Category: Myeloma

Myeloma

Farewell, friend.

I just found out that my friend, Joyce Wells, has died.  Myeloma took her life.

Joyce and I met in 2003, because she saw something I posted to the ACOR myeloma list, and wrote to me.  I always signed my posts, “Beth in NC.”  Joyce asked where I lived in North Carolina, and it turned out that we were less than a 30 minute drive from each other.  We met for lunch, and were friends ever since.  We scheduled our clinic visits and treatments at the same time whenever we could.  We’d meet for lunch before (or after) and sit along side each other when we were having infusions of something or other.  We tried to schedule our stem cell transplants for exactly the same time frame, but it didn’t quite match up.  Mine started a week before Joyce’s.  Still, our apartments were next door to each other, and we saw each other in the clinic every day.

Joyce WellsJoyce made me laugh.  I’ll never forget how she spoke of stem cell transplant programs as being either “inhouse” or “outhouse.”  Of course, she meant to say inpatient or outpatient.  It stuck though, and that’s what we called it from then on.  She explained what the term, “Massholes” meant.  It has never come up in conversation, but, if it ever does, I’m not going to have to ask what it means.

Dr. Peterson, who we both saw for a while, used to call us the “Myeloma Twins.”  I have to say that, if you can manage it, having a treatment buddy is the best way to get through chemo.

I don’t have anything more to say right now, except that I’ll miss her terribly.  I’ll never forget Joyce.  I’ll try to post more memories of her as time goes by.

Here are blog posts I’ve been re-reading to remember Joyce. I wish I had written more about her over the last dozen years.  Farewell, Joyce Wells

The Leukemia & Lymphoma Society new & improved blood cancer discussion boards

new & improved blood cancer discussion boards

The Leukemia & Lymphoma Society (LLS) is excited to announce our new Blood Cancer Discussion Boards. The discussion boards are a great place to communicate with others who are going through experiences similar to yours. Share stories, ask questions, receive and provide support, or just see what others are saying.

To access the new discussion boards, click here. If you were previously registered for the boards and have not yet logged in to the new site, you will need to reset your password. You can learn about using the discussion boards in the Getting Started Guide.

If you have any questions, please contact an LLS Information Specialist:

lls

Be your own expert!

I was going through papers a few nights ago, when I discovered the handwritten notes that Dr. Richardson (Dana-Farber) had written while I sat in an exam room, there in Boston, in March of 2003.  That was 11 years ago.  I remember him telling me, “We hope to get you to your 50th birthday — and beyond.”  At the time, I was 41 years old.  9 years seemed like a long time.  Well, that 9 years has come and gone.  I’ve known about my myeloma for more than 11 years now, and have been treatment free since 2007.  With the exception of quarterly Zometa.

Notes on my myeloma by Dr. RichardsonWhat have I learned in the last 11 years?  Lots of things. Most important among them is that no two people will have identical experiences with their myeloma disease process or treatment in the aggregate.

If someone asks me what a stem cell transplant is like, I can only tell them about MY experience.  Even if you have IgA lambda MM, and start off with the same lab values I had, and then use the exact same treatments I did, I doubt that you’d have the same experiences or outcomes.  We’re just all different.   When people ask me what I did to last so long, all I can say is, “I have no idea.”  Is it because I waited, and had the SCT later? I don’t know!

The second most important thing I’ve learned is that no other patient or caregiver is the expert, where I’m concerned.  Nobody can tell me anything I already don’t know about how to live with my myeloma. At first, I was scared of treatment side effects and procedures.  I wanted to know what other people thought and did.  I frequently asked, over and over again, things such as, “What do you do for your peripheral neuropathy?” And, “Do you have a sedative before your bone marrow biopsies?”  The answers to these questions did help me at first.  I had to find my own way, though.  I’ve been lucky enough to live long enough to keep trying different things.

At this point, I’m annoyed by people who push their opinions about the “best way” to do this or that.  It’s good to know about all of your options.  Just remember that no other person has your best interest in mind the way you do, or the way your loved ones would.  And, sometimes, you’re going to disagree with even them. Heck, yeah!

I guess I’m just trying to say that there’s no easy answer to the questions you have about what to do when you find out you have myeloma.

Here’s a short list of some things that I’ve found helpful over the years.

  • When you’re on chemo, take the anti-emetics your doctor prescribes.  If they’re not working for you, ask for something different.  Don’t stop bugging your treatment team until you get something that helps.
  • Likewise, if you have pain, keep agitating for relief.
  • For covering a Hickman or Neostar central venous catheter for showering, Glad Press-n-Seal is the best!
  • Get plenty of rest and drink plenty of fluids. Make sure your doctor recommends proper fluid intake for you, especially if you have impaired kidney function.
  • Have fun as much as is possible for you.  Just don’t hurt yourself.
  • Try to laugh.

Hang in there, everyone.

Analysis of the immune system of multiple myeloma patients achieving long-term disease control

The article is called “Analysis of the immune system of multiple myeloma patients achieving long-term disease control by multidimensional flow cytometry.” It makes me think they mean long-term disease control was achieved by flow cytometry. That would be pretty awesome. They really mean that the analysis was done using MFC.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533663/

Highlights (determined by me)

Multiple myeloma remains largely incurable. However, a few patients experience more than 10 years of relapse-free survival and can be considered as operationally cured. Interestingly, long-term disease control in multiple myeloma is not restricted to patients with a complete response, since some patients revert to having a profile of monoclonal gammopathy of undetermined significance.

My comments: How can the monoclonal gammopathy be characterized as being of undetermined significance, when the pt has had MM? Obviously, there is a significance. I’m just picking. I know what they mean. It’s good to see that they’re asserting that complete response is not required. I have never had that. I think people put too much emphasis on it.

In summary, our results indicate that multiple myeloma patients with long-term disease control have a constellation of unique immune changes favoring both immune cytotoxicity and recovery of B-cell production and homing, suggesting improved immune surveillance.

My Comments: None, really. I just like the word constellation. :) Dr. Peterson used to use that word a lot.

Despite the fact that until recently MM was considered incurable, the introduction of high dose therapy/autologous stem cell transplantation and novel drugs has made it possible for a small fraction of patients to attain long-term (?5 years) disease control even in the absence of a complete response, after reverting to having an MGUS-like profile. The underlying mechanisms leading to disease suppression in these patients are largely unknown, although immune surveillance has been hypothesized to play a critical role.

My Comments: This is me, in a nutshell. The small fraction.

Test results from September 11, 2013

These are the latest test results.

IgM
25 mg/dL (60-263)
IgG
411 mg/dL (768-1632)
IgA
891 mg/dL (68-378)

FLC with ratio
Kappa: 0.15 mg/dL (0.33-1.94)
Lambda: 2.60 mg/dL (0.57-2.63)
K/L free ratio: 0.06 (0.26-1.65)

CBC w/differential

WBC 6.6 4.5-11.0 x(10)3/microL
Lymphocytes % 31.3 20.5-51.1 %
Monocytes % 6.0 1.7-9.3 %
Granulocytes % 62.7 42.2-75.2 %
Lymphocytes # 2.1 1.5-5.0 x(10)3/microL
Monocytes # 0.4 1.7-9.3 x(10)3/microL
Granulocytes # 4.1 1.4-6.5 x(10)3/microL
RBC 4.37 4.00-5.20 x(10)6/microL
Hemoglobin 13.3 12.0-16.0 mg/dL
Hematocrit 40.9 36.0-46.0 %
MCV 93.4 80.0-100.0 fL
MCH 30.3 26.0-34.0 pg
MCHC 32.5 31.0-37.0 mg/dL
RDW 13.4 11.6-13.7 %
Platelets 162 150-440 x(10)3/microL
MPV 7.2 7.0-10.0 fL

Other stuff

Beta-2 microglobulin
1.6 mg/L  (Normal range is 1.1-2.4)

 

Serum Protein Electrophoresis

Total protein 6.7 6.0-8.5 gm/dL
Albumin 4.0 3.2-5.6 gm/dL
Alpha-1-globulin 0.2 0.1-0.4 gm/dL
Alpha-2-globulin 0.5 0.4-1.2 gm/dL
Beta globulin 1.1 0.6-1.3 gm/dL
Gamma globulin 1.0 0.5-1.6 gm/dL
M-spike 0.3 gm/dL
Globulin, total 2.7 2.0-4.5 gm/dL
A/G ratio 1.5 0.7-2.0

 

Comprehensive Metabolic Panel

Sodium 139 136-144 mmol/L
Potassium 4.0 3.6-5.1 mmol/L
Chloride 107 101-111 mmol/L
CO2 23 22-32 mmol/L
Random glucose 106 65-140 mg/dL
BUN 12 8-26 mg/dL
Creatinine 0.72 0.4-1.0 mg/dL
eGFR >60 2
Calcium 9.0 8.9-10.3 mg/dL
Albumin 3.9 3.5-5.0 gm/dL
Protein, total 7.2 6.5-8.1 gm/dL
Alkaline Phosphatase 95 50-86 Units/L
ALT (SGPT) 51 14-54 Units/L
AST (SGOT) 34 10-41 Units/L
Bilirubin, total 0.7 0.4-2.0 mg/dL
Anion gap 8.5

 

 

 

 

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

Leg Rash? Bedbugs?

myeloma blog statsI don’t really blog much anymore, because I’m not being treated for my multiple myeloma these days.  It’s been pretty stable for nearly six years.  I try not to live in the myeloma world too much.  Actually, I don’t really even try.  It just works out that way.  When I first learned I had myeloma, back in 2003, it was all I could think about, from the time I woke up in the morning, until the time I went to sleep.  I’ve talked to a lot of people who experienced the same sort of involuntary obsessive thoughts about the disease.  It’s a strange feeling.  You know there’s something inside you that’s trying to kill you, and you can’t stop thinking about it.  The farther you get from your last treatment, the less you think about it.

Since I don’t do much blogging these days, I don’t pay attention to my stats, either.  This morning I decided I’d take a look.  What surprised me was the number of people who found my blog by searching for something with the word “rash” in it.    I had written a post in 2007 about what I think could have been an insect bite on my leg.  As you can see from the image on the right, “bed bugs rash” is now the number two search phrase that brings people to my blog.  Very interesting.

In the past, my blog was a big attraction for people searching about shingles.  I’ve had shingles at least three times, and blogged about it — with pictures.  I wasn’t shocked when I used to see that turn up in the analytics.  “Bed bugs rash,” however, is surprising!