Phase I - Hit Me Hard? I Think Not!

As most of you know, this past Monday, December 9, 2013, I started my new treatment. This treatment is a Phase I Experimental Trial. The trial I am participating in is called – ready for this? It’s an awesome name – OMP 18R5. Impressive right? Such a cool name! The whole title of the study is actually called: A Phase I Dose Escalation Study of OMP-18R5 in Subjects with Solid Tumors (18R5-001).

“This is an open-label Phase 1 dose escalation study of OMP-18R5 in subjects with a solid tumor for which there is no remaining standard curative therapy and no therapy with a demonstrated survival benefit.”* 

Basically, as my research paper says, 

“Many current cancer therapies often produce an initial reduction in tumor size but may not have long-term benefits. One possible explanation for this is the presence of a specific type of cancer cell known as a cancer stem cell. Cancer stem cells represent a small part of the tumor but are believed to be responsible for much of the growth and spread of the cancer. Cancer stem cells may also be more resistant to traditional types of therapy, such as chemotherapy and radiation therapy.

The purpose of this study is to test the safety of a new experimental drug, OMP-18R5. OMP-18R5 is a humanized monoclonal antibody and was developed to target cancer stem cells.” ** 

All in all, it should actually be attacking my cancer cells at the root of it, unlike most chemotherapy and radiation therapies which hit it at the outside and work from there. The upside of this is that it’s not targeting me. It’s targeting my tumors. Meaning, it’s not hitting my white blood cells, or anything, not putting me at risk of infections like before!

Monday was a very long day for mom and I. I had a blood draw to see what my normal DNA looks like before the treatment. I then had an appointment with the doctor of this trial, and proceeded to have treatment for the next 7 hours.

This treatment is very different from the last chemo treatment I was on before. Instead of receiving 4 different regimens, fluids before, during and after, along with oral pills for vitamins, and anti-nausea through my IV, this time, my regimen is only running for 30 minutes. The only thing is, I not only am having my port accessed, but I also need an IV in my arm to put the regimen through. See my port is being used for blood draws. I have a blood draw and vitals before the chemo is pushed through, and then proceed to have another blood draw 15, 30, and an hour afterward, along with vitals and that continues for another 3-5 hours afterwards. 

Upside? I shouldn’t be having any nausea, no tiredness, maybe a little bit of muscle ache, but nothing else.

Downside? I could lose bone density.

Fix to that? A week before, I had CT scans and Bone Density tests and an injection to level my bone density and maintain it at the level it is at already, plus every day I take 1000CC of Vitamin D3 and 1250CC of Calcium twice a day.

Now Monday, that was a fun day, as I didn’t know I was going to have a normal IV in my arm. If I had known this before, I would have pounded down tons of water for 3 days leading up to Monday. So instead of knowing this, drinking tons of water and only getting ‘stabbed’ once, I was stabbed 2 times by one nurse in my left arm, had someone else who is better with tricky veins in the same arm, and then tried the other arm for a 4^th stabbing; which finally worked...after tons of digging around. We have determined that although I a people person and get along well with others, my veins on the other hand are not people oriented and are very shy and simple don’t play well with others.

The day went by smoothly, and Tuesday and Thursday (yesterday) I returned for follow-up blood draws. Once a week, every week I have to go back and get blood draws and meet with my doctor to see how I’m doing and how the chemo is affecting me.

Every 3 weeks I receive this treatment. But next time I receive this treatment, instead of being held at the hospital for 7 hours, I only have to be there for 3 hours – the first to get vitals and put the chemo in, and the other 2 to administer how I’m responding to it and have a few blood draws. Much shorter days! :D

I forgot to tell about Monday appointment with my doctor. The results of all my MRIs, CT Scans and Bone Density tests came back from the week before. My doctor said, 

“There was no growth in the tumors!” 

Woah there! NO GROWTH? While I was on chemo therapy for those 2 months before, my tumors grew a ton, almost twice their sizes, but in this last month there was no growth? MIRACLE! Granted, they haven’t shrunk….YET, but they will!

Praise the Lord that they haven’t grown at all! Thinking about that has made all of my days so much better than before!

*Clinical Trials - A Dose Escalation Study of OMP-18R5 in Subjects With Solid Tumors http://clinicaltrials.gov/show/NCT01345201

**University of Michigan Consent To Be Part Of A Research Study (my paper consent form)

Healing Realization

I want to share with you all who I am and a very important story.

My dad brought our German Shepherd, Kaiser, and one of my closest and dearest friends, Bailey, who I consider a sister, in for Thanksgiving on Tuesday, November 26, 2013. We had lots of fun, spent time with family, I showed Bailey the city I was from and where I was living and whatnot. Saturday, the day before she and my dad and Kaiser were about to leave, was a difficult day.

We were supposed to meet my boyfriend for lunch at a time, had to change the time a half hour later due to things needing to be done around the house to prep for winter. Anyone who knows me, knows that I really do not like being late. At all. It is a HUGE pet peeve of mine, and it doesn’t help that a lot of the time when I was younger I was late to things. So, Audra gets annoyed at having to postpone the time we’re supposed to meet at. Then we find out that the Michigan vs. Ohio State game is on (this was a shock to us due to the fact that we don’t have cable and were not expecting to get this game), we ended up watching some of it while things were getting done around the house and trying to get out to meet up for lunch. We finally leave and it’s 15 minutes after we’re supposed to have left. So we end up getting there 15 minutes after we should have. I became very frustrated and honestly, became very nasty to my parents.

Things blow over and the day goes on fine. We have lunch, we ignore what happened and Bailey and I go off with Ryan to hang out and get ready for a big swing dance event later that night (pictures up on Facebook if anyone is curious).

Then comes Sunday, the day Bailey, Kaiser and my dad are supposed to leave. Words are said that shouldn’t have been and an intervention is needed.

I am a Christian who knows and loves God very much and has always been raised in the faith my entire life. I have a problem though. I am very strong willed and don’t always love being under authority. For my entire life, since I can remember, I remember being this way. So when I am told I need to change, I feel people are saying that I need to be broken. That is something I don’t want to have happen. I am strong and want to stay strong; I don’t want to be broken. What I needed to realize is that these iniquities are not of me. They are not of God. And they are not who I am. They are faults in me that Satan has used through the years, and I have been so use to them that I have thought that they are of me; thus not wanting to be broken.

Fast forward to today, or rather yesterday (Tuesday) as it is past midnight. Tuesday went off pretty well for the most part until something rose up in me and my mom and I began to argue again in the car before we were going to visit my grandmother. I ended walking away to cool off. Things are ignored and we both cool down. We continue the evening as if nothing really happened.

We come home, around 10 pm, stop by the mailbox to see if there is any mail, and lo and behold, there is a package for me. There is a pair of beautifully made earrings, scarves, pictures, and a TON of letters all addressed to me.

I read through them all; very slowly and carefully, taking each word to my heart. DLT (Doing Life Together (High School Girls Bible Study)) and BOB (Band of Brothers (High School Boys Bible Study)), and people from the church who know me, and then there are people who don’t know me but have heard of my story who wrote letters to me, saying they are praying for me.

A young boy wrote a letter to me saying he was praying for me and he was sorry that I am facing what I am facing. He’s praying that I get better, and at the end he writes, “One more thing, remember NOTHING is impossible with GOD.” (ENCOURAGEMENT #1)

Girls who attend the church that I have heard of and talked to but don’t know well   write to me, encouraging me and writing out whole Psalms and other verses as encouragements. (ENCOURAGEMENT #2)

Scarves and a letter from a family are written to me to encourage me through this trial. (#3)

A letter from a friend who I know, but would love to know better, telling me that she has been stumbling over verses over the past days and shared them with me as well as telling me of how she is so glad to know me and share my story with others, sharing God with everyone she passes, and reminding me that I am never alone. (#4)

Her sister also wrote a letter to me as well from her campus telling me she and people there are praying for me and encouraging me with words reminding me that “God has a plan and He always has his children’s best interest at heard…His love is unconditional and so rich – and He is always there for you…” and that she considers me a role model. (#5)

Many pictures and drawings are sent which are very encouraging to me with the words all on them (ENCOURAGMENTS #6-16) *pictures at bottom of blog*

One young girl who I know a little from DLT wrote to me saying, “you are so beautiful in every way and SO incredible strong – such an inspiration to everybody! God is working in and through you every moment….God has a purpose for everything and someday we’ll be able to see what it is….He has a perfect plan.” (ENCOURAGMENT #17)

Another young girl from DLT who just starting DLT in my last year wrote encouraging words like, “Even through these times, you must remember that NO matter what happens on this earth, you can always find hope in the promise of eternal life. God holds you in His arms and is whispering His love in your ears. No matter how far away you feel form Him, He is right there for you. Take heart, and rejoice in His name and His everlasting love.” What words of encouragement!!! (#18)

A young girl who I’ve heard about and met once or twice but don’t know well wrote to me, “Seeing how strong you are has been a really BIG inspiration to me. You’ve inspired me to be a stronger believer in Christ the way you are. Hearing about the CHEMO not work as well as we had all hoped was a BIG upset. But seeing how strong you were made me think, ‘you know what? The chemo may not be working as we thought it would, but Audra’s going to make it because of how strongly she believes in the Lord and the Lord will see her through!’.” WOW!  She hit that spot on! I have never doubted that God is working through me. In fact, I have continued to spread the word that I am already healed, and proclaim out loud and thank Him for already healing me. I know that no matter what, I am healed, and I can stand on the conviction that God isn’t doing this to punish me or hurt me or make me learn a lesson because I did something bad. He is using this to strengthen me, but also, to strengthen EVERYONE around me. I am healed! And God has proclaimed that. The Lord’s Prayer says this:

Our Father, who art in heaven,
Hallowed be thy Name.
Thy Kingdom come.
Thy will be done on earth,
As it is in heaven.
Give us this day our daily bread.
And forgive us our trespasses,
As we forgive them that trespass against us.
And lead us not into temptation,
But deliver us from evil.
For thine is the kingdom,

The power, and the glory,

For ever and ever.

Amen

THY KINGDOM COME/THY WILL BE DONE ON EARTH,/AS IT IS IN HEAVEN

I am healed already in Heaven, but also already here on earth! (MAJOR ENCOURAMENT #19)

My DLT leader who has seen me grow these last 4-1/2 years wrote also, “I am so glad that you love Jesus. I’m sure that it is not always easy to trust God with all that is happening, but I know that you are trying. I know that God is in control and loves you very much. (So do I! & lots of others.) God does not allow things to happen without purpose. And we never do find out the whole story until heaven. We’re praying for miracles but know that God will use you in all circumstances.” (ENCOURAMENT #20)

The other DLT leader, who is new, but I have had a chance to meet and come to love her and her encouraging words. She wrote, “I pray that God gives you strength day to day, minute to minute, second to second. I pray that you remember God in everything that happens to you and everything that you do. I pray that our Father blesses your heart. Help you to make your life count for Jesus. Help you serve with strength of youth. I pray that you know that you are loved not only by your brothers and sisters in Christ, but most importantly our savior Jesus.” (ENCOURAMENT #21)

The boys in BOB also signed a page and wrote words of encouragement praying for me and wanting me to come back and get better. (ENCOURAMENTS #22-36)

Lastly, and what really hit me the most because of everything happening, I received a letter from a young woman who is so strong in her faith, I want to be like her. She has known me since I was a young, immature, silly sophomore in high school when we went on a mission’s trip to Nicaragua back in 2010. She writes this:

‘Dear Audra,

You are an amazing, strong, and beautiful young woman! You have grown so much since we went to Nicaragua together! The grace you have shown through this trial is truly something to admire!

James 1:2-4

‘My brethren, count it all joy when you fall into various trials; knowing that the trying of your faith worketh patience. But let patience have its perfect work, that you may be perfect and complete, lacking nothing.’

There are no words to describe what you are going through or to make it better. I must have started this letter 10 times over. My heart truly aches for you. Knowing what you are going through brings me to tears. I want to take this trail away, but I can’t.

Deuteronomy 31:6

‘Be strong and of a good courage, do not fear, nor be afraid of them: for the Lord your God, He is the one who goes with you. He will not leave you nor forsake you.’

When man despairs, God is strong. God is above Doctors. He is above disease. His will stands forever. No matter what His will is in your life, know that God goes with you!

What you have shown is strength, but I am you have your times of weakness, heartache, and pain. In those moments remember God’s promise and be encouraged.

Romans 8: 38-39

‘For I am persuaded that neither death nor life, nor angels nor principalities nor powers, nor things present nor things to come, nor height nor depth, nor any other created thing, shall be able to separate us from the love of God which is in Christ Jesus our Lord.’

God’s plans for you are good. We may not understand them, but they are good.

Jeremiah 29:11

‘“For I know that I think towards you,” says the Lord, “thoughts of peach and not of evil, to give you a future and a hope.”’

You are so amazing, and I am so proud of you! You are bringing glory to God through your life! You have taught so many so much! I am sure that if you go home soon or in a 100 years God will say, ‘Well done good and faithful servant!’

P.S. Always praying for you!’

WOW WOW WOW! That was all that went through my mind after reading that. But it gets better. (MAJOR MAJOR MAJOR ENCOURAGMENT #37)

I then read this letter:

‘Dear Audra,

May the Lord strengthen your spirit and renew your heart and mind in His great love daily. Look to Him; cleave to Him and pray that you stay in the center of His will for your life.

You don’t know me, but one day I know we will meet. I know of your condition through a praying, heartbroken friend of yours who is now my wonderful daughter-in-law (person of above letter). Yet she is not without hope for you. We know the Author of Hope and Miracles.

You are in my prayers.

I want you to encourage you to trust and rest in our great and loving God. And that He is in control and all Hi ways and purposes are holy and righteous and true.

He loves you very much! I pray that He will hold you close and give you the strength to trust Him with your life.

If you have your Bible, you will be greatly blessed, encouraged, and strengthened daily as you read the Psalms and spend time in prayer. Cry out in prayer to the Living God of the Universe who created it all – especially you, Audra, precious you! He hears the prayers of His children who are totally surrendered to Him.

In this journey you’re on, you will have to hold on much tighter today than yesterday, but don’t worry, He will give you the strength, and His grace, and His peace to do so. You will be amazed at the peace that passes all understanding that He will bless you with as you exchange your heavy burden for His light yolk.

May you be filled with hope today and encouraged to press on. God bless you, Audra!

Love in Christ’

And then it hit me. And I got up, walked out of my room, and went to my mom who was on the phone with my dad and said to them, ‘I just realized, I am healed, I know I am healed and God knows it, but He won’t show it to the rest of the world till I am totally His and surrender myself to Him.’

My mom just looks at me and asks me to repeat that again. And what I said is true, I am healed. I know I am. I mean, and I’m not trying to sound cocky or anything, but look at me! I look and feel healthy. My body is portrayed as diseased and sick and, since I am a stage 4 cancer patient, dying, but I don’t look it and I sure don’t feel it. I don’t feel it because God has given me the strength to not feel it, because I am not sick in His eyes, and He has made this clear to me. But because of my sins and my strong will it can’t be shown to the rest of the world for His glory until I fully 100% surrender to Him. He can’t show His glory and let it be known that it was Him if I can’t act as His child who lives my life for Him totally.

So my newest prayer request: As I have realized this and it is proclaimed and I am striving to live for Him 100%, Satan is going to try all that much harder to pull me away from Him, to sin, to disrupt the peace in the home between my mom and I, my sister and I, and anyone else he can. I am asking you all to pray for my strength to get up every day, and first thing to BEG, not ask, but BEG and PLEAD God to give me HIS STRENGTH to complete this day with Him right by my side and not let the enemy win. And that I drench myself in His word day and night and as much as I can. And most importantly, that I am seen by the rest of the world as a daughter of the living and breathing God.

And of course that God will show everyone else that I am healed as He has shown me. That there will be no question of how I was healed.

I saw this verse on a friends Facebook status and my mom shared this with me today, and I am going to leave you with this: Luke 18:27 says, ‘What is IMPOSSIBLE WITH MEN is POSSIBLE WITH GOD!’

GOD IS THE HEALER AND RULER OF THE WORLD. DISEASE IS NOT HIGHER THAN HIM AND HE MAKES THINGS POSSIBLE.

What Was The Point?

As I'm sitting here, I'm trying to understand.

I'm confused.

Boggled really.

And I'm thinking to myself, "What was the point? What was the point of those last 2 months then?"

The results were not as I expected. At all. We were hoping for a miracle and a Swiss cheese looking liver, with results of, 'The cancer is gone,' or at least, 'The tumors haven't grown at all - the chemo is working.' But what do we get instead?

The results: The chemo didn't do anything. The tumors didn't shrink. They didn't even stay at the size they were at previously. In fact, they grew. GREW! I don't even know what to say. I don't know whether to be in shock or disbelief or confused or what. 

So let's look at the pros and cons (yes there are some pros, but I think there may be more cons)

  
Cons

• The tumors kept growing without being affected by the chemo.

• The experimental trials are all phase one trials – not much known about the drugs.

• I have 30+ tumors sitting just inside my liver, plus 3-5 large tumors sitting in the free space of my abdomen.

• There is a mass that is mildly compressing my kidney.

• The same mass that is mildly compressing my kidney is near a renal artery; it isn’t compressing it yet, but it could (that’s kind of some scary stuff…basically, the mass could keep squeezing my kidney and that artery and rupture the artery causing me to hemorrhage again, like I did in Dec. 2012).

• Surgery may not be an option to just remove everything – recovery is 6 weeks. Six weeks of not doing anything but possibly letting more tumors grow in replace of what was taken out.

Pros

• My body won’t be hit with 4 of the strongest chemo drugs 4 days in a row each month.

• I can try experimental trials of chemo – there are three different types.

• My blood labs and vitals are all healthy.

• I’m not getting sick or feel the effects of the chemo.

• (My favorite one) I will start to see hair growth in 3-1/2 weeks! Hello hair and long showers, here I come! I can’t say I haven’t missed my hair, but it does help with the feminine factor a bit. Granted, I've loved taking 2-3 minute showers and being the fastest ready(always was though, now I’m just waiting around longer for everyone else), but when I want to go get dressed up and look nice, it would nice to have my hair to do as well and get 100% dolled up

Now some may ask, what about your vitals and blood work? They didn’t drop or anything? And here is my answer. Yes, they did drop. They actually dropped pretty drastically, but they also bounced back up drastically as well. For some of my counts, if they were to drop any more, they would have had to hospitalize me until my levels were a little more stable. And because they did drop so much and my doctors wanted to be on the safe side, for a week after my second chemo treatment, I gave myself a daily injection of growth factor.

The exact brand of my lidocaine cream

Growth factor is a naturally occurring substance capable of stimulating cellular growth, proliferation and cellular differentiation. (Say what?) First off, I don’t have to be hooked up to anything to get this injection. I got to take the injections home with me and do it myself. I didn’t have to access my port. I had the choice of injection into the back of my arm, like most shots at a doctor’s office are, my thigh, or my stomach. I also had the benefit of having a lidocaine cream that I apply an hour before my injection that numbs the surrounding area. Basically, it takes the edge off when I have to ‘stab’ myself. I also use this cream every time I had chemo or I have a blood draw. It comes in handy. 

Anyways, I always injected the growth factor into my stomach, at night, because an effect of it can be sore muscles, so I thought, why not inject it at night and sleep the soreness away? Worked pretty well for me. It didn’t keep me down. You also have to keep the injection in the fridge to stay cool, but take it out a half hour before injection, because it flows easier if it’s at room temp. 

Back to what it does, sorry, I end up getting on bunny trails with all the information that  I have, when you inject the growth factor, it goes to the bone marrow and produces more white blood cells. Gives my body an added boost for my immune system essentially.

My vitals, after the low 2 weeks after chemo period end, bounce back up close to a normal person’s vitals. My hemoglobin is still lower, but first off, I’ve always ran low, and second, I do have chemo running through me. But I keep my energy level up by eating and staying active. My white blood cells bounce to close to normal, my platelets and everything else. So yes I have stage 4 cancer, but I LOOK and FEEL healthy.

So now all we can do is consult the doctors, talk about our options so that we fully understand them, pray and make a decision.