A Gorgeous Weekend and the Beginnings of a Plan

First, we had a great long weekend.  We kept it pretty lazy Saturday and did a couple things around the house.  On Sunday we took Red up to the hills for a hike at Sibley.  The wildflowers were really putting on a show.  I was feeling pretty good so we did the long loop.  Inspired by that hike we decided to head to Point Reyes the next day.  We don't go as often as we used to because there aren't many trails that allow dogs there.  So we took Red for a quick trot around the neighborhood and off we went.  It turned out to be a nice clear day at Point Reyes and we had another gorgeous hike.

That's me there, almost to the top...

Looking towards Chimney Rock.

On to the plan...My medical oncologist called today with the first step in my plan.  There is too much activity for radiation at this point, so that's out.  She is suggesting I do what is the "standard of care" in this situation which is intrathecal chemotherapy with methotrexate.  Before I start the chemo she wants me to get a lumbar puncture (Monday afternoon, woo hoo!) to see if they can detect the cancer cells in my spinal fluid.  Apparently this isn't the most reliable test, there are a lot of false negatives, but nonetheless I need to get it done as a baseline before starting anything.  After we get the results of the lumbar puncture I'll get more details on what comes next, but from the sound of it, at first they'll do another lumbar puncture to administer the chemo but eventually I'll have something called an ommaya reservoir put in by my neurosurgeon (it's like my portacath, but it'll dump the chemo into my central nervous system instead of my bloodstream).

I'll know more after the procedure on Monday.  The doctor doing it is the brain metastasis specialist and hopefully I'll get a chance to pick her brain about all this stuff.  Until then we carry on.  I've got to get this house vacuumed- it's shedding season and it's getting out of control here.