The Myeloma Kid

The Ongoing Saga of Stem Cell Collection: Ok, so being 6'4", 225lbs aint good for stem cell collection. Apparently, the bigger you are, the often-times harder it is to collect stem cells. I was suppose to collect between 2 and 6 million stem cells for the bone marrow replacement. It generally takes +/-3 days. But, I was only collecting between 200k and 300k at a time. I was into my second week of collection. It's not hard. I lay in bed for 3 hrs reading the paper or doing crosswords. It was my new job. I'm out of the house by 7am, in Philly rush hour traffic, and back in bed my 8am...lol. However, the collection was going too slow. I only collected enough stem cells for one transplant (2 million). And the Doctors have stopped the collection process. So now, the inevitable - as I was figuring all along - It means all the good news about omitting procedures and not needing therapies will actually have to occur. It's going to be a busy March and April. I'm scheduling the arm fistula for March 8th. The Cytoxan chemotherapy (to help the second round of stem cell collection) will be schedule the week or so after. This is an overnight stay at the hospital and it's where I get to have a catherter inserted in places I don't want them inserted. I get to lose all my hair and have all sorts of fun side effects. Then during the next 10 days, I will again give myself neupogen shots. Then, the stem cell collection process will begin all over again. Some time in early April I will go into the hospital for the actual Bone Marrow Replacement. That starts with an even bigger and higher dose of chemo called Melphlan. It takes an hour to inject and week for the side effects to come out. It's basically poison where they give you just enough that it kills everything inside of you, but's just short of killing you. It'll be at least 3 weeks in the hospital. During that time they will begin the transplant process and re-enter my collected and clean stem cells back into my body. Hopefully everything is done by May and the beginning of the nice spring and summer weather. Ok...So I'm not really looking forward to doing any of this. For the longest time I think I've been ignoring it. I think that's what has lead to my over anxoiusness, increasing anger, sleepless nights, etc. I really didnt want to admit I was sick. And getting the fistula and having the chemo and the side effects was the reality check I've been avoiding. But, there will no avoiding it. It's the best case for remission. And, I've been hearing a lot positive stories about people in remission lately. So, I guess it's time to get everything done and stop waiting. So, I again thank everyone for their help and support. Keep the positive vibes going. You'all are in my thoughts and prayers each day. Love ya's, Lance

A Status Report: Not too much to report. No big epiphanies this week. No words of wisdom. Just a note on where I'm at. I've started the stem cell collection process. And it started with me given myself my first 8 neupogen injections. I'm not too bugged by needles. But, there's something not right about given them to yourself. I think it goes against that self-preservation mechanism, "Thou shall not hurt thy self". Anyway, I was giving myself two shots each day in the belly ("Get inside my belly!"...Austin Powers). And now I've started the actual stem cell collection process. It's no big deal. I lay in a bed for 3hrs while they circulate my blood. But, the kick is that the Neupogen shots make your bones and back ache. And, I can't lay still for 3hrs. That also means sleeping aint going real well either...if at all. And what I thought was going to be a 3-day treatment may be more now. Apparently, most people have a stem cell level near 100. Mine was 7. That gives them an idea how long the process is going to take to collect between 2 to 6 million stem cells. So, it may now last into next week. It makes for a long day. Up early into Philly for the stem cells. Stop back at the cancer floor for my Neupogen shot (they now can't let me do it for some reason) and then onto dialysis M W F. Did I tell you I can't wait til I can get a break????!!! I'm looking out the window now and I see chunks of ice floating down the Delaware River and wet, slushy snow caked onto the streets. If that isnt a reason to find someplace warm than I don't know what is. Take care everyone. And thanks again for all the help and support. Love ya's, Lance.

"Excellent Partial Remission": Those were the words that the oncologist used on Thursday to describe my current health. Incredibly ambiguous, yet incredibly good news. It means that my kappa light chain counts have remained low and I've responded well to the chemotherapy. The partial part of it is....well....the multiple myeloma will always be with me. There is no cure. But, for now we have the upper hand. So, what does this mean? It means that I may not have to go through with the bone marrow transplant just yet. It means that I may be healthy enough to continue a chemotherapy maintenance program consisting of steriods and/or in conjunction with my Velcade. Our path-forward at this point will consist of doing more blood tests to ensure my numbers are and remain low. In addition, we will prep for the bone marrow transplant. I will take Nupagen shots (I get to shoot myself...oh boy!) within the next week to boost my red and white cell counts and to coax the stem cells into the blood stream. If all goes well, we will begin to harvest my stem cells on 2/13. It's scheduled for 3 days and really only requires me to sit still for a few hours each day. (They may be able to use my dialysis catherter to collect the stem cells). We will continue with the preparations for a bone marrow transplant for early March. However, should the numbers remain low, then there's a good chance that we can hold off with the transplant until some future date; 1 month, 1 year, 5 years...who knows? The stem cells can be cryogenically preserved for however long they need to be kept. So, this way we at least the cells are collected when I am relatively healthy (kidneys aside) and they can be ready if (when) I need them. The decision to do or not to do the bone marrow transplant isnt as straight forward as it sounds. The oncologist indicated that studies have shown that people who complete transplants earlier tend to live longer. However, he caveated this statement in my terms of me having recent heart surgery and the fact I'm currently on dialysis. And, my conditions may (or may not) complicate the transplant proceedings. However, in my words....I feel pretty good right now. I'm responding well to the treatments. My quality of life is relatively good. So, I can't see pushing for a bone marrow transplant to get to "some" point afterwards that may be yet an unknown. There are no garrauntees that my quality of life, or my health, or my condition will be better after a bone marrow transplant. Who knows....all this talk may be for nothing when I get my recent tests back and show that I better get the transplant now. So, we'll see. I'm also going to look into home hemodialysis. It's where I can conduct my own dialysis each night for a couple of hours rather than having to go to a clinic for 4.5 hours 3x a week. Courses on operation and care are provided. This way, I again have a chance to improve my quality of life. It may give me the ability to resume work and resume patterns of life that I so desparately want to be a part of. So, it's good news. I may get a chance to actually relax for a bit. I may yet again be able to trust my body for a while. And, I may yet again golf....yeah....the Doctor gave me clearance to golf (and other no-impact activities). So, anyone near a golf course should be very afraid (on the course, no....near.....yes....I don't hit them very straight...lol). Thanks again to everyone. I hope everyone is doing well. Love ya's, Lance