Last month, I wrote about undergoing radiation therapy on both hips. I thought this month I would pass along how I’m doing in other ways.

First, the numbers.  My doublet therapy of Pomalyst ^[1] (pomalidomide; Imnovid) and dexamethasone ^[2] (Decadron) has now held my M-spike steady for two full months. The problem is that, even though my M-spike hovers around 0.6 g/dL (6 g/L), I get the distinct, painful feeling that lesions are continuing to develop and get worse.

The radiation did make the pain go away on my right hip. However, it has returned on my left. I believe that my insurance will pay for an additional five treatments at this point, and I may take them up on it.

After four months of Pomalyst therapy, I’m disappointed to report that I’ve become neutropenic. My absolute neutrophil count has dropped to 0.93. That’s not dangerously low, but I’m always concerned that low counts could someday prevent me from continuing the therapy, which is the only thing that’s keeping me alive at this point.

Fortunately, next week is my off week.  And, so far, my counts have shown the ability to recover.

On a more positive note, my peripheral neuropathy has improved on Pomalyst. Although I continue to drop things and have trouble writing, the tingling and other uncomfortable side effects are significantly less now.

Of course, taking oxycodone for my bone pain – and a well-thought-out and practiced preventative supple­ment and gabapentin (Neurontin) regimen – help mask any neuropathy that is still there.

My myeloma specialist on the Gulf Coast and my new specialist here at the Mayo Clinic are investigating the possibility that I’ve become a non-secretor, which means that my myeloma cells produce very little or no monoclonal protein.

If that's the case, my M-spike would no longer be an accurate indicator for what my myeloma is doing. It also would mean that using PET scans to track my bone lesions may be a better way of monitoring my disease.

My insurance will only approve a PET scan every four months, but that should be often enough. My next scan is a month away.

At my urging, my doctor here suggested we start investigating the possibility of my undergoing an allogeneic (donor) stem cell transplant. Ironically, my sometimes difficult insurance company preliminarily approved the gigantic expense of a transplant, including six months before and a full year after the procedure.

My former specialist, who heads up Moffitt Cancer Center’s transplant unit, is not enthusiastic about this option. My new specialist is open to it, but if we decide to go for it, he would like me to do one within a clinical trial. I don’t have a matching donor yet, but statistics say that it’s likely I will find one within a reasonable time frame.

Even though we know that an allo is a possibility for me, it’s a long shot at best. My wife, Pattie, is strongly opposed to it. Still, it’s good to know that the option is there, if necessary.

And, finally, I saw a new primary care physician this week. I selected him because I knew he was into com­ple­mentary medicine. We hadn’t met before, but he was just what I expected: laid-back, beard, socks, and sandals. And, yes, he was wearing an appropriate, white lab coat.

He kindly spent almost 45 minutes taking my medical history and making suggestions. One was to begin meditating.  As a matter of fact, he prescribed it to me: twice a day for at least 20 minutes at a time. He sug­gested I pick a mantra, something I repeat over and over in my head during the sessions.

It wasn’t difficult for me to find one. “It’s about the journey.”  It’s a bit too long, but the message is a real one for me: slow down and appreciate each moment, each day. So I shortened it to “the journey.” I like to med­i­tate while I swim. I get lost in laps, feeling weightless. While swimming, I found “journey” works best. So “journey” it is!

Back to the big picture. Questions about my future therapy remain. If my next PET scan shows any additional myeloma hot spots, the plan is to add at least one additional drug to Pomalyst and dex.

But for now, it’s all about the journey.

Feel good and keep smiling!