Let the Games Begin

Yesterday was my first day at Dana Farber for Cycle 1, Day 1 (C1D1) of my Mezigdomide/Daratumamab/dexamethasone (Mezzi/Dara/dex) clinical trial. I started this trial just in time since the trial is closing to any more applicants after today! Phew! I feel very fortunate. Thank goodness for Dr. Richardson. 

It took most of the day. By "most of the day" I mean I was there from 7:30 a.m. until 7:00 p.m. It was a long day for a couple of reasons. First, after my blood draw and meeting with the nursing team, I went to the Infusion Center at around 10:00 a.m. to get my study drug (Mezzi) along with the subcutaneous Dara injection and dex. The Mezzi and dex are both in pill form. However, Dr. Richardson hadn't yet put in the order for the Mezzi, so I had to wait until 12:15 for the prescription to be filled. In the meantime, I had to take a bunch of pre-meds, including Decadron (dex), Tylenol, Singular, and Benadryl. 

After I got the Dara shot in my stomach at 12:30, I was forced to wait for 6 hours of observation to see if I had any adverse reactions. It wasn't completely boring, because the nurse, Dannielle (who is great!), had to take triplicate EKGs (!) along with various blood draws every hour! I was also able to squeeze in a Zometa infusion while there. 

I had a window in the infusion room, so I got to watch the traffic outside, which was marginally more exciting than not having a window. I had a fold-down chair, so I tried to nap a couple of times between procedures. Fortunately, I had no reactions to the Dara, so I was prepared to go home at 6:30. 

The EKG machine they use is old and slow. The first reading seemed to indicate that I was having a heart attack! I felt fine, so I was pretty sure that that was not happening! All subsequent readings were fine, however, so they determined that it was just a glitch artifact of the EKG machine. So far so good. However, just as I was about to leave for home, I was told to wait for the EKG doctor to go over all the charts again to verify that I could go. Fortunately, he must have noticed that I hadn't had a heart attack, so he signed off on it, and I got on the road around 7:00 p.m. 

Now that I'm on this clinical trial, I must start taking a bunch of additional meds. I already take about 10 prescriptions and supplements every day. Along with the Mezzi pill, which I must take daily for one week on and one week off, I now also have to take acyclovir, aspirin, Bactrim, and Pepsid (I can't take PPIs like omeprazole anymore). 

I have to figure out a schedule on how to take these drugs. I'm supposed to take the Mezzi in the morning, and I can't have coffee or any hard foods 2 hours before or after! If I pop the rest of those pills in the morning without eating anything or having my coffee, I will probably upchuck the whole lot! Hmmm. 

One of the nurses said that one of her patients wakes up early (4:00 am) to take the Mezzi and then goes back to sleep for a few hours so she can have her normal coffee and breakfast when she awakes. That sounds good to me because I usually stagger into the bathroom around 5 or 6 a.m. to pee. That would be a great time to take the Mezzi. 

I am scheduled to go in early in the morning again for the next few weeks. I won't have to do the 6-hour wait again, but at first, the days will include some wait time. After that, I sweet-talked the scheduler, Carmen, (smooth talker that I am) into moving most of my appointments to late morning or early afternoon. 

In the meantime, Holly and Ryan, who live in Boston, have insisted that I stay over with them on my early-morning appointment days. I'm very grateful! They are the best! And I get to see my gorgeous and irrepressible 4-year-old granddaughter, Kaia!

Kaia and Holly

To my chagrin, I see that I am scheduled for another bone biopsy on December 4. After my last experience, I want some drugs to ease the pain the next time. Since I won't be able to drive afterward, Holly has offered to drive me there and back that day. She is such a sweetheart! 

I took 40 mg of dex today, which is a lot. I'm writing this at 1:30 a.m., and I'm not even sleepy yet. If past experience is any guide, I won't get much sleep tonight. I remember during my first bout with MM, I would get up at night after my high-dose dex and think about doing something crazy, like reshingling the roof, painting the house trim, trimming all the bushes and trees, and patching all the cracks in the driveway. Like right then, with a flashlight! 

Now that I'm in an apartment, I don't have any homeowner tasks to do. However, I might want to get up and vacuum the rugs, do the laundry, re-organize my closet, clean the refrigerator, wash the windows, sort through items to donate to charity, water all the plants, or do some other task that hasn't occurred to me yet. Who knows? I'll lie awake thinking about it and let you know in a future post.

Bone Marrow Biopsy

I am now officially enrolled in the Mezi-Dara-dex clinical trial! I made it! My first treatment is scheduled for Monday, October 30, followed every week on Mondays for the next two months. 

However, I needed to go in for one more test beforehand: a bone marrow biopsy. So Friday morning I went into Dana Farber for this procedure.

Let me tell you about this. I laid flat on my stomach while the procedure nurse, Melissa, probed for the right spot on my hip bone to insert the "instrument".  Here is what it looks like:

This device sports a needle that seems to be much longer than it should be! 

The first thing she did was to inject a local anesthetic, first into the muscle, and then deeper into the bone. So far so good. Not too bad yet.

Now I've had these bone marrow biopsies several times before, but it has been quite a few years since my last one. The last time I took some drugs ahead of time to ease the pain. I was able to do that since Gretchen was there to drive me home. 

Now that I am alone and hadn't arranged for someone to drive me back afterward, I decided to tough it out like a he-man and do it cold turkey. Maybe it's like women giving birth. They forget how painful it was the last time, so they do it again, or so I'm told.

The thing is, once this instrument of torture dives deep into the bone marrow, the anesthetic doesn't really help. Multiple samples have to be taken and the marrow has to be sucked out. It's quite painful and time-consuming. To make things worse, I had also volunteered for them to take extra samples for research purposes. Duh!

Melissa (the torturer) kept saying, "I'm almost done". I don't know how many times she said that...I lost count. As I lay there gasping for breath, I was mentally kicking myself for trying to macho this out, or maybe I was actually kicking myself... I don't remember. 

After it was over, I clambered unsteadily off the torture rack and staggered out of the chamber with my undershirt hanging out of my pants. I didn't care. Next time, just give me drugs, lots of them!

I've Relapsed!

I met with Dr. Richardson at Dana Farber yesterday to enroll in the Mezigdomide (Mezi) clinical trial. In anticipation of my MM relapsing, I signed all the consent documents. I also went through a battery of tests yesterday and today, including providing a 24-hour urine sample, a transthoracic echocardiogram, supplying at least 20 vials of blood (a new record!), an X-ray skeletal survey, and an EKG.

The one test result that I was particularly keen on seeing was the Free-light chain blood test. One criterion for MM relapse is that the involved free light chain (in my case, Kappa) increases by more than 100 mg/L from its normal value. 

In my last post, I showed a chart of those results for the past several years. Up until 2023, my Kappa light chain has hovered in the normal range at around 18 mg/L. Then on my last visit in September, it had spiked to 112.8, almost meeting the relapse criteria. As I anticipated, the result from yesterday was 120.7, so I am now in a clinical MM relapse. The good news is that I am now officially enrolled in the Mezi clinical trial before the October 31 cutoff date. I should start the trial in a couple of weeks.

Dr. Richardson was extremely upbeat about this clinical trial. He said that the response rate to this protocol is over 80%, which is very good! He will be presenting trial results at the next ASH conference in December. He also said that this is a good trial for my high-risk t(4;14) cytogenetics. I wish I had recorded his remarks about this because I didn't understand half of what he said. However, the fact that he is confident gives me confidence.

So it begins! I will occasionally update this blog when I have some results to share.

I'm Back!

It has been over 3 years since I last updated this blog. Fortunately, I have remained in remission from Multiple Myeloma (MM) for all this time. I am an extremely lucky guy to have stayed in remission for more than 11 years. It's more than I could have possibly hoped for. However, all good things must come to an end. 

Over the past 6 months, I have noticed a steady deterioration in my blood test results.  In August, I got my first sobering hint of what was to come when my electrophoresis results indicated the dreaded "M-spike detected", which meant that there was now monoclonal protein in my blood. I then realized that the party was over. 🥳

As is my wont, I started researching Relapsed/Refractory MM (RRMM) to see what the preferred treatment options are after the first relapse. I found that many oncologists are recommending a regimen using one of the newer drugs, Daratumumab (Dara). A lot of the clinical trials to date have shown very promising results with Dara. 

I had an appointment with Dr. Richardson yesterday. While I haven't actually relapsed yet, I was confident that he would want to start some treatment soon, as he likes to hit things hard up front with everything he's got.  

Based on my research, I felt that it would be likely that he would recommend a treatment option containing Dara. I wasn't disappointed, but to my surprise, he offered to enroll me in a clinical trial with a new drug, Mesigdomide (try saying that quickly 5 times), coupled with Dara and dexamethasone (dex). This is an early Phase 2 clinical trial, so there aren't any results available yet.

He also offered me an option to enlist in another clinical trial. That one involves Ixazomib (Ninlaro), along with pomalidomide (similar to Revlimid) and dex. This was a blast from the past because Ninlaro was the drug I took in my initial clinical trial back in 2011! It has subsequently been approved by the FDA and is now a standard frontline MM treatment option. 

I have to reflect on how fortunate I am to be a patient at Dana Farber and have the world-renowned Paul Richardson as my oncologist. Where else would I be able to walk into my doctor's office and be offered on the spot two state-of-the-art clinical trials to choose from? I'm glad I don't live in Alabama.

After careful consideration, I decided that I wanted to join the first option. I spoke with the nurse today and I'll be making an appointment soon for pre-screening and signing consent forms. I asked her how the results have been to date. While detailed results are closely guarded until ready for publication, she said that her observations were that patients were responding very well to this protocol. That's encouraging!

There is one issue, however. The enrollment window for this trial closes at the end of October. If I am not clinically in relapse by then, I won't be eligible for this trial! So I'm in the uncomfortable position of hoping I relapse by then! Is that sick or what?

I just got yesterday's blood tests back today, and I don't think there is much doubt that I will be clinically relapsed very soon. One relapse criterion is that my involved (Kappa) free light chain (FLC) has to increase by 100 mg/L over its normal value. Here is a chart of this over the last 2 years:

As you can see, I'm perilously close to meeting that threshold. Again, I hate to keep saying this, but how fortunate will I be if I can slip under the wire and qualify for this clinical trial at the last possible minute. 

It reminds me of how I slipped into my first clinical trial in 2011. Someone had already signed up for the spot that Dana Farber had, but he had backed out the day before. They would have lost that spot to another cancer facility, but all they had reported was his initials, which happened to be WO. Since I had the same initials, I was able to take his place. the rest is history!

I remain optimistic and upbeat about this. Those of you who know me know that I respond to a situation like this as a problem to be solved and a challenge to be dealt with, not to wring my hands and say "Woe is me!". 

I won't wait another 3 years to update this blog. You should hear from me soon!

Another Long Absence

It has been almost a year since I updated this blog.  I apologize for the long absence.  Fortunately, since then I have continued to be in remission from the MM, so there has been nothing new to report.  That is the main reason I haven't updated this blog for so long.  By the way, yesterday was the 8th anniversary of my stem cell transplant, so Happy Birthday to me!

While I am still doing fine with the MM, there have still been some recent developments that could impact my prognosis going forward.  Being of Irish heritage with fair skin, I have had my share of skin cancers over the years.  These have normally been either basal cell carcinomas or squamous cell carcinomas, which have usually occurred less than once a year.  After a MOHs surgery for a squamous cell on my forehead in December, 2018, I was fine for my next diagnostic scan in May 2019.  However, on my next visit in December, 2019, my dermatologist took five biopsy samples.  To my chagrin, all five came out positive!  Gulp!

Four of the five malignancies spanned the range from two basal cell carcinomas to one squamous cell carcinoma in situ and one moderately atypical nevus.  The pathology report described the fifth one as an "atypical intraepidermal melanocytic proliferation consistent with early, evolving lentigo maligna".  I spent some time on the Internet trying to decipher this gobbledegook.  That one was of the most concern, as it was basically a melanoma in situ (Stage 0 melanoma).  My dermatologist wanted to deal with that one immediately, so I quickly had that one removed from my neck.  I was able to deal with the squamous cell on my forehead using an ointment for a few weeks, and I had the others on my arm, back and leg surgically removed over the next couple of months.

I have been on maintenance therapy using Revlimid (lenalidomide) for my myeloma for the past 8 years.  While Revlimid has been a Godsend in helping to keep my MM in check, it has the known side effect of occasionally spawning secondary cancers.  So I decided to make an appointment with Dr. Richardson to discuss whether I should keep taking the Revlimid.  I met with him this past Monday.  He pointed out to me that the high-dose Melphalan I took to kill my immune system when I had the stem cell transplant is also known to cause secondary cancers.  The combination of the two agents may well have spurred my sudden increase in skin cancers, so Dr. Richardson recommended that I stop taking Revlimid.  So I did.  The good news is that I won't have to keep shelling out an average of over $900/month in copayments for the Revlimid.  However, what am I going to do without my blankie?

Since I'm now off the Revlimid, I will no longer have to go back to Dana Farber on a monthly basis for blood tests and checkups.  However, I will still continue to have infusions of Zometa every 3 months for my bone health.

While I was with Dr. Richardson, I asked him whether he considers me to be high risk regarding COVID-19 due to the MM.  He was very encouraging about that, as I am in remission and my immune system is not compromised.  Of course, I still have the age factor to deal with.

Hopefully, I will update this blog within a reasonable time frame to let you know how I am faring with this new normal.  I guess we will all have to adjust to a new normal with this Coronavirus.  Stay well!

I'm Back

I have been subtly reminded (well, maybe not so subtly) that it has been over 4 months since my last post.  I confess.  It's true.  What can I say?  Time just flies when you're having fun, right?

Well, maybe it hasn't been so much fun.  There have been some major changes in my life that have nothing to do with MM.  Gretchen and I are now separated.  There!  I said it.  I didn't really want to address this in my blog, so I have been procrastinating on updating my posts.  But I couldn't really go on posting and pretending that everything is the same as it was could I?  I suppose I could have, but that wouldn't really have been fair to you, my loyal (?) readers.

Suffice it to say that I am now living in an apartment in Salisbury, MA.  As they say, stuff happens (or words to that effect).  It is a difficult time, but I'm glad go say that I will be celebrating Easter Sunday dinner with the family as usual and partaking of our traditional smoked lamb, along with other delicious accompaniments.  I'm looking forward to that.

Normally, at this time of year I would be raising funds for the Boston MMRF 5k Walk/Run to be held on April 28.  I am very proud to note that over the past three years, Team Epic for Bill has raised about $30,000 to fund Multiple Myeloma cancer research.  For that, I am very thankful for the generous contributions from my family and friends.  For those of you who contributed, I am very grateful.  However, given the recent changes in my life, I have decided not to continue the fundraiser this year.  However, I would still encourage you all to contribute to the MMRF in support of this worthy cause.  Here is a link to the website if you care to make a donation:  https://walkrun.themmrf.org/boston.

Grandpa with Khoren

I'm happy to report that Jeff and Christine welcomed a new baby boy into the family in February.  His name is Khoren.  As you can see from the picture, he's adorable!  To add the the excitement, Holly and Ryan are expecting a baby girl due to be born in October!  What an embarrassment of riches!  I'm so happy for them all.

As for me, I am still continuing on my amazing journey of remission from my MM.  It's closing in on 8 years since my intial diagnosis.  So far, so good.  I'm biting the bullet and paying the $730 monthly copayment for the Revlimid, but as long as it works, it beats the alternative!

I'm still volunteering weekly at Habitat for Humanity.  I'm becoming a bit of an expert in plumbing (which I used to hate), having helped to install six heat/hot water boiler systems to date.  I'm feeling like I could do that in my sleep by now.  My next adventure with Habitat will be to help build houses in Romania for 10 days in October.  That should be fun!

I'll end this as Jimmy Durante used to say, "Goodnight, Mrs. Calabash, wherever you are".

Richardson Visit

Last week I met with Paul Richardson and his fellow, Tom Garcia, to discuss my options for Revlimid maintenance going forward.  This is the first time I had met Tom, who has worked with Paul for the last 3 years.  He was very impressed with how well I am doing.  One area I discussed with Paul was whether an MRD test would be clinically useful in determining whether or not I should remain on maintenance therapy.  His answer was no, because there have not yet been any clinical trials to demonstrate any advantage to discontinuing maintenance for MRD-negative patients.   I was not at all surprised that he strongly recommended my continuing with the Revlimid maintenance.  In other words, if it ain't broke, don't fix it!  Paul was also very upbeat about all the new treatment options now available once I eventually relapse.  It was a good discussion.

For any of you who are concerned that I might choose to stop taking Revlimid because of the cost, rest assured.  I'm not going to do that.  Life is too precious to take any gambles like that, regardless of cost.  Yes it's expensive, but fortunately I can deal with that.

In the process of preparing for our meeting, I did some research on new myeloma results presented at the recent ASH conference held in early December.  One paper in particular I found quite interesting.  Here is the link:  Revlimid, Velcade, and Dexamethasone, Followed By Stem Cell Transplantation, Yields Deep Responses And Considerable Overall Survival In Newly Diagnosed Multiple Myeloma.

This paper describes my treatment regimen almost exactly, although I was on the oral MLN-9708 instead of the infused Velcade for induction therapy.  You may recall that I am considered a high-risk patient because of my t(4;14) translocation chromosomal abnormality.  Not only that, but I also have the IgA type myeloma, which is more aggressive than the more common IgG myeloma.  Those were two things not in my favor at my diagnosis.

Two results from this study got my attention.  First, the median duration of remission of patients following stem cell transplant was only about 2 years!  That stunned me.  Here I am almost 7 years later still in remission.

The second result in this study was that the median overall survival of these patients was 8 years, but for those patients with one or more high-risk chromosomal abnormalities, the median overall survival after the stem cell transplant was only 5 years!

Obviously, I have been taking this way too much for granted.  The stark reality of my situation has suddenly crashed down on me.  I've been living on borrowed time.  I am one extremely lucky dog.  Every single day that I remain disease free is a gift.  It's up to me to make the most of it.

Sticker Shock

I've been a really lucky guy.  I have been in remission from multiple myeloma for over 6 years now.  One of reasons may be that I have been fortunate to be on a clinical trial that has provided me with continuing maintenance using the drug Revlimid on a daily basis free of charge over that time.  As you may know, Revlimid is an exorbitantly expensive drug, one of the most expensive in the world.  Lucky me.

Well, my luck is about to change.  I just found out yesterday at my monthly Dana Farber visit that the clinical trial I am on is terminating at the end of this month.  That means from now on, I will have to pay to continue with my Revlimid maintenance.  That's not good.

After my initial shock, I came back home to determine what financial effect that would have.  I am in the process of reviewing my Medicare Advantage Plan options for next year, and I have to make a decision by December 7.  I looked at my options on the Medicare website and added Revlimid to my list of drugs.  That was an eye opener!  Fortunately, I have an Advantage Plan.  If I only had Medicare Part B, I'd pay list price and my out-of-pocket cost of adding Revlimid would be about $300,000 next year!  Holy crap!  How could anyone other than the super rich ever afford that?  With the Advantage Plan, my expected out-of-pocket costs for Revlimid will be a "mere" $14,000 next year.  Whew!  I guess I should be happy, but I'm not.  That still comes to about $40 per day.

Celgene has the world by the balls and has consistently increased the price of Revlimid over the years to its currently stratospheric levels.  They have been able to do this by cleverly holding on to their patents by requiring monthly surveys to assess safety in using the drug (because it can cause birth defects).  Good for them...bad for us.

I don't think that I will qualify for any of the financial aid plans that are available out there, because I'm pretty sure I will be over the income limits.  I may look into this, but I'm not hopeful.

Now I have a decision to make.  Do I want to keep taking Revlimid at these prices and hope that I stay in remission?  How important is it that I continue to do this?  Maybe I will relapse even if I do continue to take it.  Maybe there is some other maintenance drug that is less expensive and might work.  Maybe I'm actually cured and don't need it any more.  Or maybe treatment options have improved so much over the last few years that even if I do relapse, my survival chances are good.  At what price to I decide take a chance by stopping the Revlimid?  These are important questions for me.


Today I scheduled an appointment with Dr. Richardson on December 11 to discuss these issues.  One of the things I want to discuss is how deep is my remission.  Some patients have reached a state of Mimimal Residual Disease (MRD), where less than one in a million cancer cells can be detected.  In that case, treatment options are much more flexible than with less stringent conditions.  In fact, there are some who say that a response of that level represents a "cure" for MM.  I was never tested for MRD (my remission was based on the standard test of less than one cancer cell in a thousand).  I had asked Paul last year about getting tested for MRD, but he told me it wasn't necessary since I was on a continuing maintenance protocol.  Well, I think that has now changed, right?.  I may ask him to test me for my level of remission.  If I can show that I am in MRD remission, why do I need to spend $14K a year on an exorbitantly expensive maintenance drug?  Inquiring minds want to know.

I'll update this blog once I have some answers.

Sword of Damocles

I'm going to start this off with a good story.  For the past seven years, I have been getting infusion therapy for my MM at Dana Farber, most recently with Zometa (bone building) infusions every 3 months.  For all this time, Heather has been my primary infusion nurse.  She has been a constant presence in my MM journey, and I have gotten to know and care for her.  She has been one of the constants in my Dana Farber life.  She is young and attractive and has had a constant progression of boyfriends over this time, none of whom have worked out very well.  We used to talk about how she was doing with her latest fling during my infusions.

Finally, she kissed a frog, Jeff, who turned out to be her prince!  She lives in Brookline and they got engaged last fall.  The wedding date was July 21.  Gretchen and I had recently been to a very nice Spanish tapas restaurant in Brookline, the Barcelona, so we thought a gift certificate for there would be a nice wedding gift.  In my July visit to the Farber, I left her with a card and the gift certificate.

Last Monday, I was at the Farber for my checkup and Zometa infusion.  Heather was my infusion nurse again, as I had hoped.  As I sat in the chair waiting, she walked in and asked, "Did you know that the Barcelona was where we had our first date?"  No, I didn't know that, but it was so perfect!  They had used our gift and gone there for dinner the Saturday before, and the staff, hearing their story, treated them to free dessert.  That was nice.  Some things just seem to work out.

Now what about this Sword of Damocles thing?  For those of you who don't know, the Sword of Damocles is a story about an ancient king who had an pandering admirer, Damocles, who envied his power and opulence.  The king offered to exchange places with him for one day, so he could taste that fortune firsthand.  Damocles quickly accepted, but as he sat on the throne, the king arranged that a huge sword hung above the throne held only by a single horses hair.  Realizing that with great power comes great danger, Damocles quickly relented the throne.  

In today's world, the Sword of Damocles is used more generally to denote the sense of foreboding engendered by a precarious situation, especially one in which the onset of tragedy is restrained only by a delicate trigger or chance.

I've been living under the precarious shadow of a potential relapse now for over seven years.  I've been dealing with this on a month to month basis for a long time now.  Every month, my blood test numbers have been coming back positive, which is great!  Only that delicate horse hair has kept the sword at bay.

The question is how have I been dealing with this.  I have not been consumed by a sense of foreboding, as Damocles was, but why not?  Aretha Franklin died today at an age of 76.  She was a legend and left an enormous legacy.  I am 75 years old now, and if that single horse hair should break sometime soon, what would I leave as a legacy?  That bothers me more than the thought of my mortality.  Am I to leave this world as a better place?  Have I done enough to compensate for my sins along the way?  I don't know.

When that sword finally falls, as it must, can I hold my head high and say, "I tried, I really did"?

Habitat Trip

Last weekend, we attended a birthday party for one of our friends' daughter, Annabella.  She was a lovely young lady celebrating her 6th birthday.  Now it's my turn.  Today is the 6th anniversary of the stem cell transplant that gave me my new immune system!   I call it my "second birthday".  Happy Birthday to me!  (I've decided to forego the cake and candles.)  Since that day, my new immune system has served me very well.  Today I was at Dana Farber and got confirmation that I am still in remission from my Multiple Myeloma.  I am a very lucky man.

Team Epic for Bill

One of the reasons that I am doing so well is because of the extensive research conducted on finding a cure for MM.  The Multiple Myeloma Research Foundation (MMRF) has been instrumental in bringing many new therapies to bear on MM.  Two years ago, my daughter-in-law, Pam, started "Team Epic for Bill" as a fundraiser for the MMRF Team for Cures 5K Run/Walk event in Boston.  We were fortunate to raise over $10,000 each year, and it has been a wonderful event.  This year, we are raising funds again for this event, which will be held at Carson Beach, South Boston on April 29, 2018.  I invite you to come run or walk with us that day.  If not, I would appreciate any donation you could make to this worthy cause.  Please check out my website at  https://walkrun.themmrf.org/boston18/BillOHalloran.  Thank you in advance.

As you probably know, I have been volunteering with the Merrimack Valley Habitat for Humanity (MVHFH) In Lawrence, MA for the past 3 years or so.  So far, I've been involved in four building projects, most recently on new duplex housing for low-income families.  It has been very rewarding, as well as a great learning experience.  I have worked on various aspects of house construction, from framing to flooring to sheetrock installation and mudding to insulating to vinyl siding to painting, and finally, to plumbing.  For the last year, I have been mostly doing PVC drains and vents, water and heating components, and especially heat and hot water boiler installations.  It's kind of amusing that I am now pigeon-holed as a "plumber", since plumbing was one of the things I hated the most when working on my own house!  Go figure.  Anyway, I'm having fun.

Two weeks ago, I had the privilege to visit the Dominican Republic for a week with some of my compatriots from the MVHFH to help build houses in that country.  We spent Saturday night in the capital, Santo Domingo, and then took an interesting walking tour of the Old Town the next morning.

Group picture in Santo Domingo

We then took a 4-hour bus ride (driven by a kamikaze driver with a death wish) west of the capital to San Juan de la Maguana, which was out base of operations for the next 5 days.  Those in the front of the bus compared it to a theme park thrill ride.  I was in the back, so I tried to sleep.

Ready to load the mixer

Monday we visited a cement factory, where we spent the day building concrete slabs, which serve as wall components for many of the low-income houses that are built there.  As you can see from the picture, Randy and I were hard at work shoveling sand and gravel into the cement mixer.  That was my job for the day.  Actually, this picture was taken before we even started, which may explain why I'm smiling.  It was hard but satisfying work.

The building process is interesting.  Most of the Habitat houses are only about 800-900 square feet with 3 or 4 small rooms. House walls are constructed from these pre-formed concrete slabs, which are slid into aluminum upright channels to hold them in place.  Once the concrete foundation is poured, it only takes a day or two to complete the walls.  The roofs of these minimal houses are usually metal.

Peter ready to shovel concrete

Tuesday was our hardest day, which involved pouring a concrete roof on a cinder block house.  This process was amazing.  The concrete was mixed on the ground and then poured onto a wooden slab.  Two people then shoveled it up to an intermediate platform, and from there, it was shoveled up into a wheelbarrow to distribute it to the roof.  This picture shows Peter, one of our volunteers, bravely about to take a turn shoveling.  A few of our stronger guys did this duty for about 5-10 minutes or so, but the local laborers were amazing in their ability to do this work almost all day.  I was very impressed with how hard these local laborers worked and for very minimal wages.  As for me, I stayed on the ground and shoveled sand into buckets to keep feeding the cement mixer.  I found that to be hard enough.

House before we started

The next day we spent building a concrete floor for a small house.  Here is the before picture of this shabby dwelling.  We had to remove all the items before starting, which included a chicken nesting her eggs in a corner with a rat behind her.

The family included 3-4 generations living in two small units.  Rosa, the matriarch was well into her 80s, while the youngest children were grade school age.

House when we finished

Pouring of the floor took all day, although it took a while to get started.  We didn't have a close source of water to mix the concrete, so they had to take a truck with a water barrel about 5 miles away where there was a river, and used buckets to fill the barrel from the river.

The Dominican laborers were very good at installing and smoothing the concrete floor, and it looked great when it was done.  The next day, we split the group up.  One group went to another house to pour a floor, and I stayed at this house to paint the inside.  It would have been great to have a paint sprayer, as the concrete walls were rough and full of holes and gaps, but we did the best we could with rollers and brushes.  Anyway, the place looked pretty nice when we were finished.

Rosa and me

The family was very grateful for the work that we did.  This was a family in what we would call extreme poverty, but they seemed to be happy and healthy.  I'm not sure how they survive in these conditions, but they do.  We bought the family new mattresses to replace the old ones you can see in the picture.  They were thrilled.

I have to say that it was an extremely satisfying and rewarding experience to be able to help this family live with a concrete floor instead of mud and to brighten their domicile with some lively paint.

On our last day, we also painted another house in the same region, where our other group had poured the concrete floor the day before.  This was a very large family living in a small 4-room house.  They had lived on a mud floor for the past 20 years until we arrived.  Again, this family was exceedingly grateful for our efforts.

I have to say that this was one of the best experiences I have had.  I learned so much about their building methods, their culture, their living conditions, and their people.  It was gratifying to be able to contribute some small amount to improving the lives of some of these families.  I hope I will be able to go on one of these Global Build adventures again before long.