Wednesday, May 30, 2012

My journey continues - Phase ll

The mind of man plans his way, but the LORD directs his steps.    Proverbs 16:9

Phase I is complete.  My chemo treatments of Velcade and dexamethasone ( a steroid) plus Cytoxin have ended.  I praise and thank God that I have come through this initial treatment phase with minimal side effects.  Neuropathy in my feet has been the only significant side effect I've experienced and this has been mitigated by a drug called Gabapentin.  The LORD has indeed been good to me the past four months.  He has demonstrated continually these past weeks that He is in control and even though I don't always understand, He is working events for my good and the good of others.  (Romans 8:28)

Tuesday, the 29th, Greg and I travelled to Karmonos Cancer Ctr. for my appointment with Dr. Vorivit Ratanatharathorn.  The purpose of this meeting was to discuss the results of the tests through which I had recently gone in an effort to determine the effectiveness of the chemo treatments on my Multiple Myeloma and to explain the stem cell transplant procedure scheduled to begin shortly.  Dr. "V", as he is normally called at Karmonos, was upbeat and optimistic concerning my test results and said the amount of proteins in my blood created by the cancer had been reduced 75% due to the chemo drugs regimen.  A 100% reduction would have indicated a state of remission.  He didn't really expect that to happen.  In fact, when we first consulted with him, he had indicated a 50% to  60% reduction in proteins would be necessary to consider stem cell transplantation.  Since my reduction numbers were 15% to 25% higher, he was very satisfied and we began discussing details of such a transplant process.

We had been told that we would have to secure housing in the area for a portion of my treatment protocol.  However, we were thrown a curve ball when my Stem Cell Coordinator sent us preliminary paper work which included a high-lighted sentence indicating that my health insurance would not pay for lodging.  As throughout this journey, God demonstrated that He was in control.  We received a call from my niece, Colleen, who lives with her family in Cairo, Egypt.  She had heard through the family "grapevine" that we would need to secure a temporary place to stay while we were in Detroit.  She and her husband had purchased a home which "just happened" to be 30 minutes away from the Karmonos Cancer Center and we were welcomed to stay there.  As this blog entry is being written we are staying in their house.  And a beautiful home this is.  God not only provided, but He added extra blessings to His provision.  Thank you, LORD!

Tomorrow, Thursday, we return to the Karmonos Center and I pick up two prescriptions which I will take in preparation for my stem cell transplant.  Unfortunately, these drugs are not administered orally.  Rather, they enter my body via a needle.  Yep, an injection; a shot.  And administered by whom?  You guessed correctly...ME!  Since you are on a roll, would you like to "hazard" a guess as to how many injections per day?  I'll save you a "shot in the dark" and reveal the number...SIX!  That's right...three in the morning and three at night.  These injections are two of Neupogen and one of Lovenox.  Neupogen is the drug administered to "attract" my stem cells out of my bone marrow into my blood stream.  The Lovenox is a replacement for my Coumadin pills.  All the shots work best if administered into my stomach.  I have given myself Lovenox injections before so turning my stomach into a pin cushion will not be a new experience.

I'll be able to return home after picking up the prescriptions and return to Karmonos on Monday, June 4th for the purpose of pheresis, the procedure of extracting my stem cells from my bloodstream via a special machine.  The process is not unlike the plasma pheresis which I underwent at St. Mary's Lacks Cancer Center in Grand Rapids at the beginning of this whole God-led journey.  However, this time rather than employing a vascular catheter, the veins in each arm will be used necessitating the extension of both arms for the duration of the procedure...4 to 6 hours.  This means that knitting, playing cards, eating a meal are out of the question.   However, I can watch TV or view a DVD or listen to an audio book and talk to Greg to pass the time.  Shortly after the conclusion of the process I'll be told if enough stem cells have been harvested.  If not, the procedure will be repeated the next day.  And, if necessary, a third day.  But no more than that.  Normally,  one 4 to 6 hour sitting is sufficient.  We can then return home for a few days returning the 11th to meet with Dr. "V" again followed by two days of chemo and IV infusions and then admission to the hospital for the transplant.

The really good news in all this is that my stay in the hospital will only be two weeks-roughly through the 28th of June and then I'll be discharged to go home.  That's right - HOME!  No need to hang around town for another two weeks.  I'll just have to take common sense precautions to prevent unwanted exposure to potential infection causing agents.  Furthermore, Dr. "V" said that as long as Jeff, Joyellen, and the kids were healthy, he saw no reason for me not going to meet them at the airport in Chicago when they arrive home from Kenya for their year long home assignment.  And I could start my re-immunization process after 6 months, not the 12 months we had been told by others.  Re-immunization must occur because the chemo used in the stem cell process destroys my immune system including all the immunizations I have ever had.

The first part of my journey with God had been a blessing and a learning experience.  From an initial response of "Why me?" to the present admonition of "Lead me LORD and I will follow",  He has been faithful and loving throughout Phase I.  Should I expect anything less during Phase II?  I have learned to "Commit 'my' way to LORD".  (Psalm 37:5)  A devotional I read during May of this year said the the word "commit" means "to roll".  Bible teacher Herbert Lockyear, Sr. has said, quote:  "'Roll thy way upon the Lord,' as one who lays upon the shoulders of one stronger than himself a burden which he is not able to bear.'"  Verse 5 additionally says to "Trust also in Him." This I have done and intend to continue.  As I enter Phase II of my journey, I'm reminded of these words of Thiesen which appeared in one of my devotionals:

                                               As I walk along life's pathways,
                                               Though the way I cannot see,
                                               I shall follow in His footsteps,
                                               For He has a plan for me.

As the journey continues, join me for my next steps...

Wednesday, May 9, 2012

Phase I completed; Phase II begins

The mind of man plans his way, but the LORD directs his steps.  Proverbs 16:9

Several weeks ago, Greg and I travelled to Detroit to meet with members of a stem cell transplant team at the Barbara Ann Karmonos Cancer Center.  We left at the "crack" of dawn in order to arrive for my 9:00 A.M. appointment.  The Center is currently in the process of remodeling and we met with staff members in a "state-of-the-art" second floor section that had just opened two weeks prior to our visit.  The floor above us housed all the doctors' offices and the two floors above that held all the research facilities.

The doctor assigned to my case is from Thailand.  His name is Voravit Ratanatharathorn.  (Don't even try.}  Just refer to him as Dr. "R".  He was a very friendly man with a good sense of humor.  He sympathized with my desire to have the stem cell transplant as soon as possible as our middle son and his family are scheduled to come home for a year from the missionary field in Kenya the middle of July.  Dr. "R" said,  "So you are thinking you'd like to be home before the 4th of July, yes?"  "Yes!"  I replied.  He thought such a plan was doable.  We left for home with a potential time frame in the minds of all.

I've now finished the 1st phase of my chemo treatments.  Five cycles of Velcade have been completed.  Velcade is a chemo drug that initially was introduced into a patient via IV (infusion).  Approximately nine months prior to my being diagnosed with Multiple Myeloma, Velcade was "ok'd" to be given as a shot.
The shot form dramatically reduced one of the most common side effects of the drug - peripheral neuropathy.  This is namely a sense of numbness or tingling feeling in the arms, legs, feet, and fingers.  In conjunction with the Velcade, I also took a steroid called Dexamethasone.  Side effects of this drug include flushed and puffy cheeks and a jittery feeling in the hands and fingers.  I did not escape the infusion of a chemo drug, however.  Because of bothersome side effects suspected of being caused by Revlimid, I was put on Cytoxan.  This drug is infused, the IV drip taking one hour to complete.  The final drug of this first regimen was Zometa.  This chemical is designed to build up my bones.  Zometa is also infused, the drip taking half an hour and occurring once a month.

Currently, I'm going through the testing portion of the prelims leading to the stem cell transplant.  I've already had an echo-cardiogram, chest X-ray, and full bone scan (all the bones in my body are X-rayed.)  After getting approval from Delta Dental Insurance, I have had my teeth cleaned earlier than routinely scheduled.  This week I'm scheduled for a pulmonary test and an EKG.  And next week I'll have a bone marrow biopsy.  (That will be the only test that will hurt a bit.)

Received a call from the Karmonos Cancer Center yesterday.  I'm scheduled for a consultation with Dr. "R" to discuss my test results and make future plans.  This appointment is at noon so we won't have to get up so early to make the 3 hour drive.  I'm thinking positively and planning on this meeting leading to a scheduled transplant next month.  The procedure will require Greg and me to be in Detroit for about a month:  2 weeks at the Center and 2 weeks close-by to monitor the beginning stage of my recovery process.  God's hand is in this process as well.  Recently, we received a call from our niece in Cairo, Egypt.  Last year she and her husband purchased a house in the Detroit area 23 minutes from the Karmonos Cancer Center.  They were calling to tell us that we could stay at their house during the stem cell transplant recovery time.  Not only would this save us temporary lodging expenses, but also Priority Health Insurance would not have to pay for any of our living expenses.  That should make them happy.  :)

I have been praising God concerning how well the past three months have gone.  Despite all the toxic chemicals entering my body and doing their deadly work on the cancer, collateral damage has been minimal.  I've experienced relatively mild side-effects.  The most persistent residual effects of the chemo treatments have been headaches, eye problems, and neuropathy.  A call to my Oncologist, Dr. Alguire, concerning the neuropathy resulted in a prescription for Gabapentin which is routinely prescribed to treat peripheral neuropathy.  The neuropathy may never disappear 100%, but the nerve endings affected should improve now that the chemo is no longer entering my body.  I visited our Ophthalmologist regarding my eyes.  After examining them, he pronounced that I had "Chemo Eyes".  That is, the chemo has adversely affected my eyes which also resulted in the headaches.  As with the neuropathy, the "C.E.'s" will not go away 100% at this time.  But a prescription of Fluorometholone (eye drops) will alleviate the problem 80%.

As I look back over the last 3 months, I see God working in all things.  He has shown His love and faithfullness every step of the way.  Is this the path I would have chosen for myself?  Obviously, not.  But I am not in control of my life;  God is.  He knows and sees all from beginning to end.  For reasons totally unknown to me, He is leading me along this path for reasons only He knows.  This journey is part of His plan for my life.  I admit that obedience is not easy.  I am human.  I want some control, but I also know that God wants what is best for me.  I don't pretend to fully understand how what is currently happening to me is "best" for me, but I choose to trust God's leading.  As I pray daily;  read my Bible regularly;  and engage in devotional readings everyday, God communicates to me and provides me comfort and courage.  I also realize that prayers from family, friends, and people world wide have contributed greatly to this positive first phase of my journey.  To all of you known and unknown, I thank you will all my heart.  Please continue your prayers.

I conclude this entry with the following poem from one of my recent devotions:

                                        He does not lead me year by year,
                                        Nor even day by day.
                                        But step by step my path unfolds;
                                        My LORD directs my way.

My journey  Transplant plans.