It is gray and windy here, and the sun rises late. The weather nevertheless is still fine for me to go on walks, sometimes accompanied by my grandpuppy. I have had lots to mull over on these walks the past month, since much has happened to me medically speaking.

As you may remember from my last column ^[1], I was diagnosed with ductal car­ci­noma in situ (DCIS) that required surgery. My choices were either breast-conserving surgery plus radiation, or a total mastectomy on one side. Since the first option is said to have outcomes that are just as good as the second, and it is less stressful, I opted for it.

The surgery took place just two weeks before Canadian Thanksgiving. I am grateful to be able to say that the procedure went well, and luckily no myeloma cancer cells were detected during the surgery. It was com­pleted as a day procedure. I was allowed to go home that same day since I had no complications from the anesthesia or other issues, and I had a quick recovery. I was back on my feet and walking around again the following day.

However, the pathology report after the surgery showed some cancer cells outside the ducts. So in order to determine whether the cancer had spread beyond the tissue already removed, I had lymphatic mapping with a sentinel node biopsy at the end of October. This procedure would show if the cancer was spreading into the lymphatic system. If it had, more lymph nodes would have to be removed.

I had general anesthesia again for this procedure, and was really tired afterwards. I also was in some pain from the surgery.

As it turned out, the pathology report from this procedure states that no cancerous cells were found in the sentinel nodes, so I will now be referred to a medical oncologist to discuss further treatment.

I also had an MRI at the beginning of November to determine whether there were more cancerous areas in my breast. I had never had an MRI before and was very apprehensive about having one. My concerns were unwarranted. The procedure only took about 30 minutes, I was not uncomfortable, and I did not feel claus­tro­phobic in the large machine.

The MRI results showed no malignancy in the left breast, but a nodule was noted on the right side. So a repeat ultrasound was recommended to confirm the findings.

I’m currently also in between myeloma treatments.

My hematological oncologist stopped my Revlimid ^[2] (lenalidomide) and dexamethasone ^[3] (Decadron) treat­ments for three months before my surgery to make everything a little easier for me. I think it also made it less complicated for the surgeon. I wouldn’t have so much of a risk of being at a low immune status during surgery. I also stopped taking low-dose aspirin, which I needed to take with the Revlimid to prevent blood clots, since the aspirin could have caused undue bleeding during surgery.

So, rather unexpectedly, I am on a drug holiday this autumn.

While taking my treatments, my M-spike decreased to 0.1 g/dL (1.0 g/L), and all of my other blood counts were normal. I’m hoping that my drug holiday won’t affect my myeloma blood counts too much. My doctor is keeping an eye on the counts, though, which is reassuring to me. I am still getting my usual blood tests done on a monthly basis, including the serum electrophoresis and serum free light chain tests.

After two months of being off treatment, I feel pretty good, although the first couple of weeks were a little rough.

When I stopped taking dexamethasone, I had shaking in my hands and was very, very tired. The dex cer­tainly jazzed me up, and I had gotten used to that. I also felt a bit feverish, but it was not serious.

Lately I have felt more aches and pains in the hips and legs. I have also noticed that if I walk more than about 5 kilometers (3 miles) a day, I am more stiff and tired than I was when taking dex. It occurred to me that the dexamethasone might have been masking those pains and stiffness since it is an anti-inflammatory drug. However, on the bright side of things, I am not having to deal with the mood swings and other side effects of the drug that I described in my September column ^[4].

Stopping Revlimid has allowed my gastrointestinal system to get back close to normal again. I was getting stomach cramps and diarrhea while on the Revlimid. Especially in the third week on the medication, the side effects were pretty bad. I tried to manage the gastrointestinal upsets with drugs such as Imodium (loper­a­mide), with variable results. I really looked forward to the fourth week, when I was not taking the drug, to recover.

I would also get muscle cramps in my hands and feet sometimes. I’m grateful that I have not experienced any since coming off treatment.

Stopping low-dose aspirin has decreased the easy bruising I was experiencing. It is nice that my bruises have healed now.

I was really pleased to find out that after five weeks off of Revlimid and dex, all of my blood counts were in the normal range, and my M-spike had actually decreased to an undetectable level. I really hope it stays that way because what I am going through with my new diagnosis is enough to deal with right now.

───────────────── ♦ ─────────────────

The quotation for this month is from Nancy Levin (1965 - ), an American author and life coach, who said: "Honor the space between no longer and not yet."