Friday, 1 August 2014

What Do You See ?


Truth is, you don't get to see something like this very often. When John Legend released his video for 'You & I' (Nobody in the world) using 63 different women of varying race, age and experience, he also made a separate video asking some of them to reveal 'what they see in the mirror'. The end result is really something special.

https://www.youtube.com/watch?v=kcSnUaGfm-A


If ever there was a video that could be said to capture the beauty and pain of human experience, this would be it.

Nearly There .... (Updated Version). Im Finally in the Trial



So I started all my test to see if I'd be included in the trial. I had my bloods, bp, height weight ECG and CT scan done. Tests and hospital visits felt like a big blur in my life. It's was all happening too fast and all at once. Having a hot English weather was nice but it all added to my exhaustion. CT scan was amazingly easy as there was no needles. They ve used my picc line ( my blood port) instead of injecting me. So I was very happy it was pain free. 
Liver biopsy was the last and most painful test. They gave me this beautiful gown in the super posh clinic to wear......





Than they wheeled me in my bed thru hidden tunnels of the Central London I never knew existed and finally I got to the biopsy room. I was surrounded by number of little gadgets, computers and an ultrasound machine. Doc came around and introduced himself and cracked on with a procedure. I was slightly worried as I was hoping to have some sort of sedation. I ve asked if I was having any and he said no. Not even happy air I said and he said no, not that I'm aware of. Suddenly fear came over me... He did ultrasound first, pain free so far. I could see my liver and all the cancer within it. It felt weird looking at the live images of my biggest enemy at the present. 
Than he took out the needle and injected my skin and into deeper capsule of my liver. Very painful. You could feel it going thru your skin. I shouted " this is worse than dental anaesthetics "! 
While waiting for Local to kick in he asked me some " passing time" questions one of which was what I did for living. I explained I was a dentist to which he replied that since the begging of the week he had quite a few dentists on which he performed the same procedure, biopsy of liver cancer.  Oh dear I thought, what's with the world. Cancer seems to be everywhere. Even in the morning when I read online papers there are at least 2 cancer stories each day and those are the people who have made it to the papers! What about a thousands and thousands of cases who never do? 
So he continued with a procedure. Now, up to this point I've been looking at the ultrasound screen and live images it was producing but when he pushed a big biopsy needle in between the ribs and into my liver  while i was still watching it all being done I nearly fainted. I turned my head away and asked if they wouldn't mind talking to me about anything, anything at all so I would not faint. So they continued talking about silly things until the procedure was over. They needed 9 samples of my cancer for this trial and these are the results of my biopsy. 





My CT scan showed that my cancer has not changed or grown by much. Since my last CT scan and since having a chat with nutritionist late May '14 I started eating more or less anything I fancied, whatever my body craved for  even ice cream and other sugary snacks I so much avoided !  I thought to myself I might as well enjoy food that I liked if my life was gonna be a short one. I must admit on my latest scan I expected cancer would have spread much further, especially in my liver and would be all over my body. I was so relieved when I could see on my biopsy result that that wasn't the case.

Also for this trial they needed bloods to be done as well. They seem to test everything possible in my blood. I had 11 vials of blood taken and those are some of my results:









My haemoglobin was on a low side and few other things as well. However, I didn't seem to feel any different. I guess you d expect tiredness, to feel light headed, short of breath etc with my results but I felt the same. As if my body has gotten used to the lack of major blood components. 

This is me on the finial day of testing:


So far I had height, weight, BP, ECG, bloods and liver biopsy done. This trial included people who expressed PDL1 marker and those who didn't.
Ive anxiously waited to hear if I was included in this trial. I didn't know until the very last day. Apparently sponsor needed to know if I had any progression of cancer while I was on a hormone treatment. I was placed on a hormone treatment only as an interim holding off before my 28 days washout out period (where they need my body to clear off any medication I was taking ). Also they ve requested my scans from my hospital to compare with the most recent scan. Luckily, my lovely doc Jason to which Im so grateful and proud to have as my doc sorted it all out in no time. 
So finally after everything, every piece of big puzzle was collected they told me I was included in the trial. 
I was very happy about this but part of me was very scared of this unknown treatment. I didn't know how I was gonna react to the drug but most of all I was worried about having severe allergic reaction that some people have and I was worried if i ll survive that. 

This was the pic taken by my mum on a day of infusion. I was petrified. Yes you get a first class treatment but after all you re a guinea pig 



Before the drug itself, they took some more bloods (5 blood vials ), they gave me paracetamols and drowsy antihistamine. Within a few seconds I was so sleepy and I found it so difficult to keep my eyes open. I brought some stuff to read while I was in this hospital but I really didn't need any of it. 

Moments before the infusion I was chatting to other patients. Some of them told me about their life a little, their failed relationship due to cancer, others told me about their cancers, etc, etc. Everyone was amazingly so open with me and it kind of made me happy. There was no "bullshit" talk that most people tends to have when they meet. This was very open talk about real things, real life that was happening. One person said his cancer has been stable since the start of the trial which was April 14 and the other one told me he had reduction of 50% of his cancer and has been on the trial for about 5-6 months. All of this was very encouraging to me. 
However, within the next hour, chatty and loud clinical room turned into a very quiet room. We were all given our drowsy antihistamine than made us very sleepy. Its like some kind of movie or something, very unreal and funny in our bleak reality, filled with hopes of extended life. 

Infusion seemed to have gone really well. I felt ok. I had to wait for two hours afterwards to have my ECG done. 
I was given loads of meds on my discharge. Anti sickness meds, in case I have diarrhoea meds and hydrocortisone cream in case I have a little bit of rash on my body.

This was my clinical room before I got discharged. More or less everyone had left home:


I was told I should report any side effects that I might have and was given a number to call day / night.
I must admit I didn't have major side effects. Apart from feeling tired the next day and a little bit of sore throat, everything else seemed fine. I was told sore throat would have been expected side effect as its immunotherapy drugs and flu like symptoms in the first few days was considered normal.  I was told to avoid sun exposure as my skin would burn more easily and to prevent delayed effects of sun exposure such as rash and painful skin condition that some people have developed.
 So I continued to be ok and with no problems for the first week.  
They needed to see me more often in first few weeks so they can do observations and bloods.

In the meantime I have developed a bit of the allergy to my picc line dressing. Little blisters came up on my skin just under the dressing. They have immediately changed it to sensitive skin dressing for me. 
It happened twice so we all know its certain dressing fault !



So I was happy that I didn't have major side effects to the drug, I was happy drug didn't make me feel bad like chemo did. Other patients have told me the same. Some of them were on a death bed as to say before the start of the trial and now they feel normal. I must admit this was the first time I felt normal myself. This was also the first time when I had a days that I have forgotten that I had cancer. I kind of felt normal again even though I knew I wasn't and could never be "normal " again. If it wasn't for my picc line on my arm I think I could easily pass as a normal, healthy 30 something year old woman. 
Chemo made me so unwell almost straight away and this drug didn't. I can only hope that it works as well.


We all take our life for granted at the times. It takes for us to become ill to appreciate what normal is again. It takes for us to be very close to death to appreciate life again. We all take life for granted and people around us. I ve done it myself. I got absorbed in my job, I craved for success and recognition in life, I craved for status in life and like many of us I craved material things. When I got ill none of that was important any more. What was important is my family, my friends and all good people around me. No one even cared if I was a dentist or a person with no qualifications. We re all the same.... and eventually one day (hopefully NOT in a near future !) we will all go in the same box.

So, while I can I intend to fully enjoy my life, appreciate little things around me and live in hope that my clinical trial drug will work and give me a little more of extended life Im craving for so much ...


An amazingly foamy coffee I had the other day :)

Saturday, 26 July 2014

Nearly There ..

( I will add more of my experience soon just having some "technical " difficulties ) 


So I started all my test to see if I'd be included in the trial. I had my bloods, bp, height weight ECG and CT scan done. Tests and hospital visits felt like a big blur in my life. It's was all happening too fast and all at once. Having a hot English weather was nice but it all added to my exhaustion. CT scan was amazingly easy as there was no needles. They ve used my picc line ( my blood port) instead of injecting me. So I was very happy it was pain free. 
Liver biopsy was the last and most painful test. They gave me this beautiful gown in the super posh clinic to wear......





Than they wheeled me in my bed thru hidden tunnels of the Central London I never knew existed and finally I got to the biopsy room. I was surrounded by number of little gadgets, computers and an ultrasound machine. Doc came around and introduced himself and cracked on with a procedure. I was slightly worried as I was hoping to have some sort of sedation. I ve asked if I was having any and he said no. Not even happy air I said and he said no, not that I'm aware of. Suddenly fear came over me... He did ultrasound first, pain free so far. I could see my liver and all the cancer within it. It felt weird looking at the live images of my biggest enemy at the present. 
Than he took out the needle and injected my skin and deeper capsule of my liver. Very painful. You could feel it going thru your skin. I shouted " this is worse than dental anaesthetics "! 
While waiting for Local to kick in he asked me some " passing time" questions one of which was what I did for living. I explained I was a dentist to which he replied that since the begging of the week he had quite a few dentists on which he performed the same procedure, biopsy of liver cancer.  Oh dear I thought, what's with the world. Cancer seems to be everywhere. Even in the morning when I read online papers there are at least 2 cancer stories each day and those are the people who have made it to the papers! What about a thousands and thousands of cases who never do? 
So he continued with a procedure. Now up to this point I've been looking at the ultrasound screen but when he pushed a big biopsy needle in between the ribs and into my liver  while i was still watching it all being done I nearly fainted. I turned my head away and asked if they wouldn't mind talking to me about anything, anything at all so I would not faint. So they continued talking about silly things until the procedure was over. They needed 9 samples of my cancer for this trial and these are the results of my biopsy. 

















Monday, 7 July 2014

An Update on Clinical Trial


Ok you can call me crazy but aside from watching comedies I recently discovered I like watching cancer movies too ! Actually, I ve seen one today in the cinema called The Fault in Our Stars. Its a teenage cancer movie about boy meets girl at cancer support group, romance develops, etc etc ... don't want to spoil it for you if by any chance you want to see it. Its amazing how grown up, funny yet serious movie was. No matter how old,  it seems like we all share some of the same things us cancer people +/- life experience. One the things that was mentioned in the movie was " depression is side effect of dying". Something that at the times I can truly associate with. If you see it be prepared to have tissues too !
Some of us tend to cut contacts with some people close to us in order to protect them from emotional pain in case we die. In the movie they called it and I quote " Im a grenade and its my responsibility to minimise the casualties". This is so true in some of the cases. However, we are all different in a way we deal with difficult life stuff, cancer or no cancer.

Today was also my appointment with oncology and I ve seen my lovely doc Jason. We had a chat about my treatment and also about officially including DNR (do not resuscitate ) in my file. Its a difficult conversation to have when you re having to compose yourself when actually all you want do is to cry so much when you talk about it.  Prof came to say hello too, gave me a big hug and reassured me that he s been hearing a lot of positive things about this trial. I still hope I get in, fingers crossed !

I decided to go wild and spoil myself with a big juicy burger today after my oncology appointment.  Oh it was so so tasty .... and yes my dear friend Malcolm I did have a burger today ! :) I thoroughly enjoy it.

Also I ve heard from a clinical trial people as well and this is the plan so far:

Tuesday 
1230 -  to see the nurses for blood pressure, blood test, weight, height, ecg etc (will take +- 45 mins)

1500 for 1530 CT scan of chest abdomen pelvis and head (more needles ! oh dear)
Thursday 
Have a biopsy.  Biopsies usually take most of the day as they expect you there at 0900 and will do assessment pre and observe you for a few hours post. 
Oouch ! Im really not looking forward to this one !! This one is usually the painful one !


Than: 

"Once all the screening procedures and biopsy are completed 
our Drs will review all findings and the sponsor will give us a final Go Ahead
to start treatment.  Your research nurse will call to confirm that we have 
received Go Ahead"


So providing everything goes well,  my tests are favourable and my liver / my cancer behaves I ll be starting treatment mid next week. 
I can't say that Im not afraid. Im so ( and I want to swear !) so afraid of starting this trial. I have no idea what other inclusion / exclusion things they re looking for in the trial. I have no idea if I ll be included in this trial yet. Also if i get included I'm really scared of how I will react to this drug. 
However, I do know I still have a few treatment free days to enjoy in this life and luckily weather has been on my side too. I also bought a new book today called Life after Life that one of my friends recommended so I ll give it a try reading it. 

So my dear friends ....

"Think about all the beauty that surrounds you and 
be happy"











Saturday, 5 July 2014

Its Nice Being Away


These days I feel like i ve neglected my writing a little but here I am again airing my thoughts and feelings and keeping everyone updated with my current treatments ...

So after my meeting with prof and clinical trial people I received a phone call from a nurse saying if I wanted to take a part in the trial I needed to sign a consent form by thursday 25th June as the sponsor decided to close the trial suddenly. Of course I rushed to this opportunity but in the back of my head i couldn't help but think why they needed to close it so suddenly?

So I went in to sign a consent the very next day. I had a brief chat with my lady doc before signing.  She couldn't answer my question about sudden closure of the trial and just said that sponsor decided to do so but she didn't know why. I ve asked a few questions i needed to know about the trial set up, etc and also mentioned that I d like to be involved in my care and know results of my tests if possible to which she answered yes.
I ve asked a little more about people in the trial so far and it seems like there were a few who had reaction to the drug in form of anaphylactics and they were later excluded from the trial.
Its not gonna be an easy ride this trial I thought. So after we finished with all the paperwork she said "now go on a holiday for a while and enjoy yourself".  I said I would love to but explained we had my aunty and my cousins,  twins 13 your old boys visiting from Canada. Some other time maybe I said and I left. That evening I came home and couldn't help but look at the cottages around southern uk near the sea.  I kind of narrowed my choices to two of them. Not thinking much of it I sent an email to them both asking about dogs and if they are allowed to come as well. I than shut my computer down and carried on with life.

So the next day Canadian family came over. I ve not seen them for a while and was very much looking forward to seeing them. Boys have really grown into a young men. When I initially saw them I felt very old as they are big and are nearly the same height as me!

Luckily, without chemo I started to feel better and my appetite had increased. I would have an occasional heart attack like pain on the wrong side of my body !?! (right side ) and slight discomfort around the liver. I guess I always had a low grade pain around my liver and I slowly over the past months got used to it. It almost became a normal part of my life. I ve tried not to pay too much attention to it. However, on the other hand my hot flushes, I assume partly because of zoladex and also maybe because of the extent of my cancer were getting more pronounced. I d say I get them more throughout a day these days but they are not as bad as they were when I was on tamoxifen few years back after my first lot of cancer treatment.

Having boys around made me feel younger and more able in a certain way. We visited a lot of famous sites and we even went to Hamleys (toy shop spread over 5 or 6 floors). I forgot how much fun it was to go there ! Did you know they even have small electric cars that you can drive up the wall and on the ceiling too ?
We also went to Harry Potter studio in London as well. Im not a fan of the movie and I never read any of the books either so I guess I couldn't appreciate it as much but it certainly was interesting to see all the sets that took months to create.



Harry Potter Studio


While our Canadians were staying with us I had a response from both cottages. One was closed for renovations and the other happened to be free first week in July but was otherwise booked all the way until september ! They said dogs were welcome and on the spur of the moment without much of the thinking I booked one for 4 nights.  Would have booked it for longer but had to time it in a gap between our family leaving and my oncology appointment.

 It turned out to be best of the british weather in the first fews days of our stay down south. temperatures were soaring and reached late 20s.  I was certainly glad I managed to get away from very busy and extremely polluted London.  I was worried about my nearly two hours car journey but with a stops every now and than it seemed ok. I know this might sound silly to healthy people but I was worried about getting out of my comfort zone, central London where my hospital was. I was worried if anything should happened to me on the way there or whilst over there how would my parents take it.
What if my liver can't cope any more or my cancer on ovaries spreads a little further and penetrates my peritoneal sack ( my lining protecting my insides). What if Im in horrific pain ? I know there are hospitals down there but it might take a while to get my medical history across ! Will that be the end of me?
Anyway, we somehow made it to our cottage destination and I must admit I couldn't have picked a better one. Its a perfect place for me to relax and try and recuperate a little before I start clinical trial tests next week.


View from our holiday cottage 





Just earlier yesterday morning I was watching my parents from the balcony window. They were at the back of the cottage, in the garden with our dog. I felt a great sadness for them. Instead of enjoying their older age, they are now faced with a dying daughter. The only child my mum has. I felt sad and tears without even realising covered my face. Is this what it will be like for them? Two of them with a dog wondering around like a two lost souls. Would I be able to watch them from above like I m watching them now? I ve tried to compose myself before they noticed, wiped my tears away and went downstairs to join them. I wanted to enjoy this little holiday together for now.

That night fox came around to back garden and took one of my favourite shoes. I know its my fault for forgetting to take them in but who would have thought fox would be interested in my smelly Camper shoes ! Later on I found my shoe at the very bottom of the garden near the fence with a little bite on them where she held it in her mouth.

No matter how hard Im trying to relax and enjoy some of the funny moments that I have, my thoughts are never too far away from cancer treatments and death.
Next week, fingers crossed I ll be going thru series of tests which if I pass I ll get accepted into the trial. Hopefully than, I ll start the drug infusions around 16 th july.
I still don't know if I ll pass my tests. Im very anxious about it all. All this sounds like a school tests Im required to pass to go onto the next stage. However, it couldn't be more different as this for me is the matter of living or dying.

I had too many failures in my life or at least thats what it feels like for me.
When I was diagnosed with cancer I felt like I failed in life, when I was told I might not be able to have a kids, I felt like I failed as a woman. When my relationship ended due to my cancer circumstances, again I felt like I failed in relationships..... I know many of those things might be out of my hands but I don't want to fail in this clinical trial treatment, not now, not yet



Beautiful painting like view at 5 am yesterday morning