Monday, October 10, 2005

So many diplomas!

After the bone biopsy of the sacrum showed monoclonal plasma the oncologist called it myeloma. If there were more than one site, or lesion, then it would be multiple. The only test that gave information about that was the very first MRI. The phrase that stuck out in my mind was "involvement of L4" and I suppose that is what kept the oncologist from eliminating 'multiple' easily. So I was stuck between a diagnosis of single and multiple.

The cure for the foggy diagnosis would be ... [drum roll effect here] More Tests!!

On Monday, the 3rd of October, I went back to the MRI folks who made full pictures of all three areas of my spine: cervical, thoracic and lumbar. It was really a snap. Just imagine laying completely still. Then have someone gently move you up and down through a machine. The machine makes a lot of noise. The volume and vibration is like having your head next to a vacuum cleaner -- for two hours. Except for being noisy as hell, it is easy. The lumbar had to be re-done because they couldn't see the top two vertebrae in the earlier films.

The results came fast. I got a call on Tuesday afternoon from my oncologist. The films were clear. There are several more lesions: some on my spine, some in my thoracic area and at least one on a rib. With the new results, there was no need for a murky diagnosis. I have multiple myeloma.


My appointment with a top level blood cancer specialist was set for Thursday, the 6th. I worked from home in the morning and then made the one hour trip to the super duper tip-top oncologist's office after the rush-hour was past. His office is the busiest medical office I have ever seen. There must have been seventy-five or eighty patients, some with caretakers, in the waiting area. People wearing those green, blue and dark red hospital clothes kept coming into the room to call out the name of their next victim. The victim always responded willingly to the sound of their name. I began suspecting the drinking water had been laced with a drug to make everyone calm and complacent.

I got a pack of insurance forms, releases, medical history forms and papers I had to sign to acknowledge I had been told or read everything else. They didn't give me time to sit and fill them out. Oh, no. They started calling my name and I went into one side room after another. Once for my height, weight, blood pressure and heart rate. Once for a couple liters of blood. One woman called me to sit in her room while she entered the information from one of my forms into a computer. She didn't even ask me any questions or ask me to sign anything. Maybe she just felt lonely. I did; even with all of those people around.

Every time I came out of one of those rooms someone would have taken my seat and I would have to go around to another part of the room to find an empty one. It started to get a bit tiring. Then they took me to the super duper tip-top oncologist's office. I could wait there. Not in an examining room, but rght there in the guest chair of his office. No one to watch me or make sure I didn't try to get onto the office's computer network or anything. After a quick review of my notes so my questions would be fresh in my mind, I started looking around. It was fairly typical for a doctor's office. There were lots of medical journals, lots of files piled on his desk. His bookshelves were full of medical school books and conference catalogs. His walls had his university and medical school diplomas and medical community recognition plaques. But not just the three or four in a regular MD's office. He had more than twenty. And they were all related to institutions that specialized in cancer.

When he came in, he asked me about my medical history. He asked me about how I learned I had myeloma. I almost asked him to read this blog, but I didn't. He seemed kind of short on time. Then he told me he agreed with my oncologist. He said he wanted me to start taking a combination of drugs that have been very effective at treating multiple myeloma. The combination even has a short name, "Thal/Dex".

He said that I needed to take this treatment for three to four months. They will monitor the presence of monoclonal plasma in my blood during this time and expect to see a fairly quick reduction. Next steps will depend on my body's reaction to the treatment.

Well, let's see.