CR Day 51: 13th Opdivo infusion; clear CT scan

Yesterday I received the results of Tuesday's CT scan: no evidence of pathological tumors was detected. The lymph nodes in my neck and shoulder that at the start of this year had been swollen with metastatic cancer now appear to be totally normal. Yay for nivolumab!

The CT scans did detect some nodules in my lungs. As I have had a history of pulmonary embolisms, Jennifer and I were concerned that those nodules might indicate a return of PE, especially because the scan was taken the same day that I landed from back-to-back red eye flights of 8 and 14 hours, respectively. On the second red eye, I apparently picked up a flu bug circulating in the plane, because yesterday morning I woke up with a sore throat, and it rapidly progressed to congestion, post-nasal drip, and a productive cough. Remembering how urgently NIH treated my PE last fall by insisting I immediately return to the hospital, at Jennifer's urging I called Dr. Hahn to see if the nodules required immediate action. He read the scans and said it would wait until today's appointment.

Upon arrival at Hopkins, I immediately donned a face mask and wore it the entire time I was at the hospital. I am ever aware of how other patients with compromised immune systems can suffer serious side effects from a common cold. I met with Dr. Hahn, and he told me that the nodules did not appear to be PE, and likely were related to the cold I had picked up on the flight home. He said that I could take the standard over the counter remedies for palliative care, and to notify him if the symptoms had not improved in a week.

We also discussed the high amount of blood in my urine that I saw while in Botswana. I told him that I had exchanged emails with Dr. Aragon-Ching, who supported my suspending Xarelto for a few days, then resuming the drug at half the dose I had been taking before (dropping from 20 mg to 10 mg). (Dr. Aragon-Ching also said that she was leaving GW to run the GU oncology program (geritourinary covers cancers of the bladder, prostate, kidney, and testicles) at Fairfax Inova, and suggested that Dr. Hahn assume her role as my clinical oncologist.) Dr. Hahn agreed with Dr. Aragon-Ching's recommendation to cut in half the Xarelto dose, and added that I likely could stop taking the blood thinner altogether in October if there was no evidence of either PE or any metastatic activity. He also was happy to be my clinician.

Dr. Hahn noted how more and more of his patients had mentioned my blog, and how some had exchanged notes with me. He said that he even had joined the blogosphere by writing on the BCAN web site about the recent ASCO meeting. I welcomed him to the 21st century with a fist bump.

I had my 13th infusion of nivolumab, which went just the way it was supposed to be - uneventful. I'm scheduled for treatments through the end of October, and expect that I will continue on past then until someone says enough. I've seen what good the drug has done, and with no adverse side effects, there seems to no reason to end the treatments, especially since I am a guinea pig for the thousands of patients who likely will be getting this revolutionary drug in the coming years.