Consultation with Dr. Tricot

I was instructed to arrive 30 minutes early for my 12 noon appointment with the doctor and was surprised when Emma and I were ushered into the consultation room at 11:30 to find him seated at his computer ready to question me about my health and recent activities. He said that the mass found in my lung with the PET/CT scan on Sept. 9 and disclosed by Dr. Zangari on the 17th was pneumonia and he was pleased to hear that the seven-daily infusions of the antibiotic had cleared it up. The blood cultures taken on the 17th had been negative and because I have started feeling good and he hears no congestion in my lungs he thinks the continued chemo treatment is correct. He asked if I had started the dexamethasone and cyclophosphamide on Monday as I should have assuming that Monday was day-one of cycle No. 10. I had been to the clinic on Monday morning and had started the drugs and had been told by Abby that the day was indeed day-one of Cycle No. 10.



Dr. Tricot asked about the thalidomide that I had taken a year ago and whether I had any of it left and then said he wants me to resume taking it once a day. He said the myeloma markers are not going down as fast as he had hoped and he thinks that adding thalidomide to what I am currently taking may speed things along. I was on thalidomide last September for 28 days around the time my stem cells were returned and then again for a period of 20 days that ended Nov. 23 when Dr. Tricot stopped the thalidomide and started me on cyclophosphamide. That day became Day-One of new cycle One the first of 12 28-day cycles I am to complete under his care. This pneumonia event has altered the maintenance cycles but has only extended the cycle period by one half cycle. I will now get the Aredia infusion on day 18 of the cycle instead of day 4. When Jennifer, his nurse, came in she reminded him that there had been a spike in my calcium when they decided to stop the thalidomide last November.



Jennifer told me that she will have whatever papers I need to fill out to renew the thalidomide prescription when I go to the clinic tomorrow for my Velcade shot. It has been less than a year since I last filled out papers (I have to promise not to impregnate anybody while I am taking the drug, easy to say for me), but cost is enormous and I am not looking forward to renewing the prescription. She did say that the 8 pills that I have left over from last year will provide plenty of time to get another prescription filled and will allow her time to determine whether my progress through the Medicare Part D program "donut hole" will qualify for a reduced price.