Thursday, July 31, 2008

Round 3 Chemo

THANK GOD that's over. What a long, greuling night of nausea, sweating, vomiting and pain. Just miserable, yuck. But, I made it, I'm home and round 3 of R-ICE chemotherapy is over, except for the Neulasta shot tomorrow morning, but that's no biggie.

This round is important because its the mobilization round. It stimulates my bone marrow to produce massive amounts of blood cells and stem cells, which they can then capture from my blood stream and use in my transfusion. By using my clean stem cell, called an autologus stem cell transfer, the fatality risk falls considerably. Autologus transplant carry a 2% mortality rate while donor, allogenic, transplants still carry a 25-30% mortality rate. So even though my brother's a perfect match, it not worth the risk at this point. Better to get 15 years out of a self-transfer and let technology/medicine decrease the donor risk profile before going that route.

This round of chemo was very tough. I think its because I am so run down from the previous two rounds. But I held up pretty well, and my doctor thinks things are going terrific.

Hope is doing GREAT!!! She can sit up, and she's practicing her different laughs. She's a very happy baby, from when she wakes up early in the morning until we put her gently to bed. Generally, she's only fussy when something's wrong, otherwise its laugh and play all day. Its wonderful. It is also great energy for me to be around, although I feel really guilty alot because the fatigue from the chemo limits how long I can keep up with her. I can play about 30-45 minutes on the floor, but I can only hold her about 15 before I tire out. However, I get in as much Daddy time as I can, and she loves it.

More later, I'm whipped and going back to bed.

Love,

Trav

Tuesday, July 29, 2008

Chemotherapy

My friend Tracy asked what my chemotherapy treatment entailed and I wrote her back. I then thought it might be something worth posting so you could have a feel for what R-ICE chemotherapy is like....

My chemotherapy, right now at least, is given by peripheral IV(meaning IV in my arm). It’s a four day treatment. On the first day, I am given steroids, anti-nausea drugs, ativan(relaxant), benadryl and an anti-vomiting drug(these are all pills). Then I wait a little bit, then they give me a 1 hour IV of drug called Etopocide, which specifically targets and kills young cells in my bone marrow. After that hour, they give me a 4 hour IV of a monoclonal antibody called Rituxan. Rituxan attaches itself to cancerous white blood cells and has an affinity for the chemotherapy agents administred on the second and third day. It acts to target the cells for destruction. After all this, (it takes about 5-6 hours), I go home and rest.

On the second day, I am admitted to the hospital and given the same premedications as the first day. Then they give me another 1 hour round of Etopocide. Then, I’m given a 1 hour round of Carboplat, which is a platinum based chemotherapy drug that kills blood cells throughout my body. Finally, they hook me up to a giant bag of fluid and begin administering the Ifosfomide. This is the granddaddy of bad dudes. Its so caustic, they have to mix it to a very thin solution, and administer it over 24 hours. Also, while they administer it, I am given IV fluids and electrolytes. Additionally, they make me drink as much fluid as I can stand. Without all the extra fluid, my bladder and kidneys would be burned so badly I would go into renal failure, and that’s not good.

Needless to say, I pee A LOT. And they capture all of it and test it to see if there’s any damage occurring to my kidneys or bladder. After the 24 hour drip is done, for good measure, they give me another 1 hour round of Etopocide and send me home to whimper in my own bed. The next day, I return for a Neulasta shot. Neulasta is a drug that stimulates my bone marrow to produce more blood cells and platelets.

My blood counts fall to 1/3 of their normal levels shortly after I leave the hospital. This causes all kinds of issues, like being dizzy, having no strength or stamina, and potentially can cause severe oxygen depletion in my major organs should I do too much(which thankfully I haven’t had). I will return to the hospital Monday, Wednesday and Friday next week to have my blood tested. If my counts are too low, they will give me blood transfusions to help keep oxygen levels in my body high enough. Fortunately, through two rounds of this treatment, I have not had ANY transfusions. My doctor cannot believe it. Nor can he believe that my blood cell counts returned to normal after 8 days following the second round of treatment. I am the only patient he’s ever had who did that.
Pretty amazing really. I can’t believe how lucky I am. I also cannot imagine how tough this must be for people who don’t bounce back so well. My heart goes out to them. I feel like crap, and I handle it pretty well.

Anyway, sorry this is so long, hope it helps. I’ve got to run. I have a date with an Etopocide IV.

Sunday, July 27, 2008

Great News

I got my PET scan results back and the tumors are gone! There's no presence of the cancer they can see on the PET scan. WHEW!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! What a relief, it would have been very difficult to go through two rounds of that chemotherapy and have it not work.

My other tests all came back great also. My echocardiogram, EKG, chest x-ray and blood work show that my body is holding up extremely well. There's been very little damage to my internal organs. This is great because it means they can give me the full on dose of chemo to kill my bone marrow in the transplant. That's a good thing according to my doctor.

There's something about them killing all of my bone marrow that makes me a little uneasy. I don't want to think about how much that's gonna hurt. Woof, not fun.

This changes nothing in terms of another round of chemo nor the stem cell transplant. I begin my next round of R-ICE chemotherapy tomorrow morning bright and early. Four more days, then I'm done with R-ICE chemotherapy, at least for now. Rock on, almost done.

Then, the stem cell harvest process begins on August 9th with Neupogen shots. They overdose me on the drug because it stimulates cells production in my bone marrow, and that how they get enough stem cells into my blood to harvest it with apherisis. A week of that, then 10 days to recover and I go into isolation for a month beginning 8/26.

One day at a time, that's how I keep it going. Its hard, but its what I have to do to beat this shitty disease and have any hope of spending a wonderful life with Honore and Hope. I read the other day that Randy Pascal(sp?), the Last Lecture author died. Its real, this shit kills. Cancer is deadly and you do not want to fuck with it.

I hope research finally finds a cure. We'll see. It's a beautiful day here, and I"m going to go enjoy it while I still feel good.

Love,

T

Thursday, July 24, 2008

Update Thursday - PET Scan day

Had my PET scan this morning. The PET scan is a very high tech test that can tell if the cancer has been destroyed by the chemotherapy or not. Restaging the cancer before my stem cell transplant is required so the doctors know if its gone or not. If its gone, we proceed. If not, I'm not sure what happens.

Either way, I'm fairly certain the stem cell transplant moves forward. My next round of chemotherapy begins next Monday. It will be another 4 day ordeal, but I'll get through it ok. This round however is when things get busy. During the two week recovery, I will be getting the vascular catheter put in and begin doing the apherisis to collect my stem cells for the transplant. After 5-7 days of collection, I will get a week break and then be put in the hospital for the transfer.

Right now, if things go as scheduled I'll be in Northwestern Hospital in mid to late August and will be there in isolation for a month. I will be able to take my laptop with me, so I will be able to post updates.

Because my treatment got pushed back to next Monday, we had and extra week. Since I had a surprisingly good blood test last Thursday, Dr. Grinblatt allowed us to go up north. We had a great break, and it couldn't have come at a better time. I really needed it to get my mind off the cancer for a bit and relax.

I'm going for my echocardiogram later this afternoon, which should wrap up the last of the staging tests. They also do a bunch of tests, like the echo, to make sure the chemo is not damaging my internal organs too much. The R-ICE treatment is especially hard on the heart muscle and the bladder/kidneys. We should have all the results back early next week.

Travis

Thursday, July 17, 2008

A HUGE Day!!!

Dr. Grinblatt had GREAT news today....my blood cell counts were normal! According to him this is incredible, after two rounds of R-ICE chemotherapy my bone marrow has responded amazingly well! Because my third round of chemo will not occur until July 28th due to scheduling conflicts with the transplant unit, I get next week off.

Dr. Grinblatt suggested I head to our lakehouse in Northern Wisconsin!!! YAY!!!! He warned me that I'm still a very sick man and had to be extremely careful about infections, crowds, and still be carefil about no bruising or cutting and no strenuous exercise. But I can go, so long as I'm back in time to get my PET scan and Echocardiogram completed. So we're going up Saturday and coming back Wednesday night, the tests are scheduled for Thursday.

Then, to add the cherry on top, we got the HLA test results back on my brother, Chris. He's an EXACT match! All 6 factors, which means, should this stem cell transplant fail and we have to have a donor stem cell transplant, he's my donor! This is a HUGE gift!!! I'm so lucky, because it means there's one more bullet in the proverbial treatment gun.

My cancer is extrememly difficult because its currently considered incurable. A donor transplant is the only way we could look to cure me of my disease. We cannot attempt it at this time though, because the risk/reward ratio is not worth it. There's a 1-2% mortality rate with an autologous transplant(using my stem cells), while there's a 25% mortality rate with a donor transplant, even though were an exact match.

This is why we still need support for cancer research, specifically blood cancer research. Our overall strategy in battling my disease is to knock it into remission for as long as we can, and keep doing so, hoping that research will provide me a cure one day. Honore and I have done our homework and the best charity we have found to support this mission is the Leukemia & Lymphoma Society, hence our annual fundraising drive in support of the Leukemia Cup Regatta.

By the way, this year the 12th Annual Chicago Leukemia Cup Regatta will be presented by The Rosamond Fund. Thanks to a wonderfully generous donation from my mother, Rosamond Wilhite. The event will be August 22-23rd at Columbia Yacht Club. www.sailtravis.com if you would like to make a donation or get more information about the event check out www.columbiayachtclub.com and click on Leukemia Cup/Poker Run.

Man, what a GREAT day!!! Between my bone marrow busting its butt and making me look like a hero to the news about having a donor for future treatements, today's been a banner day. However, like Grinblatt said, I'm still a sick man and am going to bed because I'm exhausted.

Cheers!

Love,

Travis

Thursday Morning Coffee

Quick thought: I HATE Neulasta. Man, is that stuff painful. It's a drug that stimulates blood cell development in my bone marrow. The issue is about a week after its given, my bone marrow has done such a good job there's not enough room for all the new cells, which makes my bones HURT. Last night was killer on my lower back. It felt like I slipped a disc in my sleep.

Fortunately, the cells migrate out into my blood stream pretty quickly, and by early this morning the pain was down to a dull ache. Now, its manageable with a heating pad. I take some ibuprofen for the pain, but it only helps a little. The up side is all the additional new cells make me feel a million times better, and my mind is clear again, which is nice.

Today's a big day, I find out the rest of the treatment schedule and when the transplant begins. I'm looking forward to meeting with Dr. Grinblatt this afternoon and finding out how things are going. One of the things we have to schedule is the re-staging. I am looking forward to that because it tells us if the drugs are working or not.

My feeling is they are working well, and the tumor will be gone. However, only a PET scan will tell.

Wednesday, July 16, 2008

Update

I have complete two rounds of Rituxan-ICE chemotherapy(Isofosfamine, Carboplat, Etopocide). Its pretty heavy duty stuff, but I'm doing very well. I have not needed a blood transfusion, which means my body is being very strong and responding well to the treatment. I find out tomorrow if my next round will be next week. I hope so because my feeling is, let's get it on.

After the third round of R-ICE, we have to re-stage my cancer, which means make sure its gone and then begin the stem cell transplant. The transplant will involve two stages. First, collection of the stem cells which will be the week after my 3rd round of chemo. It will involve 5-7 days of 6 hour apherisis treatments to get the stem cells out of my blood. Once we have enough of those, the second stage begins. I will then be admitted to Northwestern Hospital's transplant unit where I will undergo 6 days of very high dose chemotherapy, called BEAM chemo(I don't know the drugs on that one yet).

The BEAM will kill my bone marrow. Then,on the 7th or 8th day, my harvested stem cells will be returned to my body. Then, its 3 weeks or so in isolation while we wait for them to find their way back to my bone marrow and begin re-creating my immune system.

I can have a computer in my room for the month I'm in the hospital, so I'll attempt to keep the blog posted. It's easier than a million phone calls. Because of the isolation requirements, I cannot have visitors, flowers or fruit in my room. In lieu of any gift or anything, please check out www.sailtravis.com and consider making a donation. If you already have, thank you from the bottom of my heart.

Cancer doesn't win, I win. I win by being alive today and celebrating it for all its glory, painful as it may be. Back to bed.

Good Days

I woke up this morning to an incredible back ache. My pelvis and lower back felt like I slipped a disc in my sleep. Thank you Neulasta. They warned me about the pain of that stuff, but I have to say the warning was a bit milder than how much it hurts.

But its still a good day. I have learned to appreciate everyday. All the little things are what make this an amazing place, sadly most people don't even stop long enough to recognize the beauty and intricacy that flows all around them.

Cancer doesn't win. Jimmy V is right, it can't take my mind, my heart or my soul. And there's a part of me that feels like as long as I appreciate everyday, and am grateful for it, then I'm winning. Sure it hurts, but at least I have the pain to let me know I'm still alive.

Something I got from a meditation of mine: I saw my spirit guide walking through a deep valley. He was out and about, not in his tent on the shoulder of the mountain like normal. Instead, he was at the bottom of a deep canyon at the base of a HUGE mountain. In my meditation, I sense he wanted to show me something, so I went down to see him. When I got to him, the snow fed river was roaring next to us so loud I couldn't hear myself think, much less what he was saying. But like usual, he didn't say anything. He merely smiled at me, waved his arm around the small valley floor next to the raging river and then motioned his arm towards the peak of the mountain.

I looked around wondering at the place. It was like standing in the bottom of a barrel. The canyon walls rose straight up all around us. We were deep in the canyon, it felt forboding, almost claustrophobic. As I watched him wave around, I sensed that the purpose was for me to understand how closed in things could be. The raging river felt dangerous, I felt trapped. I sensed fear growing inside me.

Then, when he swept his gaze to the top of the mountain at the head of the gorge, I understood. I imagined what the summit of that mountain must be like, a broad expanse of freedom and openness.

It takes the depths of the valley, to give meaning to the height of the summit.

Monday, July 14, 2008

Day 1

Well, this is really only day one of our blog, its day 60 since the tumor was found. Can't believe its been 60 days already. It feels like this ordeal has just begun, yet in reality, its been going on a long time. An all this shit for one, lousy 1.5 cm tumor that just happened to be Non-Hodgkin's Lymphoma. RELAPSED NHL. My ticket to a stem cell transplant and learning once again what's at the forefront of modern medicinal technology.

Four years ago, June 4, 2004, I found a lump in my chin while I was shaving. After two months of trying everything to get rid of it, my doctor ordered a CT scan of my neck to see what was going on. There were 6 friends hiding in the tissue of my neck, and a follow up PET scan revealed 8 more hiding in my chest and abdomen. Very fun. Surgery, biopsy, bone marrow punch, and the famous, "That's lymphoma. I don't know if its Hodgkin's Disease or Non-Hodgkin's Disease, but I know you need an oncologist." Uttered to my wife, by my surgeon shortly after removing the offending tumor in my neck.

Six months of CHOP-Rituxan chemotherapy later, and I was alive, and in remission. I wasn't in that great a shape, and I certainly wasn't about to pull a Lance Armstrong and with 7 Tours, but I was kicking.

It took two years to get my life back together. One just to recover my short term memory, and one to learn a new career, real estate. Great timing on that. I got up and running at the height of the boom, and surrendered my license and left the business just 14 days before the new tumors were discovered.

The really sucky thing is not the cancer or the chemotherapy(oh don't get me wrong, they suck. So does the I might die part....), its the fact that Honore and I got our lives back together and earlier this year celebrated the birth of our daughter, Hope Elizabeth! She's the answer to a million prayers, and truly a dream come true. And my R-ICE chemotherapy(which I've done 2 rounds of), has me so weak I can barely hold her for more than 15 minutes. I feel like crap dawn till dusk, and I have this complete angel sitting here with me, yet I can barely play with her. Its horrible.

And talk about feeling like a bad parent. Nothing like a dash up the stairs to send stars floating in my vision, my breath panting and me wondering if I find the crib standing up or if I need to lay down a minute. The doctor says its ok, its just that my blood counts are really low and not to get too much exercise.

Anyway, this is too long already. Here's my intent, I'm going to post here from time to time my updates so people who are interested can keep up with how I'm doing. My stem cell transplant's about three weeks away, and I hope to keep posting throughout.

Love,

Travis