I met with Dr. Tricot this morning for my pre-transplant check. As expected, I’m good to go. I wasn’t expecting such encouraging, eye-opening test results.
The report from yesterday’s PET scan still aren’t available online. But Dr. Tricot had them. After he carefully examined me and double checked my numbers, Dr. Tricot flashed a big smile as he sat down in front of the exam room computer again.
“There has been significant improvement since the last time you were here (one month ago).”
Dr. Tricot rattled off some numbers he felt were now close to normal; I’m not clear which ones; he was still referencing numbers from yesterday’s early morning blood draw.
My M-spike had been stuck at 0.2 before and at my two month check post-transplant. One month later, I saw online last night that it was now 0.1. As I suspected, Dr. Tricot wasn’t interested. As I’ve shared in the past, he views the clone(s) that are measurable in a SPEP test at this point to be benign; he termed it as a form of MGUS.
Dr. Tricot quickly moved on to the radiologist’s PET report; data I didn’t know he had yet. “There has been measurable improvement in the effected lesions,” he said, adding, “There is still some myeloma left on your iliac crest and here,” rubbing the back of his head just above the neck; the site of my occipital lesion.
As he continued to scroll through my test results, I wistfully asked, “See anything there that would stop me from transplanting again?” Dr. Tricot’s forthright answer: “I’m busy looking for reasons to transplant!”
Just a trace of myeloma left in two lesions. Most doctors would say, “Great!” Then send me home after a successful result. Not my favorite “mad scientist,” Dr. Tricot! He’s even more insistent I complete the tandem.
Hard to argue; Dr. Tricot’s been right so far. I’m starting to hope (with an assist from maintenance therapy) this second autologous stem cell transplant (SCT) could knock my myeloma out for years.
It’s a big gamble. The next five or six weeks won’t be fun. It has taken over three months for my GI tract to recover from the first one.
As always, Dr. Tricot was happy to answer any questions I had. But this time things were different. I didn’t have a lot of questions; this isn’t my first rodeo. Instead, Dr. Tricot did more of the talking.
I can’t recall his exact words, but Dr. Tricot ended our meeting saying something like, “These are the results I’d hoped for, but I never thought things would go this well…”
Honestly, I was stunned; stunned and energized. It’s a lot easier checking into the hospital for three weeks when everyone is confident the plan is working.
Remember, this modified, salvage SCT was a Hail Mary. A number of respected myeloma experts had advised me not to try it. I’m getting ahead of myself (bad luck?), but so far, so good. Better than good!
The secret? When I asked Dr. Tricot if my continued improvement had more to do with positive residual effect from the SCT in July, or our maintenance regimen of thalidomide, then pomalidomide, along with dex–always with dex–he answered honestly, “It’s hard to tell, but it’s probably from the transplant.”
Breaking things down: I’m convinced adding thalidomide (which I’d never used), Velcade and dex to the standard high dose melphalan is what did/is doing the trick.
“Myeloma cells that the melphalan doesn’t get will be weakened, so the other drugs can destroy them.” I’m paraphrasing again; I can’t recall which verb Dr. Tricot used here. It could have been, “wipe them out,” or something else.
But his point was clear. Adding other drugs to the mix increases the chances that now weakened myeloma cells can’t escape.
This summer I started thalidomide/dex maintenance on Day 28. I wasn’t excited about it at the time. After all, I was just starting to feel better. But now I see the wisdom in the approach of keeping the heat on any remaining cells. Based on the data we have, I can report without reservation that the plan to modify my auto SCT worked–and worked well.
I check into the BMT unit Saturday. Good thing there isn’t a home game; the University of Iowa plays in Evanston against Northwestern tomorrow. As I’ve reported before, the hospital is directly across the street from Kinnick Stadium. Traffic must be impossible on game days!
The University is building an impressive, new, 350 million dollar children’s hospital wing next to the cancer center where I see Dr. Tricot:
If you look closely, you can see it six months ago when the exterior was still under construction. Note the view looks through the end zone of Kinnick Stadium just across the street! It’s tight and difficult to drive here, even when the Hawkeyes aren’t in town.
No time to celebrate; I hurriedly sped off to the cardiac wing on the other side of the sprawling complex, connected by sky walks. No traffic worries today; I took the hotel shuttle this morning.
Shortly after I arrived, a highly skillful surgical tech, Robin, deftly placing a PICC line in my upper right arm. The procedure barely took 29 minutes start to finish.
Before I had a chance to tell her she looked familiar, Robin smiled and said that she remembered me. It turns out that Robin was the tech who set up shop in my room and placed the PICC line in my left arm (after my chest port became infected) this summer.
I was back to the Heartland Inn–safe and relatively pain free–by noon. Proof certain that all of those reader prayers I hear from on Facebook, Twitter, via email and in our comment section are working!
That, a great doctor, good insurance and a well reasoned plan. Looks like our gamble is paying off. But it’s way too early to spike the football. Let’s see how I feel in a week or so. Shoot; forgot about that. Reality bites!
Feel good and keep smiling!