Big Sis In Burgundy: A Four-Month Report On Deana’s Multiple Myeloma

August 27 marked the four-month anniversary of my sister Deana’s diagnosis.
Our lives are forever changed. We are still seeking the “new normal,” although I’m sure we won’t be able to define that until Deana is in remission. So for now, we take each day as it comes. I wouldn’t define it as the “abnormal,” but rather, the fight: Beat The H*ll Outta Multiple Myeloma, as our slogan goes.
I spent last weekend in Pittsburgh so that I could join Deana for her appointment with her oncologist on Monday. It is always so good to be with my family, the ones who know me best and love me for who I am.
When I arrived, my mother shared an autobiography written by Deana’s 8-year old daughter, Clare. (Some of you may remember the escapades of Clare and Aunt Debbie, chronicled in my last article, “Out Of The Mouths Of Babes.”) Clare started with the basics, “My name is Clare, I am 8 years old and I live in Pennsylvania.” As I continued reading, I got choked up, “My mom has cansur. It is called multiple mieloma and it is a blood cansur.” She quickly moved on, “I have two brothers….”
As I shared in my last article, I’m glad Clare can incorporate her mother’s illness so easily into her life. But, I still wish that her sweet little story didn’t have to include something so insidious. Let’s all continue to fight and bring about a cure for multiple myeloma, for all the obvious reasons.
When we went to Deana’s appointment on Monday, I was armed with our notebook (see my article “The Battle Plan…Or Is It” for more details.) Our youngest sister, Darrie and I spent several hours on Sunday evening organizing the information and updating the various charts.
I tenderly chastised Deana as we drove to the hospital that she must do a better job of record keeping in the notebook. She responded that she does not see the purpose and asked what we’d do with this – for example, a year from now, would we look back and remind ourselves how awful she felt on a particular day? It seems that though her training as an architect means she possesses terrific attention to detail, in her opinion, her multiple myeloma battle minutiae are not worth chronicling.
Prior to her appointment, we enjoyed a delicious lunch at a charming restaurant and then we went to the hospital’s wig shop and tried on a few styles. We had a bit of fun with this and put a blonde wig on Deana, which didn’t suit her coloring, so she’ll be staying with brunette styles. I’m glad we made some progress in this area while she still has her hair. Of course, like several other experiences we’ve had on the journey so far, it feels surreal to be watching my 39-year old sister try on wigs because she’ll soon lose her hair as a result of chemotherapy. Is this really my life?
Deana’s dietician visited with us first, following an email request I made last week that she provide us with some simple documents featuring good meal options. It is my guess that many of you have also been faced with the overwhelming amount of information covering every facet of living with multiple myeloma. While the voluminous nutrition information is interesting to read when time allows, it is a lot to sift through. It will prove easiest for Deana (and our terrific mother, who handles a fair amount of meal preparation) to have a few sheets of paper to work with. Although Deana was eating well before, I’m glad that we now have a week’s worth of the best choices for each meal.
Next, we had a brief visit with the social worker. It is my assumption that protocol dictates she must check in. My interactions with her will make for a wonderful column at a later date.
Then, the man we’d been waiting for! Dr. Agha arrived, and Deana reported her neuropathy (pain and tingling in the extremities) was really bad. He decided he’d take her off the Velcade (bortezomib) and ordered a bone marrow biopsy (BMB) for Wednesday.
Deana was quite unhappy for a number of reasons, perhaps the greatest was her dread of the BMB. The one she had while in the hospital was extremely painful. I asked if there was any way it could be done while I was there, so I could hold her hand and coach her through it, but alas, it was too late in the day.
I did a lot of advance work on Tuesday, emailing the social worker and nurse, along with a phone call to Darrie, to let all parties know that if Deana was feeling anxious, she should be given something to calm her. She said they gave her some Ativan (lorazepam)…and it felt good. Her BMB went well, and while this is never a test she’ll look forward to, at least she knows that it doesn’t have to involve pain that defies description.
Through our conversation with Dr. Agha, he learned that Deana’s activity level has been virtually non-existent. Once this was revealed to him, he shared that several of Deana’s challenges (shortness of breath and lightheadedness) may very well be a result of deconditioning. After all, she was training for the Pittsburgh Half Marathon during the winter and early spring and she was lifting a 30 lb. two-year old multiple times a day, which counts as strength training. I wasn’t trying to snitch, but I am thankful that the doctor emphasized the importance of her getting some exercise each day.
It is never easy to be dropped at the airport. I’m torn. I have a very full life in Athens, Georgia, with a wonderful husband, three dogs, and a job I love. I’m still trying to assimilate the multiple myeloma journey into all of that. It is a challenge to be so far away from the rest of the family, to not be able to drive over quickly for a hug or a meal or whatever might be needed. It is hard to watch my mother sacrifice so much of herself and her life and not be able to take some of that burden away from her, a woman who has already endured far too much in her life.
(It occurred to me recently that my mother was my age when my father had his heart attack and emergency triple bypass surgery. We nearly lost him after hours of failed angioplasty. When she got home from the hospital that night, we cried in each other’s arms for a long time. How is it that I am now that age? My father died six years later. Has my mother not been tested enough?)
For now, we await the BMB results to see what’s next. Do we continue with the current chemo cocktail Revlimid (lenalidomide), Velcade, and dexamethasone (Decadron), or do we move on to cyclophosphamide (Cytoxan) and one step closer to transplant?
We also remain thankful for another day and the many blessings we have, including the wonderful support network that is a critical part of helping us to Beat The H*ll Outta Multiple Myeloma!
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Dear Deborah: Did you ever question Dr. Agha's decision to take your sister totally off Velcade? How about simply decreasing the dose? Evidence is mounting that the MM community does not know the best dose of Velcade to use for an individual patient. I hate to see your sister being treated as a lab experiment. Gary
On the west coast my wife was administered the Velcade via injection into the stomache muscle. We were told they had much less of the painful tingling reactions doing it by this method. Over the months of injections, which are much much quicker than infusions, she has had zero reations. Nurses administering noted she was one of the first this was tried with.
Hi Deborah,
My husband was diagnosed in February of this year. He is 45 and I noticed your sister is only 39. Just curious, did Dr. Agha have anything to say about the fact that the normal patient is in their 60s and older? Considering their age and health as an advantage, I definitely recommend the most aggressive treatment for your sister as it is working for my husband. He was on the "cocktail" Velcade/Cytoxan/Dex for 4 cycles. He is now 7 weeks out from his first autologous stem cell transplant and scheduled for the second in mid October. He is currently in remission and we are hopeful that by doing the second transplant, he will get an additional 10-15 years before MM rears its ugly head again! Thanks for your article, I can definitely relate.
Take care,
Patti
My sister was diagnosed when her son was just 1 years old, she is now in her 21rst year of survival. We all believe that her sucess in fighting this cancer is her attitude; she just doesn't let it run her life. We will pray for all of you and keep fighting!
Sharon
Thank you for sharing, Debbie. Your love, presence and encouragement to Deana is so important to her mentally and her ability to beat this disease. You will always be one of my favorite people for the person that you are. We are praying and cheering for Deana.
I'm with Gary! I think myeloma docs are too quick to stop using Velcade due to neuropathy or other issues. Keep taking that notebook along and asking questions! And as you learn more, don't be afraid to hit the doc over the head with your notebook to get his or her attention! Best of luck- Pat
Well, I have had just the opposite experience with Velcacde. My doctor will decrease the dosage, but never cut it out all together because of neuropathy. I have been off Velcade for a couple months now(not because of my feet, but because I was doing very well), and my hands and feet and beginning to feel better. If you are not sure about something-by all means ask.
Your sister should have the option of anesthesia for the bone marrow biopsy. My husband didn't have it for his first BMB, but did elect to have it for both of his last 2 BMB. I pretty much told him that going through that pain was not necessary.
Remember your patient. Chronicling details may not be what she needs to do. A very small part of that will be of importance to the doctor. Over time you sort out the battles to wage. Keeping her as stress free as possible in every aspect is of paramount importance to her mental and spiritual well being. My observation is that some folks want to know everything and some simply don't. Rarely is it both (the caregiver AND the patient). So my unsolicited advice is you keep whatever logs, journals and details you want and just check in with her and make notes about your observations or ask her a few questions from time to time. You'll find out more when the doc asks and she answers. In the meantime, make it safe for her to tell you of any dramatic changes so you can inquire if its typical, normal, or anything can be done. Otherwise, just be there for her. Watch a movie and eat popcorn! Its a long, rough road. I remember I was keeping track of Dave's meds in "my way" and he was so stressed about keeping it all straight, and it was causing him such turmoil that I simply did it his way to keep him calm and confident.
BMB can be easy or hard. It often depends on whose doing it.
Every good facility should and does avail you of a SW and it's an excellent sign to me that you were visited by one without asking, which is rarely the case, though it seems to be improving. They are your sister's advocate in the treatment setting and will help you all to negotiate things.
You're a wonderful sister! She is so lucky to have you in her corner.
Hi Deborah, I put off my BMB for a year due to fear (also delayed diagnosis as I had 70% cancer in my marrow). My oncologist said he was very good and if done correctly it would be pain free. He was correct. He got me through induction and ready for SCT. He moved to CA and we keep in touch. He suggested I have Chris at Hillman do my BMB as he trained my dr. I have had 6 or 7 now and am due again in Nov. So far so good and I am hoping for pain free with a good result. Linda
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