Indian Summer

Extraordinary morning light graced with a full rainbow.

Extraordinary morning light graced with a full rainbow.

In northwest Oregon, the year’s most reliably pleasant weather occurs during Indian Summer. Today, on the eve of my 70th birthday, I strolled along the waterfront of the Columbia. The prevailing westerlies have lost their enthusiasm. This morning, the river laid flat. Paddle boarders cruised the smooth surface under a cloudless blue sky.

Elsewhere, the convergence of seasons tremble with change. Hood River’s harvest of pears and apples winds down with the decline of summer. Farm workers stack their ladders with a clatter onto a trailer, returning them to a barn for storage. Forklifts load the last bins of fruit onto flatbed trucks. Air horns toot as they head out for the packing houses.

Spanky in nature's paint box.

Spanky in nature’s paint box.

The foliage of the orchard trees is still green. But other varieties, the maples, the locusts, and the poplars, hint at colors to come. Soon, frost will tip summer into autumn. Then, county roads and forest trails will display the bright colors of nature’s palette in the flattering, glamorous light of the descending sun.

The rhythm of the season resonates with me. I am, after all, a fall child. This year, my recovery from summer’s bout with pneumonia frames my appreciation of the natural world. That experience shook me up. I felt the terror of panic attacks for several weeks. Did I come close to the realm of dying? Yes, I think it’s fair to say that I was in the neighborhood.

On the cusp of autumn.

On the cusp of autumn.

I am blasé about it now, just two months removed from the fright of being unable to breath. My physiological immune system may be compromised by cancer, but my psychic immunity responded well to the salve of time. I relaxed and compartmentalized the fears. And, observing the natural world assists with adapting to how fragile life can be, how brief is our time under the wondrous canopy of consciousness.

Tagged: cancer, cats, Hood River, Hood River Valley, mortality, multiple myeloma, Pema Chodron, Pneumonia, writing

National Parks

Lake Crescent Lodge

Lake Crescent Lodge

Recently, just prior to my getting pneumonia, my wife and I traveled to Olympic National Park in Washington State. Two friends from Seattle joined us for the trip. We stayed together at Lake Crescent Lodge, which is located just inside the east boundary of the park. 

Our history with national parks is long and strong. Growing up in California, my family vacationed annually in Yosemite National Park. Later, as a college student, I worked there during the summer months. Then, after finishing with school, I decided to see all the seasons. I got a job at the Wawona Hotel, which is located inside the south gate of the park. A small pocket of private land with vacation homes and tourist accomodations exists adjacent to the hotel. I found a small cottage to rent and stayed five years.

My wife worked as a waitress at the hotel. She had followed her own unique path to end up at Wawona, where we entered each other’s orbit. With the blessing and oversight of the winter caretaker, we were married there on February 1st of 1975. 

1976, New Zealand. Arlene, Kevin, Marilyn, and me wearing our NZ bush shirts.

1976, New Zealand. Arlene, Kevin, Marilyn, and me wearing our NZ bush shirts.

Soon thereafter, we immigrated to New Zealand. During our 2nd year there, we quit our jobs. I rebuilt a Volkswagen van and we set off on a six month adventure through the north and south islands. 

On Thanksgiving week of 1976, we stopped at Tongariro National Park, a volcanic wonderland in the center of the north island. We hiked the trails of three active volcanoes, Mts. Ruapehu, Ngauruhoe, and Tongariro. We used the park’s campground as a base for our activities.

And, this is where we met our Seattle friends. As fellow Americans, the holiday drew us together. They were hitchhiking and we had a van. The joke is that we picked them up and have not been able to get rid of them.

We traveled together for the next several months. Periodically, we went our separate ways with the agreement to rendezvous elsewhere. During these travels we bonded over the rugged beauty of NZ. We backpacked together, endured rainy periods, and shared long nights of card games in the country’s campgrounds.

2016. Atop Marymere Falls. Kevin, Marilyn, Arlene, and me celebrating 40 years of friendship.

2016. Atop Marymere Falls. Kevin, Marilyn, Arlene, and me celebrating 40 years of friendship.

Accordingly, on our visit to Olympic National Park, we spent time much like we did years ago in New Zealand: day hiking, eating good meals at the lodge, and playing cards by the fire at night.

This week, as our country celebrates the centennial of America’s National Parks, we are making plans to visit Glacier National Park next year. Once again we hope to share the heritage of our preserved parklands and a friendship nurtured by their beauty.

Tagged: cancer, Centennial of National Parks, Hood River, multiple myeloma, nature, New Zealand, Ngauruhoe, Pneumonia, Ruapehu, Seattle, Tongariro National Park

Better Still

Today I felt much more like myself, even went for a stroll and mowed a little bit of the lawn.  Temps are normal and the pulse oximeter regularly shows numbers in the high 90’s.

The pneumonia is on the run, and I won’t post any more about it here unless there is a dramatic reversal.

Recovering at Home

They let me out of the hospital this noon, and I like being with my loved ones.  I feel a little better than yesterday, but the regimen is about the same at home as it has been in the hospital. Levaquin 750 mg once daily, probiotics to mediate the effect of the Levaquin on the stomach, lots of sleep.

I’m pretty sure that the pneumonia is viral, not bacterial, because it has responded so slowly to three different antibiotics.  Nevertheless I’m taking the Levaquin, despite its risk to the Achilles tendon, in case it really is a virulent bacterium.

Right now my temp is generally around normal, which is a definite improvement, and I have some appetite.  However, blood oxygen isn’t much better than it was when I called 911. I have my own pulse oximeter now, which normally would have me at 98 or 99%, but now typically shows low 90’s, which means that my lungs are not yet working very well.

Time will tell.  More tomorrow, probably.

Feeling a Little Better

Still in the hospital.  My temperature seems to have stabilized near normal, I’m coughing a little less, and blood oxygen (without supplemental oxygen) is up in the 94% range.  However, pulse rate and respiration rate are unchanged and much higher than normal, so the jury is still out.

For the medically inclined:  I was started on a Z-Pak (azithromycin) Monday, then in the hospital they added a cephalosporin IV antibiotic Tuesday.  By today (Thursday) we didn’t see much progress, so the hospital doctor finally talked me into oral Levaquin, dropping both of the others. That dose was this noon , so it’s had only about nine hours to take effect, and obviously I don’t know which antibiotic regimen might be working, if indeed anything really is working.

I’m nervous about Levaquin, because it’s one of the drugs that can cause the Achilles tendon to rupture.  If that happens my running will be dramatically curtailed (zero).  However I finally agreed to Levaquin because I didn’t see progress on the other meds, and I can live without running but I can’t run without living.

As always, I’ll know more in the morning.  I’m still alive and there is a little more light at the end of the tunnel.

Pneumonia Again

July 30, 2014

CRAP! Pneumonia certainly puts a crimp in marathon training. I have a marathon coming up in early september, with a good plan for ramping up carefully to a 20-mile long run three weeks ahead. That’s what you do. Setting aside the obvious life-threatening aspect of pneumonia, however, at the very least it puts a big crimp in the training plan.

I’ve had pneumonia five times in my life now; three times it was viral, once bacterial (last February), and now as-yet undetermined. In February the high-power IV antibiotics took effect within a day, and got me out of the hospital in two days. This time I’ve been in and out for two days already, and there is little evidence of improvement. I still have a little fever, low pulse oxygen level, a high pulse rate, and a high respiration rate. If it’s viral instead of bacterial, prevous experience suggests that the resolution will take weeks instead of days. Grrrr.

Maybe I should just stop whining and be glad I’m still alive. Eventually I will be running again, but that’s not the top priority.

I’ll know more in the morning. Perhaps the pneumonia will take a sudden turn for the better, or the doctors will try something different.

Infection alert!

Friday morning, 4 April, saw me not-quite-leaping, more like cautiously rolling my stiff self, out of bed at an early hour to go off to volunteer at a Register & Be A Lifesaver [R&BE] stem cell register recruitment event at Chellaston Academy school in Derby.

20140410-192412.jpgThe school are very supportive of R&BE and the teachers made us welcome, while the Year 12 students waited patiently and good-humouredly for their turn to spit into our little tubes. Despite not feeling 100%, I did my bit and between four of us, we registered 77 eager young people. It was an excellent morning’s work.

I got back home late morning and gradually began to feel less and less well and more and more incredibly sleepy and shivery, until I gave in and fell asleep on the couch under a blanket. I had an appointment for an MRI scan at 6:30, which I thought I might be able to make, but I slept right through until the ringing of my phone woke me up. It was already 6:30 and the scan department were asking where I was. I apologised but there was nothing I could do. I felt dreadful. Even if I had been awake, I wouldn’t have felt able to go. The appointment would need to be rearranged.

A bit later, I fed the cat, had a drink and crawled upstairs to bed. I managed to remove most of my clothes, leaving them exactly where they fell on the floor, and collapsed into bed in my t-shirt and knickers. On Saturday morning I realised that I’d gone to bed without removing my contact lenses, so I removed them and found that my eyes were so dry and sore that I couldn’t see or even open my eyes fully. Then I just slept and slept and slept, with brief awakenings for cat feeding, the odd drink, toilet visits and teeth brushing because my mouth felt so disgusting. The teeth brushing didn’t do much to alter that.

I was supposed to be on training on Saturday afternoon for a new voluntary project I’ve recently signed up for, with Nottingham Nightstop, being a host for a homeless young person for a couple of days a month. I knew I couldn’t make it, but I also couldn’t see any details on my phone to call to let them know I couldn’t come. I wrangled with my sense of responsibility for a while until I realised that there was nothing I could do and I would just have to deal with it later.

Despite alternately shivering and sweating, when I took my temperature, it was its usual 36 point something (just below what is considered normal, 37°). It even went as low as 35.6°. I did not have a temperature. I was surprised but very relieved.

Like any post-transplant patients, I have to be careful about infections, the best indicator of which is a high temperature, i.e. over 38°. If my temperature gets to 38° or over, I am supposed to call in to the hospital and as has happened in the past (in August 2011: here and here, then in December 2012: here and here), I know they will want me to come in for tests, treatment and monitoring.

Both previous times, the infections were quickly and easily treated even though they didn’t manage to identify exactly what bug I had and I was discharged after two nights each time, which is for me, two nights too long to be in hospital.

So when I woke on Sunday, like a good girl, I took my temperature again. It was now 37.1°, which is by no means high, although a little raised for me. For some strange reason, I decided to check again and this time, only a minute later, the thermometer read 38.5°. Struck by the difference, I took it again. This time I was distressed to see that it had risen to 38.6°. Now that is a high temperature!

I called the Haematology pager holder and was gratified to hear one of the Myeloma specialist nurses, Jenny answer. As I described my situation, she recognised my voice, which was most comforting, particularly when I was feeling so dreadful and alone. As expected, she told me I’d need to come in. And, also as expected, there were no free beds on either of the Haematology wards. I would have to go to SRU (the Specialist Receiving Unit).

IMG_2986I duly packed a case for about two days, asked my neighbour to feed my cat, Myfanwy Lovebug and dressed in a fashion… By which, I do not mean fashionably; I mean, I just put a dress-like nightie on, with no bra or socks, just boots and a big cardigan… and knickers of course… You can’t go anywhere safely without knickers!

Still feeling woozy, I gently and carefully drove myself to the hospital and checked in. No, it’s really nothing like a hotel, but what other term could I use?

Having tried to cannulate me a few times in my arms and hand, without any luck, they took blood for cultures out of my Hickman line. They weren’t keen to do this initially, because a Hickman line is a prime source for infection, so a ‘purer’ blood sample from a different site would be better. Alas again, my veins weren’t playing ball.

20140424-162704.jpgOn Tuesday, having filled me up with fluids – I’m not joking, I put on about 4.5kg just from the fluids… and most of that in my feet – and two types of broad spectrum IV antibiotics: Vancomycin and Tazocin, they advised me that they’d grown a culture of staphylococcus aureus from my blood.

Here’s the science bit:

Staph. aureus is a common and pretty harmless bacterium found in the respiratory tract and on the skin, but in the blood it can be life-threatening, because the bacteria can travel through the bloodstream and infect almost any site in the body, particularly heart valves, bones and lungs, leading to endocarditis, osteomyelitis or pneumonia.

Apparently, and clearly what happened with me, the bacteria can accumulate on medical devices in the body, such as a Hickman line, which is inserted through the skin into blood vessels.

And I’ve just found out that MRSA, which all in- and out-patients get swabbed for on a monthly basis, actually stands for meticillin-resistant Staphylococcus aureus. I never knew that.

They swiftly changed the antibiotics to Flucloxacillin, which has a much narrower spectrum of activity and is indicated for staph. aureus amongst other bacterial infections. Unfortunately, I had to continue with this regime by IV for a week, four times a day. That meant that I had to remain an in-patient.

The previous day I’d got it into my head that I’d had enough of being in hospital and that no matter what, I was going to leave the next day, even if it meant attending for treatment several times a day. The doctors, whom I trust, however, had other plans for me.

The news made me completely miserable. I am taking part in a year-long Certificate in Playback Theatre Practice, which takes place over nine months from March till November and that weekend (11-13 April) was the first of two workshops on Conducting. And no, we’re not talking about orchestral conducting. It’s about the role within Playback Theatre of the MC or director, the person who invites members of the audience to share their stories and invites the audience to “Let’s watch…” All I can say is that missing this weekend was a total bummer. I was so looking forward, not just to learning and participating but also to seeing some Playback friends from the previous workshop and from other Playback gatherings. Boo hoo!

But I had to just ‘suck it up’, as they say. Which I did and eventually, after a couple of days of sulking, I came around and surrendered to the inevitable. The inevitable also included being cannulated a total of five times over only eight days.

While I was in, partly due to how disgusting I find hospital food and partly due to the nauseous side effects of the antibiotics, I couldn’t eat a thing. I kept my fluid intake up but my stomach was grouchy and gurgling and that alone made me feel dreadful. Not even mentioning a few bouts of incontinent diarrhoea, brought on by the bloody antibiotics. Oh joy!

On Friday evening, my good friend Janet came to visit, complete with clothes she had fetched from my house and a Chinese take-away. I gobbled it down and we had a fun, if somewhat odd evening, chatting, eating and sorting out a knitting project that I had messed up, while ignoring the fact we were sitting in a hospital room. It alleviated the gloom I was feeling, but later my stomach revolted and gurgled into the night, along with a further unpleasant diarrhoea experience.

Finally, Monday came around and I was so happy to see Mark, the registrar, who told me I could go home. That was around 10:00. But of course, nothing is as smooth as I’d like and the oral antibiotics that I still had to take for a further week had not arrived from Pharmacy. Bloody typical!

I was not to be deterred. The nurse, Matt gave me my midday dose to take with me and I agreed to return later to collect the rest. I trotted off to spend a restful few hours at Maggie’s, on the hospital campus. I went across town for my 2:00pm Tai Chi class and returned after 3:30 to find that the lift up to the ward was not working. I climbed the stairs slowly and when I arrived at the second floor, was annoyed but not surprised to find that the blasted drugs had still not arrived.

Nurse Matt came to the rescue by offering to go and fetch them from Pharmacy, so I waited patiently in the Daycase waiting room and finally by 4:15, I left hospital properly and completely… with only the need to attend clinic again on Thursday. It’s never bloody-ending!

P.S. Common adverse drug reactions associated with the use of Flucloxacillin include diarrhoea and nausea. And yes, of course I continued with both even when I was back at home – adding to my already dodgy guts from Graft versus Host Disease [GvHD] – along with a mild bout of thrush, which I decided not to bother treating. I’m so sick of taking medication, I couldn’t bear to take anything else, and I only had mild symptoms. As anticipated, it went away once I was no longer taking the antibiotics. I’m getting quite good at being my own medical practitioner these days. Well, there have to be some benefits to this experience!

I’m fully recovered now except for my left hand which still bears the brunt of so much cannulation… One of the veins is raised and a bit hardened, so that in moments of boredom I can run my fingers over it, moving it from side to side, as though there’s a little tube inside my skin. I suppose it just makes me special, right?

Life Strings

With my usual oncologist on rotation in Kabul, Afghanistan as Army Reserve, I was reassigned to my original oncologist for the duration of his absence. He should be back in March –maybe April from what the rumor mill says. To quote Bobby Troup’s character  in the motion picture M*A*S*H, “God damned Army.” After 90 days of no oncology appointments I was finally called in for a look see. My original doctor, whom I haven’t seen in two years or so looked at me a little funny, and then turned to his computer to bring up my records. “You were in the hospital?” he asked. I spent five minutes explaining that I’d had pneumonia and spent time in the hospital, but I was back home and on the mend. Then he asked: “Home? Are you staying in a veteran home?”

“No,” I said. “I’m staying in my home.” I said.

“You’re not in constant care?”

“No, I live at home. I was only in the hospital because I had pneumonia. I don’t live in the long term care facility here.” I said.

He nodded with a perplexed look on his face and turned back to his computer. He spent literally fifteen minutes going through entry after entry in my record. After a while I tired of the silence and said that while my cancer was progressing –I had more lesions and more spinal compression problems, that I was managing pretty well on the pain meds. He asked how I knew my cancer was progressing and I replied that it could be seen in the multiple xrays that had been taken of me, including a pair of bone surveys in which my entire skeleton was imaged. I added that I had had a couple of CAT scans and an MRI, and all of which pointing to the bone damage creeping along through me steadily –albeit slowly. He then said that the only real way to gauge the cancer was looking at the protein levels and I reminded him that I was a non-secretor. No proteins to look at.

“Right. Right.” he said. “Well, don’t take this the wrong way, but I’m surprised you’re still alive. It seems as though you are doing better at fighting the myeloma than we were. But I’m amazed that you are surviving this long. I see your labs, and your blood numbers are pretty good. You’re a bit low on red and white cells at the moment and your platelets are pretty low, but all in all, well, I’m very surprised.”

“Personally, I don’t think it could have happened to a nicer guy.” I said. You gotta love it when your doctor is perplexed that you’re alive. Of course, after saying something like that to me I guess there wasn’t much more to say. Apparently he agreed.

He smiled and stood, an indication the appointment was over. “Keep doing whatever you’re doing.” he said. He shook my hand and sat back down and went back to reading my case records on his computer. It has been more than two years since I saw him as my primary oncologist, and he looked like he’d aged a lot more than I had. Gray was showing in the roots of his hair, a telltale he was a user of hair color, and his face was more deeply lined and his eyes looked tired. I, of course, have the visage of a studly twenty year old with six pack abs and clear eyes that radiate strength. Okay, that’s a load of crap. I look like a 70 year old cripple who uses hair color, except I don’t. For some reason, my hair refuses to give up its brown color, save for a few odd strands of gray here and there. I’m pudgy and have skin like tallow. But, as the doctor so quaintly put it, I’m still with us (even if I do look rode hard and put up wet).

At the first of the year I was dubious about my mortality. I was sick as a dog and barely had the strength to take the few steps from bed to bathroom. I’m well aware that I’m outside the boundaries of survivability, moving well away from the max amplitude of the bell curve.  So back at the beginning of the month I’d gone through all of the preparations I’d made for my passing, making sure all addresses were up to date and that all accounts were listed and how they were to be dealt with. All of my debts, save my balanceless Visa, are insured so my wife won’t be inundated with loan accelerations and other expenses. I’ve even made arrangements for, and paid off my funeral and cremation. I was feeling pretty low as the pneumonia gripped me like pray in the talons of a raptor, and figured that just maybe my string had run out. But no, in the hospital some unseen angel came and tied a few more feet of line to it and so my string is a bit longer. How much, I have no idea.

I hope it’s a long, long spool.

Following Up

Okay, say this four times rapidly: CEFUROXIME AXETIL. I sat holding the little amber jar in my hand and started at the label saying sefum, sefor-ix  a meh. And then just asked the doctor what it was. “This isn’t one of those superdrugs to fight MRSA or something, is it? I mean, I’m not going to start sloughing skin like a leper or something, right?”

“No no.” replied my doctor. “It’s a very potent antibacterial agent that we only use in cases where we’re combatting a severe and well entrenched bacterial infection. You pneumonia qualifies, especially since it’s spread itself beyond your lungs and is invading other areas of the body. You need to take the full regimen –that is, take every single pill, and make sure that you take this drug with food. It can be a little hard on the stomach. In fact, we’re giving you a little Omeperazole to reduce your stomach acid.”

“It’s a pretty big pill,” I said, looking at one. It was like a one inch long segment of a pencil.

“Take it with a big mouthful of milk and take it separately from your other meds so you don’t choke yourself.” I nodded my assent. “How are you getting along with the oxygen?” he asked me.

“Well, it’s made a big difference in a number of things. I was getting weird vision flashes and having difficulty focusing on stuff, and would run out of air just trying to talk to people. I breathe a lot easier and that weird stuff has gone away.”

“Good. Your oxygen density was down in the high seventies and making your heart work extra hard trying to get oxygen to the organs of your body, especially the brain. Heart attack and stroke are likely results if your oxygen isn’t pumped back up to at least the mid 90s.” He looked at the oximeter on my finger and said “see, your heart rate is 72 and your oxygen is at 96. That’s pretty good but it’s taking us pushing 2 liters of oxygen up your nose to get those values.”

“How long will I have to wear this thing in my nose?” I asked.

Probably between six weeks and the rest of your life. It depends on how well you respond to the treatment. Your pneumonia was masked by the pain and other symptoms of your cancer lesions and so it had a good, long chance to spread and take a strong hold on you. Your lungs are damaged and part of that damage is permanent.  We’ll do all we can to get you off the oxygen, but your ability to absorb and distribute oxygen will dictate the action we take. Keep in mind that your red cells are low, your platelets are low and you’re anemic, so your whole system is suffering. It’s not just the pneumonia, it’s that and the Multiple Myeloma that are working you over. You’re getting a one-two punch here so take the meds, get plenty of rest, try to exercise and and eat well.”

“Okay, how come you’re giving me lasix?”

“The Furosemide is to make your body purge water. Your illness and the meds we’re giving you tend to make you retain urine and so the lasix pushes it out. Note the edema in your ankles; that will go away because of the furosemide. The potassium is to make up for the fact that lasix will reduce your system potassium, and that can cause irregular heartbeat and other risky situations.”

“Well, this was a pretty crappy way to start the year.” I complained.

IMG_20140105_174900[1]“It’s been a bad year on a number of basis’ …the influenza season is on us and we’re seeing a much larger spread of mutations (types of flu) affecting people, and they are spreading more rapidly because they’re passed by both physical contact and breathing each other’s air. There seems to be more global travel going on this year and so we’re getting hit by viruses from all over as well as exporting ours to other countries. It’s a serious situation and people are dying because of it.”

“Yeah, I heard. I was sent a notice to report for a flu shot.” I said.

“Well, in your case, don’t. All it will do is give you a case of the flu because your system is too weak to create the antibodies flu shots are for. You already have a nasty bacterial infection and to add a virus to your woes could be catastrophic. I’ll put a note in your file so you won’t be inadvertently given a shot.”

“Okay, well, I stopped by the lab and gave them the blood samples you asked for. They took 9 little vials of blood from me and then handed me a cup and sent me to the rest room.”

“I know. I have the results back. It’s how we know the infection is in your bladder and stomach. But we should make short work of that.”

“Thanks. The idea of being sick makes me nauseous.”

“Good one. I certainly never heard that one before.” said my doctor, pokerfaced. “I want a followup xray in six weeks. Go in around the first or March and I’ll have an order in for you. There’s no need to make an appointment. Xray now works like the blood lab. It’s walk-in.” My doctor held out his hand indicating we were done. I shook his hand and thanked him for his help. “It’s what we’re here for,” he said, “but it’s nice to hear appreciation anyway.”

My wife stepped up behind my chair and rolled me out of the office and out to the parking lot. Time to go home and take a nap.

Collateral Worries

In dealing with Multiple Myeloma the focus stays pretty much on the cancer. But there are a lot of secondary issues that victims of the cancer must confront. As I write this I’m trying to not think about the pain in my sternum and spreading under my rib cage. My doctors calls it nephrotic syndrome and it amounts to me holding fluids instead of expressing them through the urinary tract. Basically, there are small perforations in my kidneys large enough to pass proteins into my urine, but not quite big enough to let blood through. But no matter, my kidneys aren’t working the way they’re supposed to and I’m starting to bloat. It began as edema in my feet, and has slowly progressed upwards through the legs, the abdomen and is now just reaching my chest. Fluid is filling the pleura, the membrane containing the lungs, so my breathing is being affected. Frankly, it’s kind of spooky.

Renal failure is not uncommon in Multiple Myeloma cases, but usually it is a function of paraprotein secretions that clog the organs, such as the kidneys. The way to deal with the problem varies by the type of kidney failure. Nephrotic syndrome isn’t the sort of thing that is easily treated and it goes away. It can stick with you for months or even years, and in some cases for the rest of one’s life. It may involve dialysis or even a kidney transplant. But with the kidneys malfunctioning, the body starts to go septic because it isn’t cleansed by the normal body functions. I had thought myself immune from such problems, being a non-secretor. But there are lots of different kinds of proteins in the body, some good and some not. And it’s bad news when proteins that are supposed to be in one place end up in another.

Of course, when the body isn’t functioning properly, the immune system is further compromised. I say further because an aspect of Multiple Myeloma is reduced immunity. Infection more easily invades the body, and with the results one might expect. At the moment, I am also dealing with a serious case of the sweats and I had to take a break in typing between the paragraphs here because I have the chills. Kinda difficult to type when you’re shaking.

The most common collateral issue in Multiple Myeloma is pneumonia. Quite a few of those in mortality statistics perish because of pneumonia, although the end responsibility is given to the cancer. Sensible, if it weren’t for the cancer, the pneumonia wouldn’t be so likely. Then too, the body can”t fight off the infections because of the reduces immunity, usually signaled by anemia. As of yesterday my blood numbers looked excellent, but infection progression can be swift, especially in bodies with compromised immunity. It makes for a vicious circle. After my appointment with the doctor yesterday, I was given a sterile jug and told to collect urine for 24 hours. This will allow the lab to do a workup that shows a more complete picture of the situation, more likely revealing proteins that could easily slip by in a single urination sample.

As well as the effect of feeling greater pain, and feeling physically ill, there is an emotional component. I don’t mind saying this is a frightening experience. Renal issues are no small matter and can, as mentioned, be a starting point from which discomfort speeds to a life threatening situation. Reading about my woes on the Internet only serve to make it worse, filling me in on all of the details for every little thing that can go wrong.

Of course, the last thing my doctor said was that he’d see me back again at the end of the month, which is a reassuring statement. It’s a lot easier to hear than being told to stay in touch and come back tomorrow.