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Need help whacking down metastatic colon cancer

  • Checking in, 2022

      18 October 2022
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    Dear all,

    It's been a year, almost, since my last "wellness check". Ha ha!

    I keep on getting distracted and then the Givealittle page logs me out and I lose my update. I should learn from this mistake, but instead I am foolishly charging ahead.

    Hopefully I will be able to maintain a stream of consciousness and stop randomly clicking on tabs. These are the things that are distracting me from finishing this post in a timely, time-bounded fashion:

    1) My son the Shoot, now 10, is very depressed about doing his piano practice and I have to keep getting up to nag him. Joseph is practicing with him now, after the Shoot spent 50 minutes sitting at the piano bench. What was the kid doing all day!? He was listening to Harry Potter audiobooks! Argh!

    2) The kids are involved in this little community nature education/weeding group I organized, called the Wetland Rangers. Across the street from our house is a little natural area / nature reserve called the Mehraban Wetland Park. (You can google it.) It is small but unfortunately the ponds are experiencing algal blooms because of the low water (due to our ongoing climate-change-induced drought) and also because of high nutrient runoff. Furthermore an invasive weed called phragmites is spreading aggressively and trying to take over. It is like the cancer of plants in Utah. So naturally I hate it with a passion. The Wetland Rangers got a grant from the Utah Native Plant Society to install educational signs in the wetlands to educate community members about the "good" and "bad" plants and give them something to do about them. We are trying to get these plants ready to print tomorrow and so I keep on jumping back to our Canva file which I am proofreading and to check that the kids' original art gets included in the signs for river birch, cottonwood, coyote willow, phragmite, Russian olive, box elder, curly willow, crack willow, etc.

    3) Joseph brought home mango mochi ice cream from the local grocery store. I got up twice to eat two. Yum.

    4) I am speaking at the Draper City Council meeting tomorrow to ask the city council members to invest in helping to solve wetland problems. Right now the engineering department is claiming that the big pond right in front of our house is not actually a recreational pond but is a stormwater catchment basin, i.e., a big puddle. "We do not maintain or invest in improvement for big puddles," they told us. However, in the use of the pond, it is clearly being used, by the public, as a recreational pond. Members of the public use the big pond just as they use the little pond (an "official" or bona fide recreational pond, according to the city). The state fishery stocks the big pond with fish just as they stock the little pond. I wrote a letter and popped out to the HOA meeting tonight to get my neighbors to sign it. I am going to bribe the Shoot to help me make the presentation tomorrow night for maximum cuteness/memorable-ness impact.

    5) I ate leftover fried rice. I always make fried rice the way my mother made it, with crispy rice. To do this, first you stir-fry all the non-rice items, like the carrot, celery, onion, eggplant, green pepper, sausage, tofu chunks. Then you tip them into a big bowl. Then you clean the bottom of the pan, add generous oil, and dump in leftover white rice from the fridge. Then you let it fry on medium heat until the rice becomes golden brown. Then you flip the rice and let the other side start to brown (but not for as long as the first side or else you will get burning because some of the rice will have started to stick). Then you dump in all the other wetter ingredients and mix together. Then you add seasoning like salt, pepper, possibly a little chili, possibly a little cayenne. I was taught by this old lady who lived next door to us in Hefei that it is always better to go light on seasoning to preserve the "original flavor" of the food ingredients themselves, like the vegetables. She was a cool person. I went shopping with her once. We walked around the market stalls and she was muttering to herself, "What kind of veggie do I want to eat today?" There were so many options from the many varieties of cabbage to bitter melon to sweet potato greens to chrysanthemum greens to spinach, bok choy, baby bok choy, Shanghai green, eggplant, etc. Unfortunately the Shoot does not like eggplant. This particular bowl of leftover fried rice had a high eggplant to other ingredient ratio because the Shoot had picked out the eggplant and put it back into the bowl before eating.

    So oh boy, I'm glad that I'm still typing. I have virtuously stuck with this task. I get after my kids for playing video games but look at me! Attention span of a goldfish!!!!

    This is where I am with health:

    Several months ago the immunotherapy I was on stopped working. Cancer starting progressing. CEA (tumour marker) was steadily rising. I was now in the land of "well, sorry, all of our tricks are used up, and you will have to try random science experiments / cutting edge research / clinical trials."

    So I tried a clinical trial at City of Hope in Los Angeles in June 2022 and I was really excited about this one because the thing they were using had achieved super awesome results in another trial in Germany. But this one turned out to be rubbish and did nothing at all, which was sort of annoying because I paid for it by myself, because my work insurance doesn't cover clinical trials. DMBA prides itself on being "really good insurance" or "better than average insurance" but the problem is, the majority of insurances pay for clinical trials. DMBA has an extremely conservative philosophy and doesn't do any healthcare if is it new, progressive, or cutting-edge, because it considers those things bad. Therefore, it does not believe in benefitting from the medical innovations of the twenty-first century.

    In July I went back to NZ for a week to teach the first week of my late imperial Chinese history class. This was super fun. I loved it so much. It was great to see so many familiar faces and to work with the Uni people again. Very interesting is, this was right in the middle of my "oh no the normal stuff is not working and the first clinical trial was rubbish so you are basically going downhill from here on out" crisis. I had a lot of pain, and could feel lots of weird stuff inside me, and had trouble sleeping. Strangely this pain and weird stuff is gone now, even before I started on the panitumimab regime I'm on now. Ah, it would have been wonderful to have stayed in New Zealand! But, I think if I would have stayed in New Zealand, I wouldn't be alive right now.

    This sort of encapsulates the problem with different healthcare systems. New Zealand wasn't cutting edge enough because there weren't enough people to provide access to dozens of metastatic cancer clinical trials (both through funding for national healthcare and also through sheer numbers of trial subjects). But in America, even when you have access to these cutting edge things, your insurance might not pay for it and so it might be thousands or tens of thousands or hundreds of thousands of dollars. It is a real problem. I wish I knew the answer.

    In all fairness, some of these clinical trials truly are science experiments that won't necessarily deliver benefit to me. In August I did a double-whammy clinical trial at the National Institute of Health in Washington DC. Both are, again, extremely cutting edge, and really cool science, but it's not looking like they will be super helpful. The more hopeful of the two clinical trials, which focusses on TIL (tumour-infiltrating-lymphocytes) didn't find anything they could use. The other clinical trial hasn't really helped anyone that much besides do some spot cleaning of the tumors (it disappears from the lungs, but not the liver, etc.), though this is still a cool idea. In August they harvested tons of lymphocytes from me and they are going to try to genetically engineer those lymphocytes to hate my tumour, and attach to it like a personalized virus and kill it. Perhaps I'll get some sort of marginal benefit from it? Maybe a slight shrinking of some tumours? It's apparently better than radiation therapy which has shown that the collateral damage is worse than the tumour control for people with my kind of cancer.

    Anyway, the current status of me is: cancer is still metastatic, and has grown and spread quite a bit, but it's not as bad as it was before HIPEC in 2020, and it's not causing me any pain. Hopefully one of these clinical trials gives it a good mow and keeps me alive long enough to find something else that continues to prolong my life.

    I climbed Lone Peak in September with the kids. I was super tired and Joseph had to carry my pack for at least two hours, but it was about 2380 meters (7800 feet) of vertical elevation gain. It was about 10 hours of stumbling uphill. But, the top was nice, and we saw mountain goats. I include a picture here from our camp just below the summit peak. The summit peak is a little overexposed but you can see it in the background.

    The kids are all growing up. I have two teenage boys now which is challenging. The sullen silences! The blatant ignoring of me, the parent! Aaaaaggghhh!!!!!

    OK, I'd better go before this form times out and I lose what I wrote. Things are going well. My cancer hasn't disappeared, and indeed is sort of slowly creeping up on me, but it feels a lot less dire than it did several months ago when I could feel it pressing against something and imagined, melodramatically, that I was being "crushed from the inside by many swelling fists". It did feel like that then, but the current treatment I'm on, panitumimab, has reduced the size of the tumours and also lowered my CEA. It won't last for more than a number of months, and it gives me acne and thin skin, but this has been pretty manageable. You can get used to anything! Life is interesting. Hope you are all well. Thanks for my life! It is good!

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    • 18/10/2022 by Eddie

      Thank you for the update, Melissa. I just had to comment about your 10 year old son and the Harry Potter audiobooks -- my 8 eight old daughter Clara is also totally obsessed with them! She listens to them overnight while she sleeps. Thinking of you and your family while silently annoyed about overnight audiobook listening. :)

  • Thanksgiving!

      23 November 2021
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    Dear everyone,

    Thank you, thank you, thank you for my still-living life!

    I am just sitting here thinking about where I was in June 2019. I was full of ascites fluid (the sign of "one year to live"). There was fluid in my lungs and I couldn't get full breaths. There was cancer in my small intestine, making it impossible to do HIPEC/CRS surgery. I was telling my husband I wanted a closed-casket funeral.

    Then miracles started to happen. Chief among these was this amazing givealittle fundraiser which allowed me to privately purchase the super expensive drug that made my chemotherapy much more effective, preventing the tumours from going crazy. It also allowed me to move back to the U.S. where I could get a number of treatments that I wasn't able to get in NZ, namely HIPEC/CRS (a surgery where they cut out all the cancer they can see and then bathe your insides in boiling hot chemo), and then more chemo, and then immunotherapy, and then a super new drug called Enhertu which I am on now. This new Enhertu drug is really cool because it's "targeted." It's an antibody that attaches to the HER2 gene in the tumour cells and then an enzyme in the tumour breaks down a membrane which releases the "payload" of eight molecules of chemo. Boom! the chemo bombs the tumour cell and just the cells immediately around it. It is way more tolerable than poisoning the whole body. It is the future of cancer treatment.

    It is incredible that I'm still around. It would not be possible without your generous support.

    I feel like I should give some accounting to the people who have invested in my life, so here's what I've done since then:

    1) I got a new job (but kept the old one). I now work as a historian at the Church History Department of the Church of Jesus Christ of Latter-day Saints, and also part time (.2 FTE) at the University of Auckland.

    2) I now have two teenagers, one of whom is now way taller than me. Okay, it's not hard to be way taller than me, but it's still fun! The Bean is 15, the Sprout is 13, the Leaf is 11, and the Shoot is 9!

    3) Joseph is now working as a math teacher. He likes being a teacher more than being a lawyer because the hours are shorter. He is very hands-on and recently built a go-cart with his kids. Then, when he was test-driving it, and had just taken it apart and put it back together but only finger-tightened some of the bolts, the bolt controlling the steering fell off and he crashed into our car at 22.5 miles per hour / 36 km per hour. He dislocated his shoulder but was fine otherwise. Oh dear, oh dear.

    4) I have gotten involved in local school politics. I am on the "School Community Council" for the Shoot's elementary school, Draper Elementary.

    5) I have had two Christmases and one pandemic.

    6) I like to go hiking in the mountains. Bertie, who was a puppy in New Zealand, now feels like a proper Utah dog. He's still really bad at "Come." Sigh.

    In short we are doing really well, though I will say, the teen years are kicking my behind!

    It's late now, and I hear that my load of laundry has just finished. Joseph is snoring on the couch. Bertie is snoring by the fireplace. The kids are asleep upstairs. This night, I am profoundly grateful for my life. In that dark time in June/July/August 2019, I never imagined I would still be doing laundry, listening to a sleeping house, over two years later. In these two years I've seen the hand of God, the skill of doctors, the diligence of scientists, and, most of all, the kindness and generosity of my friends and family. All of these are miraculous.

    Thank you so much for your kindness to me and to my family. As the holiday season approaches, best wishes to you for joy, hope, and peace.

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  • Post-HIPEC Hello!

      28 February 2020

    Dear friends, hello!

    On Monday evening I looked at my phone and saw a message from Intermountain Healthcare. Oh shoot! I thought. I missed my oncology appointment! I have gotten out of the habit of feeling cancerous and totally forgot about it.

    It is just over a month since my HIPEC surgery. The surgery itself was easy, because I was asleep. Probably the two most unpleasant things about the entire experience and hospital stay were:

    1) I had a super, super dry mouth on Day 1 and Day 2 of recovery, because of the various drugs and because I wasn't allowed to drink water because sometimes when patients get water into their stomachs post surgery they vomit and this is bad because your abdomen is being held together with staples. No vomiting for me! But, no water.

    2) I had a fit of coughing somewhere around Day 4. It hurt my stomach. I ran out into the hallway and got the nurses to tighten the binder around my stomach.

    I felt super normal and was out of the hospital after about six days but then on Day 10, I think it was, I had a horrible back spasm that was kind of like being in labor. My uncle who is a doctor thinks it was an electrolyte imbalance which can create severe cramps. Anyway it was the most horrible pain of my life, ever (ironically having nothing to do with just having been partially eviscerated) but then they gave me morphine and that was awesome.

    But it was just that one day. (That one morning, actually.) After that life was normal, except that I was fifteen pounds (about 7 kg) lighter (tumour, plus fluids, plus fat lost over the course of months and months of being full of fluids).

    None of my clothes fit, so I had the choice of either buying new clothes or eating ice cream. Of course, the correct choice here is "eating ice cream." This is working really nicely!

    All this is to say that a month after my surgery I feel completely fine, SO much lighter, and so much more comfortable! Before, when I walked up two flights of stairs, I would feel not just winded, but as if there wasn't enough. (There definitely wasn't, because two days before my surgery they took 2 liters out of my plural space.) Now it is no problem.

    In the best case scenario I have been cured of this cancer. In the worst scenario they have mowed the grass super low. In either scenario I am so very grateful to have gotten my body, my breath, and my life back.

    All of this was able to happen because you kindly gave my family and me the support we needed to relocate to a place where I could get treatment, and this surgery. I am so very grateful. I think about how close together are life's contrasts of pain and comfort, suffering and cheer. I don't understand them but I know that both of them are real and meaningful.

    I feel indebted to so many people, but this debt feels not like a burden, but like a source of richness. Thank you for your kindness, your generosity, and your faith in me. Thank you, thank you!

    Melissa

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  • Just a little holiday hello

      9 December 2019
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    Dear everyone

    This is just a note to wish everyone the greetings of the season! In New Zealand people are hitting the beaches. In Salt Lake City people are hitting the ski slopes. After the first snow, our kids were so excited they went into the backyard and used basically half the snow from the entire backyard to make a snow person (I would say "snow man" but they put my hat on it and proclaimed that it was Mama).

    There's good medical news: the HIPEC surgeon did a laparoscopic investigation of my innards and said that she was "pleasantly surprised" that the tumor was localized in one place. She said that I am a candidate for HIPEC surgery, which involves "debulking" (i.e. taking out all the visible cancer) and then filling the abdominal cavity with hot chemo chemicals and rocking my body back and forth for an hour and a half to slosh all the chemicals around and hopefully kill the other microscopic cancers. So . . . yay? (Of course, it's yay! Just sounds a bit uncomfortable.)

    This surgery was not available to me in New Zealand, so once again, I would like to thank you so much for your kind and generous support which has facilitated our move to the US where I can access these treatments, and where I have many family members around me. For my laparoscopic surgery, for instance (when the HIPEC surgeon was just looking around with the camera) Joseph had to teach at his school, so my two great-aunts took me in to the hospital and spoke to the surgeon while I was in post-op recovery. My family is surrounded by a veritable army of loving cousins, aunts, uncles, great-aunts, great-uncles, and grandparents. It is fantastic, and it is the best sort of environment for healing (for me) and family support (for Joseph and the kids) that could ever be.

    Thank you, thank you, thank you.

    Lest I make America seem like a health paradise, I will note that my insurance company recently restricted the number of doses of Cetuximab I could receive (one of the drugs I was having to pay for privately in New Zealand), so, the same problems seem to be everywhere to some degree. But, when the letter came, it wasn't devastating because we thought, "Hey, we have a medical fund for that!"

    I really don't know how to thank you enough. Thank you very, very much, from me, and from Joseph, and [though they don't yet think of life in these terms, but just complain about having to get up to go to school every day] from the kids.

    Best wishes

    Melissa

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  • healing and dealing

      9 October 2019

    Dear everyone,

    This is just a little update to say that this coming Monday will be my Fourth American Chemo (Eighth-Post-Recurrence Chemo). Time flies when you have IV infusions once every two weeks!

    I have a meeting with a HIPEC surgeon at the Huntsman Cancer Institute tomorrow. HIPEC is a surgery that in some cases has improved outcomes for metastatic peritoneal cancer patients. You have to fit a certain narrow profile, however, and in my case the cancer may be in too many places to be operable. Nevertheless I feel happy to be investigating new possibilities. The NZ HIPEC surgeons already gave up on me, but hopefully this is because the NZ system itself is just inherently more conservative when it comes to metastatic patients.

    Besides the medical stuff, things are going pretty well. The two older boys are in middle school. We were squatting at my cousin Emily's house for the first month or so, and then we found our own place to live, but it's still within the same school boundaries, so that's good. The two younger kids go to school with Joseph. Joseph is teaching at a K-8 charter school called Pacific Heritage Academy, run by a Kiwi, with a school wide ethos of honoring Pacific cultures. The school uniforms include school values like Responsibility, Craftsmanship, etc., in Samoan, Tongan, Māori, Hawaiian, and English. All this is to say that all things considered it's been a relatively soft landing for the kids, school wise. Of course it is really hard to move to a new place and a new school, especially since American schools are so much longer and have fewer breaks. (What's up with that, America!?) But the kids seem to have settled in.

    Joseph just finished the first term (PHA has a Pacific-style year-round schedule, as well). This week is their inter-term break. Yesterday he was working hard to finish the term progress reports, with a bit of furtive reduplication as he tried to come up with positive, original things to say about students. I was sympathetic as he worked his way through the stack.

    I can't believe that right now my colleagues at the University of Auckland are already beginning to see the finish line for the end of the second semester. The time has passed so quickly (and, the University of Auckland's academic calendar is the best!!!!). As I write this it is 11 PM in Utah, which means it's 6 PM in Auckland on a Wednesday. In my mind's eye I can see the end-of-day light on the Northwestern Cycleway, the golden cast on the water and the herons standing at the edge of the mangroves. I can see the traffic on the motorway as people leave the city behind and return to their kitchens and kids. I know the wet, forest-y smell in the air along the bike path that leads to our old house in Sunnyvale. I can see the kids riding their bikes at the end of our street, and Bertie the dog galloping happily alongside them.

    At times like this I feel a bit of sadness, as if life's circumstances have snatched me, my husband, and my kids from our happy, charmed life in Auckland and dropped us here in the middle of Trump-land to face uncertainty about the future. (Even Bertie the dog is a bit depressed because we live in a neighborhood where dogs are strictly on-leash.)

    But when I take time to consider the whole picture, the sadness shrinks in comparison to the gratitude that I feel to be so close to my cousins, aunts, uncles, and old friends. In this sense I really have come home to a place of refuge. I feel that this is the place that's best for healing and dealing (healing in the long term, and in the short term, dealing with vomit, IV issues, and the many indignities of treatment).

    Moving has been extremely expensive (no surprise there), as have insurance co-pays/co-insurance/premiums, and we have drawn on your generous support to get here and fund treatment. We could not have made this move without this help.

    All this is to say that I am so grateful to you for your kind support, and mindful of the responsibility to invest this support in my health and helping my family cope. Your generosity has made it possible for us to be flung across the Pacific but still land on our feet, and to access significant healthcare and family support resources that were not available before.

    At night, when I turn out the lights and stretch out to sleep, I think about all of the people who, inexplicably, have come to my aid and my family's aid, who are pulling for me with their hearts and minds. As my friend Patrick reminded me, that love has power. Thank you so much for this.

    Love

    Melissa

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    • 10/10/2019 by Tracey

      Kia ora Melissa, Lovely to here that you and the whānau are settling in and forging on. I admire your spirit.

      Ka mahi te tawa uho ki te riri.

      Arohanui, Tracey

  • Back in the USSA

      21 August 2019

    Dear all

    This is just a little update to say that after consulting with my NZ and US doctors, we have decided to move home to the US where I can be close to family support and within striking distance of any new clinical trials. I will be keeping up the same chemo schedule. Now, instead of using my GiveALittle funds to pay for private bevacumizab and cetuximab, I'll be using them to pay for insurance premiums, out-of-pocket costs, and any traveling expenses for trials or consultations with other doctors. In NZ I used them to help pay for our tickets back to the States, and our moving fees. I also used them in NZ to fund a final CT-PET scan right before I left (my US doctor requested it, but the NZ doctors said that the public system couldn't fund it, so I paid for it myself using these medical funds).

    The news from this most recent CT-PET scan is that the response to the chemo is good (tumor hates the taste of chemo chemicals as much as I do). Super!

    With regard to the treatments, I feel kind of yucky and sick on the first day of treatment, then considerably better on the second and third days of treatment, and then after the third day, when I get unplugged from the chemo, I feel just fine.

    We are living with my cousin Emily in Sandy, Utah. My kids love playing with their cousins on my side and on Joseph's side. Joseph has started his new job teaching middle school math at Pacific Heritage Academy. It's a bit of a baptism by fire, but Leaf and Shoot, who are also going to school at PHA, are enjoying spending so much time with their dad. Bean and Sprout have started middle school at Indian Hills Middle School, two blocks from Emily's house. They seem to like their teachers but are generally unimpressed by the increased length of the school day and the lack of breaks like morning tea and afternoon tea.

    Many thanks to all of you, again, for making it possible for me and my family to move forward into these new spaces and new challenges with confidence. I am so grateful for your kindness and continue to feel completely overwhelmed by your generous support for me. I will keep chugging!

    Here's a fun fact: When I am on chemo, not only the chemo chemicals itself, but also my blood and all of my body fluids are toxic and potentially damaging to human tissue. Nobody but me is supposed to touch them. Beware the poison boogies!

    Cytotoxically yours,

    Melissa

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    • 21/08/2019 by Awhi

      Love your sense of humour and kind nature even under these extreme circumstances.

      Im praying for you and your family.

      Aroha nui

    • 21/08/2019 by Amber

      Kia ora Melissa,

      It’s so good to know you’re in the family fold and feeling love and support at every turn. Kia kaha and keep on growling at that tumour. Warrior wahine! Amber xx

  • Holy smokes, this is amazing

      13 July 2019
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    Dear friends and family: I am completely astounded that after four days we have already reached the fundraising goal. I don't know what to say except to say that I am profoundly grateful.

    Usually one doesn't publicly share details about one's intestines, but I feel like I owe you all a personal sort of update. On Thursday I met with the oncologist. He gave me the results of a new CT-PET scan and said that my small intestine looks okay! So this is great! The tumour is not so great -- a big nasty mass kind of connecting part of the peritoneum and the left ovary.

    I watched the images of the scan with fascination. I saw a skeleton, lungs, kidneys, and a brightly lit mass on the left side of the pelvis. The scan images had an "animation" feature that rotated the body around. I was very angry to see the tumour, just hanging out there. I growled at it like a samurai. At least, this is how I think samurai growl.

    Your kind gestures and words of support have lifted me up. A life-threatening illness is a heavy thing but I now have your words of encouragement ringing in my head when I feel tired.

    I have my second chemo (now fully funded by you -- such a relief!) from Monday-Wednesday this coming week. Joseph, doctors, my clinical-trial-researching-friends, and I continue to monitor my health situation and explore possibilities and plans.

    I will do my best to deliver a very super return on your generous investment in my ongoing survival! Thank you, thank you, thank you!

    -- Melissa

    (p.s. the Bean, my oldest, is missing from this photo because he is visiting his grandparents in the US)

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  • Incredibly grateful

      10 July 2019

    Dear friends and family: Joseph, the kids, and I are incredibly grateful for the generous outpouring of support in just the first day since our funding appeal went out. Thank you for the messages of love and encouragement. The silver lining to having horrible health is that you get to hear from all sorts of old friends, from all over the world! It's kind of like going to your funeral early, but hopefully avoiding the death-y bits of the funeral! Anyway, these funds are literally lifesaving for me. They will buy me more time and hopefully more long-term options. And your messages of support are things to treasure. Thank you, thank you, thank you.

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