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

Saturday, March 29, 2014

My March Myeloma Madness

Hi Everyone!
First of all, thank you to my followers for your detailed replies and suggestions on my previous post! I truly, very much appreciate your comments and insights!!! Thank you to all my invisible followers too! I appreciate you checking in and reading my musings.

I'll (try) to make this short(er) than usual, as I will have more of an update after my 2nd oncology appointment next Friday.

 Here's me and sweet Abbie over a year ago. Just loooove her!!!
She's a death row rescue from the mean streets of LA

To be honest, I have been too optimistic (perhaps naive), trying to see my situation as better than it actually is... hence MY stubborn stupidity at remaining on low dose chemo. So after my oncology consult this past Thursday with my City of Hope SCT Doc, who very nicely (but seriously) let me know that the low dose Revlimid I am on needs to change NOW, if I am to make an impact on the increasing levels of cancer within me. Ok I get it. Myeloma is winning right now.

Dr Spielberger (who is Director of the Kaiser-City of Hope Hospital Bone Marrow/Stem Cell Transplant Department), clearly let me know that I should be doubling(2x), tripling(3x), quadrupling(4x), quintupling(5x) the level of Revlimid I am on. And if Rev and Dex stops working for me, we'll move on to all the other Myeloma mashers!

I laughed when he wanted me to jump from 5mg to 25mg ! ahahaha Doc... kill me fast! I reminded him of my death defying allergic reax in 2010 when we went from 10mg to 15mg. I quickly developed a lovely blotchy, patchy, raised rash moving rapidly over my body. I looked like my Appaloosa horse RedBear! I had to eat Benedryl like candy and we immediately stopped the 15 and went back to 10, and stayed there for the remainder of my initial 2010 treatment. Doc said ok, ok, we'll start slower... how about trying 15 next RX?? Hello.. NO, I said... let's be gradual here and go from 5 to 10 and then see if I can tolerate 15. He's very amused by me, in a good way :)

Why this now, after a few months of (minimal) success? My Myeloma contaminated IgA immunoglobulins haven't stopped rising (4x the high end of normal), and my M-spike is spiking more. And you know what??? I secretly knew. How? I've been a sickie most all of March. (I have to always remind myself and others: MYELOMA IS A COMPROMISED IMMUNE SYSTEM CANCER! So no wonder I am always sick! duh Julie!)
I only went in to my office a few days this month, and the times I did, I shouldn't have. Last week, the one day I went in, I was so dizzy and tingly (from hardly eating for a week), I thought I would pass out!!! I told my sweet mom/daughter student appointment that I felt faint, just in case I did a face plant on my desk!

First I had a crazy sinus fever thing for over a week to 2 weeks, then a week-ish later, I developed lower GI volcanic issues... where, (sparing you the gross details), my bathroom became my permanent residence and office. I thought, this will pass, probably related to medication overload. So I contacted my local oncologist and we reduced the levels of Mepron and Acyclovir (even though she didn't think that was the cause, but wanted to see if my GI would calm down). Well it didn't, except on Dex steroid days. I even tried going out to dinner with friends, and again, sparing you the details... had to leave the restaurant FAST, ditching them and Jim, racing home and "praying" I wouldn't ruin Jim's car ... BARELY making it to the bathroom... ugh... that was sooooo awful!!! I've lost 5 pounds this month, but that's ok. What mid-life girl doesn't want to lose a few pounds? Well, not this way, thank you very much stupid Myeloma challenged immune system!

And so, realities are (finally) setting in:
I have cancer
I'm a sickie
I feel lousy more than I feel good
I can't do much of anything, as I have to stay close to my bestfriend "John"
Cancer is winning
Myeloma is stronger than me
My internal Army, Navy, Marines, Air Force, needs better "ammunition" asap!
My immune system continues to fail me
I have felt yucky most all of March
And this... is my "March Madness"

But I will battle forward and increase my friend Revlimid
I will eat Benedryl like candy if I have to (I like that it's hot pink!)
I will TRY to accept that I have cancer, and I am not the Julie I used to be
And I will savor the good days, and be pissed at the bad days, but I will never give in Myeloma!
You hear that Myeloma...  I'm not giving in or up. I'll fight until I can't !!!

Last Sunday "selfie" when Dex steroids temporarily helped me feel better
for a day or so... then right back to GI drama.
Hello Dex again today, please let me eat and pretend to be normal!!!


Simple explanation of IgA immunoglobulins. Funny how certain article realities finally sink in!

LOL- not so short post after-all!!!
Thanks for reading and caring, and I will update on my medication plan in a week or so.

Thank you followers!!!

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

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Friday, March 14, 2014

March-ing Forward update

Well hello everyone!
I just realized how long it's been since I've updated my blog! My sincerest apologies to those that check in regularly and worried about me. Thank you for caring as you do!

   This is one of my all time fave pics of me and RedBear!

 
Taken by my amazingly skilled and creative photographer friend Kathy B

So this month's lab results revealed nothing much new from last month's results. I've kinda "flatlined" at the current levels of Revlimid (5mg) and DexSteroids (20mg) I am on. My IgA went up about 60 points (not huge, but not good) and my M-protein/M-spike went down only .07 points (tiny, but good). This is all quite negligible though. Bottom line... if I want to be more aggressive with bringing my myeloma numbers down, and rid my body of cancer, I will have to double up on my dosage levels pretty soon. At this time, my oncologists are leaving this decision up to me.

Each appointment, we discuss whether I should/could be a candidate for a second autologous stem cell transplant. At this time, both my oncologists feel the outcome would NOT justify the risk of putting me through that again. In other words, they don't think I will reach remission again, and there's really no point subjecting me to the intensity (and potential dangers) of another ASCT.

I will meet with my City of Hope (transplant) oncologist towards the end of the month, and we'll see what he says about all this.

So given the circumstances... what would you do???
Should I just mosey along at the levels I'm at since they don't bother me too much (except dealing with fatigue, intestinal issues every other day, neuropathy, being immune compromised, etc)? Remaining at these lower levels is definitely not quickly obliterating myeloma cells from my body. But raising the chemo levels to do so, will definitely impact my already impacted "quality of life" (and that does concern me).
To some this may not sound like a big deal to double my chemo levels, but I had a severe (life threatening) allergic reaction to higher doses of Revlimid back in 2010, during my initial treatments. I'm not looking forward to the "unknown" future chemo side-effects coming my way.

Currently, I am still able to work a bit (which I still have much passion for!), and I continue to be able to do a fair amount of the things I always did: (hanging with my horses, doggies, kitties, driving my ol Beetle when it's drivable lol, occasional day-trips with friends, and of course enjoying life with my amazing fambam!)  Although my energy level is greatly reduced, and to be honest, I really only feel good a few days a week... but I get by, and practice one of my fave mottos:
"Fake it, til you make it" !

Birdie cracks me up and always makes us smile!

My oncologists reassure me at each appointment, that there are several new generation myeloma treatments since my 12/2009 diagnosis. They are confident that if the Rev/Dex combo loses its effectiveness with me, they have other options in the treatment pipeline for me. (And I read voraciously online, so I know what's happening regarding the latest treatment options.) Yay!!! for all the brilliant medical researchers, chemists, oncology teams, pharmacy companies, etc, extending us "Myelomers", lives!!! Thank you!!!

So all this always make me think... what should I be doing with my life?
Status Quo? Stay the course, stay the same, maintain my current "new normal"? Remain in familiar (safe) territory on this low dose "comfort zone"? But unfortunately, this allows Myeloma to continue to multiply within me.

Or is it time to "radically" change my life, and do now what I may not be able to do in the coming months/years... (in other words, get on with the "bucket list", re-do Hawaii, etc!) ... and then get on with increasing/changing chemo levels and types?

I know many feel uncomfortable when I address the "terminal", "incurable" aspect of Myeloma... but to me... it sure would be helpful to have an idea if I am living in ignorance right now regarding my (perceived) longevity timeline. If I could "know" how much or how little time I have left, or how much "usable", feeling-ok time I have left, that might just influence me to make some changes in my current lifestyle, as I naively feel I have tons of time left that I "know" I actually really don't ...

Did I ever mention that I treated myself to this new tackroom
as my Remission celebration in 2011. Represents so much to me
and one of my all time fave views!

Time to eat some ice cream, or actually brownies sound good, (and not care about fat and calories!) It's going to be beautiful this weekend and me and Dex are headed for our love/hate roller-coaster ride for the next several days!

So tell me, what would you do...

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


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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, 15mg capsules)
Pill form Dexamethasone Steroids (40 mg, 4 days on, 4 days off!
Omeprazole for steroid acid reflux
Mepron (looks like yellow finger paint) Anti-fungal, Anti-viral, etc for my very compromised immune system
B-12
.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.