On Monday Bob completed his testing, at UT Southwestern in Dallas. He has been poked, prodded, and stuck, and infused with radioactive material a couple of times (will he glow in the dark?). All the while, I sat and worked my crossword puzzles, and waited. And, I owed him that! There were years that he had to wait while either the girls, or I, were tested or hospitalized for various and sundry reasons.
His PET/CT Scan shows increased FDG uptake (lesion, tumor, or inflammation), measuring approximately 9 mm (a little larger than a pencil eraser), in his sacrum (the large, triangular bone at the base of the spine). Prior to the PET Scan procedure, Bob was injected with 11.6 mCi (millicurrie - the way radioactive material is measured) of Fluorine-18 Deoxyglucose (FDG) a substance like glucose (a type of sugar), with a radioactive tracer attached. After 90 minutes, he was imaged in the PET machine. Tumor cells require more energy to survive and spread and consume larger amounts of the radioactive material than normal cells. The PET scan can detect cells as small as one centimeter.
The PET scan also showed some other FDG "activity", which indicates that the Myeloma cells don't want to give up. His Bone Marrow test still shows 10% - 15% myeloma cells; better than in the beginning but still more than we had hoped. Just more indication that it's going to take the high dose Chemo (Melphalan) and SCT to get him into complete remission (CR). Right now, he's probably considered to be in VGPR (Very Good Partial Remission).
I had concerns that his Beta-2 Microglobulin (protein found on the surface of many cells) continues to increase, even after 4 Cycles of Chemo. This, and the 24 hour Urine test, indicates that his kidneys aren't functioning as they should which is common among many MM patients.
His PFT (pulmonary functions) test was great, but no results yet from the heart test. The Multiple Myeloma has caused kidney problems, neuropathy, back pain, and hearing loss (although I'm not so sure if it's the MM or he's just "redefining" his selective hearing!)
Even though he doesn't feel good, and hasn't for quite awhile, his back and leg pain has responded extremely well to the injections. For a couple of weeks, he's been on 30 mg. of MS-Contin twice per day, with 4 mg of Dilaudid around midnite. Last night, we reduced the Dilaudid to 2 mg., and this morning I gave him just 15 mg of MS-Contin. What a change from those days when he was taking pills every 4 hours and was still in excruciating pain .....but we didn't have the wonderful Dr. S. in our lives, at that time.
Next week, before we head back to Dallas for the Stem Cell collection, he'll return to the PMS for the radiofrequency lumbar facet denervation (burning the nerves). This has to be completed prior to the Stem Cell transplant, and should assure Bob of no additional back pain - for several months, anyway!
Phase One - Induction Therapy (4 Cycles of Chemo) - Completed
Phase Two - Testing, Testing, Testing - Completed
Phase Three - Stem Cell Collection - Begins 2/25/11 (Prayers, please)
Phase Four - High dose Chemo and SCT - Begins 3/14/11 (Prayers, please)
We're halfway through this journey, and what a trip it has been; one we had no idea we'd be taking. We're so glad that you're going along with us! It hasn't been fun like the journey we all took to Europe in 2009, or the journey that we started last fall, over this beautiful land of ours, when MM decided to interrupt our lives. It has certainly been educational and informative, and we've learned a lot. As I've so often stated, I could have lived a lifetime without knowing anything about Multiple Myeloma!
We hope you'll continue with us - we still need your support and your prayers as we tackle the last, and hardest part, of the entire trip!