Hi folks. Thank you for not pestering me about my whole cancer situation the last week or so. I just didn’t have any information and picking at it over and over again with each well-wisher was getting to be overwhelming. This may be kind of a long post, but I have always been very straight forward and transparent with those who care about me. So far, only Tim has really been told of the extent of what was said at the Mayo Clinic because I felt he could understand a lot of it. But I am going to rewind a bit because I want to make you smile a bit as well.
Before we left Montana, the weather was SO WARM! It was in the mid-70’s and then hit 80 the day we left. We took Tallinn for some longer walks and he loved it! Put for the half mile trek to the mailbox and back, he has to carry a stick with him: the bigger, the better. It is all a lot of fun until he whacks you in the back of the calves with it unexpectedly.


We flew out of Kalispell to head to the Mayo Clinic in Rochester, Minnesota. Unfortunately, we did not have a direct route. We flew out of Kalispell at 6:05 am and flew WEST to Seattle. We were chasing the sunrise the entire time (or maybe it was chasing us). Either way, beautiful visions out of my window on the way to Seattle. We then flew back over OUR HOUSE from Seattle to Minneapolis. We rented a car and drove an hour to Rochester. Coming home late last night, we did that all in reverse. We got back to our house around 1 am this morning. It had snowed and the temp was 29 degrees. It is almost noon here now and it is a balmy 35 degrees. It is above freezing, so there’s that. Here are some of the photos from the sunrise for an hour trip to Seattle on Tuesday….




The Tuesday we flew out was the feast day of St. Anselm. I don’t know a whole lot about him, but one of his prayers is my favorite. I pray it weekly. It seemed like a message from God as I was traveling that day toward a lot of hard things to face. I will share the St. Anselm Prayer with you:
O Lord, my god, teach my heart this day where and how to see You, where and how to find You. You have made me and remade me, and You have bestowed on me all the good things I possess, and still I do not know You. I have not yet done that for which I was made. Teach me to seek You, for I cannot seek You unless You teach me, or find You unless You show Yourself to me. Let me seek You in my desires; let me desire You in my seeking. Let me find You by loving You; let me LOVE You when I find You. ~ Amen.
The Tuesday we arrived in Rochester, I got to meet up with a friend I hadn’t seen in a pretty long time. Ruth and I did kickboxing classes together. I am still amazed at how many good friends came out of that endeavor. It isn’t like we get the chance to talk much when we were working out. Ruth’s parents and brother live in Rochester…and she was kind enough to extend her stay a day to have dinner with us. It was so good to catch up. As we were leaving, she asked to pray over me, which was a huge comfort. That just isn’t really done at my very conservative Church here in Montana. It meant a lot to me.

Being in Rochester is interesting. EVERYTHING is Mayo Clinic related it seems. There are these 10 story buildings with all sorts of specialties. They are all connected underground by a walkway. I have been going to the Mayo Clinic in Rochester off and on for 6 years. They are constantly building more buildings and doing construction. I have never been there when there wasn’t heavy construction going on. I feel like everyone we passed on the street walking around were either people who worked at the Mayo Clinic in some capacity or were there as patients. The patients…it is sobering every time we go there. So many people coming from all over the world to be treated because they are so very sick and they need the highest level of care. There is a Mayo medical school and then the University of Minnesota – Rochester is clumped into the city nearby as well. There are a lot of parking structures, but I have no idea who parks there. They are always full and we always stay in a hotel close enough to walk to where we need to be in 10-15 minutes. The staff working at the Mayo Clinic are all bussed in from much further out. We went to the movies on Wednesday afternoon, and it was a filled with cars for the Mayo Clinic employees and they are bussed from there. That was a 10-minute drive from the Mayo Clinic and only one of many huge parking places they have with bus transports.
Wednesday morning, we had a surgery consult with one of the oncology surgeons at the Mayo Clinic. First off, I was under the impression that the list of suggestions from the tumor board was what my oncology doctor wanted to do…all of it. That was not the case at all. I was getting an opinion about the surgical option and then the radiation option. My oncologist had already covered the chemo option – which would be trabectadin (Yondelis). About 1/3 the way through the appointment, I realized I wasn’t getting radiation then surgery, putting me out of pocket for probably 6 months. I was getting the details of what it would look like if I chose the surgery route. The surgeon was very nice, and she had studied at one point at Stanford, where Tim used to work. She was very clear about how high risk this surgery would be. There would be at least four different specialty surgical teams to work on the different areas of my pelvis. There is only one tumor which is showing growth right now. Unfortunately, it is adhered to a much larger tumor in my pelvis which is stable. They would have to try and remove all of it. Because the tumors are vascularized (meaning it has been smart enough to create its own blood supply), there are a lot of risks. Here are some of the issues: I would have to have a serious revision of my vaginal cuff, most likely taking away my ability to be sexually active again. I would most likely lose my left ureter and part of my bladder. The larger tumor skirts around some of the biggest blood vessels in the body, and they may have to be clamped, cut, then reattached. The possibility of having to take out more bowel is quite high, with the chance of having a temporary ileostomy (where you poop in a bag from your abdomen) was also high. The nerves along my left pelvis would be involved and although she was pretty sure I would still be able to walk, I would not have feeling down part of my leg. Basically, I would not come out of surgery the same person I went in. She felt it was a pretty drastic measure considering how active I am. The surgeon also stated that the normal reactions that takes place in the body 1-2 weeks post surgery could cause any cancer in my body to start growing. All of that to just have to go back to another treatment. Honestly, she didn’t sound real thrilled about trying this. She didn’t need to convince me. I wasn’t on board with it either. She did state that doing radiation ahead of the surgery may not be optimal because of the ability to heal would be greatly increased. So we left that appointment a little shell shocked. Rich, especially. I had a feeling it was going to be really extensive. We walked to a nearby cafe for lunch and sat and talked about it. This will be our last choice. It will not allow me to have a life of what I want. With the blood supply to the tumors, it would even risk my life.
We spent the afternoon knowing we had ruled out one option and hoping that our appointment Thursday morning would be more viable…otherwise, it would be back to traditional chemo again. So those two options were on the table. We found a park in Rochester to spend a few hours at before going to see Project Hail Mary at the movie theatre. We had a great time walking around the park…we saw 6 cardinals but heard many, many more. I keep a journal of letters to my Joe, and I had told him the night before that since we were back in a place where there were cardinals, it would be great if I could see one. The next day we saw 6! It was what my soul needed at that moment.

The next morning, Thursday (yesterday) – it seems like it was longer ago than it was as so much has been happening – I met with the oncology radiologist at the Mayo Clinic. I met first with two physician’s assistants and a student physician assistant (it is a teaching hospital after all). They were all very nice and the lead PA was very knowledgeable and answered a lot of questions I had prepared for the team ahead of time. One of the PA’s was from Kalispell, Montana! (I took this as a good sign). They spent nearly an hour with Rich and me explaining the different kinds of radiation, what side effects I would have having radiation in my pelvis. They mentioned I have what is considered “oligoprogression”, meaning I have only a small portion of my tumors growing (for me – one) and the rest are stable. It is best to try and get that one taken care of rather than treating all of my tumors and risk upsetting the apple cart. The side effects won’t be great, but they won’t be life altering either, at least not long term. The radiation treatments are done every weekday and typically for 5 weeks. I mentioned this little trip I have planned to Africa on June 17th through July 4th. (How cool that I get to arrive in the United States on her 250th birthday!) They had preemptively made an appointment for my simulation (getting mapped for treatment) at the Mayo Clinic the next day (today) with the idea I would be coming back in a week to stay for 5 weeks of treatment. HOWEVER, when the radiologist came in and spoke with me after being briefed by the team of PAs, she had another plan. She thought I was healthy and active enough to bump up the dose and only be treated for 3 weeks, giving me time to recover a bit before my trip to Africa. The radiation continues to work for a few weeks after the treatments are done. She recommended photon radiation therapy (IMRT) for 15 fractions (3 weeks of 5 days a week – a fraction meeting a dose/appt). Guess what? I have the ability to get it done in Kalispell at the hospital there! This was great news. She said that if the radiation overshot the tumor they were trying to hit (which it does in photon radiation), it would land in that big tumor, which is perfectly fine, rather than hitting other structures. Will it be a walk in the park? No. Is it worth a try? We think so. Leiomyosarcoma (LMS) is not always reactive to radiation, but we are going to give it a try. If it doesn’t work, we can go to systemic chemo. And as I said, surgery is in my back pocket, but only as a last resort. We left the Mayo Clinic with the weight lifted off my shoulders. I like to have a plan.
I called my local sarcoma nurse navigator on our drive to the airport in Minneapolis. She helped get the ball rolling. We flew home and walked in our door around 1 a.m. this morning. By 10 a.m., I had already gotten a call from the radiology center in Kalispell with an appointment for Tuesday, April 28th at 10:45. I will be meeting with a radiologist to see if he agrees with the way forward. I looked him up….he has lived in the area for 10 years and he did his residency at the Mayo Clinic! (I think this may be a God thing!) Anyhow, going to get going next week and hopefully start treatment soon. I just hope he agrees to what the Mayo Clinic oncology teams says. The person I talked to on the phone this morning getting information from me was really nice and I am hoping all the puzzle pieces are falling into place. I think I have done all the things I can do at this point. So in conclusion – going to try to do a higher dose of radiation for 3 weeks….recover….go to Africa to commune with the elephants and other wild beasts for two weeks, come back and re screen to see if the radiation worked. Then we’ll move on from there. Until then, and through the radiation, I will continue to be on the medical regimen I have been on for the last 5 years. I will be adding the radiation on top of what I am already doing (as the rest of the tumors seem to be holding stable.
Thanks everyone for your many prayers. I am feeling so much less overwhelmed in the last 24 hours, which is nice. I have even gone on a medical call for the fire department already. It is good to be home and I am so happy I can be treated here. Being at home to deal with all the ick sounds way better than being in the Hope House in Rochester for 5+ weeks.


































































































