It was lovely to see her! She had just had 2 weeks off- with 2 little kids but had all the storms and rains so not a great time I bet! I big hug hello started us off..
I didn’t want to blind side her on her first appt back after vacation so I had texted her the news of my recent spread to liver, around my intestines and in the perineum. And she was very empathetic.. ii had also sent over the notes and scans from boston which she read prior to see us. Rick came too.
The first big difference from my very busy hospital practice in Boston was that we were offered a barista made coffee! Another was that during her exam she she noticed a grain of sand in my eyelash and took the time to remove it! ( swimming in the big waves after the storms means sand is all over you and in your bathing suit)
I admire both of my doctors ( USA and NZ) so much for how knowledgeable they are and how they take time with me and make me feel like they really care. My very caring usa Dr doesn’t like to talk about what ifs… and speculate what might happen or where the spread will go next. He just likes to deal with the here and now. With Karen, she was very helpful for me to know that since my ureters had shown thickening and then led to some ascites (which has resolved for now on Cape) she told me to watch for that ti come back with bloated and that feeling that I can’t empty my bladder … I will need quick attention so as not damage my kidneys- because we don’t want to not be accepted into a study by not meeting the criteria of haivng 2 functioning kidneys.she says that surgeon will fix me up with stents of some sort when the time comes.
Because my hubby writes for medical journals including the Journal of Clinical Oncology, she had printed of and explained why Enhertu was encouraging for me.. and how it delivers the drug into cell. Since it is so new she only has a few on it, but she has spoken to her Australian colleagues and she was encouraged by the real life experiences their pts were having.
she talked ver practically about what to expect with my bowels and how my diet would have to change from the mega green plant based diet to more low residue. Bummer!
the main thing that my usa Dr wanted her to do was to try to assess for xeloda was working if possible. This was hard to do as it has only been one month and in Nz they use CA 15-3 and USA they only look at ca 27-29but nz can’t do that one at their labs. But my neck lymph node was much smaller from when I last saw her… but I thought I found another enlarged one not seen on the last scan-ugh! She thought so too!
we talked about dosing and she encouraged me to stay on 2000 mg /day to keep my QOL and blisters under control. My boston drs wanted me to slowly make my way back up to 3000/ day. I had deep blisters from day one on cape from playing too much pickle ball.. stopped all that and now I only go for 1mile walks.. but I love love to swim so can still do that.
I reported that my pain level was good and without being in the CDK4-6, I had NO fatigue and felt well. Swimming in the ocean made me feel Completely well! We hired a cottage steps from the beach and now with summer and sun back just love to go for several swims per day with our friends.
Anyway- Karen gave me a big hug knowing that I have “a tough row to hoe” ahead but that I have a very good attitude of trying not to let fears of the future wreck the time now that I have with my lovely hubby and old friends here on Waiheke Island.
❤️ I was reviewing my own bloodwork over the last few months and noted with more interest how my neutrophils were at their VERY best , noticeably better, when we had JUST returned from a wonderful week away where I was daily hiking in the hills and also daily ocean swims (my dream life). Is it a co-incidence? It’s not hard to believe it really did boost my immunity! 
