Cosmetics

The chemotherapy has settled into a regular routine now, 21 days of Ninlaro, Revlimid, and dexamethasone, followed by one week with just dexamethasone. So far, this seems to be working in the sense that the kappa (that's the protein produced by the tumor cells) levels in my blood continue to decline. There's still about 7 times as much kappa as lambda (produced by properly working plasma cells), though, so there's plenty of work left to do. While all this is happening, I feel good most of the time, and I've been able to get out on my bike quite a lot during this weirdly mild winter.

When I don't feel great, it mostly seems to be something related to the drugs. Besides the chemo trio, there is a set of old-lady-who-swallowed-the-fly companion drugs, to prevent or treat possible consequences of chemotherapy: an antibiotic (doxycycline), an antiviral (acyclovir), aspirin (to prevent blood clots), prilosec (to prevent heartburn induced by dexamethasone). And stool softeners and laxatives for the usual reason (also a consequence of dexamethasone). All this is just now a part of the daily cycle.

There are a couple of things that are puzzling, and we're trying to figure them out, if only out of curiosity. I've already mentioned the rash, which I blamed on shrimp. It turns out that even now that I am avoiding shrimp, the rash still occurs, then fades after a week or so, seemingly in relation to the chemotherapy cycle. Another cyclical feature is an obnoxious rosacea or acne-like condition that will overtake my nose and surrounding skin very quickly and disappears just as quickly. The rash is still mysterious, but the acne seems to be following a predictable pattern at this point, peaking during the last 7 days of the 28 day cycle, when I am taking only the dexamethasone. On the first day of the next cycle, I take the Ninlaro and Revlimid, and the sores disappear rapidly. Of course, I'd like to know which is doing the job, but what I'd really like is to find something I could use during that week to control the nastiness.

Less annoying, though peculiar, is the fact that my hair has become curly. I'm happy to have it back, and the novelty of having curly hair is fun, although I have no idea how to deal with it. Liz has helpful advice, of course--in fact, my hair looks a lot like hers now. We've been speculating about how this happens at the cellular level. It doesn't seem possible for it to be a genetic effect, because that would be confined to one or a few follicles. Instead, it seems that all the hairs on my head decided to become curly in unison--so the follicles must be talking to one another. Maybe there's some literature on this out there somewhere.

Full disclosure: I've had curly hair before, sort of--a mid-70's perm, which explains why I didn't get many dates in college. I blame Mike Schmidt for this epic lapse in judgement. Never mind.