2nd ASCT - Day 112 - September 7 2012

Last night the temporary filling over my root canal fell out. So, this morning, I talked to the dentist office in Challis and the endodonist office in Idaho Falls. The endodonist thought I'd be fine to wait until Monday to have the permanent filling placed on Monday at Dr. Tom McGowan's office in Challis, Idaho - so, I scheduled that appointment - aren't cell phones grand! 

Up at o'dark thirty to make it to my appointment at St. Luke's Hospital in Twin Falls, Idaho. I've been having those terrible charley horse cramps in my calves and the bottom of my feet at night when I stretch - oh joy ~

I tried drinking more water while I drove the 135 miles today in hopes that I would have a better creatinine today. Had to stop in Carey to use the bathroom and then thought I might be late - but, all worked out. My mouth is extra dry these days since I started Zolinza. I continue with weird stomach and little appetite...but, per usual, I believe in feeding a sick stomach, so I had some toast and packed a peanut butter and jelly sandwich for lunch.

They took me late for my blood draw, but lab technician, Anita, is SO GOOD and got my blood on the first poke without any trauma. Anita gave me paper copies of my SPEP, free lights and Beta-2 Microglobulins. 

My M-Spike is 0.3 (4 Sept 2012). It has gone up from 0.1 (done on 8 Aug 2012) and less than 0.1 (done on 12 July 2012). So, this upward trend makes me worry a tad - oh, here we go again - However, I have decided NOT to worry about the 0.3 M Spike this month since it does NOT reflect the Zolinza (vorinostat) that I started just before the 4 Sept 2012 SPEP blood draw. I did have Cycle 1 of Velcade and Dex between 8 Aug 2012 and 4 Sept 2012 - so, Velcade/Dex may not be working or it is working and the M Spike would have been even higher without it. I'll give Zolinza a month and then decide. I have a follow-up visit at the University of Colorado Hospital on 17 Oct 2012.

M Spike       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

My 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)

I still need to see my creatinine from today, LDH, and a urine test from 4 Sept 2012 which weren't available today.

I didn't wait long until I was called back to the Infusion Area. They had to wait for my blood results before they could order my dose of 1.7 mg Velcade subcutaneously. 

Didn't wait too long and the nurse told me to take my Dex which I did. The velcade came quickly and I got the subcutaneous injection in my right arm.

It was just before lunch time when I left Twin Falls and I would usually stop at my favorite, TACO BELL, but not today - stomach not up to it. Went to Walmart to get my father a couple of new shirts and do some frozen food shopping.

Drove home 2  1/2 hours and was so glad to be there. I was exhausted. Took a nadir (nap) for about 40 minutes. When I woke, I still felt tired and my mind was "clouded". I missed the local High School Homecoming Parade and Game (they won - YEA!) and just stayed home resting. Hope this doesn't last.

2nd ASCT - Day 108 - September 4 2012

Drove to St. Luke's Hospital MSTI in Twin Falls this morning. Got there early and stopped at Sportman's Warehouse which is located just on the edge of the canyon with a great view of the Twin Falls Bridge that I have to cross over to get to Twin Falls.

Twin Falls Perrine Bridge over the Snake River today September 4 2012. Double click to full-size.

 RN Kenadi, me and my oncologist, Dr. Padavanija. September 4 2012

Had a good visit with Dr. Padavanija. She thinks I should continue Augmentin (antibiotic for one more week to make sure the root canal is totally bacteria free). I was scheduled to get Aredia (bone building medication) this week, but Dr. Padavanija thinks I should forego Aredia for this entire month in light of the root canal. So, I  only got subcutaneous Velcade today in my left arm. I was in and out of the Infusion Area in just minutes since I didn't get the 3 hour Aredia intravenous drip. I took my Zolinza 400 mg (four 100mg capsules) while I waited for the Velcade along with 10 mg of dex. I ate a peanut butter and jelly sandwich.

My blood values are good this afternoon. WBC normal at 4.7 (norms 4.5-11); hemoglobin 13.5 (norms12-15); and platelets 258 (norms140-440). They also drew a LDH and Beta2 Microglobuins along with my SPEP (includes the M-Spike) and free lights. I also gave them a urine sample.  I won't get those results until the end of the week via fax or during my Friday Velcade administration.

My comprehensive metabolic panel has a slightly abnormally high Creatinine which is NOT good - a measure of kidney function. I've been taking a lot of Advil for the root canal and I'm going to stop that now. However, my BUN is normal (another kidney function measure) - so, I'm probably alright.

Stopped at Taco Bell - yum.

Back home in Mackay, Idaho located in the smokey Big Lost River Valley by 2:45 PM. The Halstead Fire has grown to 135,779 acres and only 7 percent contained. Our air is just THICK with fire smoke - so, no walk for Kemmer and I. Can't even see the Mine Hill and it is less than 1 mile away. The sun was a bright orange, but not in my photo.

2nd ASCT - Test Results from July 12 2012

My M-Spike from July 12 2012 is <0.1 (less than 0.1) which is good (zero is normal).

Here is my M-Spike history since December 1, 2011 when I was in remission following my 1st autologous stem cell transplant (ASCT). I relapsed in late February 2012 and my M-Spike jumped up to 0.5. I received 2 course of VD-PACE in March and April 2012 and my M-Spike went down to 0.4, 0.3, and 0.2. I had my 2nd ASCT on May 18 2012 after a week of BEAM chemotherapy and on Day 55 my M-Spike is less than 0.1.

My Beta-2 Microglobulin is 2.5 (norms 1.3-2.9).

My Beta-2 Microglobulin history since June 15 2011 (prior to any ASCT) was 3.5 (norms 1.3 to 2.9). Dropped to 1.8 after 1st ASCT and only climbed to 2.2 at relapse. Day 55 after 2nd ASCT 2.5.

My free light chains are all low which is good.

I had a Vitamin D deficiency on May 15 2011 of 10 (norms 30-100). I took 8 weeks of Vitamin D pills (one pill once a week) and my deficiency is cured on July 12 2012 with 45 (norms 30-100).

M Spike - May 3 2012

My M Spike remains unchanged at 0.2.

Beta-2 Microglobulin and Free Light Chains from March 8 2012 and Overtime

Beta-2 Microglobulin is 2.2 (norms 1.3-2.9).

Free Light Chains for March 8 2012 and overtime.

 My Free Light Chains are back to my pre-autologous stem cell transplant values at 0.22.

Beta-2 Microglobulin, Immunoglobulin A, G, M, and Free Kappa Lambda Light Chain Results of January 16 2012

I finally managed to convince Dr. Shull's office to fax me the results of my January 16 2012 labs. My Beta-2 Microglobulin was fine at 1.93 (it was 1.80 last check on 11/9/2012). My Immunoglobulin A was low at  22 (norms 3.3-19.4); immunoglobulin G was low at 588 (norms 694-1618); and immunoglobulin M was low at 9 (norms 48-271). I think these values are to be expected after an autologous stem cell transplant (I had my transplant on 9/13/2011).


My Kappa Light Chain, Free was 10.76 (norms 3.3-19.4); Lambda Light Chain, Free 5.69 (norms 5.7- 26.3); and my Kappa/Lambda, Free was 1.89 (norms 02.6-1.65). They evidently did not order an m-spike value. I will discuss this with Dr. Shull. If I were to go out of remission these are the important lab values that will detect the change. So, I'll admit it - I'm always anxious about these results - but, no worry today!

M-Spike Results from December 1 2011 Results

My M-Spike results from December 1 2011 (Day 79) are back. My value continues at 0.1 which is excellent. I still have mild hypogammaglobulinemia at 0.4 (norms (0.5-1.6), however, this considered just part of recovering from the stem cell transplant done on September 13 2011. My initial M-Spike on diagnosis back in May 2011 was 3.0.

My Free Light Chains over time May 18 2011 (diagnosis) to November 9 2011

My Beta-2 Microglobulin Results over Time June 15 2011 to November 9 2011

Day 57 - Beta-2 Microglobulins - November 9 2011

My Beta-2 Mircroglobulins are within the normal range for the first time since diagnosis.

Kappa:Lambda Free Light Chains and Beta-2 Microglobulin Serum Results from August 17 2011