Chick Clarke Chick's Team

First post: Feb 8, 2017 Latest post: Feb 20, 2017

Back before Thanksgiving, Chick was having difficulty breathing, feeling short of breath. This feeling had been increasing over a few week period and so she went in to see her doctor. During that visit while checking her vitals she found out that her oxygen level was very low and was told to go to the emergency room immediately. Chick was admitted into the hospital where it was determined that she had fluid in her lungs. The respiratory  doctor performed a drain of the fluid and sent it out to the lab where it would be tested to find out why the fluid had gathered in her lung. Possibilities being an infection, pneumonia or cancer. 
After the drain, Chick felt a great deal of relief. Her breathing was not as labored and she was discharged a couple days before Thanksgiving. A couple weeks passed and she went in to see her doctor again where the test results of the drainage revealed that cancer cells were indeed found in the fluid. The fluid was accumulating again as well and her breathing was more difficult. We met with a pulmonologist and he scheduled another thoracentesis (drain) to allow the lung to have the room to expand and therefore allow her to breath easier. A PET scan was also performed to see if the cancer cells had spread. Later that same week, Chick, Michael, Steve and Shawn met with an oncologist, Dr Desai, to get the results of the PET scan. The doctor explained that there was cancer cells in the fluid surrounding the lungs, the cancer had spread to her lymph nodes and there was also an area of concern in her pelvis. The official diagnosis being Stage 4 lung cancer. He told us that surgery was not an option and that chemo would be the most likely path. The doctor also told us that he wanted Chick to have a biopsy so he could send off the samples and have her mutation markers checked to see if they came back positive for three new cancer treatments, one had just gotten FDA approval and although there was little long term data the results had been very promising. He warned us that only 10-15% of mutations come back positive for usage of these targeted treatments. In the meantime, the doctor asked if we were ready to start chemo treatments but with it being just days before Christmas the doctor suggested we wait until after the holidays so Chick could enjoy Christmas without the very real chance of feeling ill due to the side effects. So just a couple of days after Christmas, Chick went in for the guided biopsy as well as another Thoracentesis as the fluid around her lungs was gathering even quicker that in the past and her breathing was very labored. During this visit we learned that the biopsy was not possible, there was too much fluid to be able to perform the procedure. This was so disappointing to us as we knew that without the biopsy there could not be a a test for the targeted drugs leaving chemo as the only option. The first chemo treatment was scheduled for Jan 6th. Then before the first treatment Chick was scheduled for another Thoracentesis and to have a plurex catheter installed so that she would be able to drain the fluid around her lungs at home when needed. The fluid was gathering so quickly that we couldn’t get appointments fast enough for her. The day before she was to go in for these two procedures Chick’s breathing was as bad as it ever had been previously. Steve and Michael raced to her house where luckily a home nurse was scheduled to stop by for a check in. When the nurse took her vitals she found that Chick’s oxygen level was under 80% which is dangerously low. We called 911 and Chick was taken in to the hospital and admitted. During the next 7 days in the hospital the thoracentisis procedure happened, the plurex catheter was installed as was a port in her chest for IVs. Chick was also given constant oxygen, as well as an order for at home oxygen when she was discharged. During this hospital stay a biopsy was attempted one last time in hopes of getting a sample for testing. Once again the biopsy was not able to be performed but Dr Desai felt that enough of a sample could be gathered from the fluid that had been taken out and it was sent for marker testing. The first of the three marker tests came back right away as negative. Chick was discharged from the hospital to a rehab facility as her strength was greatly diminished. While in the rehab facility we received great news; one of the markers came back positive and Chick was able to avoid chemo and use Keytruda instead. Keytruda destroys a protective mechanism on cancer cells, and allows the immune system to destroy those cancer cells. It targets the programmed cell death 1 receptor. Dr Desai called this a “game changer”!!
After 11 days in the rehab center, Chick came home on Jan 21st, seventeen days after being admitted to the hospital. She has oxygen going full time and OT and PT coming to the house a couple times a week to help her regain her strength. Her sons have been staying with her, rotating overnights while her friends and family have come by during the days to visit and keep her company. A home nurse visits every other day to check her vitals and to train Michael on how to perform the fluid drain procedure.
On January 24th, Chick fought back. She went in for her first of three Keytruda treatments. We are happy to report that the side effects have been minimal, fatigue mostly and certainly a loss of appetite but no nausea. 
There is a follow up appointment on Jan 31st with Dr Desai to gauge how Chick is handling the treatment and an appointment with her pulmonologist the following day to check how the drains are coming along. The keytruda treatment schedule is a treatment every 3 weeks for the first 3 treatments then another PET scan to see how effective the treatments have been. Chemo is always an option on the horizon, whether that be in tandem with the keytruda treatments or if the keytruda is not effective.
So it has been a whirlwind the last few months for us all. Chick is doing her part and her family is doing theirs. The days are jam packed with nurse and therapist visits at the house and doctor appointments nearby. The phone rings off the hook and although most calls go to voicemail, each one is appreciated and the plan is always to call back although something mucks up those plans so often.
Our family has come together with hope, faith and love. We will continue to keep you up to speed on the journey and ask that you keep Chick in your thoughts and prayers.

Love to you all,
"Chick’s team"

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