Tag: revlimid

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Oh Yeah, That’s What It Feels Like

Jothi

That’s what I’m starting to say to myself.

It’s been awhile since I’ve felt like writing anything. I’ll have to try and remember what’s been going on, post CAR-T, in the last month or so.

I had my second infusion of antibodies and another round of myeloma blood tests. All my light chains were still about zero, below normal. My M-band is still hanging around with a reading of .5. That means that I still have cancer cells circulating in my blood. The doctor said since my light chains are basically zero, they expect my m-band to continue and drop, and hopefully disappear completely.

I have another round of blood tests this week. I’m very curious what my blood will say. I was scheduled to have a bone marrow biopsy a month ago. I was telling my doctor I didn’t see the point, since my blood was saying there was myeloma still circulating. Of course I was going to have a myeloma reading from my marrow. The thing I’m going for is MRD zero, which is no trace of myeloma in my marrow. So I got them to postpone the test.

I did end up having a few minor neurotoxicities, which turned my mind a bit sluggish. The extreme fatigue was a challenge, but I seem to be over both. I was on the antibiotic bactrim after my hospital stay, but it was dropping my platelets and red blood cells too much. Doctors are concerned with pneumonia post Car-t, so it was precautionary. They switched me over to another antibiotic, atovaquone, which is a liquid (?) type. It was basically like eating a sweet, good quality yellow paint. Gloppy, thick, and gross.

I ended up having an abnormal reaction to that stuff. It caused my inflammation to rise significantly, and it felt like I had thriving active myeloma again in my bones. It was painful, and I certainly didn’t want to feel like I had lots of cancer having a party inside of me after doing Car-t. I couldn’t help wondering if the treatment had bombed, because it sure felt like it. So it was a good mental struggle and stress, and was another hurdle to overcome. My last blood test said the opposite, so that took my load off.

So in the meantime of not doing anything medically related, I’m finding my body restarting its systems. Recently, I find myself saying “Oh yeah, that’s what it feels like to be normal”. I have energy again. My mind is sharp again. I’m not tired after doing a simple task. I’m not combating a steady dose of side effects from chemo. It’s funny what a person gets used to and becomes their version of “normal”.

I’ve been off chemo a few times in my myeloma marathon. I got Covid around 3 years ago, and the doctor stopped my Revlimid while I was dealing with that. I had a blood test before I was going to restart, and it showed the revlimid actually wasn’t doing anything. I decided to stop all chemo for about 8 months and try some alternatives.

The difference between then and now is that I knew the myeloma was increasing (very slowly) and contained somewhat, but I was getting worse over time. Now again, I’m off chemo, but it feels like the reverse is happening. I seem to be getting better over time.

So far, that makes me a big fan of Car-T. I’m still waiting and hoping the cancer zeroes out, and I don’t have to deal with myeloma. What kind of story will my blood write for me?

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3 In 2,600,000

Jothi

That’s my number.

It is test and doctor visit time, post transplant, for me. I had my meeting with my new myeloma specialist today. My old one left to go work for a drug company, so I had to get a new one, which was a bit of a challenge to get, surprisingly.

In my post transplant meetings with Stanford, the doctor kept repeatedly recommending I go on Revlimid for maintenance. In all my meetings with that doctor, I always had the feeling she would rather be off working on her projects, rather than working with patients. “Revlimid is what is normally done post transplant.” Her recommendation of revlimid, showed me she didn’t actually take the time to read my file.

To be fair, she is a transplant doctor and not an oncologist or myeloma doctor, but still, it would have been nice for a little effort on her part.

I finally had to say, “My case is not the typical myeloma case. I’m four years into myeloma and I’m just doing a transplant now. I’m already refractory to revlimid.”

“Oh really!?” She replied, looking flustered, rapidly clicking on her computer, and started trying to recover. “Let me review your case with one of my colleagues and I’ll get back to you.”

I tell you, it’s hard enough dealing with cancer without trying to manage your doctors!

Hence, my reason for paying out of pocket for a myeloma specialist at a different medical institution. I’m really glad I did. This is only my second meeting with a specialist, a year apart, and I can tell their myeloma knowledge is significantly better than my other doctors.

This new specialist told me almost right off the bat, that he is the leader in MRD (minimal residual disease) research. A mrd test is the best test you can have done for blood cancers, looking for remaining cancer cells. I’ve been pestering my regular oncologist for this test and he finally ran it with my last bone marrow sample. I’ve been waiting and waiting for the result, and I guess the specialist had it.

3 myeloma cells in 2,600,000 normal cells. My goal was zero detectable cells (MRD negative or MRD zero), I might as well swing for the fences. Second best is 1 in 1,000,000. I almost hit 1 in a million, just missed the mark. Anyhow, he was quite pleased with the numbers. His goal is to get me to MRD zero.

Although, I was thinking about the MRD test. It is only a sample of the marrow from a specific section of your bone where they pull the marrow from. So you can have different values at different spots in your bones. MRD positive in your left hip, MRD negative in your right. So I guess the MRD result is essentially flawed from the beginning. But I suppose it gives the best idea of what’s generally going on, since blood tests aren’t this sensitive.

I was thinking of the analogy of a city. If I had a city with a population of 2.6 million, and three of those people were crappy people, I would be doing pretty well. My city used to have a lot more crappy people in it, so I’m glad they are gone, but I still have work to do.

My regular oncologist recommended using carfilzomib as maintenance. I was on it prior to transplant, so that makes sense to me. The specialist recommended a higher dose, saying what was recommended wasn’t going to get it done. He also added cytoxan pills, I was also on that prior to transplant, which I’m not too excited about. It’s not an intelligent drug, and it just kills everything. I guess it’s all the lesser of two evils, maintenance versus active myeloma.

I think I’m going to be a bit more beat up from this maintenance than I was originally thinking, which is a bit of a bummer for me. Hopefully we can lessen the drugs over time….

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The First Post

Jothi

Well, where to start? My name is Jothi (pronounced Joe-T). I’m married for 20+ years at this point, and we have 4 children aged 12-19. I am a big nature person. I love spending time outdoors, gardening, hiking, going to the beach, exploring. I am also a huge gamer. Games of any type, board games, sports (both playing and watching) and occasional video games.

People who I would like to sit down and have a long conversation with are in no particular order: Dalai Lama, Barack Obama, Warren Buffett, Anita Moorjani, Neil McKinney, Shin Terayama, Ryan Reynolds, Michael Jordan, John Stewart, Helen Jane Long and Steve Kerr.

For my myeloma family out there, I have Lambda Light chain myeloma. Which means I have too many lambda light chains that make up my blood for everyone else. I have the 14;16 translocation in my myeloma genetics, which basically means my myeloma is smarter than standard myeloma and is good at side stepping drugs.

I had 2 lesions when I was diagnosed, one on my 7 rib on my right side and a bigger one on the right side of my sacrum. Sometimes, I think about tumor placement in the body, and while there are worse spots than the sacrum, the sacrum is a terrible spot to have a tumor! I don’t recommend it. That’s the spot where your spinal cord fans out in a fantastic web of nerves. To this day, it’s like a little bird sitting on my shoulder poking me, saying, cancer, cancer, cancer.

I have had radiation on my sacrum and I went through the VRD chemo protocol (Velcade, Dex and revlimid). I elected not to do the stem cell transplant at that time. My lambda light chains at the high point were 470 and my Kapp/Lamb Fr was .01. M-band was 1.4.

About a month ago I started on Dara sq, Pom and Dex. As of last blood draw, my Lambda light chains are 142.52 Kappa Light chains 5.70 and KAPP/LAMB FR is .04. My M-band is 1.4. These numbers are after being off of all Chemo for over 6 months after I had a go with covid and saw that the chemo wasn’t doing anything anyhow.

I’ve had 2 pet scans this year, with the most recent in July. Both have come back showing no cancer activity.

I have become very passionate of diet, nutrition and what actual food is along my brief journey. When I was struggling for a website name, my kids suggested: Eatyourvegetablesdotcom, but it was already taken. But it is definitely my motto.

That’s the gritty numbers post with the information download. I hope my future posts will be a bit more fun and entertaining.

EAT YOUR VEGETABLES!!!