Tag Archives: Health

Fighting Talk

This is the second post exploring “cancer cliches”, the first one being keep your chin up.  More to follow on looking well, being positive, being brave and well I could go on and no doubt will!

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When the British tennis player, Elena Baltacha died from liver cancer recently, I posted on Facebook that it was sad news but that I wished the press wouldn’t say she had lost her battle with cancer.  It seemed to strike a chord as I got quite a few comments agreeing with me. This may be controversial but I really dislike fighting talk in relation to cancer and particularly dislike hearing of people in the public eye losing their fight or battle with cancer or even beating cancer. though for some reason there is less of  the latter!  It demeans our lives if all it comes down in the end is that we lost our battle with cancer. Cancer is not like a game of tennis which you can win or lose and have some influence over depending on how well you play. I am sure that Elena Baltacha showed true grit in dealing with her diagnosis and illness but she was never going to win her battle. If I lose my battle with cancer does that mean that I’ve not fought it hard enough or that somehow I haven’t done enough to beat it, come up with the right strategy, lived the right way, had the right diet, had the right attitude etc etc ? Have I somehow failed?

Does the fact that I only got 15 months remission from my first stem cell transplant whereas some get 5 years plus mean I am not fighting it hard enough or just unlucky that my disease is more aggressive.

James Steinberg

Is cancer something I can fight against or is it just a disease following its pathological course in my body which will hopefully be abated temporarily by chemotherapy or some other treatment.  Cancer is random, recovery is random, it is not a battle, it is a disease. Does someone who has heart disease or diabetes lose their battle with it or does this just apply to cancer?   It just seems to apply to cancer maybe because it is the disease that we are all frightened of getting and probably know someone that has been affected by cancer as more than 1 in 3 people will get some form of cancer in the UK.

I appreciate that for some people fighting talk and imagery may help them deal better with their cancer but I am not at war with my body.  There have been times when feeling rotten on chemotherapy,  I have tried to console myself with the thought that at least the horrible treatment is killing off my cancer cells, imagining that I have one less bad cell to deal with.  Please note I am not talking about VISUALISATION here or invading armies!  I can’t stand that either. I also see why cancer charities use words like fight, beat, stand up to cancer etc to raise awareness and funds. They have more impact and imply that there is something we can do to beat cancer but it places too much responsibility on us which is unrealistic. Cancer will only be beaten through advancements in medical science, earlier diagnosis and awareness but not by individuals fighting their own battles. Of course the idea that somehow you can personally beat cancer leads to a whole industry of alternative remedies, therapies and diets etc etc which in my view cynically exploit desperate cancer patients.  I just looked online and here is a few examples below. There are many more.

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So I may be gritty, I may be strong, I may even be resolute at times but I am not battling or fighting my cancer and if anyone writes in my obituary that I lost my battle to myeloma, I will come back from my grave and kill them. Now that is fighting talk!

 

 

 

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Not Good Not Bad

Since my last post The Best Laid Plans I had a further light chain test, the results of which were pretty similar to the previous ones.  So not good not bad, just the same. Strangely, the last few hospital lab test results are in normal range but the trial test results are slightly out of normal range and in both sets of tests there has been little movement which my consultant finds reassuring. Perhaps the blood samples don’t travel well to where they are tested in France for the trial!

So the plan now is that there isn’t one! The situation remains the same. I have started my 12th cycle of treatment today and if my test results show any further rises the chances are I will have my second stem cell transplant sooner rather than later. If not I’ll continue with treatment hopefully until around August and then I will have a transplant. I feel much calmer about this now than I did when I wrote my last post. Right now I don’t have the energy to spend on being disappointed about not being able to plan etc because I have flu and am feeling pretty drained. It is not the way I would have liked to have come to terms with my situation but there it is (ideally I would have liked to come to accept the uncertainty of my situation through the path of spiritual enlightenment but we can’t have everything we want!).

I woke up in the early hours of Tuesday morning feeling shivery and with a temperature of 38.5. Oh dear, time to read the Haematology card I carry with me. it operates as a sort of get out of jail free card if I need to go to A&E. It means I should be seen sooner as someone with a compromised immune system and preferably in a isolation room.  Even so being in A&E is a hellish experience to be avoided.

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Although I am meant to contact the 24 hour haematology helpline with a temp of 37.5 and over, I knew they would tell me to go to A&E and I couldn’t face that so I piled on the duvets until I felt warmer and slept intermittently. Having survived the night, I then rang the trial nurse, Pippa at 9am. She arranged for me to go to the Haematology day unit and said I would be reviewed by a doctor.  Five hours later I was sent home with antibiotics after being tested, swabbed, examined and X rayed. My temperature had at least gone down but I felt exhausted. Nothing conclusive but the next day, the Italian doctor I saw rang me and said I had influenza and that he would arrange for me to be prescribed Tamiflu.  Flu?  Now I felt seriously ill!  So I have been resting but not bed resting, I am not very good at that, coughing a lot and producing copious amounts of snot. The worst thing though has been the combined effect of self pity, a lot of time spent alone and severe tiredness resulting in very negative flights of fancy about flu becoming pneumonia, treatment stopping, myeloma returning with a vengeance etc etc,  you know where this is going! I must admit too feeling a little like the cat below at times!

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As I am recovering, fortunately I am regaining my sense of perspective.  I hope that as my energy returns I don’t start getting frustrated and anxious about my situation and can retain that feeling of detachment that having the flu has given me.

Ps in case you are wondering, I have had the flu jab!

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The best laid plans……

“The best laid schemes o’ Mice an’ Men,
Gang aft agley.
An’ lea’e us nought but grief an’ pain,
For promis’d joy!

(To A Mouse)”
― Robert Burns, The Works of Robert Burns

I was feeling quite elated following my last clinic appointment because after months of uncertainty about how long I would continue on treatment my consultant and I came up with a plan. The plan was to continue with this low dose treatment regime until around August, that would be 12 months since I started treatment, and then have my second stem cell transplant (which would be three years since my first one).  The reason being that I am tolerating it well with good quality of life.  I have learnt that spinning out something that is working for you for as long as possible is a good strategy when it comes to treating Myeloma. Living with Myeloma is a marathon not a sprint and as there isn’t a cure there is no hurry to get to the finish line. Come to think of it, there isn’t really a finish line. Of course the plan is subject to my light chains staying in normal range which they have been since November. If they started rising out of normal range then I would have the stem cell transplant as soon as possible.

So finally I had something to tell people, I had a plan, I could make plans, I could reach that bit further into the future, I could say yes to this or that invitation if it was before September. I started to lay tracks across my mental calendar for the next few months.  My mind was racing with delight. I would have a glorious summer. The next few months would be my myeloma salad days before the gruelling stem cell transplant process.

Then on Monday when I went to the Haematology Day Unit in for my weekly shot of  Velcade, I was given a print out of the most recent blood test result which was out of normal range and confirmed an upward trend over the last 3 tests. I felt instantly slumped, all my hopes and plans were shattered by an A4 sheet of paper. I have had many set backs and disappointments along this journey and this was another one (not even a particularly significant one) but for some reason it has hit me hard.

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Now the plan is to have another test on Monday and if that confirms the rise, I will be coming off treatment since we must assume that it is no longer holding me in remission. I will then have a stem cell transplant in the next 4 to 8 weeks.  If my light chains return to normal range then I suppose I am back on track but whatever the result I have already reigned in my plans. hopes and dreams. To avoid disappointment I can only plan around a month ahead at a time. I know plans can be cancelled or put on hold and perhaps it is better to make them than not but for me it was not necessarily the plans themselves that were the attraction but the freedom to be able to make them.

 

 

 

 

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Viva Las Velcade!

This post is about the wonderful Velcade, the chemotherapy that I am on. If you want to know more about it you can click on the link.  I have started my 10th cycle of Velcade and Dexamathasone on the Endeavor trial, (very aptly named as it certainly feels like an endeavor!). My disease is stable and my kappa light chains in normal range since the end of the 5th cycle (see my post And on the sixth cycle). So good news, I’m still in remission!.

Hey, this warrants the inclusion of the dancing cat from an old post! I love the dancing cat but have some reluctance about putting him on again because  the post that I used it on to celebrate the fact that a previous test result that was sky high was erroneous but later on I learnt that it was right, the test that was wrong etc. I do hope that the dancing cat isn’t a bad omen.

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What the heck, lets throw in the ballerinas as well!

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I’ve been on continuous treatment for over 6 months now. I have become so used to this extraordinary way of living that it is not extraordinary to me anymore. I have attended the haematology day unit Mondays and Thursdays for the first two weeks of every cycle to receive a subcutaneous injection of Velcade (that makes 36 times). I leave work around lunchtime then go the day unit.  I sometimes have blood tests first and observations are always done. The Velcade comes out of the fridge having been ordered from pharmacy especially for me. The curtains are drawn around my chemo chair to give some privacy and I expose my bruised and battered stomach for the nurse to find a new site in which to inject the Velcade. She pinches some fat (of which fortunately there is plenty) between her fingers and injects the velcade over a period of around 10 seconds. It stings whilst it is going in and after I have had my observations done 15 minutes later I am free to go. The whole process generally takes around an hour but sometimes longer depending on how busy the day unit is.

I have never felt any immediate side effects and quite often go food shopping on my way home and or go for a run. I may feel tired later but that is counteracted by the steroids that I take on the day of and the day after treatment. A couple of days after the injection, the site starts to redden and bruise and gets extremely itchy and sore. I’ve been experimenting with different lotions and potions, aloe vera gel provides some relief. Other than fatigue which has lessened over time, I suffer from constipation and more recently aching calves. My legs feel like I have walked 10 miles but I have done nothing at all. This could be due to nerve damage caused by the Velcade, one of the main side effects of Velcade is peripheral neuorpathy but this is usually in the hands and feet. My consultant is keeping an eye on it.  The other side effects I experience are more to do with the steroids but as the dose has been reduced these have lessened.

Since my light chains went into normal range, the dose of Velcade and Dex has gradually been reduced to minimise the side effects. The previous 9 cycles involved 4 doses of velcade over a 21 day period, the 10th cycle is less dose intensive and involves 4 doses of velcade over a 35 day period. This is the lowest dose possible on the trial and the idea is for it to be more of a maintenance dose. I will have another stem cell transplant this year but I don’t know when. It rather depends on whether and how long my remission is maintained on the maintenance dose as at some point my disease will become resistant to it.  I never know what will happen from cycle to cycle or how many more cycles I will have and neither does my consultant, we just review matters at my clinic appointment at the end of each cycle. I have got used to living with uncertainty like this but it is tiresome to explain to others in the normal world.

When I finally started chemotherapy last August I assumed that my life would be on hold, that the side effects would be too great to really do much and that I would wait until after treatment to recommence my life but although the first couple of cycles were a bit rough, things have got better.  I suppose my body has got used to Velcade and the reduced dose of steroids has really eased the low mood I talked of in dexamethasone the good the bad and the ugly. Life is too precious to ever be on hold, even on bad days, it is for living now to the best of my ability, whether on chemotherapy, in remission (or both) or even when relapsing.  It is almost impossible to make any plans but in my week off treatment at the end of each cycle, I have taken trips to Majorca, Cornwall, Barcelona, Somerset, London and Lanzarote (yes that was where the photographs were taken in my last post, Keep your chin up).  I’ve also been working (to pay for all these breaks!), playing tennis, walking, getting back into running,  and in a couple of weeks time I’ll be dog sledding in Finnish Lapland!

And so I have my extraordinary routine which I have incorporated into my fairly ordinary life.

Viva Las Velcade!

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Taken in El Golfo, Lanzarote

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Why I won’t be getting run over by a bus any time soon!

How many times have I heard that I could get run over by a bus any time or other such platitudes about how none of us know when our number is up when I talk about my life shortening diagnosis.  I know it is partly because people don’t know what to say and yes it is true there is a very remote chance I could get run over by a bus…………..

About 2 in 1000000000 to be precise

I think it is far far more likely that I will die of a Myeloma related cause, in fact I would gamble my life on it!

I love this video, I don’t know why it makes me laugh so much, Jesus is being so positive and upbeat singing I will survive and then what happens…I won’t spoil the ending!

I know of 5 people between the age of 35 and 60 with Myeloma who have died recently. Three through the online myeloma community and two others in the public eye, Felix Dexter who was on the comedy show, The Real McCoy a while back and a biochemist, Professor Michael Neuberger who ironically was involved in life saving work on the immune system.

Over time I have become less affected by hearing of deaths of people I know of caused by Myeloma than I used to be.  In an oldish post In a Clod  I expressed how I felt about the death of “Outdoor Paul”. Such untimely deaths always serve to remind me that this is likely to be my fate too at some point sooner than most people of my age and whilst some will say in an attempt to blunt this fact that any of us could get run over by a bus any time, I find that cliche very annoying. I know it is meant to convey the point that although death is a certainty none of us know when it is going to happen or how but saying that takes away from the most profound effect that the knowledge of my likely early death has on my life. It degrades my experience.

Having a life shortening illness is something I have to deal with but for those don’t have their awareness of their demise in quite as much focus as I do, it is hard to talk about.  I nearly got caught out myself when I was having lunch with a myeloma mate recently and he referred to an event that would happen when he was 58 (6 years time) and then remarked that he would probably be dead by then so he wouldn’t see it happen.  I was initially shocked and the words “oh you won’t be” were nearly out of my mouth before I shut it and changed it to something like I hope you won’t be.

And I hope I won’t be too but I’ve had to adjust and accept that this might be the case. In some ways there is a liberating element to having a life shortening illness.  For example, I have

– cancelled payments into the pathetic personal pension I had

– ceased caring about how I am going to support myself financially in old age

– stopped fearing death and that I might be extremely old, out of my mind, lonely and a burden on others

– stopped shelving plans and dreams of what I am going to do when I retire, and am DOING THEM NOW, as far as possible.

Oh yes, I am living the dream (said with more than a touch of irony and a little bitterness if I am honest)!

I am pretty sure of what I am going to die of and roughly how long I have got but for those that don’t, here is another classic song from the old maestro Leonard Cohen to give you some food for thought. This post is really just an excuse to play another song by him. I am a just a little obsessed at the moment!

And who by fire, who by water,
Who in the sunshine, who in the night time,
Who by high ordeal, who by common trial,
Who in your merry merry month of may,
Who by very slow decay,
And who shall I say is calling?And who in her lonely slip, who by barbiturate,
Who in these realms of love, who by something blunt,
And who by avalanche, who by powder,
Who for his greed, who for his hunger,
And who shall I say is calling?And who by brave assent, who by accident,
Who in solitude, who in this mirror,
Who by his lady’s command, who by his own hand,
Who in mortal chains, who in power,
And who shall I say is calling?

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Butterfly On a Bush

A few days ago on a bright and breezy day I was pegging out washing on the line when I saw from behind one of my T shirts the most beautiful peacock butterfly land on the mauve flower head of a buddleia bush.  It was struggling to stay on the flower because of the gusts of wind blowing it around and it was flapping its wings to try and stabilise itself. I ran back into the house to get my camera and hoped it would still be there when I got back. It was and I managed to take a couple of shots of it.  It was clinging on resolutely, occasionally fluttering off unable to stay on but kept coming back to land.  The fragility of the butterfly’s situation reminded me of my own recently as I have been desperately holding on waiting for treatment to start, both emotionally and physically.

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Since my post the Myeloma Trilogy, I have completed my first cycle of treatment. The Onyx trial finally opened on 9 August, I was the first patient and my trial tests really were whisked off to a lab in Paris (which spookily was my fantasy involving Lizbeth Salander in the Myeloma Trilogy post) and I was so hoping to be randomised to the new drug, Carfilzomib but there was only a 50/50 chance.  Just my luck I got the old drug, Velcade, which I could have started off trial two months ago off trial before I starting feeling the ill effects of having active myeloma. I was devastated and inconsolable, the poor trial nurse who broke the news to me didn’t know what to say and then had to perform a bone marrow biopsy on me!  At this point in time, it wasn’t that I wanted the new drug because I thought it would be a more effective treatment, it was because I had waited all this time for the trial to open to the detriment of my health when I could have started the old drug off trial before that happened.

Oh well, I have become resigned to it now like many other things I have become resigned to over the course of my journey with Myeloma, the loss of control is probably one of the hardest issues to deal with. The second cycle starts tomorrow and I hope that after two cycles there will be a significant reduction in my kappa light chains. I have my treatment schedule now but plans seem impossible as it is unpredictable how I am going to feel or what I can do on a day to day basis. A holiday in Italy has been cancelled as well as a tennis holiday in Greece at the end of this month so I am feeling rather sorry for myself. My self pity has been deepened by the excrutiating shoulder and arm pain I have at the moment caused by a trapped nerve in my neck which may or may not be related to myeloma or the treatment. I will be having an MRI scan to see what is going on soon I hope.

However I have managed to do some more enjoyable things in between hospital visits and prior to my trapped nerve such as canoeing down the river wye with some friends from Kerne Bridge to Symonds Yat in a 3 person kayak which was lovely. Oh and did I mention that I managed to do the bike section in the Salford Triathlon two weeks ago?? It was hard going but I took it easy and let go of my natural competitive inclinations and “allowed” everyone else to overtake me. My team mates did brilliantly too and at the end I felt overwhelming relief, firstly because I had been able to do it and secondly because it was all over now and I didn’t have to stress about it anymore. Action photos below, the small one of me coming off the bridge I really like but I cant improve on the quality or size without buying it as it was taken by a commercial photographer. I certainly look the part, who would know that I was week one into chemotherapy treatment and that earlier that morning I had struggled to get up the stairs to the registration area for the triathlon due to my shortness of breath!

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The Loneliness Of The Long Distance Runner

Alan Sillitoe 's novel

I am obviously not a long distance runner, not even a short distance runner at the moment but the solitary nature of running is used as a metaphor in this excellent short story as the main character turns to long distance running as a way of escaping both emotionally and physically from his desperate situation.

Taking part in a triathlon this year and doing the 10k last year has become something similar to me, a way of escaping the world of myeloma both mentally and physically. It signifies that I can do normal things (though some would say that it is mad not normal) and reach a level of fitness which has no place in the world of myeloma. I truly appreciate having been able to be fit and active since my stem cell transplant if not fitter than before diagnosis without bone pain or in fact any pain that some of my fellow myeloma suffers have as a legacy of myeloma even when in remission.  As for the loneliness, living with myeloma can be lonely and scary. I appreciate the acknowledgement of this by a long distance friend who doesn’t have myeloma in a comment made by Prue about my last post, the Myeloma Trilogy  “I reckon it must be quite a lonely place at times…so this is a hello!!!

However I am pleased to say that I won’t be on my own doing the Salford Triathlon next Sunday. My individual place has been substituted for a team place and I am grateful to two friends for doing the swim section and the run section at the end. I still intend to do the middle 20k bike section but have someone on standby if I cant.  I have had to accept that I am not in a position health wise to do all of it and stopped the intensive training a good few weeks ago, finding myself breathless and exhausted. Anyone that knows me will know that I hate to admit defeat and don’t like giving up but now I have accepted it I am pleased and excited to be doing it as part of a team and hugely relieved that the pressure (all of which was self inflicted) is off.  The photos below were taken at a open water swim in a lake in Cheshire on a lovely sunny day and yes that is me gliding through the water with a Myeloma UK swim cap on! Just to prove I had been doing the training!

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So neither lonely nor a runner but I will be taking part in the Salford Triathlon on Sunday 18th August and I hope you will support me. You should be able to click on the Just Giving Link on my blog to take you to our  Just Giving Page.  Needless to say I am raising money for Myeloma UK.

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A Room With A View

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“Though life is very glorious, it is difficult.”
―     E.M. Forster,     A Room with a View / Howards End

 

 

 

 

 

 

Another of my favourite books by one of my favourite authors.

The title being apt because I have had my own room with a view of sorts recently.  I took an unplanned short break for a couple of nights in the Manchester Royal Infirmary, not quite the same as Italy!  During this recent glorious spell of hot dry weather I had been feeling a little cold and shivery and was wearing warm winter clothing in the office with the window closed, very unlike me. When I came back from work on Wednesday I was exhausted and was intending to take some paracetamol and lie down but something made me take my temperature with the old velcade thermometer I had been given when I first started chemotherapy and it was 39.1, quite high then. The advice when I was on chemotherapy and after my transplant was to contact the haematology department if your temperature was over 37.5 but did that apply when not on treatment?

I wasn’t sure so I thought I would ring the out of hours haematology line at my hospital. I explained I had relapsing myeloma and my temperature was 39.1 and the person I spoke to advised me that I should go to A&E as I may need antibiotics. I anticipated that they would say that, from past experiences, having attended several times whilst on treatment.

I rang a friend who kindly gave me a lift. I wondered about packing an overnight bag but decided that I would probably be home later and it wasn’t necessary. I duly arrived and showed my haematology alert card which means that I shouldn’t be left in the main waiting area too long and within a short space of time I saw the triage nurse. My temperature had dropped to 37.9 by then and I was beginning to wonder whether I should just go home!

I was then taken to a side room in the amber area. About 3 hours later I saw a doctor who said he didn’t want to give me antibiotics yet but wanted to admit me for observation as a high temperature and fever was a sign of infection. That was about 9pm and I was left there until about 3.30am with a break for a chest xray, after which I was eventually moved to a bay on the acute medical unit. It was a truly awful experience trying to sleep on a trolley with bright lights and continual noise! When they took my temperature again at 4am it had gone back up to 38.4.

From there I was later moved again to a haematology ward after I saw my haematology consultant who said he wanted to keep me in another night for observation and give me some intravenous antibiotics.  It was a different ward to where I had my stem cell transplant but a similar set up with haematology nurses who reassuringly knew what they were doing and with what they were dealing. I was sharing a large room with another patient undergoing a stem cell transplant who was very poorly and the room had ceiling to floor windows with a view of the a car park with some grassy areas beyond it and a modern section of the hospital on the far side of the road. Certainly one of the best views to be had from a hospital bed in the MRI!

Well before I got the intravenous antibiotics, my temperature had stabilised and I felt ok but exhausted through lack of sleep for more than 24 hours. My consultant told me I couldn’t possibly start treatment with an infection in my body as it could end up being much much worse and I expressed my frustration that treatment had been delayed to the point where I had got an infection and now couldn’t start treatment. He tried to explain in a rather abrasive manner that it wasn’t vital that I started treatment straight away as my kidney function was fine and my blood counts were normal but I didn’t really take it in and just felt that my myeloma would spiral out of control untreated. After he had gone I am afraid that I just broke down and cried and cried and cried!  I felt alone and as out of control as I perceived my myeloma to be.

I calmed down a little later on in part due to a chance encounter with my former lovely consultant in the coffee bar who reassured me with far more empathy than my consultant showed, that it would be ok to delay treatment and it wouldn’t affect the outcome although I didn’t ask her what damage if any, was being caused by my rising kappa light chains now at 1032 mg/litre.

So with all the endless waiting around for tests, doctors, nurses and medication over the next 24 hours and in the absence of a working TV or a decent mobile signal, wifi or even a book I had no distractions in my room with a view.

hospital room

I watched from the chair by the window, people sitting on the grass basking in lovely sunshine, smiling, drinking, eating, being happy and going about their business, in contrast to my sterile prison like environment. I gloomily realised a view of my future, of admissions to hospital, treatments, clinic appointments, transplants, a life over which I had no control but which was shaped and determined by medics, numbers and endless blood tests. This would be the life ahead for me and I would never experience that careless abandonment of those people outside sitting on the grass. It would be a life that set me apart from my friends and peers whom I am already conscious of boring with the latest tales of my relapse and kappa light chain figures. It can only get worse in the future and I don’t want to burden my friends with that but neither can I pretend to be unaffected by it. I don’t want talk about it but I do want to talk about it. I am in danger of becoming alienated from the world my friends and peers inhabit, of planning for their future retirement, booking holidays, downsizing, celebrating their 60th birthdays and making assumptions about their futures which I cant make.

And I know my future will be about more than that and there will be good times ahead but right now I am feeling a little bleak and don’t want to or cant feel positive or “keep my chin up”. I try to live from day to day but my two days away didn’t help to keep my spirits up.

“I never think of the future – it comes soon enough.”
―     Albert Einstein

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Falling off the plateau

It seems that I have fallen off the plateau that I had made my temporary home for the last few months before the descent into relapse.   Just as I was settling in and adjusting to my new territory,  I have yet again been reined in by my rising kappa light chains which have jumped rather dramatically from 77 mg/litre to 617 mg/litre in the space of a month.

Plateau

I didn’t stay at plateau point very long but it was great whilst it lasted!

Needless to say I was as disappointed and surprised as my consultant who arranged for me to have a retest last week to see if the jump is for real or some kind of freaky fluke.  There is an outside chance at most that there could have been a massive error in the lab testing but I am not holding my breath and I am not praying for a miracle or some such thing.

I mentioned in a previous post (Hello Relapse Goodbye Remission Part 2 The Calm after the Storm) that my consultant said as long as my light chains weren’t above 600mg/litre I could go to India. I feel so fortunate that I was able to go before the steep rise to 617 this last month.

So the plateau was short, January to April, to be precise, but I had adapted to the new phase of my disease and the fact that I was no longer in remission fairly quickly, once over the initial shock of relapse.  I was hoping that this phase might last until September, which would be two years post stem cell transplant, a respectable period of time.  I became comfortable with the new normal for me and was off again planning and booking trips, playing matches for the ladies team at my tennis club and starting a 16 week training plan for the Salford Triathlon in August.  This was on the premise that I would not be on treatment and my light chains would remain in the bracket of around 70 to 90.

And now I am back to not knowing what I can do when.  I feel like I get slapped down by my disease whenever I start taking things for granted.  Logically I know that my myeloma isn’t capable of such vindictive behaviour, it doesn’t have a personality, being just some cancer cells doing their thing, so if I get into slapping them back we are entering into battleground territory and you will see from a previous post (Hello Relapse Goodbye Remission) that I am not battling my disease.  However I do feel a little like Humpty Dumpty at the moment, getting to the top of the wall, balancing there a while, happy, and then falling off except that hopefully as I am not an egg, I can be put back together again!

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I expect to be starting chemotherapy treatment soon after 20 months of being drug free since my stem cell transplant, apart from the monthly infusion of Zometa, a bone strengthening treatment. I am dreading it and my head is spinning with the various options that are on the cards. It is good that there are options, but options mean choices and I really don’t know how I am going to decide between them… but more of that another time!

This is likely to be my last post for some time with the blog subtitle “living in remission”.  Of course I am hoping to achieve remission or stable disease at some point in the future but I am conscious that the remission I have enjoyed may not be as long again. Unfortunately the law of diminishing returns usually applies to a second stem cell transplant if that is what I decide to have so that I may only get one half to two thirds of my first remission.

Whilst the past 20 months have not been easy, they have generally been good. I have been able to live life well with no health issues and no pain unlike some with Myeloma. I want to appreciate and celebrate what I have done whilst being at the top of the mountain so to speak since from my stem cell transplant on 1 September 2011 and then latterly on the plateau.  In more or less chronological order some of the highlights are:-

  • cycling along the Monsal trail in the Peak District one fine autumnal day
  • long weekends in London, Dublin and Alicante
  •  starting my blog
  • a holiday to Tenerife
  • seeing the Northern Lights and going dog sledding in Sweden
  • playing the piano again
  • a stay in Palma, Majorca
  • running the Manchester 10k
  •  a holiday to Lake Maggiore and Switzerland
  • a trip to Oxfordshire and Somerset
  • joining an outdoor fitness class
  • giving a patient experience talk at Myeloma UK info day
  • a tennis holiday in Corfu
  • a trip to Tromso, Norway to see the northern lights and go dog sledding (P)
  • seeing a wild tiger whilst on holiday in India (P)
  • playing (albeit badly )in a tennis tournament (P)
  • training for a triathlon (P) (R)
  • finally and hopefully going to Paris on Eurostar, to see Monet’s garden at Givernay (R)

Those marked P indicate done whilst plateauing

Those marked R indicate doing whilst relapsed!

Thanks to everyone that I shared some of these things with and those that supported me and encouraged me to do them.

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Filed under Cancer, Health, Life and death, Multiple Myeloma, Myeloma, Relapse, Remission, Stem cell transplant, Travel, Uncategorized

A Passage to India

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Fortunately my experience of India was nothing like the uncomfortable story described in the book by EM Forster but as the book is one of my favorites it seemed like a good title as any. It also struck a chord with me as I am on a passage of sorts at the moment in relation to my myeloma. I looked up the meaning of passage in the free online dictionary and it came up with many as you would expect so I have just selected the ones that I find relevant to me:-

pas·sage 1 (psj)
n.
1. The act or process of passing, especially:
a. A movement from one place to another, as by going by, through, over, or across; transit or migration.
b. The process of elapsing: the passage of time.
c. The process of passing from one condition or stage to another; transition: the passage from childhood to adulthood.
d. Enactment into law of a legislative measure.
2. A journey, especially one by air or water: a rough passage on the stormy sea.
3. The right to travel as a passenger, especially on a ship: book passage; pay for
8. Physiology An act of emptying, as of the bowels.
9. Biology The process of passing or maintaining a group of microorganisms or cells through a series of hosts or cultures.
10. Obsolete Death.

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[Middle English, from Old French, from passer, to pass; see pass.]

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I have come to terms with the fact that I am relapsing and am in the process of passing from one condition or stage to another; transition as in 1c above. The difficulty I have is not knowing where I am going and how long it is going to take to get there!  I hope my passage is a long one and whilst we all arrive at no.10 at some point, I hope that isnt for a while either!  My passage or transition has already lasted four months and at my last light chain test after I came back from India my Kappa light chains had dropped from 89 mg/litre to 77 mg/litre. My haematology specialist nurse said I should go on holiday to India more often! Maybe I will?

This trip took on so much symbolic significance for me. It was the trip I had to cancel just before diagnosis due to kidney failure, it was a destination that seemed out of reach after diagnosis due to risk of infection and low immunity and then the trip I had booked was cancelled. After sorting out a new itinerary, I then found out I was relapsing and wasn’t sure I would be able to go or even wanted to go. I lost a bit of confidence.  I am not a believer in fate but I was starting to develop a sense of foreboding about the trip, that maybe I wasn’t meant to go to India.  Then there was a last minute hitch with travel insurance.

Before I knew I was relapsing I had purchased an annual travel insurance policy which was at a very reasonable price to include my condition. One of the standard questions I had to answer about my condition was whether I was currently in remission to which I answered yes. It occurred to me a few days before I was due to go that I should inform the insurance company of what I thought was a slight change of circumstance in that my light chains were out of normal range but I didnt need any treatment and was fine to go to India according to my haematology consultant. I rang them up and the conversation went something like this………….

Me “I am going to India on Friday and I need to inform you of a change to my circumstances in that my myeloma markers are out of normal range”
Them “are you in remission as you declared when you took out the policy?”
Me “I dont know, I dont need any treatment, my markers are just higher than they should be”
Them ” are you currently in remission, yes or no?
Me ” I dont know, depends on the definition of remission,  I’ve not relapsed”
Them ” Do you know what stage of disease you are at”
Me  “I dont know”
Them ” You need to ask your consultant whether you are still in remission and let us know by tomorrow afternoon, we need a yes or no answer”

So I email my consultant the next day with the question “am I in remission, the insurance company run a standard script about myeloma and the answer can only be yes or no. He kindly takes the time to reply that unfortunately he would have to say that technically I am no longer in remission and he gets this all the time.

I ring up the insurance company again and the conversation went something like this…………….

Me ” my consultant says I am not in remission but I am fine to go to India”
Them “If you are not in remission, are you at stage 1 or stage 2 myeloma?”
Me “neither apply to me, this is not a relevant question”
Them “then is the answer “I havent been told or dont know what stage I am at”
Me “Well as none of the other answers  applyI suppose this is the nearest”
Them “There has been a change of circumstances which mean that we will have to decline your policy. Is there anything else I can help you with today?”
Me “yes, travel insurance you bastards!”

So I ended up spending my last evening trying to find a reasonable priced single trip policy online, instead of relaxing and doing a little bit of tidying up and final packing.

As those of you with myeloma or other serious illness, the first hurdle to overcome is answering the question

“Has any member of your party ever been diagnosed with a terminal prognosis?

Yes No

If so, how long is the terminal prognosis from the date of return from your trip? (in months)

I always say no to this question as no one as ever told me I have a terminal illness, incurable yes but not terminal!

The next hurdle is to declare your condition and answer the specific questions relating to it as follows:-

Medical condition:
Multiple myeloma

Questions
How long ago was the diagnosis made?  Less than 5years, 5 – 10 years,, Over 10 years
Have you had a bone marrow or stem cell transplant?  Yes                                                                                                 Yes – but it didn’t workNo
If you have been told, please specify what stage your disease is at currently Stage 1Stage 2                                                                                             Stage 3My disease is currently in remissionI don’t know or have not been told my disease stage
Are strong painkillers being taken?    Yes                                                                                                 No
Has this condition caused a bone fracture in the last 12 months?    Yes                                                                                                 No
Has the condition resulted in any of the following problems? Impairment of kidney functionSpinal cord damage causing leg weakness or incontinenceBoth of these                                                                                       None of these

I have already declared these problems

I got quotes varying from £450 to the one I eventually settled on for £110 which seemed pretty good for an 18 day trip. It excluded cancellation but as my trip was less than 12 hours away I didnt think I needed cancellation cover.

From this kaftaesque experience I learned two things:-

1. That technically I am no longer in remission so my blog subtitle will have to change from living in remission to living in what?? Any suggestions welcome! With hindsight it was a silly subtitle as I knew that that remission wouldnt last indefinitely
2. Insurance companies insure you against risks but avoid taking any! However I dont regret telling them as if something had happened on my holiday which was arguably due to my “condition” I would have had a struggle getting them to pay up. What I regret is that I didnt tell them sooner so I would have had more time to deal with the fallout and get alternative cover instead of going through all that stress and venting my frustation at the poor woman on the telephone

And off I went on my passage to India and I am pleased to say that I had an absolute blast without any health issues at all. No delhi belly, no colds, nothing and I had a lot of energy which I needed for such a demanding trip.  What I didnt need was the dammed insurance!  This isnt a travel blog so I dont want to go into too much detail of my holiday but my two top things were seeing the Taj Mahal and seeing a wild tiger in Kanha National Park.  My “passage” was by car, train, bus, cycle rickshaw, autorickshaw or tuk tuk, foot, motorbike, plane and more unusually elephant, hot air balloon and safari jeep!  I made new friends, ate delicious food, drank a lot of marsala chai, and watched the famous goan sunset for 4 nights at the end of my fantastic holiday.

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What was so refreshing about the holiday was that I felt NORMAL, in fact whole days went by sometimes without me even thinking about myeloma or anything to do with it. On some of my many long “passages” I would look out of the window and have idle fantasies about my next trip to India and where I would go, would it be further north, skiing and trekking in the Himalayas or down south to Pondicherry or both? Then I would catch myself on and remember that I had myeloma, was relapsing or whatever I am doing and that I cant make any such plans. So I feel incredibly fortunate that myeloma didnt prevent me from going on this trip which almost seemed fated not to happen , that I had such a fantastic time and my expectations were met, that I didnt get ill and that my dream of seeing a tiger in the wild was fulfilled and was every bit as  inspiring as I hoped it would be .

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Filed under Cancer, Health, Multiple Myeloma, Myeloma, Relapse, Remission, Stem cell transplant, Travel, Uncategorized