Tuesday, May 10, 2016

CT Scans #11 and a New Attitude

     It has now been three years and five months since I was diagnosed with stage 4 adenocarcinoma of the lung.  It has been three years and two months that I have been taking Xalkori, the oral chemotherapeutic agent that has kept me around this long.  I was taking Xalkori for three years prior to it being FDA approved for ROS1 mutation driven lung cancer.  On March 11, 2016, Xalkori was approved - which doesn't change much for me, but will make the medication more accessible to those whose insurance companies denied coverage for it because it wasn't approved.  

http://www.businesswire.com/news/home/20160311005839/en/XALKORI%C2%AE-crizotinib-Approved-U.S.-FDA-Treatment-Patients

California poppies...one of my favorites.
     The clinical trial for Xalkori use with ROS1-mutation driven lung cancer found, that for patients like me, the median "duration of response", (the time the medication worked before it stopped working), is 18.3 months. I had CT scans last Friday - and the good news continues...Xalkori is still keeping my cancer stable.  I sure as hell don't know why I am so lucky, but I've exceeded the median response duration by 200%, and I'm going for more.  
   
     More than being happy about my most recent CT scans, I am relieved.  Living with stage 4 cancer has left me living my life tentatively.  Dictionary.com  has the following definition for "tentative":
 


adjective
1.   of the nature of or made or done as a trial, experiment, or attempt; experimental:
a tentative report on her findings.
2.   unsure; uncertain; not definite or positive; hesitant:
a tentative smile on his face.

Moonlight Beach, California
     Both above definitions apply to how I feel. I suppose everyone's life is a trial, but when I didn't know I had cancer, I didn't think much about the gestalt of my life...I just lived.  I now, most definitely, feel like I'm living within an experiment. And...without a doubt, I am unsure, uncertain, not definite and hesitant about what lies ahead of me.  
     I hate this uncertainty.  It chips away at my self-confidence.  It makes me wonder which life milestones I will be around to celebrate with Wynn and my children, and which ones I will miss.  It takes away the courage I used to mustered that allowed me to take on new life adventures. 
Nathan got up on his board the first day!


     I realize what I need is a new attitude.  Xalkori has given me much more time than I ever thought I'd have.  As always, I should not overlook any opportunities, including this second chance to try new things. There is still uncertainty about what lies ahead of me, but I'm going to try to get out from behind this 'tentative living' crap, and look into some new adventure possibilities.  I have no idea what that will look like, but I'll keep you posted. 

Wish me luck!

(I wonder if I should have tried surfing?)



 

Tuesday, April 12, 2016

Thanks, Xalkori

     It's nearly impossible for me to believe it's already mid-April of 2016!  Since January, life has been a whirlwind of good and not-so-good things.  I've come to realize that whether it's good times or bad times, being busy is being busy.  Time escapes me.  
 
     Today has been a good...no...let me start again...Today has been a GREAT day, so I'm not going to whine about anything.  Springtime in Chicago is unpredictable - sunny and warm or cold and snowy, in the same day.  This spring has been predictably unpredictable, but today in Chicago was beautiful. Although it was a little windy on Michigan Avenue, it was sunny and the temperature was around 50 degrees.

     I got to do one of my favorite things today.  Wynn and I took our day off and made our way to the Art Institute to see a special exhibit:  

 



Van Gogh's Bedrooms   


 



 
     There were no sunflowers or starry night skies at this exhibit; but rather many other brightly painted still-life and landscape paintings, and drawings, we have never seen before.  It's an amazing show.  







     Vincent wrote to his brother, Theo, that he had no money to pay for models, so he painted things that were free.






 





     The three bedroom paintings are hung together so you can compare them.






     I love these shoes.  They are said to be his.





     This is one of his latter self-portraits.  He looks more gaunt here.  His (self-) injured ear is on the other side.  








 


     This is one of his last paintings before he died of a gun shot wound...probably self-inflicted.  It's said that the whole town came to say good-bye to him, even though the folks didn't know him well.  He was gentle and kind, despite his struggle with mental health illness. 



     If you've never been to the Art Institute in Chicago, put it on your bucket list.  Tripadvisor ranked it the "BEST MUSEUM IN THE WORLD, 2014."  The Van Gogh's Bedrooms exhibit will be here until May 10, 2016.  (Sadly, those coming to the American Society of Clinical Oncology meeting will miss it.) 





     I'm not sure everyone will understand how I feel about today.  I'm certain my fellow cancer survivors will.  I lived another day...long enough to go to the Art Institute another time...one of my favorite things to do.  Thank you, Xalkori. 

Saturday, January 30, 2016

A Little Less Drama, please.

     All month, I've been trying to find time to write my next blog about how I've been doing, overall.  It was supposed to be my 3rd annual State of the Lunion Address.  Unfortunately, a few things have recently happened that have overridden that plan.

     Many of you know my mom.  She's 87 years old and nearly 20 years ago, following the unexpected death of my father, she moved to Illinois to be closer to us.  She bought a townhouse 5 blocks away from our house and when our children were young, she was incredible in helping Wynn and me care for them.  Through her 85th year, she was fiercely independent, strong and healthy.  Then in 2014, she had a stroke, and many things changed for her...and for me.  We found a wonderful caregiver, who stays with her Monday through Friday.  On the weekends, my mom would come and stay at our house, where we felt comfortable leaving her alone for a few hours at a time.  That schedule worked out really well...until earlier this month.

     One morning, a few weeks ago, my mom got out of bed and fainted from low blood pressure.  She hit her head - and ended up with a concussion and coup contrecoup injury, (a brain injury on the opposite side of the site of impact - because the brain moves on the inside of the skull.) She was in the hospital for a few days, then transferred to a nursing/rehab center. She's home now, but we've had to make changes to accommodate her new challenges.  For one, she now has a caregiver, in her home, 24/7.  After many conversations, she made it clear that she would like to live in her home for as long as possible.  No doubt, it would be easier for me if she moved into our house, but I don't have the heart to make her move at this time.  So, I told her I'd help her stay in her house as long as possible. Despite having grab bars installed in her home previously, she needs more assistive devices to help her be safe.  I try to stop in to see her at least once a day, and try to make it to her home for home health nursing and physical therapy appointments.  We are so fortunate to have warm and reliable caregivers for her.

     So this week, I was feeling a little better about my mom's situation.  We got her out of the nursing/rehab center, (which she hated), and back in her home.  I was getting all of her out-patient appointments lined up and found her a weekend caregiver.  It seemed like we were headed toward a good rhythm for her and I could put things on cruise control for a while.  

      But no....

      Wednesday night, after going out with work friends to celebrate a 60th birthday, I came home around 8:30 PM.  When I put up the garage door, I saw that Wynn's car wasn't there yet.  I went into our mudroom, as usual, and heard noises.  So I shouted, "Who's here!".  I heard more noises and quickly realized that someone was in the house.  I turned around and ran back into the garage and was headed to my next door neighbor's house...scared out of my mind.  As I reached the end of my garage I instinctively stopped, just as the burglar, who had run out the front door, crossed my path a few feet in front of me on the driveway.  He ran across my next door neighbor's front lawn, across the street, then disappeared into a townhouse neighborhood not far away...while I was shouting, "STOP YOU F*%#ING A$$HOLE!"  


      I called 911, and police cars drove past my house and into the townhouse neighborhood, while I stayed on the phone with the dispatcher.  Soon, three more squad cars showed up, including the canine patrol.  The three police officers and the police dog entered the house, guns drawn.  There was a lot of shouting warning any intruders to put their hands up or get bitten by the dog.  Two more police officers showed up and stayed outside with me and my next door neighbor, Jerry, as the other officers "cleared" the house. Many minutes later, the three officers, with the dog, emerged saying, "All clear."

     Jerry, the two officers and I went inside and found that the burglar had entered through our back door.  He had shattered the double-paned door glass with a brick, reached in, and let himself in.  A classic burglar move. 

      Then I turned, just as one of the officers said to me, "Do you have a dog?"  When I said, "No, not anymore", he pointed to a large pile of canine crap on the kitchen floor.  Then he asked, "Could there have been a dog here?" to which I answered, "Only yours."  If I wasn't so pumped with circulating adrenaline, I would have felt badly for the guy, who turned beet-red and was apologizing all over the place.  Seconds later, when I looked back, the officer had already cleaned up the mess. (Insult to injury, for sure.)
 
     The burglar got away with jewelry and cashHe put them into a pillow case he took right off our bed...another classic burglar move.  

     The next day, we met with the police detective assigned to our case.  There are leads, including security video footage from a neighbor's camera.  Maybe the police will catch him one day.  For now, we are living with a plywood boarded-up back door...a lovely reminder.  




(PS:  Dear Mr. Burglar Asshole, I am thankful that you did not take my bottle of Xalkori. It's the medication that is keeping me alive. It was in the same drawer that you took some of my jewelry from.)        



(PPS:  Shouting obscenities at a fleeing burglar, momentarily, made me feel better.)

Sunday, January 10, 2016

On the Upswing

     Since being on Xalkori, I have been fortunate to have had few cancer-related problems.  Most days I enjoy good-to-excellent health.  This past November and December were rough, however.  After returning from a trip to Japan in mid-October, I had trouble recovering from the usual jet-lag.  The jet-lag turned to exhaustion, which led to fatigue, of the undescribeable variety. I also  experienced bone achiness and weeks of headaches.  (Headaches, for those of us with metastatic lung cancer on Xalkori, are particularly bothersome.  Despite this targeted chemotherapy's ability to control cancer growth from the neck -> down, Xalkori doesn't cross the blood-brain barrier, leaving our brains vulnerable to metastatic disease.)  To complicate things, I'm a person who gets headaches;  I've had them since childhood.  So in November and December, I couldn't assess if my headaches were part of my overall fatigue, or if my cancer had spread to my brain.  The worry of having brain cancer robbed me of much needed sleep...adding to my exhaustion. 

      In the Summer of 2015, because I had been doing so well, I had negotiated with my oncologist, Robinson Ortiz, MD, a less frequent tumor marker testing and imaging strategy.  We had settled on blood drawing for tumor markers every two months, CT scans every six months, and brain MRI annually.  I felt comfortable with this schedule because I had met with Ross Camidge, MD, PhD at the University of Colorado in the Spring.  Dr. Camidge, responding to my concerns of over-exposure to radiation, reassured me that tumor marker testing would direct if I needed more frequent CT scans.  I knew that this, a more relaxed testing schedule, was out-the-window if/when I became symptomatic.

     So...in November and December I was symptomatic.  I had blood work, CT scans of my chest, abdomen, and pelvis, a bone scan and a brain MRI in early December.  I was shocked and equally relieved when all testing showed that my cancer remains stable.  Toward the end of December, I started to feel better.  Although I still have bone achiness, I no longer have daily headaches and I've started to have more energy. Added energy allows me to exercise more regularly, which always helps me feel better and stronger.  

     I don't know why I felt so crappy for those couple of months. Perhaps it has something to do with colder outdoor temperatures...I struggled last winter as well.  My guess is that it's a problem, several layers deep...cancer, piled on top of my age, piled on top of winter, piled on top of my knee injury, frosted with run-of-the-mill stresses. Unlike my pre-cancer era, I'm no longer able to juggle life as successfully as I used to and I need to be more mindful of managing stress.  I reminded myself of the mind-body-spirit triad that used to be so central to me.  Somewhere along the way, I've become sloppy about conscientiously nurturing each facet of the triad.  I allowed stresses at work, coupled with the craziness of the holiday season, (Halloween to New Year's Day), to override my well-being.  I was turning into a depressed cancer patient.

      It is now obvious to me how easily a person with a chronic illness can slip into a dark place. Although there are plenty of resources for taking care of my physical maladies, I have been less attentive to my mind and spirit needs, lately. So as part of my New Year's resolution, I plan to refocus on and rebalance the triad.  Hope it helps...

Monday, December 7, 2015

Birthday Blog

     Three years ago, on December 14th, I was in an ER trying to make sense of the words I had just been told..."We see that you have metastatic cancer, and we don't know where it started from. We'd like to admit you into the hospital."  On that day in the ER, I was 54 years and one week old, and I had no idea what having metastatic cancer meant.


     During that hospital admission, we didn't get much in the way of good news. The imaging scans I'd had showed cancer in my lung, liver and bones. One positive piece of news was that I did not have mets to my brain.  (More on that in an upcoming blog.)

     Today I celebrate my 57th birthday.  Frankly, I'm astonished that I am still here.  If it weren't for Xalkori, (my targeted oral chemotherapy,) I wouldn't be. I've been on it, off-label, for 33+ months now.  I recently heard that FDA approval of Xalkori for ROS1 mutation-driven lung cancer is expected very soon...maybe even by the end of the year.


Lorlatinib...what a gift!
     It is a known fact that Xalkori won't work for me forever and, until recently, the next promising medicine wasn't known.  But, I got an early birthday gift a couple months ago. A Phase 1/2 clinical trial opened for the next new targeted chemotherapy called lorlatinib. I've been following a few fellow lung cancer ninjas with ROS1 mutation-driven disease, who developed drug-resistance to Xalkori, and who are now taking lorlatinib under the clinical trial protocol.  Get this...they're doing well!  Their scans are showing tumor suppression with few side-effects.  Wahoo!

      Now that I know what it means to have metastatic cancer, for this birthday, please join me in celebrating cancer researchers and the brave souls that enter into clinical trials...these are truly the pioneers that have allowed me, and others like me, to enjoy another year of life.

Monday, November 23, 2015

PROFILES IN LUNG CANCER - DAY 23: RACHAEL WILLEFORD

Lung Cancer Awareness Month 2015 

November is Lung Cancer Awareness Month.  This year I am participating in an effort to raise awareness through a Lung Cancer Blog Chain.  This is my second contribution. 
I'd like to introduce....

RACHAEL WILLEFORD, Lung Cancer Advocate and Co-chair of Lafayette (Louisiana) Free to Breathe*  

Rachael with Dr. Brendan Stiles at the Free to Breathe Lung Cancer Action Summit
[*Free to Breathe is a partnership of lung cancer survivors, advocates, researchers, healthcare professionals and industry leaders, united in the belief that every person with lung cancer deserves a cure.    http://www.freetobreathe.org/  ]
Rachael's Twitter handle:  PollywogPrinces

Rachael, what is your connection to lung cancer? 
Rachael with Lafayette Free to Breathe chair Tanya Farmer
"Four members of my mom's side of the family have died from lung cancer. Two of them were my mom's best friends - her brother and her cousin. They both were ever present in my life. In 2012, I learned that someone had started a fundraiser called Free to Breathe in my town, and I decided to participate.  Afterwards, I volunteered on a committee and would eventually become the co-chair of the event a few months later. After I learned that my mom's cousin, (who passed away in 2009,) and her father, (who also passed away from lung cancer in 1978,) had virtually the same survival rate, I dove headfirst into advocacy. I now focus on patient and community education and outreach, locally, with Free to Breathe. 

What is your typical day like?
"Well...I'm a mom with a full time job, so my days are hectic. Until recently I worked an 8-to-5 job at a radiation oncology clinic holding a few positions - from insurance billing to front desk to scribe work for a physician. Now I run the roads for a healthcare linen company, solving issues and making sure things operate smoothly. Afterwards, I come home to be a mom and a wife. When there's time to spare, I am very active on social media raising lung cancer awareness via Twitter and Facebook." 


What would you like us to know about you that we might not otherwise know?
"I'm a animal lover. We currently have two rescue dogs that we spoil and a fish named Spooky. Oh, and I'm a book lover. My husband jokes that I may be addicted. I like reading so much I ended up with an English degree."

Rachael, what do you want us to know about lung cancer?
"Everyone deserves hope! Anyone with lungs can get lung cancer. However,  knowing your risk factors and what symptoms to look for, along with screening, lung cancer can be caught earlier and survival rates will increase."

What brings you hope?
Team shirt honoring family members who died from lung cancer
"Survivors and research. I recently attended the Lung Cancer Action Summit and met several long term survivors.  Along with #lcsm survivors and a few survivors from my area, these people showed everyone that survival can be a reality. Also, the amount of progress made in the past four years is astounding. Advances in research are making the commitment to hope easier for survivors and advocates."






Thank you so much, Rachael, for giving us a glimpse into your world and how lung cancer touches it.  Thank you, too, for your work in helping raise awareness.


Yesterday's blog chain post:  http://lisa.ericgoldman.org/
Tomorrow's blog chain post:  https://lysabuonanno.wordpress.com/















Sunday, November 8, 2015

PROFILES IN LUNG CANCER - DAY 8: JILL FELDMAN


Lung Cancer Awareness Month 2015


As part of Lung Cancer Awareness Month 2015, I am participating in a Blog Chain.  Along with several other lung cancer bloggers, I will be interviewing members of our lung cancer community.  Our hope is to raise awareness by bringing to our readers the faces and stories of people fighting our battle, those that care for us, and our doctors that are giving us a fighting chance.


 I'd like to introduce...





JILL FELDMAN, Lung Cancer Advocate and Warrior, (in that order.)

  • Who is Jill?  She is the 13-year-old granddaughter who lost two grandparents to lung cancer within weeks of each other.  She is the daughter whose father died at 41 years old of lung cancer, nine months after her grandparents died.  She is the daughter whose mother died at 54 years old of lung cancer.  She is the niece whose aunt died at 56 years old of lung cancer.  She is the former president of LUNGevity who was diagnosed with lung cancer, during her term, at age 39.  She is a wife and mother of four teenagers ages 18, 17, 15, and 13 years.  Jill has been a lung cancer warrior for 6+ years.
  • How does Jill incorporate lung cancer into her life?: She is a tireless advocate for lung cancer patients.  She was active in the leadership at LUNGgevity (president and board member) because of her significant family history.  Following her own lung cancer diagnosis, she became more focused on research advocacy and directly reaching out to those on the front lines of lung cancer.  As a patient, she has met with several top lung cancer specialists across the country and bravely side-stepped their recommendations; opting for her own treatment path.  Her renegade spirit was worked out well for her.  
  • A typical day in Jill's life...differs depending upon the time of year.  In the summer she works at Culver Summer School and Camps, as a program
    director. (More on this later.)  Other times of the year, Jill works as a Consumer Reviewer for the Department of Defense (DOD) researching lung cancer, online and on-sight in Virginia,
    as a member of a panel tasked with deciding where DOD grant moneys should be directed. She connects with lung cancer patients as a resource for education and support, is a frequent lecturer, and is a busy mother to her active family.  She also teaches English at vocational schools.  
  • What is something most people don't know about Jill?:   The program that she is the Director of at Culver Summer School and Camps is RIFLERY.   She holds the highest rank possible in marksmanship, "Distinguished Expert".  (Who knew?!) She loves teaching and developing campers' skills, while watching their senses of responsibility and confidence rise.
  •  What brings Jill hope?  After the deaths of three friends with lung cancer, all in their 30's with young children, Jill needed to ensure that all cancer warriors know that "nobody fights alone." From that, Jill started the Traveling Hope Blanket.  The goal of this project is to bring comfort to those who need it by sharing the message of hope.  
"The hope I have is real because I can now recognize that hope is relative. I now think, and believe, that hope means so much more than simply a ‘cure’ for lung cancer!"     – Jill Feldman

        Check out the Traveling Hope Blanket website at:  



Click on 'Stories of Hope'...you might recognize some faces.


Tomorrow's blog chain post:  https://lysabuonanno.wordpress.com/