LATE TO THE PARTY

As a quick recap, the immunotherapy drugs I am on ramp up my own immune system so it will "eat up" the cancer cells. Well, my immune system ate my tumors for lunch, but apparently were still hungry. They have, since, started nibbling on my liver for dessert. As more and more white blood cells get activated against the cancer, a known side effect is that some activity against my own, normal cells could take place. I received the full four doses of ipilimumab per the protocol, but I responded so thoroughly and quickly that many of the white blood cells got activated as the main party was winding down and headed over to my liver.

Although I had no signs or symptoms of this going on, my lab tests revealed elevated liver enzymes over 10X normal. This is not unheard of, but this side effect showed up a bit late relative to the timing of the infusions. Often, if this is going to happen, it happens after the second or third infusion. This idea of being later than normal is very out of character for me, and there is a history behind this behavior.

My whole life, people compared me to my grandfather. A bit of a free spirit, challenging the status quo at times and very handy and creative with his hands. People said I looked a bit like him, sounded like him and certainly approached life like him. One thing about his behavior stood out very noticeably -- he was always early. If he was to meet someone, he was always at least 15 minutes early. If he was to drive somewhere, he always left early. I remember one morning that he was driving from San Diego to Los Angeles - a couple of hours drive - and he was up at 4:30 AM packing up the car to get an early start. One day he told me the story of why this was so much a part of him.

My grandfather, George, was born in 1888 on the farm in Northern Ireland. He was the first child for his parents (the first of 18!), who lived in a one-room stone cottage with a thatched roof. They did almost everything themselves, but did hire extra hands to help with the harvest. Part of the hired hand's compensation was three meals each day. When George's mother went into labor, the hands were out in the fields, but she had not yet delivered when they were done for the day and showed up for their meal. Of course, they couldn't come into the cottage while she was in labor, so they patiently hung around outside but had to wait until after midnight for George to be born and then get their meal. Every time my grandfather told this story, he ended it with "And that was the last time in my life I was ever late!"

I seem to have inherited this trait, as I am almost always early and want to get an early start on things.

So, with this is mind, we got an early start on treatment of this side effect and pumped in some IV steroids and got started on prednisone to cool things off a bit. This seems to have worked and my enzymes, 5 days later, are on their way down. The second phase of my infusion therapy is  delayed a short while, but, the best news, our trip to the Bahamas is still a go! We're scheduled to head back to Florida next week to get the boat ready.

This is a party I won't be late for!