6/5/11 Monte Sano, Huntsville, AL by geweber49 at Garmin Connect - Details

6/5/11 Monte Sano, Huntsville, AL by geweber49 at Garmin Connect - Details

Had a good ride today.  It was a little warm and humid but I didn't push it to hard.  If I back off when my heart rate goes above 140 I tend to stay out of heat stress.

My Mountain Bike Ride today.

Had a good ride around the mountain today. It was a little warm late in the ride and I over heated alittle.

The Lambda Continues to Increase

The Lambda free light proteins went from 72 to 109 mg/l in a three week period ending 9 May. This was right after taking the Malphalan and Dex. So it appears it is not working very well. The next choice will be 10 mg/day of Revlimid. We plan to wait until her blood counts recover better.

The platelets are recovering slowly. They only went from 26 to 33 in ten days ending 9 May. Her hemoglobin was at 12.5 after the infusion of 2 units of red blood cells. It dropped to 10.5 ten days later. I assume the infused ones die at a faster rate than your own new ones.

The one good indicator this time was the Kappa free light proteins increased from1.8 to 10. This would indicate her immune system increased in the direction of normal. The normal range of Kappa is 2.6 to 16.5 mg/l.

The peripheral neuropathy seems to be getting a little worse. The back pain from the compression fractions seems to be worse after we go to doctor appointments due to the more activity. The gut is still causing a lot of discomfort and doesn’t appear to be working very well.

I am showing two plots of the increases in the Lambda. The one starts with the level when she was diagnosed. This is to keep in perspective that although it is increaseing at an increasing rate it is still much lower than when she was diagnosed.

Waiting for the Platelets to Recover

The platelets were at 18 yesterday when we went to The Cancer Center. They gave her an infusion of platelets. We will go back Thursday and have them checked again.


We received the results of the Freelite test from last Thursday. They increased from 62 mg/L to 72 mg/L. We were hoping they would go down since this was 3 weeks after the start of this last chemo cycle. I think it is a time for a change of the treatment plan since the Melphalan is hard on her blood counts and the free light number countinues to go up.

Her hemoglobin recovered nicely after the red blood cell infusion. It went from 8.4 to 12.5 G/dL (12.0 – 16.0).

We are crossing our fingers on the constipation issue.

Platelets Continue to Drop

Her platelets are at 20 today. She received the two bags of red blood cells yesterday. That perked her up quite a bit. They did remove the nasal tube yesterday which felt much better. Her stomach and bowels seem to be doing okay today so they are letting her go home today.

We will go to the doctors office tomorrow to get the blood checked for the falling platelets. Hopefully they will start to recover before she needs a transfusion of them. Platelets have a life span of 5 to 10 days. At the rate they are decreasing it appears her bone marrow is not producing many.

If she had not taken this cycle of chemo treatment we would not have had all these issues including the emergency room visit and hospital stay. I hope the Melphalan and Dex did some damage to the myeloma cells. This is the catch 22 of cancer treatment. Do you want to die from the treatment or the cancer? Would you rather have two years of life fighting the cancer resulting in low quality of life or one year of life without chemo and a better quality of life?

Succumbing to another round of chemo.

Rebecca is in the hospital receiving a couple of bags of red blood cells. That is not why she is in the hospital though. On Thursday we went to a regular doctors appointment. Her hematocrit was down to 23 and her platelets were down to 29. The plan was to get a shot the next day of something to stimulate the release of more red blood cells.

On the way home we picked up some food from a deli. About an hour after she ate she started to get nauseated and diarrhea. We ended up in the emergency room. Initially thought it might be food poisoning but no one else got sick who ate the same food. After an X-ray showed the small intestines to be dilated they labeled it ileus. A non physical blockage if the small intestine. I would assume her peristalsis is slowed way down due to the high amount of pain medicine and/or the neuropathy. Her stomach was very distended and firm. They put a nasal tube into her stomach. Not much liquid came out but some gas may have been released since her stomach went down.

They shut the suction off yesterday. They should be able to remove the nasal tube today. Then she can try to take more by mouth.

The platelets dropped to 23 today. Surprisingly the absolute neutrophils are at 1.96. After the last cycle of melphalan they had dropped to 0.8.

Managing bowel movement is very critical. During the last cycle she had diarrhea about three weeks into the cycle. So this time we cut back on the anti constipation medicine some. I guess it was to much. We have decided it is better to have diarrhea than constipation.

Rebecca will not be happy with me talking about her bowels.

Taking another dose of Melphalan

Rebecca started taking the 10 mg/day of melphalan two weeks ago. She is also taking 20 mg/day of Dex once a week for four weeks. She is not doing well. She is having nausea and considerable pain in the stomach. She has two doses of Dex left starting tomorrow. I would recommend she not take it.


We go to the doctor in a week. We will see how much her blood counts have been impacted by the chemo. She will also have a Freelite test. It takes about a week to get the results back from that test.

I still think she should take a couple of months off from chemo and see what the myeloma does. Some people live with the effects of the myeloma better than the effects of the chemo.

Here are some of her lab results from 4/08/2011:

WBC = 3.5 (4.8 - 10.8)
RBC = 3.0 (4.2 - 5.4)
HGB = 10.5 (12.0 - 16.0)
PLT = 91 (130 - 400)