I am lying in a windowless room with dark red blood dripping steadily into my body. I do not want to be here. Yet here I am. Once again I feel that I’m travel­ing backwards in time. Six years ago, I was diagnosed with multiple myeloma after having severe anemia. Right before and after my stem cell trans­plant, I received multiple infusions of packed red blood cells and platelets. That time remains a blur for me. Time travel can be.

Yet in the five years since my transplant, I have not needed any blood trans­fusions. Although I did relapse at the predicted two-year mark, I have been without clinical symptoms. The IgA level would rise, plus the dreaded M-spike would appear in my blood tests. Then the myeloma team knew it was time to change treatments. The decision to change treatment pro­to­cols was made based on my lab numbers, not symptoms. I only felt sick because of the treatment, not be­cause of the cancer. I have now been through five lines of treatment, and all have worked for a while.

This summer, however, I have experienced significant changes in my multiple myeloma journey. I now have real symptoms. As I described in my July ^[1] column, the disease is crowding out the cells in my bone marrow that produce red blood cells, platelets, and white blood cells. I am anemic, covered with bruises, and very immunocompromised.

So here I am, lying in a windowless room with dark red blood dripping steadily into my body. I received two units of packed red blood cells to be exact. My hemoglobin was dangerously low, and I was becoming short of breath with minimal exertion. Usually I would receive the transfusion in the cancer center, but the decision was made quickly and the regular infusion spaces were full. The room I’m in is really just a regular exam room pushed into service.

This was the first of three blood infusions I have received so far this summer.

The first one was traumatic, because I realized I was getting sicker. I coped by reading and using various visualization techniques. Over the next few days following the transfusion, I experienced more energy and less shortness of breath. I could resume my training of swimming, biking, and walking. Maybe the blood was a gift.

I needed a second blood transfusion just a month later. This time I had noticed I couldn’t even walk two miles without stopping every few minutes to take a breath. And I really wanted to complete a 5K run one week later. It was a tradition for my team and a tradition for me. So I asked the health care team to check my hemoglobin. Sure enough, the hemoglobin had dropped again; not as low as last time, but definitely low enough to cause my symptoms.

At first I was really discouraged. A second blood transfusion in a month? What does this mean? The oncol­o­gist and the pharmacist reminded me that the Empliciti ^[2] (elotuzumab) I was receiving is a targeted immu­no­ther­apy. Since the drug utilizes my own immune system, it might require more time to work. My IgA was dropping, but not dramatically.

This time for the infusion I got a room with a window, and I had a better attitude. One week later, I completed the 5k run with another cancer survivor. We were dead last. We decided that a better description would be last, but alive and walking. This time I did view the blood as a gift.

My third blood transfusion was just last week. This time I mastered the decision. Once again, my hemoglobin was dropping, platelets were really low, and I was immuno­compro­mised with a low white blood count. I was covered in bruises, and barely able to slog through my workouts. I had trained slowly but steadily all summer to complete a sprint triathlon on August 7.

Before you think I am crazy, let me review this particular race. This is the race in which, six years ago, I was able to sense something was wrong with me. I believe this race helped save my life. This is the race that I have trained for with my triathlon team all summer. This is the team I have been part of for 15 summers.

This year, 55 women traveled to Denver to complete this race. Twenty five of them had never completed a triathlon. Within the team, there are many examples of courage in the midst of life challenges. There are seven cancer survivors, three of us are currently in treatment. I learned that two young women have diabetes; each need to check their blood sugar when they complete the swim, bike, and at the end. Several could barely swim, and had to conquer the fear of open water. The laughter, the courage, the comradery of this group fill me up with hope.

And last but not least, a major portion of the proceeds from the race go toward breast and ovarian cancer prevention and education. 

This race is a yearly gift for me.

So my oncologist timed the blood transfusion a week early. We moved the Empliciti transfusion to the Monday after the race, instead of the Wednesday before. I skipped two nights of Revlimid, so nausea and diarrhea would not interfere with the race. This time I knew the blood was a gift.

The race itself was a gift as well. A gift of joy. Every woman completed the triathlon.

At the dinner before the event, the coach gave a speech building on the Olympics. How we had already earned a gold medal by facing challenges of parenting, health issues, work, and even money to be here this weekend. I shared a poem, using the green and purple butterflies on our uniforms as symbols of hope and courage.

The next morning, before sunrise, we biked two miles in single file to the venue. The sun rising over the water was a sight of immeasurable beauty. I savored each moment, letting go of any time goals. I knew this might be my last triathlon.

The day was cloudy and breezy, perfect for a triathlon. I did successfully complete the half-mile swim, 12-mile bike ride, and 3.1-mile run/walk.

Joy awaited me at the finish line. I am not just a cancer patient, I am also a triathlete.