Monday, January 28, 2008

Confounding Numbers

Sitting in the examination room on Monday. Waiting to get the velcade infusion and get out of there. No appointment with Rifkin, as I saw him last week. Expecting to get the results from the blood work that was drawn last Monday. The door opens and in walks Rifkin. "uh oh", I say, "What are you doing here?" He brushes my comment off and says its a good practice when my numbers are available for him to go over them with the patient. NOT! He rarely does that, and my blood pressure starts to creep up.

So, the Igg's have risen a bit in the last month(about 250 points) , but some of the other markers are very good. He must have said 3 times, "I'm not worried." We will stay the course on maintenance for awhile, although I was clear with him that I thought we had let the Igg's run up too high last summer before beginning treatment, as by the end of that run, I was very fatigued and my back was acting up quite a bit. He said if the Igg's continue to go up (which he isn't saying will happen in the near term), he'll probably "pulse" me with another few cycles of revlimid. As he left the room he looked me directly in the eyes and said, "you have a quality of life, Dan, and that's very important." That comment told me everything. The goals of treatment are as much directed at trying to give me the ability to have some normalcy in my life, while at the same time holding the disease at bay. Knocking me down with heavy duty chemo that might temporarily drive the numbers down wouldn't give me much quality of life. Better to play the "numbers rising, but I'm not yet worried" game and give me some good days. I can agree with that.

So, that's what living with this nastiness was like this week. Amazingly, I continue to think that perhaps someday I will go in and the numbers will all be normal. I'm reminded of a blog I wrote almost 2 years ago, on March 27, 2006, titled, "Musings of a Passenger on a Roller Coaster." Now, that was a down time. My transplant had failed and I had just been kicked out of a new clinical trial for not responding to the new drug. Rifkin wasn't sure what the next course of treatment would be or whether it would work. I had been moved to the top of the list for a second transplant with one of my brothers as the potential stem cell donor. We decided, at that time, to boost the velcade with some steroids and, miracle of miracles, it worked. We have come a long ways in 2 years, my friends! I certainly don't feel that I'm still riding the roller coaster, at least not emotionally. We've moved on to a different ride. Would it be the Tilt-a-Whirl? No. How about the Carousel? No. I'm thinking maybe the Ferris Wheel. It certainly has its ups and downs, but is a much gentler ride and you certainly get a broad perspective when you're at the top. Yeh, I'll go with that metaphor, although it's usually associated with a bit more fun than I think we're having. So, staying with that metaphor, I guess we're just swinging toward the bottom, but soon our gondola will gently rise over the carnival (I certainly like that description of our many lives!) and we will exclaim, "oh, what a great view!" Until we reach the crest, we'll keep our eyes looking upward. And the ride will continue and life will be good.

Much love to all,

Tuesday, January 08, 2008

New Year's Briefing

We saw Rifkin yesterday for the final dose of the first 4 weeks of maintenance. I get next week off and then start another 4 week cycle; provided the cancer levels are being maintained in the "acceptable" range. So far no blood has been tested to see if this reduced dosage is working and I won't have new info on "the numbers" until around Jan. 28th. Eliminating the revlimid from the regime has provided me great relief and even an uptick in energy. (or is it those notorious steriods?) I sure hope the maintenance works as a return to the revlimid would feel like shouldering a 100 pound weight for the upcoming months.

We had a nice and kind of quiet holiday, mostly with the family. The Williams family visited last week (they blog regularly--mostly Shawn and Jaike). They moved to North Carolina about 10 years ago, but they and their three girls are as interesting and lively as ever. Mike and Marta Dowell joined us and the Williams for an evening of Susan's cooking and catching up on our and our kids lives. It was great. The tree is down and tucked away and things feel like they're returning to normal; which means we feel a bit bored and are looking for a place in a warmer climate to spend a few days away from this winter weather.

Best wishes to all and may your new year be filled with joy, happiness, prosperity and good health.

Love to all,