Africa Safari Itinerary

Here is the itinerary for our forthcoming trip to Africa. We decided to go on this trip in late March, after the encouraging news of my first CT scan following the first three rounds of nivolumab. I purchased travel Insurance (including cancel for any reason and emergency medical evacuation) from April Travel Protection, just in case.

I set up this itinerary mostly by relying on TripAdvisor reviews. The cost of safaris in the private reserves were outrageous, but my family vetoed my idea of a self-driving safari. Stay tuned to see if this goes forward similar to the plan.

26 July (Sunday)

5:40 pm depart IAD South Africa Airlines Fight SA208 (using frequent flier miles from United, pus points from various credit cards).

27 July (Monday)

5:15 pm arrive Johannesburg, South Africa (JNB) (17.5 hours in plane; one hour layover in Dakar, Senegal; no change of planes).

Overnight at Protea Hotel O.R. Tambo Airport (across highway and one block down from terminal), 3 rooms (using Marriott Reward points)

28 July-2 August: six day safari with Bearded Heron Safaris in Kruger National Park

Following is a description from Bearded Heron of our activities in Kruger:
 

28 July (Tuesday) - Our road transfer driver collects you from the Protea Hotel at 8:30-9 am in a minivan for the drive to Kruger National Park. You will arrive at Berg-en-Dal rest camp in southwestern Kruger at about 2pm. Afternoon game drive with Neil Heron. 

28-30 July (Tuesday-Friday) - Two nights in Berg-en-Dal camp in southwestern Kruger. Berg-en-Dal hosts white rhino, kudu, impala, giraffe, some elephant, reedbuck, klipspringer, grey rhebok and warthog. Leopard and wild dog are regularly seen in the region. Lion are usually found in the lower plains on the roads to Skukuza and Crocodile Bridge. Bird watchers will find the appeal of the camp irresistible as a wide variety of birds species can be seen here. The swimming pool is the perfect place to cool off in the heat of the day.

Accommodation is in two private, thatched roof one-bedroomed cottages with private bath, with fresh linen and towels provided that each sleep three people (girls in one, boys in another), near to where animals are often seen walking in the river to bed towards the dam.

Neil conducts two game drives a day, one in the early morning, and another in the late afternoon. The early morning game drive departs a little before dawn and lasts until 9 am or so. Breakfast is served after the return to camp. The middle of the day is for rest, swimming, exploring the camp, etc., as animals also rest during the afternoon heat. Afternoon game drive starts at about 3 pm until 6pm; then dinner at 7pm. All meals provided by Bearded Heron’s chef, Alistair.

30 July (Thursday) - Leave Berg-en-Dal with Neil for a whole day game drive. Alistair takes the back-up vehicle full of baggage, supplies and food ahead to Skukuza camp. 

30-31 July (Thursday-Friday) – one night at Skukuza Camp in central Kruger. It is situated on the southern banks of the Sabie River. The camp is well foliaged and there are some lofty trees along the river’s edge.  Activities and facilities are diverse, as are the animals and plants found both within the camp and in the surrounding areas. Accommodation in two private en-suite cottages (serviced; fresh linen and towels) that each sleep three people.

31 July (Friday) - Leave Skukuza with Neil for a whole day game drive; lunch along the way to your next destination, Lebata camp in central Kruger. 

31 July to 2 August (Friday-Sunday) - Arrival and two nights at Letaba rest camp. The idyllic Letaba Rest Camp is situated on a sweeping bend of the Letaba River, midway between the southern and northern boundaries of the Kruger National Park. The character of Letaba Camp depends heavily on the tall shady trees (Sycamore Fig, Natal Mahogany, Sausage Tree and Apple Leaf), expansive lawns and indigenous gardens where tame Bushbuck wander. Visit in winter and you will find the gardens a riot of colour, with several species of Aloe and the Impala lily in full bloom at your accommodation in Kruger Park. The Aloes attract a variety of birds, including the White Bellied and Marico Sunbird, Crested Barbet, Blackheaded Oriole and Black Eyed Bulbul.

Accommodation in two private en-suite cottages (serviced; fresh linen and towels) that each sleep three people.

In all locations Neil and chef Alistair will stay close by and host hospitality and mealtimes from their cottage.

2 August (Sunday) - Early morning game drive with Neil + breakfast. Neil will drive your family to the Phalaborwa Gate, where you will be collected by the road transfer company.

You will drive through Gravelotte, Tzaneen, Polokwane and then follow the N1 south through to Kempton Park. The scenic area on this route is known as Magoebaskloof and takes about 6 hours. Normally we include two comfort stops into our transfers – thus the transfer via this route would take up to 7 hours. You will be back at Protea Hotel by sundown and before dinner time.

Overnight at Protea Hotel O.R. Tambo Airport (again), 3 rooms (using Marriott Rewards).

3 August (Monday)

Fly from JNB to Livingstone, Zambia on British Airways Flight 6291

Depart JNB 11:00 am Arrive LVI 12:45 pm.

Transfer from LVI to Victoria Falls, Zimbabwe Lodging at Lorrie’s B&B 3 BR guest cottage (3 nights) 3 August-6 August (Monday – Thursday): relax in Victoria Falls. Tour Victoria Falls Park explore Zimbabwe and Zambia sides Devils Pools (nice video here)  Adrenaline activities: bungee jump, swing, rafting, ultralight flight Shopping in Vic Falls and Livingstone Visit local African villages/schools 6-9 August: 3 night safari in Chobe National Park, Botswana with Steenbok Safaris 6 August (Thursday) Pick up from Lorrie’s B&B in Victoria Falls at 07h30,1 hour drive to the border then 20 minute drive to Kasane/Chobe town, 09h30 boat cruise, 12h30 lunch at the lodge, 13h30 go to the park, then game drive, 18h00 back to the camp and have dinner. 7-8 August (Friday-Saturday) Wake up 05h30 for breakfast, 06h00 go for morning game drive and back 10h30/11h00 have lunch at the camp, take a rest/nap 15h30 go on an afternoon game drive back to have dinner in camp 19h00. 9 August (Sunday) Wake up 05h30 for breakfast 06h00, then go for morning river tour. Drive to Victoria Falls airport. Fly from VFA to JNB on Fly Africa Zimbabwe Depart VFA 4:00 pm Arrive JNB 5:35 pm Collect bags from FAZ, check bags at Emirates Airlines.  8:20 pm depart JNB for Dubai, Emirates Airlines Flight EK766 (8 hour flight) 10 August (Monday) 8:20 am arrive Dubai International Airport (DXB) 18 hour layover in Dubai (we could have gone straight to DC, but figured that since we're there, why not spend the day). I've reserved a room at the Hyatt Regency Hotel for showers and changing clothes. The hotel is walking distance to Dubai souks (markets). 11 August (Tuesday) 2:20 am depart DXB Emirates Airlines Flight EK231 (14.5 hour flight) 8:35 am arrive IAD. While everyone else passes out at home, I get to drive to Hopkins for a CT scan at 2:30 pm. Yay!

CR Day 30: 12th Opdivo infusion; thyroid cyst is benign

Yesterday Hopkins posted the results of the pathology examination of my thyroid biopsy. The review apparently took some time because the amount of cells removed during the biopsy was "less than optimal." The first pathologist who reviewed the slides concluded that the small amount of tissue was "inadequate" to determine the cell type. Then the senior doctor who did the biopsy and a second pathologist reviewed the slides and concluded that, although there was a "scant specimen," the tissue was "most consistent with an adenomatoid nodule." Another line of the report simply stated, "Category: Benign."

For what it's worth, the Thyroid Cancer Survivor's Association has a good page explaining thyroid biopsies and adenomatoid nodules. As Wikipedia succinctly states, an adenomatoid nodule is "a benign tumor of the thyroid gland." Today, Dr. Hahn told me that it was something we didn't need to worry about. Unless it grows so large that I can't breathe or otherwise is interfering with my life, I'll continue to ignore it.

My 12th infusion of nivolumab was routine. My labs were boringly ordinary, and everything ran close to schedule.

I'll have another CT scan on August 11, and my next infusion will be on August 13. It will be a three week gap between infusions because, this Sunday, the family and I are leaving on a 16 day trip to Africa. We've been thinking about a safari for a while, and after getting the good news of my complete response, we decided that it would be a great way to celebrate. I'll post our itinerary before we leave, will compile a travelogue along the way, and will post it after we get home.

CR Day 16: 11th Opdivo infusion and thyroid biopsy

Before today's infusion, I met with Dr. Hahn. I told him how he was getting a lot of love from the BCAN web site. He laughed and said that last week a new patient came in with a printout of one of my recent blog posts and comments. he said that he should hire me to be his publicist, and I replied that as long as he kept on facilitating the complete response of people with metastatic bladder cancer, he didn't need a publicist.

On a more serious note, he expressed his frustration that there were not enough clinical trial slots to meet patient demand. Although more trials are supposed to open soon, apparently Hopkins has no current openings for mets BC patients with any of the immunotherapy drugs. And Dr. Hahn was frustrated that patients that should be accepted into the trials were rejected by the trial sponsor for irrelevant reasons -- for example, one patient applicant was found to have prostate cancer during the post-RC pathology (which happens in the majority of RC cases), but the trial sponsor rejected the patient because he had another form of cancer in the past two years. Stupid! And another patient had renal and pelvic cancer, and was rejected because it did not appear to originate in the bladder - even though nivolumab would likely have helped.

I shared how I had corresponded with readers of my blog about their situations, including one patient whose oncologist had written to the insurance company requesting permission to treat a mets BC patient with an off-label therapy of one of the immunotherapy drugs (none of which have been FDA approved for mets BC). The insurance company agreed. Dr. Hahn said he'd probably be writing letters like that for some of his patients.

After a brief physical exam (no side effects, nothing unusual in the past two weeks), he sent me upstairs for the infusion. Unusually for Hopkins, the drug had already been prepared, and I was ushered in for my infusion.

After my infusion was done, I could not go home, because I was scheduled for an ultrasound and guided needle biopsy of my thyroid cyst. Dr. Hahn had decided we'd ignored it long enough, and it was time to verify that it wasn't cancer.  It was straightforward - a local anesthetic, followed by four extractions of cells from the cyst. I waited while the interventional radiologist looked at the samples to confirm that she got enough tissue. Apparently not, because she came back for two more samples. She slapped on a band-aid and sent me on my way with instructions to avoid any heavy lifting. She didn't say how long her orders lasted, and I didn't ask. I've now got a doctor's excuse to avoid my honey-do list.