How Did We Get Here?

I had grandiose plans to continue my blog after our trip to Europe in 2010...obviously, that didn’t happen. I truly enjoyed blogging as we traveled, but it was definitely a commitment to post every day. Once home, the busyness of everyday life took over. I’ve mentally written multiple posts over the years...they just never made it out of my brain.

So much has changed in the seven years since that memorable trip. The most wonderful change...I’m a Grammy! Dylan was born on May 6, 2016. He is the joy of my heart and my main reason to smile during this time of overwhelming grief. Which leads to the most devastating change...cancer entered our lives. Kristine battled metastatic melanoma for over a year, and we lost our sweet daughter on September 13, 2017.

Dylan meets his beautiful Aunt Rity

A couple weeks ago, I was asked to share Kristine’s story by a woman I became friends on Facebook with through a melanoma support page. This wonderful woman, Kristi Donahue, is dedicated to increasing awareness of melanoma and sharing the stories of those who have fought and are still fighting this horrible cancer. I finally sat down this weekend to write Kristine’s story for her...talk about procrastination! I decided to share it here as a way of giving some background to how we got here.

Family Cruise - June 2013

June 2013 - Our whole family met in New Orleans and took a cruise to celebrate our 25th anniversary and renew our vows. Kristine showed me a mole on her back. She was concerned about it because it was itchy and would bleed at times. I told her she needed to get it checked out as soon as possible. I recall being worried, but not my usual over-the-top worried. If it was skin cancer, they’d remove it and that would be the end of it...right? I didn’t know that skin cancer could be deadly. I’d heard the names basal cell carcinoma, squamous cell carcinoma, and melanoma...but they were all the same to me.

August 2013 - Kristine had the mole biopsied and it was melanoma. They did a wide excision to make sure they got it all. They even did a sentinel lymph node biopsy that came back negative. For those that may want to know, it was a Clark level 3 and Breslow thickness 2 mm.

On a side note, most people that know me know that I’m a researcher...I research everything. In fact, I will not talk out of my butt...if I’m speaking knowledgeably about something, I either have personal experience with it or I’ve researched it pretty extensively. Some may call me a know-it-all, but I do NOT speak on subjects that I don’t actually know about. I know what I know and I know what I don’t know. If I don’t know something, I admit it and seek out someone who does. That said, I have no idea why I did not research melanoma back in 2013. I thought it was gone and out of our lives. It would’ve taken very little research to learn how serious it is and how watchful we should’ve been. That is my first regret in a long line of regrets concerning Kristine’s battle.

June/July 2014 - Kristine found out she was pregnant with twins. Sadly, she lost them shortly afterward. I only mention this because I have read reputable articles about a connection between melanoma and pregnancy...specifically that the hormones produced during pregnancy may cause melanoma to spread. To be fair, I have also found reputable articles stating that there is no connection. I can’t help but wonder though.

The next two years were a flurry of activity for our family. Dawn and Joe were married in March of 2015, and my adorable grandson was born in May of 2016.

Dawn's Wedding

Summer 2016 - Kristine came to California to see Dylan after he was born. She felt a lump under her breast that was painful. After returning to Alabama, she saw her dr and had the lump biopsied. It was melanoma. She had a PET scan and MRI at the end of July to see if it was anywhere else. On Aug. 2, 2016, we received the devastating news...stage 4 metastatic melanoma. She had numerous lesions throughout her body, including in her brain, liver, lungs, and spine...too numerous to count.

Treatment with Southern Cancer Center in Foley, Alabama

• Three weeks of whole brain radiation (WBRT) in Aug 2016
• Began tafinlar and mekinist combo in Sep 2016...very quickly noticed the tumors shrinking
• Brain MRI in Nov 2016...all the brain mets were gone
• Brain MRI in Jan 2017...still clear
• PET scan in early Mar 2017...only four tumors left in her body, but two are new

March 2017 - At this point, her doctor recommended staying on taf/mek until she stopped responding and then moving on to immunotherapy. She began to notice growth in one old tumor (axilla) and one new one (lower back). I had been wanting her to see a melanoma specialist and Kristine and Stephen agreed, so we went to MD Anderson for a consult in late Mar 2017. They recommended a clinical trial, but she would need to have a wash-out period and be off the taf/mek for four weeks. We left feeling very hopeful.

1st Visit to MD Anderson in Houston

May 2017 - We returned to MDA the first week of May to begin the clinical trial. She met with the dr and shared that she'd been having headaches (as well as other side effects) for a couple weeks. He sent her for a CT of the brain and we found out that the brain mets are back...too numerous to count and some very large. She was disqualified from the trial. The dr believes that while the tumors in her body had stopped responding to the taf/mek, it’s possible that the taf/mek was holding the brain mets at bay. We consulted with a radiation oncologist and neurosurgeon, both recommended WBRT. Kristine returned to Alabama where she underwent a second round of WBRT. She then began to taper off steroids in order to begin immunotherapy.

June 2017 - Kristine began to feel numbness in her right foot in early June. An MRI of her spine on 6/6 showed four tumors in the thoracic region. The numbness progressed to being unable to walk by 6/8. I flew out there and then flew back to California with her on 6/13 as we had a family vacation in Hawaii planned for 6/20. I had contacted a few top melanoma specialists in the Los Angeles area and got her an appointment with Dr. Hamid at The Angeles Clinic the day we flew in. He recommended she begin the ipi/nivo combo immediately. Our family went to Hawaii for a week...it wasn’t the vacation we all envisioned when we planned it pre-diagnosis, but I’m so glad that we all had that time together. After returning from Hawaii, Kristine and Stephen moved into our home so we could help Stephen care for Kristine.

Treatment with The Angeles Clinic in Santa Monica, CA

• 1st ipi/nivo treatment on 6/16
• 2nd ipi/nivo treatment on 7/10
• hospitalized 7/13-7/20 to deal with side effects
• 3rd ipi/nivo treatment on 7/31
• hospitalized 7/31-8/4 to deal with side effects
• 4th ipi/nivo treatment on 8/21
• MRI on 8/29...showed 20% reduction in brain mets

Kristine was hospitalized on 8/29 with a DVT and pulmonary embolism. She became unresponsive within a couple days. Doctors tried everything they could, but she did not recover. We brought her home on hospice on 9/11. She passed away, surrounded by love, just two days later.

Thank You, Mama

“Thank you, Mama.” Those were my precious daughter’s final words to me. I will never forget them nor will I ever forget the way they sounded. I can hear her saying them right now. I can see her face as she says them. I just wish I could remember the exact time on August 31st that she said them to me. Our days in ICU were such a blur, it’s hard to recall what happened on what day and when. I want to remember every single moment with her. I’m grasping onto every memory I can.

Kristine entered the ICU on the night of August 29th for a DVT and a pulmonary embolism. That very day she had had an MRI to see how she was responding to the combo treatments she’d been getting since June 16th. The next day (8/30), we found out that her tumors had shrunk by 20%...I was ecstatic...the cancer was clearly responding to the treatments. However, she had become completely unresponsive while in the hospital and the doctors had no idea why. They began running tests and calling in specialists, all while conferencing with her oncologist in LA.

She did ‘wake up’ that afternoon, but then she was agitated and in a lot of pain...she didn’t get to sleep until about 1:30 am. Thursday (8/31) was more of the same...agitated, in pain, and uncomfortable...and it was during all of this that she spoke her final words to me.

It was difficult to see my sweet girl so agitated. She was so uncomfortable and kept pulling at the oxygen thing in her nose. She’d pull it out and then alarms would go off and startle her. She’d bend her arms and the IV alarms would go off. She couldn’t get any rest. At one point, my daughter Becca and I were holding her hands just to prevent her from pulling at anything so she could try and get some sleep. She was getting so annoyed with us. I would tell her she couldn’t pull at it and she’d ask why. I’d give her a logical answer, but she kept asking why over and over. I finally said only half-jokingly, ‘because I said so!’

The doctors gave her something to help her rest, and she began to feel more comfortable. She had such a serene look on her face. We then had our final conversation.

I said, “I love you so much, sweetie.”

“I love you too, Mama,” she replied.

I could feel tears welling up as I then said, “You’re so beautiful.”

She tilted her head toward me, smiled her sweet smile, and said, “Thank you, Mama.”

I kissed her cheek and kissed her hand through my mask and then just sat in the chair next to her bed, holding her hand as she drifted off to sleep. I didn’t know at that moment that I would never hear her voice again or see her smile. While it's heartbreaking to think about that, I do recognize that our family was blessed to be able to tell her how much we loved her before she passed away...most people never get that opportunity. And I'm doubly blessed to have had such a sweet conversation with her before she was unable to communicate. Can you imagine if my final words to her were 'because I said so'!?