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Bumps in the Cancer-Recovery Road

In October 2018, my wife, Elvira, and I drove down to UCLA to meet with my neurosurgeon and melanoma expert. Following four combination treatments of the immunotherapy drugs Yervoy and Opdivo and fifty-two biweekly treatments of Opdivo alone, it was possible that I would be declared cancer-free.

For nearly two years, my scans had revealed no trace of the widespread metastatic melanoma diagnosed in May 2016. Still, we were nervous as we met with the neurosurgeon, who indicated that I had residual dead tissue on my cerebellum as a result of radiation. Fortunately, there was no evidence of cancer. Likewise, the melanoma expert noted that I had dead tissue on my kidney, but the melanoma was gone from my body.

"Go and live your life," he said to us.

Back at home in Santa Barbara, Dr. Mark Abate at the Ridley-Tree Cancer Center in Santa Barbara told me I was officially in clinical remission. (As I understand it, I could not be in radiological remission because they had not taken biopsies of my cerebellum or my kidney.) It was a wonderful moment anyway, and just as we had done when Dr. Abate first told us the immunotherapy drugs were working, we celebrated with big hugs.

My regular check-ups continued. In December 2018 the report again showed NEC. However, the UCLA neurosurgeon later called to say the necrosis on my cerebellum had increased, and I should consider laser ablation before it became worse. Elvira and I decided to wait for the next MRI to take any action. In the meantime, after the new year, I mentioned at my annual physical that I had an occasional rapid heart beat. I was given a Zio Patch to monitor it. The results showed occasional instances of atrial fibrillation and rapid heart beat.

A cardiologist prescribed 50mg/day of metoprolol, designed to reduce my blood pressure and slow my heart beat. One week later, Elvira came home to find my face smashed and a pool of blood on the living room floor. "What happened?" she asked. "I have no idea," I replied. I had no memory of falling and hitting my head on the floor, and still don't. I do remember the three stitches above my eye, the stitch in my lip, and the black eye that stayed with me for the next two weeks.

These events took an emotional toll on Elvira and me. We had been riding so high and now seemed to be heading downhill again. Black humor jokes about being lucky that it wasn't any important organs that were acting up - just my heart and brain - couldn't dispel the growing anxiety.

Still, even though it was a difficult time, it wasn't anywhere close to what we had just gone through with the melanoma. We could do this.

The return of our positive momentum began with a visit to the cardiologist's office, where they decreased the daily dose of metoprolol by three-fourths. The Zio Patch results this time showed no AFib and only minor instances of rapid heart beat. More good news came when I went to see my neurosurgeon at UCLA in March 2019. Not only was there no evidence of melanoma in the brain, but he had reviewed my history of brain MRIs and no longer believed the inflammation was increasing.

In short, both my heart and my brain seemed to have stabilized. And my most recent PET scan was crystal clear. We are back to enjoying every day: playing golf, hanging out with friends and the boys, working out at our respective gyms, visiting 93-year-old Aurora, and playing with Olive the Corgi. We frequently hear squeals of joy while driving around town because other drivers see her hanging out the window with her doggles on. Or maybe it's just us.

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