Farber Day

The day after Labor Day is not a fun day to commute into Boston.  It took me an hour and 45 minutes to make my way into the Farber this morning for my monthly checkup.  Not to worry.  The overflow of patients from the holiday had everything backed up a half hour or more in the waiting room.  I'm used to this, so it didn't bother me.  It is what it is.  I just relaxed with my laptop, checked the news and played Sudoku online.

My results today were great!  For the first time in many years, I am no longer officially anemic!  My Hemoglobin level (Hgb) came in at 13.7 (normal range is 13.2-16.7).  Yay!  Last month it was 12.9.  Until I started taking supplemental iron pills in January, my Hgb had ranged from 10.5 to 12 over the last many years.  The other measures of anemia include red blood cell count (RBC) and Hematocrit (HCT).  Both of those numbers had also been consistently low.  Now both are in the normal range.  I do seem to have more energy (although I still take afternoon naps often), and I haven't been sleeping as long at night.  I'm actually feeling really good!

On September 18, I go back to the Farber to meet with the benign hematologist NP, Samira, to assess the effect of the iron pills I have been taking.  I have a feeling that I may be able to either cut back or stop taking them.  That would be great.  They are a major pain in the ass to open.  They have a foil seal that you have to get the edge lifted up just right to peel the seal off the pill.  Sometimes I have to take scissors just to get at the damn thing.  Grrrr!  Why do drug companies have to wrap their pills as if they are some kind of gift from God that only the worthy can discover the secret of how to open them?  I must not be worthy.  It pisses me off!

Another piece of good news is that Paul has agreed to my request to cut back on my Zometa infusions to every other month instead of monthly.  That's great, as I won't have to get an IV inserted every month, and my visits will be a lot shorter on the off months.  I can feel my veins are shrinking in horror with this monthly sticking, so I think they will be happy with the time off.  I will miss seeing my infusion nurse, Heather, on the off months though.  Oh well, every silver lining has a cloud.

My other numbers were great too.  My neutrophils and platelets are all OK, so I can continue with the Revlimid.  I'm entering the 26th month of my three-year Rev maintenance therapy and there is still no detectable M-spike or monoclonal gammopathy.  I don't know why I didn't do this before, but I asked my nurse, Mary, for a copy of the lab test results and pathology report from my last bone marrow biopsy in March.

The first thing I found interesting was that the Mayo Clinic lab report FISH test for chromosome abnormalities showed that everything was normal!  There was no indication of the t(4:14) abnormality that I was initially diagnosed with in 2011.  Really?  Mary suggested that this could be due to the fact that I now have minimum residual disease (MRD), and there were only 83 plasma cells identified for analysis.  So do I have the t(4:14) abnormality or not?  If not, maybe I'm not high-risk after all.  That would be nice, to say the least.  I think I might want to ask Paul about this.

The other report I got showed the pathology results of the BM biopsy in March.  Everything looked normal except for the following observation, "...occasional atypical plasma cells suspicious for involvement by a plasma cell disorder."  Hmmm.  I am now reminded of Paul Richardson's apt metaphor about the mongoose and the cobra.  The cobra is MM and his view is that you hit it hard up front until the therapy (mongoose) has the cobra confined to a box.  The mongoose then sits on the box so the cobra can't get out.  That's what my Rev maintenance therapy is now doing...sitting on that box.  But this pathology report shows that the cobra is not dead, just dormant.  If I make it through to next July with this maintenance therapy without a relapse, then I go off the Rev.  Without the mongoose on the box, what will the cobra do?  Will it come out and sink its fangs into my bone marrow again?  Probably so, but when?  It will be a ticking time bomb.  I guess I'll just have to wait and see.

On a lighter note, Gretchen is doing well in her recovery from her broken foot.  She is able to put some weight on it without the boot, which is progress.  She'll be able to drive her car much better without the boot.  Without my knowing, she has been taking the car out for short drives wearing the boot.  I get a clue when I find mail from the end of our road sitting on the counter.  I don't blame her...I would do the same thing.  But if you happen to be in West Newbury over the next several days, watch out for a green Subaru Forester and give it a wide berth.  (Just kidding!)

Still no progress in finding a new home.  We are thinking about generating a flyer to put in someone's mailbox asking if they are interested in selling if we see a neighborhood and a house we think we might like.  We know of several people who have used this successfully to buy their homes.  Not a lot of opportunities are coming up right now, so maybe this strategy will help.