September 20, 2024

One week past my first immunotherapy treatment. It gave me a massive migraine-ish headache the day of, and I felt like I'd had a flu shot about five times over for a few days after, but that all cleared up. I'm hoping that's not an every time thing. Other than that, I'm feeling overlapping fatigue between the last lingering effects of radiation and the new effects of immunotherapy.

I had my second opinion consult with Fred Hutch Cancer Center on Wednesday. The oncologist said he'd have me doing the exact same immunotherapy regimen Virginia Mason is doing, but he wanted to speak with a transplant nephrologist there about what he would do about immune suppression for a transplanted kidney in a patient also undergoing immunotherapy for melanoma versus what my nephrologist at Virginia Mason has ordered. Good timing since I had a VM nephrology appointment yesterday. Turns out they differed, and the Fred Hutch nephrologist sent details of what he does in situations like mine to VM, and my nephrologist called me after my appointment to make adjustments. Apparently the Fred Hutch nephrologist has seen no transplant rejections with his current standard, so I'm reassured that my doc took the suggestions and adjusted his orders. They're still not exactly the same, but my situation is one that doesn't come up often, and there's not much research to draw from. A lot of it is more of an art than a set standard at this point. I wonder if I'll be the subject of a paper by one of my doctors once I'm through all this.

So I'm in for medication adjustments and lots of lab draws and tests to monitor my kidney, and discovering whether or not every three weeks I'm going to have these up-and-down symptoms from immunotherapy. It's a lot, just a different a lot from the past a lot I've had already. But – fingers crossed – it's all going to be worth it and I'll have a working kidney and no cancer eventually.