Before I give you my update today, a group of folks from work extended a very touching gesture to us recently that caused me to reflect a lot over the past few days of my more than 28 years at Blue Ridge Bank. I’ve always felt that I was led to be at Blue Ridge Bank. Not that I haven’t thought about trying something else over the years, but each time I’d get that feeling, a new door would open up offering new challenges, and I’d be satisfied for a few more years. What’s resulted is that I’m now in a position that feels like a perfect fit for me and offers new challenges constantly. I’ve been in this position longer than any other I’ve had, and still enjoy it daily.

My reflection goes back to my early days at the Bank and the quality of people that set examples of ethics and treating people with respect. These are the people that made Blue Ridge Bank special and welcomed you to the family. Many of these folks have been in touch with me through email or cards and are following my “adventure” and offering their support, and I thank them all from the bottom of my heart. As one of the few remaining ties to that generation, I feel a responsibility to set the same examples they set so BRB can remain a special place to work. I don’t know that I’m doing a very good job, but it’s good to know that someone is. Almost daily I receive a phone call or email from someone I may not have talked to for several weeks at work, letting me know they’re thinking about me. These are the kind of caring people I recall from the old days and reminds me how blessed I am to be at Blue Ridge Bank.

Okay, my update. I had my last treatment in this cycle Friday morning and so far no bad side effects. Everything was going smoothly during the treatment until they were ready to release me. When they removed the IV from the port-a-cath, the nurse noticed some discharge. She took a culture sample, got the doctor, and they decided I needed to have some antibiotics in case I’d acquired an infection. The site’s not sore at all, but I’ll need to watch it for any changes. If it turns out to be infected, they may need to remove the port-a cath, which I presume would mean IV’s through the arm again. We’ll hope for no infection.

I don’t have any treatments now until June 29th, and I’m looking forward to the break!

I had my second treatment yesterday and it didn't go quite as smoothly as the first. I started out getting blood drawn and they needed the results from the lab before they proceeded with any treatment. They said it would take 10-15 minutes to get results, but took almost an hour. All the results were good, everything in the normal range. Then they started in with the pre-meds, then the chemo. They decided to give me the infusion to help strengthen my bones, and help with bone lesions next. That took 2 hours! Then we finished up with more fluids for about 10 minutes. So we got started around 9:00 a.m. and didn't get finished until almost 1:30 p.m. Not that it was hard work or anything, I even took a couple of naps during the treatment, but I was wiped out afterwards. I went in to work for about 3 hours and didn't get much accomplished. I just felt sort of fuzzy and out of it. After I got home I took about a 45 minute nap and felt totally fine, almost like a normal person. I don't know if it was all the stuff they put in me, the sitting around for 4 hours, or a combination of the two that wiped me out, but I feel good today.
Next week I have treatments Tuesday and Friday again. They should just be the normal stuff, about 4o minutes in the chair, so hopefully I won't be so out of it afterwards!

Today was my my first chemo treatment, and it went really well. I only had the chemo infusion, not the one that's for the prevention of brittle and broken bones and is supposed to take about an hour and a half. There wasn't anything in the file in the infusion room indicating to administer it today and Dr. Hart had my main file with her at her other office. I'll probably get that one on Friday now with my regular chemo.

Tida forgot her camera today, so we had to resort to the camera on my phone for her "documentary" pictures. Please forgive the subject matter of the pictures, I only have so much to work with!

The first one is just a shot of the "room" I was in. The infusion room consists of 26 (I think) areas separated by curtains that have a comfortable chair for the patient, another side chair for a visitor, and a stool for the nurse administering the treatment. I went in with four other 8:00 patients, got to select the room I wanted, and waited for the nurse. Since this was my first visit, we went over the procedure, had to sign some more consent forms, then started in.





I didn't explain the port-a-cath yesterday, but the top part of the port-a-cath just under the skin is titanium, is about a half inch in diameter and has a mesh-like surface. Beyond that is a catheter that goes through the vein towards the heart. For the treatment the nurse feels for the surface of the port-a-cath, then inserts a special needle attached to the IV. When it's removed, the mesh area seals up. There was very minimal pain, even with just having the device implanted yesterday and having the surgical wound still healing. The nurse said there was no redness around the incision and it looked like it was healing well. This is going to be much better than having to get IV's for every treatment, especially if I have to go through 3 or 4 cycles of treatments. The other positive is the port-a-cath can be used for most of the lab work I'll need, and I'll need a lot of lab work, so hopefully not much more drawing blood from the arms for awhile. This picture shows the special needle inserted and attached to the IV.




This next shot is of the nurse flushing the line, making sure everything is working right, Then she injected pre-meds, drugs to help prevent nausea, and some other fluids.





This picture is the infusion of the hard stuff, the velcade and decadron.




The whole therapy process took about 40 minutes, which is what they had estimated. It took about 15-20 minutes for the pre-meds and the first round of fluids; 5 seconds, yes seconds, for the chemo push; then another 10-15 minutes for the second dose of fluids.

The oral chemo drug, Revlimid, was delivered mid afternoon, and I'll take it tonight with another one that right now I don't even remember what it's for. I went my whole life without taking anything stronger than Excedrin, and now I'm taking so many drugs I don't know what it's all for. Tida's marked the calendar so we know when I'm supposed to take what! Since it was so late getting the Revlimid, I didn't go into work today, but I probably feel better today than I have for a few days. Steroids at work I'm sure. I'm still being realistic. Having talked to cancer patients and survivors, I know it's common to feel good the day of therapy, it's the next day or so that kicks you in the backside. Then there's always the cumulative effect of the drugs: the more treatments the more side effects.

Still, I'm positive about getting these cycles of chemo finished, staying strong, and preparing for the next "event".

I had an 8:30 check-in this morning for my 10:00 port-a-cath procedure. Once again, radiology at St. Luke's was running on a different clock than the rest of the world. Once it got started, everything went fine, and they said it couldn't have gone better. Tida, always at the ready with her camera, took a picture of the "smart port ct" they implanted in my upper chest.




We finally left the hospital at about 12:30, had lunch, filled a couple of prescriptions, then made it to my primary physician for a pneumonia vaccine, because one of the drugs I'll be taking makes me susceptible to pneumonia.

I have my first chemo treatment first thing in the morning. I'll get velcade, a chemo drug, and decadron, a steroid through the port-a-cath, then revlemid, a fairly new drug for multiple myeloma I'll take orally. The revlimid is highly controlled and it's not available through the pharmacy, they're delivering to the house tomorrow afternoon.

I'm not supposed to have a lot of side effects, but with all the different drugs I'll be taking, there seem to be a lot of opportunities!

So far I think all my posts have been about me. Tonight I want to make it about you. I want to thank everyone who's been following my progress and supporting us with your thoughts and prayers. We have a ton of support from our friends and family, both locally and throughout the country, and Tida's participation in an email group has some wonderful folks from all over the world supporting us. I've even received a "care package" from Australia!

This kind of support is unbelievable and causes me to get emotional every time we get a note or email from one of you. You're all amazing, especially because we know that many of you are suffering or have struggles of your own that dwarf ours.

Tida's boss Jeff is doing his endurance ride this weekend. Here's pictures of the bibs he's wearing:

Let's all be thinking about Jeff and his team this weekend as they ride 100 miles to raise money for finding a cure for blood cancers.

Hopefully next year I'll be able to bug all of you to donate for my ride to wipe out cancer!

We saw Dr. Hart, my hematology oncologist today to review results from the Siteman Center. Everything was pretty much as expected. General blood work was normal; my monoclonal, or M protein (one of the indicators used to monitor myeloma) was unchanged at 0.2. The higher the m protein, the more active the disease. The goal is to get the m protein to 0, so unchanged at 0.2 is good for now. The bone marrow biopsy indicated several chromosomal abnormalities, but no deletion of chromosome 13 or 17. Tida says she now has scientific proof that I'm abnormal. Funny girl.
So now it's time to start the next round of treatment. Dr. Hart said that Dr. Vij from Siteman was recently a speaker at a national conference on myeloma, is considered one of the top myeloma doctors around, and is on the leading edge of research and treatment, so she completely backs his recommendations.
I get a port-a-cath inserted in the upper chest near the clavicle on Monday. This will ease the administration of the chemo therapy and eliminate the need for IV's every 4 days. Chemo starts Tuesday morning. My schedule will be chemo every 4 days, off for 10 days, then start the cycle over again. It's anticipated that I'll need 2-4 cycles. Once the m protein reaches 0, we'll start preparing for a stem cell transplant. I'll receive 4 days of treatment to boost stem cell production, then 1 to 3 days to harvest enough stem cells for 2 transplants.
Once the stem cells have been harvested, I'll undergo high dose chemo meant to eliminate my bone marrow and immune system. Once it's been determined this process has been successful, they'll re-infuse my stem cells and start building back up my marrow and immune system. I'll be in isolation for 2 to 3 weeks during this stage, followed by a recuperation period at home.
Some pretty heavy stuff, and a far cry from what we expected back in March when we were thinking that radiation might be the end of treatment, but I'm still positive. In fact, I probably feel more positive today than I have for a couple of weeks. We finally have a diagnosis and a plan now that all the doctors are on and are confident of.
Now, it's game on. I'm ready!