Clinic visits for both of us

My visit at the BMT clinic today was extraordi-narily slow. I arrived 5 minutes late because of stopping for virtually every red light along the way and found the waiting room full. My vitals were not aken until after 10;00 (a 9:00 AM appointment) and not because I was late, but because they were very busy today. I never was taken into the Infusion room, but instead had my meeting with Andrea (today's PA) and the Velcade shot in a small conference room. Nothing particularly notewworthy except Andrea told me that Abby had determined that I had pneumonia last week, but my lungs sounded normal today and, because I told her that I feel good although with reduced energy level, she said we could proceed with the chemotherapy, which included a Velcade shot at the clinic and a refill of the prescription for cyclophospahmide to be taken this evening. I pointed out to her that the Myeloma marker that Dr. Tricot follows (Kappa Free Light Chains) seems to be on an accelerating upward trend and asked if this is worrisome. She then said that what he really follows is the ratio between Lamba Free Light Chains and the Kappa chains. So I have re-plotted the Kappa values since Jan. 11 and added the ratios (shown in the photo of the plot above) and I wonder if she knows whereof she speaks. No ratio was shown on the printout for March 17 that I was given, possibly because the Lamba value was given as less than 0.17 and may hve been so low as to cause the ratio to go off the chart. It looks to me as though the ratio fluctuates even more than the Kappa value. I will go back Thursday for a shot of Velcade and an infusion of Aredia so it will be another long stay, but I won't get another printout of the lab work because they did not draw enough blood to determine the Myeloma markers.


Emma had an appointment this morning at 10:30 with Dr. Hull at the University of Utah dermatology clinic across the street from our dermatologist's office. I could not go with her so Nancy volunteered to meet her there and take notes on any directives that the doctor gave her. Dr. Hull told her to continue the treatment that Dr. Horsley had prescribed. He took a biopsy sample from her leg above the area of the blistering and told her to come to the clinic at the University next Wednesday for follow up. Emma had a picture of the x-ray with her and he said that infection originating at the hardware in her leg was a remote possibilty as the cause of the surface blistering, but gave it very little credence, particularly so because she had a broken right leg 15 years ago with the implantation of several screws, most of which are still in her leg.