Introducing Nitro & Tank

Our very first pet was a dog. My Dad had a co-worker giving away free puppies, and one day, unbeknownst to my Mom, my Dad brought one home. It was truly love at first sight. We decided to name the dog after its brown fur, Brownie. 

Brownie was a no nonsense dog, and always did her own thing. We craved her love and attention more than she craved ours. In her early years, she was a cranky dog; she chased us on our bicycles, and growled, barked, and bit us. As she got older, she mellowed out and enjoyed walks around the neighborhood, and being outside. She wasn't the perfect dog, but she we loved her unconditionally.

2004. 

After Brownie passed away, my sister got another dog from the ASPCA, a pix bull mix named Annie. While I was sick, and living at home with my parents, Annie played an important role in my recovery. She had lots of energy, and constantly wanted to play ball and loved to go on walks. That in turn motivated me to get out and exercise.

Best buds. 

After I moved in with Andrew, and things had settled down, we decided that it would be nice to have a pet together. We thought about taking Annie, but both of us were working full-time, and keeping any dog in our tiny one-bedroom home for the entire day was unfair.

Annie clearly happier running around in my parents' backyard.

The biggest challenge was finding something that would require little maintenance and space, and after lots of research, we narrowed it down to hamster, rat, or guinea pig. My only preference was that we get a rescue animal. Every year in the United States, too many pets come into shelters and few people consider adoption, so many millions of animals are euthanized. As luck would have it, there was a guinea pig rescue close to our home, the Cavy House Guinea Pig Rescue.

The Cavy House is run by Sue DuHamel, a retired software engineer. She rescues guinea pigs from local shelters and provides the necessary veterinary care and socializing so that they become adoptable and placed into loving, forever homes. It was started in October 2005, and she has rescued over 1,400 guinea pigs!

After submitting our application, and being approved for adoption, we finally set up an appointment to visit the rescue and meet the piggies. We drove to La Honda (about 1 hour south of San Francisco), with a few piggies in mind. Mainly, I really wanted a long-haired guinea pig breed.

Aren't they beautiful?

After spending time and playing with all the adoptable guinea pigs, we ended up selecting a pair of short-haired males (American and Abyssinian hybrid). It turned out personality was more important than appearance, and "the not afraid of peeing and pooping on you, food loving piggies" were the perfect match for us.

The challenge with having two males is that sometimes they fight because they don't get along or need to establish dominance. Oftentimes, people overlook males for this reason, but it was already too late for us; we had fallen in guinea pig love! 😍  🐹  🐹  The rescue had given them names Bart and Monroe, but Andrew and I wanted to give them machismo names to offset their extreme cuteness. There's nothing more manly than the TV show, American Gladiators, so please welcome Nitro and Tank!

The Transporter. 

YAY!

Rally pigs for Super Bowl 50

Carolina Panthers (10) vs. Denver Broncos (24)

Welcome to the family, Nitro and Tank!

Immuno Treatment 1 - Angeles National Forest

Good news!

I passed the first big step in qualifying for the trial. The results from the sponsor were positive; my cancer cells highly expressed (95%) the NY-ESO-1 gene. The next steps would be to meet the additional inclusion criteria, and then sign the consent form.

This time around, I flew to Los Angeles by myself. As much as I love having my Mom with me, getting time off from work was hard for her, and we both knew that it would be a long road ahead. Besides, I was in good hands because my bestie Jamie lives there.

Double Trouble.

Good Old Days.

Jamie's Mom babysat me, my sister, and my brother when we were young, and we all basically grew up together. We lived in the same small town, and went to the same elementary, middle, and high school. Our friendship strengthen during college, and fortified after we both experienced great loss and illness. She's one of the most generous and compassionate people I know, and anyone would be lucky to have her in their life.

Los Angeles is a big city. It's over 500 square miles. As fate would have it, Jamie's house was located close to the imaging centers, blood research facilities, and the Sarcoma Oncology Center. If I was really ambitious, I could even walk there. Most of the people in Los Angeles have to drive to get anywhere.

No one told me how much I needed to get done before enrolling into a clinical trial. I ended up having to stay in Los Angeles for a week for scans, blood draws, and doctor appointments. 

Additionally, remember how I had severe gallbladder issues a few months back, and scheduled elective surgery to remove it? Well, if I proceeded with the surgery, it would delay my treatment by four weeks.

I was very stressed and overwhelmed with everything already going on, and making the last minute decision to cancel my surgery in order to address the cancer first did not help.

Not your time yet. 

After a whirlwind of a week, and meeting all the additional inclusion criteria, I finally signed the 21-page consent form. On the day of treatment, I was randomized to the Atezolizumab and CMB305 (LV305, G305) protocol. I had prayed to receive the treatment that would hit the cancer with both drugs, and as luck would have it, somebody up there was listening.

The immunotherapy itself ended up being a piece of cake. The injections and IV only took a few hours, and the side effects were minimal that I actually flew home the same day!

Easy peasy lemon squeezy. 

Thank you Jamie for introducing me to your friends, and for taking such wonderful care of me. Enjoy my mini adventure with my new LA buddies, Eugene and Kristina!

Angeles National Forest - Switzer Falls

(4.5 miles; 650 feet elevation; 2-3 hours)

Switzer Falls is one of the best known and easily accessible waterfall hikes in Los Angeles County.  The waterfall is a series of several drops, and consists of an upper waterfall (10 feet), a main drop (50 feet), and a lower waterfall (25-30 feet). 

Getting up close and personal with the Arroyo Seco.

The trail follows the creek down into a wooded canyon.

Trying my best to not get my feet wet. 

Heading up those switchbacks. 

We're getting close. 

Enjoying the small pools and cascades of the Lower Switzer Falls. 

In order to reach the main waterfall, you had to scramble alongside a very steep and narrow use trail along the canyon wall to the right side of Arroyo Seco. 

We decided to turn around at this point for safety reasons, but if you continue down the stream scramble, you'll reach the 50 feet drop of the main tier of Switzer Falls. 

Monkeying around. 

Views of the surrounding peaks and canyons below.

Goodnight LA! 

Sit and Wait Game

I received the phone call on a Tuesday evening. By Thursday morning, my Mom and I were on a plane to Los Angeles for my initial consultation. The last minute flight was not cheap for us, but I was still working and I had saved up for rainy days like these. With any aggressive cancer, time is of the essence.

Having my Mom with me made it seem like we were on a fun girls getaway trip, but in the back of my mind, I knew and was avoiding the truth. I was extremely grateful for her presence because she has always been a pillar of strength from which I drew from.

Behind that smile, I was falling apart inside. 

As soon as I saw the Sarcoma Oncology Center, the gravity of my situation hit me. The unspoken truth was that patients are usually sent here when there is nothing left that works and all hope is lost.

The private clinic does not go through an "institutional review board" so they can open trials faster than larger institutions. They also perform many more trials than name brand hospitals. Not all the trials are promising, however. Quantity does not equal quality.

My new home.

The clinical trial that my Stanford oncologist, and my new oncologists, Dr. Chawla and Dr. Kumar, wanted me to start on was the Immune Design Open-Label Phase 2 Randomized Study 232. This clinical trial involved using a viral vector, derived from HIV. As a result, it took months for institutions to get IRB approval. In the entire United States, the Sarcoma Oncology Center in Santa Monica was the only site that was open. Only four patients were currently enrolled. I would be the fifth human ever in the entire world to receive this treatment. 

Patients may test positive for HIV, and are required to carry a special card.

How did it work?

Atezolizumab is an immune system stimulate, and increases production of specific immune system cells (dendritic cells). LV305 is an engineered viral vector that binds to the dendritic cells and changes the DNA of these cells so that it fights cancer cells. G305 trains the immune system to locate and fight my cancer cells (which express the NY-ESO-1 gene).

Image courtesy of Andrew

The first big step to qualifying for the trial was to see if my cancer cells expressed the NY-ESO-1 gene. To do this, my tissue slides and pathology report from Stanford were sent to the Sarcoma Oncology Center who then sent it to the sponsor (Immune Design) to run the tests. 

I would know the results in two weeks. Did I ever tell you that I hate playing the sit and wait game?

Los Angeles, San Diego

HAPPY 30TH BIRTHDAY TO ME!

Never in my wildest dreams did I think that I would be alive for this big milestone in my life. I'm still convinced that I'm living on borrowed time, but for now, it was time to party. To celebrate this monumental day, we watched Star Wars: The Force Awakens, and went to a nice dinner at Gary Danko. Nothing beats a fun movie, and great food. This is what I've done every year growing up, and something that I plan to do until I'm an old lady. Old habits die hard.

The best gift that I got for my birthday was time. Time with my family, and time with Andrew. We spent it taking a road trip to Los Angeles and San Diego. Overall, the trip was lots of fun, but it was overshadowed by my CT results. Below are the impressions:

1. Enlarging right lower lobe or lymph node, along with enlarging subcarinal lymph node are suspicious for progressive metastatic disease.
2. A now 2 x 4 mm nodule in the posterior left upper lobe also shows mild interval enlargement compared with 1/20/2015, suspicious for a site of slow-growing pulmonary metastatic disease
3. Post treatment changes in the right middle lobe, right lower lobe, and left lower lobe as described above.
4. Subacute fracture of the lateral left seventh rib is new compared with 10/8/2015, likely stemming from interval trauma or vigorous coughing.

It was bad news. The tumor had continued to grow. In addition, they found another enlarged lymph node, and a broken rib. The day I feared most had come; the cancer had become resistant.

I'm scared!

In the past, when nodules appeared, there were normally a few decent treatment options. Unfortunately, the location of this nodule made it almost impossible to treat. It was located near my esophagus and heart, and every choice was a bad one. Ablation was done twice already, and the nodule continued to grow. Radiation would cause damage to my esophagus and heart. Surgery would require my entire right lung to be removed, and severely limit my quality of life. Chemotherapy would have been a possibility, but I was already close to reaching my maximum lifetime dose of ifosfamide. 

After lots of thought and discussions with my Sarcoma Team, the plan would be to stop my current chemo drug (Afinitor), and to start on a new immunotherapy clinical trial in Southern California. Since my cancer diagnosis in 2011, I've always been with Stanford, so the decision to leave, and receive treatment hundreds of miles elsewhere was not an easy one to make. However, this was my best chance of being cured, and I would do what I needed to do to beat this.

What a bittersweet way to start my 30's.

The Getty

Los Angeles, CA

Spectacular views of the Santa Monica Mountains, the Pacific Ocean, and Los Angeles.

Welcome.

Covered Goblet with Mythological Scenes. 1680s. Balthasar Briessmann. Ivory.

This goblet shows a procession honoring Bacchus, the Roman God of Wine. 

Dog and Bear. 1600s. Bronze.

The Feast of Dives. Lazurus's Soul Carried to Abraham. 1510-1520.

According to the biblical account, when the beggar Lazarus approached the door to ask for food, a wealthy man sets his dogs upon him. The punishment for this lack of generosity was eternity in hell. 

The Baptism of Christ; The Marriage at Cana; Christ's Entry into Jerusalem; The Last Supper. 1320.

Four moments from Christ's life displayed chronologically from the upper left to lower right.

This frame weighs 297 pounds, and exemplifies French style under Louis XV. 

The early 1600s through the 1700s was a golden age for frame making in Paris during which functional surrounds for paintings became expressions of artistry, innovation, taste, and wealth.

Intricately carved leafs.

Hall of Mirrors déjà vu?

The identities of most frame makers in Paris were unknown before 1750. Most begun their preparation as a woodworker with nine years of training in the workshop of another master, followed by six years as an apprentice, and another three years as a journeyman.

Beautiful.

The Meeting of the Three Kings, with David and Isiah. 1480.

This panel originally formed part of an alterpiece wing. It illustrates the joyful celebration of the kings with the unification of mankind at the birth of Jesus.

La Roldana. Saint Ginés de la Jara. 1692.

The statue displays the realistic expression found in Spanish religious imagery made for churches and convents in the second half of the 1600s.

Paintings galore!

Rembrandt. A Portrait of a Rabbi. 1606-1669. Oil on panel.

Rembrandt painted and drew numerous elderly male subjects throughout his career. He was sensitive to Jewish tradition and sought to capture its character through the representation of physical appearance and an internal spiritual state.

Sister bonding time.

Gianlorenzo Bernini. Neptune with Dolphin. 1623-1700. Bronze.

Neptune, Roman God of the Sea, is shown with unruly hair and beard and wildly billowing drapery. 

No fighting allowed.

André-Charles Boulle. Cabinet on Stand. 1675-1680. Oak.

Boulle was the royal cabinetmaker. He specialized in making elaborate pieces to demonstrate the wealth and prestige of the owner through the opulence of design and ornamentation.

Sleepy time.

Jean-Étienne Liotard. Maria Frederike van Reede-Athlone at Seven Years of Age. 1755-1756. Pastel on vellum.

Liotard captured the beauty and elegance of the young baroness with her luxurious French dress, and simple English hairdo. The simple chromatic range, and the vivid ultramarine blue makes it one of the most ravishing of all 18th century pastel portraits.

Edgar Degas. Russian Dancers. 1899. Pastel on tracing paper.

In a departure from his well known depictions of ballet, Degas produced a dazzling series portraying the unfamiliar steps of Ukrainian folk dance.

Jean-Désiré Ringel d'Illzach. 1889. Bronze and copper.

This monumental vase was first exhibited at the World's Fair in Paris in 1889. Its surface include casts of spiders, a juniper branch, peacock feathers, lace ribbons, and snails.

Pierre-Auguste Renoir. La Promenade. 1870. Oil on canvas.

Themes of courtship and leisure often appear in Renoir's art. Here a young man leads an elegantly dressed woman into the shade and privacy of the woods.

Vincent van Gogh. Irises. 1889. Oil on canvas.

Van Gogh painted Irises in the garden of the asylum at Saint-Rémy, where he was recuperating from a severe attack of mental illness. Its energy and theme of the regenerative powers of the earth expresses his deeply personal belief in the divinity of art and nature.

Claude Monet. The Portal of Rouen Cathedral in Morning Light. 1894. Oil on canvas.

Between 1892 and 1894, Monet turned away from his usual landscape subjects and painted thirty views of Rouen Cathedral. The Gothic monument had rich textured surface on which light and atmosphere produced infinite colorful variations.

Auguste Rodin. Christ and Mary Magdalene. 1908. Marble.

Rodin's believed the conception of  life involved suffering and martyrdom, and incorporated these themes into his works. This group was never cast in bronze and only one other marble version exists, in the Thyssen-Bornemisza collection in Madrid.

Gardens

The Central Garden was created by artist Robert Irwin. The 134,000 square foot design constantly changes as plants grow, are trimmed, and new plants are added.

Cactus Garden.

I ♥ LA 

Car Wreck Trail via Aliso Viejo Canyon Trail

Laguna Beach, CA

On your mark, get set, go! 

Best Buds Part 1.

Best Buds Part 2.

OK, let's go.

Sweeping views of the Pacific Ocean.

We're at the Top of the World.

😄

I get by with a little help from my friends.

Making our way to the wreck.

There are no paved trails within a several mile radius, so it’s a mystery as to how the car ended up there.

Be careful on the way down.

The remnants of the car crash date back several decades. The wreck is sheltered underneath some dense overgrown foliage that extends into a creek at the canyon’s base.

"Beep beep mf!"

San Diego Zoo

San Diego, CA

Flamingo Lagoon was opened on July 1954, and has been welcoming visitors ever since.

Heading through the Fern Canyon Trail.

The takin is a type of goat-antelope that habitat in the forests of China. They are great climbers and can leap over six feet!

Make sure you go early to avoid the long lines at the Panda Trek.

Pandas are solitary by nature, and require up to 36 pounds of bamboo each day to survive.

[Vy & Andrew holding Panda]

The harpy eagle have talons the size of grizzly bear claws, and hunt large animals like sloths, monkeys, and even domestic sheep.

Entering the Northern Frontier.

That's the sealiest thing I've ever seen. 

That's impawsible. 

Arctic diving ducks feed on mollusks and crustaceans living on the ocean floor. To overcome their natural buoyancy, they reduce the amount of air in their feathers, lungs, and air lacks. 

Mom, I love you a TON!

Tapirs use their flexible snout to gather food, and as a handy snorkel when they're submerged in water. 

Guanacos are the wild relatives of the llama. They live in the Andes Mountains and are able to survive on little water from the plants they eat. 

Let's get trunk.

Pronghorns are the fastest land mammal in the Western Hemisphere with speeds up to 43 miles per hour. 

Meerkats take turns being a lookout for predators while the other eat, play, or sun. When a meerkat lookout spies a predator, it barks an alarm that sends the whole group running for cover. 

I give top-koality hugs. 

How many koalas can you spot?

You're giraffing me crazy. 

Siamang are masters of the suspended, arm swinging style of locomotion. Orangutans watch and learn from each other and pass such behaviors on to their offspring.  

A baby gorilla stays close to its mother for the three years it's nursing. When Mom travels through the dense forest, the youngster rides on her back, clinging to her long hair. 

A dominant male hippo marks his territory by flinging his dung as far as possible with his tail. The large amount of dung hippos produce fertilizes the African ecosystem.

I had so much pun at the San Diego Zoo!

Hotel del Coronado

Coronado, CA

Hotel del Coronado is one of the few surviving examples of American architectural genre: the wooden Victorian beach resort.

When Hotel del Coronado opened in 1888, it was the largest resort hotel in the world.

The Plunge. 1915.

The hotel has hosted presidents, royalty, and celebrities through the years. Notable guests have included Thomas Edison, Charlie Chaplin, King Kalakaua of Hawaii, Babe Ruth, and Katharine Hepburn. 

Goodbye 2015. Hello 2016.

Cabrillo National Monument

San Diego, CA

Cabrillo National Monument commemorates the landing of Juan Rodríguez Cabrillo and his crew at San Diego Bay on September 28, 1542. This event marked the first time Europeans set foot on what later became the West Coast of the United States.

Area map around Cabrillo National Monument.

Today, the large natural harbor is headquarters for part of the Navy's Pacific Fleet, and many shore based naval facilities. Fishing and shipbuilding are major industries, and San Diego's colleges and universities offer specialized study in oceanography and marine biology.

Cabrillo Statue. 

"Age of Exploration" Exhibit Room

On June 27, 1542, Juan Rodríguez Cabrillo set sail with three vessels (San Salvador, Victoria, and San Miguel) and about 250 men to explore the uncharted Pacific coast of the Americas. 

Cabrillo sailed north from Navidad, Mexico, and hoped to find a passageway to the Atlantic or a coastal route to the Spice Islands (Moluccas) and the riches of Asia. 

Coast Defense Exhibit

In 1918, the United States Army constructed this building to serve as its first radio station for harbor defenses in San Diego. During WWII, the building housed a meteorological station to support coastal artillery. Today, the station houses a permanent exhibit about San Diego's WWII harbor defenses.

Defenses of the West Coast 

World War II

After the attack on Pearl Harbor, San Diego seemed extremely vulnerable because only two 8-inch guns were available at Fort Rosecrans to defend against the Japanese. In 1944, the 16-inch navel surplus guns (the largest guns in the U.S. arsenal) were installed at Battery Ashburn.

Old Point Loma Lighthouse

This lighthouse was built in 1854, and was one of the first eight lighthouses on the Pacific Coast. For many years, it was the highest coastal light in the country (over 400 feet above sea level). The fog and low clouds made it difficult to see, so a new lighthouse was built at a lower elevation in 1891.

The Henry-Lepaute lens in the tower today is similar to the 3rd Order lens that was in use from 1855 until 1891.

One more lens!

This 3rd Order lens was in the "new" Point Loma Lighthouse from 1891 until 1997.

Bayside Trail

The trail winds along an old military defense road, and takes you through a prime example of endangered coastal sage scrub habitat.

Neat.

This shelter housed a 60 inch diameter searchlight used to illuminate ships approaching San Diego harbor entrance during WWI and WWII. It was stored above ground in a camouflaged shelter, and mounted on a 75 foot narrow gauge track.

Cliff areas in the park are very unstable. Stay back from cliff edges.

What a view.

Potato Chip Rock via Mt. Woodson Trail

(8 miles roundtrip; 3-4 hours; 1,700 feet elevation gain)

Poway, CA

Lake Poway.

The terrain is rough, and partially shaded. 

Unique rock formations.

Hiking up to Mt. Woodson Summit. 

Don’t be surprised to find a line of people waiting to take their picture on this popular rock.

Crazy crowds!

Amazingly delicious.

The summit complex is overrun with satellite towers.

Break time.

View of Highway 67 and Iron Mountain. 

Thank you for a great time San Diego!