It’s summer here in Calgary, and sunshine and showers are alter­nat­ing. Everything is green, and the gardens are a joy to behold. It’s not too warm; in fact, our daytime high tem­per­a­tures on the colder days have been only 52 degrees Fahrenheit (11 degrees Celsius).

This is good weather for walking, and my husband and I got out cycling on Canada Day, July 1. We went along the Bow River path­way for a few miles, and really enjoyed seeing nature there. We saw ospreys in a nest on a plat­form, geese and ducks paddling on the river, and gulls circling on thermal wind drafts. What a lovely way to get some exercise!

This month is full of birthdays and anniversaries in our family. It is the busiest month of the year that way. My husband and I are celebrating our 42nd anniversary this month. I cannot forget, how­ever, July of 2009, when my whole world crashed down around me and I spent that month and August mostly indoors, recovering from back fractures, and starting treat­ments for multiple myeloma. To be a whole decade on from that summer seems like a miracle to me now!

If I could back up a little to the months preceding my diag­nosis, some strange things were hap­pen­ing to me that I did not under­stand. Being diag­nosed in 2008 for osteopenia at the rel­a­tive­ly young age of 57, and taking a low level of the bis­phos­pho­nate Fosamax (alendronate) for that, was my first indi­ca­tion that I wasn’t very healthy. Then, aches and pains in my ribs and back intensified, and I had low back pain that would not im­prove with analgesics or muscle relaxants. Eventually my vertebrae started to compress.

I remember marching in a parade, playing bagpipes, in early June when I felt some­thing give away in my mid back area. Then, as the month wore on, pain got worse in my lower back. My family doctor did not put the facts together to sus­pect multiple myeloma. She was very conscientious in testing me for other cancers, such as breast, colon, and mel­anoma, though. It was through having a general check up that we discovered the osteopenia, so I was on some early treat­ment against bone damage.

Eventually, over the July 1 to July 4 long weekend in 2009, I just collapsed in terrible pain and could not get up on my own. This of course set off alarm bells as to what was the matter with me. My husband, a family doctor, and one of my daughters, a medical student, tried to help me. My daughter exclaimed in a Eureka moment: "There are some blood tests that Mom needs to have!" She had been studying bone health at medical school and recog­nized that this could be multiple myeloma. So we rushed to get those tests done and get an appoint­ment with a hematologist. Sure enough, it was multiple myeloma, and my new oncologist im­medi­ately started me on a dif­fer­en­t bis­phos­pho­nate treat­ment, Aredia (pamidronate), after con­firming the diag­nosis with skeletal X-rays and a bone marrow biopsy. I was scheduled to start induction ther­apy in August.

I was confused and depressed about this turn of events. At that time, from everything we read, the prognosis for multiple myeloma was quite poor; survival seemed to be measured in months, not years. My family and friends rallied around me and did their best to cheer me up.

In the autumn of that year, I had four cycles of Velcade (bor­tez­o­mib) plus dexa­meth­a­sone. I struggled with side effects from the treat­ments; I ex­peri­enced sleep deprivation, gastro­in­tes­ti­nal problems, and changes in appetite at that time. Gradually I realized that if the drugs I was taking were strong enough to kill the myeloma cancer cells, then they could have strong side effects also. After that, with all of my sub­se­quent treat­ments, I braced myself for side effects and came to accept them as part of my cancer journey.

Later in the fall, I was prepared to receive an au­tol­o­gous stem cell trans­plant. I was scared and it took all my courage to sign on for that. I could barely imagine having my bone marrow destroyed and then re-populated with my own stem cells. However, it was a highly rec­om­mended pro­ce­dure, and many patients went through with it, so eventually I decided to do it. The stem cell harvest went well, although I lost my hair from the cyclophosphamide and also suffered pain in my bones as the medications to boost stem cell pro­duc­tion took hold. A day in the apheresis unit yielded enough stem cells for two trans­plants, although I have only had one.

In Jan­u­ary­ 2010, after a break for Christmas (when I sported my new wig!), I had the trans­plant. My stem cells, which had been frozen in liquid nitrogen, were thawed and reinfused through the catheter in my chest. Comparing my trans­plant ex­peri­ence with those of other patients, I think mine was average. I was neither so ill that I stayed in the hos­pi­tal for a long time, or so well that I had no problems. The main problem I had was diarrhea that was so severe I was put in an isolation ward in the hos­pi­tal for two days to be tested for a em>C. difficile in­fec­tion. Fortunately, that turned out to be neg­a­tive, and the problem was thought to be a side effect of the Neupogen used to boost my blood counts right after the trans­plant.

I recovered after three months, and 100 days post trans­plant, my catheter was removed. Since I was still not in a com­plete remission, I took Revlimid (lena­lido­mide) at a low dose for about a year after that, which put me into a com­plete remission.

From 2011 to early 2014, I didn’t take any myeloma medications. It was a carefree time for me and my husband, full of activities and adventures.

In the spring of 2014, I started to relapse, slowly but surely. In Octo­ber 2014, I started treat­ment again, on the highest dose of Revlimid (25 mg), in com­bi­na­tion with 20 mg of dexa­meth­a­sone per week. I was more careful this time to try to control the side effects of those drugs. I responded well to the treat­ment, and once again I got very close to a com­plete remission.

In the meanwhile, I con­tinued to have annual checkups with my family physician. In 2016, I had a feeling that I should have an annual mammogram, not a bi-annual one, since studies showed that there is a higher than average rate of cancer caused by taking Revlimid. My doctor kindly obliged me, and the mammogram showed signs of breast cancer. Since I would now be treated for this sec­ond­ary cancer with surgery and radi­a­tion, my oncologist suggested I go off of myeloma treat­ments for the time being. This proved wise, since the treat­ments for the breast cancer were quite intense.

To my surprise, the myeloma did not come back quickly. It was not until last fall, No­vem­ber 2018, that my M-spike started to in­crease, although at a slow pace. So, once again, I started treat­ment with Revlimid and dex at a low level (10 mg of Revlimid, 21 days out of 28, plus 10 mg of dex weekly). I wasn’t really very happy with this devel­op­ment, but it shows how dif­fi­cult it is to com­pletely shake off myeloma. I stayed on with that treat­ment until Jan­u­ary­ of this year. After discussions with my doctors, I decided to try going off treat­ment again. When and if I fully relapse, I may be able to try one of the new myeloma drugs that have recently been funded here. Just to be safe, I am checked monthly, in case the myeloma starts to really take off on me again.

Right now, I am in a hiatus, another break in the seemingly unending treat­ments for myeloma. To have had this six months off of treat­ment has given me a chance to regain my energy. Over the last ten years, I have been off of treat­ments about half of the time, and I am very grateful for that.

I also am grateful, of course, for the treat­ments I have received that have made it possible for me to be here ten years after my diag­nosis.

It seems I have plenty to celebrate this month.

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The quotation for this month is from Lil Xan (1996 - ), American rapper, singer, and songwriter, who said: "It gets better: there's a light at the end of the tunnel. It may take one day, it may take ten years. But one day, you will find happiness if you manifest it. Put that energy out, and it'll come back."