I’m finally home from the hospital! I know I’ve said that before and then had to turn around and go right back in, but this time I’m determined to make it stick.
Just to recap, I was inpatient for three weeks total. The first two weeks were to start the immunosuppressant drug for the colitis caused by my cancer treatments. The immunosuppressant took longer than expected to start working. (I am a procrastinator in all senses of the word, I guess.) Luckily, we did start to see results, and they sent me home on a Friday night about 10 days ago.
Word of advice: if you’re going to be discharged from a hospital, don’t go home on a Friday night. It is so much harder to get in touch with your doctors or get new prescriptions over the weekend. Poor Michael (that’s what we call him now; so many people said it so often that it just became part of his name) … Poor Michael was on the phone all weekend trying to get all the supplies and new prescriptions I needed.
While I was home that weekend, I was having a lot of side effects from the immunosuppressant. Not surprising. It does suppress your immune system after all. The worst was that the drug was burning my esophagus, and it was so painful that I couldn’t eat or drink by mouth. I have a high tolerance for pain, but this was capital-P Painful. I got very dehydrated. Monday, Michael took me to the doctor, and he admitted me again.
Since we did not expect me to be admitted again, we had not warned Mara, and I had not gotten to say a proper goodbye before leaving her with my parents. So, I spent the next hour crying and pouting and sulking and acting like a real baby. Michael let me vent. Parents of toddlers know that sometimes you just have to watch as they cry and pound on the floor. Eventually, I calmed down and realized that I was only a few exam rooms down from where I first got my cancer diagnosis on February 25, 2016. That put things in perspective. (Incidentally, Mara handled the news about my admission fine.)
We did not know how long I’d be in the hospital the second time (the estimate was “a night or two” - I was there a full week), and we had not prepared for another hospital stay, so Michael had to run home and pack a bag for me. Michael and I have never been one of those couples who packs for each other before vacations, but he did a surprisingly good job. Sure, he brought 6 t-shirts and only 3 pairs of pajama pants. Fine, he forgot my slippers. Yes, all my toiletries were in weird spots and hard to find. That’s ok. The only real issue was that he forgot to bring me a hairbrush, so after a full week in the hospital without a hairbrush, believe me when I tell you that I looked like every Winona Ryder mugshot.
One tiny(?) hiccup during my hospital stay - I was seeing a doctor on my GI team nearly everyday, and last Tuesday he performed two endoscopy procedures on me. And then, the next day, he tested positive for COVID! Fantastic! So after all my family has done to protect me from COVID this entire year, I’m the only one who has actually gotten exposed. (Actually, Michael was briefly in the room with the doctor too, but only for a couple minutes.) Michael’s first thought when he heard I was exposed was, “What an f-ing mess! You’re immunocompromised, mute, and now I can’t be at the hospital with you.” My first thought was, “Damn! I could have gone to the beach this summer after all!” I mean, if I was going to get exposed anyway, I might as well have seen the ocean, right? Although I don’t discount the severity of COVID, I’m not that worried about this exposure. The doctor had an N95 mask on every time I saw him. I haven’t had any symptoms. His wife hasn’t even gotten it (although now that I think about it, that’s going to be hard to explain if I do get it from him). I’ve had two negative tests since my exposure and this Friday will be 10 days without symptoms. After that, I will get to hug my parents again!
The hospital stay should have been shorter, but the immunosuppressant kept causing other weird side effects. I started getting migraines and tremors. My hemoglobin plummeted. Stuff like that. Each one needed a workup and treatment. I got an iron infusion. I had MRIs of my head and spine (normal except for some degeneration from age. Um, what? I’m a millennial!).
I’m fairly convinced that making a person who has a migraine get an MRI is illegal under the terms of the Geneva Convention. If not, we should definitely start using it as torture at Guantanimo. If you haven’t had one, MRIs are insanely loud. They sound like someone made a mix-tape of just construction site noises and the screeching sound dial-up internet used to make. The first scan takes up to an hour. Then, they pump you full of contrast, which I imagine is sort of like tie dye for your insides, and they do the same scan again, except this time it only takes five minutes for some reason they never explain.
It takes about a hundred years to get the MRI report. When you get the MRI report, it will have a bunch of absolute jibberish sentences (“the enteoterioic hibiscus saline routes are parallel to the neurobiliac sac”) that you won’t be able to decipher even when you Google them, but, mixed in with those will be a bunch of basic statements like “Lungs are present.” These always catch me off guard. Like, was that a concern?
On Monday morning, I had been in the hospital a full week, and I was DONE. I hadn’t slept for more than two hours at a time. My body was covered in bruises from getting shots all week.
I texted my family: “I don’t care if the MRI shows a tiny alpine hiker rappelling down my spine. I am not staying in this hospital another night.”
Luckily, the MRI results were fine, and I was allowed to go home! I still have to be on tube feeds to get extra nutrition because it is still hard to swallow, and I still have a tremor. Michael keeps taking videos of it. He says they’re to show the neurologist, but I’m skeptical.
?It is wonderful being home with Mara and Michael. They have always been close, but I love watching the little rhythms they’ve developed while I’ve been gone. Mara’s desk is next to Michael’s desk, and she does her virtual learning next to him while he works. It is very cute. She doesn’t love the virtual learning, but she does love all the Facetime with our family. They’ve called to read, play, teach, and cook with her. It has been wonderful. She also loves all the food everyone has sent, and it has been such a relief to Michael to not have to worry about getting groceries or cooking. Thank you to everyone. I mean it when I say we could not do this without all of you.
One last thing I wanted to mention. I have had the most amazing nurses over the past four years. Out of the hundreds of nurses I’ve had assigned to me, there were only 3 that I didn’t think were great. I know there are a lot of people thanking Essential Workers and First Responders during COVID, but I just want to say that I witnessed first-hand how much extra work COVID is making for hospital staff - even with patients who don’t have the virus. Everyone, from maintenance to transport to nurses, has to take time to change gear constantly, put on extra gowns, take extra temperature readings, wipe down things more than usual. These are 12 hour jobs that were already chock full to begin with. If you know anyone in a hospital setting, even if they haven’t treated COVID patients directly, please thank them for all the time sacrifices they’ve been making to keep patients like me safe.
Oh, I lied. This is the last thing I want to mention. When I got cancer, a lot of people wrote to me to tell me about their cancer journeys. I never knew they were sick. When my cancer treatment caused colitis, a lot of friends messaged me to tell me they also have colitis or Crohn’s. I never knew they were sick. I am very open (probably too open) about my medical issues. Some of that is because I think it is good for people to know what is going on, and sometimes it is just easier because I can put all the information in one place and I don’t have to remember who I gave the details to. I get so much support and prayers from all of you because I’ve been so vocal (pun intended) about cancer. This time, I’d like to ask that you pray instead for someone who is sick but does not talk about it. They need the love and support. If you hear of a friend getting a diagnosis, even if they don’t complain or explain or joke or update like I do, they are still having a difficult time. If there’s anything you were thinking of offering me, please do it for them instead. That would make me so happy. You’re the best group of people, and I want to share you.
Today marks a week in the hospital, and we don't know yet when I'll be going home. Originally, we were hoping I’d only be here a week, but there were a couple small setbacks at the beginning and my progress hasn't been as speedy as I’d like. I was able to start the immunosuppresent drug cyclosporine and have been on that IV since Sunday. It seems to be helping a little. I've felt a bit better the last two days. I'm praying the improvement continues. If so, I may be able to go home in a few days, but the doctor said he can't make any promises. Still, I'm cautiously optimistic. I miss Mara and Michael terribly but am able to Facetime with them several times a day. Visits aren't much of an option because of covid precautions. Nonetheless, Michael and Mara are doing well. Thank you for everyone who has been feeding them while I'm gone! It's a relief to know they have one less thing to worry about right now. I'm looking forward to getting home and hugging them both. I'm also looking forward to finally seeing my parents again after their quarantine! My siblings and in-laws have been a wonderful support system from afar. I can't thank them enough. Michael and I are blessed to have amazing families and friends.
I have fantastic doctors and nurses here at University of Chicago, and it is a relief to know I'm in good hands. I look a bit battered and bruised from all the needles, and I have a couple small blood clots making me sore and lots of swelling from the steroids, so I'm avoiding mirrors for a little while, but I'm in good spirits and am steadily working my way through every single show on Netflix! I'll send another update as things progress. Until then, thank you for all the love and prayers.
Hi Family and Friends,
It has been quite a while since I gave everyone an update. I want to just say right off the bat at the top of the update that my cancer is not back, so no need to worry about that! I know it is probably nerve-wracking to see a new update from me. Just a quick re-cap: from the end of 2018 to April of 2020, I got infusions of the immunotherapy drug pembrolizumab every three weeks, and it has kept away any new tumors or growth of old tumors. It has truly been a life-saving drug. I’ve had CT scans every three months, including this past Monday, and the results have been great. Naturally, we get nervous before getting the results every time, but so far, my cancer has stayed away. So that’s the great news.
The crummier news is that this spring I developed an auto-immune response to the immunotherapy and had to stop treatment. (Cancer really is the gift that just keeps on giving, amiright?) Basically, my immune system got a little too strong, killed off the cancer, and then decided to attack my gastrointestinal system. It’s kind of like I developed a superpower but am really terrible at using it. I stopped the immunotherapy at the end of April, and so far the cancer has not come back, but the GI issues have persisted. I’ve been on steroids all summer, and those helped for a while, but they’re not working anymore. We’ve tried a bunch of other drugs, and in September I started infusions of Entyvio - an ulcerative colitis drug that has shown promise for treating immunotherapy-induced colitis. It takes a couple months to start working though, and my condition has gotten a bit too severe to wait that long (I’m not going to lie - I feel like garbage), so I am going to be hospitalized for about a week to get an immunosuppressant drug that hopefully will work until the Entyvio kicks in. Most likely, I will be admitted to the hospital on Friday.
Obviously, being inpatient for a week or more isn’t ideal, nor is being on strong immunosuppressants during a pandemic, but we’ve been very isolated so far and will continue to be careful. Michael has been a champion, juggling working from home and taking care of Mara. Our families have already been taking turns spending time with Mara virtually for kindergarten lessons and play time. This has been a huge help and will especially be helpful when I’m in the hospital. Mara is loving all the Facetime sessions with her relatives. My parents will be able to help in person once they get to Chicago and finish a strict two-week quarantine and then remain isolated except for seeing Michael, Mara, and me. All of these are huge sacrifices, and we are so grateful for everyone’s help.
We plan to turn the MealTrain calendar back on starting Friday and will keep it open at least for the week I am in the hospital. Hopefully, things will be better after that. Other than that, we don’t really need anything other than everyone’s continued prayers which have sustained us so far. We love and appreciate you all and look forward to spending time with you once I’m feeling better and the world is normal again!
I’m happy to report that my latest CT results were great! My lungs continue to be tumor-free, and there is no sign that the disease has spread to any other area. Michael, Mara, and I are thrilled and relieved and, above all, thankful. We are celebrating the good news and enjoying every moment.
I continue to receive immunotherapy treatment every three weeks to keep any lurking cancer cells at bay, but I am feeling much stronger now that the chemotherapy is finished. My hair is growing back, and I look a little bit like Peter Pan at the moment.
I’m still tired all the time, but I’m doing my best not to let it slow me down! It has been a busy spring. Michael, Mara, and I were able to visit friends in California for Mara’s spring break. We came home and spent Easter here in Chicago. I just returned from a trip to Santa Fe with Michael’s family, and now we’re enjoying a visit from my parents. In between treatments, I spend my days taking care of Mara or writing. It is so nice to feel like myself again. My next goal is to start running again. (I figured I’d make that public so I’d have extra motivation to actually do it!)
Below are some recent photos, but first, I wanted to mention that the American Cancer Society has asked me to be an Ambassador for their ResearcHERS: Women Fighting Cancer campaign. Through ResearcHERS, the American Cancer Society is raising money for groundbreaking cancer research led by female researchers. The treatment protocol that is working for me is based on brand-new cancer research, and I am so grateful to the people who spend their days researching new treatments and cures. The American Cancer Society has invested more in cancer research than any other non-governmental not-for-profit organization in the world. Continuing this research is essential and will lead to longer and better lives for those of us with cancer.
Funds raised through the ResearcHERS campaign will go specifically towards female-led cancer research. This is important because studies have shown that not only are there fewer women scientists than men but also that female scientists typically receive smaller research grants than their male counterparts. As a cancer patient, I want to end cancer. As an unapologetic feminist, I want to end gender disparities. When the American Cancer Society offered to let me be a part of both efforts at once, I happily accepted!
Please do not feel any pressure to donate, but if this sounds like a cause you want to support, you can give at this link: http://main.acsevents.org/goto/camillapollockflynn
If you would like to help spread the word, please feel free to share the link through social media. I appreciate you taking the time to read about this!
Michael, Mara, and I send our love to you all. Have a wonderful spring!
Update: in which I am happy and sentimental and in the mood to include demonstrative exhibits…
I am so THRILLED to be able to write this update. On Monday, I had a chest CT to see what effect the chemotherapy and immunotherapy treatment has had on the four tumors in my lower lungs. This afternoon, Michael and I met with my oncology team, and they had great news for us!
None of the four tumors show up on the CT scan! They are gone. The medical oncologist said the response to the treatment has been tremendous and better than he hoped it would be.
The change is most striking when you see my pre-treatment scan (with the tumors) next to my most recent scan (tumor free), so I’m including those side-by-side here. I’m not even joking - I love these photos so much, I might frame them!
Image 1:
The October 2018 CT is on the left, and I circled the two uppermost tumors in green. This past Monday’s CT is on the right, and the tumors are gone. (I have no idea what all that other junk in my lungs is. I have a three year old, and we do a lot of art projects, so there’s a very good chance it’s glitter.)
Image 2:
Tumor #3 is on the left-hand image in green. Nothing on the right.
Image 3:
Finally, tumor #4 (the smallest and lowest one) is in the scan on the left circled in green. Again, nothing in that same area on the new scan!
We are just so happy and relieved and grateful that I don’t even know what to say. Tonight will be the first night in a VERY long time when I won’t fall asleep wondering how many days I have left with Mara and Michael. I know that may seem excessively dark, but, sorry - the mind goes to some very dark places after you get diagnosed with Stage 4 metastatic cancer.
I will still need to get immunotherapy every three weeks for the next two years in order to fight any residual cells or nodules too small to be visualized on the scans. I do not need to continue chemotherapy though, so that is a huge relief. I’ll get additional scans every few months to confirm that all is still well. I didn’t ask what the likelihood of another recurrence is because I do not want to devote any energy to worrying about that. I am healthy now and plan to stay that way!
This entire cancer battle, and especially the last four months, has been full of uncertainty, but one thing I know with absolute certainty is that I could never have endured it all without the support of my family and friends.
Mara gave me the best reason to keep fighting, and she taught me resilience in the way she adapted so quickly to every major change. She made me smile when I didn’t feel like smiling. She was a reason to get out of bed when I felt weak. She made me feel loved. She made me feel brave.
Michael has seen me at my best and at my worst, and his love has been unconditional and unwavering. He was there for me during all the ugly moments of cancer that don’t get talked about much. For the last two years, he has been the one propping me up so I didn’t completely fall apart. He is my best friend and my greatest love, and I don’t think cancer knew what it was up against when it decided to try to separate us.
My mother uprooted her entire life (twice!) and moved to Chicago to take care of us. Many days, I was only able to be strong because I saw her being so strong and optimistic. So many people have called me strong while going through treatment, but any strength I have I owe to mom. Strong women raise strong women, after all. My mom’s faith was constant and seeing the strength of her faith was sometimes the only thing that helped me keep mine.
My father managed to balance work and spending time with us during my illness, and he never complained. He also never lost hope, no matter what. No matter what the doctors were telling us to expect, he immediately would say, “It’s going to be fine.” Now, mind you, he is not a doctor, so he had no reason to be so confident, but his certainty in the outcome was so absolute that, if he had ever expressed any doubt about my recovery, I think the rest of us would have completely fallen apart. His optimism was the canary in our coal mine.
My siblings and their spouses kept me feeling normal. They are all amazing lip-readers. So much so that I sometimes forget I’m not actually talking to them when we’re together. They made me laugh on days when laughter seemed impossible.
My in-laws fed and loved and supported us. My friends were there for us every step of the way. Everyone who read this website made us feel less alone. I believe your prayers strengthened us.
I am so thankful to God for being with me throughout this entire ordeal and for blessing me with the love of so many wonderful people. Of course, we would appreciate your continued prayers, thoughts, good vibes - whatever positive energy you care to send our way, we’ll take it! Michael, Mara, and I thank you all from the bottoms of our hearts, and we are so happy to finally have some good news to share with you for a change!
Love always,
Camilla
Happy new year to all.
Just a brief update to let everyone know that I had my fourth round of chemotherapy and immunotherapy last Friday. I’m achy and sick this week, but if the symptoms follow their usual pattern, I should be feeling stronger next week.
We are at a bit of a crossroads in my treatment. The plan was to have four rounds of chemotherapy and immunotherapy and then get a CT scan and see what the effect has been on the lung nodules. My CT scan is scheduled for next Monday, January 21st, and I should get the results when I meet with the doctor on Wednesday, January 23rd.
Obviously, the best outcome of the scan would be for the lung nodules to be gone, but it would also be promising if the tumors are smaller or if there are less of them. If either of those things happens (after taking some time to celebrate), we will likely continue with immunotherapy alone to keep any remaining cancer cells at bay.
We don’t know what the next steps will be if the nodules have not changed or if they have grown. We’ll have to go back to the drawing board and look into other treatment options if that is the case.
Naturally, our anxiety is increasing as the scan approaches. Michael, my family, and I are all putting on our bravest faces. I’m working on visualizing good scan results, but it is a scary time, and even the tiniest things can bring me to tears. Without being asked, Mara has figured out that I need extra hugs these days.
Over the past two years, we’ve had good scan results and bad scan results, and there doesn’t seem to be any rhyme or reason to it. These periods of “not knowing” are the hardest, and this is when I am most thankful for your collective prayers, positive thoughts, and love.
I know I usually try to insert some dark humor into these posts, but I’m having a hard time thinking of anything funny at the moment, so maybe you’ll forgive me if I get a little saccharin instead? A few months ago, I heard that the late writer, Michelle McNamara, had a kind of mantra about life. She would say, “It’s chaos. Be kind.” Right now, things feel very chaotic, and I want you to know that, in the midst of that, I feel your kindness and it helps. I also know that there must be many of you reading this who are also dealing with chaos but may not be as vocal about it. I hope you are surrounded by kindness too.
I just wanted to wish everyone happy holidays and let you know that treatment is going well. I’m writing this while hooked up to my third round of chemotherapy and immunotherapy. I have this treatment every three weeks, and, after the next one, I’ll have a PET scan to see what kind of impact the treatments have had. That will be in late January, we think.
The treatment side effects are not pleasant, but they are bearable. I’m on a good mix of nausea meds, so the nausea is at a level I can live with. I have some pain from the white cell boosting drugs, but I’ve had worse pain. Somehow, I have both fatigue and insomnia. You’d think these would be mutually exclusive, wouldn’t you? Apparently not.
I’m still experiencing memory loss for about a week after each round of treatment, but my brain MRI was fine, which was a HUGE relief. We think the memory lapses are just a side effect of the medications. The lapses are frustrating but do seem to get better during the second and third weeks after treatment. Now that I know the brain MRI was ok, I feel less anxious about the memory loss. Plus, it is kind of fun getting Amazon packages in the mail and having no idea what I ordered. (Michael does not think that part is as much fun as I do.)
Since Christmas will fall during the week after treatment (what I am now calling my blackout week), we celebrated early with Mara and had our own family Christmas last Saturday. It was a day full of joy and love - exactly as Christmas should be.
Most days, I stay pretty close to home since it is cold out, I’m tired, and people are extra-germy this time of year. But, I have been able to go a few places. The other day, I went to the art museum and lunch with Mara and my parents. One evening last week, I had enough energy to go see my old coworkers at their holiday party. I went with Michael to Mara’s first Christmas pageant at her preschool. It’s been nice saving up my strength for these kinds of outings.
I have not been doing much grocery shopping or cooking, so we’ve decided to turn the MealTrain calendar back on so that people can sign up to bring meals a couple times a week, starting after the new year. Everyone has been offering, but I wanted to do as much as I could on my own for as long as I could. Now that the fatigue and energy loss is getting harder to ignore, I think it is a good time to take people up on their offers to help so that I can use the energy I have doing things with Mara rather than chores. (I know. I know. I didn’t do that many chores to begin with. My mom came to visit when Michael and I were first married, and she asked me where my vacuum was, and I answered, “I know we have one, because I’ve seen Michael use it, but I don’t know where he keeps it.” So, I’m not great at housework. Sue me.)
I think that’s all for now. I have about 3 hours left to go on my infusion today. I’m going to try to convince Michael to wheel me up and down the hall of the hospital while I stand on the base of my IV pole (I saw a kid do this once, and it looked like fun). Last round, he refused because the nurses were watching, but there aren’t many people around today because of the holidays, so I might be in luck.
Thank you for continuing to pray for us. We feel very loved and supported. Happy holidays and, if I don’t write again before then, happy new year!
I am writing to wish all of you a happy belated Thanksgiving and to let you know that Michael, Mara, and I are doing well. I started chemotherapy and immunotherapy on November 9th. My treatments are every three weeks. I had some rough days with nausea and vomiting in the week following my first treatment, but those symptoms went away after a few days. I haven’t even needed nausea medication since that first week.
The nausea seemed to be my only symptom, but early last week, we realized that I was having memory lapses. We’ve figured out that I have completely forgotten one entire day and parts of a few other days - all within the first week after my treatment. This is an unsettling and upsetting symptom - especially because it is hard to know whether it is continuing or whether it is limited to that first week. I don’t know I’ve forgotten anything until someone else mentions something that I can’t remember. It is frustrating to try to figure out whether there are any other gaps in my memory. As of right now, we don’t think there are. I know that a lot of people complain about “chemo brain” and I definitely experienced some of that during my first go-round with chemo, but this is more episodic. Most likely, it is a side effect from one of the medications, but just to be on the safe side, my doctor is having me get a brain MRI this week. We are hopeful that, like the nausea, the memory lapses were just a quick blip. In the meantime, I plan to use it as a convenient excuse. “I don’t remember eating all the leftover Thanksgiving pie….”
The last symptom to appear was hair loss. In 2016, only one of my chemo drugs caused hair loss, so I only lost a medium amount of hair. This time around, both my chemo drugs cause the kind of hair loss that you imagine when you picture someone going through chemo. My medical team had told me it would likely happen, so I had been expecting it , but it was still alarming when it started. It was crazy how fast it went! I had a full head of hair last Wednesday morning, and by Sunday night I had lost all but a few stubborn wisps. Fortunately, we had prepared Mara for the hair loss, and she has handled it extremely well. Thank God that children are so amazingly resilient.
I won’t lie and say that I’m happy about being bald (given the choice, I’d choose to have hair, thank you), but we are trying to celebrate my baldness as a sign that the medicine is working. When there was just a little hair left, we had a “hair party.” Mara, Michael and my family helped me shave off the last bits, and we sprayed lots of silly string on my head. It was actually pretty fun.
Looking in the mirror is not as hard as I had expected, and if my bald head starts to bother me, I can just wear a hat. We’ve dealt with far bigger changes over the last couple years, and I know that the hair will grow back in just a few months. (Also, surprisingly, this is not the worst hairstyle I’ve ever had. I’m looking at you, third-grade-Cam.)
It is not fun to lose your hair, and I don’t want to minimize it or pretend it didn’t bother me, because it wasn’t easy. That said, I shed the tears I needed to shed, and I feel ok about it now. The anticipation of being bald was worse than actually being bald.
Not much else to report. We send you all our love and continued thanks.
Michael and I just received a phone call that our expedited appeal was a success and the denial of my immunotherapy has been overturned. Treatment has been APPROVED!
What a wonderful way to start the day.
This group. What would I do without this group of supporters? I’ll likely never know whose efforts were the tipping point, whose prayer, email, or phone call made the difference, but my suspicion is that every single one helped tip things in our favor, so I thank each and every one of you.
Who would have expected that we’d be dancing around the kitchen celebrating on the morning I get to start treatment?! What a roller coaster this has been. Thank you for riding it with me. Thank you for pushing us up when we reached the lows. Thank you for celebrating the highs with us. And, of course, my heart goes to all the other people out there who are still fighting a denial, who don’t have you wonderful people to turn to for help. I don’t know their names, but I will pray that they succeed as well.
I’m off to the hospital shortly. Know that I will be sitting in the infusion chair with a giant smile on my face.
And to celebrate the fact that these updates will hopefully now return to just being pictures of my family and my attempts to make jokes about cancer…. here’s a belated photograph from Halloween! Mara was Jane Goodall, and Michael and I were her chimps.
Friends,
Thank you to everyone who provided assistance to us yesterday communicating with Blue Cross. The response was overwhelming and surreal, and the good news is that you all helped us get in touch with the highest levels of the company and fast track the preauthorization process. The bad news is that we received a phone call this morning telling us our preauthorization request has been denied. Obviously, this is not the outcome we expected or wanted. Thanks to everyone’s efforts yesterday, it sounds like we have some well-connected people at Blue Cross who are invested in helping us appeal this decision, and we are working on that process now with the help of my medical oncology team. We have been assured that the appeal process is being fast-tracked and that Blue Cross is aware that treatment is scheduled to begin less than 24 hours from now.
We are in the process of confirming that only one of the three drugs ordered for me has been denied (the immunotherapy drug), and that the other two drugs are not part of the denial (the two chemotherapy drugs). If so, we hope to still start the other two drugs tomorrow as scheduled. There is clear documentation that the chemotherapy drugs are more effective if given simultaneously with the immunotherapy drug, and we have asked our medical team to provide this documentation to the insurance company as part of a peer to peer review. Please say prayers that logic prevails and that the insurance company eventually trusts the judgement of our medical oncologist (who is world-renowned and a truly, truly incredible doctor).
At this point, I do not want to overwhelm the people within the insurance company who are working on the issue. (One of the executives told us they received numerous emails and social media postings about me within the span of a couple hours yesterday. Thank you, thank you, thank you!). They have reassured us that the levels we wanted to reach within the company have been reached and are aware of the issue. For now, I think the best course is that you all let us work on it with them and with our medical team and see what we can get accomplished. If it becomes necessary, I will reach out to everyone again asking for help getting the word out. I know now how many of you are ready and willing to “storm the castle” again as soon as we need you to. Rest assured, I will let you know when we need that.
I can’t tell you what it has meant to have so many people get involved. From the bottom of my heart, thank you. And to those of you who wanted to help but had no way to, thank you to you too. I love each and every one of you.
The battle is just beginning, and I am angry and anxious, but I am also relieved and strengthened by the thought of the army of support behind me. More to come as soon as I have news.
Camilla
Urgent -
Friends,
So many have asked what you can do to help, and I finally have an answer. It’s a little convoluted, so bear with me…
We have become caught up in a bureaucratic nightmare at both our hospital (University of Chicago) and our insurance company (Blue Cross Blue Shield). As I mentioned in a previous update, my doctor ordered chemotherapy and immunotherapy for me. Unfortunately, there were delays in the hospital requesting preapproval from the insurance company, which caused a delay in my treatment starting. (I’ll spare you the details of how that delay unfolded because that was last week’s issue; nothing can be done about it now, and we know they did eventually send the request for preapproval.)
I still have not started treatment. I can start treatment on this coming Friday IF we can get the pharmacy preapproval department at Blue Cross Blue Shield to process the preapproval request by then. We’ve been calling and calling, but we can’t seem to convey any sense of urgency in getting the chemo/immunotherapy regimen preapproval request processed.
I know how much having the right person show some interest can speed things along. If anyone reading this knows someone in the upper echelons of Blue Cross Blue Shield and can ask them to just make a call or send an email just to see if there’s anything that can be done to get someone to put their eyes on my file in time for me to start treatment this Friday, I would be eternally grateful.
Believe me, I feel terrible asking for special treatment. I hate thinking about those who don’t have the resources or support network to even consider making a request like this to speed the process along. But, as I write this, I’m watching my three and a half year old daughter play with play-doh next to me, and my heart breaks at the thought of not using every resource available to me to get better as soon as possible.
Here’s a list of the Blue Cross Blue Shield leadership: https://www.bcbs.com/about-us/leadership. Most, if not all, of these people live and work in Chicago. Is anyone next door neighbors with one of them? Old college buddies? If not them, someone else high up in the BCBS ranks?
Just to be clear, I’m not asking for anyone to pull strings to get treatment approved that shouldn’t or wouldn’t be approved. I just need to know that someone at the insurance company is looking at the request. I just want someone to send an email or make a call to the pharmacy pre-authorization department saying, “Hey, is there any way someone could review this in time for this girl to start treatment on Friday?”
If you know someone who may be able to make this happen, you don’t have to tell me who they are or give me their contact information or anything. Just make sure they know my full name (Camilla Marie Pollock-Flynn). If you need my insurance ID number, email me (cpollockflynn@gmail.com) and I can send it to you.
Thank you, friends. Whether this works or not, thank you for your support, your prayers, your compassion, and your love.
Michael and I have spent the last couple weeks meeting with my oncology teams in Chicago and Texas to get a treatment plan together. We feel incredibly confident in the doctors we are seeing and are grateful that they have taken so much time to educate us on all the different options available … and the other options available if those don’t work … and even more options available if those don’t work... While, of course, I wish that there was just one magic treatment that would cure my cancer immediately, it is at least comforting to know that there are many different things the doctors can try.
Without trying to spell all the specific drug names, I will just summarize and say that the current plan is that I’ll receive a combination of both chemotherapy and immunotherapy treatments simultaneously. I will be getting this treatment from my medical oncologist at University of Chicago, who is amazing. I’ll see him again on Wednesday to finalize this course, and, as long as there are no delays from insurance or anything, I hope to start the chemotherapy and immunotherapy infusions on November 2, 2018.
The treatment will be outpatient, which is a big relief. My chemo/radiation in 2016 had to be done inpatient over 5 consecutive days, and I was dreading doing that again. I don’t know if the side effects of this chemo/immunotherapy combo will be the same, better, or worse than what I had in 2016, but just knowing I can be at home with my family is very comforting.
Many of you have asked what you can do to help, and I don’t really have a good answer to that. I still feel very good, and I want to keep everything as normal as possible for as long as possible. But I promise, as soon as I need help with anything, I will ask for it. We have not set up a meal train schedule yet, but Michael and I will probably do that at some point after treatment starts.
Many of you have also asked how we are doing, and I don’t really have a good answer to that either. It depends on the day, the hour, and sometimes the minute. Is there a word that describes feeling optimism, fear, denial, hope, frustration, faith, anger, and strength all at the same time? If not, someone please make one up.
This waiting period before starting treatment has been difficult, but, on the bright side, it gave Michael and me a chance to do something fun with Mara before everything really begins. A couple weeks ago, we booked a very last minute trip to Orlando and spent three days taking Mara to Disney World. It was a wonderful, happy vacation, and we are grateful to the friends who encouraged us to go. As many of you know, spontaneity is not something Michael and I are known for - we’re both notorious planners! - so this last minute trip was quite out of character but was very, very rewarding. Mara adored the Magic Kingdom, and seeing the wonder on her face as she took in everything around her made Michael and me so incredibly happy. For the days we were there, we didn’t think or talk about treatment. What a gift to be able to forget about cancer for a while.
I will send another update if there are any changes to the treatment plan. Thank you for all your prayers, thoughts, and healing energy. To those of you who are also fighting this battle or another one, know that I share those prayers with you.
Dear friends and family,
We don’t have a ton of news to report, but we wanted to let everyone know that we got the results from my lung biopsy, and the pathologist confirmed what we already suspected - squamous cell carcinoma in the lung. Even though the doctors had told us to expect this result, it is still a blow.
We do not yet know what my treatment course will look like. We are doing our best to speed the process along, but it looks like it will be at least a couple of weeks before we know my treatment options. Coordinating additional CTs, labs, and appointments with the various medical oncologists is proving to be lengthy process.
Thank you again for all your thoughts and prayers.
It occurs to me as I write it that the phrase “thoughts and prayers” is frequently a meaningless platitude, but I assure you - your thoughts and your prayers are not meaningless to me. The fact that so many people are thinking of us is humbling, motivating, and very, very appreciated. Thank you.
Love always,
Camilla
Just a very brief update…. Many people have asked whether I’ve had my lung biopsies yet. We are still waiting, but we now have a date - Monday, October 1st. I have no idea how long it takes to get the results after the biopsies are done, but I think it’ll be a few days for the initial results and longer for a full genetic panel. I appreciate all the messages, information on treatment options, well wishes, and prayers. Keep ‘em coming!
P.S. Special thanks to my friend, Al! I suspect that the biopsy date would be much further out if it weren’t for his help.
It’s been a year since I wrote last, and that year has been really good. I look and feel like myself again. I take care of Mara except when she is in preschool. I feel strong. I’ve gotten somewhat used to not talking. Life has been feeling normal again.
Unfortunately, we got some bad news yesterday, and I’m sorry to say we have another rough period ahead. I’ve been getting PET and CT scans every 3-4 months, and the results have generally been good over the past 18 months, but Michael and I are back at MD Anderson for more scans this week, and my PET and CT scans now show new tumors in my lungs.
I’ll try to get this as accurate as possible. I wasn’t really able to absorb what they were telling us when we got the results. There are 4 new tumors in my lungs - two on each side. Two of the tumors are just under an inch long, and two are just under 2 centimeters. There were always small nodules in my lungs that would show up on the CT exams, but they were tiny and didn’t light up on the PET, so the doctors were always hopeful that those spots were just radiation damage. Now, the spots are much larger, and they light up on the PET, so that’s not good.
We still have to get fine needle biopsies taken, but I asked my doctor what else the masses could be, and the doctor said there’s not much else that they could be. Since they grew since the prior CTs and since they light up on the PET, the doctors seem confident that this is metastasis of my hypopharyngeal cancer.
The biopsies will help us get a genetic breakdown of the tumors, and that might help decide what treatment to pursue. There are several treatment possibilities, and my doctors keep saying they are hopeful. The surgeon who gave us the news is a straight shooter, and we’ve been told that he wouldn’t say he was hopeful if there wasn’t hope, so that’s a good sign. Long story short - we won’t know for sure until after the biopsies, but it’s likely that I’ll either have targeted chemo treatment if there are genetic markers in the tumors that can be targeted or, if not, immunotherapy. I’ll probably need focused radiation once they can get the tumors shrunk down. It doesn’t sound like surgery is a good option, though we’ll continue to ask about it.
This is certainly news we never wanted to get. I’d be lying if I said I wasn’t scared, but I also feel strong and ready to start this fight again. Thank you all for the support, faith, and comfort you give to Michael, Mara, and me and to our family members. Please keep us in your prayers. I’d appreciate if you could all pray for Mara especially. At three, she is old enough to perceive but too young to understand, and that is hard. Thank you in advance.
Love always,
Camilla
Michael and I are back in Chicago after our latest visit to Houston for follow-up treatment at MD Anderson. We were there shortly after Hurricane Harvey, but, fortunately, the hospital appeared to have weathered the storm remarkably well. Its floodgates held, a brave team of doctors and nurses took care of all the patients marooned at the hospital, and, once the surrounding water receded, the hospital was running as usual. It was quite amazing to see. Some of our family-friends in Houston escaped the storm without damage, but others were not so fortunate. I sincerely hope that the rebuilding process will be swift for them, and I know that everyone in the area will lend a helping hand - that’s certainly what we’ve experienced from the Houston community in the time we’ve spent there.
We expected our latest MD Anderson visit to be a whirlwind. The schedule was for back-to-back appointments every day for a week, with a surgery scheduled for Friday, during which some revision work would be done to my airway, and I would hopefully receive a voice prosthesis. Not surprisingly, however, things did not go exactly to plan. (Michael and I are becoming quite used to that!)
On our first night in Houston, I suddenly came down with a stomach flu. We assumed that I had food poisoning because of how quickly it came on, but, after 24 hours, I was only getting worse, and I had developed terrible pain in my lower chest and back. I can handle pain pretty well, so, when I woke Michael up at 2 a.m. on the second night and told him I needed to go the emergency room, he knew I needed to go right then. Unfortunately, it was precisely then that we realized that someone had egged our rental car. (Apparently, we had parked in a neighbor’s spot, and that was their very grown-up way of letting us know that they were not happy about it!) So, we drove to MD Anderson in the middle of the night with egg all over the car, which I found kind of amusing under the circumstances, but which Michael decidedly did not.
To make a long story slightly less long, after a battery of tests, I was admitted to the hospital, where I spent the next four days as an inpatient, with Michael again sleeping in a chair beside my bed. Eventually, I was diagnosed with gallstones, causing a digestive blockage. As a result, my gallbladder needs to be removed. Because the blockage resolved and my elevated liver enzymes and albumin and other digestive goo(?) went back to normal, it was decided that the gallbladder removal could wait until I returned to Chicago (I see a surgeon next week and will probably get the damned thing removed shortly after). The doctors didn’t really explain why I developed gallstones, but I suspect that a combination of the diet changes and medications I’ve had in the past year have been a little difficult for my body to adjust to, and this is its way of rebelling.
Because I was inpatient at the hospital, I was still able to see many of the doctors I had planned on seeing and have many of the same tests I was scheduled to have, although I got to go to them on a stretcher half-drugged on pain meds, which probably made them more bearable now that I think about it. I’m happy to report that my PET and CT scans were overwhelmingly good, and I am still in remission, which is a tremendous relief! I’ll have a repeat CT scan in 3 months and another PET in 6. I also had a good swallow study, so I can continue to eat and drink as I have been. Everyone in my treatment team was happy that I am doing so well at this point, gallstones aside.
My main goal from this Houston trip was to get good PET and CT results, so that helped cushion the blow when we had to make the decision not to get the voice prosthesis (the TEP). The vast majority of laryngectomy patients are able to get a TEP with minimal complications; however, a small number of patients develop strictures in the esophagus following a TEP and have problems with things like leakage and aspiration (food and water being taken into the lungs). In some cases, eating becomes difficult or unsafe. Unfortunately, because of the amount of my esophagus that had to be replaced during the surgery, the location where my cancer was and the resulting placement of the surgical anastomoses, and the fact that I already have stricture even without a TEP, it is even more likely that I would be one of those unfortunate patients who has difficulty eating and drinking safely after the prosthesis is put in.
It seems unfathomable that I am having to decide between eating and speaking, but that is essentially what I find myself having to consider. Over the course of the last 1.5 years, I’ve experienced periods when I haven’t been able to eat and drink, and I’ve experienced not being able to talk. I can say with certainty that my quality of life is much better when I can eat and drink, even if that means I won’t be able to voice with a TEP. So, I don’t plan to get the voice prosthesis in the near future. I remain hopeful that circumstances will change in the future or that the technology will improve, and I might someday be able to get a prosthesis without as much risk of jeopardizing my ability to safely eat, drink, and breathe. In the meantime, I will continue to communicate in other ways.
I did still have the airway revision surgery while I was at MD Anderson, even though the prosthesis placement was nixed. It was a very easy procedure, and I was quickly recovered. Michael and I flew back to Chicago, and I have spent much of the time since hugging Mara as tightly as I can. It is hard to be apart during these Texas trips. It is hard for Michael and me, that is - Mara seems to handle it remarkably well. She spent the week with my parents, and she hasn’t stopped telling us how much fun it was! A big thank you to my mom and dad for adding another huge thing to the list of amazing things they’ve done for us, as well as to Michael’s mom and sister who cared for our pets and home and also stepped in when Nana Sherry and PopPop Jack needed a little break!
As always, I appreciate everything that you all have done for us since my diagnosis in February of 2016. I still have difficulty believing how much my life has changed since then, but I think that someday, when I look back at my life, the great beauty of it will be the love and kindness I received from so many family members, friends, and strangers. Now that I am stronger, I hope to pay it forward to as many people as I can, and I know all of you are continuing to help other people who need it. What an amazing group of people you all are. I am blessed to have you and grateful to know you. Truly.
Getting past the medical details, many of you often ask me, “How are you really doing?” and the honest answer is, “It changes constantly.” However, I have to say that I am doing better than I thought I’d be doing under the circumstances. Not speaking is a constant struggle, but it is not insurmountable. I find myself doing many of the things I would normally do, just in a different way. The game has certainly changed, but it is not over, and I will never stop feeling happy about that. Mara continues to be a constant source of joy and laughter and love. Michael continues to be my greatest friend and champion. Family and friends continue to give us more love and support than we could ever repay. And the Notre Dame football team continues to win. What more could we ask for?
Love to you all.
Cam
Yesterday, Camilla and I went to dinner and a movie. If you would have told me six months ago we’d be eating sushi and going to the Wonder Woman movie I would have politely nodded my head but inside, think, I hope so, but it’s doubtful. But there we were, eating, having a quiet conversation and then going to, and staying awake for, an entire movie. Cam ate theater popcorn (which was one of her prerequisites for ever going back to a movie theater - being able to eat popcorn again) and did not want to share it with me, an indicator she is feeling more like herself. It was a great date to share with my wife who has exhibited superhuman strength and resiliency these last 17 months.
Today, we’re celebrating Cam’s 35th birthday. She is currently having afternoon tea with her mom. To say I’m happy is an extreme understatement. There were many times I wondered if Camilla would be able to drink water again, let alone popcorn or tea cakes. I wondered if we’d ever have the banter we’ve shared for 17 years or if she’d have her moxie that made me fall in love with her. I wondered how Mara would react only hearing one parent. I wondered if Cam would want to celebrate birthdays and go out with friends.
I’m proud to say that I don’t need to wonder anymore.
Camilla is able to eat and drink basically whatever she wants. While our method of communication is different since Cam can’t speak, of course, it is still pretty effective and gets better all the time. She has almost weaned off all of her post-surgery medication and is getting her quick wit and humor back in full force. Seeing Cam interact with Mara is one of the best gifts I’ve ever been given (and it’s not even my birthday!). Camilla planned a wonderful, flamingo-themed second birthday lunch for Mara and her two cousins, and we also went to our friends’ son’s fourth birthday party on Mara’s birthday weekend. There was a bounce house (see picture). This past weekend, Camilla, Mara, and I marched in a disability pride parade on Chicago (also pictured below) and made the news. Cam said she wanted to teach Mara about advocacy.
While the road to recovery is a long one, Cam is doing well, despite not being able to speak. Physically, she is almost back to where she was pre-cancer. She recently had surgery to remove the port they used to inject her chemotherapy. She still has a stomach g-tube and we have to wait until the surgeons are confident her new esophagus will remain patent enough for her to get her nutrition and medication orally before they consider removing it. Mentally, the good days are starting to outnumber the bad. Chicago has a ton of activities, especially ones for toddlers. Getting out and just doing things has made a huge difference. Camilla takes Mara to storytime and sing-along at the library. Mara recently finished swim lessons and has music class on Thursdays. We go to the museums and aquarium. We’re planning a camping trip and are daydreaming about a longer cross-country trip, potentially in an RV (I might be dreaming about this more than Camilla). We have a few weddings that we’re excited to attend and catching up with friends that we’ve neglected these past months. I am extremely proud of Camilla and how she is handling this life-changing event. Mara has a hell of a role model in her mother.
I’d like to again take this opportunity to thank the hundreds of people that have helped us during Camilla’s treatment and recovery. I can’t even begin to list everything that the medical teams, friends, family, and complete strangers have done. From the delicious meals, gifts, Amazon wish list items, generous financial support, and just the simple “We’re thinking of you” cards, texts and emails - it has been simply amazing. Thank you all, again. A special thank you to Sherry and Jack; first for giving birth to Cam 35 years ago today, for raising her, for sending her to college at Notre Dame and for allowing me to marry her. More importantly, thanks for just being here and supporting Camilla and me. Thank you for all you have done helping with Mara during this ordeal that I know has been especially tough on the both of you. I will never be able to repay you or anyone else that has been so selfless.
In closing, I want to leave you with an excerpt from a letter a college friend, Chris Manley, wrote to us. Mind you this is one of the most gifted writers I have the pleasure of knowing and he describes Camilla in a way I never could. With his permission I’m using this portion where Chris is describing Camilla to a coworker who he asked to pray for her:
“...she’s even better. Seems to defy all the laws of social physics. The math says you can have a mind that can pass a bar exam, or you can have a personality that lights a room like a fireplace, or you can have great beauty. Maybe you can even have two, given some luck, but not all three. Cam’s got all three, though.”
(Cam blushes every time she hears that. She doesn’t believe it, but I know it is true. Thanks for putting it into words, Chris.)
My wonder woman. Happy Birthday, Love! xoxo
I don’t know why, but I dread writing these website updates. I always feel bad that I don’t have better news to share - I feel like I’m complaining. Then, I overcompensate and try to be cheery in the post, and then I feel dishonest. So, instead of writing, I procrastinate and procrastinate and find a million and one reasons why I shouldn’t update the website. My laptop is dying, the dishwasher needs to be unloaded, Mara woke up from her nap…. I started writing this update on a plane ride to Texas, nearly a month ago, but then I put it away and didn’t come back to it until now. I have to apologize to my mom and dad, because I planned to write website updates about them for mother’s day and father’s day, and I didn’t. You may not realize it, but my mom is still spending nearly all of her time in Chicago helping me, and my father is still traveling back and forth between Chicago and Tennessee so that he can spend time with us and take care of things at home. Their selflessness is beyond compare.
To stop myself from procrastinating any further, I’m just going to keep this website update somewhat brief. Michael and I flew down to Texas earlier this month for follow up appointments. We thought that I was going to receive my voice prosthesis (a piece of plastic called a TEP that will go between my trachea and my esophagus and will make it possible for me to make some noise using my esophagus since my voice box was removed during my laryngectomy in February). I had several tests to see if the TEP is a possibility, and they went well, but ultimately my surgeons decided to wait at least three more months before implanting a TEP. They want to make sure that my esophagus isn’t going to narrow or change shape over the next few months. We go back to Texas in September for more tests. If my esophagus hasn’t narrowed, then they will revisit the idea of implanting a TEP.
I was very disappointed to come home without the prosthesis; however, I am glad that the surgeons didn’t say no entirely. I can wait another few months. It is frustrating not being able to speak, but, overall, I am doing well communicating with the people around me. Mara and Michael understand almost everything I say. My parents and siblings are getting great at sign language, and we communicate with a combination of lip reading and sign language. The hardest thing is going out into the community and trying to communicate with neighbors, baristas, waiters, librarians, etc., but I have a board I write on and most of the exchanges are positive. I’ve had a few people react with disgust and fear to the fact that I cannot talk, and those times hurt more than I can say, but the vast majority of people are ok with it after a little while.
I spend my days taking care of Mara. I’ve thrown myself into the role of homemaker-mom, and I enjoy it more than I expected to, although I miss being a work-outside-the-home-mom too. Both jobs have their pros and cons. Both jobs are a lot of work. Both jobs are rewarding. Mara and I fill our days with yoga, walking, reading, playing, trips to the library, etc. We’ve had wonderful visits from family and friends, and we just spent two days with friends from California who have a child around Mara’s age. Often, life feels very normal. Other times, it hits me how abnormal things are. I can’t speak. Even though I live it on a daily basis, it still feels unimaginable. Nonetheless, we go on. (I often wear a “Nevertheless, she persisted” t-shirt that a friend sent me, and it has become a personal mantra.)
That’s all for now. I wish you all the best and want each and every one of you to know how much you mean to me. You help me persist. Thank you for that.
This update is long overdue, but it has been a strange few months, and I have been a bit unsure of what to write. As you know, in February, I had my laryngectomy surgery. Doctors removed my vocal cords and part of my esophagus and used a section of my right thigh to make a new esophagus. Because of the surgery, I cannot speak, although I am hoping to be a candidate for a prosthetic voice device in a few months.
The surgery was the most difficult thing I have ever experienced - far worse than chemo and radiation last year - and the weeks afterwards were the most difficult weeks of my life so far (hopefully ever). The week I spent in the hospital was especially hard, and even now that I am feeling much better, it is still difficult to think about what it was like. I sat down and wrote some of my memories down, thinking it would be therapeutic (it wasn’t), and now that it is time to write a website update, I can’t bring myself to write about those weeks again. It’s far easier to just post what I’ve already written, even though it is ridiculously long and quite personal.
The link below goes to a post about my surgery with far more information than I’m sure anybody wants, so for those of you who just want to know how I’m doing now, please feel free to just skip it altogether and just scroll down to the paragraphs letting you know how things are going two months after surgery.
But for those of you interested in knowing what I was thinking before, during, and after my surgery, here is essentially a peek into my diary. (If I were a Renaissance poet, I would title it: In Which I Yell at Everyone But Make No Sound.) Enjoy. Or don’t, and just skip down further. Whatever.
I’ve been doing very well recently, despite some dark weeks after my surgery. My mood has lifted significantly, especially since I was cleared to eat and drink again after a swallow test during my last trip to Houston. I had honestly never expected to eat again. Although many people can eat after a laryngectomy, my surgeons had warned me not to get my hopes up because my esophagus was so narrow and damaged, so to be sitting here eating popcorn as I write this is something I still can’t quite wrap my head around. Ok, ok, I’ll be honest. I’m eating popcorn AND ice cream! I couldn’t eat for almost nine months - what do you expect?!
Mara thinks it is hilarious to watch me eat. She was less than a year old when I could last eat food, so I am sure she doesn’t remember ever seeing me eat. At breakfast every morning, I can barely get food on my plate before she’s pointing at the chair next to her and begging me to sit down. Michael and I hear her say, “Mama eat! Mama eat!” at least 10 times a day. It never gets old.
Being able to eat again only reinforces how grateful I am for my medical staff. In the days after my surgery, I treated them horribly, and they couldn’t have been kinder or more professional about it. I had an amazing surgical team and great care afterwards. Of course there were a few exceptions, and there are definitely things that can be improved, but Michael and I have been thrilled with MD Anderson and its staff. We are also still receiving wonderful care from University of Chicago, and I have been nothing but impressed by every doctor, nurse, and therapist I’ve met there.
I had some difficulties in the weeks after my surgery with my liver. My labs were elevated but nothing we did seemed to make any difference. Eventually, I had a liver biopsy, and I am happy to report that we received good results. The biopsy did not find any cancer in my liver, which is a relief. Moreover, it showed signs that the liver was healing on a cellular level, and about a week later, my liver enzymes started to decrease. They are still above normal but seem to be headed in the right direction.
Not everything is back to normal. Obviously, not being able to talk is still a huge life change. I often forget that I have lost my voice and try to talk. Every time this happens, it feels like a punch in the gut. Michael also forgets, and he frequently asks me questions from another room which, obviously, I have no way of answering. More gut punches.
We also get occasional surprises that remind us that things are not yet back to normal. Needing a liver biopsy was one. Another occurred a couple weeks ago when Mara and I were cuddling, and she accidentally knocked my feeding tube out. I had to spend the day in the emergency room and ultimately have a small surgery to insert a new one. Never a dull moment.
Fortunately, Mara seems to be adjusting well, and I have found ways of communicating with her without speech. She picks up sign language faster than I can learn it. Her brain is such a little sponge. She amazes me every day. Lately, she has been making me laugh by making up signs when she doesn’t know them. Someone will ask her what the sign for something is, and she’ll just wave her hands around if she doesn’t know the answer.
Beyond just being a new way for me to communicate, I am finding sign language fascinating. I had no idea of the history behind it, and I assumed it was a form of pantomime, but it really isn’t. I’ve been reading about the history of the deaf community and the formation of sign languages (of which American Sign Language is just one of many). Did you know Alexander Graham Bell was opposed to American Sign Language? He wrote that it was a “calamity” and thought that the deaf would use it to rise up and be insurgent against the United States. It is probably for the best that I can’t talk right now, or else I’d be driving everybody around me nuts telling them about the history of sign language, as I tend to do when I get caught up in a topic.
My energy level is not back to normal. I still have to rest for part of each day, but I am feeling healthier than I have in a long time. I have been doing physical therapy to strengthen my leg (I have a huge scar on my right thigh from where they removed the skin graft for my throat), and while I still have difficulty walking fast or going up and down stairs, I’m much sturdier than I was a few weeks ago.
Enjoying time with Michael, Mara, and our families again is amazing, and we are all very thankful. Michael, Mara, and I had a wonderful Easter weekend with my parents. We took Mara to our neighborhood Easter egg hunt, and we went out for brunch. Sitting at the brunch table with a cup of coffee and a plate of food before me was surreal. I’ll post some pictures below.
Being able to celebrate with my parents and Michael is especially wonderful because they are three people who I know for sure would have laid down in my hospital bed at any point during this past year if it meant that I could get up and be healthy. I will never be able to repay the sacrifices they have made for me. The same is true for my siblings.
My good days are starting to outnumber the bad days, and for that I am grateful. I still get wonderful messages from friends and family around the globe. I am not great about responding - partly because I prefer to spend my “good” moments with Mara rather than at my computer, and partly because of the sheer volume of them. As I write this, I have over 1,700 emails in my inbox. The vast majority of them are junk, to be sure, but it is still going to take me some time to weed through them.
I am sure I have expressed this before, but the generosity you all have shown to us during the past 14 months has been amazing. Truly staggering. It makes me wonder what I could have done for others and failed to do. I wish I had sent notes when I heard that someone was ill, even if I hadn’t spoken to them in years. I wish I had cooked meals for friends going through difficult times. I wish I had run errands for, done chores for, or just sat with someone who needed it. All of these things have been done for me, and I wish I had been doing them first. I can’t tell you what it has meant to me. I can never repay the kindness that has been shown to me, but I will spend the rest of my life trying.
Our next trip to Houston is in June, and I will find out then if I can get the speech prosthesis. A lot of people have great success with it, and a lot of people just have complications from it. Please keep us in your prayers. You are in ours.
It has been three weeks since Camilla’s surgery. We were in the hospital for a week, and we have been back in our Houston apartment since then. The recovery process, needless to say, has been extremely exhausting for Camilla, and she doesn’t have much energy to write yet.
Physically, her surgical sites are healing well. The doctors are pleased with her progress and confident the free flap in her throat is connected properly and chances of rejection or infection get lower each day. She has been using a walker since the surgery to assist with getting around due to the graft site on her right thigh (the graft was 4-5 inches wide and ran from her knee to her hip). I’m happy to say she is now getting around more and more without the walker. This allows her to better keep up with Mara. Her neck incision also looks good, and she is getting used to the physiological changes to breathing through her stoma. On February 24th, a day before the year anniversary of Cam’s initial cancer diagnosis, the surgeon called and said all the final biopsy pathology came back and everything was negative, which is great. The surgeon took more of Cam’s tissue and organs than originally planned, but they wanted to ensure none of the cancer remained. Again, we can call Camilla cancer-free, and we’re very thankful for that!
Emotionally and psychologically the recovery has been much more difficult. The silence from Cam is deafening. We are figuring out ways to communicate but to say it’s been challenging is an understatement. You don’t realize how much verbal communication you use until it is gone. However, we are learning a lot of nonverbal communication. Cam writes and we are learning American Sign Language (ASL). I’m also getting pretty good at reading her lips. Jack, Sherry, Camilla, Mara, and I went to an ASL class at MD Anderson and learned a lot. Mara, obviously, is picking it up the quickest and her vocabulary, both verbal and signing, is very fun to watch expand. The day after the class Sherry mentioned the word “paint” at some point in conversation and Mara made the sign for “pain” (she missed the t) which she just learned the day before. It’s amazing how her little brain learns so much, and she is a ray of sunshine on otherwise dreary days. We’re taking the recovery a day at a time, and I’m confident Cam will adapt and continue to fight as she has this past year.
We are looking forward to coming back to Chicago this Saturday and being home for a few weeks. Camilla and I will go back to Houston at the end of the month for a barium swallow test. This will show how big of a lumen (opening) Cam’s new and existing esophagus have and if drinking and eating will be a possibility. Due to the radiation she received during her initial course of treatment, subsequent stenosis (scarring and closing) of her natural esophagus may prevent her from swallowing again without further medical intervention. We hope that is not the case. It is also the first step in determining the type of prosthesis (transesophageal puncture - TEP) she will get. After that short three day visit we return to Chicago for a few more weeks, then come back again to Houston for the surgical TEP placement and subsequent weekly speech therapy.
We want to thank everyone for all the support you’ve shown this year. I know we’ve said it multiple times, and will continue to, but our family will never be able to repay you for all the random acts of kindness and generosity you have shown. People we have never met gave us nicer equipment for our stay in Houston for Mara then we use at home. Cards and gifts have come from grade school, high school, and college friends we haven’t seen, let alone talked to, in years. There are times when Camilla and I feel that we’re going through this nightmare alone but a quick glance at the growing stack of cards (and empty Amazon boxes) allays that feeling. For that, again, we thank you.
Camilla's surgery completed around 5:00pm today, February 16th.
The surgeons are confident they removed the cancer and were able to get clear margins. They are keeping her sedated and in the ICU tonight.
Her ability to use a speech prosthesis and eat and drink again is unknown at this time. We still have a long road of healing and rehabilitation ahead.
Thanks to all for your prayers, support, and kind words
We have finally made some decisions about our time in Houston. We have decided not to stay in Houston for the entire 4-5 months of treatment because my doctors down there assure us that there will be fairly long stretches during which I’ll just be healing at home. During these weeks, there should be no reason for me to be near the hospital (fingers crossed).
First, we will be leaving for Houston in a week and a half or so and staying there until early March. During that time, I will have the laryngectomy/free flap surgery and immediate post-operative care. I will be in the hospital for part of the time. We have found an apartment near the hospital in a good neighborhood (thanks to many of your suggestions) for my family and for me when I am discharged.
We will return to Chicago for the remainder of March and April, except that Michael and I will need to visit Houston once during this period for a few days for my swallow test. Hopefully I will be cleared to eat and drink following the swallow study.
Then, we will have a final long stay in Houston from mid May to the end of June. During this time, I will receive my speech prosthesis and attend therapy to learn how to use it and care for it.
After that, we may have to make occasional trips to Houston, but they would be brief.
Once again, I appreciate all the information we received from you on Houston. We do plan to take many of you up on your offers to help and will be in touch. Michael and I will update the site if any changes to the plan arise.
I’ll leave it there for now. I am very tired now. The cancer has completely zapped my energy and increased my fatigue and pain substantially. I have also been losing weight again as my body tries (unsuccessfully) to fight the cancer. I am not looking forward to the surgery, and I dread the moment that I wake up from the anesthesia and cannot speak, but it will be nice to get some energy and strength back once the cancer is gone.
As always, I love and appreciate you all. In addition to your prayers for me, please pray for all those who are sick, as I have recently learned of two family friends who are ill as well.
This will be a very short post because I am sure you are all still exhausted from reading the last post, which was extremely long. I just want to let everyone know that my total laryngectomy & free flap surgery is scheduled for February 16, 2017 at MD Anderson Cancer Center in Houston, Texas.
I will have inpatient and outpatient follow up care, swallow studies, a speech prosthesis placement, and speech rehabilitation for approximately five months afterwards, although some weeks within this time period will be just for healing.
Michael and I are still trying to determine whether we should stay in Houston for this entire period, or whether there’d be a benefit to flying back and forth. We are so appreciative of all of the housing information you have sent to us. You are the best support team we could ask for.
I also want to thank you all for the thoughtful notes and generous gifts many of you sent after my last post. I am behind on my thank you emails (as always), but I do appreciate you thinking of us, and I will eventually get emails sent to everyone (although a few gifts were sent anonymously - I am not sure if this was intentional or if Amazon just forgot to include the sender’s name).
Please keep the prayers coming, especially as February 16th approaches. I am doing my best to remain calm and confident leading up to the surgery. I am successful at this about 2% of the time. I do have a new book that someone recommended about how to visualize a healthy surgery and remain calm before and after surgery. I hope it helps.
love you all and am grateful for everyone who reads this.
First and Second and Third and Fourth and Fifth Opinions
University of Chicago
As I mentioned in past updates, my doctors at the University of Chicago have recommended a total laryngectomy with a free flap from the radial forearm or thigh. In other words, my larynx would be removed, including my vocal cords. Much of my pharynx and esophagus, including the cancerous tumor, would be removed. Skin from my arm or leg would be grafted and used to create a new esophagus part. My esophagus and trachea would be completely separate from each other. I would swallow food and liquids with my mouth and esophagus. I would breathe through my trachea out of a stoma in my neck.
I would be unable to speak until a speech prosthesis (a TEP) could be placed. (University of Chicago estimated 3 to 6 months before a TEP could be placed.) Even with the prosthesis, my voice will not be normal. There is a wide spectrum of voice quality with a TEP. Some of the voices I heard were awful. Even the best examples I have heard are deep, gravelly, and somewhat unfeminine. Yet, it is apparently the best technology there is for simulating vocal cords.
After getting University of Chicago’s recommendation, Michael and I visited Memorial Sloan Kettering Cancer Center in New York City and MD Anderson Cancer Center in Houston, Texas. These are consistently ranked as the number 1 and 2 cancer centers in the world. (MD Anderson is #1 and Sloan Kettering is #2.)
MD Anderson Cancer Center - Houston, TX
MD Anderson agreed with the surgeons at University of Chicago, again recommending a total laryngectomy with a free flap. I believe MD Anderson uses the thigh skin for the free flap, rather than the radial forearm. As above, I would not be able to speak until the TEP is placed. I have asked all the surgeons we have talked to whether the TEP could be placed as part of the primary surgery (i.e., at the time of the laryngectomy). There are occasions when the TEP is placed right away, however, even then, the person is not supposed to use the TEP right away. In my case, no one recommends placing the TEP right away, because the free flap has to heal for several months first. If the TEP is in place during this healing process, it could migrate away from the stoma, or end up not properly sized, both of which would affect the quality of the speech. For the best chance of an understandable (and not horrible) voice, the TEP should be placed after the surgical site has healed. Then, the TEP puncture can be properly placed and sized. Fortunately, at MD Anderson, they estimate waiting only 2 to 3 months after surgery to place the TEP. They also estimate that I can begin to start drinking and maybe eating within 6 weeks or so after the laryngectomy. Most laryngectomees - people who have undergone a laryngectomy - can eat and drink afterwards. It takes some time to relearn how to swallow, but they are hopeful that I can do it.
MD Anderson has world-class surgeons. (All the places we have been to do. In fact, many of the surgeons we have met with at other hospitals were trained at MD Anderson). Most importantly, MD Anderson does more laryngectomy procedures every year than the other hospitals combined. University of Chicago performs about 30 per year, and they are not all for cancer patients. Sloan Kettering does about 30 to 40, and the team we spoke to at Mayo does about 20-30 laryngectomy surgeries per year. MD Anderson does over 100 laryngectomy surgeries per year, often with free flaps, and they are nearly all for head and neck cancer patients.
One of the things we really liked about MD Anderson is that the post-surgical team of speech pathologists seems very well trained. They see more laryngectomy patients than any other speech pathologists in the country, and they are involved immediately after the surgery to make sure that everything is being done in order to eventually get the best TEP voice possible. That, to me, was very reassuring. The speech pathologists we met with on our visit showed me videos of their patients speaking with TEPs, and, again while there is a wide spectrum of success, we heard better speech results there than we had heard at University of Chicago. As much as I love my speech pathologist at University of Chicago (I consider her a friend at this point since she has spent so much time with me this year), she simply doesn’t see as many post-laryngectomy TEP patients as the speech people at MD Anderson do.
Memorial Sloan Kettering Cancer Center - NYC, NY and Mayo Clinic in Phoenix, AZ
Sloan Kettering and Mayo both agreed that a total laryngectomy free flap procedure was my best chance for a cure; however, unlike the other two hospitals, the surgeons at Sloan and Mayo offered us a non-laryngectomy option, although they agreed it wasn’t ideal.
My surgeons at Sloan and Mayo said that because the cancerous tumor that has recurred is in the soft tissue and has not yet reached the cartilage of the voicebox, they could attempt to remove just the tumor and soft tissue around it with a laser. While this would leave my vocal cords in place, the damage caused by the laser would likely leave me unable to eat or drink ever again because I would have such a high risk of aspirating the food or liquids into my lungs because the area above my esophagus would have been drastically cut into by the laser. Additionally, I would retain my tracheostomy tube for breathing, and I would only have the voice I have now, which, while it is better than a TEP voice, is not my normal voice. One of the surgeons told me that only one of my vocal cords is moving, and the other is scarred from radiation damage. Additionally, if the laser surgery can’t be done through my mouth, they would have to go in through the side of the neck, which could cause damage to the nerve that goes to the voicebox, so my speech might be affected anyway. Finally, and worst of all, I would have a greater risk of cancer recurrence with this laser surgery because they cannot be sure they will get all of the cancer cells out. (I will always be at increased risk for recurrence of head and neck cancer, not to mention cancers of the nearby areas that were hit by radiation scatter - brain, breasts, lymph nodes, thyroid, etc., but all the doctors are in agreement that a total laryngectomy leaves the lowest risk of this particular cancer I have returning.)
Continue ReadingOther Opinions
While I didn’t speak to them directly, one of my University of Chicago surgeons said she reached out to her previous colleague - a renowned laryngeal surgeon in Boston - as well as friends at Johns Hopkins, and they also agreed that I need a total laryngectomy. My uncle also reached out to a colleague at the National Institutes of Health to get additional information for us.
Finally, I spoke to doctors researching immunotherapy and oncogenic targeted therapies for cancer treatment (much of which is still in the trial stages), and they told me that, unfortunately, neither of these therapies would be recommended as a primary treatment in my case. They are not considered curative, while the total laryngectomy is a good chance for a “cure” (in other words, it leaves the smallest chance for any current cancer cells to be left behind).
The surgeon I spoke to at Mayo has received a lot of press for his research and experiments with larynx transplants and implantation of laryngeal tissue grown from stem cells. Unfortunately, I would not be a candidate for a larynx transplant until I have been in remission from cancer for at least five years. (Not to mention, only a handful of larynx transplants have been performed to date and the results largely remain to be seen.) As for his other trials, they are still in the stage where testing is done on large animals, and they hope to be approved for testing on humans when the large animal trials are complete. (I tried to explain that I would be happy to sit in a room full of large animals and pretend to be one in order to be part of the trial - “I’ll be a goat!” I said - but he wasn't buying it.) It is, however, promising to know that larynx research is going on and that there might be better options for me in the future.
So, that’s what we learned from our travels. Even though we were there for less than 48 hours and spent a long time at the hospital meeting with the Head & Neck Cancer team, the New York City trip was actually kind of fun. We were able to walk around a little (I was only strong enough to walk for a few blocks at a time, but in NYC, you can see a good amount in just a few blocks). We had time to go into St. Patrick’s Cathedral just before heading to the hospital - I’ve been there before, but it has been restored and is more beautiful than ever.
Plus, the surgeon at Sloan Kettering was one of the kindest and funniest people I’ve ever met. He came recommended by a family friend, and I am so grateful I was able to get in to see him.
The best part of the New York trip is that Michael and I had just enough free time to visit the Strand bookstore before heading to the airport to fly home. The Strand is one of my favorite places on earth - it has over 18 miles of books! I only made it through part of the store before it was time to leave, but I loved every minute!
The Houston trip was not nearly as much fun. We stayed near the hospital, but we didn’t have any free time to do anything besides go to the hospital for my appointments. We were at MD Anderson from 8:30 in the morning to almost 6:00 at night, and we flew home early the next day. It was exhausting, physically and emotionally. I will say that it helped that the MD Anderson facility is beautiful. The lobby has several colorful aquariums, which makes it very peaceful. The waiting areas all have racks of books you can read. There is a giant library downstairs for patients and their families. We peeked into the chapel, and it was very calm and beautiful. The surgeon I met with, as well as the rest of the head and neck cancer team I met, were knowledgeable, friendly, and extremely intelligent. Coincidentally, my surgeon was born in Chattanooga, Tennessee, where I was born and raised. We have several mutual family friends. We asked the other hospitals about this surgeon, and he was highly respected and recommended by everyone we spoke to.
Overall, traveling itself was rough. I needed a wheelchair to get through the airports, and I had to bring bags and bags of medical equipment on the flight, all of which security had to go through thoroughly. Gone are the days when Michael and I used to get by with only one carry on bag and no checked luggage.
Decisions
The choices we have are not good ones, and they are not fair. I am very disappointed that I only have surgical options left and that neither of the surgical options leaves me with full abilities and a guarantee for a good quality of life. I don’t want to choose either option, but, of course, I can’t give up. I want to be here with the people I love, so I have to make a choice and make the best of the outcome.
After going over and over our options, Michael and I have decided to have the total laryngectomy with free flap surgery performed at MD Anderson in Houston. We don’t have a surgery date yet, but we assume it will be in February.
Because the surgery will be in Houston, we will have to spend a significant length of time down there. We have not figured out the schedule yet, but we will need to be there for at least 2 weeks for the surgery itself. I will be in the hospital for those weeks. I will then be discharged from the hospital, but will have to return several times over the weeks after that for follow-up appointments with my surgeons. At some point during those follow-ups, they will hopefully tell me that I can start trying to eat again (probably just liquids at first), and I will need to be in Houston for that process. Ideally, the TEP will be placed 2-3 months after surgery, and I will need to be in Houston for that procedure and for the follow-up speech therapy afterwards. There may be additional visits that we can’t anticipate at this point. We have not decided whether to try and stay in Houston for several months, or whether to try and travel back and forth from Chicago to Houston.
As soon as we know the surgery date, we will start to make some of these decisions. However, in the meantime, if you, or anyone you know, has an apartment or home in Houston - preferably near MD Anderson - that they are not using, we would love to discuss renting it from them! (Along those same lines, I have updated my Amazon wish list, but I should also mention that we have shared with Adam Dell some of our upcoming needs for travel, surgery and post-surgery period, and some insurance changes we will have to make. If you are interested, please contact Adam by clicking here, and he can let you know what help is needed.)
Everyday Life
Our days are up and down as we wait for the surgery. Sometimes I feel energized and am able to care for Mara or run errands with Mara and Michael and my parents. Those days are less frequent than they used to be, unfortunately. Since the cancer has returned, I have lost a lot of energy. I am exhausted much of the time. We live above a restaurant and I tried to sit with Mara and Michael last night while they ate dinner there, and I was literally falling asleep at the table. I’d be watching them eat and having a conversation, and then, all the sudden, my eyes would close and my head would flop forward. I’d force myself to wake up and then the whole process would begin again. In addition to the fatigue, I’m still losing weight even though I’m putting as much liquid ‘food’ through my g-tube as I am supposed to. I also have noticed my pain is increasing, even in new areas, like the joints of my hands and feet. I continue to battle infections involving my breathing, and antibiotics are not helping. Clearly, my body is trying to alert me to the fact that I have cancer.
Fortunately, Michael and my parents and my sister-in-law are always on call to help with Mara when I’m having a bad day. She is a happy child and loves to snuggle with me. She loves playing with her toys, reading books, and taking baths. Her vocabulary is growing every day. She is learning sign language with me, so that I can communicate with her until the TEP works (or in case it doesn’t).
Until the surgery, I plan on spending as much time as possible recording messages and words on the computer. That way, I can use an electronic assistive device (the type of thing patients with ALS often use when their voice fails) to “speak” through a tablet. We found a website that creates a simulated voice that is supposed to be close to your voice (although it still sounds robotic to me), and I can record other messages and words in the voice I have now and then play them after the surgery. Ideally, I would like to spend some time recording stories and songs for Mara. It has been hard to find time to do these recordings because I only have a short window every day when my voice is strong enough to make a recording. Also, I find the process very overwhelming and triggering. Often, I start crying at the thought of making a recording. When that happens, I tend to just quit, but now that we have the surgery looming on the horizon, it is time to buckle down and get these recordings made. I know I will regret it if I don’t.
As I mentioned, we are all trying to learn basic sign language because that could come in handy, especially when communicating with Mara. So far, I’d say we have about 20 signs memorized, but it is slow-going. Like with the recording, studying sign language also reminds me of the looming surgery, which makes me start to panic.
Coping
The stress of the upcoming laryngectomy is like nothing I’ve ever experienced before. I need medication to sleep at night, and even that sometimes doesn’t work. I have panic attacks. Just the other day, I noticed I’ve developed a tremor in my hands - it hasn’t gone away.
At least once a day, I fall completely apart. Michael picks me up and pieces me back together, over and over again, never losing patience. Once I am gathered up, Mara holds me there.
The other day, Mara saw that I was starting to cry when I was talking to my grandmother on the phone, and Mara came over to me and gave me a big kiss on the face to make me smile. When she sees me upset - which happens occasionally, even though I try to shield her from the anxiety as much as possible - she makes silly faces to make me laugh again. If she grows up to be a comedian, I think we will know why.
Having my parents nearby to give me hugs and pep talks when I need them, is better than any anxiety medication the doctors could prescribe. Looking forward to visits from my siblings (and sibs-in-law) keeps me smiling and excited for the future.
I don’t want to speak for Michael, but I’m sure you can imagine that he is as anxious and afraid and angry as I am. He does a wonderful job of getting by despite our worries. While my reaction is to curl up in a ball and do nothing, Michael’s instinct is to roll up his sleeves and start working. In between running his company and spending time with Mara, he has completed several home improvement projects. (It’s actually rather handy when he is stressed, if I do say so. A lot gets accomplished!) As I type this, he is simultaneously responding to business emails, calling my medical suppliers, and hanging shelves in our closet. Here he is, rewiring a lamp with Mara watching his every move…
We hope Mara isn’t affected by the stress and anxiety. She seems to be her usual happy self. Even as I typed that, she looked at me and let out a great big belly laugh. One of my biggest concerns is that she will be traumatized by the time we spend apart when I am hospitalized, or by the period when I won’t be able to speak to her, or by all the changes that have happened and will happen, but all the doctors, including her wonderful pediatrician, have assured me that children are more resilient than we expect them to be and that she will adjust rapidly to each change. If only they could reassure me that I will do the same…
My family needs support through this process too, of course. They do their best to hide any worries or anxieties or fears from me, but I know how they must feel, because I know how I’d feel if one of them was ill. They are so supportive and helpful and loving to me, and I just hope they aren’t too stressed or scared by all of this. They’d never let on to me, because they don’t want to upset me, but, again, I can imagine how I’d feel in their shoes. It’s such a blessing, having people who love you so much that they hurt when you hurt, but I hate to think of all my loved ones hurting.
In fact, I’m beginning to crumble, so it is time to step away from this update…. I will write again when we know the surgery date.
Thank you all for sticking with me through this long update (not to mention, this very long year)! February 25, 2017 will be my one year anniversary of getting my cancer diagnosis. Unfortunately, we are looking at another difficult year on the horizon. Please keep the prayers coming. I love you all and pray for you in turn.
Since my last post, we got the biopsy results back, and they were positive. So, the cancer is officially back in my throat. The PET scan did not show any spread of the cancer to other areas of the body, so that is the good news. From what I understand, the tumor is right at the beginning of the esophagus, directly in line with my vocal cords. It is a bad place to develop cancer because your breathing, speaking, and swallowing functions all rely on that area.
My doctors at University of Chicago have recommended a complex surgery to remove the cancer. Unfortunately, they tell me that in order to surgically remove the cancer, my vocal cords would also have to be removed, leaving me unable to speak naturally. The procedure is called a total laryngectomy with a free flap. In short, my larynx would be removed, as would a portion of my esophagus, including the portion with the cancer. My trachea would be moved up and would be attached to a stoma at my neck so that I could breathe. A plastic reconstructive surgeon would then use skin from my forearm or thigh to create a tube, and that would be implanted at the top of the esophagus, where the portion had to be removed. Skin grafting would be done to close the area on my arm or leg where skin had to be removed. The surgery is expected to take eight hours or so. I would remain in the hospital for approximately two weeks afterwards. (For those of you with a medical background, this procedure has been recommended as opposed to a total laryngectomy with a jejunum transplant or a total laryngectomy with a gastric pullup.)
Thinking about the surgery makes me nauseous. I have been having panic attacks and feel just overwhelmingly exhausted. The thought of not being able to speak is horrifying. The hope is that a voice prosthesis (a small plastic piece that fits between the trachea and esophagus) could eventually be implanted after surgery. The prosthesis allows you to talk, but it would not sound like my natural voice. It is an “understandable” voice, but not a pretty one. Even so, the prosthesis could not be implanted for three to six months after the surgery, so I would be unable to make any noise at all for those months. I have purchased several books on sign language, thinking that might be useful, and we are looking into vocal banking, which would record my voice and preserve it digitally. Michael and I are headed to a rehabilitation center today to learn about assistive technologies I might be able to use until I would be able to try the speech prosthesis. Unfortunately, the speech prosthesis does not work for everyone, so there is a chance that the speech loss could be permanent. I am hopeful that that will not happen but can’t help but worry about it.
The thought of not being able to speak to Mara, who is too young to understand why, breaks my heart. I feel it as a physical pain, and it sickens me. I can’t write more, becuase I am getting too upset, but needless to say, it consumes my thoughts. I can’t even begin to contemplate not talking with Michael, my mom and dad, my sister and brother. It is too much.
Even as we try to wrap our heads around this surgical recommendation, Michael and I are pursuing second (and third and fourth…) opinions. We have appointments scheduled at MD Anderson and Sloan Kettering after the beginning of the year. We have also been in contact with a laryngeal surgeon at Mayo, and one of my doctors has reviewed my case with a top vocal surgeon at Mass General. We are sending my records all over the country to see if someone might have a reliable alternative for us. Please, please pray that we find another cure, or, at the very least, that we get confirmation that we are doing the right thing, so that we won’t spend the future second guessing ourselves. I am forever grateful for all our family and friends who helped get us in contact with top medical providers all over the country to review my case.
I don’t really know what else to say at this point, except that this is the lowest point we have been at since the beginning of this entire ordeal. Unfortunately, I expect there will be even lower points going forward. I am finding myself consumed with unproductive and angry thoughts. I am furious that when I was diagnosed with esophageal webbing and Plummer Vinson syndrome years ago, nobody warned me about my increased cancer risk or discussed options for monitoring my throat and esophagus for signs of cancer growth. Resentments like these are not useful or healthy, and I am doing my best to let them go, but it is hard.
Please keep us in your prayers. Please be there for Michael, Mara, and my family who are suffering through this with me.
Despite this news, we are doing our best to have a happy, but quiet, Christmas for Mara. Thanks to Maura and Adam Dell who decorated a tree for us. Mara loves it.
This won’t be a very long update because I’m too tired to write much and because I haven’t really begun to mentally process the information we have been given. We had a wonderful Thanksgiving with family (I hope to write more about that later, because it was really a fun weekend), but after the holiday, I was extremely tired and felt very sick. At first, we thought I had just overdone it celebrating Thanksgiving, but it didn’t go away. Then, we thought I was just fighting off an infection, so my doctors put me on antibiotics and antifungal medications. I was still tired and was starting to lose weight again. I went to see one of my surgeons, and she looked down my throat with a camera and saw three spots that she wanted to biopsy. Last Wednesday, I went into the hospital for the biopsy procedure, and during that surgery, they found a 2 centimeter tumor in the same location where my cancer was originally found. We are still waiting on the biopsy results, but the doctors have indicated that those are mainly a formality. Most likely, my cancer has returned. I’ve already had a CT scan, and I am having a PET scan in a couple days to determine whether the cancer has spread to anywhere else.
I don’t really know what else to say at this point. Obviously, this is terrible news, and we are having a rough time with it. We haven’t made any treatment decisions yet, but we do know that the treatment options will be more limited this time around and that the most effective treatment might be the drastic laryngectomy surgery I had been hoping to avoid. Over the next couple of weeks, we hope to find out more about the options available to us and start making some treatment decisions. Clearly, this is not how we hoped to be spending our Christmas holiday.
We will try to keep everyone informed when we know more. Once again, we will need all your support and prayers. Thank you for everything you have done for us. My apologies to those of you who have reached out to me or sent me something over the last few weeks - I have not had the energy to keep up with everything. I do appreciate you all, and you have helped keep my spirits up.
Here’s a picture of Michael, Mara, and me from Thanksgiving weekend. Mara is as happy and bubbly as ever, and she is keeping us smiling and laughing. We love her beyond measure.
After my unexpected tracheotomy, I spent six days in the hospital. Just like when I was getting chemotherapy, Michael didn’t leave my side, spending his nights on a couch in my hospital room. He even ate hospital food for most of his meals so that he didn’t have to leave me to go get food. My mother stayed with Mara at our home, and my sister flew to Chicago to help. I can never thank them all enough.
For much of the time in the hospital, I had no voice at all and had to communicate by writing everything down, signing/pantomiming, or pointing to symbols on a picture board. It was extremely frustrating, and I did not handle it well at all. I was quite a little beast to my nurses and doctors, but they took good care of me nonetheless.
It was very difficult getting used to the tracheotomy tube during the hospital stay. Physically, the trach was painful for several days, and there were several times where I felt like I couldn’t breathe through it, which was very scary. As bad as those first few days were physically, the emotional toll was worse. It was (and still is) hard to contemplate having to breathe through a trach going forward. My doctors say I will need the trach for at least six months to a year, and possibly forever. To be honest, I cried buckets of tears for much of the time I was in the hospital. I was miserable and angry and defeated. My voice started to come back on the last day of my hospital stay, but it was very gurgly and robotic, and it didn’t sound like me at all. Rather than making things better, that made me feel worse.
Even after I was released, I remained miserable and weepy for my first few days at home. I absolutely fell apart the first time I tried to take a shower with the trach (which is quite an ordeal, involving wearing a plastic neck wrap to prevent water from going into the airway). I was sobbing when I saw Mara for the first time after arriving home from the hospital. Seeing me so upset scared her and made her cry, which only made me cry more. I can’t begin to explain how difficult it is to think that Mara may not ever remember me without a trach or that she may not remember what my normal voice sounded like. Thoughts like these made me want to curl up in bed, and I spent a couple days doing just that, ignoring all the kind emails and text messages I was receiving. I played with Mara but did little else. Michael, my mom, and my dad took care of me, but I was pretty inconsolable. I couldn’t even write a website update, because all I could think to say was how horrible everything was.
After several miserable days and sleepless nights, I finally realized that if I have to have this trach in for a long time, I don’t want to spend that entire time unhappy. I hate having a trach, and I will always hate it, but I REFUSE to let it ruin my life. I may not be able to do the things I used to do, but I realize that things could be worse, and I am determined to be positive and enjoy myself despite this damn breathing tube. Instead of being upset with the way things are, I am trying to be grateful for everything I have. I read some stories online about parents whose children have trach tubes, and I realized how lucky I am that I am going through this myself rather than watching Mara go through it. I also realized what a baby I was being - there are children that deal with this everyday, and they still lead happy and joyful lives.
Things have been much better since I decided not to be miserable. Rather than rely on Michael to perform all my trach care, I’ve learned how to do it myself. (It’s a lot of work. Our bedroom is now filled with even more medical equipment than we already had. I have to use a nebulizer, humidifier, and suction machine, as well as cleaners, replacement trach parts, filters, etc. That alone was overwhelming at first.) I’ve figured out how to cover my trach with a scarf and still breathe. I’ve gotten much better at speaking with the trach in, and my voice doesn’t sound completely normal, but it is stronger than I expected it to be. I’ve spent lots of time with Mara and have figured out how to interact with her without damaging any of the various tubes on my body. Fortunately, she doesn’t care about the trach at all. For the first couple of days, she looked at me a little funny when I tried to talk, but now she doesn’t even seem to think anything of it. In fact, she thinks it is quite funny to hear me cough now, and she loves when I make a whistling noise through the trach (a sound which was making me sob when I was in the hospital a couple weeks ago).
I’ve left the house on brief errands when I can, and I am getting used to interacting with people even though I have the trach (not to mention that I again have the nasogastric tube taped to my face, which always garners some second glances and, often, blatant stares). With a scarf wrapped around my neck, most people don’t even see the trach. When I talk, I have to cover the trach tube with one of my fingers, so that makes it more obvious, but I’ve decided that I’m not going to be embarrassed by it (easier said than done, but I’m determined). I’m hopeful that when Mara gets older, she won’t be embarrassed by it either. We have a book that helps explain to kids what a tracheotomy is and why someone needs a tracheostomy tube, and I hope that helps her, and eventually her friends and classmates, understand it. That is not to say that I have lost hope that the trach tube can come out in a year or so…. I’m just preparing myself for having it for the long term so that I can be pleasantly surprised if I get to have it removed sooner!
When Michael and I were first married, we used to joke that our family motto was, “Good enough!” When we missed our flight to our honeymoon destination, Curacao, and ended up in Miami for a night, we shrugged and said, “Oh well, good enough.” When our home was messy or our dinner consisted of cheese and crackers because we hadn’t made it to the grocery store in a while, we’d say, “It’s good enough!” I had forgotten this for a while, but I remembered it lately and realized I need to take the same attitude with things right now. My life may not be what I expected it to be, but it is more than good enough. I know that no one would ever wish for a tracheotomy, and I certainly wish I hadn’t needed one, but my cancer is gone, and that is good enough. I don’t have the career I once had, and I don’t look or feel like I used to, but Michael loves me, Mara is happy and healthy, and I have the best family and extended family on this planet, and that is definitely more than good enough! I still can’t eat or drink, and I still have to have surgeries every few weeks to try to stretch my esophagus and recover my ability to swallow, but my throat is hurting less than it used to and I might be able to eat or drink again soon, and that is good enough for now.
This post is longer than I anticipated, so I’ll wrap it up, but I do want to say that I was especially thankful last night that I’ve decided to try to be happy despite everything that has happened. It was Halloween, and Michael, my mom, and I took Mara trick-or-treating. I only had the energy to go to a few houses, but it was the most fun I’ve had in months. Mara loved it, and she spent the whole time smiling at all the other children in their costumes. She’s never had candy and didn’t understand what people were handing her, but she loved going up to people’s doors and saying “Eat!” (the only part of ‘Trick or Treat!’ she can say)! Below are some pictures. In an effort to teach Mara about strong women - and because I sometimes need a reminder - she and I both dressed as Rosie the Riveter! We can do it!
I’ll try to write again soon. In the meantime, please continue to keep us in your thoughts and prayers. I am grateful for you all.
We can’t seem to catch much of a break when it comes to my health. While we were still celebrating our wonderful news with the biopsy results last week, I had a huge setback yesterday. I went in for surgery to expand my esophagus, and during the surgery, the doctors looked at my airway and found it to be almost completely scarred shut. I knew I was having airway issues (hence my ambulance ride to the ER last week when I couldn’t breathe), but we didn’t realize that it had deteriorated so much. During the surgery, my ENT surgeon left the room and went to meet with Michael to get permission to do a tracheotomy on me. He explained that, without a trach, my airway could completely shut, and I’d be at risk for a brain injury from oxygen loss. Michael gave them permission for the trach, and it was all explained to me when I woke up a few hours later. I don’t envy Michael having to make that decision, and I am proud of him for facing such a difficult situation. When I woke up, I told him I thought he had made the right decision, even though it is not something either of us wanted. Two of the doctors told me that they were surprised I was able to breath before the surgery because of the amount of radiation damage to my airway and vocal cords, so I guess it did need to be done.
Now I have a tube coming out of the front of my throat that I use to breathe. I can’t talk at all because air can’t go past my vocal cords right now, but I will get a smaller trach tube later this week, and the doctors are hopeful that I’ll be able to speak again after that. (Although, we met with a vocal specialist this morning, and she explained that my voice will likely never be very strong again because of the post-radiation scarring.)
Naturally, I am upset by these developments. The past 24 hours have been very rough as I try to adjust to the trach. I’m also very upset that I have to stay in the hospital for at least five days instead of just one night, which is what I expected going into the surgery. I miss Mara so much it hurts to think about. Poor Michael can’t leave my side because I’ve been having many issues with the trach so far, so he is also missing Mara terribly. We are thankful that my mom is able to watch her and other family members are able to help out with her periodically. It is comforting to know she is in good hands.
The good news from the surgery is that they were able to dilate my esophagus quite successfully and insert a new naso-gastric tube as planned, but that is bittersweet given that I also had to have the tracheotomy.
At this point, we know I will need to have the tracheotomy tube in for several months at least. There is a chance that it will be permanent if my airway continues to grow scar tissue or if it can’t be re-opened from where it is now. Doctors expect that I will continue to develop radiation damage over the next couple of months, so we can only hope and pray that the deterioration doesn’t get much worse during that time. At the end of that period, we’ll re-assess what can be done for my airway and voice. During that period, I will likely still have procedures on my esophagus, but we don’t have a schedule for that yet because the priority is me getting used to the trach first.
I don’t know why these things keep happening. Everytime I think we’ve had as much as we can endure, something else gets thrown at us. Michael and I are reeling at this latest setback and at the thought that the trach could be permanent, and I know my family is having a difficult time with the news too. We are all very scared for the future right now. I ask each of you to continue to keep us in your prayers. I can’t tell you how disappointing it is to send this bad news so shortly after the good news last week. We are getting tired of all these ups and downs, as I’m sure you can imagine.
I have WONDERFUL news! I’m still in shock writing this. As you know, two weeks ago, I got the news that I had a positive biopsy again and that doctors were recommending a drastic surgery, which entailed removing my vocal cords and esophagus. Michael and I were devastated and immediately started looking for other treatment options. We also insisted on additional testing, including repeat biopsies, to confirm the diagnosis and determine where the cancer was exactly. Last week, I had a PET scan, a CT scan, and a surgery to take additional biopsies. I am THRILLED to report that the PET scan and CT scan both came back completely clear. There were no tumors or metastasis shown on either scan. Even better, I received a phone call from my ENT doctor today, and he said that the repeat biopsies showed NO cancer. Instead, the biopsy results were consistent with post-radiation tissue changes. He said that the pathologist who reviewed the positive biopsy from two weeks ago even went back and re-analyzed that biopsy, and now they don’t think that initial biopsy showed active cancer cells either. While they are going to “watch me like a hawk” going forward, I am cancer-free once again!
To say this process has been a roller coaster would be putting it mildly. The truth is these past two weeks have been some of the worst days of our lives. Trying to contemplate life without vocal cords has been so difficult, and Michael and I had some very hard meetings with surgeons finding out what the laryngectomy and gastric pull-up surgeries would entail. We have been agonizing over where to go for second opinions. Fortunately, with these new biopsy results, I do not need these drastic surgeries after all! The thought of not being able to talk to Mara, and her not being able to understand why, still makes me feel nauseous. I feel so grateful for these new biopsy results.
This feels like a miracle. If it’s not a miracle, it’s the closest I’m ever going to come to a miracle! I am overwhelmed by this good news and feel unworthy - but so, so grateful - for God’s intervention into my life. Thank you to everyone who sent your prayers, love, and thoughts. I truly believe you made this happen.
I still have a long way to go until I am healthy, but it is a much easier path than I would have had if we had gotten bad news this week. In the last couple weeks, I have stopped being able to swallow anything, even water. Next week, I will have surgery to open my esophagus in the hope that I will regain the ability to swallow. Unfortunately, in order to keep the esophagus open, the doctors will have to re-insert a naso-gastric tube like the one they took out a couple months ago. I am disappointed to have the tube back because it makes it more difficult to get close to Mara and because it increases my pain and nausea, but it is much, much better than the surgeries I thought I’d be having, so I am just grateful for that. I will have to have multiple surgeries for the esophagus, but we are not sure of the schedule yet. I do know that I’ll have to spend at least one night in the hospital after each procedure. Last week, they let me go home after the surgery to take biopsies, but I had swelling in my airway from being intubated. I woke up the next morning with my airway closing. My oxygen saturation dropped into the mid 80s. Michael had to call 911 and an ambulance had to take me to the hospital. Luckily, Michael and my mom were both home with me when it happened, and they both remained very calm. (I did not.) The firemen and EMTs who responded were able to stabilize me and get me breathing normally again. I spent the night in the ICU and was released the next day. In case my airway swells again, they will keep me in the hospital after each procedure for observation going forward.
I don’t know what else to say except that I am so grateful for all the kind messages of encouragement and help we received over the past couple weeks. Thank you to everyone who suggested a doctor or hospital for a second opinion. Thank you to everyone who prayed for me. I could not have imagined a better outcome. I hope to continue to only have good news for everyone going forward. I love you all.
Family and friends, This is an update I hoped I'd never have to write. During my bi-weekly EGD procedures, the doctor takes random biopsies. Unfortunately, we received word that my biopsy results from last week showed invasive squamous cancer cells in my upper cervical esophagus. This is the area just below the pharynx, where cancer was initially found last February.
At this point, we don’t know what the next step will be. Michael and I met with a surgeon who described a very drastic surgical option to us, but it would be a very poor quality of life afterwards, and therefore is not really an option. The rest of our oncology team meets Thursday morning to discuss the case and to discuss other options. We hope to have other options (like immunotherapy, more chemotherapy, more radiation…) presented to us after that meeting
We are also in the process of contacting doctors at other hospitals all over the country to get second and third and fourth opinions. We are looking for non-surgical medical options, experimental treatment, or non-drastic surgical options. We are open to recommendations if you have any and are already following up on a few leads from friends and family members.
Needless to say, Michael and I are devastated by this news. We are taking turns falling apart. Luckily, Mara is unaware and remains her happy self. She brings us great joy.
So that this post isn’t all bad news, I want to let everyone know that Michael & I found a new condo just three blocks from where we live now. Since we thought we were done with the upheaval of treatment and could start to return to a somewhat normal life, we wanted a place where Mara would have more room to run around, where Michael could have a better office, and where our house guests could finally have better accommodations than our couch. In a strange turn of events, we received the phone call telling us that my cancer had returned exactly 9 minutes after we finalized the deal on the new condo. Such is life. We’re not sure when we’ll be moving, but we’ll keep everyone posted on the transition, and we are excited about the new place.
Thank you in advance for your support, love, and prayers during this very, very difficult time.
I had yet another surgical procedure this week, and it went fine. I had some minor complications the next day when my airway started to swell, but it was fine after an evening in the ER and some steroids. That’s not really why I’m writing. I’m writing because this week my grandfather passed away. I’m not sure if this is the right forum for this, but I tend to need to write to organize my thoughts, so here goes.
My whole life, Popi lived just a few miles away from my childhood home. When I was young, we spent almost every Sunday morning with him and my grandmother at church and then brunch, and almost every Sunday evening we went to their house for dinner. I can’t tell you how many memories I have of my grandparents from those times together. At Sunday brunch, he always let us eat the praline buns that were served before the meal, even when our parents would have said no. He also used to sneak us chocolate sodas and fruit flavored gum whenever we wanted. He shared our childhood sweet tooth. He introduced me to Newman’s Own salad dressing, Dean Martin and Tony Bennett music, and the joy of watching hummingbird feeders on the patio. For the rest of my life, whenever I smell steak grilling, I will be transported back to his kitchen and those Sunday dinners.
We had almost every birthday party at Popi’s pool, and he always made sure to buy the most wild and large pool floats for us to play with. He had these two statues of Greek gods by the side of his pool, and I remember always being petrified that the statues were going to fall on us when we swam past them.
Popi loved new technology and filled his home with all sorts of gadgets and gizmos. He loved anything electronic; he was the person for whom birthday cards that play music were invented. He had a video phone decades ago even though he only knew one other person with one (his own father), so they could only use it when they called each other. He had a camera that printed 3D pictures that were mind-blowing at the time. He had an automatic soap dispenser in his kitchen years before they ever became the norm in public restrooms. He had an exhaust hood on his stove and curtains in his bedroom that opened at the touch of a button, and, when we were young, he used to pretend he could open them by magic. In fact, he was actually a pretty talented magician and taught me the only card trick I know to this day (and it’s a good one). He was not, however, a very talented physician - Once, in third grade, I had to go to school with hives all over my face because Popi mixed up an aloe vera plant with some other kind of cactus he had growing in his kitchen and put the cactus juice on my face to help with a sunburn. Turns out not all cacti are therapeutic! We learned that the hard way.
Popi had a flair for the dramatic. When he remodeled his house, he put in the largest shower that, still to this day, I have ever seen. We used to put on bathing suits and go over and run around in it. When we got bored with that, we could always go downstairs and play golf with the putting hole he had cut into his basement floor. He wanted his home to be fun.
Popi was a shrewd and savvy businessman, and, although he retired when I was still very young, he loved to tell us stories of his time in the glass business and the movie business and to show us mementos from those years. When my dad and his siblings were growing up, they alternated time between New York and California for Popi’s jobs. His claim to fame was discovering the soundtrack that became the movie musical, The Wiz. I’m more jealous that he and my grandmother got to go to Monaco when Princess Grace was hosting a movie premiere. After he retired, he had to find ways to stay busy. My favorite project of his was when he stuck straws in his nose and dunked his head into a bucket of plaster and made a model of his own head, which he then hand painted and decorated. To this day, I think that bust is my favorite thing in his house because it shows his sense of humor, originality, and determination.
Popi would have been 91 next month. He lived a long life and was in good health up until the last few years when dementia set in. Like any of us, he was not perfect, but, oh man, did he love us. He was generous beyond measure. I loved visiting him at his winter home in Florida. A few years ago, when the dementia had just begun, Michael and I went down to visit Popi and my step-grandmother, Millie, in Florida. We went to church together and Popi held my hand for most of the mass. It was the sweetest moment.
He loved golf and played as long as he was able. He loved attending mass and went every Sunday until he wasn’t well enough to go anymore. He loved his four children and eight grandchildren. Even when words failed him, he would light up when my dad came into the room. When names failed him, he started calling my father “Big guy!” I have no doubt he would have adored his four great-grandchildren had he gotten the opportunity to know them when he was healthy. I will always be sorry that he never got to meet my Mara.
As he got older, he softened. I loved when he told me how much I looked like my grandmother, Camilla, who died when I was young. It brings some consolation to know that he is reunited with her now. It is also comforting that he is reunited with his brother, Bobby. It hurts to think about how lonely Millie must be without him now. I’m so sad for my father, my aunt Patty, and my uncles Frank and Mike, and for Popi’s sister Penny. Their loss is tremendous. It hurts to think that we won’t be able to visit him anymore. The last time I saw him, we had lunch at his house and spent some time sitting with him, listening to music, going through old records, and playing with his dog. He was happy and smiling the entire time, but he was too ill to say anything to us. Even though he was happy that day, that’s not how I’m going to remember him. I’m going to remember the man who used to entertain us at the kitchen table after Sunday dinner, who let us shoot bb guns in his driveway and chase lizards on his front patio, who came to all of our graduations and holiday meals. I’m going to remember him happy and harsh and witty and original. And I’m going to miss him.
Hug your loved ones a little closer today and tell them that you never want to lose them, not even when they’re 91.
For those of you who want to know more about my grandfather and his very interesting life, here’s a link to his obituary.
I apologize for the delay in updates. Over the last few weeks, I’ve continued to have EGD procedures every other week in the hope that they’ll be able to dilate my narrowed esophagus to a normal size. Unfortunately, there’s still too much damage from the radiation therapy for the doctor to do any dilations during the procedures. I have another procedure on Wednesday, and we’re hopeful that I will have healed enough that they can start dilating. The good news is that they have been able to take biopsies of my esophagus during each procedure, and the biopsy results have all come back normal! That was very reassuring. I’ll keep having the EGD procedures every other week indefinitely. They are hard to recover from because I have to be fully intubated and put under general anesthesia for each one, which makes me feel sick, but at least they’re only every other week.
On the weeks that I don’t have surgery, I go to swallow therapy at the University of Chicago. For those of you interested, they’re using the McNeill Dysphagia Therapy Program, which basically just means I drink a lot of different thicknesses of liquid and swallow about 90 times per session. It’s sort of like exercise for the throat. I have to practice every day using liquids that I thicken with a powder. Thankfully, the program is working so far. I used to aspirate on liquids, which is how I ended up with aspiration pneumonia this summer, but I had a swallow study last week, and I am now able to drink liquids without any aspiration! All summer I was unable to drink anything. Then, I was finally cleared to drink plain water. Finally, I am cleared to drink any liquid I want! So far, I have had a few sips of La Croix, root beer, chicken broth, and miso soup. I tried a milkshake, but I’m still not doing well with thicker liquids. The swallow study also showed that I am still aspirating on food, so I still can’t eat anything, but I am working up to it with therapy. I still get my nutrition through my G-tube and my hydration through my port everyday, so I spend about 10 hours a day hooked up to my IV pole.
I’m in much less pain than I used to be, so I’m weaning off of my pain medications. I had a few rough days of withdrawal symptoms because we tapered the medication a little too quickly, but we made some adjustments, and I am feeling much more stable now.
In other news, our immediate families came into town over Labor Day weekend (my mom was already here of course - she’s been in town since March helping us with Mara), and we had Mara baptised at our church. It was a beautiful ceremony, and Mara was on her best behavior. The priest poured the water over her head, and she looked up at everyone and did her sign language for “More, more!” She loved it.
It was wonderful attending church with our families, but I was sad because I couldn’t take communion (I can’t swallow well enough yet). This morning, I started crying at church when everyone was going up to communion. I didn’t expect that loss to be as hard as it is. Of course, I cry a lot easier nowadays… I got to see several of my coworkers the other night after they finished work, and I teared up after saying goodbye to them. They are wonderful people, and I guess I just miss interacting with them every day. I also tear up every time I think about how kind you all have been to us. I am so thankful for all your messages, visits, gifts, and prayers. I’m thankful that so many of you continue to read this and to follow this long journey we’re on. Not too long ago, an old friend sent me a beautiful crystal for healing. It brought tears to my eyes. People I haven’t seen for years have sent me letters and gifts. I can’t tell you how many letters I have received that start with, “You don’t know me, but…” People I barely know have sent clothes, blankets, books…. These have been lifesavers since most days I am not well enough to get to a store, and I certainly haven’t been worried about shopping for myself! I’m especially thankful to those of you who have continued to provide meals for us. Even though I cannot eat them, it is heartwarming to know that my family is being fed even when I can’t cook for them. From the bottom of my heart, thank you.
I want to thank everyone for their thoughts and prayers this week. They have been a great comfort to me. My surgery this morning is over, and I am home resting in my bed.
In a lot of ways, the surgery went really well. The doctor was able to get a small pediatric “spaghetti” scope through my esophagus which means it didn't close completely during radiation. Since there's an opening, albeit small, the doctor can attempt to widen the esophagus through a series of dilation surgeries over the next couple of months. Unfortunately, he couldn't do any dilations today because my esophagus has several large ulcers from the radiation which need to heal first. These are likely what has been causing me so much pain, especially because they've been constantly rubbed and aggravated by the tube down my nose and throat. That's the best news of all today: they were able to remove my nasogastric tube!!! It already feels like a huge improvement. Most of all, it is wonderful being able to snuggle close to Mara without worrying about her pulling it.
So, the plan for now is to let the ulcers heal and then attempt dilations, beginning in two weeks. It will be quite painful, especially considering I'm already in a lot of pain from today and they didn't even dilate, but there is finally some light at the end of the tunnel. After the pain from the procedures recedes, I can keep working on my swallow, and the hope is I'll eventually be able to eat and drink safely.
I'm sorry I can't better articulate what all your supportive messages, emails, texts, prayers, and thoughts mean to me. I am beyond touched by the outpouring of love and support I have received. I know you will help get me through the next few rough months. Love to all.
This won't be a long post. I just want to let everyone know that on Wednesday of this week, I will undergo the first of three surgical procedures to look at and stretch my esophagus. While I'm glad they'll finally be able to see how much damage the radiation did to my throat and what can be done to fix it, I'm extremely nervous about the procedure. I usually stay pretty calm about medical procedures, but I'm having a lot of anxiety going into this one. I'm asking for your thoughts and prayers on Wednesday. You have given me so much support over the last six months, and your prayers have given me strength. I need them now more than ever. Please keep my family in your thoughts and prayers too, and especially my precious Mara, who is loving all the time she gets to spend with her Daddy and grandmothers.
It has been a while since I wrote to let everyone know how I was doing. I wish I could say I’ve been steadily getting better over the last few weeks, but that’s not really the case. I do have some days (like today) when I don’t feel terrible, but otherwise it has been a difficult summer. Even though the cancer is gone, recovering from the radiation and chemotherapy is proving to be very slow and difficult.
As you know, I lost my voice as a result of the radiation treatment. I’ve been speaking in whispers for the last couple months. Two weeks ago, I saw a voice specialist. He’s not entirely sure why my voice is taking so long to recover, but he did put a scope into my throat and verified that both my vocal chords are moving, which is great news. Since both chords are moving, my voice should eventually recover, although I may end up sounding differently than I did before treatment. Over the last couple of days, my voice has been slightly louder. Today, it was strong enough that I was able to call my sister on the phone and have her be able to hear me. For the past few months, we’ve been relying on FaceTime, and I would have to just nod or shake my head at the camera. Today, when I called her and started talking, she said, “I can hear you!” It was a big moment.
While it has been difficult not being able to talk, it has been even worse not being able to eat or drink. I developed pneumonia a few weeks ago from aspirating when I swallow. A swallow study at that time showed that about 15% of the liquids I consumed were going into my airway because my epiglottis was not closing properly. Since then, I have not been allowed to eat or drink except for the occasional sip of water. I’ve been working with a speech pathologist to try to re-learn how to swallow. I have daily exercises I have to do, and they are very painful since it is painful for me to swallow. Last week, I had a repeat swallow study to see if there was any improvement. Unfortunately, my epiglottis is still not functioning correctly, and it is still not safe for me to eat or drink. On a positive note, there was some improvement in my swallowing - it just still has a ways to go. Hopefully, I’ll continue to improve and will eventually be able to swallow liquids without any aspiration. I’ve been practicing at home with water. I can have 4 to 6 half teaspoons of water a day.
Since I can’t eat or drink really, I’ve been getting all my hydration intravenously and my nutrition through my feeding tube, so I spend many hours of my day hooked up to an IV pole. I have one in my living room and one in my bedroom. I’ve been in a lot of pain, so I’m taking pain medications, which make me sleepy, so I spend much of the day in bed resting. Lately, however, I’ve had a little more energy, and I think this is a good sign. When it is not too hot outside, I try to walk outside in my neighborhood with my mom, Michael, Mara, and our dogs.
Since I have completed treatment and some time has passed, my doctors think it is time to start trying to repair some of the damage to my esophagus from the radiation. On August 24th, I’ll have a surgical endoscopy, and my gastroenterologist will attempt to dilate the narrow areas in my esophagus or the areas with scar tissue. This is a risky procedure because my esophagus is fragile from the radiation, so I am quite nervous and would appreciate your prayers. The doctors think it will ultimately take multiple surgeries, so I’m scheduled for two additional procedures after the one on the 24th.
While I am not looking forward to the surgery, one thing I am happy about is that my doctor is going to try to remove the tube from my nose and throat during the procedure. I’ve had the NG tube in place since March because it was supposed to prevent my esophagus from closing up completely during the radiation treatment. It did what it was supposed to do, and I’m grateful for that, but the tube drives me insane. It is painful and ugly, and it makes it difficult to hold Mara because she just wants to grab the end of it. I will be very happy to see it go. I’ll still have the feeding tube in my stomach, but I can cover that one up. When I’m in public, the nose tube makes it obvious that something is wrong with me. I get lots of stares, especially from little kids. Without the tube, only my haircut will give away that I had cancer. I didn’t lose all my hair, but I lost a lot on the sides and back, and it is growing back in coarse and wiry. I’m definitely going to have a few more months of bad hair days coming up…
I appreciate your continuing thoughts and prayers. I need them now more than ever because this recovery process is rough and I’m finding it very disheartening. I’m not a patient person, and it is frustrating me that I’m not getting better faster. I know, with time, things will go back to normal, but it is painfully slow so far. I miss work and my colleagues. I miss hanging out with friends. I miss my normal life. Michael and my mom are taking great care of me and their patience has not wavered once. Michael still takes me to all of my doctor’s appointments and gives me all of my medications and hydration. My mom has been in Chicago since March taking care of Mara and me. She is amazing. I can’t wait to get better to take away some of their stress and worry.
I love and miss you all!
We received some wonderful and long-awaited news at my doctor’s appointment today. The CT scan I had this weekend shows NO sign of the original cancerous tumor and NO signs of cancer in the lymph nodes. Based on this, I can officially say that I am now cancer-free! I get to wean off a bunch of the medications I am on and know I will slowly start to feel more and more like myself.
That’s not to say I don’t still have a long road to recovery ahead of me. I’m still in a lot of pain, and I still can’t eat or drink. My voice is still a whisper, and I have to meet with a speech pathologist and a voice coach weekly for the next few months. I also have to have a series of surgical procedures to widen my esophagus.
Despite all this, we are thrilled that the chemotherapy and radiation worked to get rid of the cancer, and we are thanking God for these wonderful CT results. During treatment, it was hard at times not to question whether it was working, and there were definitely times when our faith waivered. Today, our prayers were answered. The rest of the recovery process feels very doable since the worst is behind us.
“O Lord my God, I cried out to You, and You healed me.” Psalm 30:2
This is Barb, Camila’s mother-in-law. When I was a child my grandmother taught me to always thank my mother on my birthday for giving me the gift of life. After all she was the one who brought me into this world, who nurtured me and sacrificed for me and loved me unconditionally through thick and thin. And so today, on this first anniversary of the birth of Mara, it seems most fitting that we all stop and honor Camilla, Mara's mother, and reflect on the multitude of ways that she has nurtured, sacrificed and given unconditional, selfless love to her precious and beautiful daughter.
In writing these updates, Cam has reported the details of her treatments in a clinical and at times emotional way but as one who has spent numerous days and nights in the presence of Camilla, Michael and Mara these past months I would like to give you a small glimpse into what kind of mother Cam has been during this difficult journey.
In the first days of her diagnosis when Cam learned she could no longer breastfeed her 7 month old she turned to the Doctors and rather than cry and whine she put on a brave smile and responded "Well, I guess that means 10 points lower on the SATs!". Upon hearing that response the Doctors knew they had a fighter to contend with, and one with a sense of humor! Cam went on to immediately wean her baby, a physically painful process, knowing that it would speed the beginning of her own treatment...in an effort for her to be well as soon as possible and ultimately be an active mother again.
In the next few days, surgeries were scheduled to prepare for treatment with the expectation that Cam would be in the hospital for 72 hours, then home again before her first five day stay in hospital. She kissed her baby goodbye, not knowing those 72 hours would turn into 10 days. Although desperately missing Mara, Cam selflessly chose not to risk bringing the baby to the hospital and exposing her to the dangers there, much less the tease of a short visit followed by another goodbye.
The weeks, during her 3 and 1/2 month treatment, while Cam was home were sometimes hard to watch, as Camilla often had to give over the care of Mara to others. But any time she had the strength Cam was climbing in the playpen with the baby or having Mara sit on her lap despite Mara grabbing at every tube...Cam participated in bath time, and whenever possible she lovingly fed and cuddled with Mara for nighttime feedings. Even when someone else put Mara to bed Cam almost always crept into the nursery just to pat her daughter and place a kiss on her tiny cheek. When Cam was first diagnosed Mara was just beginning to eat solid food and although Cam has been unable to eat much and has battled incredible and debilitating nausea she has still taken an active role in teaching Mara to eat and introduce her to new foods. When it would be much easier to remove herself from the sights, sounds and odors of food, Cam still manages to be part of family mealtimes and even lets Mara shake her food cans and help Daddy fill the IV bags that feed Mommy.
Above all, and in a most amazing way, Camilla has demonstrated her true and selfless love for her daughter through her indomitable spirit and will to beat her disease. For nearly 6 months, Cam has faced each day with a single mission...to get well! There have been no pity parties, no why me's? At least not for more than a few minutes. Sherry made a sign that hangs on the bathroom mirror that reads " This is temporary" . And that is the mantra around here. Camilla has endured so much pain, tough setbacks, and still has a long way to go until she is back to full health. Every Wednesday she pulls herself out of bed, dresses and endures a visit to the lab and to the various doctors that make up her medical team. She kisses Mara goodbye, never sure when she will return, in a few hours or a few days if the lab values or checkup does not go well.
One thing is absolutely for sure....Mara has a mother who loves her beyond any words can describe, who is willing to fight through any pain, to endure any procedure, even to suffer through any separation to insure that there are lots of birthdays to celebrate together in the bright future this very special mother and daughter share.
Thank you Camilla for the gift of Mara. You are a beautiful and inspiring example of a mother's love. Happy First Birthday to Mara!
All my love, Barb
I’m home from the hospital. I went in for a clinical appointment last week and ended up being admitted and diagnosed with aspiration pneumonia. Apparently, I have been aspirating food and liquids when I swallow and that caused pneumonia. I’m not fully recovered, but I am feeling much better, and I’m glad to be home.
Unfortunately, because of the aspiration, it is not safe for me to swallow food or liquids right now. I will be working with a speech pathologist for the next few weeks and will be doing exercises and in a few weeks I can start swallowing small amounts again hopefully.
It’s extremely frustrating to not be able to eat or drink and I’m having a hard time keeping my spirits up. I have a wonderful speech pathologist, and she is optimistic that I can re-learn to swallow over the next few months.
In the meantime, I have my first CT scan this weekend, and we should get the results next week.
In better news, Mara turns one this weekend. I’m going to focus on that and not on what the next few months will look like.
Hi friends and family,
This is Caitlin, Camilla’s younger sister. I’m hijacking the update today. Unfortunately, Camilla is back in the hospital. At her weekly checkup, Camilla’s doctors heard some fluid in her lungs. The X-ray shows she has pneumonia which they are treating with antibiotics. Although we wish she could be home with Mara, hopefully being in the hospital will help her breathe and feel better in general. There are two types of rooms to stay in, and luckily Camilla and Michael got the nicer type in the “new” hospital wing. There’s always a silver lining, as my dad would say!
Because I get this rare opportunity to share with you all, I thought I’d tell you about Cam and Michael and their unbelievable marriage. In their home is a framed quote, a wedding gift from Michael’s sister, Erin. It says,
“Nothing is more practical than finding God, that is, than falling in love in a quite absolute, final way. What you are in love with, what seizes your imagination, will affect everything.
It will decide what will get you out of bed in the morning, what you will do with your evenings, how you will spend your weekends, what you will read, who you know, what breaks your heart, and what amazes you with joy and gratitude.
Fall in love, stay in love, and it will decide everything.”
I can’t even begin to explain what I witnessed while visiting Chicago earlier this month. I slept on the couch (in my mom’s usual spot) to help with Mara for almost a week, so I was able to watch the schedule of a typical day for Cam and Michael (as well as Mom and Mara). The day starts with Michael giving Camilla her medicine, helping her get hooked up to fluids and starting her first can of food (through her stomach tube). He has a cute little white board where he keeps track of the number of cans he has given her throughout the day (she needs 5 a day). The whole day is scheduled around Mara and around Camilla… luckily my mom has Mara down pat, and Michael’s organized, self-made checklist allows him to take care of Camilla.
There are times Cam will just look at him, yet Michael will know what she’s needing or thinking or what’s hurting, and if not, then he has a pretty good idea. The day ends with a 30 minute routine which includes lots of medicines in the G-tube, cleaning the tube, mouthwashes, mouth guards, and finally a sweet foot massage with lotion from Michael. During this time, they chit chat, almost talking in their own language, picking on each other or just giggling.
When I first saw Michael with my sister 15 years ago, I knew they were perfect together. Seeing Michael take care of Camilla, and the unconditional love they have for each other is the best demonstration of marriage. They live their vows fully and with a smile on their faces.
I know that one day this will all be a memory as it is just temporary, but one thing I know will last forever is this type of love. And for all that Michael does, I can’t thank him enough. All of his family and ours are so grateful to him. And for my sister keeping her strong spirit, sense of humor, and still looking oh-so-stylish just to go on walks around the block, we are proud of you. We thank you both for your demonstration of love for Mara and all of us.
Please continue to pray for Camilla’s healing, comfort, strength and more than anything, positive scan results in a few weeks. And for my mom and dad, as well as Kara and Barb who are caring for Mara. Luckily Mara can’t look at ‘Nana Sherry’ without laughing, so that brings a smile to everyone’s face!
Have a happy and safe fourth of July!
I’ll leave you with this… “Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.” ~Philippians 4: 6-7~
Xoxo,
Kiks
These first few days of “recovery” after my chemotherapy and radiation have been agonizing. I’m in a terrible amount of pain from my throat, especially when I eat. I keep trying to eat to keep the mechanical ability to swallow, so the pain keeps coming back. Swallowing is a complex process, and if you don’t practice it often, you lose the ability to do it, so it has been important to me to keep eating no matter how much pain I’m in, but these last few days have been challenging for sure. I had a doctor’s appointment yesterday, and they were able to increase my pain medications, so now I am on higher meds which make me tired and kind of confused-feeling, but they do help manage the pain slightly better. Needless to say, it has been a rough week.
My doctor has started scheduling my follow-up tests which will help determine whether the treatment I just finished worked. My first CT scan will be July 9th, which is sooner than I expected it to be. It is reassuring that they set the first scan so soon, because I think all the inflammation needs to be gone before they can see anything, so I guess they think the inflammation will be resolved by then. After the CT scan, I’ll meet with the otolaryngologist and the medical oncologist to go over the results. I will be having a swallow study in July, and I’m hoping that they can take the tube out of my nose and throat after that appointment. I also will have to meet with the radiation oncologist at some point in July.
They told me yesterday that my feeding tube and port will have to stay in much longer. I won’t be able to get the feeding tube out until I am able to eat on my own for several weeks without needing the tube. That feels impossible right now. In fact, during this pain, it feels impossible that I’ll ever feel better again, but my family is doing a good job of reminding me that this is temporary and that it will go away. It just doesn’t feel like it right now.
Please keep the thoughts and prayers coming. I can use them for sure right now. I am trying to be strong through the pain. I am trying to enjoy my time at home with Mara. She is a wonderful pain relief, and I love watching her play and read. Please pray that the doctors are correct that I am reaching a tipping point and that the pain will start to get better soon. Thank you.
I’ve spent the last week trying to think of the words to describe how Michael has been as a husband and father during this experience, and there just are no words. Michael used to be squeamish around anything medical. He couldn’t stand the sight of a needle and could not discuss any medical procedure. The most medication he handled was an occasional allergy tablet. This afternoon, he gave me 17 different prescription medications through a G tube and removed a needle from my port so that I could take a shower. This was after driving me to my second doctor’s appointment of the week. He did all this without batting an eye.
At the hospital, Michael kept a massive checklist of all my medications, symptoms, vital signs, and lab results. He checked and double-checked what everyone was doing and was my advocate for every procedure. Several times he stopped the wrong medication from being given. Several times he was angry with the care I was receiving. He was demanding and got me what I needed when I was too weak to do much except lie there. He was always on my side.
Michael has shielded me from the outside world and has taken on every burden that he can. He schedules all of my outpatient nurses, keeps track of all of the medications and supplies, deals with the insurance companies and billing matters. Any one of these tasks is demanding and he is handling them all. The other night, I was with Michael at the pharmacy to pick up yet another prescription. Michael knew the names of everyone working behind the counter and questioned them about their recent vacations and weekend plans. At the hospital, he was able to remember an endless stream of nurses and nurse technicians, and he got to know all of them. People would stop by our room to say goodbye to him before leaving for the week.
Several weeks ago, I lost my voice and everyone except Michael has had trouble understanding me. He has been my voice for the last couple months. When I talk, everyone looks at Michael to find out what I said. Most days, it seems he is the only one who can hear me.
Beyond responding admirably to medical aspects of my treatment, Michael has been my constant emotional support. He immediately told me we would take this one day at a time, and he truly has done that. He has not let me get caught in the anxiety that I can feel bubbling up about whether the treatments have worked. He keeps reminding me that we can only take one day at a time and wait for the next result. He keeps pushing me to plan a fun vacation or something to look forward to after this. He reminds me that there will be a day when life will feel normal again, even if it doesn’t feel like it now.
As a father, Michael shines. He has not let this diagnosis change the way he interacts with Mara at all. He sings with Mara, laughs with her, tickles her, plays games with her. Every night he gives her a bath. There is no sadness or sickness allowed and if you saw him interact with her, you would never know that there is anything weighing on his mind. He has made sure Mara’s life has stayed constantly happy no matter what else we are feeling. Watching Michael and Mara together has been the best medicine for me. It’s impossible not to smile watching them together.
I can’t let Father’s Day go past without talking about the support of my dad through this process. Since my diagnosis, my dad has been traveling back and forth from Chicago to Tennessee to help. He must feel like he lives out of a suitcase. On the weeks he is in Chicago, it doesn’t feel like he is here to visit a sick person. He makes it feel like he’s here for a vacation. He is so strong and calm and peaceful that it makes it difficult to even be scared of what we’re going through. He is so certain that the treatment is going to work that it seems impossible that it wouldn’t. My father reminds me to be patient when I am getting impatient for better results, less symptoms, faster healing. He has the most amazing attitude that it has changed mine for the better.
Crazily, Dad was diagnosed with surface melanoma the day after my cancer diagnosis, and he had a surgery to have it removed. Luckily, it was able to all be removed and he does not need any more treatment, but he had to go through it all by himself because all the attention was focused on my treatments. Instead of being able to be taken care of and get pampered, Dad got his face glued shut and came up to Chicago to make endless trips to and from the grocery store for me. Instead of worrying about his own health, he has made it his mission to find foods that I can eat. One of the most frustrating things during treatment has been losing my sense of taste, and dad has taken it upon himself to find foods that I can get any flavor from. He seems to get true joy from finding ways to make me happy. Dad has also become a champion babysitter for Mara. He changes diapers and feeds bottles without being asked, and Mara adores her Papa Jack.
This coming week is what I consider the test week for recovery since we have not been through it before. It is the first week that I get to stay at home and recuperate rather than go back to the hospital and get attacked by another round of chemo/radiation. So far, I have been trying to be as active as possible, and I am feeling better than I have in past weeks, although I am dealing with a lot of pain in my throat. Without the chemotherapy, my nausea is better, and we are thankful for these small mercies. Also, the hair, nail, and taste bud loss should have stopped since there’s no more chemotherapy. Now I just wait for things to come back. I’ll keep everyone posted as I start to feel more strong. I’ve been told not to expect to feel better right away - one of the doctors described it as turning on a dimmer switch rather than switching on a light, so I’m trying to wait patiently for the dimmer switch to come on. Today, I can taste the coffee my mother just brought me, so that feels like a notch on the dimmer.
Well, I’ve completed chemotherapy and radiation. Seven cycles of inpatient therapies, and I have no scheduled hospital visits left. I feel like the treatment has broken me down as much as it can and now I can start the process of building back up to health.
This week in the hospital was very rough and emotional. Because I had a respiratory virus I was confined to my room unless I was going to or from a radiation treatment. Even though that meant only that I couldn’t take my usual two to three walks in the hospital hallways, it felt very restrictive, and I had a constant feeling of claustrophobia. Fortunately, I was blessed with several colleagues visiting me, and I was able to FaceTime with my family a lot, and that made the week bearable. Nonetheless, the confinement was tough and I am glad to be done with it.
Because of all the steroids I’m on, my face has swollen, so my last radiation treatments were my most uncomfortable. The mask I had to wear just barely fit on my head at the end and I think they would have had to make me a new one if treatment had continued any longer. They gave me the mask to take home with me, so now it is hanging like a sculpture in my house. Someday, I’ll figure out how to destroy it or something. Leaving radiation was exciting. I hugged my favorite technician goodbye. If I ever have more kids in the future, I’ll consider naming them after her. She made me feel human during the very scary head radiation sessions and somehow made them bearable. I also said goodbye to several oncology nurses this week who kept me sane and human during this process. Having a good nurse on any given day made all the difference in the world.
The week ended with the staff on the hospital floor singing “For She’s a Jolly Good Fellow” which was very touching. I was also gifted with a beautiful quilt made by a group of volunteers. There is kindness everywhere.
The first day home after treatment has been great. The yucky chemotherapy side effects haven’t set in too much yet, so I have been able to rest and relax without too much discomfort. My wonderful sister is visiting, and she spent the day making baby food for Mara to stock our freezer. My parents are also both in town, and I had a very content day just laying on the couch being close to everyone. It’s lovely to know that, barring the unexpected, I won’t have to leave Mara again for any more hospital admissions.
Mara is eleven months now. She was around seven months when I received my diagnosis. I remember saying to the doctor that I had a seven month old so I couldn’t have cancer. No, thank you. She is standing with assistance and babbling up a storm. Currently, we’re introducing her to a new inflatable bathtub shaped like a duck. She is not a fan. Her life is continuing right alongside all this cancer stuff.
Even though I’m impatient to feel better right away, the doctors have cautioned me that it will take a month or two to start feeling better. As I said, the medicine has broken me down and now I need to build back up to the start. I’m making a list of things I want to do when I feel better. One of the things at the top of my list will be writing thank you notes to so many of you. I received so many gifts and cards from you and I haven’t been able to thank anyone properly. I’ll never be able to thank everyone, especially because many things arrived without saying who sent them. Please know I appreciate everything I received.
I’m thrilled to be finished with radiation and chemotherapy but am anxious for other things to return to normal. For one, I cannot wait to get the tube out of my nose. That will be a big day. That won’t happen for several more weeks. First, I’ll have an EGD and CT scan. I also will have the stomach tube and chest port for several months still. In the meantime, I’m going to enjoy being home recuperating and snuggling with my Mara.
Today is my last day at home before going in for my seventh inpatient stay for Round 7. We had some pretty scary days during my “rest week” between rounds 6 and 7. On Thursday, I started having trouble breathing so we had to go to the emergency room, and I was admitted to the hospital. I was diagnosed with a respiratory virus. After several steroid doses, antibiotics, and nebulizer treatments I am feeling much better. Until the virus was diagnosed, it was frightening and there were some scary talks about having to put in a tracheotomy. Fortunately, I did not need anything as drastic as that. I am thanking God for that. I was discharged on Friday night. I am glad they let me go home last night even though I only have a short stay at home before going back for my scheduled inpatient stay.
Our emergency room trip was scary and even though I was frightened about not being able to breathe well, when we were sent into a treatment room, hospital staff members were wheeling out the body of a fireman draped in an American flag. It immediately put it into perspective that whatever frightening thing we are facing, we are fortunate not to be dealing with the difficult things other people are encountering.
Please keep the prayers coming for a smooth Round 7. This week was a good wake-up call as to how tenuous my health is. I’m lucky not to have picked up any viruses before now, and I’m lucky my treatment will not have to be delayed because of the virus. I just want to get through the last round with no more complications so I can start healing.
Tonight I came home from Round 6 of inpatient chemotherapy and radiation. As planned from the beginning, I will have 7 rounds total, so I only have one round left. The end is finally in sight.
Even though I’m looking forward to Round 7 being completed, I know it will be a while before I really start to heal. I won’t start feeling better as soon as Round 7 is complete because the radiation and chemotherapy have so many side effects. Sometimes it seems like the treatment causes more harm than the disease.
The symptoms and side effects from the chemotherapy and radiation set in during my week at home after each hospitalization Those side effects last several days, so I know even when Round 7 is over I have some rough days ahead. The difference with Round 7 will be that I’ll be allowed to recover from those symptoms and side effects without being bombarded with another round of chemotherapy and radiation. I’ll be allowed to start to heal.
I asked my medical team, and they think I should start feeling better about 3 to 5 weeks after my last treatment date. I’m very much looking forward to that. I can’t wait for the internal and external damage to my throat from radiation to be healed. I also am especially looking forward to my taste buds coming back. I didn’t lose all my hair, but I’m looking forward to regrowth of the hair that I did lose. Other than that, I’ve got some minor side effects I’ll be glad to be rid of and then I’ll be back to normal.
For those of you wondering, I will have CT and PET scans several weeks into my recovery to find out how the treatments affected the cancer. I will not know until those scans whether I am in remission. I know the treatments must have been doing something though. One of my doctors said to me, “If you’re feeling this bad, imagine how your cancer cells must be feeling.” Some days I can swallow easier which makes me think that the medicine is working to shrink the tumor in my throat. Other days it is hard to tell because the inflammation makes it difficult to swallow sometimes.
As I near the end of my inpatient treatments, I want to say again how amazed I have been with the amount of kindness you all have shown me these past months. I have so many people to thank and not a day has gone by that I haven’t been stunned by something someone has done for us. There are some wonderful people in this world, and I am blessed to know you.
Please pray that I have the strength for the last treatment and the weeks of recovery afterwards. I am so glad that the final treatment is around the corner. I’m looking forward to feeling like myself again. I’m looking forward to being a wife and mother and lawyer and sister and daughter and all the other things I was before this began. In the meantime, the battle continues.
I have been trying to write this post for weeks, but the chemotherapy makes it hard to concentrate on anything and puts me in a fog, so I’m going to put this here as is, even though I know there’s more I’d love to say.
When I got diagnosed a family friend who had been through cancer treatment told me that I would see God’s hands at work during treatment. He saw God’s hands through his oncology nurses. I see God’s hands at work through my mom.
I called my mom to tell her about my cancer diagnosis on February 25th. My dad was at a meeting, so mom was alone when she got the news. She didn’t miss a beat. Immediately, she started putting together a list of questions about treatment options. Before I had even processed the diagnosis, mom was already getting helpful information from people familiar with the treatment. To this day, she researches my symptoms and helps me verify that everything will go away.
My dad travels to and from Chicago during my treatments because he still has to go to work, but my mom bought a one way airline ticket to Chicago for March 1st. She has been here ever since. She helped me through my first oncology appointments and learned how we do everything for Mara so that my hospital stays wouldn’t be as disruptive. She’s watched Mara while Michael and I are at the hospital, and on days when Michael can be home, she comes and keeps me company during treatment
Since March 1, my mom has done everything for us. She cooks and cleans and makes baby food. She plays with Mara. She cares for our home, our dogs, us. I cannot even start to list all of the tasks and chores she has taken on. It is hard that I cannot do everything in the “mommy” role that I would be doing if I was healthy, but it makes me so happy to see my mom interact with Mara and sing songs to her and feed and dress her. If I can’t do these things, I’m lucky my mom can.
Most nights my mom sleeps on a sofa to be closer to Mara so she can get up with Mara if she wakes. My mom has not complained once about everything she does for us. Taking care of a 10 month old is exhausting but she laughs and talks with Mara all day long. Mara is so lucky to have Nana Sherry taking care of her. My mom has a wonderful sense of humor and a way of making everything more fun and colorful. She knows every song or story a child would ever want to hear.
Most of all, my mom calms me down when the stress of this process takes over and I get scared. She gives me pep talks and keeps me focusing on the positive. She reminds me this is temporary. She does the same for everyone in my family. She is keeping me sane through this. I keep remembering the Footprints story about Jesus carrying us during hard times, but I keep picturing it as my mom carrying my whole family through this.
Please keep my tremendously strong mother in your prayers. I wish I could think of something people could send to her but she says she doesn’t need anything.
Update from Michael:
I tried to coax Camilla to write an update, but the cumulative effects of the chemo and radiation have made her extremely tired. The doctors also increased her pain medications so that takes its toll. Good news is we're on day 57 of 90. Over halfway! Camilla is very happy to be over the hump. We both know the second half of the marathon won't be easy, but the finish line is in sight.
Despite her lethargy, we were able to take walks around the neighborhood Monday and Tuesday. The blooming flowers, fresh air, and green grass do wonders for all our moods. She is still able to swallow some foods but her voice is gone.
Mara is a constant ray of sunshine. We've been trying new foods and everyone enjoys the funny faces (plain yogurt was a good one) and incessant laughter. We are lucky to have such a happy baby. We have a video of Mara laughing that we watch in the waiting room for radiation and it always makes us smile. Mara wasn't sleeping well for her grandparents, Nana Sherry & Papa Jack, while Camilla and I were in the hospital for round 4, but after returning and Camilla helping to get her to bed, she slept through the night. None of us think that's a coincidence!
We've been asking for prayers and recently found out our requests went right to the top. Camilla's mom has a childhood friend who works at the Vatican. He recently had the opportunity to speak to the Pope and asked him to pray for Cam. The Holy Father asked for Camilla's name and promised a special remembrance. All of your continued prayers and support are really helping Camilla through this fight.
Camilla was going to write something eloquent for Mother's Day and will when she is up for it. In the interim, Happy Mother's Day!
Update from Michael:
Camilla “suggested” I write an update and during her treatment (and really ever since we got married) I understand what “suggested” means and will do as I'm told. I will start with the disclosure that I am not as eloquent a writer as Camilla but I will do my best to convey her status as we wind down our week at home and prepare for round four (I'm not sure if it's just me, but every time I say or write "round x" I hear a bell go of in my head and someone yelling "Fight!")
This week has been the best recovery time to date. We're not sure if it's that the mix of medications is finally right, that all the invasive surgery sites have healed, and/or that they slightly lowered one of her chemo doses during round three (ding!) but we really don't care. Camilla is much more present than the first few rounds. We've been able to walk outside and she is able to sit in Mara's playpen. Mara is consistently saying “Mama” when Cam is around so we're calling that her official first word. As the week has progressed, Camilla’s pain has increased, so we’re figuring out the right balance of pain medications.
Camilla is still able to swallow milk shakes, thin soups, and some cereals which I, and all her doctors, are very pleased with. There is such a complex network of intricate muscles and reflexes that 99% of people (including Camilla and me before all this) take for granted when you chew and swallow and breathe. Camilla has to fight through a lot of pain caused by the radiation to get stuff down but keeping those muscles active is very important for her quality of life after we're through with all this cancer stuff. She has lost her voice and is showing some burns on her neck but that is normal from the radiation. We're developing our own basic sign language and the fact that we've been together almost 16 years means I can usually guess what she wants.
The medications she is on leave her in a fog which is frustrating for her in the moment but might be a blessing long term as she hopefully won't remember all the discomfort and pain she is in. Sherry and I were telling her how much better she seems this round but she said she really doesn't recall the first two so doesn't think she's improving, although she is. Also, because the first two rounds were so tough, it wasn’t too difficult to improve.
Our doctors seem confident the treatment is progressing as expected, and they are very pleased that Camilla is putting on some weight (which they say is an anomaly for the treatment she is going through). I'll take a little credit as I force her to "eat" through her G-tube and offer her ice cream throughout the day.
I'll wrap it up there and reiterate the same thanks Camilla has for the outpouring of support, be it notes, food, visits, gift cards, or purchasing things from the Amazon list, we are completely overwhelmed and thankful for all of you. We are keeping a running list of what people have done and are going to need a bigger notebook. Please continue with the positive thoughts and prayers for Cam as we head in for round 4 Sunday and will leave being over halfway through treatment. Ding, fight!
Hi all,
I’m finished with Round 3 out of 7 of chemo/radiation, and I am home with my family. I’m nearing the halfway point, but the side effects are cumulative, so I’m not feeling great. Michael and Mom say that I’m doing much better than I was when I first came home from Rounds 1 and 2. The chemo messes with my memory, so I’ll have to take their word for it. I’ve got some burns from radiation, but they don’t hurt. My hair is slowly falling out, but I still have a lot more than I expected to this far into treatment. The 6 nausea medicines I’m on work for most of the day. It hurts to swallow because of the radiation, and I’ve lost a couple pounds, so I’ll be working on gaining weight again this week. Bring on the milkshakes.
Round 3 was about passing the time. I got the ok to walk around other hospital floors, and Michael and I found a nice space to play cards and watch the sunset over the skyline.
I’m so glad to be home, and today was a beautiful day in Chicago. We even went outside to take a walk with Mara in the stroller; however, in some ways, it was easier to be sick when it was cold and grey out. I didn’t feel like I was missing as much. Days like today make me miss our normal life. I know we’ll be back to normal in a few months, but it is hard. I let myself feel a little sorry for myself today, but now I’m back to trying to be positive.
One other thing to report this week - I met another patient on my floor named Carmela. In addition to our names being similar, she’s 35 years old, has a similar type of cancer, and she has a 4 month old baby at home. It was a little surreal for both of us to meet someone else who is going through this too. She is further along and is finishing treatment. Please include her in your prayers too.
I really appreciate everyone still thinking of me and praying for me. Please, please keep it up. I need the extra strength you send on days like this when I’m not feeling very strong at all.
Love,
Cam
And just like that, my week at home is drawing to a close. Sunday, I’ll check back in to the hospital for Round 3. I had a rough week off - the chemo and radiation cause me to have a lot of mouth and throat pain, and the fatigue is overwhelming. Michael, my mom, and my mother-in-law have been taking great care of Mara and me. Also, everyone’s been so generous and sending care packages, so I’ve been well equipped with all the gifts.
Michael’s devotion is the stuff of legend. He gives me all of my medicines, hooks up my home hydration every day, feeds me through my feeding tube, and even rubs lotion on my feet before bed every night. Today, he washed my hair for me. I would do the same thing for him if the roles were reversed, of course, but with a lot more complaining and a lot less patience.
Mara is doing well. I love being home with her. I can’t hold her for long, because I have a tube taped to my face that she wants to grab and because I’m pretty weak and tired and she’s getting big, but we sit next to each other, and I feed her pureed foods. She’s learning to stand and loves to move around. She’s a very happy baby and she keeps us all smiling and laughing no matter what. A lot of you have offered to babysit or mentioned that you want to come see her. However, we’re keeping her away from people as much as possible, because, if she gets sick, I won’t be able to be around her. Thank you for being so understanding when we’ve kept visits at bay. Even people who have been dropping off dinner have not been invited in, which feels so rude, but it is what we have to do right now.
The most frustrating thing right now (other than not being able to interact normally with Mara) is eating. I have lots of food cravings (I’m keeping a list), but nothing tastes the way it is supposed to because of the chemo, and I have trouble swallowing because of the radiation. The good news is that the taste buds will come back once the chemo is over, and I basically have a private speech pathologist to help with my swallowing in my sister-in-law, Kara. Michael and my mom are eating well with all the food that people have been sending through the MealTrain site, so thank you!
I’m dreading going back into the hospital, but I’m trying to stay positive despite that. I have lots of books and movies (people have been so generous sending them!) to watch during my stay, and I even pulled out an old needlepoint project to bring. We all laughed a lot when I pulled that out and started working on it. Nine years ago I bought a needlepoint kit to make a Christmas stocking for Michael, and nine years later, I’ve only finished about 4 inches of the stocking. Apparently it takes me getting sick to sit down and actually needlepoint the darn thing.
I don’t know how to thank everyone for your support. So many of you have reached out to me. I’ve heard from people that I’d lost touch with over the years, and I’ve been reminded of how many wonderful people I have in my life. Some of you I haven’t seen since high school or college. Please know that your notes and gifts and messages have brought me to tears. On days when I don’t have a lot of strength, you give me the extra boost I need. No matter how bad this is, it has shown me how great my family, friends, and colleagues are. I love you all.
I’m finished with Cycle 2 of 7. It was a long week in the hospital, but I came home Friday night. I went into Cycle 2 with high spirits, but it dragged on quite a bit, and I’ve lost a lot of my energy. I finally made it through the week though, and I’m thrilled to be home. Michael, Mara, and Mom are taking great care of me at home.
My first few days at home have been rough with symptoms from the chemotherapy and radiation. The fatigue is overwhelming, and my hair has started to fall out, which is hard. I don’t recognize myself in the mirror, so that’s difficult to deal with. It makes it much more real, and I think it is finally starting to sink in that I have cancer. It hasn’t really felt real until recently. Even now, it catches me off guard.
There are 7 rounds total, and I’ve only finished 2, so treatment seems endless right now, but the nurses say that it will go fast. I have good nurses for the most part, and that makes a huge difference.
I can’t think of much else to say today. Part of me wants to wait until I’m in better spirits to write an update, but I’m allowing myself to write during the hard parts too. I miss everyone and thank you all for your continued prayers.
Happy Easter! I had a wonderful morning at home with Mara, Michael, and my parents. We gave Mara her Easter basket, and she ate some peas and carrots (parrots, as my mom calls them).
Then, it was time for Michael and me to head to the hospital to be admitted for Round 2 of chemo/radiation. That’s where I’m writing from now. They just started my chemo, which will stay on until Friday when I get discharged. I get two other types of chemo periodically in between now and then, but I stay hooked up to the primary drug the whole time I’m here. I get radiation therapy one time per day. Sometime I’ll post pictures of the radiation process. It’s crazy. They put me in a giant mask and bolt me to a table.
We’re just sitting here watching basketball. You guys, Notre Dame made it to the Elite 8 (I’m told that’s good). I’m happy for them and all, but I thought everyone was supposed to be praying for me - not for Notre Dame’s basketball team. Lying around with nothing to do during March would be much more enjoyable if I was a bigger basketball fan. I did fill out a bracket. I’m currently 3rd to last in my pool. I picked teams based on which team’s name had the least letters of the word ‘cancer’ in it. It turns out that’s not a great way to do a bracket. I did not think Syracuse would go this far.
Not much else to report. Some parts of the day are awful, other parts are fine. The fatigue and boredom are two of the hardest things, although, as hard things go, that’s not that bad. I spend a lot of time coloring, which is a thing I didn’t expect to say at my age, but it is actually pretty soothing. No need to send more supplies - I have plenty, and they are getting put to good use. On that note, I have been so overwhelmed by how generous so many of you have been. I have wanted for nothing so far. Thank you!
Time for me to go eat. That seems to be how most of these posts end. I wish I had more poignant things to say, especially with it being Easter. Just know that it is not lost on me that this is a season of new life, renewal, and resurrection. I’m finding a lot of comfort in that. I’m finding comfort in prayer. I have no doubt God will get me through this as easily as possible, and this journey is helping me appreciate everything about my normal life. I will be back in that routine soon with a new appreciation for every aspect of it. The things I thought were hard before don’t seem that hard anymore. Seeing some of the people in the hospital has made me realize how lucky I am. Even the hard things I’m dealing with aren’t the worst. Everything is bearable. Someone sent me the poem Invictus (shout out to cousin David!) and the line “My head is bloodied but unbowed” has been in my mind lately. I’m in high spirits and ready for Round 2.
I’ve completed round 1 of chemo/radiation and am home from the hospital! Hooray! I get 9 days at home to recoup and regroup before round 2. I’m dealing with some unpleasant side effects from the chemo, and my bedroom looks like a pharmacy, but who cares? I’m home!!!
Michael and my parents are taking great care of me. Michael slept on a cot by my side every night in the hospital, and he is quickly earning a medical degree with the home health care. (I’m getting home IV fluids through a port, and I have a feeding tube, and Michael has learned to care for both.) It’s almost too bad that there’s already a Saint Michael, because otherwise that title would go to my Michael.
Mara is a delight and is babbling up a storm. Her favorite thing to say is ba-ba-ba, but, occasionally, she sneaks a mama in there! She is loving all the time she is spending with her grandparents, and my mom and dad clearly haven’t forgotten a thing from their days when we were babies.
I’m spending lots of time resting and sitting with Mara while she plays in her playpen, but the days are also busy with mouth exercises, medications, feedings, etc. It is a lot to take in - we had to call the doctor twice before I’d even been home for 24 hours. We are figuring things out as we go, and it often hits me how bizarre the things we are now dealing with are. For instance, last night I had to ask Google if we’re supposed to tip a home healthcare supply delivery man. The things you don’t learn in school….
Today I got my hair cut short to prep for the hair loss that should start in the next week or two. The girl who came to my house to cut it provides that service free of charge for cancer patients. I’m meeting a lot of really good people on this journey.
Please pray that the worst of the chemo symptoms go away.
Xoxo,
Camilla
I had procedures last Thursday to implant a feeding tube and infusion port. They went smoothly. However, I thought I'd only have to stay in the hospital for a night and would get to go home again before starting chemotherapy and radiation. Sadly, I was not able to go home between my procedures and my treatments, so I've been in the hospital since Thursday. Chemotherapy starts tonight and radiation tomorrow (Monday). I should be discharged in 5 days for some much-needed time at home.
These last few days have been some of the hardest of my life and it is scary to know I'm just at the beginning. I'm so thankful for my mom and Michael who have taken wonderful care of Mara and me, not to mention Kara and Tom who have stepped in wholeheartedly. I am also so thankful to have seen so many friends who work at U of C while I have been here. The rest of you have been so kind and generous. I know I have not responded to all the emails, cards, and gifts. Please know they are not going unnoticed. You have all brightened these dark days so many different ways. You have no idea.
I'm trying to find something beautiful everyday. Today the beautiful things were a text message convo with my sister about Harry Potter trivia and watching Michael try to sneak onto the hospital scale without the nurse noticing. (Spoiler alert: he got caught). And, of course, Mara is the most beautiful part of every day. Well, I'm getting emotional and it's time for me to eat some vanilla pudding from my hospital tray, so more news will have to wait until later....
On February 25, 2016, I was diagnosed with cancer of the pharynx, which is an area of the throat above the esophagus. To say that Michael and I were shocked to receive this diagnosis is an understatement, but we’ve adapted over the last few days, and we are very confident and positive as we prepare for me to begin treatment. We have spent the last few days enjoying lots of time with our wonderful daughter, Mara (7.5 months old), and with our fabulous family members.
In the week since my diagnosis, I’ve had several imaging studies to investigate whether the cancer has spread, and I am very happy to report that I have had very good results from these tests. My CT scan and PET scans indicate that the cancer is confined to the throat, which is fantastic news! My doctors do not think the cancer has spread to my lymph nodes or lungs, and I thank God for that. Also, the doctors were originally concerned that the mass could extend down my esophagus, but the PET scan shows that it does not extend as far as they expected. We were all able to breathe a sigh of relief after getting these good scan results this past week.
Continue ReadingMany people have asked what my symptoms were, so here’s a little background: I’ve always had difficulty swallowing food due to esophageal webbing, but just before the holidays, I began choking on food more frequently than usual, and early this year, it became painful to eat and even liquids felt like they were choking me. I went to my gastroenterologist for an endoscopy; however, during the procedure, he identified a mass in my throat. I returned for a surgery the next day, and an ENT was able to biopsy the mass. Unfortunately, the doctor confirmed that it was squamous cell cancer of the pharynx. While the exact cause of my cancer is unknown, the doctors tell me that they suspect that I have a rare condition called Plummer-Vinson Syndrome, which apparently can make a person susceptible to pharynx and esophageal cancers.
I have a wonderful team of doctors at the University of Chicago, and I feel very fortunate to have a top-tier medical center in my backyard. The treatment will be aggressive. Surgery is not an option at this point, because the surgery to remove the tumor would also remove my vocal chords. Instead, I am going to have radiation and chemotherapy, and my doctors seem confident that these treatments, while rough, will work. I have no doubt that I will be healthy again in a few months!
Before chemotherapy and radiation starts, I have to have two feeding tubes and a port placed, so I will be spending time in the hospital this coming week for those procedures. My first chemo/radiation cycle will begin on Sunday, March 13th. I will spend 5 days in the hospital for each cycle, and then I will be home for 9 days before the next cycle begins. I will have 7 cycles of treatment.
I cannot even begin to tell you all how much the outpouring of support over the last few days has meant to Michael and me. Thank you, thank you, thank you. The calls, messages, emails, cards, prayers, and offers to help have made us feel very, very blessed. We have not had a chance to respond to all of you, but please know that we appreciate everything that has been done for us, and it is wonderful to know we are not in this alone.
I’ll be honest - I’m not looking forward to the treatments I’m going to have over the next few months, and I hate the thought of being weak and ill, but I feel incredibly lucky to have Michael, Mara, my wonderful mom and dad, my fantastic siblings, loving in-laws, and all my other family members and friends. I’ve tried to write this paragraph about how important they are to me, but it makes me tear up, so I’ll just say this: I feel loved beyond words.
We will post updates on the website CamillaFlynn.com to let everyone know how treatment is going. (I wanted to buy the domain Camcer.com because I thought it’d be funny, but, strangely enough, someone already owns it.) I think the website will also be a good way for people to know what they can do to help. We have had so many people generously offer their time and care to us. I know we will need help over the next few months, but it is hard to know right now exactly what we’ll need. We appreciate your offers of help so much, and we will let everyone know as soon as we know what kinds of help we need. Knowing that we can reach out to so many people is very comforting.
Finally, I am a firm believer in the power of prayer, so I ask each of you to keep my family and me in your prayers. Thank you all again for your love and support during the next few, challenging months.
Love,
Camilla, Michael, and Mara