Wednesday, July 15, 2009

What a difference a day makes (in labs)

This is something that hopefully everybody with this diagnosis -- or anybody looking at their blood on a daily basis for some other reason, God forbid -- can benefit from.

I went to the infusion center today to get my 24-hour chemo pump changed. Interestingly, looks like I get the Adriamycin for four days straight while they swap out the Platinum, Cyclophosphomide and Etoposide over that time period.


I got my labs from YESTERDAY back today (I prefer the 7th floor way of doing things, but they get quicker response from the lab there) and my white counts fell from 6.8 to 4.4. My Hemoglobin fell from 14.2 to 12.2 (I told you I'd be back to anemia quickly!) and my platelets rose from 170 to 180. All expected.

By my Phosphorus was 1.5 (normal is 2.0 to 4.0). And my Uric acid, which the nurse in BB's clinic had flagged as high on 7/8 when it was 8.2, was now 8.7. BB didn't think anything of it being 8.2 but I wanted to at least ask my APN about it.

So I was prescribed a bag of Rasburicase administered IV while I waited, and given an infuser of phosphorus for the road.

While the Rasburicase was dripping in and my phosphorus infuser was hooked up, I got TODAY's labs back.

Uric acid fell to 6.2, well within normal limits, and Phosphorus was at 2.5, also well within normal limits. White count up to 11 (still normal, but what a change!) and hemoglobin at 12.2. Sigh. 14 felt good while it lasted -- for about 18 hours, it seems.

I asked the APN if we should disconnect the phosphorus (the Rasburicase was already fully infused by this time) and she said that the chemo will push uric acid up, and bring phosphorus down, so we were ending up taking prophylactic measures.

That's fine by me. But it does highlight how these numbers can pop up and down and you really need to look at them in context / over time to make sure you aren't overreacting one way or another!

Generally speaking I am feeling fine, other than being exhausted from no sleep last night, and the general dex bloating that has set in (five pounds of weight gain overnight). I also got the hiccups something fierce today, which happened when I was on these drugs before, so I took a couple of Baclofen and they seem to have subsided.

Lastly, for the benefit of my two brothers who read this and anybody else who is a fan of very, very old movies...I looked to my left in the infusion center and there is a woman, probably in her late 50s, who is completely bald and who must have felt cold (despite it being 90 degrees here now) and had draped blankets over her lap and pulled another tightly over her head like a shroud. I had to do a double take but she looked just like Eduardo Gianelli (the bad guy) in the 1939 Gunda Din.

Dinner with BB's assistant Bonnie tonight, then lunch with fellow MM travellers Phil and Cassie tomorrow, and then the arrival of my friend Matt from DC for what should be the last relief mission for Jill, as she goes home for the weekend to see the kiddies. Lots to look forward to -- though perhaps nothing more fervently than the result of tomorrow's M-spike lab, which should be available on Sunday or Monday.

Be well, everyone!


  1. "Kill for the love of killing! Kill! Kill! Kill!" While Eduardo may have been speaking of the limeys, we can transfer this to your stubborn m-spike!

  2. Also, I believe it was "GunGa Din." You may have been referring to Bill Murray's "total enlightenment" moment from Caddyshack, Gunda,gunnunga!"

  3. Nick-
    What an amazing blog! I thought my friend Don, from Minnesota, was technical! I just had a book published, Living with Multiple Myeloma, and it is much more basic than your detailed journal. But I must ask you, my research tells me the difference between CR and VGPR makes no difference in overall life expectancy... I wonder why our perception is so different? I am CR right now, thank goodness, but would not be worried if I weren't, as long as my myeloma was stable. Good luck you you... I am looking forward to following your journy. I have 2 blogs: and Please visit sometime. Good luck! Pat

  4. all I can say is rock and roll hoochy koo thats what mamma means to you (a frequently used quote of mine) see you in august, good talking last night.

  5. I must confess Nick, I have the same information as Pat, that VGPR and CR are essentially the same in the big picture, so I too was a bit surprised by your statements on the subject. However, I know too that MM and the docs/researchers understanding of it is constantly evolving and changing and tweaking and I would be also be wanting my hubby to get to CR if possible.

    Having said that, I'm still mocking you up in CR! You are there buddy, can you feel it?

    Best, Lori

  6. BTW, when you meet up with Jan and Bruce Bertsche, give them hugs for me unless you guys are, you know, neutropenic or something! We don't know if we will catch them when we come in the beginning of Sept or not.