More Answers, a Treatment Date, and One of Those Harder Days 💜

Well, things are moving forward, and I have quite a few updates to share. We're getting closer to actually starting treatment, which is both a relief and, if I'm being completely truthful, a little terrifying.

Today I had my Keytruda (pembrolizumab) education appointment, where we went over the medication, possible side effects, risks, warning signs, and what to watch for once treatment begins. I've even made myself a quick-reference sheet with all the information, because there is SO MUCH to remember, and I want to be prepared. With my rheumatoid arthritis and other chronic illnesses complicating things, I feel like understanding what might happen and knowing when to contact my care team is especially important.

My first immunotherapy treatment is now scheduled for October 20th, and I'll be meeting with the surgical oncologist on October 23rd to discuss the surgical side of treating my melanoma. It's becoming very real now. No longer just waiting for appointments, biopsies, pathology reports, and answers. We're actually getting to the part where we start treating this thing.

I also received the results of my Minnesota Cancer 500 genetic testing, which identified a mutation called BRAF V600E in my melanoma. This is potentially encouraging because there are targeted medications specifically designed for melanomas with this mutation, meaning there may be additional treatment options available to me. The testing also identified a PBRM1 mutation, low tumor mutation burden, and microsatellite stability. I don't fully understand how all of those findings fit together yet, or what they might mean for my particular cancer, so I sent my oncology team five questions about the results, whether they affect our treatment plan, the risks associated with my rheumatoid arthritis, and whether we can now confirm my precise Stage III classification.

And, of course, yesterday's brain MRI came back with NO evidence of metastatic disease in my brain, which was an enormous relief. I'm still holding onto that bit of good news, because it really WAS good news.

I also had an appointment with my primary internist, and we made some pretty significant changes to my regular medications. We're cutting WAY back on what I'm taking. No more metformin, no more chlorthalidone, and no over-the-counter supplements beyond my multivitamin. So, goodbye to my biotin supplement, I guess! LOL. It's strange, after years of managing multiple chronic illnesses with what feels like an entire pharmacy's worth of medications, to suddenly be simplifying everything so much. It's another reminder of how much my medical care is shifting right now.

So, medically speaking, we're making progress. Things are getting organized, questions are being answered, medications are being adjusted, and treatment is right around the corner.

Emotionally, though? Today has been hard.

I've spent a good portion of the day crying, and honestly, I feel physically awful because of it. My head hurts, I'm nauseated, I'm exhausted, and I just feel sickly and sad. It's remarkable how much our emotional state can affect how we physically feel, especially when our bodies are already dealing with so much. And I think I've been trying so hard to stay positive, organized, informed, and focused on the next step that sometimes the actual enormity of what's happening to me catches up all at once.

Because underneath all the appointments and test results and plans, there are thoughts that creep in when things get quiet.

But I wanted to be here five years from now. Ten years from now. Fifteen years from now.

I want to see who my daughter becomes in this life. I want to watch her grow up, discover herself, find what makes her happy, and become whoever she's going to be. I want to be there for all of it.

And I FINALLY found my person. After everything life has thrown at me, I found Heiko. We just got married, for goodness' sake. I want more time with him. I want the ordinary days together, the adventures, the stupid little disagreements, the laughter, the growing old together. I want the life we've been planning.

And the thing is, nobody has told me that I won't have those things. I don't have some specific prognosis saying I only have so much time left. I have Stage III melanoma, a treatment plan with curative intent, and statistics about survival rates and outcomes that describe groups of people, not necessarily me. I understand that intellectually. I know that averages aren't predictions of my individual future.

But emotionally? Sometimes knowing that doesn't stop the fear.

I think there's this expectation, sometimes even one I put on myself, that having cancer means you're supposed to be brave, positive, hopeful, and ready to fight every single day. And I AM hopeful. I want this treatment to work. I want to get through the surgeries, manage whatever side effects come along, and eventually put this chapter behind me. I want to live, and there is SO MUCH living I still want to do.

But I also get scared. I get overwhelmed. I have days where I'm sad and angry that this is happening at all, and days where the uncertainty feels heavier than I know what to do with.

Today is one of those days.

I don't think that means I've lost hope, and I don't think having a difficult day means I'm somehow failing to stay positive. It just means that cancer is frightening, and loving my life and the people in it so deeply makes the thought of losing any of that time incredibly painful.

So tonight, I'm trying to give myself a little grace. The appointments are scheduled, the questions have been sent, the information is organized, and there is a plan. I've done what I can do today. Now I need to rest, let myself feel whatever I need to feel, and remember that being afraid of an uncertain future doesn't mean that future has already been decided.

I still have hope. I still have things to look forward to. And I still have a whole lot of living I intend to do.

October 20th, here we come. 💜