At hospital, checked in to start biochemo...

Spent the day doing misc. tests and getting a PIC line inserted. All is going well. Getting some IV nausea meds now. Chemo and bio meds to start in an hour or two. Anxious but feeling good. The kids gave me some little guardian angel stuffed animals. Reminds me of the kids :). Had a yummy turkey dinner with mashed potatoes and spinach. Feeling comfortable. Our nurse, Hong, is from China. Fun to speak Chinese with her.

Had to wait 2 hours for appt with Dr. Patel. She was on vacation last week so she's trying to catch up. Kristin and I watched Shawshank Redemption (one of my all-time faves) and eat pray love - loved the line in eat pray love "Ruin is a gift, ruin is the road to transformation."

Had a great nurse named Gladys from Columbia do my PIC line today. Very old school nurse. She was a fantastic communicator - both talking and listening - and just seemed to be a very powerful woman. Grateful for interactions and people like that. Those connections and comfort are priceless.

Was a little worried about a tickle in my throat for last 1.5 weeks, but it looks like my chest X-ray is clear. Irritating that every little thing that is weird with my body now has to be examined with melanoma goggles.

"It is better to not shrink than to survive."

Getting ready to head to Houston in a few hours. Kristin and I watched a video by Elder David E. Bednar of our church last night. I had watched it before (thank you to my brother Brad for sharing it with me), but ran across it again and was impressed to rewatch it. It has a beautiful message that sunk deep within me last night and struck me as particularly relevant. I'm grateful for the example of Elder Maxwell and "John" in the story and how they bravely dealt with their sicknesses.

http://youtu.be/_cpyPUEQlDY?t=18m44s

I was also struck in this talk about the duality of complete faith in Jesus Christ and submitting ourselves to Heavenly Father's will. We so often think of our faith being able to heal us. "Do you have the faith not to be healed." I need to have the faith that I can be healed, but then I need to humbly submit myself to the all-knowing will of a loving God. He knows what's best for me. He knows what's best for my family. His best is not just for this life, but for the eternities to come.

As I prepare to begin the Biochemotherapy tomorrow, I feel a deep yearning within me to tackle this challenge with courage and dignity. My middle son did a lesson last night about courage. He taught us about what courage is and shared some examples of how he can show courage. He also talked about Joseph in Egypt who was sold into slavery by his brothers and how he faced each challenge in his life with courage and determination to do his best. As my son continued his lesson, he talked about for himself that telling the truth, regardless of the consequences, was an important way that he could show courage. I was touched by his sweetness and sincerity as he is trying to be better. It was a beautiful thing to witness as a father. If he can learn that lesson of courage it will serve him well in his life. He is on a good path. So grateful to be his dad. He celebrates his 9th birthday in two days, but unfortunately Kristin and I will be in Texas. We celebrated it a few days ago with some of Kristin's family and hopefully we'll get to FaceTime him on Thursday. It was fun to have a some friends of ours (the Eimar's) over to do family home evening (FHE) with us. Kristin visit teaches (monthly assignment to talk to her and share friendship and the gospel message) Sister Eimar. She brought her husband with her (who is not a member of our church) and it was so nice to have them in our home and get to know them better and discuss life and faith and challenges. Very sweet people.

I have to go finish getting ready. We leave in a few hours.

My prayer and thoughts at this time are "That (I) might Not... Shrink" in facing this challenge.

Watched a really cool video about T-cell therapy for Melanoma. Very cutting edge... not good to ever get Melanoma, but "better to get it now than 2 years ago." http://youtu.be/yGzJzzGj5Jw

Biochemo start date

Finally got my drain out of my stomach yesterday. Hooray! It actually feels really good to have it out. I kind of overdid it yesterday though. Have to be careful not to do so cause now the fluid doesn't have any way out of my body. My body has to figure out how to function without the lymph nodes for my left leg. Really actually pretty amazing that our bodies do figure stuff like that out. Also, pretty amazing that they we can get cut up by surgeries and other stuff and our bodies heal themselves. It's just like in the movies...just a little slower than wolverine :). I have an appointment with an oncology therapist tomorrow to help me figure out how to deal with swelling/lymphedema and also determine how much I can and should be doing.

So, after I got the drain out I called MD Anderson. I am set to start Biochemotherapy on July 31. I have to do some heart stress tests and some other things that morning and then I start treatments that night. How fun... Actually the sooner I start the sooner I can finish. So, I'll be in the hospital from Wednesday to Wednesday. Kara (Kristin's sister) has graciously offered to come to our home for that week. So grateful the kids will have the stability of being home during that time and have a loving aunt and uncle and 2 cousins here with them. I know it's not easy for Kara to uproot her family and I'm so grateful for her love and service in action. We are so blessed with so many loved ones. Hopefully, I'm learning in this process how to be better at that. I'm thankful that Kristin will be down at the hospital during that time. I was nervous to be alone. Just so much unknown.

Heading into the treatments, I am very anxious to see how I respond. I am praying for courage and strength to bear this suffering. I am hopeful that it can/will be a growing experience for me. I am so grateful to know about the atonement of Jesus Christ. Not only are we given opportunities to "start over" when we make mistakes and sins because of Him, but importantly, he also descended below all suffering and can help in those times to lift us up and make our burdens bearable. I really do believe that we won't be given anything we can't handle. I hope to remember that as they put the poison in my veins to root out the cancer and as all the good things in my body (immune system, organs, others systems) are struggling to do their jobs. I hope to keep my faith strong. I hope to remain open and vulnerable to my loved ones.

On a very side note... got this flashback picture from my good friend Ryan Cho via text message last night. Great memories. Shout out to diversity of growing up in California. We called ourselves the Rainbow Tribe - in our group of friends that hung out and played sports we had a Korean, Japanese, Philippino, couple Mexican, couple black, couple white, Columbian, Puerto Rican and Italian in our group. So grateful for those mind opening times to cultural diversity. It's been something Kristin and I relate in a deep way in and have both felt very strongly in our lives (and driven some of our desire to travel and live abroad as we want our kids to have cultural sensitivities).

Adjuvant Treatment Plan

This is the first official post on my blog. Wanting to do this to share with family and friends the latest with my cancer. The post gives a brief background of my illness and treatments to date and then an overview of the next step - biochemotherapy. I hope to have the blog arranged to keep my loved ones updated and share this experience (the physical, emotional and spiritual journey) as well as being a source of information. I feel like I'm getting so much info these days.

For those that don't know I was diagnosed with melanoma on May 9, 2013. This was done via a shave biopsy of my left lower leg by a local dermatologist here in Peoria, AZ. I decided to go to MD Anderson Cancer Center in Houston for follow up. I had a surgery on May 21 that included a Wide Local Excision (WLE) to cut an area of my skin out of the side of my calf. They also did a sentinel lymph node biopsy and removed 3 lymph nodes from my groin and 1 from my left lower abdomen. 3 of the 4 lymph nodes came back positive for melanoma. I also had a satellitosis in the piece of my leg cut out.

All of this means that I'm stage 3c for Melanoma. The 5 year survival statistics are not good - somewhere between 26-40% based on historical figures. Fortunately, I'm not a statistic. Also, fortunately, the last couple of years have seen some pretty compelling drugs come out  to treat melanoma. I'm cautiously hopeful, but also very much at peace at accepting God's will in this process.

I went in for an additional surgery on June 13, 2013. This was a complete lymph node dissection of all the lymph nodes in my groin and lower abdomen. They also did an MRI of my brain and CT scans of various parts of my body. All of the lymph nodes they took out were negative for melanoma and they couldn't see anything in my scans. I am offically at a state called "no evidence of disease" or NED.

I will be starting biochemotherapy soon. I was set to start on July 17, but I have a drain in my stomach from my last surgery and it is still draining too much so they cannot do the biochemo for fear of infection. I have to wait until the drain is out before I can begin treatment. Hopefully not too far away.

The biochemo is a treatment that consists of 1 week in the hospital receiving 3 chemo drugs and 2 biological agents - they put you near to organ failure (heart, lung, kidney failure etc). This is why they need to keep you in hospital during that time. From a buddy of mine that has been through this - he said the time in the hospital actually isn't the worst of it cause they can give you tons of meds (pain meds and ativan among other things). After 1 week in hospital, then 2 weeks at home recovering (I'll travel back to AZ for this time). The first week back I hear is the worst, you feel awful, but don't have the same meds from the hospital. The second week back you start to feel a bit better. This cycle happens 6 times - so a total of about 18 weeks.

As I don't currently have any evidence of disease, this treatment is considered adjuvant. There could be (and probably is) microscopic disease that they just can't see yet on the scans. This is meant to help kill anything that is floating around.

The only other option was a thing called Interferon, which was a year long treatment and also pretty awful. Similar positive impacts as biochemo - unfortunately both of them have questionable positive impacts at best. I preferred the more intense and shorter treatment versus the longer interferon. When comparing the two, the overall survival rate was the same for the two - about 56% (included all stage 3 levels - unfortunately I'm the worst of the stage 3's). The biochemo did have a longer disease free survival. With interferon, the melanoma came back on average of 1.4 years. With biochemo, the melanoma came back on average of 4 years... but again both types of patients expired at the same time on average. Thus, when it came back on biochemo it came back more aggressive.

We decided biochemo partly because the treatments for melanoma are progressing rapidly. The longer I can last with disease free survival, the more opportunities for treatment plans to improve.

There are a number of more promising treatment plans for stage 4 melanoma. I went to John's Hopkins in Baltimore (they concurred more or less on my treatment plan) and they talked about a promising treatment they do for stage 4. Interestingly, they don't do biochemo for stage 3, but only stage 4. I also talked to a nurse at the National Cancer Institute in Bethesda. They also have some promising treatments, but again only available to stage 4 patients. A bit of a conundrum - better treatments for worse disease. I'm grateful to know there are options down the line.

I'm also excited about some integrative medicine, naturopath and diet options that I have. I am just learning about these and will do them in conjunction with the other treatments I pursue.

Emotionally, I have up days and down days. I definitely feel like I've awakened from the fog of my life (pre 5/9/13). I'm grateful to be awake. I feel more strongly (both ups and downs). I'm more engaged in my marriage and my kids lives.

More to come.