Conference with Dr. Zangari

Emma accompanied me to the BMT  clinic Friday to meet with Dr. Zangari and Nancy joined in time to visit with Dr. Zangari.  His examination consisted of questioning me about my general health and then listening to my breathing and heart.  I told him that the neuropathy in my fingers and feet had persisted and some times it was severe enough in the morning that I could not button my shirt cuffs.  He did not dictate a letter to me as he always has previously, but he then told me he was going to reduce the amount of Velcade that I have been receiving every Monday by 30% and change my schedule so that I not go to the clinic for 2 weeks afer each 4 week cycle.  He also said that I do not need to see him for 6 months.   Today is the first day of my first 2-week"holiday."  We will now have enough time to consider some long distance travels, but the cost may dissuade us from doing so.

 

The graphs shown here are part of a data package given to me by Carol Nielson, my temporary patient coordinator (until a new one can be trained) and by Jen, Dr. Zangari's nurse, after he had concluded his visit and left the room.  They worked out that today will be the beginning of my break and that I will have an Aredia infusion when I return on the 18th and warned that it will take 4 hours.  The top graph shows the cratinine content as determined by the blood work since I began treastment.  When the amount is below 1.4 mg/dl the infusion only takes 2 hours, but when it is at 1.4 or above the required time is 4 hours.  There have only been a few times in the first 18 months or so of  treatment when I was getting the Aredia every 4 weeks that the infusion has been 2-hours.  I now get it after three 4-week cycles.  The generally flat lines on the graphs explain why Dr. Zangari thinks a visit every 6 months will be often enough.

 

Emma hasn't been to her aquasize class since the stormy and generally very cold weather began in December.  She has been meeting her friends from the class for socializing on Fridays and so today after getting up almost in time to go to class she decided to stay home.  She has frequently expressed a need to go and said she will go to the 10:00am class tomorrow.  I no longer need to get up at 7:00am for the BMT visit, but will get up at whatever the time she needs to be up for aquasize.