Ice, Ice and more Ice!

Last Thursday night and off and on Friday Little Rock got rain, sleet, ice and snow.  Fortunately the ice didn't form on the trees.  With our 4-wheel drive Highlander we were able to get in to the blood lab for tests on Friday and Saturday.  We were able to help transport another patient whose wife was afraid to drive on the ice.  Harvey did not go in to the lab on Friday and by Saturday he was in need of a blood transfusion and antibacterial IV.  His CRP was over 200.  Normal CRP range is 0 - 10.  He had a sinus CT scan yesterday as the doctor feared he had a sinus infection.

Our apartment is in the southwest corner of the parking lot.  There is a hill just in front of our apartment where I park our car.  These Little Rock folks don't get enough ice and snow to be experienced at driving on ice.  A Ford Expedition attempted to turn the corner and go up the hill in the parking lot.  Sitting in our apartment I could smell burning rubber.  I went out to help but didn't want to actually climb in behind the wheel in case I would hit other cars.  He left his car in the middle of the parking lot.  He put a huge rock behind the wheel but during Friday night the car slide down the hill and into another car.

Ford blocking part of driveway

This picture is taken from the back of our car.  You can see how much this white Ford blocks the drive.  I was able to back up the hill and get around the Ford on Saturday after helping another patient get his van moved.  The van driver and his daughter are both being treated at the Myeloma Institute.  He needed to get in to have his stem cells harvested.

At the top of the hill behind our car was this view.

View from our parking spot

This gives a view of the ice coated hill.  Note the black car at the top that has slide into another car.  We got both of the cars out Sunday afternoon.  The drivers had never heard of using sand to get better traction on the ice. 

Once I got our Highlander out, I parked in a different spot.  I felt fortunate that no car had slid directly down the high into our car!

Blood Clot

Carla's blood chemistry had been so good the end of last week that on Saturday they told us not to come in on Sunday but rather come in Monday at 7:30 a.m. so the results would be back before our 10:00 appointment with Dr. Barlogie. The APN predicted that we would be able to get the catheter out and we could go home for a few days before starting the first stem cell transplant.


The blood test results had a moderately high CRP of 50 which can indicate an infection or some inflammation. The doctor had them do a blood culture and an ultra sound on her legs. They found a new blood clot in Carla's left leg and an old one in her right leg. One of the side effects of Thalidomide is blood clots.

Carla had to go back to the blood lab and get a Lovenox injection. She will have to continue these for a few days.

Carla had an MRI for a hour late last night and is getting a PET scan this morning. Hopefully these will show no active lesions!

The hardware in Carla's back tends to shift around some in spite of her brace. We wanted to get a consultation with the neurologist but haven't been able to get that arranged. If it would require major surgery she could not have it until she is finished with all of thise chemo. It would be nice to know what our options are for repair of the August surgery.

Basically we were rather discouraged last night. At the start of the day we had high hopes of being back in Springfield Monday night or Tuesday. Now we don't know if we will be able to go home before Carla has the first stem cell transplant.

White Count on the upswing!

Carla's white blood count the past three days has been 0.08, 0.16 and 0.50! I think her induction II chemo has bottomed out and she is on the upswing. Her platelet count was low enough one day last week she had to have a platelet infusion. They give those when her platelet count falls below 20. Hers had dropped to 28 yesterday but was up to 39 today.
Last Friday, Carla had a CT scan supposedly to determine if the bottom screw in T9 vertebrae had pulled loose. The neurologist happened to give me a copy of his orders and they were for a thoracic scan. We met with Dr. Barlogie on Monday and I asked to see the radiologist's report. He quickly printed me a copy. It was a cervical scan and did not cover the thoracic region where the rod is holding her back together.
The short of it we had to get another CT scan today. Carla made certain the tech knew what region he was to scan. He replied that they had already been there and he gotten the T-shirt! I think Dr. Barlogie made several folks aware of this mistake. Now we have to watch to make certain we only get billed for the one scan.
We are hoping that they might be able to do some corrective action on Carla's back later this week. We have our next appointment with Dr. Barlogie next Monday. Hopefully Carla's blood will have rebounded sufficiently for us to go home for a short break (a week or less) before they prepare Carla for her first stem cell transplant.

The neurologist met with us Tuesday and analyzed her Carla's back.  He thought a screw had pulled loose and 

• Ordered CT scan for this Friday morning
• Got Carla fitted with a back brace to wear when she wasn't in bed or sitting
• Did paperwork to get information from Springfield neurologist who did the surgery in August

Carla's new back brace

We are still dealing with the results of Induction II chemo.  Carla is getting a growth factor shot each day.  Her white blood count has been falling but hasn't gone below 2.0 yet.  Her platelet count has dropped consistently.  Hopefully the WBC and platelet count will bottom out soon.

Black Bag is OFF!

Well another milestone has been reached. Carla got rid of the chemo black bag with its two IV infuser pumps. Her blood work had good results. Her CRP which can indicate infection or other inflammation was moderately elevated yesterday but was back to normal today. He white blood count is dropping fast. It was 3 something today. When it gets below 2 is when she is neutropenic and we have to be careful about germs.

Because if this upcoming germ problem, I spent time this morning cleaning the carpet in our apartment. It was terrible.

Since my last post we have had a bout with severe constipation. After 14 hours of cramps and little sleep two nights and much prayer we hopefully have that under control.

Yesterday was her last day for Thalidomide tablets and the nurse had assured us they had faxed the prescription and she would call us when they were in. Well, she didn't call and the fax was to the wrong department of CareMax. I think Calgene, the maker of Thalidomide, gave the Myeloma Institute the wrong fax number for CareMark. Anyway, after four long phone calls yesterday we got the Thalidomide over night express by FedEx this morning. Carla was only 12 hours late on taking it. The nurses have assured us this is OK. The problem is you generally take it just before bedtime as it tends to put you to sleep. Carla spent most of her three hours at the blood lab dosing in the recliner.

Since her Kyphoplasty and epidural on Tuesday her back has felt great until today. You can feel the bottom of the rod on her back. This is strong evidence that the lower screw in her rod has pulled out from the T9 vertebrae like a screw in soft wood. Except for her daily trip to the blood lab she is staying in bed protecting her back. We have an appointment with a spine specialist Tuesday at 9:45. We really feel this is our current prayer concern. It is a huge disappointment for Carla. She is feeling rather down.

Long Day

I have good news and bad news.  Carla went into the hospital at 7:30 this morning and didn't leave until after 3:00. 

The good news is she is feeling much better and not in pain.  The doctor did kyphoplasty on the T7 vertebrae that had collapsed even more after her surgery in Springfield on August 28th.  Basically this involved drilling a hole in T7 and using a balloon to make a pocket in the vertebrae and then injecting a pastic cement into this cavity to stabilize this area.  Kind of reminds me of my model car days ;-)

The doctor also gave an epidural injection of a steroid into Carla's back below the metal rod that was implanted on August 28th.

The bad news is the CT scan showed the screw in the T9 vertebrae was almost pulled loose from the vertebrae.  He thought the epidural would suffice for 4 - 6 months.  He will keep watch on her back as Carla goes through the rest of her multiple myeloma therapy.  They don't know what they would have to do to repair her messed up implanted rod but it will possibly involve opening up her back again.  We hope not. 

If any of you happen to know someone diagnosed with multiple myeloma, insist that they get it analyzed at the Myeloma Institue in Little Rock or at least by someone who has dealt with many myeloma cases before.  I am certain the neurologist in Springfield did what he thought best but he had not dealth with enough recent myeloma patients to be up to date on the newest treatment methods.  Myeloma weakens the bones and they aren't strong enough to hold screws used to fuse vertebraes. 

Carla also got her central venous line (catheter) implanted in her chest so she is ready to start her chemo tomorrow.

Induction II

We met with Carla's neurosurgeon in Springfield last Monday.  He thought the bottom screw in vertebrae T9 was moving out.  He did not know how to fix it while Carla was in chemo.  So we headed on to Little Rock on Tuesday as planned.

We drove the westerly route through Joplin and Fayetteville so we could visit my son, John, in Centerton, AR.  Olivia Marie Ferguson was born on December 22.

Lauren, John and Olivia

We were fortunate to get a furnished apartment through a church's "Home Away from Home" program.  It isn't quite as nice as the one we had last time but it costs about $1,000 a month less.  The cold front followed us south and Little Rock isn't used to freezing temperatures as evidenced by the warning sign in our apartment complex.

Warning Sign in our Apartment Complex

Wednesday, Carla had another bone marrow biopsy and a MRI.  We met with Dr. Barlogie on Friday and he said her blood and urine tests were good.  The PET scan had shown that of the 11 original active focal lesions only 1 was now active and the MRI revealed that it was shrinking in size.  The MRI showed that Carla's bones were repairing the myeloma damage.

Dr. Barlogie thought we should see a doctor in the Intervention Radiology group and he got us in to see him on Friday.  This doctor is well known for balloon Kyphoplasty.  A lot of the patients coming to the Myeloma Institue have fractured vertebrae.  Kyphoplasty involves insertion of a balloon into the vertebrae and expanding the collapsed bone.  Once this bone is expanded the balloon is removed and replaced by plastic cement.  All of this procedure uses a CT scan to enable to doctor to see the spine.

This doctor lookedat Carla's MRI's and thought he might be able to repair her back with kyphplasty and perhaps give an ephidural to help with the pain.  He wanted to take a CT Scan to better see Carla's back.  We were unable to get the scan on Friday because the extra load on the electric lines due to the extreme cold had caused voltage fluctuations and the hospital had shut down all non-critical instruments.  Carla got pain relief by staying flat on her back in bed.  This is where she spent most of the weekend.

We have a 7:30 a.m. appointment Monday to get the CT Scan, analyze it and perhaps do the Kyphoplastic work and/or ephidural.  Probably they will insert the catheter again as this is the same department.  Carla would then be ready for the chemo.

Pray that the doctor will have wisdom in knowing how to repair Carla's back.

Carla's son was having a check up with his doctor in New York City.  He told the doctor about his Mom's myeloma.  The doctor asked where she was being treated.  The doctor said all of their myeloma patients they sent to the Myeloma Institute in Little Rock, Arkansas!  This even strengthened our confidence in the work Dr. Barlogie heads up here.  I only wish that we had taken Carla to Little Rock rather than have her back surgery in Springfield.  Most doctors and surgeons don't deal with myeloma and therefore don't know what to expect when normal screws are inserted in vertebrae.