Fighting for his Family

Written by Timothy Pridmore

5/3/2020 Spring 2019 had just arrived and everything was going wonderful for my family and I. We truly believed we were getting ahead in life. My wife was moving quickly up the management ladder at her work due to her experience, knowledge and well-developed customer service abilities. My 10-year-old son and 6-year-old daughter where doing great in school. I had my dream job. I was a fisheries pathologist for Idaho Fish and Game. I spent my days traveling the state monitoring the health of hatchery raised fish and diagnosing fish when they became sick. Little did I know, I was about to be the one needing diagnosing. Starting in January, I started using sick days more frequently due to what I thought was either food poisoning or the stomach flu. I never really enjoyed going to the doctor, so I would just ride out the pain and then return to work. I don’t think a doctor could have done much anyway due to the difficulty that doctors had diagnosing me once things became serious in April, 2019. For roughly four days, I had been dealing with some severe upper abdominal pain, which was not getting better. The pain was increasing in severity, dissimilar to sick days I had prior. There are two normal sized speed bumps at the entrance to my work. On day five of the pain, when I drove over the first speed bump at a safe speed, I almost passed out from the pain the motion had caused. I took the second bump at a much slower speed and at an angle to reduce the bump motion but it was still painful. I found a parking spot and stumbled into my office. After sitting at my desk for about 30 minutes I realized I needed to go to the doctor. The pain was almost crippling, I probably shouldn’t have been driving. Only one other person had arrived at work by this point, my friend and collogue Dave. I informed him of the situation and told him I was going to the doctor. I knew there was a Saint Alphonsus (St. Als) urgent care facility just down the street from my house, so I drove directly there. Within ten minutes of being at the urgent care, they advised me to take an ambulance to the nearest emergency room. I found myself being rushed to St. Als Medical Center in Boise. After a short stay in the emergency room I was admitted into the hospital for further testing. After running their tests and scans they concluded I was dealing with chronic pancreatitis due to unknown reasons. Once we realized I was going to be in the hospital until the doctors could get the pain under control, we asked my parents to come help take care of the kids and spend time with me. My parents, especially my dad, played a key role in this whole story and I don’t think I'll ever be able to thank them enough for their contribution. Once the pain was under control and the proper medications needed to manage the pain were prescribed, I was released to return home. The first hospital stay was about five days long. A specialty doctor was recommended to me for fallow up tests and scans. For roughly two weeks the pain was bearable due to the medications but soon it flared back up and sent me back to the emergency room. Followed by another five day stay in the hospital. Other than an inaccessible small mass on my pancreas seen during a CT scan, there was still no explainable reason for the pain. All tests for cancer kept coming back negative. I was eventually approved for a PET scan. And that’s when we found out I had cancer. Due to previous testing they had determined it was not pancreatic cancer but they still didn’t know the type. But thanks to the PET scan results the specialty doctor was able to refer me to the St. Als Cancer Care Center (St Als CCC) where the doctors had more experience diagnosing cancer types. After a number of visits and a lot more tests, the doctors determined I was a complete mystery which was to my disadvantage because they could not start a treatment. They needed to biopsy that mass on my pancreas, but it was in a very difficult location. The doctors finally found a surgeon that was willing to attempt an endoscopy to biopsy the mass. She was semi successful. It was not the greatest of samples but test results did come back as large b cell lymphoma. My oncologist did not hesitate, I was scheduled for a five-day chemo inpatient treatment the fallowing Monday. It was the beginning of June by this time. I was still working at this point so plans had to be made for missing an entire week and whatever days I might need for recover the week after. I was scheduled for six rounds of this chemo. That was a lot of time away from work By this time bills were arriving for ambulance rides, doctors’ visits and hospital stays, these where very big bills. My wife and I realized our hopes and dreams of getting ahead in life where quickly fading away. Thanks to the generosity of co-workers a go-fund-me* page was started and has helped significantly keep us out of debt especially once I used all my sick and personal hours and had to quit working and go on disabilities. Thank co-workers, family, friends and anonymous people. Co-workers donated the maximum number sick leave hours that our human resources would allow. The people I worked with where more like family than co-workers. Chemo had its moments of success and moments of failure. It seemed to slow down the cancer more than kill it. Numerous times I found myself admitted early because the cancer was causing all sorts of problems around my pancreas includes pinching a bilirubin duct closed to the point a stint was needed. Around the fifth cycle of chemo a mass had formed in a location that was much simpler to biopsy, which was completed ASAP. Samples where sent off to a specialty lab to determine the type of large b cell lymphoma I had. It took the lab rough four weeks to make the determination I had triple hit large b cell lymphoma. A rare and very difficult cancer to treat. Our treatment regimen should have been much different from the beginning. Car T cell therapy is the most effective treatment against this type of cancer. So, the hunt was on for a hospital that would treat me using this novel cancer treatment. A hospital in Salt Lake City was recommended and we started the process of getting treated there. A couple weeks in, the Salt Lake City hospital contacted us and said my insurance would not cover treatment from that facility, large waste of time. That hospital recommended the Colorado Blood Cancer Institute (CBCI). I was quickly given a referral to their oncology doctors and was excepted. Even thou the referral was fast, a lot of time had passed, it was now early December. I flew out to Denver for my consultation meeting with my soon to be new oncology doctor. They presented me with two options of treatment, the commercial therapy or a novel car T cell therapy trial being conducted in England. They recommended I apply for both just so I didn’t carry all my eggs in a single basket. The commercial treatment was approved by my insurance almost immediately but I needed to have some lab numbers fit into the trials parameters before they would give me approval. So, for I a couple weeks I did everything known to boost my immune system and I was tested every day until finally, one day I passed their tests by a meager eight points. We wanted to be part of the trial because it offered a series of advantages over the commercial therapy but it also included all the elements of the commercial therapy. We scheduled a date in mid-January for my car T call with-draw. This was all scary to me because I new they where going to stick a very large tube in my neck. Little did I know that having the tubes in my neck was nothing compared having my blood drained from me three times in order to collect enough car T cells. The process took about five hours in total, but once I was done, I was able to return home until it was time to receive the cells back. I returned to Denver at the end of March, so the doctors and nurses started preparing me to receive the new genetically modified car T cells. I received the cells the first full week of April. I had never been so nervous. I knew the procedure would be simple but it was one of the most important things I had ever undergone. It took about two hours to replace my car T cells and it was a fascinating process. The hospital monitored me inpatient for about 10 days before I was released to stay in a local hotel. I was going to stay in the hotel for an additional 20 days so the doctors could monitor me closely. This gave me the opportunity to spend time with my kids, mom and dad. The following morning, I was required to return to the hospital so they could check vitals and draw blood for labs. I wish I would had known that would be the last time I could see my kids for almost two months, thanks to the covid-19 isolation policy. When they where checking my temperature, I was 0.1 degrees over their acceptable range, therefor I was admitted back into the ICU. It was very frustrating but I figured it would be short term. I had never been so wrong. My temperature kept rising over the next few days, concerning the doctors. Luckily a couple heavy night sweats returned it to expectable levels. But my lab values taken from my blood showed the doctors that my immune system had started to fail. This became a much bigger issue than a high temp. To this day my ANC, a measure of immunity straight, has not risen above zero, with the exception of a few days recently, but it’s still so low that I am not allowed to leave the hospital. On two occasions I was given the opportunity to see my family threw glass windows, but I was so wrapped up in personal protective gear that I was barely recognizable. But seeing the smiles on my kids’ faces gave me the strength to keep fighting on. We shared lunch together and I read Harry Potter to my kids. I love them very much. It has been even longer since I've seen my wife but after twelve years of marriage, we have a bond that no amount of time can break.

Another helpful situation for being a long-term patent was that a nurse signed me up for the Small Choices Foundation. I have never seen such a loving and caring group of people. They work closely with hospital staff to bring long term patents like me groceries, food and hand made items like pillowcases and blankets to brighten my room from the outside world. They also do my laundry every week and have purchased items like headphones, socks and a jacket that I was in need of. Even during these stay-at-home times, they are working hard to ensure patents receive stuff from the outside world that makes our stays a little more bearable. Thanks Kate!!

My main doctor determined that a stem cell transplant was the next best option. The doctors did try a couple other minor treatments but none did the job, they only caused more work for the already overworked nursing staff. I have had a couple bone marrow biopsy’s and a couple PET scans to ensure we kept following the procedures of the trial and all showed massive reduction of active cancer cells since I received the car T cells, meaning they had done their job well with the exception of the side effect that caused my immune system to crash. Tomorrow (5/4/2020) my older brother is donating some of his stem cells here at CBCI and I be receiving them the following day. Both him and I have been prepping for these days, him receiving a drug that stimulates the stem cells to be ready for collection and me receiving chemo to prepare my immune system to receive his cells. I owe you my life big brother, love is not a strong enough word to describe my feelings for you. To be continued .......