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

Sunday, March 18, 2018

You Can Stop It Now Myeloma

Hello 3.18.18

Here I go again... thinking I wouldn't have any "interesting news" to share... but I do, I always do, thank you Myeloma.

My unrealistic, dream-world thinking is that this roller coaster ride will chill, and my life will "just get back to "normal"! Ha ha.
Yep, Myeloma is Forever. Treatment is Forever. Incurable is Forever.


This past Monday, I had my monthly Dr appointment and Darzalex infusion. But prior to Monday, I ventured out a bit, to a few tiny social events.  Now that it seems the worst of the flu season is passing, I'm getting braver about going out and about. I'm taking a few chances, that I didn't take in January and February. Although I'm always borderline Neutropenic, or fully Neutropenic, and could live in a "sanitized bubble" forever... it hits me:   I Have To Live. I Can't Wait. I Can't Postpone. I can't live hoping things will magically get better, or be different in a week, or a month. Now Matters. I can't postpone doing things any longer. When I feel halfway ok, I gotta get out there and live life.

So I went to a few events. Just out to eat events. Nothing big, like a germ free, medivac private jet to Hawaii lol. Minimal crowds. Just out to eat, celebration events with colleagues and friends. I mention this as I was later surprised and sabotaged by my ol volcanic GI acting up. Surprised, because fortunately I don't have days and days, weeks and weeks of surprise diarrhea anymore. I left that "behind" (lol) with Revlimid.

Yes, I've been a bit spoiled this past year with Darzalex, Pomalyst, Dex with a somewhat predicable "crash". Generally on infusion day, I'm fine, as I'm all loaded up on steroids. The following day I'm generally ok too. Sometimes though, late at night on Day 2, the "cleanse" begins, but for sure on Day 3, I know to stay home, close to "porcelain John". Then for several days, my body tries to process and regulate all the meds. I never know what to expect, regarding which side effects will hit, and how intense. Often by day 4, 5, 6, I get tingly, prickly, fever-ouchy skin pain, sometimes a sore throat, sometimes headaches, hot flashes, and always, always extreme fatigue.

But (lol) since I was on my 1 week Pomalyst break this past week, I didn't expect any side effect drama. Yet surprise GI drama came my way. I mention all this, as after each social event, I spent the rest of evening in the bathroom paying for it. Unfortunately, I was surprised by another "cleanse" Monday morning, right as I was trying to leave for the chemo lab! Why is all this worth mentioning... well, when I finally arrived at the chemo lab (a little late!), after taking a swig of Imodium at home to insure I wouldn't have any "disasters" on the commute there, I wound up somewhat dehydrated, and my nurses had a challenging time, finding a happy infusion vein. Three sticks later, the hydration bag is flowing, Benadryl is pushed, and soon Darzalex is flowing, an I'm fully "corked up" :))



Some of you reading this little adventure might be thinking, "Oh big deal Julie", "Myeloma has so many bigger challenges"! I agree, but because I hadn't encountered this for a while, it totally took me by surprise. I've recounted so many (scary hilarious) volcanic GI stories throughout this blog, that truly this recent reality was nothing in comparison, but it's a telltale sign of the news I found out during my Dr appointment...

Yes, myeloma's on the move. In the wrong direction. For several months now my IgA has been creeping up. As I make the associations now, it makes sense. I was sick in Nov, Dec, Jan. I've been more fatigued. I've had more side effects. Headaches, backaches, extreme fatigue, and now the diarrhea seems to be a thing again. All these represent side effects I experience when my numbers escalate. But to keep everything in perspective, the IgA climb is minimal compared to where it's been in the past, so I am not inclined to panic at this point.


So prior to my Darzalex infusion, my Dr and I discussed my upwardly mobile IgA, and what to do about it. If you've followed my blog for a while, you know I'm a minimalist and I don't like to treat "aggressively". I'm inclined to try medication changes gradually, and hopefully "preserve" their longevity-effectiveness, rather than go aggressive, high dose, and burn out my options fast. My Dr suggested upping the Dex steroids to 40mg, and upping the Pomalyst dose from the current 2mg and 3mg, to just the 3mg. What do you think I pushed for? Yep, one or the other, not both, as I always like to identify the minimum that works. If we change 2 things, we won't know if it's the Dex increase or the Pom increase, affecting things. Additionally, there is concern with high dose Dex causing glucose-sugar level increases, and I certainly don't want to invite Diabetes into the picture. We also discussed going back to bi-monthly, or every 3 weeks Darzalex. 

Fortunately my M Protein is still not quantifiable. 

And there's more... In addition to the 3 sticks to find a vein, my nurse also surprised me with a finger stick for my A1c, glucose-sugar level (I think this is what it's called?)... heck, I don't know, Diabetes has never been an issue for me, thank goodness. My level was 112, so I'm ok now. We'll see what 40mg Dex does this coming month. As a matter of fact, now that I'm writing this, I think I'll start today. Again, seriously not a huge deal to me, as for initial treatment in early 2010 forward, I was on... get this.. 40mg steroids, 4 days ON, 4 days off, for 4 months. I was in such "shock and awe stunned mode" back then, I don't even recall how it affected me. I think I was super functional on the 4 days On, but I do recall feeling quite yucky on the crash days. But before the crash got too awful, it was then time to pound down 40mg again, so I quickly felt ok again lol! And I've been on 40mg Dex weekly many times throughout my 8 years of treatment! 
Oh myeloma, you are quite the adventure. Quite the UNwanted adventure... 

It's always a party in the chemo lab! 
Karon, Karen and me

Finally, I started my monthly 21 day cycle of Pomalyst a few days ago, still at 3mg alternating with 2mg. I'll try the 40mg Dex steroids weekly, and we'll see in a month what myeloma has to say about this. Hopefully, high dose steroids will put those misbehaving myeloma cells in their place, and all will be ok for a while. If not, we'll see if upping Pomalyst or Darzalex is the next fix. What's your opinion? If anyone reading this has gone from the "normal Darza protocol" back to more frequent infusions, please comment and let me know your story, and outcomes. 

Although myeloma is on the upward move again, I always count my blessings and good fortune that I have the Quality of Life I do, and I'm here to tell about it 8 years later. Truly, my life is amazing, and I am so grateful for the high quality medical care I've had. Which reminds me, my Dr also ordered a Pet Scan and Bone Density Scan for me, so I'll be doing that in a week or so. Here we go again... I'll have lots to update you on in my coming posts. So I'l just shut my trap now... I'll always have news and updates. I'm A Cancer Patient In Treatment For Life...



This little pup is so hilarious, so innocent, so happy, so unaware of the seriousness of life! Found him destroying a feather duster last night. Looked like an Ostrich murder scene! 

So happy, so silly, so innocent.
Just love our newest little rescue boy :)) 



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




Posted by

4 comments:

  1. AnonymousMarch 18, 2018

    Julie, I hope you know, "8's" are my favorite day of the week because your new blog post is ready for me to read. Go dex! How high has your M-Protein been? That feather duster never had a chance...too cute. J.

    ReplyDelete
    Replies
    1. JulieMarch 18, 2018

      Ahh Jan, you are so adorable, and I am so glad you found me :)) Thank you so much for checking in and being such a loyal blog follower and cowgirl friend :)) Funny thing, I edit and edit and edit after I post. And yes, my SEP results shows as "Abnormal" but no M Protein measurable. I posted the screen shot, and the result is the last value.
      Thank you for caring as you do sweet friend! I will message you too xoxo

      Delete
  2. tahoegirl.blogMarch 18, 2018

    It is going up but it's not too dramatic yet. With the tweaking of your meds, it may just stabilize again. Even after all this time being off Revlimid, I still have bouts of 'OMG, am I going to make it too the bathroom'. I think that's one of the more difficult things to deal with. I don't take the Questran every day so some days are a " crap shoot" pardon my humor ...... Love the new doggie so cute!!

    ReplyDelete
    Replies
    1. JulieMarch 30, 2018

      So funny Christina with the "crap shoot"!! Yes, we never know when our GI will sabotage us :(( Which is so amazing that you can do all the walking, hiking and adventures you do! So happy your numbers remain stable and still in "remission"! Congrats on all your years! xoxo

      Delete

Subscribe to: Post Comments (Atom)

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.