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!