Wednesday, 18 November 2015

Leukapheresis procedure today successful (stage 1)

Good news, the number of T-cells from today's leukapheresis procedure was successful in extracting sufficient T-cells for the trial. This means Lauren doesn't have to bat up for this procedure again tomorrow. Lauren was the third person in Australia to go through this new procedure. This in itself is not a full solution, but the start of the journey to get to a new cure. Other good news is this procedure, if successful and if we are able to continue, might negate the original need for a bone marrow transplant. Thanks to Dave and Sophie for their professionalism and care today. Was great hearing Dave's 40+ years experience as a nurse and how much it's changed over the years in procedures and processes in paediatrics.


Tonight, they'll take out the vascath that was inserted on Monday to extract the T-cells as it won't be required going forward.

So tomorrow is just an MRI scan and hopefully we'll be OK to return to Adelaide on Friday. Back here Monday week, 30 Nov for another bone marrow biopsy.

Tuesday, 17 November 2015

At the Royal Children's Hospital Melbourne (RCH)

So yesterday saw Lauren book into the RCH to start the process of the trial just started here in October. This will happen in stages as Lauren doesn't fully qualify for the trial just yet. One of the stumbling blocks is she needs a 5% blast count (leukaemic cells) and hers have been under 1% thanks to the success of the trial drug Inotuzumab. Even with a bone marrow biopsy yesterday, her blast count is only 1.6%. So we'll have to wait before she can proceed to have her T-cells sent to the USA for genetic modification in the laboratory.

Aside from the bone marrow biopsy yesterday, she had a 'vascath' inserted in her groin which will be used tomorrow to extract her T-cells through a process which might take all day. Basically they'll run her blood through a machine, something like what you see if you donate platelets at the blood bank, extract the T-cells and put the rest back into her. These T-cells will be frozen until she has the required blast count so we can continue.

So tomorrow starts this new journey with the Leukapheresis procedure, which is easier here in Melbourne than having to go to the US to access it.

This hospital is amazing to say the least. Someone had a massive vision what a hospital should and could be in building this. It feels more like a hotel, looks like a modern office complex with shops and eateries on the ground floor - even has a cinema and meditation and prayer room and heaps to keep anyone occupied. It's so modern and what any hospital in any first world country should be these days. Up until now I was under the impression that only people living in the 1800's and early 1900's had any vision to build hospitals.

Turns out we should be grateful a response was never received when querying the RAH Adelaide medical teams' recommended switch from Inotuzumab (Pfizer) to Blinatumomab (A....). If Lauren had ever accessed this later drug, she would have been precluded totally from this trial in Melbourne. However, what's concerning is such a switch would have also have precluded her from the trial in Washington as well, where she was supposedly on a wait list for for the last few months. The trial being the same one. Just confirms that just because a medico says something, doesn't mean it is necessarily correct. People should be encouraged to question their treatment and any professional should be happy to respond to those questions.

The team here at the Royal Melbourne are extremely professional and give you confidence in how they approach their roles. No question is buried and openly encouraged by them. They even respond to emails in writing, which isn't a problem either - at all levels in their hierarchy! This is what all hospitals should be modelled on in admin and professionalism (from what I've seen so far). Makes you wonder what the centres of excellence in Germany and the USA are like?

Here's some photos of this hospital




















The trip across to Melbourne was also used to achieve part of Lauren's goal to see all the 'Big things' in Australia. So we visited the Big Lobster, Larry in Kingston in SE (SA) and the Giant Koala at Dadswell Vic


Saturday, 14 November 2015

MELBS ESSAY UPDATE (Lauren's FB post yesterday)

MELBS ESSAY UPDATE (not sure if it's under 1000 words, sorry!) :

Basically I have enough lymphocytes (don't worry just a fancy name for an immune cell) to go ahead with step 1 of the 'CAR T-Cell' trial in Melbourne. Was up there yesterday to have a whole heap of tests done as well as sign paperwork etc. with questions like have any of your past lovers been sex workers and the classic are you sure you are not pregnant 😐.

After flying back to Adelaide this morning will head off again to Melbs on Sunday with Dad where we will spend the week. Monday I will be completely knocked out (as children's hospitals are nice and put you under General Anaesthetic for everything) and have a bone marrow biopsy and a vascath (basically a bigger version of the PICC line I have in now) inserted into some big vein near my groin for the collection of my T cells.

Then Tuesday I will pretty much be a vegetable lying in bed waiting for some results to come back as you can't do much moving with this vascath thing in your groin. I've even been told I can't wear underwear 😥 just a nightie because of the bloody thing. So Tuesday I'm thinking will = Netflix.

If all the tests come back ok, Wednesday will be the day they collect my T cells - and for those of you who want to be extra smart this process is called aphresis (just don't ask me how to pronounce it) and I basically get hooked up to this machine via my lovely undie free vascath where one bit of the vascath takes my blood to the machine, which will somehow whiz around at the right speed to collect the right T cells, and then all the leftover blood and cells come back to me via another part of this charming vascath thing. This aphresis procedure usually takes four hours to collect the cells and if they don't get enough I may need to do a second collection but hopefully that won't happen.

After the aphresis I will part with my dear vascath by some nurse giving me this drug called madazaland (literally truth/drunk syrup as it's better known among patients) and pulling it out and the T cells collected will be frozen and stored until I have that 5% of leukaemia in my bone marrow where they will be shipped off to America to get genetically modified.

And yep I'm scared - absolutely terrified. At Least with chemo and Inotuzumab I sort of knew how it worked - drug goes in, side affects, drug kills certain cells, bobs your uncle if you keep positive. But this is so new and foreign to me and I feel like the world just keeps throwing all these extra challenges my way - I'm sick of being tested, I'm sick of seeing other 21 year olds having fun, looking pretty, flirting, going dancing, having lunch, finishing their degrees, making a path for themselves, not worrying about tablets or booking appointments for your PICC line dressing to get changed, not worrying about how the hell you're going to make your lovely little Afro look not like an Afro because when you were in yr 9 and had the same haircut some people used to tease you about it and not worrying about the lumps that continually start popping up on you like fungus because you are sick, because you have a disease and you have to fight it whether you like it or not. I'm so frustrated and angry and hurt.

But as hard as it can seem sometimes (and believe me it's so super hard somedays/weeks) I just have to remind myself and my fears to somehow be grateful. Grateful that I have an amazing support network of family and friends beside me, grateful that I still have options open to me, grateful even for the fact that my steroid fluid has come down so much I can now fit into my jeans again without busting the zip.

I really just want to invest all my hope into this new treatment and that it will finally work for me, but at the same time I'm so tired of investing so much hope only to be let down time and time again. But what else can I do. One of my favourite quotes is
'When the world says give up... Hope whispers, try it one more time.'
As for that here's hoping cancer finally receives the bloody message ‪#‎FUCKOFFLEUKAEMIA‬ ‪#‎FUCKCANCER‬

Wednesday, 4 November 2015

Back in the RAH - because of wisdom teeth

Lauren went into the RAH tonight because of a suspected infection from getting her wisdom tooth out yesterday. Should only be a short stay, all things going well. Looked 100% better at 11:30pm tonight than she did at 5:30pm as she was running a fever and being sick, so couldn't hold down any fluid or antibiotics she was on.

Apparently her Lymphocytes are OK to proceed to stage one in Melbourne. So we're just waiting to hear when they want us over for the extraction of her T-Cells for freezing and then genetic modification and harvesting in the USA under their Car T-Cell therapy - science fiction stuff according to some who studied only 20 years ago in this field!!!

Sunday, 1 November 2015

Gigantic Update (from Lauren's facebook post today)

GIGANTIC UPDATE (Goodluck reading it): I always know when to do another one of these because a lot of people start messaging me asking how I am going so...
last update was that I found two swollen lymphnodes (one in my neck and one near my sacrum) that were filled with leukaemic cells. For those of you who are going what the hell are lymphnodes - they are part of the immune system and are filled with lymphocytes (usually white cells in the blood) which help tackle any viruses or bacteria that enter your body. These lymphocytes often swell when they are working extra hard or if something else (like leukaemia cells) clog them up, hence the name lymph-node. Because of these nodes I could no longer continue with the next dose of Inotuzumab. And after talking with my doctor the Inotuzumab isn't a complete failure - my bone marrow still to this day only contains 0.1% of leukaemia cells which is fantastic - it's just a shame that the disease progressed to my tissue/lymphnodes and the Inotuzumab was ineffective in the tissue to prevent this. 
So what's the plan now?
Well when we first found out about the lymphnodes we thought we would be needing to go to America to receive cutting edge 'Carr T Cell' treatment BUT GUESS WHAT... It's been doing so well in America that the trial has just been brought to the Royal Children's in Melbourne - that's why I was up in Melbs last Wednesday. So after talking to the doctor up there, fortunately I'm not too old to qualify for the trial as the cut off point is 22, but unfortunately, I don't qualify for the trial just yet as I don't have enough leukaemic cells in my bone marrow. (I know, talk about backwards) So because this treatment is so new there needs to be a disease marker so they can see how well the treatment works against the disease and this marker is 5% of leukaemia in the bone marrow. However, I can take the first step and at least get my 'T cells' (a specific type of white cell in your blood) harvested and frozen ready to be sent and genetically modified when I do eventually end up on the trial. Hopefully that will happen sometime in the next month or two.
As for now it's just living life. My blood counts have been pretty good so I've been trying to get out and about as much as I can. In Melbs on Tuesday night, caught up with some family friends in fed square for dinner and almost laughed my head off, last Friday helped out selling bandannas in Adelaide CBD for CanTeen's national bandanna day, can finally do 10min at 9.7km/h on the treadmill and last night had the chance to catch up with all my third year actor peers around a gorgeous bonfire in Charleston!!
Not gona lie - the past 2-3 weeks have been tough because of not knowing a plan and when people say I'm so strong and optimistic it's because I only allow you to see what I want you to see - did you know I broke a light bulb/fixture with my shoe the other day because I was so angry at everything and everyone?? Well I guess now you do but I believe if you were in my position you would also somehow tap into this weird strength that people seem to see so vividly because you simply have to in order to live. There's no choice really, unless you really want to die.
Anyway I think that's enough soppiness for one day!! Haha but yes for now just trying to get out and do as much as I physically and mentally can! ‪#‎FUCKLEUKAEMIA‬ ‪#‎FUCKCANCER‬

Wednesday, 28 October 2015

The Royal Children's Hospital Melbourne

Lauren is in Melbourne today to investigate a new treatment/trial (global) which has commenced at the Royal Children's Hospital Melbourne. Sounds like Lauren is blown away by the infrastructure there. Even has it's own Hoyt's cinema!!

Anyway, funny looking back when we came to forks in the road re treatment(s) we went down some tracks, thinking it was the poor cousin within a trial, only to find out now, the fact some treatments weren't selected randomly has actually potentially opened new doors through new trials rather than closing them, which some drugs usage would have done.

The one the RAH gave me an ~88K euro bill for last week turns out is one of the drugs that would preclude us from these current new trials. Thank goodness someone there was arrogant enough not to answer the questions I raised to make an informed decision on paying the bill. Otherwise we might have gone down the wrong path!

This treatment effectively replaces the CAR T-Cell treatment in Washington Lauren was allegedly on the wait list for. No more 'flying under the radar' and hopefully explains why I never put those proposed treatments in the blog previously. Hopefully now we can operate with transparency. Not out of the woods yet, but seem to be possibly progressing again.

On a separate note, New Idea published the #cranesforlauren article last week - page 44 if you have it.

Monday, 19 October 2015

Not such good news today

I'm not sure the comment "I have relapsed again" below is technically correct as I'm not sure if we were ever given a remission status, but Lauren's facebook update puts you in the picture. Much happening behind the scenes. Lots of confusion and unanswered questions at the moment being followed up with the right people.

Lil Update: I have relapsed again. Found a lump on my left neck/shoulder area about 2 weeks ago, had an ultrasound and biopsy on it last week and I got told this morning it is leukaemia. Not sure what the plan is yet but I'm having further scans today and a bone marrow biopsy tomorrow to make sure it's no where else. Will let you all know more as soon as I know more. ‪#‎FUCKLEUKAEMIA‬ ‪#FUCKCANCER‬

Saturday, 3 October 2015

#cranesforlauren

As mentioned in recent posts, Lauren was surprised this week for her 21st birthday with 20,000 origami cranes and photos from people all over the world wishing her all the best. Below are various news items (television and press) from this week. Unfortunately the 'Cranes for Lauren' group on facebook cannot be sent live and remains 'secret' because of some rule facebook has when membership is over 250. Cranes for Lauren is around 3,800 members.

Been a busy week and the cranes have certainly helped Lauren bounce back quickly from the news her bone marrow transplant (second) is not going ahead next week. We need to clarify the exact position of whether she is in remission or not with her haematologist which will happen in an appointment in two weeks. On the 'old' system of measurement, it appears she is in remission, however with a new screening now available, there are some blast cells still present <1 in 10,000. Will update this stuff after that appointment.

Channel 7 news (Mon night 28/9/15):
https://www.facebook.com/7NewsAdelaide/videos/1048817101815611/?pnref=story

The Advertiser (Tues 29/9/15):
https://m.facebook.com/story.php?story_fbid=10153210363156947&id=92701406946


The Messenger/Adelaide Now (Wed 30/9/15):
http://www.adelaidenow.com.au/messenger/east-hills/celebrities-among-tens-of-thousands-whove-made-birthday-paper-cranes-for-three-time-leukaemia-fighter-lauren-krelshem/story-fni9lkyu-1227547647854

Daily Mail UK (Fri 2/10/15):
http://www.dailymail.co.uk/news/article-3252913/Cranes-Lauren-campaign-fills-young-woman-cancer-s-home-colourful-Japanese-birds.html?ito=social-facebook


Rip It Up (28/9/15):
http://ripitup.com.au/culture/social-media-campaign-for-adelaide-girl-goes-viral#.Vg_VasbMcUX

The Australian:
http://www.theaustralian.com.au/news/celebrities-among-tens-of-thousands-whove-made-birthday-paper-cranes-for-three-time-leukaemia-fighter-lauren-krelshem/story-e6frg6n6-1227547647854

Sunrise Ch 7 (Thurs 1/10/15):
https://au.tv.yahoo.com/sunrise/video/watch/29688643/paper-cranes-carry-a-special-message/#page1

Michael Mills video (summary of day 28/9/15): (This is a great summary of the day
https://youtu.be/igQ5bouICXY

Photographs by Jo-Anna Robinson - Photojo
https://www.facebook.com/media/set/?set=a.509387095877914.1073741871.137573849725909&type=3