The mind of man plans his way, but the LORD directs his steps. Proverbs 16:9
Just finished riding the exercise bike for 10 Km. (6.2 mi). Walked 1 mile and biked the equivalent of 1.25 miles during the day. Exercise is important for recovery during this process and praise God, I'm feeling good enough for physical activity.
Had just one nauseous moment. Lunch was brought and as the turkey sandwich approached my mouth, my mind took umbrage and enlisted the assistance of my stomach at expressing displeasure concerning this diet choice. But I persevered and managed to complete most of my lunch and later dinner selections.
Regarding the other unpleasant side effect, Immodium has been added to my pharmacy list. This appears to be having its expected affect.
My numbers on Day +2 are: WBC: 0.5; Hemoglobin: 8.4; and Platelets: 48. These lower readings are expected and welcome. The WBC will remain extremely low for the next four days. On the 6th day Neupogen will be injected encouraging the development of WBC and bringing their count up. If and when my Hemoglobin falls below 8.0, I'll be given a blood transfusion which is not an unexpected consequence of this procedure. Should my Platelets fall below 10.0, I will also receive an infusion of these as well. Since my WBC are so low, Greg and I have to be sure to wash our hands frequently with both soap and antibacterial liquid to help prevent exposure to germs and resultant infections. Any visitors during this period must be healthy.
As I think about what is happening within my body I am reminded of Psalm 139:14. "I will praise You, for I am fearfully and wonderfully made." Thank you, God!
Next...Day +3
Saturday, June 16, 2012
Friday, June 15, 2012
Day +1
The mind of man plans his way, but the LORD directs his steps. Proverbs 16:9
Just completed my dinner. Today has been marked by walking my suggested 16 laps which equates to 1 mile. I've enjoyed several naps and worked on a knitting project. In between, a little bit of TV viewing helped pass the time as well as talking on the phone with well-wishers and FaceTime with grandkids.
Side effects continue. The thought of breakfast this A.M. caused my mind to send a message to my stomach resulting in a negative response. However, since my brain is involved in the process, this is a "mind over matter" situation. The remaining day's meals were eaten very slowly giving my stomach time to mull over what to do with the new contents and telling to my mind to leave the "stuff" in there. So far, this plan is working.
The "other end" is a different story. Have made a few trips to the bathroom in "urgency" mode today. The Nurse Practioner, Katherine, says this is an expected reaction to the preservative used and injected with the stem cells. Will be a welcome relief when the preservative has completely exited my body.
My new counts were posted this morning. I asked which are the main ones to monitor. They are:
white blood cells (WBC), Hemoglobin, and Platelets. Day 0 (Thursday) provided the baseline for the counts. So the starting numbers are as follows: WBC: 3.9; Hemoglobin: 11.0; and Platelets: 233.
Today's (Day +1) counts are: WBC: 3.0; Hemoglobin: 10.7; and Platelets: 206. For the next several days, these counts ARE supposed to go down. Along about days 6, 7, or 8 the counts should bottom out and then start to climb. I'll be posting my numbers each day so you can track my downward trend (supposed to happen) and my upward trend (will happen, LORD willing).
Prior to Greg and me going for a few more laps before retiring for the night, I'd like to quote from an e-mail which we received from our good friend, Dr. Tim Mead, serving in Al Ain, UAE as a medical missionary. He writes an excellent report to supporters, friends, and others weekly. The portion I have chosen to quote applies directly to what I and others with cancer are experiencing.
"All people live life sometimes finding our expectations unmet and our plans changed. We can easily become bitter and feel we deserve better. Although trials are never fun at the time, I think back and realize that because of the tough times I am a different person. Trials, big or small, will either build your character or send you into bitterness and despair. Your attitude is critical. (emphasis is mine) I need to constantly remind myself to start each day in thanks knowing I do not travel life alone. I live and travel Life in His Grip..."
Next: Day +2
Just completed my dinner. Today has been marked by walking my suggested 16 laps which equates to 1 mile. I've enjoyed several naps and worked on a knitting project. In between, a little bit of TV viewing helped pass the time as well as talking on the phone with well-wishers and FaceTime with grandkids.
Side effects continue. The thought of breakfast this A.M. caused my mind to send a message to my stomach resulting in a negative response. However, since my brain is involved in the process, this is a "mind over matter" situation. The remaining day's meals were eaten very slowly giving my stomach time to mull over what to do with the new contents and telling to my mind to leave the "stuff" in there. So far, this plan is working.
The "other end" is a different story. Have made a few trips to the bathroom in "urgency" mode today. The Nurse Practioner, Katherine, says this is an expected reaction to the preservative used and injected with the stem cells. Will be a welcome relief when the preservative has completely exited my body.
My new counts were posted this morning. I asked which are the main ones to monitor. They are:
white blood cells (WBC), Hemoglobin, and Platelets. Day 0 (Thursday) provided the baseline for the counts. So the starting numbers are as follows: WBC: 3.9; Hemoglobin: 11.0; and Platelets: 233.
Today's (Day +1) counts are: WBC: 3.0; Hemoglobin: 10.7; and Platelets: 206. For the next several days, these counts ARE supposed to go down. Along about days 6, 7, or 8 the counts should bottom out and then start to climb. I'll be posting my numbers each day so you can track my downward trend (supposed to happen) and my upward trend (will happen, LORD willing).
Prior to Greg and me going for a few more laps before retiring for the night, I'd like to quote from an e-mail which we received from our good friend, Dr. Tim Mead, serving in Al Ain, UAE as a medical missionary. He writes an excellent report to supporters, friends, and others weekly. The portion I have chosen to quote applies directly to what I and others with cancer are experiencing.
"All people live life sometimes finding our expectations unmet and our plans changed. We can easily become bitter and feel we deserve better. Although trials are never fun at the time, I think back and realize that because of the tough times I am a different person. Trials, big or small, will either build your character or send you into bitterness and despair. Your attitude is critical. (emphasis is mine) I need to constantly remind myself to start each day in thanks knowing I do not travel life alone. I live and travel Life in His Grip..."
Next: Day +2
Thursday, June 14, 2012
Day 0
Thursday, June 14, 2012; Stem Cell Transplant Day; Day 0 of the countdown. A three member transplant team oversaw the reintroduction of 1/2 the number of my stem cells which were collected on Tuesday of this week. About two and 1/2 small bags of my preserved stem cells were injected into my Picc Line utilizing a large syringe. The cell/preservative mix looked like a red slushy or V8 juice. While one syringe full was being injected, a lab tech extracted another syringe full from a small IV bag which minutes earlier had been frozen. The three stem cell bags were placed in a warming machine which was brought to my room. The third member of the team, a RN, monitored my vitals during the procedure. The whole process took less than 1/2 an hour. So...a half of my harvested stem cells are now back in my body and the remaining collected stem cells will remain frozen in the unlikely event I have to undergo another transplant sometime in the future.
In the meantime...the chemo in my system continues to track down and annihilate unwelcome cancer cells. The newly injected stem cells float through my body via my blood stream and find their way into my bone marrow where they will mature for the next several days. During this maturation process, my white blood cell count as well as my red blood cell and platelet counts will drop. After about 5 to 7 days of falling counts, the process reverses as the matured stem cells leave the bone marrow to become new, healthy white, red and platelet cells. This rebuilding process lasts about another 5 to 7 days. The chemo has, meanwhile, completed its killing spree leaving dead cancer cells to be flushed out by my body.
Typically, days 6, 7, and 8 is the time I will feel the least well as my counts reach their lowest. On day 6, Neupogen shots begin again for about the next 6 days to encourage the production of white blood cells. As my counts of red and white blood cells and platelet cells rise, I will feel better and better. A chart has been affixed to a white board in my room to record the down and up progress of my cell counts. Over the next several days, I will blog daily the progress of my cell counts and the resulting bodily responses. Thus far, I have experienced minimum side effects. This morning, before eating anything, I drank a glass of ice water. Unfortunately, the water returned right away via the same route it took to enter my body. But, this has been the only negative bodily response thus far.
God has indeed been good during this journey. Thinking about what is now happening in my body and how these stem cells will know what cells to become as they mature reveals to me the fantastic plan God had as He designed this wonderful universe of which we and our Earth are a part.
"...And we, out of all creation, became His prized possession." James 1:18
Next: Day +1
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| Louise in her "single" double-sized room. |
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| Aaron prepares stem cells for injection. |
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| Drawing warmed stem cells into syringe. |
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| Melissa injects stem cells into Louise. |
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| Laurie-Anne monitors vitals. |
Tuesday, June 12, 2012
Chemo !
Monday, Greg and I returned to the Barbara Ann Karmonos Cancer Center in Detroit. I was scheduled for the insertion of a Picc line at 10:00 in the morning followed by an appointment with Dr. V at 1:00 in the afternoon. Both events occurred, but not at the times listed. One thing I have learned throughout this whole process is to have patience. Activities do happen, but usually not at the times listed or planned. Thank you, God. for teaching me to slow down and wait. Everything does not need to happen "here and now". I should enjoy each day You provide me and count my daily blessings.
Tuesday, we returned to Karmonos for my scheduled chemo infusion. This appointment was "at the crack of dawn" - 7:00 a.m. I think we arrived before the sun was awake to begin its day. Not being a morning person, as is Greg, any time before 9:00 a.m. is too early for me. We experienced another "1st" for us as we arrived and checked in. We were directed from the lobby of the recently opened Dresner Family Center (our first "1st") to the brand new infusion center which opened its doors yesterday. In fact, I was very possibly the first person to receive a chemo infusion in the new center.
The process began with an infusion of anti-nausea fluids. While I was being hydrated, the pharmacy mixed up a small batch of my chemo drug, Melphalan. After a couple hours, the drug was delivered to my room and attached to my infusion rig. As Melphalan is light sensitive, a black shroud was hung over the pint bottle which was filled only 1/3 full of the chemo. This was worth about $6,000.00. The actual chemo infusion lasted about 1/2 hour with another 3 hours of hydration. During the whole process I was encouraged to do one of my favorite past times: eat ice chips. Since the Melphalan attacks fast growing cells such as those of the hair and the mouth, ice chips stimulate the mouth cells to close up and prevent the absorption of the chemo. At the time of this posting, I have experienced no nausea or vomiting and my appetite is intact. In fact, I ate the lunch supplied by the hospital and survived. Actually, the food was quite tasty, especially the chicken.
I have been supplied with three anti-nausea meds: Zofran and Compazine (to be taken daily) and Ativan (to be taken as needed). These are designed to keep my stomach happy as the Melphalan does its job of killing cancer cells and other fast reproducing cells. In the meantime, I'm to return Wednesday morning to receive another 3 hours of hydration and then come back on Thursday to be admitted to the hospital for observation about the next 1 and 1/2 weeks.
Thursday, I'll begin daily postings to chronicle my progress and that of any side effects. Until then, my journey continues with God's leading.
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| Saline - left. Shrouded Melphalan - right. |
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| Receiving my Chemo. |
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| Here I am back at Colleen's after my chemo doing what I enjoy. |
Tuesday, June 5, 2012
The Harvest
The mind of man plans his way, but the LORD directs his steps. Proverbs 16:9
I'm lying is a hospital bed, IV lines in both arms while a machine to my right takes blood from my body; removes stem cells; and returns the red, life sustaining fluid to me. As the machine whirrs away, a nurse is asking questions and filling out a form. As I reply "NO" to inquiries such as "Do you have any pain?", "Do you have any nausea or vomiting?", "Are you constipated?", "Are you fatigued?" she looks up from the paperwork and says, "Why are you here?".
I am "here" because, living in a "Fallen" world, I''m experiencing cancer. A journey I did not expect while planning my life; but a journey whose steps are directed by my God. Because God is leading me through this dark valley and knows the outcome of this trip, I have chosen to put my complete faith in Him. Even though I don't know or understand all the twists and turns of this safari, Gods knows and I trust Him...with my life. Since the beginning of this adventure, I have witnessed God at work. At His direction, doctors, nurses, and other medical staff have sprung into action utilizing their skills, training, and intellect to diagnose and implement treatment in an extremely timely manner. And because of the prayers of family, friends, churches, and strangers literally around the world, I have been able to respond to my treatments in an atypical manner.
For reasons known only fully to Him, God has blessed me with exceptional responses to treatment protocols since the beginning. My early regimen of Velcade and Revlimid did not result in the usual physical responses of the human body to these chemo drugs. Nausea and vomiting did not make an appearance. In fact, these two unpleasant side effects have yet to rear their ugly heads, praise the LORD! Neuropathy has manifested itself as a result of the Velcade, but not to the extent of being debilitating and currently is manageable using Gabapentin. The Revlimid caused some pretty painful headaches and was replaced with Cytoxin which caused no unwelcome side effects.
My lack of side effects to treatment caused me to question the effectiveness of the preliminary protocol for the harvesting of my stem cells. I had to inject myself with 600 mcg. of Neupogen twice a day beginnng Thursday, May 31 and ending Monday, June 4. That's four shots per day plus two per day (morning and night) of Lovenox which replaces the Coumadin. The Neupogen is designed to stimulate my bone marrow to produce sufficient number of stem cells prior to harvesting. I was told to expect the Neupogen to possibly cause nausea and vomiting, extreme fatigue, and bone pain. When I didn't experience any of these downsides to the drug, I began to question whether the Neupogen was working. But when I remembered that I and many others were praying that side effects would not be a problem, I knew that God was listening and responding to everyone's prayer. Thank you, LORD!!
Harvest day was Monday. We arrived at the Karmonos Cancer Center early, 7:15 a.m., and had blood work drawn. We had to wait a little over two hours, for tests to be run that would determine if the Neupogen had done its work. We finally received word that results showed I had enough stem cells floating around so I could be hooked up to the machine which would capture these little guys. Getting two IV lines into my arms and connected to the pheresis machine took a bit of time. But at 11:30 the procedure was underway.
The process required that I keep both arms extended at my sides, so at lunch time (the hospital supplied a sack lunch), Greg had to feed me. When my nose itched, Greg had to help me scratch. He said he was drawing the line at picking my nose, however. (He said, "You can pick your friends. You can pick your nose. But you can't pick your friend's nose.") Finally, the procedure was completed at about 3:15 p.m. I was untethered from the machine. The nurse said that a determination would be made by the lab whether enough stem cells had been harvested. If not enough were obtained, we would have to return on Tuesday and undergo this process again although I wouldn't have to undergo the preliminary blood test. I could go on the machine immediately upon arrival. The lab would call me before 5:30 p.m.
We returned to Colleen's house to await the call. At 5:10 the lab phoned. They threw out numbers I didn't understand, but Praise God!, these were numbers we wanted to hear. The lab tech said that the number needed had to fall within a range between 2 and 5. My number was 8.3!! More than enough for two transplants!!! Prayers had be answered. Once again God had blessed me. We return to Karmonos next week where my frozen stem cells will be reintroduced into my body after a treatment of chemo kills all my white blood cells. Then the stem cells, by God's great design, will grow into new white blood cells and my immune system will be reborn and, the LORD willing, the cancer will be in remission. I look forward to this future trusting God and His plans.
"I know who holds the future,
And I know who holds my hand;
With God things don't just happen --
Everything by Him is planned." A. Smith
Next entry: The Transplant. The journey continues....
I'm lying is a hospital bed, IV lines in both arms while a machine to my right takes blood from my body; removes stem cells; and returns the red, life sustaining fluid to me. As the machine whirrs away, a nurse is asking questions and filling out a form. As I reply "NO" to inquiries such as "Do you have any pain?", "Do you have any nausea or vomiting?", "Are you constipated?", "Are you fatigued?" she looks up from the paperwork and says, "Why are you here?".
I am "here" because, living in a "Fallen" world, I''m experiencing cancer. A journey I did not expect while planning my life; but a journey whose steps are directed by my God. Because God is leading me through this dark valley and knows the outcome of this trip, I have chosen to put my complete faith in Him. Even though I don't know or understand all the twists and turns of this safari, Gods knows and I trust Him...with my life. Since the beginning of this adventure, I have witnessed God at work. At His direction, doctors, nurses, and other medical staff have sprung into action utilizing their skills, training, and intellect to diagnose and implement treatment in an extremely timely manner. And because of the prayers of family, friends, churches, and strangers literally around the world, I have been able to respond to my treatments in an atypical manner.
For reasons known only fully to Him, God has blessed me with exceptional responses to treatment protocols since the beginning. My early regimen of Velcade and Revlimid did not result in the usual physical responses of the human body to these chemo drugs. Nausea and vomiting did not make an appearance. In fact, these two unpleasant side effects have yet to rear their ugly heads, praise the LORD! Neuropathy has manifested itself as a result of the Velcade, but not to the extent of being debilitating and currently is manageable using Gabapentin. The Revlimid caused some pretty painful headaches and was replaced with Cytoxin which caused no unwelcome side effects.
My lack of side effects to treatment caused me to question the effectiveness of the preliminary protocol for the harvesting of my stem cells. I had to inject myself with 600 mcg. of Neupogen twice a day beginnng Thursday, May 31 and ending Monday, June 4. That's four shots per day plus two per day (morning and night) of Lovenox which replaces the Coumadin. The Neupogen is designed to stimulate my bone marrow to produce sufficient number of stem cells prior to harvesting. I was told to expect the Neupogen to possibly cause nausea and vomiting, extreme fatigue, and bone pain. When I didn't experience any of these downsides to the drug, I began to question whether the Neupogen was working. But when I remembered that I and many others were praying that side effects would not be a problem, I knew that God was listening and responding to everyone's prayer. Thank you, LORD!!
Harvest day was Monday. We arrived at the Karmonos Cancer Center early, 7:15 a.m., and had blood work drawn. We had to wait a little over two hours, for tests to be run that would determine if the Neupogen had done its work. We finally received word that results showed I had enough stem cells floating around so I could be hooked up to the machine which would capture these little guys. Getting two IV lines into my arms and connected to the pheresis machine took a bit of time. But at 11:30 the procedure was underway.
The process required that I keep both arms extended at my sides, so at lunch time (the hospital supplied a sack lunch), Greg had to feed me. When my nose itched, Greg had to help me scratch. He said he was drawing the line at picking my nose, however. (He said, "You can pick your friends. You can pick your nose. But you can't pick your friend's nose.") Finally, the procedure was completed at about 3:15 p.m. I was untethered from the machine. The nurse said that a determination would be made by the lab whether enough stem cells had been harvested. If not enough were obtained, we would have to return on Tuesday and undergo this process again although I wouldn't have to undergo the preliminary blood test. I could go on the machine immediately upon arrival. The lab would call me before 5:30 p.m.
We returned to Colleen's house to await the call. At 5:10 the lab phoned. They threw out numbers I didn't understand, but Praise God!, these were numbers we wanted to hear. The lab tech said that the number needed had to fall within a range between 2 and 5. My number was 8.3!! More than enough for two transplants!!! Prayers had be answered. Once again God had blessed me. We return to Karmonos next week where my frozen stem cells will be reintroduced into my body after a treatment of chemo kills all my white blood cells. Then the stem cells, by God's great design, will grow into new white blood cells and my immune system will be reborn and, the LORD willing, the cancer will be in remission. I look forward to this future trusting God and His plans.
"I know who holds the future,
And I know who holds my hand;
With God things don't just happen --
Everything by Him is planned." A. Smith
 |
| Left arm is the return line. Right arm (covered) is the output line. Couldn't move from this position from 11:30 to 3:15. Praise the LORD enough stem cells were harvested the first time! |
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...
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 continues...next: Transplant plans.
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 continues...next: Transplant plans.
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