Cowgirl Up!!! ... Does Horse Poop Cause Cancer??

Friday, September 16, 2016

So Many Events, So Little Energy! Rock on Break Week!

Hello 9.18.16
Darn I missed posting on 9.16.16 as soooooo much happened this past week. I started my 9.16.16 post, then life happened :)) I pack way too much into my chemo break weeks, as that's when I feel a tiny bit "normal"! (I think I'll "cheat" and postdate this back to 9.16.16 just to keep my 6's tradition for 2016 :)
I'll skip writing a major newsbreaking post for now, and post my current status after my next Dr appointment this week. Hoping for good results...


Wow! This week was incredibly busy, too busy, but in a wonderful way, with notification of several recognitions and a speaking event at a Cancer Survivor's Day. I am so very grateful for all the recognitions and appreciation of my philosophy and outlook on life. People say I am so positive and my perspective is so great. Well... that's how I've always been. Cancer really hasn't changed me that much psychologically, just physically. If cancer would just go away, I could get back to REALLY being me!

Cool pic my daughter took :) 

 My heart is full of gratitude even though my body is so exhausted. Crazy how I could handle so much prior to my myeloma diagnosis. Back to the chemo lab tomorrow. Mon Tues. Mon Tues. Mon Tues. I can rest when I'm hooked up. Chemo treatments are my new "spa treatments" lol...
   


Thank you for caring as you do, and following my crazy cancer trail ride.


 Live happy, live well, and make a difference somewhere, somehow, with someone or something as often as you can! 




Tuesday, September 6, 2016

Some Days Imodium, Some Days Prunes

Hello 9.6.16

Oh Myeloma, you are becoming too predictable in your unpredictably! I make plans, I change plans. I think I'm ok, I'm not ok. I feel well one moment, and awful the next. I can "tell" now when I am "worse", I can just "sense it" myeloma. Then my lab results confirm it. I've sure learned a lot about life, myself and my physiology in 6 years 9 months. I know my body, I know what's happening.
Truly now, living life one day, one week, one month at a time.


In 2008/2009 prior to diagnosis, I was in denial. Actually it was "selective ignorance". With little cancer history in my family (except 3rd gen cousins on my Dad's side with breast cancer), it NEVER crossed my mind that my symptoms and side effects then, represented anything more than "normal" physiological changes, allergies, stress and calorie-counting, minimalist eating (almost vegetarian, as I love animals too much to eat them). Being the intuitive aware person I am, I was very aware of my exhaustion, extreme fatigue, crazy bleeding, losing weight, dizziness, headaches, GI issues, food allergies, bone pain, etc, but I "ignored" the symptoms and wrote it off as "too busy at work", "too busy with family and animals", " it's just this time in my life, getting older", "allergies", "female change of life", blah blah.
Stupid me! Bleeding out for years is just Not normal! I look back on some of my "bleeding out" experiences with humor and horror. Sometimes I would just stand over my sink and just let my nose bleed until I felt light headed, thinking "ok, nose, time to stop bleeding from "allergies". Stupid! Times during "that time of the month" I would bleed like crazy (I'll spare you the details).., I got so I would only wear black pants, "just in case". I wouldn't let myself think something was actually "wrong" with me. I really truly just thought it was a "phase in my life".
Eating the "healthy rainbow" sure didn't prevent myeloma in my case!
Fast forward to now.
I can sure tell now when myeloma is "winning" and the meds are not stronger than the battle they are fighting. I can just feel it. The Fatigue. Achiness. The lack of physical "helium". The Headaches, Dizziness, GI issues, and the Unquenchable Thirst. Ugh, I drink water like a fish, and still I feel so thirsty and dehydrated. And then..., my lab work confirms my intuitions and suspicions. WBC's low. RBC's low. ANC low. Platelets low. Hemoglobin low. Myeloma markers up. The return of GI issues. Yep, myeloma you're "slightly" winning now. Crazy how I can feel you brewing, swirling, churning up disaster throughout my body.

Yet, I still feel so disassociated (mentally) from this whole experience. I "force" my life to be "normal", fun and productive (on good days that is). I just go about my life, saving other lives, as if my life was ok. I am not a panicker. I'm not a worrier, and I have really reduced most all stress in my life. Actually, I have always tended to under-react to things I should be reacting more intensely too. More than ever now, I am following my old adage "You Can't Control The Things You Cannot Control, So Analyze It, Understand It, Accept It, Move Forward". But there are those times when suddenly it hits me: I HAVE INCURABLE CANCER. I know I am going to get sicker than I ever expected, and I'm going to leave this earth... sooner than I "planned"...
I physically feel you creeping further into my life myeloma and I realize I have little to no control. It's a very strange, surreal feeling. After 6+ years of treatments, 7+ years of symptoms, I "know" you myeloma! You are the monster that lives within me.


So with all the reading I do about myeloma, all the blogs I follow, all the posts I follow, all the research I read to stay informed about current and new medication options, it hits me there will come a time I will exhaust all my medication options. Wow, it hits me: I REALLY am not in control of my body. Medical science and medical research (and all the brilliance behind that...) controls whether I live or die. So when I have run through all the myeloma meds.. What then? Start over again? Go back to meds that stopped working and see if they may work again? Try higher doses of ones I've become "refractory" to? Agree to another stem cell transplant, if I am even eligible? Participate in clinical trials? What happens when I run out of options? What would it be like to not be in treatment at all? What would happen if to me if I didn't have anymore chemo or medication options, or if at some point I just reached my limit of being in treatment and decided, ok, enough. No more treatment, no more meds... let nature takes it's course...

I asked my Doctor this last month...

Here's how the conversation went (after going over all my labs and concluding I will need to change to another treatment soon).
Me: "So my amazing Doctor, let me ask you a question that I know you don't want to answer"... "Not to worry, I have NO intention of doing this", I reassured him... "but me being me, I need an honest "reality check"...
"What if I decided to not treat any more"... "What if I decided that's it, I'm done with meds, tired of side effects, and I just want to live life "freely"... (I take a breath, and so does he and so does my hubby Jim)... I continued, "So How Many Years Would I Have, If I Decided To Go Off All Meds?" .... pause ... "Months", he replied. I thought he may not have understood what I asked, so I rearranged my question and restated it: "Sooooo, if I decided to not treat anymore, how many YEARS would I have?"

He leaned closer to Jim with a smile and said, "You know I am not God, and I don't have a crystal ball, doctors are only human"... he continued after a pause... "If you chose to not treat any more, and go off all meds, you would have months"..."Your treatment medications are keeping you alive".

Saaaaay Whaaaaat? Process Julie, Process. What? Huh? Ok, move forward, respond.

"Ohhh, wow... really...well ok..."months"... "Soooo... if we really wanted to do that Hawaii trip I keep mentioning, it's time, right?" Me being me, I need further reality in my face...

"Yes", he replies, "do whatever trips you want, but be aware your immune system may not be able to handle all the potential infections out there"... (We discuss and recount what happened in 2012 when we went to Hawaii and was sick for most all of the trip.)

"Travel may not be the best thing for you Julie, but I understand", he comments. "It's not necessarily the myeloma itself that will "get you", it's the (potential) complications and (potential) organ failure and compromised immune system, that "gets" most patients..."

Process, Julie, process...

I ask: "so when would be the best time for me to take a trip, if I decided to take the risk?" He replies, "Actually, the best time would be between your upcoming medication change."That would be an ok time to take a little break, go on a trip, then begin the new treatment"... "But be aware", he continues, "something could happen on the trip (like 2012), and this trip may not turn out to be what you "expect" it to be... your energy, stamina, compromised immune system..."

 Process, Julie, process...


I love this Doctor. He's intelligent, insightful, caring, thorough, goes along with my blunt, direct and joking personality. We understand each other. He thinks I'm a bit "off the wall" and nutty, and that's good, I am. I'm not the typical cancer patient. I'm verbally direct, mentally strong, and want reality. Always, reality.

Jim and I drive home just like any other appointment. Navigating the freeways distracts me and forces me to focus on safe driving. I always drive. "So Jim, did you hear what I heard?" Jim's eyes are moist and emotional. "I did", he says... "Did I really hear "MONTHS" I ask him. Jim is having a hard time. We're trying to process what we heard. Did we misunderstand. Hear wrong. We talk about what we "think" we heard. We talk about what it means. Surreal. Unbelievable. Hard to digest.

Process, Julie, process..... Myeloma is Incurable. I've known this from the moment of diagnosis. Myeloma is "treatable", but myeloma is chonic, myeloma is forever. Myeloma changed my life forever and continues to.
Process, Julie, process...

  ****************


So it's been so hot I haven't taken my lil bug out for a spin in a long time. The other evening, I finally felt I had the energy to clutch and shift, so lil "Bucket List Bug" and I went for a short spin around the block. 

Sunset over Bug

***************

And we have a Rooster! 
Our little grayish/blackish chickie became
"Domino" the Rooster. 
He crowed his first "cockadoodledo" the other day. 
So adorable!!

Baby Domino! Back then, I called him "Charcoal"
Isn't nature amazing!!

One of our new girls- "Henrietta" :))



And so...
That's my life today, 9.6.16.
How's your life, your challenges, successes and joys? What plans and goals do you have? Let me know by leaving a comment.



Live happy, live well, and make a difference somewhere, somehow, with someone or something as often as you can! 



Friday, August 26, 2016

Thanks for Stealing My Life Myeloma

Hello 8.26.16
I'm moving like a sloth today, thank you Dex crash, Chemo crash and low blood counts. How about a pictorial update this time!


~ Poof! 35 years as a college counselor... my 35th anniversary recognition celebration recap. So nice to see all my colleagues I rarely get to see anymore.

2017 will be my last... thank you myeloma. Proud I hung in there for 35 years!
Tuesday night's smaller dinner celebration recognition of long term colleagues
Chancellor Dr Dianne at Friday's all-staff Opening Day Celebration
She's such an inspiration, and I admire her so much! 
The "Godfather of Counseling", Dr Al
My Counseling mentor and friend for life!
Friday's all-staff Opening Day celebration. Hundreds of colleagues there

Should have worn a mask, but cross your fingers, I'm still ok!
Without Dr Al and Dr Dianne, (and Joan and Bob)
I wouldn't have ever been Counselor Julie
Love you endlessly and thank you for my COC life!

Hard to believe this chapter in my life book will be coming to a close in 2017. I always thought I would be Counselor Julie forever. Becoming the lil ol lady who's been there since dinosaurs roamed the college hills. Never did I ever think my career would be edited for me, due to cancer. As I've written before, I pushed myself to work during initial treatments, returning back just "months" after my July 2010 stem cell transplant, working while on maintenance chemo, immune compromised, etc, continuing to work after relapse in 2013 to present, while in continuing chemo treatments, so fatigued, so immune compromised, with crazy side effects. What a dedicated goof I am! But I just love helping students realize their dreams and goals, love the mission of our college, and I have so much passion for the educational environment, my students and colleagues. Seriously, it's not an easy decision to give up half your identity. So very fortunate to have had the wonderful career I've had, for 35 years! I still feel half my age (mentally), with so many unfinished, unrealized plans... Hard to process...

~ My Numbers update: 
Not good as I suspected due to the steady upward climb for months now. Conversations with my local oncology team and my SCT team are: "Maybe time for a medication change Julie"... (as sadly Kyprolis may not be my magic elixir anymore I have to acknowledge)..."Time to change to something else soon Julie" they suggest... Ugh, Cccchange... again. I was hoping Kyprolis and I would be friends for a while... Oh well, such is the nature of myeloma, right. No matter how it is medicated and treated, it will always outsmart any chemo fighting it. I'm finally accepting, myeloma is stronger than my ability to keep it consistently controlled. Next in line will most likely be Pomalyst. We'll see.. the plan though is to stay the course with Dex and Kyprolis for another month or so...

Lol- my arm looks fat and distorted here! Just the camera angle.
I'm IgA Myeloma:

(Normal IgA = 70 - 400, Normal IgG = 700 - 1600, Normal IgM = 40 - 230)

Date                      IgA        IgG         IgM 
8/20/15                1530       258         < 18
9/13/15                1770       268         < 18
10/18/15              1890       240         < 18
BEGIN NEW KYPROLIS + DEX TREATMENT:
11/18/15              1440       233         < 18
12/2/15                862         230         < 18
12/30/15              482         262         < 18
1/18/16                426         228         < 18
1/27/16                432         221         < 18
2/10/16                551         227         < 18
2/28/16                635         226         < 18
3/22/16                533         242         < 17
4/17/16                717         251         < 17
5/15/16                808         232         < 17
6/23/16               1140        267         < 17
7/21/16               1180        247         < 17
8/17/16               1540       238         < 17
                Yep! Up it went...

M Protein: PROTEIN ELECTROPHORESIS RESULT, SERUM
Normal = 0 ... Zero

July = 1.26
Aug = 1.01
Sept= 1.37
Oct = 1.58
BEGIN NEW KYPROLIS + DEX TREATMENT: 
Nov =  1.12
Dec and Jan = Not Detectable! thank you Kyprolis + Dex
Feb =  0.62 Ugh! Quite a jump in a short period of time (Off Dex)
March = Abnormal, but no M-Protein number mentioned (On Dex)
April =  Abnormal,  but M Protein value not detectable (On Dex)
May = .75 That's a BIG upward Trend in just one month!
June = 1.06
July =  1.01 
Aug =  1.58 
Up again... back to where I was in Oct 2015

Awesome Nurse Josie!
My veins are tired. 2 sticks on Mon and Tues :(







































































I remember arm IV's from my 2010 SCT!








































































































































































































































Awesome Nurse Tracy

~ Did I ever tell you about my "cover girl" status for a myeloma magazine? 
Have you seen me in your oncology hematology office yet?


I was interviewed waaaaay back in November 2015 and the magazine is just now being published! Unfortunately, things have changed quite a bit for me since the interview, and I am not doing as well now, as I was then. My hair was still full from Revlimid and Dex, and now it's thinner and short. Kyprolis and I were best friends (see my stats above for Dec - Mar), and I was so hopeful myeloma would be controlled for loooooong time. I laugh at the front cover quote: "I feel more alive than ever"... as that was in reference to when I am on steroids LOL!, or my excitement that Kyprolis was working so well...  


My interviewer Debbie was super positive, caring and a really sweet person. She wrote the article from a positive, all is great and well in myelomaville perspective. I appreciate all the effort that went into interviewing me, the photographer Dana's personalized photo session, and all the effort the editors and publisher have done to make this a great magazine for myeloma patients. I still haven't seen the physical copy, but you can read online here at Guide2MultipleMyeloma and Patient Stories and HealthMonitor.  It loads really really slow, so be patient (lol no pun intended!). I have to let them know something's up with their website. 


~ And I have a psychological/philosophical question for you... But I'll do that next blog, as this post long enough!! I asked my Doctor a difficult (timeline) question, and received an answer I didn't quite expect...

Crazy how fatiguing myeloma is! I push myself so much, but my helium tank is empty


Thanks for checking in and reading and caring about my myeloma journey. Let me know you've stopped by, tell me your story, and where you're from!




Live happy, live well, and make a difference somewhere, somehow, with someone or something as often as you can!   

Saturday, August 13, 2016

Better, Battling Forward

Hello 8/13/16
Surprise surprise I am posting 3 days early, as so many have asked how I am after my most recent awful fever bug. I thought 13 would be a lovely date to update my status :))  Thank you everyone for caring about my crazy myeloma life as you do! Deeply appreciated.


As yucky as I still felt this past Monday, I pushed myself to show up for chemo. I had already missed the previous week, due to being so sick and feverish. I kept thinking about the irony of missing chemo to get better from this awful fever bug, yet myeloma was probably diggin in deeper without the chemo. I knew I'd better not miss another chemo week, if I could manage to go. So I went. I was quite surprised when my nurse took my temp and I still had a slight fever. Good thing I didn't check before I left home, as I probably would not have gone. Turns out that they don't really consider a fever a fever until it's over 100.3(?), and mine was 99.7, so they were ok with going forward with my treatment. I was somewhat dehydrated too, as who drinks enough when you feel so lousy with a fever?! And to top things off, it wasn't easy finding a good infusion vein, so I had several "sticks", but my expert nurses finally succeeded. Fortunately, good ol Dex steroids propped me up a bit, so I finally felt better by Tuesday. Not great, but ok! Whew, 2 more chemo treatments down.

But here I go again, trying to figure out how to live life while in continuous treatment. I'm supposed to have my chemo "make up week" this coming week, but I also have my 35th anniversary recognition at my college. Previously, (prior to getting sick) it would have been my chemo break week, so no problem attending 2 events without having to worry about post chemo/steroid side effects. But now, as a result of being sick, and missing a treatment week, I will only have had 2 weeks of Kyprolis, rather than the regular protocol of 3 this month. I know I should do my 3rd treatment week, but seriously, it's not possible to attend "normal" events close after treatments and with yucky crashing side effects. Who wants to show up to be honored and celebrated, feeling half dead and sick! Ugh, the conflicts of Treatments vs Living Life. I just can't let cancer can't steal all of my life, so I opted out of my chemo "make up week". Yes my numbers will probably Not be good this month, (due to my illness and minimal chemo), but these are the choices we have to make having incurable cancer, being continually treated. Icing on my cupcake, this 35th recognition will be my "last big hurrah" at my college, as I've finally reckoned with accepting that myeloma has stolen my career, and disability/retirement is just around the corner...


So I last left off several posts ago, that I made the decision to cut my hair. My poor little pony tail was thin and lifeless and I knew it was time. Ironically, my hair grew full and fast on Revlimid and Dex steroids, but I guess there's something about Kyprolis that thins the hair, so I knew it was time to accept a change was needed. I always had fun with my short sassy styles after my stem cell transplant in 2010, so it really wasn't a big deal to me to go short again. A a matter of fact, it's exactly 6 years ago that my hair really really thinned from Cytoxan and Melphalan. I cut my pony tail off June 2010, prior to admission to the hospital, and then I fully buzzed late September 2010.

So here's a fun Then and Now:
Pony tail chop June 2010

Pony tail chop July 2016
It's so thin and tiny,
it's hard to see me holding it here

2016- It was really really thin and tiny

June 2010 make over

July 2016 make over

2010 full buzz!

2016 mini buzz

So I'm enjoying my new hair, and great timing too, as it's really been hot this summer. Interesting, as my hair now is not as thin, and not falling out as much, and some waves are developing. It's even longer now than this pic from a month ago. I don't have a current one, as it wasn't long after this I bit the dust with my fever illness. I sure have gotten beyond my "vanity", as I'm posting goofy, not so flattering pics of me. Oh well, my life now.

Right before I got sick, my daughter went with her friend to a local "Clear the Shelter Day". She wasn't "planning" to adopt, but this little gem "picked" her, and now we have another amazing rescue that has joined our pack. Poor lil girl had been a stray on the streets, and not treated well either in her previous home, or while a stray, as she was thin and scared and timid and showed signs of abuse. The lack of love and consideration of living beings by humans, will always mystify and anger me...
She is safe with us now, and it's been a delight to watch her darling personality emerge as she learns to trust and be a happy puppy. We doggie-sit while our daughter is at work, so she's been with us a lot these past few weeks :))

So here's our new little family member: Nala!
 At the shelter, meet and greet! 
What a lil darling she is!

About a week later with us
Poor lil girl, didn't even know about "treats"

This was just after our daughter left for work
and little Nala climbed into her bag! 
How adorable is that!

And here she is being fully introduced to "ranch life"!
Anyone living with dogs and horses knows 
you can't keep dogs from snacking on horse poop!
No matter how we try, they sneak "apples" like 
humans do chocolate. Look it up! 


And lastly, remember the lil chickies we raised? 
They're almost full grown chickens now,
and happy happy in their "grown up" coop!! 


Thank you for reading and caring about my crazy story and life. Hope all is well with all my fellow patients and you're winning the myeloma battle and enjoying life in all ways you can. Truly, it's one day at time, one treatment at a time, one blood test result at a time. Life is so unpredictable, but so grateful to still be here! Cross your fingers for me, myeloma hasn't marched forward too much this month, and I'll post my labs when I have the results after 8/22.




Live happy, live well, and make a difference somewhere, somehow, with someone or something as often as you can! 



My Story... How my MM was diagnosed

October/November/December 2009...

Most of my life I was VERY presumptuous about being healthy, taking my (mostly) GOOD health for granted...
I was committed to annual check-ups for all of us, and so late October 2009, my daughter and I went for our annual and very routine physicals.

Surprise, surprise... my routine blood tests revealed extreme Anemia, significant White and Red Cell issues, low Platelets, and a variety of other CBC red flags! I was (stupidly) not worried when my GP doc left repeated phone messages to contact him, and when we did speak, I (stupidly) requested postponement of his referral appointment to the Hematology Dept until the end of the Fall academic term.

Arriving for my first appointment Dec 14, 2009, I was confronted with the check-in sign that read: "Hematology/Oncology"... What? Nooooo! not me... I must be in the WRONG place! And so my diagnosis journey began with vials and vials of blood drawn "stat", urgent Dr consultations, a surprise and painful Bone Marrow Biopsy, a full body Skeletal Scan, more blood tests stat, and then on 12.30.2009... THE revealing meeting... the "huh-what" moment ... the confirmation diagnosis that I, Julie, have CANCER!!!

Happy New Year to me, I just learned a new vocabulary word:
Multiple Myeloma!!! MM, Multiple Mye-what-loma!!!

January - June 2010

My medical metamorphosis began.
I read, and read, and read and researched and researched MM. I trusted my expert Oncology/Hematology team's plan and began my "New Normal" as a cancer patient.
My treatment plan was developed to include powerful Dexemthesone steroids paired with Revlimid chemotherapy, with the plan to be hospitalized for an Autologous Stem Cell Transplant July 2010.

I began living "one day at a time" like never before.
Jim was a wreck. Alissa and Scott were stunned; family and friends shocked.

Me... Cowgirl Up! I got back in the saddle and knew I was in for the ride of my life!
I did well on my initial pill-form Revlimid Chemo, "roid-rage" Dex Steroids and other supportive meds. I am forever deeply grateful and appreciative for all the love and support from everyone in my personal and professional life! I thank all of you for working along with me, and allowing me to continue to lead a semi "normal" life!
YOU have helped save my life!

My treatment trail ride forks to City of Hope hospital as I will saddle up beginning June 9, 2010 for a new rodeo called an Autologous Stem Cell Transplant!
Ye-Ha, let the adventure begin!

Chemical Warfare...

January 2010 - May 2010:
My initial chemo regimen:

Pill form Chemo= Revlimid (10mg capsules)
Pill form Dexamethasone Steroids (40 mg!) paired with Omeprazole
Mepron (looks like yellow finger paint) Anti-fungal, Anti-viral, etc for my very compromised immune system
B-12- to build those cells!
.81 Aspirin to prevent DVT, Revlimid complications
Allopurinol- keeping the kidneys healthy
Acyclovir- anti-Shingles, anti-viral

June 2010:
High dose IV Cytoxan chemo
Neupogen to build up stem cells for Apheresis, stem cell harvest, which was very successful, as City of Hope was able to collect 9.5 million of my own stem cells

July 2010 Hospitalization:
Two days of high dose Melphalan chemo
Then July 5, 2010 = my Autologous Stem Cell transplant infusion!

And you can read my whole story from that point forward in this blog!


What is multiple myeloma?

Cancer starts when cells in the body begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas of the body. To learn more about how cancers start and spread, see What Is Cancer?

Multiple myeloma is a cancer formed by malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system.

The immune system is made up of several types of cells that work together to fight infections and other diseases. Lymphocytes (lymph cells) are the main cell type of the immune system. The major types of lymphocytes are T cells and B cells.

When B cells respond to an infection, they mature and change into plasma cells. Plasma cells make the antibodies (also called immunoglobulins) that help the body attack and kill germs. Lymphocytes are in many areas of the body, such as lymph nodes, the bone marrow, the intestines, and the bloodstream. Plasma cells, however, are mainly found in the bone marrow. Bone marrow is the soft tissue inside some hollow bones. In addition to plasma cells, normal bone marrow has cells that make the different normal blood cells.

When plasma cells become cancerous and grow out of control, they can produce a tumor called a plasmacytoma. These tumors generally develop in a bone, but they are also rarely found in other tissues. If someone has only a single plasma cell tumor, the disease is called an isolated (or solitary) plasmacytoma. If someone has more than one plasmacytoma, they have multiple myeloma.

Multiple myeloma is characterized by several features, including:

Low blood counts

In multiple myeloma, the overgrowth of plasma cells in the bone marrow can crowd out normal blood-forming cells, leading to low blood counts. This can cause anemia – a shortage of red blood cells. People with anemia become pale, weak, and fatigued. Multiple myeloma can also cause the level of platelets in the blood to become low (called thrombocytopenia). This can lead to increased bleeding and bruising. Another condition that can develop is leukopenia – a shortage of normal white blood cells. This can lead to problems fighting infections.

Bone and calcium problems

Myeloma cells also interfere with cells that help keep the bones strong. Bones are constantly being remade to keep them strong. Two major kinds of bone cells normally work together to keep bones healthy and strong. The cells that lay down new bone are called osteoblasts. The cells that break down old bone are called osteoclasts. Myeloma cells make a substance that tells the osteoclasts to speed up dissolving the bone. Since the osteoblasts do not get a signal to put down new bone, old bone is broken down without new bone to replace it. This makes the bones weak and they break easily. Fractured bones are a major problem in people with myeloma. This increase in bone break-down can also raise calcium levels in the blood. (Problems caused by high calcium levels are discussed in the section “How is multiple myeloma diagnosed?”)

Infections

Abnormal plasma cells do not protect the body from infections. As mentioned before, normal plasma cells produce antibodies that attack germs. For example, if you developed pneumonia, normal plasma cells would produce antibodies aimed at the specific bacteria that were causing the illness. These antibodies help the body attack and kill the bacteria. In multiple myeloma, the myeloma cells crowd out the normal plasma cells, so that antibodies to fight the infection can’t be made. The antibody made by the myeloma cells does not help fight infections. That’s because the myeloma cells are just many copies of the same plasma cell – all making copies of the same exact (or monoclonal) antibody.

Kidney problems

The antibody made by myeloma cells can harm the kidneys. This can lead to kidney damage and even kidney failure.