2nd ASCT - Day 131 - September 26 2012

Well, I gave 100 mg of Neurontin (gabapentin) a try at bedtime last night. It worked great and reduced my neuropathy burning in my left foot and leg by half. So, that means I went from 6 on the 1-10 scale to 3. I was able to sleep, but still woke every 2 hours. Didn't feel hung over this morning and I think I'll be able to take Neurontin at least 100 mg at night.

My transplant onoclogist, Han Myint, MD at the University of Colorado Hospital has retired his position effective September 13  2012 (I was notified via certified letter). He has been replaced by Clay Smith, MD from the University of Pittsburgh. 

I have my follow-up UCH appointment with Dr. Clay Smith on 15 October 2012. Here is link to Dr. Clay Smith's Vita http://www.cudoctors.com/find-a-doctor/profile/?providerID=4647 

I wrote Dr. Clay Smith a letter of introduction and sent it snail mail (U.S. Postal Service):

18 September 2012

Clay Smith, MD

UCH

Re:      Judy Malkiewicz (BD 12-08-1950)

Hi Dr. Smith, Just a letter of introduction.

My name is Judy Malkiewicz and at the age of 60, I was diagnosed with High Risk Monocolonal IgG Kappa Multiple Myeloma on May 24, 2011 after a routine physical exam blood test revealing anemia with no bone lesions or kidney involvment. I had 80 percent neoplastic plasma cells with cytogenetic 4:14 and deletion of 13 changes in my bone marrow; M-Spike of 3.0. I started induction chemotherapy of IV Velcade, IV Dexamethasone, and PO Revlimid on June 13 2011 and did 3 ½ cycles. I was admitted to the University of Colorado Hospital (UCH) for a four day course of VDT-PACE (Velcade IV, Dexamethasone IV, Thalidomide P, Cisplatin (P) IV, Adriamycin IV, Cytoxan IV, and Etopside IV) as my cytogenetic profile changed to include 1q21 with good response.

Harvested my stem cells and had an autologous stem cell transplant on 13 September 2011. My bone marrow 50 days after transplant was deemed in Stringent Complete Remission on 2 November 2011; M-Spike of 0.1.

Complication: As a result of my Trifusion Hickman Catheter and implanted port, I developed blood clots in the right atrium of my heart. The Trifusion Catheter and Bard Power Port were removed and I continued Fragmin for 9 months when the clot was thought be resolved 2 Aug 2012.

I went on Maintenance Chemotherapy of Velcade/Dex/Revlimid and Zometa started 1 December 2011 at home in rural Idaho. Unfortunately, my M-spike increased to 0.59 on 27 Feb 2012 and I returned to UCH in Colorado.

Relapse confirmed with Bone Marrow Biopsy with greater than 50% plasma cells on 9 Mar 2012 with continued 4:14 and 1q21 cytogenetic changes. Admitted UCH for PICC Line Placement and received 2 cycles of VDT-PACE 16-20 March 2012 and 13-17 April 2012.

Bone Marrow Biopsy on 3 May 2012 reveals 1 percent plasma cells with 1q21 (3.5 percent) and 4:14 (0.3 percent) cytogenetic changes.

Admitted UCH for 2nd Autologous Stem Cell Transplant 11 May 2012 with 1 week BEAM Chemotherapy prior. Melphalan given 16 May 2012 and my 2^nd ASCT stem cells were given to me on 18 May 2012. Returned home to Idaho on Day 28.

2nd ASCT Follow-up on Day 55 at UCH, 12 July 2012, showed M-Spike of less than 0.1 and bone marrow biopsy shows persistent abnormal cytogenetics 4:14 and 1q21.

Started continuing chemotherapy of Velcade and Dex 20 Aug 2012 and Vorinostat (Zolinza) 400 mg 14 days on 14 days off added 4 Sept 2012.

My Day 152 Post 2^nd ASCT follow-up appointment is with you on 17 October 2012. I look forward to meeting you and hope you have a high-risk plan for me because I have at least 30 mountain lake hikes right in my back yard that I want to visit at the TOP OF IDAHO~ The BEST place in the world to live UNLESS you need specialty medical care~

Sincerely,

 Judy Malkiewicz, Mackay, Idaho 83251

I am anxious to meet Dr. Clay Smith and hopefully we'll know if the Zolinza (vorinostat) is working to hold my M-Spike down by the time of the October 2012 appointment.

I walked home 0.71 miles with Kemmer after dropping Jonah (1999 Passport) off for a brake check.

I wore my N-95 mask because the air quality is still not good from the forest first north of Mackay. We've had smoke in Mackay most days since lightning started the Halstead and Mustang Complex Fires on 27 July 2012 and 30 July 2012. We have never had a summer like this and I HATE IT!