Journal entry by Dave Clark

Well jumping the gun here a bit, after my last Journal update, where I said would next report back after Chemo Cycle 4 was complete. 

But have some very good news to share, now that Chemo Cycle 3 is complete.

At the bottom of this journal entry is a timeline graph of my blood Hemoglobin levels, over the past year, since last fall 2017.   That graph appears very small, but if you click on it, it will appear bigger so that you can see the details more clearly.

At the left end of that plot, a year ago, I was finding myself regularly experiencing increasing breathlessness when engaging in aggressive exercise.  Bike speed dropping, kayaking pace slowing down, even walking up a mild uphill fairway on a golf course would require me to stop periodically to catch my breath.   And this past winter’s Ski Racing season, even a quick 30 second run down a Slalom or GS race course here, at near sea level, rendered me so out of breath that it would be over a full minute before I could even talk coherently.  Clearly something was badly wrong with David by that time, but my Oncologist still hadn’t fingered what it was.  That diagnosis didn’t surface until this past April, from the Bone Marrow Biopsy done at that time – which is where I began this journal.

In 20-20 hindsight, those continually increasing breathlessness experiences were the direct result of ever-increasing Anemia – due to the normal blood plasma cells in my bone marrow being crowded out by the aggressively cancerous Myeloma cells – and resulting in much lower levels of oxygen-carrying Hemoglobin in my circulating blood.  From that personal experience, I can now assure you all that those two phenomena – ie Hemoglobin level and breathlessness – are perfectly correlated.  That’s the Statistician in me talking.

And from this trend over time, you can see those points where my Hemoglobin level dropped below the 7.0 “Critical Anemia” threshold, where I was sent directly to the hospital to receive a transfusion of Packed Red Blood Cells (PRBC).  The first of those coincidently occurred the week of my first Bone Marrow biopsy this spring – the analysis of which is what finally fingered Multiple Myeloma as the root cause of the ever-increasing Anemia.  You can see That supplemental transfusion kicked my Hemoglobin level up, and I clearly recall feeling much better for the next couple of weeks.  But that was fleeting, and within a few weeks, just as we started the Chemotherapy treatment, it was down into the “Critical” level again – back to the Hospital for another “Top me Off” transfusion.  And on through Chemo cycles 1 and 2, you can see three additional “Top me Off” transfusions, on three additional occasions.

But as reported in my last update, the mid-course 2nd Bone Marrow biopsy showed there had been a very significant drop in the level of cancerous Myeloma Cells in my bone marrow by last month, which meant that there was now room for the normal healthy Blood Plasma cells to start flourishing again.  While that internal situation hadn’t shown up yet in my blood counts as of that last Journal update, now that I’ve got the weekly blood count numbers through the end of Cycle 3 – as depicted above – we can now see that my Hemoglobin level has started to shoot up rapidly. 

While there isn’t any outwardly visible signs of that internal change, I can report that I’ve been feeling a lot peppier in these past 3-4 weeks.  And with my Hemoglobin level today being higher than it was at this time last fall, I’ve even taken the kayak out for a spin in the river a couple of times, and felt fine on both of those jaunts.  And in the evening golf league I play in, last week I decided to forego the powered golf cart and walk the 9 holes, and managed quite well.  Haven’t been able to do that in over a year.

So things are definitely looking up – the Chemotherapy is doing what it’s supposed to, and I can now see those effects in this timeline trend, and can feel it in my daily activities.  

Of course, what we’re seeing here isn’t a long-term cure.  Myeloma is a permanent condition, so while this current reversal feels great at the moment, it will take a Stem Cell transplant to hopefully stabilize me into remission.  And then will need ongoing maintenance therapies, for the rest of my life, to hold off recurrence for as long as possible.  So we’ve got a long road ahead – as another MM patient recently conveyed to me, “you think chemo was arduous, wait until you get into the Stem Cell transplant and recovery”.

But I’m entering this 4th Chemo cycle with spirits high, and feeling lots better than in a long time.

Thank you all again for your continued support and prayers – they’re working !

To be continued in September …

Dave Clark.


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