Julie Hirtzel Julie Hirtzel

A Quick Update

Hi Friends… Julie here for a quick update. I’ve been on hospice now for almost eight weeks. (As a reminder, hospice is basically started when no more oncology treatments will be given and comfort becomes the main goal for the terminally ill person. I am still doing some natural protocols.) It’s been a weird two months to say the least. Some days I am riddled with pain and sometimes vomiting, etc with so, so much fatigue. Other days I feel almost normal if I stay still. What remains a constant is that almost all movement will trigger pain and fatigue. I can get around the house slowly, but if I try to do a little cleaning or anything, I will pay the price for a few days with severe pain on the right side of my torso. You may wonder what I do with my time. I visit with my Mic and my kids a lot. My extended family comes by a lot just to hang out. We set up a few visitors a week. I stream a lot of shows. Reading is difficult. I listen to the Bible app and hymns. I pray and pray some more. I occasionally do a little writing. I sleep. And then I sleep more. Honestly, I probably sleep more than I do anything else. I feel calm most of the time. Yet, seeing the sadness in my family and friends is heart-wrenching. When I am with people, we are generally spending time in “a house of mourning.” All of my interactions are heavy, which you can imagine, is difficult. There is not a way to “fix” this. It is where we are. Of course there is some laughing, some chit-chat, but it is heavily clouded.

Physically I don’t feel like I am doing worse in the last eight weeks and not better either. It’s all very up and down and hard to measure. I hope to share more soon, but I just wanted to let everyone know what’s been going on. We are thankful for all the help people have been giving us… prayers, cards, lots of meals and more. We appreciate you all.

I will leave you with these verses from the Apostle Paul from 2 Corinthians, chapter 4:

It is written: “I believed; therefore I have spoken.” Since we have that same spirit of faith, we also believe and therefore speak, because we know that the one who raised the Lord Jesus from the dead will also raise us with Jesus and present us with you to himself.  All this is for your benefit, so that the grace that is reaching more and more people may cause thanksgiving to overflow to the glory of God.

Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day.  For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes not on what is seen, but on what is unseen, since what is seen is temporary, but what is unseen is eternal.

May we all be renewed inwardly day by day!

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breast cancer Julie Hirtzel breast cancer Julie Hirtzel

End of March 2024 - The H Word

Wow. So much has happened since my post about two weeks ago. In truth, a few days ago I thought that I would probably not be doing any more blog updates personally, yet, here I am! (Queue lyrics by Chumbawamba, “I get knocked down, but I get up again, you are never gonna keep me down…” lol… a silly song that runs through my head more than I would like to admit.) A little more than a week ago I ended up taking an ambulance to the ER at Little Company. On the second cycle of the new targeted therapy that I mentioned in my last post, I had tremendous side effects as well as increased cancer issues at the same time. I don’t have the energy to describe all of these side effects, but suffice it to say, this was one of my worst experiences yet, from which, I am still recovering. But I will say, one issue I was having was intensely increased pain, therefore much of the time in the hospital was spent introducing and adjusting to new, stronger pain medications. Adding to the terribleness that I was experiencing is the fact that some hospitals seem to be in a bad way these days. I spent three nights in an overflow area that had one restroom for 12 beds and no showers!!! Due to this, the level of care was substandard to say the least (though many of the hardworking nurses were trying their best with what they were handed). Anyway, I do not think it is wise to continue on this new medication, so as I have mentioned before, I am out of treatment options other than chemo infusions, which I will not be taking.

(AN ASIDE: I mentioned in my last post that I am personally not interested in harsh chemo with advanced stage four. I want to clarify a bit because I received some kickback in my messages for this recent statement. I am not against chemo. I have taken lots of it. I do think they will come up with something better some day (and they are), but for now, it is the standard. It’s funny… when you have cancer, a lot of people have medical advice they want to give because they truly care. In my experience I’d say about 70% of said people are pro-western medicine protocols, fervently believing that a person is “giving up” if they don’t take every possible medicine and procedure available to them for “the battle” they are fighting. Then about 25% of people fall into the “take western medicine, but you must add a lot of other therapies to it” such as: cannabis protocols (RSO, THC, CBD, etc.), numerous herbal protocols, hyperthermia treatment, Metformin/berberine pills, copper therapy, baking soda/molasses protocol, hyperbaric oxygen treatment, coffee enema protocol, mushroom micro-dosing, broccoli/sulforaphane pills, apricot seeds protocol, various ivermectin/fenben protocols, soursop tea, essiac tea, pectasol tablets, turpentine protocols, various protocols to lower PH, dietary therapies (no sugar, no meat, only meat, high carb, low carb, vegan, etc.), 7 day fast protocol, 3 day fast, intermittent fasting, cottage cheese/flax seed protocol and the list goes on. And… all cancers are not alike. For example, there are some promising cannabis protocols, but these same protocols do not help and may even worsen the category of cancer I have: hormone positive. I have studied/given time to all of the alternative therapies mentioned here (and more) and have implemented more than a hand-full of them. In the world of alternative therapies I find it very difficult to decipher success stories from anecdotal success from sensationalism from, sadly, straight-up, very expensive scams. Then, about 5% are the alternative therapy only folks. No chemo, no or maybe surgery, no radiation and yes to one or many alternative therapies. Each group is quite passionate! All of this information is a lot to navigate when you are the one with cancer, especially if you know a lot caring people. Like I said, I believe people give information out of love and concern, but it can be overwhelming on the receiving end. So overwhelming, that I am taking the time to write about it during this stage of my life! Does this mean never give any interesting information to a sick person? Probably not. Asking if a person wants more input is probably a great place to start. I don’t know the right answer, but for me, at the beginning I asked for input from my closest family and friends. Together we researched, discussed and came to conclusions. Is there a one size fits all answer for things like this? Just know that the patient may be receiving a lot of input and they may be exhausted. For me, I can even feel guilty for not taking someone’s advice. (Please don’t feel bad if you have given me input! I know it was in kindness and I may have even tried it. Truth be told, I’ve given this type of advice before!!!) I guess there is another group of folks (even though I’ve run out of percentages, ha ha)… the ones like me… not really sold on any of the options, but just doing the best they can. Anyway, the following link explains, more or less, how I think about chemo for “advanced” stage four breast cancer in particular. https://link.springer.com/article/10.1007/s11606-019-05158-5 )

Back to the issue at hand. On the fourth day (Friday) of being in the hospital purgatory area, I decided to go home on hospice. I know. Hospice. It doesn’t seem real. My palliative care team and one amazing friend in particular made this happen in a matter of hours, while at the same time, my family was getting the house ready. It was quite the whirlwind morning to say the very least. Coming home strapped down in an ambulance is hard. Really hard. Really, really hard. I could see some of my neighbors from the gurney. I saw family members waiting nervously at the door. Even our dog seemed anxious. Coming home in an ambulance may be hard, but coming home is wonderful. A true glimpse of heaven. I could not be more thankful for the home and family I have been given.

The aforementioned friend explained my hospice situation to a text group of mine beautifully and succinctly. She wrote:

Thank you for your prayers. After some pain control was figured out in the hospital, Julie decided on her own to go home with Hospice Care yesterday morning. She is no longer going to be on cancer treatment.

To clarify the H word. It’s a service in which people have a diagnosis of 6 months or less. People survive beyond that and can be on it for a couple years. Some people decide last minute to accept hospice and therefore it is a short period. (any questions, you can ask me, I transition people to hospice as part of my work with Palliative)

Julie, has not accepted Hospice at the last minute. She qualifies because she is no longer doing treatment. She will have good care to manage her pain and check on her more often. Julie is strong. She walked up her steps to her bedroom when she arrived home. She looked comfy in her bed yesterday with good color and smiling, chatting, even had some tapioca pudding.

Please continue to pray however the Lord leads you.

So… that’s the state of things. The past few days have been exhausting with many, many in-home appointments (necessary), visiting with my beautiful family (needed), but mostly dealing with physical and emotional pain. Today I turned a corner. My physical pain is getting under control. My home health care visits will only be weekly now. I had a nice long catch up with one of daughters tonight and it didn’t completely wipe me out! My family is taking SUCH GOOD care of me. I’ve needed help with almost everything the past few days. They have been exceptional with an extra call-out to Mic. Wow! He is taking the brunt of it all and truly caring for me as he deals with his own sadness.

I don’t know If I will personally be writing anymore updates. I might try though as I find writing cathartic. We shall see.

As always, thanking you for checking in, praying and caring.

Julie

P.S. If you are new-ish here, please poke around the blog. If you would like to know me better, check out these posts: https://www.juliehirtzel.com/shadows/my-story https://www.juliehirtzel.com/shadows/looks-can-be-deceiving-13 https://www.juliehirtzel.com/faqs My Instagram: https://www.instagram.com/julieannehirtzel?igsh=OGQ5ZDc2ODk2ZA%3D%3D&utm_source=qr

Yea, though I walk through the valley of the shadow of death, I will fear no evil: for thou art with me; thy rod and thy staff they comfort me. Psalm 23:4

Mic and I headed out to a “prom” costume party a few years ago.

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stage four cancer Julie Hirtzel stage four cancer Julie Hirtzel

March 2024 Update

(I wrote this towards the end of February. I’ve hesitated to post it until now. There is an updated addendum at the end.)

I wasn’t sure I’d make it to 2024.  I know… none of us know if we have another hour…  But, I’m talking about the likely progression of my disease.  (If you are new here, you can find my cancer history above where it says, FAQs/History) For example, last January I had a fairly serious metastatic pleural effusion (cancerous fluid around the lung).  According to stats, 73% of people with metastatic pleural effusions are dead within one year.  Life expectancy of liver metastases? Four to eleven months from discovery. Life expectancy of skin metastases with metastatic breast cancer?  Less than one year.  The statistics go on.  You get it. Discouraging numbers. The medications and procedures I’ve been given have helped to extend my life during the two and half years I have been receiving them.  Last fall one of the therapies shrank my total cancer burden quite a bit! In late December of 2023, I stopped all treatment because I had burned through all the types of medicines available to me except for chemotherapies. I’m not open to taking chemotherapy infusions for stage four cancer.  This past week I had a PET/CT scan which showed that my cancer has been aggressively growing since my last scan three months ago.  I’m going to give you the nitty-gritty details of the medical side of my life, but not yet.  I know some of my loved ones want to know everything, others do not and I understand both positions.  So, I guess this post is for those who like a lot of information. For me, knowledge is power. (How many of you just heard the School House Rock song in your head?) Some people assume that my detailed research means I am obsessing, but that is not the case.  I don’t research in a frenzy with anxiety. Research and knowledge make me feel prepared.  Prepared for what?  Pain. Side effects. Grief. Sadness. Death.  How about you?  Do you like to know all the facts or would you rather not?  

This past Sunday I made it to church.  I haven’t been much lately because I’m often just not feeling well enough.  Today I doubled up on my opioids and off I went. (Now there’s a sentence I never thought I’d say.)  Towards the end of the service we sang, It Is Well With My Soul, a profound song that was written by a man who had recently lost his children in an accident. The lyrics are moving for the Christian whether this is the first time reading them or thousandth. 

When peace like a river, attendeth my way

When sorrows like sea billows roll

Whatever my lot, thou hast taught me to say

It is well, it is well, with my soul

It is well

With my soul

It is well, it is well with my soul

Though Satan should buffet, though trials should come

Let this blest assurance control

That Christ has regarded my helpless estate

And hath shed His own blood for my soul

It is well (it is well)

With my soul (with my soul)

It is well, it is well with my soul

My sin, oh, the bliss of this glorious thought!

My sin, not in part but the whole

Is nailed to the cross, and I bear it no more

Praise the Lord, praise the Lord, o my soul!

It is well (it is well)

With my soul (with my soul)

It is well, it is well with my soul

It is well (it is well)

With my soul (with my soul)

It is well, it is well with my soul.

When the Christian states that they are at peace, or all is well, etc., I don’t think it means that they are in a state where they have perfectly achieved these things. It is more a state of being or a position.  As a child of God, I have been given His peace. I believe that God is bigger than my problems. He can hold me in a place of being soul-well, if you will. I can truthfully state that I am at peace, yet still have sadness, pain and insecurities. So, I want your know, it is well with my soul. It is well with my soul.

Back to the medical side of things.  When I had my first scan in this metastatic journey, the report said that I had “innumerable” liver lesions.  Innumerable is a word that hits hard!  I mean, what do they mean?  They actually can’t count them?  They don’t want to take the time to count them?  Whatever the reason for choosing this particular word, it. is. not. good.  A few months ago, I saw the word innumerable again, but in reference to bone lesions (tumors).  :/  This most recent scan used the word again, but in reference to pulmonary micro-nodules (small lung tumors).  Throughout the past years the scan results have ebbed and flowed, but this last scan was not “good”, to say the least. A hard providence, so to speak. Innumerable liver, bone and lung tumors.  My oncologist said that my liver “lit up like a Christmas tree.” Festive. The cancer grew very fast in January while I was having no treatment.  Much faster than anticipated.  As an aside, since December I have been hitting the alternative treatments with increased vigor.  Lots of special teas, supplements, therapies, etc.  Sadly, it does not seem as though they helped.

On the maybe-up-side-of-things a new non-chemo medicine came out that I am going to give a try.  It’s called Truqap and I’ll start it later this week.  It’s so new that not a lot is known about it.  I’m taking it as sort of a, why-not?  Obviously, it has been through many trials, but when I say not much is known about it, I just mean it’s new. If there are a lot of side effects, I can stop it.  Also, I’ll be starting a short round of radiation in a few days.  Did you know that radiation is often given palliatively for pain?  I’ll be getting it to my right iliac wing (hip bone area).  Got my tattoos today!  Yep.  Radiation tattoos.  They are all the rage… you should look into them.  Lol. 

I had a little get away in the San Diego area this past weekend with two of my girls.  We had a GREAT time, but it was also really physically challenging.  

It is well with my soul.

Update on 3/9/24:

I finished my palliative hip/tailbone radiation and it seems to have reduced the pain in that area!  I have also started my new meds.  I initially had some medication side effects, but now they are minimal.  However, the cancer side effects have increased.  For the past few weeks, I have needed to spend almost the whole day in bed, with only an hour or two in other parts of our house.  Walking more than a few minutes is not currently happening and even riding in the car has become challenging.  I have upped my pain meds and feel decent in bed, but as soon as I try to do anything else, I’m quite uncomfortable.  It is difficult to share this news.

P.S. It is tiring for me to respond to texts and calls. Please feel free to reach out… I love hearing from people, but also know it might take me a while to get back to you.



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