April 2011 - Induction - Cycle 3 - Day 11

Well it has been a busy couple days, fifth grade orchestra concert Wednesday, fifth grade open house last night...

Went for my last injection for cycle 3 yesterday, counts were down but okay. This injection went very smooth, had our favorite nurse.

WBC	5.1	Down
Grans	3.8	Down
Hemoglobin	13.7	Down
Platelets	131	Down

All counts except platelets fall into the normal category.

I have come up with many questions regarding the stem cell transplant and will be meeting with the doctor at Rush next Thursday to get these questions answered. I do so much research and have so many questions, I am glad the doctor is able to sit down with me and discuss. He knows I have many questions and has slotted a large amount of time for me. I have well over 20 questions. While visiting the doctor next Thursday he has also scheduled some additional labs.

Happy Mothers day to all the Moms have a great weekend.

April 2011 - Induction - Cycle 3 - Day 8

What a nice weekend, no rain for two plus days! Got a lot of walks in, walked 2 miles Saturday, a mile on Sunday and a mile today. Even played tennis for a half an hour on Sunday. It was nice to be out and enjoy the weather.

Back to the clinic today for another injection, my blood counts were surprising very good.

WBC	5.4	Up
Grans	4.8	Up
Hemoglobin	14.6	Up
Platelets	160	Down

All numbers are up since I started treatment except for Platelets.

Treatment Explained
I thought I would describe my treatment to give everybody a better understanding of the treatment. The doctor does not call it chemo, but the nurses do. I have two drugs injected, one is for anti-nausea and the other is a drug called Valcade (Bortezomib). Valcade is a targeted therapy, it prevents cancer cells from dividing, prevents new cancer cells from forming and causes cancer cells to die. Not all people respond to Valcade. Valcade does all this with minimal disruption to normal cells. So no hair loss (but the will happen with the Stem Cell Transplant along with many other side affects), really haven't had any side affects from this medication. The most common side affect is neuroupathy, which I have not experienced either (I hope I didn't jinx myself).

I arrive at the clinic at 1:05 (5 minutes late on purpose to let the waiting room clear out for the 1:00 appointments, otherwise it is standing room only). The clinic and the doctors office is the same place. I then wait in the waiting room for 5-10 minutes and then I am called back to the chemo area. In this area there are about 10 reclining chairs, some patients receiving treatment have a slow drip IV and have to spend 3-4 or more hours getting treatment. My treatment is as follows:

- First I get a stick in the arm and they draw blood for a CBC and sometimes another vial of blood is drawn for a INR test.
- Next saline solution is injected into my vein.
- Then I wait while they run the CBC, if the numbers are too low then they have to find the doctor to decide if treatment is to be given, I only had this problem during cycle 1. The CBC takes takes the most time of the treatment.
- Vitals are checked next, blood pressure, temperature and oxygen level.
- Finally the medications are administered. They use the same stick used for blood draw and clip in the anti-nausea medication, next a little more saline then the Valcade and a little more saline. Takes no more than 5 minutes.
- That is it, the treatment is done.

All this takes about 30 minutes, depending how busy the nurses are. It is really not that bad, not worse than a blood draw, unless...keep reading.

Today's Visit
Today's visit was a little different. First the blood draw was slow, then the injection of the saline started to hurt, I noticed the nurse was having a hard time injecting the saline. I looked down and my arm had a lump where the needle was. I brought this to the nurses attention and she stopped the saline injection and pulled the needle out. This was really uncomfortable for about 5 minutes. The nurse then stuck another vein to inject the medications and all went well. I am assuming the nurse did not pierce the vein completely the first time and the saline was going under my skin instead of into the vein. Anyway all is back to normal now.

Last Thursday's Visit
Last Thursday's visit was a little uncomfortable also the nurse stuck a vein in my forearm instead of the elbow. This caused a little lump for a couple days and a connecting vein turned red. Then a two inch by one inch bruise formed. Looks like Jane has been beating me, though you know that is far from truth.

There are three nurses in the chemo unit, I am starting to pick favorites.

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

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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.