As you saw from my post the other day, I have not been feeling well lately. Boy, howdy, was I not feeling well. But now I'm feeling a bit better. Why you ask? A trip to the outpatient clinic at Gritman Hospital and a nice infusion of hydration and anti-nauseal drugs. Aaahh.
Let me tell ya, though, it took forever to get this set up. Because all of my treatment has been focused in Portland, I have no clue what resources there are here in Moscow. If I'm dehydrated, what do I do??? I'm 400 miles from the infusion clinic at the Oregon Clinic. I have only been to my primary care physician here in Moscow twice. I've been to the oncologist in Lewiston once. So how do I get about getting what I need to make me feel better while not in Portland? After having a rough weekend, and a rough early week, I called the nurse's line at the Oregon Clinic to try to get someone to write orders for hydration here in Moscow. But I had no answers for them as to where to go. My bad. Out of town doctors can write orders for medical needs at private clinics, but not at local hospital outpatient clinics like we have here in Moscow. You need to have privileges at that particular hospital. Therefore, the Oregon Clinic had to send orders to my primary care physician, who then wrote his own orders to get me in for hydration at the hospital. SIGH. It took 24 hours to get it set up, and I finally got in yesterday. Two hours at the hospital, and I definitely felt better. Last night I even ate a bit of dinner (mmmm...split pea soup from a can).
What this fiasco has taught me is to get myself educated! I need to talk with more people, and my PCP, and the oncologist in Lewiston, to see what identify what they can do for me in the area. Especially since I'm only going to Portland every 3 weeks now.
Today I'm doing a bit better. I'm eating crackers, drinking Powerade, and have only hurled once, and that was early after drinking an Ensure shake. I think my body does not like Ensure. I'm gonna take a break from them for a while.
Other than that, no new news. My next appt in Portland is June 12. Oh, and the new treatment drug's name is IPILIMUMAB. I-pili-moo-mab. I think. ;)
Cheryl
Friday, May 30, 2008
Monday, May 26, 2008
Dave & Cheryl At The Movies: Indiana Jones and the Kingdom of the Crystal Skull
Just got back from Indiana Jones and the Kingdom of the Crystal Skull, another one of the many films I was looking forward to this summer and (spoiler alert - read no further unless you want plot points revealed) we both agreed it was kind of "meh." I thought the first hour was great stuff (Russians! Atomic bombs! And was that the Ark of the Covenant?) that was vintage Indiana Jones, but as soon as that crystal skull showed up, the movie started to go off the rails.
I know Lucas & Co. were going for a 50's B-movie feel here, but it felt a little too forced in spots, overreliant on CGI, and, again, after the fiasco that was the Star Wars "prequels," it's painfully apparent that George Lucas should not be allowed anywhere near a keyboard ever again. Seriously.
On the one hand, any Indy is good Indy, but I can't help but feel that they should have let the franchise ride off in the sunset, literally and figuratively, in The Last Crusade. However, given the ginormous opening of the film, and the passing of the fedora to Shia LeBoeuf at the film's conclusion, I suspect we may not have seen the last of Dr. Jones.
Fine by me, as long as we get Lawrence Kasdan back to write it. I said back away from the keyboard, George! I'm serious!
Dave and Cheryl give Indy 4 a solid thumbs in the middle.
I know Lucas & Co. were going for a 50's B-movie feel here, but it felt a little too forced in spots, overreliant on CGI, and, again, after the fiasco that was the Star Wars "prequels," it's painfully apparent that George Lucas should not be allowed anywhere near a keyboard ever again. Seriously.
On the one hand, any Indy is good Indy, but I can't help but feel that they should have let the franchise ride off in the sunset, literally and figuratively, in The Last Crusade. However, given the ginormous opening of the film, and the passing of the fedora to Shia LeBoeuf at the film's conclusion, I suspect we may not have seen the last of Dr. Jones.
Fine by me, as long as we get Lawrence Kasdan back to write it. I said back away from the keyboard, George! I'm serious!
Dave and Cheryl give Indy 4 a solid thumbs in the middle.
Question: Is it the Treatment or the Cancer?
Oh, lordy, have I been sick for the past four days! I haven't been able to keep anything down, including liquids, since Thursday, and I've had a temperature running as high as 102.5. Yuck. Finally, I'm feeling a bit better today. The question has been whether my symptoms are from the evil cancerous tumors in my tummy, gastroenteritis, or the initial response to my new treatment regimen, which started on Thursday. We're hoping its the latter. We almost went to the emergency room yesterday, as I was soooooo dehydrated and my temp was pretty high, but as of 9:00 last night, I was feeling a lot better, and was able to drink some powerade overnight.
Today has been touch and go, but my temp is only running around 99, and I'm taking tylenol for that. I was even able to eat granola bar and not feel like I was going to bring it back up immediately. I'm feeling well enough now to go off to the movies. We had originally planned to go see the new Indy movie Friday night, but, well, um, yeah. I'm a bit weak from lack of calories, but I'm slowly (and carefully) trying to fix that.
I'll give you an update on the movie when we get back!
Toodle-ooo!
Cheryl
Today has been touch and go, but my temp is only running around 99, and I'm taking tylenol for that. I was even able to eat granola bar and not feel like I was going to bring it back up immediately. I'm feeling well enough now to go off to the movies. We had originally planned to go see the new Indy movie Friday night, but, well, um, yeah. I'm a bit weak from lack of calories, but I'm slowly (and carefully) trying to fix that.
I'll give you an update on the movie when we get back!
Toodle-ooo!
Cheryl
Tuesday, May 20, 2008
Another Day, Another Dollar (or three)
Sorry I haven't put up a blog post in a while. Last week was, shall we say, an icky week for me. The tummy was not cooperating. At all. I tended to be a lump on the couch under the afghan groaning a lot. This week I'm doing much better.
I started acupuncture last week. Ever since my first trip to Portland last fall, I've been wanting to go outside my comfort zone and try some chinese medicine treatments, and after Dave nagged me for a couple of months, I finally made an appointment at a clinic in Moscow. The needles don't hurt when they go in, much, but its been an interesting experiment for me. Mostly because there seems to be somewhat of a correlation between the acupuncture treatments, and my stomach going, um, yucky. The 24 hours after each appointment I have had the worst stomach problems! Its possible that my body, since its been in poor shape for a while, is rebelling against attempts to realign the whatevers that acupuncture realigns. Or it could be just wacky coincidence. I'm thinking its part of the acupuncture. I have another appointment on Wednesday. I'll keep ya posted.
Thursday I start the Ipilumamab (is that how you spell it???) treatment at the Oregon Clinic. I fly into Portland early Thursday, and fly back home that afternoon. I'm not sure what to expect, so I'm hoping I don't have an immediate response to the treatment. Flying by myself and feeling like crap is never a good thing. Everyone keep their fingers crossed that this treatment does the trick!
Other than that, not much is going on. The weather has been beautiful here for the past week. When I wasn't lying under a blankie on the couch groaning, I was on the deck lying on a lounger reading a book, groaning a little in the shade. Ah.
Cheryl
I started acupuncture last week. Ever since my first trip to Portland last fall, I've been wanting to go outside my comfort zone and try some chinese medicine treatments, and after Dave nagged me for a couple of months, I finally made an appointment at a clinic in Moscow. The needles don't hurt when they go in, much, but its been an interesting experiment for me. Mostly because there seems to be somewhat of a correlation between the acupuncture treatments, and my stomach going, um, yucky. The 24 hours after each appointment I have had the worst stomach problems! Its possible that my body, since its been in poor shape for a while, is rebelling against attempts to realign the whatevers that acupuncture realigns. Or it could be just wacky coincidence. I'm thinking its part of the acupuncture. I have another appointment on Wednesday. I'll keep ya posted.
Thursday I start the Ipilumamab (is that how you spell it???) treatment at the Oregon Clinic. I fly into Portland early Thursday, and fly back home that afternoon. I'm not sure what to expect, so I'm hoping I don't have an immediate response to the treatment. Flying by myself and feeling like crap is never a good thing. Everyone keep their fingers crossed that this treatment does the trick!
Other than that, not much is going on. The weather has been beautiful here for the past week. When I wasn't lying under a blankie on the couch groaning, I was on the deck lying on a lounger reading a book, groaning a little in the shade. Ah.
Cheryl
Friday, May 9, 2008
Six of one, half a dozen of the other
Whew! Dave here. What a long trip...we hit all the popular hotspots in the Pacific Northwest on this trip; Portland, Seattle, Enumclaw...
We got into Portland on Wednesday evening, got a CT scan, then went out for Indian food with Cheryl's friends, Blair and Noel - very tasty! You just can't get good ethnic cuisine up here. Hell, a bratwurst is considered ethnic in this neck of the woods, but that's beside the point. I waaay overate, and felt like a python that had swallowed a goat and needed to go digest under a tree for a week or so.
Sadly, Cheryl ended up puking around midnight, which has been a common occurrence lately, so we weren't surprised when Dr. Crocenzi informed us that the tumors had grown a bit, so no more Plan C. Phooey. We weren't terribly upset about this, as being a double-blind study, we had no clue that we were getting the good stuff or the placebo.
However, the following news was somewhat better. While Cheryl got an IV of fluids and a little anti-nauseals, Chris Fountain came by with the paperwork for Plan D, an anti-CTLA4 drug called ipilumimab (say that five times fast and it sounds like you're calling the legal offices of Bob Loblaw).
So what's this drug do? As mentioned previously, melanomas are something the immune system should recognize and destroy, but doesn't. This is partly because melanomas have a "shield" of an animo acid (CTLA-4, duh), which blocks the killer T-cells. Basically, the T-cells come up to the melanoma cells, John Cleese pops out and taunts them, and the T-cells go away to plot some other way to get into the castle.
Ipilumimab, according to this study, will strip the CTLA-4 shield from the melanoma cells, enabling the T-cells to sneak inside the cells using a giant rabbit...or maybe a badger.
However, since CTLA-4 protects many other things in the body from indiscriminate immune responses, there's a possibility of many other autoimmune side effects, similar to what happened when Cheryl underwent IL-2 therapy, most commonly a nasty skin rash.
But it gets more interesting! The paperwork we had says that, on average, about 10-15% of all patients see some kind of response - about the same as IL-2. However, Chris told us that 20 people have undergone ipilumimab therapy at the Oregon Clinic so far, and 16 of them have been in the program long enough to undergo further CT scans. Of those 16 people, a whopping 14 have seen some kind of response, varying from no further growth to, in at least one case, complete remission. Apparently, if you have seen some kind of response in IL-2 therapy (which we have), the odds are much greater that you will see a response in ipilumimab therapy.
And, this isn't chemo, so there'll be no nasty chemotherapy side effects, and it's only one treatment every three weeks, not three weeks/one off.
So Plan D sounds like a winner in our book (which is good, as we're not sure what Plan E might be as yet).
Heartened by the possible good news, we ventured up to Seattle to visit my friend Scott Rudi and catch a Mariners game, which was sadly unexciting save for a unexpected bench-clearing brawl (but, I mean, Sexson is all of six feet thirteen, and you throw a helmet? Come on!), topped by a fantasy-league-killing performance by Felix Hernandez. Thanks for nothing, Felix.
(Cheryl here)... Just wanted to report that we stopped by to see our friend Vanessa at her parents home outside of Enumclaw. Three weeks out from major brain surgery, and she is walking, talking, and overall doing really well. So well, that she and I are going to plan a trip to New Mexico in the fall, baring health ickies. Whoopee! Balloon Fiesta, here we come!
We got into Portland on Wednesday evening, got a CT scan, then went out for Indian food with Cheryl's friends, Blair and Noel - very tasty! You just can't get good ethnic cuisine up here. Hell, a bratwurst is considered ethnic in this neck of the woods, but that's beside the point. I waaay overate, and felt like a python that had swallowed a goat and needed to go digest under a tree for a week or so.
Sadly, Cheryl ended up puking around midnight, which has been a common occurrence lately, so we weren't surprised when Dr. Crocenzi informed us that the tumors had grown a bit, so no more Plan C. Phooey. We weren't terribly upset about this, as being a double-blind study, we had no clue that we were getting the good stuff or the placebo.
However, the following news was somewhat better. While Cheryl got an IV of fluids and a little anti-nauseals, Chris Fountain came by with the paperwork for Plan D, an anti-CTLA4 drug called ipilumimab (say that five times fast and it sounds like you're calling the legal offices of Bob Loblaw).
So what's this drug do? As mentioned previously, melanomas are something the immune system should recognize and destroy, but doesn't. This is partly because melanomas have a "shield" of an animo acid (CTLA-4, duh), which blocks the killer T-cells. Basically, the T-cells come up to the melanoma cells, John Cleese pops out and taunts them, and the T-cells go away to plot some other way to get into the castle.
Ipilumimab, according to this study, will strip the CTLA-4 shield from the melanoma cells, enabling the T-cells to sneak inside the cells using a giant rabbit...or maybe a badger.
However, since CTLA-4 protects many other things in the body from indiscriminate immune responses, there's a possibility of many other autoimmune side effects, similar to what happened when Cheryl underwent IL-2 therapy, most commonly a nasty skin rash.
But it gets more interesting! The paperwork we had says that, on average, about 10-15% of all patients see some kind of response - about the same as IL-2. However, Chris told us that 20 people have undergone ipilumimab therapy at the Oregon Clinic so far, and 16 of them have been in the program long enough to undergo further CT scans. Of those 16 people, a whopping 14 have seen some kind of response, varying from no further growth to, in at least one case, complete remission. Apparently, if you have seen some kind of response in IL-2 therapy (which we have), the odds are much greater that you will see a response in ipilumimab therapy.
And, this isn't chemo, so there'll be no nasty chemotherapy side effects, and it's only one treatment every three weeks, not three weeks/one off.
So Plan D sounds like a winner in our book (which is good, as we're not sure what Plan E might be as yet).
Heartened by the possible good news, we ventured up to Seattle to visit my friend Scott Rudi and catch a Mariners game, which was sadly unexciting save for a unexpected bench-clearing brawl (but, I mean, Sexson is all of six feet thirteen, and you throw a helmet? Come on!), topped by a fantasy-league-killing performance by Felix Hernandez. Thanks for nothing, Felix.
(Cheryl here)... Just wanted to report that we stopped by to see our friend Vanessa at her parents home outside of Enumclaw. Three weeks out from major brain surgery, and she is walking, talking, and overall doing really well. So well, that she and I are going to plan a trip to New Mexico in the fall, baring health ickies. Whoopee! Balloon Fiesta, here we come!
Friday, May 2, 2008
Dave & Cheryl at the movies: Iron Man
People have asked me, "oh, come on, there must be something you like about Pullman," and I'd think for a bit, waiting for the rubbing-my-chin-in-thought glissando, and I'd respond with "Well, there is this one mini-mart that usually gives me pop refills for free," and that's pretty much it. Okay, there's one other thing: since this town empties out in the summer, that means no lines at the movie theaters; and since Cheryl and I are both big comic geeks, this summer is shaping up to be a fun one, what with The Dark Knight, Indiana Jones 4, The Incredible Hulk, etc., etc.
So, last night, we got tickets to the early showing of Iron Man, and we were rather geeked, since the trailers looked good and the early reviews have been phenomenal. And the theater was only half-filled. Thank you, empty Pullman.
Now, I've been geeked to see movies before and been disappointed. This is not the case. If you are a comic geek, run, don't walk, to see this movie. I'm not sure I'd call it the best super-hero movie ever, but it's definitely in the discussion (I'd still give Spider-Man 2 the nod there, but I could easily be convinced otherwise).
If you aren't a comic-book geek, you'll still get a kick out of this film. Robert Downey Jr.'s performance alone is worth the price of admission, and the supporting cast - Jeff Bridges, Terence Howard and Gwyneth Paltrow - that's a cast out of some hoity-toity for-your-consideration art flick, not a $200 million summer blockbuster. These are people who can make expository dialogue sing, and, mercifully, there's not all that much of it. Downey's performance, in fact, might be remembered at Oscar time; the sort of out-of-left-field wow-where-did-that-come performance akin to Johnny Depp's first go as Jack Sparrow.
In short: Dave and Cheryl give Iron Man two thumbs up, way, way up - we would offer more praise, but that we had more thumbs.
P.S. Don't leave until the credits are completely over, as there's an unbilled cameo that, again, will make us comic book geeks squeal with delight.
So, last night, we got tickets to the early showing of Iron Man, and we were rather geeked, since the trailers looked good and the early reviews have been phenomenal. And the theater was only half-filled. Thank you, empty Pullman.
Now, I've been geeked to see movies before and been disappointed. This is not the case. If you are a comic geek, run, don't walk, to see this movie. I'm not sure I'd call it the best super-hero movie ever, but it's definitely in the discussion (I'd still give Spider-Man 2 the nod there, but I could easily be convinced otherwise).
If you aren't a comic-book geek, you'll still get a kick out of this film. Robert Downey Jr.'s performance alone is worth the price of admission, and the supporting cast - Jeff Bridges, Terence Howard and Gwyneth Paltrow - that's a cast out of some hoity-toity for-your-consideration art flick, not a $200 million summer blockbuster. These are people who can make expository dialogue sing, and, mercifully, there's not all that much of it. Downey's performance, in fact, might be remembered at Oscar time; the sort of out-of-left-field wow-where-did-that-come performance akin to Johnny Depp's first go as Jack Sparrow.
In short: Dave and Cheryl give Iron Man two thumbs up, way, way up - we would offer more praise, but that we had more thumbs.
P.S. Don't leave until the credits are completely over, as there's an unbilled cameo that, again, will make us comic book geeks squeal with delight.
Thursday, May 1, 2008
It had to happen eventually
I'd been holding out for far too long, skirting the law, but I finally broke down and did it...
I got Idaho license plates for my car.
I'd been holding on to the Oregon plates forever, maintaining Oregon residency for longer than recommended, just to keep another reminder of my home state, but I finally ran out of excuses and was forced to register my car in The Mississippi of the West.
Strangely, it feels like my driving IQ has gone down by about 20 points, and I no longer have the desire to use my turn signals...hopefully, I'll be able to resist the urge to tailgate unnecessarily.
Dave
I got Idaho license plates for my car.
I'd been holding on to the Oregon plates forever, maintaining Oregon residency for longer than recommended, just to keep another reminder of my home state, but I finally ran out of excuses and was forced to register my car in The Mississippi of the West.
Strangely, it feels like my driving IQ has gone down by about 20 points, and I no longer have the desire to use my turn signals...hopefully, I'll be able to resist the urge to tailgate unnecessarily.
Dave
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