Adrenal Courage

The next few months were filled with family time—and lots of naps. We enjoyed a wonderful Thanksgiving with my dad visiting, followed by a Christmas trip to Cleveland to see my family. Unfortunately, Aubrey was sick the entire time, and we ended up leaving early due to a snowstorm. That very night after we got home, I came down with flu-like symptoms. I felt so incredibly awful that I worried I might end up hospitalized. I called my oncologist to see if they would prescribe Tamiflu, but they asked that I get tested first. Low and behold—it was COVID. Thankfully, by the next day I felt noticeably better and it seemed more like a bad cold than anything else. 

Life carried on as normally as it could. I celebrated my 35th birthday surrounded by my beautiful family. Nick and I spent the day enjoying some skiing despite it raining the whole time. I remember feeling a little anxious at dinner because I became full so quickly, but we still went out for ice cream—my favorite—and ended the night snuggled up in bed. My 35th birthday felt incredibly bittersweet. Just one year earlier, I wasn’t sure I would even make it to this milestone. And if I did, I certainly never imagined I would be doing as well as I was. Little did I know, life was about to throw me another curveball. 

I woke up the next morning feeling quite unwell. At first, I blamed the ice cream, as that had happened before. The medication I’m on, cabozantinib, increases in concentration by about 50% when taken with fatty foods, which is why I have to take it on an empty stomach. I was nearly ready to swear off ice cream entirely. Over the next few days, my symptoms worsened. I developed high fevers up to 102.5, along with body aches, headaches, extreme fatigue, and a complete loss of appetite. 

Three days after my symptoms began, I went to our local ER out of concern for possible hydronephrosis and infection. My tumor is quite large in my left upper abdomen and does cause some compression of my left kidney. I worried that the tumor may have shifted and was preventing proper drainage. Thankfully, the imaging didn’t show anything concerning in that regard. Everything appeared normal—except for significantly elevated liver enzymes. Unfortunately, the radiology reports at our local hospital aren’t always as detailed as those from UofM, so it was unclear whether there had been any tumor progression. 

I followed up with my oncologist the next day. She was unsure what was causing my symptoms, especially since only one of my liver enzyme levels was elevated. She gave me IV fluids in hopes of providing some relief. Three days later, I still felt no better. With the help of our neighbor—who also happens to be the ER director—I was able to have labs drawn on a Sunday. While my liver enzyme had improved significantly, the results still didn’t point to a clear cause. 

I met with my oncologist again the following day. She ordered blood cultures along with several additional tests that I had suggested. My inflammatory markers came back quite elevated. After seven straight days of fevers, Nick finally won the battle and insisted we head to the University of Michigan ER for further evaluation.