Sunday, November 20, 2011

November 20, 2011

Today is another 10 mg of dex day--probably will not sleep tonight.

Had a visit with O/H last Monday (11/14/2011). lab results of 11/7/2011 were in and can be compared to 10/7/2011 lab results. Kappa Light Chains dropped to 2.45 mg/dl from 2.82mg/dl(uppermost normal is 1.94mg/dl); obviously any drop is good news. M-spike dropped 10 1.3g/dl, which is a drop from the previous months value of 1.4 g/dl. Igg dropped to 1572 mg/dl from 1622 mg/dl. Uppermost normal Igg is 1554 mg/dl. In other words all of the three cancer makers dropped.

I continue to be off chemo (except for the twice weekly dex (10 mg twice a week)). Will go back to the O/H in early January.

Thursday, October 27, 2011

October 27, 2011

Today is dex day; 10 mg before 9 am. I am now on two 10 mg doses per week. Well not exactly, I take 10 mg, then wait 4 days before I take another 10 mg. Thus it is two doses every 8 days. I find that I need 3 nights of good sleep before taking another dose.

Wednesday, October 19, 2011

October 19, 2011

I came across some old blood work that I had back in December 2004, before I was diagnosed with MM. Here are the results compared with my October 7, 2011 blood work; the first number is the December 2004 results; all results are in the same units so they can cross compared.

WBC 4.2 4.1
RBC 4.2L 4.8
HGB 15.2 16.0
HCT 42 46
Plt 231 227
glucose 96 (fast) 102 (non fast)
Creatinine 1.0 1.0
calcium 8.7 9.7
total protein 7.3 7.5

Not really much difference; while it may be possible that I had MM in December of 2004; there would have been no symptoms whatsoever.

Saturday, October 15, 2011

October 15, 2013

Last week I noted that my Kappa Light Chains, collected on 9/23/2011, had been significantly elevated at 3.93 mg/dl (from 2.56 mg/dl on 8/12/2011). This was disturbing; however, the higher values came from a different lab. On October 7, the labs were repeated at the lab that I typically use. This time, the Kappa Light Chains were 2.82 mg/dl. This is not far different than the values that I had back on 8/12/2011 (2.56 mg/dl),3.26 mg/dl on 5/18/2011, and 2.68 mg/dl on 4/20/2011.

My Igg values increased to 1622 mg/dl; however, they were 1606 mg/dl on 4/20/2011.

My M-spike is now 1.4 mg/dl.

Everything appears to inching upward; but not as rapidly as the 9/23/2011 lab results suggested.

I am on dex twice a week (10 mg on Sat and Wed).

CBC values are ok wbc, total protein, creatinine,hemoglobin, hematocrit, platelet counts, neutrophils, and RBC are all in normal range.

Will see the O/H in early November; for the time being, no chemo (other than the dex) is scheduled.

Friday, October 7, 2011

October 7, 2011

Well it looks as if my 15 month reprieve from chemo may be coming to an end.

My Kappa Light Chains, which my O/H thinks are the best MM marker, increased from 2.56 mg/dl to 3.93 mg/dl. Lamda Light Chains were .56 mg/dl which also is an increase but the lower normal is .57 mg/dl.

The rise in the Kappa values is disturbing but at my O/H visit today, the following course of action was decided:
1. Immediately increase dexamethasome to 20 mg (10 mg, twice a week)
2. Do a new set of blood work to confirm if Kappa Light Chains actually are higher or whether the previous analysis is just an aberration.
3. If Kappa Light Chains actually are higher, then go back on chemo (probably Velcade on a once a week basis--higher dosages have caused me significant neuropathy).
4. If Velcade doesn't do much, consider using something different like Revlimid (Some chemo treatments become non-effective with time). On the other hand, if Velcade is reasonably effective, then continue and monitor.

I feel ok but hopefully I can nip this increase in the bud. I should have the lab results by the latter part of next week

Saturday, September 17, 2011

September 17, 2011

It has been 2 months since I last posted; labs have been more or less the same and I feel good. Right now, I have been in Poland for the past 2 1/2 weeks. Will get back to USA on the 21st. Have O/H appointment in early October. Nothing much else to say for the time being.

Saturday, July 16, 2011

July 16, 2011 (2)

I just received my statement for charges from my insurance carrier for my Zometa Infusion on 6/27/2011. I have a Medicare A, B, D plus supplemental provided by my former employer. For the Zometa Infusion, the clinic billed Medicare $3609.00, however of this, Medicare excluded $2,583.23 and only paid the clinic $976.27. My co-pay was $50.00. This included the infusion plus all of the blood work. Since this was my 25th infusion, billings would have been over $90,000 with actual payments being only about $24,400 and my out of pocket being $1250 over a 2 1/4 year time period.

While I don't like to pay more, a $50.00 per infusion co-pay is unrealistically low. Doubling or tripling the co-pay is no big deal.

American seniors are treated like royalty; and the working folks with children must bear the pain of taxation and much higher health insurance. Virtually every senior I know is living like a king taking cruises, weeks at the beach, dinner at nice places, new cars, and so forth.

Friday, July 15, 2011

July 16, 2011

Lets start with some photographs of our recent vacation to the Finger Lakes of New York. We visited quite a few wineries, probably drank to much.

Visited the H/O this past Tuesday. Kappa Light Chains are back in the normal range at 1.93 mg/dl; the upper normal is 1.94 so I am just in. My O/H believes that Kappa Light Chains are a better myeloma marker than the M-Spike. Igg was 1571 mg/dl which is slightly above the upper normal of 1554. With the exception of my WBC, which was a bit below normal, my other blood counts were normal. We have decided to stay off chemo for another 6 weeks; at that time, we will redo my blood work and reassess my cancer burden. On June 27, I had my 25th Zometa infusion, this was my 25th, and it had been 3 months since my previous Zometa infusion. At the aforementioned H/O appointment, we decided that we would discontinue Zometa for the time being. The H/O believes that since I am more or less in a stable condition; the risks of bone necrosis out weighed the benefits of increasing bone density.

However, I have had a bout of MRSA in the left elbow. This is my third event. After installing new sprinkler heads in the yard, I woke up with a swollen and painful left elbow. I immediately went to a Walk In Clinic, a culture was drawn and I was put on an antibiotic. However, it turned out this antibiotic was ineffective for MRSA and I had to switch to Doxcycline which is supposed to be effective for MRSA. My swelling has diminished and the pain is gone; however, there are still thick areas under the skin. I have consulted with an orthopedic physician that specializes in MRSA and his recommendation is to watch and wait; If it gets worse, he will see me quickly and open up my elbow and treat it with a new drug that kills MRSA on contact.

Next week I go back to north Georgia for some consulting and then on Thursday we take off to Kansas City for my cousin's 50th wedding anniversary.

Saturday, June 11, 2011

Friday, May 20, 2011

May 20, 2011

Nothing new to report. Spent last week in the north Georgia mountains, mostly drinking wine.

Went and had my blood work done in anticipation of my June O/H appointment. From the time I walked out of the parking garage to time I walked back in the garage was only 1 hour. Didn't have an appointment but I am on good terms with the folks at the clinic; thus I just have tell to run the labs and they draw the blood. Minimal paperwork.

Thursday, April 21, 2011

April 21, 2011

Today is dex day (10 mg/wk) so I probably will not fall asleep until 5-6 am; the lack of sleep is more of a nuisance that a real problem.

I went to see the H/O yesterday and got my latest lab results. BP, CDC, and creatine were all in normal range, as of yesterday. I had IGG, M-spike, and Kappa Light Chains done a few weeks ago in anticipation of this visit. Igg went up to 1571mg/dl; but this is only slightly above normal and more or less the same as it was back in November and December of 2010. M-spike went up 1.3 from 1.2; but this is the same as it was back in December. HOWEVER, Kappa Light Chains dropped 1.73 mg/dl; this is the lowest ever and marks the first time since diagnosis that the value is the normal range.

I will continue to stay off Chemo for the time being; but sooner or later, I know I will have to restart. Zometa treatments will now be quarterly instead of monthly; this is because of the marked improvement in bone density.

Presently I live a normal but somewhat subdued life.

Thursday, April 7, 2011

April 7, 2011

For the past few months, I have had aches in my right knee; went to the orthopedic doc and got a cortizone shot and have now started physical therapy; this is not related to my MM. Other than the knee, I feel good.

Saturday, March 26, 2011

March 26, 2011

Yesterday, I had my 24th Zometa infusion; CBC blood work was in normal range except for glucose. Creatin was 0.8, which is good. Nothing much else to say at this time.

Wednesday, February 23, 2011

February 23, 2011

Today is the second aniversary of my first going to the doctor for the symptoms that eventually led to my diagnosis with MM. So I guesss this is my second aniversary; although the actual diagnois cam on March 30, 2009.

I got the results of my bone density test that was done yesterday; there was "marked improvement" over the 2008 results, which were pre-diagnosis. Since there has been improvement, I anticipate that the Zometa infusions will drop to a lower frequency after the March infusion (which will be the 24th).

Zometa, after the first 2 or 3, was no big deal; but neverthless it was a once a month activity.

Friday, February 18, 2011

February 19, 2011

Visited the H/O last Monday and got results of last lab work (labs were done 2/7/2011). BP was normal but on high end (133/87). Weight was up a tad (about 1.5 pounds). WBC = 4.3 (up from last month). Hemoglobin = 15.5. Hematocrit = 45.7. Platelets = 252.0. RBC = 4.59. Creatine = 0.87. Calcium = 8.8. All of the above are in the normal range.

M-spike was 1.2 g/dl, which is a drop from last month. Igg and Kappa LC were not available. When considering that the M-spike went down even though I have been off chemo for 7 months now, I see that as a good sign. Still taking 10 mg of dex once a week; this, however, is manageable. M-spike will not stay in this range forever; so sooner or later I will go back on chemo.

I take my 23rd Zometa bone infusion on the 25th of this month. On the 22nd, I will have a bone density scan. Depending on the results of the scan, a decision will be made about continuing.

My next appointment with my H/O is the first week in April. At that time, I will have been of chemo for 9 months.

Friday, January 28, 2011

January 28, 2011

Today is dex day; so I probably won't sleep tonight. I am used to this by now.

On Tuesday, January 25, I had my 22nd Zometa infusion. Spent more time in waiting room than for the infusion; 2.5 hrs from checkin to checkout. Two more infusions to go and I will have completed my initial 24-month therapy. After that it will probably be once a quarter; this just gives me greater flexibility.

BP and blood work all fell in the normal range. WBC, however, were at the low end of normal.

Will have cancer numbers checked on 2/7/11 so that they will be available for my H/O for my 2/14 appointment. It takes about 4 days to turn around the cancer values such as IGG, M-spike, and Kappa light chains.

Saturday, January 15, 2011

January 15, 2011

On Monday (1/3/20110), I had my appointment with my H/O and I got the results of my 12/27/2010 lab work. Igg was 1564 mg/dl, up slightly from 1558 on 11/22/2010--upper normal is 1554, thus 1564 is only slightly above normal; total protein was 7.1 g/dl, normal and unchanged; M-spike was 1.3 g/dl up from 1.2 in November (it also was 1.2 last June, thus no large change); Kappa Light Chains were 2.42 mg/dl (normal is less than 1.94)--up from November but less than June of 2010. Because there were no large changes and the values were not that different than 6 months earlier, I decided to stay off chemo for another 6 weeks. I have another appointment on Valentine's Day.

On the 25th, I have my monthly Zometa; only 2 more after this on the 2-year schedule. After that, the H/O suggests every other month or quarterly. Zometa has not been a big deal after the second or third time, when I did experience some aches and minor pains.

Later that same day, I had my teeth cleaned and it was decided that I needed a root canal, which was scheduled for the next day. This was done.

On Thursday (1/6/2011), we took off for a week in Puerto Rico, where we did some snorkeling and lots of sunbathing.

Tonight is dex day thus I probably won't sleep tonight. Tomorrow, I take off for Atlanta for some business meetings.

Nothing much else to say; will keep all of you posted; but there is not much to say right now.