Tuesday, July 21, 2009

Consistent labs, inconsistent points of view on lesser matters

Well, they were quick in the lab and I got the results of yesterday's blood draw, which were consistent with last Thursday. Trace M-protein in the blood. On the whole, this is good -- I'd rather have two consecutive readings which confirm the low number than have it bounce up. Of course I'd gotten accustomed to the notion of it being gone, but I must remember these are very early days. We could be seeing the ongoing impact of my FIRST transplant, much less the second, much less the consolidation treatment. I am confident that "trace" will become "none" -- it's just a matter of time.

Having said that...SOON, PLEASE. :)

The APN confirmed that trace is less than 0.1. She said we might also see a marking indicating that they aren't able to tell whether it is there or not. She said that trace amounts of lambda is common in the general population. Perhaps. All I know is, I want CR in order to feel good about the likelihood of putting this all behind me forever, and in the event that I ever want to purchase more life insurance they will want to know more than "it's probably nothing."

Other labs were more or less as expected. My WBC was at 1.75 yesterday so today it's probably no more than 1 and on its way down. Electrolytes were all good. Liver numbers are even settling down -- perhaps it was the Melphalan that irritated the liver. Who knows. Kidneys are champs. I am anemic and platelets are falling, down to 117 and counting. All par for the course.

I asked a few things that I still don't get consistent answers on.

* Would I be likely to lose the hair? So far, so good...except it wasn't really until maybe 10 days after my Adriamycin last time that it fell out. Now obviously losing one's hair is no big deal at all in the scheme of things, but it did take five months to grow back to the state where it is now, and I'd just like some idea of whether or not I should be shaving it in preparation for it to fall out, or if it will come back in at this point.

* How long will I be neutropenic? This is of interest because we want to GET HOME and call our primary therapy a day. BB had told me (as had BJ, his assistant) that neutropenia from consolidation is less severe because the dosage is reduced. However the APN pointed out that unlike after the transplants, I'm not getting any cells, so the recovery isn't as quick. She thought, in any case, I would probably be out of it by next Monday or thereabouts. We shall see. I have been a quick responder in the past so hopefully my marrow's got another round of cells in it.

* Do I need reimmunization? This is a new one. I came across a mention of this topic in another MM blog last night, and I remember asking the question very early on of one of the doctors with whom I spoke but I honestly can't remember the answer. From the limited Google search I did, it looks like there (a) isn't a lot written on this, and (b) there doesn't seem to be a consensus. What a shock -- lack of consensus in Myeloma treatment! I will speak with BB about this when I meet with him -- the meeting has been pushed back from this Thursday to next Monday since I won't be able to be discharged on Thursday anyway, and that will allow Monday to be a more substantive appointment (including more updated lab data). My hunch is BB will say that no reimmunization is necessary. In fact from a conversation I had, which I believe was recorded here, one of his former patients said that BB believes the immune system is stronger post transplant than before. We shall see.

Lastly, I am trying to work out the logistics for maintenance care. More on this tomorrow -- I'm starving and it's time to eat!