Love and Hate

We've all heard the term "love and hate relationships".  Well, I have one of those.  No, not with my wife!  Or my dogs......or......   Anyway, I have it with my Zometa treatments.

My wife said use this picture because I like dice!

Last week I had my quarterly visit with the oncologist/physician assistant and my lovely Vitamin Z treatment/infusion.  I have been doing this now for three years, and used to do it every month, so this is easy, breezy, right?  Sort of.

The process itself was fairly simple, and I am used to that.  While I waited for the stuff to drip into my veins, I chatted with my neighbor and found out that he has colon cancer that has metastasized to his abdomen, lungs, and brain. Wow. That was hard to hear, but the he asked me about my situation, and I also found out that his wife was just diagnosed with Multiple Myeloma.  When it rains it pours. I offered my sincere sympathy and gave him some suggestions for his wife to help her prepare for stem cell transplant.  I've been through a bit, but I think they are really struggling. He said how fortunate he felt for the love and support he has received from his ward and community, so I am also grateful for that.  I hope, in a small way, that I also helped.

After my infusion finished, I went to school for some meetings.  I usually get hit by the Zometa the evening of the same day, but I didn't feel too bad.  I thought, "Well, maybe I'm getting the hang of this."

Wednesday, I woke up, feeling a bit stiff and a bit more tired than usual, but doing pretty good.  I had a productive day and went to game night (hooray!), but got more and more tired as time went by.  Still, I thought things had gone pretty well.  Hah!  Wednesday night I really had trouble sleeping.  I increasingly had pain and exhaustion.  I felt like I had been nicked by a bus.  Everything hurt from my head to my toes.  In the morning, I woke up and decided no exercising for that day.  I could barely walk.  Arrrgh. So I think it is easy to understand the "hate" part of the dice. What is the love part?

The love part is that Zometa may be part of what is keeping me stable.  During my checkup, the PA looked everything over and said I was still stable; the results didn't look too bad (especially compared to what she usually sees).  She wanted to keep an eye on some of the tests, just as I do, but said for now, we wouldn't change anything.  So if Zometa is keeping this going, I love it!  ❤️ The best part of the recent results is that my liver function scores are dropping from moderately abnormal to less abnormal.  Not sure why, but maybe exercise?  That is good news, so I hope it keeps happening.

Here's the update:  As noted above, things are not much worse.  That said, nothing is normal.  Here are the big four -- I decided to make up charts for you guys!  The first chart shows my White Blood Cell counts, since March, 2016, so 2 years and 4 months worth of data.  Keep in mind the later numbers are a bit more spread out over time.  NORMAL range for WBC's are 4.3 - 11.3; my average over 28 months is the green line:  3.2. The red line is the bottom of the normal range (most people are generally not at the bottom).  So, yes, I'm still doing fist bumps, lots of hand washing, and taking antiviral medications.
I almost hit bottom end of normal there, in January 2017, but they look a bit squashed the last several blood draws.  We'll keep an eye on it.

Next on stage is my Red Blood Counts or RBC.  This is what keeps me anemic, makes it a bit harder to breathe and have energy etc.  NORMAL range is 4.7 - 6.1; again, the red line is the bottom of the normal range.  The green line is the average over the 28 months -- not terribly low which is good.  Just not high enough!  I'll keep eating spinach and kale.  Note the chart starts at 2 and goes up to 5.  Overall, the RBC's are probably the most consistent.

Now for one of the villains; the chart below shows those pesky platelets, you know, the cells that aggregate to prevent blood loss?  Thems the ones.  They are not so low that I can't stop bleeding, but when I was in chemotherapy, they would not give me Velcade is my platelets dropped to 30 or less and usually would give me an infusion at that point.  The latest ones are in the mid 50's, so I hope they do not drop any further.

Normal range for platelets is 159 - 439.  The red line is the bottom of the normal range.  My average over the 28 months is the green line:  65.  So I have been below my own average now since December, 2017.  You can see the blue line below the green line.  The last time I was just above my own average was in November, 2017.

And the coup de grace is my M-spike.  That is the number that I personally worry about most; my doctors look at a bunch of different things, but for me, that is my indicator of cancer activity.  Normal is zero.  Hopefully all of you have an M-spike (monoclonal protein spike) of zero.  So in this case, the red line represents my average over 28 months which is 0.75.  Not bad compared with my 1.7 at diagnosis, but higher than my 0.3 after my stem cell transplant.  However, look at the blue line.  You'll see a jump above the red line around July, 2016 which stayed stable for a long time.  However, the last four blood draws, going back to November, 2017 are all above that line.



So there you have it!  The latest update, by the numbers.  The last few M-spike numbers are moving around more than they did for a while and are ticked upwards, but not by a lot.  So I'm not that worried about them, but I do want to see what will happen over the next six months. I am anticipating some ongoing fluctuations, and hopefully not much going above 1.  A lot also depends on what happens with the other numbers, so I'll keep you posted.

So, in life we all have things that we have love/hate relationships with, sometimes even in our own bone marrow.  I am grateful for my abnormal stability and hope it keeps growing v e r y slowly.  Every day, new treatment are being tested and approved, and every day is one more day to enjoy my wife, my family, my friends and neighbors, and the beauty of the world we live in.  I hope that I convey that gratitude in how I treat all of you and in my relationships with my students.

May the Lord bless and keep you!  See you at the next update.