New Developments

Suddenly it has been 2 ½ months since my last blog post.  In part that was because I didn’t have a clear story to tell.  My free lambda numbers have been bouncing around without a consistent direction.  Here’s the latest:

Yes, they are gradually coming down, but not infrequently they go up.  And if I had any of the recent numbers back in the spring, they would have been close to new records.

I complained that my left leg had stopped healing, and it felt weak.  So, they decided to give me radiation in the left hip and femur.  After initial prep where they put tattoo spots on the target areas so they can aim the radiation accurately, the treatments were quick (10-12 minutes) and uneventful.  That is to say there were no immediate aftereffects.  Even after 10 days of treatments there were no negative effects.  X-rays of the hip and femur still show spots where the bone has been sculpted away, but none of it is concerning to the doctors.  The x-ray sessions occurred November 7 – 20, which may account for some of the reduction in the free lambda readings during that time.

Perhaps of more concern is the fact that my lower left leg has developed a feeling of fragility.  It doesn’t exactly hurt, but it sure tells me not to push off with my calf muscle.  The net result is that I hobble along, limping with my left leg and pushing with my right leg.  I have been taking weekly physical therapy sessions (and actually doing the exercises in between – mostly), so the leg is not weak.  But it sure feels as if I would do harm to myself if I did any drastic motion with that part of my leg.  Within the last 10 days or so I have started to feel the same fragility in my right lower leg.

I happened to have follow-up appointments with both the surgeon who repaired my hip back in May and the doctor who oversees the radiation treatments.  The radiation doctor volunteered to radiate the lower leg, and the surgeon offered a metal pin as a potential solution if the bone were in danger of breaking.  Each sees the situation through his or her own lens.

In the process they did x-rays of the lower leg.  Here is an x-ray of a normal lower leg.  One you can find using Google:

The big bone to the left is the Tibia, which carries most of your weight.  The smaller bone to the right is the fibula, which helps with balance and maneuvering.  Note the contrast between the bone and the surrounding flesh.  The calcium in the bone makes it stand out as white, especially on the outer edges.

In contrast, here is an x-ray of my lower left leg:

The tibia looks pretty robust.  The fibula does not.  The part that is 2/3rds – 3/4ths of the way up the bone has very little contrast with the surrounding flesh.  The surgeon says that is the result of the multiple myeloma causing the component in the blood that absorbs calcium from the bones to have an upper hand over the component that deposits calcium in the bones.  The net result is that I am probably feeling fragile around there because the bone is weak. 

I had a PET scan today taking images of all my bones.  On Monday I will have a session with my oncologist to determine what the course of treatment will be. 

Since the start of December, I have a new oncologist.  My former oncologist, Dr. Nahas, has moved to California to take a job with a biotech company doing research on CAR-T cell therapies.  My new oncologist, Dr. Liegel, is quite young (and pretty).  I have been assured that she is good and that the entire medical team reviews all patients weekly, so she won’t be totally out there on her own.

Meanwhile over the holidays I was extensively exposed to grandchildren, which means I was exposed to multiple germs. I was hopeful that I would get through the exposure without any consequence, but since they have all gone home, I have come down with a pretty bad cold.  Coughing hard or sneezing really causes problems.  It feels as if I have done damage to one of my right ribs, so finding a comfortable position to sleep in is difficult.  The pet scan should show what is going on, and the treatment plan will make everything all better.  I wish.