Week 178 of chemo complete: Everything’s blurry

Chemo treatment is a journey into the unknown. You’ll wake up on morning and something will be different with your body. It may not necessarily be painful or require immediate medical attention, but rather present an inconvenience that you didn’t expect.

Last week I woke up and noticed that I couldn’t see clearly out of my left eye, everything was blurry. Fortunately my right eye seemed fine, so I was able to read, walk around, and get things done without significant difficulties. Sometime during the afternoon, it cleared up, without me even noticing. Why did this happen? I don’t know. It may be a side effect of chemo treatment or a symptom of my cancer.

I took this self-portrait a couple days later. Yes, my right eye looks a little red. My eyes became red a couple times that day, before returning to normal. I didn’t experience any pain and I have no idea why this happened. Perhaps it was chronic fatigue from multiple myeloma or caused by my chemo.

I always keep my specialists fully informed regarding any changes to my health. I don’t want small issues to become big problems.

Week 178 of chemo complete: Everything's blurry

To recap: On Sunday, July 8th, I completed Cycle 45 Week 2. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and Dexamethasone chemo treatment (Pom/Dex). On July 16th 2017, my Dexamethasone treatment ended, due to right eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Steveston May 2014: Steveston, BC

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Week 177 of chemo complete: Ready for the unexpected

This morning a hummingbird appeared outside my window, hovered, and then disappeared. Wildlife rocks! It reminded me that at anytime something unexpected can happen that will brighten my day. Excited for tomorrow, ready for the unexpected.

Week 177 of chemo complete: Ready for the unexpected

To recap: On Sunday, July 1st, I completed Cycle 45 Week 1. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and Dexamethasone chemo treatment (Pom/Dex). On July 16th 2017, my Dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Steveston - Canada GeeseMay 2014: Steveston – Canada Geese

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Week 176 of chemo complete: My 3 options when I need to change treatment

In March my Myeloma Specialist/Hematologist provided me with 3 options, should we need to change my chemo. My current treatment is Pomalyst + Ninlaro, which are chemo pills. At the time, my cancer levels (m-protein) had been stable for the previous 3 months at 13. Last month my cancer levels spiked from 20 to 25.

This knowledge was very much appreciated as it allowed me to leisurely think about the advantages and disadvantages of each, without pressure. I feel better prepared and confident that when necessary, I’ll make the right decision – in consultation with my Myeloma Specialist.

Option 1: Velcade (high-dose chemo injections) + Cyclophosphamide (chemo pills) + low dose Dexamethasone (steroid pills)

Advantages:
Back in 2013, I had 9 months of treatment followed by 8 months of complete remission, meaning my myeloma was undetectable. So Velcade had previous success.

Disadvantages:
Velcade excited the myeloma cells in the bone marrow of my t7 vertebrae causing immense pain as it slowly collapsed. Although Velcade shortened my height, I feel fortunate not to be paralyzed.

Treatment Setting: Hospital

Option 2: Pomalyst (chemo pills) + low dose Dexamethasone (steroid pills)

Advantages:
This was my treatment from Feb 2015 – July 2017. I believe this combination is likely to lower my cancer levels and keep them low and stable, because that is what was happening before we stopped Dexamethasone.

Disadvantages:
Recall that I was on Dexamethasone with my current Pomalyst treatment from Feb 2015 until July 2017. My Myeloma Specialist stopped it after my Glaucoma Specialist found that Dexamethasone increased my eye pressure. I was prescribed eye drops, which have kept my eye pressure normal, however the Dexamethasone caused right eye damage. As my eyes are steroid sensitive to Dexamethasone, renewing this treatment could result in further eye damage. I would have to find an Ophthalmologist to monitor my eye pressure monthly.

Treatment Setting: Home

Option 3: Pomalyst (chemo pills) + Darzalex (high dose IV targeted treatment)

Advantages:
I would remain on Pomalyst, which doesn’t seem to have any major side effects for me. Combined treatment may be more effective that just Pomalyst or Darzalex alone. As targeted treatment (this is a monoclonal antibody), Darzalex attaches directly to my myeloma cells to kill them and/or allow my immune system to destroy them. This option would be an opportunity to try something new and different.

Disadvantages:
It is unknown what side effects I may experience and there are always general concerns with any IV treatment.

Treatment setting: Hospital

Everything is going to be alright. When I think positive, positive things will happen.

Photo:
These fruit represent my 3 treatment options. The Granny Smith apple is Option 1. It is a common fruit that I’ve had before. I know what I’m getting and what it tastes like. Similarly I know what Velcade + Dexamethasone treatment will be like and the side effects I should experience.

The navel orange symbolizes Option 2. I’ve eaten navel oranges before and know how they taste. Comparably, I know what to expect from Pomalyst + Dexamethasone treatment and the side effects likely to occur.

Option 3 is the Asian pear (front). I have never had an Asian pear before so eating one would be something novel. It is a different colour and shape from what I’d expect a pear to look like. Likewise, Darzalex would be a new experience for treating my multiple myeloma.

Week 176 of chemo complete: My 3 options when treatment change needed

To recap: On Sunday, June 24th, I completed Cycle 44 Week 4. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and Dexamethasone chemo treatment (Pom/Dex). On July 16th 2017, my Dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

No lawn to mowMay 2014: Coal Harbour – Vancouver

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Week 175 of chemo complete: Cancer levels have spiked

My June blood test results show that my cancer levels (m protein) spiked from 20 to 25. It is difficult to get an accurate m protein value with my particular type of multiple myeloma, so my Myeloma Specialist/Hematologist also looks at another more general measure, called an igG. Together they provide a more complete picture of my progress. My igG increased from 25.8 to 30.5.

During my July appointment, we will discuss these results and decide when the right time is to change my treatment. During my last appointment I learned about the treatment options available to me. Breaking down the advantages and disadvantages of each alternative will help me make an informed decision supported by my Myeloma Specialist.

Recall: Jan 2015 – began Pomalyst chemo + Dexamethasone (steroid). July 2017 – taken off Dexamethasone due to eye damage. January 2018 – added Ninlaro chemo. Currently on Pomalyst and Ninlaro chemo.

I’m not upset or sad. Everyday I try to stay positive and create a happiness bubble around me. I enjoy reading, I love photography, and I welcome opportunities to explore new places.

Glaucoma Specialist Appointment
I have ongoing appointments with my Glaucoma Specialist to monitor my eyes. I’ve been on an eye drops prescription since November 2016, because the long term use of Dexamethasone adversely affects my eye pressure, resulting in eye damage. That’s why I was taken off Dexamethasone in July 2017. The eye drops keep my eye pressure low and stable. At my June appointment, my Glaucoma Specialist found my eye pressure to be normal (14 each eye), which is good news.

X-ray of Right Femur
I woke up one morning and my right thigh was sore causing me to limp off and on. Sometimes simple tasks like putting on a sock is difficult, other times I don’t even notice the soreness. I don’t know what is going on, as my right thigh feels weaker. My Myeloma Specialist ordered an x-ray and we will discuss the results next month. I suspect it is either a symptom of my multiple myeloma (e.g. bone pain, lesions, bone degeneration) or a side effect (e.g. muscle or joint pain) of my chemo treatment.

M protein (g/L) (0 = cancer undetectable)
June = 25
May = 20
Apr = 20
Mar = 13
Feb = value missing (believe similar to Jan)
Jan = 13 (began Ninlaro chemo 2 weeks prior)
Dec = between 10 and 11
Nov = 8
Late Oct = 9
Early Oct = between 5 and 6
Sept = under 7.7
Aug = value missing
July = 3.0 (ended dexamethasone – steroid)
Feb 2015 (began Pomalyst chemo + Dexamethasone) = 36.1

The goal of multiple myeloma treatment is to improve survival, by reducing the cancer cells (myeloma) in the immune system as much as possible for as long as possible. The more myeloma (m protein > 0), the greater likelihood of cancer symptoms affecting my everyday life.

igG protein (6.7 – 15.2 normal levels)
June = 30.5
May = 25.8
Apr = 22.7
Mar = 22.0
Feb = 23.1
Jan = 20.6

Photo:
Early Saturday morning I was walking to the nearby forest, when I stopped to watch the sunrise. The beginning of a beautiful day on the Sunshine Coast.

Week 175 of chemo complete: Cancer levels spike again

To recap: On Sunday, June 17th, I completed Cycle 44 Week 3. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th 2017, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

StevestonMay 2014: Steveston

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Week 174 of chemo complete: Nature makes me happy

This morning I sat on a rocky formation watching the water rushing back and forth. I love the sounds the waves make and enjoy seeing wildlife flying overhead. Nature makes me happy.

Week 174 of chemo complete: Nature makes me happy

To recap: On Sunday, June 3rd, I completed Cycle 44 Week 1. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

English Bay - VancouverMay 2014: English Bay – Vancouver

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Week 173 of chemo complete: A quiet moment of solitude

One of the side effects of chemo treatment is how it affects my body temperature. I’m always feeling cold and continue to wear a toque when I feel chilly. This morning, I found it too cold (probably 10-11C/50-52F), to take a beach photo, so instead I waited until the weather warmed up, closer to noon. I then had a quiet moment of solitude.

Staying positive!

Week 173 of chemo complete: A quiet moment of solitude

To recap: On Sunday, June 3rd, I completed Cycle 44 Week 1. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

No lawn to mowMay 2014: Coal Harbour – Vancouver

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Week 172 of chemo complete: Admiring the beauty of nature

In the front area of my home is a Pacific Dogwood tree. I enjoy admiring this beauty of nature each time I look out the window. The tree blooms in April and May and it is the provincial flower of British Columbia. Saturday evening I knew I had to take a self-portrait here before it was too late. Nature rocks!

Week 172 of chemo complete: Admiring the beauty of nature

To recap: On Sunday, May 27th, I completed Cycle 43 Week 4. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Steveston - Britannia ShipyardsMay 2014: Steveston

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Week 171 of chemo complete: Cancer levels mostly the same

My May blood test results remained mostly the same as April. My M protein (specific measure of cancer levels) remained the same at 20. It is difficult to get an accurate M protein value with my particular type of multiple myeloma, so we are also looking at another more general measure, called an igG, to get a more complete picture of my progress. The igG showed a slight increase (22.7 -> 25.8). However, as my cancer levels have not spiked again, there will be no change in treatment.

I’m focusing positive energy on good results for June. Feeling content.

M protein (g/L) (0 = cancer undetectable)
May = 20
Apr = 20
Mar = 13
Feb = value missing (believe similar to Jan)
Jan = 13 (began Ninlaro chemo 2 weeks prior)
Dec = between 10 and 11
Nov = 8
Late Oct = 9
Early Oct = between 5 and 6
Sept = under 7.7
Aug = value missing
July = 3.0 (ended dexamethasone – steroid)
Feb 2015 (began Pomalyst chemo + dexamethasone) = 36.1

The goal of multiple myeloma treatment is to improve survival, by reducing the cancer cells (myeloma) in the immune system as much as possible for as long as possible. The more myeloma (m protein > 0), the greater likelihood of cancer symptoms affecting my everyday life.

igG protein (6.7 – 15.2 normal levels)
May = 25.8
Apr = 22.7
Mar = 22.0
Feb = 23.1
Jan = 20.6

Week 171 of chemo complete: Cancer levels mostly the same

Photo: Thursday evening I went back to the forest near my house. I just love the forest energy around me when I walking down a path, it is so still and quiet. Looking forward to exploring again soon.

To recap: On Sunday, May 20th, I completed Cycle 43 Week 3. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Sun sets on Granville IslandMay 2014: Sun sets on Granville Island

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Week 170 of chemo complete: Forests are happy places

Saturday evening as the sun was setting, I headed to a nearby forest. I always meet nice people that chat or say hello. Yesterday a jogger enthusiastically provided advice on cool places to explore and photograph. I love spending time in forests.

Week 170 of chemo complete: Forests are happy places

To recap: On Sunday, May 13th, I completed Cycle 43 Week 2. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Steveston - Canada GeeseMay 2014: Canada Geese – Steveston

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Week 169 of chemo complete: A beautiful start to the day

This morning I travelled to the beach to relax and listen to the sounds of birds and waves. I found a log where I watched people walking their dog or relaxing with a friend nearby. There is something about watching water ebb and flow that is so calming. A beautiful start to the day.

Week 169 of chemo complete: A beautiful start to the day

To recap: On Sunday, May 6th, I completed Cycle 43 Week 1. I have multiple myeloma and anemia, a rare cancer of the immune system. Multiple myeloma affects the plasma cells, a type of immune cell that produces antibodies to fight infection. These plasma cells are found in the bone marrow. As a blood cancer, it is incurable, but treatable. Since February 9th 2015, I have been on Pomalyst and dexamethasone chemo treatment (Pom/dex). On July 16th, my dexamethasone treatment ended, due to eye damage, reported by my Glaucoma Specialist, from long-term use. On January 9th I began Ninlaro chemo to combat steadily rising cancer levels.

Weekly chemo-inspired self-portraits can be viewed in my flickr album.

Take a book, return a bookMay 2014: Granville Island

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