Last Minute Reprieve

Another tough month, but ending on a hopeful note?

I started the new chemo (DDVVCC) on Monday the 19th - four doses of six drugs over eleven days. As one might expect from that many "poisons" there are side effects: loss of taste and appetite, nausea, fatigue. I also learned that my kidneys had taken a "hit" from the bone hardening medicine (Zometa) they'd given me the week before. (A small consolation was that pelvic ultrasound at that time proved there was no blockage of the right ureter by the pelvic mass.) I had a needle biopsy of the pelvic mass that confirmed it's a plasmacytoma (all Myeloma cells - not some second cancer). The second dose of the chemo series had to be delayed because of an episode of shaking chills and fever, successfully treated with a course of antibiotic. During this time the pelvic mass and right leg swelling continued to worsen. I saw a cancer surgeon in Spokane who confirmed that the mass was too big for surgery and that radiation was indicated. So I reinitiated the Radiation option. This took a week: new CT scan (mass indeed 15% bigger than a month ago), mapping, planning, tattooing, and a "simulation" session. The actual radiation was scheduled to start on Monday the 2nd of November, right after my last dose of this chemo cycle. However, over the weekend of the 31st I began to see steady shrinkage of the right leg swelling, and the pressure, and possibly the size, of the pelvic mass seemed reduced. My excitement is tempered by the fresh memory of the transient response we had to the first cycle of DVD last July. However, in view of this new development, I felt compelled to once again hold off on the radiation. I was hoping to see a significant drop in my tumor marker, the blood IgA level which would confirm a significant anti tumor effect, but the level earlier this week was actually up slightly from Mid October. Maybe the IgA is lagging behind the clinical response?
Even if it's just temporary it's absolutely delightful to have a nearly normal right leg again! I can wear regular pants again - for most of the month I'd had to resort to sweats. It's easier to ride my commuter bike around town. I can sit for long periods without having to lie down and elevate my leg. I can swim! Getting in and out of the Comanche is easier. I was even able to go on a 20 mile ride on my road bike one sunny brisk morning. To me this was almost miraculous, as I'd begun to wonder if I'd ever ride that bike again. With the transient response last summer the swelling started to come back about a week after the end of the chemo. So I guess we'll just have to wait and see what the leg and pelvic mass do over the next ten days. I start the next cycle of chemo on the 16th.
In the midst of all this we had a number of visitors. Cassie, a nurse anesthetist from my Denver Residency days flew up from Wyoming with her husband Ron in their twin Cessna just for an afternoon! Jim and Cindy Fisher came up from Moscow, and Kathy and Mike from Spokane. Sarah came over from Seattle the last few days of the month, and did a nice job carving a pumpkin that had appeared anonymously on our porch.
I still managed to get in some flying. Before I started the chemo I passed my biennial flight review - an oral "quiz" and 1+ hour flight with an instructor. I flew my friends Nancy and George down to Spokane for coffee. I did some safety piloting for a couple of friends, and got in some instrument practice myself too.
However, I'm faced with the realization that even if I get another complete remission I won't be able to pass my next FAA physical in February, so I've put the Comanche up for sale. In the current depressed market I expected it would take months to sell. But to my surprise, I've already had a serious inquiry. I'm finding this more emotionally challenging than I expected. I know, no matter what happens, I need to simplify my life. Maintaining a complex instrument certified airplane, and my proficiency require large amounts of time, money and energy.
On the 17th we attended a party for some friends who married this summer. There was good food and a lively local band. I managed to stumble through a couple of dances with Mary Catherine; one of the small ways I can express my appreciation for her strong unwavering love and support through all this mess!

Phil