It seems that one of the most common (and reviled) topics in the Beacon's columns and forums is dexa­meth­a­sone and its side effects.

For most of the 15 cycles I've been receiving treat­ment, I haven't had much in the way of side effects related to the dexamethasone ^[1] (Decadron).  I certainly haven't experienced some of the significant issues that a lot of others have.

Recently however, the effects have been getting more noticeable.

Still, I hadn't planned on using it as a subject for a column, but as fate would have it, I had a "dex" night fol­low­ing treat­ment last week.

I was fairly exhausted and fell asleep by about 10 p.m., then woke up shortly after midnight with my mind in overdrive.  I ended up getting out my computer and put in over four hours of work.

In addi­tion to the work, I also went on several mental side trips, including coming up with the fol­low­ing story.  I think it reflects, in a somewhat twisted sense, how unpredictable and absurd our lives can get as we deal with treating our disease and the asso­ci­ated side effects.

I don't want this to be another dex rant, so I hope everybody takes it for the tongue-in-cheek analogy of my changing dexa­meth­a­sone world that it's meant to be.

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Who knows when this war first started.

I expect sleeper cells were in place long before there was evidence the enemy had invaded my homeland, though I can only guess at how long the cells festered before revealing themselves.

Once the war was engaged, however, I could see that it was going to be a fight to the death, that it would be fought on several fronts, and that it could go on for a long time.

I had several options available to try and combat the enemy's first incursion, and I chose what I hoped would provide the best counterassault - one that would provide an effective, decisive response and force the enemy back for some time.

I ended up going with a tactical insurgence team and recruited agent C, agent R, and agent D, more commonly known as team CRD (sort of like recruiting the Men in Black).^{† [2]}

Agent D had been around for some time and had taken on this enemy many times before, whereas agent R had only some recent experience, and agent C was basically a newcomer.

To date, the team has more than met my expectations, and it looks like they have the enemy on the run for now.  However, recent devel­op­ments made me question the loyalty of the team and I wondered whether one or more of the agents may have their own agenda.

I originally thought the issue might be with one of the newer agents, but evidence suggests it's most likely agent D, because some weeks I utilize the entire CRD team, other weeks agent R and D, and once a month just agent D, yet the issues occur every week.

There's been nothing outright insubordinate in agent D's actions and he's still doing his job, but he seems to be getting more difficult to deal with and our rela­tion­ship recently has been more strained.

I find myself getting more irritable after dealing with agent D and can pretty much count on losing my voice for a day or two after meeting with him.

He also has a knack for getting my heart rate up, and my face gets flushed to the point it looks like I was on an all-night drinking binge.

It's even to the point now where I'm losing sleep over the situation and stay awake for hours after our mission briefings.

I suppose I shouldn't be surprised with these devel­op­ments since I had heard rumors of others having similar issues with agent D.  I guess I may have been a bit too overconfident though, thinking I was immune to his maneuverings or could keep him under control. I'll just have to hope that things don't get worse.

And if that's not trouble enough, I'm now also hearing concerns that agent R may have been compromised.  It appears there's evidence to suggest that, although he may be effective fighting the enemy, secondary assault teams are crossing the borders to the homeland in his wake - but that's a story for another time.

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Peace, and live for a cure.

carfilzomib ^[3] (Kyprolis ^[4]), Revlimid ^[5] (lena­lido­mide), and dexa­meth­a­sone.