Kappa/Lambda Ratio Low; Early Relapse?

We got the results of the latest myeloma panel. Up to now, both the Lambda and Kappa light chains have been rising - but the ratio has been within normal limits. Now the Lambda is rising and Kappa is dropping, so the ratio is low. The specialist has been watching, and he said as long as both go up, it could mean recovery of immune system. If Lambda goes up more than Kappa, it could mean a relapse.

And now the myeloma panel shows a slight M-spike. This is the first time we've seen an M-spike since the myeloma mutated to light chain deposition disease back in 2011. Interesting, but may not be anything to be concerned about.

We have faith in the specialist and we know he has a plan, so we are not worried, just alert for changes.  Knowing there are new drugs available is reassuring.
We also have faith and trust in God, and we know HE has a plan!

Both Doug and I have been expecting another relapse at some point, that's the nature of the beast. Sometimes the myeloma sleeps, but it always awakens eventually.
Meanwhile, Doug feels good and we are grateful.

Love to all.

"Peace isn’t the absence of the dark. Peace is the assurance of God’s presence in the midst of the dark." Ann Voskamp 

IgG now, was IgA

The regular monthly trip to Denver today. We had an 8:30 a.m. appointment so left at 5:30. It was already almost light out, thankfully.
Lab results are mostly okay, with just a few borderline but nothing alarming. We won't get the myeloma panel results for 5 to 7 days.
Interestingly, Doug's myeloma has changed from IgA Lambda to IgG. The specialist isn't sure what this means, either a lab error or the myeloma is changing. But he doesn't think it has any significance as to treatment in the future.
Doug is still on chemo vacation. He's not having clinical problems (aside from the neuropathy) so the specialist doesn't want to initiate any new drugs yet.

Doug didn't get the Zometa infusion this time, since it had been only three weeks since the last one. He'll get it next month. That saved an hour of infusion time.

So it was a good visit. Afterward we stopped for a late breakfast - in the hospital cafeteria of all places. They have really good hash browns and sausage. Eggs are passable. And we didn't have to move the car.

We are counting our blessings and praising the Lord!

Love to all.

Light Chains Still Rising; no chemo yet

Doug had his  monthly Denver myeloma specialist visit last week. The cancer numbers - Lambda light chains in Doug's case - are starting to rise a bit faster. But the Kappa light chains are also rising, so the Kappa/Lambda ratio is within normal limits for now. As long as the ratio is okay, Dr. M doesn't want to start the new chemo yet. Sounds good to us!

The peripheral neuropathy in his feet is still present, but Doug is able to cope with it. Dr. M says we have the option of trying Cymbalta, but we decided against it for now. Better not to add another drug to his system unless he really needs it.

Summer is in full swing here, with the usual influx of summer people. Traffic is busy by our small town standards, and our only grocery store is swamped. Best not to complain too much since the tourists spend a lot and that helps our tax base.

We have started geocaching again after several years of Doug not being able to do it. Fun way to get outside and be more active.

Love to all.

Cold/cough; Eye Infection

We had to cancel our trip to Nebraska again. Last month we cancelled due to Doug getting the flu.
This time he developed a cold with cough and a slight fever. And green mucus in both eyes.

We called our local clinic but couldn't get in yesterday. Today is Saturday and the clinic is closed. We had two choices - go to Salida to the ER, or drive up to Leadville to the urgent care clinic. We opted for Leadville. Doug was seen by a young PA who was very good. He took an excellent history and did a brief physical. He prescribed an antibiotic eye ointment and said to do warm compresses on the eyes every four hours. The cold is most likely a viral infection. He refilled a codeine cough syrup that has worked for Doug in the past, and considering Doug's compromised immune system, prescribed an antibiotic to prevent further secondary infection. We were very happy with the level of care at this clinic.

Doug's blood pressure is low at 101/67 but he's not dizzy. We're going to keep checking the BP.

We are counting our blessings, especially that all this came on before we left home on our trip. So much better to be home when not feeling well!

Love to all.

Off Gabapentin; Kidneys doing good

Doug has weaned off the gabapentin, with the doc's approval. The increased dose wasn't helping the peripheral neuropathy, and it was making him very drowsy. So he decided to quit it since we have an upcoming trip to Nebraska.

Doug has finished his physical therapy; it has helped him. His gait is still off, but better than before, and his balance is quite a bit better.

Yesterday we went to the nephrologist in Salida. He says Doug's kidneys are doing pretty good now. Just lay off the salt! He never tells anyone "no salt" since he knows they won't do it, but reduce salt. The doc is putting Doug on a small dose of Lisninopril. It's a blood pressure drug; Doug's BP is already on the low side, but the kidney specialist says Lisinopril helps protect kidneys from the myeloma protein. So as long as Doug's pressure doesn't drop too low he wants him on it.

We have an appointment with the myeloma specialist June 19. For now, we are doing well, and enjoying the warmer weather. We started up geocaching again - haven't done that for some time. Doug can't do climbing or actual hiking, but there are quite a few easy caches to find. Fun way to get outside.

Blessings to all.

Light Chains Rising

The latest myeloma panel shows Doug's Lambda light chains are rising - doubling from last month. This what is used as his cancer marker. Obviously this is not good, but right now the light chain level is not alarming. Just a sign the cancer cells are awake, maybe starting to rumble a bit. We already know he will need to restart treatment at some point, maybe in the near future.

The new dosing of gabapentin - 600 mg three times a day - is making Doug tire even more easily, and sometimes a bit dizzy, but its too soon to tell if it will help the neuropathy. Naps are a good thing. Otherwise, he is feeling pretty good.

More Gabapentin

Doug has recovered from the flu and is gaining strength every day. He is back to Physical Therapy and the dreaded exercises. We even went out to lunch the other day - something we haven't done for a while. We tried a new lunch place in town and really enjoyed it.

Yesterday we went to Denver for the monthly oncology check. This time we saw the specialist's nurse practioner because the specialist was on a bicycling vacation in Italy. He always comes back refreshed and "pumped up", pardon the pun. The NP is very good; we have seen her before. Since Doug still has the peripheral neuropathy in his feet, she suggested increasing the Gabapentin dose. Currently he takes 600 mg twice a day. He will now be taking 600 mg three times a day. If he can tolerate it, that is. Gabapentin can cause dizziness and mental fog.
While in the clinic, Doug got his infusion of Zometa.

Still on chemo vacation, as long as the cancer numbers are not rising too high, and he continues to have PN.

Praise the Lord for his provision!

Love to all.