(Original title – Through The Trapdoor)

Oh my goodness, I never thought this day would come.

I don’t have to have chemo anymore, and I am thrilled.

The plan was, if the liver spot was shrinking – one more chemo. If it hadn’t, then no more chemo.

Today I started my day at 7am with my alarm going off just after I filled in my sleep diary, because that’s a thing I do now. I got dressed, having procrastinated too long and missed my window for having a shower, and ordered an uber. I had to fast because of the scans I was having this morning, so I was forced to miss breakfast, even though I wasn’t even hungry. I always allow 45 minutes to get to the Peter Mac if I need to be there between 8 and 9:30am because traffic on Geelong Road would give anyone the shits.

My first scan was at 8:30, I made it there with 10 minutes to spare, and was called in at 8:30 on the dot. A new person got to see my boobs as I lay on the table next to the ultrasound machine so they could have a squiz at my heart. He explained what they were looking for and when I showed particular interest in things, he would explain what we were seeing on the screen. (Work buddies note: they use CAD software to show stress in the heart, exactly like engineers use for showing stress on buildings.) He’s about to publish a paper on using the software to predict heart failure in cancer patients, and he’s been collecting data for two years.

I got to see the little flappy bits in my heart doing their little flappy bit thing as blood gets squished through the chambers. I had to hold my breath a lot to push my heart to the front because ultrasound can’t see through air (i.e. your lungs are filled with air), and it wasn’t super comfortable, but not painful. Mostly awkward.

I got dressed again and made my way upstairs for my liver ultrasound at 9:15.

Thankfully, no disrobing was required this time. It’s not that I’m against new people seeing me half-naked, but it’s a hassle to remove your wig, remove your shirt, remove your undershirt, remove your bra, and then put it all back on again afterwards, especially where ultrasound gel is involved. The tech announces he’s going to have his minion-in-training join us for part of it, which is totally fine by me, and we all get down to the business of looking at my insides.

There’s a lot of breath-holding to push the liver forward and then some wincing because the wand is pressing on your abs (yes, they exist under all this flabby excess) hurts.

The little bastard they’re looking for is located in segment 4b of my liver, on the edge of 5 (the liver is divided into segments to make it easier to locate and identify things like cancer, I’ve stolen an image from google to illustrate). They used three different ultrasound wands and weren’t sure if they found the spot, or it was the tail of the gallbladder. It was a very amusing conversation to overhear as they discussed what they were seeing on the screen.

I wiped the rest of the gel off and straightened my clothes up while I waited for the all-clear to leave, which came after just a couple of minutes. I took this time to come to terms with the fact that I was going to have chemo next week.

After getting the all-clear I headed across the road to keep a friend company while she had her baby appointments at the Women’s. It’s nice that our appointments for our parasitic growths fall on the same days so we can keep each other company.

My oncology appointment was at 2:30. We rocked up just before 2:30, I checked in, grabbed my ticket, and had barely sat down when I was called straight in. After waiting 2.5 hours at the previous appointment with her, I was expecting to wait again, but DING went the bell and my ticket number popped up on the screen just as we’d sat down. Winner.

She opens with the news: No chemo next week. Liver is good, but my heart isn’t so good, so we’re stopping.

The deal with the heart is this: I knew that my chemo drugs were cardio-toxic. They’ve caused my heart to not pump so much blood out of it with each heartbeat. A heart usually pumps between 50 and 75% of the blood held in a ventricle out of it with each heartbeat, called an ejection fraction (EF). 50 – 75% is considered “normal”, and this number is expressed as a percentage, i.e. an ejection fraction of 60% means that 60% of the total amount of blood in the left ventricle is pushed out with each heartbeat.

My score was 46%. Not super low, but also not great. The cut-off for continuing chemo is 50%.

This would explain the breathlessness and additional fatigue I’ve been feeling over the past 6 weeks or so. Theoretically, this is reversible with more walking and continuing exercise, but puts me out of the game for running a marathon anytime soon. It can also lead to heart failure, so I need to keep an eye on it.

She also went on to explain that there’s a new drug she wants to put me on as the next stage in my treatment, to start as soon as my ovaries are removed. It will work to basically stop the cancer cells from up taking estrogen, and work with my other hormone therapy that prevents estrogen from being made by my fat stores. That was my understanding of it. It’s a form of chemo, it still has the risks of illness and infection and reduced white blood counts and fatigue but doesn’t involve me being poisoned every three weeks. Instead, it’ll be a tablet every day for 21 days, then 7 days off, like the Pill.

It means that my 90 day wait for my oophorectomy is being brought forward to possibly next week (but likely not), or shortly after the Easter break (hopefully, but likely not), and likely towards the end of April. As long as I’m not booked in on my birthday, I’ll be fine.

So it was good news, bad news, good news today. I am ecstatic, I finally know what it’s like to receive good news about my predicament, and I know what the next steps are for treatment. For now, I get to recover from chemo, and enjoy my short holiday from cancer treatment.