Process of Elimination

Maybe it's the chemo...

On my last visit to Dr. Joudeh on November 24th, I again complained about the pain. I hate the word "complain." In nearly every situation, it does no good at all and tends to cause everyone subjected to the complaints to feel negative. Medical doctors make a living resolving peoples' complaints, so they are an exception. That's why I make a list whenever I go to see him just to make sure I don't forget something. He always leans in and listens attentively, and he doesn't pretend to have an answer right away if he doesn't know or isn't sure. Sometimes, answers come when we use the process of elimination. Are there factors that could be contributing to the problem, and if we begin to eliminate them one by one, does it make a difference?

"I want you to stop taking the Revlimid for a cycle," he said.

Revlimid, you may remember, is the oral chemotherapy medicine that was part of a drug combination that I took for several months after my initial diagnosis. The full dosage is 25 mg, but the standard of care following a stem cell transplant is a lower dose, 10 mg, following the same 28-day cycle of one capsule per day for 21 days with 7 days off in between. At the time, I had only one more capsule to take of the current 21-day cycle. It didn't really occur to me that the chemo might be the cause of the pain in my arms and nearly every other joint in my body, but particularly my hands and my hips, because I didn't experience those issues in those months prior to the stem cell transplant when I was taking the larger dose. It just didn't make sense to me.

At the center of it all was the stem cell transplant. Who knows what changes have occurred in my body since that time? Heaven knows, there have been some, resulting in, I believe, some unusual outcomes. My curly hair, for instance, or the seborrheic dermatitis.

"Do you want me to finish this cycle or just stop now?" I asked.

"Stop now and don't start the next one. Let's see how things go," he said.

Well, I am thrilled to report that last night, for the first time in weeks, I didn't take a Norco, a Tramadol, or even a Tylenol, and I slept until around 3:15 when I stirred, I think because I heard Keifer getting ready for work down the hall. Until last night, I hadn't slept longer than a four-hour stretch in months! I had noticed over the last several days that I no longer looked like a wooden marionette rising from a chair and haltingly taking a few steps after sitting for 20 or 30 minutes. My arms and hands didn't ache and go numb during the night, and the tenderness in my fingers had decreased. I'm going to resume my walks to see if I feel sore, like I have over the past weeks when I would try to walk a good distance at least two or three times per week but could never get past the stiff aching in my muscles and joints. I'd like to think I'm not such a grouch now that I'm not hurting like I was, but that may be a stretch.

At any rate, I give God, Dr. Joudeh, and your thoughts and prayers for me the praise for the relief I have felt these past few days. I'm eager to report my improved condition when I see Dr. Joudeh again at the end of this month and hear his feedback. For now, cautious optimism is the order of the day that there will be either an alternate course of action that will sustain my remission, or in the absence of that, that I will continue to thrive without the potentially damaging effects of another chemotherapy.