jm's Adventure with Multiple Myeloma: 2nd ASCT - Day 123 - September 18 2012

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Tuesday, September 18, 2012

2nd ASCT - Day 123 - September 18 2012

Drove to St. Luke's Hospital MSTI in Twin Falls this morning for my blood draw and subcutaneous Velcade and Dex 10 mg. RN Kendi was my nurse.

My CBC has been effected by the Zolinza (vorinostat) Cycle 1 (14 days). My white blood cell count is lower at 3.8, but still good (norms 4.5-11); my hemoglobin is lower at 13.6, but still good explaining my continuing energy (norms 12-15); however, my platelets are much lower if I expected in light of the new bruising I have on my left arm at 128 (norms 140-440).
My Chem Panel continues to show abnormally high creatinine at 1.23 (norms 0.52-1.04) and a just barely normal BUN level on the high side of normal at 17 (norms 7-17). Plus the creatinine to BUN Ratio is high today at 21 (norms 10-20). These are tests of kidney function.
I made a chart to review my creatinine and BUN levels over time since 19 Jun 2012 when I returned to Idaho from Colorado after my 2nd ASCT on Day 32. My creatinine was slightly high at 1.13 (norms 0.52-1.04) then, but returned to normal. I am wondering if my creatinine/BUN increases might be due to supplements with I added: Curcumin and Pterostilbene??? I started the Curcumin 400 mg twice at day on 8 Aug 2012 and the Pterostilbene 50 mg once a day on 26 Aug 2012.
I also kept careful track of my fluid intake all week:
9/12/12     4,500 ml.
9/13/12     4,000 ml.
9/14/12     3,500 ml.
9/15/12     4,000 ml.
9/16/12     3,500 ml.
9/17/12     4,000 ml
9/18/12     3,500 ml.

However, fellow MMer , Danny Parker has pointed out that the increase in creatinine is probably due to Zolinza (vorinostat): From

Dr. Padavanija is out of the office this entire week, so I was unable to discuss my concerns with her about the kidney function test results. I left her this note:
Notes to Dr. Padavanija  18 Sept 2012 (My Day 123 Post 2nd ASCT)

1.    Velcade neuropathy in L foot, leg, and fingers seems reduced since 11 Sept 2012. Experienced as like stepping on a HOT IRON and radiating up the back of my leg behind my knee (STILL waking me at night, necessitating ½ Percocet), with only slight radiation up to my left groin area. I’ve rated the neuropathy today 9/18/2012 as 4. Continued post-shingles pain R back at lower scapula with no shingle outbreak.

2.    Dexamethasone – will take 10 mg today 11 Sept 2012 and 10 mg 12 Sept 2012.

3.    Zolinza Experience (1st Cycle Completed started 4 Sept 2012 and ended 17 Sept 2012)
·      HA first night, but resolved with ½ Percocet
·      Dry mouth and tongue and very thirsty (have to drink 2 bottles of water each night). Have been careful to drink 3,500 to 4,500 ml daily.
·      Altered taste severe (can only taste really sweet and really salty)
·      Esophageal Reflux x2 – SUDDEN with no nausea (only occational after 1st 24 hrs)
·      Very full gastric feeling all the time.
·      Awareness of pounding heart without increase in respiratory rate
·      Sustained tachycardia (96-119) at times (feel weak during)
·      Increase in blood pressure (140’s/high 80’s) initially, but not always
·      Many (3-5) soft formed stools daily, but no diarrhea
·      A return of my post-shingle pain - right-sided at the lower scapula level from mid-line around right side to front without skin lesion outbreak
·      New leg cramps and charley horses in both legs and feet when stretching in bed
·      Decreased memory – drawing blanks (new)
·      Increasing fatigue, but still able to do all activities
·      Bruising easily since 15 Sept 2012 (? platelet count)

4.    Oral Thrush (started 7 Sept 2012) and resolved 12 Sept 2012 with daily Fluconazole 100 mg. Stopped fluconazole 12 Sept 2012.

6.    Creatinine and BUN Concern (Need CHEM PANEL today 18 Sept 2012)
·      Creatinine     4 Sept 2012     1.09 (norms 0.52-1.04);  BUN nl.
·       Creatinine     6 Sept 2012     1.26                                       BUN 20 (norms 17)
·       Creatinine     11 Sept 2012      1.23                                     BUN 26 

7.    M-Spike Watch
·      12 July 2012          Less than 0.1 (Day 55 after 2nd ASCT)
·        8 Aug 2012          0.1 (No chemo since 2nd ASCT)
·        4 Sept 2012         0.3 (Cycle 1 of Velcade/Dex) completed)
·         4 Sept 2012         Started Zolinza (vorinostat) 14 days on 14 days off
o   Completed Cycle 1 (4-17 Sept 2012)
·        2 Oct 2012                 Next M-Spike blood draw

·      IgG immunoglobulin is on the rise too at 527. 
·      IgG               12 July 2012        380 (Day 55 after 2nd ASCT)
·                              8 Aug 2012        482 (No chemo since 2nd ASCT)
·                               4 Sept 2012       527 (Cycle 1 of Velcade/Dex completed)

·      Beta-2 Microgloblulin is 2.17 (norms less than 2.51)
·      Beta-2 Micro     12 July 2012    2.5 (Day 55 after 2nd ASCT)
·                                    4 Sept 2012    2.17 (Cycle 1 of Velcade/Dex Complete)

LDH 4 Sept 2012 HIGH at 661 (norms 313-618) – Not sure this is the same measure done at UCH (LDH norms are 98-192) there.

8. Will need summary for Clay Smith, MD at UCH (17 Oct 2012 appt).

Drove home to Mackay and was greeted with the THICK, PERVASIVE forest fire smoke. You should see the Lost River Range in the photo below taken on Highway 93 looking north from just before Darlington, Idaho (18 miles from Mackay, Idaho).
 My cousin Diane Miller sent me this Celtic Sea Salt as a possible cure for the nighttime leg cramps/Charley Horse episodes I've been having. It arrived today and I'm going to try it on some steak tonight.
My father had another arterial stent placed in his right thigh area today. Gretchen Lawrence took him to Bingham Memorial Hospital in Blackfoot, Idaho for the all day procedure by Dr. David Shelley since I had chemo in Twin Falls. Gretchen dropped him off at my house and I'll watch him for the night. He seems to be doing fine.

Jani had a colonscopy in Colorado today and all was clear~ Yippee.

So, all 3 of us had medical procedures today and survived.

1 comment:

  1. JM, kudos for watching out for your kidneys. I received my MM diagnosis when my kidneys failed. My wonderful nephrologist told me right off the bat that NO ONE will care as much about my kidneys as I do, and the first words out of my mouth before any procedure or drug change should be, "How will this affect my kidneys?"