labs

Labs 12/14/24 and 1/13/25

Here are my latest set of numbers for curious people. It’s been around 5 months since I had my car-t cell infused. By the looks of it though, I still have cancer in my blood at this point. I asked the doctor about it, and he said my having a value for my m-band didn’t necessarily mean I have malignant cells still circulating, and that sometimes it just takes awhile for the m-band to clear.

It has never taken me this long to clear my m-band, and it feels like a bit of sugarcoating on his part. But I’m trying to keep an open mind about it. I find my anxiety level is a lot higher after my car-t, which come to read recently, can be a side effect of car-t.

My light chains are still obliterated, which is good on the cancer front. In December, my m-band had a 50% drop, from .4 to .2, which I was pretty excited about. In January though, my m-band didn’t seem to move at all, which I feel kind of stinks.

Although to be fair, my December test, I could have been at .2999 and it would still show .2, and now I could be at .2001, which would also show as .2. The test isn’t that sensitive though, so I’m having to try and not worry about it for another month until my next test.

My reds in my blood are still lousy. They never recovered after my stem cell transplant and are beat up more from the car-t. But they could be worse, so I’m still eating my plant iron to try to support them.

I had a new blood test done in December called TBNK Single Platform. It is a test that measured my various T cell levels, which I found pretty fascinating. In a nutshell, after some research, my low CD4 reading is normal after car-t, and it means that I have low immunity against germs and viruses. CD4 T cells also support cancer-killing T cells to do their job, so low isn’t the best, but it’s expected. They just have to work hard.

My CD8 T cells are high, which means my genetically engineered cells are doing quite well, multiplying and there are plenty of them to do their job of disposing of myeloma. I guess I just need them to get in all the little nooks and crannies in my body to do their job completely.

Overall, I do feel pretty good. Being off all treatment is awesome. I’ve taken up jogging again, which does feel good to move my body, get my heart pounding hard, and work out my lungs.

I did get sick at the beginning of January, which did end up sending me to the emergency room. My sickness wasn’t too bad, and honestly it did tick me off that I had to go to the ER. My fever spiked up to 102.4 and that’s what earned me the trip. It was just a run of the mill virus after all the tests that were done. It has taken me 2 weeks to mostly get over it, though. My wife caught it from me, and it took her only 3 days to get over it.

I guess CD4 cells really matter…..

TBNK Single Platform
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White Blood Cell Collection

Step one for my Car-T is done ✅.

I had my white blood cells collected on Monday. They are on their way across the country to New Jersey, to be engineered into Chimeric antigen receptor T cells to kill myeloma cells.

The procedure went well, thankfully. My veins were good enough and held up for a double IV, one in each arm. The nurses decided my best outflow vein for the big IV was in my bicep. That was a new one for me. But it was actually a pretty good spot.

I had 15 liters of blood pumped out of me. The white blood cells were filtered out and then the remainder was pumped back in.

The human body holds about 5 liters of blood, so all of my blood was taken out and put back in 3 times. So, as you could image, I’m pretty tired from all of that. It sort of feels like I ran a marathon and I’m ready for a goodnight sleep, except I just woke up in the morning.

I usually don’t post pictures of hospital things, but since Car-T is newer, I thought I would show a bit more.

This is what my bag of white blood cells looked like. It has some red blood cells mixed in with it, which is why it’s pretty red. Your red blood cells and platelets also drop as a result from the apheresis, so that’s part of the reason for the tiredness.

I’m told, that when they come back from being engineered, they will be a light pink color.

In the lab in New Jersey, they will filter all the other cells out until it just down to T cells. Then they will test the T cells to see how viable they are and make sure they are of good quality. The finished edited cells have to have a quality rating of at least 80, which was set my the FDA. If they are 70-80, you and your doctor have to decide whether to go through it still or not. If they are below 70, then they get scrapped and you have to try again.

So I was trying my best to try to scrub my cells and get them as healthy as I could. When I had my cells collected, it had been 7 weeks since the last chemo infusion. So I was factoring 2 weeks for the chemo to mostly be cleared, which left me with 5 weeks to heal.

Well, I think I’m going to take a nap 🥱, hopefully I snap out of the fatigue thing soon!

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It’s Been Awhile

Looks like I haven’t written anything for awhile. For no particular reason; I guess I just haven’t felt inspired. Hmm…. I wonder what has happened recently in my myeloma world.

I had a bone marrow biopsy (maybe in January?) to check my MRD status. I went up to 27 myeloma cells in a million. That was from about 1 in a million. So that was a bummer to see. MRD is pretty cutting edge. Nothing showed up on my blood tests, although the following round of blood tests showed my m-band moved to “detectable but not quantifiable”. BLAH, it would have been nice to hit MRD zero and stay there.

My oncologist didn’t want to make any changes based on MRD as most oncologist would follow. The myeloma specialist then spoke to the oncologist and then had a meeting with me to talk things over. He said that the numbers were not trending in the right direction, and what was the point of waiting until things significantly elevated. The specialist said he went through the list of drugs and wanted to add in a drug that “wasn’t going to do me harm”. He recommended adding back in Dara to punch the numbers back down.

I was on Dara prior to transplant, but Stanford stopped it because it was not working fast enough. Since it didn’t seem to give me any problems, I agreed to go back on it. If he was recommending something like cytoxan, I would have said no.

Well, as it turns out, side effects can change post transplant. I had my first dose of Dara with carfilzomib and it was rough. I turned into a 90-year old, with super fatigue. My skin on my torso also went hypersensitive and wearing a shirt was unpleasant. Too bad we were still in winter ❄️. That lasted for about a week. I had another round two weeks after the first, and the same thing happened again. The oncologist was baffled. We ran some blood tests, but nothing showed up. I’ve noticed that if something is out of the ordinary and not listed on a clinical trial, the oncologist is left bumbling his bottom lip and saying, “Good luck with that”.

Fortunately for me, by the third dose, my body was getting used to the drug and the symptoms significantly lessened. I didn’t have any of those symptoms by the fourth dose. So I’m back to being left with the few days of being miserable from the carfilzomib side effects. Maybe the cancer gods will show me some favor and things will get good enough to eventually drop the carfilzomib and just stay on the Dara.

But then again, at this point, I’m pretty sure the cancer gods don’t like me very much 😜. But then again again, they just updated all the five year cancer survival rates, and myeloma is now 59%. I’m going to hit 5 years soon. Not that I attribute that to the cancer gods, I’ll take the credit with my efforts.

I guess the other thing physically that happened was that, I developed a frozen shoulder. Possibly from the chemo, they aren’t actually sure what causes them. It’s quite bizarre. I can’t raise my right hand or arm above shoulder height or move it in an outward direction. I guess the tissue surrounding the “ball” of your arm, that goes into your socket, just seizes up. It can take 8 months to 2 years to “unfreeze”. Fortunately, it looks like I’m going through the stages at the faster rate. I’m sure the infrared sauna and turmeric are helping. Too bad my muscles didn’t freeze in a better spot 💪🏼. Imagine having your six pack be frozen and being ripped for 2 years.

Let’s see, I guess I have some blood numbers to share, here you go.

My medical provider made it a pain for me to transfer over my data, so that’s why I don’t post much about it (plus, I don’t have blood run much these days). Because of my weird side effects from the Dara, they did run a whole metabolic panel. My red blood cell numbers are still low. From the metabolic panel, they ran iron.

As you can see, my iron is quite well, from all those goji berries and beets. So my poor red blood cells are just quite beat up from the chemo. I thought that was interesting to see.

Well, I can tell your attention span is beginning to wane by this part of the post so I’ll be quick with the rest.

I made it to a succulent nursery, “Succulent Gardens”, down by Monterey, that I always wanted to go to. That was pretty awesome to visit. I’m a huge succulent fan, as you may have noticed from the pictures on my website. They supply plants to a lot of the other nurseries in California, so I was cool to visit the source. Here are some pictures.

I took a mushroom propagating class at a local collage. I sort of knew how to grow mushrooms from books and the internet, but I wanted some hands on training. So I know how to do that now. I have mushrooms growing inside the kitchen cupboards now. Hopefully at some point I’ll have a bigger space to really get into it.

Preparing mushroom growing media.

Finally, spring has sprung. Here are my irises that I planted last year. They had a year to grow and be undisturbed, so they are happy. Yukon likes to eat the grass around the pot.

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Labs 12/1/23

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.

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Labs 7/30/23

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