The Six Weeks

The brain scan that I talked about on my last post happened two weeks ago to try to understand how effective the last treatment (not the current treatment, which is Taxol) was on the cancer in the brain.  A week ago we were given the results.

They found 8 more tumors in Anne-Marie's brain, which brings the total to 10.

It's hard to find any comfort in the oncologist telling us they are all "small" brain tumors, but we'll take all the comfort we can get while understanding very clearly that Anne-Marie is under full assault by this deadly disease.

The oncologist has formed a plan to continue the Taxol treatment for one more three-week cycle then on the fourth week, another set of scans will be performed.  Last week was Taxol treatment #3, this week is a week off, then three more weeks of Taxol, then scans the next week, for a total of six weeks.

Dr. Solti has told us that she does not expect the Taxol to help the tumors in the brain but wants to continue through the next cycle to give some relief from the tumors in Anne-Marie's lungs.

The proposed treatment after week six is to return to the Xeloda/Tykerb chemo pill regimen that happened back in 2018.  It is the most ruthless chemo we've faced in the entire 14 years.

We are between the jaws of two challenges.  The doctors are already telling us it won't happen, but we need the scans to come back clear.  Our family appreciates your prayers during this time.

Five weeks to go.

The Way Through

The scan results from last Friday have come in.  The chemo isn't working.  Cancer in Anne-Marie's lungs is growing, which is why the bad weeks in between treatments have been so bad.  The chemo was doing all the bad things chemo does, but without the benefit of killing the tumors.  

Dr. Solti has decided that Taxol will be our next option.  This was the original slow-drip chemo infusion that Anne-Marie started on way back in the fall of 2006.  It was a harrowing experience, but back then it was paired with Adriamycin and given in a very intense dose once every three weeks.  Since then, oncologists have changed the typical prescription to a low dosage for three weeks with a one week break following.  A brain scan will happen by end of month.

After two failed treatments in 4 months, we're desperate for something to work.  That desperation is greater than the disappointment.  Hope is born of suffering, so if the only way out is through, we just need God to show us the way.

New Chemo Now

Today is Anne-Marie's 41st birthday. She has been a lot of pain today, sleeping off and on. We kept things pretty quiet around the house, with Anne-Marie requesting her favorite Thai food via DoorDash.

Last Thursday was the end of the initial phase of the Tucatinib clinical trial.  Dr. Solti informed us that the trial was successful to the extent of what was reasonably expected.  The latest set of scans showed us that the trial drug did indeed stabilize (prevent growth and spread) of the cancer in the brain.  At the same time, the use of the drug combined with the reaction of the cancer in Anne-Marie's lungs confirmed what was has only been speculation for the past two years.  The scans revealed that the cancer in the lungs is a different cancer than all the other cancer in her body.  It's likely a mutation of the original breast cancer.  

This means that the treatment was not effective on the cancer in her lungs.  We learned instead that the cancer has been spreading for the past few months and is now in one of her kidneys.  For these reasons, Anne-Marie cannot stay on the clinical trial.

Instead she begins a conventional chemo on Thursday morning.  This has always been an option, just not a desirable one.  We are bracing ourselves for several very intense weeks.

All that said, I hate cancer.  I hate it.  It's like an unsatisfied fire.  A greedy animal that destroys just to enjoy destruction.  It's the playground bully that tells you he'll beat you up if you refuse to fight him. 

And I would do anything to make it better.  Give it what it demands.  I'd negotiate for a truce. 

But so far it's broken every treaty.  This month marks 14 years and the hopes of 2006, 2012, 2016 and 2018 are no longer on the table.  We fight for our now.

2019 on go

NOTE: I temporarily changed the name and color scheme of the blog after a conversation with a few friends on Tuesday reavealed that the name was "depressing" and that the blog was a good read "if you want to cry".  Now, with a name like "happiness", it's much more cheery.  Why is the name darksayings?  This post from the archives will tell you.

The starter pistol has fired and we're out of the blocks.  Did this year seem to accelerate faster than normal for anyone else?  We're somewhere in the middle of a pack of circumstances looking for a shot at cutting around the outside.  Here's what's up:

First: I think I messed up the permitting process on our basement remodel.  In fact, I know I did because if the city says you messed up, you messed up.  You can't fight city hall, but you can spend plenty of time and cash there.  But don't you worry, I got it cleared up this week in rather painless and genial fashion and we're back on our way.  Still hoping to finish by Christmas 2018 (hahahahahahahahaha).

Next: I think I snapped the tendon in my ring finger.  Yeah, really.  We were out fooling around throwing the football on Christmas Day and I went to catch a pass and instead I missed the ball and somehow did something terrible to the 2nd finger in my left hand.  The doctor says if I don't get it looked at that I'd be permanently deformed (I can't straighten it completely no matter how hard I try or how long I rest it.)  I was thinking the deformity was a legitimate option but Anne-Marie said no.  So I'm seeing the specialist in a few weeks.

Which brings us to the last one: Anne-Marie is scheduled for February 7 and 11 to see how the treatment is working.  My clinic is across the street from the where we are doing the scans on the 11th, so this will work out nicely. The scans are just routine (full body MRI, bone scan, etc.) and we expect good results within 2 business days after each.

While we expect the results of the scans to show that the treatment is continuing to be successful, whether or not it's sustainable is in question.  From May to November of last year, the two-part oral chemotherapy Anne-Marie has been prescribed has caused off-and-on extreme, flu-like symptoms and caused her feet to swell and crack.  She's had trouble walking anything but short distances because of it.  She ended up having a few small surgeries at the podiatrist to help along with burn care-type treatment.

Last month the rest of Anne-Marie's skin started to be affected by the chemo.  She's started to lose dexterity and her hands are swelling and cracking.  The onocologist has reduced her dosage three times, but either the reduction hasn't helped yet, or it's something that is unavoidable.

(This is PARP)

There is quite a bit of promise in a brand new branch of cancer treatments called PARP inhibitors that only cleared FDA a year ago.  It attacks cancer cells in a different way than what we've tried in the past and the side effects may be less.  We're looking into it, will pray about it and talk it over with the doctor.

October 2018 scan results and what that means

Hundreds of you saw last week's post on insta/FB, so I probably don't need to go into the specifics except to say 12 out of 14 tumor sites look good and we're working on the other two.  We are grateful to God for a good report (and don't forget those doctors).

Here's the epilogue of what that means to us on a daily basis: It means nothing.  It appears that all of the pain, fatigue, skin problems, stomach flu is not from cancer but from the treatment.  We are still fighting the same battles and more* that we were fighting a week ago.  But in a different sense it means everything because we know the treatment is working.  We waited through the entire summer and half of the fall blindly going through misery without promise of a return, but now we know.  That's huge.

*By the time we hit Monday morning we found a new arena for this battle.  Anne-Marie's feet have become so damaged by the chemo that a previously-recommended visit to the podiatrist has now been rushed.  The appointment happens today and I have exercised my spousal naggingness to demand she remain in bed until we know what to do.

I'm glad we got some good news to remind us why we're fighting because the bell just rung and we're about to start throwing more punches.

Shrinking world

We have now reached the five-month mark of chemotherapy. As of last week, this is the longest treatment plan Anne-Marie has ever been on. This one's different because, as far as we know, it's perpetual.

The past two and a half months has been the most challenging of any treatment we've done these past 12 years. Daily doses of the chemo pills have affected Anne-Marie's tolerance of food, sleep patterns, energy level.

I'm sure some of you reading this can understand what it's like to have a single circumstance that affects your life completely in every area and never goes away night or day. We have fought to maintain an atmosphere of normalcy at our house for years, but lately that has become nearly impossible.

Every item that is a "must-have", every action that is a "must-do" and every event that is a "must-go" is put on trial for the sake of survival. It is the poverty of everything; it is the possession of everything that matters.

Starting this month I have decided to step away from many things, including responsibilities at our church, in order to relieve stress in this situation and regain focus. This continuing adjustment of priorities is helping me understand and prove to myself where my values really lie.  And it's allowed me just a few more moments of quiet to remember that there's always a light in every darkness.

It's taken me 2 weeks to write these six paragraphs, so I guess I'll click Publish. CT scan and bone scan are scheduled for October 16 with the results given two days later on October 18. Pray for us. Anne-Marie has fought through so much to get to this point.

The Summer of 2018

I'm not sure how I keep taking summers off of blogging.  This time has its own unique list of excuses, I guess.  That's what this post is about.

Excuse #1: I'm now a general contractor.

When we bought the house back in June of last year, it was considered a "livable fixer" with only 2 real bedrooms, a kitchen that needs an intervention and a (yet-to-be-discovered) river running through the basement.  I have been making it my business to get all these issues fixed.

With the help of some friends, we've managed to get the dying furnace out of the middle of the basement and replace it with something with air conditioning that's more efficient and out of the way of everything else.

From there we celebrated on the 4th of July and called a team of professional waterproofers the next morning to fix the newly-discovered river.  We were pretty shocked when they told us they could start tearing apart the basement in less than a week.  That put us in a mad rush to complete the demolition, preparation and to move Elisha upstairs from his temporary spot to nowhere in particular.

Basement waterproofing took three weeks and immediately I got put in the role of framing walls (it's only been 20 years, so why not?), repiping the house (it's only been 80 years, so why not?), redoing the basement electrical (it's only deadly, so why not?), ductwork (it's only...ok, you probably get it), drywall, flooring and trimwork.  If I forgot anything, I don't want to hear about it because it's not in the budget.  Here's some of our progress so far:

Excuse #2: WFH w/Kids

One thing they don't explain in the employee handbook of a company that is 100% work from home is how to handle summer break.  The kids have been running around my office screaming and throwing stuff for seven weeks now.  Just kidding, I don't have an office.  My office is going to be right where the laser is sitting in that last photo.  

Maybe by Christmas.

Obviously, things have been pretty distracting at "work".

Excuse #3: Jr. Bible Quizzing

Elisha spent the first six months of the year as a Junior Bible Quizzer in the Oregon District and learned most of the New Testament book of Galatians and some of the book of Hebrews.  He worked really hard and--let's be honest: I worked really hard--to get through the year.  The poor guy had so many distractions between January in June, but he finished his first year as Rookie of the Year for the state of Oregon.  Good job, Buddy!

Excuse #4: Cancer

This is the always excuse.  The good news is that the brain scans I referred to in my previous post came back very good.  Everything from the conventional surgery is gone and the site from the gamma knife surgery has had noticeable shrinkage.  That area is expected to slowly go away.

The real challenge this summer has been the chemo.  Anne-Marie has been on the chemo pills Xeloda and Tykerb for about three months now and the side effects seem to have a cumulative effect.  Anne-Marie is very sick on a weekly basis, often for stretches of a few days at a time.  Scans are due within a few weeks, but the date is pending.  We hope to have results by the end of September.

We did sneak away for a quick date night at the end of June to enjoy Anne-Marie's favorite restaurant ever.  We don't get out much, but we try to make it good when we do.  So--and I'm sure she would never say this herself--if you see her in person, know that Anne-Marie very much prioritized the event on her calendar.  

Just a few more weeks of summer left! I think we might celebrate by staying home and building some walls.

Chemo 1 & 2

Anne-Marie's first chemotherapy session was on Thursday, May 26, 2016.

The chemo this time is Taxotere (also known as Docetaxel or the evil twin of Taxol, Anne-Marie's chemo from 2006). The chemo is assisted by Herceptin and Progeta, which are hormonal therapies. Taxotere will do the work of poisoning the cancer to death while the other two do their best to starve it.

After this four-hour process, Anne-Marie is fitted with a timed-release of Neulasta. This white blood cell booster is placed in a special electronic box and will inject the booster into her bloodstream exactly 24 hours after she finishes the chemo treatment. This counters the chemo's tendency to mess up blood count and potentially cause a blood infection or sepsis. (Anne-Marie had this very thing happen in September 2006 before they freely prescribed Neulasta injections.)

Now that Anne-Marie is in her second chemo cycle--the second was Friday, June 17--we're beginning to see a pattern in the side effects. 

The first two days of the cycle come with moderate fatigue. Days three through five have extreme body aches, mouth pain and nearly disabling fatigue. Six through thirteen give you stomach discomfort and bizarre appetite swings. Fourteen through seventeen the poison sets in and you lose your hair. The eighteenth through the twenty-first day the symptoms taper off and normality comes within reach. Then you start over.

I am not a doctor, chemist or scientist of any kind, but from our personal observation it seems like that stretch between days 14 and 17 is key. The way it's been explained to me is that chemotherapy targets and kills the cells in your body that are dividing (aka growing) the fastest. So once the chemo kicks into gear it works to kill invasive cancer cells, fingernail cells, hair cells and white blood cells: stuff that your body cranks out really quick. 

After having a heavy cough for more than two months, (we believe) the cancer cells were killed off enough during the third week after chemo to make it mostly go away. Of course this means that Anne-Marie has lost almost all of her hair.  

As I said earlier, we are well into the second 21-day cycle and we're starting to learn the ropes again. Because, God knows, this isn't our first voyage. We will cherish every day we have, but our eyes are on late-September when the last of the poison is absorbed into Anne-Marie's cells and we will have a chance to enjoy the beginning of fall.

Kicking Tykerb to the curb

And we're done.

Our first attempt to treat Anne-Marie's cancer is done and over.  A couple of weeks ago, Tykerb (the pill-form chemo treatment) made Anne-Marie break out in a rash all over.  This was not just any rash.  It was a rash that nearly incapacitated her for ten days.

After lowering the dosage three times, we figured that balance and harmony had been acheived and we could set a schedule for next couple of months.  We got the calendar all figured out.  Anne-Marie only had to go to Seattle Cancer Care every three weeks and take three chemo pills every night.

It took three or four days to realize her body was saying, "I don't think so."  By the time Anne-Marie quit taking Tykerb, the damage was done.  She had a rash all over her body that wouldn't go away and began to lose her hair.  Even though she quit taking the pills, the rash lingered on for another week.

Let's fast-forward from three weeks ago to today.  The doctor says that--putting aside the horrible side effects--the treatment was working.  The tumor has shrunk by about 30%.

The question is whether or not it was Tykerb or Herceptin (Anne-Marie's other treatment she gets at the clinic every third week) killing the cancer.  Dr. Korde is counting on Herceptin only to eliminate the tumor prior to surgery.  Because of this, the doctor is recommending doing Herceptin weekly (starting 9/6) instead of every three weeks.

We don't know how to work this out with our schedule yet, but there's probably more good news here than bad.

Checkup and Herceptin

Today I had a checkup with Dr. Korde and my second Herceptin treatment.  Thankfully, I did not have any problems with the Herceptin this time, but I did come home and sleep for three hours!  That stuff just wears me out!  A few days ago, Dr. Korde had instructed me to stop taking the Tykerb pills once again due to troublesome side effects I was having.  It has been a difficult balancing act trying to figure out how much medication to take to lessen the side effects versus too much extra medication causing a whole different set of side effects.  Today we discussed how I could better manage the symptoms and medications.  I can't say that we have it figured out completely, but hopefully it will be better.

Dr. Korde also believes that my tumor has shrunk just from the small amount of treatment I've already had. That is really great news, especially since today was only my second Herceptin and I've stopped, then started, then stopped taking Tykerb again in that short span of time!  She says I may not need to take Tykerb after the surgery, especially considering it's effect on me, but she may want me to continue Herceptin for two years instead of just one. 
 
 I have a lot of difficult decisions to make in the coming months regarding the next phase of treatment after surgery.  I received some very tough news Friday at my consult with the plastic surgeon at University Medical Center in Seattle. What they are recommending for me to do is physically and emotionally difficult, mostly because of what I've already been through the first time around.  It's a long story and a bit personal to convey on here to everyone, but it has to do with radiation and RE-reconstructive plastic surgery.  I'm trying to figure out how I want to proceed, especially since the news was worse than I thought it was going to be.  There are pros and cons, of course.  I know what THEY want me to do, but I ultimately have to make the decision.  So puhleeeze don't start offering me opinions and advice, haha!  =)

Tykerb Treatment and Effects

On July 7th I began taking Tykerb, which is a chemo pill.  The dosage Dr. Korde prescribed was 4 (very large) pills at once daily.  The normal dose is 5 pills, but since I am a smaller-than-average person, my dose was 4.  I woke up VERY sick to my stomach the next morning and it continued throughout that day into the next couple days.  I became dehydrated and weak.  Monday morning Dr. Korde's nurse emailed me to ask how I was doing with side effects of the pill.  I explained the situation and she told me to stop taking the pills until further notice and to keep in touch about how I was feeling.  It took several days for my body to recover from the side effects (including a mysterious case of vertigo and nausea), so I didn't end up resuming the medication until Friday night, July 13th.

Dr. Korde lowered my dose down to 3 pills at once daily.  I still became very sick even with the lowered dose, so they began having me take another medication twice daily to counteract the effects of the Tykerb on my stomach. Now I am starting to develop another common side effect of Tykerb, which is a rash.  It is only on my face so far and is somewhat itchy.  I'm not sure how severe or widespread it will become, but time will tell.  I have been blessed never to have had acne (even in my teen years), so this is not going to be fun for me.  I am also developing mouth sores, which are a common side effect also.  The nurse called in a prescription mouth rinse that should at the very least help me be more comfortable when eating.  It contains a numbing medication. 

Life's not too fun or comfortable these days, but I'm thankful to be alive! Taking it one day at a time. =)

Starting Treatment (Herceptin and Tykerb)

Update from Anne-Marie's Facebook statuses this past weekend.

Friday, July 6th:

It's warm outside, but I'm missing the electric blanket. Home and in bed with severe chills and body aches after my 1st Herceptin tx this afternoon. I looked like a mummy during the tx due to being swaddled with mounds of oven-warmed blankets. 

Saturday, July 7th:

Started my chemo pill Rx last night. I was very nervous to take it and had a few tears. Been really sick to my stomach all day long today. The dosage may need to be adjusted. Average dose is 5 huge pills at a time daily. They started me at 4 since I'm a small person. I'm thinking maybe 3 would be better?!? Need to contact my Dr tomorrow.

Certificate of Completion

From Northwest Cancer Specialists!

An entire Oreo Cheesecake...

...A delicious after-dinner snack!

"Congrats on your last chemo."

Thanks Eva!

Eva is the one who originally turned us on to the Cheesecake Factory Pumpkin Cheesecake that capped off our Thanksgiving celebration.

Recovering

Anne-Marie is back on her feet after dealing with sickness/after effects for the past week. She is feeling better every day but has had trouble sleeping at night. Hopefully she'll be able to regulate her schedule and be ready to start work at the dental office next Monday.

Fighting on two fronts

Anne-Marie seems to have caught the bug that's been going around. She's had a fever off and on for the past few days. She's dealing with this along with the painful side effects of the last treatment.

Chemotherapy 8

Friday, December 29, was Anne-Marie's eighth and final chemotherapy treatment.

I brought her to the treatment this time.

The day started out early with one of my crazy ideas: a celebration breakfast at Mother's Bistro. We left the house at about 8:30 and headed to the downtown Portland comfort-food restaurant. The service was prompt and friendly. I had the Crunchy French Toast; Anne-Marie had the Biscuit Breakfast. Best breakfast I've ever eaten.

The service was so fast, in fact, that we were in and out of the restaurant in 40 minutes. I was quite disappointed that the parking lot attendant took his liberty in charging me for the entire day.

We arrived at Providence Portland Medical Center at 10 and realized we still had plenty of time until our 10:40 AM appointment. We ran to the hospital gift store to buy a magazine. We walked back to our car, grabbed our stuff, and headed through the skybridge and into the Providence Portland Professional Plaza (the PPPP).

The clinic was running late, but soon enough, Anne-Marie was brought in for her blood work. It came back with better results than ever. The tests had come back anemic for the last six tests, but Friday's counts were much improved.

We consulted with Dr. Smith about the treatment plan beyond chemo and what to expect in the next few years. He informed us that Herceptin treatment will continue until the fall. Anne-Marie will also begin Tamoxifen within a few weeks that will last for the next five years.

Dr. Smith gave Anne-Marie a hug for finishing her chemo and we walked back to the treatment room.

We were delighted to find the complimentary snack counter fully stocked and ready for service. I grabbed a cup of hot chocolate and windmill cookie. As I sat down, the nurse was getting Anne-Marie ready for the first stage of treatment.

As the IV was being set up, a robust, middle-aged gentleman sat down next to me to begin his treatment. (Treatment? This guy looked like he should be in a boxing ring.) His nurse came over and started getting him set up. In the middle of the small talk she grabbed my book--David McCullough's 1776--and said, "This looks like a 'school' book? Are you in school?" "No. Just a nerd." She and the man went on to emphasize the irony of youth. When they tried to teach us history in school, we didn't want to learn it; now that we're out, we spend leisure time trying to catch everything we missed!

Anne-Marie fell asleep for the next few hours. Time passed as I slowly made my way from Boston to New York City with the chemo drip-drip-dripping away. When the Taxol was finished, the nurse came to start the Herceptin. After it was set up, the drip speed was too slow (or so it looked to me). We would have been there for seven hours at that rate. Another nurse came along and saw the problem and set the drip to "solid stream mode." The fastest Herceptin treatment in the world took all of 25 minutes! After checking my wife over for obvious side effects, I had no problem with this. It was 4:15 and time to go home.

Pictures (top to bottom): Anne-Marie drinking cocoa at Mother's, 1776, the last of the chemo, Anne-Marie crossing the skybridge for the last time (totally posed)

Chemo 8 coming up

Chemo 8 is Friday. Tomorrow we will not be going to see Dr. Burgess, but instead going straight to see Dr. Smith at 11:00. This is Anne-Marie's last one.

I will be taking her to the treatment.

Merry Christmas!

We want to wish you all a merry Christmas! Thanks to all the people from all around the world that have stopped by DARKSAYINGS over the past seven months. Your support means the world to us!

Only four days 'til Christmas! Only eight days 'til chemo is over!

Chemotherapy 7

Friday, December 8, was Anne-Marie's seventh chemotherapy treatment.

Phil Huffman, Anne-Marie's dad, took her to the treatment for the first time.

I met Anne-Marie at Dr. Burgess's office again for our final appointment of the year. This time we scheduled the pre-surgery appointment for a few weeks before the February 7 operation. I again missed breakfast at Miller's due to a 9:30 meeting back at work. I will manage to go one of these times.

Dad and Anne-Marie arrived early. Blood check was OK, with the help of Aranesp. Dr. Smith, along with the resident, checked Anne-Marie's fingernail and hair growth. (These things are important to oncologists.) Clearance was given to begin treatment.

Pre-meds were administered, then the chemo. Phil left once everything was set up to get more decorating magazines. He came back about an hour later, began pillaging the complimentary snack counter, and tried--and failed--to read a Louis L'Amour western (Fallon, for all of the fans).

Anne-Marie was reading her magazines and eating her free granola bar when something strange happened.

One of the patients had a guest--who happened to be her son--show up while she was in the middle of a nap. This poor lady was sound asleep when her son lumbers in and shouts, "So, do you wanna sleep, or do you want me to stay here to talk to ya?!" His octogenarian mother was startled awake by the commotion and asked what time it was. She decided she would wake up and talk (since she was awake already).

She began to talk very loudly to her vociferous son about a granola bar. She had requested that the nurse bring her a granola bar from the complimentary snack counter and it had been too long. She began an attempt to flag down her nurse to get her tardy confection. Her son began complaining to the whole room, "Looks like SOMEONE is being impatient!" Another nurse brought her the granola bar.

The real problem arose when the mother's treatment was finished and the pair was about to leave. She had to find out how to get out of the recliner. After trying to wrestle it back into the upright position, her son informed her that the lever on the side was the only way to release it.

"Where?"
"Right there on the side?"
"Right here?" (Arm flailing randomly at the side of the chair.)
"No, too far back."
"Right here?" (Arm flailing randomly again, now redirected.)
"No, too far forward! FORGET IT, I'LL GET YOU OUT!" (Hits lever. Pulls mom out.)

Next, the son "helped" his mother into her coat, grabbed her stuff, and prepared to walk out when he looked at her: "What-r-ya, LOOZIN' A LIMB?" His mom's coat had only one arm in the sleeve while the other side of the coat hung limply behind her. They then began what would become quite the show.

(While 85-year-old mother is trying, blindly, to place her remaining arm in the armhole of the coat behind.)
"Lift your arm a little higher, mom! HIGHER! HIGHER!"
"How much higher is it?"
"HIGHER!"

At this point the patient sitting next to Anne-Marie began explaining his solution to the problem: "Yeah, I've had this problem before. They gotta take the one arm out. See how it's too tight on that one shoulder? Yeah, she needs a little more slack if she's ever gonna get that on!"

Anne-Marie and Phil were laughing unabashedly at the display. Finally the exasperated son hollered, "I CAN'T FIGURE OUT HOW TO DO IT! I GIVE UP!" A nurse came and helped the poor lady into the coat. It went on with no problem and the mother and son walked out. Thus, the episode came to an end.

Anne-Marie fell asleep for the last hour. She woke up during the "rinse cycle" or, just in time to pack everything up and go home.

One more to go!