Friday, July 31, 2015

faith in every footstep

I borrow my title from a comment made here by a dear friend.  It feels like such a good way to describe how we are trying to face my battle with cancer.

Wednesday I had sinus surgery.  The tumor tissue in my nose was so swollen that I could't breath through my nose on either side.  It was getting annoying.  I had a visit with an ENT and he said that it could be corrected without too much risk.  I checked with my doctors in Houston and they were fine with removing the tissue as long as we would preserve it and mail it to Houston for analysis.  So, with all that said, I went ahead and scheduled.

The surgery was scheduled for 6:00 am on Wednesday morning at a new hospital out near Thanksgiving point.  Tuesday night a nurse called up to get information before my surgery.  She wanted a short history of my condition that had lead to the need for the surgery.  I think she may have gotten more than she bargained for.  I told her briefly about my battle with cancer and also about some of the miracles along the way that have preserved my life.  I also told her about the current experimental therapy we were undergoing.  I told her that we felt like it was a miracle prepared by God to preserve me.  After a few minutes of that she finally said,

"Wow, that is the most amazing story I think I have ever heard.  You sure aren't shy about talking about God and stuff.  You are kind of a different sort of person"

That made me laugh.  I told her that I fully believed that my life would be spared and that I don't plan on keeping it a secret that God had a hand in my preservation.  I told here "

"Pretty much anybody who will lend me their ears for 5 minutes is going to hear a little about God's hand in my life." 

She laughed again and said,

"I wasn't scheduled early tomorrow for work but I think I will come in anyway.  I would really like to meet you in person."

Anyway, so we showed up Wednesday morning.  The hospital was very nice and the nurse I had talked to the night before was there to meet me.  She had gotten up at 3:00 am and driven from Moroni.  Everything went really well.  I woke up able to breath again.  They cleaned out my nasal passages and my sinuses as well, at least partially.  It was so nice to breath again.  I expected some pain from the surgery but was pleasantly surprised to find that my overall pain was actually less than before.  It must be because they cleaned out the sinus and removed some of that pressure.  The tissue had been saved and JoLynne took charge of preserving it on dry ice and mailing it to Houston.  It arrived there safely the next day.  We will be very interested to hear about the analysis that they do there.

Friday, July 24, 2015

"World War T" (as in T-cells)

On Tuesday we returned home to Utah from Houston.  It is SO NICE to be home.  To see our children's smiling faces and feel their hugs, to look at the beautiful mountains and see our friends and neighbors that we love.  Home is awesome.  We have a dear friend who offered to buy our plane tickets to and from Houston this time.  The flight both ways was direct with no layovers.  That makes the journey so much more pleasant.  We are so blessed to be surrounded by the nicest people that can be imagined.

Graph showing the expansion of T-cells in my blood
Monday was our last visit in Houston with our Doctor.  It was a wonderful visit.  Before I tell you what he said let me tell you a little about T-cell biology.  We all have T cells in our bodies.  They are part of our bodies immune system.  T cells are kind of like the special forces in the army.  Most T-cells are keyed to look for very specific things and to defend us against them.  For example, if you had chicken pox as a child your body built specialized T-cells during your illness that would remain in your body as long as you live and continue to provide you protection as long as you live.  If, later in life you are exposed to chicken pox again, those very specialized T-cells will quickly identify the invading virus, they will latch onto it and produce replicas of themselves to fight off the infection before it ever happens.  Some people estimate that we may have was many as 25 million different types of T-cells roaming our body protecting us from a myriad of threats.  When T-cells find a threatening cell they literally punch holes in the invading cells and poison them to death.

T-cell attacking cancer cells
Okay, with all that said, lets come back to my current treatment.  The idea is that if they could find something on my cancer that was unique, different from my other cells, they could possibly create in a laboratory T-cells that were keyed to my cancer.  In my cancer they found at least two unique traits. The one that they are currently targeting is a protein on the surface of the cell called HER2.  It is a protein that is sometimes found in breast cancer as well.  The protein is only on my cancer cells, no others normal cells.  So, months ago, they took out some of my blood, isolated some of my natural T-cells and then began to genetically alter them using viruses to insert new pieces of DNA into my cells that would force them to target all cells that have HER2 protein on the surface.

There have been some other studies that have shown that if your are trying to insert new T-cells into a person that they will take hold better if you thin out the normal ones a bit and thereby make room for the new ones to grow.  So, my study thinned out my normal T-cells by giving me chemotherapy for 5 days.  Chemotherapy is hard on T-cells.  This chemotherapy had be given to me as an in patient in the hospital.  After they had thinned out my normal T-cells they then injected the newly created cells into of my veins.  It is hard to know for sure what is happening from that point on but one way that they monitor it is to take samples of blood at regular intervals after the injection and essentially count how many of the new T-cells are present in your circulating blood.  They can be the original cells that were injected or copies of the injected ones that the body has made.

So, with all that said, Monday we went to visit with our Doctor.  He and his staff seemed pretty pleased with what they had to present.  They showed me a graph of the specialized T-cell counts in my blood.  Basically the graph goes up at a very steep angle as the specialized T-cell count climbed in my blood stream.  Dr. Gottschalk told us that my response to treatment was the best that had ever been observed in the history of the research center.  Essentially those T-cells that they injected must have found my cancer, locked onto it and began replicating themselves like crazy to mount a major assault on the invading cancer.  It was amazingly good news.  .

They had warned us in advance that if the T-cell attack was successful that the areas of residual tumor would swell as they were attacked.  This has very much turned out to be the case.  I had tumor remaining in a number of places that couldn't be removed surgically because the operation would have been too dangerous.  One area was my right sphenoid sinus.  Within about 6 hours of the T-cells being injected the tissue in my right sinus/nasal passage swelled dramatically making it nearly impossible to breath through my right nostril.  It is annoying but we are grateful that the attack seems to be working.  I also had tumor in the lining of my brain.  The outside lining is called the dura matter and the cancer had spread extensively through that lining.  Again, after the injection I experienced some amazing headaches.  We believe that is from the dura lining of my brain swelling in response to T-cells attacking the cancer cells there.  I don't enjoy the headaches but I console myself thinking about those cancer cells getting beat up.

When they showed us the results of my blood work on Monday where the T-cells had expanded in number so dramatically, I found myself feeling so grateful.  For four years now we have been praying our hearts out for a miracle that would lead to a cure.  I have had a number of priesthood blessings by very righteous men.  Invariably, in those blessings, I have been promised that God would cure me.  In addition, I have so many friends and family members who have used their faith praying for me to be healed.  I know without a doubt that God has heard those prayers and seen the faith of those who have offered them.  Needless to say we had hoped that the miracle would come sooner but God is in charge and we trust him.  On Monday the thought that kept popping up in my mind was this "could this finally be the miracle that we have prayed so hard for?"  We sincerely hope that it is.  In the middle of August we will have a new MRI scan done.  Assuming that the tumor is being effected the way that we want it to be then we will return to Texas and they will continue to send in new, fresh T-cells to continue the battle.  They have them all stored in freezers down there just waiting for their turn to fight.  They have enough made for four doses.

Once again, let me thank each of your personally for your faith and prayers.  JoLynne and I can literally feel the power produced by your faith.  Thank you.  We love and appreciate you all.

Friday, July 10, 2015

A poem

Well. Here we are still doing the Houston hangout. I am feeling better mostly. All the symptoms associated with inflammation are still very prominent.  Mostly it's the headaches that drive me crazy. Both the doctor and I both feel that the tumor that had invaded the lining of my brain is probably swelling just like my sinus and my eye and that is leading to the headaches. I guess it is all supposition at this point but we are hopeful. If those tumors are swelling due to the attack  by the T cells then I'm all in favor.

Night time is the worst. The headaches are pretty bad. It makes it hard to sleep so I exercise. Last night at 1:00 am  I was going up and down the stairs to  the six story parking garage. When my legs start to hurt bad enough I forget my head. It was actually quite nice out. Very peaceful and it was a lovely view of the city from the sixth floor

We met with the doctor today again. He is such a kind man. The nurses are amazing as well. We are surrounded with the nicest people. We talked about my symptoms. He seems very encouraged by all the signs thus far.

Here is a Poem that I wrote while JoLynne was getting ready to leave for our appointment

Upon the Rock of Christ, my Lord
I've built my humble little home
It's plain and simple to the eye
But here it stands amidst the storm

The rains have come, the winds have roared
The very earth, it seemed to tear
I must confess, some damage done
But on the whole it still stood there

At first I thought, "How well I built. 
Behold the house made by my hand"
And then the truth, it softly speaks,
"Because of Him, your house still stands"

Oh God, forgive me, I am young
How quickly I would seek to claim
The credit for thy miracle done
I always knew from whence it came.

And as I live my knowledge grows
And finally I can understand
Thou art my God, who saves my soul
Not house, but Rock where on it stands

Wednesday, July 8, 2015

48 hours

Well the last 48 hours have been "interesting".  After five days of chemotherapy the stage was set. Monday morning they brought me in and pumped me full of fluids then brought in what we hope will be 25 ml of miracle. It was an unusual experience for me. As they prepared to inject the T cells I had a strange surreal feeling come over me. The room suddenly become much brighter. Time seemed like it slowed down or something. And I had a distinct impression that there were things going on in that room that were not readily apparent to my eyes.   Anyway the moment passed and everything went back to normal but it was strange in a good way.  They kept me around for another four hours to guard against severe reactions then they let us go home. Boy was I ever tired after that. I couldn't hardly keep my eyes open.

My right sinus has always been a little congested since my surgery. They tell me that it is partly due to the residual tumor in my right sphenoid sinus that they couldn't  remove. Dr Gottschalk had warned me before hand that any remaining tumor would likely swell when attacked by the T cells. Within six hours of the infusion my right sinus was completely blocked off. I can't move any air through that nostril no matter how hard I push.   It's annoying but not too bad. At least I can still breath through my left nostril.

As you know, I have also had visual problems with my right eye. I have issues with motor control and at times with visual clarity. When I woke up Tuesday morning and lifted my right eyelid I had lost all vision in my right eye. It was pitch black. That was a little spooky. This is probably also due to swelling. Within a few hours the image in my right eye began to come back. It is dim but it's there. Other than that I have just felt like I have a real whopper of a flu. aches, pains, throwing up, sleeping around the clock, no appetite.

So today we went back in and had some more fluid pumped in and I am actually feeling quite a bit better. Since I am only patient number two I don't think that they really know what to expect but the symptoms associated with swelling where we know that there is tumor seem encouraging to both Dr Gottschalk and to us. We are full of hope and prayers that this will finally be the way that God brings a miracle. We have been so grateful for your faith in our behalf as well. I know that sincere prayers are heard personally by our Heavenly Father. He loves his children. Of that I have no doubt.

Sunday, July 5, 2015

Independence day.

So, JoLynne and I are back in Houston.  Today I finished my fifth day of chemotherapy and was discharged from the hospital.  The objective was to deplete my immune system so that tomorrow, when they implant the new genetically enhanced immune system, there will be room for them to grow.  Chemotherapy is not fun.  It makes me tired and nauseated and this time it has given me a lot of headaches.  But, if it accomplishes what they want then I am glad to suffer in order to gain the final desired result.

Tomorrow is a big day.  The actual infusion really only takes a short time.  From last time I remember that the injected cells had a golden color to them.  Oh and they smell like some weird fruit.  This dose will be much higher than what I was given last time.  In January when they did this they were still trying to determine how much could be safely given.  I was only the second patient so the dose I was given was very small.  The result of that and other experiments has shown that the maximum dose had no safety concerns.  So, this time I start at maximum dose.  I like that.  In addition, assuming that my tumor shrinks or even doesn't grow, they will give me another high dose every six weeks for six more times.  I like that too.  Last time when I was in this study my blood supply to the right side of my face was seriously damaged.  Many of the major blood vessels had been destroyed by radiation.  That makes it harder for the T cells to get where they are supposed to go.  Part of my reconstruction in Miami involved rebuilding the blood supply to my face.  Lots of fancy plumbing work.  I think that should also work in my favor.  But, mostly we are relying on the hand of God to direct the affairs of my health.  Only He knows ultimately what the outcome will be and when I am cured, I will gladly give the credit to Him.  He is in charge and for that I am eternally grateful.  We are ready to celebrate "Independence from cancer" day.