Yesterday I shared my first impressions of Moffitt Cancer Center, which is just north of Tampa. I found that, like Mayo Clinic in Rochester, Minnesota, Moffitt was a warm and welcoming place. Moffitt is much smaller than Mayo. It is easier to find your way around. But what about the techs, doctors and nurses?
My visit last Thursday was an introductory one. I met Dr. Melissa Alsina, her oncology nurse, Ally Zheng, and another oncologist, Dr. Kenneth Shain. Dr. Shain was excellent and thorough. He had reviewed my medical history from both Mayo and my local medical oncologist, Dr. Daniel Anderson, from Minnesota. A short time later, Dr. Alsina introduced herself and her nurse, Ally. All three sat-in on the 30 minute meeting which followed. Dr. Alsina was quiet, yet engaging. I believe she is originally from Spain, but her English is very good. All agreed I should continue with my current course of treatment: 10 mg Revlimid 14 days on/14 days off. No dex. If and when my myeloma becomes measurable, Dr. Alsina suggested I consider a stem cell transplant (SCT). No surprise there–SCT is Dr. Alsina’s specialty–and her RN, Ally, is a Transplant Nurse Specialist. I countered with my plan to increase my dose and frequency of Revlimid to see if that might knock the myeloma back down–possibly even adding dex if necessary. No one objected to this anticipated plan of action. However, Dr. Alsina did point out that, with my worsening history of peripheral neuropathy (PN), I may want to consider a transplant sooner rather than later. “Why?” I asked. “Because if your PN gets any worse, you may lose the option of using Velcade later.” she replied. I understood immediately. Velcade does have a reputation for being more likely to cause PN than Revlimid. So, if I already have an issue with PN while using Revlimid, there is a strong likelyhood that trend would continue–or even get worse once I started Velcade.
I hadn’t considered the possibility that if I allowed my neuropathy to get worse by staying on Revlimid, I might lose the option of using Velcade, either before or after a SCT. Multiple myeloma patients are often forced to make many difficult and unfair treatment choices, aren’t they!
I will share more of my thoughts about future treatment options on Sunday. For now, let me conclude by adding how pleased I was with my new medical team’s first meeting! Since Moffitt is more than an hour’s drive from my home, Dr. Shain and Dr. Alsina both agreed it might be a good idea to find a general practitioner/internist and possibly even a medical oncologist closer to home. Pattie and I both thought that was pretty “cool”–showing a willingness to work with other docs outside Moffitt–and putting my convenience and welfare ahead of Moffitt’s business self-interest. I was to return to Moffitt one week later for some baseline medical testing and a blood draw to check-out my M-spike, which had been present but not yet measurable on my last pathology report from up north.
Feel good and keep smiling–and may all of you have M-spikes too small to measure for many years to come! Pat & Pattie