Today Will Not Be Here Tomorrow

Meanwhile, someplace in the world, somebody is making love and another a poem.”

From Figuring by Maria Popova

Periwinkles, ducks, and clouds. Hood River waterfront on 3/20/20.

I fed hummingbirds all winter. Each time I thought they had departed for a warmer climate, they would appear and take a big slurp from the feeder.

I received two petunia plants in September. They continue to flower. I did not tend them. Still, they survived outside, in northern Oregon, on relative humidity and indirect light.

This is unusual.

In late January, following our return from a Christmas vacation in California, the first news of the coronavirus came from China. The world scoffed aloud, “Hmph”. Now, barely two months later, it stammers a collective, “WTF”. The upheaval is astounding.

The Columbia River looking west from The Hook in Hood River, OR. 3/20/20

Worldwide, half a million people are infected with the virus. More than 25,000 have died. The travel industry needs a ventilator to breathe. Cruise ships are floating petri dishes. Professional and amateur sports suffer in an induced coma. Many states have closed schools. Shortages exist for supplies of hygiene related products. Restaurants across much of the USA shutter their doors in adherence to social distancing. Mayors and governors issue sheltering in place edicts. Bustling downtowns look deserted. The stock market plummeted to record lows, millions are suddenly unemployed, and everyone with a 401k is hyperventilating.

My ukulele-a Mike Pereira “Cali” Baritone.

To the rescue, the federal government …? Wow, where to begin? The kindest thing I can say is that our president’s leadership has been sub-optimal. Evidence of the country’s unpreparedness is matched in degree only by the administration’s improvised responses that, thus far, promise but don’t deliver. Congress, prone to partisan dithering, slogs along. Emergency relief is imminent, albeit late. More will be necessary.

Are we all going to die? No. But, it’s possible someone we know will. Better leadership and foresight could have minimized the number.

I belong to one of the high risk groups. I am older. And, I have a suppressed immune system due to my cancer, multiple myeloma. Fortunately, I am a home body by nature. Social isolation is not a personal hardship. I read, I write, and I play my ukulele.

I am 12 years out from diagnosis. Like those petunias in my front yard, I exist on the relative humidity of my good luck. My anxiety about the Covid-19 virus is tempered by experience. The grim prospect of mortality is an acquaintance. I am no more susceptible to contracting the virus than you. However, I may have a more serious response should it come my way. So be it.

Closed the waterfront to walkers on March 22nd

Our fragility as a species is revealed by a microscopic organism. Knowing better, we nonetheless chose to be unprepared. The current administration dissolved pre-existing institutions established for a menace such as Covid-19. Now, we pay the price for that choice.

Similarly, we will pay a price for our indifference to the threat of climate change. It’s cheering to see hummingbirds visit during the gloomy days of winter. Remember, though, this is unusual. It’s not equivalent to the Australian brush fires or 69 degree temperatures that recently occurred in Antarctica. But it serves to remind me, overwhelming evidence exists of this threat to humanity.

The coronavirus teaches us that calamities occur that effect all of mankind. It also shows that we can respond unilaterally for the greater good of everyone. We will survive Covid-19. Climate change will be a much more formidable challenge. Let’s hope we choose to be better prepared for its consequences than we were for this disease.

Now, a song … 

Today Will Not Be Here Tomorrow

The latest numbers …

The Drill

Bleurgh – bored and fed up now!

So I’ve now been on treatment for 6 months and I am ridiculously fed up with feeling exhausted and good for nothing for 3/4 of the week. What is worse, is that my figures for the last 2 months haven’t improved, if anything, they’ve gone up ever so slightly. We’re still hoping that’s a blip but it does make you wonder why you put yourself through the grimness of chemo if it doesn’t do what it’s meant to do.

I shouldn’t moan. (But I will).

Other people have it far worse than me. Their side effects are worse (or they say they are!), they suffer with bone issues on top of all of the chemo treatment, they have other significant side effects or additional complications that make it worse.

But I just hate not being able to do the things I normally take for granted. Some days, I haven’t even had the energy to walk Marley. Others, I can’t make dinner for the kids and they have to do it themselves while I’m asleep on the sofa. The ironing piles up to the point the MIL offers to do it. I can’t really work now as I can’t focus on it and I don’t know when my bad days will happen sometimes, and working, even in my job, can take it out of me. Sport, and especially netball has had to be paused. I can’t go out more than one day at the weekend and even that, exhausts me the next day. And then when I do feel well, I do silly things like wallpaper stripping that totally wipe me out afterwards! That’ll teach us for continuing the house renovations right up to transplant date!

Basically, my whole life has pretty much gone on hold, and its a total drag if I’m honest. I’ve gone from feeling (even if I wasn’t ‘myelomawise’), 100% fine to feeling like I’m about 50% most of the time. It’s a strange concept taking drugs that make you much worse before they make you better. I know when I get to the transplant I’ll feel like 0% for a while, but it feels like the journey moves homeward at that stage. At this moment in time it still feels like I’m touring with no idea of what direction I’m going. Maybe I’ll feel better once I have a transplant date in the diary.

Anyway, I’m ok so this really isn’t a call for sympathy. Last week I was REALLY fed up, this week only semi fed up (at the moment). Today I feel ok – I normally do on a Monday until late evening…that’ll be the devil steroids (although they seem more under control now and the sleeping tablets help counteract that side of them too). Wednesday and Thursday are my worst days normally. And I just have to make the most of the weeks where I don’t feel bad on a Tuesday or Friday….I never quite know. Perhaps I need to avoid that wallpaper stripping in the house….but I get so bored if I don’t do anything!

Enough of the wingeing though. On a positive, my friends in Belbroughton arranged a brilliant ‘no frills’ disco for my #50KB450 at the weekend. It worked brilliantly, hopefully wasn’t tooooooo much work for them all, and raised £500 for Myeloma UK and my target. And it was loads of fun!!

It will take us over the 10% mark which is great! If you want to see an update on what has been going on just pop to my #50KB450 tab at the top of this page. The next event is that Deb and Brigitte are doing a 3 hour body combat event in Stourbridge on the 29th Feb.

Finally a big 🎉🎂Happy 18th Birthday🎂🎉 to Holly for Wednesday! She has really generously asked friends to donate to her fundraising page for #15KB450 instead of presents – not many 18 year olds would be that selfless! She’s also doing the 2020 challenge and running that many miles in 2020….mental! If anyone else would like to support her, it would obviously be great!

Stanyan Street

The Oakland Gang: niece Tillie, me, Nephew Joey, my wife Marilyn, and Noah our oldest son.

Due to my cancer, multiple myeloma, the physical adventure of traveling challenges my attitude. I dislike flying: the herding, the depressing bag of pretzels, and the cabin’s claustrophobic fit. Yet, once again, my wife and I chose to spend the holidays in San Francisco’s Bay Area.

We stayed in Oakland at a hotel on Broadway, close to where our oldest son lives. We were joined by a niece, who lives and works in a town nearby and her brother, our nephew, who was visiting following the completion of his degree at Tufts University in Boston.

Lake Chalet

I’d arranged to re-schedule my twice monthly infusions so as to not interfere with our activities. My treatment also includes oral drugs, which can continue when I’m on the road. I take a chemo type pill once a day and a steroid once a week. I’ve become inured to the daily pill. Its side effects blend into the general fatigue syndrome that characterizes my blood cancer. The steroid, though, radically alters my mood, my energy, and, perhaps, my personality.

IMM

We dined at a number of excellent restaurants: Itani, brunch at Lake Chalet, The Berkeley Social Club,  a morning snack at The Rotunda on the first morning, the hotel’s restaurant for breakfast Christmas day, then Farley’s East on the penultimate morning. Prior to seeing the movie, Little Women, we ate Thai street food at IMM and finally a goodbye meal at Tay Ho, a French/Vietnamese restaurant.

The highlight, however, was Christmas dinner at my brother and sister-in-law’s house in San Francisco. The Oakland gang merged with the San Francisco gang. 

Brother and Sister-in-Law’s house on Stanyan Street

The house sits near the top of Stanyan Street above Golden Gate Park. It is of Victorian vintage, built early in the twentieth century. (1904)

There are three levels situated on a steep slope adjacent to Sutro Forest. My brother and his wife live on the top floor. Their daughter and son-in-law and 12 year old grandson occupy the main floor. A laundry and storage, as well as a small studio apartment finish out the dwelling. There is also a two car garage, quite a luxury in parking starved San Francisco. They bought the house for $100,000 in 1973.

Oakland street art.

They admit to initially being anxious about the mortgage. At the time, my brother was a San Francisco fireman. His wife worked in medical research. She then chose to get a law degree and eventually became a patent attorney. Along the way, she also bore a child. By investing in their ingenuity, they were able to persevere through those early busy years. The house is now worth much, much more than the purchase price.

Stanyan Street

Main floor of the Rotunda in Oakland, CA

Christmas day was my steroid day. Under the influence of the drug, I sometimes jabber too much. I have also been known to say the wrong thing at the wrong time. Such are the perils of the steroid high. My faux pas filter, however, managed to keep me out of trouble. The convivial conversation even  prompted me to toast the three family lines in attendance. 

But, the enduring star was the house itself. Nurtured by my brother and his wife through the years, it has hosted numerous events commemorating family passages. There was a going away party for my wife and I decades ago when we immigrated to New Zealand. Then, in the not too distant past, a support reunion party for me prior to my stem cell transplant.

Tay Ho

Furthermore, two of their granddaughters lived there while launching into adulthood. And, my SIL’s mother spent her final days in one of the downstairs apartments. Birth, death, and all the transitions in between: such is the legacy of the Stanyan Street house.

When the evening ended, my wife and I returned to Oakland with our son. The lights of the Bay Bridge glittered with holiday flair. My slumpiness from the myeloma had vanished temporarily, along with other aches and pains of disease and aging. The day’s activities had drained the jolt of energy caused by the drug. Yet, I still floated in the steroid’s groove and mused, without judgment, as to how my body is no longer entirely my own. It is managed, to a degree, by pharmaceuticals. That’s ok. I would not be alive without them. 

Still Lifes

“In every heart there is a god of flowers, just waiting

to stride out of a cloud and lift its wings.”

Mary Oliver from The Kookaburras

Still Life With Wildflowers

In late August of this year, of the summer when my wildflower garden flourished and yielded a wealth of colorful bouquets, crickets sang each evening their mindful refrain. “Soon,” they said, “the season will tip into autumn.”

In the garden, cosmos plants stretch beyond my height, seven feet or more. The flags of their flower petals flutter with the benediction of a breeze. Coreopsis and zinnias; daisies and coneflowers; bachelor buttons and black eyed Susans spill across the borders of the rocky path.

Poppies

Gardening focuses a too busy mind. Often, I am knuckle deep in soil and its mix of bugs, worms, and microbes. I breathe the earthy fragrance of organic material and enjoy common cause with other creatures.

Birds visit during the day. They pluck seeds from the same blossoms where bees nuzzled pollen. Beetles, spiders, and winged insects are drawn to the abundance of plants as they make their way through the territory of their brief lives.

Early Summer Wildflowers

Me too … I reap the peace of communing with wildlife and harvesting flowers that pose as still lifes in the kitchen and bedroom.

The late American poet, Mary Oliver, created still lifes with words rather than paint or photography. Her poetry arose from wandering in the hills and fields of New England. She developed a knack for finding the extraordinary in the ordinary.

Wildflower Bouquet

In her later years, she moved to Florida. She continued to write until the end of her life, taking inspiration from nature in the estuaries, ponds, and dunes of her new surroundings. At the age of 83, she died from lymphoma, a kissing cousin to my blood cancer, multiple myeloma.

My disease paints a picture similar to a still life: it doesn’t move, yet there is a fascination with the details. I have ups and downs but, basically, things are about the same this year as they were last summer when the season began to turn. I persist in a plateau phase with a lengthy history. The relevant blood markers remain stable, the treatments have not changed, and my quality of life is decent.

Still Life with Ukulele

Metaphorically, though, I am under house arrest. I don’t travel well due to the side effects of a busy treatment plan and Mr. Fatigue visits on a regular basis. Nonetheless, I approach 12 years since diagnosis. Cautious management and lots of luck has forestalled the incurability associated with MM.

There is much to be grateful for. Lately, it’s wildflowers, still lifes, and Mary Oliver. That’s plenty … until I write again.

 

Who Made The World

 

The University of Cancer, Part 4

Love Potion #10-IVIG

Multiple myeloma is a chronic incurable disease. When I was diagnosed in 2007, the prognosis was three to five years. Little more than a decade later, due to advances in research, the statistics have improved. Some patients persist upwards of ten years. I fall into that category: one of the lucky ones.

Chronic means it doesn’t go away. You either treat the disease or risk having it run amok. The cancer subsides with treatment, but one drags around a significant baggage of side effects. 

MM is a nimble adversary. At first, there are plenty of ways to fight back. But each treatment has a finite period of effectiveness, therefore, the incurable tag. That’s how you manage multiple myeloma: you just kick cans down the road until you run out of cans …

I am an easy patient, passive as a cloud. I don’t demand or complain. I accept the discomforts: the teeter-totter of steroids, the malaise associated with most chemotherapy, and the many, many needle sticks.

Decisions, Decisions

For sixteen months, my last regimen consisted of a three drug combo that balanced disease control with side effects. It necessitated weekly visits to oncology for injections or infusions but I felt good … well, goodish. Last summer, the stability waned and toxicity from two of the drugs finally exceeded their benefits. I still had options. Nothing of what remained, however, offered a long term solution.

Myelomiacs, if they are fortunate, eventually reach this point. What, then, is the goal? They can move along and exhaust the options. Or, they can consider a clinical trial and treatments that have yet to be approved. 

Decisions, decisions.

The most promising trials revolve around a groundbreaking new “living drug.” It’s called Chimeric Antigen Receptor Therapy or CAR-T. The technique involves gathering T cells (a type of immune cell) from the cancer patient’s blood, engineering them in a lab so they will recognize cancer cells as an “enemy,” then reintroducing these weaponized T cells to the patient’s body.

The “Hutch”

Nationally, there are a dozen or more clinical trials of CAR-T aimed specifically at multiple myeloma patients. Last July, my wife and I consulted with a trial administrator in Seattle.

The consensus of opinion and early trial results affirm CAR-T as a viable treatment. Nonetheless, science is a process made whole by both success and failure. There are risks. Questions remain about the optimal dosage and durability of the methodology. The time commitment averages 30-60 days away from home, more if complications occur. There is no guarantee of admission or success. 

Still, hundreds seem willing to participate. For some, the trial might be a last ditch effort to buy more time. Others may have young children and hope to pre-empt the many temporary fixes with a single extraordinary treatment. 

My point of no return is not imminent. My children are grown and comfortable in their own lives. And, with the can currently being kicked down the road, I am seeing a bit of a bounce back from last summer’s decline.

Zero is normal. The trend has improved since mid-summer decline.

My treatment philosophy has always been that “less is more.” Yet hope tempts one to manipulate logic. I want to believe the CAR-T product is less than the more of doing the same thing with different drugs from the FDA’s medicine cabinet. Such is the allure of hype.

Veterans of this disease face a choice: to explore, or not, the outer edge of treatment modalities via a clinical trial. Scientific research extended the life span of an entire generation of MMers. The blood of participating volunteers fueled that improvement.

Is there more to come?

CAR-T science is beautiful, a source of wonder. To genetically modify one’s immune system is unprecedented. Each recruit into these trials marches to a drum beat of hope and an echo of doubt. Their leap of faith may seem prudent given the slow pace of the regulatory process. Certainly, the wiles of multiple myeloma won’t wait. And, though disease control may not be refined, perhaps some can capture the future.

 

Read all about it in The Drill.

Wow, It’s Been A Long Time!

I’ve started writing on Medium.com which means I’ve stopped writing here.  In addition to that, I was cancer free from my transplant till my 5th year anniversary – almost to the day.  With that said, below area  few links to my most recent posts on Medium and here is the text of my last post on Medium.  s always, thank you for reading!

It’s Not The Chemo…
Fighting Again…
My Re-Birthday

It’s Not The Chemo…
The last few weeks have been a roller coaster. There are a number of things being juggled right now but the funny thing is, it’s not the chemo that’s causing a concern. Sure, the disease is back, I’m back in treatment, but that was the least of my worries. Here’s my most recent timeline, so you can get caught up on the craziness:
  • Feb 7 — The decision is made, my January biopsy and blood work identified that the disease is definitely back and it’s time to take action. Feb 28 is my first date for treatment.
  • Feb 23 — I get an Explanation Of Benefits, via SNAIL MAIL, from my insurance company that the treatment plan has been denied as “not medically necessary” (again, treatment was scheduled for Feb 28 , 5 days later— so I went and got a tattoo!)
  • Feb 26 — I am told I will be on a clinical trial, but will need tests first, so treatment will start Mar 8.
  • Mar 2 — a littany of tests: echocardiogram, EKG, skeletal X-ray, bone marrow biopsy (again), blood work, urine, etc.
  • Mar 8 — I arrive for my first day of the clinical trial. They insert the IV and then the NP tells me I was denied the clinical trial — I am “relapsed” not “refractory” — this is a good thing but it didn’t feel like it at the time.
  • May 8 — I raise holy hell!
  • Mar 9 — I begin a “standard of care” treatment that is easily approved by insurance and start day 1 of my Daratumumab and Velcade immuno- and chemo-therapy regime.
Honestly, the chemo has been fine but the roller coaster of emotions and decisions over a three week period was simply mind blowing. Unlike the chemo that many others take, where they are sick for days or weeks after, the side effects for me have been minimal. That being said, the Dara is closely monitored for the first two sessions as it will cause allergic reactions. My Day 1 had an arrival to Mt Sinai at 0750 — my departure — at 2134 (for those not accustomed to military time 7:50a to 9:34p). I gave up Lent after that and had a beer — i’ll make my peace with the big man above!
Every time I had an allergic reaction they had to stop the infusion, give me something to address the reaction, and then wait 35–40 minutes for that to kick in. Then they re-started the infusion, at a very minimal rate, to see if the reaction returned. I had two reactions with the second being in the early afternoon. With 700ml of Dara remaining, they re-started the infusion with the rate at 25ml/hour. If we were doing 100ml/hour that would be seven hours! It took an hour at 25 till we could increase to 50. An hour later we increased to 100, then 150 then finally 200, the max. It was a long day.
Day 2 (which apparently is Day 8 in treatment-speak) was easier and I had no reactions. Still it was from 0700 to 1720, so a long day! This week I had my first real side effect, which was simply an achey feeling. It was like the flu without the flu-like symptoms. Moving just ached — the shirt moving on your skin didn’t hurt but it was sensitive, like sun burn. The docs gave me Dex, which did help, but caused me to not go to bed till 0100 last night (this morning) and I was up by 5 with one time awake in between. The only other side effects were caused by the Velcade. The Velcad is delivered sub-cutaneous, a shot that goes into the fat in your belly, just under the skin, but before the muscle. The first one left me with a bright red mark, that was hot and did hurt like sunburn. Not bad but noticeably irritating. The second shot had a similar reaction but not as bad. I’ve used Aquaphor to keep the area from getting too dry.
Day 3 is tomorrow and should be quick (relatively, but still guessing around 6 hours). That is my update. Thanks for reading and I’ll have an more info on everything else in the next day or so!
Cheers and keep fighting!

Six Weeks

It’s been two months since I last published a blog and let me tell you this, it has been quite the two months. After having this wretched disease for over five years, I thought little would surprise me. Well, I expected the whole looming death part to have a different trajectory to the routine I am used to, but as I said, I expected that to be slightly different. I never considered what the steps will look like getting from the relapse stage , to the end of the line stage. I always assumed it’d be easy but increasingly, I feel I might have been far too optimistic.
Somehow, in five years, I had settled into an uneasy routine with My Myeloma. It’s quite simple really, I would have some sort of treatment, which would work for a bit, then it would fail, then the Medically Trained People would somehow magic up another treatment for me to start, and thus the cycle would start again. 
I had five years of this. Don’t get me wrong, some horrible things happened along the way; it shouldn’t make the list, but losing my hair is still up there in the shitty events. I didn’t really enjoy any of my transplants and I definitely did not enjoy the time I had to spend five days in St Bart’s because I caught Influenza B. On the plus side, I thoroughly appreciated any drug regime that could be taken at home. I had a few of those.
What am I saying, all of that is in the past? If the last two months have taught me anything, and I am still trying to decipher exactly what further lessons I needed to learn by the age of 33 about my cancer, is, that Myeloma is a load of fucking shit that if there were a hell, it should be confined to purgatory trapped under a full, infected bed pan, never to bother nice (even horrible) individuals again. Oh yes, just to keep you up to date, I have also learnt about bed pans recently. And sick bowls. And those cardboard things that collect one’s waste by resting on the loo seat. I know it all.
On 7th September, I returned to UCLH for a clinic appointment. Prior to that I had found out that the trial at St Bart’s was no longer working and I had been experiencing what can only be described as extreme and unbearable pain that I had blamed on doing too much on holiday. The pain itself was predominantly in and around my right rib cage. 
As I had self diagnosed every relapse since 2012, I had spent about a month begging for some imaging. St Bart’s took no action, I would question if the staff knew my name, but thankfully UCLH did know my name and once they had the necessary images, man, did they take action.
I was admitted to UCLH immediately on the 7th September following an appointment, during which my family and I were told we were coming to the end of the line of treatment. Not only that, but there was also something wrong with my neck. I say ‘something’ because I think it took me well over a week to get my head round what a compression on one of the C vertebrae meant. I don’t recommend it. I don’t recommend developing a mass that pushes through your rib cage either, Alien (or at least that’s how I like to picture it) style. It cannot be sugarcoated. I entered that hospital with Mamma Jones and Big Sister in a bad way. 

And that bad way only worsened over the next six, that’s right, SIX weeks…

I don’t even know where to start. If you are independent, like to toilet alone and enjoy walking around, I’d say what followed would be your worst nightmare. It was mine. 

You may have deduced that not all was or is well with my spine. Due to the compression and the location of it, I arrived at my bed to be told that I was no longer permitted to walk. As in, no walking at all. Not only was I not allowed to walk but if I wanted or needed to be moved in my bed, I would have to be rolled by four Medically Trained People. My head and neck, could not be elevated anymore than 30 degrees. Three weeks later, this changed to 40 degrees and the news that I could roll myself, but by this point, the damage to my ego had already been done. Not to mention the damage to my legs for not walking for three weeks.
Despite being in denial about it, shitting is a necessity that eventually cannot be avoided. The day I could not avoid it was Day 11 in hospital when there were only male nurses available. I’m a 21st Century Woman, so I went ahead and let the team of four roll me onto a bed pan. I did not say anything when they had to roll me again to clean my bum. Nor did I say anything the next day, during one of my five daily bedsore checks, when a different Medically Trained person discovered a lump of faeces stuck in my bottom from the previous day. 

That was a low point.
Washing myself alone, was and remains impossible and for the duration of my stay, washes were restricted to hand towel baths in my hospital bed. If I was lucky, the Medically Trained Person cleaning my nether regions might have even shut the window to my room for some privacy. Due to staff shortages, during the last week of my stay, no washes were offered and I went a week without being cleaned. Needless to say, washing hair is extremely difficult and something that has happened twice between the 7 September and now.
Thankfully, due to what I like to call ‘performance issues’ I was given a catheter for the first three-four weeks of my stay. After that, I relied on my good old pelvic floor muscles to stop me from soiling myself. How can that be when you cannot walk, I hear you ponder? The answer is long, boring, excrutiatingly painful and another blog post. In the interim however, you just need to know that I have a full back brace, handcrafted to fit my body and imagined perter boobs, which I am allowed to wear to mobilise. 
…………………………………………………………….

This really is a story of never ending gibberish. Maybe grab a cup of tea. Have a wee break. I’d have one with you but my mouth is currently tainted by the delectable taste of 60 mg of steroids per week, so I am only able to stomach the taste of fruit juice. 

Where was I? Right, my health. In addition to the bony stuff, the really smart Medically Trained People had to find out what was wrong with me and if there was anything that could be done about it. This period felt like it would never end, with the feedback I was getting changing nearly everyday. I’m not going to regurgitate all of it, just trust me when I say it was very confusing and everyday resulted in me hysterically crying and Big Sister getting angry. 
I lost count of how many CTs, MRIs, ultrasounds and x-rays I had, but I know it was a lot. It was not uncommon to be collected by the porters, without any clue where I was going or why. I knew where they were taking me on week one, when I had five fractions of radiotherapy to heal my ribs, but as for the rest, it was not like I was in the strongest position to argue or question. I simply did.
Things went downhill relatively quickly. By Day 4 I had tested positive for Paraflu, which gave me a chest infection and resulted in me being relocated to an isolated room on a ward where the staff are nice, but significantly understaffed. One night, I rang my bell for 2.5 hours before I saw a nurse. On the plus side, it meant that I had my own room with a nice view over London. A bonus when you consider the fact that the woman opposite me on the shared ward addressed me as ‘Emily’ and wished me well. 
The hardest part of having the lurgy was that I did not see somebody without a mask on for five weeks. Talk about dehumanised. 
The chest infection persisted, so for extra buoyancy, I also developed sickness and diarrhoea and a temperature. It was lush. 

Notice how I am yet to mention My Myeloma? There’s a reason. My Myeloma failed to behave in the manner of which I have become accustomed. For the first time since I was diagnosed with the wretched beast, I was afraid of it. It wasn’t behaving how I have known it to behave. My paraprotein was the highest it had ever been, and no matter what drugs were tried or the volume of fluid pumped into me, my calcium would not shift below 3.0.

And still I carried on. It may be the biggest test of my willpower and personal strength (because I really have no meaningful life until I am rid of the brace), but I unequivocally told the Medically Trained People that I am not ready to give up with my life yet. As long as the treatment maintains a reasonable balance between quality of life and those dastardly side effects, count me in. Sign me up.

I’m not ready to die yet.

Unfortunately, we soon ended up spending some time thinking about my death. I completed my will and paid for my funeral. Once I was fortunate enough to be on a reasonable treatment regimen, I suffered from what I now believe to be called an Acute Kidney Injury. At the time, it was badged as something far graver than that. I cried for what felt like days. I got so angry with My Myeloma, I told it I hated it. I begged for a reprieve, identifying many people other than myself who deserved the award for ‘Most Deserved Recipient Of The Most Stubborn Myeloma in This Fair Land.’ I really am not saying that other people deserve this illness; I was just surprised to learn that I had not come to terms with the fact I have it. Death seemed so much closer than before I walked into clinic on the 7th September. I don’t know when it will come and that’s the scariest part. How long is my piece of string?
My need for tears grew when I was taken off my morphine, which I had taken in slow release form everyday for five years. There were nightmares and ticks, to accompany my sickness and diarrhoea. I won’t lie; it was a tough, sleepless few days.
Do not fear, I will not prolong this anymore than I need to. They require near constant testing, but for the moment, my kidneys are behaving. It took a week or so for them to turn around. For how long they’ll stay in this state, only time will tell…

Six weeks after I entered UCLH, on 19 October, after a lot of pushing from my family, I was discharged. Gone were the at least daily bloods, out with the cannula resulting in the constant beeping of unanswered alarms. Goodbye to the four hourly observations, even at 3am. Welcome to sudden and ill prepared loneliness with an absent of nurses. So long institutionalised regime. Hello privacy. After six weeks, I am to fend for myself once more. 
Just between us friends; It’s fucking terrifying.

The view from my hospital window

EJB x
P.S. New treatment regime (Velcade twice weekly for three weeks;20mg Dexamethasone the day before, of and after Velcade; Veneoclax eight pills daily

It’s Supposed To Be A Marathon Not A Sprint

The month of August is the one month where I am guarenteed to feel nostalgic about my life pre and post My Myeloma. I might have such thoughts at other times of the year, but these usually occur when I am in some sort of drug and/of fear induced melancholy. August however, is different and this August has been more so.

August marks the anniversary of my diagnosis, my Cancerversary if you will. This year it was my five years Cancerversary. Not only do I get warm and bleak feelings about my once able body in the run up to my diagnosis. I am reminded of the stats. I am reminded of the stats I was told on the 21 August that I was then quickly told to forget about. ‘Survival rate is about 10 years, but this may be different for you because of your age’. I have had other stats thrown at me in the five years since, usually at the start of each treatment and with each treatment, My Body has come up wanting. 

There are several important dates in August; admittance to UCLH on the 14th,preliminary diagnosis on the 17th, formal diagnosis on 21st, kyphoplasty on the 24th and treatment commencing on 28th; each are packed full of memories.  This summer, I have found the memories on these dates amplified. Maybe it is something about five years and the fact that anniversaries are usually celebrated in fives. Maybe it is because I have felt my current treatment fail leading to the constant whirl of long forgotten stats and the big question that is , will I make it to the next big anniversary? Try as I might, I cannot forget about this. I even struggle to schedule a brain appointment for it, so I can lock it away again until the next scheduled appointment; my usual coping mechanism.

Every year since the cement was inserted into my L4, I have had to complete a survey about my health. What is that but a ticking clock counting down to… something? This year, the Medically Trained Person at the end of the phone said to me ‘don’t worry, next year is the last year we have to do this’. I responded, quite seriously with ‘good, that gives me something to aim towards. I hope I get to speak to you next year’. 

Some people may call these thoughts unhelpful and morbid, but I call them realistic. To me, not talking about my death, doesn’t make the chance of it less so. Avoiding such talk just makes me feel more isolated than my body is currently making me. I’m do not feel in anyway ready to kick that bucket, but I am realistic to the fact that in the five years I have had myeloma, I have had three failed transplants, multiple failed treatments and two, yes TWO failed trials. Yesterday, I was informed what my aching back had been telling me for weeks, that the Daratumamab trial had failed. I was taken off it immediately, and today I shall return to my home from home of UCLH, with the hope that they can pull something else out of the hat.

I think the fact that it was August has made me hypersensitive to any changes in my body, because those changes mirrored to some extent what I felt all the way back in the Summer of 2012. August 2017 is not the first time I have been made bedbound with a sore back. The difference now is that I know what is causing my sore back now, but I do not know the extent of the whys it if the damage is permanent. Nor is it the first time I have had high calcium, as I was told I had a fortnight ago. I was admitted to hospital in 2012 with high calcium. I have a constant sense of  déjà vu, mostly concentrated in my belly of worry. The difference? I no longer have the naivety and hope I had at the end of August 2012 that carried me along for years. 

Today, I feel like my chances of survival are dwindling. 
Three weeks ago, I turned on my television to find what the BBC were billing as a second Super Saturday. I had tuned into the athletics and believe it or not, a sporting even where people are at the peak of their physical fitness reminds me that I am not. As strange as it sounds, I feel like my diagnosis and thus My Myeloma by default is intertwined with the recent history of the sport. 

During the first fortnight of August 2012, I, like most of the country was glued to the London 2012 Olympics. I was sick at this point, but I did not know why. I recall Mamma Jones telling me on Day 1 of the Olympics that I looked grey and weak. I didn’t believe her, all I knew then was that I had a never experienced pain in my back before and that my GP could not diagnose it. Whilst I was waiting for an answer, I was prescribed a pain medication that made me slur, which led to me being signed off work. Well, removed against my will  from the office. So, I got to spend a fortnight, unable to move from my sofa (it wasn’t a sofa then but a really uncomfortable futon not suitable for grown ups), watching the fittest of the fittest take each other on in a myriad of activities. My memories of this time are fond ones. The irony that I was so enthralled by a sporting event pitched as the ultimate sporting event, whilst I was physically deteriorating day by day, does not escape me. The sane feelings emerged during the Paralympics, only with these games, I had the added jealousy of hearing how these athletes had managed to overcome adversity to be there. 

By the time the next Olympics and Paralympics rolled round last year, I knew that I was once again hooked. Watching as many events as possible was akin to torture but a torture I had welcomed. The athletes wept and I wept. I wept because I felt their pain. I wept because I knew that I was long past the point of ever being able to run anywhere let alone complete  a marathon. I wept because I knew I could not jump over a hurdle and I wept because I would never being able to learn to ride a bicycle around the corner let alone a Velodrome. When the games ended, I wept because I feared that I would not be alive for the next games in 2020. A feeling based on my then trajectory and not depression.

And so, with this year’s World Athletic Chanpionships being held in London, I was engulfed with myeloma based emotions once again. They have statistics too. For all the trying and all the rules I imposed on myself, this month had me thinking about my stats.

 I cannot help to being a different person now to the person I was when I was diagnosed in 2012. 

As scary as all the stats were back then, like I said earlier, I was naive to what they meant or could mean. I thought and hoped that I was told to pay no attention because I was going to be the medical marvel who could withstand every drug thrown at me and survive. I thought remission was a distinct years plus possibility. I believed I had many days ahead of living in me.  Now, in 2017, I think the stats have been long thrown out of the window and the best I can hope for is to exist day by day and try to fit some living, when my body allows, in there too.

There are moments in time when I feel tremendous guilt in how, after just five years, I could end up here. Should I not be pre-paying for my funeral? Is getting a will a sign of giving up rather than an act of mere financial sense. I know my nearest and dearest loathe me talking about the possibility of my death, and now I fear that  these once in a blue mood chats, honest chats, have tipped my hand. I hope not, and if push came to shove, I believe not, and yet I still have moments when I feel guiltily that I may have jinxed myself. Perhaps this is how a favourite athlete feels when the bomb out in the semi finals… 

I know in regard to my treatment that I  done everything I was supposed to do. More open to discussion is how I have mentally got through the last five years, but with regularly counselling sessions and honesty, I personally believe that I have done everything in my power to not be in the medical position I am in today. I renewed my latest cinema memberships by direct debit, not for the financial benefits but because I wanted to commit to being a member next year. For all years. Last week, I spent far too much money on bedding and other soft furnishings, and I spent that amount of money because I want to believe that I will need said bedding for a long time to come. A fortnight before that, I invested in a limited edition backpack, not just because I liked it, but because I needed something of good quality for all my future visits to the hospital. I have more examples, but essentially, I do things to show I am not ready to die. 

My treatment has failed. Again. As of March, I had exhausted traditional myeloma treatments. That’s a lot to take in and let’s face it, these are odds never in my favour. That was a failed attempt to  shoehorn a film quote into my blog, the odds are not in my favour. 

I was supposed to have at least ten years; the marathon. Five years might not exactly be the 100 metre sprint, but it’s no marathon. I want the marathon.

Let’s see what is offered to me today. Who knows, I might be reinstated.

EJB x

Things Fall Apart

“There is no goal, but only the path.”

Taoist saying



Recently, my wife and I traveled with friends to Glacier National Park. Our journey through the Northwest included a stop at the classic Davenport Hotel in Spokane, WA. From there we visited historic lodges in Montana and Waterton Lake, Alberta. We dined in expansive dining rooms, day hiked around glacial lakes, and played cards in the grand lounges constructed from massive logs harvested a century ago.

One of our companions is a retired journalist. But the writer in her is still working. This summer she ruminated about the labels for our aging populace in an OpEd for the Seattle Times. Her main premise: “Language reflects what’s important to us and communicates our feelings as well as thoughts. And it’s always evolving.” With respect to words like elderly, older, and senior citizen, the aging labels “start feeling out of date or too confining.” People are living longer and their later years are more active and healthier. Accordingly, we need a vocabulary that speaks to the new realities.





So, too, the language of cancer evolves with improvements in quality of life and survival statistics. For example, I prefer the label “veteran” to survivor and QOL drives my choices in therapy, not lab results. Relapse, remission, chemo, and even the word cure have more nuance in definition than the same words of decades past. To these subtleties we can add concepts such as immunotherapy and monoclonal antibodies.

For me, things fall apart … and then they come together again. That’s been my experience living with cancer. The lesson, like a Buddhist riddle, is that nothing really gets solved. For many patients, the challenges come and go and then they come and go again and again. Me? I get better, then I relapse and then I get better. Right now, I’m good, and what lies ahead is, well … it will be different.

This coming December will mark ten years since I was diagnosed with multiple myeloma, an incurable blood cancer. I expect to be here to celebrate the occasion. My disease, though evident in laboratory tests, persists in tenuous stability.




Furthermore, in my mind, the cancer, in spite of a rigorous ongoing treatment program, has achieved a ” a cured state.” I have doubled the original prognosis. And, as the patient, its my privilege to define the situation. Living these ten years with MM has been like having a long conversation with my body: my body on drugs; my body on aging; my body as a vessel of consciousness; my body as it used to be; and my body and the certainty of mortality.

I am held together periodically with neck braces, back braces, chemical poisons, uppers and downers, and the luck of having inherited a constitution that can tolerate treatment. I manage neuropathy, anemia, pain, and etcetera. Yet, like soft luggage, there seems to always be space for one more item. Whatever is next, I’ll try to make room for it.

Tagged: anemia, Arlene Bryant, cancer, chemotherapy, Davenport Hotel, Glacier National Park, mortality, multiple myeloma, nature, peripheral neuropathy, Prince of Wales Hotel, remission, Seattle Times, steroids, Waterton Lake, writing

Trial By Error? 

It has been a mere 16 weeks since I started my trial, which now consists of fortnightly doses of Daratumamab, steroids and an antihistamine. 

I say ‘mere’ in an attempt to justify the fact that there have been no blogs for nearly that entire period. On the one hand, mere sums it up nicely. The weeks and the doses have flown by and I have nothing to show for it. Looking back on it now, I feel like hardly any time has passed at all. 

On the other hand, I am telling major porkies, for there have been several periods during the last 16 weeks where I would have described the trial as relentlessy slow,  frustrating and exhausting. Perhaps if I shared these feelings with you at the time, I would made things just that little bit easier for me. I could have had mini data dumps on you and off loaded. I was just too tired to put words to keypad.

There is another reason too, one which came into my head only yesterday. On this trial, I am always waiting for something. Waiting for a result, waiting for a clinic appointment, waiting to see how I feel, waiting for a development. Waiting for something that gives me some sort of conclusion to these short stories about my life that I have decided to share with you. The conclusions have not come.  Thus, this has made me feel like any recent story I had to tell about my treatment (or anything else for that matter) would be incomplete. It worried that it would be more of a whinge about how much of my life is about waiting for something to happen with my treatment. At times, it feels like I am waiting for everything. I do not wish to come across that way. I like to think I am realistically positive, but can that be interpreted through my writing when my brain feels less able than it was when I started it. 

I like a story with a beginning, middle and and end, featuring as little ambiguity as possible. Don’t get me wrong, I do not need to be spoon fed (drugs permitting) and I can withstand the test of endurance that is a modern day Terrence Malick film, or in fact any film that is described by a film critic as ‘meditative’ but personally, I prefer just a little bit more clarity. And my life of late has been left severely wanting in that area.
So, here I am. There is no end to this story. All I can say to you is that I am not dead. Not yet. To those of you who were concerned that I may have passed to the other side, I thank you for thinking of me and for worrying about my absence. I am back. It does seem like a lot is going on at the moment, so I will have many a half finished tale to tell you. Fingers crossed.

Yesterday, the 17 August, marked my five year cancer anniversary. It was a loaded day. There is so much to remember about this period, and Daratumamab accounts for just 5% of the five years. You would think that I would know by now that I rarely get an end to my stories. Only occasionally have I been able to announce an end; the end of a chapter, or an end of volume have been my particular favourites. In reality, I know I should just face the facts that my life from now is ongoing, until it stops. And thus, I have no excuse to not share what is going on with you. You are, after all my cancer diary. 

Getting back to The Daratumamab, the one thing I do know, is that it has not been easy nor straight forward. Has any of my treatments? 

I flew into this treatment after a week’s radiotherapy and two weeks after I had received some very bad news. I was shell shocked and exhausted. I started the treated not knowing what it was and without fully understanding what the aim of the treatment is. I still don’t know and this is because every time it is explained to me, my painkillers kick in and my brain floats off into NeverNever Land.  I just know that being on the trial far outweighs the alternative of not, and for now, that’s okay with me. 

If I have learnt anything important since I started on the Daratumamab, besides from how to pronounce it, it’s that being on the trial is better than not being on it. It may be lonely, my body may be being used as a corporate guinea pig, but I don’t care. I am happy I am on the trial. Scratch that, I am grateful to be on the trial and everthing it encompasses far outweighs the negatives of being on a trial. The negatives by the way, are several, but in the grand scheme of my life, I can live with them. 

It would be really nice if I were now to talk you through each of my treatments. To build up a narrative, and to get you to feel even a little bit of what I feel every time I enter St Bartholomew’s Hospital and the times I am not there, lying in my bed thinking about it. That’s an awful lot of visits to go through and my short term memory is highly questionable, so I am not going to do that. Maybe I will one day. Maybe I will today. Right now however, I’m going to jump straight into what I assume you want to know and that is, how am I doing? 

How am I doing? 

Medically, I had to wait a long time for that to be answered. Two weeks ago, I did have an answer, but as of yesterday, I am right back into the Land of Worry, led by the President of Anxiety with her Cabinet of the Unknown. 

I did not have a clinic appointment for the first two cycles, which for cyber attack reasons, was nine weeks. Before that, I faithfully went in for my treatment each week, without knowing if the trial was doing anything. I went through various emotions during this period and in the end, I had decided that I would prefer to not have clinic appointments and only be informed if something bad was happening. Unfortunately, I didn’t actually tell any Medically Trained People this, so when I was telephoned on a Friday afternoon to say that I had to see The Big Prof on the following Monday morning, great panic ensued. Why now, I thought? Why with the greatest of haste? 

In my panic, I ignored the fact that the appointment marked the end of my weekly doses and the beginning of a new cycle. I also ignored the fact that I had not seen The Big Prof since I had walked into his office eleven weeks earlier and he made a space for me on his trial. I irrationally thought the worst.

This was sometime around the beginning of June and I can confirm that it was not the end. My paraprotein had remained stable throughout the nine weeks of treatment; it had not fallen and it had not risen. As a layman, I would have liked to hear that my paraprotein had gone down, but The Big Prof said he was happy with my results and signed me up for another cycle. I was to return to see him at the end of the next cycle, four weeks later. Apparently, that’s how frequently I should have been seeing him; at the end of each cycle. 

Something happened between my first clinic appointment and the second appointment. Well, a few things. I went on holiday, which meant having a month’s break between treatment and more importantly, pain returned to my body. That’s wrong too, I am not sure why I am unable to say what I mean on the first attempt. Pain is a multiple, but mostly managed daily experience. I do not have a day without pain. The word I omitted was ‘new’. New pain returned to my body. I have only experienced ‘new pain’ in the past when my disease was increasing. So, in this circumstance, I did what any sensible person would do who was desperate to go on holiday. I kept it a secret. I kept it a secret for two whole weeks before I blurted it out to Mamma Jones before we went on our holiday. I do not think I could have held it in any longer without inflicting serious mental health issues upon myself. 

Three to four weeks later, it was clinic time once again and if I thought I had been nervous at the start of June, I do not know what words could be used to describe what I was feeling on 2 August. It was not pretty. I had roped Mamma Jones into this one. I knew I could not do it alone and not surprisingly, my dear Mamma used up a day’s annual leave to come and support her baby during her appointment. I’m not ashamed to admit when I need my Mamma and she is always willing to oblige. I don’t want to gloat, but she does it so well. She even managed to keep me calm during the two hour wait in the most uncomfortable of uncomfortable waiting areas with her small talk and usually, small talk is not her forte. 

I had somehow managed to avoid thinking about it on holiday, despite increasingly bad pains, which just so happened to coincide with too much physical exertion. My holiday is another blog, but for this story you just need to know that I pushed my body to it’s limits, and beyond what I have medically been told I can do, so I could enjoy myself.  Experience it properly. By the end of the holiday, I could no longer put on my own shoes and socks. It was all worth it of course. The new pain, however in my right rib cage, once the excitement of the holiday was over, started to cause more pain than just the physical pain. 

So, having self diagnosed myself, we walked into the Medically Trained Person’s office to be told that everything was okay. I was shocked. My paraprotein still remained stable and despite putting on a bit of weight, I was clinically well. Mamma Jones and I left, I apologised to her for having to lose a day’s annual leave over nothing and I breathed a massive sigh of relief. Or four.

It was not long however, maybe even in a matter of hours, that I realised that I was predestined to have these feelings of anxiety repeated in the lead up to all future clinic appointments. I personally feel like I am hanging on to this trial by a thread, with what happens to me, being completely out of my control. When the bad thoughts creep into my head, I do quickly try and grasp on to a more positive spin. I want to stay on to the trail. I want to stay on and experince more of what this mortal coil (the right term for the state of the world at the moment) has to offer. I would say that in the circumstances, I am as positive as I can be. I’m realistic with it too, so when I feel something new in my body or I experience something that is not quite right, I am bound to worry. I am concerned that there are times that I can be too negative. I have discussed my behaviour with my counsellor and she says that pre clinic anxiety is perfectly normal and that acknowledging my fears is much healthier than behaving like I do not have cancer and I am not where I am in the long line of myeloma treatment.  I’ll take her diagnosis. 

It does feel natural now to worry about my success on the trial, given there isn’t that much out there, drug wise available to me. I can understand why I never truly feel comfortable too. Between appointments, I try to block as much of this out as possible. In my free time, I make sure I do as much as my body enables and that definitely goes someway to refill my faithful old ‘good cylinder’. Since my treatment moved to fortnightly, I have fully embraced getting a week back of my life, and I use it productively to live and not wallow. I have also lost the guilt I felt whilst my treatment was weekly, that I was not living enough. I was just too bloody tires 

In the last few weeks of the weekly doses, I really struggled. During the first few weeks, I had calculated that with treatment including steroids on a Thursday, steroids at home on a Friday and Saturday, followed by the inevitable crash on at least Saturday if not Sunday (and Monday), I was afforded two to three good days before I was back having my bloods done on a Wednesday morning. Then, everything started again on the Thursday. That two-three ‘good days’, days in which I was able to do something like a single trip to the cinema or a trip to the pub were invaluable but fleeting. A ‘good day’ did not equate to A full day. 

Gradually, as the weeks progressed, the number of ‘good days’ decreased and I longed for the fortnightly treatment. I had a week off treatment because my hospital was a victim of the NHS cyber attack, or whatever you wish to call it; I am no IT expert.  That week gave me a taste of what was achievable in a week off, and it felt like  freedom. Realistically, when you count the days I had appointments at UCLH too, I was down to one ‘good day’ by this point. As much as I enjoyed that week’s break, it made the remaining weeks feel like torture. Thank goodness for my Support Network.

I started receiving the Daratumamab fortnightly on the 14 June. To date, I have completed one and a half cycles, which equates to four doses. Technically, I do not require any more doses in this cycle but the next one, will not (hopefully) start for another 13 days. 

All of that nearly brings me up to date. Nearly. Yesterday was treatment day and it was five years and three days since I was admitted to another hospital with an elevated calcium level in my blood, leading to my diagnosis of multiple myeloma on 17 August 2012. Yesterday, I was told that I once again had an elevated calcium level. I am sure there are many medical reasons for this result, but to me, it answered my questions of why I have been experiencing the ‘new pain’, memories of five years ago fresh in my mind.  

The Medically Trained People I saw yesterday were ward based, which means they are not responsible for my overall treatment, if they know anything about my overall treatment at all. They approached the subject part calmly and part like a headless chickens.
The news of a high calcium level was met with my tears. The tears may not have come were it not for the anniversary, but I doubt it. I am so aware of failure that I probably would have blubbered like a baby regardless of the date or regardless of the cold way it was broken to me. “Are you on any supplements?” probably was not the best way to tell me, but that’s what happened so I just have to move on and acknowledge that the Medically Trained People working on St Bart’s daycare are extremely busy. 

As I wrote a few paragraphs ago, the result would answer why I had been experiencing the ‘new pain’ and generally why I have recently been feeling a little ‘off’. I asked  for my paraprotein result and I was told by the doctor that it had risen by a tiny amount. ‘Tiny’ was emphasised by a hand gesture and a closed eye. I asked for the actual figure and it had risen by six based on the bloods taken on 2 August. Is an increase of six tiny? I would have said it was, but then, I am not medically trained. 

So, where does this leave me now, does this story have an ending? In a word, or in four words, I do not know. Yesterday it meant receiving two large bags of fluids, which has left me peeing practically non-stop since. In terms of my long term health?  I do know is still my answer. I will have to wait for my next clinic appointment on 30 August. A clinic appointment where they will thankfully not be working on month old results. I know it will be a clinic appointment where my anxiety levels will once again go sky high. I will try and live next week, but I doubt the next clinic appointment will be far from my mind. 

Last week, I told various people in an attempt to justify my feelings about my treatment and life in general, that I lived month by month. I strongly, most adamantly believe this to be true. It’s like waiting for scraps, accept just with higher consequences…

So, this blog has now come to an end.  Is there an ending? I hope it is not the start of one. 

EJB x