Category: Medical

It was just two years ago I got the dreaded phone call from my oncologist.  I had been fighting Multiple Myeloma (bone marrow cancer) for the previous fifteen years and I had suddenly started seeing bruises all over my chest and arms.  After a couple weeks of blood tests and a bone marrow biopsy – where they “drill” into your hip and pull out a sample of your bone marrow for the lab to run tests on – my oncologist called to tell me I had Acute Myeloid Leukemia. 

My brain had a hard time registering this info.  I knew Leukemia was pretty serious stuff, but why would I have it?  It turned out the drug I had been taking over the past several years to fight off my Multiple Myeloma and very much keep me alive had likely caused my Leukemia.  My oncologist informed me I needed to go into the hospital the next day, where I would be for a month starting some heavy duty chemo treatments.  I said “come on, really?”  I needed to go into the hospital for the entire month of December?  Then he informed me that if I didn’t I would be dead in two weeks.  Well, guess who went into the hospital the next day? This guy!

That was the start of a long treatment process that included more stays in hospitals, more heavy chemo and eventually a stem cell transplant at Duke using one of my brother’s donated stem cells.  Love that Kyle!!  At the time I was told I had a fifty-fifty chance of surviving the next six months of treatments.  Hell, that’s a flip-of-the-coin.  But I told myself I could do it and I chose to be in the positive side of the fifty percent.  I was also very lucky to have such a great oncologist in Norfolk (Dr. Dean McGaughey really is the best!), all of the terrific doctors and nurses at Duke and most importantly the bottomless love and support from my wife, Nancy, my entire family and all my friends.

It was a tough fight, but I made it.  Several months ago I heard about someone dying from Leukemia and I got thinking that you never hear of someone living after Leukemia.  So I GTS (Googled that shit) and found out only twenty-five percent of people my age and up who have Acute Myeloid Leukemia survive for five years or more.  When I saw my doctors at Duke I asked them if this was true.  They told me sheepishly “yes, this is mostly true but we don’t talk about it much.” Well I would think not! 

But they told me I was on the younger end of the spectrum of people with this kind of Leukemia, so that was in my favor.  They also told me the majority of people who relapse usually do so within two years of their treatments.  Again, I chose to believe I would be in the twenty-five percent and here I am now three months shy of my two year anniversary of my stem cell transplant and doing great!!  Also, with the exciting new treatments being tested, especially the promising new CAR-T Cell therapy treatments there is starting to be a real chance for a cure.

As you can tell I am a firm believer in the “you make your own luck” theory, which is what I mean by “I choose” how things are going to turn out.  While I also know there is a lot more than that going on, like great doctors and a loving, supportive family, it all starts with you and your attitude.  Even if things don’t work out, at least you know you went down swinging.  As my Dad once told me “never give them a standing target!”  Thanks, Dad!

Nancy just reminded me that in another week it will be sixteen years since my first stem cell transplant (using my own stem cells) at Duke. Wow! Not bad considering at the time they said I would be lucky to get three years.

I was initially diagnosed in early April with a full blown case of Multiple Myeloma – nearly 85% of my bone marrow had been taken over by the Myeloma cancer cells.  I then went through seven months of aggressive treatments to beat down my cancer to the point when I could have a stem cell transplant.

During my treatments I wore a small pump under my business suit that was pushing timed doses of chemo into me; all the while I was still working as the Executive Director at Virginia Opera.  I remember sitting in Board meetings not letting on that anything was wrong and thinking how surreal it all was.

Even though the treatments were pretty intense, fortunately I managed them fairly well and never missed much time at work until November and December when I had to go to Duke for my transplant.  In hindsight, even that went well.  I mean it knocked me out and I had a few close calls with infections, but by early January I was back to work.  I wasn’t at 100%, but I managed.

Unfortunately I returned to a rather unwelcoming work environment.  The founding Artistic Director at the Opera did not like the fact that prior to my illness I would stand up to him and say “no” to his capricious and often volatile whims on how the company should be run.  In fact I learned that while I was at Duke, the Artistic Director used that opportunity to tell the Board the company could not afford to have its Executive Director die on them so it would be best to let me go.

As a result, on my first day back at work our Board President (who was a good guy) took me out to lunch and informed me that the company would not be renewing my contract when it expired.  Also, they had determined that it would be “confusing” to the staff to have me continue in my position knowing that I wouldn’t be staying with the company so I should just stay away from work until my contract ran out.  Welcome back!!

I was crushed.  Nothing like that had ever happened to me before.  And needless to say, I was very angry at the Artistic Director for his underhanded way of doing things.

But a couple years ago when I was in the hospital dealing with my Leukemia treatments I had a lot of time to think about things, including what happened to me at the Opera.  I realized there was no point in carrying my anger at the Artistic Director along with me.  It wasn’t helping matters and it certainly wasn’t healthy for me.  I came to understand that it was the Artistic Director’s issue, not mine.  It was incredibly “freeing” to let that anger go, like a load of rocks had been taken off my heart.

So November 20^th is always a bittersweet day for me.  It was the day of my first transplant and is considered a person’s “birthday” because the transplant process brings you close to death then back to life again with the infusion of your stem cells.  While it marks a very difficult time in my life, Nancy, my family and I all consider it a day for celebrating.  And who can’t use an extra birthday?

So you have made it through a stem cell transplant and are now mostly recovered.  Awesome, congratulations!  But be sure to adjust your expectations that you will quickly return to your baseline physical and mental condition from before your diagnosis.  While you will feel pretty good, know that it takes a long time to fully get back to what you were.  And some people never get back to 100%.

It really becomes a matter of managing your expectations and gradually working on your physical and mental recovery.  Just like the way you worked through your treatment regimen – patience and one day at a time – is the same thing you need to do with your long term recovery.  Stay with your daily workout routine, which should include walking, and try to gradually increase the level of workout and distance covered.  “Gradually” being the operative word here.  Don’t push yourself too hard or too fast, or you will find yourself being set back.  Just resolve yourself to the reality that you can’t rush things, no matter how badly you want to speed up your recovery time.  And you should also find something to challenge yourself mentally to give your brain a workout.  I found playing Scrabble worked well for me.

You will eventually get to a good physical and mental condition.  It might not be fully what you were before, but it is certainly better than the alternative!  While your physical recovery will be fairly easy to measure, your mental recovery is a trickier thing to quantify.  Depending on the level and intensity of your treatments, “chemo brain” can be a very real and annoying condition.

Don’t let yourself get too frustrated when you find you can’t remember things that you know you knew before your treatments.  You have to cut yourself some slack and admit this is what happens to a person after they go through the tough treatments you did.  At the risk of being the bearer of bad news, I don’t know if it ever comes back 100%.  I am now sixteen years post auto stem cell transplant and I still experience chemo brain moments.  And this was before my Leukemia treatments started a year and a half ago!  Maybe it is a bit of senior-ites, but I don’t think so.  Nancy is close to my age and she doesn’t seem to have these issues.

I think the best answer is to keep at it and to admit to yourself that it is okay when you hit a wall of physical endurance or mental clarity.  After all that we have been through, we deserve to be given a break once in a while.

So I had a follow-up appointment at the Duke Cancer Institute a few days ago.  It has been a year and four months since my stem cell transplant (using my brother’s cells) to knock out my Leukemia.  I wasn’t expecting any major news and indeed, the doctor was very pleased with my progress.

They did however spring a bone marrow biopsy on me.  Surprise!  That is where they drill into your back hip bone and pull out some marrow for evaluation.  It is the most accurate way they have to test what is actually going on in your bone marrow.  As you can imagine, the procedure is not a lot of fun but I have been through enough of them that it is now somewhat tolerable.  In fact, I joke that I have had enough of those biopsies that they ought to make everyone’s life easier and just install a beer tap back there.

While I haven’t been up nights worrying about a recurrence of my Leukemia, it is always in the back of your mind playing the “what if” game.  Like a Whack-a-Mole game it pops up when you are thinking of other things, usually late at night, and then you can’t ignore the train of thought.  Then you have to work very hard to not let it take off and snowball into a mountain of worry.

So when the nurse from Duke called me yesterday to give me the preliminary results from my biopsy, I fought off a minor anxiety attack and took the call.  Needless to say, I was very happy to hear there is currently no sign of Leukemia or Multiple Myeloma in my bone marrow.  Whew! I knew that was what they were going to say.  Yeah, right!

You know what it feels like to have a really big weight taken off your shoulders?  It is amazing to me how a mental game like this can so greatly affect the way you look at everything.  It is all part of the emotional yo-yo ride you live on when you have cancer.  I think the best answer is to enjoy what we have and make the most out of each day.  I know that sounds corny and over-simplistic, but to me it really is the truth.

I posted this a while ago, but I think it is important enough that it should be repeated for those who haven’t read all of my past posts.

So you have been diagnosed with Multiple Myeloma (bone marrow cancer) or Leukemia.  It is time for a crash course in cancer education.  Also, if you have lost your job due to your treatments, what the hell are you going to do to make ends meet in the bills department?

For information about Multiple Myeloma, you can’t beat:

International Myeloma Foundation: https://www.myeloma.org/ for information and emotional support, including area support groups.

Multiple Myeloma Research Foundation: https://themmrf.org/ for information including new drugs that are “in the pipeline”

For information about Leukemia and Lymphoma, the best is:

The Leukemia and Lymphoma Society: http://www.lls.org/ for information and support.  They also have some financial assistance programs, which will be addressed below.

Of course, there is also The American Cancer Society: https://www.cancer.org/ for information and support.

For financial support, you should Google: cancer financial support.  Be prepared, you will get a ton of different listings.  Unfortunately, you will need to slog through each of them to determine if they can apply to you.  Some are cancer type specific and some are geographic area specific, and most require proof of financial need.  You should also ask your oncologist if their office has a person on staff to help you find local sources for financial assistance.  All of this is really a difficult burden on top of dealing with your cancer treatments, but unless you are financially sound, we really don’t have much choice in the matter.  Just keep at it and chase them all down.

Here are some of the organizations that I found who can help with grants and financial support.  Most of them are only able to offer support when they have funds “on hand” which is not always year-round.

The Leukemia and Lymphoma Society: http://www.lls.org/  They have a $500 travel assistance program.  They also have a separate support fund specifically for people with Multiple Myeloma.

Patient Advocate Foundation: https://www.copays.org/  They have a program that will help pay for your co-payment on your medicines.  Be prepared, they ask for a ton of paperwork.

Daniel’s Grace Foundation: http://danielsgrace.org/  They are a great, all-volunteer organization that serves the Hampton Roads, VA area.  Their mission is “to ease the financial burden of cancer.”  They also have a scholarship program to help student whose lives have been affected by cancer.

Mercy Medical Angels:  http://mercymedical.org/  Their mission is “to ensure that no one in need is denied medical care because of a lack of transportation.”  In my case, they provided a round trip airfare for my stem cell donor. 

Angel Wheels: http://angelwheels.org/  They are “dedicated to providing non-emergency, long-distance ground transportation to financially disadvantaged, ambulatory patients who are traveling for treatment. “  A typical trip supported by Angel Wheels does not exceed 300 miles (one-way), and they do not normally handle trips within a local area or community. Exceptions are made on a case-by-case basis, routinely for cancer patients traveling daily for treatment.  Angel Wheels to Healing utilizes the following resources for assisting patients: Gas cards (provided to help off-set fuel cost for patients), Bus Tickets (Greyhound, Trailways, etc.) and Train Tickets (Amtrak).

Family Reach: https://familyreach.org/  They are a national nonprofit dedicated to alleviating the financial burden of cancer.

The Bone Marrow Foundation: http://bonemarrow.org/   They provide financial assistance and resources for patients, caregivers and survivors.

Lee’s Friends: http://leesfriends.org/  They are a Hampton Roads, VA based organization whose primary mission is “To offer person to person help and needed emotional and practical support to cancer patients and their families who are facing the crisis of diagnosis and treatment of cancer.”

Good Days: https://mygooddays.org/  For support and financial assistance.

The Actors Fund: https://actorsfund.org/  They can provide some short term support “for everyone in entertainment. “

Also, most pharmaceutical companies have financial assistance programs to help if you cannot afford their drugs.

Patient Resource: https://www.patientresource.com/Financial_Resources.aspx  This is a lengthy, but VERY comprehensive list of organizations that provide support.

Don’t despair.  You can do it and find help!  GOOD LUCK!!

Multiple Myeloma is a “hard to figure out” cancer.  It is a cancer of the bone marrow that will take over your marrow and crowd out its ability to produce platelets and red and white blood cells. In a small percent of cases, it can be caused by a defect in your chromosomes which makes it hereditary.  Otherwise, they do not know what causes it.

I have heard some people blame over-exposure to petroleum chemicals, while others say over-exposure to wood working saw dust (I assume from cutting up plywood and other chemically-joined wood products) can be the cause.  But nothing definitive has been shown to prove any of this.  And stupid me thinks that if these were the causes, why aren’t all gas station attendants or carpenters affected with Multiple Myeloma?  I guess those of us who get it are just the “lucky” ones.

There are five subsets of Multiple Myeloma and two types of light chains which they produce in your blood – called kappa and lambda.  My Myeloma (which always reminds me of the Knack’s song My Sharona!) did a very strange thing when it came back on me three years ago, my light chains changed from lambda to kappa.  Very weird!  I am told this can happen in about five percent of the people with Multiple Myeloma.  Again, I guess I won the lottery.  Maybe I should be buying more Lotto tickets!

Another word of warning: sixteen years ago when I was initially being treated for my Multiple Myeloma,  in their efforts to reduce the level of cancer so I could have an auto-stem cell transplant they gave me a combination of drugs that included platinum.  Well, it did a terrible number on my kidneys.  I eventually recovered but my kidneys have been compromised ever since.  I don’t know if they prescribe that anymore, but keep this in mind and talk with your doctor about it if you hear they want to give you a drug with platinum in it.

Something to know about Multiple Myeloma is that even if your initial treatments are successful at eliminating its presence, it is highly likely that it will eventually come back on you.  They call this a recurrence.  The thing to remember is this is very likely to happen to you, and you should not panic when it does happen.  It does not mean this is the end of the line.  It means you and your doctor need to decide on the next treatment option – of which there are many! – to throw at it to knock it back down.  And then again and again as you work down the list of treatment options and keep buying time.  And hopefully before we run out of options they will have discovered a cure.  Please God!