Good news and bad hose

The news from our visit to the Mayo Clinic last week was very good, indeed. The myeloma is still present in measurable amounts, but it is not resurgent--all of the pertinent numbers are still stable, which means that I am still in remission. No further treatment--other than quarterly monitoring--is necessary at this time. The blood clot is gone, but best practice is to keep wearing those stylish support stockings, so I will continue to be a fashion plate (more like a platter) with those hose. I will continue to take coumadin indefinitely to keep the INR at targeted levels, and I will have to return to Mayo later this Fall to have the vena cava filter removed (since there is no longer a clot, there is no longer a need to have a last line of defense in case it breaks loose). Minor surgery, that. Actually, right now, my biggest medical problem is high cholesterol--which in the great scheme of things, doesn't seem so bad anymore. Oatmeal, anyone?

My friends, the old adage that "no news is good news" certainly holds true for me. I have been back at work (half time) since the first of June, and things have been going quite well. Other than the fact that my large bones have been permanently compromised (there goes any chance of winning Olympic Weightlifting gold) and muscles in my legs are still stiff (ditto my chance for Olympic gymnastic glory), I'm doing very well. Stamina is not quite what it used to be, but it is getting better. But I feel generally quite good, have (unfortunately) a strong appetite, and have pretty much gotten back into the rythm of my old life. Come mid-September, though, there will be the big hurdle. Florence and I return to the Mayo Clinic where I will undergo tests to determine whether I am still in remission--or if the myeloma is becoming resurgent. I feel so well that I can't imagine that we will get anything but good news. If the news is not so good, we'll learn what can be done to make it better, for the docs still have a lot of arrows in their quivers. So come September 13-15, say a little prayer for good outcomes--or a big one, if you like!

He's Back--and He's Healthy!

Kind readers, when I started this blog (with the indispensable help of Ashima Saigal), I was so sick that I sometimes felt as if I would have to get better in order to die. Now, with the indispensable help of Mayo Clinic physicians and nurses, my incredible wife Florence, and the dear friends and relatives who supported us by cooking, cleaning, visiting, praying, and sending cards that were hilarious, if often of dubious taste, I am feeling remarkably better. I'll always have lifting restrictions due to my bones having been compromised, but this mainly means that I won't be able to help my kids move furniture into dorm rooms (too bad for them, quite a good deal for me), and I don't have the endurance I once had. but otherwise I am my old self again, or at least a reasonable facsimile therof. I have improved to such an extent that, as of today, I returned to work, on a half-time basis, at the Dorothy A. Johnson Center for Philanthropy and Nonprofit Leadership of Grand Valley State University. If you are reading this post, I can't thank you enough for all that your support and encouragement has meant to us. You have helped us return to a normal life, at least until September, when next I will be checked at Mayo for any signs of the myeloma becoming resurgent. But we are taking the optimistic view that my remission will last for many years. I am taking on the personal goal of living to see the Detroit Lions win the Super Bowl--which means that I intend to live for centuries!

The mission is remission

Ninety days ago, I had my stem cell transplant. Every day since has pointed toward today, when the follow-up testing would determine if I am in remission, or if the myeloma is still active. For the past two days, I have undergone extensive testing, including a bone marrow biopsy and a PET scan, to determine the outcomes of the chemotherapy and stem cell transplant. This afternoon, we got the results, and I'm happy to say that they are very positive. It is not a Complete Response, in which none of the markers of myeloma can be detected, but it is a "Very Good Partial Response," which is pretty darned good. Every marker of the disease has been drastically reduced. Total proteins from 17,000 mg to 99 mg; monoclonal proteins from 15,000 mg to 45 mg; hemoglobin back into the normal range for the first time in a year; less than 5% bone marrow involvement; no detectable circulating cells. The doctors think that it is possible that the markers will continue to decline for several more months. All of this means that I am in remission, and my unmutated chromosomal makeup suggests that it should be durable, which is defined as two or more years. The median remission lasts two years, but this number is dragged down by patients with mutated chromosomes, who tend to have very short remissions. I am confident that my remission will last much longer than that. No further treatment is necessary at this time; just ongoing monitoring on a quarterly basis. Even when the myeloma comes back, as it inevitably will if I live long enough, I have another stem cell transplant in the bank, and there are a number of promising therapies that are in testing stages right now that will by then be available to beat the disease back into remission once more. I now view multiple myeloma as a chronic condition that can be managed, not as an acute disease. This should allow me to dance at my kids' weddings and spoil their children for many years to come! I am so grateful to the physicians here at the Clinic for the superb care they have provided. I am also thankful for Florence, who has been my everything during this long ordeal. Finally, I will always be filled with gratitude to our friends, relatives, and followers of this blog for your help, your prayers, your support, and your all-around indispensableness! All of that good karma is not only appreciated--it worked!

A Week of Testing Ahead

May 11 is not only the day after Mother's Day, it is the day that we return to the Mayo Clinic for my 100 day testing. In truth, it's little less than 100 days post-transplant, but it's close enough to do the definitive testing that will determine my status. The possibilities are full remission, partial remission, and active disease. I feel so much better than I did immediately post-transplant that I simply cannot imagine that the myeloma is still active. I'm being optimistic, and predicting that the verdict will be a ful remission. If so, there is likely to be minimal follow-up. If the remission is partial, there is likely to be follow-up chemotherapy. If the disease is still active, then there will be more chemo, followed probably by a second stem cell transplant. I REALLY don't want to go through another stem cell transplant, so I would appreciate it if, next week, you would send my way any prayers, positive karma, and good ju-ju you may have to spare. I'll be sure to share the news, whether good, bad, or ugly, with all of you via this blog, so watch for it toward the end of th next week. In the meantime, fingers crossed, please!

My moving experience

Do you recall the old Charles Atlas ads, in which the "bully of the beach" kicks sand in the face of the 98 pound weakling, who then gambles a 4-cent stamp, takes the Charles Atlas course and punches out the bully? Alas, at the moment, I am the weakling, albeit a 230 weakling, before he took the Atlas course. The last couple of days, I've been moving my library from scattered points around the house to a newly-completed, consolidated library space. Well, maybe "moving" is a bit of an overstatement. It's more like grabbing a small handful of books, taking a few steps, getting out of breath, sitting down and resting. Needless to say, the vast majority of the books still have not been moved. It doesn't help that the docs have placed lifting restrictions on me--the bones that were compromised by lesions heal, but they don't come back with their old strength--so officially, I'm not supposed to lift more than 20 pounds. I'm also discovering how quickly 52 year-olds get out of shape when they don't exercise for a few months. My legs in particular are really stiff from the exercise I've gotten over the past couple of days. My take-away from all of this is that I should not consider a new career with Two Men and a Truck any time soon! The key here is patience. A month ago, I couldn't have dreamed of moving any books at all. A month from now, I will probably be able to tote books with much less stop-and-gasp action. And, a month from now, I return to the Mayo Clinic for the thorough testing that will tell us whether I am in remission or--well, let's not contemplate that possibility. In the meantime, there are books to move--does anyone out there have a few spare oxygen canisters I could use?

Recovery and Blah Writing

It is getting tougher to write a self-respecting blog about an illness when you are on the way to recovering from that illness. To be sure, I still get fatigued far too easily, and I continue to have trouble getting to sleep at night, and my back still hurts when I bend over, but overall, I'm slowly getting better. Now where's the excitement in that? I've actually reached the point at which I no longer need a nap or two to get through the day. I still need to lie down 2-3 times in order to give my back a rest, but that is less than I used to require. We also finally have the protime level of my blood where it ought to be (actually at last measurement, it was slightly higher than it should be--too "thin"--but that is better than the weeks in which it remained stubbornly low). It's also great that Florence no longer has to give me inoculations of anticoagulants, a fact for which both Florence and my stomach (the injection site) are grateful. So the order of the day is to exercise, build stamina, and get back into a normal sleep pattern. Pretty mundane stuff for the "Stem Cell Stud," but I guess recovery is inherently less dramatic than disease. If any follower of this blog has an idea about how I can make this story of recovery a more compelling read, please let me know!

Day 40 Report

Today is day 40 post-transplant, which seems like an auspicious pretext for an update. I also just returned from an appointment with my Kalamazoo hematologist, Dr. Vemuri, so there is actual news to convey. The news is, according to Dr. Vemuri, quite good: my blood counts are satisfactory, I am physically where I am expected to be at this stage of recovery, and completely free of infections. On the other hand, I still have protime problems (my blood is too "thick") and I need to start working out again, even if it is fatiguing, in order to maintain muscle tone. I just wish that I felt as good as the report sounds; the thought of a workout on the elliptical machine sounds to me like being tortured in a third world prison, but I suppose that this is just the fatigue talking. The thing I should be focusing on is not my lack of stamina, but rather my lack of infections--most stem cell transplant patients get at least one infection during the first month of their recovery, and I have dodged the infection bullet completely. In two months, I return to the Mayo Clinic for extensive follow-up testing that will tell us whether the chemo and transplant therapy was successful in driving the myeloma into remission. That is the real test; if I am in remission then all of the unpleasantness will have been worth it. If I'm not in remission, then there will be more unpleasantness dead ahead. In the meantime, if you have any spare energy lying about, please send it my way--I'll need it for my first session on the elliptical!

Home Again, and Dog Tired

Thanks for your patience, for it has been a long time between posts. Not as long a wait, mind you, as for the new season of Law & Order: Criminal Intent with Jeff Goldblum, but a long silence nonetheless. Part of that was the sheer hubbub of coming home, which occurred exactly a week ago today. Our return to Kalamazoo made Florence and me happier than Rush Limbaugh with a dozen doughnuts and a new prescription for Oxycontin. The rest of it was the fact that just after getting back, I fell apart like a 1974 Chevy. I was just plain exhausted, and the slightest activity--like taking a shower-- felt like a triathlon. For days, I was taking three naps, waking mainly to eat, and then back to sleep once more. Then at night, I wasn't tired, and I discovered that no one seemed interested in pulling all-nighters with me, fascinating though my repartee may be at 3 am). I'm still easily exhausted (one filght of steps and I'm done for the next quarter hour), but at least I'm not sleeping during the day, or staying awake all night, any longer. I'll close with a few answers to questions you may have. No, we haven't fully unpacked yet. No, we haven't caught up with all the mail that arrived in our absence. Despite that fact, we have thus far evaded debtor's prison. Yes, it's marvelous to be home. True, I'm at least a week behind on my e-mail. But now, it is at last false that my blog has been cruelly ignored. Finally, yes, we are both very grateful for all of the cards, notes, and e-mails received from friends and family cheering us on--those pieces of inspiration and cheer made a huge difference in our lives at a very rough time. Thank you all so much for writing!

The worm turns!

Who'd a thunk? Less than a week ago, I was in the hospital, my left leg was a pain magnet due to the clot, my blood numbers (hemoglobin, white blood cell, platelet), were vying with the Dow-Jones Industrial average for basement-dweller status, and I wore a perpetual aspect of run-down, hang-dog loserdom. Today, I am an oupatient, my left leg is feeling better due to my first therapeutic shot of fragmin (today was the first time that my platelets were high enough to get the dose I needed, more than 3x what I have been getting), my blood numbers are as robust as a bull market index, and I have confident aura, as Mark Twain once said, of "a Christian holding four aces." The docs are now telling me that by early next week--Tuesday or Wednesday--they will be ready to turn me loose, and Florence and I will be able to go home. If you are among the dozens of friends and relatives who have sent or are contemplating sending cards, please direct them to us at home, rather than here in Rochester. If you just sent one, never fear--it will be forwarded. One thought as our adventure in Rochester comes to a close. Florence deserves so much of the credit for my coming through this ordeal in one piece. A single example: she slept in my hospital room every night so that she could be there in the morning to talk to the doctors on rounds, and be up on the latest. You know it's love when someone will sleep on a crummy couch, eat hospital food, get sleep interrupted, all when you don't have to, because you care that much about your spouse. It just goes to show that all you have to do is marry the right woman, and everything else you do will fall into place!

Clots and Shots is what I Gots

On February 17, I limped into my outpatient appointment, with a decided pain in my left calf muscle. Doctor Haman was not overly concerned, but ordered an ultrasound. The result showed a large blood clot in my left calf. Now, Dr. Haman was concerned, and ordered a CAT scan, which revealed a smaller clot in my right calf, and, more ominously, a piece of the original left-side clot that had broken off and lodged in my lung. Dr. Haman immediately ordered a filter to be inserted in the inferior vena cava, to prevent a stroke if a bigger chunk of the clot broke off. Then there was the problem of deaing with the clots. Normally, you would use IV heparin to respond to a clot of this size, but it would not be possible because my platelets were depressed from the chemo--so IV heparin would cause internal bleeding. The compromise was a single daily shot of fragmin--admininstered with great skill by nurse Florence herself!--which broke up the clots very slowly, but prevented internal bleeding. So, that has been the past week--recovering gangbusters from the transplant, but very slowly from the clots. As for clotting, it is a side effect described in the literature, but it is very rare, so no one was expecting it. Looking forward, tomorrow (Thursday) will be Day 13 post-transplant. Goals continue to be to get the the White Blood Cell counts up over 1000 for three consecutive days. Today, they clocked in at 300. And, of course, continuing to redcue the clotting is an ongoing priority.

My first thoughts from the other side...most important, this isn't the "recovered" Joel speaking, but rather, the very, very early phase of "recovering" Joel...the first gaps in the mist. The second thought is that irony is everything. You will remember that there were all sorts of dreadful side effects for which I needed to be prepared after the stem cell transplant. Nausea: in the past week, I had a couple of easily controlled bouts. Fever: not once. Loose Stools: a few easily controlled episodes. Exhausion: some, but never debilitating. Insomnia: not a bit. Inability to taste food, inability to consume enough calories to support oneself, and inability to hydrate sufficiently: I ate full meals and drank plenty enough to stay hydrated. My recovery has, in short, been one of the best that the Clinic has witnessed in years. Ah, but irony: with all of these ideal outcomes, why is it the case that I have not sailed through as as outpatient, but instead have spent the past seven nights hospitalized? And why am I still stuck in the hospital? I've promised my daughter Mariann that I will explain the problem that landed me here, but that will require an entirely new posting.

Down the slippery slope.....

Day three after the transplant, and I have a curious feeling that everything in the world is coated with a thick veneer of molasses. I feel my energy ebbing slowly away; the daily walk to the checkup at Mayo seems like a stage of the Tour de France; foods and drinks are starting to taste a bit off; my stomach is beginning to protest about what gets put into it. And most of all, sleep is starting to sound like the answer to every question that can be posed. "What do you wish to eat?" "I think I'll have a nap, thanks." By day 4 or 5, or day 6 at the latest, it will be all I can do to drink 10 cups of liquid per day and consume 1600 daily calories--maybe it will be more than I can do, until the white blood cells start to recover. If so, I will be hospitalized, so that these important matters can be managed by intervenous means. If I stumble through as an outpatient, it will only be due to the care of Florence and her support team. Our dear friends Frank Taylor and Barry Schroeder will be here days 4 through 6, to be followed by one of Florence's childhood friends, Nancy Stockdale, who will be here days 7-9, then Amy Upjohn will be back for her second round of support. There's just no substitute for caring for the caregiver--thank heavens that, due to our family and friends, we have that essential task covered! As for me, I am signing off for a few days of nastiness, with high hopes for better times on the other side. Thanks to all who have read, commented, prayed, and good karmaed in response to this blog thus far: I plan on completing it after I am once more among you, in the land of the living!

Since my last post, I have undergone the second infusion of melphalan chemo (on Thursday), and then the actual stem cell transplant (on Friday). The two chemo sessions have done their job of killing off the bone marrow and all of its contents. As a result, my white blood cell counts are dropping, and by Wednesday or so, they will be near zero, and will hover there until the transplanted stem cells begin to produce new white cells. This will mean that for a week to 10 days, starting Tuesday or Wednesday, I will be one sick puppy. I will be exhausted, my taste buds will be destroyed, so eating and drinking will become difficult, my hair will fall out, and there will be other, more disgusting side effects, not worthy of mentioning in a family blog! So, counting the day of the transplant as day 0, the real nasty times will begain day 4 or 5, and probably continue until day 15 or so. During that time, I expect to be too sick to blog or otherwise to tend to e-mail. Mainly, I'll be sleeping and trying to walk and eat and drink enough to stay out of the hospital. One interesting point about the stem cell transplant itself--since I am the "Stem Cell Stud," and collected in a single sitting, all of the 5,000,000 cells that were transplanted on Friday fit into a single large syringe. It was fascinating watching these cells flow through the IV and back home. It was also a bit of an anticlimax, for it took almost a month to do all of the preliminaries and testing and intitial therapies, but only ten minutes to do the actual transplant. So, gentle readers, I am feeling kind of like somone who is trapped on the railroad tracks and watching a freight train rumbling toward me, in incredibly slow motion, taking days to get here, but when it does....well, it will make an impression upon me, I am sure! I'll keep blogging until the train hits me--and will pick it up again after I recover sufficiently, probably toward the end of this month. My best to all readers--and my thanks for Florence, Amy , and Ann and Don Parfet for their superb care!

Skydiving, anyone?

Today was the first of two runs of melphalan, the chemotherapy that will wipe out the myeloma where it lives, in the bone marrow--but will wipe out the bone marrow with it. I came through with no nausea and all of my hair, although the doctors assure me that in the future, nauesea will move in and my hair will move out. One of my doctors also pointed out that this therapy was akin to skydiving: once you jump out of the plane, you can't react to the fear of falling by jumping back into the plane. No, you have to fall for a while at terrifying speed until you pull the rip cord and land safely. I see his point, and though it looks like that farm down below is getting bigger awfully fast, I'll just keep hand on rip cord ready to pull it. Stay tuned, folks, and hope for well-packed parachutes!

Run over by a turtle, or, the Stem Cell Stud!

I am reminded of the story about the snail that was stepped on by a turtle. When the police officer asked the snail how the accident occurred, he replied, "I can't tell you, officer--it all happened so fast!" For the past four weeks, Florence and I have been going through test after test, procedure after procedure, and it seemed that nothing we did was getting us closer to the ultimate goal. In fact, with the post-Cytoxan low I felt last week, it sometimes seemed that we were losing ground. Then, Sunday evening, we were run over by that proverbial turtle. I got a call from the lab about my CD-34 levels--that it is to say, the measure of the stem cells in my bloodstream. The goal was for the Neupogen injections to raise that level to 10 or higher. My score was a whopping 54. Feeling very manly indeed, I reported Monday morning for the first of five scheduled stem cell collection sessions. Watching blood flow out of your body into a machine, and not seeing it flow back for several minutes, was enough to rattle me. But flow back it did, although without the stem cells. That evening, the Bone Marrow Transplant Coordinator called me with the news that I continue to be one of those obnoxious Boomer overachievers: the goal was 8 million stem cells to be collected over five sessions, but I had bagged 10,240,000 in just one session! My dear sister-in-law, Amy Upjohn, promptly gave me a nickname that I kinda like: The Stem Cell Stud! Then, this morning, the staff at Mayo pulled out all of the stops, and scheduled the two key remaining procedures for this week: the melphalan chemo on Wednesday and Thursday, and the stem cell transplant itself on Friday. The melphalan will wipe out the myeloma, but will also wipe out all of my bone marrow. The transplanted stem cells will rebuild the marrow. However, the combined side effects from the chemo and the transplant with make for a couple of weeks of nasty and unavoidable side effects. All of this is daunting, but the great thing is that we are finally taking the decisive steps that will drive this disease into remission. That, dear friends, is worth a lot of suffering to achieve.

A stroll in the park--on Jupiter!

More of the same to report. My white blood cell count really crashed today due to the Cytoxan chemotherapy, so I feel as if I'm trapped on a planet with very strong gravity: every step, every movement, is a real effort. The docs assure me that I will feel better early next week, when the counts recover. In the meantime, I will be checked on Sunday morning to see how many stem cells are circulating in my bloodstream. If there are enough, we will start collecting on Monday, if not, we will continue with the Neupogen injections, albeit at a higher rate. It occurred to me today that this is my dear mother's revenge. I stopped taking naps at about a year old, when she desperately needed some sleep. Now, I'm making up for all those I missed. So, Mom, this nap's for you! And thanks to all who have been sending cards and notes--they really are a perk-up for Florence and me. Florence, by the way, has gotten over her cold, and is taking superb care of me.

Foggy and groggy, but main lined

Today is the day they warned me about--the day that my counts would get low as a result of the the Cytoxin pulse--and they were right. I awoke this morning feeling as if I was walking through a vat of molasses, and the feeling was made all the less pleasant by the low-grade pain that resulted from the installation of the central line yesterday. That paid off, however, when I went in for my daily injection of Neupogen, for they gathered all of the blood they needed through the line, and there was no need to stick me. So, after having napped most of the day, I'm still foggy, groggy, and sore, and looking less like George Clooney every minute. The good news is that the nurses who are giving me the Neupogen injections feel as if the stem cells are being stimulated by them--although we won't know for sure until Monday, when they test to see what I've got in my bloodstream. If there are enough stem cells in the bloodstream, we can start gathering on Tuesday. And again, the blessing is that collecting will be done through the main line. Collecting can be done through a traditional needle, as well, but I've seen it, and it is more closely descended from Ahab's harpoon, than a doctor's spindly chemo needle. Thanks, but I'm a main line kinda guy!

And now, the fun begins...

The adventure continues. On Friday the 30th, I had the "pulse" (as they call it at Mayo) of Cytoxin chemotherapy. Then, on Saturday, the 31st, I had the first injection of Neupogen, the stem cell stimulating factor that will make the stem cells migrate from my bone marrow into the bloodstream, where they can be harvested. So far, no significant ill effects from either, although the side effects of Cytoxin (hair loss and nausea), are generally delayed for a few days, and the side effects of Neupogen (bone pain) is cumulative, and with this being the first of at least nine daily shots of the stuff, I imagine that about Wednesday or Thursday, I may be one hurting puppy. In the meantime, on Tuesday, the surgeons will install a central line (also known as a palindrome catheter), in my chest. Two tubes will be attached, one to a vein so that chemotherapy and shots can be injected, and one to an artery, so that blood samples, and more importantly, harvesting of the stem cells, can take place without further poking of my hands and arms. These are big advantages, and other than looking like the spawn of alien every time I take off my shirt, there will be no drawbacks. So the schedule for the next week is a Neupogen shot every day (it's one of the few things that can't go through a central line), and the installation of the central line on Tuesday. Then, on February 9, they will see if I have enough stem cells in my bloodstream to try to collect them. If not, more Neupogen shots, and if that fails, another, just-approved stem cell stimulating factor will be tried. If it does work, on the other hand, it will be on to collection time--but that will be a story for another posting. I hope your team wins the Super Bowl--or at least that you enjoy the commercials!

And Now the Fun Begins...

A "Booster Shot" of Chemotherapy

Last week's extensive testing revealed good news and bad news. The good news is that I am a 51 year-old with the body of a 40 year-old. The bad news is, that 40 year-old body has myeloma that is beginning to make a comeback. My last Velcade treatment was January 9, and the little beast is taking advantage of that lull to regroup and reassert itself. It is not advisable to enter the stem cell stimulation and collection phase with resurgent myeloma, so the solution is a "booster shot" of chemotherapy. On Friday, I will be treated with a single dose of Cytoxan, which will knock back the myeloma sufficiently to allow stem cell stimulation to begin the very next day. The really bad news is that, as the name suggests, Cytoxan is toxic, or at least more so than Velcade. This means that the process of nausea, hair loss, and listlessness will begin a good week earlier than originally planned. Ah, well, I always was precocious! I did have one small compensation earlier today. While walking through the skyway to Mayo, I held a door open for Florence and a middle-aged woman who was walking just behind us. Florence commented on my politeness, and I rejoined, "People often mistake me for...." planning to finish up that sentence by saying "...a gentleman." Before I could finish, however, the woman piped up: "....George Clooney!" She made me a friend for life! Florence, however, teases me by saying that the woman really said, "Mickey Rooney!" Be that as it may, I'm feeling, as Austin Powers would say, "Dead Sexy" right now....which is a whole lot better than feeling just plain dead, which I did a lot in October.

Now is the time that tests my body

The title of this post, of course, paraphrases Tom Paine's immortal line, "Now is the time that tries mens souls." Florence and I are in Rochester, and the next few days will be occupied by a long list of tests to determine if I am healthy enough to undergo the chemotherapy and the stem cell transplant that will, God willing, get me into remission. Here are the tests (leaving our routine blood and urine tests), in the order in which they will be administered: bone marrow biopsy, chest x-ray, electrocardiogram, transfusion access evaluation, dental examination, general x-rays, echocardiogram, pulmonary function test, PET scan, psychiatric evaluation, MRI, and renal function test. If I pass all of these, we can then proceed to harvesting stem cells for eventual transplantation. If I don't pass, my doctors will prescribe whatever it takes to get me to pass. Actually, I feel as if I have already passed the most rigorous test: the first two nights that Florence and I were in Rochester, the temperatures dipped to minus 26 and minus 24 degrees F. Now, temps in the mid-20s seem balmy, indeed! We will let you know the outcomes of these tests as soon as we can. Unless, that is, the keyboard freezes solid!

End Of 2008 Report

In the spirit of our great business tycoons (well, at least of those who are not currently bankrupt or under indictment), I thought I would send along to you a year-end report on my current condition. And what a year it has been! In early September, I thought I was healthy man with a slight backache. By the middle of October, I was so racked with pain from myeloma and reactions to medicines that I sometimes wondered if I was dying. By November, thanks to velcade chemotherapy, I turned the corner, and by Christmas I was virtually pain-free: the best gift for which anyone could ask.

Velcade has literally saved my life. Besides the cessation of constant pain, it has beaten back the power that myeloma had to weaken bones. For example, from July to October, I fractured five of my ribs, at first by bumping them, but finally just by lying down a bit too hard on the table on which I was getting a radiation treatment. But no more broken bones from November to date, which is in itself a blessing.

I'm still a long way from cured, of which I am reminded every night when the lesions in my larger bones--especially the pelvis--begin to ache. I am receiving treatments that are promoting the healing of these lesions, but it takes time to fill them in--hence the evening aches. Still, I have begun to do things that would have been unthinkable even a month ago. I am up to as much as 30 minutes on the easiest setting of our elliptical exercise machine, and I have even started lifting weights on my weight machine, albeit at much reduced weight totals and at fewer repetitions than before I got sick.

The whole idea is to keep both weight and endurance up and strengthen muscle tone prior to the stem cell transplant coming up later this month at the Mayo Clinic. I'll have much more to report on that front as I endure it. For now, it remains to wish you all a wonderful 2009 (2008 was such a lousy year for us all that 2009 should seem like a vintage year without much effort). I have personally found new meaning in this season of thankfulness--for having the best wife in the world, for having family and friends who rally round at every opportunity, for having skilled medical practitioners who use the fruits of modern pharmaceutical research to save lives. My 2009 bring us more of the same in every category!