Treatment plan

Posted on February 5th, 2008 by Cam.
Categories: Let's talk.

Hospital today to check in with my haematologist. He is happy. I am happy. I was pretty happy before I found out he was happy, but now I am happier seeing him as happy as he was. My Kappa light chains are a key indicator for active cancer growth in my body. Up until my re-staging to Multiple Myeloma, they were hovering around the low 20′s in count. Not enough to cause any concern. The blood test just before my re-staging showed a massive and rapid jump in the light chain count to about 114. This was enough to get me started on chemo that afternoon.

Today I finished my first 21-day cycle (of four) for this course of chemo. My bloods revealed that my Kappa light chains have come back down to 18 which is brilliant. It essentially means that the chemo is doing a good job and that treatment is going very well. I had no nastiness to report on really, as I have been feeling quite chuffed with how things are going. I get tired when I walk, my feet are hot at night (peripheral neuropathy due to amyloidosis), my ribs have pretty much melded themselves back together, I have been off all pain medication since Sunday and Elizabeth made a fantastic curry last night. Things couldn’t be better.

We also spent some time talking with the specialist nurse at the Haematology Care Centre who took time to explain my high-dose therapy procedure coming up in mid-April. That is when I need to take it a little easier. I will be having a central line put into my heart from my jugular or just under my collar bone. This tube will allow the high-dose chemo to be injected directly into a large pool of blood without doing too much damage to my tissue. The line will stay in for about 2 weeks so they can take daily blood samples and inject whatever they need into me without having to tap a new vein every time.

I will go in for daily checkups at the care centre where they can check my temperature and sample my blood. Any sign of febrile neutropenia (indicates infection) and I will be admitted to the ward to continue the treatment. It is quite common to get an infection during this time, but the thinking is that if they can keep me as an outpatient as long as possible, I will be more comfortable at home. I bring in my PJ’s each time I have a check up so that I can go straight into isolation if need be. Very slick operation!

The high-dose chemo will essentially get rid of my bone marrow. Not natural they tell me. The goal will be to remove the lesions at the same time as the marrow. Thankfully, they see fit to return the stem cells that were harvested from me at the end of last year back into my blood stream two days after my ‘marrow cleansing diet’. I will be back on the same injections into my belly that I was on to increase stem cell production during this time also.

This whole process will take about two weeks and to expect to be the most tired soul I have ever been. My hair will fall out, my digestive tract will be damaged, my energy will disappear and my bones will ache. I should be honky doory though by the beginning of May to become an Uncle for the first time. Not many people have the privilege of having a bone marrow transplant whilst becoming an Uncle, although I am not sure if there are many specific studies on this exact phenomenon.

I will then spend the next two months in convalescence, basically recovering. It will be a slow process of getting my fitness back and colour back in my cheeks. In preparation, I will be starting ‘chemo gym’ next week. There is a gym locally that opens up a few times a week with volunteers that work with chemo patients to assess them and give them a training program to work with while they go through chemo and to prepare for chemo. Sounds fantastic. The more I can do to get into shape now before heading into nasty days, the better I will be in recovery. Once again, very well looked after. I get free massages, and so does Elizabeth because she is a carer. I cannot say enough about how well I feel we are cared for in all respects.

My specialist today told me that he won’t spend too much time with me today because he needs to tend to some sick people. Fine with me. We left pretty darn happy. My new cycle starts Thursday. This time I am only taking tablets for the first 4 days of the 21 cycle. No need for the 4-days-on, 4-days-off Dexmethasone. I just take it all in the first four days with the other cytoblastics and take the rest of the cycle off. Things are looking good.


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