This morning I reported early for the 9:30 stress echo test. I had just sat down in the waiting room and plugged in my iPad and Matt Baum popped his head out of the door to the treatment area and called my name out like I was being introduced for a comedy roast. Mmiiikkeee Vvennabbllee! Turns out his cheery demeanor and his cheerleading abilities would be important to me once they introduced me to the treadmill.
I haven’t ever had one of these tests, so this was all new ground for me. Here’s how it went: First, you lie down on a hospital bed and they get a resting heart rate and blood pressure. Then I was asked to stand up and Matt went at a double handful of spots on my ridiculously hairy chest with a safety razor. After he created a pile of hair — enough to build a complete toupee for Howie Mandel — he filled those freshly shaved gaps with stickers that contain contact points for the wires he plugged in.
By the way, Matt Baum went to Shaw High School in Columbus! I told him that I had a surprise for him when the test was over (if I lived through it). He was interested in what was going on with the Chattahoochee and I whipped out my iPad after my test and wowed him with videos of the Thursday and Friday rafters from last week. He was stunned. Wants to come back and see it for himself.
So, back to the stress echo. Once I was wired up, another technician came into the room and did a cardiac ultrasound. That wasn’t much, except for the goo that was left on my skin. Once that part was over, I was asked to stand up onto the treadmill. Matt explained that he would be asking me questions about how I feel during the test. I was asked to tell him about how much exertion I was feeling (on a scale from 6-20) and how I felt I was breathing.
Then they turned it on and I started walking. The plan is to push you to your maximum heart rate and really get the heart pumping. He predicted my maximum heart rate would be about 161 beats per minute. I made it to 162 before I felt like I just couldn’t breathe. Then I was plopped back down on the bed and underwent another ultrasound of the heart.
I think I must have done well because they were both complimentary of how things went. Dr. Michael Morse will review the stress echo study tomorrow and my insurance will be checked and if all looks well, we should be good to go early next week.
This afternoon, we met with Dr. Morse. He just left the John B. Amos Cancer Center last week for a speech he made to caregivers there. He is exceedingly knowledgeable about certain types of cancer, including melanoma. Melanoma is an immune system cancer, as is renal cell cancer.
He answered all of our questions. We’ll start the therapy on Tuesday. We’ll check in around 1 p.m. and do some paperwork and some labs. They’ll settle us into the intensive care step-down room (where Jill will be allowed to stay, too) and they’ll put in a picc (peripherally inserted central catheter) line. The picc line will deliver the HD-IL2 straight to my heart, where it’ll disperse on a mission to wake up and piss off natural killer cells so they can seek out and kill this cancer.
Here is the plan: We will likely come back home on Sunday, September 9. After a few days to recover, we’ll report back to Duke on Monday, September 17 for five more days of HD-IL2 infusions. Then back home on or about Saturday, September 22. That will constitute round number one of a possible three or four rounds. They will continue infusions until either A) I throw in the towel, or B) I’m in danger of developing life-threatening complications or C) I become delirious or exhibit bizarre hallucinations. The goal is to get as many as 14 doses per five-day stay.
I like Dr. Michael Morse a lot. He is extremely bright and is easy to talk to. He says they’ll exact an agressive application of this therapy, but that they’ll stop short of forcing me into kidney failure or something worse. Now that I think about this, this therapy is much like that stress test. Go until you can’t go any more is the plan.
They will do CT scans about a month after the start of the HD-IL2 therapy. If there is tumor shrinkage, round two will be ordered. If there is stability, round 2 will be ordered. If the tumors are larger, I’ll be declared an HD-IL2 non-responder and I’ll immediately go on one of the TKI therapies and prepare for surgery to remove the left adrenal gland and some sort of cryotherapy (or other ablation treatment) to deal with the two small tumors in Strainer.
We’ll leave to come back home tomorrow morning and we can’t wait to see friends, family and co-workers!