Thursday, July 30, 2009

Therapeutic dosage of vitD, vitC and melatonin

Dr Sinclair has increased my vitD dosage to 7,000 IU daily. We are working our way up to 10,000 IU. A vitD deficiency is common in melanoma patients and recent studies have shown that the once recommended 2,000 IU daily dosage is far too little. After a 2 - 3 month period at this new level we expect my blood levels of vitD to be substantially higher. This is a critical element in my fight against cancer as vitD has been proven to slow tumor growth and even reverse malignancies.

Many people who take the levels of vitC that I am taking start seeing adverse reactions. I'll let Google give you examples if you are interested. I am taking about 3,000 mg per day via two drinks broken out at mid morning and mid evening. It is a really good sign that I am not seeing any of these negative side effects as Dr Sinclair mentioned that my body is able to effectively use all of it. It is now safe to add a little bit more vitC to the mixture and slightly increase that dosage as well.

I am now taking 9 mg of melatonin just before bed. I started at 3 mg for a few days and was on the look out for any side effects including morning grogginess (more than normal) or vivid dreams. Sadly, I have not experienced any vivid dreams. However, this is an indication that my body is actually using the melatonin.

We chatted about the study at NCI with Dr Rosenberg. Dr Sinclair then told me about another interesting fact. When Naturopathic Doctors find themselves in a battle with cancer, including a few of his close colleagues in recent years they look at all their options. They are not ruling out chemo or other conventional methods just because they are conventional. This goes inline with my thought process of there being a winning combination between both of the worlds. In "Beating Cancer with Nutrition", author Patrick Quillin talks about using nutrition to boost the immune system and still leveraging modern medicine to rid yourself of the "tumor burden". Sounds logical.

The NCI study is apparently a 3-6 week treatment plan in which patients receive a combination of chemo, immunotherapies as well as this new TIL experimental treatment. Usually chemo is highly toxic when given over a long period of time. Since this treatment is only a few weeks long, the toxicity may be minimal. -- Oh my questions for Dr Rosenberg are building up nicely now.

Friday, July 24, 2009

Bristol-Myers Squibb thinks they have a winner against melanoma

Bristol-Myers Squibb recently purchased Medarex showing that they are willing to gamble billions of dollar on the experimental drug called ipilimumab. Having just concluded final stage clinical trials early results are showing that some people are seeing complete and lasting remissions from this immunotherapy agent. Like other immunotherapies, ipilimumab works with your immune system to help fight off the disease. This particular drug attempts to block the activity of a molecule on your T-cells called CTLA-4 which studies have shown can suppress the immune system's response against melanoma.

"We wouldn't be betting $2.4 billion in cash unless we were optimistic" it would work, said Bristol-Myers Chief Executive James Cornelius

Results from this most recent trial are expected next year. Positive results could lead to FDA approval. The FDA has already designated fast track status for ipilimumab which helped get it quickly through clinical trials.

I am excited to see that there is a lot of buzz about this treatment, but only time will tell what if any effect this drug will have. There was another clinical trial that included this drug along with another immunotherapy agent that was in Phase III study. It had closed just about the time I was diagnosed with Stage IV melanoma. There are currently no other clinical trials that include ipilimumab that I am interested in.

More Information:

Thursday, July 23, 2009

I am HLA-A2 Positive

As it turns out, I am HLA-A2 positive. This has been confirmed by blood work at both UPMC and Johns Hopkins. Being HLA-A2+ is a good thing in this case because researchers have discovered that they can more easily target melanoma cells in these patients with their drugs.

There are a few treatments / studies that are available to me due to this recent discovery. Among them are the new and exciting studies at the National Cancer Institute run by Dr Steven Rosenburg. Dr Sharfman is working on getting my information sent over. I was told to call the NCI after my MRI next Tuesday. The MRI is a prerequisite for the Tumor Infiltrating Lymphocyte (Adoptive Cell Therapy) study. They want to make sure I have no mets to the brain.

Looks like I need to do some more reading and build a new list of questions for when I meet with Dr Rosenburg.

Tuesday, July 21, 2009

Quarterly Teleconference: Update on Immunotherapy of Melanoma

The Melanoma Research Foundation sponsors a quarterly teleconference that brings together advocacy groups, survivors and family member and friends. The guest speaker on this teleconference is Jedd Wolchok, M.D., Ph.D an Assistant Attending Physician at Memorial Sloan-Kettering Cancer Center. Dr. Wolchok's expertise is in the treatment of metastatic melanoma.

You can get more information or download the audio recording of the teleconference from the Melanoma Research Foundation's Website.

I've also provided a summary of the teleconference below. This was to help me ensure that I had an understanding of what was talked about. I decided to share for those who are interested.

The immune system has a role in the treatment of melanoma. Documented cases of "spontaneous remissions" have occurred. They are usually cases of melanoma. This happens when the immune system learns something and can begin to recognize the tumor. There is proof that a cell called a Macrophage can recognize tumors. Immunotherapies are designed based on the idea that the immune system can in fact fight off melanoma cells.

Active immunotherapies like vaccination train the immune system to recognize and target melanoma cells. These drugs are injected with a sole purpose of training the immune system what to look for.

Passive immunotherapies like interferon and interleuken-2 are generalized treatments that merely activate the immune system. In cases with interferon, studies have seen that patients who develop auto immunity were most likely to benefit from the treatment. Auto immunity is a state where your immune system is without prejudice attacking normal cells.

Cancer vaccines are not typically given to those with fast growing advanced melanomas. It takes time for the immune system to build antibodies as a result of the vaccine. In advanced cases, time is a precious resource that must be used wisely. Though some regression has been seen, there are currently no vaccines have been proven to show a prevention of recurrence or long term durability.

The immune system has built in checks and balances that prevent it from attacking normal cells. Since melanoma cells look very similar to melanocytes, it is difficult to get the immune system to recognize the bad cells. Potency of a particular vaccine would be the difference of finding a working dose versus putting the body into auto immunity. Some vaccine trials are seeing negative results where some people receiving the placebo are doing doing better than those receiving the vaccine.

IL-2 is the only FDA approved immunotherapy agent for Stage IV Malignant Melanoma. The other approved treatment is a chemotherapy drug called Dacarbazine. IL-2 was approved nearly 11 years ago based on studies that showed that a small number of patients had long term remissions (over 10 years). IL-2 doesn't attack the tumor, instead it activates the immune system in an attempt to fight off the disease.

There are severe side effects experienced with IL-2 and it is difficult to tolerate. It requires a highly experienced staff to identify and treat the side effects. In addition, a very low success rate of about 5% is seen for this type of treatment. For those small few, the benefits are huge!

Experimental therapies for metastatic melanoma include targeted agents such as one called anti-CTLA4. There is a protein on the T-cell called CTLA4. This protein acts like a brake and prevents the T-cell from becoming over active. Over activation can lead to cell death or auto immunity. A drug Ipilimumab (MDX-010) is an experimental drug that prevents the CTLA4 from suppressing the T-cell and allowing it to become more active with the hopes that it will be more aggressive against melanoma cells. Current studies are showing up to 15% of patients are receiving objective responses. An additional 15% are seeing stable disease. A person can live a long time with a so called "stable disease". Results from recent studies which could lead to FDA approval are still pending.

A similar drug called Tremelimumab did not have as much effect. Clinical trials have been cut short when in comparison to the already available chemo agent, patients did significantly worse.

Trials with immunotherapies are difficult to administer because unlike chemo where effects are seen right away, it take time for the body's immune system to activate and forge an attack. Tumor shrinkage can sometimes take months. Additionally, one may see tumor shrinkage after earlier scans show tumor progression. Results are therefore better recorded in survivability of patients versus objective response from tumors. How many people are living one year after treatment, etc.

Another experimental drug targets a protein call PD1 which is also found on the T cell. When activated will cause programmed death on the T cell. Melanoma cells express PD1 ligand which quickly kills the T cells and prevents the immune system from winning the war. The new drug prevent the activation of the PD1 protein in an attempt to keep the cell alive to continue fighting.

In conclusion, Dr Wolchok expressed that we have a lot of reason to believe that the immune system can play a role in treating melanoma. We have tools that prove that it can cause regression. Next steps are to find the right combination of treatments to setup a multi pronged attack against this disease. We must impair the pathways and prevent melanoma cell division.

Dr Wolchok then continues for another 30 minutes answering questions from those who attended the teleconference.

Saturday, July 18, 2009

Studies show cough suppressant Noscapine is shrinking melanoma tumors!

A cough suppressant called Noscapine is studied for its anti cancer properties. A research student at Emory University School of Medicine in Atlanta, Georgia has shown that this opioid drug reduced the size of melanoma tumors by 85% within a three week period in mouse models. These results were seen without any signs of toxicity to the host. Similar results were even seen when the drug was taken orally with water.

Another set of tests were later studied and showed that a combination of a chemotherapy agent called Paclitaxel and Noscapine. These results showed the same 85% tumor inhibition as when Noscapine was solely administered. This allowed this particular researcher to conclude that Noscapine does in fact significantly inhibit the progression of melanoma cells with no detected toxicity.

This drug has similar effects as taking Vitamin C. Among other aspects, it inhibits the production of HIF-1 which is required for cancer cells to survive.

Why is Noscapine not available as an anti cancer drug?

Great question! This drug has already been patented and approved for use in many countries including the United States as a cough suppressant. Emory University currently holds the patent with slight modifications for this drug as an anti-cancer drug. They are seeking corporate sponsorship but most larger companies are put off. Since it is already patented as a cough suppressant they won't retain sole rights to the new drug.

More information can be found here:

Studies show that the cough suppressant Noscapine is shrinking tumors in Malignant Melanoma patients.

Thursday, July 16, 2009

Reduce your risk of cancer and join me in Meatless Mondays!

I stumbled upon this website the other day and I thought it was a great idea. Presidents of our past had asked all Americans to reduce their meat intake as well as gasoline and bread in both of the world wars to conserve these resources for military families fighting abroad. By reviving this American tradition, and reducing our intake of meat we can help address some of today's largest health concerns. You can easily reduce your intake by 15% by simply removing meat from your diet one day each week. Why should you remove meat from your diet? Among other things, meat has been linked to cause certain types of cancer.

I joined the meatless every day brigade about 3 months ago and I haven't looked back. Obviously I've gone to the extreme and for good reason. I don't think my diet is for everyone. However, I do think that with as much information is coming available as to the health risks of consuming too much meat, you should at least consider this movement. Besides, humans were not built to consume so much meat anyway.

So what do you say? Join me! Improve your overall health. It's amazing, you might actually be able to stay awake after lunch on Mondays. :) You don't have to sign up on the website (unless you want to), just reduce your meat intake.

Here is more information:

Wednesday, July 15, 2009

Improving the Immune System and Fighting Cancer the Natural Way.

I met with Dr Steven Sinclair today. Dr Sinclair is a naturopathic doctor that Amy found in Frederick, MD. This was both an enjoyable and educational meeting where we talked about everything from Gerson Therapy to Vitamin C. Dr Sinclair has helped support numerous patients fighting cancer including a few with melanoma. He recounted numerous times where nutritional diets and supplements have both helped stabilize or even eliminate cancer.

The first thing we talked about, after my medical history, was my diet and supplement regimen. Since I had already cut out meats and processed foods from my diet, none of the other changes we talked about scared me at all. In fact, nothing really changed he basically just gave me more ideas and some recipes to ensure that I am getting enough nutrients.

I take a good amount of supplements every day. For the most part, the things I am taking are known cancer fighters and immune builders. He increased the doses on a few and guided me to proper intake on others. I am now taking:

PB8 Pro-Biotic Acidophilus - 2 capsules @ 500 mg each in the morning on an empty stomach. Digestive aid for the body.

Turmeric - 2 capsules @ 300 mg with 1 at breakfast and the other at dinner. An asian spice which is believed by many to be the reason Asians are the most unlikely to have cancer. There is also research being done that shows turmeric is a immune system stimulator and can help ward off cancer.

Selenium - 1 capsule @ 200 mcg with breakfast. This is another mineral only required in small doses that is shown to be an excellent anti-oxidant. You can get selenium naturally from root based foods like garlic and onion when they are grown in nutrient rich soil.

Vitamin D3 - 2 capsules @ 1000IU with 1 at breakfast and the other at dinner. A deficiency of this vitamin is thought to be one source of melanoma. In fact, it has also been shown to have an anti-proliferative effects and apoptosis (cell death) on malignant melanoma.

Alpha-Lipoic Acid - 1 capsule @ 100 mg with breakfast. Lipoic Acid is a fatty cell lives naturally inside every cell in the body. It is another anti-oxidant with another very special function. It will recycle other anti-oxidants like Vitamin C and allow them to be more effective.

CoQ10 - 1 capsule @ 100 mb with breakfast. Enhances overall cellular health and helps prevent cellular damage. Studies have shown that CoQ10 can help reduce the risk of melanoma progression.

Pancreatin - 3 capsules @ 500 mg in between meals. 1 mid morning, mid afternoon and bedtime. Pancreatin is a digestive enzyme. It contains a few different enzymes, including an important one called chymotrypsin. When taken on a full stomach this enzyme will aid the body in digesting the fats and protein. When taken between meals, it begins to digest the proteins that surround and protect cancerous cells. Once the cells protective layer has been removed, the immune system is then able to effectively begin it's attack.

Melaton-3 - 1 capsule before bed. This supplement provides extra melatonin that the body uses to regulate sleep. It does two things for me. It will first of all help me get the required deep sleep required for life. Melatonin is also known to have an anti-proliferative effect on cancerous cells, especially melanoma. This Sloan-Kettering web page on integrative medicine explains it very well. They also reference studies that support the information.

Basic Nutrients III - 1 capsule in the morning and 1 capsule with dinner. This is a standard multi-vitamin.

In addition to these supplements I am also drinking a mix of buffered ascorbic acid and water twice daily to get a boost of Vitamin C. Now this is interesting. As I have mentioned in earlier blog posts cancer cells feed on sugar / glucose. Vitamin C and Glucose share similar molecular structures. So similar in fact that cancer cells are unable to tell the difference. The cells absorb the Vitamin C thinking that it will break it down for energy but instead since Vitamin C is an anti-oxidant, the free radicals which are required by cancer cells to perform the conversion of sugar into energy are removed and the cell then starves and dies off. An actual medical study at Johns Hopkins proved this theory.

Coffee is a beverage that I love. Although Gerson does not approve, Sinclair does. It's a simple question of is it processed? Has man been able to screw it up over the years? If not, then it is probably okay. Amy was once told that if you were looking at the ingredients of a package and your grand mother would recognize the contents, then it is probably okay. The American Diet is FULL of processed this and simple carbohydrate that, oh and MEAT. These things are scientifically proven to be harmful to the human body. More on that later. Bottom line is that I still get to drink my coffee and I'm just fine with that!

I'll go back to see Dr Sinclair in about two weeks where I'll start getting into acupuncture as well. My Shifu has talked with me at great lengths about the mind body connection. During my last few months of study I had changed over to Tai Chi and have learned quite a few breathing exercises and ways to help locate my energy. Though I must admit that I've not quite kept that in my schedule as much as I should. Dr Sinclair recommended setting aside at least 20 minutes a day for it. Who here has heard of the pac man theory?

Tuesday, July 14, 2009

The results are in, it appears we have tumor progression.

On my drive home from Pittsburgh, I got a call from Dr Sharfman. As a side note, Dr Kirkwood and Dr Sharfman know each other and had discussed over the phone my case earlier in the day. It was a bit of an awkward moment when he asked if I we're driving as he knew exactly where I had been driving from. ;-)

He called me to let me know that the results were in and that he and the radiologist both agree that they see tumor progression. There certainly are areas where tumors are no longer, but there are other areas where new tumors are now present. There is some shrinkage, and there is some growth. It's a bit of a gray area but they apparently apply more weight on the growth side.

I personally think that it is all in the timing. Follow me for a second. Late April is when I first started feeling cramps in my stomach. Two weeks after is when I had my first CT scan where the lesions were present on the liver. About two weeks later is when I started the IL-2 regimen. The way it was explained to me is that tumor growth can occur periodically. Meaning, there are times when the tumors are stable and there are other times where the tumors go through a period of time in which they grow. Chances are, I was in the middle of a growth period during my first CT scan. It was because of the new pain in my stomach that alerted me to call the doctor. What if the growth and new tumors we see now were in fact already present prior to the start of IL-2. What if the shrinkage and disappearance of tumors that we do see is a result of my treatment. That would mean that my treatment is in fact working.

It's not worth the argument at this point especially since at least one of my leading treatment options include more IL-2 along with some other experimental drugs. It is now time to look into these other options and figure out which treatment plan is right for me. Dr Sharfman is currently working on the paperwork to get me into the NCI trial with Dr Rosenberg. The Adoptive Cell Therapy has recently seen objective results of 72% in tumor regression or total and durable remission. This and a few others are all based on the condition of blood typing that is currently being done at both Johns Hopkins and UPMC. I should have those results by the end of the week.

Depending on the timeline of my next treatment, you might be reading my blog as I post from Mexico. The Gerson Therapy also maintains high success rates especially in melanoma patients. It is an alternative treatment based on the idea that toxicity and nutrient deficiency cause disease. This vegetarian / juice fasting / detox protocol is a grueling regimen that must be followed strictly upon returning home.

There is much to consider. This is a week of research and internal debate. As always, you will know more as soon as I have more to share.

Meeting with Dr Kirkwood at UPMC in Pittsburgh.

Amy and I drove for 3.5 hours on our way to meet Dr Kirkwood at the Hillman Cancer Center in Pittsburgh. I've done a bit of reading and was excited to finally get a chance to meet with him and hear another medical opinion about my situation. Coming into the meeting I still did not have my results from the second CT scan so my goal was simply to find out what kind of therapies were available and find out how they differ from the ones already being offered.

One of the first things that I learned is that the use of Interferon has been seen to be quite effective against stage IV melanoma. This was not an option presented by Johns Hopkins since it is not approved by the FDA as a standard therapy for advanced cancer. Researchers at UPMC have have been using it along with experimental drugs in a trial setting and have been seeing good results.

Another interesting treatment option comes in the form of a cancer vaccine trial. There is an antigen identified as Gp100 that is part of each melanocyte. (Normal cell that produces melanin) Researchers have discovered how to target these Gp100 antigens with tumor-infiltrating lymphocytes (white blood cells). The thought is that these transformed white blood cells can now target and attack the melanoma tumors. This vaccine trial seems very close to the Adoptive Cell Therapy treatment being offered by Dr Rosenberg at NCI. And since Dr Rosenberg has published articles on the topic of identifying this so called Gp100 antigen, it would be nice to hear his take on the differences of the two treatments.

I liked both of these treatment options but now I have to compare them to the ones I originally received locally. Amy and I are going to put together a questionnaire of sorts that will help us identify the pros and cons of each treatment. Once all of the facts are in, we will be able to make our decision.

Friday, July 10, 2009

Now you can be the judge, er doctor.

Because I heard that some of you were complaining, I decided to post the CT scans right here on the blog so that each of you can be the doctors too! I exported each of the scans to AVI and they both show a scan of the abdomen moving from the top of the liver to the bottom. See if you can line them up and see for yourself if you think my plan is working. Please remember to post your prognosis, doc.

CT Scan from May 05, 2009 ( Old Scan )

CT Scan from July 07, 2009 ( New Scan )

Email me if you would like the higher quality video.

Thursday, July 9, 2009

Left adrenal gland is tumor free

I could be a radiologist. In fact their written report was just about as informative as mine when I posted that there are still lesions on the liver. They didn’t compare the results from the previous scan so there is not yet a clear indication of progress. One thing is for sure, the left adrenal gland is now tumor free. From a quick comparison, Dr Sharfman did seem to think that there was progress or shrinkage of tumors on liver. He is going to call the radiology department at Washington Hospital Center and have them actually compare the results.

Having no real results ready all we could really do was speculate and talk about the options for either outcome. He did confirm that if his quick comparison holds true that we would continue with IL-2 for another two rounds of treatment. I always said that I would stick with a plan or treatment while it is working. I think in this case I would go for it and head back to the hospital. On the other hand if the results come back showing that we are not making progress we would want to change gears and Dr Sharfman had quite a few options.

The first option was a Phase II Trial at the National Cancer Institute run by Dr Rosenburg. It is a type of cell therapy where they would surgically remove one of the tumors from my liver and extract the white blood cells. The cells are then regrown and administered back into my system with IL-2. The thought here being that the white blood cells that made their way into the tumors are especially wired to identify and attack the malignancy where others are not. The chances that they can fight off the disease are then increased when these white blood cells are cloned and the new reinforcements are sent back in. They are seeing somewhere near 50% of their patients receiving significant responses. Of course there are restrictions, candidates must have the correct blood typing and genetic markers. Apparently 60% of people have these markers. I had blood work taken today before I left just in case. This option would have me held up at the NCI in Bethesda for about three to four weeks. Doesn’t sound like a whole lot of fun.

The BRAF inhibitor is an option where I would take a pill at home. This option has minimal side effects and they have seen a nice success rate or about 60%.

ANTI PD1 treatment is given via IV in an outpatient setting. Every two weeks I would go back to the hospital for a new dose. The concept here is that the immune system has certain brakes (PD1) so that it won’t harm healthy cells. Sometimes those brakes also prevent the immune system from fighting off melanoma. The thought here is that once the brakes are removed, the already super-charged immune system (after IL-2) can then fight off the disease.

"This is the second trial to evaluate MDX-1106 in cancer patients.  In the first-in-human clinical trial recently conducted at Johns Hopkins and 3 other centers, patients received progressively higher doses of MDX-1106 as a single intravenous infusion every 1-3 months.  Tumor regressions were observed in some patients with melanoma, kidney, colon and lung cancer, and there were minimal side effects.  This new trial will use more frequent dosing of MDX-1106, every 2 weeks in 2-month cycles.  Patients with advanced metastatic melanoma (stage III or IV) whose disease has recurred after standard treatment may be eligible for enrollment, regardless of the site of their original melanoma (skin, eye, mucosal, unknown).   In addition to melanoma, patients with advanced cancers of the kidney, lung and prostate will be included.  Because MDX-1106 has immune stimulatory properties, patients with autoimmune diseases are not eligible." --

Temodar is a chemotherapy option in a pill format which can be taken at home. Side effects are supposedly more mild than chemo drugs of the past. For example, patients on Temodar do not usually lose their hair. I also asked about its known toxicity and how harmful it was to the liver. He told me that it was a safe drug and that the liver would be fine. I'll need to do a little more research on that. Temodar still only has a 15% success rate and typically holds off melanoma for one or two years. Thought here being 5 days of pills could provide two years of survival. If the tumors come back, try the pills again.

Temodar with PARP Inhibitor - Same as above except 2 out of 3 patients get an additional trial drug that attempts to inhibit the DNA repair of melanoma as the chemo does it’s job. Apparently while the Temodar drug breaks down the DNA in the malignant cells, this PARP enzyme begins repairing it allowing the tumor to stick around. This experimental drug will attempt to prevent this PARP enzyme from doing it’s job.

The first three options are all Phase II trials in which are not random. I would actually get the medication in a full dose. Temodar, like IL-2 is an FDA approved chemo drug that is considered a standard treatment. The fifth option which includes the inhibitor is a random trial where I would still get the full amount of Temodar, but I may or may not get the experimental drug. All of these options are worth having a close look. Monday’s trip to Pittsburgh to see Dr Kirkwood might also provide more options.

With any luck I’ll have the new results from the radiologist by tomorrow. I’ll then post the official findings. It would also be nice to have the results prior to seeing the new doctor. I’d like to have as much information as I can seeing as driving up to PA for a follow up visit would be quite a PITA.

Another exciting route that I am taking is with at the Natural Health and Acupuncture Clinic in Frederick, Maryland. I want to talk with them about my diet choices. See what they have to say about blood alkalinity and associated diets. Also I want to start down the path to find a doctor that knows supports or knows anything about LDN and some of the low cost medicines that are thought to fight off diseases such as MS and cancer with no side effects. I have an appointment next Wednesday.

Tuesday, July 7, 2009

New diagnosis ...

Doctor's Amy and Kaige both tell me that the scans show tumor shrinkage. We compared them against the previous results and I think they are correct. There was one new tumor in the new scan, but when we lined them up side by side some of the smaller ones no longer appear. A few of the larger ones do appear to be smaller as well. Again, we'll find out for sure on Thursday ... stay tuned!

Strange CT Scan Results

Seems like this scan is showing more than just my guts. What do you see?

Barium Sulfate, er Scan Day is Here!

Scan day is here. It's time to find out if the combination of eating healthy, removing chemicals from my everyday life and IL-2 has helped me. I do feel good moving into today. Though I still have some cramping in my stomach, I believe that we are making progress. I'm here at the hospital now and I have my three bottles of Barium Sulfate Suspension. I'll drink my first bottle at 9:30 AM and then another at 10:30 AM. I brought my laptop, and so the plan is to hang out here in the waiting room all day and work while I struggle through this crap. I'll enjoy my final bottle at 12:30 this afternoon and then go in for my scan at 1:30 PM. I have my internet card so I will also be keeping tabs on Michael Jackson today. :-)

** Updated **

9:39 AM - I just got back from tackling my first bottle. It helps to drink this stuff in private, so I found a bathroom that is hidden behind the elevators. I remembered it from the last time I was here, I kind of stumbled across it. The funny thing is, if you ask someone that works here, they point you a set of bathrooms on the other side of the building. I must have either found the staff bathroom, or it is simply a secret. Either way, you all know about it now.

10:33 AM - The second bottle does not go down as well as the first. It has kind of a citrus flavor and chalky texture. Good thing is, it's down and I have only one more bottle to go. I was getting a little nervous as I looked around earlier. I didn't see a power outlet for the laptop! I decided to walk around and eventually found one that I could sit next to. We're now good, and I am able to continue working with music and internet!

12:50 - Bottle number 3 is in! I'm back now in the waiting area just waiting for my name to be called. I have another 40 minutes or so. I had to fill out a questionnaire which asked for my previous scan date. Cinco de Mayo or 5/5. Hopefully today's scan on 7/7, exactly two months and two days later will provide better results. I revisited the images from the last scan and realized that the rumors were teeny tiny. No way did they stand a chance against my immune system after all that IL-2 was introduced. We'll know soon enough. I will be asking for a copy of the results and so hopefully I'll be able to see the results when I get home. -- My next update will be after I get home. Wish me luck!!

7:57 PM - I'm home now. Sorry, I've actually been home a while but with dinner and Ella's bedtime. Well, you get it. I looked on the scans and from what I can tell, nothing seems to have changed. It will take closer examination from someone who knows what they are looking at. :) No change is good this early in the game. It's only been two months since we've known about it. I will meet with my doctor again on Thursday to get the official word. I'll update you again when I know more.