Written March 15, 2018

My name is Jennifer Miller. Some may know me as Jennifer Willard. I want to share my story with Melanoma. First a little bit of history of who I am. I am wife to an amazing husband Kenny and the very proud mother of Paige. Paige is 12 years old. I am no stranger to health issues. As a child I was diagnosed with Asthma at 18 months old. I have had endured a great deal of time in the hospital. I have been on life support two times due to the inability to support my own breath. The first time was when I was in elementary school. The second time I was an adult. One month after Kenny and I had gotten married in 2001. I have endured other issues in my childhood as well into adult hood. However, I wish to share my journey with Melanoma.

It was in the summer of 2012; Kenny and I were driving to a softball game. You know how you can feel someone is just staring at you and youre like whats up. That was the feeling I had. I said, What are you looking at? Kenny was like, your ear, it looks funny. My ear looked like someone dumped ink on the top of my ear. My left ear now had the appearance of ink splattered. So, I called my dermatologist. I told them what it resembled. As well I informed them that my Mam has had Melanoma in the past. They were able to schedule me in an acute appointment. I had to go to a clinic location that I normally dont go to. But wouldnt you know it, it was my Dermatology doctor that walked through the door. My left ear was biopsied and sent to pathology. Within a few days I received a phone call. The words spoken to me, Mrs. Miller Im sorry to tell you but you have Melanoma. The tears flowed down my face. Paige at the time was only in first grade. I didnt know what to think. We went to see a surgeon who specializes in Melanoma. I had a wide resection with reconstruction of my ear performed. That was all the intervention needed. I had sentinel lymph node mapping done to my ear. It was four injections of contrast in the ear to evaluate any spread to the nearest lymph nodes. I had two lymph nodes taken out the day of surgery because they had uptake of the contrast. Now we went for the pathology results of the lymph nodes. We received the call. The lymph nodes were fine. With exception of dermatologist visits every three months, graduating to every six months. Awesome right?

Well, shortly after reaching my two-year cancer free markit all changed. This was the talk end of 2014. I had developed what appeared to be a blood blister on my left ear. The location of this blood blister was where my resection of ear had taken place. I called my dermatologist made an appointment. Told them of my history of Melanoma. I received an appointment very quickly. My left ear was biopsied and sample sent to pathology. This time my Dermatology doctor wanted Kenny and I to come into the office when the pathology results came in. I knew in my heart it was not good. We went back to the clinic and the words its Melanoma. That day was a whirlwind. My Dermatologist made a phone call to the cancer clinic. Before I could catch my breath and wrap my thoughts around what was happening, we were in stride towards the cancer clinic. That day I had an appointment for surgery on my left ear, a Pet scan, and a brain MRI. The Pet scan and MRI were to look for any spreading of the cancer to other organs. I also had the sentinel lymph node mapping. The injections of contrast in my left ear. Pet scan and MRI were fine. The lymph nodes were fine. Another wide resection of my left ear took place. After surgery was completed the next course of action was Interferon. During this journey I had surgery for placement of a medication port. It is under the skin. Reflecting back, it was several weeks, Monday through Friday I had received Interferon. I completed the course of Interferon. I then was placed on Sylatron. An injection that I had to give myself every week. The plan was to be on that for a year. During this time, I also had genetic testing done. I have a genetic mutation known as ATM. This now places me 52% higher risk to develop Breast cancer and 7% higher risk to develop Pancreatic cancer. I did have two spots on my right breast that were of concern. They were biopsied and sent to pathology. Results were good. Because of this gene I have been getting breast mammograms and breast MRIs every six months since 2015.

While I was on Sylatron my Melanoma had spread farther down my left ear. It appeared as two blue dots. Called the dermatology clinic once again. Went in and the doctor biopsied my left ear. Sample sent to pathology. Results Melanoma again. Sylatron was stopped. Radiation treatment to the left ear in conjunction with Yervoy infusion began. After radiation course I had developed cellulitis of my ear. I was admitted to the hospital and received three intravenous antibiotics. I was in the hospital a week. Sent home on oral antibiotics. It didnt get better. Back to the hospital. This time I went back into the operating room. I had what us called a wash out and more of my ear removed.

Since 2015 I have been getting Pet scans every three months. I had finally returned to work in mid 2016. April 2017 my pet scan revealed a hot spot in my lymph node located in the left side of my neck. My esophagus also appeared as a hot spot. I had an endoscopy. All good just reflux. I had my lymph node biopsied. Not good. Positive for Melanoma. Also, my lymph node revealed that I have NRAS gene. This is one of the genes associated with Melanoma. Thus, unfortunately is the one with a poorer prognosis. Treatment plan was radiation to my neck on the left side and start Keytruda. I have been receiving Keytruda since May 2017. I have infusion6of Keytruda every three weeks.

Last Petscan in January 2018. I had some hotspots. Biggest one of concern my tibia. I had a bone biopsy and yet again, positive Melanoma. I will receive Radiation therapy to my tibia and stay on the Keytruda. May or may not add another medicine.

This is my journey thus far with Melanoma. I have endured side effects from the treatments. One is that I now have conducive hearing loss. Most likely from radiation. This us one thing that saddens me because by profession I am a Respiratory Therapist. My ears are my tools. I love what I do. I have been at the bedside of a patient and assisted in their first breath. Also, to the other extreme I have been at the bedside when their last breath was taken. What I have learned is that my life is how I make of it. To see me physically on the outside I look fine. However, I am not. Though days can be tasking and I might have a meltdown. Let it be known I will stand up and fight as hard as I can. My story doesnt end here. I have a beautiful daughter and great husband. I have a wonderful family and an army of friends supporting me. I am truly blessed. My mission is to share my story with Melanoma. Melanoma is not just a skin cancer. It is aggressive and unpredictable. It can spread to any organ of the body. Whether youre a person if Faith or not, I truly believe God has chosen me to share my story about Melanoma. He knows Im small and I will embrace what comes my way. I will not give in. Like I said you might see me crying, but rest assured I will stand up and fight for my life.

2019

January 3

So my journey continues..... my pain that I have been having is a result of my Melanoma spreading. It has spread to my spine. I have progression of cancer and new nodal growth of cancer.

So things will be added to my treatment plan. Please pray for Paige as she is very angry. Quite understandable. And pray for Kenny as he came home early today from work to be with me. I was crying uncontrollably. I love my parents dearly. They came to my home to spend time with me when Kenny had to leave to get my pain medicine patches. Next week will be a busy week getting everything scheduled and started. Not to mention I have a breast MRI next Monday routine because of my ATM gene. So I wouldnt be alone. My brother has checked on me via phone. Even though Melanoma you keep invading my body.... I will not go down without a fight.

January 14

Truth. Even more as the days pass recently. Limitations all I can do is trust in God. I must continue to believe that God has a plan for me. I still believe I have been chosen to travel this path so others can learn through me.

January 20

This weekend has been eventful. As some may know that on Friday I had a petscan. On our way home from Hershey we got a phone call that we needed to turn around and come straight to the emergency room. It was concern that I had a C1-C2 fracture. The oncologist on call told me the emergency department knew I was coming and I needed to put on a neck brace as soon as I got there. I cried the whole way to the hospital. I had an MRI and there was no fracture but the cancer has spread to my cervical spine and thoracic spine. I do have compression in my T9-T10. We knew it was already in my lumbar spine. It has gotten much worse in the last months. The melanoma has spread to my sternum, scapulas, some rib involvement some to more nodes and tumor in breast got bigger. Other areas have Metastatic disease as well. While in the ER spinal surgery seen me. I am instructed to wear a c collar, a neck brace. Because of my cancer eating my bones Im more at risk for bones breaking. With a heavy heart I know the end is potentially closer than I like. Im still going to fight as hard as I can until I take my last breath. This has been an emotional weekend. Thank you for those who have visited me and who have texted me. Thank you for all your love and support. I love you all.

February 1

Thank you to everyone who has made a meal for my family. Who have reached out to me. Whether by visiting me or texting me. I pray that Paige and Kenny receive the support and love as well. They are seeing me struggle in the front line. Just like my Mom and Dad. I pray for them too.

Thursday I received my last radiation treatment for this treatment plan. I had several areas radiated. This was palliative radiation that I received. To help with my pain. During this schedule these are the areas radiated... thoracic spine and lumbar spine, cervical spine, both right and left clavicles and sternum, right shoulder, lumbar spine and sacrum, and both right and left hips and right femur. These are skeletal areas that have Metastatic Melanoma cancer. I also have several lymph nodes involved with cancer as well.

Im very blessed to have the love and support I do. Someone is always with me that Im never alone. Im very blessed to have my parents. Kenny wants to be with me, but he needs to work. I still believe God has a plan for me. I trust in the Lord. I do have moments of despair and cry. Im not ready to leave this earth. Im not ready to not being Paiges mom or being Kennys wife. I wish I could grow old with him. Its all in Gods hands. Anyway thank you Everyone for the love and support. It matters so much. Much love to you all.

February 20

Then today just sharing some radiation burn on my sternum and clavicles. Its all good. My pain management had to be increased yesterday. So praying for more pain relief after this increase in dose of my pain patch. Because it can always be worse. Im still blessed.

March 6

It is how you choose to handle what has been given to you. I choose to trust in God and never give up. Until my last breath I will keep fighting and trusting in God.

March 17

So this past week wasnt the best. I have had increased pain that my pain management wasnt helping. So I needed to call palliative care for more intervention. So we increased my pain pill dose and am doing that every 3 hours and we are changing my Pain patch every 2 days instead of every 3 days. Its a little better but not a lot. Standing up brushing teeth and to shower I still have enough pain in lower back and sacrum area that I complain about it. I generally have a high tolerance pain level. So for me to give in , is a big deal. And other places. To do simple things the pain wins. Im suppose to call palliative care tomorrow to let them how the pain is. One of my BFF s sent me this song this morning. My guess I will be making more changes to my Pain management But I needed to hear those words thank you.

March 20

So this is what I need to remind myself the last couple days. I am a warrior and I will get through this. The journey wherever God takes me I am not alone.

So last week I had increased pain. So we had changed my pain management last Friday. Then I had to call palliative care Monday to let them know how I was feeling with this new pain management. Needless to say I had no change in my level of pain scale. So Monday we changed my pain management again I know am oxycoden at a higher dose 30mg every 3 hours and I am now taking morphine MS Contin 60mg twice a day. Monday night was a bad night. I woke up coughing and wheezing and throwing up mucus that made my throat burn. I already take medicine for my reflux ompremozole. I couldnt catch my breath. Kenny woke up from me making loud noises. He brought my nebulizer machine out with my nebulizer and albuterol medicine. I did two treatments back to back. I started to feel better slightly. So we both eventually went to bed. I did fall asleep and woke up around 5 am. I did another nebulizing treatment. This is when Kenny gets up for work. As the day went on yesterday it was better. My mom came for the day. Then I got a surprise visit from my brother and sister n law. That was very good medicine!!! Then later I had a visit from my super awesome friend Julie Bower. Another great dose of medicine. Whats better than these. My mom is always a good dose of medicine.what beats family and friends. For me its wonderful medicine for me. Emotionally it treats me incredibly well. I love you all. Also the great texts messages I get. I will not give up when not a great day or night comes my way I will fight through it. I love you all.

March 28

As this week comes to an end so did a chapter in my life. One of the most emotional things I have had to do came to an end. When you love your profession and your told by your oncologist that your cancer has overtaken you to the point that you must resign. Ironically at the same time I had reached 20 years of service of being a Registered Respiratory Therapist at Penn State Health. On Tuesday I handed in my letter of resignation. I will miss my coworkers, my friends, my friends that have turned into my family. Thank you all for being a chapter in my life. I love you all. I know this is the path that is needed but yet saddens me so. My pain management has changed yet again. More pain meds needs more frequently and increased doses. I will not give up. Because I know Im not alone and God has a plan for me. I trust in God.

April 4

To bring strength to the storm is what I try my best to achieve. It comes in degrees and I push forward. Then I need to rest. Restart all over again. Why....... because Im not ready for my story to end.

April 14

The devotional reading today. Its pretty amazing how things just fall in your path when life is doing its thing.

So my petscan results showed that everything skeletal that wise inflicted with cancer remains inflicted with cancer. All the nodes that were inflicted are still inflicted with cancer. I have 3 new pathological fractures in my spine and pelvis area. Also looks like currently I have a pneumonia and pleural effusion in the left lung. What do we do we.... I keep fighting. Im not giving up. Things can always be worse. Im thankful for the breath that I have today. I know I have many blessings. Thank you to my friends and family for all the prayers, love, and support. I love you all.

May 4

May is Melanoma Awareness Month. As we go out in the sun to watch our children or whomever it may be play softball or baseball. Or we simply spend more time outside please remember your sunscreen. Your protective clothing and hats. Dont forget to put sunscreen on your ears. My left ear the very top of my left ear is where my journey began. The sun is a BIG agitator of this Cancer, so are genetics. Please be proactive use the sunscreen and only experience this aggressive cancer through me. I tell you all my journey to make you aware. That you may not ever need to live through this. WHITE is the new tan. Love your skin. Its your largest organ you have. Thank you all for the blessings, love, support, and prayers.

May 9

Just an update on my journey. I have been taking 2 chemo therapy pills for a few weeks now. Before that I was only taking one chemo therapy pill. Since adding the second chemo I have needed to have blood drawn every week. Also I had a pneumonia and a left pleural effusion a few weeks ago. My cough has returned and so forth. So back on an antibiotic. As far as my blood work today my values have decreased on the low side of concern. The intervention thats going to take place is the one chemo therapy pill will be on hold until blood work next week and then re evaluate. My hemoglobin is on the lower side it has been low but now it has reached the point of concern for intervention. Tomorrow I will go into the hospital and get a blood transfusion. Our day will begin early. At 0745 I will need to get typed and crossed. Then we will need to wait for 2 hours then return to rapid infusion and the transfusions will begin. My oncology nurse told me the transfusions will take 4 hours alone. So you guessed it I will be crocheting while this takes place. Please pray that I have no allergic reactions while this takes place. Thank you for all the prayers and support

July 4

I always say that if anyone can learn from what my journey has been, all the fight and perseverance is completely worth it.

July 13

Well celebrating a day early. Married to this guy for 18 years tomorrow. What a ride we have had. There are not enough words or ways to show you how much I love you and how blessed I am that you are mine. How blessed that you are an amazing father to our daughter Paige. Everything you do for me and Paige. This last year has been the most challenging with this stupid cancer. Knowing and being told by my medical oncology team that I am now palliative. This word brings in a whole new meaning of what life can be and how you choose to embrace that word palliative. He has kept active in the things he has been involved with because I didnt want his life or Paiges life to change anymore than it needs to. At the end of the day he is there for me. Some may have walked away from this kind of marriage. But Kenny did not I love you so much for staying by my side and my best friend. I pray we have more Anniversaries to celebrate. Thank you for everything.

August 2

Cancer sucks especially when you health changes over to palliative care. You know your time is even more on limit. You try to do the best you can with every blessing of breath and day you get to be with your family and friends. But your body doesnt always allow this. When you look fine on the outside but in the inside death is overcoming your body from the cancer.

August 20

This is something I need to lean on these words. Also I can do all things through Christ. I will trust in God so that he is the only one who knows the plan for me. Im asking for prayers. Prayers for acceptance into a clinical trial in New Jersey. Last week I had some appointments that gave us some info that was not in my favor. I had a mammogram that in the right breast something suspicious rised concern for the physician. So I was to have an ultrasound guided biopsy. Friday I had 2 moles removed. Today I had a whole body cat scan due to increased pain throughout my body and issues walking at times. Last couple weeks not feeling well at all. Bloodwork revealed today that my counts are low. I will be returning to hospital tomorrow to receive 2 units of blood. My white count also is on the low side as well. We received a phone call from my oncology nurse in regards to cat scan...... turns out the Melanoma has metastasized more!!! It has spread its ugliness in my liver, nodes in the pelvis area are larger. So now plan is to not worry about biopsy in breast because if it comes back as new breast cancer it would completely expedite me from any clinical trial out there. So sending my information to New Jersey in hopes I get accepted into clinical trial. So I ask for prayers for this acceptance into clinical trial. I must trust in God as he wraps his arms around me and carries me through.

September 7

Ashley Null I want to express my most appreciation to the sell of Whoopie Pies for my family and me. I want to send out a great big thank you and hug to all of those that purchased a Whoopie Pie(s). We recently received a phone call from the New Jersey Coordinator for the Clinical Trial. I have been accepted for the screening tests. The rest sounds promising but I will still need to pass their screening tests in order to move forward. For just the first part we will need to stay in Bee Jersey for at least 2 days. I am very blessed for the financial gifts for whats to come. Please continue your prayers that I will pass the screening tests and move forward with the entire clinical trial. As always much love to all of you and thank you.

September 17

Today we had a dr appointment. We received news that we did not want. I was Denied for the trial in New Jersey. However on this Thursday I will start chemotherapy. Ill get it every 3 weeks. I know this treatment will not kill the cancer but hopefully it will slow down

the progression of the Melanoma. So I can only pray for this to work and give me more time with my family and friends. As we take in this next adventure please pray for Paige and Kenny and myself. This journey has not been fair to Paige at all. This is what makes me most upset. She knows only of me being sick. I feel she needs the most prayers of comfort. She puts on a very strong face, but I know she cries in her room. I ask for prayers for Kenny. As he does a fantastic job keeping our family together. I know hes hurting, but like our daughter he puts on a strong face. Hes the rock that keeps our family strong. Thank you everyone for all your love and support. Im going to keep fighting thats for sure. Not giving up!

October 3

With a heavy heart my journey continues. It turns out I was denied the clinical trial in New Jersey. But what is more heavy on my heart is that I now have BRAIN METS. I feel numb but what I know is that my story will not end so easy. Im going to continue to fight. I want all the time I can get with my family and friends. I love you all with all my heart. I hope you all will never forget that. So the plan is next Thursday, October 10 I will have Gamma Knife Radiation Surgery to my brain. My Radis toon Oncologist and Neurosurgeon will be with me the whole time. I will also continue the chemo therapy that was just started. My chemo therapy is every 3 weeks. So next week I will also have my second dose of intravenous chemotherapy. This is my story please learn through me the aggressive path that Melanoma can take. Please pray for my family. I know some of them are really struggling with the latest news of brain Mets. They need your prayers of comfort. I ask that you pray for guidance and skills put forth from medical team that will be with me during the gamma knife procedure. As always thank you for all the love and support you have given me and continue to give me and my family. I am forever grateful. I still believe that I am blessed as well. I will not give up. Love you all.

October 10-Gamma Knife Surgery

October 16- Admitted to hospital for infection and told found a 9mm tumor in stomach.

October 18-Told would be coming home with hospice

October 23-Came home from hospital

October 26- passed away