Stanford – Carrots Over Cancer

3 In 2,600,000

July 17, 2023July 16, 2023 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….

Blog, Nutrition

My Stem Cell Transplant Strategy

May 28, 2023May 29, 2023 Jothi

I had a simple strategy for my stem cell transplant. I thought about the procedure for a little while, and this is what made sense to me. For me, it’s all about increasing odds and outcomes. I viewed this transplant as a major ordeal for the body. You wouldn’t get off your sofa and do a decathlon! Why would it make sense to get off your sofa and do a transplant? I went into transplant training.

The procedure in its essence is killing off your bone marrow and therefore your blood as well. Trying to wipe the slate clean. It is regrown from stem cells that were collected from yourself previously.

My step one, thinking about it logically, I wanted to have the highest quality possible of stem cells that were going to be collected. After all, this little bag of stem cells is what was going to regrown all my marrow.

I’m a huge plant person. Growing plants isn’t complicated. Give them the nutrients, light and water they need in the right amount and they thrive. Humans aren’t much different.

I wanted to spam myself with nutrition. I tend to do that all the time, but I made an extra effort. Your food is your cell’s building blocks. Healthy grains, berries, a rainbow of vegetables, lentils, healthy proteins and oils. Diversity is the key.

(👈🏼 Bitter melon is great for detoxing your liver, yes, it’s very bitter).

Second, I wanted to detox my body as much as I could, from all the chemo and drugs I had done. I mainly did this using a little personal infrared sauna. I sat in the sauna daily at 170 degrees and let my body sweat out the junk it could. Besides the big nutritional benefit of fresh vegetable juice, it also detoxes your organs, particularly the kidneys, liver and intestines.

Thirdly, I increased my exercise regiment. Walking, running, weight lifting and exercise biking. I also made it a priority to go hiking for miles, as much as I had time for. Sweating and heavy breathing, helped detox. Increased breathing, increased oxygen for my cells. Plus, hiking in nature helped my mental facilities and forest bathing can have a positive effect on cells.

Fourthly, I needed to work on my mental game. I increased my breathing, meditation and Qi gong. I felt it was important to have a level calm head, so I could overcome the mental lows that I knew were coming up. I went over breathing techniques in my How to stop freaking out post.

Meditation is the best way to keep control of your mind. Early in my cancer journey, for some reason, I was resistant to meditation. I kept hearing how beneficial it was, and I eventually overcame my resistance. It was the single biggest reason for my mental U-turn out of cancer negativity. I highly recommend learning a simple practice and doing it daily. Qi gong is kind of like a walking meditation (I’m planning a series of posts on Qi gong upcoming).

I also feel that the power of music is underestimated. I worked on creating a playlist of uplifting and positive songs that I could listen to. When you’re down in the dumps, sometimes music can help flip your script. I ended up with a wide variety of genres that clicked with me. I used it to get my positive vibe up, especially while cooking (didn’t you know food tastes better if you dance while it’s cooked?) Although, during the transplant, I mostly listened to my favorite pianists, Ludovico Einaudi and Helen Jane Long (Ludovico’s songs Ascent Day 1 and Nuvole Bianche are epic).

So these were my pre transplant regiment. During transplant, I once more wanted to keep up as much as I could on the nutrition. This was the building blocks of my new cells. I wanted to create good tissue and give my cells what they need to thrive. I was really excited when they said I could drink fresh vegetable juice, I drank it daily.

Besides the vegetable juice, it was also imperative for me to keep up on my fluids. Drinking was also a challenge. I drank water, coconut water and bubbly mineral water for the minerals and it helped with the nausea. I also asked for if fluids every day whether I needed them or not. Certainly high dose chemo is highly toxic itself and the fallout from it is a lot of dead cells. I wanted to flush things out as much as possible once the chemo was done doing its job. You have to protect your kidneys!

(A juice man created by my daughter 👉🏻)

Having my GI tract destroyed was a challenge for wanting to eat anything. I mostly ate my normal breakfast just in a smaller portion. Mung beans and vegetables for lunch and whatever I could get down for dinner (by dinner I usually wasn’t interested in eating at all). I do feel like having the wholesome diet helped a lot with not having extreme nausea and keeping my blood and electrolytes up.

It was also important for me to keep moving every day and get exercise through it. After breakfast, I would do my Qi gong exercises. I would then take a rest and then no matter how tired I was, I’d scrape myself off the sofa and go walking in the park every day. I do believe movement is life and if you want to keep living, keep moving.

I’ve gone back to my pre transplant regiment except for the sauna, which I’m not allowed to do until day +60. I have random pain in some of my tissue, which can be a sign of toxicity. I’m looking forward to some good sweating. My GI tract went back to some semblance of “normal” at around day +27. The doctors and nurses keep telling me how good my blood numbers are. I feel like I got through it easier than some people, from reading their stories.

This is my strategy, I guess we will see where the chips end up. If the myeloma is going to thrive through all this, it’s going to have to do it eating broccoli.

Blog, labs

Stem Cell Transplant Labs

May 16, 2023May 16, 2023 Jothi

I thought it may be interesting for Myeloma people to see my stem cell transplant labs. It’s a ton of data, there is a scroll bar on the bottom of each table, but it gives a pretty good picture. There are blanks on the “cytes and phils” because there weren’t any to measure at a certain point.

Stem cell collection on 3/31 (note the sky high white blood cells to be collected)

High Dose Chemo on 4/11

Stem Cell Infusion on 4/13 (interesting to see the decline and then the climb)

NAME (STANDARD RANGE)	3/20/23	3/31/23	4/10/23	4/13/23	4/14/23	4/15/23	4/16/23	4/17/23	4/18/23	4/19/23	4/20/23	4/21/23	4/22/23	4/23/23	4/24/23	4/26/23	5/2/23	5/11/23
Basophil % (%)	0.2		0.2	0.2			0.0										0.3	0.2
Basophil, Absolute (0.00 – 0.25 K/uL)	0.01		0.01	0.01			0.00										0.01	0.01
Eosinophil % (%)	1.8		0.8	0.2			1.0										0.3	5.9
Eosinophil, Absolute (0.05 – 0.55 K/uL)	0.10		0.04	0.01			0.03										0.01	0.24
Hematocrit (40.0 – 52.0 %)	33.3	36.8	32.6	30.9	29.7	29.3	27.9	28.4	27.2	25.7	23.4	21.7	21.5	19.5	20.7	21.1	25.1	28.3
Hemoglobin (13.5 – 17.7 g/dL)	12.2	13.2	11.9	11.1	10.5	10.6	10.3	10.5	10.3	10.0	9.2	8.5	8.1	7.4	7.6	8.0	9.0	10.2
Imm. Granulocyte, % (0.0 – 0.7 %)	0.4		0.2	0.2			0.7										0.6	0.2
Imm. Granulocyte, Abs (0.00 – 0.06 K/uL)	0.02		0.01	0.01			0.02										0.02	0.01
Lymphocyte % (%)	18.1		18.0	7.4			1.4										26.1	27.7
Lymphocyte, Absolute (1.00 – 3.00 K/uL)	1.02		0.92	0.31			0.04										0.87	1.13
MCH (27.0 – 34.0 pg)	34.0	34.3	33.7	33.5	33.8	33.4	33.2	33.0	33.9	34.0	33.9	33.5	32.4	33.2	31.9	33.5	33.3	34.1
MCHC (32.0 – 36.0 g/dL)	36.6	35.9	36.5	35.9	35.4	36.2	36.9	37.0	37.9	38.9	39.3	39.2	37.7	37.9	36.7	37.9	35.9	36.0
MCV (82.0 – 98.0 fL)	92.8	95.6	92.4	93.4	95.5	92.4	90.0	89.3	89.5	87.4	86.3	85.4	86.0	87.4	87.0	88.3	93.0	94.6
Monocyte % (%)	9.0		7.0	3.3			0.0										22.2	17.6
Monocyte, Absolute (0.30 – 0.95 K/uL)	0.51		0.36	0.14			0.00										0.74	0.72
Neutrophil % (%)	70.5		73.8	88.7			96.9										50.5	48.4
Neutrophil, Absolute (1.70 – 6.70 K/uL)	3.98		3.78	3.72			2.77										1.68	1.97
nRBC, Abs (K/uL)	0.00		0.00	0.00			0.00										0.00	0.00
nRBC, % (%)	0.0		0.0	0.0			0.0										0.0	0.0
Platelet count (150 – 400 K/uL)	165	125	146	104	95	85	85	65	54	36	22	15	7	17	20	34	90	110
RBC (4.40 – 5.90 MIL/uL)	3.59	3.85	3.53	3.31	3.11	3.17	3.10	3.18	3.04	2.94	2.71	2.54	2.50	2.23	2.38	2.39	2.70	2.99
RDW (11.5 – 14.5 %)	13.1	13.7	13.1	13.2	12.9	12.2	12.3	11.8	11.8	11.5	11.2	11.2	11.1	11.1	11.5	11.6	16.6	17.2
WBC (4.0 – 11.0 K/uL)	5.6	45.4	5.1	4.2	4.0	3.6	2.9	1.4	0.3	0.1	<0.1	0.1	0.1	0.3	2.0	2.6	3.3	4.1

NAME (STANDARD RANGE)	3/20/23	3/31/23	4/10/23	4/13/23	4/14/23	4/15/23	4/16/23	4/17/23	4/18/23	4/19/23	4/20/23	4/21/23	4/22/23	4/23/23	4/24/23	4/26/23	5/2/23	5/11/23
Albumin, Ser/Plas (3.5 – 5.2 g/dL)	4.7		4.7	4.2	4.0	4.3	4.2	4.4	4.3	4.2	3.9	4.2	4.0	3.9	3.9	4.0	4.4	4.5
Alk P’TASE, Total, Ser/Plas (40 – 130 U/L)	55		69	56	55	54	56	56	58	58	59	57	53	48	51	51	52	51
ALT (10 – 50 U/L)	20		17	11	13	15	15	13	15	14	10	11	10	10	12	12	16	30
Anion Gap (5 – 15 mmol/L)	10		9	11	11	12	11	12	10	11	11	10	11	11	9	7	9	9
AST (10 – 50 U/L)	15		15	9	13	14	11	12	15	11	12	11	14	12	12	11	16	21
Calcium (8.4 – 10.5 mg/dL)	9.4		8.9	8.6	8.3	8.9	8.8	8.8	8.8	8.9	8.7	8.6	8.4	8.3	8.7	8.3	8.9	9.3
Chloride, Ser/Plas (98 – 107 mmol/L)	106		109	105	106	106	104	106	104	102	104	101	103	105	106	107	107	105
CO2, Ser/Plas (22 – 29 mmol/L)	24		24	23	21	22	22	22	22	21	21	22	20	18	22	23	24	25
Creatinine (0.67 – 1.17 mg/dL)	0.70		0.68	0.68	0.57	0.60	0.60	0.60	0.64	0.65	0.67	0.65	0.62	0.66	0.55	0.59	0.62	0.74
EGFR (>60 mL/min/1.73 m2)	117		118	118	124	122	122	122	120	119	118	119	121	119	125	123	121	115
Fasting																		No
Globulin (2.0 – 5.0 g/dL)	1.2		1.3	1.3	1.2	1.1	1.3	1.4	1.5	1.4	1.5	1.2	1.2	1.3	1.7	1.4	1.2	1.6
Glucose, SER/PLAS (Manual Entry) See EMR for details (70 – 140 mg/dL)	100		108	127	127	110	114	112	105	105	107	106	146	113	104	117	102	97
Potassium (3.5 – 5.5 mmol/L)	3.6	4.0	4.1	3.9	3.8	4.5	4.0	4.2	4.3	4.3	4.1	4.1	3.7	3.7	4.2	4.4	3.9	4.0
Protein, Total, Ser/Plas (6.0 – 8.3 g/dL)	5.9		6.0	5.5	5.2	5.4	5.5	5.8	5.8	5.6	5.4	5.4	5.2	5.2	5.6	5.4	5.6	6.1
Sodium (135 – 145 mmol/L)	140		142	139	138	140	137	140	136	134	136	133	134	134	137	137	140	139
Bilirubin Total (<1.2 mg/dL)	0.8		0.6	0.9	0.6	0.5	0.6	0.7	0.6	0.9	0.9	0.9	0.8	0.7	0.5	0.4	0.4	0.5

Nutrition

Stanford Nutrition Guidlines

May 15, 2023May 15, 2023 Jothi

I was on my way out the door from Stanford a few weeks ago, and I was given this document about nutrition. I must confess, I rolled my eyes a bit and said sarcastically, “this ought to be good”.

To be fair, the nutritional advice that I got from my regular provider is “eat a bunch of doughnuts to gain some weight”. Also, during my transplant, I don’t know how many times I was told to eat ice cream and drink gatorade (which I didn’t do). So, I was expecting more of the same advice as I was on my way out.

I started reading and my jaw hit the floor in shock. I told my wife, “Wow, this is actually really good”. It’s so good, that I wanted to share it with you.

It’s solid advice whether you have cancer or you want to avoid getting cancer (or other chronic illnesses). I feel if all Americans adopted this diet, 75% of illnesses would go away or be prevented automatically.

One of my favorite lines from it is, “At least 2/3 of your plate should be comprised of fruits, vegetables, minimally processed grains, and beans”. I think most people’s plates are the opposite or worse. Observe what your plate looks like at your next meal.

Here you go. Give it a try.

Survivorship Nutrition.PDF Download

Blog

Plus 23

May 6, 2023May 6, 2023 Jothi

Hello, I finally feel like writing again. I’m at +23 on my stem cell transplant today. It has been an interesting past month to say the least. I’m still in recovery mode, and I’m told I will be this way for a few months at least.

The doctor told me that I did better than most. The end result is all that matters though, how much cancer is left or not left. I would rather be more miserable for longer and have a better response. I won’t know that answer for a few more months. I’m praying for MRD negative test result (zero cancer cells in a million).

I did get an engraftment fever, which wasn’t a surprise to me, since fevers are kind of my thing and I usually get them when I’m sick. Fortunately, I was able to stay out of the hospital from that.

Where my picc line went into my arm, that started to bleed one day, which was alarming because my platelets were so low. They put a plastic dressing over the line to hold it in place and keep germs out. It filled up with blood and I had a sack of blood hanging from my bicep. Fortunately, my measly number of platelets stopped the bleeding and the dressing just got changed.

The nausea was pretty challenging. Not surprising, since the chemo heftily kills off GI tract cells as well. I was only able to eat a third of what I normally eat, and that was forcing myself to eat. I managed it with ginger tea and drugs. I was told I could drink fresh vegetable juice if I made it myself (which I do anyhow). I feel like that helped my nutrition immensely, and kept my remaining blood cells alive and kept me away from transfusion.

I engrafted (my blood started growing again) on day +10. To my surprise, I was told I could go home on day +13 (I had to move into hospital apartments across the street from the ER, since I lived outside the “safe zone”). I didn’t need a red blood transfusion and I only needed one platelet transfusion.

My hair fell out as expected. I wear a beanie to keep my head warm. When I look into the mirror, I think I look like Toad from Mario brothers. Oh well, good thing it’s not permanent.

There was a park that was in walking range of the Stanford apartment that we walked to every day. There were some amazing oak trees there. Their branches went out horizontally for 20-30 feet from the trunk. I was amazed they didn’t snap off. Oak wood sure is hard.

One of the oak trees. I had a friend tell me I look like a ninja all covered up 😜.

I’m pretty tired all the time. Go to bed tired. Wake up tired. Tired from doing the smallest things. It’s getting old already. I’m the type of person who does things pretty constantly. I have a whole list of things I’m not allowed to do (due to germ, bacteria and mold risks), and it’s hard to get inspired to do things from what I am allowed to do. I don’t golf, but I’m not allowed to golf for 6 months, I think that one is pretty weird 🤪.

I got the picc line pulled out a few days ago, and today I’m allowed to use my right arm again. Even though I’m tired, I’m really looking forward to exercising again. I have been keeping up on my walking, about a mile every day. Call me crazy, but I did an almost 4-mile flattish hike the other day. I really needed to get out into nature. It makes me feel alive and quite frankly, sometimes I feel half dead these days at times.

Well I’m off to the exercise bike, hopefully I don’t collapse from it 🥴. Again, the only way is forward and I’ll keep on trucking….

Eat your vegetables!

It’s California poppy season and boy are they ever blooming after all the winter rain.

Blog

My Central Catheter Humor

April 18, 2023April 18, 2023 Jothi

I had a central tunneled catheter placed in my chest for harvesting my stems cells and transplant. I got to the operating area early in the morning and waited for my name to be called. After 15 minutes or so I was called and walked back to the prep area with the nurse.

She gave me a gown and told me to change. When I was done, she asked,

“Do you have a hairy chest?”

“Umm…. Yes?”

“I’m shaving it off.”

“Ok”

So she had me lay down on the bed, open up my shirt, and she got to work. Buzz buzz buzz. It turns out she only needed to shave my upper part of my chest, right above my nipples, all the way across.

I saw myself later in the day, shirtless in front of a mirror. Clear skin on the top and a hair bottom. It looks like I have a tube top on. Too bad I’m not busty. Actually, I take that back, I’m not interested in man boobs.

Speaking of boobs, the way they placed the catheter, I had both lumen ends in my armpit, which was a bit annoying. I was telling my family this, and said,

“I’m going to start wearing a bra just to hold my tubes from swinging around.”

My daughter quickly volunteered to take me bra shopping.

Anyhow, the catheter did its job. It turns out, one of my ends fell apart after stem cell collection and no one noticed. Come to find out, without the ends on, it’s like having a (clamped) plastic vein hanging out of your chests. Due to the infection risk, they yanked it out, only after a few days of having it. A week later they installed a picc line in my arm for the high dose chemo and stem cell rescue procedure.

I’m at day +5 right now for the myeloma people out there, and I’m hanging in there.

Blog

Zap!

April 13, 2023 Jothi

A number of my labs look like this. My poor cells after getting hit with high dose chemo. I hope the myeloma cells are following a similar trajectory 😅…..

Blog

7.1

April 1, 2023April 1, 2023 Jothi

The Stanford apheresis nurse called in the evening to let me know if they got enough stem cells. She sounded a little downtrodden, and I started to think, “Dang, I guess they didn’t get enough and I have to go back tomorrow”.

Then she got excited and told me they got a whopping 7.1 units in 4 hours. The goal was 4. For perspective, it takes 2 units for the transplant, to regrow your blood, and they want an extra 2 as back up, in case the first set fails. Guess I could do it 3 times, if it’s fun 🤪?

I guess all those vegetables helped out? It’s hard to get too excited about it though. I feel like I’ve cleared 1 hurdle and still have another 20 to go. Still, I’ll take my small wins where I can.

I get to go home and have a week off before the big test starts….

Blog

It’s A Bit Odd

March 31, 2023March 31, 2023 Jothi

I’m at the Stanford cancer center right now. I’m sitting in a chair having my blood pumped out of my body. It’s laying across my chest and lap, on its way to a machine to filter out my blood stem cells. Another line, from the outlet on the machine, is running up my lap and chest and going back into my body. It’s rather odd (and maybe a bit grody) seeing your blood outside your body, in your lap, going in and out of your body. At times, I feel like my bones are exploding from the stem cell growth factor drug affecting my marrow.

I had to go to the infusion center last night to get a drug that encourages my blood stem cells to leave my marrow to go into my blood, so it could be collected today.

I saw my chemo chair, this one colored orange. It was in a large room that has multiple treatment chairs in it, separated by curtains, that is typical for these rooms. All types of cancer are treated in this infusion center.

I sat down in the chair, awaiting the nurse to run all the regular pre-checks, blood pressure, oxygen level, temperature, etc. She had to run off to do something else. I scooted my butt back and forth in the chair to get comfy.

The room was mostly empty, since it was at night, except for the chair next to me. Almost as soon as I sat down, a nurse went to the woman sitting next to me. I couldn’t see her, since the curtain divided the spaces, but I could hear everything.

“I have some bad news, unfortunately” said the nurse.

“Your labs just came back. It showed that your kidneys are starting to fail and your liver is in trouble. We need to run an EKG to check your heart.”

“Your tumor burden is too much for your organs.”

“We need to admit you to the hospital right now to help clear out your kidneys and liver.”

My heart went out to this woman. I wanted to get up and go over and give her a hug.

A soft sob came from the other side of the curtain.

“How long do I have to be hospitalized for?”

“We aren’t sure, at least a couple of days.”

My nurse came back.

She started saying to me, “Do you have this problem, that problem?

“No” I said, a bit guiltily.

Part of me felt guilty, I don’t know, humans are a bit odd. I guess, I was experiencing some survivor guilt? My situation has nothing to do with hers, and I suppose I could be in a similar situation in a few weeks with the nuclear bomb drop happening on me (sct).

There is really not much I could do for this person, but I still wanted to do something. The feeling of wanting to control a situation that I have absolutely no control over.

I finished my treatment. I was going to go over and just offer a few words of encouragement to this woman, after she was just crushed. But by the time I was done, so many nurses and even some family members showed up, her area was packed with people and activity.

I’m pretty sure I would have just been in the way, so I left.

I couldn’t help thinking, if my few words would had made any difference for her. Or if I wanted to say something, maybe subconsciously, just to make myself feel better about her situation.

Our time will come for all of us at some point. I’m grateful that I’ve found some peace within myself. It was just another reminder for me to be grateful for what I have and the health I have, whatever level that is.

My blood running through a machine, filtering out the blood stem cells.

A snapshot of my specs, I guess I better sit back down, my return is low 😅.

Blog, labs

Labs 3/2/23

March 6, 2023March 6, 2023 Jothi

Hot off the press, my latest numbers. Not much new. Although, my ratio of Lambda and Kappa finally are at a normal ratio, which it’s been awhile since that happened. Things do look pretty good though, despite the weekly chemo hammerings.

I’m marching towards high dose chemo with stem cell rescue (SCT) at Stanford, with collection at the end of this month. High dose chemo and stem cells infused back around April 10th. I feel pretty grateful that I’ve been referred to them for this procedure.

My last zap of chemo is on March 11. My self-imposed training regiment begins after that. I want to be in high gear physically and mentally. My goal is to restore and revitalize my cells and organs as much as possible prior to collection.

I have a meeting with two Stanford nutritionists tomorrow, I hope I learn something. The last time I had a meeting with a nutritionist, I was teaching them things. “Oh wow! I didn’t know that”, they said. As I’ve mentioned previously, I’m pretty passionate about nutrition.

But, I would like to point out, because sometimes I feel like I’m on a box preaching about nutrition, with no one listening. I feel like most people, if not all, would say Stanford is pretty top notch, as far as health care. They are making a point about how important nutrition is while you go through this procedure.

I’ve known people who have gone through medical procedures, and they’ve said to me that they want to eat really healthy and well, so they recover quickly. I find it funny, how it doesn’t compute with them about eating good food all the time, and they go back to eating garbage food after they’ve healed.

I’ll get back up on my box and say it matters all the time….

Component	Your value	Standard range
IgG, urine, electrophoresis	<0.6 mg/dL	<=0.5 mg/dL
IgA, urine, electrophoresis	<0.5 mg/dL	<=0.4 mg/dL

IgM, urine, electrophoresis	<0.7 mg/dL	<=0.6 mg/dL

Component	Your value	Standard range
Creatinine	0.77 mg/dL	<=1.34 mg/dL

Component	Your value	Standard range
Bilirubin, total	1.2 mg/dL	0.2 – 1.2 mg/dL

Component	Your value	Standard range
Neutrophils, Automated Count	3.2 K/uL	1.8 – 7.9 K/uL
Lymphocytes, Automated Count	1.3 K/uL	0.9 – 3.2 K/uL
Monocytes, Automated Count	0.5 K/uL	0.3 – 0.9 K/uL
Eosinophils, Automated Count	0.1 K/uL	0.0 – 0.4 K/uL
Basophils, Automated Count	0.0 K/uL	0.0 – 0.1 K/uL
Immature Granulocytes, Automated Count	0.0 K/uL	0.0 – 0.1 K/uL
Neutrophils %, Automated count	63 %	%
Lymphocytes %, Automated count	25 %	%
Monocytes %, Automated Count	10 %	%
Eosinophils %, Automated Count	2 %	%
Basophils %, Automated Count	0 %	%

Component	Your value	Standard range
WBC COUNT	5.2 K/uL	3.7 – 11.1 K/uL
Red blood cells count	3.73 M/uL	4.10 – 5.70 M/uL
Hgb	12.7 g/dL	13.0 – 17.0 g/dL
Hematocrit	35.6 %	39.0 – 51.0 %
MCV	95 fL	80 – 100 fL
RDW, RBC	13.3 %	12.0 – 16.5 %
Platelets count	154 K/uL	140 – 400 K/uL
RBC’s, nucleated	0 /100WC	<=0 /100WC

Component	Your value	Standard range
SPEP INTERPRETATION	SEE ABN
Homogeneous Band In Gamma Region.
M-protein band 1	SEE ABN g/dL	<=0.0 g/dL
M-Band detected; not quantifiable.

NameStandard range	1/6/23	2/3/23	3/2/23
KAPP/LAMB FR 0.26 – 1.65	0.39	0.73	1.13
KAPPA LIGHT CHAIN FREE 3.30 – 19.40 mg/L	2.25	2.14	3.91
LAMBDA LIGHT CHAIN FREE, SERPL 5.71 – 26.30 mg/L	5.82	2.92	3.45

Component	Your value	Standard range
Beta-2-microglobulin	1,543 ug/L	900 – 2,300 ug/L

Component	Your value	Standard range
Potassium	4.0 mEq/L	3.5 – 5.3 mEq/L

Component	Your value	Standard range
ALT	14 U/L	0 – 47 U/L