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Thursday, December 10, 2020

One Day at a Time, Just Trying to Pummel you Myeloma!

 12.10.20

Hello Friends and Loyal Followers!

What a life this has become for all of us! Who knew a vicious virus could be set free and do what it has done to so many, millions, billions of people, and have the all-incompassing-impact personally and globally it has. For my life, and for most of those with all the various chonic illnesses, the immunosuppressed, immunocompromised patients out there, Corona-Covid has actually "helped" us. Everyone, everywhere is now so acutely aware of cross contamination, how germs and cooties are spread, and how no one can take their health for granted, etc, The world is so much cleaner now in many ways, for all of us continual sickies. I feel so bad for all the lost lives and all those sick and battling with the virus, but I do wish we knew the actual "underlying condition(s)", and the "what" someone passed from. It would be so helpful to know what else their body was battling that facilitated the virus to ultimately take their life. For me, I have told my adult kids, MYELOMA must be on my Death Certificate, because no matter what else attacks me, to me, ultimately Myeloma compromised me and killed me!

I am happy to report that the High Dose Dexamethasone Steroids (40mg, 4days on) have helped me. I so wish I had done this daily back when I was suffering so much in June, July, Aug, Sept, etc, from whatever Elotuzumab-Emplicity did to my system. No way of ever knowing, well there is, but I would have to be professionally studied in research lab, to know how Elotuzumab/Emplicity morphed my system personally (as an IGA Lambda type myeloma)... I will always feel this treatment stimulated all the FAST growth of the "Extramedullary" masses, tumors, fractures, and painful body reactions that were "quietly" there, kinda dormant and slow growing. I just can't stop thinking about all that happened to me when we changed to that treatment (Dex, Pomalyst, Emplicity). I did so well on Velcade, Cytoxan, Dex for so long. Then I became "refractory" to Velcade, and boom came the incredibly awful side effects in the summer with the new treatment, Pain like non other, continual Fever unless I continually used Tylenol, Flexeril, etc. The growth of the soft tumors outside my bones still baffles my brain! WoW! How can I have a Mass in my R side Skull/sinus area, Mass in my R side Lung, Mass in my backside Abdomen. Radiation multiple times, for multiple weeks. So amazing what the body does and can survive. I now can reflect back to the most awful 2020 summer, and see all my symptoms and side effects and understand where they came from. They were growing all along, just the summer treatment extravaganza sped up the damage up exponentially! Just incredible how much the body can handle, create cellularly, and live with! Almost 11 years officially with Myeloma, but I KNOW I was smoldering for years before that... And yes, I was "Bubble Girl" long before the Virus woke everyone up with the very basic awareness  that extreme cleanliness and avaoiding cootie cross comtamination, can save our lives! Ya, Duh!! No one laughs at me now, lol... 


So at this time, doing the 4 days of High Dose steroids (40mg, 4days) has very nicely reduced the extreme bone and all over body pain, even when I overdo chores and crack or pull, or pinch, or damage something by mistake. Since the other day, I have had excruciating pain in R side ribs and upper chest lung area, and a bit of breathing challenges. I most likely did some damage pulling the hose around the yard, trying to do some hand watering of Jim's roses, beyond what the sprinklers do. I felt pain, and heard a little snap, crack sound, but I push on, and kept doing what I was doing. DUMB. Yes I listen to my body, but I am so "desperate" to be who I used to be... Independent and a "Do-er", I just keep on keeping on doing as it's so hard for me to be a sitting around sickie! The Dex and muscle relaxant Flexeril and Tylenol is my "magic" formula for relief. I learning it's ok to do pain relief medications, and not to just suffer. My parents raised us with the philosophy of power thru things, don't be a softy, and take very few meds. We sure didn't have pain meds in the house, and I remember suffering thru annual colds, fevers, flus, and maybe my mother gave me a low dose aspirin back then, but we never did the typical "make you feel better meds". And my Dad at 94 now, still has the same perspective. He is so well, and has very few medical issues. So amazing. But earlier in the year, he had some pinched nerves, muscle issues, etc, but he basically doesn't do any pain relief medication, no matter what I recommend or explain to him. He was "bumped" in the Costco parking lot, did go to his Dr, and did try the Methocarbamol muscle relaxant and was shocked how much it helped him lol.  I am learning about my pain management everyday, and adusting everything everyday to feel ok, and hopefully pummelling myeloma at the same time. Why you wonder and ask that I don't just automatically take pain relief meds regularly? I am trying to preserve my other organs, so I can stay Alive! But after all this time, nope, not suffering anymore!! I'm learning :))

So this week was my Kyprolis break week. No IV chemo this past Mon and Tues, just the high dose Dex for 4 days. Mid to late Friday and most of all of Saturday are my so not fun crash days where I feel bloated, food tastes yucky, I spend a lot of time in bathroom for 24, 36, 48 plus hours, I'm dizzy, my brain is definitely "medication/chemo fog" mode, the Fatigue is Extreme, and the pain comes creeping back. But to me, that's a small price to pay if the high dose Dex is working. And besides, cleansing is good, right :)) 

I am slowly feeling better in the R rib, chest, lung area, and can breathe more deeply. It would be so amazing to be able to see inside my body, every time I injure, reinjure something, so I know what I've done to myself. It's a beautiful day out today, so my goal is to get outside in the sun. I want to do things, and not just sit around. But I have to accept I'm Not the cowgirl I once was, my body is so fragile now, and injuring myself is just not worth trying to keep up with ranch chores. Just getting outside is a challenge because of the extreme fatigue. So crazy for who I used to be. Fatigue is so disabling. It's such a different exhaustion from being "healthy tired" from doing life. The fatigue is also from my low low low CBCs. Hoping my "forced" good eating is building my platelets, hemoglobin, red cells etc. I did not do weekly labs this past Sunday, as I knew I wasn't doing Kyprolis this week. So it will be interesting to see how my CBCs are without Kyprolis. 

My next regular Dr appt is at the end of the month, so no new Myeloma status labs yet. I always can't wait to see my status, wish I could do those weekly or every other week, "just to know"! Maybe I will add the Thalidamide-Thalomide to the Kyprolis Dex mix. Maybe I will brave up and add a newer immunotherapy. Maybe I will ask to add the Cytoxan back in. Maybe try Darzalez again in a combination I didn't do before. Fortunately I do have a variety options and combinations to play with. My Dr is very research, follow the current treatment recommendations oriented and prefers to follow the studies for medication options. This is great, and I appreciate her knowledge, insights, recommendations and sticking with what is "proven" per clinical trials. But I'm more of an open-ended, bend the boundaries thinker, who wants to avoid yucky side effects at all cost. So we will see...

Just keep your fingers crossed for me that this High Dose Dex is pummelling Myeloma. If it is, I'll do it longer, but then perhaps reduce the dose at some time. I have heard from many of you, that you do low dose steroids more often than the traditional "One Day Slam". And many don't do the super strong Dexamethasone, but instead do Prednisone or Medrol. I think doing steroids more often attacks the Myeloma daily. 

Oh, and for those of you recommending I get a "2nd opinion", and wondering why I haven't previously, I have, and I am. First of all, I like being part of a broader team of multiple Drs as I have at Kaiser, secondly I have always had a 2nd opinion with my SCT Dr team. I haven't seen my SCT Dr for quite some time now, so I contacted the SCT BMT Dept at Kaiser-City of Hope the other day, and made an appt with the "Myeloma specialist". I've seen her briefly previously, during my SCT July 2010, but haven't had a full appt with her. Looking forward to our meeting early January 2021. But really, I am happy with my current Dr and I have access to any treatment I want. It's me that's "conservative" with my choices. It's me that is not brave enough to jump from a "predictable treatment" to an unknown. It's me that doesn't want to do Clinical Trials. It's me that puts the halt on new meds. I HATE NEW SIDE EFFECTS AND I HATE THE UNKNOWN. I AM NOT BRAVE ANYMORE. I used to like "challenges", and saw new treatments as me challenging myeloma to an internal duel. Not now, I just want to feel ok.

Ok, Julie be a "patient paitient". Go outside, enjoy this beautiful life in tiny ways. Stop trying to get back to your 30s, and 40s. I always "forget" that my current "age" does factor in to everything now, all the side effects, pain, myeloma growth, injuries, etc. I have to recognize that 11+ + years with Myeloma is a wonderful milestone, but I will never be back to who I used to be...  Meanwhile, I'll just keep reading about EXTRAMEDULLARY!

Pain, Pain stay away... meds meds please keep working!

Look at me back in 1980, just a kid!
Loved Mr SkyeHorse!
He was a tall Polish Arabian. 
Jim and others always wanted to trade their horses for him.
Nope, Never!
He was so loyal to me, and such a wonderful pal.
 He was the reason Jim and met.
Oh our lives, what a story it is...





2 comments:

  1. Hi Julie, So happy to hear the dex is helping you feel better! I love your throwback photo, I had the same hairstyle:) I honestly have never seen an arabian horse in a western saddle, very pretty boy. B

    ReplyDelete
    Replies
    1. Ah, thank you Bonnie! Yes, amazing how wonderful and awful Dex is! When it really kicks in, I almost feel like my ol self again, but I am still super cautious with everything I do. Worst I worry about now is falling, as I am dizzy. But I sure do have relief on steroid days! The crash is awful, but doesn't last for more than a couple of days. Then back to feeling "Dexified" again :)) I've certainly improved on how to "poof" my hair since back then, and yes, my beautiful horse Skye was an amazing Arabian buddy!! Did you ride, or do you now? Us horse girls have to stick together xoxo

      Delete

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.