How do you manage setbacks? (Joyce)

 Last week was a good week. We were given the unanimous recommendation of an oral medication that targets the rare RET gene fusion mutation, which is responsible for driving the replication my cancer’s cells, called selpercatinib. We were given two separate and personal accounts of people around my age who were living full lives 5+ years out of their diagnosis of similar stage 4 cancer who were being treated with this same strategy. The first 48 hours of selpercatinib were well-tolerated, without side effects. I still have all my hair despite the rounds of preceding chemotherapy received.  I could appreciate the large lymph nodes in my neck shrinking in size (they are barely palpable now) and so could both of my curious kids! Results of my PET/CT, done only 3 weeks after starting the prior chemotherapy showed considerably less activity in the entire chest, including the right lung and lymph nodes of the chest and neck. I was feeling more energy and barely any bone pain over the past few days. This was a great week!

 

Then on Saturday, in the middle of my daughter’s Christmas dance recital, I experienced what was probably the worst headache of my life. In medical training, when we hear “worst headache of my life”, we get concerned about some pretty sinister causes.  Sure enough, after a phone call with the on-call oncologist, given my known brain metastases, prior gamma knife radiation to the brain, and the recent start of a medication that had some rare but serious side effects, I was advised to be evaluated in the local emergency room to rule out the worrisome things including a brain bleed, brain swelling, hypertensive crisis, and stroke. I am very grateful for the staff and providers at the Eastern Idaho Regional Medical Center (EIRMC) emergency room who executed this. In less than 3 hours, I had a physical exam, laboratory testing and a brain MRI done. As I laid in the MRI, coping with the starting noise of the machine, I prayed continually for favorable news.  Thankfully all results were reassuring. Not only that, but the brain MRI was read a “normal,” meaning none of the sinister concerns were seen and furthermore, the radiologist could not see ANY evidence of where my previously seen brain metastases had been. Praise God for this good news!

 

While this is all extremely encouraging, my suspicion is that the severe headache I experienced was the result of a common side effect reported with selpercatinib. And the following day, I experienced a similar, though less severe, headache at the same time of day which I think further argues for the drug as the cause.  While a headache seems like a pretty benign side effect, the intensity of these two headaches make this issue one that I would not be able to live with long-term.  If these headaches persist, the dose of drug may need to be lowered (not excited to lower the dose of the cancer treatment if it can be helped), or I may need to be switched to another medication entirely (which would be very disappointing). So, I am praying (and you can join me in this prayer) that the headaches subside this week as my body acclimates to the drug. I am also praying over the discussion about these headaches with my oncologist when he returns on Thursday – that the team be given wisdom in advising us on next steps. But mostly, I am hoping these headaches gradually improve and disappear!

 

This past week’s Bible study covered Revelation 7. In this book, the disciple John describes what God has revealed to Him about the end times and in this chapter, God holds back his judgement so that His people can be marked with a seal to be protected and spared from the coming eternal judgement.  God restrains His judgment while He seals and protects His people. He does not pull them OUT from the situation, but He does strengthen and protect them IN the situation, ultimately sparing them from eternal judgement. One question that struck me on the notes from this passage was: “Have you ever faced a situation where God did not remove you from trouble but rather protected and guided you through it?”

 

Um, YEAH!

 

And I know I can be secure in God, even when my personal health situation seems anything BUT secure.

As Paul writes to the church in Rome, “For I am convinced that neither death [and I’ll insert death from cancer or any other cause] nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord.” Romans 8:38-39