It’s all in the numbers

Monoclonal immunoglobulin, or more commonly known as M-protein, is one of the telltale signs of multiple myeloma. I have been sitting at or near zero since my stem cell transplant six years ago.

Advertisements

April 2019

3.2 – my M-protein level detected in June 2018 at a regular bloodwork appointment. Monoclonal immunoglobulin, or more commonly known as M-protein, is one of the telltale signs of multiple myeloma. I have been sitting at or near zero since my stem cell transplant six years ago.

6.5 – my M-protein level in September 2018. Something’s brewing in my body.
Dr. Tiedemann has said not to worry until it reaches double digit numbers, so I take a deep breath.

12.9 – my M-protein level in Jan 2019. I finally muster the courage to tell Shayne and Sabrina.

16.4 – my M-protein level in April 2019. The writing is on the wall. My myeloma is making a comeback. Treatment is inevitable.  4 months of chemotherapy. A second stem cell transplant.  3 to 6 months of recovery. My mind begins recollecting difficult memories of depleted energy, blood transfusions, hair falling out, yo-yo emotions and hospital stays.

“Can I start treatment in August?” I ask Dr. Tiedemann. I had planned a trip to Nairobi in July for a delicious month of hanging out with Sabrina for precious mother-daughter time.  A time to enjoy long hikes and bake muffins, of deep conversations in pyjamas and mini getaways.

Dr. Tiedemann listened to my plan and shared his concerns that if I wait until August, I run the risk of bone lesions and kidney failure, common symptoms of myeloma.

Shayne had the brilliant idea to move my trip up a couple of months. We secured dates for May and I felt a sense of energy and excitement to pack my bags. I’ve always been a believer in “ending before you begin”, and time with my kids in Nairobi would be the perfect way to “end” before I begin a year of treatment.

As quickly as the excitement rose, it burst in a giant, unanticipated pop. At an appointment with my family doctor, Dr. Baghdadlian, the following week, my hemoglobin showed a sudden drop to the 90’s, the nose bleeds began and I started to feel tired. This was similar to how I was diagnosed with multiple myeloma all those years ago. Given my history, my family doctor, who is also an infectious disease specialist, forbade me to travel. I called the kids with the news.

I asked my family for space and permission to just be, without questions or judgement while I processed what was happening to me.  I cried.  I slept a lot.  I prayed.  When I was ready, I spoke to Nagib, Shayne, Sabrina and Afzal.  We talked about options, about how everyone was feeling and how we could support each other.

After nine days, I pulled myself together and started to see my situation in a different light.  On average, a stem cell transplant lasts for 3 years (3.5 years if you are on maintenance drugs).  My stem cell has lasted 6 glorious years without maintenance drugs.  Myeloma is an incurable cancer and there was no question that one day the cancer would come back.  The fact that it took so long to return is indeed a blessing.  Dr. Tiedemann also reminded me that this time I would not need to get my stem cells harvested, which was a huge issue six year ago when my body refused to produce enough stem cells for the transplant.  Now I have a bag of stem cells just sitting in a frozen container on the 12th Floor of Princess Margaret Hospital, waiting for me when its transplant time.

The only question now is when do I start treatment.  Every two weeks, I get bloodwork done that will determine the optimum time to begin chemotherapy.  If I were a betting person, my guess is that I will begin chemotherapy in the next couple of weeks.  In the meantime, I am preparing my body to deal with the ravages of chemotherapy by working out and eating right.

After dealing with 3 cancers, my approach to this latest saga is to succumb and surrender to the will of God, and to do so joyfully.  Mentally, I am ready for what comes next. Emotionally, I am prepared. Physically, I am a bit tired.  Now I wait.

Photo: Cape of Good Hope, South Africa, the most South-Western point of the African Continent, according to the numbers (February 2019).