Relapsed High-Risk Myeloma Update with Bone Marrow Biopsy - April 26 2013

Lana picked me up at 6:30 AM and we were off to St. Luke's Hospital in Twin Falls, Idaho for my ELEVENTH (11th) Bone Marrow Biopsy (my 3rd under conscious sedation) in 23 months since my high-risk 4:14, 1q21 and others cytogenetic changes multiple myeloma diagnosis on 24 May 2011. I am a non-secretory and my myeloma does not show up well in my blood tests - hence, requiring frequent bone marrow biopsies. I feel well today!

Bone Marrow Biopsy History:

1. 24 May 2011 (Diagnosis, Dr. Moore in Ft. Collins, Colorado; traditional trocar)
2. 20 Aug 2011 (1st at UCH with Glen, NP; traditional trocar)
3. 1 Sept 2011 (Karley, NP, UCH, traditional trocar)
4. 2 Nov 2011  (Karley, NP, UCH, tradition trocar)
5. 9 Mar 2012  (Karley, NP and 1st with OnControl Driver, UCH)
6. 3 May 2012 (Shannon, NP with OnControl Driver, UCH)
7. 12 July 2012 (Trish, NP with OnControl Driver UCH)
8. 17 Oct 2012 (Angela, NP with OnControl Driver UCH)
9. 20 Dec 2012 (Kirk Peterson, MD, St. Luke's Hospital, Twin Falls, Idaho) Conscious Sedation; traditional trocar
10. 20 Feb 2013 (Kirk Peterson, MD, St. Luke's Hospital, Twin Falls, Idaho) Conscious Sedation; traditional trocar
11. 26 Apr 2013 (John Gray, MD, St. Luke's Hospital, Twin Falls, Idaho) Conscious Sedation; traditional trocar

Checked in the Cancer Center to have my Bard Power Port accessed and a CBC (complete blood count) drawn. RN Rhonda took good care of me. I saw RN Kenadi (Dr. Padavanija's nurse) and asked her to ask Dr. Padavanija if my platelets were greater than 50, if I could re-start Pomalidomide and they decided I could at 2 mg daily, but she wanted me to know that my myeloma was progressing and she didn't think it work. Turned out to be a non-issue since my platelets were only 39.

My IgG on 23 Apr 2013 continues to soar upward to 1,701 (up from 1,247 in less than a week).  My IgG at diagnosis was 3,422 (24 may 2011).

My M-Spike also continues increase to 1.3 on 23 Apr 2013 from 0.8 (norms ZERO) on 16 Apr 2013. My M-Spike at diagnosis was 3.0 (24 May 2011).

My white blood cell count is way up, but still low to 4.0 (norms 4.5-11); ANC (absolute neutrophil count) is NORMAL at 2.83 (norms 1.9-8.8), so no mask this week!; hemoglobin low at 9.7 (norms 140-440); and platelets STILL MISERABLY LOW at 39 (norms 140-440). 

We walked over and checked in to Interventional Radiology for my 11th bone marrow biopsy. I had RN Shanna an she works knowledgeable and "HAPPY" so, it was great. Pathologist, John Gray, MD came to do my bone marrow biopsy. They let Lana watch.

After the bone marrow biopsy procedure, Lana drove me home to Mackay. I didn't feel as drugged as I have in the past and we chatted away the whole way even though I received a little more Fentanyl and Versed (conscious sedation intravenous drugs) than I have in the past. 

I do have quite a bit of post-procedure pain a the site on the left side with pain radiating down the back of my left leg - WHICH BETTER BE TEMPORARY!!!!! I decided to take my Saturday 10 mg Dex dose tonight to decrease any inflammation around the bone marrow biopsy site. It helped some.

Now, I just have to wait until 9 May 2013 for the bone marrow biopsy results AND, hopefully, come up with some kind of chemo plan to beat the myeloma down again - may only be wishful thinking on my part. I'm going to guess that my plasma cell percentage (myeloma cancer) in my bone marrow today will be at 85 percent (my plasma cell percentage on diagnosis was 80 percent on 24 May 2011). It was at 63 percent on 20 Feb 2013 - just 2 months ago.

I'll be getting my CBC checked next on 2 May 2013.

Lana had me home in Mackay by 2:30 PM and Dianne brought Kemmer home.  Dianne was lucky this evening and saw a bull moose on her walk right here in town.

Bone Marrow Biopsy #9 and Bard Power Port Placement December 20 2012

We drove to St. Luke's Hospital in Twin Falls, Idaho from Mackay, Idaho for my 10:30 AM appointment for a bone marrow biopsy under conscious sedation and the placement of a Bard Power Port (intravenous access that is place under the chest skin) also under conscious sedation.

Had my blood drawn first. All of my multiple myeloma labs SPEP were drawn too, but I won't get those results for a week or so.

My white blood cell count was low at 2.3 (norms 4.5-11). Hemoglobin was low at 10.9 (norms 12-15); and my platelets were awesomely normal at 143 (norms 140-440). My Absolute Neutrophil Count (ANC) was 1.51 (norms 1.9-8.8) which means I need to watch my exposure with persons who are couging and/or sick. 

My LDH was great at 516 (norms 313-618). This slightly down since my 11 Dec 2012 value of 529.

They ran Protime, INR, aPTT, PFS Collagen-EPI since I'm on the blood thinner Fragmin 15,000 units subcutaneous injection daily. They, incorrectly said I was on Coumadin in the report of 20 Dec 2012.

Jani and I were taken to the Interventional Radiology area where I met my nurse for the day - RN Mendi and surgeon, Cameron Evans, MD.

RN Mendi started my IV on the first poke and decorated it for the Christmas season :)

That little piece of plastic hanging down from the nasal oxygen is CO2 monitor.

Kirk Peterson, MD from the Pathology Department did my bone marrow biopsy first - all under conscious sedation. I remember meeting Dr. Peterson, but that's all. 

Conscious sedation with intravenous Fentanyl (275 mcg was used total for the 2 procedures) and Versed (14 mg was used total for the 2 procedures) administered by RN Mendi is the ONLY way to go! I'm sorry I fretted at all prior to the procedures. This was my 9th bone marrow biopsy since diagnosis 19 months ago and by far "THE BEST" (my first at St. Luke's Hospital).

After the bone marrow biopsy, Dr. Evans place a Bard Power Port under the skin of my right chest wall just below where I had a previous Bard Power Port placed 13 June 2011. Me and Jani after the port placement.

Especially nice was the fact that RN Mendi was my nurse for EVERYTHING - I was never passed to another nurse and I LIKED THAT! RN Mendi was an excellent nurse with all the technical skills and caring bedside manner that every patient should experience!

We were on our home to Mackay, Idaho at 3:15 PM. I slept the entire 2 1/2 hour drive home while Jani drove. The port insertion site was VERY PAINFUL and I'm glad I had Percocet to take.