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

Saturday, August 18, 2018

To Share or Not Share... Your Myeloma Story

Hello 8.18.18
Lots of 8's today, this 8.18.18 in my 8th year with Myeloma.

Recently, I was chatting with other Myeloma pals about the reasons, risks, benefits and the "need" to, or not, share our Myeloma story.

Since I spent my adult life as a college Counselor- analyzing and delving deep into life-- sharing comes natural to me on all levels. But I am highly aware that I am in the minority, not the majority, when it comes to sharing and bearing deep thoughts, feelings, anxieties, stories, events, challenges, etc. Personally, I cannot imagine keeping one's cancer story inside. It's just so HUGE and life changing. As much as we don't want the title of "Cancer Patient", it is us. We can suppress and deny, but once diagnosed, cancer is us, and our life. It invades our being, as our body has betrayed us, and we cannot magically undo what has happened cellularly. Especially with an Incurable cancer such as Myeloma, which is a Forever cancer. Myeloma will affect my life Forever, and I choose to share my journey, and all the experiences and emotions that go along with it.


No doubt Cancer changes us deeply. The day, the minute of our diagnosis, we are changed... forever and ever. Deeply, profoundly, irrevocably. We are never the same again, no matter what we try to convince ourselves of. A cancer diagnosis changes our life, our view of life forever. It changes every facet of our lives and those in our lives also affected. How we, the cancer "recipient" deals with the diagnosis, treatment and future journey, can determine how everyone in our circle processes it, handles it.

When I was diagnosed, mid morning, early afternoon December 30, 2009, I was in shock, like most everyone would be. I was incredulous, in disbelief, and in denial. I just knew my labs were mixed up with someone else's, or the lab results were in error. It just wasn't possible, that I could have cancer, and INCURABLE cancer at that! I processed it as if I was hearing a diagnosis on a vehicle or other mechanical thing that just needed to be repaired. Take more labs, go get these pills, plan for this, plan for that, come back for this and that. I went into procedure mode. I kept saying cancer cancer cancer cancer cancer over and over and over and over to myself. I tried to have it sink in. It didn't. As I walked the corridors of Kaiser, from Oncology Hematology to the lab, to the cafeteria, I remember suddenly feeling like an entirely different person. I was suddenly not "me" anymore. For one brief moment, I looked into a poster of a forest and cried, this new reality slamming me, that my life, as I knew it, would never ever be the same again, and I wouldn't be able to be or do, what I once did, no matter what I tried to pretend or convince myself of. I had 70% Myeloma cancer coursing through my body, and the fight was on. For my life.

I don't think the depth of the situation hit Jim at that time. He was overwhelmed with the medical information, but heard Cancer, and that was it. He was devastated for me. He went in to "doing mode", keeping busy all the time mode.

Driving home, I think I thought about how to tell our kids, family members, friends, colleagues. I was trying to process what I had been told, but I think foremost on my mind was sharing this crazy, awful, unbelievable news. Sharing. I needed to share. Not everyone does. I did, and I do.

To this day, I share. I share my story with everyone, everywhere, anytime. Myeloma is my story. Myeloma has taken over my life. Myeloma changed my life entirely. Changed my lifestyle, my career, my body, my routine, how I  think, eat, sleep, suffer, and occasionally play. Myeloma invaded and changed everything about me and my life, internally and externally. I live with Myeloma every second of the day and night. I cannot avoid Myeloma's symptoms and ravages on my body and life. How can I not, as I am reminded I have incurable cancer every day, most every moment. I am in continuous medical treatment, have continual, on going side effects, have bones that have holes in them from head to toes. I'm always having to avoid cootie contamination, and the possibility of breaking bones. I feel so fragile and vulnerable now. If it wasn't for being diagnosed with Myeloma, my life would be radically, incredibly different right now. I can't even imagine what my life would be now... One thing I do know, I would not be writing this blog. You would not know me, and I, you...


From the beginning, I "had" to share my story. I had to tell my family, my friends, my colleagues. How could I not. Nothing about my life was the same since 12/30/2009. How could I "hide" the fact that I was now taking powerful medications 24/7 that caused, causes me physiological and psychological havoc! How could I not tell those around me. I was no longer silly, carefree, "healthy" Julie. I was sick. Very sick. Everything was different. I had to give an explanation. It would be weird if I didn't, with all the things that changed. Forward I went with explanations, descriptions, and being baffled that I was talking about me, describing my "new life, my new normal". "What the heck is Myeloma?", everyone asked. "Why is it not curable?", they couldn't understand. "Why do you have to always be in treatment, won't you be in remission after all the medications?" "How come they can't cure it? like all the other cancers." "Why can't you take this or that and be done with it. How can you look so good and be so sick?" LOL 8 years later... here I am, same status, same questions, different meds, still battling myeloma, same story, different day.

But this is my life, and what works for my life. My choices are not for everyone. I can't pretend I'm not battling a serious enemy every second, of every day.

I feel as if I "need" to tell my story. Partly because I have so many things I cannot do any more, or because I have to be super cautious about so much now. All my compromised immune system precautions could appear quite "odd" to the outsider who knows nothing about me, so I briefly explain my status. I dislike being "high maintenance", but I have to protect myself. My life is different, I am so different, my "needs" are so different. I feel I must explain. And then there's the "external judgement". Because I am not the type to "let myself go", externally, I don't look sick.. When I am "sick" I do look SICK, especially when I have a fever, like all of last July! I am forever explaining how I can "look good" on the outside, but be so sick on the inside. Same story for most myeloma patients. There are times I just want to shave my head, so the visual of "CANCER PATIENT" screams at people when they see me. I am exhausted explaining, almost justifying my status... Some don't understand "why I am still alive", while others don't get "why I am still in treatment"...

I've shared my story with anyone that wants to know. I share for me, for them, for you. I share personally and I've shared my story in professional situations. I've been interviewed about my story quite a few times. I share my story to inform, educate, and to lend empathy, understanding to others. I share my story in the Chemo Lab, when asked. So many patients are incredulous that Myeloma is truly incurable, and that I have been treating for over 8 years. When I tell my story to fellow cancer patients, non-myeloma cancer patients, it hits me what I have been through and for how long. It is incredible to have an incurable cancer, and have been through what I have been through, and continue to go through. Sometimes I'm just so used to being a cancer patient, that I "forget" how crazy and challenging my life is. Other times I am acutely aware how so many others are so much "worse off" than I am. But I share me, my life, my story, my struggles and successes, and I want to know yours too.

2016
Sharing my story at Amgen

This quote should have read: 
"I feel more alive than ever...
WHEN ON STEROIDS!"
lol lol :))
My eyes look like slits, as it was early in the morning

Amgen 2017

And on and on and on

Sharing our stories helps others understand what we are going through, and as a result, we enrich their lives, while clarifying ours. For me, being diagnosed with myeloma cancer, so completely changed my life, that I can't separate me and my diagnosis. Some people can, and are adamant that they are "not their diagnosis". I think that's awesome for them, and perhaps they can live their life, and engage in their daily activities without cancer or treatments continually reminding them of their diagnosis and status. Me,... myeloma affects everything I do, and everything I am, because myeloma stole my life as I once knew it...

The Chemo Lab is my 2nd home
for life, forever,
because myeloma stole my life.
That Is My Reality



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



Wednesday, August 8, 2018

Let's Go, Double Darzalex, Starting Now

8.8.18

Hello August that is so far, so much better than July!

Happily I don't have any new news for you since my last posts and I am thrilled to have July's craziness behind me! I'm looking forward to seeing how my body responds again to Darzalex every other week, 2x per month. My first "retro" infusion will be next Monday, Aug 13th. 


I've been very very fortunate that the triplet of Darzalex, Pomalyst, Dex steroids has been as successful as it has been since March 2017. My IGA began rising early this year by a few 100 points per month, and is now around 1430 (normal = 70-400), hence my "insistence" that we try going back to 2x per month infusions, back to when my IGA was in the hundreds, not thousands. Drs worry about doing what is not a standard protocol, but what the heck, if it worked once, it hopefully will work again. And it seems like most every treatment we do with Myeloma is a "science experiment anyway, so I'm certainly willing to try something that worked before, that hasn't been "officially studied or researched". It's the new treatments and clinical trials, with new unknown side effects, that scares me... the UNbrave cancer patient I have become :))

Perhaps I live in a "myeloma dream world", wanting, hoping, expecting to remain on the same treatment for a while, but darn it, I want whatever "quality of life" I can have, while I can. Quality of life for me, is manageable, somewhat predictable side effects. Yes, I have lousy side effects weekly, but at least I have some predictable consistency in my limited life.  Fighting cancer and dealing with my body's betrayal for 8.8 years is exhausting, day in and day out. As I always say... can you even imagine Knowing you'll be "sick" every week? Imagine- weekly, daily, trying to Plan some semblance of "living" around treatments, crazy, debilitating side effects, and the the "unknown" surprises". It's daunting and mind bending and truly exhausting. I still cannot believe this is MY life. 


Last Darza infusion, July 30-
Got to hang out in the chemo lab 
with my fave volunteer, Karen xoxo

 Met a new cancer warrior Paul

And here I was with girlfriends, summer 2009
just months before I was diagnosed
My IGA was over 5750, 
M Protein around 4.3
And first BMB showed 70% myeloma cancer

Yes, I must live life while I can
If only side effects and debilitating FATIGUE
would stop sabotaging me...
But then again, there are those 
that are in and out of the hospital weekly, monthly
And myeloma bone lesions break their bones regularly

One Day At a Time-
I'm always grateful for all the good 
I am so fortunate to have in my life. 



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



Thursday, August 2, 2018

Hellooooo August, Good Bye Awful July!

8.1.18

Hello August!
Looking forward to never ever seeing another July like this past one. Cannot believe all the drama I experienced, and I am so glad to have it behind me!


Had my Darzalex infusion on Monday, July 30. Took 40mg Dex steroids prior to, so I always feel ok on infusion days. I "enjoy" the up up up, relief relief relief from the steroids, then the sleepy calm of the Benadryl during the Darza infusion. I never did much medication, not to mention, never doing drugs or alcohol prior to my myeloma diagnosis, so here I am mid life, experiencing these crazy rides from the cancer meds. Of course the medication CRASH days later are no fun, but as long as I don't break any more bones, or have extreme fever and pain beyond pain like I did from the Zometa infusion, I can suffer along with all this insanity. (Yes... the future... I know... more is always coming... Myeloma will continue to mutate and challenge me forever, until, until... but I don't focus on that... One day, One drama, at a time for now..., I just want to feel somewhat ok, if I can, if myeloma let's me... I live in the moment now, I live today...

So just a quick update prior to my usual On The 8's update, as I had such awful news my last few posts. The "good" news is my IGA "only" went up 100 points this month, the Zarxio brought my WBCs up into the super "normal" range, my rib is better, pain and fever from the stikn Zometa is gone, and my Dr and I agreed to going back to Darzalex every other week, to see if that will bring my rising IGA back down.





WOW! look how 3 injections of Zarxio raised my 
WBCs from 2.0 to 8.2!!
WOW, look how Zarxio raised my ANC! 
From .71 last labs, to 5.93 in just 3 injections!

======================
And now on this again.
Was on it in 2010 at the beginning of all my treatments,
due to how immune compromised I always am,
and the high dose steroids.
Looks like yellow preschool finger paint!
"BRAND NAME(s): Mepron. 
"USES: This medication is used to prevent or treat 
Pneumocystis jiroveci pneumonia 
(previously known as Pneumocystis carinii pneumonia or PCP)." 
"It is an antiparasitic that prevents the growth 
of the germ responsible for this infection."
======================


The longer myeloma and I have this crazy relationship, the more I know I just don't want to suffer, and feel awful. I'm just not as "brave" as I used to be. I prefer not to jump from one type of treatment to another (if possible), and I definitely don't like the risk of UNKNOWN NEW SIDE EFFECTS FROM NEW TREATMENTS (altho I know this is ultimately unavoidable).

Everyone is suggesting I get into clinical trials, do another SCT, or go for the CAR T, or change this, change that, get 2nd, 3rd opinions, etc etc etc. 8 years is a long time (at least for me) to be on continuous treatment, so if I can lessen my side effect suffering, I'm all about that. Plus my stats right now just aren't anything to "panic" about. My IGA is "only" 3x the high end of normal, I don't have a M Protein spike, and equally important, my organ status is good! The elusive "remission" is not my goal. Feeling ok, and having myeloma "controlled" is my goal. And of course... QUALITY OF LIFE! Everyone approaches this crazy ride differently, so for me... less is more.

My Drs have never let my roller coaster status get out of control. We treat continually, and when the numbers jump quickly, or seem to not be responding to the current treatment, we switch. My Drs hit my myeloma intense at Dx 2009/2010, then after coming out of SCT "remission" mid/late 2013, then late 2015, then late 2016, early 2017. I'm super happy that Darzalex, Pomalyst, Dex has been working for me since March 2017!!! I'm actually kinda spoiled by it, hence not want to switch, and hoping going back to every other week, will bring me back to where I was this time last year! Yep, as awful as all this is, thankfully my body responds well to treatments... when it doesn't... I'll cross that swaying bridge when I come to it. But in the meantime...





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



Saturday, July 28, 2018

Sick of Being Sick and Other Myeloma Nonsense

7.28.18

Yes there was a time in my life when I was well. Well all the time. Took my body and body functions for granted. Living a "normal" life, with only the "regular" annual bugs parents and kids get. I really never thought about illness or sickness, only when we were, and then we all got over it.. Never thought about what it would be like to feel "sick" and exhausted all the time, and never occurred to me to "plan" for being sick.

Now that's all I do. Feeling sick, being sick, thinking about illness and sickness, avoiding being sick from unplanned cootie contamination, or planning when I'll be "sick" from medication side effects. Even after 8 and a half years, it's still so strange to for me to "have to" focus on, plan for, be aware of sickness and feeling sick. Just so weird still. Spins my head being "sick" each week. Sick for me is unrelenting fatigue, achy, weak muscles, joints, nerves, bones, headaches, bloating, swelling, some GI issues, all around malaise and so little energy. And then on top of the weekly "predictable" medication crash, there's the surprise sicknesses, or new yucky side effects, new pain, fevers, from myeloma morphing, mutating all the time, and daily, weekly, monthly, myeloma treatments.


I'm still reeling from my July 3rd broken rib incident, and then the awful, horrible, painful, pain beyond pain, high feverish reaction to my first Zometa infusion July 10th. I finally began to feel better this past week, and 40mg of Dexamethasone steroids helped. After about 9 days the fever was finally gone, and slowly the crazy achy bone, muscle, joint, nerve pain lessened and subsided. I still can't believe all this happened to me. I thought I'd have the "normal" Zometa side effects for a few days, not the EXTREME torture I had for 2 weeks! I just don't see myself as a "sickie" and I just can't stand feeling unwell all the time. Just not me!

So just when I started to feel relief and think I'd get a break this last week of July, before my next round of chemo July 30th, boom!, body sabotage hits me again. My blood tests reveal I'm Neutropenic AGAIN. Yep, did my monthly Labs yesterday, July 27, and in no time heard from my Dr that I'll need to start 3 days of Neupogen Zarxio injections, as my WBC is 2.0 (4 - 11 normal range),  and my ANC is .71 (1.80 - 7.70 normal range), yes "point" .71

Whoo hoo. Isolation Bubble Time... again..., no events, no eating out, no crowds, no fresh fruits and veggies, etc etc etc Hello Neutropenic life, Neutropenic diet...  Time to grab some belly fat, and stick that needle in. Just like tossing a dart at close range :)) Get in my cells magical Zarxio and pump up my immune system!

OMG, just read the fine print on this!
"Derived from E-Coli"!! Whhhaaaattt??!!!
What the Heck! Medication to build me up
is derived from sickie cooties!
Ugh, have to read up on this for sure!

================

Forgive me if I sound whiny, as I am always super aware of how awful "It Could Be", and how challenged so many of my myeloma pals are, not to mention 3/4 of the world! But all this affects me so much, as I was so well for 48 years of my life. And just as I was getting over the broken rib pain, and the crazy Zometa reaction, our A/C died when it was 110 for days, my dryer tried to start a fire and burn our house down, I walked into a black widow web, and was almost bit, and one of my horses was on the verge of Colicing in this horrible HOT weather, and I have more and more "caregiving" tasks for my ol hubby, as he too, is being sabotaged and betrayed by his body...but that's a whole 'nother blog...

As a Counselor for 35 years, I was focused on helping others analyze and solve their issues, and I was super focused on my family life, so I didn't focus on me. I didn't need to. Now, sadly, myeloma "forces" me to constantly think about my situation, and constantly "feel" all my physical side effects. I'm "sick" of me and my issues... 8 years, 7 months is a long time... soon 8 years, 8 months... is a long time to be focused on staying alive, a long time to be treating incurable cancer, a long time to feel unwell, and a long time to always be surprised by unwanted side effects... 8.8 years... wow... waahh, waaahhh...

Anyway, here's my Neutropenic labs:



And the first hint of myeloma on the move-
I'll see all my labs on Monday, July 30
at my next Dr appt and Darzalex infusion


And lest I forget, 8 years ago TODAY, July 28, 2010, I was finally released from City of Hope hospital, after being there for all of July, for my Autologous Stem Cell Transplant. How fitting that I'm Neutropenic this month, and have had so much myeloma DRAMA, right! Just a "little" reminder of what I went through 8 years ago! So no complaints, as I haven't been hospitalized since then, and I hope to be able to continue out-patient treatment for a long time...  

This was an amazing crescent moon earlier in the month
with Venus close by!


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


Wednesday, July 18, 2018

What The Heck Zometa! A Week of Fevers and Pain

Hello 8.18.18

Really Body? What's up with all this torture? What did I ever do to you to deserve this backlash? Remember,... at this time in my life, we were supposed to be PLAYING, winding down my career, and chillin for a change? I won't even list all my mid-life, second half of my life goals and plans. It's just waaaaay too sad. Never ever, did I ever think I'd be faced with all the challenges I am. Mine and my husband's...


Everyone's Myeloma, or chonic, incurable, forever illness attacks differently. Everyone handles illness, pain and challenges differently. Myeloma faked me out in the beginning. Faked everyone out who knew me and saw me in public. No one could ever understand how sick I was on the inside, and the intensity of the monster growing daily inside of me. I didn't get it either or comprehend what "aggressive myeloma" meant back then. Now I do.

Immediately, after my Dec 30 2009 diagnosis, I was put on Dexamethasone steroids. Never had been on steroids in my life, so the fun ups, and the crazy downs, were a new ride for me. Back then, for a month, I started on 20mg 4 days on, 4 days off. But when when my Dr tried upping Revlimid from 10mg to 15mg, I developed the dreaded Revlimid body rash. So from February 2010 to end of May 2010, I was on 40mg of Dex, 4 days on, 4 days off. THAT'S 160mg OF STEROIDS PER WEEK FOR 4 MONTHS! Wow!!

As a result of this high dose, the many "typical myeloma side effects" remained "hidden" to me. And with all those steroids in me, Revlimid didn't stand a chance of causing me "volcanic GI issues", as the steroids corked me up! So thanks to steroids masking symptoms, I was thinking, "hey, this 70% myeloma cancer thing is "tolerable", and I can still continue on being "Julie"" LOL LOL

I then had one dose of IV Cytoxan, which woke me up and made me FEEL LIKE A SICK CANCER PATIENT for 24 hours. But after that, I sailed through the Stem Cell Transplant prep, harvesting 9.5 million stem cells, and the first few days as an inpatient at City of Hope Hospital wasn't bad at all. But midway through the process, when THE HIGH DOSE MELPHALAN CHEMO KICKED IN, I TRULY LEARNED WHAT A BEING A SUPER SICK CANCER PATIENT WAS ALL ABOUT. That was challenging beyond all words.

After my recovery in August and September, as I slowly crept back to beginning to feel like Julie again, and finding out that my SCT process was successful, I began to think I could put it all behind me, "and get back to my "normal" life again" LOL LOL. My son buzzed me October 1, 2010, and that was great symbolism of my new beginning! I remained on 5mg Revlimid maintenance for 2 years. I was very immune compromised, still extremely fatigued, and had GI issues, aches, pains, etc, but overall had a good quality of life that allowed me to get back to 50% of my life.

My Dr then wanted to try a "medication holiday", so I went off maintenance Revlimid. Within a year Myeloma roared back, late (2013) and the rest is history.


For 7 years, any xray, or skeletal scan I did, showed NO BONE INVOLVEMENT. I was a little snarky about this, as I always thought "I was different". Shame on me. Then my first visible lytic lesion was seen in my annual skeletal scan, April 2017. Of course it was a "Hole in my Head"!! A hole in my skull. Of course that's where my first lesion was seen. My myeloma cells definitely have a sense of humor with me! I didn't panic or worry, as me and my Drs seemed confident that was the "only one".

But a year later, April 2018, I was sent for a full body Pet CT Scan. If you've been following my blog, you know the dramatic and shocking news that the results brought. I think my Drs have "regret", or feel bad that none of my Drs had ever requested an earlier baseline Pet CT Scan for me. I'm a little upset it wasn't done sooner, but then again, "Ignorance is Bliss", and I lived for years thinking my bones were strong and "holeless"! My treatment meds probably wouldn't have been any different, just that Zometa may have been introduced years ago? Who knows and I don't look back with regrets, as perhaps not knowing this news, helped with my positive optimistic fighting attitude. Who knows if all my "INNUMERABLE" holes just grew in one year. Probably not possible. With the extensive amount of holes I have, and with terms on the scan result report mentioning something about lesions "treated", I've most likely been "holey" for sometime now. Thinking back over the years, I do recall several Drs mentioning that I should probably do Zomenta.

WELL I DID, and ZOMETA I HATE YOU! I hate what you have done to me this past week. I hate the pain and suffering you caused me. I hate the awful, high fevers (101+, 102+, 103+ for 3 days), I had to endure. And I still have a fever over 99 daily, some days over 100! 8 days so far, with today's reading, 100.9. I hate the awful, deep, painful, searing, pounding, slicing, piercing, electrical current pain you sent throughout my entire body, and weirdly all up and down my left side butt to lower leg. Crazy deep pain that drives me batty. I try to walk it out, stretch it out, sit it out, lay, lie it out, liniment it out, stamp it out, pound it out, pain pill it out, and it's relentless! Especially at night...

I read all about the side effects.Talked to tons of myeloma patients about their Zometa experiences. I did all the right things to "prevent extreme side effects". My infusion was 30 minutes long. My nurse did hydration before and after. I asked her to finish the rest of the bag, after Zometa was done. I hydrated like a fish. I always hydrate a lot. As a matter of fact, I'M SICK OF HYDRATING. I'm so tired of trying to do the right things, eat right, drink right, move right, blah blah blah. I did all the right things, AND I STILL HAD HORRIBLE SIDE EFFECTS, AND I STILL HAVE A FEVER, DAY 8! I still ache all over, and have a headache. I rarely get headaches. And when I move, I get surprising shocking twinges all of a sudden.

I am better, pain wise from a week ago for sure. A little more relief everyday. But yesterday, I knew in the middle of the night I still had a fever. When I took it, it was 99.8. Dang it! Thought I was done with fevers. But the fever yuckiness feeling is indisputable. Felt the same telltale signs again today... Yes, a Zometa fever for 8 days now.

Early yesterday, my husband had cataract surgery scheduled in the morning. I never feel well in the mornings anyway, and the fever was just complicating everything. Of course all week I "worried" that it was going on a week with a roller coaster fever, but each day I kept thinking it would disappear, and so would my awful symptoms. Tylenol and Advil of course masked the fever symptoms, and only when I let it's affects wear off, did I know the "real truth" about my status. All this was not what I had heard, not what I had read, not what I expected regarding Zomenta infusions. Zometa is not supposed to be a "big deal". It was a HUGE deal with me.

I worried about the length of time I've had a fever, so I had our super helper daughter go with Jim to his surgery, and I went to Urgent Care. They always apologize for the limitations of what they can do for me, as my situation is so complicated for Urgent Care, and I am always encouraged to go to ER instead. Um, Nope! Further away, I feel lousy, and waiting in ER! OMG, no thank you! I had a very caring UC Dr who set me up for many blood tests, bacteria tests, and a chest xray. She also contacted my Oncology Office, letting them know of my situation.

I was there for hours. Hours. I didn't bring my pantry and refrigerator with me, so midway through, I'm starving. I did have enough water in my car, so I kept hydrated. Funny though how I was in eyesight of the Vending Machine, but yuck! All the human cooties on that, grossed me out, no matter how hungry I was!

My labs came back ok. Not much different than they "normally" are... EXCEPT my WBC was skyscraper HIGH (for me) of 6.8. Ok, for most of you, that's normal, and good. My WBCs barely get out of the 2's... so to me, something was up. Must be a crazy battle inside me. Having a strong WBC, wow, my cells must partying it up. I pictured the newly powered whites beating up the myeloma cells, and the Zometa in there fueling the fire. I thought hmmmm, wonder if all my EXTREME PAIN and fevers for a week was due to Zometa doing something "good", powering up my system, infiltrating my bones, boosting up my plasma cells, and pummeling the myeloma cells?


My xray showed clear lungs, no pneumonia. Still waiting on the bacterial cultures. But I'm not worried. And thankfully my UC Dr did not want to give me antibiotics unnecessarily. I was beat up from being there for hours, but very appreciative for the quality care.

But I still have a fever...

So where does all this insanity leave me today, 8.18.18... still with a 99.4(am), 100.9(pm) fever, that of course varies with when I take Tylenol or Advil. The killer bone pain has subsided, but I tingle and get twinges all over. I feel weird feelings everywhere, even my teeth and jaw hurts periodically... great, here come's ONJ, my greatest fear with Zometa.

Who knows why I had such an awful and excruciatingly painful reaction to it, but as I said in my previous post, I just don't know if I can do it again... But, If, If, If, my myeloma labs I'll do next week, (and then see at my July 30 appointment), show that Zometa had a dramatic affect... maybe, just maybe I may "elect" to SUFFER again in several months. And yes friends, I will grow up, and ask for stronger big girl Pain Meds!!! And to those that have mentioned Xgeva, I will inquire about that too. But for now I am just reveling in feeling a tiny bit, yes a tiny bit, better each hour!



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



Friday, July 13, 2018

Zometa Backlash, I Can't Handle the Pain... Sometimes Myeloma Wins

Hello Friday The 13th!

7.13.18 - Friday the 13th.
It's so ironic, and so fitting that I've had awful, pain beyond painful pain, these last few days, as 8 years ago this month, I was at City of Hope Hospital, experiencing all the yucky Melphalan chemo, Stem Cell Transplant Crash side effects. I was in the middle of the process, with my CBCs near nothing, feverish, trying desperately to survive and heal, fighting to become me again, desperate to get from the hospital to home.

So how fitting I had my first Zometa infusion on Tuesday, along with finding out about my Broken Rib. Of course my "friend" Dex Steroids propped me up that day, but it was all downhill from there these last few days, and I thought I would never come out of the pain, fever and awful physical suffering that I endured from early Wednesday through all of Thursday, and Thursday night, and into today Friday the 13th, and I suspect onward for several days...


I wrote the following thoughts early this morning, after 2 1/2 days of the worst bone, muscular, nerve, feverish pain I have experienced in a very long time, if ever? I don't know... I have so many incidences of pain to recall now, I can't remember...

%%%%%%%%%%%%%%%%%

True (unfiltered) Confessions of a Tired Cancer Warrior

Sitting on the edge of my bed at 2:30am weeping from the depths of my extreme pain, and frustration with my ongoing, never-to-end-battle with myeloma, I questioned whether I could keep doing this... The pain was just unbelievably excruciating...  

8 1/2 years is a long time, for me at least, to be sick and in a constant battle with my body.Too long (for me, who used to be so healthy), to be constantly challenged. I am fighting an internal monster that is much stronger and smarter than my body, and eventually always stronger than all the medications I have taken or will ever take. Myeloma will always mutate and outsmart any treatment I do. I will never have a break, never "remission" without continuous chemo. Never, Ever.

Simply put, if I want to live, I must treat, always, continually, non stop. This is my myeloma life sentence. Yet I am so tired fighting and feeling awful for most days of every week, except on steroid days. I am not as strong everyone thinks I am. I really am not. 

To be candid friends, most of my (facebook) posts, where you all so kindly compliment me on my smile, my energy, my fighting spirit, are the days I am all "Roided up", "Dexified" (as my dear myeloma cowgirl Jan calls it), on powerful medical steroids. Dexamethasone is a fun, crazy making medication the first day or 2. It energizes me, gives me fake euphoria, temporarily heals my body, mask's pain and even has strong myeloma killing properties. But as anyone who drinks or drugs knows, the crash crashes you, and the physical awfulness eventually overcomes, enveloping your body, your entire being for days. 

So I retreat into a yucky blah, for days, only to surface again for the same drill. Chemo, steroids, chemo, steroids, chemo, steroids, the next week, the next week, the next week, the next week, for my forever... Imagine knowing that EVERY WEEK OF YOUR LIFE, YOU WILL BE SICK from side effects. Every week you must plan your life around when to be sick, when to crash, when to feel awful. Every week for the rest of your life.


And the crazy irony is I'm "sick" from side effects of medications trying to make me "well". Yes, I have to be sick in an attempt to be well. I have to be sick, to survive, I have to be sick to stay ahead of myeloma. 

BUT WHAT SENT ME into the depths of "I CANT TAKE THIS ANYMORE", "I dont know if I can keep suffering like this any more, with literally no end in sight", was the horrible, unrelenting PAIN I experienced from Tueday"s new IV bone strengthener, Zometa infusion. 

I expected side effects and was mentally prepared for "something". But the something turned in to a fever as high as 102 -103, with unrelenting deep bone pain and body aches as I have never experienced. The depth of pain is truly indescribable. I couldn't get relief. Yes, I only do advil and tylenol, as I don't want to chance another side effect making me feel sick.

The unrelenting deep ache was overwhelming. I paced, I sat, I reclined, I stretched, I walked, I kneeled on the edge of my bed, awkwardly angled to try to sleep. I tried a heating pad, Solanpas, and those menthol minty ointments. I hydrated, but had little appetite. I cried and I cussed. The fever exaggerated the pain too. And at my depths, I looked skyward and cried, "Why me, Why?" "I can't do this anymore"... 

I'm really not strong friends. Well yes, mentally I am, but not physically. I can handle most things of a psychological nature, but each time I am confronted with REAL physical pain, I crumble. I don't know how most people who live with worse challenges than me, do it. And in comparison, my challenges are tiny, compared to others. I am not strong friends, and I am so very tired of this battle... 

I woke up today with less a fever, and without as much killer bone, nerve pain. I can breathe better, and I have a better perspective. I still feel like I was hit, rolled over by a giant tractor with huge spikes, but I am better. But I don't think I will do this medication again... I am not strong, I hate pain, and I hate suffering. 



Thank you for reading and being loyal blog followers! 


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




Tuesday, July 10, 2018

No Way! Can't Be Possible! I Have a Broken Rib!

7.10.18

What a day today! OMG! Getting my new bone strengthener Zometa IV, and then down to Urgent Care for consultation and Xrays on my painful Left side rib chest area, where I think I strained, sprained, tweaked, pulled, spasm-ed a muscle! I really didn't think I could have broken or fractured a bone from repressing, suppressing a sudden choke, cough, sneeze when driving home from my Darzalex infusion last Tuesday...

But what was I thinking this last week with all the crazy intense pain I endured for a week so far? Well I wasn't thinking smart, I was in denial. I really didn't believe, me cowgirl Julie, could "break" a bone. I always secretly think I'm Dominating myeloma, Not myeloma dominating me. Honestly, even with all my Myeloma damage, I really didn't think it was, or would be my story. Blame it on being "Blonde" or the "chemo fog" :))

Yes, just slam me with reality Xray results, as I do in fact have a Broken Bone! Never in all of my lifetime, broke anything. Even with all my outdoor sports, horse riding activities and events with my kids! Never ever had I broken a bone. Well I did, I broke, fractured a left rib with my crazy swallowing water the wrong way, then trying to suppress, repress the ensuing all-in-one choke, cough, sneeze, so I wouldn't blast water all over my car's dash! I broke my rib doing that! Seriously, laugh with me... I'm "dying laughing" here!!! :)) See my previous post for the ridiculous story. Next time, actually hopefully never another next time, but next time, I'll spit that water out all over whatever or whomever is near me :))

I shouldn't be surprised, right. I am riddled with Myeloma bone lesions, holes, holey tumors, lytic lesion tumors from my skull to my lower legs! Maybe to my toes? Holes to my toes. LOL. But the irony friends... Here I was at my very first Zometa IV treatment to Strengthen my bones, and then a few hours later, I find out I have bizarrely broken a bone, a rib! OMG, can my life get more ridiculous and ironic? Hello vicious myeloma complications.

Yep! The evidence!

When consulting with the Urgent Care Dr, I candidly tell my story as if I was talking about someone else. I still feel all this just couldn't be happening to me! He and others tell me they, "can't believe how positive, up-beat, fun, funny", and in his words" with amazing energy" I am, not to mention I "look "normal" lol. As he reviews my complex medical records, he says it just don't fit the person in front him. I Quickly Clarify that I took 20mg of Dexamethasone steroids much earlier, "so you're getting the extra animated, fully energized, "Dexified" Julie today". I even cheated and only took 20mg today, as all this muscle wasting, muscle pains and strains side effects are concerning me regarding the high dose 40mg Dex. Indeed, the external misrepresents the internal disaster...

Yes, last Tuesday, July 3, I was driving myself home from my Darzalex IV infusion, and swigged too much water in one gulp, causing me to choke, and need to cough, sneeze and spit out all at the same time, and unbeknownst to me, by suppressing this craziness, just to save my car dash I break a rib! Really this did happen. I broke a Rib, suppressing a monster choke! Never again, I've learned the lesson about my fragility.

Then for a few days, high on 40 Dex, I have fun on July 4th, feeling the pain buried under the false pretenses of steroids, but I was still able to carry on. Did I mention, I even scooped horse apples in the arena, took care of the other animals, did some watering of our yard, which involved pulling the hose around, took our 27+ year old Box Turtle to the Vet to have his nails and beak trimmed, and did a zillion other "normal" chores around our house, etc... Until suddenly, Dex, Advil, Tylenol and Flexeril wore off, and reality slammed me! Ouuuuchie... OMG I really do hurt, hence my Urgent Care visit today. Dex steroids dulled the pain, but Xrays don't lie! I have a stikn broken rib!


Yep, loaded up on "fix that rib supplies" tonight. My kind Dr asked me what kinds of meds he could prescribe to help me out, and mentioned all the "big dogs". I thanked him, but said no thanks, as I didn't want to add a new Rx to the mix, that may cause some new side effect. OTC meds have helped out to this point, with the lovely Wintergreen scented patches and good ol Bengay! Can you even imagine if I had an upper GI reax to strong pain meds, and my body wanted to vomit? OMG the pain in the ribs, muscles trying to retch! I don't even want to think about it!

So thanks to Dex steroids, I'll get thru the night, if I can ever get sleepy lol, and I see what tomorrow brings. Will be interesting to see what, if any, side effects I have from the Zometa... please "cancer angels", look out for me...

And thought you'd enjoy the shock and awe of my 21 days of Pomalyst invoice:


And I remember seeing the retail cost of my Darzalex infusion around the same amount. Thank you awesome Kaiser insurance for keeping me alive!


Super awesome chemo lab treats today :))
Just perfect for animal lover me!

Huge huge thank yous to my wonderful chemo nurses! 
Thank you for being a huge component to why I am still here :))
And huge thank yous to my wonderful Urgent Care Dr tonight.

One more point of gratefulness. I wound up seeing a bunch of my friends, colleagues, students, tonight, from my good ol college of employment of 35 years! Seemed more like a summer reunion today, tonight, then being at a medical clinic receiving jaw dropping news, say whaaat news!

Ok, Dex steroids, time to chill and let me go to bed... wonder what tomorrow and tomorrow will bring... May I please have a boring life for a while Myeloma...


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


Rib Pain Pain, Go Away... It's Zometa Day

7.10.18

That term... "No Pain, No Gain". Ha, Lie!! For me, pain is absolutely debilitating physically and mentally. No "gain" for me. Pain causes me to "rethink" my life when I am so incredibly miserable. I know pain has a biological, physiological purpose, to alert us there's something wrong, something going on... but geezzz, can't there be an "off" switch for it, once we get the message.

I remember all the pains I had from FUN things I used to be able to do. Outdoor sports, horses, playing with my kids, family trips, animals, etc. Muscular pain from that was annoying, and yes painful, but it has a positive cause. There is not positive purpose, except the physiological awareness-alarm, to this awful, take my breath away pain I've had since steroids wore off last Thursday, July 5th, my 8th SCT anniversay.

Here's what happened:

You can see from my previous post, I managed to have a fun 4th of July, of course because of DEX STEROIDS masking side effects from my chemo day before lol. But on the way home July 3rd, I caused a crazy, stupid, random injury to myself by swallowing water wrong!! Yes, swallowing water wrong! I always try to hydrate well prior to and after my Darzalex infusion, and speaking of that, I must grab a water bottle NOW to hydrate for my 2:00pm, FIRST ZOMETA infusion...

Anyway, on the way home Tues July 3, I took a big swig of water as I was driving, and managed to swallow it wrong, which for me, causes me to need to choke, spit out, cough and sneeze all the same time. This reaction has been exaggerated since my SCT, so something must have changed in my Esophagus? So anyway, in that split second event, I had to choose to spit out in my car, or suppress, repress the choke, sneeze, cough. Well I made the STUPID choice to repress, suppress, restrain that urge, and pushed down the cough, sneeze, choke, awkwardly swallowing the water. You know that feeling when you repress a sneeze. Bad for anyone, but super bad move on my part, as apparently sitting seat belted in, I managed to jar and shock my body into a horrible muscle spasm!

I immediately felt a shocking sharp, searing, tearing, stabbing blot of pain, pinching and ripping in to my Left side rib, chest area, under my bra. Absolutely took my breath away. I kept driving, tried deep breathing, adjusting my posture, and doing mini stretches at the red lights. (Yes, I routinely take the street route home after chemo just in case I am not ok, and can easily pull over). But thanks to Dex steroids, I didn't feel incapacitated at that time and continued home. For the rest of evening and into July 4th, I felt a deep suppressed pain, but it was definitely masked, buried deep, unbeknownst to me, ready to attack in the next several days.

The 40mg steroids I took Tuesday morning suppressed and masked the pain for about 48 hours, but I could feel the deep intense pain coming on, in the middle of the night, Thursday. By this time, I had already done 2 of the 4 Zarxio injections to up my WBCs, so I thought maybe the pain was exacerbated by that, or was being caused by what Zarxio Neupogen is supposed to do... grow more White Cells fast.

Late Friday night, I Googled Left side pain, and was alarmed that it could be my spleen or other vital organs, which is a side effect from Zarxio! I continued to read more about muscle pain, tearing, spasms, and causes, and the good and bad of steroids, as the pain intensified. I learned there is definitely muscle weakening and "muscle wasting" from steroids, and there's differences between all the different types of steroids, Dexamethasone being the strongest. It was too late to get myself to Urgent Care, so I took more Advil, and a muscle relaxant I've had on hand for times like this. Made me think of how many times since Myeloma, I've had excruciating muscular pain, tears, spasms...

"Prednisone is 4 to 5 times more potent than Hydrocortisone and has a longer duration of action, perhaps 12 hours or more. Dexamethasone is 40 to 50 times more potent than hydrocortisone and even longer-acting, 18 to 24 hours.

"Steroid myopathy is damage to the muscle fibers caused by treatment with corticosteroids, such as prednisone, cortisone, dexamethasone and fludrocortisone or overproduction of steroids associated with Cushing's disease. Myopathy causes changes in muscle fibers, including atrophy (shrinkage), lipid (fatty) deposits, necrotic (dead) areas and increased interstitial (connective) tissue between fibers. You may have severe damage to the muscles while the muscles appear normal in size."

"Muscle wasting, weakness with Dexamethasone
Glucocorticoid-induced myopathy is the most common type of drug-induced myopathy
Although any commonly used glucocorticoid can cause myopathy, it is implicated more often with the fluorinated glucocorticoid preparations, such as dexamethasone, triamcinolone, and betamethasone. Switching to a non-fluorinated agent are associated with improvement in muscle weakness."

Those are just a few statements from when I Googled muscle pain, spasms, wasting, etc, regarding Dexamethasone and various steroid side effects. If you haven't before, Google it, very interesting...

So my mind is racing and my body aches. I'ts difficult to breathe, or breathe deeply. I take short little breaths. I can barely adjust myself in chairs, and in bed the pain is so intense, even with Advil and Flexeril. Every time I shift my body, I get searing, tearing, sharp awful stabbing pains. And I can barely get in and out, of a chair. Lying in bed was worse. I could hardly adjust my self one way or another. Just ridiculous and debilitating. I question "everything" at this point, and ask myself, what I do with my beloved animals when they are in pain or in a medical crisis: "Am I Prolonging Life.... or Extending Death".... I'm so miserable at this point...


The days roll into themselves, with me just trying to breathe, move, and get by to the next day, with hopes the extreme pain will diminish. Friday rolls into Saturday, into Sunday. Of course my family is urging me to go to Urgent Care, but as always I resist. I'm so miserable and painful, I couldn't bear the thought of going anywhere in a car and trying to speak to people about my situation. So I don't. Meanwhile, I take Advil hoping it's anti inflammatory properties kick in. I question my life, what I'm doing, what happens from just a random event, that would probably not even affect the "normal" person. I think about everything I have been through in the last 8 years. I think about how all this will be never-ending, and I'll never get a break, and it's only going to get worse. I think and think. I'm so frustrated with what happened to my life. Inwardly I cry "no fair", "why me", "how come". What really is my life now, or to come... I look at my property, animals, family, and remind myself how incredibly blessed I am. I shut down my negative thinking... 

Sunday and Sunday night was the worst. The tearing, searing immobilizing pain. But I am very careful how much Advil I take, as I don't want to cause damage to my Liver, Kidneys, etc. I still wonder about Zarxio and my Spleen, but I didn't think I had a spleen crisis, as I don't have those symptoms, thank goodness! But just in case, I didn't do the 4th Zarxio injection...
And in the middle of all this, when Advil quieted my horrible pain just a tiny window, I took our Box Turtle to the Vet to have his nails and beak trimmed. I had made and cancelled this appointment too many times, so between immobilizing moments, Dot the Turtle had his pedicure :))

Monday, as I wake up and begin move around, I feel some relief. I haven't had any medication since Sunday night. I realize relief is coming, slowly, but on it's way. I continue to move as if I'm made of glass. I do this because of my Myeloma "holes". I do this because of muscular issues. I hate living like my body is glass, but I hate pain more. I take an Advil and wonder what the day will bring. I move slowly, aware of every ache, pain, tearing sensation. I am so angry at my body's betrayal. Slowly, with an irregular Advil, again worrying about my Liver and Kidneys, I feel slow relief. I move ever so tentatively, but I know I must move and try to unstiffen these stiff, pulled, torn, spasmed muscles. I admonish myself for my stupidity for repressing the cough, sneezed last Tuesday.

Now you know why I couldn't post on my "regular 8", July 8th. I started a post, but gave up. I was a mess. Overcome with pain and frustration. Today, Tuesday July 10th, I am leaving soon for my FIRST ZOMETA IV. My pain is better, but of course, guess why??? Yes, today is Tuesday, and when did I last take my weekly steroids? Yes, last Tuesday! So good timing with my weekly, or should I say "weakly" Dex steroids... to the rescue today. But with all I read, I only took 20mg of the "requested" 40mg. 

Also, I did call Urgent Care today, and I will go in for an xray after my infusion, unless the infusion makes me feel yucky, but I suspect now, because again, Dex to the rescue, I'll be ok... today... Who knows how I will feel when my nemesis Dex wears off in 36, 48 hours??? Ugh, waah, waah, waah,... I have to deal with the new Zometa side effects, on top of the muscle spasm, on top of the steroid crash, and oh yes, did I mention, I started my 1,000,000th cycle of Pomalyst Sunday night! Really life? Is all this for real or am I just writing a fiction novel here? 

(Sincere apologies to those reading this who have much more intense life challenges than me.)


Onward I march daily, 
because I "have to", 
because I want to... 
because, because, I must...


Here's my Lab results from last Tuesday's Dr appointment: 

Still no MProtein
Maybe masked by Darzalex?


Darn, IgA over 3x the high end of normal


Not too bad, but WBS = super Immune Compromised
ANC was .8, therefore my Dr prescribed Zarxio

And so dear friends and followers, near and far, that's my story for this week. I keep hoping for a BORING BLOG  POST, but Myeloma just wants me to keep all of entertained. As always, thank you so very much for caring as you do. Hope your life is as smooth as a lake a sunset. 



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?

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.