Diagnosis, Prognosis and Treatment

This post is #3 in a series:

I met Dr. James Neel on Saturday morning, September 17th, after my first night in the hospital.  Dr. Wahl told me Friday night that the on-duty oncologist/hematologist would see -me at Holmes over the weekend.  Gina spent the night in my room, sleeping in a recliner, and she went home to shower and change soon after waking.  So she missed most of my morning doctor visits with Dr. Neel and Dr. Wahl over the next few days, and she had to depend on my layman’s attempt to explain the things they told me.  Knowing that Gina would want to know as much as possible heightened my focus during those visits because I knew that I would need to replay the meetings for her.

Dr. Neel impressed me immediately as a competent, compassionate professional.  When my dad was battling cancer, he told me that he sometimes felt like he was a secondary player in the battle between the doctors and the disease, but that has not been my experience.   I have consistently felt that my doctors and all of the hospital staff who attended me that weekend were committed to taking the best possible care of me. 

Dr. Neel started with the diagnosis:  “Mr. Deming, I’m 95% sure that you have multiple myeloma.”  He went on to explain that final confirmation would follow a bone marrow biopsy on Monday, but that he was so sure of the diagnosis he wanted to begin preliminary treatment right away. He then taught me all about multiple myeloma, and the news was not nearly as bad as I expected.

Multiple myeloma is a blood cancer that attacks the bones.  It is not curable, but it is highly responsive to treatment.  Because the field is advancing rapidly, internet sources that discuss this disease are out of date and more pessimistic than the current reality.  Four new treatments have been implemented just in the last year, and they are working.  Dr. Neel told me that he has been treating some patients with this diagnosis for over ten years.  He also told me that he had already reviewed the reports from my blood test in January and my colonoscopy in March, and I was fine then.   It is good news that we caught this early and that I am relatively young (for this diagnosis) and in decent shape (for a 55-year-old).  I lost fifty pounds last year because I was trying to avoid diabetes (also deadly), and it turns out that my weight loss was good preparation for the battle ahead.  Although multiple myeloma is technically not curable, patients are responding to treatment so well for so long that it is way too early to consider this my terminal illness.

The chemo is easier for this than for many other cancers.  It is all outpatient, two shots and a pill.  I go into the cancer center twice a week for the shots, and I take the pill at home.  The side effects are minimal, no nausea or hair loss.  The most common side effect is fatigue, so I need to allow space in my life for a nap or two every day, and I have not minded that at all.  Chemo vs. cancer is a battle of poisons, and my body is the battlefield, so I take several other prescriptions to prepare or repair the battlefield.  One of those is a steroid, and I’ve found that I’m more likely to feel jacked up from the steroids than fatigued from the chemo.  My back is still sore, but my energy level has been high. 

The chemo schedule is two weeks on, one week off, for three months.  Then after the first of the year, I will go to Moffitt in Tampa for a bone marrow transplant.  According to Dr. Neel, this is “no big deal,” not like it used to be.  There is no need for a donor because they will remove my own bone marrow, clean it up or something, and then put it back in.  It is an inpatient procedure because they will want to watch me for a few days to see how I respond.  After that, more tests to see how effective the first round of treatment was.

I have just finished week three of the chemo schedule, my off week, and I’m surprised at how good I feel.   Last Friday, I met with Dr. Neel and told me that my blood tests were already showing improvement.  I am impressed with the everyday miracles of modern medicine, but I also know that many people are praying for me, and I am sure that it is helping. 

Next blog:  How cancer has helped me become a better pastor and teacher