I am getting real burnt out on delivering less than stellar news 🥲 

Unfortunately, there are no clinical trials that are a match for my cancer within driving distance. I am unwilling to travel out of state - if I could be guaranteed they'd be effective and I'd get more years with my family, I would have already bought a plan ticket! But I refuse to gamble with time with my family. I've never been a gambler but I've known for two years now that the stats are not on my side. After some imaging last week, we confirmed that the shoulder mass is a metastatic tumor inside the trapezius muscle. That bitch HURTS 😫

So, now what? A couple things will all happen at the same time:

1. Adam and I will drive down to Mayo on 10/15. Even though they don't have a Clinical Trial open for me, there are two that match me but neither are enrolling patients. That can change any time and I want to be established as a patient to smooth the process, if that happens. Also, my Onc still recommended I do an appointment for a second opinion. Their review team scoured my medical record and one of the Oncologists picked up my case! 

2. I will go in for a biopsy of the shoulder mass on 9/23. My Onc will send this tissue, along with my previous lung biopsy, for some gene sequencing and further testing. Hopefully this can open up another treatment option as well. 

3. I will start radiation on the trapezius muscle mass and pectoral muscle mass. Because my chest has already been radiated. We will use a lower dose and spread out the radiation to avoid damaging "hot spots" which can lead for bone weakness, nerve damage, and secondary cancers. I am willing to do anything to try and lessen the pain. I can't even describe how hard it is to get though every day. I feel incapable and completely reliant on Adam. I can't get groceries or pick up the house. I can barely walk because the moment of my arm is so painful. I've tried a sling, a couple pain management options, chiro, massage, heat, ice, arnica gel... nothing brings relief. I am really needing this radiation to be effective because my quality of life is not acceptable right now.

4. I also had an echo cardiogram on Froday 9/20 to assess heart function compared to my echo in April 2022 before I started chemo the first time. I've now had 6 different types of chemotherapies 😵‍💫 and many of them are hard on the heart. All clear! Heart is healthy ❤️ Heart problems could disqualify potential trials so it's good to have that out of the way.

5. I'm going to start Enhertu, another type of systemic treatment. This treatment is not the best option for me but it's truly all that's available right now, and the hope is I can tolerate it long enough and keep the cancer at bay until a trial or another treatment option becomes available. I hate this feeling of bring backed in to a corner but I have too much to live for. 

We had the hardest conversation of our lives with Callie & Geno over the weekend. We have been weighing the pros and cons of taking to them about what stage four means since I was first diagnosed in December. We have always been honest, in kid friendly language, about everything during this journey because kids are perceptive and we would rather they hear hard stuff from us versus overheating a conversation or putting pieces together on their own. What we concluded is there's never going to be an ideal time for this conversation and we want them to feel prepared for the obstacles coming our way. It's so fucking unfair. Kids should not be in this position. Everything about it is raw and painful. Thankfully we can reassure them that we are surrounded by the most amazing support system. People who will love and care for them alongside Asam. Callie said "that's not fair if I only get seven years with you" and, damnit, that absolutely broke me. Seven years isn't enough. I got 19 with my dad and that didn't feel like enough, either. I don't think it really ever feels like enough when it comes to thos you love the most. We will keep trying to turn our minds to living in this moment and trying to focus less on the "what ifs", and anxiety that comes with all of this.

My job now is to practice living mindfully and model this for our kids as often as i can, and to pour unconditional love into my family for every second we have together. I'm so proud of Adam and I, and the beautiful life we've been able to make with our babies. It's not enough time but we sure made the most of every moment. But I'm not done yet and am still manifesting many more years here with my family 🩷

We've gotten lots of "how can I help?" messages and we are so grateful. Please keep an eye on the "needs" tab of the website as we post everything there. The most helpful thing right now is meals. The brain fog from chemo & having so much on my mind is making is very challenging for me to plan ahead, organize shopping lists, and by the time I need to start dinner, I'm absolutely tapped out most days. I'll continue to post needs in there as we learn more about what comes next - we are very much living day-to-day right now and things are rapidly evolving.

Thank you for all of the love and compassion you've extended our way. We feel it!!! 🩷

Love & Gratitude, 

Elizabeth