Miscellanea

The bone marrow biopsy performed three weeks ago at Johns Hopkins came back negative: "No evidence of plasma cell myeloma". Unfortunately, the accompanying blood protein test was somehow botched, so I have to wait until later this month to have my anxieties around the results of the January test assuaged. Meanwhile, the Hopkins oncologist seems unenthusiastic about my idea of travel to Vietnam, punting me to the Johns Hopkins travel medicine team.

I am in the midst of a two-week course of Xifaxan (Rifaximin), an antibiotic prescribed for me by the GI doc who recently performed upon me a combination colonoscopy and endoscopy. I was overdue for the colonoscopy, my second; I am on a five-year cycle for this procedure, since the first one turned up benign polyps. This time, no polyps of any sort. I requested the endoscopy to investigate a few nagging problems I have been having, including occasional trouble swallowing, the odd belching fit, and chronic abdominal bloating (some days, I look like I'm expecting). It's not clear whether these symptoms have anything to do with the chemotherapy, but in any case the GI doc is diagnosing mild esophagitis and gastritis, meanwhile awaiting the results of multiple biopsies.

Finally, my primary care doc ordered some X-rays of my neck and right shoulder; I have been having some pain in these areas that doesn't seem to want to go away. This makes me nervous, since as the reader may recall, the myeloma originally masqueraded as muscle pain that wouldn't go away. The X-rays didn't turn up any lytic lesions, though, and the primary care doc is pushing me off to an orthopedic specialist, if I want to pursue the matter further.

Johns Hopkins: The Final Chapter

I forgot to mention that I spent the entire day a week ago Thursday being poked, prodded and interrogated at Johns Hopkins for the last time (well, the last time that has anything to do with the stem cell transplant, anyway). This was the somewhat overdue two-year follow-up visit. As usual, blood and bone marrow were extracted for evaluation (still waiting for the results). And I was given the final round of childhood immunization boosters, so I am as close as I can get to having an adult immune system again.

The Hopkins oncologist waved off my concerns about the dangers of long-term exposure to Revlimid (increased risk of developing second cancers), saying that the benefits far outweighed the risks, and were in any case overwhelmed by the increased risks introduced by the transplant itself (first time I heard this, so there you go).

He also encouraged me to participate in a clinical trial that was offered to me recently by the Christiana oncologist (I think I probably forgot to mention this as well -- I'm definitely slipping). This is a trial of a vaccine for shingles. Although the post-procedure incidence of shingles is very high (30%+) for bone marrow and stem cell transplant patients, both oncologists think that if I was going to get shingles, I would probably have gotten it by now; but both also seem to think that participation in this trial is a good idea for me. I may have mentioned this before, but myeloma survivors are a valuable commodity in the cancer research community; for a number of reasons, myeloma receives proportionally more attention from the researchers than the raw percentages would suggest. Then again, maybe these guys are trying to prepare me psychologically for a future of clinical trials that will be my only resort, once I exhaust, inevitably, one by one, the standard treatment protocols.