Well Dad is off his steroids for now. His voice is getting better too, he is no longer hoarse. He slept really well, his back was not bothering him at all. He has gotten into the habit of stretching every morning. It helps to warm up his muscles and prevent new injuries.
Today is the opening game for the Longhorn Football season. Dad had tickets to the game, but decided it was best to avoid the large crowd. Instead he is rooting on the Longhorns from home. HOOK'EM HORNS!
Saturday, August 30, 2008
Friday, August 29, 2008
Day 4
Day 4 was the second dose of chemo for dad.
Dad slept well last night, although he still seems to think he can do anything, including help move a refrigerator. He was trying to help mom move the upstairs mini fridge and in attempts to slide it out of it's spot he pulled a muscle in his chest, this time on the left side. He also realized that he just can't pop out of bed like he use to when he was younger. He did need to take his pain medication this morning because of his muscle pull, but was not in too much pain.
0845: Arrive at the boutique for labs and vital signs.
o900: In the office waiting for Dr. Kahzdan. He decided to use this time to stretch, which will be part of his daily routine from now on. He is learning from Rocky, the dog who stretches every morning before he gets up and runs around. Oops, no one told Dr. Kahzdan we were waiting, so she was embarrassed.
0920: Meet with Dr. Kahzdan and is examined. Dad's labs all look good, his kidney function tests look even better, the only thing is Dad is anemic. Dad will also need some magnesium today with his fluids.
1000: In with Elizabeth, the nurse to start his IV. She was very nervous with Mom and I in the room. We stepped out and she got it on the 3rd attempt.
1040: IV fluids infusing with the magnesium. Dad is reading his chemo information about eating habits and answering emails and calls. In between he sneaks a small nap in.
1145: Nausea medication in, Dad's feeling great. A little flushed from the magnesium, but no other problems.
1155: Velcade in
1204: Elizabeth checks his blood pressure one last time, removes his IV and we are released.
Dad is now going to have to take supplemental magnesium, since his levels stay low. We will try to get some magnesium rich foods into his diet to help with this.
Mom and Dad drive home to check his blood sugar, take his insulin, dex and eat lunch.
1645: Dad relaxing and trying to take a nap
2000: Lupita and Lico came to visit Dad, his sister and brother in law. They visited briefly, saw the house and went home. Dad is a little tender from his muscle pull, but his throat is a little better and he is feeling good.
I will post some pictures tonight of Rocky and Dad at the boutique. Thank you for your support and comments.
Dad slept well last night, although he still seems to think he can do anything, including help move a refrigerator. He was trying to help mom move the upstairs mini fridge and in attempts to slide it out of it's spot he pulled a muscle in his chest, this time on the left side. He also realized that he just can't pop out of bed like he use to when he was younger. He did need to take his pain medication this morning because of his muscle pull, but was not in too much pain.
0845: Arrive at the boutique for labs and vital signs.
o900: In the office waiting for Dr. Kahzdan. He decided to use this time to stretch, which will be part of his daily routine from now on. He is learning from Rocky, the dog who stretches every morning before he gets up and runs around. Oops, no one told Dr. Kahzdan we were waiting, so she was embarrassed.
0920: Meet with Dr. Kahzdan and is examined. Dad's labs all look good, his kidney function tests look even better, the only thing is Dad is anemic. Dad will also need some magnesium today with his fluids.
1000: In with Elizabeth, the nurse to start his IV. She was very nervous with Mom and I in the room. We stepped out and she got it on the 3rd attempt.
1040: IV fluids infusing with the magnesium. Dad is reading his chemo information about eating habits and answering emails and calls. In between he sneaks a small nap in.
1145: Nausea medication in, Dad's feeling great. A little flushed from the magnesium, but no other problems.
1155: Velcade in
1204: Elizabeth checks his blood pressure one last time, removes his IV and we are released.
Dad is now going to have to take supplemental magnesium, since his levels stay low. We will try to get some magnesium rich foods into his diet to help with this.
Mom and Dad drive home to check his blood sugar, take his insulin, dex and eat lunch.
1645: Dad relaxing and trying to take a nap
2000: Lupita and Lico came to visit Dad, his sister and brother in law. They visited briefly, saw the house and went home. Dad is a little tender from his muscle pull, but his throat is a little better and he is feeling good.
I will post some pictures tonight of Rocky and Dad at the boutique. Thank you for your support and comments.
Thursday, August 28, 2008
Day 3
Day 3 has been good. Thank you to those that have posted well wishes and prayers, we all really appreciate it and are very touched.
Dad's back was hurting him last night. He did take his pain medication, but during the middle of the night he still felt very tender as he tried to get up.
Dad went to work today, so he is still hoarse from all the talking he is doing. His blood sugars are very well regulated with the insulin they have him on. He has a great appetite and has been eating well.
Mom got bit by a spider- her whole hand is swollen and red. She went to the doctor today and now is taking antibiotics and steroids. One thing is for certain--they are certainly well medicated between the two of them.
Tomorrow is the second round of treatment. It will be an early and long morning, since Dad needs blood work, a visit with Dr. Kahzdan plus his IV fluids and velcade. I will post tomorrow and let you all know how it went.
Dad's back was hurting him last night. He did take his pain medication, but during the middle of the night he still felt very tender as he tried to get up.
Dad went to work today, so he is still hoarse from all the talking he is doing. His blood sugars are very well regulated with the insulin they have him on. He has a great appetite and has been eating well.
Mom got bit by a spider- her whole hand is swollen and red. She went to the doctor today and now is taking antibiotics and steroids. One thing is for certain--they are certainly well medicated between the two of them.
Tomorrow is the second round of treatment. It will be an early and long morning, since Dad needs blood work, a visit with Dr. Kahzdan plus his IV fluids and velcade. I will post tomorrow and let you all know how it went.
Wednesday, August 27, 2008
Day 2
Day 2 has been a great day for Dad.
The Back: doing great- he slept well last night without pain meds. Most likely the steroids have reduced any swelling that may have been making the pain worse. Time will tell if he will stay pain free when he is off the steroids.
Work: He went to work today! He felt good this morning, no back pain. Apparently he did a lot of talking at work, because he is hoarse.
Nausea: None!!
Blood sugar: staying fairly well controlled with the insulin they have him on.
All in all this was a good day, he got some work done, was able to get a little rest late this afternoon and ate really well. Thank you all for your prayers! More to come tomorrow.
The Back: doing great- he slept well last night without pain meds. Most likely the steroids have reduced any swelling that may have been making the pain worse. Time will tell if he will stay pain free when he is off the steroids.
Work: He went to work today! He felt good this morning, no back pain. Apparently he did a lot of talking at work, because he is hoarse.
Nausea: None!!
Blood sugar: staying fairly well controlled with the insulin they have him on.
All in all this was a good day, he got some work done, was able to get a little rest late this afternoon and ate really well. Thank you all for your prayers! More to come tomorrow.
Tuesday, August 26, 2008
Day 1
Today was day 1 of Dad's treatment. It did not start great- his back is still bothering him so much that he had a bad night last night. So he was pretty exhausted.
0900 Arrive at the boutique for round one.
0930 Vital signs done, IV started (it took 2 attempts to get it and she felt really bad!) and IV fluids infusing.
1030 IV fluids mostly done, nausea medication in
1040 Velcade in and no problems.
1100 IV out- no problems
1130 Metabolic doctor appointment.... more insulin :(
1245 To the pharmacy to pick up his dex and insulin
1330 Back home. Checked his blood sugar, gave his insulin and ate lunch. Steroids are in, more insulin. Try to rest and work
1930: Talked to Dad. He was doing better, his back wasn't bothering him and he had dinner and was getting ready to sleep since he was drained from the last 4 days of lack of sleep. I told him I would create this blog for him- he seemed to like this idea.
2130: Talked to Mom. Dad's back is feeling good, he didn't need his pain medication. No nausea and he ate a really good dinner and is in better spirits now that his back is feeling better.
We go in again on Friday for the second dose. In the meantime I will post updates on how he is doing. Keep faith in prayer, our journey has begun.
0900 Arrive at the boutique for round one.
0930 Vital signs done, IV started (it took 2 attempts to get it and she felt really bad!) and IV fluids infusing.
1030 IV fluids mostly done, nausea medication in
1040 Velcade in and no problems.
1100 IV out- no problems
1130 Metabolic doctor appointment.... more insulin :(
1245 To the pharmacy to pick up his dex and insulin
1330 Back home. Checked his blood sugar, gave his insulin and ate lunch. Steroids are in, more insulin. Try to rest and work
1930: Talked to Dad. He was doing better, his back wasn't bothering him and he had dinner and was getting ready to sleep since he was drained from the last 4 days of lack of sleep. I told him I would create this blog for him- he seemed to like this idea.
2130: Talked to Mom. Dad's back is feeling good, he didn't need his pain medication. No nausea and he ate a really good dinner and is in better spirits now that his back is feeling better.
We go in again on Friday for the second dose. In the meantime I will post updates on how he is doing. Keep faith in prayer, our journey has begun.
The worst pain of his life
This last weekend Dad was in El Paso for a wedding. Well, that was the plan anyway. He started to feel a twinge in his back on Friday night as he got out of bed. When he woke on Saturday, the pain was still there, so he thought a warm shower would help. Enter the worst pain ever! Dad's back spasmed on him while he was in the shower, making it so that he couldn't move. Several hours later he was able to make it up to the ER in El Paso. Lots of pain meds later, and it was still hurting. What happened? They still don't know. They do know that it is not his bones, they are all fine. It could be the dex he took last week- rarely it can cause muscle spasms. One of his heart medications can also cause muscle spasms, but that is usually in the legs. Needless to say- he didn't make the wedding.
You really don't know how much you use for back until it is hurt. Getting out of bed, out of a chair, coughing, hiccups- everything hurts! The last several days have been rough for Dad. He hasn't been able to sleep at night because of the pain. The doctor gave him a different pain medication- one that helps with nerve pain a little more and gave him a muscle relaxant. He took it last night, but his back still gave him problems. Heat seems to help him now, but anytime he is in one place too long, the pain comes back. This has been frustrating for him- he's trying to get work done and start his treatment, but his back just won't cooperate. Hopefully it will heal and he can get back to business.
You really don't know how much you use for back until it is hurt. Getting out of bed, out of a chair, coughing, hiccups- everything hurts! The last several days have been rough for Dad. He hasn't been able to sleep at night because of the pain. The doctor gave him a different pain medication- one that helps with nerve pain a little more and gave him a muscle relaxant. He took it last night, but his back still gave him problems. Heat seems to help him now, but anytime he is in one place too long, the pain comes back. This has been frustrating for him- he's trying to get work done and start his treatment, but his back just won't cooperate. Hopefully it will heal and he can get back to business.
Dad's Treatment plan
Everyone agrees- the best plan is to start treatment and to start is as soon as possible. Dad's treatment will consist of 3 drugs- dexamethasone (a steroid), velcade and revlimid. These drugs work well on their own at treating cancer, but work even better with each other at really killing off the cancer cells. The dexamethasone, or dex as I will refer to it is a pill or liquid solution he takes once a day. The velcade is given by IV injection and the revlimid is also a pill he can take.
The problem is that the revlimid can cause his body to form clots. Well as all of you know, Dad had a heart attack in May and has stents in place holding the coronary arteries open. Dad also needs to have the other artery fixed. Clots are not a good thing for anyone, but for Dad especially since it can cause him to have a massive heart attack. Originally, before the cancer, Dad was going to have bypass in October, a new type of bypass done fiberoptically through a small 2 inch incision. Dad's oncologist did not want to wait until after that to start treatment. And so it was decided they would place another stent in dad's other artery as a temporary fix so that he could start. Dr. Lyons, the myeloma specialist disagreed with this because of the chance of clot formation with the revlimid. Since the stent was a temporary fix, he suggested proceeding with the bypass after an initial round of chemo. The initial round would help get his body in tip top shape to best recover from the bypass, and also help protect his kidneys in the process.
****************THE PLAN*************
Dad will take the dex and one of the chemo drugs, the velcade for one cycle. After this cycle they will let him recover for ~ 2 weeks, recheck his blood work and then have the bypass. If everything goes according to plan, this would put his bypass at the end of September, beginning of October. After he recovers from the bypass, they will start the 3 drug cycle. He will have treatment for a few months, then harvest his bone marrow for transplant to be done several months later.
The schedule for this first cycle is over 12 days. The first day of chemo is day 1. His schedule will be Tues/Friday for the next two weeks starting on 8/26. Every Tuesday/Friday he will go to the Dr. Kahzdan's office, or boutique as we call it, have lab work done, get IV fluids and have the velcade. During the this time, he is also taking dex. He takes dex on days 1-4 and again on days 9-12. They don't anticipate that he will have any nausea with the velcade, but just in case, he gets nausea medication before they give him the velcade. He also has nausea medication he can take at home to help him feeling well.
The sticky part of the dex is that it makes your blood sugar high. The dose Dad gets is fairly high- which means his blood sugar will be very high. In order to help regulate this, Dr. Kazhdan had Dad meet with a metabolic specialist to talk with him about diabetes and insulin. While Dad is on the dex he will have to take insulin as well. This means he has to check his blood sugar, and take the insulin with the steroid dose and before each meal.
What else? Well the velcade and revlimid are medications that act like other chemo drugs- meaning they target areas of rapid cell growth. This happens in the bone marrow, stomach and intestines and on your skin and hair. Unfortunately the drugs haven't been designed smart enough yet to recognize which cells are normal cells and which are cancer cells. This is why people with chemo get nausea, lose their hair and are very susceptible to infection and anemia. With the medications Dad is getting, they don't think he will have a problem with his skin or hair loss. He might have some nausea, but usually the steroids help prevent that. He will be at risk for infection. Handwashing is the key and he needs to avoid anyone that is sick. As a precaution, Dr. Kahzdan has put him on an antiviral drug and an antibiotic to help prevent any illness. Still, we are being very cautious. So while he is undergoing treatment, he is going to avoid large crowds and anyone sick.
The problem is that the revlimid can cause his body to form clots. Well as all of you know, Dad had a heart attack in May and has stents in place holding the coronary arteries open. Dad also needs to have the other artery fixed. Clots are not a good thing for anyone, but for Dad especially since it can cause him to have a massive heart attack. Originally, before the cancer, Dad was going to have bypass in October, a new type of bypass done fiberoptically through a small 2 inch incision. Dad's oncologist did not want to wait until after that to start treatment. And so it was decided they would place another stent in dad's other artery as a temporary fix so that he could start. Dr. Lyons, the myeloma specialist disagreed with this because of the chance of clot formation with the revlimid. Since the stent was a temporary fix, he suggested proceeding with the bypass after an initial round of chemo. The initial round would help get his body in tip top shape to best recover from the bypass, and also help protect his kidneys in the process.
****************THE PLAN*************
Dad will take the dex and one of the chemo drugs, the velcade for one cycle. After this cycle they will let him recover for ~ 2 weeks, recheck his blood work and then have the bypass. If everything goes according to plan, this would put his bypass at the end of September, beginning of October. After he recovers from the bypass, they will start the 3 drug cycle. He will have treatment for a few months, then harvest his bone marrow for transplant to be done several months later.
The schedule for this first cycle is over 12 days. The first day of chemo is day 1. His schedule will be Tues/Friday for the next two weeks starting on 8/26. Every Tuesday/Friday he will go to the Dr. Kahzdan's office, or boutique as we call it, have lab work done, get IV fluids and have the velcade. During the this time, he is also taking dex. He takes dex on days 1-4 and again on days 9-12. They don't anticipate that he will have any nausea with the velcade, but just in case, he gets nausea medication before they give him the velcade. He also has nausea medication he can take at home to help him feeling well.
The sticky part of the dex is that it makes your blood sugar high. The dose Dad gets is fairly high- which means his blood sugar will be very high. In order to help regulate this, Dr. Kazhdan had Dad meet with a metabolic specialist to talk with him about diabetes and insulin. While Dad is on the dex he will have to take insulin as well. This means he has to check his blood sugar, and take the insulin with the steroid dose and before each meal.
What else? Well the velcade and revlimid are medications that act like other chemo drugs- meaning they target areas of rapid cell growth. This happens in the bone marrow, stomach and intestines and on your skin and hair. Unfortunately the drugs haven't been designed smart enough yet to recognize which cells are normal cells and which are cancer cells. This is why people with chemo get nausea, lose their hair and are very susceptible to infection and anemia. With the medications Dad is getting, they don't think he will have a problem with his skin or hair loss. He might have some nausea, but usually the steroids help prevent that. He will be at risk for infection. Handwashing is the key and he needs to avoid anyone that is sick. As a precaution, Dr. Kahzdan has put him on an antiviral drug and an antibiotic to help prevent any illness. Still, we are being very cautious. So while he is undergoing treatment, he is going to avoid large crowds and anyone sick.
The dog that saved his life
This is just a brief history of Dad's myeloma.
It all started with the dog. Mom was in El Paso visiting Robert and her family. Dad was playing with Rocky, lying on his stomach tossing the ball to him. He reached for the ball, and the rest as they say is history. That simple action caused him to pull a muscle on his right chest tracking along his ribs. Tylenol and heat would help temporarily, but it still bothered him so much that it interrupted his sleep. Mom was worried this could be related to his heart and so he went to see his doctor. They did a chest xray, saw "something concerning," and so the long series of poking and prodding began.
As it turns out, there were no broken bones, but what is called "lytic" lesions on the bones. They are called lytic lesions because they are weakened areas on the bones much like what you see with osteoporosis. Since dad isn't an 85 year old woman, his bones should look healthy. These lesions were the "something concerning" that caused all these further tests. A nuclear med bone scan and lots of blood work later helped his doctor come up with the likely diagnosis of multiple myeloma. On this blog are links related to multiple myeloma that can give you more information. They are great sites and I recommend looking them over if you haven't already.
So why the lytic lesions? Well, these cancer cells, the specific type of cancer that dad has float in his bone marrow. Your bone marrow is where all of your blood cells are formed, the ones that fight infection- or white blood cells, the ones that carry your oxygen, or red blood cells and the ones that help you from bleeding to death, or platelets. The cancer cells in Dad's bone marrow tend to grow much faster than any of the normal cells, bone marrow bullies so to speak. These bullies can cause him to be anemic, make him prone to infection and have problems with bleeding. These cells also activate the cells in your body that break down bones, called osteoclasts. These osteoclasts are in everyone and under normal circumstances don't cause any problems. With dad's cancer cells they are supercharged and break down bones they shouldn't much quicker than normal. This is what caused these lytic lesions, or weakened areas on the bones that showed up on the xray.
In comes Dr. Kahzdan. She is his oncologist, or cancer doctor that will be coordinating all of his treatment. All of the lab work and the bone marrow aspiration and biopsy confirmed the diagnosis of multiple myeloma. We also met with Dr. Lyons, the top oncologist in the city that specializes in multiple myeloma. He agrees and is working with Dr. Kahzdan in formulating dad's treatment regimen.
There is no cure for multiple myeloma, but there are a lot of treatment options available. With the newer drugs and a bone marrow transplant there is now an increasing number of people that are living 10 years in remission and still doing well and living fairly normal lives. Is this the cure? Maybe, hard to say what will happen in the future. We want to believe that it is the closest thing to a cure this disease has yet seen.
Most of the time people with multiple myeloma don't know they have it because there are not any obvious symptoms. Fatigue and back pain are common, but who isn't fatigued and has some back pain on occasion? Most of the time people aren't diagnosed until they are in Stage 3, meaning the disease has progress so far that they have broken bones or they are in kidney failure. Thankfully, Dad is in Stage 2, which means he has more lytic lesions to be considered Stage 1, but his kidneys and everything else are still working great. This means we can treat it early and get him into remission before it can damage his kidneys. So when you talk with him, he will tell you about the dog that saved his life.
It all started with the dog. Mom was in El Paso visiting Robert and her family. Dad was playing with Rocky, lying on his stomach tossing the ball to him. He reached for the ball, and the rest as they say is history. That simple action caused him to pull a muscle on his right chest tracking along his ribs. Tylenol and heat would help temporarily, but it still bothered him so much that it interrupted his sleep. Mom was worried this could be related to his heart and so he went to see his doctor. They did a chest xray, saw "something concerning," and so the long series of poking and prodding began.
As it turns out, there were no broken bones, but what is called "lytic" lesions on the bones. They are called lytic lesions because they are weakened areas on the bones much like what you see with osteoporosis. Since dad isn't an 85 year old woman, his bones should look healthy. These lesions were the "something concerning" that caused all these further tests. A nuclear med bone scan and lots of blood work later helped his doctor come up with the likely diagnosis of multiple myeloma. On this blog are links related to multiple myeloma that can give you more information. They are great sites and I recommend looking them over if you haven't already.
So why the lytic lesions? Well, these cancer cells, the specific type of cancer that dad has float in his bone marrow. Your bone marrow is where all of your blood cells are formed, the ones that fight infection- or white blood cells, the ones that carry your oxygen, or red blood cells and the ones that help you from bleeding to death, or platelets. The cancer cells in Dad's bone marrow tend to grow much faster than any of the normal cells, bone marrow bullies so to speak. These bullies can cause him to be anemic, make him prone to infection and have problems with bleeding. These cells also activate the cells in your body that break down bones, called osteoclasts. These osteoclasts are in everyone and under normal circumstances don't cause any problems. With dad's cancer cells they are supercharged and break down bones they shouldn't much quicker than normal. This is what caused these lytic lesions, or weakened areas on the bones that showed up on the xray.
In comes Dr. Kahzdan. She is his oncologist, or cancer doctor that will be coordinating all of his treatment. All of the lab work and the bone marrow aspiration and biopsy confirmed the diagnosis of multiple myeloma. We also met with Dr. Lyons, the top oncologist in the city that specializes in multiple myeloma. He agrees and is working with Dr. Kahzdan in formulating dad's treatment regimen.
There is no cure for multiple myeloma, but there are a lot of treatment options available. With the newer drugs and a bone marrow transplant there is now an increasing number of people that are living 10 years in remission and still doing well and living fairly normal lives. Is this the cure? Maybe, hard to say what will happen in the future. We want to believe that it is the closest thing to a cure this disease has yet seen.
Most of the time people with multiple myeloma don't know they have it because there are not any obvious symptoms. Fatigue and back pain are common, but who isn't fatigued and has some back pain on occasion? Most of the time people aren't diagnosed until they are in Stage 3, meaning the disease has progress so far that they have broken bones or they are in kidney failure. Thankfully, Dad is in Stage 2, which means he has more lytic lesions to be considered Stage 1, but his kidneys and everything else are still working great. This means we can treat it early and get him into remission before it can damage his kidneys. So when you talk with him, he will tell you about the dog that saved his life.
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