April 2011 - Induction - Cycle 3 - Day 4

Boy I have been crabby the last two days and I know it, seems the more doses of steroids I get in my body the harder I crash. Bless my family for dealing with my crabbiness. The good news is I should be at the bottom of my crash this week and ready for a great weekend.

Back to the clinic today for another injection, while I was there I also picked up some more blood test results. The doctor has not presented these results yet, but I was curious. So here are the unconfirmed results. The blood test I was waiting for was the Lamba Free Light Chain, originally this test was high (7350), the normal range is 5.7 - 26.3. The "unconfirmed" test result from last Monday's test was 17.9! These are some powerful drugs.

Blood test results were pretty good also.

WBC	4.5	Up
Grans	2.8	Down
Hemoglobin	13.6	Down
Platelets	225	Down

It is expected that these numbers would be going down due to the treatments, so no real surprises.

April 2011 - Induction - Cycle 3 - Day 1

Well here we are at cycle 3. We met with the doctor at 1:00 today and I was not sure what to expect at my doctors appointment and was a bit nervous which my blood pressure reading validated this fact; though by the time I received my treatment by blood pressure was back to normal. I also gained 1 pound, which I was told not bad with being on steroids. I was also cleared to play tennis, jog and do pretty much anything I wish, the doctors word of caution was to not hit take an injury to the head. I still need to stay away from sick people, guess who was sick today, you got it the doctor. Wasn't sure if I should have put on mask or ask him to, there was no hand shaking today he said he will shake my hand twice next visit.

Here are test results...Drum Roll Please...Kidney and liver functions are stable. The 24 urine analysis showed no proteins, this number was 4gm when I started and was one of the factors leading to my diagnosis. I said to the doctor that is good news, he corrected me and said that is excellent news, the disease is not detectable in the urine anymore. I asked if I was in complete remission, he did not go as far to agree with this statement, yet. The doctor also did a Freelite test last week, which he did not have the results yet, this test tests for free light chains (fragments of monoclonal proteins) in the blood. This test originally was high (Lambda Light Chain) with a result of 7,350mg/L when the normal range is 5.71 to 26.30. For my next visit he is ordering a Serum Protein Electrophoresis test to check for monoclonal proteins in the blood, similar to the urine test but checks the blood; this test was originally normal. But I believe the reason the test was normal was due to the fact the kidneys were dumping the proteins into the urine. Since the urine shows no indication of the proteins he wants to make sure they have not entered into the blood (I was not smart enough to ask this question when we met with the doctor, but it dawned on me when I was writing the blog entry). We hope all of these tests provide the same result as the urine test.

So what does all this mean? My local doctor will be talking with the doctor that will be doing the stem cell transplant to see if Cycle 4 of treatmenst is needed. If they agree Cycle 4 is not needed then they will be moving up the stem cell transplant. I kind of think why not continue with Cycle 4 to maybe blast out a few bad cells that might be undectible in tests. Though that might just be me conscious trying to put the stem cell transplant off for four more weeks.

Blood test results were pretty good also.

WBC	4.2	Up
Grans	3.8	Up - Almost to 2003 Levels
Hemoglobin	14.2	Up
Platelets	274	Up - Past 2003 Levels

Thanks agains for all the prayers, cards, thoughts and positive energy.

April 2011 - Induction - Cycle 2 - Day 28

Back to the clinic today for the blood draw, CBC is looking good to me.

WBC - 3.4 (Up)
Grans - 2.9 (Up)
RBC - 3.81 (Up)
Hemoglobin - 13.5 (Up)
Platelets - 269 (Up)

All numbers are going up, at a much more rapid rate than Cycle one, I believe this to be good news. I will get the rest of the test results and my doctors thoughts next Monday. All in all today was a good day.

They also tested my INR today, which is used to determine how thin my blood is, 1.7 was the result. The doctor wants this number between 2.0 and 3.0, so it time again to change the dosage of my Warifin.

Okay I realize that many people reading the blog might not know what these numbers mean, and if I read these numbers a year ago they would not mean much to me. So I will do my best to explain them the best I know.

Definitions
WBC is white blood cell count, white blood cells defend the body against infection. There are many types of white blood cells including neutrophils (grans), lymphocytes, monocytes.

Grans / Neutrophils are a type of WBC, grans are responsible for fighting infection. When this number is below 1, then special precautions are taken, such as no fresh fruit or vegetables, all meat must be well done...stay away from crowds and sick people.

RBC are red blood cells, red blood cells pick up oxygen and carry it the body's tissues.

Hemoglobin this is the part of the red blood cell responsible for carrying the oxygen to the tissues / organs. If this number is too low, it causes fatigue and loss of energy and other complications.

Platelets are a type of blood cell that helps the blood to clot. If this number is too low bleeding and bruising could happen easily. If it is really low (below 10) bleeding can happen for no apparent reason.

Reference Ranges
Keep in mind that different labs can have slightly different reference ranges and reference ranges are different between males and females. The ranges I listed below are the ranges on the paperwork I receive from my Hematolgist. These ranges give a good indication of how treatments are going. The more diseased cells destroyed the more room in the bone marrow for normal cells to grow. Keep in mind the ranges and numbers I post represent thousands so 4.1 is really 4,100 white blood cells in a sample.

WBC - 4.1 - 10.9
Grans - 2.0 - 7.8
RBC - 4.2 - 6.3
Hemoglobin - 12.0 - 18.0
Platelet - 140 - 440

I hope you enjoyed todays lesson on blood.

April 2011 - Comments Welcome

Feel free to leave any comments or questions you might have. I have made it easier to leave comments allowing readers to leave comments as anyomous, this way you don't need a google or other account to post a comment.

To leave a comment just click the comment hyperlink at the end of the post and type away. Then click Post Comment. Once you click post comment, you will have to enter a word verification and then click the Post Comment again to have your comment posted.

Give it a try and post a comment and tell me hello if you read this post.

April 2011 - Induction - Cycle 2 - Day 21

My week off of being a human pin cushion ends tomorrow; though the needle sticks in the arm really hasn't bothered me; back to the clinic for a blood test tomorrow. I was reviewing my blood tests from cycle 2 and so far the WBC has climbed every time I had my blood tested in cycle 2, so I do have some high expectations for tomorrow's blood test. I expect my platelets to be down since two of the medications I am on reduce platelet production. I believe there will be 4 vials of blood drawn tomorrow, 4 different tests.
- CBC
- INR - Blood thinner
- Chem - Kidney, Liver...functions
- Free Light Chain - Checks the lamba and kappa light chains, the original test was really out of whack, hoping for better numbers.

Anyone every complain about peeing in a cup? Try a 24 hour urine test, when you pee in a jug for 24 hours, and the jug has to be kept cold. Not only do I get to go to the refrigerator for a drink, but to expel the drink also. I get to start this test tomorrow. I did one of these a few months back, which led to my diagnosis. The test showed high monoclonal protiens, the test that starts tomorrow will show how well the first two cycles of treatments are going.

Well it was a pretty good weekend despite the weather. Down to just one medication this week, just the steroid.

April 2011 - Induction - Cycle 2 - Day 17

Nice day today, the weather was good and was able to get out for a walk. The last couple days have been pretty good. Though Jane is suffering from a toothache and will have a root canal done tomorrow (Thursday), she is having a tougher time than me right now. She is in a lot of pain and on antibiotics, which gave her the chills in the middle of the night last night.

Had a call today from the Patient Coordinator from the Hospital that will be doing the Stem Cell Transplant (SCT), and have some updated information. I will complete Cycle 4 of my treatments in the Middle of June. The Patient Coordinator states the SCT usually occurs 6-8 weeks after the last treatment cycle. So, here is a tentative schedule on how things will occur. After cycle 4 is complete, it will be test time. Another bone marrow aspiration, heart test, lung test, blood tests, skeletal survery...and any other tests the insurance company requires. All of these tests can be done at the local hospital. Then around the beginning of July I will meet with the involved parties at the hospital. At this time the hospital will also submit all the necessary paperwork to the insurance company for approval. This sets the SCT process to start around the middle to end of July.

Below is some additional information from the Patient Coordinator:
- While in the hospital I will get to walk the halls 4 times a day
- Most people are only in the hospital two and half weeks
- Only one day / dose of high chemo, possibly as out patient then check into the hospital the next day to start the proces.
- I can bring my computer and the hospital has wireless Internet access.

I have had a lot of offers of blood donations in my name (thanks for all the offers), so I brought this up with the patient coordinator, and only platelets can be directed to a patient. Platelets only have a 5 day shelf life and would have to be donated directly at the hospital. There is some type of virus check against the platelets and if the donator has had a virus that I have not, then they can't be used (I think I understood this right).

April 2011 - Nice Weekend

Starting to recovery from my down days of last week.  The good weather helps with this and being able to be outside.   Looking forward to hopefully two good weeks before Cycle 3.  No scheduled doctors appointments or blood tests this week, first week I have had off in about 6 weeks I think. 

A rash has started on my arms, not sure if this is caused by the medications or the heat (unseasonably warm this weekend) or something else...the rash seems to come and go.  

April 2011 - Induction - Cycle 2 - Day 11

Back to the clinic today for my last injection in cycle 2. CBC counts so far are holding strong for this cycle.

WBC - 3.2 - Up a little from Monday
Grans - 1.9 - Down a little from Monday
Platelets - 102 - Down from Momday but expected.

I had a lot more energy during cycle 2 treatments, though both the doctor and nurses told me I would probably have less energy. Energy levels were pretty good up until yesterday and today, though I think the steroids might be partially the cause for energy loss.

Now my body gets two weeks to rest and rebuild before cycle 3 begins. As each cycle completes I am one step closer to the stem cell transplant; which the more I read about the less I look forward to it.

April 2011 - Induction - Cycle 2 - Day 8

The weather her yesterday was nice and spring like, got out for a walk yesterday and today. Not 100% sure the walks are having a positive impact on my treatments, but at this point in time I am going to say they are helping my counts. I also switched to drinking a liter of Smartwater a day, which is plain water enhanced with electrolytes. I started this last week and maybe that has an impact on my counts also? I spend a lot of time on the Internet searching and reading and if I find something that seems simple to try, that might help, I run it past the nurses or doctor and try it out. Sometimes I think the nurses and doctors think I am crazy, but nobody cares more about me than me. Spending time on the internet can be a very scary, sometimes it can play be a roller coaster on ones emotions, I am surprised Jane has not taken my computer away yet.

Back at the clinic today for another treatment and now what I wrote above might make more sense. My CBC test came back pretty good, I was concerned because at this point in cycle 1 my counts really took a dive.

WBC: 2.8 - up from last Thursday
Grans: 2.4 - Wow - best since 2009
Hemoglobin: 12.3- Wow - Best since 2009
Platelets: 120 - Down but expected, the drugs destroy and prevent platelet production. Just hoping the platelets stay above 50 when I am rechecked on Thursday. When the platelets drop below 50 is when extra precautions are required.

My counts might explain my increased energy level today. I actually had good energy today and was not tired at all, though Wednesdays and Thursdays are usually my down days, that is when I am crashing from the steroid. Though Cycle 1 Week 2 I was taking power naps during lunch and before dinner.

Last night I experienced a new side effect, the bottom of my feet swelled up and had an itchy rash from my ankle to the bottom of my foot. I elevated my feet and everything returned to normal. Asked the nurse about this today and she stated it could be a side affect of the drug Revlimid that I am taking and it was nothing to worry about since it cleared up quickly.

Taking the Zantac has also helped my steroid enduced hoasreness, I don't think I sound hoarse at all, though Jane tells me I sound a little hoarse.

Hope you are still awake after reading my wordy entry.

My quote for the day:

"It doesn't matter what you've heard
Impossible is not a word
Its just a reason for someone not to try".

This is a lyric from a group by. The name Kutless, song title - What Faith Can Do. It is a very inspirational song, click the link to listen: Kutless - What Faith Can Do.  I never let my girls use the word impossible, because I myself never think anything is impossible.