I'm more than a little tardy posting this update, as it's been almost a month since we visited Mayo for a follow-up visit. The main news is that all is relatively well. In fact, not much of anything has changed meaningfully since last November.
The kappas are actually in the normal range now, and if only the lambdas would get back up into the normal range, the kappa/lambda ratio might be closer to the magic 1.0 (it's bouncing between 4 and 6 now). The official line is not to worry about the lambdas, since they're not the problem and their numbers are depressed by the chemotherapy. That makes some sense to me, but I think the "normal" range for kappa is probably irrelevant for myeloma patients for the same reason. It's good that the levels are low, because too much of that protein will cause organ damage, but it would be wrong to think (I think) that "normal" levels mean normal functioning. Probably I have about as much normal kappa as lambda, and the rest (3 to 5 times as much) is the bad stuff. All in all it's better to have less, and I have much less than I did two years ago (when it was several hundred times as much). So that's good.
There is no more bone damage apparent, although I have been driven slightly crazy by one comment in the radiologist's report: "the prominent lesion on the left scapula is unchanged." I have not been able to find any previous reference to a prominent lesion on my left scapula, and I just want to know where it is, mostly out of curiosity. Apparently it's been there awhile. I've been thinking that I'd like to try hitting some tennis balls after too many years, and (since I'm a lefty) I do want to know if my left shoulder is up to it. Don't really want to find out the hard way.
The only trend line that's really trending these days is my platelet count, which is going down. It hasn't dropped into a dangerous zone yet, but it means I bruise and bleed easily (always did, just more so now), so we're making a small change to the meds to see if that helps. My old friend dexamethasone is used to treat autoimmune thrombocytopenia (low platelets), but that probably has to do with its immune-lowering functions rather than any stimulation of platelets. Cutting down on aspirin (which I take to prevent blood clotting) seems like a good idea. It might not bring the counts up, but it should improve the clotting ability of the platelets that I do have, and the risk of unwanted clotting must be reduced if I don't have much of the stuff that does the clotting in the first place (that would be the platelets).
Reading all that, I think I've done my best to put a dark spin on a good report. I'm feeling good, staying active, riding 30-40 miles a week, and have all the support a person could hope for. Survival stats for myeloma patients keep improving, and some of the newer drugs will probably blow the previous results away. Mel Stottlemyre (look him up, kids) has been hanging in there for many years now, diagnosed in 2000, and he had it tough (chemotherapy-wise, at least). Lou Brock was diagnosed more recently, and now says he's "cancer free" (I'd beg to differ, but he is a Hall of Famer). I was a little too young to remember seeing them (if I did) on TV in the 1964 World Series, but it must have been a good one.
Speaking of baseball, at some point I want to review the Phillies' glioblastoma issues. More on that later.
