Tuesday, August 23, 2022

Day 365: Post Transplant - 1 Year!




We made it! 

One year! I cannot believe it. I know many of you feel that it went by so quickly, I am here to say...it did not.... but here we are. Stronger than we were a year ago. This week is filled with mixed emotions! Of course, I am so excited to be celebrating ONE YEAR, but Wednesday morning is also my one year pet-scan and there is always that small possibility that the cancer returns, so there is some degree of anxiety there.  From experience, I know that attitude is everything, and there is power in positive thinking and prayer. So I will ask for both from all of you - Wednesday morning around 6:45am PST. Yes, that means that Dana and I are leaving the house at 5:15 am to get to Cedars Sinai for a 6:25am check in. Good news is that we will miss the traffic and at about 11am, we will have the results. 


I wanted to share these pictures because although, I am still being careful from covid, and any other germs that are out there - I am starting to live again and loving life! I got to spend some time on a ranch, met a goat named Beth (Yellowstone) started watching the show and am now obsessed with visiting  Montana, finding a cowboy and riding a horse (of course - running into John and Kayce Dutton aka Kevin Costner and Luke Grimes wouldn't be a bad thing either).

Keeping this short! Raise a glass for me today! Happy Re-Birthday! Cheers 🥂 and send a prayer, positivity, good mojo, whatever you have - for clean scans on 08.24.22! Stay #cancerfree. 

❌⭕️❌⭕️



One of my happy places

Sisters



Sunday, June 19, 2022

Celebrating 300 Days Post Stem Cell Transplant

Wow people! Can you believe it has been 300 days? That is a LOT of days! 


I know I have not been great about posting updates here or even on social media, I think I got busy living life a little. While I am not quite back to my #livelife status of travel, social engagements, dinners out with friends, wine tasting, yachting (a girl can dream) I did actually return to the office on March 14th. This felt like a gift! I was a kid on her first day of school (assuming you loved school), getting ready every morning, picking outfits out the night before (in my head), it was so exciting and a yes, a little stressful. While I was so happy to see people in 3D after almost two years of only seeing most through a square Zoom window, they were potential germ carriers. My immune system is so young and immature right now (yes, a little like me...lol) and I felt like I had to wear this invisible 6 foot protective armor keeping my distance from everyone. When I would let my guard down, I would have a scare like someone I had just seen, texting me to tell me they tested positive for COVID.  In early May, COVID decided to play house in any "body" (a lot of people) in my building who hadn't had the joys of COVID over the past two years. This sent me back into a mini retreat of work from home status. When I asked my oncologist for a note to return to work in March, he said I was his only patient asking to go BACK to the office - and so in May when I said I needed a new note to work from home again, he gladly wrote it. Luckily, for my sanity, that did not last long and within 10 days, I was back in the office, dodging hugs and handshakes of colleagues who had not seen me in a long time. What weird times.


So what is different on Day 300?

I have not had an infusion, transfusion, steroid, or chemo cocktail in 300 days, so
1. My body is stronger 
2. My hair is growing 
3. My brain is clear
I am grateful everyday even though 
5. I still have to wear a mask inside with pretty much anyone or anywhere
6. I still worry that cancer will come back (out of my control, I know)
7. I still have the extra weight but as I say "my body is a wonderland" so I am trying to be kind to it
What is worth celebrating? 
8. ALL OF IT! 
9. Life!
10. My health
11. Being cancer free
12. Have had 2 rounds of childhood vaccines 
13. 65 more days until my Re-Birthday - August 23, 2022 😉

There is a transition period that you go through from surviving/fighting mode to living again - it is strange and hard to explain but definitely a phase of this entire process. I am happy to say, I am more on the living side of things now, letting go of that fight mentality. Excited and scared about the future, mostly because I have no idea what that looks like, but I know adventure awaits for sure! 

So raise a glass with me today, and let's toast!  


Here's to 300 days and #livinglife #fuckcancer #onlywayoutisthrough #warrior #grateful 

Friday, February 25, 2022

6 Months Post Stem Cell Transplant Update

Warning: Lots of medical jargon ahead.

February 23, 2022 marked 6 months post stem cell transplant. As many of you know from social media, my 6 month pet-scan showed "no evidence of disease, NED!" This is really fantastic news! Here is what else I learned from this visit.
__________________________________
Progress notes from visit with Cedar Sinai Oncologist 2.21.22

In doctor speak.....

Today is day +182.

Just a few tests...
• Plan for restaging at days +100, +180, and +365
• Day +180 PET/CT reviewed in detail with her today. Findings consistent with CR (complete response).
• She has now recovered from her transplant and has resumed care with her primary oncologist Dr. Nguyen.
• Today we again discussed rituximab maintenance. It's unclear that she would benefit from this as she progressed on a rituximab containing regimen and only achieved a remission after an obinutuzumab containing regimen; there are no great data regarding obinutuzumab maintenance after transplant. The additional consideration is the risk/beneift balance of prolonged anti-CD20 therapy in the setting of the covid pandemic. Therefore, given the potential risk and unclear benefit we have decided against rituximab maintenance.

Plan to start post-transplant vaccines at this time. She says that she would prefer to get them done with her PCP and has already confirmed that this could be done. Therefore, I have provided her with a detailed vaccine schedule.


She received the covid vaccine on 3/20/21, 4/22/21, 12/3/21, 1/5/22, and 2/3/22.

I have checked spike protein antibodies today and they are undetectable. Therefore, will arrange for Evusheld infusion.


RTC (return to Clinic): 6 months with PET/CT for 1 year visit - August 23, 2022

_____________________________________________

Let me translate...

1. I don't have to go back to Cedar Sinai for 6 months (at the 1 year mark) for another pet-scan.  Then I will continue to get pet-scans every 6 months, indefinitely - good times.

2. I am recovered from SCT!! Yay!

3. I will continue to see local oncologist every 4 weeks to check blood counts.

4. We will NOT do maintenance therapy because we tried that and it didn't fucking work.  LOL.  

5. I got a 36 month long schedule for repeating my childhood vaccinations! Woot woot. 

6. I received FIVE doses of the covid vaccine over the course of a year - there are ZERO antibodies detected!  WTF.  Basically, since my immune system was wiped out from the high dose chemotherapy pre-transplant, and now it is super young and apparently not mature enough (kind of like me 😆) to know what to do with a complicated vaccine, it leaves me with no immune response to the vax.  Which means, I have absolutely no protection from covid.


The great news, I think, is that I have been approved for Evusheld.  This is an investigational medication that has an EUA approval from the FDA (thus the "great news, I think" part). Evusheld is made up of two monoclonal antibodies that mimic the immune systems's ability to fight off harmful pathogens. Tixagevimab and cilgavimab (really?? who comes up with these names) are long-acting monoclonal antibodies that are specifically directed against the spike protein of SARS-COV-2, designed to block the virus' attachment and entry into human cells.  Science is amazing! 


On March 10th (yes approved and scheduled), I will get two injections - one in each buttocks - again, really? and thank you... did they have to find the biggest muscles in my body. This will act as a pre-exposure prophylaxis (prevention) of Covid. 


March 14th - I can return to the world. I can return to work IRL!! I will continue to wear a mask and social distance. But I can start living again - co-mingling with people.  No super spreader events...but this is all GREAT news. All food restrictions also lifted.


Fun Fact.  March 17, 2022 would have marked two years of working from home.  I am so ready to be back in the office! I love my house and my dogs and I will love coming home to both each day. But I need people.  2022 has not disappointed. We are counting on that for the next 10 months too! 


Next post. A New Perspective. 










Tuesday, January 4, 2022

Reflecting on this Live Life Detour.

Today is another milestone. January 4th. Three years since my initial diagnosis. I thought I would pause and reflect. Here are my 2021 and  2020 reflections.

You do not ever forget the moment a doctor tells you that you have cancer. The good news is that today, this year, 2022, I have no evidence of disease (NED) in my body. Hooray!

In looking back over the last three years, I know, the last two sucked for everyone with COVID and all, but for me, it has been three challenging years.  

From January - June in 2019 I had 6 rounds of RCHOP chemotherapy, loss of hair, a myriad of chemo side effects and fun and then a pet-scan that showed no evidence of disease (NED). 

July 2019 - December 2020, I continued with maintenance therapy from that point on and received the R in RCHOP, Rituxan (an awful drug that caused terrible side effects, and kept me on constant steroids, that my body does not like). This happened every 8 weeks through November, 2020. 

Because I was still getting infusions so often, I was considered immune compromised and when the world started to open up a bit, I had to continue to work from home even after everyone returned to work.  Actually, I did show up to the office for 3 days in October of 2020, until I got booted and told I needed a doctor's note to stay. I did get the doctor's note, and it said to stay at HOME. Ugh. Through this 16 months of maintenance infusions - I got scans every 6 months.  I cannot lie, each time, it was like, oh no - is the cancer back? Luckily, I made it 16 months, unfortunately, I needed to make it 2 years for the odds to really work in my favor.  

November 27, 2020 - cancer returned. If you recall, it was another lump in my neck in the same location as original lump and they weren't sure if it had spread anywhere else. They ordered a pet-scan, and I met with the radiation oncologist as the plan was to just zap it. Fast forward...to scan results - cancer had spread and was in my chest as well, radiation was off the table - and now we were looking at more chemo.

January-June 2021, 12 days of chemo spread over 2 days every 4 weeks for 6 months. No hair loss, some side effects but made it through that with fewer side effects but a LOT of anxiety. As the reality of having a stem cell transplant became more real.

July 2021, remember, it was #livelifejuly - I had a lot of tests but no treatment, a little break was nice.

August 2021, was 18 days in the hospital, and a stem cell transplant on 08/23/2021 - my new birthday.

September - December 2021 - Recovering at home.

2021 Recap by the numbers: 23 chemo treatments, 3 pet-scans, port placement and removal, stem cell harvesting, stem cell transplant, blood transfusion x 2, platelet transfusion x 2, over 50 blood draws, lots of anxiety, lots of love and lots of support! Let's not do that again.

January 2022.  Still living in a bubble, especially with omicron out there but luckily, I am getting stronger everyday and feel pretty good. I have some residual side effects but nothing too awful. Life is good. 

Since they wiped my immune system, they also cleared any and all vaccinations, including the ones we get as babies...and COVID. So, December 3rd, I got my first dose of Pfizer vaccine again, but of course they are saying it is my booster, since they do not know how to handle someone with stem cell transplant and covid vaccines. When I went to get my 2nd dose (or 4th dose which in an immune compromised person is not unheard of) I was turned away saying that this is not in their protocol (oh I even had a doctor's note). Upon leaving, they said if I had come in and lied and said I lost my vaccine card, they could have done it. So tomorrow, I am trying again. Then we will see if I can actually get the 3rd dose that my doctors want me to get (all within 21 days of each other) I am lucky that I do not have any adverse reactions to the vaccines.

In February, I will have another pet-scan to check for any evidence of disease again. I also start the 2 year long process of getting revaccinated - I will get a schedule just like a newborn and follow that - should be fun! I hope there are no side effects - as a baby, even if there are, who remembers and you have no idea what they are since you cannot speak yet - haha funny not funny. I am also hoping to return to the office in February (fingers crossed).

In full disclosure, I do have a small lump in my neck, in the same location both of the other lumps appeared, but it is not registering as cancer on the scans so we are just keeping an eye on that - they say, it might just be some stubborn lymphoma - and if it is we will just blast it with some radiation (as if that is so easy). So, I am just tucking that away, it could be anything.   

I do apologize, to those following along, for the recap, but this blog is my way of processing all that I am going through - it felt like an appropriate time to reflect on the past 3 years, and remind myself all that I have been through. I see pictures of myself from three or four years ago and think why can't I be back in THAT body - that version of myself, but I realize, not only was THAT body riddled with cancer (no thank you), but I needed my body to be strong, to fight, and in time, I will get a version of myself back that I am comfortable with. 

And here is to 2022 being the year of NED, goodbye cancer, please do not come back. I am really looking forward to getting back to living life again. Happy New Year. and Thank you. xoxo