Doug has hit plateau

Yesterday went to Denver to CBCI - Colorado Blood Cancer Institute where the myeloma specialist Dr. Matous has his practice. We saw his Nurse Practitioner; we knew we wouldn't see Dr. M this time. He has become so busy that we get to see him every other time we go. He told us early on that he picks out only highly qualified people who already are PA or NP and trains them himself in the nuances of myeloma, so he is confident that patients are not getting second rate care. Of course we would prefer to see Dr M every time but that just isn't possible. He is amazing and so are his team. There are several other physicians at CBCI but they don't know Doug's case.
Not only is his practice growing, as he is the premier myeloma doc in Colorado, but he also travels to medical conferences around the world to keep up with the newest in myeloma treatment advances. And as he learns the latest, he in turn speaks at conferences in the U.S. to help educate others.

The NP "Kate" said that it appears from the special blood work that Doug has indeed hit a plateau. This current treatment is not working anymore.
For the first three months the results were very good, then not quite so good, then not good at all. Kate said in cases like this Dr. M often will keep the same drug combo but put patients back on weekly treatment. He has gone from weekly to every other week, and was supposed to start once a month in August. Kate says patients often will begin seeing improvement when they are back to once a week. Dr. M prefers this to starting all over with a different drug.
This makes sense to us, but Doug is not excited about it. Kate will discuss this with Dr M at the all-patient conference on Monday.

Regarding the hypogammaglobulinemia, Kate said that as long as Doug is not getting frequent infections, especially in sinuses or lungs, doing nothing is best. She said we should just use common sense but not to stay home and be isolated.

Kate prescribed a special drug for the diarrhea that is common when patients have been on Revlimid for a while.

Back in December 2018, on Doug's latest PET/CT scan, there was a finding that has been a bit worrisome: "hypermetabolic lytic lesion in the inferior aspect of the left maxillary sinus which could be related to malignancy or inflammatory disease". Lately his nose has been kind of runny but no infection. Kate is going to order a repeat CT for comparison, to see if it has changed. We have to wait for insurance approval for that.

We talked about Doug losing weight. Kate looked back and said that Doug has lost 20 pounds in eight months - a significant weight loss! I think hearing that from her shook him up a little. If he just can't gain weight we will have to do something.  Right now he is drinking a Boost. Boost is not instead of meals - in addition to meals.

We left home at 10:00 a.m. and got home at 7:10 p.m.  It was a long day but I was able to drive okay. We had one detour and some heavy traffic but no problems. I have never liked driving on busy highways but God sent his angels to look out for us.
Here is a partial list of what I'm thankful for:

• Safe travel, good weather
• Kind neighbor who came over to feed the dogs and play with them. 
• Great medical team
• People who pray for us
• Doug's good attitude

These are lyrics to the song God Will Make a Way by Don Moen

God will make a way

Where there seems to be no way

He works in ways we cannot see

He will make a way for me

He will be my guide

Hold me closely to His side

With love and strength for each new day

He will make a way, He will make a way