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Wednesday, February 25, 2015

First Injection Done

Some of you have been following this on Facebook today, but you will still get something out of it as I have added more photos of the actual procedure.  But, most of the journaling is for those who didn't see the Facebook posts:

Today Tim received the first injections of the genetically modified herpes virus directly into 2 lumps of melanoma that are on the left side of his chest. It is a clinical trial treatment. Praying this is the treatment that the Lord uses to make him cancer free! Thank you ALL for your prayers!

Lots of preparation before Tim actually gets the injections. The doctor had to measure the lumps to determine how much injection each lump would receive. Then the nurse took some blood to run labs on. And she had to order the injections from the pharmacist. It is frozen and will need to thaw for about half an hour. So we went to the food court to eat lunch.

The doctor will topically freeze the skin, insert the needle and "wiggle it around" in the lump to spread the medicine around. There will be a warm feeling, but no real side effects.  2cc's (ml) and 1cc (ml) are the injection amounts.

Waiting patiently, no punishment intended.

So, the lumps will look bigger before they start shrinking. I asked if they would ever inject the lump under the eye. She said probably not. They have found that it will probably disappear with the lumps that are being injected!

OK, so here's where the procedure actually happened.  Read the captions under each picture for explanations.

This is the largest lump.  The RN laid this paper measure down and took a picture for making notes of the progress during this trial study.

Then she sterilized the area.

Before the injections were administered, she sprayed a numbing agent on the spots.

The doctor instructed Tim to look away while he did the injections.

This is the smaller of the 2 lumps and was injected with 1 ml of the drug.

The doctor rotated the needle around to different areas of the lump to make sure the drug went to all parts of the tumor.

This smaller lump is a new lump that popped up maybe a month ago.  That is how we knew for sure that the other treatment had stopped working for Tim.

One last twist before moving on to the other lump.

This is the stubborn lump that refused to go away with the very effective Zelboraf treatment.  This lump was injected with 2 ml.  The doctor rotated the needle same as for first lump.

The gowns, gloves, masks, all the needles and paraphernalia were then disposed of in this Biohazardous Waste bag.

It is hard to see, other than part of it being shiny from the light reflecting on it, but on top of the lumps a clear, water proof bandage was applied.  This bandage must be left on for 7 days.  If it comes off, we have another one to put on immediately.  The only real chance of being infected with this modified herpes virus is by touching the injection site.  I'll explain more below.
They flushed Tim's port while we were there, so everything was finished by 2:00.  The appointment was for 11:00, which means we arrive by 10:45.  Since it took so long, the RN is going to try to schedule the next appointment for 9 a.m.  The next appointment will be 3 weeks from today and then every 2 weeks after that.  For how long, I do not know.  I guess until the lumps are gone!  :D

Here's some information to help you understand, somewhat, the treatment.

The name of the study drug is Talimogene Laherparepvec, TVEC for short. It "contains a weakened form of the Herpes Simplex Virus Type 1 (the "cold sore" virus or "HSV-1").

"TVEC could potentially be spread to family or people who have close physical or intimate contact with the clinical trial participant after tumors are injected with the study drug. So far there have been no reported cases in clinical trial participants who have received TVEC of spreading to family members or other close contacts. So far, no TVEC has been detected outside of the dressing that is placed on top of the site where it was injected."

"Spreading of HSV-1 occurs through direct contact from one person to another, particularly if a cold sore or genital sore is present. The virus is "shed" from active sores and may be present even if the person has no symptoms. It may also be spread by sharing a razor, towel, dish that has come in contact with a sore or bodily fluids. Unlike the naturally occurring virus, however, TVEC is administered into tumor lesions and is not expected to be able to replicate effectively in other noncancerous tissues. There have been no cases of spreading of TVEC to close contacts reported in clinical studies to date."

So, I am not concerned with being "infected" with the herpes virus, as long as the normal precautions are taken. The injection sites are completely covered with a waterproof bandage that is to remain on for 7 days. If it happens to come off we have been given another one to put on right away. So, please don't be afraid to shake Tim's hand at church!

When we left the church, nothing was happening weather-wise.  We were supposed to get rain beginning at 6 p.m. but the weather people said it was so dry that the rain was evaporating before it hit the ground.  But she said that would eventually change.  Well, Tim just looked outside and we don't know when it started, but we now have more snow than what we had yesterday morning!  It is coming down pretty heavily!  Here's a couple of pictures I snapped.

You can see it looks like fog in the street light.

I used the flash so the light would reflect off of the flakes to show you a better picture of how thick it is coming down!

I took this one through the door and got some reflection off of the glass.
 OK, that's it for me tonight!  The snow may delay our thrifting tomorrow!  We also want to go and see the movie, McFarland USA.

Nite all!