Holiday Dash

It's the Holiday Dash - those busy weeks between Thanksgiving and Christmas! 

I'm in a holding pattern at the moment and am so thankful that I'm not having chemo these past few months with everything else that has been going on.  After Steve recovered from shingles, one of his knees started really hurting.  After x-rays, cortisone shot, anti-inflamatories and MRI, he had arthoscopic surgery last week to repair the meniscus.  He is on one crutch now and improving.  Doc says new knees are down the road, but is hopeful this procedure will help.

Saw my specialist at UCSF in November.  Bone marrow hasn't recovered enough as yet to consider transplant.  Blood work done recently is not very encouraging.  Bone marrow still not recovering and things have actually gone down hill instead of improving.  Cancer loads are rapidly rising again and bone marrow not adequate to withstand treatment at this time. The next few weeks are filled with Dr. appointments, MRI, x-rays, bone marrow biopsy, and possibly heart and lung function tests.  Transplant is beginning to look like it will not happen even if we decided to go forward with it. I continue my monthly infusions of Aredia, for my bones, and Gamma-globulin, for my immune system.

Right now there are days to be enjoyed through the holiday season.  My choir concert, Christmas parties, carol sing with friends, and looking forward to family that will be here sometime during the holidays.  It will be baby Grey's first Christmas.  Our newest little grandson was born to parents, Jeremy & Holly, on October 20.  We also are celebrating Jeremy's completion of his B.S. degree in business management from National University.

We pray for those of our loved ones who are struggling with health issues, too, and cancers that would try to destroy our life and our hope.  We daily remind ourselves that our hope is in the Lord; He is the giver of life enternal.  It is the time of year that the whole world must stop and take notice of his birth and life on this earth!  Merry Christmas!

The Party's Over

The wedding is a beautiful memory now and the photos are arriving from the photographer and others who took snapshots.  It was a joyous celebration!  And we celebrate the addition of another wonderful son-in-law whom we love.  We're still finishing up dealing with "stuff" we accumulated for the wedding.  A yard sale was on the calendar for next week, but is on hold at this point.  Steve has come down with Shingles and is quite miserable!  I was able to quickly identify the rash that was just beginning and got him to the doctor in time for anti-viral medication which has helped stop the spread of the rash.  However, he is still very fatigued and very uncomfortable from the nerve pain that accompanies this virus. 

I made it through all the busy, hectic pace without getting sick inspite of my very low blood counts.  However, I was my usual germophobe-self and was extremely careful, and followed my doctor's orders about no one working in my kitchen without washing their hands first.  Until my health became so precarious, I never really noticed how much people work with food without washing their hands, and handle things that are not clean (such as money, menus in restaurants) then handle food.  My back held up pretty well, too, as I was very careful not to lift anything that was more than a few pounds.  My back has been painful since the wedding from doing housework, sitting at the desk catching up on bookkeeping, sorting mail that piled up for two weeks, etc.

The week following the wedding, I saw my onc-doc and was pleased that my cancer load was staying low and my blood counts were slowly improving.  Had my monthly infusion of Aredia (bone builder) and slept through the enitre 3-hour infusion!  hmmm....maybe a little fatigued following the wedding?!  I was very grateful for the burst of energy through the final 10 days of prep for the wedding.  It truly was a miracle.

Monday is my monthly gamma-globulin infusion and I am feeling the need of the boost to my immune system as I feel like I'm on the verge of a cold.  This is a typical scenario for me when I am due for this infusion.  It will have me feeling strong again within a few days afterward.

We're awaiting the arrival anyday of our new grandson, Grey Steven Rosten.  He is lovingly referred to as "Baby Grey" by his big brother Ty.  Jeremy will finally finish his B.S. in Business Management this month also. 

Jesse & Lyn took off a few days after the wedding and are touring Europe on BMW motocycles on loan from a couple they met through his business.  Am so happy for this opportunity for them and I find it's not easy being green!

I feel like I've been let out of prison now that I'm not quite so tied down with treatments and feel so much better without chemo drugs on board.  I don't want to think about the fact that this is a temporary break.  I just want to travel and see something or someone other than the inside of a medical facility of some type.  However, Steve and I seem to be having a problem being healthy at the same time right now.  We're praying he recovers quickly and doesn't have to experience months of nerve pain before the virus is completely out of his system.

I'll be seeing my specialist at UCSF the first week of November.  Am waiting to hear if I'll be having a bone marrow biopsy prior to that appointment.  I will be able to have this done in Chico.  We're so grateful for the wonderful care we get in Chico and I really like my onc-doc there.  However, we are really feeling the effects of gas prices here in our state!

Thank you for your continued interest in our lives and for your prayers that sustain us.

Smoke Gets in Your Eyes!

     Anyone remember this old song?  Or am I REALLY showing my age?!  We have suffered for many weeks now from smokey air from all the fires around us.  It has actually been much worse in the last couple of weeks.  Many days it is so smokey it looks like winter fog and there have been times in my travels to and from Chico, that the visibility has been poor.
     Saw my specialist at UCSF a couple weeks ago.  The cancer load is down, but needs to come down more before a stem cell harvest could be done.  However, it has been difficult to gain any ground this summer due to low white blood counts.  My bone marrow is showing the effects of being on chemo for over a year.  Even with numerous shots to try to bring it up so I can have a treatment, it just drops even lower afterward.
     The plan was to get enough treatments done by the end of August that I could have September off for the wedding.  Due to the ongoing struggle with my white blood count, we have not been able to get all the treatments on the schedule completed.  My doc at UCSF was hopeful we could at least get one more treatment done last week.  Instead, I have had to drive to Chico 4 days in a row for shots as my white blood count last week was considered extremely low; the lowest it has ever been.  So, now the plan is to have another blood test on Wednesday this week and if white count is ok, treatment on Friday.  My doc at UCSF says I need to take at least 2 months off treatment to let my bone marrow recover and will monitor me through monthly blood tests.

The options for future treatment:
     1) possibly qualifying for a clinical trial with my doctor at UCSF;  would require many days a month staying in the city.
     2) qualifying for a new drug just approved by FDA in August
     3) additional treatment with current regimen then stem cell harvest for transplant in the near future.

     I have been fortunate that all of my drugs to date have only made my hair thin and dry, not turn loose.  Future drugs will be stronger and hair loss will be involved.  Also, to date, my drugs have made me "fat and flushed."  I'm thankful that I look healthy eventhough my health is actually quite precarious.  I've had to become a total germophobe to lower the possibility of contracting illness or infection.
     Had to cancel my Myeloma support group meeting this month due to my "shot" schedule (those are only done in the mornings on the weekends) and none of my alternates could be there. It's the first time I've had to do that, but I've been either emailing or calling everyone to check in on them and then will send an update out to everyone by email.  We all keep close tabs on each other.  A dear precious lady from our support group passed away recently. I'm constantly aware how precarious our health is in the group and try to share my faith when there is an opening. Most attend church and are clearly Christians or at least have a faith in God. I pray especially for those who do not. I also pray that the Lord would continue to use me in this new mission field He has brought me to.
     We continue to attend too many funerals this summer.  A good friend, only 68, last week who was part of our group who planted a church in Redding when we first moved here.  He was actually the third one who passed away this summer out of our small church planting group, all younger than Steve. It is a constant reminder of how temporary this life is and the importance of the Christian legacy we leave behind.  This week we will head south to attend service for one of Steve's relatives who lived a long life into his 90's.  We are comforted by the promise of eternity in Heaven with our Christian friends and relatives.
     Wedding preparations are in the final weeks.  There is always so much to do to prepare for a big event such as this.  I have Lilian's flower girl dress half done.  Haven't started Evelyn's dress yet.  Will make my skirt and friend will make top.  She can design and make patterns out of ideas, so we are able to create the look I want.  There are 30 pies in the freezer I've made over the summer.  The bride and groom requested pie instead of cake.  We're praying the smoke will be gone and that it will not rain the day before or the day of the wedding!
     We thank you again for your faithfulness to us through your love and prayers.  Your communication with us through various means always reminds us of your love and care for us.

Mid-summer update

I guess June was a busy month, too, since I haven't had time to post an update!  Where did the time go?!

My appointments at UCSF in June have provided some help with my back issues.  The orthopedist didn't find any additional problems with the 2 remaining unrepaired compression fractures nor any new ones.  He wrote an extensive Physical Therapy order to help me regain some strength and flexibility in my back.  The pain management clinic provided lots of options that could be explored to help with pain.  However, since I've begun P.T., I have had a great deal of improvement and am not wearing the back brace anymore!  Praise the Lord for that!  It has been difficult to keep on a regular schedule with appointments as I only have so much energy each day, but the exercises I do at home have improved my strength and flexibility, and the T.E.N.S. machine that has been prescribed for home use has helped break up the muscle spasms that will continue to plague me.  There are certain movements that will always set off the muscle spasms, but at least I am feeling much stronger and they are not as painful as they were all last year.

Just had chemo again yesterday after a 4 week break.  My white counts were too low and have been slow in recovering due to the fact that I have been having chemo for a year now.  Shots and blood tests for several days 2 weeks ago replaced my regularly scheduled chemo.  Other numbers are improving, for which we are thankful.  Immunoglobulin proteins will be checked again in the next few weeks to see if there is any improvement.  The last time they were checked they had not improved which has caused concern that my bone marrow is being supressed by the Cytoxan, one of my chemo drugs.  However, I am not in a position, as yet, to discontinue treatment for any length of time to see if there is recovery in this area.

Almost didn't get my gamma globulin infusion this month.  When I arrived at the hospital this week for my monthly infusion, the nurses discovered that there had been a mix-up in the date of my appointment and the pharmacy gave my allotment to another patient in the hospital thinking I was a "no-show".  However, they finally determined they could use the allotment for another patient who wasn't schedule until the end of July with the hope they could order more and if not, she would only have to wait a few days until the August allotment was received.  It's an involved process regarding allotments for specialty items such as this.  Was very thankful it all worked out as waiting until August with my bone marrow so supressed would have put me on "house arrest" until then! 

The summer is half over already and the days are going by more quickly than items are being crossed off the list of projects to be accomplished before the wedding in September. The girls were here for a week - Jen & family, Johanna & Titus - beginning on the 4th.  It was fun to have them here and to get better acquainted with our future son-in-law.  He seems to be a wonderful man and love was definitely in the air around here!  It was a fun, but busy time.

We have been saddened by the loss of two friends lately whose illnesses were diagnosed recently and have taken them already - pancreatic cancer and Lou Gehrig's disease.  It makes us pause and be thankful for the years the Lord has granted me since my diagnosis.  We continue to pray regarding the possibility of a stem cell transplant.  We know that the prayers of so many friends and our families sustain us in a way that we cannot adequately describe!

May Days

     It's a holiday weekend and time for a rest or at least a little slower pace.  May was a very busy month, but filled with lots of enjoyable activities.  My trip to Ashland with my girlfriends was great fun loaded with lots of good theater, good food (according to my friends since I can no longer taste), shopping and a street fair with lots of unique crafts.  Having my cousin from Medford join us Thursday evening and enjoying the art & craft fair with she and her husband on Saturday were an added bonus.  My choir concert went really well and I was able to take enough Advil to keep the pain in my back under control so I could go without my brace for the evening.  One of the choirs sang the next night at a graduation and again I went without my back brace.  I was pretty sore for a couple days after but managed through it.  Wedding plans for Johanna's fall wedding have added to the busy schedule; but, again a happy event is good for the soul!
     Physcial Therapy has finally started.  The Therapist is actually a former student from the early days of choir when our kids were in it.  He has specialized in back problems and we are slowly, carefully starting to build up the muscles above and below my line of fractures.  I have exercises that I do at home in between our appointments.  I must admit, however, that I have not kept up with them like I should as I can only handle so much activity each day and my "fun" activities have taken priority the past 2 weeks.  Now that all of those commitments are behind me, I can budget my time a little differently. 
     I have started my new chemo regimen of every other week.  It is so nice to have a week that I feel well enough to do other things besides "recover".  I am hopeful this schedule will keep the cancer under control. There was a short lapse of time while switching from one schedule to the next that I hope was not so long that it allowed the cancer to gain ground again.  We were just starting to see some good progress.
     One of the tests that I know helps me determine my cancer load is one that is not routinely done.  It is a test for the blood levels of the immunoglobulin proteins.  My particular form of myeloma interferes with my body's ability to produce those proteins, so when those numbers are low I know the cancer levels are higher than what they show on other blood tests.  I requested those numbers to be run a couple of weeks ago and was disappointed to see how very low they are.  I was not able to compare those numbers to the free light chain test as the lab neglected to run that test, which is part of my regular monthly regimen.  If both numbers were low, it would indicate my bone marrow is starting to fail.  If free lights were higher than they've been, then it would indicate the cancer is on the rise again.  So much technical data!!  But learning all of this info has made it possible for me to better understand the amount of cancer that is actually present at any given time and how susceptible I might be to illness or infection.
     I have an appointment with a world reknowned back specialist at UCSF on June 11 and an appointment with their pain clinic the same day.  I'm not really expecting to hear anything different than what I've been told before, but will be nice to have a second opinion.
     We survive day to day on the strength of your prayers!  We thank you for your faithfulness to us through this long journey.  We are grateful for each day the Lord gives us together, even though many of those days are filled with medical stuff and the altered routines of daily living.

The Expert Speaks

Our appointment at UC San Francisco with a myeloma expert was very enlightening. Through the one hour he spent with us and his comments and questions, my concerns about not having adequate oversight were confirmed. The one time I would have preferred being wrong since the issues that were not addressed at the appropriate time are here to stay. He confirmed that my case is particularly difficult and labeled me a total "non-secretor". This means that the special blood test that has been used to track my cancer numbers is not an accurate picture of the extent of the cancer in my body. Multiple types of tests need to be done every year to try to get a handle on the cancer activity in my body, such as CT scans, PET scans, bone marrow biopsy. He was surprised that I hadn't had a bone marrow biopsy in 3 years and I'm quite sure one will be ordered in the very near future. However, even the bone marrow biopsy cannot be used alone. He was very surprised about how much bone disease I have in my back and that I just recently was started on IV bisphosphonates. "I wish you had come sooner," was his comment early in the hour.

So where does this leave us now? He is taking me on as his patient, so my future care will be directed by him. He is referring me to their back specialist and pain management clinic. I will be on maintenance chemo for the duration. For the next 3 1/2 months I will continue with the same drugs I am taking now, but the schedule will change to every other week. In August a new drug is being released and he will put me on that as soon as it's available. It requires an infusion but I won't have to take any steroids with it. Hooray!! Those metabolism and mood-altering, sleep depriving meds are really a challenge; but they are very effective against myeloma. So you feel like it's "Pick your poison". We will see him again the first week of October.

We did gleen some info from him regarding my back issues. We know that my vertebrae are very fragile and compromsied, and as it turns out, I should have continued with the back brace and allowed the Aredia (bisphosphonate) to help rebuild some bone structure before having any repair procedures. The reason I keep getting fractures is that every time cement is put into a vertebra the weight causes the one below to fracture. This is a much more plausible explanation than all the reasons I've heard up to this point. He did indicate there is a good chance I will have to wear this back brace the rest of my life. I'm grateful for its effectiveness in helping me function. However, it is very warm and the thought of wearing it during our summers here makes me have a hot flash and heat rash!

What about stem cell transplant, since that was the reason for our referral? He is concerned with my overall stamina right now due to the loss of mobility from my back. He was very surprised that no one had written an order for physical therapy and said he would take care of it right away. The other issue is the chemo drugs I've taken and am currently taking. They can suppress the bone marrow to the point that harvesting adequate numbers and appropriate quality of stem cells can become difficult or even impossible. He did indicate that it would have been much better if I had entered a transplant program much earlier. When I told him I was not encouraged to think about SCT (stem cell transplant) due to genetic markers, he indicated that my markers were good and that some of the previous information had been interpreted from the wrong test. With all that is going on in our life right now, January 2013 would be the earliest I could even consider starting that all-consuming, lengthy process.

An alternative would be a clinical trial. This expert at UCSF writes the protocol for many clinical trials in myeloma. However, since I am a non-secretor, I am not eligible to participate as they have no way to monitor my progress using the standard tests used for "regular" myeloma patients. What few numbers I do produce are too low to even be eligible. He has one trial running right now that I might have qualified for but there are too many evaluations needed to assess my current situation before I could even possibly enter a trial.

There is much to consider and pray about the next few months.  In the meantime, I'm fairly stable.  Even though I will continue chemo, the schedule will be much easier to deal with.  Having happy events to look forward to, do help keep me going.  Weekend trip to Ashland with girlfriends to see plays and my choir concert will make May whiz by.  Also, wedding preparations are in full swing for Johanna's wedding in September.  Over the summer, we will visit Titus and meet his parents and help move Johanna to Texas.  The next big event following the wedding, will be the arrival of another grandchild in October, Jeremy's second child.

We continue to be sustained by your faithful prayers and know that He is the source of our strength.

Another Pause

Bronchitis/Laryngitis seems to be the bug of choice in recent weeks in our area and I was not able to escape taking a turn entertaining this bug. So, antibiotics, cough syrup, vicks, and lots of fluids and rest finally got me well enough to resume treatment. However, it created a 4-week pause just before my last 2 treatments due to the doc's request that my residual cough be completely gone. All the juggling and rescheduling of appointments has my schedule really full over the next 2 weeks. Our visit early in March to visit Miss Lilian for her 2nd birthday had to be postponed, too, so we will enjoy her company next week just before Easter.

I was able to resume treatment yesterday. Since it was the first day I was receiving a different bisphosphanate, (Aredia), I just received my steroids and one chemo drug. My schedule for the last 2 treatments has been modified some to fit schedules, so the last one will be on Tuesday, April 10. At that time I will get both chemo drugs. Still waiting for decision whether I will take additional steroids that day or on another day. The Aredia infusion takes 3 hours, but I have not had the reaction that I was having with the other bisphosphanate (Zometa). Other than the fact that the steroids only allowed me 2 hours sleep last night, I am feeling good today. I know I will get shaky and tired over the next 2 days as the steroids leave my system, but I'm feeling so much better than I was with the other drug. Quality of life has to be a consideration since I have been on chemo since July, with just a couple breaks due to my back procedures and illness.

My back continues to be a very limiting issue and I have to wear the back brace most of the day. I try not to wear it for awhile in the mornings if my back doesn't hurt when I wake up. But that only works if I avoid bending over very much or lifting anything. I get really warm with the brace as it doesn't "breathe" and I have a shirt under it and another over it to cover it. If I have to wear it much this summer, I am quite concerned about how I am going to do with the heat.

I finally have an appointment with a myeloma specialist at UC San Francisco next week. My list of questions is almost ready and need to finish getting all the requested records in order and
filling out forms. I have heard this doctor speak at seminars and he is a very respected authority in the world of myeloma. We primarily will be seeking a second opinion regarding a possible stem cell transplant and/or entering a clinical trial. They have many clinical trials for myeloma at this medical center.

I have one more appointment scheduled at Stanford at the end of April for follow-up evaluation when I complete these last 2 treatments. Following the appointment at UCSF, we will have to make a decision regarding which doctor we will use for my ongoing care. Eventhough UCSF is in the city of San Francisco and is not as easy to navigate and park, it is about 40 miles closer and less travel time.

Thank you for your faithfullness to us with your communications and especially your prayers. Your interest in our lives and your love are a great comfort and encouragement.

Still Persevering

My weeks have been filled with treatment and, consequently, dealing with the side effects each brings. My neuropathy continues to get more pronounced, but my Stanford doctor has asked me to try to hang in there until March when he will see me and can evaluate my response. Acupuncture treatments do help some. They're not covered by medicare but I still try to go at least once a week.

Once a month I get all of my drugs and so it has taken a little time to determine which drug is causing me such severe side effects. Through email conversations with my Stanford doctor it has been determined that I am having a rather severe reaction to the Zometa (bisphosphonate). It was given over a longer infusion time of 1 hour this past week which did reduce the level of side effects, but we have decided to switch to a different one and this infusion may also be moved to a day that I'm not getting chemo.

Friday, February 10, was my big treatment day for this month. My blood work was done the week before and my white count was too low for treatment. So we had to travel to Chico on Wednesday and Thursday for neupogen shots to force my bone marrow to make more white blood cells. As it turned out, one shot would have been enough as my white count was really high on Friday and my red count was really low and was borderline for ordering a transfusion. Blood counts always get a lot lower in the succeeding days following treatment, so within a few days I could barely get around as my red count got really, really low. A CBC was done again on the 17th prior to treatment and I was glad that things had leveled out. Fortunately, I was only getting one chemo drug and my steroids, so shouldn't have as much difficulty this week.

In January I had a follow up appointment for the kyphoplasty done here in Redding in September. We took all the reports and CD's from the MRI's done at Stanford to this appointment with the local interventionl radiologist. He discovered that there is another compression fracture visible on the CD that the Stanford report did not mention. He showed me on a chart that this is the fracture that is causing my current discomfort. He does not want to do a procedure now either, but it means I have to wear the back brace again and am very limited again with what I can do. I am to contact him after I complete my treatment. He is hopeful that if I don't have to be in treatment too long, that there might be some healing without further procedures. However, the steroids I have to take every week interfere with the healing and the bone building from the bisphosphonate will take quite a bit of time before I experience much help with my bones.

After much consideration and prayer, I did go ahead and begin another semester of choir. Since my treatments are on Friday, I am feeling pretty good on Thursday. I was told again that I need to keep moving and keep my arms moving without lifting, so choir does satisfy those requirements. Also, in all the reading I have done about living with cancer, it is encouraged that a person have something they do that is not related to cancer cause cancer can and does end up consuming your life.

We have determined at this time that the protocol for stem cell transplant at Stanford would not be a good fit for me. We have asked for a referal to the transplant program at UC San Francisco and are waiting to hear from them.

Thank you for you email, notes, cards and phone calls. They always seem to come just when they are needed most. Your encouraging messages always lift our spirits. It is a constant battle to keep our spirits up when my side effects have to be dealt with on a weekly basis and there are sometimes just a few days of feeling like I can function. It is also a struggle for me to have lost so much independence. I am very dependent on Steve, or whoever I'm with, to lift things for me and to have an arm to hang onto when I walk so I don't fall. My feet are numb, my lower legs are numb, my vision is a little blurry, and my drugs make me dizzy enough that I sometimes feel like I'm on a boat, and I must not fall anymore as my back cannot take another injury. Other than that, I still have hair, although quite thin, and I still have a rosy glow to my cheeks compliments of my steroids.

Conquering the Tube!

I'm sure everyone is wondering what we found out at Stanford this week and how I did with my MRI's.

The first MRI on Tuesday afternoon went quite well, in spite of the fact that I was given my sedation just 30 minutes prior to the procedure instead of the recommended 1 hour. We hadn't eaten lunch until we arrived at Stanford which was just before 3:00, so it didn't help that my stomach was full of food. However, I did really well and the tech was really good about talking to me through the microphone and keeping me informed of each step and how long it would take. A friend from my support group said it really helped her to cover her eyes with something so she wouldn't be tempted to open them and then see how close around her everything was. I took her advice and covered my eyes with a handkerchief. I tried not think about the correlation to a firing squad! I did have one brief moment of panic when I realized I was entering the tube before 4:30, the time I had asked everyone to pray. But I took a deep breath and in my mind sang the words to the hymn "Abide with me....". Of course, I only remembered the first verse, but it was enough to keep me occupied for the next 45 minutes. For those who have never had an MRI, those things are NOISY! Ear plugs are required and provided and they are still noisy. I soon realized that I was singing louder in my mind as the machine got noisier! One thing that helped, too, was that I didn't feel the edges of the tube touching me which would not have been a good thing for me. The tech's assistant didn't quite know what to think when I was finished and he came to help me off the skinny little table and I lifted one side of my handkerchief and said "peek-a-boo!" I was just practicing for the next event of the day - a visit with our little granddaughters. We headed on down the road with everyone else vacating the city at 5:00 pm on our way to Jen and Jeff's where we spent the night. I was really sleepy all evening and slept really well all night and was still tired the next morning from the sedation I was given. Jeff is still laughing cause I fell asleep in the middle of a sentence when I was sitting on their comfy couch talking to him!

Just as we were leaving Jen's Wednesday morning, this dizzy gal with the numb feet took another fall. Fortunately, the steps were shallow, the fall was onto their wooden deck and I landed on my side not my bum. Having shoes on spared my ankles from serious sprain. There was some hyper-extension, pulling and bruising to the bottoms of my feet. Jen quickly got an ice pack and ace bandage and I was able to ice and elevate as we drove back to Stanford. Walking was difficult that day, but I managed with slow, rather stiff strides. I was able to ice and elevate again that evening when we visited our friends in Mountain View for dinner and then again in the motel that night and Thursday morning. Felt much better on Thursday, although still a bit sore.

After the fall, it was back to Stanford on Wednesday morning for appointments with various people in the transplant department which lasted from 11:30 to 3:00, again leaving us with a "lick and swallow" lunch just before my check in time of 3:30 for my next MRI. My sedation was given earlier this time and my procedure a little delayed so I was really relaxed. My tech was very nice but not quite as talkative. It did help both days that the initial images took about 30 minutes then they brought me out for an IV of contrast for the final 10-15 minutes of images.

Thursday morning at 8 am we met with the Interventional Radiologist and his nurse coordinator. There was another compression fracture found in the upper lumbar region and there was evidence of small patches of myeloma throughout my bone marrow. There are also degenerative discs which could be caused by aging or as a result of all the compression fractures. He didn't want to do anymore procedures right now so that I can continue in treatment without further interruption. There have been too many interruptions over the past 6 months which has not afforded the consistency that is needed. We talked about options for pain control and he highly recommended some specialized physical therapy. This is something I've been asking about for several months. His nurse coordinator will include this info in her follow-up letter to my local oncologist so it can be ordered. There is an excellent physical therapist in Anderson, so am hopeful he will have the expertise that is required for my situation.

In answer to my questions, the radiologist explained why he preferred vertebroplasty over kyphoplasty. After much research and many tests, they have found that vertebroplasty gives a better long term result for myeloma patients. Also, the two different processes create very different environments in the vertebrae. Even though the inside of the vertebrae have thinned out significantly to the point of collapse, there are still bony structures there providing some support. This is an important consideration when repair is made in a myeloma patient. Vertebroplasty fills in all the space around the bony structures giving them added support and filling all of the vertebral cavity. It is an easier procedure and doesn't require as much sedation. Kyphoplasty is a much more involved procedure requiring a larger incision and more sedation. A balloon is inserted into the vertebra to make a space where a "ball" of cement is then inserted (that's what it looked like on the MRI today). It doesn't completely fill the space leaving the outer edges still vulnerable to collapse and when the balloon is inserted it crushes all of those important bony structures.

Before we left we made my follow up appointment with the neurosurgeon. Between his schedule and mine, I won't be seeing him until March 5.

We are still processing all of the info from the meeting with the transplant department and have a notebook full of information we are to read through, so I will share more about that in a later post. In the meantime, you can continue to pray for us as we make this decision.

Thanks to your faithful prayers I conquered the tube!!