Several months have gone by since I last wrote about my current myeloma treat­ment regi­men con­sist­ing of Darzalex (dara­tu­mu­mab), Revlimid (lena­lido­mide), and dexa­meth­a­sone.

As you may remember from my last treat­ment update ^[1], my Darzalex in­fusions were scheduled to be admin­istered once a week for eight treat­ments, then once every two weeks for another eight sessions, and then once every four weeks there­after. I am now on the once every four-week schedule.

Overall, I’m happy to report that I have man­aged to live a fairly nor­mal life, up until the point when the coronavirus pandemic, or COVID-19, arrived in Canada (more on that later in this column).

Since my last update in No­vem­ber, my treat­ments with Darzalex, Revlimid, and dex have con­tinued as planned.

I have noticed that I tend to be quite tired after the Darzalex in­fusion, so I don’t drive myself home afterwards even though it is only a 20-min­ute commute. For the same reason, I don’t schedule any­thing else on the in­fusion day.

The weekly dexa­meth­a­sone con­tinues to cause me to be­come restless and too talkative, and to­wards the end of the Revlimid cycle, I am more likely to catch in­fec­tions and get cramping in my legs and hands.

Some slight mod­i­fi­ca­tions have been made to my sup­port­ing med­i­ca­tions to simplify my life.

Because I am taking two drugs that could cause blood clotting – Revlimid for my multiple myeloma, and anastrozole (Arimidex) as main­te­nance ther­apy for breast cancer – my doctor thought it would be a good idea for me to take the anti-clotting med­i­ca­tion Eliquis (apixaban), which comes in pill form, twice daily, rather than a daily in­jec­tion of Innohep (tinzaparin), a dif­fer­en­t anti-clotting med­i­ca­tion. Of course I like taking the pills better than having a daily in­jec­tion.

Since I con­tinued to have problems with my gastro­in­tes­ti­nal tract, despite taking Imodium (loper­amide), my doctor prescribed me the bile acid sequestrant colestipol (Colestid), which comes in the form of a large pill. That helped a lot in nor­malizing me again, and I felt much better soon after I started to take that drug. However, after a few weeks, the Colestid was dis­con­tinued because it was no longer avail­able to the pharmacy, and my pharmacist switched me to Olestyr (Questran, chole­styr­amine for oral suspension). The Olestyr is mixed with a liquid such as water and taken three hours away from other pre­scription drugs. Since I now take drugs in the morning and the evening, I take the Olestyr mid-day.

As I pointed out earlier, things did change a bit when COVID-19 arrived in Canada. All of a sudden, we were in a quarantine sort of mode. Of course, my family and I are trying to avoid getting ill with COVID-19. We are practicing keeping a safe distance from others, and if any of us be­come sick with an upper res­pira­tory in­fec­tion, we stay home for two weeks.

In addi­tion, I encountered a glitch when I had my latest Darzalex in­fusion in March. I had caught a cold at the beginning of March, and given the current cautious times, I isolated myself for two weeks. That meant that I had to postpone my appoint­ment with the myeloma specialist preceding my Darzalex in­fusion, and the in­fusion itself, at the cancer center to the fol­low­ing week.

I still had a slight cough at my doctor’s appoint­ment and, as a precaution, was tested for COVID-19. After waiting anxiously for the results, I found out that the results were neg­a­tive for COVID-19, but pos­i­tive for cold viruses. As a result, my treat­ment, which was scheduled for the end of the week, could be admin­istered as planned.

Normally, I have a blood panel and a 24-hour urine test done before my Darzalex in­fusion. But when I asked at the appoint­ment if I needed to get my blood panel done before my treat­ment, I was told that they are cutting back on blood testing and that my last results were good enough for me to take the Darzalex in­fusion.

For the in­fusion itself, I was treated in an area of isolation. A curtain was drawn around the treat­ment area, and the nurses work­ing with me were in full masks, gloves, and gowns. It was a bit unnerving, but I got through the in­fusion just fine.

As for the efficacy of the Darzalex, Revlimid, and dex regi­men, I am very pleased with the results. At my latest blood draw, my mono­clonal pro­tein came in under 0.1 g/dL (1.0 g/L), and the kappa and lambda values as well as the ratio of the two were close to nor­mal ranges. My other blood markers, such as the neu­tro­phils and platelets, are fine as well.

Given these pos­i­tive results, you can probably imagine how grateful I am that my treat­ments are being con­tinued during this time of COVID-19 precautionary measures.

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The quotation for this month is from Albert Einstein (1879 – 1955), who said: "The measure of intelligence is the ability to change."