Living with multiple myeloma: Pomalyst chemo begins this month

Just when I thought I was out...Chemo starts in Feb

In January I had my monthly blood test. I felt great going into it and chatted a bit with the lab technician that took my blood. She recognized me from previous blood test because I always like to photograph the process. I wasn’t carrying a tripod, so I had one of the other technicians take my photo. The next day I logged into so that I could view my lab results. It is really beneficial being able to view my lab results the next day. When I saw them, I actually laughed out loud. The dramatic change in my cancer levels (igG) surprised me as they actually jumped for the second consecutive month. Although this news shocked me, I didn’t feel sad or unhappy. I felt that I was mentally prepared to face chemo again whenever it happens.

Serum Proteins (Electrophoresis & Immunoglobulins) (g/L)
Date Albumin Beta Globulin 2 Gamma Globulin igG igA igM
Reference Range 34.0-53.0 1.8 – 4.8 5.1 – 15.0 6.7 – 15.2 .70 – 4.00 .40 – 2.30
Jan 39.3 30.6 3.7 33.4 .29 .22
Dec 42.4 17.9 5.1 24.3 .33 .38
Nov 41.3 11.8 5.5 16.9 .37 .36
Oct 46.2 9.5 6.4 14.8 .39 .27
Sept 45.1 6.2 7.1 12.8 .36 .21
July 45.9 4.9 6.9 10.8 .34 .25
June 45.3 4.0 6.6 9.9 .33 .30
May 46.5 3.5 7.3 9.2 .33 .26
Apr 47.9 2.8 7.0 9.2 .28 .23
Mar 48.3 2.8 7.0 8.9 .31 .33
Feb 51.4 2.8 6.4 7.7 .24 .38
Jan 47.6 3.0 6.2 7.5 .17 .33
Nov 45.6 3.5 5.1 7.1 .14 .10

Last week I had my Hematologist appointment. As I sat in the waiting room I reflected on how the previous two appointment had changed my perspective about my health. In early July I learned that I had actually been in complete remission (no cancer detected in my blood) since November 2013. From Feb to Nov 2013, I had nine months of Velcade chemo. From my appointment last November I learned that in late July my cancer had returned.

Hematology Profile
Date WBC Hemoglobin Platelet Count Neutrophils
Reference Range 4.0 – 11.0 135 – 170 150 – 400 2.0 – 8.0
Jan 4.4 129 206 2.3
Dec 3.8 128 235 1.9
Nov 2.7 130 265 1.3
Oct 4.1 139 305 2.1
Sept 3.7 135 241 1.8
July 2.9 133 247 1.4
June 3.4 135 265 1.8
May 3.2 138 294 1.5
Apr 2.3 137 243 0.9
Mar 2.0 135 211 0.8
Feb 2.0 132 208 0.9
Jan 1.9 124 217 0.7
Nov 2.2 118 220 1.1

January blood testJanuary blood test

When we got to discussing my blood test results, for me, the only issue was when chemo would start – sooner or later. As my cancer levels had spiked, I thought it would be later in February or early March. As my Velcade chemo treatment was a success (re: complete remission for 8 months), I thought that I would be going back on that again. Instead, I’m going to be put on a fairly new chemo treatment called Pomalyst (Pomalidomide). This is because I would be partially resilient to Velcade. Right now Pomalyst, has completed clinical trials for a couple of years and has approval in BC, but hasn’t yet been licensed for general patient use. My Hematologist made a request for compassionate access as I need it now and I found out this week I had been approved. I also learned that as I don’t have private insurance I would receive Pomalyst for free on compassionate grounds.

Unlike my previous weekly injections as an outpatient, Pomalyst is an oral drug I can take anywhere. The treatment cycle is one 4mg pill a day for 21 days and then 7 days off. The Pomalyst is combined with dexamethasone, an oral steroid (10 pills X 4mg each week) to help augment the treatment, called Pom/dex. I have always taken dexamethasone with my previous treatment. There are side effects, such as depression, weight gain, and insomnia. I take a baby aspirin daily to help reduce the likelihood of a stoke and works as a blood thinner. It is possible that Pomalyst can cause blood clots as well as diarrhea and constipation.

Round 4 chemo treatment next weekChemo 2013: Dexamethasone on left

As I’m going back on dexamethasone, it is expected that my eye pressure will increase again, so I will have to let my Glaucoma specialist know so that eye drops can be prescribed to lower my pressure, when necessary.

There isn’t an set date for when treatment will end. My Hematologist stated that I will remain on Pomalyst until I no longer respond to treatment (cancer levels lower or remain stable). However there will always be new drugs in the pipeline to treat me.

I’m focused on staying positive each day.

To recap: I have Multiple Myeloma, a rare blood cancer. It is incurable, but treatable. From February to November 2013, I received Velcade chemo through weekly in-hospital injections as an outpatient. From February 2015, I will be on Pomalyst, which are chemo pills.

I love photography and use it for personal health and healing. You can view my photos on Pinterest.

English Bay - VancouverEnglish Bay – Vancouver

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