silver lining

Today was an appointment-heavy day. Let's get into it!

The first appointment I had was at the Cancer Center. The financial counseling didn't occur whatsoever, maybe because I have a good health insurance (who knows) but I almost wish it had just so I could point out that the hospital's federally-mandated cost list website link is broken. Ah well. Guess I'll find out when I'm billed!

I finally met my oncologist. She seems very serious and very knowledgeable. The things I took away from the meeting include the following:

• It is likely that this metastatic melanoma stems from a primary that was a mole on the middle of my back. This mole was giving me trouble and unfortunately I... unceremoniously took matters into my own hands to remove it during the dark days of early COVID when I was between jobs and had no health insurance. Yay, America!

• If that mole was the primary melanoma, then we will know for sure when the genetic testing is completed on my biopsy. Genetic testing will also help us know exactly what kind immunotherapy I will have. If my biopsy contains the genetic markers they're looking for we will know with high confidence how to treat it. Additionally, it will mean that there's no point in having my eyes or anything else checked out unless the biopsy does not have those genetic markers.

• I will likely start immunotherapy the week after next (so the week of 9/13 -- conveniently just after one of my singing gigs with Opera on Tap NH! though now I am concerned how this will impact church singing since that starts shortly after). From what I understand I can either take therapy slow or fast. Fast is riskier because it would be more toxic on my body. I am hoping we start slow and see how effective it is.

• Immunotherapy can have many side effects. Nausea, fatigue, discomfort, loss of appetite. Rarely, and of course more likely if we choose the super-fast mega-treatment, risks include diabetes, hypothyroidism, or lupus. If one of these things happens, I will have it for the rest of my life.

• The treatment plan shouldn't be significantly impacted by whatever the PET scan results are, but the PET scan is still important to make sure there are no other sneaky little melanoma monsters hiding out inside me.

After hanging out with the oncologist for a bit I had my blood taken and from what I can tell of the very complicated results I got, it was mostly normal (small platelets, I'm probably dehydrated, a couple of other things where I wasn't in the green, but nothing hugely alarming) -- I'm sure we will go over that next week. I will try to drink more water for now, and also forever, because I am a human raisin.

After a drive and some late and far-too-rich breakfast, it was time for my follow-up with the doctor who did the biopsies two weeks ago (that is, the doctor who insisted it wasn't an interrogation when I nervously announced I'd had two hot dogs for dinner-- or, more specifically still, a very kind and personable surgical physician's assistant because the doctor was on vacation). This follow-up was mainly to get the staples removed from the biopsy sites and boy howdy, I am so glad they're gone. They were also kind enough to give me some special better bandages for my shoulder (the original excision site) because it is STILL not healed. But they gave me the a-okay to do strenuous exercise again (YAY I CAN GO FOR A RUN!).

Overall, today was actually pretty encouraging. Hopefully it means this is just in my skin and nowhere else. And knowing generally when treatments will start is a huge weight off my shoulders.

Tomorrow is the PET scan, which will leave me radioactive for about 24 hours so if I'm going to transform to my superhero persona I guess that'll be the time. I won't get results from that until next week. I'll surely update everyone when I do. Or, obviously, if I get my superhero persona.

Anyway, here's a song: