A Little Chemo Goes a Long Way

This has been a busy week already for treatment. Yesterday I had my Velcade injection, and I’ll have another one on Thursday. Today I had blood drawn and saw Dr. Joudeh, my oncologist. I always go into the appointments with a list of questions, but as has happened on every preceding appointment, he answered many of them before I asked. Today I wanted to know about the timeline and next steps.

I am nearing the end of my first 21-day cycle of the RVD regimen. Dr. Joudeh told me that after two cycles, he is hopeful we will have a better idea of how effectively the drugs are killing the cancer cells in my plasma. When the abnormal cells are destroyed and my numbers are in normal range, I will be in remission, at which point the harvesting of my stem cells can begin. They will be taken through blood draws done over a period of time. After that, I will prepare for the bone marrow transplant.

In the interim, Dr. Joudeh wants me to research the cancer treatment centers that I am interested in, such as M.D. Anderson in Houston, Texas; University of Arkansas for Medical Sciences Winthrop P. Rockefeller Cancer Institute in Little Rock, Arkansas; Moffitt Cancer Center in Tampa, Florida; and O'Neal Comprehensive Cancer Center at UAB, Birmingham, Alabama, to name a few. A primary consideration, he told me, would be how far away from home and from my family the center was because I would need to be prepared for an extended stay. He didn’t mention COVID-19, but of course, that is also a major consideration for me because I am hopeful that by the time I have the procedure, restrictions will be significantly lighter. I’m not holding my breath over that one. Once I make a decision, he will send all of my records to them, after which they will reach out to me to arrange for one or two visits prior to the transplant. The way he described these visits, they would be kind of like meet-and-greets, so they could introduce their teams to me, show me around, answer my questions, and alleviate concerns.

I really have no idea when I will be ready for the transplant; it is still far too soon. But I am encouraged by the sense of urgency and Dr. Jourdeh’s confidence in my overall health being a tremendous advantage. He has always been very transparent and forthcoming about the situation and told me today that I could even opt not to have the bone marrow transplant, if I chose. If I did, I would continue on the chemotherapy regimen, modified as needed, indefinitely. In either case, I will most likely take Revlimid for the rest of my life, after the transplant at a much lower dose, so it begged the question, why should I put myself through a very tasking bone marrow transplant? The thought was creeping into my brain when John, who accompanied me to my appointment, asked, “Is there an advantage to her having the transplant?” to which Dr. Joudeh gave an unequivocal, “Yes, definitely.”

So I will stay the course and continue to research and pray for guidance. In the meantime, I am tolerating the chemo fairly well. Some days I feel like my legs are full of lead. I felt downright awful on Thanksgiving and missed out on a wonderful dinner with family. I have not lost my hair yet and am hopeful I won’t, but if I do, it should begin to be evident in about another week. There are things I want to do in the coming months, too. My nephew is getting married in February in Oklahoma City, and I have a paid-for-and-postponed-from-earlier-this-year dive trip with my son and a bunch of dive buddies to Little Cayman in May about which I will remain hopeful and resolute that I will be able to go. Time will tell, but if stubbornness is a factor, I’ll be on my way, chemo or transplant notwithstanding.