Well, after my last posting, I said that we were going on the Tuesday to get Brian's last chemo that would be the last for Round #2; that unfortunately did not happen. Even though I had given Brian two neupogen injections the week before, his neutrophils on the Tuesday (day of chemo) came back at 0 again. We were shocked; obviously Brian's body is having a hard time recovering his good white cells after a chemo session, even with two neupogen injections. So we were instructed to go home and once again I would administer two injections of neupogen, one on Thursday and one on Sunday, and then we were to see Dr. McCarron on Monday, Oct 31 to followup. On Monday (Oct 31), we went for blood work and then saw Dr. McCarron. Now his neutrophils (white count) was at 43!!! So way high! She is concerned that Brian's blood counts are all over the place as this is "unusual" with this chemo regimen. She has decided that she will need to do a bone marrow aspirate to see where his cancer is at and whether it is responding to chemo. So this procedure is booked for Tuesday Nov 8. She told us to go ahead with the chemo scheduled for the next day (Nov 1) and she would see us again next Monday before the bone marrow. So Brian had chemo on Tuesday and so far this week, he has remained feeling well. That chemo then marks the end of Round #2. Round #3 will possibly start next Tuesday right after the bone marrow aspiration.
In the meantime, we had a followup appointment with the stem cell doctor in Hamilton on Thursday. We were feeling a little hesitant on what she would say about what has been happening with Brian. I counted how many chemo sessions he had missed because of his abnormal blood work, and he had missed 6 sessions. Dr. Marcellus sat down with us and said that perhaps stem cell was not going to be a go for Brian. She wanted to reassure us that stem cell is not the "be all and end all for all cancer patients" and that it was just another way to treat cancer, but not necessarily is it the plan for everyone. She said that other chemo regimens have really improved over the last 10 years and that another chemo regimen may be what would work best in Brian's case. She still hasn't completely ruled out stem therapy, but she reiterated that having the bone marrow aspirate was the right step to take to find out how his disease has responded to the chemotherapy so far. Once the results of that aspiration are available, then further decisions can then be made. She explained that because Brian is already needing neupogen to bring his white count back, that will not bode well for stem cells and this means they will not be able to get enough stem cells to rescue, and that even if they got enough stem cells, he may not be able to tolerate the Melphalan that is required to be given after stem cells are removed. She said that what is happening with Brian's goods cells is that his bone marrow is having a difficult time reproducing all the good cells quickly after chemo and; hence, why we are basically having to miss chemo every other week - just so it gives his body a chance to bring his counts back up again. This could also be related to his having chemotherapy five years ago and why his bone marrow is reacting this way.
Anyway, I can't say that Brian was disappointed, in fact, I think he was feeling a bit relieved. He has been quite worried about what it may be like to have stem cell therapy as he knows it is a hard procedure to go through. So, we will await the results of the bone marrow aspirate, see where his disease is at and then follow whatever recommendations Dr. McCarron has now that we know that stem cell may not be what Brian can have now. She may stay with the same chemo if it is working or change to another regimen that may not be so hard on all those good white cells. If she stays with the same therapy and it does work in eliminating the cancer, there is the slightest chance that they could try stem cell therapy to see if they could get enough cells for transplant. But if she finds the cancer is not regressing with the current therapy, then she will have to change the chemo regimen and, in that case, stem cell will be completely out of the picture. The possibility is that he will then go on revlimid which is the newest drug in myeloma treatment that has come out of clinical trials with a good outcome.
It certainly is a roller-coaster ride that is for sure. Thankfully though, Brian is feeling well, has not developed any infection or viral illnesses without his immune system intact, and so life basically goes on as normal with these slight interruptions of doctor/clinic appointments! Brian has also gotten back to doing some exercising which always makes him feel good. One good thing is that Brian's weight has come completely back to normal, in fact, he weighs more right now that he has in years - so he really does look quite well. No one would actually know there was anything wrong with him! We are so fortunate in that sense and we feel we will beat this thing into remission even if it takes a little extra time. Our short-term goal is get in remission and then Brian and I are going to book a lovely vacation on a beautiful resort somewhere to celebrate in the new year!
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