Tuesday, February 27, 2018

Immunotherapy

It's been a couple of weeks since my last update, so I figured now would be a good time to sit down and write another one.

I had labs/blood work done on the 14th, which showed that my white blood cell count was still very low, as well as my red blood cell count, so I was told to basically continue to avoid all contact with anyone who has been sick recently. Considering this is the season for flu and strep and everyone has been sick, I should stay quarantined to avoid getting sick myself. My platelet count had also dropped a little bit, again, but was at the borderline for regular and low, so that wasn't concerning. I had my first of three immunotherapy treatments for the clinical trial on the 15th, which was 12 days ago. I received Pembrolizumab, aka Keytruda. This drug is already used to help in the treatment of cancers in the upper body, such as head and neck cancer, lung cancer, lymphoma, and melanoma. The purpose of the trial I'm participating in is to see if it can also help with cancers in other parts of the body. Chemo is used to slow the growth and destroy rapidly-dividing cancer cells in the body. The downside is, we also have rapidly-dividing cells in our body that are good, but the chemo can't distinguish between the two so it attacks all of them. That's why I got so sick, why my blood cell and platelet counts dropped so low, and I had to have the blood transfusion. But Pembro/Keytruda only goes after the cancerous cells, and also prevents them from hiding. I am incredibly lucky to be part of this trial to get this drug because it's extremely expensive and insurance doesn't cover it.

It was given to me through an IV in my arm, and took only 30 minutes. I did get some saline fluids beforehand, but that took even less time. They said there wouldn't be many side effects of this drug. Most common ones were joint pains, muscle pains, coughing, wheezing, general symptoms of an upper respiratory infection. I am happy to report that I've had none of those symptoms, for the most part. That first week after the treatment, I did have something - not sure how to explain it, except for like this: you know how when you work out or be very active and your muscles are tight-feeling the next morning, and you have to stretch them a lot? I had that feeling for the first week. It wasn't painful or even sore feeling, just basically a tightness feeling. I also had a sore throat for a week but that was due to pollen. If you're local in Alabama, then you know exactly what I'm talking about.

I'm no longer quarantining myself either, by default. My daughter made the soccer team at school, and due to practice EVERY SINGLE DAY after school, plus games, there's no way I could avoid human contact. Even if I'd wanted to, my two younger kids both ran fevers for days and with my husband working, I had no choice but to be around them. Zoey likes to stay right on top of me even when she's not sick, so avoiding her wasn't happening. Kollin, on top of his fever, also had diarrhea and vomiting. I thought maybe he had the flu, but a trip to Urgent Care proved otherwise. Point is, I made it through both of their sicknesses and didn't get sick myself, so I declared this QUARANTINE OVER.

I personally feel great. Every side effect I had from chemo is gone, except for my super thin hair, but I've started taking Biotin to help with that. I no longer have any side effects from radiation either, which was mainly just diarrhea and fatigue. I have my energy back and I feel like my old self again, for the most part. My brain and my body aren't on the same page - I don't quite have all my strength back yet, so when I try to do things (for example, yardwork with Kris last week) I tire out faster. That's okay though, it'll come. I'll get there again. I'm just glad to be able to do what I can now.

I go back for my next treatment on March 6th, but I'll have my labs/blood work done the day before. I'm curious and excited to see how my both of my blood cell & platelet counts are by then. As soon as they are all back up to normal range again, I am having my cancer ribbon tattoo retouched. I had it done two days after I was diagnosed, and since it is on the top of my foot, she couldn't do it deep and some of the color faded as it healed. I want to have it redone and have it healed up before swimming time!

In the meantime, it's so nice being out of the house again! I've done some yard work with my husband, went to Kylie's soccer games, painted Zoey's bedroom pink (she's only been asking for over a year), went to a birthday dinner for my friend Holli, and this coming weekend I am doing the Colors of Cancer Glow Run 5K. I won't be running, of course. I'll be walking, but it will be fun and I am looking forward to it. This will be my first 5K in the dark and all the glowing things are just a bonus. A few friends have signed up to do it with me, so I'm thankful for them for doing that. It will be fun to get out and do something. I'm a little desperate for a date night, seeing how the last one was November 3rd, the night I got the above-mentioned cancer ribbon tattoo. I realize that was only a few months ago, but so much has happened since then, that it feels like years ago. The only alone time Kris and I have had since then was going to chemo or radiation,but that's hardly a date, and definitely not romantic - but I wouldn't undo it for anything. I don't know what I would have done without him there with me every step of the way. He's the best, period.

Friday, February 9, 2018

BELL RINGING!

So I went in for brachytherapy and took all the radiation staff some goodies. I made some cupcakes and I made some teal cancer ribbons out of fondant to go on top of them. I also made some chocolate covered apple slices, and then just threw a bunch of other goodies in a bag because I ran out of time to do the rest of what I had planned. I bought some thank you cards and wrote them some personal notes and gave them out. I wish I would have taken pictures, but I didn't have time.

Turns out, it was my last Brachytherapy session! I don’t have to have the last one on Monday because my body responded so well. This session took a little longer than normal because they had a medical student come in and so they were talking about the whole process and showing him everything & explaining what they were doing (and why) as they did it. He’s the one you’ll see in the group photo. Yep, I told him to jump on in the pic with us. Anyway, my treatment itself was longer too since it was my last one, and then when it was over, Dr. Outlaw went up in my vag to cut the stitches and remove my Smit Sleeve. Apparently I’ve been spelling it wrong. When she told him what it was called, he repeated it and she said yep, Smit, S-M-I-T. Like Smith without the H. Dang it! I’m not going back and editing all the previous posts though.

I also asked Angel if they could tell me now exactly what stage the cancer was. If you recall, I had asked at the beginning and Dr. Scalici told me it was probably a 1B or 2A, but she couldn’t tell just yet for whatever reasons (I forgot) and I just never remembered to ask again. So Angel went and had Dr. Outlaw come tell me and show it to me on a diagram exactly where the tumor was and everything. Turns out it was a stage 2B cancer. How about that.

After that, we went out to the radiation lobby and got to ring the bell! Hardly anyone was there because it was after 4pm by then, and they leave early on Fridays. I tried to get Zoey to ring the bell with me, but she wouldn’t. I'm attaching photos. Please ignore the weird lumps in my hair. It’s super thin now because chemo caused a lot to fall out, so after laying flat on my back for hours for the treatment, it tends to look wonky. Also ignore how pale I am. Brachytherapy does that to me. My color is already back, mostly anyway. Zoey refused to be involved in any of the pics.




I’m happy my treatment is done, but I’m not happy to be done there. It's bittersweet. I've really come to love these people. I'm normal there. I'm not looked at all pitiful like I am by other people. I'm not 'the girl with cancer' when I'm there because everyone there has cancer. But I’ll be back there soon, as a volunteer in the radiation department, and I’m super excited about that part. That’s all the info I’m giving out about that. I don't want to jinx anything, plus it'll be tricky getting timing right as well as a sitter for Zoey. I'm sure by now everyone is tired of keeping her daily.

Tuesday, February 6, 2018

Brachytherapy #2

Brachytherapy/HDR number 2 went better than the first. It was still painful, but I guess just because I knew what to expect this time, it was easier to deal with. I took a new book to read this time while I waited the long time for the planning period. Apparently my nurses are all bookworms too, because they were all asking about the book and we all had a good laugh about it and the irony of it. In short, the book is about a woman who died from cancer and her husband keeps getting handwritten letters from her after she’s dead that apparently contain secrets about her that he never knew. I’ll attach pics of the back cover so you can read it for yourself.



Anyway, apparently we are passing this book around the nurses station when I finish it (which will be by tonight) and Brandy (another nurse) couldn’t wait, so she went and downloaded it as soon as she read the cover. I’m excited about that because I love discussing books.

I had labs done before brachytherapy to check all my levels. My platelets are fantastic now! Remember they had dropped down to 28, then dropped again to 25, so I had to do the blood transfusion and that got them up to 54. Yesterday, they were... drumroll.... 238!!! Does that tell you how horribly low they were? Yikes.
My white blood cell count, however, is still bad low. Normal range for someone in my position is 4.30-10. My count is 1.18. I asked her what that meant and she said, “It means you have no immune system right now. You can’t fight off infections or sickness and if you catch something, you’ll end up in the hospital.” So now I’m told not to go in public if necessary and if I do, then I must wear my medical mask and use GermX immediately after touching public doors, store buggies, etc. so I guess it’s a good thing I didn’t go to the ball or birthday party or my aunt’s event. I’m tired of being quarantined!

My first immunotherapy is next week on the 15th, so I have to go in on Valentines Day and get more blood work done for the trial.

When I’m done with brachytherapy, I plan to take some homemade goodies to all my nurses and doctors and some of the other staff members because seriously, they are the nicest people. And they saved my life. Yes, we are paying for those services, but these people go way above and beyond what is required of them. They all greet me by my name when I walk in, and treat me like family. There’s hugs at every single visit. Dottie and Raymond at the front door, they'll chase you down if you somehow manage to get past them without a hug. And then there's Joanie, my clinical trial worker. She has gone out of her way to check on me all the time. I see her at every visit, which obviously was a lot. She's been the one consistent person there through all of this. I am going to miss her, and everyone else, when it's all over.

Usually when cancer patient’s treatments are all over, they say they never want to see “that place” again. But this whole experience changed my life in more ways than one, and my treatments may be ending soon, but me going to that building won’t be ending. That’s all I’m saying for now. There’s still details that have to be worked out.

If any of you, whether I know you or not, have questions about ANYTHING, please feel free to ask. Seriously. No matter how personal, because clearly I have no problems sharing details. Want to know my symptoms, ask. I'm an open book.

Sunday, February 4, 2018

Brachytherapy has begun.

I started Brachytherapy this past Friday. In case you're just joining in on the blog, brachytherapy is also called HDR, which stands for High Dose Radiation. It's done internally. This is how the first one went for me...

Unlike the external radiation, there was no Gas-X to take and no excessive amount of water to drink before each session. Instead, one hour before my appointment time, I have to take two pills: one is Dilaudid, which is for pain. The other is Valium, which is to make me relaxed and calm. When I got there, I got brought into the room to remove my clothes from the waist down & put on a gown. I was told to leave my socks on since the room is cold. Then I'm taken into the procedure room. I lay on a very narrow bed and my legs go up into stirrups. Not typical stirrups where your ankles sit in the little cup thing - nope, it's a long one. Everything from my knees to my feet go into the stirrups, and then they velcro a few straps over each leg. Then Angel (my nurse) tilts this table to where my butt is up in the air and my head is tilted down toward the ground, and then inserts a catheter into my peehole. This was not pleasant. It hurt quite a bit. I've never had a catheter put in when I was awake. She did put something on there beforehand to somewhat numb it, but it didn't help much. Anyway, one the catheter is in, she inflates some balloon up inside me to push my bladder away from the area that will be treated. After that, Dr. Outlaw comes in and inserts several metal rods into my smitt sleeve (the plastic tube they sewed into my vagina) to see which one is going to work the best for what needs to be done. This is also pretty painful, as you can imagine it would be. I mean, metal rods being put in and out of you, being tilted and shifted in different angles, it hurts. Once she found the one she wanted to use, Dr. Outlaw takes what felt like 40 yards of gauze (which is soaked in saline and KY Jelly for comfort) and packs it up into my vag. This is by far THE MOST PAINFUL PART. So as of that moment in time, I have a catheter, a balloon, a plastic tube, and metal rods inside me already. Now she's adding gauze. And the more she adds, the more painfully aware you become of all those things inside you. Everything hurts. It's taking everything in me to be still and not to move, and thankfully Vickie, the radiation tech, is up by my shoulders giving me pep talks and just talking to me about random things, trying to keep my mind off the process. She says just pretend I'm a turkey being stuffed for Thanksgiving, to which I immediately replied "Turkeys are dead!" They laughed, and then I did, and at least for a moment I wasn't thinking of the pain. But for real, OUCH. You think there's no possible way anything else is going to fit in there and she proves you wrong. Yall, I was never a slutty girl, my vag is not loose enough nor equipped to handle this type of load. Gah. Finally that's over, and then Angel pushes several big syringes of saline into the catheter to fill my bladder to max capacity. Then they very gently take my legs out of the stirrups and prop them up under a couple of pillows on the table. I get covered up with a few sheets, and then they tilt the table back flat and wheel my bed out into the hallway and down a million hallways. We end up in the room for a CT scan to make sure the placements of the rods (and everything else inside there) is exactly here it needs to be. Then we go back to the procedure room I was in and the waiting begins while they plan my treatment doses. This is serious business and takes a long time. This session took an hour and a half of waiting, which honestly I didn't mind. The only thing is you can not move! You have to lay there with the rod poking out of your vag and all that gauze and the full bladder and be as still as you possibly can. They turned on some music for me and Angel sat in there and talked to me for the majority of the time. I told her she didn't have to, but she said she had nothing else to do but paperwork and it could wait. We talked about lots of things and I enjoyed our conversations very much. I wish I could share them, but I am going to wait on that for now, but I'm super excited about some future plans! The other nurse came in for a bit and talked too, but she mostly stayed out there and did her paperwork while we waited. Finally, a man doctor comes into the room with some rolling machine. He hooks some wires from the machine to the thing in the closet, then some more wires from the machine to the rod sticking out of my vag. Dr. Outlaw says "It's showtime, see you in 184 seconds!" Wait what, that's only 3 minutes! Yes, the actual radiation part is 3 minutes. And I could feel it pulsing inside me. That part didn't hurt, just felt weird. When it was over, he came back into the room, unhooked the wires from my cooter-rod, then unhooked the other wire from the closet thing and left. Dr. Outlaw and the nurses come back in and she removes the gauze from in there. It felt... I don't know. In between uncomfortable and painful. She just kept pulling and pulling. You know the clown trick where they pull the colorful ribbon rope from his sleeve or hat and it just keeps coming and coming? That's what I pictured while it was happening. After that, she removed the rod and then Angel drained the saline from my bladder, and then removed the catheter. Again, OUCH. Although it wasn't as bad coming out as it as going in. After all of this, I am done. I get dressed and they rave about how great of a patient I was, how I must have a high pain threshold. I don't feel that way, because that shit hurt pretty bad... but they said if I saw how everyone else acted, I'd be amazed as how well I did. Hmm.

Overall, it was a long session. Started at 11, done at 3. Mercy. Only 4 more of these to go. Yay.
But then, I am done with it and all I'll have left is Immunotherapy for the trial.

Side effects from brachytherapy: Pain, obviously. Bleeding. Pain. Cramping. Pain. Soreness in the whole downstairs area. But considering everything they did, that's all to be expected.

As a result, everything we were supposed to do this weekend, I didn't do any of it. We were going to go to the St. Jude Joy of Life Ball last night, which I was really looking forward to because not only does the money go to St. Jude to help children with cancer, the band playing at the ball was Fly By Radio. First of all, I love them. Second of all, it seemed soo fitting that I'd see them at the end of my cancer journey because in a way, it started with them too. No, the band didn't give me cancer. But the night we went to see the play for my birthday back in September is the same night my symptoms got so bad that I knew it was time to call the doctor. So since they were at the beginning of it all, it was going to feel a little symbolic and awesome to me to see them at the end of it. But like I said, I didn't get to go. However -- my friend Erinn, who is on the committee of the ball, surprised me with a video clip of her and the band giving me a personal get well message and blowing me kisses. Kris saw it before I did and of course I got teary-eyed. It meant so much that she went out of her way to do that, and that they took time to actually do it. We also had a birthday party for a friend's twin boys and another event at my aunt's house and I just didn't go to any of them. I hope everyone understands. It's almost over y'all, just bear with me.

So anyway, that's the update on that. I get to go back this week and do it all again on Monday, Wednesday, and Friday. But they said these won't be as bad as the first one. The first one is always the worst, they said. And at least now I know what to expect.