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Tuesday, January 17, 2012

Transplants and Finance

Yesterday, Pat Killingsworth's blog referenced an article about him and Autologous Stem Cell Transplants (ASCT) that recently appeared in Nature Magazine.  It's an interesting piece, which addresses most of the issues I am now currently facing in making my decision on which way to go.  Here is a link to the article:

http://www.nature.com/nature/journal/v480/n7377_supp/full/480S46a.html

There is a good discussion on the question of early versus delayed ASCT.  Here is a quote from the article:

"Opinion is divided on the best treatment. Some myeloma specialists favour an aggressive treatment tactic, in which transplants are administered soon after diagnosis, when the disease is thought to be at its most vulnerable. Others opt for a milder protocol that reserves the hard-hitting transplant option — with its attendant risks of infection, bleeding and anaemia — as a last line of defence if less toxic therapies fail."

It will be years before enough data are collected to resolve this question.  In the meantime, it is up to the individual patient (that would be me) to try to figure out which way to go.  Would somebody please hand me a crystal ball?  It's like I'm playing Blackjack with all my chips in, trying to decide whether to hit or stand holding a hard 12 with the dealer showing a 3 or a 4.  For my MM situation, I see the dealer with a 3, so "Hit Me"!  (Unfortunate phrasing, perhaps?)

Last year, I was fortunate to receive a stipend from Good Days of the Chronic Disease Fund to defray the exorbitant costs of my Revlimid prescriptions.  As a result, I only had a $20 co-payment every month.  I have been very lucky!  However, I just found out that my application for 2012 was rejected, as I don't meet their financial criteria.  Oh well.  I can't wait to see how much I will owe when I pick up my prescription next week. 

You may notice the time on this post.  Yes, it's oh-dark-thirty!  I've had some issues dealing with the dexamethasone this past week.  Thursday night, I couldn't sleep at all, as I was in what one patient has dubbed my "dexametha-zone".  By Sunday, after tailgating and attending the Patriots/Broncos playoff game on Saturday night (Go Pats!), I finally crashed and caught up...so much so that now I can't sleep again.  Aaarghhh!

We leave for our Arizona vacation on Wednesday, so I may not be posting any updates for the next week or so.  We'll be back in time to meet with Dr. Richardson on Jan. 25.

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