropathy from the taxol seems to be getting a little better in my hands.  I still feel it, but not nearly as much.  My feet are still a mess though, and it's worse when they are cold.  At best it's like walking around with feet that are asleep, and even my softest cashmere socks feel like sandpaper.  At worst, when it's cold, it's like they've turned into bricks.  I can't feel anything at all, and that's pretty scary.  It should get better, but it makes walking really uncomfortable and something that I have to pay full attention to.  Unfamiliar stairs are downright terrifying.  I cannot afford another fall/sprained ankle/broken whatever.  

That's it for now.  I'm off to eat some really bland lasagna from Trader Joe's for dinner and watch something terrible on television before bed. 

Starting chemo again on Wednesday...

..and not a minute too soon - the thing is growing again.

This week of medical crap includes an echocardiogram on Monday, and I'll talk to the cardiologist about the fact that my grandmother was treated for tachycardia for years (I had no idea until a couple of days ago), so it looks like this might just be a coincidence and they found it now because of my hospital stay.

Tuesday I go in for my bloodwork.  Wednesday is chemo.  Thursday I go back for a Neulasta shot to stimulate white blood cells.

Bob's going to go to chemo with me, and Cait's going to babysit me Wednesday night while he goes to a JUG meeting, and then Elise is going to hang out with me on Friday while he works a football game.  

Another loooong day at Stanford.

I'm kind of annoyed.  So far the biopsy from Monday is inconclusive.  Also, when I walked into the pulmonary clinic this morning the doc said he got a call from the lab today to let him know that my influenza finding from the broncosopy was a false positive.  WTF?  Also, the TB test they did was only for active TB, so the inconclusive thing in my lung could still be TB (there are millions of carriers who never convert to active).  My last skin test for it was years ago when I was teaching, and I've done a lot of travel to places where I'd be more likely to pick it up since then (India, Russia, Morocco).  Nobody's asked me to do a skin test yet, and I didn't think to ask for it today either.  I may just do a walk in appointment with my GP and get that done. 

On the plus side, everybody thinks my lungs are doing much better, and I get to step down to 15mg of prednisone tomorrow, then 10 next week, and then 5 after that.  So I guess I can expect to be a smidge more tired again this weekend, although I think that might be balanced out now by the fact that I'm a month out of my last chemo and my lungs are better.  Who knows?  At this point I feel like I need to take every prediction with a grain of salt, even my own. 

After that appointment, I ducked out and went to the office to attend the luncheon with a bunch of executives in our division for the five of us who won the "Marketing Excellence Award" this quarter.  I'm glad I did, there were twelve of us in the room - a mix of the winners and a bunch of the senior executives in marketing. It was actually quite casual and the CMO happened to sit next to me, and we had a nice chat.  Good stuff on the career front, even if I'm not actually working.

After lunch I went back down to Stanford for a pulmonary function test.  The first thing they did was do an arterial blood draw from my wrist - that was a new one for me.  She numbed me up a bit with lidocaine.  It didn't quite kill the pain, but it was tolerable, and then she went into my right wrist with a longer needle than usual to draw blood - the idea being that this was the first stop after my lungs and they would test for blood gasses.

Then she had me do a series of tests where I breathed normally and then inhaled or exhaled faster/slower/more completely into a contraption while wearing a noseclip.  The good news there is that all of my lung functions were completely normal, except (I think) total capacity.  She said that was at 74% of what they would expect, but it could be explained by my weight which could be restricting expansion.  But everything else was perfectly fine, which means I'm safe to exercise and undergo anesthesia and all that good stuff in the future.

I just sent a note off to Dr. W (oncologist at Alta Bates) to let her know and see if she wants to officially greenlight chemo on Wednesday.  I should know tomorrow.  

Nothing else going on until my ECG on Monday.  

Much much much better today.

No pain meds, it's just a slight dull ache now and a little itchy where they did the initial poke in my skin, but I think I'm responding to the dressing not the wound itself.  I don't think I could find the actual puncture mark if there wasn't a giant black X scrawled in sharpie over it on my chest. 

So the biopsy was on Monday.  Yesterday a very stoned Sonya and a very sober Bob went to the second plastic surgery consultant.  She was really great, but she doesn't do the diep flap.  So we talked about what she would recommend for me, and she agreed that she thinks that the diep flap is the best option for me, if we can find someone who will take me as a patient.  She gave me a referral to the expert at UCSF who has done several hundred of these.  The issue is my size - a heavier person is the best candidate for this surgery but not toooooo heavy, and I'm right over the border. 

I asked her what the reasoning is and basically it comes down to blood supply to the tissue, but she thinks the expert guy would take me because I'm very well proportioned for my size, and apparently my skin is in great shape and a scar as minimally as she's ever seen on a patient.  If I carried most of my extra weight on my waist it would never happen. 

The other thing she said was that she doesn't recommend doing the mastectomy and reconstruction in one go.  Lots of people do it, but like the immediate lumpectomy or mastectomy for people who just found the tumor - it actually increases your chances of dying.  But people do it and doctors support it for psychological reasons.  Which I get. 

But can I, personally, live without boobs for a couple of months?  Yes.  And if I can't, this is why Gawd made Xanax.  Seriously. 

So I've got the number for the guy at UCSF and will call him in the morning and see if I can get an appointment.  If he'll do the diep flap, that's the route we'll take. If not, I'll do the lat flap (where they pull the latissmus muscles around from the back to the front) with Doctor Hobson.  It's a plan.  She was really awesome.  She's had breast cancer herself.  I asked her who did her reconstruction and she started laughing and said "who has time for that?"  It's been five years. 


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This morning I went to see Wexler at Alta Bates about starting AC.  She changed things up a bit.  Some new data has come in about doing dense dose being superior, especially in patients like me who advanced really well with taxol.  This means that under the assumption that whatever comes back from the lab about my lung node (tomorrow, I hope) doesn't delay treatment, I'll be starting AC on Wednesday 11/20 at 1pm.  And I'll do it every other Wednesday for four treatments, which puts the last one on New Year's Day.  Which I'm sure they won't do, but I think bumping it back to NYE would actually be an awesome (although very low key) way to end the year.  Because my pulse and blood pressure are still all over the map I have to get a new echocardiogram on Monday. 

Tomorrow I see the pulmonary people at Stanford for what should be the last time unless I need something major done with my lung.  I expect they will tell me to step down to 10 mg of prednisone (I'm on 20 now, down from 40 when we started) for a week or two , and then five for a week or two after that.  And then I can give all the O2 equipment back. 

After I get my lungs checked out I'm stopping off at the office to have lunch with the CMO of the company since I won our equivalent of employee of the month for marketing (-ish - I think there are five winners every quarter)  Anyway, it's an opportunity to get face time with executives who don't know who I am today.  So as long as I'm still feeling good, I'll be there.  And they'll remember the bald lady for sure. 

Friday I have no medical stuff!  It's a miracle.  But I'm having lunch with Mo and we'll start planning out the lotsa helping hands site stuff for real, because now we're getting to where I'm really going to need it. 

The biopsy didn't go as planned, but it went.

The lung nodule biopsy that I wasn't scared of?  Shoulda been scared.  It was yesterday, and it was pretty miserable. 

I was told no food or water after 6am, and to be there at noon to check in and prep for a 1:30 procedure which should take about 30 minutes, and then I would be there for another four hours in recovery because they take two x-rays three hours apart to confirm that my lung wasn't leaking air into my chest cavity/collapsing (pneumothorax).   As part of the procedure consent forms you have to sign a consent for a chest tube and overnight hospitalization in case you get a bad pneumothorax, which does happen in 40% of patients.  Spoiler alert:  I got a pneumothorax (that is really fun to type), which hurts like hell but I did not require a chest tube and did get to come home last night. 

Sooooo.  I got up at 5:15 to give myself enough time to eat breakfast and drink a whole bunch of water.  We left home at 10:45 and checked in right at noon.  One of the CT scanners broke and so of course there was a delay.  They finally brought me in to start my procedure at 2:30.  I was told to expect about 15 minutes of prep and then about 15 minutes with the needle actually in me.

They decided to go in through the front.  I had to be awake for the procedure so I could follow commands as they moved me in and out of the scanner to position the needle correctly.  They rolled me in there, got me on the table, set up the IV but didn't start anything other than saline, and then did an initial scan to locate the mass and choose their entry point.  As that was happening I heard somebody say "oh shit" and a whole lot of commotion, but nobody came into the room for a while.  The nodule was 1cm on the scan from 10/21.  It was 7mm yesterday.  I've had no chemo since 10/21, so yay!  Not a tumor! 

But the doc says that's a really small target and he's not sure it's worth the risk of pneumothorax because he's not confident he can hit it.  So he called Dr. T, the oncologist, and she said she felt it's worth the risk because we need to know what it is before we knock my immune system down again with the AC and the other option is actual surgery.  So he came back in to ask me and I chose to go ahead with it, because doing this wouldn't delay surgery if he couldn't get it, and I want to start AC as soon as possible.  And I was already on the table and ready to go.

They went straight through my right breast at about 2:00 if you're facing me, and about three inches in from my sternum.  They started with lidocaine and the longest needle I've ever seen in my life, and fentanyl and verced in an IV which was supposed to make me sleepy.  HAHAHAHAHAHA.  It did make me sleepy, and then they stabbed me in the chest which woke me right back up, real fast.  I'm pretty sure I did a really good Uma Thurman impression there for a minute.

So then we spent about half an hour with the doc trying to position the needle, and then moving me into the scanner to see if it was close, and then moving me back out of the scanner so he could move the needle a little more, in and out, I have no idea how many times.  And there's this red light thing on the top of the machine and I know the drugs were affecting me even though I was wide awake because I felt like he was feeding me to a Cylon and it was looking me right in the eye.

And then he told me he wanted to stop trying because it was just too small and it was moving every time I breathed and he was very very sorry.  So I asked him if we could try it one last time with me holding my breath, and he humored me, and then seemed really surprised that I had the level of control that I did (thanks pilates!) and then we spent another 45 minutes doing it all again except slower and with me holding my breath in the machine and then trying to hold my breath in the exact same way out of the machine and the lidocaine was wearing off and the Cylon was eating me and he finally got the thing and it hurt so bad I couldn't stop crying.  And I'm crying now, just typing it out.

They clearly were not prepared for the level of pain I was having.  The worst part is that the way I (along with most people) try to calm down and deal with pain is to take deep breaths, and when breathing at all is excruciating that's not possible.   Oh yeah, forgot to mention that they did this in the children's hospital because of that broken CT in the main hospital, so it was a 10 minute ride on the gurney back to recovery through a bunch of public parts of the hospital with me sobbing and Bob following behind carrying my purse and looking as worried as I've ever seen him.  And then another 10 minutes in recovery to get some morphine into my IV.

First chest x-ray, small pneumothorax.  I was still hurting so they gave me vicodin too.  It dulled the pain a bit but didn't even begin to make me sleepy.  Three hour wait.  When they came back to check on me and I had gotten myself back together I asked the doc what the smallest he'd ever done was - and he said "hospital policy is nothing smaller than 8mm".  Oh.

Second x-ray, the pneumothorax was exactly the same size, so they decided to let me go home.  I took another Vicodin and we stopped at Umami Burger because it was 9pm and I was absolutely starving and while it still hurt to breathe deep the pain was under control.  I am convinced of the healing powers of a Royale, poutine style.  (That would be a hamburger patty served on a bed of fries, topped with a short rib, truffle cheese, and gravy.) 

We still have the oxygen equipment here at the house so when we got home I took a percocet and went to bed with the oxygen turned on.  Woke up and took another one at 2am, and another one at 6am, and then I've been OK since.  It's just a dull ache now.

And then I went to the second plastic surgery consult and you'll have to read about that tomorrow because I am tired of typing.  Also, first appointment with oncology at Alta Bates in the morning to talk about when I start chemo again.  

Next week my job is going to see doctors.

Slow progress is still happening.  At this point it's hard to tell what's leftover from my lung issues and what's become difficult from so many months of basically no exercise and the fatigue that follows chemo (they said to expect it to stick around for at least 3 months, and I'm only 3 weeks out now). 

Either way, things are better.  This week has been good, so I dropped down to 20mg of prednisone this morning and will stay on that until I see the lung doc next Thursday, when I expect he'll drop me to 10 and then 5 over the next couple of weeks. 

Next week my calendar is filling up with doctor stuff:

Monday:  Lung biopsy at noon.  They said to expect to be there 4-6 hours including recovery time, and to bring somebody to drive me home because they're going to be giving me fentanyl and verced.  It happens to be Veteran's Day, so Bob doesn't have school.  That worked out well. 

Tuesday:  Consult with the second plastic surgeon. 

Wednesday: See the oncologist at Alta Bates about starting the AC chemo.  Probably schedule another ECG since my pulse has been so wonky and the A part of AC is known to damage the heart.  It's not like I have a choice here, the risk has to be taken or I die of cancer in the next year or two, but at least we'll know the risks and what to look out for. 

Thursday: Check in with the lung doc and a pulmonary function test. 

I should have results back from the lung biopsy by Thursday and expect I'll be starting the next round of chemo during the week of 11/18. 

Checked in with the oncocologist today.

Long evening at the hospital - my appointment was at 4:20 but we didn't actually get seen until 5:30, and weren't done until 7:15.  Bob came with me and we rewarded ourselves with dinner at Umami Burger before heading home. 

Everything is looking good.  I feel like my lungs are almost back to normal, they cleared me to start doing a little bit of exercise, so I'm going to start slow in the morning.  I haven't taken the dog for a walk in three weeks, so I'll take him out in the morning and set a timer when we walk out the door for five minutes, and see how far I get, then turn around and come home.  I'll add time until I'm back up to a 30 minute total walk if I can do it.  Realistically, the next round of chemo may make that goal impossible.  I'm not going to kill myself to do it, but I think getting some kind of regular exercise again will help my body and my head a lot. 

Dr. T. thinks I'm fine to do the biopsy on my lung this week, so we're scheduling it ASAP, and then as soon as that's booked we'll schedule my next batch of chemotherapy for one week after the biopsy.  So I could be starting the AC as soon as next week, which is a huge relief. 

I'm also clear to get my own flu shot this week, so I'll get that done tomorrow or Wednesday.  Once that's done I don't need to be quite so paranoid about being out in public.  I bought a heavier duty fabric version of those paper masks with an exhale valve that makes it comfortable to wear for longer periods of time.  The lung people said I don't need to wear it all the time, but keep it around in case I get into a situation where people are sick around me.  

Both the oncology people and the pulmonary people have said that they really doubt the thing in my lung is cancerous - if it was a a metastasis of my breast cancer it would have shrunk during chemo and it didn't, and it would be extremely rare for someone of my age to have two different cancers at once.  They are concerned that it might be a dormant infection of some kind.  It's definitely not TB, but it could be Valley Fever or some other random thing that I picked up in my travels.  Or it could just be scar tissue from an old infection.  They expect a 72 hour turnaround from both pathology and microbiology once they get a piece of it. 

The biopsy itself doesn't scare me.  They'll put me in a CT machine and go in between my ribs in my back.  The nodule is right up at the top of my right lung so it should be pretty easy to access and they'll do it under a local.  I'll take a valium or two like I do for the MRIs and it should be fine.  The CT isn't nearly as claustrophobic, and this shouldn't take very long. 

I am scared of the AC.  No question there.  It's probably going to be a lot harder on me physically than the taxol was, but I'm also eager to get started.  The tumor doesn't seem to have grown at all in the last couple of weeks and I don't want to give it a chance to start now. 

Tired, but I think that's a good thing.

I stepped down the prednisone (from 40mg to 30mg) yesterday and my breathing still seems fine.  I also dropped the cough suppressant by half yesterday and haven't taken any today, and haven't had a major coughing fit.  All good. 

I also took a real nap for the first time in over a week yesterday, and I'm tired enough to do it today .  I think it's probably a good thing - sleep is an important part of healing and one of the things that bothers me most about all the steroids I've been on is the insomnia.  My body needs to take a break but the drugs won't let it. 

Yesterday I stayed home but stepped up my activity significantly - we did a bunch of long neglected stuff around the house.  Bob did all the heavy lifting, but I went up and down the stairs multiple times yesterday where I'd be really careful to minimize that for the last week. 

Today I went out for breakfast with Cait and then did half the grocery shopping (Trader Joe's and Whole Foods), and I am dead on my feet.  But it's a different kind of exhausted from what I was a couple weeks ago.  I don't know if that makes any sense at all outside my own head, but it feels better.  It's the right kind of tired.  

Lungs are working, so let's take some risks!

I left the house this morning for the first time since I got home from the hospital last Saturday, to drive back to the hospital for a check in with the pulmonary team.  They are really happy with my progress.  I don't need to use the I.S. to expand my lungs any farther.  I took the emergency O2 with me and carried it around, but I felt well enough to walk from the parking structure to the hospital.   There's a bunch of construction, so it's maybe a 6-8 minute walk, which is sadly the most exercise I've had in at least three weeks now.  That went fine, I was a smidge out of breath and tired by the time I got into the clinic, but I think that's just complete lack of activity catching up with me.  We did another O2 test in the hospital where I walked with the monitor on my hand and was breathing well enough to sustain conversation with the doc for about five minutes and never dropped below 92%.  My heart rate is still totally bonkers.  It was 106 when I was sitting there in the office chatting.  It dropped into the 90s while I was walking, and then spiked back up to 120 after I sat back down. 

I finished the Tamiflu yesterday and the original antibiotics this morning.  I still do have a little bit of that dry cough though, which has now been here since the last week of September and was really the first sign of something going wrong.  And that means it's not all right.  It's definitely better, but clearly there's still something happening there. 

So I'm stepping down the prednisone from 40mg a day to 30mg a day, and monitoring myself for any changes tomorrow, and if I continue to be stable or improve, I'll drop down to 20mg a day next Friday.  Of course, prednisone is a major double-edged sword.  It's fixing the inflammation, but reduces my immune response further, so I get to start two weeks of Bactrim tomorrow, to protect me from a fungal infection in my lungs that I'm apparently now at high risk for.  Yay. 

They're scheduling me for a general pulmonary function test sometime next week and then a follow up with them on Nov 14.  

The lung docs feel like I'm safe to do that biopsy, but want to follow the oncologist's lead on it.  I meet with her on Monday afternoon and I think it's likely we'll get the biopsy in late next week if I don't react badly to the prednisone drop over the weekend. 

I utterly failed at not working today, but only because I had a couple of hours worth of final wrap-up phone calls I wanted to do and couldn't get on the schedule yesterday.  I'm really done now.  I do have a couple of things to keep me busy as I feel up for it though, "wedding" planning and I've been trying and never finding the time to do a Project Management Professional certification (PMP) for a couple of years now.  I've got all the books and never had time to study for the test, so I'll spend an hour or two a day on it as I feel up to it over the next few months.  It's not work-work, but it's good to have something to focus on that I can completely set my own pace with.