Rehab and Other Gab

I went to our mailbox today to post a letter that I wanted the mailman to pick up when he delivered today's mail.  When I checked the box, however, the mail had already come.  Drat!  So I picked up today's mail and drove to the post office to mail my letter.  When I got there, the letter had disappeared!  What?  I searched the car fruitlessly, so I drove back to the mailbox to see if I had dropped it along the way.  When I got there, I found the letter neatly nestled in the mailbox.  Duh!  Chemobrain?  Old age?  Some combination of the two?

I read recently that doorways are memory erasers.  I can purposefully walk from one room to another to accomplish something, but after going through the doorway, I stand there in bewilderment wondering why am I here in this room?  I'm sure this doorway theory has some merit, because I have a lot of experience with it.  I think the National Science Foundation should sponsor a study to verify this obvious conclusion.  I mean really, it makes sense, doesn't it?

Monday was my monthly Farber day.  Originally, I was scheduled to see Richardson, but the appointment was changed to see his nurse, Mary.  I did have a couple of questions for Paul about the potential Lyme Disease connection, so I was a bit disappointed.  On the other hand, I'm grateful that I'm doing so well that he doesn't need to see me on a regular basis.  That puts things into the proper perspective.

My pathology results from last month's serum electrophoresis and immunofixation tests continue to show no M-spike and no gammopathy, which is great!  So far, so good.  Some of my other numbers have slipped a bit, however.  My WBC dropped from 4.2 to 3.0, below the normal range, and my neutrophil count plummeted from 2.45 to 1.56, but still above the threshold of 1.0 where I would have to suspend taking the Revlimid.  My hematocrit also fell to 33.9, the lowest level in more than a year.  I just can't seem to shake this persistent anemia.  Oh well, at least I feel good, except for needing more sleep than I used to.

I asked Mary how long I should keep taking monthly Zometa (bisphosphonate) infusions.  She indicated at least two more years before moving to a 3-month schedule, because I need to build back my bones.  I knew I had severe osteopenia at the the time of my MM diagnosis, but I didn't realize until Monday that I actually have a compression fracture of the L1 vertebra.  That might explain why my lower back doesn't always feel so good.  Do ya think?

I finally went to the physical therapist for my knee on Tuesday.  I'm glad I went.  Karen, the PT, gave me a number of exercises to keep limber and build up the muscles around my knee.  I can do these exercises at home and at the gym.  I have to admit that I have been slightly remiss about going the gym lately.  By "slightly remiss", I mean I haven't been to the gym in about 4 months.  OK, OK...20 lashes with a wet noodle, as Ann Landers used to say.  Anyway, this should motivate me to get off my lazy ass and get back into the groove.  Fortunately, the cortisone shot is still working, and I don't even notice my knee most of the time.

I want to thank the goodly number of my readers who responded to my posts about the possible connection between Lyme Disease or other autoimmune maladies and monoclonal gammopathies (MGUS/SMM/MM).  There seem to be a lot of patients out there who have suffered the symptoms of chronic Lyme Disease some years before contracting MM or its precursors, some of whom have contracted other maladies along the way.  Of course, these anecdotal cases don't show a definitive connection, but I smell enough smoke to think that there's a fire there somewhere.  The real question is what is the mechanism for an overloaded immune system to trigger the mutations leading to myeloma?  Perhaps understanding this could help lead to better treatments or at least increased vigilance leading to earlier diagnosis.  I'm still soaking some of this in.  I'll update this blog with my conclusions, assuming I come up with any.