Category: Blog

Blog

An Audience For My Buns

Jothi

I haven’t been inspired to write much as of late, as you can tell by my lack of posts. I was just more interested in doing other things.

Not much is new. Still doing maintenance carfilzomib chemo every two weeks. I still get high fevers from it every time. I’m into the 103 degrees now, so it’s been a challenge. I’m signed up for the flu every two weeks. Blah.

I went out to San Francisco a few weeks ago to visit my brother. We went for a hike at Land’s End, which I had never been to before. It was a cloudy day, but it was still scenic. It was pretty crowded, since a lot of people were off from work because of the holidays.

We hiked down to the ocean, and I found a big rock to climb up onto that part of it was in the water. I sat down to watch the ocean. California was having a storm coming in, which made the waves quite large. It was very satisfying watching the waves come in, break cleanly, and then smash into the rocks.

I’m always amazed by the power of the ocean. I’m also equally amazed, how rows of rocks in the ocean can dissipate that power. Waves that seem to be coming to run you over and churn you into dust, just dissipate into nothing. It’s fun to watch.

My view from the rock

I had a bone marrow biopsy the other day. I agreed to it 6 months ago. The myeloma specialist wanted to check on things, more specifically, he wanted to check my MRD status. Last time, I had 3 myeloma cells in 2.6 million.

Coming up to the biopsy, I was wondering why I choose to have it done. If it’s MRD zero (zero cells in a million), which would be awesome or if it showed 100 myeloma cells in a million, I’m not sure what would change much currently.

I suppose I would get a mental boost if it was zero, but what if it was worse? Would I feel dragged down? What am I going to gain from this? I feel pretty level-headed about it all, no matter what the result is, but those were my thoughts leading up to it. Anyhow, I just decided to go ahead and do it, because the specialist thought it was important. He probably knows more about myeloma than I do 😜. Maybe he will share with me his thoughts sometime. My regular oncologist was against it (mostly because of the cost for the hospital), but I twisted his arm (go figure, twisting an arm to have my marrow sucked out).

They take the bone and the marrow out of the iliac crest. I had them take it from my left side, because that’s where I had it done last time, and MRD can vary from location to location.

So I hopped up on the procedure table, face down. The nurse then came up and pulled down my pants to expose my butt. Then she tucked in some disposable cloths to my pants to contain the blood.

I’m lying there with my buns just hanging out. Minute after minute pass, and the nurse finally says, I’m going to find out where the guy is who is going to do the procedure. She flies the door open to the busy hallway and disappears.

“Don’t mind me, I’m just airing out my buns”.

She comes back after a few minutes and says he is at the hospital next door and will be here shortly.

Five minutes later, he comes in and says hello, and says he brought a friend to come and watch (he really said, can I have my student in here to observe?).

In my head I say, “sure, I’m lying here exposed, let’s get a bunch of people in here”.

Now, it’s a good thing I don’t actually care. I gave up caring about people seeing my butt awhile ago.

They numb me up as much as possible and start getting to work with the core needle, a needle so strong and sharp it cuts bone. Eventually they get through the bone and have access to my marrow.

There is no numbing of the marrow, so it’s the most painful part of the procedure. The nurse came over and gave me a back rub while they pulled it out this time. Which didn’t make any difference, but it was a nice gesture.

Afterwards, I was chuckling to myself. I was laying on a small table with my butt exhibited, with three people surrounding me, like I was on a stage doing a performance. The things people do for entertainment these days….

Anyhow, that’s my (hopefully entertaining) story, we will see what the marrow numbers are in a few weeks.

Blog

Labs 12/1/23

Jothi

My blood is back from the vampires. I haven’t had any run for two months now, so that was a change for me. I wasn’t having any test fears (Scanxiety) that a person can sometimes get, but I have been wondering how my numbers are looking.

I was especially wondering if my m band was a one month wonder or if I was going to sustain things, even though I cut out one of the maintenance chemos. I’ve been feeling pretty good, so my guess was that it’s still zero, and it is.

My reds (red blood cells) are still challenged. I was expecting them to get a boost since I dropped the cytoxan, but that wasn’t the case. I wouldn’t want things to get too easy, it’s best to be short on oxygen for a challenge 😜. Although my mcv is at the top, which means my red blood cells are large, so there can be fewer of them.

They also ran a blood test to check out my heart, which I was happy about since it’s possible carfilzomib can damage the heart. I had been wondering if anyone was monitoring things because I hadn’t seen any evidence of it so far. Thankfully, it tested normal.

Anyhow, here are the numbers:

KAPPA LIGHT CHAIN FREE

Normal range: 3.30 – 19.40 mg

DateValueNormal Range
Dec 1, 20233.06mg/L3.3 – 19.4 mg/L
Oct 7, 20235.2mg/L3.3 – 19.4 mg/L
Aug 25, 20235.32mg/L3.3 – 19.4 mg/L

LAMBDA LIGHT CHAIN FREE, SERPL

Normal range: 5.71 – 26.30 mg/L

DateValueNormal Range
Dec 1, 20232.01mg/L5.71 – 26.3 mg/L
Oct 7, 20233.03mg/L5.71 – 26.3 mg/L
Aug 25, 20232.66mg/L5.71 – 26.3 mg/L

KAPP/LAMB FR

Normal range: 0.26 – 1.65

DateValueNormal Range
Dec 1, 20231.520.26 – 1.65
Oct 7, 20231.720.26 – 1.65
Aug 25, 202320.26 – 1.65

WBC

Normal range: 3.7 – 11.1 K/uL

DateValueNormal Range
Dec 1, 20234.4K/uL3.7 – 11.1 K/uL
Oct 5, 20234.9K/uL3.7 – 11.1 K/uL
Sep 8, 20234.8K/uL3.7 – 11.1 K/uL

RBC’S

Normal range: 4.10 – 5.70 M/uL

DateValueNormal Range
Dec 1, 20232.9M/uL4.1 – 5.7 M/uL
Oct 5, 20233.15M/uL4.1 – 5.7 M/uL
Sep 8, 20233.19M/uL4.1 – 5.7 M/uL

HGB

Normal range: 13.0 – 17.0 g/dL

DateValueNormal Range
Dec 1, 202310.5g/dL13 – 17 g/dL
Oct 5, 202311.3g/dL13 – 17 g/dL
Sep 8, 202311.3g/dL13 – 17 g/dL

HCT

Normal range: 39.0 – 51.0 %

DateValueNormal Range
Dec 1, 202329%39 – 51 %
Oct 5, 202331.2%39 – 51 %
Sep 8, 202331.9%39 – 51 %

MCV

Normal range: 80 – 100 fL

DateValueNormal Range
Dec 1, 2023100fL80 – 100 fL
Oct 5, 202399fL80 – 100 fL
Sep 8, 2023100fL80 – 100 fL

PLT

Normal range: 140 – 400 K/uL

DateValueNormal Range
Dec 1, 2023109K/uL140 – 400 K/uL
Oct 5, 2023116K/uL140 – 400 K/uL
Sep 8, 2023150K/uL140 – 400 K/uL

PROTEIN ELECTROPHORESIS INTERPRETATION, SERUM – No Homogeneous Band Or Spike Seen.

B type natriuretic protein Normal value: <=100 pg/mL

Value 43

>= 100 pg/ml may be associated with congestive heart failure. Other causes should be excluded. < 100 pg/ml clinically significant congestive heart failure unlikely. Clinical correlation required.

Blog

Just Over It Mindset

Jothi

I was reading another myeloma blog today. The author, who has had myeloma for over ten years, was expressing his feelings of just being over it at this point.

I’ve been aware of the “just over it” concept for a while. I’ve seen in other people who had cancer, and I’ve seen it in older people who had lived long enough, having had their fill of life’s experiences.

An interesting thought popped into my head. I wondered what would be better, having a cancer like myeloma that can last years, or have a different cancer that just wraps up your lifespan rather quickly. It’s hard to be over it, when you don’t get the time to be over it.

I suppose it matters greatly on the person, their age, and how much they want to keep living. Not that you always have any measure of control over things. I’ve seen too many stories, such as an example, of a parent of young children, who develop cancer and are no longer with us, who probably would have rather kept living.

Time toxicity is something very real. I think the first time I heard of the concept was from reading an article by an oncologist. Basically, time toxicity in cancer is taking a chemotherapy that they can estimate, will add X amount of time to your lifespan. You gain X amount of time, but you will spend 3/4 of that time driving to the therapy, waiting for the therapy, getting the therapy, being sick from the therapy, getting tests for the therapy, etc etc…

So the end result is gaining a small amount of good lifespan.

Which leads back to the “just over it” mindset. If you are getting to that point, I think it’s important to review what your reasons for doing what you are doing are, and what you have to be grateful for in your life. Then it becomes easier to see what your effort is worth. And if it’s not worth it to you anymore, I think it’s ok just to be over it and move on from your body. It’s a personal and family choice.

I’m personally, not “over it”. Although, on chemo days, when I feel like crap, I do find myself asking the question, “is this worth it”. The answer is always “yes”, but I can see the perspective of “just being over it”.

Anyhow, that’s my random thought for today. Blood test tomorrow, maintenance chemo the following day. I only have blood tests every 2 months now, which is great. I’ll share the results when I have them.

Blog, labs

Zero

Jothi

I had some big news with this set of labs. I was actually on a video visit with my myeloma specialist when the rest of my labs finally showed up. My wife and I quickly scrolled through them to see if there was anything that we wanted to ask the doctor about.

When we saw the myeloma marker M-band test, we both raised an eyebrow.

“No Homogeneous Band Or Spike Seen”

“Does that mean what I think it means?” I asked the doctor.

“Yes, your M-band reached zero and that’s a very good sign. With that result, it is probable that an MRD test would show zero myeloma cells in a million now.”

!!!!!!!!! (Inside of me)

For Non myelomers, basically what it means is, the cancer is no longer detectable from a blood test. It doesn’t mean I’m cancer free, there is just isn’t enough of it anymore to register. We are going to do another bone marrow MRD test in January, which is a lot more sensitive.

Honestly, I had given up on hitting zero for now, since I didn’t achieve it with the bone marrow transplant.

Then he went on talking about this, that and the other thing. The visit ended and a few minutes later, it really started to sink in. A wave of emotions hit me like a truck. I don’t even know what emotions I had, but it was overwhelming. Happiness? Joy? Relief? Exhaustion? I broke down crying.

An oncologist once told me that only 50% of myeloma patients are able to achieve a zero reading on their M-band, and even less in people who have my myeloma genetics. I’m not tooting my own horn, I’m just trying to convey what it means to me. It’s been one of my goals since the beginning.

I’ve been trying to achieve this result for over 4 years. The number 4 doesn’t sound very large, but it’s been nonstop for me. It’s over 1500 days of trying. Over 36,000 hours of trying to get zero.

Literally drinking thousands of carrots and beets. Hundreds of needle jabs. Days sweating in the sauna. Fevers, throwing up. Truck loads of vegetables. Bags and bags of IVs. Fatigue, like I’m walking up Everest without oxygen. Pounds of turmeric. How am I painting my picture?

I suppose I won’t actually know what ended up flipping the switch for me. Was it just the constant ponding from the chemo that did it? Did adding in the bacteria help? I won’t say I was just lucky, because I don’t believe in randomness when it comes to health. There is a reason, I just won’t ever know the reason.

I know full well that it’s possible it could only be for one month and I could have a reading next month, but I will take my small victory. It’s only a stepping stone for me, with still lots of work to go. I can’t let off the gas. I need to have repeat readings and prolong results of zero.

My other news is, that the Doc and I agreed that I would stop taking the cytoxan and just stay on the carfilzomib. I really can’t stand the cytoxan and I feel intuitively I should stop. It can be a bit scary to stop something that maybe helped stomp the myeloma. But, making decisions based of fear, is something that I try not to do. So, I’m going with my gut (also literally, since it’s shredding my digestive system).

Anyhow, here are some other labs results. My provider changed their system, which made it more difficult to transfer results over. I just picked the main ones I thought people would want to see.

I’m off to go eat some vegetables…..

WBC

Normal range: 3.7 – 11.1 K/uL

DateValueNormal Range
Oct 5, 20234.9K/uL3.7 – 11.1 K/uL
Sep 8, 20234.8K/uL3.7 – 11.1 K/uL
Aug 25, 20233.8K/uL3.7 – 11.1 K/uL
Jul 30, 20234.1K/uL3.7 – 11.1 K/uL
Jun 9, 20236.6K/uL3.7 – 11.1 K/uL

RBC’S

Normal range: 4.10 – 5.70 M/uL

DateValueNormal Range
Oct 5, 20233.15M/uL4.1 – 5.7 M/uL
Sep 8, 20233.19M/uL4.1 – 5.7 M/uL
Aug 25, 20233.25M/uL4.1 – 5.7 M/uL
Jul 30, 20233.57M/uL4.1 – 5.7 M/uL
Jun 9, 20233.65M/uL4.1 – 5.7 M/uL

HCTNormal range: 39.0 – 51.0 %

DateValueNormal Range
Oct 5, 202331.2%39 – 51 %
Sep 8, 202331.9%39 – 51 %
Aug 25, 202330.9%39 – 51 %
Jul 30, 202332.7%39 – 51 %
Jun 9, 202335.2%39 – 51 %

RDW, RBC

Normal range: 12.0 – 16.5 %

DateValueNormal Range
Oct 5, 202312.9%12 – 16.5 %
Sep 8, 202314.2%12 – 16.5 %
Aug 25, 202313.8%12 – 16.5 %
Jul 30, 202313.5%12 – 16.5 %
Jun 9, 202313.3%12 – 16.5 %

PLT

Normal range: 140 – 400 K/uL

DateValueNormal Range
Oct 5, 2023116K/uL140 – 400 K/uL
Sep 8, 2023150K/uL140 – 400 K/uL
Aug 25, 2023127K/uL140 – 400 K/uL
Jul 30, 2023129K/uL140 – 400 K/uL
Jun 9, 2023109K/uL140 – 400 K/uL

KAPPA LIGHT CHAIN FREE Normal range: 3.30 – 19.40 mg/L

DateValueNormal Range
Oct 7, 20235.2mg/L3.3 – 19.4 mg/L
Aug 25, 20235.32mg/L3.3 – 19.4 mg/L
Jun 9, 20236.78mg/L3.3 – 19.4 mg/L
Mar 2, 20233.91mg/L3.3 – 19.4 mg/L
Feb 3, 20232.14mg/L3.3 – 19.4 mg/L

LAMBDA LIGHT CHAIN FREE, SERPL

Normal range: 5.71 – 26.30 mg/L

DateValueNormal Range
Oct 7, 20233.03mg/L5.71 – 26.3 mg/L
Aug 25, 20232.66mg/L5.71 – 26.3 mg/L
Jun 9, 20233.86mg/L5.71 – 26.3 mg/L
Mar 2, 20233.45mg/L5.71 – 26.3 mg/L
Feb 3, 20232.92mg/L5.71 – 26.3 mg/L

KAPP/LAMB FR

Normal range: 0.26 – 1.65

DateValueNormal Range
Oct 7, 20231.720.26 – 1.65
Aug 25, 202320.26 – 1.65
Jun 9, 20231.760.26 – 1.65
Mar 2, 20231.130.26 – 1.65
Feb 3, 20230.730.26 – 1.65

PROTEIN ELECTROPHORESIS INTERPRETATION, SERUM

No Homogeneous Band Or Spike Seen!!!!!!!!

Blog

Birthday Ponderings

Jothi

I had a birthday recently, which of course got me thinking about birthdays. I couldn’t help chuckling to myself about how birthdays have different meanings depending on the age.

Age 0-2 – I have no idea what’s going on, but look at all these people.

Age 3-9 – Presents! Cake!

Age 10 – Double digits, fist pump.

Age 11-12 – Presents! Cake!

Age 13 – I’m a teenager, chest puffed up.

Age 14 -19 – I’m really cool, but secretly Presents! Cake!

Age 20 – Twenty!

Age 21-39 – Lets party!

Age 40 – Forty?! Crisis time?

Age 41-55 – My body doesn’t work as well as my mind thinks it should, and what’s that wrinkle?

Age 56-65 – I’m starting to look old.

Age 66-75 – I’m passed the speed limit!

Age 76-79 – I’m starting to feel old.

Age 80-89 – How did I get so wise?

Age 90-99 – I have no idea what’s going on, but look at all these people.

Age 100 – Score! I reached level 100!

Any age- If you have cancer, I made it another year!

Blog, labs

Labs 8/25/23

Jothi

Here are my latest numbers. My numbers are pretty punched down. I am currently doing my labs mid-maintenance cycle, so I guess it’s not surprising. I was getting my labs done when I was told the doctor’s office needed them, but they just figured out that they had me doing it mid-cycle. I’ll be switching back to getting them done prior to the beginning of the cycle. Hopefully, my poor CBC can recover. I don’t think my HCT has ever been this low. I have Lambda myeloma (where I have too many Lambda light chains), so the rising ratio of Kappa is not a concern.

NameStandard range1/6/232/3/233/2/236/9/238/25/23
KAPP/LAMB FR 0.26 – 1.650.390.731.131.762.00
KAPPA LIGHT CHAIN FREE3.30 – 19.40 mg/L2.252.143.916.785.32
LAMBDA LIGHT CHAIN FREE, SERPL 5.71 – 26.30 mg/L5.822.923.453.862.66
NameStandard range6/9/237/30/238/25/23
HCT 39.0 – 51.0 %35.232.730.9
HGB 13.0 – 17.0 g/dL12.512.111.4
MCV 80 – 100 fL969295
NRBC <=0 /100WC000
PLT 140 – 400 K/uL109129127
RBC’S 4.10 – 5.70 M/uL3.653.573.25
RDW, RBC 12.0 – 16.5 %13.313.513.8
WBC 3.7 – 11.1 K/uL6.64.13.8
NameStandard range6/9/237/30/238/25/23
BASOS % AUTO%000
BASOS ABS AUTO0.0 – 0.1 K/uL0.00.00.0
EOS % AUTO%522
EOS ABS AUTO0.0 – 0.4 K/uL0.30.10.1
IMMAT GRANS ABS AUTO0.0 – 0.1 K/uL0.00.00.0
IMMAT GRANULO % AUTO%000
LYMPHS % AUTO%232122
LYMPHS ABS AUTO0.9 – 3.2 K/uL1.50.80.8
MONOS % AUTO%91211
MONOS ABS AUTO0.3 – 0.9 K/uL0.60.50.4
NEUTROPHILS % AUTO%626565
NEUTROPHILS ABS AUTO1.8 – 7.9 K/uL4.12.72.5
M-protein band 1SEE ABN g/dL<=0.0 g/dL
M-Band detected; not quantifiable.
NameStandard range7/15/227/14/238/25/23
ESTIMATED AVERAGE GLUCOSE 85 – 126 mg/dL747777
HGBA1C %<=5.6 %4.24.34.3
Blog

Are You Curious About My Kale?

Jothi

I always enjoy a time-lapse update of things and just in case you do too, here is one of the garden. The first picture was posted in my “That’s Some Big Kale” post. The picture was taken on June 16th.

By accident, I took the below updated picture exactly 2 months later on August 16th. It has looked like this for a while now. What a picture of life and vitality. It is such a treat to be able to harvest kale daily for lunch, and we sometimes have it for dinner as well.

I saw someone write on the internet recently saying something like, if you don’t have bugs eating part of your plants, you don’t have a thriving ecosystem. I was reminded of working on the soil earlier in the year. Pre-soil work, there was close to nothing as far as worms or bugs in the earth. Post-soil work, the earth was swimming with life, and I could take handfuls of worms out of the ground and bugs running all over the place. Truthfully, I was a little worried about the young plants getting devoured, but it never happened.

I’m also learning about “no-dig” gardening, which is an interesting concept. You leave the soil intact, as not to disturb the soil biome, and just add nutrients on the top. I tinkered with the concept slightly this year, and I think I will try it fully next year (although, I do love sticking my hands in the earth).

People ask me what I’m growing in the garden. I rattle off my list, and when it comes to saying kohlrabi, people stop me because they don’t have any idea what it is. So here is an updated picture of that as well. It’s ready for harvest (maybe a little late). This one is being engulfed by the tomatoes. It’s from the broccoli family. You can eat the leaves, which taste like taro leaf to me, and the bulb tastes like mild broccoli. I like to add it to my soup, stir-fry is quite good, and we have even cooked it on the BBQ.

Blog, labs

Labs 7/30/23

Jothi

Here is my latest set of labs, posted super late. I went on vacation and I didn’t have time to post them before I went. Light chains or M band weren’t run. My doctor’s office really screwed up all my lab orders, from not having them at all or trying to run tests they weren’t supposed to do. They had it set up to run a Hep B test, daily, if I wanted to get stuck every day and not something simple, like a CBC.

Nothing too exciting with my labs. I’m not too thrilled with my Red blood cells, Hematocrit and Hemoglobin. Although, I’m not really that far from the transplant in reality and my blood still gets punched in the face every 2 weeks. Maybe I need to eat more beets and goji berries.

Name Standard range6/9/237/30/23
BASOS % AUTO %00
BASOS ABS AUTO 0.0 – 0.1 K/uL0.00.0
EOS % AUTO %52
EOS ABS AUTO 0.0 – 0.4 K/uL0.30.1
IMMAT GRANS ABS AUTO 0.0 – 0.1 K/uL0.00.0
IMMAT GRANULO % AUTO %00
LYMPHS % AUTO %2321
LYMPHS ABS AUTO 0.9 – 3.2 K/uL1.50.8
MONOS % AUTO %912
MONOS ABS AUTO 0.3 – 0.9 K/uL0.60.5
NEUTROPHILS % AUTO %6265
NEUTROPHILS ABS AUTO 1.8 – 7.9 K/uL4.12.7
Name Standard range6/9/237/30/23
HCT 39.0 – 51.0 %35.232.7
HGB 13.0 – 17.0 g/dL12.512.1
MCV 80 – 100 fL9692
NRBC <=0 /100WC00
PLT 140 – 400 K/uL109129
RBC’S 4.10 – 5.70 M/uL3.653.57
RDW, RBC 12.0 – 16.5 %13.313.5
WBC 3.7 – 11.1 K/uL6.64.1
Name Standard range6/9/237/30/23
CREAT <=1.34 mg/dL0.770.77
ESTIMATED GFR >=60 mL/min/1.73 m2>60>60
Name Standard range6/9/237/30/23
TBILI 0.2 – 1.2 mg/dL0.70.8

Blog

We Are Doing This Right Now!

Jothi

I had my first infusion of maintenance carfilzomib and pills of cytoxan the other day. I had them both prior to my transplant, so my body has prior experience with them (or so I thought), so I didn’t think it was going to be much of a deal. I was a bit tired, so I went to bed a little early that evening.

I got into bed and tried to get comfy. My wife came to bed about an hour later. I was still awake and asked for the thermometer since I was feeling a bit cold. We are going through a heat wave and it was 95 degrees outside, and we don’t have an AC, so it was a little unusual.

98.9 was the reading.

I laid there for a bit longer, pulling up the sheet to my neck. I was starting to shake a bit. I got a fever when I first started carfilzomib and cytoxan months ago, so I guessed I was going through it again since it had been awhile.

99.8 at the next check.

I was really starting to shake, so we added another blanket. Time went by, and I added the comforter. I had all my winter blankets on and it was still quite hot outside. I took a tylenol trying to get my shaking to knock it off, so I could sleep.

102.6 the thermometer read a little while later.

Everyone who has been on chemotherapy knows 101.4 is that magic number when you call the on call nurse and most likely head to the ER. I didn’t want to call, since I had been through this before with these drugs and talked about it with the oncologist last time. I knew they would have dragged me down t the ER to get checked. They (and I as well) are very concerned about infections, but I knew this was just a chemo reaction.

Phase 2 of my reaction was about to begin.

I feel like a lot of people have conversations with themselves when throwing up is involved. Sometimes the buildup lasts for quite a while. “I don’t want to throw up, maybe if I lay this way or that way, I won’t puke.” I didn’t have any buildup or warning.

For a bit of dramatic effect, I’ll narrate the conversation between my body and head.

“Jothi! Get up right now!

“Why?”

“We are going to throw up right now!”

“Really? I don’t really feel nauseous.”

“We are doing this right now! Make a run for it.”

I went to the bathroom and almost immediately threw up. I found it very funny and ironic. I didn’t throw up at all during my transplant or at all during any of my previous times on full strength chemo, and I puked with “maintenance”. Go figure.

I got back into bed and started to shiver again. In hindsight, that probably was not a good omen for my stomach and esophagus. Half an hour later, I asked my wife for a zofran to try and settle things down. Twenty seconds later, my body said:

“Let’s do this again.”

“Are you serious!? We just did that!”

I just got into the bathroom again, and out came the remainder, and it felt like my intestines and liver as well. I got back into bed, with my shakes gone now, and promptly fell asleep for the rest of the night.

My saint of a wife volunteered to dispose of my two rounds of half digested dinner. I only made it to the garbage can both times, so it was very kind of her.

When I woke up in the morning, I didn’t have any fever or vomiting. I spent the day replenishing my fluids.

It’s only been about 4 months since I was on carfilzomib and cytoxan, but I forgot all my do’s and don’ts for those drugs. Maybe I should write a post on it, so I can read it.

But jeez, my torso was sore! I haven’t thrown up at all, probably in nine years. I guess you must have special puking muscles, and mine weren’t at all developed. I wonder if they have a work-out for that?

“For the low low price of $19.99, you can get our puking muscle training program. Strengthen your back muscles, side muscles and abdomen. We guarantee you can puke 5 times in a row without getting sore, or your money back!”