I was discharged from my second hospital stay at MD Anderson today and we headed home after being away for 2 weeks!  We still don't know exactly why the drastic pain flair up occurred on Thursday.  It's possible the prior liver biopsy was part of it.  I was admitted to the hospital again on 4/26 and was discharged 4/30.  

They kept me on antibiotics throughout my hospital stay and doubled my morphine dose taken daily.  My temperature is now consistently reading normal (under 99).  I've had a low grade fever of around 100 for the last several weeks and it was as high as 101.8 when I first went back in the hospital.  The hot flashes and chill spells I've had for the last 2 weeks stopped as well.  During the hospital stay they also started me on an anti-inflammatory drug called Celebrex that I will continue to take daily.  The fever being gone could be attributed to the antibiotics or anti-inflammatory med, as well as the immunotherapy helping my immune system to begin attacking the tumors.  Who knows, but I feel a lot better.

The radiation team reviewed my case on Friday 4/27 and they are in agreement with providing Gamma Knife Radiosurgery to treat/destroy the brain tumors.  Ultimately my medical oncologists recommended that I wait for the procedure until we have the new scans that will be taken 6 weeks from the date of the first immunotherapy injections, which I had on 4/21.  The radiation team and neurologist were in agreement with his recommendation to wait.  With the wait period, if the tumors shrink there is less risk of bleeding within the brain and we can also catch any new tumors that may show up before the immunotherapy was able to kick into high gear.

My liver has very severe swelling, so I have ongoing pain that I will be managing.  I returned home with all the medications to deal with pain and side effects at this point.  Hopefully the tumors on my liver will begin to shrink and the deformity of my liver will be reversed and the pain reduced.

Due to the immunotherapy having the risk of causing my immune system to attack things it shouldn't, I have to hope that such side effects are minimal or able to be controlled.  As long as I can tolerate each subsequent round of the immunotherapy injections and manage any side effects, I will receive them every 3 weeks with the next dose being on 5/16.

The week of 5/14 I will return to MD Anderson for blood work, an appointment with the supportive care team that manages my medications, an appointment with my medical oncologist, and the 2nd round of immunotherapy infusion.  The 6 week mark when scans will be performed is also the time frame for the 3rd round of immunotherapy infusion.

The goal of the current Ipilimumab and Nivolumab drugs (immunotherapy) is to shrink the tumors and prevent any new ones.  Best case scenario would be what is referred to as a "complete response", meaning that my immune system successfully kills off all of the tumors.  This occurs in a very small number of patients.  I went disease free for almost 8 years, which was exceptional considering the fact that the cancer had spread to my lymph nodes, so I have all the luck and momentum on my side to be a "complete response"!  THINKING POSITIVE EVERY DAY!!  I'm very lucky that I am dealing with this now and not back within the first several years when I was first diagnosed with the disease, back at that time there were really no treatment options.

The boys were able to be with us the first several days when we went to Houston.  They also got to come visit this last weekend when my mom brought them down for Friday and Saturday nights (Thank you Mom!).  

I'm cutting the school year short to focus on living daily with minimal stress and giving my body/immune system all the help I can.  There's 4 weeks of the school year left, so I will have missed about 6 weeks of work in all before summer break.  I am so glad my amazing friends and coworkers are taking up the slack for me.  I know my kiddos are in good hands to finish out the school year.  It will also be nice that our boys will be out for the summer and relieve that part of the scheduling consideration for a while.

That's it for now.  I plan on everything going well over the next two weeks and being geared up for the next trip to Houston.  Thank you for the overwhelming love and support provided by so many during this turbulent time.  We love you all!

Here is a good resource on the MD Anderson website if you would like to know more about Melanoma and the treatment. 

WEAR YOUR SUNSCREEN AND KEEP ANY ONE YOU LOVE AWAY FROM TANNING BEDS ;)

www.Harvster.com
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We made it to the 1:00 consultation with the radiation department today.  Unfortunately, Erica woke up this morning in a lot of pain on her right side.

By the time we were at the 1:00 appointment her pain was out of control.  The Radiation Oncologist made the call to cut the appointment short and send her the emergency room.  The emergency room has ordered a CT scan of the chest and abdomen.  They want to ensure the pain isn't attributable to the liver biopsy that was done this past Monday.

The emergency room doctor also spoke with Erica's primary Medical Oncologist Dr. Hwu, and they have decide to admit her to the hospital again.  It's a little after 6pm right now and there aren't any rooms available.  As soon as a room becomes available they will transfer her from the emergency room.  The emergency room got her an IV going and has been able to get the pain knocked down to a tolerable level.  

One day at a time, it's simply one day at a time.

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Unfortunately, it's time to resume the updates here.  We want to be sure that everyone we know and love have the opportunity to stay informed about the new status of Erica's journey with Metastatic Melanoma Cancer.  

Since Erica's last surgery in March 2010, the dozens of follow up appointments were luckily "all clear".  About 6 weeks ago she began to experience symptoms that seemed to mimic acid re-flux.  This continued and progressed a few weeks ago to the point of pretty severe abdominal pain.  On Tuesday April 10th, she visited her local general doctor to discuss the symptoms she was having.  The prognosis from that appointment was suspecting a peptic stomach ulcer.  She was prescribed Prilosec to control stomach acid and completed a number of samples for lab testing.  We were waiting on the lab test results to confirm if there was some form of detail that supported the likeliness that she was dealing with an ulcer.

Midday on Monday April 16th Erica was feeling a very sharp pain on her right side just below her ribs.  She was also feeling fatigue and dizzy.  She went home early from work that day and followed up with the local doctors office.  They informed her they were referring her for a colonoscopy and a endoscopy.

On Tuesday April 17th we woke up and got the boys off to school.  The pain experienced the prior day was persistent and she described it as probably being worse.  We went on to the emergency room at Health South in Burleson that morning about 8:30.  The emergency team there worked quickly to control the pain and anxiety.  About 90 minutes after we arrived they performed a sonogram of the pelvis and a CT scan of the pelvis.  The doctor came in to inform us that the CT scan detailed 25 plus lesions on her liver.  This was a very sad moment, a moment we will never forget.

Because Erica has been a patient at the Melanoma Clinic at MD Anderson since 2010, we were able to immediately contact them.  The emergency room doctor also contacted MD Anderson and provided them the test results.  Both of our mothers and some of Erica's other family were able to make it to emergency room quickly to be there to support us.  The emergency room provided her pain and anxiety medications to help as we moved forward.

We arrived home from the emergency room about 1:15.  We decided we needed to get the boys from school and inform them of what we found out.  We spoke to MD Anderson again within a few hours and they informed us that she could be seen the following day.  We took a long nap and packed up for the drive to Houston that night.

On Wednesday April 18th Erica had an MRI of the brain and blood work at the hospital.  On Thursday April 19th she had another CT scan to cover the portion of the chest that hadn't been scanned at the emergency room back in Burleson.  Later Thursday afternoon we had an appointment with a Medical Oncologist at the Melanoma Clinic.  This is where we received the sad news that there were 11 lesions detected in the lungs and 6 others detected in the brain.  Devastating news to say the least.  The decision was made at that appointment to admit her the hospital within MD Anderson.

The hospital was able to start controlling her pain and continue blood tests.  During the hospital stay the team of Melanoma specialists collaborated to determine the initial scope of treatment to be pursued.  They decided to get things rolling to administer a relatively new treatment referred to as Immunotherapy.  They also began preparation to administer a type of "pin point" radiation therapy to alleviate/cauterize the brain lesions.  Based on blood work results and the history of metastatic Melanoma they are fairly certain the lesions are malignant metastatic Melanoma.  The metastatic portion of the description details that the cancer is a result of exposure from the previous malignant tumors found in her lymph nodes back in 2010. 

The Immunotherapy is a combination of the drugs Ipilimumab and Nivolumab.  The first dose was administered on Saturday April 21st and is scheduled to be administered three additional times, three weeks apart.  The drugs are intended to stimulate the immune cells and their functions which can attack the cancer cells.  There have been numerous breakthroughs in the treatment of Melanoma over the last 8 years, several have become FDA approved treatments.  At the time of Erica's original diagnosis there weren't any treatments at all, only that tumors capable of being surgically removed had that option to be dealt with.  Although there is the new treatments available, they only serve to try to shrink existing tumors and fight spreading/progression.  This is now a disease that must be managed from here on out, but we will never rule out a miracle that 100% rids her body of the cancer.

On Wednesday April 25th Erica has additional blood work and an appointment with her primary Medical Oncologists Dr. Patrick Hwu at MD Anderson.  You can read more about this amazing man and doctor by clicking here.  Dr. Hwu has been out of town since we arrived in Houston, so this will be our first visit with him. 

On Thursday April 26th she will be meeting the radiology team for her consultation in preparation for the brain radiation therapy that has yet to be scheduled.  We are anticipating the radiation therapy will be scheduled within the next week to 10 days.

Whew...that's it for now.  The outpouring of thoughts, prayers, support, and financial assistance has been beyond belief.  We are so blessed and we "feel" the army of support behind us each and every moment.  We will try to keep this site updated as often as possible.  It's so much less stressful for both of us to explain updated information this way, than it is repeating it and talking about it over and over.  The battle has just begun, but Erica is a fighter and every single avenue will be pursued to win this fight.  We are blessed beyond our wildest imagination!

Erica and Harvey Braden

www.Harvster.com

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