A retired professional baseball player, Don Baylor, was picked to catch the opening pitch for the Angels opening game. When he leaned from his squatting position to catch the ball, his leg broke. It turns out that he suffers from multiple myeloma, and he had to be helped from the field and reportedly underwent surgery.
The Angels manager called it a freak injury, but of course those of us battling know it isn't as uncommon as one would hope.
Forums
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Don Baylor - multiple myeloma in the spotlight
Yes, I read that too and having known he had myeloma I knew this was bad. It's amazing how many articles on the incident make no mention that he has cancer, much less multiple myeloma.
Does anybody know what kind of transplant he had when first diagnosed? I read one article that stated his brother was a perfect match, so Don decided to have an autologous stem cell transplant, using his own stem cells. Huh?
Diagnosed in 2003 and still active in baseball is a great story.
Does myeloma affect bone healing after an injury?
Does anybody know what kind of transplant he had when first diagnosed? I read one article that stated his brother was a perfect match, so Don decided to have an autologous stem cell transplant, using his own stem cells. Huh?
Diagnosed in 2003 and still active in baseball is a great story.
Does myeloma affect bone healing after an injury?
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Stann - Name: Stann
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 9/11/09
- Age at diagnosis: 46
Re: Don Baylor - multiple myeloma in the spotlight
Stann asked: "Does myeloma affect bone healing after an injury?"
I was told that it doesn't, but while the break itself will likely be stronger, the area where it broke is still weak. I suppose it's like a chain. The weakest link breaks and gets repaired, but there is still the second weakest link to contend with.
I was told that it doesn't, but while the break itself will likely be stronger, the area where it broke is still weak. I suppose it's like a chain. The weakest link breaks and gets repaired, but there is still the second weakest link to contend with.
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Wayne K - Name: Wayne
- Who do you know with myeloma?: Myself, my sister who passed in '95
- When were you/they diagnosed?: 03/09
- Age at diagnosis: 70
Re: Don Baylor - multiple myeloma in the spotlight
If a guy can be out coaching professional ball players 11 years after diagnosis, that is great news for the rest of us (and him). If I recall, he was the "most hit batsman" in the league for a few years. That means he's courageous at the plate, so he probably has a great mind for battling this disease.
Since "natural" turf requires 2,4D sprays to keep out the non grasses, I wonder if the rates of myeloma are higher for ball players? Golf included. (Those players should not kiss the ball after nice shots).
Since "natural" turf requires 2,4D sprays to keep out the non grasses, I wonder if the rates of myeloma are higher for ball players? Golf included. (Those players should not kiss the ball after nice shots).
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Stann - Name: Stann
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 9/11/09
- Age at diagnosis: 46
Re: Don Baylor - multiple myeloma in the spotlight
I saw the video. It was VERY SCARY. The leg just collapsed and flapped under him. When he tried to stand on it, it just flapped under him again in an "L" shape.
What does this mean for those who have been living with this disease for several years? Will your bones become so brittle that you can't even walk? Does the deterioration ever stop? There apparently is no warning sign before something like this happens ...
The worst part of this disease is not knowing what is going on after all the tests are done. Did Don Baylor get the Zometa, or Aredia? By now, if he did, his doctors probably stopped it. What kind of treatments did he receive? Not much is ever said about his disease. How can you remain active when you know there is a chance that anything you do might break a bone?
Any hopeful insight would help.
What does this mean for those who have been living with this disease for several years? Will your bones become so brittle that you can't even walk? Does the deterioration ever stop? There apparently is no warning sign before something like this happens ...
The worst part of this disease is not knowing what is going on after all the tests are done. Did Don Baylor get the Zometa, or Aredia? By now, if he did, his doctors probably stopped it. What kind of treatments did he receive? Not much is ever said about his disease. How can you remain active when you know there is a chance that anything you do might break a bone?
Any hopeful insight would help.
Re: Don Baylor - multiple myeloma in the spotlight
It is my understanding that, while the bone damage caused by myeloma can be slowed or stopped by treating the disease to reduce the tumor burden and using bisphosphonates such as Zometa or Aredia, the damage that is already done from myeloma is very slow to heal or does not at all.
When I was reading on this subject last, it was not well understood why this is, as in other diseases that cause bone injury recovery and healing is usually seen. I had also thought that bisphosphonates like Aredia will heal bone damage. but that is not exactly how they work.
In normal healthy bones, old bone tissue is constantly being broken down and recycled into new bone growth and over the course of our lives our skeletons are replaced several times. The cells that break down bone are the osteoclast cells and the cells that grow new bone are the osteoblast cells.
Myeloma accelerates the activity of the osteoclast cells that destroy bone and inhibit the activity of the osteoblast cells that grow new bone, resulting in the bone damage those with myeloma have and the high calcium blood levels often seen from all the broken down bone from osteoclast cell activity that is not being recycled into new bone by the osteoblast cells.
It is my understanding the bisphosphonates work by inhibiting the activity of osteoclast cells that break down bone, slowing or stopping bone destruction, but do not enhance the bone building activity of the osteoblast cells. In a normally healthy person this would result is strengthening of bones because the osteoblast cells would be working to build new bone while the osteoclast cells are being restricted from destroying bone by the bisphosphonate.
But in those with myeloma, for reasons not fully understood, even after tumor burden is significantly reduced, the osteoblast cell activity that builds new bone remains below levels normally seen and bisphosphonates do nothing to help this.
From all of this my understanding is that someone like Don Baylor could be in long term remission and being treated with bisphosphonates for years but still have the bone damage from earlier years that would cause his leg to fracture. Then again maybe he is not in remission and had a big tumor in his leg.
I know a lot of Beacon readers do know a lot about this so if I have any of this wrong please let us know.
When I was reading on this subject last, it was not well understood why this is, as in other diseases that cause bone injury recovery and healing is usually seen. I had also thought that bisphosphonates like Aredia will heal bone damage. but that is not exactly how they work.
In normal healthy bones, old bone tissue is constantly being broken down and recycled into new bone growth and over the course of our lives our skeletons are replaced several times. The cells that break down bone are the osteoclast cells and the cells that grow new bone are the osteoblast cells.
Myeloma accelerates the activity of the osteoclast cells that destroy bone and inhibit the activity of the osteoblast cells that grow new bone, resulting in the bone damage those with myeloma have and the high calcium blood levels often seen from all the broken down bone from osteoclast cell activity that is not being recycled into new bone by the osteoblast cells.
It is my understanding the bisphosphonates work by inhibiting the activity of osteoclast cells that break down bone, slowing or stopping bone destruction, but do not enhance the bone building activity of the osteoblast cells. In a normally healthy person this would result is strengthening of bones because the osteoblast cells would be working to build new bone while the osteoclast cells are being restricted from destroying bone by the bisphosphonate.
But in those with myeloma, for reasons not fully understood, even after tumor burden is significantly reduced, the osteoblast cell activity that builds new bone remains below levels normally seen and bisphosphonates do nothing to help this.
From all of this my understanding is that someone like Don Baylor could be in long term remission and being treated with bisphosphonates for years but still have the bone damage from earlier years that would cause his leg to fracture. Then again maybe he is not in remission and had a big tumor in his leg.
I know a lot of Beacon readers do know a lot about this so if I have any of this wrong please let us know.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Don Baylor - multiple myeloma in the spotlight
Eric's explanation is accurate as to the turnover of bone needed to maintain bone strength; However it is the osteoclasts that break the bone down and are blocked by bisphophonates and osteoblasts build the bone up. [Moderator: This error in Eric's posting has been corrected.]
When the osteoclasts are blocked by bisphosphonates (in some cases are wiped out and absent in bone samples), there is no new bone formation and the bone can be dense but brittle. With Don Baylor's femoral fracture, we don't know the history; there could have been a large lytic lesion from active myeloma that fractured through, but as well there is a rare complication of long term bisphosphonate use that causes an atypical stress fracture of the femur.
The largest pool of these patients are post menopausal women but it occurs in myeloma patients as well and whose bisphosponates, Zometa and Aredia, are more potent than those used by postmenopausal women and bind to the bone for longer periods, increasing the risk of this complication.
When the osteoclasts are blocked by bisphosphonates (in some cases are wiped out and absent in bone samples), there is no new bone formation and the bone can be dense but brittle. With Don Baylor's femoral fracture, we don't know the history; there could have been a large lytic lesion from active myeloma that fractured through, but as well there is a rare complication of long term bisphosphonate use that causes an atypical stress fracture of the femur.
The largest pool of these patients are post menopausal women but it occurs in myeloma patients as well and whose bisphosponates, Zometa and Aredia, are more potent than those used by postmenopausal women and bind to the bone for longer periods, increasing the risk of this complication.
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bond007
Re: Don Baylor - multiple myeloma in the spotlight
Those interested in this discussion may want to check out the following article:
"Revlimid-Dexamethasone Has Mixed Effects On Bone Disease In Relapsed/Refractory Multiple Myeloma"
It has somewhat simplified information on the process that Eric described in his post and also discusses how certain myeloma treatments (Revlimid and Velcade) do or do not affect myeloma bone disease.
By the way, a mnemonic that we've found helpful for remembering the difference between osteoblasts and osteoclasts is:
osteoBlasts = bone Building
osteoClasts = bone destruCtion.
"Revlimid-Dexamethasone Has Mixed Effects On Bone Disease In Relapsed/Refractory Multiple Myeloma"
It has somewhat simplified information on the process that Eric described in his post and also discusses how certain myeloma treatments (Revlimid and Velcade) do or do not affect myeloma bone disease.
By the way, a mnemonic that we've found helpful for remembering the difference between osteoblasts and osteoclasts is:
osteoBlasts = bone Building
osteoClasts = bone destruCtion.
Re: Don Baylor - multiple myeloma in the spotlight
Thanks everyone for clearing things up in my post and for the mnemonic for remembering which cells bring down bone and which build up bone.
bond007 makes a good point about the dosage of Aredia and Zometa given to myeloma patients being far higher than what is given to late middle age women for postmenopausal women. I did not know this until just last year when I read about it here on the Beacon.
When I talked to my dentist about Aredia use and the risk of osteoporosis jaw bone loss, he mentioned that the risk is higher for those receiving bisphosphonates by infusion. I told him that, to the best of my knowledge, all myeloma patients receive bisphosphonates by infusion, typically monthly during induction therapy and, for many, about every three months thereafter for an indefinite period of time.
He appreciated knowing that -- it is an important piece of information for him to know when doing treatments that my risk is atypically higher. He also mentioned that he had read somewhere that it was believed osteoporosis jaw bone loss from bisphosphonate use was caused by the bone density increasing in the jaw, as bond007 described, to the point where it restricts blood flow in the jaw bone, resulting in death of bone tissue.
bond007 makes a good point about the dosage of Aredia and Zometa given to myeloma patients being far higher than what is given to late middle age women for postmenopausal women. I did not know this until just last year when I read about it here on the Beacon.
When I talked to my dentist about Aredia use and the risk of osteoporosis jaw bone loss, he mentioned that the risk is higher for those receiving bisphosphonates by infusion. I told him that, to the best of my knowledge, all myeloma patients receive bisphosphonates by infusion, typically monthly during induction therapy and, for many, about every three months thereafter for an indefinite period of time.
He appreciated knowing that -- it is an important piece of information for him to know when doing treatments that my risk is atypically higher. He also mentioned that he had read somewhere that it was believed osteoporosis jaw bone loss from bisphosphonate use was caused by the bone density increasing in the jaw, as bond007 described, to the point where it restricts blood flow in the jaw bone, resulting in death of bone tissue.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Don Baylor - multiple myeloma in the spotlight
Hi everyone - If you google up the topic, 'stress fractures and bisphosphonates', many articles appear, since sheer fractures have been known to occur in osteoporotic patients who have been taking alendronate (Fosamax). I would just assume that men may also be taking alendronate, since osteoporosis crosses genders.
Hope that helps! Fosamax is taken orally, and is lesser in strength to Aredia or Zometa.
Hope that helps! Fosamax is taken orally, and is lesser in strength to Aredia or Zometa.
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Nancy Shamanna - Name: Nancy Shamanna
- Who do you know with myeloma?: Self and others too
- When were you/they diagnosed?: July 2009
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