Monday, July 20, 2020

Update 6 weeks after therapy suspension

Nivolumab (Opdivo) has a half life of about 25 days. Doctors generally agree that a drug in the body needs to go through five half lives before it is considered to be completely out of the system. For nivolumab, that's 125 days. So far, 39 days have passed since my last infusion, so I'm not even one-third of the way to having the drug totally flushed from my body. Not surprisingly, little has changed with my side effects: I still have a rash on my face and scalp, and the skin on the back of my calves and around my groin remain increasingly sensitive. My GI tract is still loose. My cuts and abrasions take longer to heal. These are the same side effects that I've had since I resumed my nivolumab therapy in early 2018. I likely won't know until late in the year whether the side effects will dissipate as the drug exits my system.

I've also wondered when my metastatic tumors will return Not if. I am assuming that the tumors will come back. The only question is when. Strangely, my family has not been enthusiastic about my invitation to form a pool of guesses for the mets return date. I guess that they don't share my black humor that comes with living with a diagnosis of death.

In non-cancer news, my life continues to stagger along in this unremittingly weird year. Coronavirus is like the bad house guest who never leaves. For me personally it meant welcoming my fifth grandchild, but spending less time with the grandkids from mid-March until mid-May, when Chelsea and Josh got more comfortable with expanding their quarantine. I drove to California three times to help support Spencer during his hiking the Pacific Crest Trail. I drove to Denver over Memorial Day weekend to be with Kirsten after the long-expected but still-painful death of our standard poodle, Nephi, after sixteen and a half years of living with our family. It meant my joining Garrett in rereading the 14 books of the Wheel of Time. It meant lots of rides on my Fat Boy. It meant seeing much less of Jennifer, as her long term care center followed county guidelines and forbade any visits not deemed medically necessary. Recently I have been deemed an essential medical worker in helping her resume her physical therapy. She continues to slowly decline and her frontotemporal dementia gradually destroys her short term memory. As a cynical teenager, my friends and I would tell each other, "life sucks, then you die." How pathetically prophetic.