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

Thursday, July 30, 2020

Radiation Radiation Radiation- Zap You Myeloma

7.30.20

Hello Friends-
Been quite a couple of weeks, months...
Pain, Pain, Pain Extraordinaire!
Assessment Assessment Assessment
Suffer Suffer Suffer
Brought to the brink so many times
Pain is way too humbling
I was too smug for too long, thinking I was dominating myeloma, ha!

I can take a lot, but all this pain and bone scan realities of my crumbling bones, spine, neck, clivus, skull has really challenged my strength... brought some new fears too. If my "neck crumbles or breaks"... being a "paraplegic" is not an option for me...

Radiation all this week... Thank Goodness! Zap and kill those cells!

I've been doing 20mg Dex steroids daily to get through this. I have to have mobility and pain relief to get on to the treatment table and in the correct, exact position. Thank you killer steroids for helping as an anti inflammatory! But yikes, I am so bloated up from this dose, and feel so FAT. Can't wait to get back to "normal"... hahahhaaaaaa... Normal, hahahhaaa... never again, sadly :((

Hoping for relief
Hoping to kill some myeloma cells
Hoping to untangle all the angry nerves and muscles wrapped up in tumors, lesions, holes, masses, etc. I feel so fragile, and hate being so limited. We take our physical freedoms so much for granted, until something jolts us into another reality.

I just didn't think Myeloma would eat Me up like this... I'm always thinking "I'm different", that I will defy the odds... (well actually I have with my almost 11 years (probably a lot more), of survival...  But cancer and myeloma just doesn't care who you are, how much you try to be ok.,. how positive you are, how informed you are, how well you are treated, how much fight you have, etc. Myeloma will just gobble you up alive... biology and chemistry is just so powerful, and we only have so many tools in the toolshed to fight back... Thank goodness for all the brilliant medical science researchers out there always researching the next option for us.

https://www.cancer.gov/about-cancer/treatment/drugs/multiple-myeloma

https://www.myeloma.org/multiple-myeloma-drugs

https://themmrf.org/multiple-myeloma/treatment-options/standard-treatments/

https://www.myelomacrowd.org/myeloma-news/

If you have your Health, you really do have "everything"... if you don't, you don't. Real Pain, deep spirit killing pain, prolonged pain, limiting your life and movement pain, just steals your life, energy and optimism... So many challenges in my life were "temporary". I could always see options and choices. Myeloma and fighting cancer is so different. We are no longer fully in control of ourselves, our lives, our bodies, and most scary... life extending, life saving treatment options. If there aren't treatment options... well... myeloma wins. Just so huge to think how I so little "own my own life" now.

Here's my recent Radiation adventure pictures. I'm too limited to drive myself to treatments, as I did back in 2018. The tangled nerves and muscles within the tumors is limiting my movements and flexibility like none other. I am very fortunate to have family and friends available to drive me and help care for me. Such a twist, as I was always everyone's caregiver...

Best care ever at Kaiser!

Best son ever driving me to my appts

Can you find all my holes, lesions, tumors, mass?

Let's get this Radiation party started!

With the damage to my Clivus, spine, skull, neck area
I'm in danger of becoming a "Bobblehead"! or worse, 
Paralyzed from a break!!!
Rods, pins, surgery, Kyphoplasty  
If radiation doesn't work??

Git er done Radiation!
Zap those crazy myeloma cells

Ouch! This crazy Clavicle mass, hole, tumor
with the muscles, nerves pinched and wrapped around and in it
Such intense, immobilizing pain

Best caregiver, driver, chore daughter ever!

Can you find all my holes, lesions, mass, tumors? 
Wish I knew how to really read these scans

Don't move Julie!
Wow, then they snap this mask in to the table
to hold me steady, whew
If it's not perfectly aligned...
Owwie!!!

My Thurs and Fri amazing limo driver Kristin!
Couldn't do this without all my amazing
caregivers and "support staff" :))

Such amazing Technology

LOL, didn't intend to match so perfectly!

And I'm all ready for Halloween
Do you have a Mask as cool as mine :))


Myeloma Beacon Patient Stories:
https://myelomabeacon.org/tag/patient-column/

Love Dr Durie of the IMF - International Myeloma Foundation
Great question and answer videos re everything Myeloma!





Monday, July 20, 2020

My Stolen Life...

7.20.20

Hello Friends,

My physical PAIN suffering is off the charts. This bone, muscle, nerve, tumor, lesion, mass, myeloma cancer pain is doing me in. I can't even convey the level of pain, and how I hurt, and how simple everyday, ordinary tasks hurt so much to even attempt to do. I ache so much. I cry too often now. I cry from physical pain. I cry because I am so very very sad about what has happened to me that I have no control over. Myeloma is in control. Myeloma is eating me up like Termites to Wood. I've never been a "crier" as I never let things build up inside. Nothing wrong with crying. Clears the soul in many ways, but not this time. Even crying hurts. Hurts physically. Serves no purpose for me. Sobbing last night, I stop, and say, "just Shut Up Julie, just Shut the F up Julie, no one hears you, no one can help you, just Shut Up Julie, crying servers no purpose and just tenses your body even more, just shut up Julie"... I grimace, I deep breathe as I try to get into bed... I hurt so much... I stop crying and eventually fall asleep for a few hours...


It hurts to brush my teeth, to lift my arms, to move my head, to bend my arms, hands, neck, etc. It hurts me everywhere my upper body moves. It hurts on both sides of my collar bone and shoulders and arms, up my neck and in to my head. Everything I want, need to do is stolen from me. I want to do chores, clean my house, do laundry, shower, change my clothes, do animal chores, lift food to my mouth, open medication containers, water the plants, fly spray the horses, clean the corral, do inside animal chores, do anything I used to do so easily. Reaching to wash my hands aches so much. I feel the nerves, muscles, tightening, tearing, hurting so much with this simple, so needed task. I do it anyway. My eyes tear in pain. My heart skips a beat in physical pain and mental recognition of my situation. I just want to do simple things in my life. I can't drive right now. I am dependent on others. I hate that. My wonderful adult kids have been driving me to Dr appts and lab tests. I hate being dependent. I hate needing, asking for help. I was always the Helper, not the Needer.

Little controlled me before Myeloma... now myeloma controls every aspect of my life, my being, my days, my nights. I cry from pain. I cry from feeling so out of control. I cry from feeling desperate for relief. I cry because I just hurt so much. I cry because I force myself to do things. It hurts to do anything I used to do so easily, so presumptuously. I cry because I am so limited with pain. Typing this painful. Everything I attempt to do creates excruciating pain. My life is stolen. The ability to do simple tasks has been taken away from me. I don't understand what happened to me. I don't understand my suffering. I don't understand why I am being so tortured. Yes, why me? Why life? Why, I cry out.... I "ugly cry sob". This is not how I imagined this time of my life.... I cry out how I "hate my life"... I correct myself... I don't hate my life, I hate what my life has done to me, what my body has done to me, what myeloma has done to me, what cancer has done to me... why? why me? I am so sad...

LOOK AT THAT! BONE PAIN... 
I'm not imagining this. Bone pain is Excruciating!

Think about all the things you do. Little, big. routine, required, fun. Things we all take for granted, and assume we can always do. Think about how each and every one of those is now a huge painful challenge for me. Simple things, huge pain. Huge ridiculous, painful challenges. My stolen life...

I must take a break here. Typing and using the mouse hurts so much. But I have a story and pictures to share with you of my first Radiation consult from last Thursday July 16... here's a hint...

Yep, that's me in there!
I'll be back in a few hours, promise, as this story has a super funny twist :)) 

!!!! Updated below :))

And I just got notification of lousy IGA upward moving stats :((
720 points up in just 10 days without chemo...

Grrrrr!@#$%%+*** !!!!

UPDATE :))
UPDATE
UPDATE :))

So this last Thursday, my son drove me downtown for my Radiation planning consult appt. With all this stikn pain, I can't drive myself anywhere, as I don't have the ability to move fast, turn, react, etc. Not doing LA freeways in my condition. 


I wasn't sure what they were going to "do" with me, thought this was just a verbal "planning" appt. Turns out, I needed another CT scan for the awful Clavicle, collarbone, shoulder pain. Makes sense, just didn't know it would be done. When the Rad Tech explained what the Plan was, I was... oooohhh nooo, I can't possibly lie down flat on the CT table for a scan. The pain would launch me to never never land, and I probably couldn't get down or up from the narrow table. Well obvi Julie, if you can't do the scan, they can't move forward, so I convinced myself to absorb more torture and agreed. 


I remembered I had a little pill container with Tylenol in it, in my purse. So I CHEWED 2 "generic 325" Tylenols. Scott's laughing that I just chewed them, but that's what I do regularly now, and have for a long time, as 1- it takes affect faster, and 2- I just don't swallow pills well anymore, as I have to swallow so many, and I sometimes just can't swallow them without my standby protein shake drinks (like Ensure) ... After I chewed the 2 little white pills, something made me look back in the bottle and check what they were. OMG there was one left, and it DIDN'T say 325!!! It said 512... Google that friends...

From Google: "People ask...
OMG, what the F did I just do. I'm laughing, scared and laughing. Scott's incredulous of what I have done, and says, Wow Mom, you'll be feeling pain free in no time"... ahahahaaa
I asked the Tech and Nurse for water, and explained to them and the Dr what I just done, and they laughed too, and weren't worried, even though I explained I'd never taken these before, and that they must have been my husband's RX from a while ago, for Spinal Stenosis and his venous ulcers from his blood clot destroyed leg... 

OMG, I turn myself into a science project all the time. Just couldn't believe what I had done, and really the only worry I had, was if I had a GI reaction... can you imagine becoming GI sick, while restrained on the CT table. OMG, Julie... the drama never lessens. 

So I went with the Rad Techs to the CT room, not feeling anything different at all, got onto the narrow, sliding table with their help, and waited for a reaction. And I waited. And I waited. And I waited. LOL nothing. Nothing from Norco a week or so ago. Now Nothing from what I found out was Percocet. Nothing. No high, no low, no extra relief. Probably the only relief I got was from the little bit of Tylenol mixed with the Oxy. So I made it through the scan, and also through the forming and fitting of the personalized head protector, mesh head stabilizer mask with no drama, no issues, with no notable fun druggie relief feelings. Nothing, no extra pain relief at all. How crazy is that. Nothing lol. Nothing. 

All this confirmed again, my magic formula for nerve, muscle, bone pain is DEXAMETHASONE STEROIDS, with plain and simple Acetaminophen Tylenol and Flexeril muscle relaxant. And those really don't do much either. Just takes the "edge" off. Would have to take double dose of Flexeril to probably really feel relief. But I won't do that to my body....

Guess this cowgirl has a pretty high pain tolerance and pretty high resistance to drugs lol.  

So I go back this coming Friday for the final mapping and maybe my first Radiation treatment. Bring it on, can't wait. Let's git er done! Zap these outta control myeloma cells causing me so much pain and grief! 

The things I'm able to do.
Thank you Dex steroids and Tylenol


Pretty cool how they make the mask.
Wasn't expecting that at all. 
It's a soft plastic mold, that is mold-able, pliable in the beginning, to shape.
As the Techs put it on me, they told me it would warm, steamy and damp.
And gooie. 
Felt kinda like making a dental mold and having a facial at the same time.
I'm ready for Halloween now!
And I get to keep this party favor when all my radiation treatments are over. 

I still can't believe this story is my story

And we have a new rescue doggie
She's the black one. 
She's from Arkansas.
Only one missing in this picture is our
brown Lab

The craziness never stops here, but it sure keeps me going!

Yes, every day is an adventure here. Horrible and Wonderful at once. How was I able to post this today? DEX STEROIDS from this morning, thank you very much my fave friend. My arm is killing me still, my neck is cramped, the clavicle tumor bumps against things when I move, and my muscles and nerves burn and pull and hurt, but less than last night, or yesterday, etc. 

Dr consult tomorrow and I will insist on being back on some sort of chemo. I feel very uncomfortable letting the myeloma grow outta control while waiting for the Radiation to be completed. Chemo is systemic and kills the myeloma throughout the whole body. Radiation is targeted to the specific areas of my current pain, tumors, mass, lesions, holes, etc. 

Earlier the Pain management Pharmacist called and we talked about my pain med options. She was incredibly helpful and encouraging. When the Dex steroids wear off, I will try the Norco again. Or not, not sure. We'll see. I'll let you know. 

Thank you for reading and caring and following my crazy almost 11 year myeloma story. Hope you are doing better than me, and doing ok in these crazy Virus times. 











Friday, July 10, 2020

Just soooooooo Beat Up :(( ... UPDATED 7.11.20!

7.10.20

Hello Friends,

So much to share...
Pain is off the chart
MRI results: Holes, Tumors, Mass, Lesions
Skull, spine, neck, collarbone
Crazy painful swollen awful tumor bump protruding on L side collarbone clavicle driving me nuts- wanna see a picture of it?

Radiation coming next week forward
Myeloma is eating my bones, like Termites to wood
Finally gave in and tried Norco; not even making a dent in the pain lol!

Took Labs Thurs July 9
May have results to share
I think it will be GOODBYE Elotuzumab Emplicity, as I think you are the Pain Culprit, and not really doing me any good anyway
Decisions to make re next line of treatment
How about going backwards to good old Revlimid, Velcade, Dexamethasone... skipped that firstline option back in the day
Hate switching to new meds
Hate the unknown side effects out to get me 
Just hate you Myeloma for stealing my life

I'm so beat up, so discouraged in so many ways, scared in ways I haven't been before
But looking forward to Radiation to put this Humpty Dumpty back together again

I just want to live
Live a calm, peaceful, pain free life
I don't mind being on chemo for life, so used to it now
Just want freedom of movement and to feel good a few days a week
Is that too much to ask Universe!

I'll be back with the details, Dr reports, and a bit of reminiscing about my 10 year Stem Cell Transplant anniversary on July 5th! Wow, 10 years ago where I was, what I was doing, and what my body was doing to me... guess as bad as things are now, I sure wouldn't want to be where I was then, as the Melphalan chemo was totally crashing my system, and wow, was I sickie. Have linked my July blogs below...


Too be continued....
.....

7.11.20 **** UPDATE !!!!!

So my Left side Clavicle, Collar Bone area continues to do me in. I feel so disabled, but still trying to be me, and do something, anything around here. I feel better if I can move around, as sitting or reclining or trying to sleep is even more painful. I'm beginning to wonder if this DRAMA began with the immobilized position I was in for so long for the MRI scans back on June 30. Seems as if it's a knotted bundle of muscles and nerves wrapped around a tumor, pulling and tweaking EVERYTHING :((( Here's a lovely picture of it my daughter took the other day. I've been trying to carefully stretch, bend, creak, tweak, crack, move on my L side, but this is just so dang painful, and limiting. Amazing how our anatomy and physiology is such an incredible interconnected machine. Which is wonderful when it's healthy, but so awful when not.


Hilariously, I did try a Norco 5mg/325 on Thursday night, and it literally did NOTHING for me! Didn't even take the edge of the pain, or give me any woozy, relaxing relief. So who needs that stuff, if I just have to take a larger dose. Plain Tylenol, Advil, muscle relaxer Flexeril AND my BEST FRIEND EVER Dexamethasone Steroids, seem to be the best treatment for me. I just need Anti-inflammatories!!! I don't have an "addictive personality", so I was never worried about taking the Norco. All I want is to be pain free, without meds. I don't "need" anything to boost me up when I feel ok!!! Feeling ok for real, is the BEST feeling Ever!!!

And did I mention, the disabling pain is so awful, I've been using my hubby's remote hospital bed to sleep in, as I can't get in and out of a normal bed with the intensity of my pain. I use the side bar and vertical head lift position to get in and out. He hasn't used it in months, after his weird seizures earlier in the year. He does better sitting up in a chair. We're a crazy train wreck... Ridiculous and unreal!

So the main concerns my Drs have is the bone damage in my neck, skull base, skull bones, R side head, etc. Thankfully, my lovely mass is NOT a brain tumor, but a mass, tumor, holes, lesions, etc, in the skull and bones. Areas I have read and reread as I never fully learned detailed Anatomy and Physiology. Just took sooooooooo much for granted, as we all do, when we are Well!!

Here's a summary report of about 20 pages of MRI, CT, Xray reports. Main areas of concern are the: clivus, foramen magnum, chordoma, You can Google those, as there's so much info there, my head is spinning. OOpps, shouldn't use that term, as that's what will happen when myeloma cracks all those body parts and my head starts spinning on it's own. I've become a "bobble head"!!

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

RECENT IMAGING Report June, July 2020

6/30/2020:
MRI BRAIN: There is abnormal bone marrow signal within the clivus which enhances heterogeneously postcontrast. There is also abnormal enhancement within the right side of the skull base at the foramen magnum.
There is no intracranial mass or intracranial extension from an enhancing right skull base tumor involving the clivus.                              
In a patient with known multiple myeloma, metastatic disease is most  likely etiology...  Other skull base lesions including a chordoma are not excluded

6/30/2020: MRI NECK:
Normal soft tissue neck MRI pre and postcontrast.                     
There is bone marrow replacement within the clivus most consistent with metastatic disease in a patient with known multiple myeloma.          

6/30/2020: MRI C SPINE:

There is age expected cervical spondylosis that causes mild C4-C5 and mild C5-6  central spinal stenosis. There is abnormal bone marrow signal replacing the clivus. There is patchy enhancement in the cervical vertebral bodies consistent with the patient's known metastatic disease.  


7/5/2020: XR LEFT CLAVICLE:
The bones are demineralized. There are 2 well-defined lytic lesions of the clavicle lesion of the mid clavicular shaft, unchanged from the prior CT scan. There are no fractures or dislocations. There is mild degenerative change of the AC joint.      

PHYSICAL EXAMINATION:
GENERAL: She appears well in no acute distress. Speech is fluent and
coherent. Cognition is normal.

ASSESSMENT: 60 year old female with progressive myeloma with left clavicular pain and neck pain. Recent imaging showing clivus, cervical vertebrae and left clavicular involvement.

RECOMMENDATION: A lengthy discussion took place with the patient. Offered palliative radiation therapy to the clivus/c-spine region and the left clavicle areas. The indications for radiation therapy in this setting were discussed in detail. Also discussed were the potential risks and side effects of treatment. Specifically emphasized was the risk of radiation damage to the normal tissue structures in the treatment field including the skin, underlying bone, throat, brain and lung. Logistics discussed. She agrees to treatment. She was advised to call should she have any further questions or concerns.

Department of Radiation Oncology

* L clavicle pain, tenderness, feels getting more painful and swollen, protruding large. Has headaches on right lower head/neck area. Neck pain - clicks and stiff. Dr prescribed Norco today since Tylenol does not help much.

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

Am I really writing about my Life? How can this be? I think back over the 10.7 years of treatment and realize how "lucky" I was in the beginning with not having to deal with Bone Involvement with this stikn Myeloma. I was so Naive and Optimistic, and just didn't think this awful cancer would attack ME as it has. But ha ha on me, it did, always was getting worse, and now I cannot ignore or laugh off it's impact on my life. 

I'm still waiting for my IGA results from Thursday. I really don't have an intuition as to how Bad or Good my status is. I'm just so worried about what treatment to do, as I hate side effects, and there are some I just won't tolerate. Not sure come Monday, if I will be doing Elotuzumab/Empliciti, or try Velcade again, with the Revlimid and Dex steroids. Can you even comprehend how medications are the "only" thing keeping me alive. And without an effective treatment... yikes... won't go there now... 

Here's a look back on my 10 year July 2010 Stem Cell Transplant:












So Crazy how I've been writing my Myeloma Life story for this long. And that's only the July posts! I'm glad I have been loyal to writing, as it's so helpful to look back on my status, treatments, feelings, life stories, and this will be the "book of life" everyone tells me to write. 

Ok, my Farrier is here to trim the horse hoofs, it's a million degrees of heat out, and gotta go get all doggies corralled. I will post my IGA when it comes in, and next post will be all about the Radiation plan and hoping to get this pain under control and the muscles and nerves calmed down, so I can live my life! 

Thank you for reading and caring as you do! Stay well, healthy and pain free, as truly "Health is Everything"!!! 







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.