Category: Duke

Six years ago

Six years ago on this date, I had a stem cell transplant at Duke Medical Center.

You can read what I wrote that day by clicking on the picture of my stem cells.  I didn’t document it very well.  I remember feeling just terrible when the stem cells were being injected into my line.  I felt so bad that they gave me something that pretty much knocked me out.  It felt like someone punched me in the chest.  I felt sick, too.  I can’t even remember if I took this picture, or if someone else did.  Ativan. :)

Stem Cells

The Myeloma Twins

During the time I was in treatment, I coordinated my doctor visits and chemo with another myeloma patient who lives about 25 miles from here.  We traveled to Chapel Hill appointments together and, when we were told the only treatment left to us was a stem cell transplant, we had ours together through The Duke Adult Blood and Marrow Transplant (ABMT) Program in Durham, NC.  We even had apartments next door to one another!

One of our doctors started calling us the “myeloma twins.”

I’m really glad to have just gotten the news that Joyce is moving to Pinehurst, which borders on Southern Pines (where I live)!  She’ll only be a few miles away, so we’ll get to see each other more often.


My two m-spikes

I wanted to post my results, and got a little behind! Here it is:


The two m-spikes have been staying this way for several months now. The complete bone survey report says, “No
aggressive lytic or sclerotic osseous lesions.”

Good, eh?

H1N1 flu that’s resistant to Tamiflu

I just read about a strain of H1N1 flu that’s resistant to Tamiflu. Four of these cases have been reported at Duke Medical Center in Durham, North Carolina.  I wondered if it has possibly infected people in the transplant clinic? A friend had her SCT at Duke one year when the flu was rampant in the transplant clinic.  She said that a few of the patients became quite ill.  She had the flu herself. She recovered and had a second stem cell transplant.

“All four of the North Carolina patients were hospitalized and were very ill with underlying severely compromised immune systems and multiple other complex medical conditions, according to researchers from the Duke University Medical Center. Three of the four died. No details have been released about how the patients caught the resistant virus or whether there was any contact among them.”

Maugh II, T.H. (2009, November 20). Swine flu seems to be trailing off — for now, at least. Retrieved from

If you’re sick, please stay home!

The last few appointments I’ve had at the Bone Marrow Transplant Clinic, I’ve had to wear a mask into the facility.  Everyone has always had to wash their hands before entering, but the masks are a new thing.  It’s meant to protect the patients whose immune systems have been wiped out or weakened by high dose chemo.  A few days ago when I was there, I saw a woman walk up to the desk to check in and heard her say, “I think I might have the flu.”  They whisked her off to an exam room so she wouldn’t be putting others at risk.  The first thing I wondered was why didn’t she call ahead and ask if she should show up for her appointment?  She could have rescheduled.  I noticed that they sanitized the desk top after she was gone, and I imagine they probably had to do the same with the exam room.

It seems like the flu (seasonal and H1N1) is getting all the attention lately.  Have a look at this article to take your mind off of it all: Don’t Be a Statistic

Myeloma Treatment

Flu Preparedness Advice

This arrived in my inbox, and I wanted to share.  What preparations have you made?  I have a prescription for Tamiflu, but have not had it filled yet.  I haven’t had my seasonal flu shot yet, but will get that done soon.

To: Duke University Health System Patients

From: William J. Fulkerson, M.D.
Senior Vice President, Duke University Health System

Date: September 16, 2009

Re: Influenza Preparedness: Advice to our Patients

Dear Duke Patients,

As we approach the official beginning of autumn, we are entering the annual cold and flu season. This year’s flu season is expected to arrive early, stay late and be more intense than the flu seasons we have experienced in the recent past. The H1N1 influenza pandemic (aka “swine flu”) continues to intensify throughout the world, and public health officials fully anticipate a second and third wave of illness similar to what was experienced in the spring of 2009. Given the magnitude of health implications the flu can have on individuals (and their families), Duke Medicine is recommending the following steps to stay well this fall and winter.
Understand the facts about the flu. The H1N1 (aka “swine flu”) and seasonal flu are contagious respiratory illnesses caused by influenza viruses. They are spread mainly from person to person through coughing or sneezing and less commonly by touching a contaminated surface. The circulating strain of H1N1 causes an illness pattern similar in severity and duration to typical seasonal flu in most patients.
Know if you are in a high-risk group for complications from influenza. The high-risk groups for complications from H1N1 and seasonal influenza are similar. The major difference is that pregnant women and younger patients seem to be at a slightly higher risk to contract H1N1 (possibly because older patients have developed immunity to similar viruses over the years). The following are high-risk groups whose Duke health care provider should be contacted immediately if they become ill with influenza like symptoms: children less than 5 years old, pregnant women, adults and children who have chronic illnesses or compromised immune systems, persons aged 65 years or older, residents of nursing homes and other chronic-care facilities.
Understand the symptoms associated with the flu. Seasonal and H1N1flu symptoms are indistinguishable. They include: fever, sore throat, chills, body aches, cough, runny or stuffy nose, diarrhea, vomiting and headache. Please note that many of the recommendations regarding when it is safe to return to work or school are based on knowing your body’s temperature. If you don’t have a thermometer in the house, consider purchasing one now.
Understand when to seek medical care. Most patients recover from the flu completely in a few days and do not require a visit to their health care provider. But it is important to know when you should seek medical care. Flu symptoms typically resolve in 5 days, but if your symptoms persist beyond 5 days, contact your primary care doctor. If you have any of the following potentially life-threatening symptoms while battling the flu, immediately contact your health care provider or go to the closest Emergency Department: difficulty breathing or shortness of breath, pain or pressure in the chest or abdomen, sudden dizziness, confusion, severe or persistent vomiting, flu symptoms that initially improve but then return with cough and fever. Infants should be taken immediately to the Emergency Department if there is a bluish or gray skin color, lack of responsiveness or extreme irritability.
Get a seasonal flu shot! The seasonal flu vaccine is the single best way to avoid getting the seasonal flu. It does not protect you from the H1N1 (aka “swine”) flu, but is highly effective against most strains of the seasonal flu. Duke Clinics will begin offering seasonal flu shots as early as mid-September this year. By obtaining your flu vaccine well before the peak of flu season, you give your body the ability to build immunity to the flu before you are exposed. It takes about two weeks for your body to fully build its defenses after receiving the vaccine.
Consider getting the H1N1 vaccine. This year in addition to the seasonal flu vaccine there will be a separate vaccine for H1N1. This may be a one part or two part vaccine aimed directly at the circulating H1N1 influenza virus. The vaccine is highly recommended (and will be prioritized) for pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages 25 through 64 who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems. Once there is adequate supply of the vaccine, we encourage all patients to get vaccinated. Talk with your health care provider about when you should be vaccinated for H1N1.
If you’re sick, stay home! The flu is spread when an infected individual coughs and sneezes. Once it is in the environment, the rest of us can get from handshakes, by simply being in close contact with someone who is infected, or by touching contaminated surfaces. If you come down with flu-like symptoms, stay home (away from other people) until at least 24 hours after your fever has naturally resolved.
Wash your hands frequently. Frequent hand washing is a simple activity to avoid a multitude of infections – including the seasonal flu, swine flu and the common cold. Wash your hands well using soap and water; alcohol-based hand gels are a good alternative when you are away from a sink. Avoid touching your eyes, nose and mouth, as these are the routes of entry for cold and flu viruses into the body.
“Eat right and sleep tight. Stay hydrated.” Diet and sleep patterns have a profound effect on your body’s ability to fight infection and disease. Eating green, red and yellow fruits and vegetables and sleeping a minimum of 8 hours a night boosts your body’s immune system. A healthy adult needs to drink about 64 ounces of water each day.
Stay calm and don’t panic. Pandemics can be scary times – but rest assured the federal, state and county governments and Duke University Health System are all working together to address this pandemic. Duke Medicine is committed to helping you and your families stay healthy this cold and flu season. Please do not hesitate to visit for updates on the flu season, or contact your health care provider with questions.

William J. Fulkerson, MD

Immunoglobulin Profile for June 1, 2009

GENLAB Immunology: Final    06/01/2009 15:03

  IMMUNOGLOBULIN G                  *410         mg/dL       [588-1573]
            NOTE:  African-American reference ranges differ slightly from
                   those listed.  Please call the Immunology Lab at 684-6939
                   for race specific ranges.
  IMMUNOGLOBULIN A                  *432         mg/dL       [46-287]
  IMMUNOGLOBULIN M                  *26          mg/dL       [57-237]
  IMMUNOGLOBULIN E                   30          IU/mL       [4-269]

Serum Protein Electrophoresis for June 1, 2009

Lab Report: Final    06/01/2009 14:36

  0.14 TO 0.19 G/DL.
  "I have personally performed the interpretation".  Dr. S. Pizzo, MD,PhD

  SPE TOTAL PROTEIN                  6.8         g/dL        [6.0-8.0]
  SPE ALBUMIN %                      65.6        %
  SPE ALBUMIN                        4.46        g/dL        [3.97-5.34]
  SPE ALPHA 1 %                      2.9         %
  SPE ALPHA 1                        0.20        g/dL        [0.11-0.32]
  SPE ALPHA 2 %                      10.5        %
  SPE ALPHA 2                        0.71        g/dL        [0.40-0.88]
  SPE BETA %                         11.3        %
  SPE BETA                           0.77        g/dL        [0.60-1.02]
  SPE GAMMA %                        9.7         %
  SPE GAMMA                          0.66        g/dL        [0.53-1.37]
  SPE M-SPIKE 1 %                    3.7         %
  SPE M-SPIKE 1                      0.25        g/dL
  SPE M-SPIKE 2 %                    2.8         %
  SPE M-SPIKE 2                      0.19        g/dL