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Wednesday, May 2, 2012

Back to Dana Farber

After a couple of dry spells lately when I didn't update my blog for up to a week, I am now subjecting you to my third post in as many days.  Oh well, it is what it is.

Today we went in to see Dr. Richardson for the first time in three weeks.  My blood test results came back great!  The white blood cell count stayed about the same, a little below normal range, and my platelet count was also steady and within the normal range.  The hematocrit and hemoglobin both increased, so my anemia is slowly improving.  I'm not surprised, since I have more energy and I haven't been as tired lately.  However, Dr. Paba Prada said that it will take a long time for these numbers to get back into the normal range.  Most of the other results were either normal or not a cause for alarm.  They drew blood to perform an electrophoresis/immunofixation test for the M Spike, but those results won't be back for a few days.  I would be shocked if an M Spike could be detected after all I've been through lately.

Because of my progress, some of the restrictions I have been living with can be lifted.  For example, I can now visit with my grandson Logan, so we can go ahead and schedule that for sometime this month.  Also, I was cleared to play golf (as long as I don't smoke cigars), move around more freely in public, eat more raw fruits and vegetables (if they're washed and prepared at home), and even travel by plane soon!  I should still avoid gardening and mowing the lawn.  I should also avoid undercooked meat and fish, at least for the next few weeks.  This is great news, as I can now resume an almost normal life.  This is far sooner than I would have thought possible.

The doctors and Muriel, the transplant nurse, were all pleasantly surprised by how well I am doing.  I seem to be the poster child for how to respond to these treatments...well, poster geezer might be a more accurate description.  ;-)

I broached the subject of my Peripheral Neuropathy (PN) to Paba Prada and Richardson.  Surprisingly, they didn't have that issue on their radar from my previous visits, although I have mentioned it before.  I think I was more emphatic about it this time.  Claudia also said that PN usually gets worse for most patients after a stem cell transplant, which corresponds to my experience.  It turns out that there are a number of things that can be done to mitigate PN, and they gave me a packet with suggestions.  These include Vitamin B6, cocoa butter, and some other supplements that I plan to try soon.  They want me to start immediately, because they would like for it to subside before I start my Consolidation Therapy in a few weeks.

Dr. Richardson was also very responsive to my concern about the PN side effects of the Velcade that I will soon be taking.  He plans to monitor this closely, and he will adjust the Velcade dose accordingly if PN becomes an issue.  I was very pleased with how they responded to my concerns about PN, so I am feeling much more comfortable with the whole situation.

The next step is for me to come back in a couple of weeks to get a full set of tests, including another bone biopsy (yippee), to assess the status of my MM.  Muriel said she would be surprised if I haven't achieved a stringent Complete Response (sCR)!  Wow, that's setting the expectation bar a bit high.  Wouldn't that be nice, though?

After this re-staging process, the Consolidation Therapy protocol will probably start in another week or so.  None of this has been scheduled yet, but I will probably start the protocol near the end of May.  This will consist of four 3-week cycles, where I go into DFCI for Velcade infusions twice a week for the first two weeks of each cycle, and then take the third week off.  Muriel even offered the possibility that it could be scheduled such that our 25th Anniversary week (June 19) is one of the weeks off.  That would be nice, but we aren't going to push for that to happen.  If it does, it does.  They've already jumped through enough hoops accommodating our vacation schedules.

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