Liver Function Progress

I’m getting closer! Last week my liver function number was 67, and this week it’s down to 36! Normal is between 0 and 33, so I’m almost there. This week’s number is good enough to drop my prednisone dose to 10mg, and it puts me on track for infusion next week. The only changes I’ve made are taking 2 doses of Aleve each day to manage low-level pain, and I’ve been a complete teetotaler for the past few weeks instead of having an occasional glass of red wine or dark beer. I do miss my nightly glass of red wine! Oh well, small sacrifice if it’s making a difference. I’m hoping the lower prednisone dose will let me lose my steroid “moon face,” get my tastebuds back, and decrease the sensitivity in my teeth.

I started with a new physical therapy practice last week, and my exercise regimen has doubled. The therapist is hooking me up with a hand specialist for a consult to see if they think any improvement can be made with my left hand function. She’s also given me contact information to have my left foot/calf brace re-evaluated for one that might allow for more ankle movement. All of this exercise has me feeling good!

I also had my first acupuncture appointment last week and go again today. It went really well! She used 15 needles, including 4 in my right ear for PTSD, for the trauma she said I’ve been through with cancer treatments – interesting. She put needles around both elbows and ankles, and I think there might have been one on my left shin. I was very comfortable and relaxed throughout the appointment. I had been having terrible cramping in my right foot and ankle almost nightly that would wake me up and get me out of bed to do stretches and massage. The last time that happened was the night before my first acupuncture. I haven’t had any of those episodes since! The other change I’ve noticed is that I’m dreaming a lot more. I’m anxious to discuss those changes with her today.

We hosted a Super Bowl party with friends and family. The planning and preparations were fun, keeping me busy with games, a points pool, and Philly food (cheesesteaks with Amoroso rolls and whiz, soft pretzels, and Tastykakes). Everyone seemed to have a good time, and the Eagles won!!!

The first ever Melanoma Support Group meeting is in the books! Patients and caregivers came, and our program was well-received. We’re on our way! This makes me SO happy!

This week I’m on the dreaded PET scan diet for 3 days – low carb/low sugar. I’m always sick of eggs and strawberries (only fruit allowed and limited to 10/day) after these 3 days! However, I seem to have a better attitude about it this time around because I know I needed a diet reset. My weight has been slowly creeping up since Christmas, and this will start the decline that I hope to continue. Once I lose the 8 pounds I’ve gained since Christmas (already halfway there), my goal is to lose at least 14 more.

The PET scan and brain MRI are both scheduled for this week, and our fingers are crossed for no new surprises. As long as my tumor load stays low, we’ll continue to have hope and wait for the next research breakthrough that might finally get me into remission. Cheers!!

 

Oh January!

It has been over a month since my last post, and I could just write “ditto” and be done! My Opdivo infusions are still being withheld due to an elevated liver function, I’m still exercising, and the new Melanoma Support Group is still on track for its first meeting February 6th. I’ll fill in a little bit (or a lot!).

The highest number for my liver function was 362 on November 16th. It dropped weekly until December 12th when it peaked again at 295, a lower peak. Then it dropped weekly until it peaked again on January 18th at 197, an even lower peak. Last Thursday, January 23rd, it dropped to 82. Normal is between 0 and 33. I’ll have it checked again this Tuesday – bets on a peak or lower? Of course my prednisone dose is continually adjusted based on the number – back up to 60mg/per day when the number peaks, and lower dosages in between the peaks. Right now, since the number dropped, I’m at 20mg/day. The goal is 10mg/day with a “normal” liver function to make me eligible for infusion in February.

Christmas happened since my last post and it was wonderful! Anytime we have our family together, I’m happy. My taste buds weren’t working, but I prepped, baked and cooked anyway. I had so many cookies in our home! The prednisone kept me moving! We went to the library with the grandkids to see the train display, and got to spend quality time enjoying them. It was fun watching how much they enjoy playing with each other. We even got to be part of a new puppy adoption which was the sweetest thing ever! Welcome to Libby, our new grandpuppy golden doodle!

We also took a short trip to Topsail and Raleigh to celebrate a grandchild’s 8th birthday. We stopped in Salisbury on the way down to visit with Steve and Em, and enjoyed our new favorite Italian restaurant only minutes from their home. The beach is a magical place of healing, except when a stomach virus goes through your son’s family! Our granddaughter was sick just before the trip, and then our son got sick that Sunday, our grandson Sunday night, and our daughter-in-law on the way home Monday. We were still able to enjoy each other and the puppy, the sand, ocean sounds, shelling, seeing dolphins,  finishing a puzzle, reading, and watching the Eagles win! Bill and I made it home Wednesday before we both got a mild case over the next two days.

I’ve kept up with my exercises except for two weeks when I felt too sick – sinus infection (prescribed Augmentin but given generic – Amoxicillin) and stomach virus. I had to call to have the prescription extended after 10 days because I still had no sense of taste, my teeth still hurt, and I still had ear pain and sinus pressure. The extra 4 days ran out, and it’s still not gone, but better. I think doing a sinus wash nightly is helping a lot.

I met with the exercise specialist, and she suggested that I just do one exercise per day instead of trying to do the entire set. What a difference that made! My mindset changed from “I can’t do this because I don’t feel well enough/I’m too tired/I have too much pain” to “I can do this one easy thing.” After doing that “one easy thing,” I was often able to do one more, and then one more. Now I’m doing several exercises each day and working back up to the full set every other day. The one thing I haven’t been doing is walking – first it was too cold outside, the sidewalks were snowy/icy, and then too much pain. I guess I’ll have to join the mall walkers!

The exercise specialist also encouraged me to try a Tegaderm dressing on the deep scab that remains on my right leg wound. This clear dressing basically seals the wound and softens the scab. She used to play softball and always had painful brush burns that healed by using this dressing on them. The scab is quite painful and is taking forever to heal, especially with the prednisone. So I started Tegaderm, showering and changing the dressing when it becomes “goopy.” I use the handheld shower attachment and really spray the heck out of the scab. Then I blot it dry with a 4×4 and apply a new dressing. It’s working!! The pain has lessened and the scab is slowly softening and reducing in size bit by bit. March 10th will be a year since the surgery that created the wound! What a journey!

I was surprised by a lot of right hip pain this past Tuesday and Wednesday. I blamed it on over doing it on Monday and causing extra lymphedema. Knowing I shouldn’t take Tylenol because of my elevated liver function, I called my oncologist’s nurse to learn if there was anything I could take to get some pain relief. She said that Tylenol will mask the pain, but Aleve or ibuprofen will actually lessen the inflammation causing the pain. I’m taking two Aleve a day and it has helped tremendously!

I’ve started back into crafting. Being creative helps my mood. I was actually able to do some cross-stitch on a plastic canvas. It’s not as neat as I used to be able to do with two hands, but it’s not horrible. I saw a collage another patient completed using the greeting cards she had received, so I got out my bags of cards and cut out inspirational sayings, birds, flowers, dragonflies, sunshine, and hand-written messages of love, encouragement and support. Next I plan to arrange them on a canvas so I can look at it and feel the collective love! I’ve also painted more rocks and just collected even more to start painting this week. After the threat of snow is gone, I’ll place them around the walkway at the Cancer Institute. I also have a small Christmas tree I want to make with my daughter using my mother-in-law’s jewelry. She loved Christmas so I hope this will become a fitting keepsake.

I have my 3-month scans scheduled for February 9th, and infusion (hopefully!) for February 13th. As usual, there’s a lot of hope focused on the results! Decisions will be made on potential radiation at that time.

In the meantime, I’ve set up a new physical therapy consult with our neighbor, and I’m going to try acupuncture for the first time this week. Something is bound to help! Onward!!

Prednisone Continued

My Opdivo infusions continue to be withheld due to my elevated liver function blood tests thanks to Yervoy causing autoimmune hepatitis (after colitis). I was down to 10mg of prednisone a day but my numbers jumped up a bit, so last Friday I had to start back on 60mg of prednisone a day for a week, then go to 40mg for a week, 20mg for a week, and then 10mg for a week (or longer), which will put me on track for infusion on January 4th. That was the plan till yesterday’s liver function bloodwork came back with an even higher number (295) than last week’s (152). So today I start five daily infusions of Solumedrol (methylprednisolone) in place of the prednisone, which should provide a faster response. Solumedrol is a potent anti-inflammatory steroid with greater anti-inflammatory power than prednisolone so it should knock down this autoimmune response, and I’m hoping for lower liver function numbers next week! I’ll start back on 60mg of prednisone Monday morning and have my liver function tested again.

Although I voiced my concerns about being off infusions for two months, my oncologist assured me that this is not unusual, and that the Yervoy is still working in my system. Plus, I had no new metastases in my last scan, just already existing tumors.

I asked about scheduling radiation on my right hip now that I’m feeling better, but my oncologist wants me to hold off till I’m on the Opdivo infusions. That gives me a reprieve till January, at least.

Last week I revisited the audiologist for a 6-month checkup on my hearing and ear tubes. I had to have the tubes inserted during my hyperbaric oxygen therapy treatments back in June. My hearing is good, and both tubes were still firmly in place. I asked about having them removed rather than continue to wait for them to fall out on their own (could take another six months!). My concern was how much it would hurt. The doctor said that some describe it as the worst pain they’ve ever felt, while others tolerate it well. He also said that women tend to tolerate it better than men. Well, I knew it wouldn’t be the worst pain I’ve ever endured, but I wasn’t too excited about having to deal with any pain on any level. I finally decided to have one tube removed to see how it went. The doctor said the left tube was a bit crustier and might be the easiest to remove. The shape of the tube is like a bar bell that has to be pulled/maneuvered out of the ear drum. Well, it did hurt and was uncomfortable enough that I chose to stop after one. Now, of course, I wish I had just gotten the right one removed too. Oh well. I go back in six months so, if it hasn’t fallen out by then, I’ll have it removed in June.

Exercise is still going well. I’ve walked as far as a mile, including yesterday, and I feel as though I have more endurance. Of course the prednisone has me in fairly constant motion. I’m increasing my reps, though I haven’t increased weights yet. Completing the exercises and documenting my progress gives me a great sense of accomplishment! I like feeling as though I’m doing something every day to become stronger and healthier.

The Penn State Cancer Institute Melanoma Support Group is all set for its first three meetings. The flier is ready to be printed, a Facebook group has been created (Penn State Cancer Institute Melanoma Support Group), I ordered some resources from the Melanoma Research Foundation to distribute, and I couldn’t be more excited! I created a meeting evaluation form, a survey to learn of members’ interests in meeting topics, and we have a great start on a set of resources to share that include books we’ve read, blogs we follow, and organizations, conferences, and websites we recommend. We’ll meet the first Tuesday of each month from 5:30 to 7:00pm in the Cancer Institute. The first meeting is in T2500 where Cathy Bryan, Cancer and Exercise Specialist, will introduce us to the research being done in the Exercise Medicine Unit (EMU), an exercise room located in the 2^nd floor infusion suite. The EMU opened in late summer 2016, and is part of the Schmitz Cancer and Energetics Lab. The mission of the Schmitz Lab: “The Schmitz Lab is leading a transformation in cancer care, by establishing evidence-based physical activity and nutrition interventions as the standard of care from the point of diagnosis forward, including active treatment, rehabilitation, and for the balance of life.” The most prominent study currently running in the EMU is the EnACT Study, Exercise in All Chemotherapy, an exercise intervention that offers an individualized exercise program for patients currently going through chemotherapy. With 50 patients currently enrolled, the goal is 250. This is the study in which I’m enrolled!

This month, December 17th to be exact, marks the 10-year mark since I was diagnosed with Stage II melanoma. I’ve been Stage IV for a few years now and can barely believe all my hubby and I have survived together! Just last year I was preparing for a December 22nd brain surgery! Our scars are our marks of struggle, strength, and endurance. Cancer doesn’t take a break, but is a journey full of twists and turns, highs and lows. Cancer has been a life-changing event for both of us. We continue to love and move forward through all of it. Together we are facing the future with great hope. I read this in the Lily Oncology On Canvas: Expressions of a Cancer Journey, “Living each day as though it was the most important day of your life is the strongest defiance that one has against the devastation of cancer. One may not always come out on top of the disease, but is always able to be victorious if each day of one’s life brings new wonders, joys, and triumphs.” Every day is a gift with a new sunrise and I feel blessed. Life is too short to be grumpy and miserable! I strive for happiness and good health, and a new day to celebrate life.

Recovery Going Strong

We met with my radiation oncologist on November 7th and discussed treatment options for my right hip. He recommended a 5-course treatment over 5 consecutive days that shouldn’t produce any major side effects. Since I was (and still am) recovering from my last combo infusion of Yervoy and Opdivo on October 12th (plus the flu shot), we decided to wait till I was fully recovered and at least until after Thanksgiving. So I’ll be calling him eventually to set up an appointment to sign the consent and get the simulation done.

I was really impressed with the care I received from everyone at the Breast Center! I had the breast biopsy on November 14th, and the results came back the next day as melanoma – no shock there. There’s no big rush to treat it although I’ll probably have it surgically removed and just get rid of it while it’s still small (9mm). We might wait till after my next PET scan in February to make that decision.

My first scheduled infusion of Opdivo was withheld on November 2nd because I was still suffering from colitis. My second scheduled Opdivo infusion for November 16th was also withheld, even though the colitis was resolved, because my liver function bloodwork was wacky. The ALT normal range is 0-33, and my number was 362. Although it had been climbing through the fall (9 on 8/31, 21 on 9/21, 35 on 10/12, 61 on 11/02), it took a big jump this time. The AST normal range is 0-32 and my number was 205 after being 32 on 11/02. Together, this points to autoimmune hepatitis thanks once again to Yervoy. The prednisone treatment I thought I had successfully avoided was now back on the table. Starting Friday, November 17th, I take 60mg every morning through at least Tuesday the 21st. That’s when I’ll have the labs redone to see if I can start tapering off or not. The prednisone has me cranked up with extra energy and little sleep (guesstimating 3-5 hours per night), but it hasn’t made me extra hungry yet so I’ve been able to maintain my 25 lb. weight loss – yay me!

I completed my exercise sets six times over the first two weeks. Since Thursday I’ve already completed them three times – steroid energy for the win! Today I even completed a goal I’ve been working towards – I walked to the corner and back in 18 minutes. Now my sights are set on a half block roundtrip walk! It felt great to be outside!! I loved the smell of the fallen leaves and watching them swirl in the wind. I felt blessed just to be able to enjoy those simple things – nothing is taken for granted anymore!

We’ve got great momentum on the new Melanoma Support Group! The two women on the committee with me are fabulous and bring a wealth of insights and experiences. It’s amazing to hear how different our stories are and all we have survived! We are made of strong stuff – scars and all!! Our dates are chosen with a February start date, a room is being reserved, and the flier is ready for final approval. We have a great list of potential guest speakers that will certainly get us through our first year. I still want to create a survey to capture participants’ interests on meeting topics to be sure we’re addressing their needs, and an evaluation to gauge what we did right and on what we can improve from meeting to meeting. This fills my heart with hope – a gift we all can give to someone else!

If you made it to the end of another long post, thanks for being on this journey with me! Wishing you and your family a wonderful Thanksgiving together – make some memories!! We’ll have a full house and I can hardly wait!!

 

Recovery Mode

Earlier this week I met with my surgeon to check on the skin graft’s healing. The “islands” of skin coverage are larger. He wants me to leave it exposed to the air as much as possible so it dries. I’m also supposed to gently wash it with Dove and a washcloth to debride some of the gunk. He’ll check again in a month.

After that appointment I met with the Cancer & Exercise Specialist (exercise physiologist) working with solid tumor patients on a research study, “Exercise in All ChemoTherapy (EnACT)”. The purpose is to learn if one-on-one exercise counseling will help one become more active, resulting in fewer side effects, less cancer related fatigue, improved quality of life, and improved function. She’ll provide a customized exercise prescription to follow and chart at home. The program includes cardiovascular exercise, strength training, balance training, flexibility and range of motion, and relaxation and rest. It was a no-brainer and I signed the informed consent.

Thursday was my PET/CT scan with labs, oncology, and infusion (1st Opdivo only, w/no more Yervoy) also scheduled – a long hospital day. Bill had to wheel me to nuclear medicine because I was too weak to walk that far. I had been feeling ill since my last combination Yervoy-Opdivo infusion 3 weeks prior, so I wasn’t feeling very hopeful about the scan results. Immediately after the scan I scarfed down two granola bars (I actually felt hungry!), and then we checked into the Cancer Institute.

After the scan and check-in to the Cancer Institute, we met with the exercise physiologist. She reviewed my notebook with all of the PT exercises I’ve done, and tried out a few exercises with me. She’d prepare the exercise program and deliver it to me while I was in infusion later that day. She also provided me with some equipment to use at home to do my exercises.

Scan Results: Overall, big picture, the results were fairly better than I expected because there was nothing new. There were two “old” things that need attention. First is the right outer lower breast nodule that was 8mm and mildly FDG avid 3 months ago, and is now 9mm and moderately to intensely avid. It’s still small, but moving in the wrong direction, so it was recommended to follow-up with ultrasound. Second is a new intensely avid linear lucency in the right hip that appears as a fracture. Since the rest of the right hip showed slight metabolic improvement, x-rays were recommended to rule out a fracture.

Right Breast Ultrasound Results: Because it had been 6 months since my mammogram, which was clear, I had a 3-D mammogram and ultrasound. It was confirmed that it’s a small solid tumor, but cannot distinguish between breast cancer or melanoma. I’m scheduled for a quick biopsy on the 14th to help make that determination which will decide treatment options.

Right Hip X-ray Results: “No radiographic correlate for abnormality in the anterior column of the right acetabulum seen on PET/CT.” In other words, no fracture!

Because I was still suffering the side effects of the Yervoy-Opdivo combo infusion from 3 weeks ago, my oncologist withheld my Opdivo infusion – I’ll start in 2 weeks. He prescribed a higher dose (60mg/day) course of prednisone to try and break me out of this sickness cycle and end the diarrhea. Well, my appetite improved a bit during Thursday afternoon. I woke up Friday feeling a bit better and decided to wait and see if I would have another episode of diarrhea before starting the prednisone (I really don’t do well on it!). I’m still waiting for that episode, knock on wood, so I haven’t taken any prednisone yet. I’m certainly not ravenous, but I’m trying to eat a little more and actually feel hungry at times, and I haven’t lost any more weight. I’m also finally starting to get some sleep, which the prednisone would have fully robbed from me. So I think I’ve turned a corner and am improving. The exercise feels good and I think it has helped my mood and ability to sleep. At least I’m not a constant lump on the recliner anymore!

My thyroid function had a bit of a change from low functioning to higher functioning, so my levothyroxine dosage was decreased. Yervoy had effected it 3 years ago.

This coming week we meet with the radiation doctor to review all of these results. There’s no urgency in immediate treatment, so we’re inclined to let my body continue to recover a bit longer. We’ll see what he recommends and go from there.

I finally made the move to begin a melanoma support group at the Cancer Institute. The nurses put me in touch with two other women with a similar interest and they’re both onboard to help. We meet for the first time on the 13th. This is something I’ve been wanting to do for years, and it gives me a great feeling of purpose!

Yervoy Side Effects

From https://www.yervoy.com/side-Effects: “The most common side effects of YERVOY include tiredness, diarrhea, itching, rash, nausea, vomiting, headache, weight loss, fever, decreased appetite, and difficulty falling or staying asleep.” I’ve already had the itching and rash side effects, so I guess that left all the rest for after the 4th and final treatment. Luckily, knock on wood, I haven’t been vomiting. What I still have since Thursday night are tiredness, diarrhea, nausea, minor headaches that come and go, fever, decreased appetite (as in no appetite) with corresponding weight loss, and difficulty falling or staying asleep. I’m either sweaty or chilly, especially throughout the night, which might be fever-related?

Last night I pulled out Dr. Block’s book, Life Over Cancer, to search for some solutions. To offset the diarrhea, it suggests to drink lots of filtered water to stay hydrated. Sip small amounts of clear, room-temperature liquids throughout the day. To maintain the electrolyte balance, eat fish, bananas, and potatoes, as good sources of potassium, and crackers and pretzels because of their sodium content. Diarrhea-fighting foods include rice porridge, tapioca, barley broth, miso, and potato-based veggie soup. Some other foods that might help are white rice, cream of rice cereal, refined white flour products such as white bread and noodles, eggs (not fried), low-fiber veggies (peeled cucumber, peeled potato, peeled zucchini, mushrooms), and low-fiber fruit (applesauce, grapes, peeled peaches, bananas, mandarin oranges, tangerines, melons, mango, plums). Bananas and applesauce are the fruits of choice because they contain pectin. Eat small, frequent meals and snacks.

I am waiting for a callback from my oncologist’s nurse to see if there is anything else I can do to offset these side effects besides chewing a GasX tablet four times a day and taking Omeprazole. . . After a few back and forth messages, orders are now in for me to pick up a “kit” from the lab tomorrow to provide them with a stool sample, and to get an x-ray to rule out any blockage. In the meantime, I’m wondering if I might need a higher dose of my thyroid medicine (initially needed after taking Yervoy a few years ago). I’m going to message my oncologist now in case I could have blood taken while I’m there tomorrow. It’s time to get to the bottom of this so I can begin feeling better.

Last Combo Infusion & Skin Graft Update

This past Thursday the surgeon checked my skin graft and said that there are islands of the graft that have taken. I still have to redress it daily but can drop the wet-to-dry step. He also said to let it air out as I’m able so it dries a bit. I’ll see him again in almost three weeks.

Thursday was my last Yervoy/Opdivo combo infusion (4th of 4). After this I’ll only get Opdivo every two weeks (easily tolerated and a much shorter infusion). I also got my flu shot. Although the only side effect I had experienced up till now was a slight decrease in appetite, that changed Thursday night with an entire lack of appetite and chills that kept me awake till 1:30am. Yesterday I still had no appetite and added a second dose of omeprazole to try and ease the belly bloat and constant burping (didn’t work). The chills started earlier around 5:30pm and I couldn’t get warm. We finally took my temp – 102.9F. I took two extra strength Tylenol and that helped a bit. This morning was the same story: bloating, burping, no appetite. Then my body added an episode of diarrhea – grrreat. These are all common side effects of Yervoy that I was fortunate to avoid through the previous three treatments.

To make sure I am doing all I should to control side effects, I talked to the on-call doctor. Sounds like I’m doing everything right except I should increase fluids. If I worsen or feel that I cannot manage at home, he suggested I visit the ED for lab work. However, without examining me, his best guess is either the Yervoy catching up with me, or the Opdivo (immunotherapy) ramping up to interact with the flu vaccine. Makes sense.

Tonight I took the Tylenol around 4:30 before I got the chills, and it seems to be helping. I do NOT feel horrible, just slightly under the weather. Chocolate Ensure, hot tea and a daily banana are sustaining me. I have survived much worse than this! 😁

Onward and looking to a better week ahead!

Learning Never Ends

It’s only Wednesday, but I’ve already done so much learning this week! It has raised a ton more questions, which is a bit frustrating but also motivates me to learn more. It all started with news from the Melanoma Institute Australia on their clinical trials of COMBI-AD: Dabrafenib (Tafinlar) with Trametinib (Mekinist). It’s a BRAF inhibitor, and that’s the tumor gene mutation I have. Most research is done on the NRAS mutation because it’s more common. They’re also doing a trial called CheckMate 238 which compares Nivolumab (Opdivo) to Ipilimumab (Yervoy). Those are the two drugs I’m currently taking. “These clinical trials show we now have ammunition to prevent melanoma spreading and progressing, which until now was a critical area of disease behaviour where we had no control,” Professor Georgina Long, the institute’s conjoint medical director, said (http://www.sbs.com.au/news/article/2017/09/11/we-now-have-ammunition-breakthrough-fight-against-melanoma).

There’s another study, KEYNOTE-022, in Phase 2 that is testing Pembro (Keytruda) with the addition of  Dabrafenib and Trametinib: see http://ascopubs.org/doi/abs/10.1200/JCO.2016.34.15_suppl.TPS9596 and https://clinicaltrials.gov/ct2/show/NCT02130466. So, thank goodness for continued research!

Also this week I started watching Square One modules from https://www.chrisbeatcancer.com/. Module 1 opened last night and a new one (10 modules in all) opens each night at 9pm and is only available for viewing for 24 hours. Module 1 basically boiled down to this – your body (and your diet, lifestyle, environment) created cancer and your body can heal it. Your choices matter. Make your internal terrain inhospitable to cancer. You are what you eat. There’s no magic bullet – small changes will not lead to big results. You need to commit to at least a 2-year hard core life change to heal and reduce the risk of recurrence.

In addition to Chris’s testimony (13 years cancer-free), there are other patient testimonies on his site with links to resources, products, etc. I was especially interested in the story of Bailey O’Brien who beat Stage IV melanoma (also my stage). She has her own website here: https://www.baileyobrien.com/. After she reached a dead-end with traditional therapies, she looked into alternative therapies and traveled to Mexico for treatment. She is now 6 years cancer-free! I have followed her links to Gerson Therapy and Coley Fluid. Although she went to CHIPSA hospital, it closed in 2013 and has since reopened under new management. She seems to be recommending the St. Andrews Clinic now, also in Tijuana, Mexico.

Other resources I’m still reading include:

http://gerson-research.org/

Beta Glucan (supplement) – supercharges your immune system?

The Truth About Cancer

Believe Big

I’ll have a few new questions for my oncologist next week, and then it might be time for a phone consult with the Block Center. I think it’s been 2 1/2 years since our initial visit. Here’s to learning!

The Summer of HBOT

The longer I wait to post, the harder it is because so much happens each month! The trouble is that in the cancer world, if you don’t post regularly folks start thinking the worst. Well, we’ve put off “the worst” for a bit longer :-). I’m doing well!

In my last post I mentioned the bulge in my left pectoralis muscle and the discussion over possible treatments. Well, I ended up having radiation at the end of June. The radiation consultation was on my birthday with the planning session a week later. I had five treatments each day for five days (June 27-30, July 3). My left shoulder area still feels heavy as a result which I guess will dissipate over time. In my last PET scan, the “bulge” was getting smaller.

In May I began HyperBaric Oxygen Therapy(HBOT) treatments every weekday. During my ninth dive I experienced ear pain and had to visit an ENT doc to get tubes in my ears. Otherwise it’s been quite uneventful, thank goodness. From the time I leave the house till I get back home again, it’s about four hours. Next Tuesday is my 70th and final treatment. It’s been quite the commitment and the sacrifice of my summer. The good news is that it’s working (VERY slowly) and my wound is filling in. It won’t be completely skin graft ready by next Tuesday, but it’s gotten me a lot closer. I also had outpatient surgery last Friday to complete the debridement in areas that would have been too painful to debride while I was conscious, and to drill small holes in the exposed bone in order to encourage tissue growth in that area. I had this bone drilling procedure two years ago and it was quite successful then. My pain level seems much lower since Friday, and I even decreased my pain meds, going off the long-term pain patch Sunday night. Now my dressing is just wet-to-dry twice a day, which is a bit simpler. I do NOT miss the Mesalt dressing at all!! That bugger hurt!!

I had been on Keytruda infusions every three weeks since May 29, 2015 – over two years! While I’ll say that it kept me alive, it never got me to remission. Every PET scan, every three months, had some new suspicious area, inflammatory spot, and/or metastases. It was always small, but was always something worrisome. My last PET scan was the same way with a very small spot in my right breast and inflammation back in my right hip, so my doctor finally decided to change things up. My last infusion was a combination of Yervoy (ipilimumab) and Opdivo (nivolumab), both still immunotherapies like Keytruda. Yervoy stimulates T cells to fight melanoma and Opdivo allows those T cells to recognize melanoma and attack it. Good combo, right?! It was expected that I would get diarrhea from the change in drugs, but I didn’t. I also expected a full body rash from the Yervoy, which I’ve had by itself before. I didn’t get the rash, but I do get a new itchy red welt every few days. That’s it for side effects so far – very manageable! I’ll get a total of four combo infusions, and then be on Opdivo by itself depending on the next PET scan.

The great news is that my tumor load continues to be small. With new metastases showing up in every PET scan we’re devastated for about 24 hours because we’re always hoping for no evidence of disease. Then we get back in fight mode and remind ourselves of the small tumor load. We’re at least grateful for that! Sometimes I have to look at a ruler and remind myself how small mm and cm are!

So, coming up is my next combo infusion (#2 of 4) and finishing up the tissue growth in my wound so I can get the skin graft to finally close it! Remember, the initial surgery that started this wound was March 10th. It will easily be six months from that surgery till the skin graft is scheduled in late September (I hope!!). I’m hoping that my next post will be about the skin graft!

With the skin graft done, I’ll rejoin the gym and do that regularly to lose steroid weight and get strong. They know me there, so I know I’d be in good hands. I’m hoping that with the wound finally closed, I’ll be able to ditch the brace a few times a week to help strengthen my left side. I’m anxious to be more active, especially outside. This week I’ve had two people tell me that they think I’m moving better already :-).

Think good thoughts for granular tissue growth in the wound!!! I look for it every time I do the dressing change!

PET Scan Results & New Treatment

I’ve had lots of appointments in planning for healing my surgical wound, which they’re now calling a radiation wound since the radiation I had for the tumor back in July is the reason for the tissue damage and the reason it won’t heal.

I visited my family doctor (ended up being a physician’s assistant, but he was great!) for my left knee pain since it’s no better and is really impacting my mobility. After a thorough exam, he recommended an x-ray and prescribed additional physical therapy just for the knee and Meloxicam to reduce inflammation. The xray results: Findings: “There is mild narrowing of the medial joint compartment and tricompartmental marginal osteophyte formation. No joint effusion. No fracture. No lytic lesion.” Impression: “Moderate degenerative change of the left knee” I’ve already begun the physical therapy sessions to strengthen my quads, something I’ve been trying to do for months. I’m even going without my brace every other day to try to strengthen my ankle and knee. Next step will be to see an orthopedic doctor.

I had a consult at the Center for Wound Care at the Rehab Hospital for hyperbaric oxygen therapy (HBO). Apparently my wound is a perfect candidate for HBO since this kind of wound has the most success with that treatment. I needed a CT scan of my lungs and a current echocardiogram to be approved.  My echocardiogram was clear with little change from 3 years ago. My lungs were clear in the PET/CT scan I had yesterday. My wound care specialist prescribed Ciprofloxacin Hcl 500mg for 10 days to combat the pseudomonas infection. She also prescribed Neurontin (Gabapentin 300mg), starting me on the lowest dose for the nerve pain I have in my right lower leg.

I’m scheduled to begin HBO on Monday morning. I need to arrive 30 minutes prior to my treatment to prepare. That means changing into a 100% cotton gown. I’ll also be checked by a doctor for clear lungs, temperature, and blood pressure. Then the hospital bed is rolled into the chamber for treatment to start. First the pressure is increased gradually for 10 minutes as though I’m scuba diving 45 feet down (they call it a dive). I’ll need to pop my ears. Then I’ll breath 100% oxygen for 45 minutes. I get a 10 minute break by wearing a mask to breath “regular” air for 10 minutes to avoid oxygen toxicity. Then I’m back to the 100% oxygen for a final 45 minutes. The process is completed by decreasing the pressure over 10 minutes and I’ll need to pop my ears again. I’ll be checked by the doctor once more, and that’s it. There are a lot of things to avoid prior to each treatment: no lotions, makeup, hair products, deodorant, jewelry, perfume, etc. New nail polish needs to be applied the Friday before a Monday treatment so all fumes are dispersed. It’s very specific! I can watch Direct TV (no HGTV though), listen to music or watch movies with CDs I bring along, etc. I think I’d like to listen to books on CD. If anyone has any good ones, let me know. I need to visit my local libraries to check out their selections.

The HBO requires quite a time commitment! They have recommended 40 treatments (insurance approved 30). I will go 5 days a week (Monday-Friday) for 8 weeks, hopefully. Initially I may feel more energized and the therapy may even reduce my pain. We’re hanging a lot of hope on this!!

The PET scan was good overall. The only thing that needs to be investigated is a small bulge on my left pectoralis muscle. It’s suspected that it’s a result from my arm exercises, but we’re going to be cautious and check it out. I have a needle biopsy scheduled for next Thursday under local anesthesia to learn whether it’s melanoma or not. If it is melanoma, it will get radiated and I’ll be done with that. If it’s not melanoma, then I will have No Evidence of Disease (NED) for the first time in years!!! It would almost be a miracle!!! All fingers and toes crossed!

Pain management and exercise are at the top of my to do list. Thank goodness for my wonderful hubby – I could not do this without his constant support and love! He is my rock and, with him, we can do this!! I also greatly appreciate the encouragement I receive from my blog readers! There are days when it’s your motivational messages that keeps me going! Many thanks and love!!