Relapsed High Risk Myeloma – Update July 2 2013

Jani and I arranged to have Andrea Marinac come and stay at the house with our 3 dogs and her cute little dog, Koko since we were anticipatingag a 2-day stay in Twin Falls, Idaho with a motel stay to begin Cycle 3 of Bendamustine, Revlimid 5mg/Dex 40 mg. 

My chart below may not be correct – I have to study the original documents.

We arrived in Twin Falls just in time for my 9:40 AM appointment. Everything was running late in the MSTI Infusion Center. Had my blood drawn and then we waited in the examine room while they searched for the results of my bone marrow biopsy done 26 June 2013.

Dr. Padavanija came in and said the bone marrow biopsy results weren’t any better – at least 95% and/or 100% plasma cells. However, the M-Spike had dropped from 1.3 to 1.2. I didn’t get any hard paper copies of the bone marrow biopsy results and will have to wait until next week.

My white blood cell count (fights infection) is low, but okay for me at 1.9 (norms 4.5-11); ANC (absolute neutrophil count determines if I should wear a mask or not) is low, but okay for me at 1.24 (norms for 1.9 to 4.8); platelets MISERABLY LOW at 17 (norms 140-440) and I have not been on any chemo for the last week. They don’t like to intervene with a platelet transfusion until the platelets drop below 10 because you make antibodies against platelets and they only last 1-2 days in your body; They did not draw a LDH today.

My Chem Panel was good for my kidney function – continued mild kidney failure.

I continued back to the MSTI Infusion Room for my monthly Aredia 30 mg intravenously. I remembered to take my Claritin and Tylenol by mouth. This always helps the aches and pains that Aredia can cause post-infusion. They cannot tell you take Claritin/Tylenol because no evidence based (research) data exists on its use – but, IT has ALWAYS helped me with Zometa, Aredia, and Neupogen infusions.

While I was infusion, Dr. Padavanija called Clay Smith, MD at the University of Colorado Hospital. He was involved in an emergency, but did get back to Dr. Padvanija. Since the Bendamustine/Revlimid/Dex doesn’t seem to be working, they decided I should switch to:
Option: carfilzomib intravenously 2 days in a row/pomalidomide 21 out or 28 days orally/dex 40 mg weekly

I’ve been on both of these chemotherapy medications before, but not in his combo.

Summary of Chemotherapy Agents I’ve Had Since Diagnosis 23 Months Ago:
  1. Revlimid (lenalidomide)
  2. Velcade (bortezomib) 
  3. Decadron (dexamethasone)
  4. Thalidomide (took a couple of days and discontinued due to neuro complications)
  5. Cisplastin
  6. Adriamycin
  7. Cytoxan
  8. Etoposide
  9. Carmustine
  10. Cytarabine
  11. Melphalan
  12. Vorinostat (Zolinza)
  13. Carfilzomib (Kyprolis)
  14. Pomalidomide (Pomalyst)
  15. Bendamustine
  16. Carfilzomib Kyprolis)/Pomalidomide (Pomalyst)/Dex

I will still require “rescue blood and platelet transfusions as my platelets are not not likely to recover on this chemo cocktail. They will have to get my medical insurance approval first. That, along with 4th of July 2013 Holiday probably will delay the start until next week. The carfilzomib (Kyprolis) is given intravenously 2 days in a row and the pomalidomide (Pomalyst) is given by mouth for 21 out of 28 days.

After the Aredia ran intravenously, Jani and I went to get my hair cut. My hair has been looking like a very messed up Einstein look.

Taco Bell and Shopko. I needed shorts for a “michelin-tire-sized” girl.

On the way home, we saw a grass fire near Richfield, Idaho, called the Jim Brown Fire (below).

Then, once in our Big Lost River Valley, there was a larger fire just south of the King Mountain roads (I think they are calling it the Beaver Creek Fire). It was raining north of the fire in Leslie, Idaho – so, hopefully the moisture will go south and put the fire out.

My post-hair cut look once home – my post-chemo hair continues to have its own curl and fuzz to it, so it is HARD to control – but, my ugly Einstein look is better.

We had dropped Jonah off at M&C Lube for an oil change when we left town, so we stopped so I could pick him up and drove him home.

Relapsed High-Risk Myeloma Update – Cycle 2 Bendamustine Day 1 – June 4 2013

Jani drove me to St. Luke’s Hospital in Twin Falls, Idaho this morning. Trouble with my GI tract moving SOUTH way too quickly, but I took some Imodium once I arrived at St. Luke’s Hospital.

They drew my SPEP blood values today which I should have the final results by the end of the week. All of the SPEP myeloma tests are sent out for processing. 

My known lab values were better today. My white blood cell count (WBC) was up to 5.4 which is NORMAL! (nomrs 4.5-11). My ANC (absolute neutrophil count) is NORMAL TOO at 3.97 (norms 1.9-8.8); hemoglobin 9.6 which is low, but not low enough to require a packed red blood cell transplant (norms 12-16) – my blood transfusion threshold is 9.0 or lower.

Unfortunately, my LDH peaked upward to 1349 (norms 313-618) from 735 on 21 May 2013. Not sure what this might mean and neither did Dr. Padavanija, but it probably isn’t good.

My chem panel lab values are pretty good, with just mild kidney failure values for BUN and BUN/Creatinine Ratio

Jani and I met with Dr. Padavanija and she thinks I should continue on with the bendamustine Cycle 2, as well as the Aredia 30 mg IV (bone building medication) today. RN Melisa was terrific getting every thing hung, but I did spend from 10 AM to 3 PM in the Infusion Room. Jani went shopping and I slept in the Infusion Center recliner. 

The bendamustine has a 2 1/2 week until nadir (lowest blood values), so I can expect low hemoglobin and platelets again – probably requiring blood transfusions – so, we will probably have several trips back here to Twin Falls. I’ll get my blood tested at the Lost Rivers Medical Center in Arco each week and if the values are too low, will continue on to Twin Falls for the transfusions.

Had a good visit with St. Luke’s Hospital Nutritionist Alisa who grew up in Kemmerer, Wyoming – my Kemmer’s namesake. Both she and Dr. Padavanija recommended that I start on probioics, which support your health immune system, boost digestion and restore the natural balance of good bacteria in your digestive tract.

They didn’t recommend a specific brand of Probiotic, but Jani bought this one.

Checked in to the Quality Inn in Twin Falls (a terrific place to stay with terrible internet access) so I can get my second dose of bendamustine tomorrrow at 8 AM. Bendamustine is given intravenously Day 1 and Day 2 of each Cycle. Then, we will head back to Mackay tomorrow 5 Jun 2013.

Jani and I went to Target so I could get some larger t-shirts for my Michelin-Tire-Me!

Had take out from Taco Bell and came back to the motel to eat. Then, Jani went to get her hair cut at the Twin Falls Mall – turned out nicely. Pre-photos before haircut. Post-photos tomorrow.

Jani has a lot more beauty aids than Kemmer and I.
My hair products today, however, I have spent most of the last 2 years bald, which I didn’t mind at all.
Kemmer’s hair products – she is easy and is so good in the shower.

We sat in the hot tub at the Quality Inn – I liked it a lot – with my Bard Power Port, which is implanted under the skin of my right chest wall – it is no problem going swimming or in a hot tub.

Relapsed High-Risk Myeloma Update with CT of Sinuses – April 23 2013

On the road to St. Luke’s Hospital, Twin Falls, Idaho at 7 AM – the sun just peeking over Pass Creek. Cold morning with just 24 degrees.

Two antelope crossed in front of me on Highway 93 near the Craters of the Moon.

My lab values were all improved except for my platelets.
White blood cells up, but still low at 2.7 (norms 4.5-11); ANC (absolute neutrophil count) up, but still low at 1.54 (norms 1.9-8.8); hemoglobin up, but still low at 10.6 (norms 12-16); platelets miserable at 38 (norms 140-440); and LDH high at 1516, up from 913 when last tested at St. Luke’s (norms 313-618). I haven’t been on my chemotherapy since 10 Apr 2013.

I’m still in mild kidney failure with creatinine high at 1.17 (norms 0.52-1.04); BUN high at 20 (norms 7-17); and GFR low at 50 (norms greater than 60). Plus, my total protein was slightly up for the first time to 8.4 (norms 6.3-8.20). 

I had my clinic visit with Dr. Padavanija and RN Kenadi and we decided I would take 10 mg Dex every other day and see how I do with the “ups and downs”. I am emotional liable.

I complained of sinus pain especially on the left side over my eye with neck pain. Dr. Padavanija ordered a CT without contrast of my sinuses and they were able to squeeze me right in this afternoon. Results revealed that I have blockage (maybe a tumor of some kind).

I faxed Dr. Padavanija my last sinus surgery report and pathology report from 4 May 2007. I had something very similar in 2007 that was operated on by Dr. Mark Loury in Ft. Collins, Colorado. She wants to refer me to an ENT, but my platelets are too low for any type of intervention – so, we will wait until 9 May 2013 and re-evaluate my platelets.

Back to the infusion center for my monthly 30 mg Aredia intravenously. I took Claritin 10 mg and 500 mg Tylenol to decrease the aches and pain associated with Aredia.

On the road home to Mackay by 2:30 PM – arriving at 5 PM because I was behind the Butte School Bus and had to make many stops. Clark delivered Kemmer and I had an almost 3 hour long nadir.

Bone Marrow Biopsy Results and MORE – February 27 2013

Drove to Twin Falls, Idaho in very cold Minus 2 temperatures, which gradually warmed up as I left the Big Lost River Valley and approached the Magic Valley.

Highway 93 to Carey, Idaho. Look in the middle and you’ll see an avalanche chute.
I delivered my 24 hour urine collected from 26-27 Feb 2013 kept in a cooler with ice to the St. Luke’s Hospital Lab. 

My appointments at St. Luke’s Hospital, Twin Falls was all mixed up and they didn’t have me down for a lab draw prior to my doctor’s appointment and no Infusion Room appointment. So, I waited while very nice receptionist Pamela got it figured out for me.

My hair is growing again and I actually have bangs!…me and Michelle Obama!  However, my hair is WILD and won’t do anything I try to do with it. I had to shave my legs for the first time this morning for a very little stubble.

They finally drew my blood from my Bard Power Port and and waited while the results were done. Dr. Padavanija came in and told me my 10th bone marrow biopsy results “weren’t good”. 

Evidently, I have been looking at the apples to oranges vs apples to apples on my previous bone marrow biopsy results. When I reported that my plasma cell percentage in my bone marrow was 60 percent on 16 Oct 2012 and then down to 40 percent on 20 Dec 2012, I was reporting TWO DIFFERENT methods – flow cytometry for plasma cells and a manual count of plasma cells from the slides. Evidently, the manual count for plasma cells is the most accurate. You’d think I know this before the 10th Bone Marrow Biopsy!!!

On 16 Oct 2012, the flow cytometry was 27 % plasma cells and the manual count was 60 %.
On 20 Dec 2012, the flow cytometry was 40 % plasma cells and the manual count was not done. Dr. Padavanija sent Pathology a request to do it today, and the manual count was 50 %.
On 20 Feb 2013, the flow cytometry was 26 % plasma cells and the manual count was 64 %.

On the cytogenetics report, I have two lines of abnormalities with a final note indicating, “This result is indicative of persistent disease. The findings of abnormal metaphases in a patient with myeloma is also an indicator for increased cell proliferation, which has been shown to be predicative for shorter event-free and overall survival (Haematologica, 96(1): 87’11). Clinical correlation is required.”

My peripheral blood on 20 Feb 2013 was summarized as:
1. Moderate anemia with slight macrocytosis (oxygen carrying ability and energy)
2. Severe leukopenia/neutropenia (ability to fight infection)
3. Moderate thrombocytopenia (ability clot blood)

SPEP Blood Values from 20 Feb 2013:

My M-Spike was sligthtly down to 0.3 (20 Feb 2013) from 0.4 (22 Jan 2013 and 20 Dec 
M-Spike Hx since 2nd ASCT (autologous stem cell transplant):
20 Feb 2013      0.3 (Idaho)
22 Jan 2013      0.4 (UCH)
20 Dec 2012     0.4 (Idaho)
27 Nov 2012     0..5 (Idaho)
20 Nov 2012     0.5 (Mayo Scottsdale)
16 Oct 2012      0.3 (UCH)
2 Oct 2012        0.4 (Idaho)
4 Sep 2012       0.3 (Idaho)
13 Aug 2012     0.1 (Idaho)
8 Aug 2012      <0.1 (Idaho)
18 May 2012     2nd ASCT (UCH)

My M-Spike history is not very valuable since I am a non-secretory myeloma patient where the bone marrow values are more valuable than the blood values.

Total Protein: normal at 6.3 (norms 6-8.2)

IgG low at 556 (norms 700-1600)
IgA low at <13 (norms 70-400)
IgM low at <8 (norms 40-230)

Lamba Qnt FLC results BELOW reportable range of 1.9 (norms 5.7-26.3)
Kappa Qnt FLC 3.64 (norms 3.3-19.4)
Kappa/Lamba FLCR Unable to calculate ratio since values below reportable range.

Dr. Padavanija called Clay Smith, MD at the University of Colorado while I waited today, 27 Feb 2013 and they decided my bone marrow biopsy results mean I have failed on carfilzomib/dex/revlimid with a couple of cytoxan doses. I will discontinue carfilzomib/revlimid/ and cytoxan today. 

They will attempt to get approval to put me on pomalidomide (Pomalyst) 21 out of 28 days and Dex 40 mg (Days 1, 8, 15, 22. The approval of the pomalidomide may take weeks, but they wanted me to start the Dex 40 mg today. I asked if I should continue Revlimid 10 mg until the decision is made on the pomalidomide and Dr. Padavanija said no. So, I will continue off chemotherapy for another week or 2. Hopefully, my lab values will have time to recover during this time. 

The good news is that pomalidomide (Pomalyst) is a pill taken daily at home and I will not have to go to St. Luke’s Hospital two days a week with a motel stay like I have been doing for carfilzomib chemotherapy. I will have to week blood tests once I start pomalidomide.

The Myeloma Beacon had an article about a French study on polalidomide today [French Study Provides Further Insights Into Pomalyst’s Efficacy, Safety, And Dosing
[ by Virginia Li | Feb 27, 2013 4:47 pm |] which was interesting. Click here to go to article:

Today’s lab values:
White blood cells (WBC) continue low at 2.1 (norms 4.5-11); Absolute neutrophil count (ANC) continues low at 1.25 (norms 1.9-8.8); hemoglobin continues low at 9.8 (norms 12-16); and platelets continue low at 128 (norms 140-440).
My LDH was up at 633 (norms 313-619), a gross indicator of inflammation and rapid cell growth.

My kidney function blood test showed an increase in creatinine again to 1.11 (norms 0.52-1.04).

I received my monthly bone building medicine, Aredia 30 mg intravenously. I took over-the-counter Claritin and 500 mg of Tylenol to decrease the headache, body aches, and flu like symptoms of Aredia. 

I received the  40 mg of dex intravenously today since my stomach has been so upset. Dr. Padavanija said the IV Dex would also upset my stomach. She gave me a prescription for Carafate 1 GM/10 ml Suspension to be taken 4x per day which will be hard for me since it has to be taken on an empty stomach not within eating for 1 hour before or 2 hours after eating and not within 30 minutes of taking any antacids…we’ll see how I do…because I’m a snacker.

They were able to schedule the MRI of my hip and pelvis for tomorrow morning, 28 Feb 2013, so I kept my motel reservation for tonight, 27 Feb 2013 even though I didn’t get any chemotherapy today and I won’t get any tomorrow. 

I also got a new prescription for oxycodone 5 mg immediate release tabs to replace my use of Tylenol and Percocet (which has Tylenol in it). They are very small pills, but I think I can cut them in half for a 2.5 mg dose.

Happily went to Taco Bell for dinner!  :) That part of my life GOOD!

Aredia 30 mg vs 90 mg Dosage Experience

I have been receiving Aredia 90 mg intravenously once a month for bone building. I’ve had terrible side effects lasting up to 4 days after each infusion including headache, aches all over, and severe fatigue. I tried taking Claritin on the the day of the infusion and it helped the aches to some degree, but not the headache. I complained that I was no longer willing to lose a week per month to Aredia. 

One of my blog readers, Terry from New Jersey, commented that he had gone to a reduced dosage of 30 mg as a result of a study published in the Lancet October 2010 by the Nordic Myeloma Study Group[

I shared the study with my oncologists and on 2 Jan 2013 and I received the the lower 30 mg dosage. I took Claritin for insurance. On this day, I also received 20 mg of Dex IV with my IV carfilzomib, IV cytoxan, and Revlimid 10 mg by mouth, so this isn’t a true test of just Aredia.

However, the day of the Aredia infusion, I felt fine. I woke the next morning feeling well. By evening, I developed a headache (all over type) and low back aches. I took plain Tylenol and had a nap. I woke from the nap without headache, but the low back ache persisted until the next day and then was gone. 

So, overall, I did a LOT BETTER with the 30 mg vs 90 mg dosage of Aredia (pamidronate).

Walked Kemmer 0.8 miles at noon – nearly 30 degrees today January 6 2013.

Bone Marrow Plasma Cells down to 40 Percent from 60 Percent – January 2 2013

Chilly drive to St. Luke’s Hospital MSTI, Twin Falls, Idaho with temperatures hovering at MINUS 12 degrees.  However, the roads were dry, skies blue, with sunshine.

Had blood drawn from my new Bard Power Port for the first time – all went fine except for the adhesive dressing they used to cover the Huber Needle access – which itched me. They took it off and replaced it with my Durapore silk tape.

Saw Dr. Padavanija and she had my bone marrow biopsy results from 20 Dec 2012. My plasma cell concentration had decreased from 60 percent (17 Oct 2012) to 40 percent after 2 cycles (a cycle is one month in duration) of carfilzomib/dex/revlimid 10 mg. She was able to speak with Raphael Foncesa, MD at Mayo Clinic Scottsdale, AZ during my appointment to get recommendations on how to proceed. Dr. Foncesa said he was hoping for a better response and now wanted to add Cytoxan to the carfilzomib/dex/revlimid and repeat bone marrow biopsy after 2 cycles.

So, off to the infusion room I trotted. I received the bone building medication, Aredia first at 30 mg vs the 90 mg that I had been receiving. I’m hoping this will reduce or eliminate the flu-like and tiredness that the higher dosage has caused. I have Terry, a 50 year old man from New Jersey who commented on my last Aredia administration to thank for the decreased dosage and the Lancet article supporting its use. Thanks Terry! PS I was born in New Jersey.
RN Brittany gave me IV Aloxi as a pre-treatment for the Cytoxan. Then, I got my 20 mg of Dex IV. Both Dr. Padavanija and Dr. Foncesa are in agreement that I can take more Dex during the week – I will start at 10 mg about 3 days after the 20 mg dose – this should help my tiredness.

I spent well over an hour on the phone with my specialty pharmacy trying to get a refill on my Fragmin 15, 000 units pre-filled injections…this does NOT make me a happy camper!
I got my first Cytoxan dose at 500 mg. I got it IV today, but will be taking it orally once my insurance approves it and it is delivered.
I arrived at St. Luke’s MSTI at 10:20 AM and didn’t get finished until 5:45 PM – a long day in the Infusion Center.

Went to Taco Bell and checked in to my motel – just 9 degrees outside. Fell asleep and woke with redness over my Bard Power Port site…perhaps I am allergic to the plastic on the Huber Needle. The old port site is red too – from the dressing they initially used yesterday.
My other labs from 2 Jan 2012 drawn prior to the start of Cycle 3 of carfilzomib/dex and the beginning dose of cytoxan.

My white blood cell count is low at 3.0 (norms 4.5-11); hemoglobin low at 10.4 (norms 12-16); platelets slightly low at 138 (norms 140-440); and Absolute Neutrophil Count (ANC) low at 1.73 (1.9-8.8).

My kidney function tests are ALL NORMAL on 2 Jan 2012
Creatinine 0.94 (norms 0.52-1.04); BUN 12 (norms 7-17); BUN/Creatinine Ratio 13 (norms 10-20) and GFR >60 (norms > 60).

I Think, NO, I KNOW – December 1 2012

I think, NO, I know – I hate Aredia (bone building medication). I received intravenous Aredia on Tuesday, 27 Nov 2012 and I have been wiped out ever since! First, it gave me a headache, and aches all over, then completely sapped my energy for 3 days.

I went to the Lost River Medical Center in Arco, Idaho yesterday for a blood draw to check my platelets. My white blood cell count is down to 1.9 which is considered “critically low” (norms 4.5-11). My ANC (absolute neutrophil count is 1.05 (norms 2-8). Lost River Medical Center faxed the results to St. Luke’s Hospital MSTI in Twin Falls and RN Brittany called me to caution me to stay away from sick people and to do good hand washing.

My hemoglobin is a tad low at 10.9 (norms 12-16) and my platelets were 108 (norms 140-440) so I can continue on my full-dose 15,000 units Fragmin injections.

I also got my SPEP results drawn on 27 Nov 2012 at St. Luke’s Hospital MSTI, Twin Falls. My M-Spike is 0.5. My free light chains were unable to be calculated because my values were below their reportable ranges.
History of SPEP Overtime 8 Mar 2012 to 27 Nov 2012:

My immunoglobulins are still non-existent except for IgG is 720 (norms 700-1600); IgA Less Than 13 (norms 70-400), and IgM Less Than 8 (norms 40-230).

Total Protein 7.1 (norms 6-8.2)
Albumin 4.2 (norms 3-5.2)
Alpha 1  0.3 (norms 0.1-0.4) 
Alpha 2  0.7 (norms 0.5-1.1)
Beta   1.2 (norms 0.7-1.5)
Gamma  0.7 (norms 0.5-1.6)
M Spike 0.5 (norms 0)
Alpha/Gamma 1.5 (0)

History of my immunoglobulins since 2nd ASCT 18 May 2012 and before.

Cycle 2 Week 1 Day 2 Carfilzomib and Dex – November 28 2012

I had a slight headache during the night which I attributed to the intravenous aredia (bone building medication) that I received yesterday. I took 500 mg of Tylenol twice during the night and seemed better by the time I arrived at the Infusion Area for my 7:30 AM appointment.

My IV started yesterday and heparin-locked overnight was still working – YEA! I received my carfilzomib (dosage 27 metered-squared).

 I wore a mask because some of the staff have colds right now.

I was on my way back home in Mackay within an hour. I felt fine during the 2 1/2 hour drive.

Stopped in to visit my father for a few minutes and did his dishes – he is fine.

Ron brought stinky-skunk-smelling Kemmer over to my house. He put some of the Nature’s Made Skunk Off on her that I bought in Twin Falls. I’ll have to work on her tomorrow when I have more energy.

I had some lunch, became one-with-my-sofa and slept for several hours. Woke with a pretty good headache, creepy legs, and aches which I, again, attributed to the aredia I received yesterday. I finally took a Claritin – WHICH I SHOULD HAVE TAKE yesterday when I got the aredia. My history with zometa and aredia has ALWAYS resulted in headache and aches and Claritin has always helped – what was I thinking?

I slept again and woke around 6 PM without the headache and feeling pretty well. At bedtime, I remembered to take my Revlimid 10 mg (Day 2 or 21) and gave myself my Fragmin injection 15,000 units.

Cycle 2 Week 1 Day 1 Carfilzomib and Dex – November 27 2012

Made to St. Luke’s Hospital MSTI in Twin Falls, Idaho without closely encountering any wild life. I did see a big buck mule deer, but he was about 40 yards off the highway. My appointment was at 9:20 AM, so I had to do the first 45 minutes or so in the dark…I am deer-shy after hitting one 30 Oct 2012. At least I have my repair Bart (2006 Honda Pilot) back to drive, as the transmission is “iffy” in Jonah (1999 Honda Passport).

Saw Dr. Padavanija and shared my experiences at the Mayo Clinic, Scottsdale. She had the dictated reports from Dr. Foncesa, but hadn’t had time to review them yet. We decided to start back on the Aredia (bone building medication) today; increase the carfilzomib dosage from 20 metered squared and 27 metered square and have my blood checked in Arco, Idaho on Friday to check my platelet count.

We discussed the possibility of getting a port placed in my chest for intravenous access and having a bone marrow biopsy BOTH under conscious sedation, one right after the other in the same room after Cycle 2 of the carfilzomib is completed. It will be scheduled for either 19 Dec 2012 or 20 Dec 2012 giving my bone marrow a period of time to recover after the completion of the 2nd Cycle of carfilzomib is completed on 12 Dec 2012. Jani will be here in Idaho (visiting for Christmas) to take me. They don’t have the OnControl Driver, but I figure with conscious sedation, I’ll be okay. Otherwise, I would have to drive or fly to the University of Colorado Hospital just for a bone marrow biopsy WITHOUT conscious sedation, but with the OnControl Driver~

Today, they drew my multiple myeloma blood tests including the M-Spike. It was 0.5 at the Mayo Clinic on 20 Nov 2012. Will have to wait a couple of days for results from today.

My white blood cell count was improved today to 4.1 but, a tad low (norms 4.5-11); my hemoglobin improved, but little low at 11.3 (norms 12-16); and my platelets were NORMAL at 155 (norms 140-440). My LDH has increased again to 867 (norms 313-618).

My creatinine was NORMAL today at 0.99 (norms 0.52-1.04) and I was HAPPY about that. My BUN was normal at 17 (norms 7-17) and even my GFR was NORMAL at greater than 60 for the first time!

I was in the infusion area for a long time because the IV took 2 pokes to work and then, the Aredia takes 2 hours to run – I thought about taking a Claritin to ward off the Aredia “flu-like” aches and pains that I sometimes have with the bone building medications. I decided to “wait and see” and then take Claritin if needed.

Followed by intravenous dex, intravenous carfilzomib at 27 metered square dosage (an increase from 20 metered squared). They decided not to give me the liter of extra fluids because my kidney function tests were normal, so I’ll drink extra fluids this afternoon and tonight.

However, they did give me a nice free lunch consisting of a sandwich and pudding.

My mind seems somewhat clearer (prior to dex administration) and I’m not very tired for someone who has spent more than 5 hours lounging in a recliner – ha~

Went directly to the pet store and bought Nature’s Miracle Skunk Remover for Kemmer who I’m sure rolled on some dead skunk over by Ron’s house yesterday while I was at the dentist.  I put Skunk OFF on her last night, but it just covers the smell with a TERRIBLE floral scent. She is back at Ron’s today and tomorrow until I get home – so, I’ll need the real stuff by then.

Drove to the motel and checked in around 3:30 PM. Will return to the Infusion Area tomorrow morning at 7:30 AM to get Day 2 of the carfilzomid/dex.

2nd ASCT – Day 108 – September 4 2012

Drove to St. Luke’s Hospital MSTI in Twin Falls this morning. Got there early and stopped at Sportman’s Warehouse which is located just on the edge of the canyon with a great view of the Twin Falls Bridge that I have to cross over to get to Twin Falls.
Twin Falls Perrine Bridge over the Snake River today September 4 2012. Double click to full-size.