{"id":87,"date":"2009-02-21T20:49:20","date_gmt":"2009-02-22T01:49:20","guid":{"rendered":"http:\/\/blog.larrygauthier.com\/?p=87"},"modified":"2010-03-25T15:51:12","modified_gmt":"2010-03-25T20:51:12","slug":"chemo-maintenance-%e2%80%93-end-of-cycle-19","status":"publish","type":"post","link":"http:\/\/blog.larrygauthier.com\/?p=87","title":{"rendered":"Chemo maintenance \u2013 end of cycle 19"},"content":{"rendered":"

<\/span><\/span>March 22nd<\/sup> 2009 is the second anniversary of my cancer diagnosis. Incredible to look back and review all of this experience, consider how our lives have changed, and to recognize everything that has stayed pretty-much the same.<\/span><\/span><\/strong><\/p>\n

<\/span><\/span><\/p>\n

In general, things are going quite well and I am feeling pretty good. I\u2019ve gotten to the point where I\u2019ve accepted my physical limitations and know how hard I can push myself and when I just need to sit back and say \u201cno, I cannot do that.\u201d<\/span><\/span><\/p>\n

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<\/span><\/p>\n

MULTIPLE MYELOMA STORY ON NATIONAL PUBLIC RADIO<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

In January NPR ran a short segment on Multiple Myeloma. You can read it or listen to it at:<\/span><\/span><\/p>\n

http:\/\/www.npr.org:80\/templates\/story\/story.php?storyId=99970093<\/span><\/a><\/span><\/p>\n

\n

<\/em><\/span><\/span><\/p>\n

Be sure to read all of the\u00a0 comments from patients and patients’ families – those are as interesting and informative as the article itself. <\/em><\/span><\/span><\/p>\n

\n

This information parallels the very latest info that the folks at UofM are telling us. Two years ago everybody was getting Bone Marrow Transplants; today new patients are less likely. (although many still do – must be related to the stage of their disease. _I_ for one sure wished I\u2019d avoided the BMT) Two years ago the UofM folks predicted a 5 year median survival rate; now they are saying “many years.”<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

The article mentions thalidomide as the drug-of-choice in fighting this disease. My chemo drug, Revlimid, is a thalidomide derivative.<\/span><\/span><\/p>\n

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NEWS FROM MY CLINIC VISIT<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

At the end of cycle 19 we met with Dr. J and Christine (Tara took time off to get married) to review my labs and discuss any necessary changes in treatment. There were no surprises in my lab work, and I really didn\u2019t have any ailments to report to Dr J. He talked to me about two things:<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

First, after this length of time Revlimid starts affecting a patient\u2019s digestive system and they experience \u201cloose bowels\u201d and\/or constant diarrhea. When that happens he told me that they can prescribe pills to counteract it. Fortunately there has been no evidence of that problem yet.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

Second, I\u2019ll get only one more infusion, in March, of the bone-strengthener Pentamidine. I have been on that medication for 18 months and that is the maximum recommended period before the drug starts damaging other organs \u2013 particularly the liver and kidneys. He ordered a Bone Densitometry scan (a fancy x-ray) which will set a baseline so that we can monitor how much and how fast my bones deteriorate without that drug. I\u2019m not really sure what we do when that happens \u2013 guess we cross that bridge when we get to it.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

MEDICATION CHANGES<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

Aside from the previously-mentioned discontinuance of Pentamidine, my drug list is unchanged. I only pop 5 pills a day.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

I received my second round of immunizations against all the regular childhood diseases. I have one more batch to go, late this year, before I am fully immunized.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

SIDE EFFECTS<\/span><\/span><\/p>\n

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Neuropathy \u2013 No change from my previous report. This at a stable state \u2013 no better, no worse. Some individual days are better than others depending on where I am in the 3 week chemo cycle, but it\u2019s been so long since my feet felt \u201cnormal\u201d that my brain just ignores my feet most of the time.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

Neutropenia \u2013 My chemo drug Revlimid reduces WBC (White Blood Cell) and ANC (Neutrofill) counts, key indicators of the strength of my immune system. Normal ANC counts range from 2 to 7 million cells. Last summer when my counts dropped below 2 I\u2019d be instructed to go the refrigerator and give myself an injection of Neupogen. This January when my count dropped below 2 they shortened the time between lab work to watch me more closely and see if my body would correct itself. Over a three week period things got kind of spooky: 2.1, 1.7, 1.4, 1.1… But then ANC started climbing without medical intervention: 1.4, 1.7\u2026 not back to normal yet but getting close. We don\u2019t know what happened to me that the numbers fell so low, but we are pleased that I was able to recover by myself. [Of course, with my ANC count at 1.1, advice from the medical staff was that I needed to be extremely careful when out in public places or visiting anyone.]<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

NEXT STEPS<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

Things are going to be downright boring the next few months: daily pills, monthly blood tests, one final Pentamidine infusion, quarterly visits with the medical staff.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

Unless something goes wrong, my next blog posting won\u2019t be until May.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

That\u2019s the latest news from Hamburg.<\/span><\/span><\/p>\n

<\/span><\/span><\/p>\n

-larry<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

March 22nd 2009 is the second anniversary of my cancer diagnosis. Incredible to look back and review all of this experience, consider how our lives have changed, and to recognize everything that has stayed pretty-much the same. In general, things are going quite well and I am feeling pretty good. I\u2019ve gotten to the point […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[10],"tags":[],"_links":{"self":[{"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/posts\/87"}],"collection":[{"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=87"}],"version-history":[{"count":8,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/posts\/87\/revisions"}],"predecessor-version":[{"id":124,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=\/wp\/v2\/posts\/87\/revisions\/124"}],"wp:attachment":[{"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=87"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=87"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.larrygauthier.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=87"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}