My cardiac tests all came back pretty normal. They want me to wear a cardiac monitor for 2 weeks but it is a strong adhesive and I can't wear it in an MRI or during radiation treatment so we are trying to plan a time to complete that. Cardiac concers are much less now.

The team chose to continue treatment with Enhertu and to treat the brain mets with cyber knife radiation. I started Enhertu and after a few days I was able to be treated by cyber knife. The radiology team informed me that they were able to treat all 6 

(6!!!!!) small brain tumors with 99% success rate because they were all so small. Very grateful for that!

My reaction to Enhertu has been pretty difficult. I've been losing weight because my appetite doesn't exist. I have to fight with myself to eat every day and am working on stopping the weight loss without having to go on steroids, which have a lot of uncomfortable side-effects. I also am struggling with extreme fatigue sometimes sleeping 12/13 hours. Trying to get moving to help with the energy. I started physical therapy and it has been helpful.

Another unfortunate update is that the lower back pain I have been experiencing started to increase. Thanks to encouragement from my husband, I requested imaging for my low back. I had a thoracic MRI recently but it did not reach my lumbar area. I was able to obtain the lumbar MRI and, unfortunately, the imaging showed mets in my lumbar and in my pelvis. This is probably the source of increasing pain. The good news is that these tumors are in the bone of my spine and bone of my pelvis. This is much more treatable than if it had gotten into the spinal cord. Since these tumors are over a larger area and there are more mets, cyber knife is not able to treat these tumors.

So the plan is to continue the Enhertu infusions and plan for regular radiation over my low back and pelvis to help alleviate the pain. Looking forward to a much less eventful month next month? hopefully?