Well folks, things haven’t exactly gone as planned lately. The little bout we had in the hospital back in June when that whole stroke thing happened turned out to be a precursor to a recurring problem. Namely, the fever kept returning about a week following each time that Sherri finished a course of antibiotics. The latest episode landed us back in the hospital at Fox Chase for 6 days to try to sort it out. The short version of the story is that it appears she has been playing against a gall bladder infection that thinks it has a shot at the Final Four, so it won’t go away. In the meantime, we missed the start of the scheduled NIH PDL-1 clinical trial while tending to this problem, and now the docs have determined Sherri is no longer a good candidate. So we are moving on to “Plan H.” Our oncology team warned us we needed a Plan A, B, and C, but fortunately we are not out of options quite yet even though we’ve had to move substantially further down the alphabet. It seems that the pancreas is a very active area for cancer research these days, so we can’t complain about that.
Want the longer story? Read on if you dare (because we already know you care…)
GALL DARN IT
Apparently gall bladders are known to start having problems when one’s liver is in jeopardy. There are a load of ominous sounding diseases of the gall bladder, and Sherri undoubtedly has one of them but so far we don’t know exactly which one. Normally, the prudent course of action would be to ditch that particular organ – it’s not that important. However, Sherri is not a good candidate for abdominal surgery just now so other alternatives are vastly preferable. The most conservative option is to treat it with a longer course of several different antibiotics to try to sterilize the infection and keep the fevers at bay. This is the first time since diagnosis that a new organ has gotten involved in the symphony, so we are wary that this could be a sign that things are progressing differently. We’re working it.
The NIH trial is an immunotherapy, and the trial team has taken the position that messing with the immune system when there has been a recurring infection could be dangerous. My take is not quite so conservative, but I’m not in charge. Last week they told us they would reschedule Sherri for this trial when her blood parameters came back in line (which they have) and when the infection was handled. Recently, I asked them how long we would need to go off antibiotics without a recurrence of the fever before they would consider it gone. They called back the next day and said never mind, we think it’s too risky.
<RANT> NIH moves at a different pace than the research centers they fund in industry. They have been unable to schedule this trial since we visited them on June 10, when we were originally accepted. I have to wonder if their concern is that they might not get the outcome they want for getting their treatment approved, as opposed to this being about patient safety. NIH allows their doctors to invest in the drugs they administer in their trials, and because they disclose this they say it is not a conflict of interest. If your patient is a scientist, maybe they could be involved in the safety judgment, just sayin’. </RANT>
Meanwhile, back at the ranch… We have been working to get a treatment for Sherri that has been approved for breast cancer, but not specifically for pancreatic. Insurance has agreed to it, so that makes life a little easier.
The treatment is Herceptin, which attacks the cancer cells that make too much of a protein called HER-2. It has been relatively successful in treating breast cancer. Herceptin works by attaching itself to the HER-2 receptors on the surface of cancer cells and blocking them from receiving growth signals. By blocking the signals, Herceptin can slow or stop the growth of the cancer. Herceptin is an immune targeted therapy, but so far we don’t think having the recurring fevers will prohibit Sherri from starting the treatment. Her pancreas tumor was tested for a variety of gene mutations, and was found to have the HER-2 mutation, and there is a chance this will work in the pancreas similarly to it’s relatively high success in treatment of breast cancer. It’s still working the percentages, but let’s see what happens.
LIFE’S A BEACH
In addition to messing up the NIH trial, Sherri’s latest hospital stay threatened a few of our family plans. But we have to draw the line somewhere, don’t we? Sherri recruited one of the nurses at Fox Chase to help her escape in time to make our planned trip to North Carolina for a reunion with her mom’s family at her beloved Core Point on the Pamlico River. So we got out of the hospital on Thursday July 23 and drove 10 hours to NC on Friday… It was therapeutic and the trip back was a little more sane thanks to our friends Buck and Deb in Virginia Beach. Many others in our friends and family network have offered to accommodate, fly us around (thanks JC), or hide us from doctors and nurses wielding syringes. Thank you, as always.
Last Wed, Sherri ended her latest course of antibiotics, and predictably with disappointing undertones, her fever came right back. We persuaded her docs to extend the antibiotics and yet again we escaped, this time to a beach house in Ocean City NJ, her dad’s birthplace. So we are still working hard to deny fate, with some degree of success so far.
In the process, we are reflecting on the amazing gift of life. Won’t you join us?
Of course you will… Thanks for your continued support, your gifts of meals and walks in the park and good vibes and check-ins and visits and prayers and random acts of kindness.